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Inoculation theory, which applies the biological concept of vaccination to misinformation, provides a range of ways to effectively build resilience against misinformation. In this article, we define and organize the various types of inoculation, which includes three delivery mechanisms that can be useful in the classroom—passive, active, and experiential. In passive inoculations, students passively receive inoculating messages, whereas in active inoculations, students actively generate misinformation using misleading techniques. We introduce a new category of inoculation—experiential—which involves misleading students and then debriefing them on how they were misled. We then describe how these three techniques were implemented in a general education science class designed to teach critical thinking and science literacy. Through these activities, we illustrate how the different types of inoculation can be creatively combined to maximize student engagement and learning. [ABSTRACT FROM AUTHOR]

Although officer proximity to a grade 2 (non-emergency) incident is the primary metric used by dispatchers to allocate officers from deployment, other (informal) factors may influence the decision. The purpose of this research was to identify additional metrics that could be used to better match officer attributes to incident characteristics. Using a form of grounded theory, interviews with dispatchers in a single constabulary were used to identify 14 additional metrics that could be used in a formal decision-making process implemented through software assistance. The metrics broadly fell into the three categories of response time, officer attributes, and incident attributes. Dispatchers generally considered the introduction of a greater range of metrics implemented as software assistance to be beneficial but considered software decision-making tools to be unacceptable. We conclude that the weighting attached to each new metric relative to others should be tailored to the constabulary and operation group with which the dispatcher works. Overall, it is considered desirable to introduce a wider range of metrics through which dispatch of officers to non-emergency incidents may be managed. [ABSTRACT FROM AUTHOR]

This paper contributes new knowledge and understanding about the role that Product Passports might play in advancing sustainable business practices towards a Circular Economy. The significance of this research is the proposed universal definition of a Digital Product Passport Ecosystem (DPPE) for international policy, industrial and technical communities. The novelty of this research lies in the systems thinking approach, coupled with systems engineering, to define and model a DPPE as a System of Systems to derive a definition. Stakeholder perspectives and requirements concerning Product Passports were synthesised using data and analysis from the European Commission's (EC) open consultation on the Sustainable Products Initiative (SPI). Nine high-level capabilities of a DPPE have been identified, and each is explored by mapping a list of information requirements discussed within the consultation. It is shown that different Product Passport applications benefit (or detriment) different stakeholder groups. Findings suggest that DPPE solutions must be systemic, providing interoperability across multiple product life cycles, organisations, supply chains, and value chains in order to operate across international borders: thus realising benefits for world (circular) economies and the planet. Furthermore, it is proposed that if stakeholders utilise a universal definition of a DPPE in conjunction with a set of agreed ethical principles to underpin legislation, there would be fewer contradictions and ambiguity between stakeholders regarding the purpose of a Product Passport and the reasons for sharing data. Finally, the authors conclude that more research is needed on incentives for producers to share data and integrate their existing production systems with the broader ecosystem architectures to allow for maximum interoperability with minimal duplication. In addition, future research should determine specific DPP information requirements on a product-by-product basis, along with opportunities that a DPPE will enable towards industrial symbiosis. [Display omitted] • Novel holistic systems approach used to analyse worldviews of Digital Product Passports. • 9 system of system capabilities inherent but needs agreed sustainability principles. • A socio-technical ecosystem requiring values-based design for systemic change. • Needs architecting for legal, organisational, semantic and technical interoperability. • Different Passport applications benefit or detriment different stakeholder groups. [ABSTRACT FROM AUTHOR]

Misinformation about climate change is a consequential societal issue, causing polarization and reduced support for climate action. However, the seriousness of the problem does not preclude non-serious solutions. There are numerous potential benefits to humor as a strategy to counter misinformation, such as attracting attention and engaging disengaged audiences. This paper describes a humorous serious game—"Cranky Uncle"—developed in the U.S. to inoculate players against climate misinformation. The game combines psychological research into active inoculation, critical-thinking work on misleading rhetorical techniques, communication research into cartoon debunking, and gamification. The game's cartoon humor and the creative potential of active inoculation lends it to classroom applications; educators have thus used classroom activities to complement the game in order to improve students' climate literacy and critical-thinking abilities. We present several qualitative U.S.-based case studies, in formal English-speaking tertiary classrooms and informal public education settings, to illustrate the utility of a humorous, game-based approach to building resilience against climate misinformation. The approaches adopted in our case studies are offered as a model for other educators looking to use interactive games to teach critical thinking. [ABSTRACT FROM AUTHOR]

Intracerebral hemorrhage (ICH) is the most common form of hemorrhagic stroke, accounting for 15% of all strokes. ICH has the highest acute mortality and the worst long-term prognosis of all stroke subtypes. Unfortunately, the dearth of clinically effective treatment options makes ICH the least treatable formof stroke, emphasizing the need for novel therapeutic targets. Recent work by our laboratory identified a novel role for the necroptosis inhibitor, necrostatin-1, in limiting neurovascular injury in tissue culture models of hemorrhagic injury. In the present study, we tested the hypothesis that necrostatin-1 reduces neurovascular injury after collagenase-induced ICH in mice. Necrostatin-1 significantly reduced hematoma volume by 54% at 72 h after-ICH, as compared to either sham-injured mice or mice administered an inactive, structural analogue of necrostatin-1.Necrostatin-1 also limited cell death by 48%, reduced blood-brain barrier opening by 51%, attenuated edema development to shamlevels, and improved neurobehavioral outcomes after ICH. These data suggest a potential clinical utility for necrostatin-1 and/or novel necroptosis inhibitors as an adjunct therapy to reduce neurological injury and improve patient outcomes after ICH. [ABSTRACT FROM AUTHOR]

Highlights: [•] R-7050, a novel TNFR antagonist, reduces neurovascular injury after ICH. [•] Pharmacological inhibition of TNFR improves outcomes after ICH. [•] TNFR may represent a viable therapeutic target after ICH. [ABSTRACT FROM AUTHOR]

The last couple of years have brought a rise in the number of institutional repositories throughout the world and within UK Higher Education institutions, with the majority of these repositories being devoted to research output. Repositories containing teaching and learning material are less common and the workflows and business processes surrounding these types of repositories were unclear. The user motivations to contributing to and downloading from repositories were also unknown. This article reports on two studies: a wide- scale survey carried out with HE staff to identify barriers and incentives to contributing to teaching material repositories; and inter- views carried out as part of a workflow study at Loughborough University, to identify existing practice in the creation and sharing of teaching material. Confusion is reported with regard to the difference between a Virtual Learning Environment (VLE) and a repository. However, many different purposes of a teaching and learning material repository are highlighted. This article discusses how repositories could successfully interoperate with other institutional applications and highlights the benefits of teaching material repositories to the user, through scenarios. Recommendations relating to the key aspects of the design and implementation of a repository service are outlined. [ABSTRACT FROM AUTHOR]

Copyright of Obstetrics & Gynecology is the property of Lippincott Williams & Wilkins and Its content may not be copied or emailed to multiple sites or posted to a listserv without the Copyright holder's express written permission. [Extracted from the article]

The impact of CD4+ regulatory T cells (Tregs) on human immunodeficiency virus type 1 (HIV-1) pathogenesis remains incompletely understood. Although it has been shown that Tregs can be infected with HIV-1, the consequences of infection on a per-cell basis are still unknown. In vitro HIV-GFP infected and noninfected Tregs were isolated by flow-based cell-sorting to investigate Treg suppressive capacity and gene expression profiles. Our data show that HIV-1-infected Tregs were significantly less suppressive than noninfected Tregs and demonstrated down-regulation of genes critical to Treg function. This impaired function may have detrimental consequences for the control of generalized immune activation and accelerate HIV disease progression. [ABSTRACT FROM AUTHOR]

While modulation of regulatory T cell (Treg) function and adoptive Treg transfer are being explored as therapeutic modalities in the context of autoimmune diseases, transplantation and cancer, their role in HIV-1 pathogenesis remains less well defined. Controversy persists regarding their beneficial or detrimental effects in HIV-1 disease, which warrants further detailed exploration. Our objectives were to investigate if functional CD4+ Tregs can be isolated and expanded from HIV-1-infected individuals for experimental or potential future therapeutic use and to determine phenotype and suppressive capacity of expanded Tregs from HIV-1 positive blood and tissue. Tregs and conventional T cell controls were isolated from blood and gut-associated lymphoid tissue of individuals with HIV-1 infection and healthy donors using flow-based cell-sorting. The phenotype of expanded Tregs was assessed by flow-cytometry and quantitative PCR. T-cell receptor ß-chain (TCR-β) repertoire diversity was investigated by deep sequencing. Flow-based T-cell proliferation and chromium release cytotoxicity assays were used to determine Treg suppressive function. Tregs from HIV-1 positive individuals, including infants, were successfully expanded from PBMC and GALT. Expanded Tregs expressed high levels of FOXP3, CTLA4, CD39 and HELIOS and exhibited a highly demethylated TSDR (Treg-specific demethylated region), characteristic of Treg lineage. The TCRß repertoire was maintained following Treg expansion and expanded Tregs remained highly suppressive in vitro. Our data demonstrate that Tregs can be expanded from blood and tissue compartments of HIV-1+ donors with preservation of Treg phenotype, function and TCR repertoire. These results are highly relevant for the investigation of potential future therapeutic use, as currently investigated for other disease states and hold great promise for detailed studies on the role of Tregs in HIV-1 infection. [ABSTRACT FROM AUTHOR]

Abstract: Background: Increasing demand for emergency care and crowded emergency departments (EDs) lead some planners to conclude that inconvenient primary care scheduling increases the number of “unnecessary” ED visits. The reasons that the planners argue for more primary care are: to increase funding for primary care; the unfounded notion that it is less expensive to see a primary care physician (PCP) than an Emergency Physician; and the impractical goal that the ED should be used only by intellectually interesting life- or limb-threatened patients or “true emergencies.” Objective: To explore the rates of patient-reported access to primary care in ambulatory presentations to a rural tertiary care ED. Methods: An observational study was performed in which an anonymous survey was given to a convenience sample of patients who presented by walking into the ED. Results: Overall, 70.4% (686/975) of respondents stated that they had a PCP, and 38.1 % (252/661) of the sample had attempted to contact their physicians before presenting to the ED. Of the group who attempted to contact their physicians, 62.8% (130) were neither spoken to nor seen by any doctor. These rates did not change by time of presentation or by day of the week. Conclusion: The results suggest that it is neither a lack of primary care, nor the time of day or night that drives patients to come to the ED. [Copyright &y& Elsevier]

Résumé: Contexte: Les facteurs de risque de complications graves de l'infection par le SRAS-CoV-2 n'ont pas été bien établis chez les enfants. Nous avons voulu décrire les hospitalisations pédiatriques associées au SRAS-CoV-2 au Canada et identifier les facteurs de risque de maladie grave. Méthodes: Nous avons procédé à une étude prospective nationale en utilisant l'infrastructure du Programme canadien de surveillance pédiatrique (PCSP). Les hospitalisations d'enfants ayant contracté une infection par le SRAS-CoV-2 confirmée en laboratoire de microbiologie ont été rapportées du 8 avril au 31 décembre 2020 au moyen de questionnaires hebdomadaires en ligne distribués au réseau du PCSP, qui compte plus de 2800 pédiatres. Nous avons catégorisé les hospitalisations comme suit : liées à la COVID-19, infections découvertes fortuitement, ou hospitalisations pour des raisons sociales ou de contrôle des infections, et dégagé les facteurs de risque associés à la gravité de la maladie chez les patients hospitalisés. Résultats: Sur les 264 hospitalisations d'enfants ayant contracté le SRAS-CoV-2 au cours de la période de l'étude de 9 mois, 150 (56,8 %) ont été associées à la COVID-19 et 100 (37,9 %) étaient des cas découverts fortuitement (admission pour d'autres raisons et découverte fortuite du SRAS-CoV-2 par dépistage positif). Les nourrissons (37,3 %) et les adolescents (29,6 %) représentaient la majorité des cas. Parmi les hospitalisations liées à la COVID-19, 52 patients (34,7 %) étaient atteints d'une forme grave de la maladie, dont 42 (28,0 % des cas liés à la COVID-19) ont eu besoin d'une forme d'assistance respiratoire ou hémodynamique, et 59 (39,3 %) présentaient au moins 1 comorbidité sous-jacente. Les enfants atteints d'obésité, de maladies neurologiques chroniques ou de maladies pulmonaires chroniques, à l'exclusion de l'asthme, étaient plus susceptibles de présenter une forme grave ou critique de la COVID-19. Interprétation: Parmi les enfants hospitalisés au Canada chez lesquels on a diagnostiqué une infection par le SRAS-CoV-2 au début de la pandémie de COVID-19, la découverte fortuite du SRAS-CoV-2 a été fréquente. Chez les enfants hospitalisés pour une COVID-19 aiguë, l'obésité et les comorbidités neurologiques et respiratoires ont été associées à une gravité accrue. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to evaluate the effect of oral dexamethasone in attenuating palmar-plantar erythrodysesthesias (PPE) in Doxil®-treated patients for gynecologic malignancies.Methods. An IRB-approved prospective case study was conducted in patients with recurrent gynecologic malignancies who were treated with Doxil® (50 mg/m2) on a 28-day cycle. Patients experiencing grades II–IV PPE were delayed until resolution then retreated without dose reduction and with a tapering oral dexamethasone regimen (8 mg BID days -1 to 4; 4 mg BID day 5; 4 mg day 6). Standard treatment for grades II–IV PPE in those not receiving dexamethasone was weekly dose delay until resolution of symptoms up to 2 weeks. If resolution occurred within 3 weeks of delay, a 25% dose reduction was made. Persistent grades III/IV PPE resulted in withdrawal of Doxil®.Results. Twenty-three patients (ovarian-16, uterine-7) were treated between January 1998 and December 2000. The median number of cycles administered was 5 (range 1–20). Nine patients (39%) developed grades II–IV PPE. All nine patients received more than five cycles of Doxil®. The median time to PPE was 3 cycles (range 2–5). Six out of nine PPE patients received scheduled dose dexamethasone. All six had complete or near complete resolution of PPE and all continued treatment without subsequent dose modification. All three of the nine PPE patients not receiving dexamethasone required treatment delays and were dose reduced.Conclusion. Oral dexamethasone is effective in attenuating or eliminating Doxil®-induced PPE. The use of the dexamethasone regimen prevents treatment delay and dose reduction. [Copyright &y& Elsevier]

Background: Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease.Methods: We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital.Results: Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19.Interpretation: Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease. [ABSTRACT FROM AUTHOR]

The 2014-2015 epidemic of Ebola virus disease in West Africa primarily affected Guinea, Liberia, and Sierra Leone. Several countries, including Mali, Nigeria, and Senegal, experienced Ebola importations. Realizing the importance of a trained field epidemiology workforce in neighboring countries to respond to Ebola importations, the Centers for Disease Control and Prevention Field Epidemiology Training Program unit implemented the Surveillance Training for Ebola Preparedness (STEP) initiative. STEP was a mentored, competency-based initiative to rapidly build up surveillance capacity along the borders of the at-risk neighboring countries Côte d'Ivoire, Mali, Senegal, and Guinea-Bissau. The target audience was district surveillance officers. STEP was delivered to 185 participants from 72 health units (districts or regions). Timeliness of reporting and the quality of surveillance analyses improved 3 months after training. STEP demonstrated that mentored, competency-based training, where learners attain competencies while delivering essential public health services, can be successfully implemented in an emergency response setting. [ABSTRACT FROM AUTHOR]

Regulatory T cells (Tregs) are potent immune modulators, but their role in human immunodeficiency virus type 1 (HIV-1) pathogenesis remains poorly understood. We performed a detailed analysis of the frequency and function of Tregs in a large cohort of HIV-1–infected individuals and HIV-1 negative controls. While HIV “elite controllers” and uninfected individuals had similar Treg numbers and frequencies, the absolute numbers of Tregs declined in blood and gut-associated lymphoid tissue in patients with chronic progressive HIV-1 infection. Despite quantitative changes in Tregs, HIV-1 infection was not associated with an impairment of ex vivo suppressive function of flow-sorted Tregs in both HIV controllers and untreated chronic progressors. [ABSTRACT FROM PUBLISHER]

The 2014-2015 epidemic of Ebola virus disease in West Africa primarily affected Guinea, Liberia, and Sierra Leone. Several countries, including Mali, Nigeria, and Senegal, experienced Ebola importations. Realizing the importance of a trained field epidemiology workforce in neighboring countries to respond to Ebola importations, the Centers for Disease Control and Prevention Field Epidemiology Training Program unit implemented the Surveillance Training for Ebola Preparedness (STEP) initiative. STEP was a mentored, competency-based initiative to rapidly build up surveillance capacity along the borders of the at-risk neighboring countries Côte d'Ivoire, Mali, Senegal, and Guinea-Bissau. The target audience was district surveillance officers. STEP was delivered to 185 participants from 72 health units (districts or regions). Timeliness of reporting and the quality of surveillance analyses improved 3 months after training. STEP demonstrated that mentored, competency-based training, where learners attain competencies while delivering essential public health services, can be successfully implemented in an emergency response setting. [ABSTRACT FROM AUTHOR]