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This paper describes forms of online youth civic engagement that center the experiences of youth with historically marginalized identities and documents ways that youth are civically engaged. Twenty U.S.-based, digitally active youth ages 16 to 21 years old were interviewed. Seven participants (35%) identified as female, nine (45%) as male, and four (20%) as gender nonbinary. Twelve (60%) identified as a first or second generation immigrant. Youth were recruited through youth-led movement accounts on Twitter and contacted via Direct Messaging. Semi-structured interviews were conducted with youth between March and September 2020, a period spanning the outbreak of COVID-19 and rise in participation in the Black Lives Matter movement. Inductive Constant Comparative Analysis was used to document forms of youth civic engagement on social media and understand how youth ascribed meaning to their civic engagement. Framed by literature on critical consciousness and psychopolitical resistance to oppression, findings highlight three forms of online youth civic engagement: Restorying, Building Community, and Taking Collective Action. These findings indicate that, for youth with identities that have historically been marginalized, social media is an important context to be civically engaged in ways that resist oppression and injustice.

This qualitative study utilized semi-structured interviews with 22 Indian youth climate activists (mean age = 19) from 13 cities across India to explore factors that sustain or detract from climate activism. Data were analyzed using reflexive Thematic Analysis. In addition to two gatekeeping factors (lack of family support and financial and job pressures) that may prevent youth from joining or cause youth to quit their climate activism entirely, this study identified factors that affected youth’s sustained climate activism: two detracting factors (negative interactions with government, and online and in-person bullying and harassment); four supporting factors (sense of community, internal motivations, seeing tangible achievements, and personal growth); and one factor (climate anxiety) with mixed effects on sustaining youth activism. Further, we describe ways in which youth holding minoritized identities, including lower-income, Muslim, and rural youth, had distinct experiences.

Abstract Depression is associated with dysregulated circadian rhythms, but the role of intrinsic clocks in mood-controlling brain regions remains poorly understood. We found increased circadian negative loop and decreased positive clock regulators expression in the medial prefrontal cortex (mPFC) of a mouse model of depression, and a subsequent clock countermodulation by the rapid antidepressant ketamine. Selective Bmal1KO in CaMK2a excitatory neurons revealed that the functional mPFC clock is an essential factor for the development of a depression-like phenotype and ketamine effects. Per2 silencing in mPFC produced antidepressant-like effects, while REV-ERB agonism enhanced the depression-like phenotype and suppressed ketamine action. Pharmacological potentiation of clock positive modulator ROR elicited antidepressant-like effects, upregulating plasticity protein Homer1a, synaptic AMPA receptors expression and plasticity-related slow wave activity specifically in the mPFC. Our data demonstrate a critical role for mPFC molecular clock in regulating depression-like behavior and the therapeutic potential of clock pharmacological manipulations influencing glutamatergic-dependent plasticity.

PURPOSE: To evaluate the effectiveness of plasma exchange (PLEX) for optic neuritis (ON). METHODS: We conducted an international multicenter retrospective study evaluating the outcomes of ON following PLEX. Outcomes were compared to raw data from the Optic Neuritis Treatment Trial (ONTT) using a matched subset. RESULTS: A total of 395 ON attack treated with PLEX from 317 patients were evaluated. The median age was 37 years (range 9-75), and 71% were female. Causes of ON included multiple sclerosis (108), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) (92), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) (75), seronegative-NMOSD (34), idiopathic (83), and other (3). Median time from onset of vision loss to PLEX was 2.6 weeks (interquartile range [IQR], 1.4-4.0). Median visual acuity (VA) at the time of PLEX was count fingers (IQR, 20/200-hand motion), and median final VA was 20/25 (IQR, 20/20-20/60) with no differences among etiologies except MOGAD-ON, which had better outcomes. In 81 (20.5%) ON attacks, the final VA was 20/200 or worse. Patients with poor outcomes were older (P = .002), had worse VA at the time of PLEX (P < .001), and longer delay to PLEX (P < .001). In comparison with the ONTT subset with severe corticosteroid-unresponsive ON, a final VA of worse than 20/40 occurred in 6 of 50 (12%) PLEX-treated ON vs 7 of 19 (37%) from the ONTT treated with intravenous methylprednisolone without PLEX (P = .04). CONCLUSION: Most ON attacks improved with PLEX, and outcomes were better than attacks with similar severity in the ONTT. The presence of severe vision loss at nadir, older age, and longer delay to PLEX predicted a worse outcome whereas MOGAD-ON had a more favorable prognosis. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

During the COVID-19 pandemic, youth experienced abrupt closures of in-person spaces that were vital for their civic development, like schools and community organizations. Social media became the primary context for youth to make their voices heard and mobilize around important sociopolitical issues like anti-Asian racism, police violence, and elections. However, youth experienced civic development in different ways during the pandemic. Some youth gained a critical awareness of societal inequities, while others were radicalized into far-right ideologies. Racially minoritized youth experienced vicarious trauma and racism while civically engaging in 2020, and their civic development must be viewed in the context of the dual pandemics of COVID-19 and structural racism.

Abstract Background Age-related macular degeneration (AMD) affects quality of life and independence, and its incidence and prevalence are increasing due to ageing of the population. Access to effective timely treatment can improve vision and reduce incidence of blindness. This study aimed to explore the perspectives of ophthalmologists in the Israeli public healthcare system regarding timely treatment of AMD patients. Methods Qualitative semi-structured interviews were conducted in 2020-2021 with 22 senior ophthalmologists, from 10 general hospitals and from two HMOs, representing different geographic regions. All interviewees specialize in retinal diseases and work with AMD patients. Interviews discussed patient pathways involved in the diagnosis and treatment of AMD, access to care, and obstacles to timely care. Thematic analysis was conducted. Results Based on the interviews, we describe the usual referral and treatment pathways. Themes included regional disparities, long wait times in some areas, a lack of retina specialists, differences in referral pathways, inappropriate use of emergency department to obtain timely treatment, and second-line treatment not fully covered by insurance, most affecting the weakest segments of the population. Conclusions Loss of vision incurs high health and societal costs. In the context of insufficient medical manpower in Israel, the healthcare system will need to assess future resources to cope with accumulating burden of AMD cases over time in an ageing population. Precise referral information, and simultaneous referral to imaging and retinal clinics, may minimize delays in treatment. Awareness of AMD symptoms and the importance of early intervention could be highlighted by campaigns, particularly among high-risk groups. Highlights • Interviews with hospital-based and community ophthalmologists showed regional disparities in AMD treatment, with long wait times and a lack of retina specialists in some areas. • Differences in referral pathways, inappropriate use of emergency department to obtain timely treatment, and second line treatment not fully covered by insurance were highlighted. • The healthcare system will need to assess future resources to cope with accumulating burden of AMD cases over time in an ageing population • Precise referral information, and simultaneous referral to imaging and retinal clinics, may minimize delays in treatment. • Awareness of AMD symptoms and the importance of early intervention should be emphasized in high-risk groups.

Background The COVID-19 pandemic significantly impacted emergency department (ED) operations and patient care. Understanding its effects on nursing processes, triage accuracy, and wait times is pivotal for optimizing outcomes. Objectives This study aimed to analyze the differences in nursing processes, triage accuracy, and wait times before and during the COVID-19 pandemic. Design A retrospective cohort study. Methods The study analyzed 224 electronic medical records from a single ED, with 120 records from the pre-pandemic period (January 2019–February 2020) and 104 records from the pandemic period (March 2020–March 2021). Dependent variables included missed nursing care per validated scales, triage accuracy per Emergency Severity Index, and wait times for nursing triage and physician examination. Independent factors encompassed sociodemographic, clinical characteristics, and organization dynamics. Results Sociodemographic and clinical profiles were comparable between periods. Triage accuracy remained high except for older patients. Nursing triage wait times differed little, yet physician examination and urgent case waits decreased amidst the pandemic. Nursing documentation completeness, such as recording patient status and mental state, augmented during this crisis period. Conclusion This evaluation identified differences in triage accuracy, wait times, and documentation completeness before and during the COVID-19 pandemic period at a single institution. Patient age and clinical status influenced some metrics. Lessons from comparing precrisis benchmarks to intra-pandemic nursing performance may guide pandemic preparedness strategies. Further research is warranted to optimize emergency processes and outcomes during public health emergencies, as well as examine strategies through multicenter investigations comparing prepandemic to intra-pandemic performance to provide broader insights into challenges and inform efforts to bolster emergency care through future crises.

Emerging parasitoids of aphids encounter secondary plant chemistry from cues left by the mother parasitoid at oviposition and from the plant-feeding of the host aphid. In practice, however, it is secondary plant chemistry on the surface of the aphid mummy which influences parasitoid olfactory behaviour. Offspring of Aphidius colemani reared on Myzus persicae on artificial diet did not distinguish between the odours of bean and cabbage, but showed a clear preference for cabbage odour if sinigrin had been painted on the back of the mummy. Similarly Aphidius rhopalosiphi reared on Metopolophium dirhodum on wheat preferred the odour of wheat plants grown near tomato plants to odour of wheat alone if the wheat plants on which they had been reared had been exposed to the volatiles of nearby tomato plants. Aphidius rhopalosiphi reared on M. dirhodum, and removed from the mummy before emergence, showed a preference for the odour of a different wheat cultivar if they had contacted a mummy from that cultivar, and similar results were obtained with A. colemani naturally emerged from M. persicae mummies. Aphidius colemani emerged from mummies on one crucifer were allowed to contact in sequence (for 45 min each) mummies from two different crucifers. The number of attacks made in 10 min on M. persicae was always significantly higher when aphids were feeding on the same plant as the origin of the last mummy offered, or on the second plant if aphids feeding on the third plant were not included. Chilling emerged A. colemani for 24 h at 5°C appeared to erase the imprint of secondary plant chemistry, and they no longer showed host plant odour preferences in the olfactometer. When the parasitoids were chilled after three successive mummy experiences, memory of the last experience appeared at least temporarily erased and preference was then shown for the chemistry of the second experience.

Abstract Background Medical imaging tests are vital in healthcare but can be costly, impacting national health expenditures. Magnetic resonance imaging (MRI) is a crucial diagnostic tool for assessing medical conditions. However, the rising demand for MRI scans has frequently strained available resources. This study aimed to estimate the prevalence of different imaging tests in individuals who eventually had an MRI, in the Israeli public health system. Methods An online survey of patient experience of scheduling an MRI was conducted in January–February 2023, among 557 Israeli adults, representing all four health maintenance organizations (HMOs). All participants had undergone an MRI in the public health system within the past year. Results Results showed that 60% of participants underwent other imaging tests before their MRI scan. Of those, computed tomography (CT) scans (43%), X-rays (39%), and ultrasounds (32%) were the most common additional imaging procedures. In addition, of the 60% of participants, 23% had undergone more than one prior imaging examination. Conclusions These findings highlight the high prevalence of preliminary imaging tests prior to MRI, with many patients undergoing multiple tests for the same problem. The health system may need to evaluate whether current clinical guidelines defining the use of various imaging tests are cost-effective.

Abstract Introduction Examining the safety of theBNT162b2 mRNA vaccine in multiple sclerosis (MS) patients remains inconclusive, particularly regarding the potential for disease exacerbations. This study aims to assess the effects of BNT162b2 COVID‐19 vaccination on disease activity in MS patients through sequential MRI imaging. Methods A retrospective study of 84 MS patients from five Israeli hospitals was conducted. MS lesion load was determined from three brain MRI scans, one postvaccination and two prevaccination scans. A post hoc analysis compared subgroups featuring vaccinated and unvaccinated patients respectively, with early onset MS. Results The cohort included 70 women with early onset (mean age 16.4 ± 0.8 years) and adult onset (mean age 34.9 ± 1.1 years) MS. Among the early onset group, vaccinated patients showed an increased risk of new lesions (p = .00026), while there was no increased risk among adult‐onset patients. Additionally, a comparison between early onset vaccinated and nonvaccinated groups revealed a higher risk of increased lesions in the vaccinated group (p = .024). Discussion Overall, the study suggests that the BNT162b2 vaccine is generally safe in MS patients, with no association found between vaccination and new lesions in most patients. However, close MRI follow‐up is recommended for early‐onset MS cases to monitor lesion development.

Introducción: La endodoncia es la disciplina odontológica que estudia la morfología, fisiología y patología de la pulpa dentaria y del tejido perirradicular. Comprende la etiología, prevención, diagnóstico y tratamiento de las alteraciones pulpares, así como sus repercusiones en la región periapical y el resto del organismo. Su finalidad es aliviar el dolor y preservar las piezas dentales en función dentro del sistema estomatognático. El dolor que se origina en piezas dentarias o tejidos circundantes es uno de los principales motivos de consulta odontológica. Objetivo general: explicar el uso de la crioterapia en endodoncia. Objetivos específicos: analizar su mecanismo fisiológico de acción; la eficacia en la reducción del dolor en las terapias endodónticas con diferentes diagnósticos iniciales; describir sus formas de aplicación clínica; establecer las contraindicaciones o los posibles inconvenientes que pueda presentar su aplicación. Metodología: El trabajo es una revisión narrativa. Se realizó la búsqueda bibliográfica con los siguientes términos MeSH (Medical Subject Heading): cryotherapy, endodontic, intracanal irrigation, dental pain y sus correspondientes descriptores en ciencias de la salud DeCS: crioterapia, endodoncia, irrigación intracanal y dolor dental. Los criterios de inclusión fueron: artículos disponibles a texto completo que contengan al menos una palabra clave en título y/o resumen, en idioma inglés, español o portugués, sin límite temporal. Se excluyeron los artículos con estudios en animales o en piezas dentarias deciduas. Conclusiones: De acuerdo al presente trabajo existen estudios científicos que sostienen positivamente la aplicación de la crioterapia para el control del dolor en endodoncia.

As a dimension of a blue economy, marine ecotourism should, in theory, not only increase economic viability and environmental sustainability but, most importantly, pursue socially equitable outcomes. In tropical and sub-tropical island regions, where substantial tourism development is often coupled with widespread strains on public infrastructure and services, including water access, there exists a need to better understand the expansion of this industry is felt at the community level; more importantly by individuals who are reliant on these infrastructures and services. Through a case study of the Bocas del Toro Archipelago, where water insecurity is becoming acute, we draw on and mobilize stories from local community members, alongside non-participant observations and document collection, to 1) document the experience of some community members with water insecurity and shortages, including how they perceive the roles played by the central government and marine ecotourism sector, and 2) examine how community members feel about how communities feel about policies and investment priorities of the central government regarding water insecurity, including the extent to which they view marine ecotourism development as undermining or promoting local needs. Our results underline the complex nature of marine ecotourism governance and infrastructure development outcomes in a resource-insecure island region, demonstrating that current issues are greatly impacted by historical and social underpinnings of neo-colonialism and systemic racism, misalignments of community vs. government development priorities, and eroded political trust, that shape local experiences with sustainable development and local residents’ perceptions of the ability of marine ecotourism to address issues of water insecurity. Moreover, while our focus is on the marine ecotourism industry, the significance of these findings contributes to a growing body of literature that places local experiences at the forefront of research into the implications of sustainable development in island regions.

Abstract: Calls to address social equity in ocean governance are expanding. Yet ‘equity’ is seldom clearly defined. Here we present a framework to support contextually-informed assessment of equity in ocean governance. Guiding questions include: (1) Where and (2) Why is equity being examined? (3) Equity for or amongst Whom? (4) What is being distributed? (5) When is equity considered? And (6) How do governance structures impact equity? The framework supports consistent operationalization of equity, challenges oversimplification, and allows evaluation of progress. It is a step toward securing the equitable ocean governance already reflected in national and international commitments.

This multi-method qualitative study explores how immigrant-origin (I-O) youth express civic engagement on social media, and how youths' immigrant identities shape their online civic engagement. We analyzed 2,203 Twitter posts collected over a 6-month period from 32 racially and ethnically diverse I-O youth (an average of 69 posts per participant). Interviews with 11 participants supplemented Twitter analysis. Using a critical consciousness framework as a guiding lens, we identified three broad themes: Using Critical Reflection to Shift Culture and Minds, Navigating and Drawing on Multiple Identities, and Building Collective Political Efficacy. Findings contribute to a growing body of literature on how I-O youth are harnessing social media as agents of their own, and their peers', critical consciousness development.

The focus on flag States for the purpose of attributing fisheries catch is inconsistent with the assignment of sovereign rights to coastal States under international law and undermines equity in contemporary quota allocation negotiations. We propose modernizing reporting frameworks to include zone-based reporting of fish catches to more equitably present data, ensure consistency with the Law of the Sea, and better support the realization by developing coastal States of their development aspirations consistent with SDG 14, Life Below Water. States are already required to collect the data necessary to support this change, and many regional fisheries management authorities already do so. Reforms to data collection and reporting mechanisms should support zone-based catch attribution as a central feature of negotiations around access to future fishing opportunities on shared resources. Doing so will ensure that the sovereign rights of developing coastal States are properly accounted for and implemented.

Recent calls for an International Panel for Ocean Sustainability (IPOS) to provide consensus-based science advice for global ocean sustainability appeal to the successes of global science–policy platforms, specifically the Intergovernmental Panel on Climate Change (IPCC), the Intergovernmental Science–Policy Platform on Biodiversity and Ecosystem Services (IPBES), and the World Ocean Assessment (WOA)1. A new IPOS may facilitate global ocean sustainability, but only if it proactively addresses the challenges facing existing international science–policy platforms—namely representation, accountability, and politicization.