The United States is plagued with the highest rates of preventable metabolic diseases it has ever seen, and while poor nutrition is increasingly recognized as a critical contributing factor, good nutrition has been shown to be a potent factor in prevention and management of these illnesses. Notably, nutrition is inextricably intertwined with farming practices and the stewardship of our environment – particularly its soil. In this proposal, we propose a method to expose medical students to basic agricultural and environmental knowledge regarding the production of food, as well as educate them in practical nutrition education within the interactive, case-based, and longitudinal preclinical curriculum at Case Western Reserve University School of Medicine (CWRU SOM). We propose a two-part approach; first: integrating relevant topics in nutrition, culinary medicine, and farming practices into the preclinical blocks through Official Learning Objectives, and second: an optional 8-week, zero credit elective for students interested in pursuing a deeper understanding of these topics. Through these interventions, we believe courses like this will support a generation of physicians able to understand health from soil to plate with a consideration for the environment in addition to exemplifying healthful lifestyles themselves. We believe these kinds of future physicians will be the most effective in treating (and ideally reversing) the chronic disease epidemic.

Pyrolysis is a combustion process of woody biomass conducted under low or no oxygen conditions. New innovations and the need to limit open burning has resulted in numerous mobile and fixed plant pyrolysis methods that burn a variety of woody residues. Production technologies that reduce the need for open burning, the main source of potential pollutants, fall under the regulations in the Clean Air Act of 1990. This Act is the legal instrument to regulate air pollution at its source across the United States of America and it is implemented and enforced through the Environmental Protection Agency, in coordination with sister agencies. One newer innovation for reducing woody residues and emissions is an air curtain incinerator. Currently, the Clean Air Act regulates stationary solid waste incinerators, and this is also applied to mobile air curtain incinerators burning woody biomass. However, other woody biochar production methods (e.g., flame cap kilns) are not subject to these regulations. Discrepancies in the interpretation of definitions related to incineration and pyrolysis and the myriad of differences related to stationary and mobile air curtain incinerators, type of waste wood from construction activities, forest residues, and other types of clean wood make the permitting regulations confusing as permits can vary by jurisdiction. This review summarizes the current policies, regulations, and directives related to in-woods biochar production and the required permits.

From their discovery in 2002, BRAF mutations have been identified as clear drivers of oncogenesis in several cancer types. Currently, their incidence rate is nearly 7% of all solid tumors with BRAF V600E constituting approximately 90% of these diagnoses [1]. In melanoma, thyroid cancer, and histiocytic neoplasms, BRAF hotspot mutations are found at a rate of about 50%, while in lung and colorectal cancers they range from 3 to 10% of reported cases [2-5]. Though present in other malignancies such as breast and ovarian cancers, they constitute a small portion of diagnoses (<1%). Given their frequency along with advancements in screening technologies, various methods are used for the detection of BRAF-mutant cancers. Among these are targeted next-generation sequencing (NGS) on tumor tissue or circulating tumor DNA (ctDNA) and immunohistochemistry (IHC)-based assays. With advancements in detection technologies, several approaches have been taken for the treatment of BRAF mutant cancers. In this review we retrace the milestones that led to the clinical development of targeted therapies currently available for these tumors.

We present an ontology log-OLOG- representation of the classical Miller-Urey experiment, usually considered as a paradigm for spontaneous generation of biomolecules on the prebiotic Earth and also, as a key in understanding the chemical evolution phenomena linked to the origins of life. Ologging The Miler-Urey experiment enables us, through the categorical notion of fibre product or pullback, to define the concept of Biogenic Space, as a space containing low complexity biogenic units subjected to appropriate physical and chemical conditions, facilitating the synthesis of highly complex organic molecules. Also, we characterize the Biogenic Space as a concrete universal object that could be associated with the preconditions for life inside various structures in the universe such as exoplanets and exomoons located in habitable zones, but also in interstellar and intergalactic organic clouds.

Digital skills are essential in today’s digital age, which means that students must gain technology-enhanced skills from higher education for their future careers. Studies in Art & Design (A&D) programs in this university surveyed three faculties’ perspectives and nineteen students’ experiences. During the COVID-19 pandemic, this university changed its teaching and learning strategies by offering courses online during autumn 2020 and spring 2021 during mandatory quarantine. However, the A&D program was not entirely based online. As a result, it is important to take a closer look at the A&D programs offered in order to assess the faculties’ perspectives and students’ experiences during the two online semesters. The study included online surveys from instructors’ perspectives and with regard to students’ experiences about the quality of studio learning, traditional studio learning opportunities, and online studio learning opportunities via either live (on-campus) or online studios. Using relationship-based research design, posttest data surveys were collected to ascertain the differences in the mean scores, standard deviations, and percentages of some forms of agreement between the faculties’ perspectives and students’ experiences of the quality of studio learning, traditional studio learning opportunities, and online studio learning opportunities in these Art & Design (A&D) programs. This quantitative research aimed to develop formative assessments and suggestions while establishing whether it would be possible to hold all A&D courses online in a higher education setting.

Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS). It is largely a clinical diagnosis based on the classical features of ataxia, areflexia, and opthalmoplegia. Its clinical evolution is most often favorable. However, other neurological signs and symptoms may also be present. Supportive laboratory studies (positivity of antibodies, CSF albumin-cytological dissociation and nerve conduction studies) are useful especially in uncommon presentations. We report a case of a 74-year-old patient who exhibited dysphonia and difficulty to swallowing previously to the classic triad of ataxia, areflexia, and opthalmoplegia, characteristic of MFS. CSF analysis demonstrates an albumin-cytological dissociation but anti-GQ1b antibody were negative. The patient has spontaneously and completely recovered after several weeks.

Introduction The climate crisis is essentially a public health crisis. Response is imperative to prevent economic and social crises associated with the growing burden of climate impacts on human health and the health care sector. Green Podiatry Pillars By adopting the three pillars of Exercise, Evidence, and Everyday changes, podiatrists can contribute to more sustainable health and health care. Discussion Educating our patients to use their feet for low carbon active transport, eliminating interventions not supported by evidence, and reducing fossil fuel driven supply chains and energy use, are three impactful measures that all podiatrists, and indeed, all health and medical personnel, need to adopt. The avoidable suffering, enormous and costly use of resources for diabetic foot disease, is a scourge that must realise its preventable potential. It is too late, too costly, too polluting, and too sad, to continue to direct health care and research efforts and budgets, to an expensive modifiable diabetes disease process, potentiated by poor food and physical inactivity. Affected patients require skilled support, to avert such chronic disease processes, often not of their making. Conclusions Healthcare contributes 5 to 8% of green house gases (GHG), and non-communicable diseases (NCD) are increasing, so healthcare must lead on primary health. As citizens and health professionals, we must advocate for better community health, and educate our patients. Future Directions All health and medical personnel need to consider planetary health and sustainable healthcare within their daily work. Healthcare must act to address climate change, and realise benefits for people and planet.

Although different assessments and evaluations of Dual-Miller cycle performed, specified output power and thermal performance associated with engine determined. Besides, multi objective optimization of thermal efficiency, Ecological Coefficient of performance ( ) and Ecological function ( ) by the mean of NSGA-II technique and thermodynamic analysis performed. The Pareto optimal frontier obtaining the best optimum solution is chosen by fuzzy Bellman-Zadeh, LINMAP, and TOPSIS decision-making techniques. Based on the results, performances of dual-Miller cycles and their optimization are improved.

The use of plastic in agriculture has become so omnipresent within the industry that it has acquired it own lexicon to become known as ‘plasticulture’. However, since, compared to other industries the quantities consumed are low, little attention is granted to this waste stream. This is the case both with local and international policies even though it bears a close connection to soil health and therefore is a prerequisite to improve the sustainability of food production processes including food security. Using Malta as a case study, the research utilises quantitative and qualitative tools to identify and quantify the most common types of agricultural plastic waste generated and determines the attitudes of farmers towards a collection and recycling scheme. While it identifies that incineration and ploughing of plastic waste as regular practices, it also ascertains the willingness of farmers to acquire more knowledge about more appropriate methods to dispose of this waste stream thus guiding policy makers towards the need to initiate educational measures for farmers to prevent these harmful practices. Through stakeholder interviews the research highlights that the present lack of data is a major hindrance for policy to take account of this waste stream.

We develop an optimized force-field for poly(3-hexylthiophene) (P3HT) and demonstrate its utility for predicting thermodynamic self-assembly. In particular, we consider short oligomer chains, model electrostatics and solvent implicitly, and coarsely model solvent evaporation. We quantify the performance of our model to determine what the optimal system sizes are for exploring self-assembly at combinations of state variables. We perform molecular dynamics simulations to predict the self-assembly of P3HT at ~350 combinations of temperature and solvent quality. Our structural calculations predict that the highest degrees of order are obtained with good solvents just below the melting temperature. We find our model produces the most accurate structural predictions to date, as measured by agreement with grazing incident X-ray scattering experiments.

Ante-mortem bovine tuberculosis (bTB) tests for buffaloes include the single comparative intradermal tuberculin test (SCITT), interferon-gamma (IFN-γ) release assay (IGRA) and IFN-γ-inducible protein 10 release assay (IPRA). Although parallel test interpretation increases detection of Mycobacterium bovis-infected buffaloes, these algorithms may not be suitable for screening buffaloes in historically bTB-free herds. In this study, the specificities of three assays were determined using M. bovis unexposed herds, and a high specificity diagnostic algorithm developed. Serial test interpretation using the IGRA and IPRA showed significantly greater specificity (98.3%) than individual tests or parallel testing (73%). When the SCITT was added, the algorithm had a 100% specificity. Since the cytokine assays had imperfect specificity, potential cross-reactivity with nontuberculous mycobacteria (NTM) was investigated. No association was found between NTM presence (in oronasal swab cultures) and positive cytokine assay results. As a proof-of-principle, serial testing was applied to high-value buffaloes (n=153) in a historically bTB-free herd. Buffaloes positive on a single test (n=28) were regarded as test negative. Four buffaloes were positive on IGRA and IPRA, and M. bovis infection was confirmed following culling. These results demonstrate the value of using IGRA and IPRA in series to screen buffalo herds with no previous history of M. bovis infection.

The aim of this pilot study is to evaluate and compare the quality of the genomics and proteomics data obtained from paired formalin fixed paraffin embedded (FFPE) and frozen (FF) tissue percutaneous core biopsies of LIRADS 5 hepatocellular carcinoma (HCC) of varying histological grade. The preliminary data identified differentially expressed proteins and genes in poor, moderate and well differentiated HCC biopsies, with a greater efficacy in fresh frozen samples.

Expression of the breast cancer resistance protein (BCRP/ ABCG2) transporter is downregulated in placentas from women with preeclampsia (PE) and in an immunological rat model of PE, which closely resembles human PE. While many drugs are substrates of this important efflux transporter, the impact of BCRP downregulation on maternal and fetal drug exposure has not been investigated. Using the PE rat model, we performed a pharmacokinetic study with rosuvastatin (RSV), a BCRP substrate, to investigate this impact. PE was induced in rats during gestational days (GD) 13 to 16 with daily low-dose endotoxin. On GD18, RSV (3 mg/kg) was administrated intravenously, and rats were sacrificed at time intervals between 0.5-6 hours. Placental expression of Bcrp and Oatp2b1 significantly decreased in PE rats. A corresponding increase in RSV levels was seen in fetal tissues and amniotic fluid of the PE group (p&lt;0.05), while maternal plasma concentrations remained unchanged. An increase in Bcrp expression and decreased RSV concentration, was seen in the livers of PE dams. This suggests that PE-mediated transporter dysregulation leads to significant changes in the maternal and fetal RSV disposition. Overall, our findings demonstrate that altered placental expression of transporters in PE can increase fetal accumulation of their substrates.

Background—In 2011, Miller and Goldman published a study in Human and Experimental Toxicology that found a counterintuitive, positive correlation, r = 0.70 (r² = 0.49, p < .0001), demonstrating that as nations require more vaccine doses for their infants, infant mortality rates (IMRs) tend to increase (worsen). The dataset (n = 30) included the United States, a nation that required the most vaccines for their infants, and all nations with better IMRs than the United States. Dr. E. Bailey, a professor at BYU, and her students, recently read the Miller-Goldman study and found it "troublesome that this manuscript is in the top 5% of all research outputs" and falsely claimed that its findings were due to "inappropriate data exclusion," i.e., failure to analyze the "full dataset" of all 185 nations. The "Bailey reanalysis," titled Infant vaccination does not predict increased infant mortality rate: correcting past misinformation, was posted to the medRxiv preprint server on September 10, 2021 (version 1) and October 5, 2021 (version 3) and Europe PMC preprint server on September 10, 2021. Objective—This present study examines the various claims postulated by the Bailey reanalysis and assesses the robustness of their methodology, analyses, and reported results and conclusions. Methods—Data discussed in this paper are based on the previously mentioned study by Miller and Goldman and the Bailey reanalysis. Results—Linear regression analysis of IMR and the number of vaccine doses for each country yield a statistically significant positive correlation of r = 0.70 (p < .0001) for the top nations (n = 30) chosen by Miller-Goldman and r = 0.16 (p < .04) for the "entire dataset" chosen by Bailey et al (n = 185). Bailey also conducted linear regression analyses (for the year 2019) of IMRs as a function of vaccination rates for each of eight different vaccines and reported statistically significant inverse correlations for 7 of 8 vaccines over the entire range of vaccination rates. However, Miller and Goldman reanalyzed the Bailey analyses for nations with vaccination rates below 60% and found no statistically significant correlation for six vaccines (DPT, Hib, hepatitis B, polio, rotavirus, and measles) and statistically significant positive correlations for tuberculosis (r = 0.8, p < .005) and pneumococcal (r = 0.6 p < .023) vaccines. Conclusions—Bailey’s reanalysis corroborates a statistically significant positive correlation originally reported by Miller and Goldman. However, Bailey’s reported correlation (r = +0.16, p < .04) is small, likely due to poor methodology (failing to account for covariates, i.e., disparities among numerous socioeconomic factors that add uncertainty to their conclusion). The r-value reported by the Bailey reanalysis demonstrates an effect size that is about one-fourth (0.16/0.70) that reported by Miller-Goldman—underscoring how critically important it is for Bailey's reanalysis to eliminate confounding variables. Moreover, Bailey’s linear regression analyses of IMR as a function of vaccination rates for each of eight different vaccines demonstrate that some countries with low vaccination rates have low IMRs, while other countries with high vaccination rates have high IMRs. Rather than supporting a strong inverse correlation, the Bailey reanalysis demonstrates high vaccination rates are neither necessary nor sufficient to cause low IMR.

Since certain Mycobacterium tuberculosis complex (MTBC) members, like M. bovis, are endemic in specific South African wildlife reserves and zoos, cases of clinically important nontuberculous mycobacteria (NTM) in wildlife may be neglected. Additionally, due to the inability of tests to differentiate between host responses to MTBC and NTM, the diagnosis of MTBC may be confounded by the presence of NTMs. This may hinder control efforts. These constraints highlight the need for enhanced rapid detection and differentiation methods for MTBC and NTM, especially in high MTBC burden areas. We evaluated the use of the GeneXpert MTB/RIF Ultra, the Hain CMdirect V1.0, and novel amplicon sequencing PCRs targeting the mycobacterial rpoB and ku gene targets, directly on antemortem respiratory samples from known MTBC-infected and NTM culture-positive African elephants (n=26 animals) and rhinoceros (n=23 animals). Our findings suggest that the Ultra is the most sensitive diagnostic test for MTBC DNA detection directly in raw antemortem respiratory specimens and that the rpoB PCR is ideal for Mycobacterium genus DNA detection and species identification through amplicon sequencing.

Bladder cancer (BC) diagnosis is reliant on cystoscopy, an invasive procedure associated with urinary tract infections. This has sparked interest in identifying non-invasive biomarkers in body fluids such as blood and urine. A source of biomarkers in these biofluids are extracellular vesicles (EVs), nanosized vesicles that contain a wide array of molecular cargo, including small non-coding RNA such as microRNA and transfer RNA-derived fragments (tRF). Here we performed small-RNA next-generation sequencing for urine EVs, serum EVs and serum supernatant from 41 patients with non-muscle invasive BC (27 stage Ta, 14 stage T1) and 15 non-cancer patients (NCP) with benign cystoscopy findings. Serum and urine samples were collected before transurethral resection of bladder tumors (TUR-b) and at routine postsurgery check-ups. Expression levels of tRFs in presurgery samples were compared to those at postsurgery check-ups and to NCPs. To strengthen the reliability of our results, samples from 10 patients with stage T1 disease were resequenced. When comparing tRF expression in urine EVs between BC patients with stage T1 disease and NCPs, 14 differentially expressed tRFs (DEtRFs) were identified. In serum supernatant, six DEtRFs were identified among stage T1 patients when comparing presurgery to postsurgery samples, and four DEtRFs were found when comparing presurgery samples to NCPs. By performing a blast search, we found that sequences of DEtRFs aligned with genomic sequences pertaining to processes relevant to cancer development, such as enhancers, regulatory elements and CpG islands. Our findings display a number of tRFs that may hold potential as biomarkers for the diagnosis and recurrence-free survival of BC.

Alteration of land use and climate change are among the main variables affecting watershed hydrology. Characterizing the impacts of climate variation and land use alteration on water resources is essential in managing watersheds. Thus, in this research, streamflow and baseflow responses to climate and land use variation were modeled in two watersheds, the Upper West Branch DuPage River (UWBDR) watershed in Illinois and Walzem Creek watershed in Texas. The variations in streamflow and baseflow were evaluated using the Soil and Water Assessment Tool (SWAT) hydrological model. The alteration in land use between 1992 and 2011 was evaluated using transition matrix analysis. The non-parametric Mann-Kendall test was adopted to investigate changes in meteorological data from 1980-2017. Our results indicated that the baseflow accounted for almost 55.3% and 33.3% of the annual streamflow in the UWBDR and Walzem Creek watersheds, respectively. The contribution of both land use alteration and climate variability on the flow variation is higher in the UWBDR watershed. In Walzem Creek, the alteration in streamflow and baseflow appears to be driven by the effect of urbanization more than that of climate variability. The results reported herein are compared with results reported in recent work by the authors in order to provide necessary information for water resources management planning, as well as soil and water conservation, and to broaden the current understanding of hydrological components variation in different climate regions.

Canadians overwhelmingly do not want to live in long-term-care (LTC) facilities when they age; yet many end up there for lack of homecare, because family caregivers burn out, or because they and their professional advisors are unaware of alternatives to institutions. Not only is institutional dementia care problem-driven, it segregates disabled people, thereby abrogating human rights. Because systemic ageism and ableism cloud elder care, institutions remain the default option for Canadians with dementia. Yet, decades of deinstitutionalization enabled younger disabled Canadians to live in the community with supports. Why not elders? We describe a plethora of noninstitutional dementia-care alternatives. We then present a roadmap for considering all relevant care options in service plans, one that incorporates supported decision-making by people with dementia. We propose a paradigm shift in how Canada serves its elder citizens—not just the current generation, but those to come, including ourselves.

This work is the first part of a series of papers on a comprehensive analysis of the processes of prebiotic self-organization and protophotosynthesis on the surface of semiconductor minerals and in systems of natural dispersed semiconductors. Comprehensive analysis within the framework of the "semiconductor world" concept allows integrating a variety of models on a single physical basis - from ZnS world and FeS world (based on inorganic semiconductors) to the PAH world and aromatic world (including organic semiconductors). Thus, we do not put forward a new alternative hypothesis of chemical evolution - a new "chemical world", but only integrate the evolutionary and geochemical criteria of different "chemical worlds" into a single "physical world", which gives one the opportunity to reconstruct and predict the directions of chemical evolution according to the uniform principles of physical chemistry. In the first part of this series we consider photoinduced self-organization and "photo-controlled" evolution of the early protobiological systems performing solar energy conversion on the surface of dispersed semiconductor minerals capable of (photo)catalyzing and photosensitizing prebiological processes. The latter include a transition from the elementary cycles of photocatalytic reactions on the surface of semiconductors to protophotometabolic cycles and protophotosynthesis, from photophysical processes on the surface of mineral semiconductors to photoinduced membrane potentials, from photocontrolled sorption on the surface of such minerals to the formation of photosensitive protomembranes and selection of photosynthetic structures. The evolutionary approach to the analysis of protobiological mechanisms and protobioenergetics within the framework of the "semiconductor world" concept provides a new approach to the study of the last common point of divergence of protobiological systems, where the emergence principles of different energy supply schemes (like the energy source-specific photoautotrophy and substrate-specific chemoautotrophy) merge at the physicochemical level. The proposed integrating scheme is consistent with most biological, geological, and physicochemical concepts, which ensures its complete cross-checking and internal consistency.

Brain-derived neurotrophic factor (BDNF) is a key molecule in promoting neurogenesis, dendritic and synaptic health, and neuronal survival, plasticity, and excitability, all of which are disrupted in neurological and cognitive disorders such as Alzheimer’s disease (AD). Extracellular aggregates of amyloid-β (Aβ) in the form of plaques and intracellular aggregates of hyperphosphorylated tau protein have been identified as major pathological insults in AD brain, along with immune dysfunction, oxidative stress, and other toxic stressors. Although aggregated Aβ and tau lead to decreased brain BDNF expression, early losses in BDNF prior to plaque and tangle formation may be due to other insults such as oxidative stress and contribute to early synaptic dysfunction. Physical exercise, on the other hand, protects synaptic and neuronal structure and function, with increased BDNF as a major mediator of exercise-induced enhancements in cognitive function. Here, we review recent literature on mechanisms behind exercise induced BDNF upregulation and its effects on improving learning and memory and on Alzheimer’s disease pathology. Mechanisms include elevations in peripheral BDNF-inducing hormones such as osteocalcin, FNDC5/irisin, and lactate. The fundamental mechanisms of how exercise impacts BDNF and cognition are unclear but are a prerequisite to developing new biomarkers and therapies to delay or prevent cognitive decline.

Raindrop erosion is a significant materials limiting issue. It can affect materials for transportation and renewable energy converters such as wind turbines as well as all external structures used in the construction industries. In such cases, the raindrop effects can occur over a wide range of impact velocities and particles sizes. In understanding tribological variable effects, it is useful to study using reference materials. This is because the reference material is well characterized, from previous knowledge of the tribological and corrosion patterns. Further, the well established chemical composition and stochiometry of the corrosion products provide some background understanding of how effectively, during tribological action, the surface scale adheres to the substrate. In this study, a carbon steel was used as a reference to study the effects of velocity and drop diameter in a whirling arm erosion test rig. The results were used to establish the conditions where corrosion was accelerated and the environments where aerodynamic effects may have resulted in droplets being deflected the surfaces. Erosion maps were generated to illustrate such mechanisms based on the results.

Diagnosis of bovine tuberculosis (bTB) may be confounded by immunological cross-reactivity to Mycobacterium bovis antigens when animals are sensitised by certain nontuberculous mycobacteria (NTMs). Therefore, this study aimed to investigate NTM species diversity in African buffalo (Syncerus caffer) respiratory secretions and tissue samples, using a combination of novel molecular tools. Oronasal swabs were collected opportunistically from 120 immobilised buffaloes in historically bTB-free herds. In addition, bronchoalveolar lavage fluid (BALF; n=10) and tissue samples (n=19) were obtained during post-mortem examination. Mycobacterial species were identified directly from oronasal swab samples using the Xpert MTB/RIF Ultra qPCR (14/120 positive) and GenoType CMdirect (104/120 positive). In addition, all samples underwent mycobacterial culture, and PCRs targeting hsp65 and rpoB were performed. Overall, 55 NTM species were identified in 36 mycobacterial culture-positive swab samples with presence of esat-6 or cfp-10 detected in 20 of 36 isolates. The predominant species were M. avium complex and M. komanii. Nontuberculous mycobacteria were also isolated from 6 of 10 culture-positive BALF and 4 of 19 culture-positive tissue samples. Our findings demonstrate that there is a high diversity of NTMs present in buffaloes, and further investigation should determine their role in confounding bTB diagnosis in this species.

This study explores the crucial roles of energy literacy, transition, and justice in addressing the global climate crisis. Through a systematic bibliometric survey and thematic analysis of existing literature, we identify a scarcity in research (<0.1%, n = 17,773) concurrently integrating the three crucial terms: energy literacy; energy transition; and energy justice. This study emphasizes the importance of energy literacy in empowering societies to make informed decisions, which is essential for facilitating equitable energy transitions and achieving sustainability goals. We delve into the interconnections between energy literacy and energy justice, proposing the integration of these concepts into educational systems, including social media platforms to foster an understanding of energy systems, their environmental impacts, and socio-economic implications. Emphasizing the strategic use of social media, the study also introduces the ‘COMPEL Justice’ framework—Communities Prepared for Energy Literacy and Justice—which aims to enhance public engagement and participation in energy transition initiatives. By analyzing publications from various academic and governmental sources, we provide insights into the challenges and opportunities that lie in promoting energy literacy and justice, particularly in the context of global efforts to mitigate climate change and enhance energy equity. Finally, exemplary application and implications associated with the adoption of the proposed framework within the context of oil-producing regions (e.g., Louisiana in the United States) are presented.

The global centenarian population is expected to reach 3 million by 2050, yet little is known about the health status of centenarians in Sub-Saharan Africa. A case study examined the health conditions and functionality of nine Ethiopian centenarians. In-depth interviews revealed that all nine were Orthodox-Christians and lived with extended family; eight were male. Aside from minor health complaints, centenarians in rural Ethiopia perceived that their sensory/cognitive functionality was normal until their late 90s. Despite a lack of medical care, the centenarians included 2 survivors, 4 delayers, and 3 escapers. Centenarians in rural Ethiopia were embedded in closely-knit, religious, multigenerational households and communities and aspired to live resiliently. Findings call for consideration of the unique health status of centenarians in Global South nations in their own cultural context.

The change in both streamflow and baseflow in urban catchments has received significant attention in the latest decades as a result of their drastic variability. In this research, effects of climate variation and dynamics of land use are measured separately and in combination on streamflow and baseflow in the Little Eagle Creek (LEC) watershed (Indianapolis, Indiana). These effects are examined using land use maps, statistical tests, and hydrological modeling. Transition matrix analysis was used to investigate the change in land use between 1992 and 2011. Temporal trends and changes in meteorological data were evaluated from 1980-2017 using the Mann-Kendall test. Changes in streamflow and baseflow were assessed using the Soil and Water Assessment Tool (SWAT) hydrological model using multiple scenarios that varied in land use and climate change. Evaluation of the model outputs showed streamflow and baseflow in LEC are well represented using SWAT; however, comparing the calibration and validation period showed SWAT performs better for the calibration. During 1992-2011, roughly 30% of the watershed experienced change, typically cultivated agricultural areas became urbanized. Baseflow is significantly affected by the observed urbanization; however, the combination of land and climate variability has a larger effect on the baseflow in LEC. Generally, the variability in the baseflow and streamflow appears to be heavily driven by the response to climate change in comparison to variability due to altered land use. The results reported herein expand the current understanding of variation in hydrological components, and provides useful information for management planning regarding water resources, as well as water and soil conservation in urban watersheds in Indiana and beyond.

Nuʻupia Ponds, a traditional Hawaiian fishpond system, are located at Marine Corps Base Hawaii (MCBH) and part of the Nuʻupia Ponds Wildlife Management Area, a wetland refuge for native, endangered, and protected birds and Hawaiian green sea turtles, as well as many native fish species. Currently, there is uncertainty regarding the ecological status and condition of the fishponds following prior modification of wetland habitats in and around the ponds. This study examines circulation dynamics and characterizes water exchange, pond volume, and residence time across the full tidal spectrum at Nuʻupia fishponds. Our results indicate a general west to east gradient in current flow; with higher flushing rates and lower residence times of fishponds in the western ponds of the Nu’upia system compared to the eastern ponds. We further found low flushing rates at several sites causing limited water exchange with Kāne’ohe Bay, as well as within Nu’upia Pond system. Sufficient water circulation plays a fundamental role in maintaining a healthy balance of fishpond flora and fauna and preserve ecosystem health. The results from this study provide a baseline of current physical water circulation dynamics and implications for ecosystem health, as well as inform science-based conservation and management strategies moving forward.

Primates have an unparalleled ability to produce a wide range of dexterous movements, each sensitive to context and robust to perturbation. Recent progress in understanding the neural basis of movement generation comes from two largely independent ideas, “Optimal Feedback Control” and “Neural Dynamical Systems”. The optimal control framework was largely inspired by research programs from the ‘80s showing that the brain doesn’t seem to plan a simple desired movement trajectory, but instead produces movements by transforming sensory information into motor output that satisfies an optimality criterion. The more recent idea that the motor cortex acts as a dynamical system came about only as it became possible to analyze large numbers of simultaneously recorded single neurons. These two framings of the motor system have been largely incommensurate, neither able to contribute much to the understanding of the other. In this review, we reconcile these two views into a single model we call “Dynamical Feedback Control”. We propose that the dynamics in the motor cortex emerge from a sensorimotor transformation that couples the motor cortex to sensory input from the periphery, and to contextual inputs from other cortical and subcortical areas. Dynamics in motor cortex can be thought to approximate gains of a feedback controller, and by moving the neural state to different regions of state space, the motor system can rapidly alternate between different controllers. The DFC framework presents a new lens to interpret neural dynamics, and to understand how ensembles of neurons generate flexible and responsive patterns of muscle activity.

Recently, coastal swamps have been acknowledged for their capability to alleviate shorelines and defend coastal communities. Mangroves play a prominent role in obstructing water currents in riverbanks, shorelines, and coastal areas. Mangrove roots have the significant contribution to the resiliency of the vegetation structure. Yet, mangrove model has lately been called into question by lab experimental evidence. In this paper, the flow characteristics past root models are reviewed. coastal swamps are among the most fruitful and carbon‐rich ecosystems on the planet. Long‐term carbon putting away in coastal wetlands happens mostly below ground as soil organic matter. Mangrove servs as a carbon sink, impacts wetland ecosystem configuration, purpose, and firmness. To expect and ease the properties of climate change, there is a necessity to advance considerate of environmental controls on wetland. The impact of four soil formation factors are reviewed. Across the shorelines, soil organic matter was highest in mangrove forests and it was lower areas.

Reassessment of the fatigue life for wind turbines structural components is typically performed using deterministic methods with the same partial safety factors as used for the original design. However, in relation to life extension, the conditions are generally different from the assumptions used for calibration of partial safety factors; and using a deterministic assessment method with these partial safety factors might not lead to optimal decisions. In this paper, the deterministic assessment method is compared to probabilistic and risk-based approaches, and the economic feasibility is assessed for a case wind farm. Using the models also used for calibration of partial safety factors in IEC61400-1 ed. 4 it is found that the probabilistic assessment generally leads to longer additional fatigue life than the deterministic assessment method. The longer duration of the extended life can make life extension feasible in more situations. The risk-based model is applied to include the risk of failure directly in the economic feasibility assessment and it is found that the reliability can be much lower than the target for new turbines, without compromising the economic feasibility.

Pathologic angiogenesis is responsible for much of the vision loss that stems from several chorioretinal vascular diseases including neovascular age-related macular degeneration (nAMD), diabetic retinopathy (DR), and retinal vein occlusion (RVO). Because vascular endothelial growth factor (VEGF) serves as a pivotal angiogenic molecule, it has emerged as the primary target for therapeutic drugs. Current anti-VEGF therapy is dominated by bevacizumab, ranibizumab, and aflibercept, all of which have been available for more than a decade, but new drugs, both biosimilars (Byooviz and Cimerli) and drugs whose primary aim is to decrease treatment burden (brolucizumab, faricimab, and the ranibizumab port delivery system), have been approved. Recent failures (conbercept, abicipar, and KSI-301) emphasize the complexity of drug development and the difficulties faced by innovators. Most therapies under development, including tyrosine kinase inhibitors and gene therapy, include VEGF-A blockade as their primary function and aim to extend durability rather than increase peak efficacy. But even as many new drugs look to extend durability, cost containment with mandated use of biosimilars serves to balance the therapeutic landscape.

Children with autism spectrum disorder (ASD) may have impaired vision from high refractive errors: near-sighted-myopia or far-sighted-hyperopia and aversion to spectacles or contact lenses. Refractive surgery can restore sharp vision and eliminate the need for spectacles or contact lenses. Restoration of sharp vision may improve ASD behaviors. Data were collated retrospectively for 267 children with refractive errors and neurodevelopmental disorders (NDD) diagnosed as ASD alone or NDD with ASD-like behaviors. Surgery was either laser photo-refractive keratectomy (PRK; 131 children), implantation of a phakic intra ocular lens (pIOL; 129 children) or removal of the crystalline lens and implantation of an IOL (refractive lens exchange, RLE; 21 children) under general anesthesia. Median age was 10.9 yrs. and median follow-up 3.1 yrs. Pre-operative refractive errors ranged from a mean +7.5 ± 0.9 D to -14.3. ± 4.8 D. Surgery corrected 87% to normal focal length (± 1 D). Visual acuity improved an average 0.6 logMAR. Social interactions and ASD behaviors improved in 55% (146/267) of the treated children (p &lt; .01), including school performance; motor skills; depth perception; repetitive or stereotyped movements; anxiety/fear; and attention. Refractive surgery improves both visual function and behaviors in the majority of highly near-sighted or far-sighted children with ASD.

Research rarely explores LGBTQ+ youth bullying in the context of culture-specific outcomes (e.g., LGBTQ+ identity development) and what can mitigate the impact of peer stressors. This study used a concurrent mixed methods design to explore how experiences of peer victimization predicted LGBTQ+ youth’s identity development (i.e., stigma sensitivity, concealment motivation, and difficult process) and whether social support and outness served as protective, moderating factors. The mixed-methods approach provides a culture-specific context via qualitative inquiry to inform whether the quantitative findings align with how youth qualitatively discuss their experience of bullying, negative outcomes, and social support. Our sample consisted of 349 LGBTQ+ youth 14-17 years old who completed a survey (quantitative sample), and a subset of 39 LGBTQ+ youth who completed a semi-structured interview (qualitative sample). Our quantitative findings indicated that greater overall peer victimization was positively related to LGBIS-revised subscales of stigma sensitivity, concealment motivation, and difficult process, where both outness and social support moderated such relations. Qualitatively, victimized youth also reported stigma sensitivity and concealment motivation, while also endorsing how being out and having a support system played a role in their experience of being victimized. These qualitative findings align with our quantitative findings that classmate support mitigated the effects of peer victimization on difficulty of coming out. Implications for practitioners and researchers are provided.

Accurate and consistent rainfall observations are vital for climatological studies in support of better planning and decision making. However, estimation of accurate spatial rainfall is limited by sparse rain gauge distributions. Satellite rainfall products can thus potentially play a role in spatial rainfall estimation but their skill and uncertainties need to be under-stood across spatial-time scales. This study aimed at assessing the temporal and spatial performance of seven satellite products (TARCAT (Tropical Applications of Meteorology using SATellite and ground-based observations (TAMSAT) African Rainfall Climatology And Time series), Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS), Tropical Rainfall Measuring Mission (TRMM-3B43), Climate Prediction Center (CPC) Morphing (CMORPH), the Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks- Climate Data Record (PERSIANN-CDR), CPC Merged Analysis of Precipitation (CMAP) and Global Precipitation Climatology Project (GPCP) using gridded (0.05o) rainfall data over East Africa for 15 years(1998-2012). The products’ error distributions were qualitatively compared with large scale horizontal winds (850 mb) and elevation patterns with respect to corresponding rain gauge data for each month during the ‘long’ (March-May) and ‘short’ (October-December) rainfall seasons. For validation only rainfall means extracted from 284 rain gauge stations were used, from which qualitative analysis using continuous statistics of Root Mean Squared Difference, Standard deviations, Correlations, coefficient of determinations (from scatter plots) were used to evaluate the products’ performance. Results revealed rainfall variability dependence on wind flows and modulated by topographic influences. The products’ errors showed seasonality and dependent on rainfall intensity and topography. Single sensor and coarse resolution products showed lowest performance on high ground areas. All the products showed low skills in retrieving rainfall during ‘short’ rainfall season when orographic processes were dominant. CHIRPS, CMORPH and TRMM performed well, with TRMM showing the best performance in both seasons. There is need to reduce products’ errors before applications.

Body-Esteem Scale is an assessment tool for adolescents and adults that evaluate three dimensions of self-evaluations of one’s body. Body-Esteem Scale has been translated and validated in some countries since America down to Europe. Lack of translation and reliability evidence in Portugal was detected. This study aimed to translate and test the validity and reliability of the Body Esteem Scale for Adolescents and Adults (BESAA) in students in the context of Portuguese higher educa-tion. A total of 173 students (60.7% are female) with a mean age of 19.7 (standard deviation = 2.2) years participated. Categorical Principal Component Analysis was used to assess the underlying dimensions of BESAA. Construct validity was evaluated through correlation with the Appearance Schemas Inventory – Revised and a three-factor model (“Appearance”, ‘‘Weight’’ and “Attribu-tion’’) was established. Confirmatory factor analysis was performed to verify the construct validity of the instrument. Items that had factor weights (λ)<.40 were removed, as well as those that were considered redundant by the modification indices estimated by the Lagrange Multipliers (LM) method (LM>11, p<.001). We observed high correlations between theoretically similar factors, and low correlations between different factors. The Portuguese BESAA showed adequate validity and reliability.

Evaluating new, promising organic molecules to make next-generation organic optoelectronic devices necessitates the evaluation of charge carrier transport performance through the semi-conducting medium. In this work, we utilize quantum chemical calculations (QCC) and kinetic Monte Carlo (KMC) simulations to predict the zero-field hole mobilities of ~100 morphologies of the benchmark polymer poly(3-hexylthiophene), with varying simulation volume, structural order, and chain-length polydispersity. Morphologies with monodisperse chains were generated previously using an optimized molecular dynamics force-field and represent a spectrum of nanostructured order. We discover that a combined consideration of backbone clustering and system-wide disorder arising from side-chain conformations are correlated with hole mobility. Furthermore, we show that strongly interconnected thiophene backbones are required for efficient charge transport. This definitively shows the role "tie-chains" play in enabling mobile charges in P3HT. By marrying QCC and KMC over multiple length- and time-scales, we demonstrate that it is now possible to routinely probe the relationship between molecular nanostructure and device performance.

Quaking aspen (Populus tremuloides Michx.) landscapes are valued for their biodiversity, water retention, fire mitigation, aesthetics, and recreation opportunities. Across North America, some aspen populations are experiencing population declines as they face uninhibited ungulate browsing, drought, fire suppression, insects, disease, and inappropriate management. Increased human development and recreational use within aspen landscapes can serve as additive stressors, though there is a dearth of literature examining these elements. At a popular recreational area in Utah, USA, identifying the cause of apparent decline within a larger aspen community is complicated by development upstream and recreation-related activities. We sought to: 1) assess the overall condition of the aspen at the site, 2) understand key variables that influence aspen conditions, and 3) elucidate how aspen fitness varies across the site. We collected data from forty-five plots using established aspen sampling methods, including ungulate presence, tree characteristics, soil chemistry, and environmental descriptors. Results suggest that a combination of higher levels of browsing and elevated soil sodium may be causing premature mortality and limiting aspen recruitment in a portion of the study area. These findings will inform future management at this site, as well as similar recreational forest settings experiencing compound stressors.

Pulmonary Hypertension (PH) is a terminal disease characterized by severe pulmonary vascular remodeling. Unfortunately, targeted therapy to prevent disease progression is limited. Here, the vascular cell populations that contribute to the molecular and morphological changes of PH in conjunction with current animal models for studying vascular remodeling in PH will be examined. The status quo of epigenetic targeting for treating vascular remodeling in different PH subtypes will be dissected, while parallel epigenetic threads between pulmonary hypertension and pathogenic cancer provide insight into future therapeutic PH opportunities.

Glaucoma poses a serious public health concern as it is the second leading cause of blindness after cataracts, while also being the leading cause of irreversible blindness worldwide. Glaucoma is more prevalent among Black, Latino, and Asian populations and it is essential to examine both racial and ethnic disparities that exist in treatment and prevention. As the number of people with glaucoma continues to grow, it is important to review aspects of this condition in order to better care for those affected. This article will review significant forms of glaucoma and what differentiates them in a diagnosis, treatment options, and recommendations on prevention and improving awareness

The nucleation and dynamics of Josephson and Abrikosov vortices determine the critical currents of layered high-T_c superconducting (HTS) thin films, grain boundaries, and coated conductors, so understanding their mechanisms is of crucial importance. Here we treat pair creation of Josephson and Abrikosov vortices in layered superconductors as a secondary Josephson effect, in which each full vortex is viewed as a composite fluid of micro-vortices, such as pancake vortices, which tunnel coherently via a tunneling matrix element. We introduce a two-terminal magnetic (Weber) blockade effect that blocks tunneling below a threshold current, and simulate time-correlated vortex tunneling above threshold. The model shows nearly precise agreement with voltage-current (V-I) characteristics of HTS cuprate grain boundary junctions, which becomes more concave rounded as temperature decreases, and also explains the piecewise linear V-I behavior observed in iron-pnictide bicrystal junctions and other HTS devices. When applied to either Abrikosov or Josephson pair creation, the model explains a plateau seen in plots of critical current vs. thickness of HTS coated conductors. The observed correlation between theory and experiment strongly supports the proposed quantum picture of vortex nucleation and dynamics in layered superconductors.

Retinoic acid receptor-related orphan receptor γ (RORγ) is a transcription factor regulating the expression of the pro-inflammatory cytokine IL-17 in human T helper 17 (Th17) cells. Activating RORγ can induce multiple IL-17-mediated autoimmune diseases but may also be useful for anticancer therapy. Its deep immunological functions make RORɣ an attractive drug target. Over 100 crystal structures have been published describing atomic interactions between RORɣ and agonists and inverse agonists. In this review, we focus on the role of dynamic properties and plasticity of the RORɣ orthosteric and allosteric binding sites by examining structural information from crystal structures and simulated models. We discuss the possible influences of allosteric ligands on the orthosteric binding site. We find that high structural plasticity favors the druggability of RORɣ, especially for allosteric ligands.

Fermented foods play an important role in the human diet and particularly so in under-resourced environments where cold preservation is not attainable due to irregular supply of electricity. Fermented foods are reported to support gut health by contributing probiotics and the purpose of this study was to investigate the microbial diversity and metabolic potential of spontaneous millet fermentation. The literature in the field was reviewed and analysis conducted on publicly available Sequence Read Archive (SRA) datasets. Quality analysis was performed with FastQC, and operational taxonomic units (OTUs) generated using Quantitative Insights Into Microbial Ecology (QIIME2) and Divisive Amplicon Denoising Algorithm (DADA2) pipeline with Greengenes as the reference database. Metagenomics and pathways analysis were performed with Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt2). Statistical analysis and visualization were accomplished with Statistical Analysis of Metagenomic Profiles (STAMP). At the family taxonomic level, there were significant differences in the relative abundances of bacteria involved in the spontaneous fermentation of millet namely, Lactobacillaceae, Leuconostocaceae, and Clostridiaceae in one dataset. The incidence of Lactobacillaceae and Bifidobacteriaceae suggest the probiotic characteristic of fermented millet. The datasets were collected with fermentations mediated by autochthonous microorganisms and the presence of some potential pathogens such as Enterobacteriaceae, Clostridiaceae, Aeromonadaceae, Microbacteiaceae, Pseudomonadaceae, and Neisseriaceae suggest the need for standardization of fermentation approaches. The genomes show the potential to synthesize metabolites such as vitamins suggesting that the respective fermented foods can be further optimized to enhance nutritional benefits.

Physics has been thought to truly represent reality since at least Galileo, and the foundations of physics are always established using philosophical ideas. In particular, the elegant naming of physical entities is usually very influential in the acceptance of physical theories. We here demonstrate (using current developments in thermodynamics as an example) that both the epistemology and the ontology of physics ultimately rest on poetic language. What we understand depends essentially on the language we use. We wish to establish our knowledge securely, but strictly speaking this is impossible using only analytic language. Knowledge of the meanings of things must use a natural language designed to express meaning, that is, poetic language. Although the world is really there, and although we can indeed know it truly, this knowledge is never either complete or certain but ultimately must rest on intuition. Reading a recently discovered artefact with a palaeo-Hebrew inscription as from the first century, we demonstrate from it that this ontological understanding long predates the Hellenic period. Poetic language is primary, both logically and temporally.

We present a new perspective of the link between QED and Maxwell's equations. We demonstrate that the interpretation of $\mathbf{D}=\varepsilon_{0} \mathbf{E}$ as vacuum polarization is consistent with QED. A free electromagnetic field polarizes the vacuum, but the polarization and magnetization currents cancel giving zero source current. The speed of light is a universal constant, while the fine structure constant, which couples the electromagnetic field to matter, runs as it should.

Advances in remote sensing have led to use of satellite-derived rainfall products to complement the sparse rain gauge data. Although globally derived and some regional bias corrected, these products often show large discrepancies with ground measurements attributed to local and external factors that require systematic consideration. Decreasing rain gauge network however inhibits continuous validation of these products. We propose to deal with this problem by the use of Bayesian approach to merge the existing historical rain gauge information to create a consistent satellite rainfall data that can be used for climate studies. Monthly Bayesian bias correction is applied to the Climate Hazards Group Infrared Precipitation with Stations (CHIRPS v2) data to reduce systematic errors using a corresponding gridded (0.05°) rain gauge data over East Africa for a period of 33 (1981–2013) years of which 22 years are utilized to derive error fields which are then applied to an independent CHIRPS data for 11 years for validation. The bias correction is spatially and temporally assessed during the rainfall wet months of March-May (MAM), June-August (JJA) and October–December (OND) in East Africa. Results show significant reduction of systematic errors at both monthly and yearly scales and harmonization of their cumulative distributions. Monthly statistics showed a reduction of RMSD (29–56)% and MAE (28–60)% and an increase of correlations (2–32) %, while yearly ones showed reductions of RMSD (9-23)%, and MAE (7–27)% and increase of correlations (4–77)% for MAM months, reduction of RMSD (15–35)% and MAE (16–41)% and increase in correlations (5–16)% for JJA months, and reduction of RMSD (3–35)% and MAE (9–32)% and increase of correlations (3–65)% for OND months. Systematic errors of corrected data were influenced by local processes especially over Lake Victoria and high elevated areas. Large-scale circulations induced errors were mainly during JJA and OND rainfall seasons and were reduced by the separation of anomalous years during training. The proposed approach is recommended for generating long-term data for climate studies where consistencies of errors can be assumed.

The article discusses issues related to the optimization of the operation of medium voltage networks, focusing on the optimization of network division points and the selection of the optimal network configuration aimed at reducing power and energy losses. The article provides a critical review of selected scientific works from recent years on the issue of network configuration optimization. The developed solution uses non-deterministic network models and statistical and probabilistic approaches. Optimization studies were carried out using heuristic optimization methods and proprietary algorithms for forecasting the load and power generated from renewable energy sources. The solution proposed in the article has many application possibilities. It can be used to optimize the location of network division points (reducing economic costs related to the modernization of network infrastructure) as well as to optimize the reconfiguration process in order to reduce power losses while maintaining voltage criteria.

Higher consumption of fruit and vegetables has been associated with a lower risk of various chronic diseases including coronary heart disease, obesity, and certain cancers. Recently, fruit and vegetable intake has also been linked with mental health, including depression. This systematic review aimed to evaluate the association between fruit and vegetable intake and depressive symptoms in young people and adults aged 15-45. The systematic review focused on peer-reviewed cohort studies published from 1 January 2000 to 31 August 2020 using searches of six electronic databases. The exposure was fruit and vegetable consumption analysed both separately and/or together, and the outcome was depression or depressive symptoms. Data from eligible studies were extracted according to predefined criteria and the studies were appraised using the Newcastle-Ottawa Scale (NOS) for Cohort Studies to evaluate for study quality and risk of bias. To evaluate the association between fruit and vegetable consumption and depressive symptoms, a narrative synthesis was conducted. Of 9667 potentially relevant studies that were screened for title and abstracts, 144 full text studies were evaluated, and 12 studies from seven countries were deemed eligible and included in the qualitative synthesis. Using the NOS framework one study was categorised as ‘very good’ quality, ten studies were ‘good’ quality, and two studies were ‘moderate’ quality. With respect to combined fruit and vegetable consumption, two studies demonstrated an inverse association with depression. When the effects of fruit and vegetable on depression were analysed separately, five studies showed significant associations in fruit consumption, and two studies showed significant associations in vegetable consumption. Four studies showed no association between combined fruit and vegetable consumption and depression, one study showed no association between fruit consumption and depression, and two studies showed no association between vegetable consumption and depression. Despite some contradictory results in the studies included in this review, the evidence seems to be building that a possible association exists, and this may have implications for addressing the burden of mental illness in young people and adults aged 15-45 years. Well-designed prospective cohort studies are needed to provide more robust evidence on the diet-depression relationship.

This research focussed on utilisation of salmon protein and lipid to manipulate pasta glycaemic index and protein digestibility. Salmon fish (Oncorhynchus tschawytscha) powder (SFP) supplemented pasta flour at the from 5% to 20% (w/w). Inclusion of SFP lead to a significant reduction in starch digestibility and hence the potential glycaemic values of pasta (experimental pasta being up to 143% lower than control values). SFP addition to pasta increased the release of phenolic compounds from pasta during both a gastric digestion (179%) and pancreatic digestion ( 133%) in comparison to the control sample. At the same time, the antioxidant activity of the digested pasta was increased by up to 263% (gastric) and 190% (pancreatic) in comparison to durum wheat pasta alone. Interestingly, although protein levels increased with incorporation of SFP, the digestibility values of the protein decreased from 86.41% for the control pasta to 81.95% for 20% SFP pasta. This may indicate that there are interactions between phenolic and protein in the pasta samples which affect overall protein digestibility levels.

The development of autonomous vehicles is becoming increasingly popular and gathering real world data is considered a valuable task. Many datasets have been published recently in the autonomous vehicle sector, with synthetic datasets gaining particular interest due to availability and cost. For a real implementation and correct evaluation of vehicles at higher levels of autonomy it is also necessary to consider human interaction, which is precisely something that lacks in existing datasets. In this article the UPCT dataset is presented, a public dataset containing high quality, multimodal data obtained using state of the art sensors and equipment installed onboard the UPCT’s CICar autonomous vehicle. The dataset includes data from a variety of perception sensors including 3D LiDAR, cameras, IMU, GPS, encoders, as well as driver biometric data and driver behaviour questionnaires. In addition to the dataset, the software developed for data synchronisation and processing has been made available. The quality of the dataset was validated using an end-to-end neural network model with multiple inputs to obtain speed and steering wheel angle and obtained very promising results.

Oxalate, a compound produced by many edible plants and as a terminal metabolite in the liver of mammals, is a toxin that has a detrimental role to human health. Humans and other mam-mals do produce the enzymatic machinery to degrade oxalate. However, numerous oxa-late-degrading bacteria reside in the mammalian gut and thus provide an important function for hosts. The current review focuses on the environmental factors that influence the efficacy of pro-biotic oxalate-degrading bacteria, relative to oxalate metabolism. We describe the mechanism of oxalate catabolism and its consumption by obligate and facultative anaerobic oxalate-degrading bacteria, in both in vitro and in vivo environments. We also explore the environmental variables that impact oxalate degradation. Studies on single species degrade oxalate have not shown a strong impact on oxalate metabolism especially in high oxalate conditions such as consumption of foods high in oxalate (such as coffee and chocolate for humans or halogeton in animal feed). Considering effective variables which enhance oxalate degradation could be used in application of effective probiotic as a therapeutic tool in individuals with hyperoxaluria. This study indicates probiotics can be considered a good source of naturally occurring oxalate degrading agent in human colon

This paper describes the feasibility and probable benefits associated with greening the Tahliah Channel, a concrete drainage channel that was originally built to relieve urban flooding in Jeddah City, Saudi Arabia. It includes an estimation of irrigation needs for channel greening based on a standardized planting specification. The study also demonstrates alternative strategies for meeting the required irrigation demand, including water harvesting and graywater reuse on a residential scale. The study shows that greening Tahliah Channel is possible relying mainly on graywater reuse from the surrounding buildings. Also, the study shows that rainwater harvesting is not a reliable source for irrigation. Rather, it can cover only part of the irrigation needs (6%) and so can be used as a secondary supporting source. The positive results of this case study will be of interest to those in arid countries who are looking to upgrade and replace traditional, single function drainage infrastructure with more sustainable, green infrastructure systems. More specifically, the objectives of the study are consistent with the goals of the Saudi government’s ongoing initiative that advocates for more resilient and sustainable cities. (Vision 2030 year).

Given their severity and non-healing nature, diabetic chronic wounds are a significant concern to the 30.3 million Americans diagnosed with diabetes mellitus (2015). Peripheral arterial diseases, neuropathy, and infection contribute to the development of these wounds, which lead to an increased incidence of lower extremity amputations. Early recognition, debridement, offloading, and controlling infection are imperative for timely treatment. However, wound characterization and treatment are highly subjective and based largely on the experience of the treating clinician. Many wound dressings have been designed to address particular clinical presentations, but a prescriptive method is lacking for identifying the particular state of chronic, non-healing wounds. The authors suggest that recent developments in wound dressings and biosensing may allow for the quantitative, real-time representation of the wound environment, including exudate levels, pathogen concentrations, and tissue regeneration. Development of such sensing capability could enable more strategic, personalized care at the onset of ulceration and limit the infection leading to amputation. This review presents an overview of the pathophysiology of diabetic chronic wounds, a brief summary of biomaterial wound dressing treatment options, and biosensor development for biomarker sensing in the wound environment.

Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) of infants have some form of malnutrition. Among malnourished infants, 44.7%(~15.4% of the total sample) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF(65.4%) or weaned infants(13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting and underweight with both wasting and stunting by 1.96(1.12-3.47) and 2.25(1.16-4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protects infants in Pakistan from various types of CFM during the first six months of life.

In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, the Precision Medicine Research (PreMeR) Diversity Consortium was formed by four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN). This synergistic approach proposed evidence-based, best practices used by experienced researchers to engage, recruit and retain diverse populations in the All of Us initiative. Conceptualization of the proposed approach was aided by social influence theories to better understand how people’s beliefs and opinions should be modified to affect change leading to action [1]. The Social-Ecological Model (SEM), for Health Promotion [2], from Stokols [1] and Community-Based Participatory (CBPR) Models[3],[4] guided proposed engagement, recruitment, and retention strategies contextualized with the individual, interpersonal, organizational, community, and policy spheres of influence. The PreMeR produced a partnership to evaluate and improve the effectiveness of current engagement, recruitment, and retention strategies for minority participation in scientific studies. This approach illustrates the need to incorporate multiple methods of engagement to reach a diverse audience to participate in scientific research. Engagement, recruitment, and retention strategies in community and biomedical research must be viewed as community engaged public health interventions, utilizing the same theoretical principles and approaches.

Alberta Cancer Exercise (ACE) is an exercise oncology program that transitioned from in-person to online delivery during COVID-19. The purpose of this work was to understand participants’ experiences in both delivery modes. Specifically, survivors' exercise facilitators and barriers, delivery mode preference, and experience with program elements targeting behaviour change were gathered. A retrospective cohort design using explanatory sequential mixed methods was used. 57 participants completed a survey, and 19 subsequent, optional interviews were conducted. Most participants indicated preferring in-person programs (58%), followed by online (32%), and no preference (10%). There were significantly fewer barriers (i.e., commute time) (p<0.01), but also fewer facilitators (i.e., social support) (p<0.01), to exercising online. Four themes were generated from the qualitative data surrounding participant experiences in both delivery modes. Key differences in barriers and facilitators highlighted a more convenient experience online relative to a more socially supportive environment in-person. For future work that includes solely online, focusing on building social support and a sense of community will be critical to optimizing program benefits. Beyond the COVID-19 pandemic, results of this research will remain relevant as we aim to increase the reach of online exercise oncology programming to more underserved populations of individuals living with cancer.

Animal-assisted interventions (AAI) use human-animal interactions to positive effect in various contexts including cancer care. This systematic literature review is the first part of a two-part paper series focusing on the research methods and quantitative results of AAI studies in oncology. We find methodological consistency in the use of canines as therapy animals, in the types of high-risk patients excluded from studies, and in the infection precautions taken with therapy animals throughout cancer wards. The investigated patient endpoints are not significantly affected by AAI, with the exceptions of improvements in oxygen consumption, quality of life, depression, mood, and satisfaction with therapy. The AAI field in oncology has progressed significantly since its inception and has great potential to positively impact future patient outcomes. To advance the field, AAI research in oncology should consistently improve the methodological design of studies, report data more completely, and focus on the therapy animal’s well-being.

Animal-assisted interventions (AAI) are a unique class of complementary medical treatments that can improve a patient’s quality of life, both physically and psychologically. Part I of this two-paper systematic literature review series focused on the study methods and quantitative results of researchers in this field. We continue this in-depth review here in Part II by discussing the common theories associated with AAI in the context of cancer. Of all the factors at work in human-animal interactions, researchers explicitly cite compatible animal personality, physical touch, physical movement, distraction/entertainment, and increased human interaction as the mechanisms responsible for the positive clinical outcomes observed in AAI. In various combinations, these mechanisms group under broader theoretical frameworks that attempt to fully explain the AAI context as it relates to cancer care. The social support hypothesis and the conception of a human-animal bond are the most referenced overarching frameworks. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are also referenced. We briefly consider other relevant theories commonly noted in the human-animal interactions literature that have the potential to clarify aspects of cancer-related AAI. We also discuss the neurobiological transduction mechanisms needed to connect theoretical frameworks and their mechanisms directly to the observed clinical outcomes. To advance the field, researchers should consider overarching theories with testable hypotheses when designing studies, and use consistent terminology when reporting results. This review lays a foundation for progress towards a unified theoretical framework and for effective treatment of the whole cancer patient.

Coronaviruses (CoVs) are enveloped positive-sense single-stranded RNA viruses with a genome 27-31kbases in length. Critical genes include the spike (S), envelope (E), membrane (M), nucleocapsid (N) and 9 accessory open reading frames encoding for non-structural proteins (NSPs) that have multiple roles in the replication cycle and immune evasion (1). There are 7 known human CoVs that most likely appeared after zoonotic transfer, the most recent being SARS-CoV-2 responsible for the Covid-19 pandemic. Antivirals that have been approved by the FDA for use against Covid-19 such as Paxlovid can potentially target and successfully inhibit the main protease (MPro) activity of multiple human CoVs, however alternative proteomes encoded by CoV genomes have a closer genetic similarity to each other, suggesting that antivirals could be developed now that target future CoVs. New zoonotic introductions of CoVs to humans are inevitable and unpredictable. Therefore, new antivirals are required to control not only the next human CoV outbreak, but also the 4 common human CoVs (229E, OC43, NL63, HKU1) that circulate frequently and to contain sporadic outbreaks of the severe human CoVs (SARS-CoV, MERS and SARS-CoV-2). The current study found that emerging antiviral drugs, such as Paxlovid, have only been proven to target SARS-CoV-2. Other drugs which have the potential to target other human CoVs, are still within clinical trial and are not yet available for public use. Monoclonal antibody (mAb) treatment and vaccines for SARS-CoV-2 can reduce mortality and hospitalisation rates, however they target the Spike protein whose sequence mutates frequently and drifts. Spike also is not applicable for targeting other HCoVs as these are not well conserved sequences among human CoVs. Thus, there is a need for readily available treatments globally that target all 7 human CoVs and improve the preparedness for inevitable future outbreaks. Here we discuss antiviral research contributing to the control of common and severe CoV replication and transmission, including the current SARS-CoV-2 outbreak. The aim was to identify common features of CoVs for antivirals, biologics and vaccines that could reduce the scientific, political, economic and public health strain caused by CoV outbreaks now and in the future.

Over the past decade and a half, dynamic functional imaging has revolutionized the neuroimaging field. Since 2009, it has revealed low dimensional brain connectivity measures, has identified potential common human spatial connectivity states, has tracked the transition patterns of these states, and has demonstrated meaningful alterations in these transition and spatial patterns in neurological disorders, psychiatric disorders, and over the course of development. Recently, researchers have begun to analyze this data from the perspective of dynamic system and information theory in the hopes of understanding how these dynamics support less easily quantified processes, such as information processing, cortical hierarchy, and consciousness. Consciousness, in particular, appears to be strongly linked to entropy production in the brain. Little attention has been paid to the effects of psychiatric disease on entropy production in the human brain, however. Even disorders characterized by substantial changes in conscious experience have not been widely analyzed from this perspective. We begin to rectify this by examining the complexity of subject trajectories in state space through the lens of information theory. Specifically, we identify a basis for the dynamic functional connectivity state space and track subject trajectories through this space over the course of the scan. The dynamic complexity of these trajectories is assessed along each dimension of the proposed basis space. Using these estimates, we demonstrate that schizophrenia patients display substantially simpler trajectories than demographically matched healthy controls, and that this drop in complexity concentrates along specific dimensions. We also demonstrate that entropy generation in at least one of these dimensions is linked to cognitive performance. Overall, results suggest great value in applying dynamic systems theory to problems of neuroimaging and reveal a substantial drop in the complexity of schizophrenia patients’ brain function.

Current dry powder formulations for inhalation deposit a large fraction of their emitted dose in the upper respiratory tract where they contribute to off-target adverse effects and variability in lung delivery. The purpose of current study is to design a new formulation concept that more effectively targets inhaled dry powders to the large and small airways. The formulations are based on adhesive mixtures of drug nanoparticles and nanoleucine carrier particles prepared by spray drying of a co-suspension of leucine and drug particles from a nonsolvent. The physicochemical and aerosol properties of the resulting formulations are presented. The formulations achieve 93% lung delivery in the Alberta Idealized Throat model that is independent of inspiratory flow rate and relative humidity. Largely eliminating URT deposition with a particle size larger than solution pMDIs is expected to improve delivery to the large and small airways, while minimizing alveolar deposition and particle exhalation.

Water mist systems (WMS) are used for evaporative cooling in public areas. The health risks associated with their colonization by opportunistic premise plumbing pathogens (OPPPs) is not well understood. To advance the understanding of the potential health risk of OPPPs in WMS, biofilm, water and bioaerosol samples (n = 90) from ten (10) WMS in Australia were collected and analyzed by culture and polymerase chain reaction (PCR) methods to detect the occurrence of 5 representative OPPPs: Legionella pneumophila, Pseudomonas aeruginosa, Mycobacterium avium, Naegleria fowleri and Acanthamoeba. P. aeruginosa (44%, n = 90) occurred more frequently in samples, followed by L. pneumophila serogroup (Sg) 2 - 14 (18%, n = 90) and L. pneumophila Sg 1 (6%, n = 90). A negative correlation between OPPP occurrence and residual free chlorine was observed except with Acanthamoeba ,rs (30) = 0.067, p > 0.05. . All detected OPPPs were positively correlated with water temperature. Biofilms contained higher concentrations of L. pneumophila Sg 2 - 14 (1000 – 3000 CFU/ml) in comparison to water samples (0-100CFU/ml). This study suggests that WMS can be colonized by OPPPs and are a potential health risk if OPPP contaminated aerosols get released into ambient atmospheres.

The exposure of people to opportunistic premise plumbing pathogens (OPPPs) such as Legionella, Mycobacterium and Pseudomonas in aerosolised water has been linked to opportunistic infections. Water mist systems (WMS) that are used to cool public places by flash evaporation of tiny water aerosols are gaining prominence in hot climatic regions of Australia. Their potential to be colonised by OPPPs has not been adequately studied. The public health impact of OPPPs is significant, as Legionella caused 63% of waterborne disease case hospitalisations in the United States associated with drinking water systems during 2013–2014, and the incidence of Mycobacterium avium over the same period was 647 cases per 100,000. As WMS are part of premise plumbing, they have structural characteristics that can promote biofilm formation, as well as the presence of free-living amoebae (FLA), low residual disinfection levels, elevated water temperatures and oligotrophic conditions, all of which can promote OPPP inhabitancy. This review highlights the potential public health risks of using WMS as a cooling intervention in public places and advocates for their regulation in places of public assembly and entertainment.

This paper compares a series of traditional and deep learning methodologies for the segmentation of textures. Six well-known texture composites first published by Randen and Hus{\o}y were used to compare traditional segmentation techniques (co-occurrence, filtering, local binary patterns, watershed, multiresolution sub-band filtering) against a deep-learning approach based on the U-Net architecture. For the latter, the effects of depth of the network, number of epochs and different optimisation algorithms were investigated. Overall, the best results were provided by the deep-learning approach. However, the best results were distributed within the parameters, and many configurations provided results well below the traditional techniques.

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL and Scopus were searched, and comparisons grouped as: exclusive human milk (EHM) vs exclusive preterm formula (EPTF), any HM vs EPTF and higher vs lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n =9,963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

This manuscript critically reviews the design and delivery of spray-dried particles for the achievement of high total lung doses (TLD) with a portable dry powder inhaler. We introduce a new metric termed the product density, which is simply the TLD of a drug divided by the volume of the receptacle it is contained within. The product density is given by the product of three terms: the packing density (the mass of powder divided by the volume of the receptacle), the drug loading (the mass of drug divided by the mass of powder), and the aerosol performance (the TLD divided by the mass of drug). This manuscript discusses strategies for maximizing each of these terms. Spray drying at low drying rates with small amounts of a shell-forming excipient (low Peclet Number) leads to formation of higher density particles with high packing densities. This enables ultrahigh TLD (>100 mg of drug) to be achieved from a single receptacle. Emptying of powder from capsules is directly proportional to the mass of powder in the receptacle, requiring an inhaled volume of about 1 L for fill masses between 40 and 50 mg and up to 3.2 L for a fill mass of 150 mg.

Hydroponic farming systems play an increasingly important role in the sustainable production of nutrient-rich foods. The contamination of surfaces in hydroponic fresh produce production poses risks to the food safety of crops, potentially endangering public health and causing economic losses in the industry. While sanitizers are widely used in commercial hydroponic farms, their effectiveness against human pathogens on surfaces, and their impact on plant health and quality are not known. In this study, we evaluated the efficacy of chemical sanitizers in eliminating Salmonella Typhimurium from inanimate surfaces in commercial hydroponic Nutrient Film Technique (NFT) systems. Further, we assessed the impact of sanitizers on the yield, quality, and nutritional value of lettuce and basil. Sanitizers (Virkon, LanXess; Sanitate 12.0, Bi-oSafe Systems; Kleen Grow, Pace Chemical Ltd.; Green Shield, United Labs Inc.; Zerotol, BioSafe Systems; Bleach, Pure Bright), were tested against Salmonella Typhimurium inoculated on NFT surfaces (nutrient reservoirs, growing channels, top covers, drain lines). The effective treatments were then tested for their impact on lettuce and basil in a split-plot experiment conducted in commercial NFT units. Crop yield, color, and nutrient content were measured throughout the crop life cycle. While all quaternary ammonium compounds (QAC), SaniDate 12.0 (200ppm), Zorotol (5%), and Virkon (1%) eliminated Salmonella Typhimurium from commercial NFT surfaces, chlorine-based sanitizer treatments were statistically similar to water treatments on most surfaces. All chemical sanitizers impacted the yield, color, and nutritional value of lettuce and basil. SaniDate 12.0 (200ppm) was the least detrimental to crops and was identified as a potential candidate for further validation in commercial hydroponic settings. The findings of this study will be translated into recommendations for the industry and will contribute to the development of future food safety guidelines and policies.

Culture exploits the acquisition of meaningful content by crafting regimes of shared attention, determining what is relevant, valuable, and salient. Culture changes the field of relevant social affordances worthy of being acted upon in a context-sensitive manner. When relevant affordances are highly weighted, their attentional capture and their salience increase the probability of them being enacted due to the associated expectation for minimizing prediction error. This process is known as active inference. In the digital era, individuals need to infer the action-related attributes of digital cues, here characterized as digital affordances. The digital affordances of digital social platforms are of particular interest here. Digital social affordances are defined as online possibilities of social interactions. By their own nature, these are salient because they are related to social interactions and relevant social cues. However, the problem of digital social platforms is that they are not equivalent to situated social interactions because their structure is built, mediated, and defined by third-parties with diverse interests. The third-parties behind the digital social platforms are using the same mechanism exploited by culture to manipulate the shared patterns of attention. Moreover, digital social platforms are deliberately designed to be hyper-stimulating, making digital social affordances highly rewarding and increasingly salient. This appropriation, for economic purposes, is an issue of great importance, especially as the COVID-19 pandemic brought deep global changes, pushing societies to an online digital way of life. Here, we examined different types of digital social affordances under an active inference view, placing them into two categories, those for self-identity formation, and those for belief-updating. This paper aims to analyze digital social affordances in light of the prediction error dynamics they might elicit to their users. Although each of the analyzed digital social affordances allows different epistemic and instrumental digital actions, they all share the characteristic of having an "easy" and a fast expected rate of error reduction. Here, we aim to provide a new hypothesis about how the design behind digital social affordances is built on our natural attractiveness to minimize prediction error and the resulting positive embodied feelings when doing so. Finally, it is suggested that because digital social affordances are becoming highly weighted in the field of affordances, this might be putting at risk our context-sensitive grip on a rich, dynamic and varied field of relevant affordances.

The prevalence of type-2 diabetes mellitus (T2D) is increasing worldwide and there are no long-term preventive strategies to stop this growth. Emerging research shows that perturbations in the gut microbiome significantly contribute to the development of T2D, while microbiome modulators may be beneficial for T2D prevention. However, microbiome modulators that are effective, safe, affordable, and able to be integrated daily in the diet are not yet available. Based on our previous pro- and prebiotic studies, we developed a novel synbiotic yogurt comprised of human-origin probiotics and plant-based prebiotics and investigated its impact on diet- and streptozotocin-induced T2D in mice. We compared the effects of our synbiotic yogurt to those of a commercially-available yogurt (control yogurt). Interestingly, we found that feeding of this synbiotic yogurt significantly reduced the development of hyperglycemia (diabetes) in response to high-fat diet feeding and streptozotocin compared to milk-fed controls. Surprisingly, the control yogurt exacerbated diabetes progression. Synbiotic yogurt beneficially modulated the composition of gut microbiota compared to milk; conversely, the control yogurt negatively modulated the gut microbiota by significantly increasing the abundance of detrimental bacteria like Proteobacteria and Enterobacteriaceae. In addition, the synbiotic yogurt protected intact pancreatic islet morphology compared to the milk control, while the commercial yogurt demonstrated worse effects on pancreatic physiology. These results suggest that our newly developed synbiotic yogurt protects against diabetes in mice and can be used as a modality to prevent diabetes progression.

Residential burns camp programmes provide help and support to children with burn injuries by providing activities designed to build their confidence and self-esteem. Our regional burns service has been running camps for over 20 years and evaluation is an important part of assessing their effectiveness. In this study we report both qualitative and quantitative data from 10 consecutive years of burns camps. Qualitative feedback was gathered using Likert scales and free response questionnaires at the end of camp and six weeks post-camp. Three quantitative outcome measures, the Paediatric Quality of Life Inventory v4, the Children’s Revised Impact of Event Scale (CRIES8) and the Satisfaction with Appearance Scale (SWAP) were completed before and six weeks after camp. Children and their parents/carers both reported attending burns camp was helpful for them/their child; the themes of meeting other children with burn injuries and developing confidence and self-esteem were cited as reasons. Parents/carers also reported significant improvements in their child’s physical and psychological functioning post-camp in some years. These findings confirm the importance of providing burns camp programmes for children with burn injuries as part of their post burn rehabilitation.

Antibiotic resistance is a persistent and growing concern. Our objective was to analyze antibiotic prescribing in the United States (US) in the Medical Expenditure Panel System (MEPS) and to Medicaid patients. We obtained total MEPS prescriptions for eight antibiotics from 2013 to 2020. We extracted prescribing rates per 1,000 Medicaid enrollees for two years, 2018 and 2019, for four broad spectrum (azithromycin, ciprofloxacin, levofloxacin, and moxifloxacin) and four narrow spectrum (amoxicillin, cephalexin, doxycycline, and trimethoprim/sulfamethoxazole) antibiotics. Antibiotics in MEPS decreased from 2013 to 2020 by -38.7% with a larger decline for broad (-53.7%) than narrow (-23.5%) spectrum. Antibiotic prescriptions in Medicaid decreased by -6.7%. Amoxicillin was the predominant antibiotic followed by azithromycin, cephalexin, trimethoprim/sulfamethoxazole, doxycycline, ciprofloxacin, levofloxacin, and moxifloxacin. Substantial geographic variation in antibiotic prescribing existed with 2.8-fold between the highest (Kentucky = 855/1,000) and lowest (Oregon = 299) states. The South prescribed 52.2% more antibiotics (580/1,000) than the West (381/1,000). There were significant correlations across states in antibiotic prescribing. This study identified sizable disparities by geography in prescribing rates of eight antibiotics with over three-fold state level differences. Areas with high antibiotic prescribing rates, particularly for outpatients, may benefit from stewardship programs to reduce potentially unnecessary prescribing.

The improved understanding of the underlying mechanisms of oxidative damage and/or chronic diseases is of high priority in dietary research. Although the chemical extraction of biofunctional molecules from different fruits and cereals have been studied extensively, the impact of food processing and digestion on bioactivity has not been studied systematically. The aim of this study was to investigate the biofunctional potential of blackcurrant powder incorporated into wholemeal wheat and barley cookies in after simulated in vitro digestion. The incorporation of blackcurrant significantly (p<0.05) increased the total phenolic content (about 60 %), significantly improved oxygen radical absorbance capacity (about 25 %) of the cookie digesta. Additionally cellular antioxidant and anti-proliferative activity (lowest EC₅₀ value 1.02 mg/mL) on human liver cancer cell model, HepG2 was significantly enhanced. Bioactive metabolites of blackcurrant incorporated cookies were significantly supressed the inflammatory cytokine genes IL-1β (about 3-fold), IL-6 (about 0.5-fold) and NF-kB (about 2-fold) regulation and upregulated satiety gene NUCB-2/Nesfatin-1 (about 5-fold) compare with wholemeal wheat and barley control cookies. The exerted synergistic effects of this study suggest that there may be a new and effective option to prevent and control chronic diseases in human.

Over the past 30 years, the use of field spectroscopy has risen in importance in remote sensing studies for the characterization of the surface reflectance of materials in situ within a broad range of applications. Potential uses range from measurements of individual targets of interest (e.g. vegetation, soils, validation targets etc.), to characterizing the contributions of different materials within larger spatially-mixed areas as would be representative of the spatial resolution captured by a sensor pixel (UAV to satellite scale). As such, it is essential that a complete and rigorous assessment of both the data-acquisition procedures, and the suitability of the derived data product be carried out. The measured energy from solar-reflected range spectroradiometers is influenced by the viewing and illumination geometries and the illumination conditions which vary due to changes in solar position and atmospheric conditions. By applying corrections, the estimated absolute reflectance (Rabs) of targets can be calculated. This property is independent of illumination intensity or conditions and is the metric commonly suggested to be used to compare spectra even when data are collected by different sensors or acquired under different conditions. By standardizing the process of estimated Rabs, as is provided in the described toolkit, consistency and repeatability in processing are ensured and the otherwise labor intensive and error-prone processing steps are streamlined. The resultant end data product (Rabs) represents our best current effort to generate consistent and comparable ground spectra which have been corrected for viewing and illumination geometries as well as other factors such as the individual characteristics of the reference panel used during acquisition.

Objective. The primary aim of this 6-month randomized, controlled, blinded clinical pilot study was to compare the percent root coverage obtained using an acellular dermal matrix allograft (ADM) and a coronally positioned tunnel (CPT) technique with two different suturing techniques. Materials and Methods. Sixteen patients with at least one Miller Class I or II recession defect ≥ 3 mm were randomly selected to receive a CPT with ADM using either two independent continuous sling sutures to secure the graft and the soft tissue separately (SEP) or a single continuous sling suture to secure both the graft and the soft tissue together (TOG) in the test group. Percent defect coverage, predictability of achieving 100% root coverage, keratinized tissue width, and attachment levels were assessed. Results. Both TOG and SEP suturing techniques achieved a significant amount of defect coverage, 83 vs. 85%, respectively, with no significant differences between groups. The predictability of achieving complete defect coverage was 63% for both groups. All maxillary sites had 100% coverage. There was a statistically significant gain of keratinized tissue for the TOG (1.1 ± 0.9 mm), while the SEP group gained only minimal amount (0.2 ± 0.8 mm). Conclusions. The single sling, for simultaneous suturing of the soft tissue and acellular dermal matrix, worked as well as two sling sutures used separately for the soft tissue and ADM. Suturing time was reduced by about 50% for the single sling group indicating a significant clinical advantage for the patient and surgeon.

Precision medicine seeks to use genomic data to help provide the right treatment to the right patient at the right time. Next-generation sequencing technology allows for the rapid and accurate sequencing of many genes at once. This technology is becoming more common in oncology, though the clinical benefit of incorporating it into precision medicine strategies remains under significant debate. In this manuscript, we discuss the early findings of the impact of next-generation sequencing on cancer patient outcomes. We investigate why not all patients with genomic variants linked to a specific therapy receive that therapy and describe current barriers. Finally, we explore the current state of health insurance coverage for individual genome sequencing and targeted therapies for cancer. Based on our analysis, we recommend increased transparency around the determination of “actionable mutations” and a heightened focus on investigating the variations in health insurance coverage across patients receiving sequencing-matched therapies.

Globally, over the past several months millions of persons contracted the coronavirus disease 2019 (COVID-19) resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as AST, ALT, GGT and ALP are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

Abstract: 1) Background. This research examined feasibility, acceptability and outcomes of delivering a 6-week yoga-based meditation intervention to clinical teams of hospice professionals (HPs) at a large non-profit hospice organization. The intervention was designed to increase mind-body integration and combat burnout. The manuscript was written for different audiences including research scientists who study interoception, burnout, meditation, or yoga, designers of meditation interventions, and hospice organizations looking for ways to mitigate HP burnout. 2) Methods. The intervention was launched within clinical teams, beginning with a half hour online introduction to the program and exposure to the week 1 meditation at each team’s monthly all-staff meeting. Throughout the program, HPs could access the meditations on their own via their workplace computers, tablets, and smartphones. Online pre- and post-intervention surveys with 151 HPs assessed burnout using the Professional Fulfillment Index and mind-body integration using the Multidimensional Assessment of Interoceptive Awareness sub-scales. 3) Results. Half of HPs expressed a desire to continue to have access to the meditations after the 6-week program ended. Due to covid-19 work from home restrictions, three-fourth of HPs did a meditation at home, 29% in a car between patient visits (not while driving), and 23% at the office. Higher interoceptive awareness was significantly related to lower burnout, particularly lower work exhaustion. Meditation frequency was significantly related to higher interoceptive awareness but not to burnout. 4) Conclusions. Findings showed that yoga-based meditation intervention was feasible and acceptable and associated with higher interoceptive awareness. The results point to a role for interoceptive awareness in reducing the risk for burnout.

Phylogenies depict shared evolutionary patterns and structures on a tree topology, enabling the identification of hierarchical and historical relationships. Recent analyses indicate that phylogenetic signals extend beyond the primary structure of protein or DNA, and various aspects of codon usage biases are phylogenetically conserved. Several functional biases exist within genes, including the number of codons that are used, the position of the codons, and the overall nucleotide composition of the genome. Codon usage biases can significantly affect transcription and translational efficiencies, leading to differential gene expression. Although systematic codon usage biases originate from the overall GC content of a species, ramp sequences, codon aversion, codon pairing, and tRNA competition also significantly affect gene expression and are phylogenetically conserved. We review recent advances in analyzing codon usage biases and their implications in phylogenomics. We first outline common phylogenomic techniques. Next, we identify several codon usage biases and their effects on secondary structure, gene expression, and implications in phylogenetics. Finally, we suggest how codon usage biases can be included in phylogenomics. By incorporating various codon usage biases in common phylogenomic algorithms, we propose that we can significantly improve tree inference. Since codon usage biases have significant biological implications, they should be considered in conjunction with other phylogenetic algorithms.

Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadien-3,5-dione], a component of Curcuma longa L. rhizomes, displays various biological and pharmacological activities. However, it is poorly bioavailable and unstable in physiological pH, which has led more stable and effective curcumin analogs (e.g., monoketone curcuminoids, or MKCs) to be synthesized, and their biological activities to be described. In this review, we cover papers published between 2019 and 2023 on the antimicrobial, anticancer, antioxidant, and antiparasitic actions as well as other less common MKC biological and pharmacological activities. We also address the Claisen-Schmidt condensation as a standard procedure to synthesize MKCs.

Background: A large majority of primary school pupils fail to achieve 30-minutes in-school moderate-to-vigorous physical activity (MVPA). The aim of this study was to investigate MVPA accumulation and subject frequency during academic lesson segments and the broader segmented school day. Methods: 122 children (42.6% boys; 9.9±0.3yrs) from six primary schools in North East England, wore uniaxial accelerometers for eight consecutive days. Subject frequency was assessed by teacher diaries. Multilevel models (children nested within schools) examined significant predictors of MVPA across each school-day segment (lesson one, break, lesson two, lunch, lesson three). Results: Pupils averaged 18.33±8.34 minutes of in-school MVPA and 90.2% failed to achieve the in-school 30-minute MVPA threshold. Across all school-day segments, MVPA accumulation was typically influenced at the individual level. Lesson one and two - dominated by Math and English - were less active than lesson three. Break and lunch were the most active segments. Conclusion: This study breaks new ground, revealing MVPA accumulation and subject frequency varies greatly during different academic lessons. Morning lessons were dominated by the inactive delivery of Math and English, whereas afternoon lessons involved a greater array of subject delivery that resulted in marginally higher levels of MVPA.

Herpes simplex virus type 1 (HSV-1) is a lifelong pathogen characterized by asymptomatic latent infection in the trigeminal ganglia (TG) with periodic outbreaks of cold sores caused by virus reactivation in the TG and subsequent replication in the oral mucosa. While antiviral therapies can provide relief from cold sores, they are unable to eliminate HSV-1. We provide experimental results that highlight non-thermal plasma (NTP) as a new alternative therapy for HSV-1 infection that would resolve cold sores faster and reduce the establishment of latent infection in the TG. Additionally, this study is the first to explore the use of NTP as a therapy that can both treat and prevent human viral infections. We investigated the antiviral effect of NTP using an in vitro model for HSV-1 cold sores, involving the application of NTP from two separate devices to cell-free HSV-1, HSV-1-infected cells, and uninfected cells. We found NTP reduced the infectivity of cell-free HSV-1, reduced viral replication in HSV-1-infected cells, and diminished the susceptibility of uninfected cells to HSV-1 infection. This triad of antiviral mechanisms of action suggest the potential of NTP as a therapeutic agent effective against HSV-1 infection.

The prevalence of autism has been increasing at an alarming rate. Even accounting for the expansion of autism spectrum disorder diagnostic (ASD) criteria throughout the 1990’s, there has been an over 300% increase in ASD prevalence since the year 2000. The often debilitating personal, familial, and societal sequelae of autism are generally believed to be lifelong. However, there have been several encouraging case reports demonstrating reversal of autism diagnoses with a therapeutic focus on addressing the environmental and modifiable lifestyle factors believed to be largely underlying the condition. This case report describes the reversal of autism among dizygotic, female twin toddlers and provides a review of related literature describing associations between modifiable lifestyle factors, environmental exposures, and various clinical approaches to treating autism. The twins were diagnosed with Level 3 severity ASD “requiring very substantial support” at approximately 20 months of age following concerns of limited verbal and non-verbal communication, repetitive behaviors, rigidity around transitions, and extensive gastrointestinal symptoms, among other common symptoms. A parent-driven, multidisciplinary, therapeutic intervention involving a variety of licensed clinicians focusing primarily on addressing environmental and modifiable lifestyle factors was personalized to each of the twin’s symptoms, labs, and other outcome measures. Dramatic improvements were noted within several months in most domains of the twins’ symptoms, which was manifested in reductions of Autism Treatment Evaluation Checklist (ATEC) scores from 76 to 32 in one of the twins and from 43 to 4 in the other twin. The improvement in symptoms and ATEC scores has remained relatively stable for six months at last assessment. While prospective studies are required, this case offers further encouraging evidence of ASD reversal through a personalized, multidisciplinary approach focusing predominantly on addressing environmental and lifestyle risk factors.

Recently, NOAA has included GNSS (Global Navigation Satellite System) Radio Occultation (RO) data as one of the crucial long-term observables for weather and climate applications. To include more GNSS RO data in the numerical weather prediction system, the NOAA Commercial Weather Data Pilot program (CWDP) started to explore the commercial RO data available on the market. After two rounds of pilot studies, the CDWP decided to award the first Indefinite Delivery Indefinite Quantity (IDIQ) contract to GeoOptics and Spire Incs. in 2020. This study examines the quality of Spire data products for weather and climate applications. Spire RO data are collected from commercial CubeSats through careful comparison with the data from Formosa Satellite Mission 7–Constellation Observing System for Meteorology, Ionosphere, and Climate-2 (COSMIC-2), ERA-5, and high-quality radiosonde data. The results demonstrated that although with lower Signal-Noise-Ratio (SNR) in general, the pattern of the lowest penetration height for Spire is similar to those for COSMIC-2. The Spire and COSMIC-2 penetrate heights are between 0.6 and 0.8 km altitude at the tropical oceans. Although using different GNSS RO receivers, the precision of Spire STRASP receivers is of the same quality as those of COSMIC-2 Global Positioning System - GPS, GALILEO, and GLObal NAvigation Satellite System – GLONASS (TGRS) receivers. The retrieval accuracy from Spire is very compatible with those from COSMIC-2. We validated Spire temperature and water vapor profiles by comparing them with collocated radiosonde data. Generally, over the height region between 8 km and 16.5 km, the Spire temperature profiles match those from RS41 RAOB very well with temperature biases &lt; 0.02 K. Over the height range from 17.8 to 26.4 km, the temperature differences are ~-0.034 K with RS41 RAOB being warmer. We also estimated the error covariance matrix for Spire, COSMIC-2, and KOMPSAT-5. Results showed that the COSMIC-2 estimated error covariance values are slightly more significant over the oceans at the mid-latitudes (45oN-30oN and 30oS-45oS), which may also be owing to COSMIC-2 SNR being lower at those latitudinal zones.

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goal in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n=42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat %: 24.2 ± 5.3%) and men (n=25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat %: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e. lose, maintain, gain weight). Athletes answered 47.98 ± 11.29 % of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p=0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (r = -0.330; p=0.008), and fat mass (r = -.268; p=0.032) was observed for all athletes. Fat mass (β = 0.224), BF % (β = 0.217), and BMI (β = 0.421) were all significant (p&lt;0.05) predictors of body weight goal in women. All athletes significantly (p&lt;0.001) underestimated daily energy (-1,360 ± 610.2 kcal/d), carbohydrate (-301.6 ± 149.2 g/d), and fat (-41.4 ± 34.5 g/d) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF %. Women athletes with a higher body weight, BF % and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.

Chronic wasting disease is a fatal transmissible spongiform encephalopathy (TSE) of cervids caused by a misfolded variant of the normal cellular prion protein, and is closely related to sheep scrapie. Variations in a host’s prion gene, PRNP, and its primary protein structure, dramatically affect susceptibility to specific prion disorders, and breeding for PRNP variants that prevent scrapie infection has led to steep declines in the disease in North American and European sheep. While resistant alleles have been identified in cervids, a PRNP variant that completely prevents CWD has not yet been identified. Thus, control of the disease in farmed herds traditionally relies on quarantine and depopulation. In CWD-endemic areas, depopulation of private herds becomes challenging to justify, leading to opportunities to manage the disease in situ. In the present study, we developed a selective breeding program for farmed white-tailed deer in a CWD-endemic area, focused on reducing frequencies of highly susceptible PRNP variants and introducing animals with less-susceptible variants into historically high prevalence areas. We found that breeding followed predictable Mendelian inheritance, and early data support our project’s utility in reducing CWD prevalence. This project represents a novel approach to CWD management, with future efforts building on these findings.

Feline immunodeficiency virus (FIV) is a naturally-occurring retrovirus that infects domestic and non-domestic feline species, producing progressive immune depletion that results in an acquired immunodeficiency syndrome (AIDS). Much has been learned about FIV since it was first described in 1987, particularly in regard to its application as a model to study the closely related lentivirus, human immunodeficiency virus (HIV). In particular, FIV and HIV share remarkable structure and sequence organization, utilize parallel modes of receptor-mediated entry, and result in a similar spectrum of immunodeficiency-related diseases due to analogous modes of immune dysfunction. This review summarizes current knowledge of FIV infection kinetics and mechanisms of immune dysfunction in relation to opportunistic disease, specifically in regard to studying HIV pathogenesis. Furthermore, we present data which highlight changes in the oral microbiota and oral immune system during FIV infection, and outline the potential for the feline model of oral AIDS manifestations to elucidate pathogenic mechanisms of HIV-induced oral disease. Finally, we discuss advances in molecular biology, vaccine development, neurologic dysfunction, and the ability to apply pharmacologic interventions and sophisticated imaging technologies to study experimental and naturally occurring FIV, which provide an excellent, but often overlooked resource for advancing therapies and management of HIV/AIDS.

Additive manufacturing (AM) provides opportunities to design objects differently than traditional manufacturing methods allow, but only if designers understand the possibilities AM presents. In this study, we examined whether an AM workshop combined with an idea generation session could inspire engineering professionals to use AM solutions to solve current technical problems they face. All subjects were employees at an organization that will be referred to as Company X, a multinational commercial organization based in North America. During the study, we collected ideas for 24 projects generated before and after a training workshop focused on design for AM. In the workshop, we provided three hours of instruction about design for two metal-based AM processes. The participants’ ideas were assessed using four specific metrics: (1) cost, (2) time,(3) completeness of solution, and (4) quality, which was a function of feasibility, usefulness, and novelty. Using these data, we explored whether the workshop was effective in inspiring the participants to use AM methods and techniques from AM research in their concept generation and whether participants’ AM solutions showed improvement in cost, implementation time, and quality over non-AM designs generated before the workshop.

Background: Recent work has investigated significant force transmission between the compo-nents of myofascial chains. Misalignments in the body due to fascial thickening and shortening can therefore lead to complex compensatory patterns. For the treatment of such nonlinear cause-effect pathology, a comprehensive neuro-musculoskeletal therapy such as the Rolf Meth-od of Structural Integration (SI) could be targeted. Methods: A total of 727 subjects were retro-spectively screened from the medical records of an SI practice over a 23-year period. 383 subjects who had completed 10 basic SI sessions met eligibility criteria and were assessed for active range of motion (AROM) of the shoulder and hip before and after SI treatment. Results: Shoulder flex-ion, external and internal rotation, and hip flexion improved significantly (all p < 0.0001) after 10 SI sessions. Left shoulder flexion and external rotation of both shoulders increased more in men than in women (p < 0.0001), but were not affected by age. Conclusions: SI intervention produces multiple changes in the components of myofascial chains that could help maintain upright pos-ture in humans and reduce inadequate compensatory patterns. SI affects differently the outcome of some AROM parameters in women and men.

Red beetroot, is a well-recognized and established source of bioactives (e.g., betalains and polyphenols) with anti-inflammatory and antimicrobial properties. It is proposed as a potential alternative to zinc oxide, with a focus on gut microbiota modulation and metabolite production. In this study, weaned pigs aged 28-days were fed either a control diet, diet supplemented with zinc oxide (3,000 mg/kg), or 2% and 4% pulverized whole red beetroot (CON, ZNO, RB2 and RB4; respectively) for 14 days. After the pigs were euthanized, blood and digesta samples were collected for microbial composition and metabolite analyses. Results showed, red beetroot supplemented diet at 2% improved the gut microbial richness relative to other diets, but marginally influenced the caecal microbial diversity compared to zinc oxide supplemented diet. Further increase in red beetroot levels (4% -RB4) lead to loss of caecal diversity, decreased short chain fatty acids and secondary bile acid concentrations. An increased Proteobacteria abundance, presumably due to increased lactate/lactic acid producing bacteria was also observed. Summarily, red beetroot contains several components conceived to improve the gut microbiota and metabolite output of weaned pigs. Future studies investigating individual components in red beetroot will better elucidate their contributions to gut microbiota modulation and pig health.

There is limited evidence for the association between malnutrition and hospital mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients’ nutritional status within 48 hours of ICU admission. Multivariate analyses were conducted in two ways: 1) presence versus absence of malnutrition, and 2) dose-dependent association for each 1-point decrease in the 7-point SGA. There were 439 patients of which 28.0% were malnourished, and 29.6% died before hospital discharge. Malnutrition was associated with an increased risk of hospital mortality [adjusted-RR 1.39 (95%CI: 1.10–1.76)], and this risk increased with a greater degree of malnutrition [adjusted-RR 1.09 (95%CI: 1.01–1.18) for each 1-point decrease in the 7-point SGA]. No significant association was found between malnutrition and ICU-LOS. Conclusion: There was a clear association between malnutrition and higher hospital mortality in critically ill patients. The association between malnutrition and ICU-LOS could not be replicated and hence requires further evaluation.

Carbon monoxide (CO) is a colorless, odorless gas emitted from carbon fuel combustion. In this study we monitored indoor carbon monoxide (CO) levels for 120 homes over three seasons in the North Denver metropolitan region as part of an environmental justice initiative to quantify health and social well-being impacts from a major freeway construction upgrade nearby. Urban outdoor CO levels are typically very low (less than 1 ppm in Denver) due to air pollution control strategies and technologies implemented over the past several decades. However, people can still be exposed to higher than outdoor levels of CO in their homes due to the operation of indoor appliances that use carbon fuels such as natural gas. Our data show that ~10% of the homes had consistent daily average levels of CO above 3.5 ppm and 24-57% of the homes showed peaks greater than 9 ppm. While much higher levels can result in CO poisoning and fatalities, these lower levels of CO have been associated with adverse health impacts, especially pregnant women, and sensitive populations. Our results highlight the need for increasing awareness regarding CO exposures in homes with gas appliances and motivate the transition from non-electrified homes toward electrification.

SARS-CoV-2 is a novel betacoronavirus and the aetiological agent of the current COVID-19 outbreak that originated in Hubei Province, China. While polymerase chain reaction is the front-line tool for SARS-CoV-2 surveillance, application of amplification-free and culture-free methods for isolation of SARS-CoV-2 RNA, partnered with next-generation sequencing, would provide a useful tool for both surveillance and research of SARS-CoV-2. We here release into the public domain a set of bait capture hybridization probe sequences for enrichment of SARS-CoV-2 RNA from complex biological samples. These probe sequences have been designed using rigorous bioinformatics methods to provide sensitivity, accuracy, and minimal off-target hybridization. Probe design was based on existing, validated approaches for detecting antimicrobial resistance genes in complex samples and it is our hope that this SARS-CoV-2 bait capture platform, once validated by those with samples in hand, will be of aid in combating the current outbreak.

Oxidative stress is increasingly implicated in male secondary infertility, where the seminal plasma altered proteome composition plays a critical role. This study aims to explore proteomic changes in the seminal plasma of fertile individuals with oxidative stress and secondary infertility patients, hypothesizing oxidative stress as a key factor in secondary infertility. Pooled semen samples from both groups underwent quantitative proteomics analysis using advanced mass spectrometry, with subsequent bioinformatic analysis using tools like DAVID, STRING, and IPA for identifying differentially expressed proteins (DEPs). The study identified 377 DEPs in the secondary infertile group and 523 DEPs in healthy controls, revealing seven mutual pathways including acute phase response signaling and free radical scavenging. Significant alterations were noted in proteins like C3 and SERPINA3, associated with sperm function and fertility. The findings suggest that oxidative stress-induced proteomic alterations in seminal plasma are linked to secondary infertility, highlighting potential biomarkers and therapeutic targets. This research underscores the importance of understanding the interplay between oxidative stress and seminal plasma proteins, potentially guiding personalized treatment strategies to improve fertility outcomes in affected individuals.

Age is the primary risk factor for neurodegenerative diseases such as Alzheimer’s and Huntington’s disease. Alzheimer’s disease is the most common form of dementia and a leading cause of death in the elderly population of the United States. No effective treatments for these diseases currently exist. Identifying effective treatments for Alzheimer’s, Huntington’s, and other neurodegenerative diseases is a major current focus of national scientific resources, and there is a critical need for novel therapeutic strategies. Here we investigate the potential for targeting the kynurenine pathway metabolite 3-hydroxyanthranilic acid (3HAA) using Caenorhabditis elegans expressing amyloid-beta or a polyglutamine peptide in body wall muscle, modeling proteotoxicity in Alzheimer’s and Huntington’s disease-related, respectively. We show that knocking down the enzyme that degrades 3HAA, 3HAA dioxygenase (HAAO) delays age-associated paralysis in both models. This effect on paralysis was independent of protein aggregation in the polyglutamine model. We also show that the mechanism of protection against proteotoxicity from HAAO knockdown is mimicked by 3HAA supplementation, supporting elevated 3HAA as the mediating event liking HAAO knockdown to delayed paralysis. This work demonstrates potential for 3HAA as a targeted therapeutic in neurodegenerative disease, though the mechanism is yet to be explored.

Although cancer care is often contextualized in terms of survival, there are other important cancer care outcomes, such as quality of life and cost of care. The ASCO Value Framework assesses the value of cancer therapies not only in terms of survival but with consideration of quality of life and financial cost. Early palliative care for patients with advanced cancer is associated with improved quality of life, mood, symptoms, overall survival, and cost savings. While palliative care has been shown to have numerous benefits, the impact of real-world implementation of outpatient embedded palliative care on value-based metrics is not fully understood. We sought to describe the association of outpatient embedded palliative care in a multidisciplinary thoracic oncology clinic on inpatient value-based metrics. We performed a retrospective cohort study of 215 patients being treated for advanced thoracic malignancies with non-curative intent. We evaluated the association of outpatient embedded palliative care with inpatient clinical outcomes including emergency room visits, hospitalizations, intensive care unit admissions, hospital charges, as well as hospital quality metrics including 30-day readmissions, admissions within 30 days of death, inpatient mortality, and inpatient hospital charges. Outpatient embedded palliative care was associated with lower hospital charges per day ($3,807 versus $4,695, p=0.024). Furthermore, patients who received outpatient embedded palliative care had decreased hospital admissions within 30 days of death (O.R. 0.50; 95% CI 0.34, 0.74; P<0.001) and decreased inpatient mortality (O.R. 0.46; 95%CI 0.23, 0.94; p=0.032). Our study further supports that outpatient palliative care is a high-value intervention and alternative models of palliative care, including one embedded into a multidisciplinary thoracic oncology clinic, is associated with improved value-based metrics.

Parental refusal of childhood vaccines is a growing public health concern. Numerous reasons exist for this refusal, including religious, personal, and philosophical beliefs, and safety concerns. However, parental refusal of childhood vaccines is not simply an individualized problem for the family; this impacts herd immunity and affects the entire community. To improve vaccination rates among the pediatric population, understanding the thought process and decision-making behind parental opposition and refusal of vaccinations is essential. Using a survey developed to assess attitudes towards recommended childhood vaccines and the COVID-19 vaccine, this study examined the correlation between vaccine literacy and hesitancy among parents and legal guardians of elementary school-aged children in the Midwest. Responses were analyzed using Chi-squared tests on “R” software. Significant negative correlations were found between COVID-19 hesitancy and vaccine literacy, and resistance towards all vaccines and vaccine literacy. No significant negative correlations were found between hesitancy towards all vaccines and vaccine literacy, or hesitancy and literacy among different income and education brackets. Our results suggest that vaccine education may lessen vaccine hesitancy among parents and may be an essential factor in improving vaccination rates among the pediatric population.

Cytochrome-c-oxidase (COX) subunit 4 (COX4) plays important roles in the function, assembly and regulation of COX (mitochondrial respiratory complex 4), the terminal electron acceptor of the oxidative phosphorylation (OXPHOS) system. The principal COX4 isoform, COX4-1, is expressed in all tissues, whereas COX4-2 is mainly expressed in the lungs, or under hypoxia and other stress conditions. We have previously described a patient with a COX4-1 defect with a relatively mild presentation compared to other primary COX deficiencies, and hypothesized that this could be the result of compensatory upregulation of COX4-2. To this end, COX4-1 was downregulated by shRNAs in human foreskin fibroblasts (HFF), and compared to patient's cells. COX4-1, COX4-2 and HIF-1α were detected by immunocytochemistry. The mRNA transcripts of both COX4 isoforms and HIF-1 target genes were carried out by RT-qPCR. COX activity and OXPHOS function were measured by enzymatic and oxygen consumption assays, respectively. Pathways were analyzed by CEL-Seq2 and by RT-qPCR. We demonstrate elevated COX4-2 levels in the COX4-1-deficient cells with a concomitant HIF-1α stabilization, nuclear localization and upregulated hypoxia and glycolysis pathways. We suggest that COX4-2 and HIF-1α has the are upregulated, also in normoxia as a compensatory mechanism in COX4-1 deficiency.

The COVID-19 pandemic period, from 2020 - 2022 had a significant impact on maternal infant health with mothers impacted more than their infants. We questioned whether there have been any lingering effects from the pandemic. We examined intermediate and long-term pandemic effects of maternal and neonatal outcomes before, during and after the COVID-19 pandemic period. We reviewed mother-infant pairs from three epochs: 1) the pre-COVID-19 period, 2) the COVID-19 pandemic period, and 3) the post-pandemic period. The Case Mix Index (CMI) for the neonates from all 3 epochs were detailed. Post-pandemic we noted a rising trend of LGA infants (10%), and an increase in SGA infants (13%). For women in 2023 we noted an increase in hypertension, preeclampsia, diabetes, and a higher BMI than the pre- pandemic period. There have also been more congenital anomalies (9%), and neonatal CMI increased in the post-pandemic period. Well after the pandemic period, maternal-infant health continues to be affected. For women, increase in hypertension and diabetes during pregnancy is concerning. For the infants, being LGA or SGA may have long-term consequences. The post-pandemic increase in infants with congenital anomalies compared to the pre-pandemic era is an area that needs ongoing review.

Survivors of severe brain injury may require care in a neurointensive care unit (neuro-ICU), where the brain is vulnerable to secondary brain injury. Thus, there is a need for noninvasive, bedside, continuous cerebral blood flow monitoring approaches in the neuro-ICU. Our goal is to address this need through combined measurements of EEG and functional optical spectroscopy (EEG-Optical) instrumentation and analysis to provide a complementary fusion of data about brain activity and function. The present case demonstrates in a patient with traumatic brain injury, noninvasive cerebral blood flow transients can be recorded that correlate with gold-standard invasive measurements and with the frequency content changes in the EEG data during clinical care.

In Hawaiʻi, the transition from customary subsistence flooded taro agroecosystems, which regulate stream discharge rate trapping sediment and nutrients, to a plantation-style economy (c. the 1840s) led to nearshore sediment deposition - smothering coral reefs and destroying adjacent coastal fisheries and customary fishpond mariculture. To mitigate sediment transport, Rhizophora mangle was introduced in estuaries across Hawai’i (c. 1902) further altering fishpond ecosystems. Here, we examine the impact of cultural restoration between 2012-2018 at Heʻeia Fishpond, a 600-800-year-old walled fishpond. Fishpond water quality was assessed by calculating water exchange rates, residence times, salinity distribution, and abundance of microbial indicators prior to and after restoration. We hypothesized that R. mangle removal and concomitant reconstruction of sluice gates would increase mixing and decrease bacterial indicator abundance in the fishpond. We find that Heʻeia Fishpond’s physical environment is primarily tidally driven; wind forcing and river flux are secondary drivers. Post-restoration, two gates in the northeastern region account for >80% of relative flux in the fishpond. Increase in exchange rates during spring and neap tide and shorter minimum water residence time corresponded with the reconstruction of a partially obstructed 56 m gap together with the installation of an additional sluice gate in the fishpond wall. Lower mean salinities post-restoration suggests increased freshwater influx due to R. mangle removal. Spatial distribution of microbial bio-indicator species inversely correlated with salinity. Average abundance of Enterococcus and Bacteroidales did not significantly change after restoration efforts, however, average abundance of a biomarker specific to birds nesting in the mangroves decreased significantly after restoration. This study demonstrates the positive impact of biocultural restoration regimes on water flushing and water quality parameters, encouraging the prospect of revitalizing this and other culturally and economically significant sites for sustainable aquaculture in the future.

Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, study suggested that the current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guideline (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators at four health systems to conduct quantitative surveys and qualitative interviews for context assessment. The identification of implementation strategies was done by applying the CFIR-ERIC Implementation Strategy Matching Tool and soliciting stakeholders’ inputs. We then co-designed with patients and frontline teams, developed and tested specific strategies. Results: 114 clinicians completed surveys and 32 clinicians and stake-holders participated in interviews. Results from the surveys and interview indicated low awareness of syncope guidelines, and communication challenges with patients, lack of CPG protocol integration into ED workflows, and organizational process to change were recognized as major barriers. Thirty-one patients and their family caregivers participated in interviews and ex-pressed their expectations: clarity regarding their diagnosis, context surrounding care plan and diagnostic testing, and a desire to feel cared about. After identifying change methods to address those barriers, the multilevel, multicomponent implementation strategy, MISSION, included pa-tient educational materials, mentored implementation, academic detailing, Syncope Optimal Care Pathway and corresponding Mobile App, and Lean quality improvement methods. The pilot of MISSION demonstrated feasibility, acceptability and initial success on appropriate testing. Con-clusions: Effect multifaceted implementation strategies that target individuals, teams, and healthcare systems can be employed to plan successful implementation and promote adherence to syncope CPGs.

Pediatric onset multiple sclerosis (POMS), characterized by the onset of multiple sclerosis before the age of 18, is gaining increased recognition. Approximately 5 percent of MS cases manifest before the age of 18, with less than 1 percent occurring before the age of 10. Despite its rarity, pediatric MS exhibits distinct characteristics, with an association between younger age at onset and a comparatively slower disease progression. Despite this slower progression, individuals with POMS historically reach disability milestones at earlier ages than those with adult-onset multiple sclerosis. While various immunomodulatory agents demonstrate significant benefits in MS treatment, such as reduced relapse rates and slower accumulation of brain lesions on magnetic resonance imaging (MRI), the majority of disease-modifying therapies (DMTs) commonly used in adult MS lack evaluation through pediatric clinical trials. Current evidence is predominantly derived from observational studies. This comprehensive review aims to consolidate existing knowledge on the mechanisms of action, efficacy, safety profiles, and recommended dosages of available DMTs specifically in the context of pediatric MS. Furthermore, the review outlines recent advancements and explores potential medications still in developmental stages, providing a thorough overview of the current landscape and future prospects for treating POMS.