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We examine the association between aggressive tax planning and labor investment efficiency among U.S. firms. Labor is an important input to production that is material to many firms, and prior research suggests that inefficient labor investments can negatively affect future profitability and growth. We provide evidence that firms engaging in aggressive tax planning are associated with deviations from expected labor investments, which is indicative of labor investment inefficiency. We find that our results are concentrated in labor underinvestment, consistent with risks and uncertainties from aggressive tax planning making firms more cautious when investing. Our findings are strongest among firms with greater tax risk, higher labor costs, and weaker corporate governance. Our study contributes to the literature examining tax planning consequences by providing evidence that a tradeoff exists between aggressive tax planning and investments in labor. Therefore, our results suggest that managers should carefully consider the cash flow benefits of tax planning in conjunction with the potential effects of lower labor investments to ensure that the overall long-term effect of the tax strategy is value-increasing. [ABSTRACT FROM AUTHOR]

Copyright of Contemporary Accounting Research is the property of Canadian Academic Accounting Association 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. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Uranium-based materials are valuable assets in the energy, medical, and military industries. However, understanding their sensitivity to hydrogen embrittlement is particularly challenging due to the toxicity of uranium and the computationally expensive nature of quantum-based methods generally required to study such processes. In this regard, we have developed a Chebyshev Interaction Model for Efficient Simulation (ChIMES) that can be employed to compute energies and forces of U and UH3 bulk structures with vacancies and hydrogen interstitials with accuracy similar to that of Density Functional Theory (DFT) while yielding linear scaling and orders of magnitude improvement in computational efficiency. We show that the bulk structural parameters, uranium and hydrogen vacancy formation energies, and diffusion barriers predicted by the ChIMES potential are in strong agreement with the reference DFT data. We then use ChIMES to conduct molecular dynamics simulations of the temperature-dependent diffusion of a hydrogen interstitial and determine the corresponding diffusion activation energy. Our model has particular significance in studies of actinides and other high-Z materials, where there is a strong need for computationally efficient methods to bridge length and time scales between experiments and quantum theory. [ABSTRACT FROM AUTHOR]

Copyright of Contemporary Accounting Research is the property of Canadian Academic Accounting Association 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. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Scaffolded molecular networks are important building blocks in biological pigment–protein complexes, and DNA nanotechnology allows analogous systems to be designed and synthesized. System–environment interactions in these systems are responsible for important processes, such as the dissipation of heat and quantum information. This study investigates the role of nanoscale molecular parameters in tuning these vibronic system–environment dynamics. Here, genetic algorithm methods are used to obtain nanoscale parameters for a DNA-scaffolded chromophore network based on comparisons between its calculated and measured optical spectra. These parameters include the positions, orientations, and energy level characteristics within the network. This information is then used to compute the dynamics, including the vibronic population dynamics and system–environment heat currents, using the hierarchical equations of motion. The dissipation of quantum information is identified by the system's transient change in entropy, which is proportional to the heat currents according to the second law of thermodynamics. These results indicate that the dissipation of quantum information is highly dependent on the particular nanoscale characteristics of the molecular network, which is a necessary first step before gleaning the systematic optimization rules. Subsequently, the I-concurrence dynamics are calculated to understand the evolution of the vibronic system's quantum entanglement, which are found to be long-lived compared to these system–bath dissipation processes. [ABSTRACT FROM AUTHOR]

GeSnC alloys offer a route to direct bandgap semiconductors for CMOS-compatible lasers, but the use of CBr4 as a carbon source was shown to reduce Sn incorporation by 83%–92%. We report on the role of thermally cracked H in increasing Sn incorporation by 6x–9.5x, restoring up to 71% of the lost Sn, and attribute this increase to removal of Br from the growth surface as HBr prior to formation of volatile groups such as SnBr4. Furthermore, as the H flux is increased, Rutherford backscattering spectroscopy reveals a monotonic increase in both Sn and carbon incorporation. X-ray diffraction reveals tensile-strained films that are pseudomorphic with the substrate. Raman spectroscopy suggests substitutional C incorporation; both x-ray photoelectron spectroscopy and Raman suggest a lack of graphitic carbon or its other phases. For the lowest growth temperatures, scanning transmission electron microscopy reveals nanovoids that may account for the low Sn substitutional fraction in those layers. Conversely, the sample grown at high temperatures displayed abrupt interfaces, notably devoid of any voids, tin, or carbon-rich clusters. Finally, the surface roughness decreases with increasing growth temperature. These results show that atomic hydrogen provides a highly promising route to increase both Sn and C to achieve a strongly direct bandgap for optical gain and active silicon photonics. [ABSTRACT FROM AUTHOR]

Climate change (CC) is the most significant global issue facing humanity, yet research addressing the perspectives of the key players influential in developing and implementing school-based CC curricula at a cross-country national level is scarce. This study examined the perceptions of policymakers, teacher professional development providers and CCE teachers in relation to: CC knowledge, representation in the curriculum, content and pedagogy, and support for teaching. The voices of these educators were gathered across five countries (Australia, England, Finland, Indonesia, and Israel) through semi-structured interviews. Analysis revealed much commonality across the countries and across role types. Although participants agreed that CCE is multidisciplinary and expressed widespread support for including CC in the curriculum through a cross-curriculum approach, their conceptualisations of CC knowledge were inconsistent. Participants recognised the importance of a science basis in CCE, and of student action, with some participants also emphasising emotional, ethical and value-based inclusions. Most suggested active learning focused pedagogies. Variations in approaches to CC implementation between countries suggest that CCE is in a transitional phase. In all five countries, the interviewees called for the curriculum to make more explicit connections to CC and for governmental leadership in supporting CCE, professional development and provision of resources. [ABSTRACT FROM AUTHOR]

Enzyme replacement therapy (ERT) is the only approved disease-modifying treatment modality for Pompe disease, a rare, inherited metabolic disorder caused by a deficiency in the acid α -glucosidase (GAA) enzyme that catabolizes lysosomal glycogen. First-generation recombinant human GAA (rhGAA) ERT (alglucosidase alfa) can slow the progressive muscle degeneration characteristic of the disease. Still, most patients experience diminished efficacy over time, possibly because of poor uptake into target tissues. Next-generation ERTs aim to address this problem by increasing bis-phosphorylated high mannose (bis-M6P) N -glycans on rhGAA as these moieties have sufficiently high receptor binding affinity at the resultant low interstitial enzyme concentrations after dosing to drive uptake by the cation-independent mannose 6-phosphate receptor on target cells. However, some approaches introduce bis-M6P onto rhGAA via non-natural linkages that cannot be hydrolyzed by natural human enzymes and thus inhibit the endolysosomal glycan trimming necessary for complete enzyme activation after cell uptake. Furthermore, all rhGAA ERTs face potential inactivation during intravenous delivery (and subsequent non-productive clearance) as GAA is an acid hydrolase that is rapidly denatured in the near-neutral pH of the blood. One new therapy, cipaglucosidase alfa plus miglustat, is hypothesized to address these challenges by combining an enzyme enriched with naturally occurring bis-M6P N -glycans with a small-molecule stabilizer. Here, we investigate this hypothesis by analyzing published and new data related to the mechanism of action of the enzyme and stabilizer molecule. Based on an extensive collection of in vitro , preclinical, and clinical data, we conclude that cipaglucosidase alfa plus miglustat successfully addresses each of these challenges to offer meaningful advantages in terms of pharmacokinetic exposure, target-cell uptake, endolysosomal processing, and clinical benefit. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to test the effect of Seattle's discontinuous sidewalk requirement, on the number of housing units per construction permit. Design/methodology/approach: This study uses discontinuity linear regression (DLR) on a database of Seattle's housing construction permits during January-2015 to January-2018, controlled by 51 socioeconomic, planning and geographic variables. The sidewalk requirement is continuous inside the designated urban villages; however, it is spatially and quantitatively discontinuous in the rest of the city: certain blocks at certain locations require sidewalks' design and construction in permits with six or more housing units. DLR detects the effect of the discontinuity while controlling for a vast array of confounding variables. Findings: The primary finding is that the discontinuous requirement reduces the number of housing units in about 75% of a housing unit per permit, which at the aggregate level amounts to around 335 fewer housing units during the period of analysis. Research limitations/implications: The database is relatively small, which has limited a more thorough specification process and robustness tests. Originality/value: Besides directly testing the effect of a discontinuous in-kind development contribution, the research setup allows to discuss a wider, more structural problem: the possibility of contributions avoidance due to spatial substitution. In contrast, spatially continuous (i.e. city-level) contributions cannot be avoided by performing spatial substitution, and they are internalized by the housing supply side (market-neutral). [ABSTRACT FROM AUTHOR]

Purpose: The inclusion of quality improvement (QI) and patient safety (PS) into CanMEDS reflects an expectation that graduating physicians are competent in these areas upon training completion. To ensure that Canadian postgraduate specialty training achieves this, the translation of QI/PS competencies into training standards as part of the implementation of competency-based medical education requires special attention. Methods: We conducted a cross-specialty, multi-method analysis to examine how QI/PS was incorporated into the EPA Guides across 11 postgraduate specialties in Canada. Results: We identify cross-specialty variability in how QI/PS is incorporated, positioned, and emphasized in EPAs and milestones. QI/PS was primarily referenced alongside clinical activities rather than as a sole competency or discrete activity. Patterns were characterized in how QI/PS became incorporated into milestones through repetition and customization. QI/PS was also decoupled, conceptualized, and emphasized differently across specialties. Conclusions: Variability in the inclusion of QI/PS in EPAs and milestones has important implications considering the visibility and influence of EPA Guides in practice. As specialties revisit and revise EPA Guides, there is a need to balance the standardization of foundational QI/PS concepts to foster shared understanding while simultaneously ensuring context-sensitive applications across specialties. Beyond QI/PS, this study illuminates the challenges and opportunities that lie in bridging theoretical frameworks with practical implementation in medical education, prompting broader consideration of how intrinsic roles and emergent areas are effectively incorporated into competency-based medical education. [ABSTRACT FROM AUTHOR]

PROPEL (ATB200-03; NCT03729362) compared the efficacy and safety of cipaglucosidase alfa plus miglustat (cipa + mig), a two-component therapy for late-onset Pompe disease (LOPD), versus alglucosidase alfa plus placebo (alg + pbo). The primary endpoint was change in 6-min walk distance (6MWD) from baseline to week 52. During PROPEL, COVID-19 interrupted some planned study visits and assessment windows, leading to delayed visits, make-up assessments for patients who missed ≥ 3 successive infusions before planned assessments at weeks 38 and 52, and some advanced visits (end-of-study/early-termination visits). These were remapped to the respective planned visits. To evaluate if remapping may have overestimated treatment effects, we conducted post hoc analyses using a mixed-effect model for repeated measures based on actual time points of assessments. In this post hoc analysis, estimated mean treatment difference between cipa + mig and alg + pbo for change from baseline to week 52 in 6MWD was 11.7 m (95% confidence interval [CI] − 1.0 to 24.4; p = 0.072). In the original published analyses, between-group difference using last observation carried forward was 13.6 m (95% CI − 2.8 to 29.9; p = 0.071 [p value from separate non-parametric analysis of covariance]). Both statistical analysis approaches led to similar results and consistent conclusions, confirming the efficacy of cipa + mig for adults with LOPD. NCT03729362; trial start date: December 4, 2018. Trial registration number [ABSTRACT FROM AUTHOR]

Objective: Head and neck cancers (HNCs) have increased in prevalence and often require free‐flap reconstruction (FFR) after tumor ablation. Postoperative complications following FFR can be high, occurring in as many as 48% and 71% of cases. HNC patients also have many disparities in Social Determinants of Health (SDOH), but the potential impact of SDOH disparities on postoperative complications following FFR has not been formally assessed. Study Design: Retrospective cohort review. Setting: Academic Tertiary Care Institution in Northeast United States. Methods: Patients that underwent head and neck FFR between January 2018 and December 2021 were analyzed to determine associations between quartiles of the national Area Deprivation Index (ADI), a proxy for SDOH disparity, and various medical and surgical postoperative complications. Associations were assessed using χ2 analysis. Results: Two hundred four patients were included in the study, and 61 patients had 97 complications. Significant associations between higher national ADI quartile and incidence of several postoperative complications were identified, including any surgical complication (P =.0419), wound dehiscence (P =.0494), myocardial infarction (MI) (P =.0215), and sepsis (P =.0464). Conclusion: There are significant associations between SDOH disparities and postoperative surgical complications, wound dehiscence, MI, and sepsis following head and neck FFR. Addressing SDOH disparities in HNC is pivotal to enhance postoperative outcomes and promote holistic patient care. [ABSTRACT FROM AUTHOR]

Alissa Klots' book "Domestic Service in the Soviet Union: Women's Emancipation and the Gendered Hierarchy of Labor" explores the role of domestic workers in Soviet socialism, highlighting the challenges faced by women balancing household labor and waged work. Klots examines the evolution of domestic service from the Revolution through the postwar years, emphasizing the state's efforts to regulate and protect domestic workers. The book sheds light on the complex dynamics of domestic labor, gender roles, and socialist ideals in Soviet history, offering a nuanced perspective on the significance of domestic work within the broader context of socialist development. [Extracted from the article]

Background: While often used, Hilgenreiner's line may not always be a reliable reference plane following triple innominate pelvic osteotomy or trauma to the triradiate cartilage. The inferior sacral-iliac line is a horizontal line connecting the sclerotic corners of the inferior sacral-iliac joints. This is a consistent landmark in the ossifying infant pelvis as well as the fully developed adult pelvis. The goal of this study was to determine if there is a difference in measurements between the inferior sacral-iliac line and Hilgenreiner's line in order to identify an alternative horizontal reference plane. Methods: 3 reviewers (fellowship-trained paediatric orthopaedic surgeon, junior orthopaedic resident, senior orthopaedic resident) reviewed 100 paediatric non-osteotomized pelvises. The difference between Hilgenreiner's line and the inferior sacral-iliac line were measured and reported. Measurements were repeated a minimum of 48 hours apart, resulting in 600 comparisons between Hilgenreiner's line and the inferior sacral-iliac line. The standard error of measurement was calculated to assess the variation in measurements between each individual observer and the group as a whole. Results: The mean standard error of measurement between Hilgenreiner's line and the inferior sacral-iliac line was 0.44° (95% CI, ± 0.86). Reviewers 1–3 demonstrated a mean standard error of measurement of 0.38, 0.28, and 0.35 (95% CI, ± 0.74, 0.55, and 0.86) respectively. There was no statistically significant difference between reviewers (p > 0.05). Intra-observer reliability for reviewers 1, 2, and 3 was 0.64 (0.47–0.76), 0.75 (0.63–0.83), and 0.54 (0.32–0.69) respectively, with an inter-observer reliability of 0.42 (0.20–0.60) degrees. Conclusions: In this proof-of-concept study, the inferior sacral-iliac line was found to be an appropriate alternative to Hilgenreiner's line that is easily identifiable for all levels of orthopaedic training. Future inferior sacral-iliac line studies should demonstrate the reliability of multiple acetabular measurements, both pre- and post-osteotomy. [ABSTRACT FROM AUTHOR]

The public sphere has become increasingly digitalized and transformed by the intermeshing of social media platforms and mobile devices cultivating reimagined selves. The negative impact of living in a deeply mediatized world has fostered a phenomenon both in the public mind and academic discourse known as "fear of missing out" or by its acronym FoMO. Historically, and consistent with the "media effects" tradition, hundreds of studies have highlighted the psychological and behavioral dimensions of this construct, noting its negative effects. In opposition to the "effects" paradigmatic studies, we utilize social constructionist mediatization theory and Q methodology as frameworks for audience research that foreground subjectivity and understandings concerning the mediations of FoMO as a sociocultural construct. A total of 37 millennials and post-millennials Q sorted 55 statements resulting in three selfhood factors. Both dominant and counter "hegemonic" accounts were uncovered in the factors, respectively, identified as envy/exclusion, grounded vigilance, and managed vulnerability. [ABSTRACT FROM AUTHOR]

The article discusses urethral obstruction as a potential complication following surgery for stress urinary incontinence in women. It highlights the challenges in diagnosing and treating this condition, emphasizing the importance of timely recognition and intervention. Various surgical techniques, including urethrolysis, are described for addressing iatrogenic bladder outlet obstruction. Patient presentation, evaluation, and postoperative outcomes are also discussed, providing a comprehensive overview of managing this complication. [Extracted from the article]

An inequity persists between women and men in nearly all scientific fields. A clear indicator of this bias is the disparity between women and men in authorship of scientific papers, as publications are a critical part of a researcher's career. Our objective was to describe gender equity (sensu women, men) in wildlife‐related publishing in recent decades. We reviewed all research articles published in The Journal of Wildlife Management (JWM) from 1999 through 2020 and collected author names, affiliated institutions, and study species taxa from each paper. To help understand representation by gender in publishing, we classified the gender of each author using the online tool Genderize.io. We then calculated the women‐to‐men ratio in publishing as first‐ and co‐authors across time. We further investigated whether there were biases by country, institution, and taxon of study species. Our results revealed that authorships were dominated by men 22 years ago, with 14 and 12 women/100 men for first‐ and co‐authorships, respectively, in 1999. Since then, apart from year‐to‐year fluctuations, the overall gap between women and men gradually narrowed until the mid‐2010s, reaching approximately 60 and 30 women/100 men for first‐ and co‐authorship, respectively. The percentage of women increased across institutions, taxa, and countries during the study; however, the percentages of women associated with each institution type and most wildlife taxa were lower than the percentages of men. Although it is encouraging to see the improvement in equity in publishing since 1999, there are still substantially more men publishing than women, which indicates there is still a need to remedy known barriers and identify additional barriers that contribute to publication inequity. [ABSTRACT FROM AUTHOR]

Protein phosphatase 2 regulatory subunit B56δ related neurodevelopmental disorder (PPP2R5D‐related NDD) is largely caused by de novo heterozygous missense PPP2R5D variants. We report medical characteristics, longitudinal adaptive functioning, and in‐person neurological, motor, cognitive, and electroencephalogram (EEG) activity for PPP2R5D‐related NDD. Forty‐two individuals (median age 6 years, range = 0.8–25.3) with pathogenic/likely pathogenic PPP2R5D variants were assessed, and almost all variants were missense (97.6%) and de novo (85.7%). Common clinical symptoms were developmental delay, hypotonia, macrocephaly, seizures, autism, behavioral challenges, and sleep problems. The mean Gross motor functional measure‐66 was 60.2 ± 17.3% and the mean Revised upper limb module score was 25.9 ± 8.8. The Vineland‐3 adaptive behavior composite score (VABS‐3 ABC) at baseline was low (M = 61.7 ± 16.8). VABS‐3 growth scale value scores increased from baseline in all subdomains (range = 0.6–5.9) after a mean follow‐up of 1.3 ± 0.3 years. EEG beta and gamma power were negatively correlated with VABS‐3 score; p < 0.05. Individuals had a mean Quality‐of‐life inventory‐disability score of 74.7 ± 11.4. Twenty caregivers (80%) had a risk of burnout based on the Caregiver burden inventory. Overall, the most common clinical manifestations of PPP2R5D‐related NDD were impaired cognitive, adaptive function, and motor skills; and EEG activity was associated with adaptive functioning. This clinical characterization describes the natural history in preparation for clinical trials. [ABSTRACT FROM AUTHOR]

Background: Prospectively tracking errors can improve patient safety but little is known about how to successfully implement error reporting in a home-based palliative care context. Aim: Explore the feasibility of implementing an error reporting system in a home-based palliative care program in Toronto, Canada, and describe the possible factors that may influence uptake. Design: A convergent mixed-methods approach was used. Participants prospectively documented errors using a novel reporting tool and completed monthly surveys. Following the reporting period, we conducted a semi-structured interview exploring participants' experiences and perceived factors influencing reporting behaviors. Error, survey, and interview data were analyzed separately, then integrated for comparison. Setting and participants: Thirteen palliative care physicians from a single home-based palliative care organization in Toronto, Canada anonymously reported errors between October 2021 and September 2022. Of these, six participated in the exit interview. Results: Participants reported 195 errors; one-third (n = 65) involved internal staff or systems. Three themes describe the factors impacting the likelihood of reporting errors: (1) High levels of cognitive burden decreases the likelihood of error reporting; (2) Framing errors as opportunities to learn rather than reason for punishment improves likelihood of error reporting; (3) Knowing that error data will improve patient safety motivates individuals to report errors. Conclusions: Physicians are amenable to error reporting activities so long as data is used to improve patient safety. The collaborative nature of care in a home-based palliative care context may present unique challenges to translating error reporting to improved patient safety. [ABSTRACT FROM AUTHOR]

Introduction: The increased use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has extended to revision THA. This systematic review evaluated studies reporting both the utility and clinical outcomes of revision THA using DAA, focusing on studies comparing revision approaches. Materials and methods: A review of the Cochrane Library, EMBASE, and MEDLINE databases identified 577 publications. 538 were excluded after abstract screening. Full-text review identified 21 studies with 1627 patients. All studies were retrospective, level IV evidence. MINORS criteria rated 14 as poor and seven as moderate. Five studies compared DAA to alternative approaches. Meta-analysis was not performed due to significant heterogeneity and lack of comparative studies. Results: The most common indications for revision were aseptic loosening (n = 929) and polyethylene wear (n = 158). The majority of the studies (n = 11/21) performed primarily acetabular revision or head-liner exchanges. Half the revisions (50.6%; n = 823/1627) included femoral revisions (35.2%; n = 573/1627) or combined femoral-acetabular revisions (15.4%; n = 250/1627). However, 80.6% (n = 462/573) of femoral revisions were from two non-comparative studies. Among the five comparative studies, two included femoral or combined revisions with significantly more performed using the posterior approach. Three of the five comparative studies did not find the DAA protective against postoperative dislocation. The overall complication rate was 14.0%; periprosthetic femoral fracture (n = 106), dislocation (n = 80), and infection (n = 36) were most common. Fourteen studies reported patient-reported outcome measures, demonstrating consistent improvements following revision THA. Conclusions: Current data on revision DAA THA are limited due to their retrospective nature. They demonstrate the ability to safely perform acetabular and head-liner revisions in carefully selected patients. Comparative studies lack femoral revisions, show a propensity for femoral fractures, and exhibit selection bias. Higher-quality, comparative prospective studies are needed. Trial registration: PROSPERO: CRD4202236457. [ABSTRACT FROM AUTHOR]

Disparities in older age cognitive health by race/ethnicity persist even after controlling for individual-level indicators of childhood and adult socioeconomic status. High levels of labor market segregation mean that Black and Latino workers, on average, may not have the same exposure to jobs involving complex work with data and people as their White counterparts, aspects of work that appear to be protective of older adult cognition. However, the role of variation in exposure to occupational complexity by race/ethnicity remains understudied as an explanation for cognitive disparities at older ages. This paper uses detailed work histories constructed from the Health and Retirement Study (HRS) Occupation and Industry life history data to understand the role of occupational complexity in the development of dementia at older ages. It also addresses a conjecture that complexity reflects occupational status. Findings highlight that: (a) occupations involving complex work with data during working ages may be protective against dementia at older ages, potentially contributing to the differentials in dementia prevalence for Black, Latino, and White workers, and (b) occupational complexity reflects occupational status. This research increases understanding of the implications of labor market segregation for cognitive health disparities by race/ethnicity. [ABSTRACT FROM AUTHOR]

The essence of language and its evolutionary determinants have long been research subjects with multifaceted explorations. This work reports on a large-scale observational study focused on the language use of clinicians interacting with a phrase prediction system in a clinical setting. By adopting principles of adaptation to evolutionary selection pressure, we attempt to identify the major determinants of language emergence specific to this context. The observed adaptation of clinicians' language behaviour with technology have been confronted to properties shaping language use, and more specifically on two driving forces: conciseness and distinctiveness. Our results suggest that users tailor their interactions to meet these specific forces to minimise the effort required to achieve their objective. At the same time, the study shows that the optimisation is mainly driven by the distinctive nature of interactions, favouring communication accuracy over ease. These results, published for the first time on a large-scale observational study to our knowledge, offer novel fundamental qualitative and quantitative insights into the mechanisms underlying linguistic behaviour among clinicians and its potential implications for language adaptation in human-machine interactions. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic may have interfered with individuals' access to alcohol use disorder (AUD) treatment, but limited research has documented the impact of treatment interference on drinking behavior. This study's purpose was to examine the associations of AUD treatment interference with problematic alcohol use, and the moderating roles of perceived stress and resilience. Method: A cross-sectional survey design was employed. Data were drawn from the baseline assessment of the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study. Between June 2020 and March 2021, 288 participants (48.6% female, 51.4% male) responded to key measures of interest by phone and/or through an online survey. Study hypotheses were tested using multiple linear regression models adjusted for demographic characteristics (age, sex, race, ethnicity, years of education, household income, marital status), study enrollment phase, and history of AUD. Results: Self-reported AUD treatment interference was positively associated with problematic alcohol use as measured by the Alcohol Use Disorders Identification Test (b = 2.05, p < 0.001). Significant moderation effects indicated the association between AUD treatment interference and problematic alcohol use was stronger at a high level of perceived stress (b = 3.08, p < 0.001) and was attenuated at a high level of resilience (b = -0.13, p = 0.874). Conclusions: Self-reported AUD treatment interference may indicate interruption to individuals' support systems and highlight the need for continued access to treatment. Fostering positive coping strategies and resilience may help individuals mitigate risks of problematic drinking amidst a public health crisis. [ABSTRACT FROM AUTHOR]

Background: In the complex landscape of modern warfare, understanding combat-related injuries leading to hospitalization is crucial for optimizing injury treatment. This study aims to compare combat casualty characteristics and outcomes during the major conflicts between Israel and Hamas in 2023 and 2014 as a basis for understanding the effectiveness of trauma care practices for wounded soldiers. Methods: A cohort study of soldiers hospitalized due to combat injuries during two major wars between Israel and Hamas in 2023 and 2014, using data from the Israeli National Trauma Registry. This study did not include deaths before hospital arrival or casualties who were discharged from the Emergency Department. Results: Of the 1,198 study subjects, 67.8% belonged to the 2023 cohort and 32.2% to the 2014 cohort. The percentage of casualties with severe and critical injuries (Injury Severity Score [ISS] 16–75) was higher among the 2023 cohort (18.6% vs. 13.7%, p = 0.036), as was the percentage of casualties with multiple severe injuries (≥ 2 regions with Abbreviated Injury Score ≥ 3: 11.5% vs. 7.5%, p = 0.035) and firearm injuries (19.6% vs. 14.5%, p = 0.081). Injuries to the torso and extremities were more frequent among the 2023 cohort. Among the critically injured casualties (ISS 25–75), the mortality rates were 17.3% vs. 28.6%, respectively, for the 2023 and 2014 cohorts (p = 0.351); adjusted HR (95% CI): 0.56 (0.21–1.49). The 2023 cohort had higher rates for treatment in the trauma bay (61.5% vs. 47.9%, p < 0.001), ICU utilization (admission: 16.3% vs 11.7%, p = 0.036), surgical intervention (51.5% vs. 42.7%, p = 0.005), longer duration from arrival to surgery (median [interquartile range]: 4.6 (1.2–18.5) vs. 2.6 (1.1–10.1) hours, p = 0.037), and longer hospital stays (> 14 days: 15.5% vs. 8.8%, p < 0.001). Conclusions: Our data demonstrated that more casualties who survived to hospital arrival were severely and multiply injured in the 2023 Israel-Hamas war as compared to the 2014 war. Despite the increased severity, in-hospital survival did not worsen though there was an increase in hospital resource utilization. [ABSTRACT FROM AUTHOR]

Background: A direct comparison between glycemic-based and lipid-based insulin sensitivity indices (ISIs) for ECG findings and all-cause and cardiovascular mortality is lacking. Methods: 963 community-dwelling older adults, examined as part of the third phase of the Glucose intolerance, Obesity, and Hypertension study between 1999 and 2008, were followed until December 2016 and December 2019 for cardiovascular and all-cause mortality, respectively. Eleven different ISIs were calculated and evaluated against ECG findings, all-cause, and cardiovascular mortality with multivariable regression models. The area under the receiver operating curve (AUC) and net reclassification improvement (NRI) analysis were implemented to compare ISIs performance. Results: Mean age was 72.3 ± 7 years and 471 (49%) were females. Ischemic ECG changes were observed in 107 (11.2%) individuals. Upper quartile (Q4) of triglyceride-glucose waist-to-height ratio (TyG-WTHR) was associated with 220% greater odds for ischemic changes on ECG compared with lower quartiles (Q1-3) (95%CI:1.3–3.7, p = 0.004), an association that was not observed with other ISIs. During a median follow-up of 13 [IQR-8] and 11 [IQR-6] years for all-cause and CV mortality, respectively, 466 (48.4%) participants died, of them, 179 (38.4%) were attributed to cardiovascular causes. TyG-WTHR was the only ISI that was associated with both all-cause (HR = 1.3, 95%CI:1.0–1.6, p = 0.04) and cardiovascular (HR = 1.7, 95%CI:1.2–2.4, p = 0.004) mortality. Lipid based and glycemic ISIs showed similar predicative ability with slightly better predictive performance for TyG-WTHR for all-cause mortality (AUC = 0.46, 95%CI:0.4–0.5, p = 0.02). The NRI analysis revealed better reclassification ability for triglyceride-high-density-lipoprotein ratio (95%CI: 0.02–0.27, p = 0.03) and TyG-WTHR (95%CI: 0.0004–0.01, p = 0.03) for all-cause mortality while TyG-WTHR-based model correctly reclassified 19% of participants (95%CI: 0.02–0.36, p = 0.03) for cardiovascular mortality compared with model unadjusted for any ISIs and correctly reclassified 3% (95%CI:0.003–0.05, p = 0.02) compared with QUICKI based-model for all-cause mortality. Conclusions: TyG-WTHR was the only ISI associated with ischemic changes on ECG and all-cause and cardiovascular mortality and significantly improved the predictive performance for all-cause cardiovascular mortality. While most glycemic-based and lipid-based ISIs showed similar predictive ability, TyG-WTHR stands as the preferred ISI and should be considered for screening at-risk individuals for cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

The advent of large language models (LLMs) such as BERT and, more recently, GPT, is transforming our approach of analyzing and understanding biomedical texts. To stay informed about the latest advancements in this area, there is a need for up-to-date summaries on the role of LLM in Natural Language Processing (NLP) of biomedical texts. Thus, this scoping review aims to provide a detailed overview of the current state of biomedical NLP research and its applications, with a special focus on the evolving role of LLMs. We conducted a systematic search of PubMed, EMBASE, and Google Scholar for studies and conference proceedings published from 2017 to December 19, 2023, that develop or utilize LLMs for NLP tasks in biomedicine. We evaluated the risk of bias in these studies using a 3-item checklist. From 13,823 references, we selected 199 publications and conference proceedings for our review. LLMs are being applied to a wide array of tasks in the biomedical field, including knowledge management, text mining, drug discovery, and evidence synthesis. Prominent among these tasks are text classification, relation extraction, and named entity recognition. Although BERT-based models remain prevalent, the use of GPT-based models has substantially increased since 2023. We conclude that, despite offering opportunities to manage the growing volume of biomedical data, LLMs also present challenges, particularly in clinical medicine and evidence synthesis, such as issues with transparency and privacy concerns. [ABSTRACT FROM AUTHOR]

An atomic‐level understanding of radiation‐induced damage in simple polymers like polyethylene is essential for determining how these chemical changes can alter the physical and mechanical properties of important technological materials such as plastics. Ensembles of quantum simulations of radiation damage in a polyethylene analog are performed using the Density Functional Tight Binding method to help bind its radiolysis and subsequent degradation as a function of radiation dose. Chemical degradation products are categorized with a graph theory approach, and occurrence rates of unsaturated carbon bond formation, crosslinking, cycle formation, chain scission reactions, and out‐gassing products are computed. Statistical correlations between product pairs show significant correlations between chain scission reactions, unsaturated carbon bond formation, and out‐gassing products, though these correlations decrease with increasing atom recoil energy. The results present relatively simple chemical descriptors as possible indications of network rearrangements in the middle range of excitation energies. Ultimately, the work provides a computational framework for determining the coupling between nonequilibrium chemistry in polymers and potential changes to macro‐scale properties that can aid in the interpretation of future radiation damage experiments on plastic materials. [ABSTRACT FROM AUTHOR]

Background: Femoral torsional malalignment is a common cause of in-toeing and out-toeing in children, often leading to gait disturbances, functional limitations, and increased risk of falls. Traditionally, osteotomy was the only surgical option for correction. A minimally invasive technique known as rotational guided growth (RGG) has recently been introduced to address these malalignments. This study aims to assess the effectiveness of rotational femoral malalignment correction by rotational epiphysiodesis with tension band 8-plates (Orthofix, Verona, Italy). Methods: Eleven patients with in-toeing and out-toeing (19 femurs) were treated using RGG with 8-plates. The 8-plates were applied laterally and medially, with screws placed above and below the growth plate of the distal femur, angled obliquely to the long axis of the bone in opposite directions. Changes in foot progression angle (FPA), femoral version, the alteration in the angle between the 8-plates, and the rate of correction were recorded. Results: All patients reported functional gait improvement. The FPA was corrected from a mean of 32 degrees to 7 degrees, the femoral version improved from a mean of 60 degrees to 22 degrees. The angle between the 8-plates changed from a mean of 75 degrees to 28 degrees, with a correction rate of 4.1 degrees per month. The average time for correction was 11 months. No complications were observed during the treatment. Conclusions: RGG using 8-plates is a novel, minimally invasive surgical technique that effectively corrects rotational femoral deformities and may serve as a preferred alternative to derotational osteotomy in growing patients. [ABSTRACT FROM AUTHOR]

Background and Objectives Information communication technologies (ICTs) can enhance older adults' health and well-being. Most research on the use of voice-activated ICTs by older adults has focused on the experiences of individuals living in the community, excluding those who live in long-term care homes. Given evidence of the potential benefits of such technologies to mitigate social isolation and loneliness, more research is needed about their impacts in long-term care home settings. With this in mind, we evaluated impacts and engagement of older adults with voice- and touchscreen-activated ICTs in one long-term care home in Canada. Research Design and Methods Interviews were conducted with older adults who were provided with a Google Nest Hub Max and with staff as part of a larger implementation study. Participants completed semistructured interviews before the technology was implemented, and again at 6 and 12 months. The interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Results We found that residents primarily used the technologies to engage in self-directed digital leisure and to engage with others both in and outside the home, and that this in turn enhanced their comfort, pleasure, and social connectedness. We also identified ongoing barriers to their engagement with the technology, including both personal and structural factors. Discussion and Implications Our findings suggest that implementation of voice-activated ICTs can bring added value to broader efforts to improve well-being and quality of life in long-term care by enhancing choice, self-determination, and meaningful relationships. [ABSTRACT FROM AUTHOR]

The article "Climate Change and Health: Occupational and Environmental Medicine at the Frontlines" discusses the impact of climate change on health, particularly in the workplace. It highlights the role of Occupational and Environmental Medicine (OEM) specialists in identifying and mitigating workplace hazards related to climate change. The article emphasizes the importance of integrating climate health education into graduate medical education programs and suggests initiatives to enhance awareness and resilience to climate change. OEM specialists collaborate with various professionals to address climate-related health impacts and promote well-being through interdisciplinary approaches. [Extracted from the article]

Editing and revising is a necessary, yet complex, stage of the writing process that is challenging for students with and without disabilities. One solution to improve overall writing outcomes is with strategy instruction, such as the Strategic Instruction Model for writing. More specifically, strategies such as the Error Monitoring Strategy, that support editing and revising. Additionally, with the increase in access to devices, and the continued development of tools that support writing, these strategies should be aligned to technologies to further support students with learning disabilities and other struggling writers. Simply providing teaching strategies to students and providing them with devices is not enough to improve writing outcomes. Rather, explicit instruction in the strategy and the tool, along with how to use them together, is necessary.The purpose of this article is to offer an example of how educators can combine effective writing strategy instruction with readily and easily available technology tools to support the needs of students who struggle with writing. [ABSTRACT FROM AUTHOR]

The article critiques the coloniality embedded in traditional study abroad (SA) programs and argues for a decolonized approach to better serve Latinx and BIPOC students. Topics include the reimagining of SA spaces to support identity-affirming experiences for Latinx students, the practical strategies for creating heritage-seeking programs in Latin America, and the importance of local community engagement in rethinking SA program design.

Background: The purpose of this study was to understand antibiotic use in families presenting to the emergency department (ED) for odontogenic infection secondary to facial swelling requiring primary tooth extraction under sedation. Methods: A retrospective, observational study was completed at a tertiary-care children's hospital with a dental residency program. Children were identified through dental resident clinical logs from March 2021 to June 2023. Patients aged 1–13 years seen in the ED for extraction of a primary tooth due to odontogenic infection with facial swelling under sedation were included. Results: In a multivariable logistic regression, gender (for the purpose of this paper, gender refers to biological sex) and race were significantly associated with the absence of antibiotic use in patients presenting with facial swelling due to odontogenic infection. The odds of female patients not using antibiotics were approximately 80% lower than those of their male counterparts. Compared with Caucasians, African American (AA) patients had 82% high odds of having antibiotic use. Conclusions: Health inequities likely contribute to the significant difference in prior antibiotic use in Black/African American children presenting to the ED with facial swelling due to odontogenic infection. Female patients have been identified in some literature to have greater anxiety surrounding dental procedures. This may lead to infrequent/inconsistent dental care or inability to complete care without the use of an advanced dental management technique, which may explain the significant difference in odds in female patients presenting to the ED with facial swelling on antibiotics. Practical Implications: Antibiotic prescription with odontogenic infection. [ABSTRACT FROM AUTHOR]

Background: The association of body mass index (BMI) and an "obesity paradox" with cardiovascular risk prediction is controversial. This study aimed to evaluate the impact of elevated BMI on the outcome of transcatheter aortic valve replacement (TAVR) for aortic stenosis. Methods: This retrospective study included 1019 patients with a BMI of ≥18.5 kg/m² divided into 3 groups: 1) normal BMI (18.5-24.9 kg/m²), 2) overweight (25-29.9 kg/m²), and 3) obese (≥30 kg/m²). Propensity score matching was used to compare normal BMI with overweight and normal BMI with obese. Results: The median age of the cohort was 82 years, and 348 patients had a normal BMI, while 319 and 352 patients were overweight and obese, respectively. After 1 : 1 propensity score matching, 258 and 192 pairs between normal BMI and overweight, and normal BMI and obese patients, respectively, were analyzed. Both overweight and obese patients had higher post-transaortic mean gradients and lower indexed effective orifice areas compared to normal BMI patients. During a median follow-up of 25 (range: 0.1-72) months, all-cause mortality was similar between overweight or obese patients and patients with a normal BMI. However, in a subgroup analysis of patients with moderate/severe chronic lung disease, all-cause mortality was significantly higher in obese patients compared with normal BMI patients (hazard ratio = 3.49, 95% confidence interval, 1.21-10.0, P = .021). Conclusions: In this study, the "obesity paradox" was not observed in patients undergoing TAVR; rather, in patients with significant lung disease, obesity may be associated with worse mid-term outcomes after TAVR. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is one of the foremost causes of disability and mortality globally. While the scientific and medical emphasis is to save lives and avoid disability during acute period of injury, a severe health problem can manifest years after injury. For instance, TBI increases the risk of cognitive impairment in the elderly. Remote TBI history was reported to be a cause of the accelerated clinical trajectory of Alzheimer's disease-related dementia (ADRD) resulting in earlier onset of cognitive impairment and increased AD-associated pathological markers like greater amyloid deposition and cortical thinning. It is not well understood whether a single TBI event may increase the risk of dementia. Moreover, the cellular signaling pathways remain elusive for the chronic effects of TBI on cognition. We have hypothesized that a single TBI induces sustained neuroinflammation and disrupts cellular communication in a way that results later in ADRD pathology. To test this, we induced TBI in young adult CD1 mice and assessed the behavioral outcomes after 11 months followed by pathological, histological, transcriptomic, and MRI assessment. On MRI scans, these mice showed significant loss of tissue, reduced CBF, and higher white matter injury compared to sham mice. We found these brains showed progressive atrophy, markers of ADRD, sustained astrogliosis, loss of neuronal plasticity, and growth factors even after 1-year post-TBI. Because of progressive neurodegeneration, these mice had motor deficits, showed cognitive impairments, and wandered randomly in open field. We, therefore, conclude that progressive pathology after adulthood TBI leads to neurodegenerative conditions such as ADRD and impairs neuronal functions. [ABSTRACT FROM AUTHOR]

In this paper, we establish a C 1 , α -regularity theorem for almost-minimizers of the functional F ε , γ = P - γ P ε , where γ ∈ (0 , 1) and P ε is a nonlocal energy converging to the perimeter as ε vanishes. Our theorem provides a criterion for C 1 , α -regularity at a point of the boundary which is uniform as the parameter ε goes to 0. Since the two terms in the energy are of the same order when ε is small, we are considering here much stronger nonlocal interactions than those considered in most related works. As a consequence of our regularity result, we obtain that, for ε small enough, volume-constrained minimizers of F ε , γ are balls. For small ε , this minimization problem corresponds to the large mass regime for a Gamow-type problem where the nonlocal repulsive term is given by an integrable kernel G with sufficiently fast decay at infinity. [ABSTRACT FROM AUTHOR]

PURPOSE: Paired tumor-germline sequencing can identify somatic variants for targeted therapy and germline pathogenic variants (GPVs) causative of hereditary cancer/tumor predisposition syndromes. It is unknown how patients/families in pediatric oncology use information about an identified GPV. We assessed recall of germline results and actions taken on the basis of findings. METHODS: We completed phone surveys with patients (and/or their parent) with GPVs identified via a single academic medical center's paired tumor-germline sequencing study. Seven hundred forty pediatric (aged 0-25 years) oncology patients were enrolled in this sequencing study between May 2012 and August 2021. Ninety-six participants (13.0%) had at least one GPV identified and were therefore eligible for this survey. The parent/guardian (for patients younger than 18 years or deceased patients) or patients themselves (if 18 years or older) were contacted. Survey topics included germline result recall, experience with genetic counseling, changes to patient's cancer treatment/screening, sharing of results with family members, and lifestyle changes. RESULTS: Fifty-three surveys (response rate, 55.2%) were completed between October 2021 and June 2022. Thirty-seven (69.8%) respondents correctly recalled the identified GPV. Discussing results with a genetic counselor (P =.0001), having a GPV related to the cancer/tumor diagnosis (P =.002), and non-Hispanic White race/ethnicity (P =.02) were associated with accurate recall. Twenty-five respondents (47.2%) reported a change in the child's cancer treatment and/or screening recommendations, 17 respondents (32.1%) made a lifestyle change on the basis of the results, and 44 respondents (83.0%) shared results with at least one family member. CONCLUSION: While most respondents remembered that a GPV was identified in the patient, some did not recall having a GPV found, and others recalled germline findings incorrectly. Future work may determine patient/family preferences for timing/method of result return to optimize patient recall and use of germline results. Pediatric oncology family recall of germline findings varies by age of onset of hereditary cancer risk. [ABSTRACT FROM AUTHOR]

Couples in long‐distance relationships face unique challenges that affect their health outcomes and relationship dynamics in ways that are different from couples in close proximal relationships (PR). The results of previous literature analyzing health outcomes for long‐distance relationship (LDR) couples have been mixed, and factors such as couple satisfaction and gender of the individuals contribute to the variance. This study examined the good health practices of couples in LDRs, the ways in which partners influence each other's health, and the health outcomes of these couples as compared to couples in PRs. Multilevel multivariate analysis showed that couples in LDRs had better health practices than those in PRs, and men overall had poorer health practices than women. There was no main effect seen for LDRs when we examined strategies used for influencing health. There was a main effect for gender, though, and we found that women tend to use more collaborative and pressurizing strategies for influencing their partner's health. On health indices, we found that LDR couples tended to have lower levels of fatigue and sleep disturbance as compared to PR couples. In the adjusted model with covariates, which included age, income, couple satisfaction, and married or unmarried couples, we found that lower couple satisfaction and lower income significantly predicted poorer health on all health indices. These results are discussed in light of unequal gender roles, social control, and positive aspects of LDRs on health in an attempt to understand LDRs better and destigmatize the narrative of these relationships as 'less than' PRs. Implications for health and mental health practitioners are also discussed. [ABSTRACT FROM AUTHOR]

Progressive multifocal leukoencephalopathy is a demyelinating infection of the immunosuppressed brain, mediated by the gliotropic polyomavirus JCV. JCV replicates in human glial progenitor cells and astrocytes, which undergo viral T-antigen-triggered mitosis, enabling viral replication. We asked whether JCV spread might therefore be accelerated by glial proliferation. Using both in vitro analysis and a human glial chimeric mouse model of JCV infection, we found that dividing human astrocytes supported JCV propagation to a substantially greater degree than did mitotically quiescent cells. Accordingly, bulk and single-cell RNA-sequence analysis revealed that JCV-infected glia differentially manifested cell cycle-linked disruption of both DNA damage response and transcriptional regulatory pathways. In vivo , JCV infection of humanized glial chimeras was greatly accentuated by cuprizone-induced demyelination and its associated mobilization of glial progenitor cells. Importantly, in vivo infection triggered the death of both uninfected and infected glia, reflecting significant bystander death. Together, these data suggest that JCV propagation in progressive multifocal leukoencephalopathy might be accelerated by glial cell division. As such, the accentuated glial proliferation attending disease-associated demyelination might provide an especially favourable environment for JCV propagation, thus potentiating oligodendrocytic bystander death and further accelerating demyelination in susceptible hosts. [ABSTRACT FROM AUTHOR]

Objective: This review aims to emphasize the role of pharmacists for optimization of evidence-based outcomes of finerenone in multidisciplinary kidney care teams during the early detection process of CKD patients. Data Sources: A PubMed literature search was performed using keywords pharmacists, chronic kidney disease (CKD), type 2 diabetes (T2D), and finerenone. Study Selection and Data Extraction: All English-language studies on the role of pharmacists in managing CKD patients or finerenone prescriptions were evaluated. Data Synthesis: CKD is a major health problem affecting millions worldwide, especially those with T2D. In recent years, new drugs have been added to the treatment options for patients with T2D and CKD, which have been shown to reduce the risk of cardiovascular and renal complications in large clinical trials. Conclusions: Pharmacists can help detect and treat CKD in patients with T2D. They may use indicators to identify potential candidates for appropriate finerenone therapy, such as stage of CKD, albuminuria level, serum potassium concentration, and use of RAAS inhibitors. Pharmacists can provide education on the benefits and usage of finerenone, monitor response to therapy, adjust the medications and doses, prevent drug interactions, help with adherence and tolerability issues, and coordinate with other healthcare providers. [ABSTRACT FROM AUTHOR]