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BACKGROUND: Life-space mobility captures the daily, enacted mobility of older adults. We determined cross-sectional associations between life-space mobility and cognitive impairment (CI) among community-dwelling women in the 9th and 10th decades of life. METHODS: A total of 1375 (mean age 88 years; 88% White) community-dwelling women enrolled in a prospective cohort of older women. Life-space score was calculated with range 0 (daily restriction to ones bedroom) to 120 (daily trips leaving town without assistance) and categorized (0-20, 21-40, 41-60, 61-80, 81-120). The primary outcome was adjudicated CI defined as mild cognitive impairment or dementia; scores on a 6-test cognitive battery were secondary outcomes. RESULTS: Compared to women with life-space scores of 81-120 and after adjustment for demographics and depressive symptoms, the odds of CI was 1.4-fold (OR 1.36, 95% CI 0.91-2.03) higher for women with life-space scores of 61-80, twofold (OR 1.98, 95% CI 1.33-2.94) higher for women with life-space scores of 41-60, 2.6-fold (OR 2.62, 95% CI 1.71-4.01) higher for women with life-space scores of 21-40, and 2.7-fold (OR 2.71, 95% CI 1.27-5.79) higher for women with life-space scores of 0-20. The association of life-space scores with adjudicated CI was primarily due to higher odds of dementia; the odds of dementia versus normal cognition was eightfold (OR 8.63, 95% CI 3.20-23.26) higher among women with life-space scores of 0-20 compared to women with life-space scores of 81-120. Lower life-space scores were associated in a graded manner with lower mean scores on tests of delayed recall (California Verbal Learning Test-II delayed recall) and language and executive function (phonemic fluency, category fluency, and Trails B). Life-space score was not associated with scores on tests of attention and working memory (forward and backward digit span). CONCLUSIONS: Lower life-space mobility is associated in a graded manner with CI among community-dwelling White women in the 9th and 10th decades of life.

This article discusses the use of the Quality Matters Rubric for Higher Education, 6[superscript th] ed. to self-review an asynchronous information literacy course. In this instance, the authors acted as reviewers and subject matter experts (SME). The Rubric proved to be a useful tool that encompasses several instructional design best practices. After the official self-review period, the QM Rubric influenced the enhancement and updates to the course. The authors recommend more use of the QM Rubric by teaching librarians, collaboration with instructors going through a QM Review, and training for online teaching in Library and Information Science graduate programs.

Unintentional injuries are one of the leading causes of death in Americans. A large proportion of these deaths are attributable to accidental drownings and falls, both of which oftentimes take place in or around swimming pools and swimming pool-related apparatuses such as diving boards. The American Academy of Family Physicians (AAFP) has reported drowning incidents as the most common injury-related cause of death in children ages one to four years. Although the AAFP has outlined steps to take to prevent drownings, there has not been a current large-scale study illustrating the effectiveness of these strategies with regard to their effect on the prevalence of swimming pool drowning cases in the last 10 years. Thus, we aim to utilize the National Electronic Injury Surveillance System (NEISS) database to uncover these rates, which can ultimately help aid in the reevaluation of current recommended guidelines.

BackgroundThis study aimed to examine the epidemiology of firework-related injuries within a national population between 2012 and 2022, including the severity of injury by year, patient demographics, body region injured, firework type, and diagnosis category of injury.MethodsData were collected from the Consumer Product Safety Commission's National Electronic Injury Surveillance System, which is a representative nationwide database that collects data on consumer product-related injuries occurring in the US. Injury rates were calculated based on patient age, sex, body region injured, firework type, and diagnosis category.ResultsA total of 3219 injuries, representing an estimated 122,912 firework-related injuries, were treated in emergency departments within the US from 2012 to 2022. The overall incidence rate of firework-related injuries in the study rose by over 17% from 2012 [2.61 cases per 100,000 people (95% CI 2.03-3.20)] to 2022 and [3.05 cases per 100,000 people (95% CI 2.29-3.80)]. The rate of injuries was highest in adolescents and young adults (age 20-24; 7.13 cases per 100,000 people). Men experienced firework injuries at more than double the rate of women (4.90 versus 2.25 cases per 100,000 people). The upper extremities (41.62%), head/neck (36.40%), and lower extremities (13.78%) were the most commonly injured regions. Over 20% of cases in patients older than 20 were significant injuries requiring hospitalization. Aerial devices (32.11%) and illegal fireworks (21.05%) caused the highest rates of significant injury of any firework type.ConclusionsThe incidence of firework-related injuries has risen over the past decade. Injuries remain the most common among adolescents and young adults. In addition, significant injuries requiring hospitalization occur most often during aerial and illegal firework use. Further targeted sale restrictions, distribution, and manufacturing regulations for high-risk fireworks are required to reduce the incidence of significant injury.

Many challenges related to carbon-dioxide ([Formula: see text]) sequestration in subsurface rock are linked to the injection of fluids through induced or existing fracture networks and how these fluids are altered through geochemical interactions. Here, we demonstrate that fluid mixing and carbonate mineral distributions in fractures are controlled by gravity-driven chemical dynamics. Using optical imaging and numerical simulations, we show that a density contrast between two miscible fluids causes the formation of a low-density fluid runlet that increases in areal extent as the fracture inclination decreases from 90[Formula: see text] (vertical fracture plane) to 30[Formula: see text]. The runlet is sustained over time and the stability of the runlet is controlled by the gravity-driven formation of 3D vortices that arise in a laminar flow regime. When homogeneous precipitation was induced, calcium carbonate covered the entire surface for horizontal fractures (0[Formula: see text]). However, for fracture inclinations greater than 10[Formula: see text], the runlet formation limited the areal extent of the precipitation to less than 15% of the fracture surface. These insights suggest that the ability to sequester [Formula: see text] through mineralization along fractures will depend on the fracture orientation relative to gravity, with horizontal fractures more likely to seal uniformly.

Sea-level rise and associated flood hazards pose severe risks to the millions of people globally living in coastal zones. Models representing coastal adaptation and impacts are important tools to inform the design of strategies to manage these risks. Representing the often deep uncertainties influencing these risks poses nontrivial challenges. A common uncertainty characterization approach is to use a few benchmark cases to represent the range and relative probabilities of the set of possible outcomes. This has been done in coastal adaptation studies, for example, by using low, moderate, and high percentiles of an input of interest, like sea-level changes. A key consideration is how this simplified characterization of uncertainty influences the distributions of estimated coastal impacts. Here, we show that using only a few benchmark percentiles to represent uncertainty in future sea-level change can lead to overconfident projections and underestimate high-end risks as compared to using full ensembles for sea-level change and socioeconomic parametric uncertainties. When uncertainty in future sea level is characterized by low, moderate, and high percentiles of global mean sea-level rise, estimates of high-end (95th percentile) damages are underestimated by between 18% (SSP1-2.6) and 46% (SSP5-8.5). Additionally, using the 5th and 95th percentiles of sea-level scenarios underestimates the 5%-95% width of the distribution of adaptation costs by a factor ranging from about two to four, depending on SSP-RCP pathway. The resulting underestimation of the uncertainty range in adaptation costs can bias adaptation and mitigation decision-making.

The social cost of carbon dioxide (SC-CO2) measures the monetized value of the damages to society caused by an incremental metric tonne of CO2 emissions and is a key metric informing climate policy. Used by governments and other decision-makers in benefit-cost analysis for over a decade, SC-CO2 estimates draw on climate science, economics, demography and other disciplines. However, a 2017 report by the US National Academies of Sciences, Engineering, and Medicine1 (NASEM) highlighted that current SC-CO2 estimates no longer reflect the latest research. The report provided a series of recommendations for improving the scientific basis, transparency and uncertainty characterization of SC-CO2 estimates. Here we show that improved probabilistic socioeconomic projections, climate models, damage functions, and discounting methods that collectively reflect theoretically consistent valuation of risk, substantially increase estimates of the SC-CO2. Our preferred mean SC-CO2 estimate is $185 per tonne of CO2 ($44-$413 per tCO2: 5%-95% range, 2020 US dollars) at a near-term risk-free discount rate of 2%, a value 3.6 times higher than the US government's current value of $51 per tCO2. Our estimates incorporate updated scientific understanding throughout all components of SC-CO2 estimation in the new open-source Greenhouse Gas Impact Value Estimator (GIVE) model, in a manner fully responsive to the near-term NASEM recommendations. Our higher SC-CO2 values, compared with estimates currently used in policy evaluation, substantially increase the estimated benefits of greenhouse gas mitigation and thereby increase the expected net benefits of more stringent climate policies.

Despite improvements in the awareness and acceptance of lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) individuals, the LGBTQ+ community continues to experience discrimination, which can result in adverse health outcomes. In particular, LGBTQ+ youth have an increased risk of experiencing depression, substance abuse, and suicide. Societal stigma and rejection, bullying, and familial disapproval all contribute to these health disparities. In recognition of these inequities, an interprofessional team of biomedical faculty members, staff, and trainees from the Louisiana State University Health Science Center (LSUHSC) in New Orleans developed the needs-assessment evaluation, the Gender and Sexual Minority Youth Outreach Survey (GSMYO) for high school students. Health science centers have access to resources and experienced personnel who can provide support and education to high school students, teachers, and administrative staff. However, it is important to first determine the high schools’ specific needs, attitudes towards LGBTQ+ acceptance, and their current resources. Faculty, staff, and trainees from the LSUHSC Science Youth Initiative (SYI) and the LSUHSC LGBTQ+ Organization, Tiger Pride, administered the short, anonymous survey to adolescents attending Southeast Louisiana high schools. English Language Learner (ELL) students received the survey in Spanish. Results from the GSMYO needs-assessment survey are presented. Other health science centers may adapt the presented survey to develop needs-based LGBTQ+ high school programs to address the educational and health inequities in their own communities, regardless of location or demographic region.

Abstract Introduction We used a Programme Science platform, to generate evidence to support the implementation of programmes for sex workers in Africa. Female sex workers are estimated to make up 1.6% (1.3%–1.8%) of the population of women aged 15−49 years in Zimbabwe. We highlight how programme science can be used to help distinguish between when, where and with whom programmes need to be implemented and discuss two case studies that exemplify implementing better (Case study 1 (1 June 2019−30 June 2021) Optimizing implementation of a risk differentiated microplanning intervention) and implementing differently (Case study 2 (1 October 2016−30 September 2022) Reorientating implementation of DREAMS for young women selling sex). Methods Zimbabwe's nationally scaled programme for sex workers was established in 2009 in partnership with sex workers to provide comprehensive services for sex workers and generate evidence for programme design, implementation and scale up. Since inception, comprehensive data have been collected from all sex workers seeking services. As the scope of service provision has expanded so has the scope of data collection and analysis. At enrolment, sex workers are assigned an alphanumeric unique identifier which links consultations within and across programme sites. We conduct descriptive analyses of the Key Population (KP) programme data to guide programme implementation and redesign, embedding programmatic qualitative enquiry as required. Results Two case studies describing different approaches to programme optimization are presented. In the first, an optimization exercise was used to strengthen programme implementation ensuring that the KP programme got back on track after SARS‐COV‐2. In the second, an in‐depth review of research and programme data led to a re‐orientation of the DREAMS programme to ensure that young women at the highest risk of HIV acquisition were enrolled and had access to DREAMS social support interventions in turn strengthening their uptake of HIV prevention. Conclusions Optimizing and sustaining HIV care and treatment programmes requires effective delivery with sufficient scale and intensity for population impact. Our programme science approach guided the scale up of the KP programme in Zimbabwe, providing evidence to support strategy, implementation and ongoing management, and importantly helping us distinguish between when we needed to just implement, implement better or implement differently.

Objective: Hypothalamic signals potently stimulate energy expenditure by engaging peripheral mechanisms to restore energy homeostasis. Previous studies have identified several critical hypothalamic sites (e.g. preoptic area (POA) and ventromedial hypothalamic nucleus (VMN)) that could be part of an interconnected neurocircuit that controls tissue thermogenesis and essential for body weight control. However, the key neurocircuit that can stimulate energy expenditure has not yet been established. Methods: Here, we investigated the downstream mechanisms by which VMN neurons stimulate adipose tissue thermogenesis. We manipulated subsets of VMN neurons acutely as well as chronically and studied its effect on tissue thermogenesis and body weight control, using Sf1Cre and Adcyap1Cre mice and measured physiological parameters under both high-fat diet and standard chow diet conditions. To determine the node efferent to these VMN neurons, that is involved in modulating energy expenditure, we employed electrophysiology and optogenetics experiments combined with measurements using tissue-implantable temperature microchips. Results: Activation of the VMN neurons that express the steroidogenic factor 1 (Sf1; VMNSf1 neurons) reduced body weight, adiposity and increased energy expenditure in diet-induced obese mice. This function is likely mediated, at least in part, by the release of the pituitary adenylate cyclase-activating polypeptide (PACAP; encoded by the Adcyap1 gene) by the VMN neurons, since we previously demonstrated that PACAP, at the VMN, plays a key role in energy expenditure control. Thus, we then shifted focus to the subpopulation of VMNSf1 neurons that contain the neuropeptide PACAP (VMNPACAP neurons). Since the VMN neurons do not directly project to the peripheral tissues, we traced the location of the VMNPACAP neurons' efferents. We identified that VMNPACAP neurons project to and activate neurons in the caudal regions of the POA whereby these projections stimulate tissue thermogenesis in brown and beige adipose tissue. We demonstrated that selective activation of caudal POA projections from VMNPACAP neurons induces tissue thermogenesis, most potently in negative energy balance and activating these projections lead to some similar, but mostly unique, patterns of gene expression in brown and beige tissue. Finally, we demonstrated that the activation of the VMNPACAP neurons' efferents that lie at the caudal POA are necessary for inducing tissue thermogenesis in brown and beige adipose tissue. Conclusions: These data indicate that VMNPACAP connections with the caudal POA neurons impact adipose tissue function and are important for induction of tissue thermogenesis. Our data suggests that the VMNPACAP → caudal POA neurocircuit and its components are critical for controlling energy balance by activating energy expenditure and body weight control.

Can we again learn about ourselves and our surrounding world through dance as we age, thereby promoting our own health? This article documents facts of life showing that “older adults” do not have to learn to be cognitive of their movement, affective dispositions, or surrounding world; they have been experientially cognitive of all by way of tactility, kinesthesia, and affectivity from the beginning. Present-day cognitive neuroscience, concentrating and theorizing as it does on the brain's neuroplasticity, is however deficient in recognizing these experiential realities. Research studies on the brain and behavior, in contrast, demonstrate that coordination dynamics are the defining feature of both neurological and kinesthetic coordination dynamics. These dynamics are central to corporeal concepts, to the recognition of if–then relationships, and to thinking in movement. In effect, the brain is part of a whole-body nervous system. The study proceeds to show that the qualitative dynamics of movement that subtend coordination dynamics are basic to not only everyday movement but also to dancing—to experiencing movement kinesthetically and to being a mindful body. When Merce Cunningham writes that dance gives you that “single fleeting moment when you feel alive” and is not for “unsteady souls” and English writer D. H. Lawrence writes that “[w]e ought to dance with rapture that we are alive, and in the flesh, and part of the living incarnate cosmos,” their words are incentives to those who are aging to awaken tactilely, kinesthetically, and affectively to the existential realities of dance.

In the United States, great inequities exist within the science, technology, engineering, and math (STEM) fields in individuals who self-identify as belonging to underrepresented groups (e.g., from socioeconomically disadvantaged backgrounds, people with disabilities, and Black/African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander). Underrepresentation in STEM careers has been documented to be due to a lack of qualified and diverse teaching personnel, limited access to resources in disadvantaged schools, and implicit bias within US institutions. In recognition of these inequities, an interprofessional team of biomedical faculty members and diversity, equity and inclusion (DEI) educators from the Louisiana State University Health Science Center (LSUHSC) in New Orleans developed and implemented a STEM educational training pipeline for elementary, middle, and high school (K-12), undergraduate, and medical students, with accompanying DEI training for LSUHSC mentors and staff to mitigate implicit bias and promote a welcoming environment for participants from different backgrounds. Our findings focus on one social determinant of health: access and quality of education. Other institutions can implement a program as described in the present study to address the educational and health inequities in their own communities.