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As breast screening services move towards use of healthcare AI (HCAI) for screen reading, research on public views of HCAI can inform more person-centered implementation. We synthesise reviews of public views of HCAI in general, and review primary studies of women's views of AI in breast screening. People generally appear open to HCAI and its potential benefits, despite a wide range of concerns; similarly, women are open towards AI in breast screening because of the potential benefits, but are concerned about a wide range of risks. Women want radiologists to remain central; oversight, evaluation and performance, care, equity and bias, transparency, and accountability are key issues; women may be less tolerant of AI error than of human error. Using our recent Australian primary study, we illustrate both the value of informing participants before collecting data, and women's views. The 40 screening-age women in this study stipulated four main conditions on breast screening AI implementation: 1) maintaining human control; 2) strong evidence of performance; 3) supporting familiarisation with AI; and 4) providing adequate reasons for introducing AI. Three solutions were offered to support familiarisation: transparency and information; slow and staged implementation; and allowing women to opt-out of AI reading. We provide recommendations to guide both implementation of AI in healthcare and research on public views of HCAI. Breast screening services should be transparent about AI use and share information about breast screening AI with women. Implementation should be slow and staged, providing opt-out options if possible. Screening services should demonstrate strong governance to maintain clinician control, demonstrate excellent AI system performance, assure data protection and bias mitigation, and give good reasons to justify implementation. When these measures are put in place, women are more likely to see HCAI use in breast screening as legitimate and acceptable.

Abstract Background Transvaginal mesh (TVM) surgeries emerged as an innovative treatment for stress urine incontinency and/or pelvic organ prolapse in 1996. Years after rapid adoption of these surgeries into practice, they are a key example of worldwide failure of healthcare quality and patient safety. The prevalence of TVM-associated harms eventually prompted action globally, including an Australian Commonwealth Government Senate Inquiry in 2017. Method We analysed 425 submissions made by women (n = 417) and their advocates (n = 8) to the Australian Senate Inquiry, and documents from 5 public hearings, using deductive and inductive coding, categorisation and thematic analysis informed by three ‘linked dilemmas’ from healthcare quality and safety theory. We focused on women’s accounts of: a) how harms arose from TVM procedures, and b) micro, meso and macro factors that contributed to their experience. Our aim was to explain, from a patient perspective, how these harms persisted in Australian healthcare, and to identify mechanisms at micro, meso and macro levels explaining quality and safety system failure. Results Our findings suggest three mechanisms explaining quality and safety failure: 1. Individual clinicians could ignore cases of TVM injury or define them as ‘non-preventable’; 2. Women could not go beyond their treating clinicians to participate in defining and governing quality and safety; and. 3. Health services set thresholds for concern based on proportion of cases harmed, not absolute number or severity of harms. Conclusion We argue that privileging clinical perspectives over patient perspectives in evaluating TVM outcomes allowed micro-level actors to dismiss women’s lived experience, such that women’s accounts of harms had insufficient or no weight at meso and macro levels. Establishing system-wide expectations regarding responsiveness to patients, and communication of patient reported outcomes in evaluation of healthcare delivery, may help prevent similar failures.

Transvaginal mesh (TVM) surgeries were introduced as an innovative treatment for stress urine incontinency (SUI) and/or pelvic organ prolapse (POP) in 1996. Years after rapid adoption of these surgeries into practice, it emerged that TVM-associated adverse events were uncommon but potentially severe. This initiated global action, including an Australian Commonwealth Government Senate Inquiry, in 2017. This inquiry was both a causal factor in, and surrounded by, a significant epistemic shift towards recognition of women's own accounts of their experience. The Inquiry generated copious data, mostly publicly available. There has been no systematic investigation of how professional stakeholders—clinicians, health services, regulators and manufacturers—contributed to the epistemic environment of this inquiry. Method: We analysed 42 submissions made by professional stakeholders to this inquiry, and documents from 5 public hearings. We used framework analysis methods, applying deductive and developing inductive codes from the documents, and charting patterns across the documents.Our aim was to map:1. Professionals’ contribution to the epistemic environment of this inquiry;2. How professional actors constructed TVM-associated problems and proposed potential solutions; and,3. The relevance of conflicts of interest in TVM-associated harms. Results: We categorised the reasoning of professionals into two groups:a. Contesting the significance of, or evidence for, TVM-associated harms; andb. Denying or minimising conflict of interest.Professionals’ advocacy regarding policy solutions emphasised incremental change, aiming to retain TVM procedures to treat SUI and, under certain conditions, POP. Conclusion: Contestation regarding harms led to a testimonial quietening of TVM-affected women's interests. The close and normalised relationship between treating professionals and TVM manufacturers may have created a conflicted environment for practice. It seems unlikely that self-regulation will be adequate to ensure that harms are minimised, conflicts of interests well-managed, and patients' interests are the first priority when innovative surgical treatment options become available to practice.

Abstract Biological pest control relies on interactions between herbivores and their natural enemies. Maintaining this ecosystem service requires considering herbivore and natural enemy interactions and their response to anthropogenic change at multiple scales. In this study, we used ecological networks to quantify the network structure of interactions between herbivorous insects and their parasitoids. We examined how herbivore host abundance, parasitism rates, and shifts in network structure relate to changes in local habitat management and landscape context. We sampled herbivores and parasitoids in Brassica oleracea plants at 22 urban gardens in the Central Coast of California. At each site, we measured local management characteristics (e.g., vegetation, ground cover, canopy cover) and quantified surrounding landscape composition (e.g., urban, natural, open, and agricultural cover). For the eight sites with large enough networks, we calculated three network structure metrics (interaction richness, vulnerability, and functional complementarity). We then used generalized linear and mixed models to examine relationships between herbivore host abundance, parasitism rates, garden management and landscape characteristics, and network metrics. We found that both local management and landscape composition influenced parasitism, while only local factors affected host abundance and network structure. Higher network interaction richness was marginally associated with enhanced parasitism rates for two host species and lower parasitism rates for one host species. Our results suggest that local garden management decisions may shift the structure of host–parasitoid networks, which may subsequently affect host parasitism rates, but outcomes for biological pest control will likely vary across host species.

Abstract Background Parental refusal of routine childhood vaccination remains an ethically contested area. This systematic review sought to explore and characterise the normative arguments made about parental refusal of routine vaccination, with the aim of providing researchers, practitioners, and policymakers with a synthesis of current normative literature. Methods Nine databases covering health and ethics research were searched, and 121 publications identified for the period Jan 1998 to Mar 2022. For articles, source journals were categorised according to Australian Standard Field of Research codes, and normative content was analysed using a framework analytical approach. Results Most of the articles were published in biomedical journals (34%), bioethics journals (21%), and journals that carry both classifications (20%). Two central questions dominated the literature: (1) Whether vaccine refusal is justifiable (which we labelled ‘refusal arguments’); and (2) Whether strategies for dealing with those who reject vaccines are justifiable (‘response arguments’). Refusal arguments relied on principlism, religious frameworks, the rights and obligations of parents, the rights of children, the medico-legal best interests of the child standard, and the potential to cause harm to others. Response arguments were broadly divided into arguments about policy, arguments about how individual physicians should practice regarding vaccine rejectors, and both legal precedents and ethical arguments for vaccinating children against a parent’s will. Policy arguments considered the normative significance of coercion, non-medical or conscientious objections, and possible reciprocal social efforts to offset vaccine refusal. Individual physician practice arguments covered nudging and coercive practices, patient dismissal, and the ethical and professional obligations of physicians. Most of the legal precedents discussed were from the American setting, with some from the United Kingdom. Conclusions This review provides a comprehensive picture of the scope and substance of normative arguments about vaccine refusal and responses to vaccine refusal. It can serve as a platform for future research to extend the current normative literature, better understand the role of cultural context in normative judgements about vaccination, and more comprehensively translate the nuance of ethical arguments into practice and policy.

The objective of this study was to determine impacts of environmental enrichment (EE) on turkey meat quality. A randomized complete block design was used with commercial turkeys (n = 420) randomly assigned to 6 EE treatments (control [C], pecking block [PB], platform [P], wooden platform þ straw bale [PSB], straw bale [SB], and tunnel [T]) across 24 pens (16 to 18 turkeys/pen). At 19 wk, turkeys were weighed (live weight [LW]), and 6 birds per pen were harvested, a subset (n = 96 carcasses) fabricated into wings, drumsticks, and boneless breasts and thighs. From the breast and thigh, samples were taken for pH and drip loss. From the breast, samples were taken for instrumental color and shear force, with remaining breast portions further processed into boneless turkey breast logs. From each log, slices were taken for packaged purge loss (PPL), expressed moisture loss (EML), instrumental color, and texture. All EE treatments were analyzed using PROC GLM. For LW, SB turkeys were lightest, PB turkeys were heaviest, and T, PSB, C, and P were intermediate (P = 0.01). For fresh turkey, EE treatment did not impact the fabrication values, fresh breast color, breast or thigh drip loss, or breast or thigh pH (P > 0.05) and had minimal impact to thigh color with significant differences only in the b* values (P = 0.04). For processed turkey, EE did not impact processing yield, PPL, a*, b*, or texture (P > 0.05). For L*, SB, T, P, and PSB were lighter, C were darker, and PB had intermediate values (P = 0.02). PB, PSB, C, and T had greater EML loss, P had the least, and SB had intermediate EML (P = 0.04). The results indicate some variations of turkey quality due to EE, but the impacts of specific enrichments were not consistent across quality parameters.

Abstract Objective Governments use vaccination mandates, of different degrees of coerciveness, to encourage or require childhood vaccination. We elicited the views of well‐informed community members on the public acceptability of using childhood vaccination mandates in Australia. Methods Four community juries were conducted in Canberra, Launceston, Cairns and Melbourne, Australia between 2021 and 2022. We recruited 51 participants from diverse backgrounds, genders and ages through random digit dialling and social media. Two juries were held in metropolitan areas, and two in regional/rural settings. Outcome measures included jury verdicts and reasons in response to structured questions. Results All juries were concerned about collective protection and individual rights but prioritised the former over the latter. A majority in all juries supported mandates but juries disagreed with respect to the appropriate mandate types. All juries endorsed using the least restrictive or coercive means to encourage vaccination (providing incentives or education, e.g.) before imposing penalties such as financial losses and school exclusions. The overriding view was that it is fairer to place a direct burden on parents rather than children and that mandates should be designed to avoid inequitable impacts on less advantaged groups in society. Many jurors found conscientious objection acceptable as a controlled option for resolute refusers, provided that overall vaccination coverage remains high. Conclusion This paper gives policymakers access to the reasons that Australians have for supporting or opposing different mandates under conditions of high knowledge, understanding and deliberation regarding policy options. Sustaining high rates of vaccination requires high levels of co‐operation between governments, public health actors and the public. Our findings highlight the importance of considering public values in the design and implementation of vaccination mandates. Patient and Public Involvement We sought input from individuals who did and did not vaccinate during the study design. The views and perspectives of nonvaccinating parents were presented in the evidence to juries. We deliberately excluded nonvaccinating individuals from participating, as the divisive and often hostile nature of the topic, and their minority status, made it difficult to ensure they would feel safe as members of the jury without overrepresenting their perspective in the sample. Two related projects engaged directly with these parents.

Agroecosystem management at microhabitat, habitat, and landscape scales shapes natural enemy communities, with critical implications for ecosystem services. Yet few studies examine the impacts of small to large scale habitat management features on predator communities, abundance of predator species, or removal of prey items from urban agroecosystems. In this study, we used observations and a sentinel prey removal experiment to examine the impact of substrate (prey placed on the ground vs. on kale plants), microhabitat (prey placed under vegetation, on bare soil in open areas, or on mulch in open areas), local garden management features, and landscape features on predator species composition and removal of two prey species in urban gardens in the California central coast. We found that both microhabitat characteristics and substrate type shaped prey removal rates within urban gardens, and microhabitat, but not substrate, impacted predator species composition. In addition, both garden management (floral abundance, herbaceous plant richness, and tree and shrub abundance) and landscape features (urban land cover within 2 km) influenced prey removal and predator composition. Nearly all prey removal of eggs was accomplished by ants; larvae predators were more diverse and included ants, birds, lizards, wasps, and spiders. Although predator composition was mediated by many habitat features, prey removal was greater under vegetation, from the ground, when floral abundance in gardens was high, and in gardens with fewer trees and shrubs. Considering how these different management features affect predator foraging behavior and interactions will be a promising next step in this field.

Effective ocean management asks for up-to-date knowledge of marine biogeography. Here we compare eDNA and gear-based assessments of marine fish populations using an approach that focuses on the commonest species. The protocol takes advantage of the "hollow curve" of species abundance distributions, with a minority of species comprising the great majority of individuals or biomass. We analyzed new and published teleost eDNA metabarcoding surveys from three neighboring northwest Atlantic coastal locations representing sandy, rocky, or estuary habitat. Fish eDNA followed a hollow curve species abundance distribution at each location-the 10 commonest taxa accounted for more than 90% of eDNA copies. Top ten taxa were designated eDNA-dominant species (eDDS) and categorized as habitat-associated (top 10 in one study) or as shared. eDDS by category were similarly abundant in concurrent bottom trawl and seine surveys. eDDS habitat category profiles correctly classified most (94%-100%) individual eDNA and capture measurements within surveys and recognized estuarine sites in other regional eDNA and seine studies. Using a category metric like that for habitats, eDDS demonstrated strong seasonal turnover concordant with trawl catch weights. eDNA seasonal profiles applied to historical trawl and seine records highlighted known long-term trends in mid-Atlantic fish populations. This study provides evidence that eDNA-abundant fish species differ among coastal habitats and by season consistent with gear-based assessments. Grouping abundant species by category facilitated comparisons among habitats and integration with established surveys. eDNA metabarcoding of dominant fish species potentially offers a useful tool for marine biogeography and ocean monitoring.

BackgroundNewborn bloodspot screening is a well-established population health initiative that detects serious, childhood-onset, treatable conditions to improve health outcomes. With genomic technologies advancing rapidly, many countries are actively discussing the introduction of genomic assays into newborn screening programs. While adding genomic testing to Australia's newborn screening program could improve outcomes for infants and families, it must be considered against potential harms, ethical, legal, equity and social implications, and economic and health system impacts. We must ask not only 'can' we use genomics to screen newborns?' but 'should we'?' and 'how much should health systems invest in genomic newborn screening?'.MethodsThis study will use qualitative methods to explore understanding, priorities, concerns and expectations of genomic newborn screening among parents/carers, health professionals/scientists, and health policy makers across Australia. In-depth, semi-structured interviews will be held with 30-40 parents/carers recruited via hospital and community settings, 15-20 health professionals/scientists, and 10-15 health policy makers. Data will be analysed using inductive content analysis. The Sydney Children's Hospital Network Human Research Ethics Committee approved this study protocol [2023/ETH02371]. The Standards for Reporting Qualitative Research will guide study planning, conduct and reporting.DiscussionFew studies have engaged a diverse range of stakeholders to explore the implications of genomics in newborn screening in a culturally and genetically diverse population, nor in a health system underpinned by universal health care. As the first study within a multi-part research program, findings will be used to generate new knowledge on the risks and benefits and importance of ethical, legal, social and equity implications of genomic newborn screening from the perspective of key stakeholders. As such it will be the foundation on which child and family centered criteria can be developed to inform health technology assessments and drive efficient and effective policy decision-making on the implementation of genomics in newborn screening.

Abstract Introduction Transvaginal mesh (mesh) surgeries have been used to treat stress urinary incontinence (incontinence) and/or pelvic organ prolapse (prolapse). In Australia, as in many other countries, the harms caused by mesh eventually prompted individual and collective attempts to achieve redress. The rise of mesh surgery as a procedure, the experience of mesh‐affected women and the formal inquiries and legal actions that followed all occurred in social, cultural and discursive contexts. One strategy to understand these contexts is to track how the mesh and key actors in the mesh stories have been portrayed in mass media sources. We conducted a media analysis of the most highly read Australian newspapers and online news media platforms, focusing on how mesh and the interaction of stakeholders in mesh stories were presented to the Australian public. Method We searched systematically in the top 10 most‐read print and online media outlets in Australia. We included all articles that mentioned mesh, from the date of first use of mesh in Australia to the date of our final search (1996–2021). Result After early scant media reporting focusing on the benefits of mesh procedures, major Australian medicolegal processes created a hook to shift reporting about mesh. The news media then played a significant role in redressing women's experienced epistemic injustice, including by amplifying previously ignored evidence of harm. This created an opportunity for previously unreported suffering to be revealed to powerful actors, in settings beyond the immediate control and epistemic authority of healthcare stakeholders, validating women's testimony and creating new hermeneutic resources for understanding mesh. Over time, media reports show healthcare stakeholders responding sympathetically to these new understandings in public discourse, contrasting with their statements in earlier media coverage. Conclusion We argue that mass media reporting, in synergy with medicolegal actions and the Australian Senate Inquiry, appears to have provided women with greater epistemic justice, giving their testimony privileged epistemic status such that it was considered by powerful actors. Although medical reporting is not recognised in the hierarchy of evidence embedded in the medical knowledge system, in this case, media reporting appears to have contributed to shaping medical knowledge in significant ways. Patient or Public Contribution We used publicly available data, print and online media outlets, for our analysis. Therefore, this manuscript does not contain the direct contribution of patients, service users, caregivers, people with lived experience or members of the public.

Inflammation and oxidative stress are implicated in the pathogenesis of Crohn’s disease. Cerium oxide nanoparticle (CNP) conjugated to microRNA 146a (miR146a) (CNP-miR146a) is a novel compound with anti-inflammatory and antioxidative properties. We hypothesized that local administration of CNP-miR146a would improve colitis in a 2,4,6-Trinitrobenzenesulfonic acid (TNBS) mouse model for Crohn’s disease by decreasing colonic inflammation. Balb/c mice were instilled with TNBS enemas to induce colitis. Two days later, the mice received cellulose gel enema, cellulose gel with CNP-miR146a enema, or no treatment. Control mice received initial enemas of 50% ethanol and PBS enemas on day two. The mice were monitored daily for weight loss and clinical disease activity. The mice were euthanized on days two or five to evaluate their miR146a expression, inflammation on histology, and colonic IL-6 and TNF gene expressions and protein concentrations. CNP-miR146a enema successfully increased colonic miR146a expression at 12 h following delivery. At the end of five days from TNBS instillation, the mice treated with CNP-miR146a demonstrated reduced weight loss, improved inflammation scores on histology, and reduced gene expressions and protein concentrations of IL-6 and TNF. The local delivery of CNP-miR146a in a TNBS mouse model of acute Crohn’s colitis dramatically decreased inflammatory signaling, resulting in improved clinical disease.

Objectives The objective of this study is to map the range and variety of direct-to-consumer (DTC) tests advertised online in Australia and analyse their potential clinical utility and implications for medical overuse.Design Systematic online search of DTC test products in Google and Google Shopping. DTC test advertisements data were collected and analysed to develop a typology of potential clinical utility of the tests at population level, assessing their potential benefits and harms using available evidence, informed by concepts of medical overuse.Results We identified 484 DTC tests (103 unique products), ranging from $A12.99 to $A1947 in cost (mean $A197.83; median $A148.50). Using our typology, we assigned the tests into one of four categories: tests with potential clinical utility (10.7%); tests with limited clinical utility (30.6%); non-evidence-based commercial ‘health checks’ (41.9%); and tests whose methods and/or target conditions are not recognised by the general medical community (16.7%). Of the products identified, 56% did not state that they offered pretest or post-test consultation, and 51% did not report analytical performance of the test or laboratory accreditation.Conclusions This first-in-Australia study shows most DTC tests sold online have low potential clinical utility, with healthy consumers constituting the main target market. Harms may be caused by overdiagnosis, high rates of false positives and treatment decisions led by non-evidence-based tests, as well as financial costs of unnecessary and inappropriate testing. Regulatory mechanisms should demand a higher standard of evidence of clinical utility and efficacy for DTC tests. Better transparency and reporting of health outcomes, and the development of decision-support resources for consumers are needed.

BackgroundHomegardens in agricultural areas are important refuges for pollinators and other valuable species due to the extensive plant diversity therein. Yet, plant diversity may strongly depend on the identity of the gardeners and their knowledge of plant identification and plant uses.ObjectiveIn this study, we used botanical surveys and homegardener interviews to explore plant diversity in homegardens in coffee-producing regions of Colombia, and to examine how homegardener identity influences their knowledge of plants, plant uses, and motivations for maintaining a homegarden.MethodsWe collected information in three villages in Cauca, Colombia and interviewed campesino (n = 30) and indigenous (n = 30) homegardeners. Half of the respondents from each social group were women and half were men.Results and discussionOf the 566 plant species that we detected in botanical surveys, the most recognized spontaneous herbs among homegardeners were “papunga” (Bidens pilosa, n = 38), “lechuguilla” (Emilia sonchifolia, n = 32), and “escoba” (Sida acuta, n = 31). Homegardeners identified multiple uses of spontaneous herbs including for food, material, medicine, plants for bees, and other environmental, conservation, or social uses. In addition, three different groups of gardeners emerged from social groupings and interview responses: (1) indigenous men with little knowledge of the uses of spontaneous herbs; (2) indigenous and campesino women who considered it beneficial to have flowers and crops for pollinators; and (3) male farmers who described detailed mutualistic plant-pollinator interactions that benefit crops, and who use spontaneous herbs to maintain soil moisture. In conclusion, homegardeners kept very diverse gardens and identified spontaneous herbs and pollinator functions, but this strongly depended on age, knowledge, and social group. Thus, homegarden presence within agricultural landscapes is of great importance to sustain functional biodiversity and ecosystem services in Colombian agroecosystems.ConclusionIn conclusion, homegardeners kept very diverse gardens and identified spontaneous herbs and pollinator functions, but this strongly depended on age, knowledge, and social group. Thus, homegarden presence within agricultural landscapes is of great importance to sustain functional biodiversity and ecosystem services in Colombian agroecosystems.

Since emerging in French Polynesia and Brazil in the 2010s, Zika virus (ZIKV) has been associated with fetal congenital disease. Previous studies have compared ancestral and epidemic ZIKV strains to identify strain differences that may contribute to vertical transmission and fetal disease. However, within-host diversity in ZIKV populations during vertical transmission has not been well studied. Here, we used the established anti-interferon treated Rag1-/- mouse model of ZIKV vertical transmission to compare genomic variation within ZIKV populations in matched placentas, fetal bodies, and fetal brains via RNASeq. At early stages of vertical transmission, the ZIKV populations in the matched placentas and fetal bodies were similar. Most ZIKV single nucleotide variants were present in both tissues, indicating little to no restriction in transmission of ZIKV variants from placenta to fetus. In contrast, at later stages of fetal infection there was a sharp reduction in ZIKV diversity in fetal bodies and fetal brains. All fetal brain ZIKV populations were comprised of one of two haplotypes, containing either a single variant or three variants together, as largely homogenous populations. In most cases, the dominant haplotype present in the fetal brain was also the dominant haplotype present in the matched fetal body. However, in two of ten fetal brains the dominant ZIKV haplotype was undetectable or present at low frequencies in the matched placenta and fetal body ZIKV populations, suggesting evidence of a strict selective bottleneck and possible selection for certain variants during neuroinvasion of ZIKV into fetal brains.

Abstract Spaceflight-Associated Neuro-ocular Syndrome (SANS) is a significant unexplained adverse reaction to long-duration spaceflight. We employ an ex vivo translaminar autonomous system (TAS) to recreate a human ocular ground-based spaceflight analogue model to study SANS pathogenesis. To recapitulate the human SANS conditions, human ocular posterior segments are cultured in the TAS model for 14 days. Translaminar pressure differentials are generated by simulating various flow rates within intracranial pressure (ICP) and intraocular (IOP) chambers to maintain hydrostatic pressures of ICP: IOP (12:16, 15:16, 12:21, 21:16 mmHg). In addition, optic nerves are mechanically kinked by 6- and 10-degree tilt inserts for the ICP: IOP;15:16 mmHg pressure paradigm. The TAS model successfully maintains various pressure differentials for all experimental groups over 14 days. Post culture, we determine inflammatory and extracellular component expression changes within posterior segments. To further characterize the SANS pathogenesis, axonal transport capacity, optic nerve degeneration and retinal functional are measured. Identifiable pathogenic alterations are observed in posterior segments by morphologic, apoptotic, and inflammatory changes including transport and functional deficits under various simulated SANS conditions. Here we report our TAS model provides a unique preclinical application system to mimic SANS pathology and a viable therapeutic testing device for countermeasures.

Repeated, long-term (weeks to months) exposure to standard antidepressant medications is required to achieve treatment efficacy. In contrast, acute ketamine quickly improves mood for an extended time. Recent work implicates that hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are involved in mediating ketamine's antidepressant effects. In this study, we directly targeted HCN channels and achieved ketamine-like rapid and sustained antidepressant efficacy. Our in vitro electrophysiological recordings first showed that HCN inhibitor DK-AH 269 (also called cilobradine) decreased the pathological HCN-mediated current (Ih) and abnormal hyperactivity of ventral tegmental area (VTA) dopamine (DA) neurons in a depressive-like model produced by chronic social defeat stress (CSDS). Our in vivo studies further showed that acute intra-VTA or acute systemic administration of DK-AH 269 normalized social behavior and rescued sucrose preference in CSDS-susceptible mice. The single-dose of DK-AH 269, both by intra-VTA microinfusion and intraperitoneal (ip) approaches, could produce an extended 13-day duration of antidepressant-like efficacy. Animals treated with acute DK-AH 269 spent less time immobile than vehicle-treated mice during forced swim test. A social behavioral reversal lasted up to 13 days following the acute DK-AH 269 ip injection, and this rapid and sustained antidepressant-like response is paralleled with a single-dose treatment of ketamine. This study provides a novel ion channel target for acutely acting, long-lasting antidepressant-like effects.

In June 2019, New York State (NYS) adopted Senate Bill 2994A eliminating nonmedical vaccine exemptions from school entry laws. Since student noncompliance with the law required school exclusion, we sought to evaluate the law’s effects on student enrollment and absenteeism, and school workloads related to its implementation. In November 2019, we sent an electronic survey to NYS (excluding New York City) schools. Due to the COVID-19 pandemic, outreach was curtailed in March 2020 with 525 (14%) of 3,759 eligible schools responding. To account for non-response, results were analyzed using inverse probability weighting. After weighting, 39% (95% CI: 34%, 44%) of schools reported enrollment changes and 31% (95% CI: 26%, 36%) of schools reported absenteeism related to the law. In addition, 95% (95% CI: 93%, 98%) of schools reported holding meetings and/or preparing correspondence about the law, spending a mean of 14 (95% CI: 11, 18) hours on these communication efforts. Schools in the highest pre-mandate nonmedical exemption tertile (vs. lowest) were more likely to report enrollment and absenteeism changes, and higher workloads. While our results should be interpreted with caution, changes in student enrollment, absenteeism, and school workloads may represent important considerations for policymakers planning similar legislation.

Objective Mammographic screening for breast cancer is an early use case for artificial intelligence (AI) in healthcare. This is an active area of research, mostly focused on the development and evaluation of individual algorithms. A growing normative literature argues that AI systems should reflect human values, but it is unclear what this requires in specific AI implementation scenarios. Our objective was to understand women's values regarding the use of AI to read mammograms in breast cancer screening. Methods We ran eight online discussion groups with a total of 50 women, focused on their expectations and normative judgements regarding the use of AI in breast screening. Results Although women were positive about the potential of breast screening AI, they argued strongly that humans must remain as central actors in breast screening systems and consistently expressed high expectations of the performance of breast screening AI. Women expected clear lines of responsibility for decision-making, to be able to contest decisions, and for AI to perform equally well for all programme participants. Women often imagined both that AI might replace radiographers and that AI implementation might allow more women to be screened: screening programmes will need to communicate carefully about these issues. Conclusions To meet women's expectations, screening programmes should delay implementation until there is strong evidence that the use of AI systems improves screening performance, should ensure that human expertise and responsibility remain central in screening programmes, and should avoid using AI in ways that exacerbate inequities.

Urban ecological communities are shaped by an array of environmental and physical factors that include climate, biogeography, species interactions, dispersal, and ecological filters at the habitat and landscape scales. In addition, many social dynamics, decision-making processes, and other social characteristics, such as development, policy, government actions, as well as socioeconomic status of residents – the so-called ‘luxury’ effect – may also play strong roles in shaping which species occur within the urban context. This interaction between ecological and social drivers may impact species richness and may also influence functional traits and functional diversity, with important implications for ecosystem services provided within urban spaces. Urban agroecosystems provide food and other well-being benefits to urban residents, and are valuable green spaces in the city that provide refuges for biodiversity. Despite this fact, one of the biggest risks to gardens is insecure land tenure. While plant communities within gardens may be shaped by gardener demographics, food cultures, and ecological processes, little is known about how factors such as luxury and land tenure security may impact plant diversity, plant functional traits, and functional diversity, as well as species and trait composition. In this study, we ask how garden physical features, luxury, and land tenure security influence plant species richness, functional diversity, and species and trait composition within gardens in the California central coast. We surveyed vegetation, assessed plant traits related to growth form, plant defense, and floral characteristics, and collected information on multiple factors associated with land tenure and luxury. We found that land tenure secure gardens had higher plant and crop richness. Variables associated with garden luxury boosted ornamental plant richness, flower abundance and height, lowered crop richness, and strongly impacted plant species composition. Garden plot size negatively correlated with plant species and functional richness and relative abundance of trees. Weed species richness was not impacted by any social or physical feature examined. Thus overall, in community gardens, cultivated plants, and their traits, are strongly shaped by the socioeconomic factors of land tenure security and luxury as well as the spatial distribution and size of garden plots, with important implications for both conservation and ecosystem services provided by garden habitats within cities.

To determine the effects of zilpaterol hydrochloride (ZH) on growth performance, carcass characteristics and meat quality for steers differing in breed type, steers with British (B; n = 76) or British × Continental (BC; n = 57) backgrounds were allocated to a randomized incomplete block design with a 2 × 2 treatment structure. Pens within each block × breed type were randomly assigned to either ZH (8.3 mg/kg of DM; fed for 20 d before slaughter, followed by a 3-day withdrawal) or control (CON; 0 mg/kg ZH). Steers were subjected to ultrasound immediately before ZH inclusion and following withdrawal to determine the influence of ZH on changes in longissimus muscle area (LMA), fat thickness and percent intramuscular fat (IMF). Carcass data were collected, and the longissimus lumborum was collected for analysis of tenderness, moisture percentage, crude fat content, collagen content, postmortem proteolysis and sensory attributes. The ZH × breed type interaction did not influence (p > 0.05) the feedlot performance, carcass or meat quality attribute traits evaluated, with the exception of moisture percentage. Responses among breed types were as expected for B vs. BC cattle types. Supplementation with ZH improved (p < 0.05) LMA and yield grade but increased Warner–Bratzler shear force.

In urban community gardens, cultivated vegetation provides variable levels of habitat complexity, which can suppress pests by promoting predator diversity and improving pest control. In this study, we examine three components of the structural complexity of garden vegetation (cover, diversity, and connectivity) to investigate whether higher garden vegetation complexity leads to fewer herbivores, more predators, and higher predation. We worked in eight community gardens where we quantified vegetation complexity, sampled the arthropod community, and measured predation on corn earworm eggs. We found that plots with high vegetation cover supported higher species richness and greater abundance of predatory insects. High vegetation cover also supported a greater abundance and species richness of spiders. In contrast, high vegetation diversity was negatively associated with predator abundance. While high predator abundance was positively associated with egg predation, greater predator species richness had a negative impact on egg predation, suggesting that antagonism between predators may limit biological control. Community gardeners may thus manipulate vegetation cover and diversity to promote higher predator abundance and diversity in their plots. However, the species composition of predators and the prevalence of interspecific antagonism may ultimately determine subsequent impacts on biological pest control.

Abstract Background Reflections on the response to the COVID‐19 pandemic often evoke the concept of ‘resilience’ to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representatives in healthcare services in initiating changes to the way they participated in the pandemic response in the state of New South Wales in Australia. Methods In‐depth interviews were conducted with two cohorts of consumer representatives. Cohort A included experienced and self‐identified consumer leaders, who worked together in a COVID‐19 Consumer Leaders Taskforce; Cohort B included participants outside of this group, and purposively included consumer representatives from rural and regional areas, and culturally and linguistically diverse communities. Results The pause in consumer engagement to support health service decision‐making in responding to the pandemic forced consumer representatives to consider alternative approaches to participate. Some initiated networking with each other, forming new collaborations to produce consumer‐led research and guidelines on pandemic‐related patient care. Others mobilized support from community and politicians to lobby for specific healthcare issues in their local areas. Conclusion The response to the COVID‐19 pandemic made visible the brittle nature of previous engagement processes of involving consumers in organizational design and governance. However, the momentum for proactive self‐organization in an unexpected crisis created space for consumer representatives to reset and reimagine their role as active partners in health services. Their ability to adapt and adjust ways of working are key assets for a resilient health system. Patient or Public Contribution This project is a collaborative study between academic researchers and health consumer (patient and public) representatives. It followed the principles of codesign and coresearch, whereby both consumer representatives and academic researchers contributed equally to all stages of the project. The study was cofunded by both academic institutions and consumer representative organizations.

Abstract Background In recent years, innovations in artificial intelligence (AI) have led to the development of new healthcare AI (HCAI) technologies. Whilst some of these technologies show promise for improving the patient experience, ethicists have warned that AI can introduce and exacerbate harms and wrongs in healthcare. It is important that HCAI reflects the values that are important to people. However, involving patients and publics in research about AI ethics remains challenging due to relatively limited awareness of HCAI technologies. This scoping review aims to map how the existing literature on publics’ views on HCAI addresses key issues in AI ethics and governance. Methods We developed a search query to conduct a comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Academic Search Complete from January 2010 onwards. We will include primary research studies which document publics’ or patients’ views on machine learning HCAI technologies. A coding framework has been designed and will be used capture qualitative and quantitative data from the articles. Two reviewers will code a proportion of the included articles and any discrepancies will be discussed amongst the team, with changes made to the coding framework accordingly. Final results will be reported quantitatively and qualitatively, examining how each AI ethics issue has been addressed by the included studies. Discussion Consulting publics and patients about the ethics of HCAI technologies and innovations can offer important insights to those seeking to implement HCAI ethically and legitimately. This review will explore how ethical issues are addressed in literature examining publics’ and patients’ views on HCAI, with the aim of determining the extent to which publics’ views on HCAI ethics have been addressed in existing research. This has the potential to support the development of implementation processes and regulation for HCAI that incorporates publics’ values and perspectives.

Objectives: Applications of artificial intelligence (AI) have the potential to improve aspects of healthcare. However, studies have shown that healthcare AI algorithms also have the potential to perpetuate existing inequities in healthcare, performing less effectively for marginalised populations. Studies on public attitudes towards AI outside of the healthcare field have tended to show higher levels of support for AI among socioeconomically advantaged groups that are less likely to be sufferers of algorithmic harms. We aimed to examine the sociodemographic predictors of support for scenarios related to healthcare AI.Methods: The Australian Values and Attitudes toward AI survey was conducted in March 2020 to assess Australians’ attitudes towards AI in healthcare. An innovative weighting methodology involved weighting a non-probability web-based panel against results from a shorter omnibus survey distributed to a representative sample of Australians. We used multinomial logistic regression to examine the relationship between support for AI and a suite of sociodemographic variables in various healthcare scenarios.Results: Where support for AI was predicted by measures of socioeconomic advantage such as education, household income and Socio-Economic Indexes for Areas index, the same variables were not predictors of support for the healthcare AI scenarios presented. Variables associated with support for healthcare AI included being male, having computer science or programming experience and being aged between 18 and 34 years. Other Australian studies suggest that these groups may have a higher level of perceived familiarity with AI.Conclusion: Our findings suggest that while support for AI in general is predicted by indicators of social advantage, these same indicators do not predict support for healthcare AI.

Background:. The risk of women developing breast cancer after augmentation mammaplasty may be lower than the general population, with minimal current literature on breast reconstruction in this population. We sought to evaluate the impact of previous augmentation on postmastectomy breast reconstruction. Methods:. Retrospective review of patients who underwent mastectomies from 2017 to 2021 at our institution was performed. Analysis included frequencies and percentages, descriptive statistics, chi-square analysis, and Fisher exact test. Results:. Four hundred seventy patients were included, with average body mass index of 29.1 kg/m2, 96% identifying as White, and an average age at diagnosis of 59.3 years. Twenty (4.2%) patients had a prior breast augmentation. Reconstruction was performed in 80% of the previously augmented patients compared to 49.9% of nonaugmented patients (P = 0.01). Reconstruction was alloplastic in 100% of augmented and 88.7% of nonaugmented patients (P = 0.15). All reconstructed augmented patients underwent immediate reconstruction compared with 90.5% of nonaugmented patients (P = 0.37), and two-stage reconstruction was most common (75.0% versus 63.5%; P = 0.42). Of the previously augmented patients, 87.5% increased implant volume, 75% underwent same implant plane reconstruction, and 68.75% underwent same implant-type reconstruction as their augmentation. Conclusions:. Previously augmented patients were more likely to undergo reconstruction after mastectomy at our institution. All reconstructed augmented patients underwent alloplastic reconstruction, with most performed immediately in staged fashion. Most patients favored silicone implants and maintained the same implant type and plane of reconstruction, with increased implant volume. Larger studies are required to further investigate these trends.

Abstract Background Bladder cancer is one of the top 10 cancers diagnosed in Americans with a median age of 73. This is the patient population that tends to be older with multiple medical conditions, and previously described variability in treatment in the earlier stages of the disease. This study aimed to evaluate the first‐line therapeutic choices for older adults newly diagnosed with advanced bladder cancer. In addition, this work evaluated predictors of response as well as the role of events of functional importance in relation to treatment assignment. Methods A population‐based cohort study was conducted using the SEER‐Medicare database of patients with advanced stage bladder cancer not eligible for curative intent therapy between 2010 and 2013. Patient groups of interest were compared via univariate and multivariate associations. Additionally, a latent class analysis was applied to identify classes with similar features in reference to events of functional importance—events linked to the maintenance or improvement of physical function status. Results Within the sample, we noted that a minority of patients received a standard cisplatin‐containing regimen (14.77%) and a majority did not receive any chemotherapy (59.69%). Most patients were over age 75. The adjusted odds ratio of no chemo versus cisplatin in patients aged 76 and older compared to patients 66–75 was 6.61 (4.79–9.13; p

Vegetation connectivity is an essential aspect of the habitat complexity that impacts species interactions at local scales. However, agricultural intensification reduces connectivity in agroforestry systems, including coffee agroecosystems, which may hinder the movement of natural enemies and reduce the ecosystem services that they provide. Ants play an important role in regulating the coffee berry borer (CBB), which is the most damaging coffee pest. For arboreal ant communities, the connections between trees are important structures that facilitate ant mobility, resource recruitment, foraging success, and pest control ability. To better understand how connectivity impacts arboreal ants in coffee agroecosystems, we conducted an experiment to assess the impact of artificial (string) and naturally occurring vegetation (vines, leaves, branches) connectivity on Azteca sericeasur behavior on coffee plants. We compared ant activity, resource recruitment, and CBB removal rates across three connectivity treatments connecting coffee plants to A. sericeasur nest trees: vegetation connectivity, string, and control (not connected) treatments. We found higher rates of ant activity, resource recruitment, and CBB removal on plants with naturally occurring vegetation connections to A. sericeasur nest trees. Artificial connectivity (string) increased the rates of resource recruitment and CBB removal but to a lesser extent than vegetation connectivity. Moreover, vegetation connectivity buffered reductions in ant activity with distance from the ant nest tree. These results reinforce how habitat complexity in the form of vegetation connectivity impacts interspecific interactions at the local scale. Our results also suggest that leaving some degree of vegetation connectivity between coffee plants and shade trees can promote ant-mediated biological pest control in coffee systems.

Anxiety and depression are highly comorbid, yet the distinct or shared neurobiological correlates of anxiety remain elusive. Here, Morel et al. define that the midbrain projection to the basolateral amygdala control anxiety but not depression.

Since 2020, hundreds of thousands of more deaths than expected have been observed across the globe. Amid the coronavirus 2019 (COVID-19) pandemic, current research priorities are to control the spread of infection and minimise loss of life. However, there may be future opportunities to learn from the pandemic to build a better healthcare system that delivers maximum health benefits with minimum harm. So far, much research has focused on foregone benefits of healthcare services such as cancer screening during the pandemic. A more balanced approach is to recognise that all healthcare services have potential harms as well as benefits. In this way, we may be able to use pandemic ‘natural experiments’ to identify cases where a reduction in a healthcare service has not been harmful to the population and some instances where this may have even been beneficial.

Background:. Factors that influence breast reconstruction after mastectomy have been previously examined in national databases. The purpose of this study was to determine the impact of patient travel distance and income on breast reconstruction after mastectomy in a rural population. Methods:. Retrospective review of mastectomy patients from 2017 to 2021 was performed from our prospectively enrolled tumor registry. Analysis included frequencies and percentages, descriptive statistics, χ2 analysis, independent sample t tests, and multivariable analysis. Results:. In total, 462 patients were included. Median BMI was 27.6 kg/m2, 96.1% of patients were White, and median age at diagnosis was 60.0 years. Reconstruction rate was 52.6%, and median length of follow-up was 24.6 months. No significant difference was found in the distance traveled by patients who underwent reconstruction (16.6 versus 16.7 miles; P = 0.94). Rates of reconstruction in patients who traveled 0–10 miles, 11–30 miles, and over 30 miles did not differ significantly (P = 0.16). Median household income was significantly different in reconstructed and nonreconstructed patients ($55,316.00 versus $51,629.00; P = 0.047). Rates of reconstruction were significantly higher in patients with median household income greater than $65,000 (P = 0.024). This difference was not significant on multivariable analysis. Conclusions:. Travel distance did not significantly impact reconstruction rates after mastectomy, while household income did on univariable analysis. Studies at an institutional or regional level remain valuable, especially in populations that may not be accurately represented in larger database studies. Our findings highlight the importance of patient education, resource allocation, and multidisciplinary approach to breast cancer care, especially in the rural setting.

Several theories of fertility behavior assume that planning is important to women. Is this a reasonable assumption? To answer this question, the authors used the National Survey of Fertility Barriers. Among women with unsure or positive fertility intentions at wave 1, most (75 percent) agreed with the statement “It is important to plan my pregnancies.” Logistic regression, adjusted for control variables, indicated that fertility intentions are a distinct construct from pregnancy planning attitudes. Multinomial regression of retrospective pregnancy attitude three years later among a subsample of women who had pregnancies during that period indicated that women who felt that it was more important to plan pregnancies had higher odds of describing their intentions at the time of a subsequent pregnancy as “trying to” become pregnant compared with “okay either way.” Therefore, it is useful to measure and include pregnancy planning attitude, in addition to intentions, in fertility research.

BackgroundFirearm safety among individuals with Alzheimer disease and related dementias (ADRD) is an underdiscussed and underresearched concern in the United States, especially given the growing population of community-dwelling adults with ADRD. The “Safety in Dementia” (SiD) web-based decision aid was developed to support caregivers in addressing firearm access; the efficacy of SiD is unknown. ObjectiveThrough the SiD decision aid, the Safe at Home (S@H) study aims to support caregivers in making decisions about home safety that align with their goals and values, and behaviors regarding firearm access for persons with ADRD and firearm access. MethodsThe S@H study is a 2-armed randomized controlled trial to test the effect of the SiD decision aid on caregivers of community-dwelling adults with ADRD who have firearm access. S@H aims to recruit 500 ADRD caregivers (age ≥18 years, fluent in English or Spanish, and in the United States) through online or social media advertisements and through relevant organizations. Participants are randomized to view SiD or a control website at their own pace; all participants complete web-based questionnaires at baseline, 2 weeks, 2 months, and 6 months. The primary outcome is immediate preparation for decision-making; secondary outcomes include longitudinal decision outcomes and self-reported modifications to firearm access. The relative reach and effectiveness of each recruitment method (online/social media and through relevant organizations) will be assessed by examining differences in caregiver participation, retention rates, and relative cost. ResultsThe study enrollment began in May 2022. As of December 2022, a total of 117 participants had enrolled. ConclusionsThe S@H study is the first randomized trial of a firearm safety decision aid for ADRD caregivers. The results from this study will inform how best to support caregivers in decision-making regarding firearm safety. Further, results may guide approaches for recruiting caregivers and for dissemination of resources. Trial RegistrationClinicalTrials.gov NCT05173922; https://clinicaltrials.gov/ct2/show/NCT05173922 International Registered Report Identifier (IRRID)DERR1-10.2196/43702

Word-picture verification, a task that requires a yes/no response to whether a word and a picture match, has been used for both receptive and expressive language; however, there is limited systematic investigation on the linguistic subprocesses targeted by the task. Verification may help to identify linguistic strengths and weaknesses to ultimately provide more targeted, individualized lexical retrieval intervention. The current study assessed the association of semantic and phonological skills with verification performance to demonstrate early efficacy of the paradigm as an aphasia assessment. Sixteen adults with chronic post-stroke aphasia completed a battery of language assessments in addition to reading and auditory verification tasks. Verification scores were positively correlated with auditory and reading comprehension. Accuracy of semantic and phonological verification were positively correlated with accuracy on respective receptive language tasks. More semantic errors were made during verification than naming. The relationship of phonological errors between naming and verification varied by modality (reading or listening). Semantic and phonological performance significantly predicted verification response accuracy and latency. In sum, we propose that verification tasks are particularly useful because they inform semantics pre-lemma selection and phonological decoding, helping to localize individual linguistic strengths and weaknesses, especially in the presence of significant motor speech impairment that can obscure expressive language abilities.

The responses of rare plants to environmental stressors will determine their potential to adapt to a rapidly changing climate. We used a common garden approach to evaluate how six populations of the annual San Diego thornmint (Acanthomintha ilicifolia Lamiaceae; listed as endangered in the state of California and as threatened by the US Fish and Wildlife Service) from across the species range respond in terms of growth (biomass, height, and width) and reproduction (seed production, floral production, and next generation seed viability) to experimental differences in water availability. We found a significant irrigation-by-population interaction on the aboveground growth, wherein the differences in the magnitude and direction of treatment did not correlate directly with climate variables in natural populations. With respect to reproduction, the low-irrigation treatment produced more seeds per plant, more reproductive individuals, and a larger proportion of viable seed in most, but not all, populations. The seed production and the effect of irrigation on seed production correlated positively with rainfall at wild source populations. These results suggest that Acanthomintha ilicifolia responds to water limitation by creating more and higher-quality seed, and that plants locally adapted to a higher annual rainfall show a greater plasticity to differences in water availability than plants adapted to a lower annual rainfall, a finding that can inform the in situ demographic management and ex situ collection strategy for Acanthomintha ilicifolia and other rare California annuals.

Fat smearing, or poor fat particle definition, impacts the visual quality of sausage. However, objective methods of assessing fat smearing have not been identified. Therefore, the objective of this experiment was to determine the relationship between fat smearing and instrumental color analysis for fresh sausages to create a standard method for using instrumental color in fat smearing analysis. Meat blocks of pork (PK), beef (BF), and a mixture of pork and beef (P/B) were formed and processed at three different temperatures to create varying degrees of fat smearing. The average fat smearing score of each sausage was used to determine if a relationship existed with instrumental color measurements (CIE L*, a*, b*, and reflectance percentage at 580 nm and 630 nm) and color calculations. A correlation was observed for L* (R = −0.704) and the reflectance at 580 nm (R = −0.775) to PK fat smearing (p < 0.05). In P/B sausage, both reflectances at ratios between 630 nm and 580 nm were correlated to P/B fat smearing. No measurement or calculation was correlated with BF fat smearing (p > 0.05). Therefore, it is possible to use instrumental color analysis for the evaluation of fat smearing in pork and pork/beef blended sausage products, but not in beef sausage products.

Abstract Background There is good evidence of both community support for sharing public sector administrative health data in the public interest and concern about data security, misuse and loss of control over health information, particularly if private sector organizations are the data recipients. To date, there is little research describing the perspectives of informed community members on private sector use of public health data and, particularly, on the conditions under which that use might be justified. Methods Two citizens' juries were held in February 2020 in two locations close to Sydney, Australia. Jurors considered the charge: ‘Under what circumstances is it permissible for governments to share health data with private industry for research and development?’ Results All jurors, bar one, in principle supported sharing government administrative health data with private industry for research and development. The support was conditional and the juries' recommendations specifying these conditions related closely to the concerns they identified in deliberation. Conclusion The outcomes of the deliberative processes suggest that informed Australian citizens are willing to accept sharing their administrative health data, including with private industry, providing the intended purpose is clearly of public benefit, sharing occurs responsibly in a framework of accountability, and the data are securely held. Patient and Public Contribution The design of the jury was guided by an Advisory Group including representatives from a health consumer organization. The jurors themselves were selected to be descriptively representative of their communities and with independent facilitation wrote the recommendations.

The purpose of this research study was to assess the impact of professional learning on teachers' reported beliefs about students identified as twice exceptional (2e) and students from culturally, economically, and linguistically diverse (CLED) populations, using a semi-randomized experimental design intervention. Teachers in the experimental condition participated in professional learning opportunities featuring curriculum materials, lessons, and activities highlighting support for students identified as 2e or from CLED populations. Teachers in the control condition received no intervention. Across 16 United States' schools, 53 grade 3 classroom teachers were selected to complete two sets of pre-intervention and post-intervention surveys assessing their reported beliefs about students identified as 2e or from CLED populations. The results indicated that all teachers consistently reported accurate and positive beliefs about the characteristics and needs of these populations, both prior to and after participation in relevant professional learning opportunities. Although analyses revealed main effects of condition and time for certain scales, the reported interaction terms suggested that the professional learning opportunities did not specifically increase questionnaire scores for teachers in the experimental condition. The implications of these findings regarding professional learning and efforts to improve equity in gifted and talented education are discussed.

This article analyzes teachers' perceptions and experiences using an educative curriculum designed to promote high levels of mathematical discourse. After participating in 2 days of professional learning, grade 3 teachers implemented a predifferentiated and enriched mathematics unit in their classroom. The curriculum was designed to be educative, meaning that teaching it served as professional learning. During implementation, researchers conducted an observation of each treatment teacher and after implementation was complete teachers participated in a post interview about their experiences. Findings from this qualitative study indicate that after teaching the curriculum teachers understood the value of oral discourse and how to implement it in their classroom and could identify student benefits from participating in this type of curriculum. This study illuminates promising practices that may support teachers in implementing research-based best practices.

(1) Urbanization threatens biodiversity, yet urban native plants support native biodiversity, contributing to conservation and ecosystem services. Within urban agroecosystems, where non-native plants are abundant, native plants may boost the abundance and richness of beneficial arthropods. Nevertheless, current information focuses on pollinators, with little attention being paid to other beneficials, like natural enemies. (2) We examined how the species richness of native plants, garden management, and landscape composition influence the abundance and species richness of all, native, and non-native bees, ladybeetles, ants, and ground-foraging spiders in urban agroecosystems (i.e., urban community gardens) in California. (3) We found that native plants (~10% of species, but only ~2.5% of plant cover) had little influence on arthropods, with negative effects only on non-native spider richness, likely due to the low plant cover provided by native plants. Garden size boosted native and non-native bee abundance and richness and non-native spider richness; floral abundance boosted non-native spider abundance and native and non-native spider richness; and mulch cover and tree and shrub abundance boosted non-native spider richness. Natural habitat cover promoted non-native bee and native ant abundance, but fewer native ladybeetle species were observed. (4) While native plant richness may not strongly influence the abundance and richness of beneficial arthropods, other garden management features could be manipulated to promote the conservation of native organisms or ecosystem services provided by native and non-native organisms within urban agroecosystems.

Illnesses transmitted by food and water cause a major disease burden in the United States despite advancements in food safety, water treatment, and sanitation. We report estimates from a structured expert judgment study using 48 experts who applied Cooke’s classical model of the proportion of disease attributable to 5 major transmission pathways (foodborne, waterborne, person-to-person, animal contact, and environmental) and 6 subpathways (food handler–related, under foodborne; recreational, drinking, and nonrecreational/nondrinking, under waterborne; and presumed person-to-person-associated and presumed animal contact-associated, under environmental). Estimates for 33 pathogens were elicited, including bacteria such as Salmonella enterica, Campylobacter spp., Legionella spp., and Pseudomonas spp.; protozoa such as Acanthamoeba spp., Cyclospora cayetanensis, and Naegleria fowleri; and viruses such as norovirus, rotavirus, and hepatitis A virus. The results highlight the importance of multiple pathways in the transmission of the included pathogens and can be used to guide prioritization of public health interventions.

Abstract Background To optimise medication use in older people, it is recommended that clinicians evaluate evidence on potential benefits and harms of medicines in light of the patients’ overall health, values and goals. This suggests general practitioners (GPs) should attempt to facilitate patient involvement in decision-making. In practice this is often challenging. In this qualitative study, we explored GPs’ perspectives on the importance of discussing patients’ goals and preferences, and the role patient preferences play in medicines management and prioritisation. Methods Semi-structured interviews were conducted with GPs from Australia (n = 32). Participants were purposively sampled to recruit GPs with variation in experience level and geographic location. Transcribed audio-recordings of interviews were coded using Framework Analysis. Results The results showed that most GPs recognised some value in understanding older patients’ goals and preferences regarding their medicines. Most reported some discussions of goals and preferences with patients, but often this was initiated by the patient. Practical barriers were reported such as limited time during busy consultations to discuss issues beyond acute problems. GPs differed on the following main themes: 1) definition and perception of patients’ goals, 2) relationship with the patient, 3) approach to medicines management and prioritisation. We observed that GPs preferred one of three different practice patterns in their approach to patients’ goals in medicines decisions: 1) goals and preferences considered lower priority – ‘Directive’; 2) goals seen as central – ‘Goal-oriented’; 3) goals and preferences considered but not explicitly elicited – ‘Tacit’. Conclusions This study explores how GPs differ in their approach to eliciting patients’ goals and preferences, and how these differences are operationalised in the context of older adults taking multiple medicines. Although there are challenges in providing care that aligns with patients’ goals and preferences, this study shows how complex decisions are made between GPs and their older patients in clinical practice. This work may inform future research that investigates how GPs can best incorporate the priorities of older people in decision-making around medicines. Developing practical support strategies may assist clinicians to involve patients in discussions about their medicines.

Abstract Background Healthcare is a rapidly expanding area of application for Artificial Intelligence (AI). Although there is considerable excitement about its potential, there are also substantial concerns about the negative impacts of these technologies. Since screening and diagnostic AI tools now have the potential to fundamentally change the healthcare landscape, it is important to understand how these tools are being represented to the public via the media. Methods Using a framing theory approach, we analysed how screening and diagnostic AI was represented in the media and the frequency with which media articles addressed the benefits and the ethical, legal, and social implications (ELSIs) of screening and diagnostic AI. Results All the media articles coded (n = 136) fit into at least one of three frames: social progress (n = 131), economic development (n = 59), and alternative perspectives (n = 9). Most of the articles were positively framed, with 135 of the articles discussing benefits of screening and diagnostic AI, and only 9 articles discussing the ethical, legal, and social implications. Conclusions We found that media reporting of screening and diagnostic AI predominantly framed the technology as a source of social progress and economic development. Screening and diagnostic AI may be represented more positively in the mass media than AI in general. This represents an opportunity for health journalists to provide publics with deeper analysis of the ethical, legal, and social implications of screening and diagnostic AI, and to do so now before these technologies become firmly embedded in everyday healthcare delivery.

Abstract Recent stroke studies have shown that the ipsi-lesional thalamus longitudinally and significantly decreases after stroke in the acute and subacute stages. However, additional considerations in the chronic stages of stroke require exploration including time since stroke, gender, intracortical volume, aging, and lesion volume to better characterize thalamic differences after cortical infarct. This cross-sectional retrospective study quantified the ipsilesional and contralesional thalamus volume from 69 chronic stroke subjects’ anatomical MRI data (age 35–92) and related the thalamus volume to time since stroke, gender, intracortical volume, age, and lesion volume. The ipsi-lesional thalamus volume was significantly smaller than the contra-lesional thalamus volume (t(68) = 13.89, p

Adenovirus transcripts contain N6-methyladenosine (m6A) modification. Here the authors profile m6A modification sites on adenovirus mRNAs using Illumina meRIP-Seq and nanopore direct RNA sequencing, and showcase a role for m6A in splicing of viral late mRNAs.

Abstract Background To examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAPd) and non-donor kidneys (MAPnd) with post-donation renal function. Methods Three hundred thirty-one patients undergoing hand assisted laparoscopic donor nephrectomy (HALDN) were reviewed. MAPd and MAPnd were obtained. Estimated glomerular filtration rate (eGFR) was recorded preoperatively and at 1 day, 1 month, and 6 months postoperatively. Results Two hundred females and 131 males were evaluated with median BMI 26.4 kg/m2 (range 17.1–39.6) and median age 45 years (range 19–78). MAPd score was 0 for 231 patients (69.8%) and > 0 for 100 patients (30.2%). MAPnd score was 0 for 234 patients (70.7%) and > 0 for 97 patients (29.3%). The median preoperative eGFR was 86.6 ml/min/1.73m2 (range 48.8–138.4). After adjusting for preoperative eGFR, BMI, ASA score, and kidney sidedness, postoperative eGFR was associated with MAP score in the non-donated kidney (p = 0.014) but not in the donated kidney (p = 0.24). Compared to donors with MAPnd = 0, donors with a MAPnd > 0, mean eGFR was − 2.33 ml/min/1.73m2 lower at postoperative day 1 (95% CI − 4.24 to − 0.41, p = 0.018), − 3.02 ml/min/1.73m2 lower at 1 month (95% CI − 5.11 to − 0.93, p = 0.005), and − 2.63 ml/min/1.73m2 lower at 6 months postoperatively (95% CI − 5.01 to − 0.26, p = 0.030). Conclusions MAP score > 0 in the non-donated kidney is associated with worse renal function in the 6 months following HALDN.

Abstract Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing (WGS) and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in New South Wales, Australia (western Sydney, Wollongong, Tamworth, eastern Sydney) to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health research using this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected.

Breast cancer care is a leading area for development of artificial intelligence (AI), with applications including screening and diagnosis, risk calculation, prognostication and clinical decision-support, management planning, and precision medicine. We review the ethical, legal and social implications of these developments. We consider the values encoded in algorithms, the need to evaluate outcomes, and issues of bias and transferability, data ownership, confidentiality and consent, and legal, moral and professional responsibility. We consider potential effects for patients, including on trust in healthcare, and provide some social science explanations for the apparent rush to implement AI solutions. We conclude by anticipating future directions for AI in breast cancer care. Stakeholders in healthcare AI should acknowledge that their enterprise is an ethical, legal and social challenge, not just a technical challenge. Taking these challenges seriously will require broad engagement, imposition of conditions on implementation, and pre-emptive systems of oversight to ensure that development does not run ahead of evaluation and deliberation. Once artificial intelligence becomes institutionalised, it may be difficult to reverse: a proactive role for government, regulators and professional groups will help ensure introduction in robust research contexts, and the development of a sound evidence base regarding real-world effectiveness. Detailed public discussion is required to consider what kind of AI is acceptable rather than simply accepting what is offered, thus optimising outcomes for health systems, professionals, society and those receiving care.

The objective of this study was to determine the effect of various dry-aging methods on meat quality and palatability attributes of cull cow beef loins. Paired bone-in loins (m. longissimus lumborum) from 13 cull cow carcasses (Holstein, 42þ mo) were obtained at 5 d postmortem, divided into 4 equal sections, and randomly assigned into 4 aging methods (wet-aging [WA], conventional dry-aging [DA], dry-aging in water-permeable bag [DWA], and ultraviolet light dry-aging [UDA]). The beef sections were aged for 28 d at 2°C, 65% relative humidity, and 0.8 m/s airflow. Following aging, surface crusts and bones were removed, and loin samples were collected for the meat quality, microbiological, and sensory analyses. Results indicated that all dry-aged loins had greater moisture and trimming loss compared with WA (P < 0.05), while DWA had lower loss than DA and UDA (P < 0.05). No differences in shear force, cook loss, or both lipid and protein oxidation across all treatments were observed (P > 0.05). Among all treatments, DWA exhibited the least color stability indicated by rapid discoloration observed in the sample, while UDA had color attributes comparable with WA throughout the whole display. Microbial analysis indicated that UDA had lower microbial concentration on the surface than the other samples (P < 0.05). The consumer panel analysis found that all loins were acceptable, and the trained panel analysis indicated that DA loins decreased sourness and animal fat flavor (P < 0.05) and had a trend of decreasing oxidized flavor (P = 0.07). The results indicate that dry-aging can potentially be utilized as an effective natural process by nullifying some of well-known off-flavor attributes associated with cull cow beef while not compromising other meat quality attrib- utes or microbiological shelf life.