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Abstract Background Children’s active travel to school is associated with physical activity and thus health. Safe Routes to School (SR2S) programs identify ‘safe routes’ to promote children’s active travel to school. No field audit tool exists specifically to assess the microscale built environment of these ‘safe routes’ within Australia. This study describes the reliability assessment of the Field Audit for Children’s Active Transport to School (FACTS) tool. Methods The FACTS tool was developed using a multi-step process, including a literature search, expert opinion, and pilot testing. For the reliability assessment, two trained auditors collected data at eight schools over three weeks in April 2021. For inter-rater reliability, auditors conducted audits on the ‘safe routes’ for the same six schools. For intra-rater reliability, auditors conducted repeat measures on the ‘safe routes’ for four schools each (eight schools total), including three different schools each from the six used for inter-rater reliability and one additional school. Item-by-item reliability was assessed using Cohen’s Kappa, Cohen’s Weighted Kappa, and percentage agreement. The reliability of calculated domain scores was assessed using intraclass correlation coefficients. Results For inter-rater reliability, 31 of the 45 (68.9%) items had moderate to almost perfect agreement, seven items (15.6%) had below moderate agreement, and a Kappa statistic could not be calculated for seven items (15.6%) due to constant values. For intra-rater reliability, 37 of the 45 (82.2%) items had moderate to almost perfect agreement, two items (4.4%) had below moderate agreement, and a Kappa statistic could not be calculated for six items (13.3%) due to constant values. For inter- and intra-rater reliability of the segment domain scores, three of the four domains had substantial to almost perfect agreement. For inter- and intra-rater reliability of the crossing domain scores, all four domains had moderate to almost perfect agreement. For inter- and intra-rater reliability of the segment, crossing, route, and school scores, all had substantial to perfect agreement. Conclusions The FACTS tool can reliably characterise the microscale built environment of promoted ‘safe routes’ for their use within SR2S programs, and should be considered for use in future SR2S programs within the suburban Australian context.

Purpose: Shoulder arthroscopy and arthroplasty are increasingly common procedures used to address shoulder pathologies. This study sought to evaluate the incidence of hand-related pathologies, including carpal tunnel syndrome (CTS), cubital tunnel syndrome (CuTS), trigger finger (TF), de Quervain tenosynovitis, and Dupuytren disease following shoulder arthroscopy and arthroplasty procedures. We hypothesized that patients undergoing shoulder surgery would have a higher incidence of hand-related pathologies within 1 year of surgery compared to controls. Methods: This was a retrospective analysis of 12,179 patients who underwent shoulder arthroscopy or arthroplasty surgery that were subsequently diagnosed with CTS, CuTS, TF, de Quervain tenosynovitis, or Dupuytren disease within 1 year after surgery. Relative risk of having associated hand pathologies following shoulder surgery was compared to controls. Results: In total, 10,285 patients underwent shoulder arthroscopy procedures during this period, of whom 815 (7.9%) had an associated hand pathology within 1 year from their shoulder procedure. Arthroscopic surgery was associated with an increased likelihood of having a hand pathology (RR 1.65, 95% CI 1.54–1.76), CTS (RR 1.57, 95% CI 1.42–1.73), CuTS (RR 2.25, 95% CI 1.94–2.61), TF (RR 1.76, 95% CI 1.53–2.03), and Dupuytren disease (RR 2.02, 95% CI 1.54–2.65), but was not associated with a higher likelihood of having de Quervain tenosynovitis. In total, 1,894 patients underwent shoulder arthroplasty procedures during this period, of whom 188 (9.9%) had an associated hand pathology within 1 year. Shoulder arthroplasty was associated with an increased likelihood of having a hand pathology (RR 2.04, 95% CI 1.78–2.34), CTS (RR 2.10, 95% CI 1.72–2.57), CuTS (RR 3.29, 95% CI 2.48–4.39), and TF (RR 1.99, 95% CI 1.47–2.70), but was not associated with an increased likelihood of having de Quervain tenosynovitis or Dupuytren disease. Conclusions: Shoulder arthroscopy and arthroplasty procedures were associated with an increased likelihood of having a CTS, CuTS, or a TF diagnosis made within 1 year of surgery. Only shoulder arthroscopy procedures were associated with a higher likelihood of having Dupuytren disease. Neither shoulder arthroscopy nor arthroplasty procedures were associated with an increased likelihood of a diagnosis of de Quervain tenosynovitis. These associations, however, do not necessarily imply causation, and further investigation is warranted to delineate this relationship. Type of study/level of evidence: Differential Diagnosis/Symptom Prevalence Study Level 3.

The NOAA Chemical Sciences Laboratory (CSL) conducted the Southwest Urban NOx and VOCs Experiment (SUNVEx) to study emissions and the role of boundary layer (BL) dynamics and sea-breeze (SB) transitions in the evolution of coastal air quality. The study presented utilizes remote sensing and in situ observations in Pasadena, California. Separate analyses are conducted on the synoptic conditions during ozone (O3) exceedance (>70 ppb) and non-exceedance ( ppb) days, as well as the fine-structure variability of in situ chemistry measurements during BL growth and SB transitions. Diurnal analyses spanning August 2021 revealed a markedly different wind direction during evenings preceding O3 exceedance (northerly) versus non-exceedance (easterly) days. Increased O3 occurred simultaneously with warmer and drier conditions, a reduction in winds, and an increase in volatile organic compounds (VOCs) and fine particulate matter (PM2.5). While the average BL height was lower and surface pressure was higher, the day-to-day variability of these quantities led to an overall weak statistical relationship. Investigations focused on the fine-structure variability of in situ chemistry measurements superimposed on background trends were conducted using a novel multivariate spectral coherence mapping (MSCM) technique that combined the spectral structure of two or more independent measurements through a wavelet analysis as reported by maximum-normalized scaleograms. A case study was chosen to illustrate the MSCM technique, where the dominant peaks in scaleograms were identified and compared to BL height during the growth phase. The temporal widths of peaks (τmax) derived from VOC and nitrogen oxide (NOx) scaleograms, as well as scaleograms combining VOCs, NOx, and variations in BL height, indicated a broadening with respect to time as the BL increased in depth. A separate section focused on comparisons between τmax and BL height during August 2021 revealed uncorrelated or weakly correlated scatter, except in the case of VOCs when really large τmax and relatively deep BL heights were ignored. Instances of large τmax and relatively deep BL heights occurred near sunrise and as onshore flow entered Pasadena, respectively. Wind transitions likely influenced both the dynamical evolution of the BL and tracer advection and thus offer additional challenges when separating factors contributing to the fine structure. Other insights gained from this work include observations of descending wind jets from the San Gabriel Mountains that were not resolved by the High-Resolution Rapid Refresh (HRRR) model and the derivation of intrinsic properties of oscillations observed in NOx and O3 during the interaction between an SB and enhanced winds above the BL that flowed in opposition to the SB.

Abstract The acute phase of ischemic stroke presents a critical window for therapeutic intervention, where novel approaches such as hyper-acute cerebral flow augmentation offer promising avenues for neuroprotection. In this study, we investigated the effects of two such therapies, NEH (a combination of norepinephrine and hydralazine) and Sanguinate (pegylated bovine carboxyhemoglobin), on resting-state functional connectivity, global mean signal (GMS), and blood oxygen level-dependent (BOLD) time lag in a pre-clinical canine model of stroke via permanent occlusion of the middle cerebral artery (total of n = 40 IACUC-approved mongrel canines randomly split into control/natural history and two treatment groups). Utilizing group independent component analysis (ICA), we identified and examined the integrity of sensorimotor and visual networks both pre- and post-occlusion, across treatment and control groups. Our results demonstrated that while the control group exhibited significant disruptions in these networks following stroke, the treatment groups showed remarkable preservation of network integrity. Voxel-wise functional connectivity analysis revealed less pronounced alterations in the treatment groups, suggesting maintained neural connections. Notably, the treatments stabilized GMS, with only minimal reductions observed post-occlusion compared to significant decreases in the control group. Furthermore, BOLD time-lag unity plots indicated that NEH and Sanguinate maintained consistent hemodynamic response timing, as evidenced by tighter clustering around the line of unity, suggesting a potential neuroprotective effect. These findings were underscored by robust statistical analyses, including paired T-tests and Mann–Whitney U tests, which confirmed the significance of the connectivity changes observed. The correlation of BOLD time-lag variations with neuroimaging functional biomarkers highlighted the impact of stroke and the efficacy of early therapeutic interventions. Our study supports the further study of flow augmentation therapies such as NEH and Sanguinate in stroke treatment protocols and suggests flow augmentation therapies should be further explored in an effort to improve patient outcomes.

Abstract Background The Collaborative Care Model (CoCM) is an evidence-based mental health treatment in primary care. A greater understanding of the determinants of successful CoCM implementation, particularly the characteristics of multi-level implementers, is needed. Methods This study was a process evaluation of the Collaborative Behavioral Health Program (CBHP) study (NCT04321876) in which CoCM was implemented in 11 primary care practices. CBHP implementation included screening for depression and anxiety, referral to CBHP, and treatment with behavioral care managers (BCMs). Interviews were conducted 4- and 15-months post-implementation with BCMs, practice managers, and practice champions (primary care clinicians). We used framework-guided rapid qualitative analysis with the Consolidated Framework for Implementation Research, Version 2.0, focused on the Individuals domain, to analyze response data. These data represented the roles of Mid-Level Leaders (practice managers), Implementation Team Members (clinicians, support staff), Innovation Deliverers (BCMs), and Innovation Recipients (primary care/CBHP patients) and their characteristics (i.e., Need, Capability, Opportunity, Motivation). Results Mid-level leaders (practice managers) were enthusiastic about CBHP (Motivation), appreciated integrating mental health services into primary care (Need), and had time to assist clinicians (Opportunity). Although CBHP lessened the burden for implementation team members (clinicians, staff; Need), some were hesitant to reallocate patient care (Motivation). Innovation deliverers (BCMs) were eager to deliver CBHP (Motivation) and confident in assisting patients (Capability); their opportunity to deliver CBHP could be limited by clinician referrals (Opportunity). Although CBHP alleviated barriers for innovation recipients (patients; Need), it was difficult to secure services for those with severe conditions (Capability) and certain insurance types (Opportunity). Conclusions Overall, respondents favored sustaining CoCM and highlighted the positive impacts on the practice, health care team, and patients. Participants emphasized the benefits of integrating mental health services into primary care and how CBHP lessened the burden on clinicians while providing patients with comprehensive care. Barriers to CBHP implementation included ensuring appropriate patient referrals, providing treatment for patients with higher-level needs, and incentivizing clinician engagement. Future CoCM implementation should include strategies focused on education and training, encouraging clinician buy-in, and preparing referral paths for patients with more severe conditions or diverse needs. Trial registration ClinicalTrials.gov(NCT04321876). Registered: March 25,2020. Retrospectively registered.

Determining offshore wind energy operational expenditures relies on acquiring reliability data, particularly as turbine power ratings increase. The uncertainty surrounding operational costs and optimal drivetrain configurations for larger turbines persists. While previous research has addressed reliability data for 3 MW offshore wind turbines, this study reviews and collates updated failure data for 15 MW turbines, comparing direct-drive and medium-speed configurations. It employs an operation and maintenance (O&M) modelling tool to calculate total operational costs. The study concurs with existing literature, showing that direct-drive turbines have lower operational costs than medium-speed turbines in three case studies. However, the cost and availability differences between configurations are smaller than previously suggested. For 15 MW turbines, the analysis reveals that the cost disparity between direct-drive and medium-speed turbines is significantly smaller than for smaller-rated turbines, with percentages of 1.59 %, 1.58 %, and 5.78 % for the three ScotWind sites selected. Previously, the absolute percentage difference in cost between direct-drive and medium-speed turbines was estimated to be 29.79 %. Sensitivity analyses explore the influence of three factors – failure rates, accessibility limits, and major replacement times – on total operational costs. These analyses demonstrate that medium-speed configurations exhibit more significant cost fluctuations, and the cost gap between configurations is reduced if failure rates are lowered at the same rate for each configuration, accessibility increases, or the major replacement time is reduced for the larger wind turbine components.

Abstract Extraction of nucleic acids (NAs) is critical for many methods in molecular biology and bioanalytical chemistry. NA extraction has been extensively studied and optimized for a wide range of applications and its importance to society has significantly increased. The COVID-19 pandemic highlighted the importance of early and efficient NA testing, for which NA extraction is a critical analytical step prior to the detection by methods like polymerase chain reaction. This study explores simple, new approaches to extraction using engineered smart nanomaterials, namely NA-binding, intrinsically disordered proteins (IDPs), that undergo triggered liquid–liquid phase separation (LLPS). Two types of NA-binding IDPs are studied, both based on genetically engineered elastin-like polypeptides (ELPs), model IDPs that exhibit a lower critical solution temperature in water and can be designed to exhibit LLPS at desired temperatures in a variety of biological solutions. We show that ELP fusion proteins with natural NA-binding domains can be used to extract DNA and RNA from physiologically relevant solutions. We further show that LLPS of pH responsive ELPs that incorporate histidine in their sequences can be used for both binding, extraction and release of NAs from biological solutions, and can be used to detect SARS-CoV-2 RNA in samples from COVID-positive patients.