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Traditional methods for monitoring pathogens in environmental waters have numerous drawbacks. Sampling approaches that are low-cost and time efficient that can capture temporal variation in microbial contamination are needed. Passive sampling of aquatic environments has shown promise as an alternative water monitoring technique for waterborne pathogens and microbial contaminants. The present systematic review aimed to compile and synthesize existing literature on the use of passive samplers for the monitoring of microbes in different water sources and identify research gaps. The review summarizes current knowledge on materials used for detection, deployment durations, analytical methods, quantification as well as benefits and limitations of passive sampling. This review found that electronegative nitrocellulose membrane filters are effective for both detection and quantification of viruses in wastewater, while gauze passive samplers have been effective for detecting bacterial targets in wastewater. There is a large knowledge gap in the use of passive samplers in a quantitative manner, especially for the back-calculation of water-column microbial concentrations or for correlation to outcomes of interest (e.g. prevalence rates). Further, there is very limited attention paid to the use of membrane filters for the monitoring of bacteria in any water source as well as a lack of studies utilizing passive sampling approaches for protozoa., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Heather Murphy reports financial support was provided by Canada Research Chairs Program. Heather Murphy reports financial support was provided by Natural Sciences and Engineering Research Council of Canada. Heather Murphy reports financial support was provided by GIER University of Guelph. Heather Murphy reports a relationship with International Joint Commission that includes: board membership. Heather Murphy reports a relationship with Philadelphia Department of Public Health that includes: funding grants. David McCarthy is an editor for Water Research. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

The indiscriminate administration of broad-spectrum antibiotics is a primary contributor to the increasing prevalence of antibiotic resistance. Unfortunately, culture, the gold standard for bacterial identification is a time intensive process. Due to this extended diagnostic period, broad-spectrum antibiotics are generally prescribed to prevent poor outcomes. To overcome the deficits of culture-based methods, we have developed a rapid universal bacterial identification system. The platform utilizes a unique universal polymerase chain reaction (PCR) primer set that targets the internal transcribed spacer (ITS) regions between conserved bacterial genes, creating a distinguishable amplicon signature for every bacterial species. Bioinformatic simulation demonstrates that at least 45 commonly isolated pathogenic species can be uniquely identified using this approach. We experimentally confirmed these predictions on a representative set of pathogenic bacterial species. We also show that the system can determine the corresponding concentration of each pathogen. Finally, we validated performance in clinical urinary tract infection samples., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study critically examines the biases and methodological shortcomings in studies comparing deaf and hearing populations, demonstrating their implications for both the reliability and ethics of research in deaf education. Upon reviewing the 20 most-cited deaf-hearing comparison studies, we identified recurring fallacies such as the presumption of hearing ideological biases, the use of heterogeneously small samples, and the misinterpretation of critical variables. Our research reveals a propensity to based conclusions based on the norms of white, hearing, monolingual English speakers. This dependence upholds eugenics ideas and scientific ableism, which reinforces current power dynamics that marginalize the epistemologies and lived experiences of deaf populations. Going forward, it will be imperative for deaf people to be included in meaningful roles in deaf-related research as active contributors who help define the whole research process. Without this shift, the research risks remaining detached from the very populations it seeks to understand., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Open dumping and burning of solid waste are widely practiced in underserved communities lacking access to solid waste management facilities; however, the generation of microplastics from these sites has been overlooked. We report elevated concentrations of microplastics (MPs) in soil of three solid waste open dump and burn sites: a single-family site in Tuttle, Oklahoma, USA, and two community-wide sites in Crow Agency and Lodge Grass, Montana, USA. We extracted, quantified, and characterized MPs from two soil depths (0-9 cm and 9-18 cm). The average of abundance of particles found at community-wide sites three sites (18, 460 particles kg -1 soil) equals or exceeds reported concentrations from currently understood sources of MPs including biosolids application and other agricultural practices. Attenuated total reflectance Fourier transformed infrared (ATR-FTIR) identified polyethylene as the dominant polymer across all sites (46.2-84.8%). We also detected rayon (≤11.5%), polystyrene (up to 11.5%), polyethylene terephthalate (≤5.1), polyvinyl chloride (≤4.4%), polyester (≤3.1), and acrylic (≤2.2%). Burned MPs accounted for 76.3 to 96.9% of the MPs found in both community wide dumping sites. These results indicate that solid waste dumping and burning activities are a major source of thermally oxidized MPs for the surrounding terrestrial environment with potential to negatively affect underserved communities.

Background: Canine infectious respiratory disease complex (CIRDC) is a common respiratory condition typically associated with high-density populations., Objectives: The objectives of this study were to determine the most common pathogens involved in CIRDC and to identify risk factors (pathogens, environmental exposures) associated with the diagnosis., Animals and Procedure: A prospective, multi-clinic, case-control study was conducted in Canada from April 2017 to May 2018. A total of 110 dogs (74 cases, 36 controls) were enrolled by participating veterinary clinics. Pathogens were detected using a respiratory PCR panel., Results: Canine parainfluenza virus (CPIV), Bordetella bronchiseptica , and canine respiratory coronavirus (CRCoV) were detected in cases only. According to 2 logistic regression models, detection of CPIV (OR: 14.42; 95% CI: 2.24 to ∞) and CRCoV (OR: 8.64; 95% CI: 1.26 to ∞) were associated with CIRDC disease status. In another model, exposures to multiple-dog gatherings also increased the odds (OR: 3.39; 95% CI: 1.26 to 9.81) of CIRDC diagnosis., Conclusions: Consistent with other studies, this study determined that CPIV, CRCoV, and B. bronchiseptica were important contributors to CIRDC cases. Detection of CPIV and CRCoV and exposure to areas of dog gatherings were identified as having a role in disease status when evaluated statistically, under the conditions of this study., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Numerous tick species are undergoing significant range expansion in Canada, including several Dermacentor spp Koch (Acari: Ixodidae). With the recent description of Dermacentor similis Lado in the western United States, additional research is required to determine the current range of this species. Five hundred ninety-eight Dermacentor spp. were collected from companion animals in the western Canadian provinces of British Columbia, Alberta, and Saskatchewan. Ticks were morphologically identified to species, followed by PCR and gel electrophoresis of the ITS-2 partial gene target (n = 595). Ninety-seven percent (n = 579/595) generated valid banding patterns. The banding pattern for the majority (74%, n = 206/278) of Dermacentor spp. from southern British Columbia was consistent with D. variabilis (Say), while 26% (n = 72/278) was consistent with D. andersoni Stiles. For samples from Alberta, 38% (n = 3/8) had banding patterns consistent with D. variabilis and 63% (n = 5/8) with D. andersoni. All (n = 293) ticks from Saskatchewan had banding patterns consistent with D. variabilis. After the description of D. similis was published, DNA sequencing of mitochondrial (16S rDNA gene, COI gene) and nuclear (ITS-2) markers was used to confirm the identity of 40 samples. Twenty-seven samples that had banding patterns consistent with D. variabilis from British Columbia were confirmed to be D. similis. One sample from Alberta and five from Saskatchewan were confirmed to be D. variabilis and seven samples from British Columbia were D. andersoni. The ITS-2 amplicons were not useful for differentiating between D. variabilis and D. similis. These results provide evidence of D. similis in western Canada and highlight that sequences of the mitochondrial genes are effective for distinguishing D. andersoni, D. variabilis, and D. similis., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America.© His Majesty the King in Right of Canada, as represented by the Minister of Agriculture and Agri-Food Canada, 2024.)

Functional neurological disorder (FND) is a heterogenous group of disorders with limitations in one or more neurologic systems without a structural or anatomic cause. Elements of diagnosis, evaluation and management are similar between children and adults though diagnostic considerations can be more complex with suspected FND in adults. This article will focus on issues specific and relevant to adults.

Background: Bipolar Disorder (BD) is associated with alterations of circadian rhythms of activity (CRA). Experimental research suggests that lithium (Li) modifies CRA, but this has been rarely explored in BD using actigraphy., Methods: The sample comprised 88 euthymic BD-I cases with 3 weeks of actigraphy. We used a Principal Component Analysis (PCA) to generate CRA dimensions. We then used linear regression analyses to compare these dimensions between groups of individuals defined according to prescribed mood stabilizers: Li monotherapy ("Li" group, n = 28), anticonvulsant or atypical antipsychotic monotherapy ("AC or AAP" group, n = 27) or combined treatments ("Li+AC or Li+AAP" group, n = 33). Analyses were adjusted for potential confounders (gender, age, body mass index, depressive symptoms, co-prescribed benzodiazepines and antidepressants, smoking status and past alcohol use disorder)., Results: The PCA identified two dimensions: "robust CRA" (high amplitude and interdaily stability, with low intradaily variability) and "late chronotype". Univariate analyses showed higher scores for "robust CRA" in the "Li" versus the "AC or AAP" (p = 0.021) or "Li+AC or Li+AAP" groups (p = 0.047). These findings remained significant after adjustments (respectively p = 0.010 and p = 0.019). Post-hoc analyses suggested lower variability, higher stability and higher amplitude of CRA in the "Li" group. Medication groups were similar for the "late chronotype" dimension (p = 0.92)., Conclusions: This actigraphy study is the first to show more favorable CRA in BD-I individuals receiving a Li monotherapy when compared with those receiving other classes or combinations of mood stabilizers. Replications in larger samples are required. Prospective studies are also warranted to elucidate whether the introduction of Li or other mood stabilizers might influence CRA in BD-I., Competing Interests: Declaration of competing interest B.E. has received honoraria for consulting from Sanofi. F.B. is an advisor on mental health to the French government. All other authors have no conflict of interest regarding this work., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The coronavirus disease 2019 pandemic highlighted the need for more rapid and routine application of modeling approaches such as quantitative microbial risk assessment (QMRA) for protecting public health. QMRA is a transdisciplinary science dedicated to understanding, predicting, and mitigating infectious disease risks. To better equip QMRA researchers to inform policy and public health management, an Advances in Research for QMRA workshop was held to synthesize a path forward for QMRA research. We summarize insights from 41 QMRA researchers and experts to clarify the role of QMRA in risk analysis by (1) identifying key research needs, (2) highlighting emerging applications of QMRA; and (3) describing data needs and key scientific efforts to improve the science of QMRA. Key identified research priorities included using molecular tools in QMRA, advancing dose-response methodology, addressing needed exposure assessments, harmonizing environmental monitoring for QMRA, unifying a divide between disease transmission and QMRA models, calibrating and/or validating QMRA models, modeling co-exposures and mixtures, and standardizing practices for incorporating variability and uncertainty throughout the source-to-outcome continuum. Cross-cutting needs identified were to: develop a community of research and practice, integrate QMRA with other scientific approaches, increase QMRA translation and impacts, build communication strategies, and encourage sustainable funding mechanisms. Ultimately, a vision for advancing the science of QMRA is outlined for informing national to global health assessments, controls, and policies., (© 2024 The Author(s). Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

Background: For rare neuro-endovascular cases in which transfemoral access is not feasible and the palmar circulation is insufficient for radial artery access, ulnar artery access may be considered., Materials and Methods: Mechanical thrombectomy via ulnar artery access was performed to preserve the dominant radial artery. The ulnar artery was serial dilated to 7-French with microdilator. Angiography was performed using a diagnostic catheter. The sheath was exchanged for a guide catheter, and a triaxial system was inserted. A mechanical thrombectomy was performed. The systematic literature review included all studies pertaining to techniques for ulnar artery access for neurointervention in the last 20 years (2003-2023) published in the PubMed, Web of Science, and Embase databases., Results: 67-year-old male developed left MCA syndrome in the setting of an infected abdominal aortic endograft. A transfemoral approach was ruled out due to concern for crossing the infected endograft. Allen test and ultrasound demonstrated that the right radial artery was of adequate size for access, but the ulnar artery was insufficient to support the palmar arch. Mechanical thrombectomy resulted in TICI 3 reperfusion. Systematic review of the literature yielded 2 case series and 1 case report of transulnar neurovascular procedures. Access site complications were rare and included 3 access site hematomas and 1 ulnar artery occlusion., Conclusion: We report our technique of serial dilation of the ulnar artery for neuroendovascular procedures and provide a systematic review of the literature for complication avoidance in ulnar artery access., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Understanding how continental radiations are assembled across space and time is a major question in macroevolutionary biology. Here, we use a phylogenomic-scale phylogeny, a comprehensive morphological dataset, and environmental niche models to evaluate the relationship between trait and environment and assess the role of geography and niche conservatism in the continental radiation of Australian blindsnakes. The Australo-Papuan blindsnake genus, Anilios, comprises 47 described species of which 46 are endemic to and distributed across various biomes on continental Australia. Although we expected blindsnakes to be morphologically conserved, we found considerable interspecific variation in all morphological traits we measured. Absolute body length is negatively correlated with mean annual temperature, and body shape ratios are negatively correlated with soil compactness. We found that morphologically similar species are likely not a result of ecological convergence. Age-overlap correlation tests revealed niche similarity decreased with the relative age of speciation events. We also found low geographical overlap across the phylogeny, suggesting that speciation is largely allopatric with low rates of secondary range overlap. Our study offers insights into the eco-morphological evolution of blindsnakes and the potential for phylogenetic niche conservatism to influence continental scale radiations., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Society for the Study of Evolution (SSE).)

Lipid metabolism is recognised as being central to growth, disease and health. Lipids, therefore, have an important place in current research on globally significant topics such as food security and biodiversity loss. However, answering questions in these important fields of research requires not only identification and measurement of lipids in a wider variety of sample types than ever before, but also hypothesis-driven analysis of the resulting 'big data'. We present a novel pipeline that can collect data from a wide range of biological sample types, taking 1 000 000 lipid measurements per 384 well plate, and analyse the data systemically. We provide evidence of the power of the tool through proof-of-principle studies using edible fish (mackerel, bream, seabass) and colonies of Bombus terrestris . Bee colonies were found to be more like mini-ecosystems and there was evidence for considerable changes in lipid metabolism in bees through key developmental stages. This is the first report of either high throughput LCMS lipidomics or systemic analysis in individuals, colonies and ecosystems. This novel approach provides new opportunities to analyse metabolic systems at different scales at a level of detail not previously feasible, to answer research questions about societally important topics.

SummaryThis article highlights the crucial role of blood transfusion in trauma care and explores the historical and contemporary use of whole blood and freeze-dried plasma in Canadian health care. Early use of whole blood and freeze-dried plasma during global conflicts led to advancements in transfusion medicine. The transition to blood component therapy improved transfusion safety and precision. However, there is an increasing interest in using whole blood and freeze-dried plasma, supported by recent evidence suggesting potential benefits over blood component therapy, particularly in trauma cases. Canadian initiatives, such as leukoreduced whole blood production for the military, indicate efforts to address logistical challenges in delivering trauma care, especially in remote areas. Challenges remain, including logistical issues and regulatory complexities, requiring coordinated efforts for effective implementation. Overall, there's growing support for integrating whole blood and freeze-dried plasma into trauma care across Canada., Competing Interests: Competing interests:: None declared., (© 2024 CMA Impact Inc. or its licensors.)

Inappropriate antibiotic use is a key driver of antibiotic resistance and one that can be mitigated through stewardship. A better understanding of current prescribing practices is needed to develop successful stewardship efforts. This study aims to identify factors that are associated with human cases of enteric illness receiving an antibiotic prescription. Cases of laboratory-confirmed enteric illness reported to the FoodNet Canada surveillance system between 2015 and 2019 were the subjects of this study. Laboratory data were combined with self-reported data collected from an enhanced case questionnaire that included demographic data, illness duration and symptoms, and antibiotic prescribing. The data were used to build univariable logistic regression models and a multivariable logistic regression model to explore what factors were associated with a case receiving an antibiotic prescription. The final multivariable model identified several factors as being significantly associated with cases being prescribed an antibiotic. Some of the identified associations indicate that current antibiotic prescribing practices include a substantial level of inappropriate use. This study provides evidence that antibiotic stewardship initiatives targeting infectious diarrhoea are needed to optimize antibiotic use and combat the rise of antibiotic resistance.

Objectives: The objective of this paper was to examine the predictors of breastfeeding exclusivity at two time-points (6 and 26 weeks postpartum) using a dyadic mother-father extended model of the theory of planned behaviour., Design/method: A sample of 1139 first-time Australian mother-father dyads completed measures of each of the Theory of Planned Behaviour variables (intention, attitudes, subjective norms, and perceived behavioural control) and additional psychosocial and behavioural predictors of breastfeeding, including problems with breastfeeding, psychological distress, childcare stress, partner support, and the frequency and time of first public breastfeed. Confirmatory factor analyses were used to determine the factor structures of the latent constructs to be included in the structural model. Structural equation modelling was used to model pathways between variables., Results: Breastfeeding exclusivity at 6 weeks was significantly predicted by breastfeeding self-efficacy at 6 weeks, intention to exclusively breastfeed, and frequency of public breastfeeding over the month prior, whereas childcare stress, partner support, time of first public breastfeed, and fathers' variables (attitudes and subjective norms) had little influence. Self-efficacy mediated the relationship between mothers' attitudes, psychological distress, and breastfeeding problems with breastfeeding exclusivity at 6 weeks. Breastfeeding exclusivity at 26 weeks was significantly predicted by mothers' attitudes, self-efficacy, breastfeeding exclusivity at 6 weeks, and frequency of public breastfeeding in the month prior., Conclusions: The results highlight the importance of breastfeeding self-efficacy and confidence to breastfeed in public as crucial constructs in promoting long-term exclusive breastfeeding and provides support for an extended theory of planned behaviour model in predicting breastfeeding outcomes., (© 2024 British Psychological Society.)

Despite having a higher risk of hepatitis C virus (HCV) infections, people who inject drugs (PWID) in sub-Saharan Africa (SSA) have limited access to HCV treatment. There is scarce literature on treatment delivery modalities that overcome logistical and financial barriers. We utilized different service delivery modalities to provide direct-acting antivirals (DAAs) to PWIDs infected with HCV through methadone clinics and needle and syringe program (NSP) sites in Kenya. In collaboration with Kenya's National AIDS and STI Control Programme (NASCOP), we enrolled individuals with active HCV infection confirmed by HCV RNA detection from methadone and NSP sites in Nairobi, Mombasa, and Kilifi counties. Liver function and hepatitis B virus (HBV) status were assessed at baseline. Those eligible for treatment were offered ledipasvir-sofosbuvir treatment provided by NASCOP through directly observed therapy (DOT). Participants completed a follow-up visit 12 weeks after completing treatment to measure sustained viral response (SVR-12). Challenges faced while delivering HCV treatment at participating sites included the limited availability and reliability of laboratory assays, and financial constraints faced by PWIDs to attend daily DOT. Based on our experience, strategies to deliver HCV treatment for PWID in Kenya should consider improving the availability of laboratory tests and prioritizing treatment through methadone centers to achieve good outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Boke, Monroe-Wise, Umutesi, Mbogo, Sambai, Bukusi, Chohan, Scott, Gitau, Sinkele, Musyoki, Herbeck, Farquhar and Guthrie.)

Not available.

Objective: To report quantitative PCR (qPCR) detection of Echinococcus multilocularis DNA in fecal samples from 26 dogs in the US and Canada., Animals: 26 dogs with fecal samples submitted for parasite screening by qPCR., Clinical Presentation: Dog signalment, presenting concern, preventive care, and outcomes were obtained from the primary veterinarian via email or telephone, where available., Results: Echinococcus multilocularis was detected in 26 of 2,333,797 dog fecal samples by reference laboratory fecal qPCR surveillance between March 2022 and July 2024. Seventeen E multilocularis-detected samples were sequenced as European haplotypes (E3/E4). Taenia-type eggs were identified by zinc sulfate centrifugal flotation in 8 of 17 samples (47%). Dogs were from the US (n = 16) and Canada (10). Ten dogs had gastrointestinal signs (diarrhea) reported on initial presentation. Clinical history revealed that some dogs were receiving a monthly antiparasitic preventive in the 6-month period prior to sampling (n = 10) and had regular wildlife (rodent) exposure (13). Twenty-five dogs were subsequently confirmed to have received treatment with praziquantel for detected E multilocularis, and 25 of these dogs were qPCR negative 3 to 5 weeks after treatment., Clinical Relevance: Veterinary awareness of endemic risk regions for E multilocularis and its emergence in novel areas (Colorado, Nevada, Wyoming, Montana, Illinois, Washington, Idaho, Kansas, and Oregon) are key for One Health. Dogs can serve as sentinels for Echinococcus tapeworm risk, and detection of E multilocularis tapeworms in dogs through routine qPCR fecal screening can alert clinicians to zoonotic concern and common environmental exposure risk.

The 2022 monkeypox virus (MPXV) outbreaks spurred global public health concern. In response, we undertook a living systematic review of its zoonotic characteristics, including potential reservoirs and susceptible species, transmissibility, and clinical presentation in nonhuman species. Electronic database searches yielded 148 eligible records published between 2000 and 2022. Primary reservoirs remain unidentified, with natural isolation identified in 2 species, the sooty mangabey monkey and rope squirrel. Transmission primarily occurs from animals to humans, but evidence of reverse zoonosis has emerged. Data on clinical infection and manifestations are sparse, with evidence of potentially susceptible species drawn primarily from experimental studies. Only 10% of articles were appropriate for quality assessment and most of these were rated as critically low. Overall, while evidence regarding MPXV exists, the quality of data are extremely poor, resulting in significant uncertainty regarding MPXV's zoonotic traits. High-quality empirical research to understand the impact of MPXV on animal and human populations is warranted., Competing Interests: Potential conflicts of interest. The authors report no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Integrated care can be broadly defined as the delivery of high-quality and safe care for patients as they cross organizational boundaries or when care is delivered with multiple health care teams, professions, or organizations. Successful integration of care services is contingent on multiple and complex factors across macro, meso, and micro levels of health and social care systems in lower-, middle-, and higher-income countries. Previous priorities for the future development of integrated care have focused on designing and implementing models or approaches to integrated care rather than establishing the research needed to underpin them. This study aimed to address this evidence gap by developing a consensus on international research priorities related to integration of care and cross-boundary working., Methods: We conducted a sequential electronic Delphi (eDelphi) study from September 2023 to December 2023. The eDelphi process consisted of initial priority generation followed by two rounds of consensus development via an online survey. Sixty-six priorities were generated by 19 delegates at an international conference workshop titled, 'Priority setting for future research on integration of care and cross-boundary working'. Workshop delegates then identified other experts in integrated care and cross-boundary working from their networks. In each eDelphi round, participants then provided item-by-item responses using a seven-point Likert scale, with consensus defined a priori as ≥80% agreement (strongly agree or agree). Priorities that reached consensus were conceptually grouped into topics., Results: Twenty-five of 66 unique (37.9%) research priorities achieved consensus after two eDelphi rounds. In Round 1, 63/85 (74.1%) experts from 10 countries across 4 continents achieved consensus on 12/66 (18.2%) priorities. In Round 2, 51/63 (81.0%) experts achieved consensus on a further 13/54 (24.1%) priorities. From the 25 priorities, we derived six conceptual groupings that represent broad topics for future research on integrated care and cross-boundary working: (i) access to care, (ii) data sharing and technology, (iii) measurement of care quality, (iv) patient experience and satisfaction, (v) service design, integration and governance, and (vi) teamwork and leadership., Conclusion: Integrating care services and improving cross-boundary working is important for improving the quality of care provided to patients, regardless of country. Therefore, the conceptual topics and individual priorities identified in this study can inform policymakers, practitioners, and researchers when designing or evaluating integrated care services across the world in pursuit of improved integrated care systems., (© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Quality in Health Care.)

Self-reactive T cells experience chronic antigen exposure but do not exhibit signs of exhaustion. Here, we investigated the mechanisms for sustained, functioning autoimmune CD4 + T cells despite chronic stimulation. Examination of T cell priming showed that CD4 + T cells activated in the absence of infectious signals retained TCF1 expression. At later time points and during blockade of new T cell recruitment, most islet-infiltrating autoimmune CD4 + T cells were TCF1 + , although expression was reduced on a per T cell basis. The Tcf7 locus was epigenetically modified in circulating autoimmune CD4 + T cells, suggesting a pre-programmed de novo methylation of the locus in early stages of autoimmune CD4 + T cell differentiation. This mirrored the epigenetic profile of recently recruited CD4 + CD62L + T cells in the pancreas. Collectively, these data reveal a unique environment during autoimmune CD4 + T cell priming that allows T cells to fine-tune TCF1 expression and maintain long-term survival and function., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: This paper aims to identify specific personality traits that could potentially undermine the overall satisfaction of the patient with the prosthodontic treatment., Materials and Methods: A literature review was conducted to identify the personality traits (PT) relevant to patients requiring dental treatment. Later, a Delphi process was employed to classify the selected PT into risk levels to prosthodontic treatment satisfaction, ultimately leading to the development of a personality risk profile (PRP) proposal. The expert panel consisted of specialists with over ten years of practice. The Delphi process involved three rounds of evaluation and consensus building., Results: Twenty-six PT associated with dental treatment satisfaction were identified. Following the three rounds of the Delphi method, a consensus was achieved, resulting in the classification of these PT into three PRP, as follows: Low Risk (cooperative, understanding, compliant, trusting, concerned about their health, willing, thankful, and responsible), Moderate Risk (Insecure, Over-informed, Demanding, Appearance-obsessed, and Pessimistic), and High Risk (mistrustful, skeptical, unwilling, defiant attitude, unrealistic expectations, neglectful, treatment resistant, patient refers negatively about other dentists, violent, irresponsible, idealise the dentist, and controller)., Conclusions: This study identified and categorized PT that have the potential to adversely impact prosthodontics treatment satisfaction. Through this PRP proposal, dental professionals can recognize these patients before initiating prosthodontic interventions.

Study Design: Analysis of data from two cohorts of Spinal Cord Injury Model Systems Database (SCIMS) participants, pre-pandemic (2017-2019, n  = 6368) and during pandemic (2020, n  = 1889)., Objectives: To examine differences in substance use during the pandemic compared to the years prior to the pandemic., Setting: 19 SCIMS Centers., Methods: Participant characteristics, wellness (depression, life satisfaction, resilience), participation, and substance use between the two cohorts were compared. Multiple logistic regression examined the association of the pandemic with substance use after accounting for other factors., Results: Characteristics of the two cohorts were similar. Cannabis and sedative uses were not greatly different (28.8% vs 25.1%, and 8.3% vs 6.6%) but did reach statistical significance. Non-prescribed opioid use was double for the pandemic group (6.6% vs 3.3%). Alcohol use patterns were similar across the two cohorts. Measures of wellness were similar, while the pandemic group reported lower participation. The odds of use of cannabis, sedatives, and opioids were 1.3, 1.3, and 2.2 times greater, respectively, for the pandemic cohort after accounting for demographics, wellness, and participation. Greater use of non-prescribed opioids was reported during the pandemic in the South compared to prior to the pandemic (13.8% vs 6.1%)., Conclusions: The pandemic may have been associated with increased use of non-prescribed substances in the traumatic spinal cord injury population. Efforts to pursue longitudinal investigations would be warranted for definitive analysis of trends. The provision of demonstrably effective substance use treatment resources delivered via accessible methods will likely be needed in this population, particularly opioid treatment.

As per- and polyfluoroalkyl substances (PFAS) infiltrate the environment via industrial, commercial, and domestic sources, the demand for robust, cost-effective, and straightforward analytical assays intensifies to enhance PFAS characterization and quantification. To address this demand, this study introduces a novel UV-H 2 O 2 -TOP assay, identifying optimal parameters such as pH (5-9), oxidant concentration (500 mM H 2 O 2 ), activation rate (63 mM H 2 O 2  h -1 ), and an acceptable total organic carbon (TOC) limit (~1000 mg/L TOC) to achieve maximum PFAA precursor conversion. Additional work was performed further optimizing the UV-TOP assay, by confirming its superiority to heat activation, identifying the effectiveness of different persulfate salts, and investigating different concentrations of sodium persulfate and sodium hydroxide at a 1:2.5 ratio on PFCA yield. Our investigation concluded by applying the UV-H 2 O 2 -TOP assay, using sodium persulfate as the TOP assay oxidant, to 6:2 FTS and five different AFFF samples. High-resolution mass spectrometry and an expanded analytical suite support sample analysis, facilitating direct quantification of ultra-short chain perfluoroalkyl carboxylates (PFCAs) and common fluorotelomer compounds including 5:3/5:1:2 fluorotelomer betaine and 6:2 fluorotelomer sulfonamido betaine. Results highlight several advantages of this tandem UV-activated method, including enhanced preservation of perfluoroalkyl chains (post-oxidation of 6:2 fluorotelomer sulfonate resulted in 28 % PFHpA, 47 % PFHxA, 25 % C3-C5 PFCA), capacity to handle high TOC limits (1000 mg/L TOC), and ability to incorporate higher persulfate concentrations in a single oxidation cycle., Competing Interests: Declaration of competing interest The authors declare no competing financial interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: CPT codes for ventral hernia repair (VHR) changed in January 2023 to address the heterogeneity of procedures with a concomitant shift from a 90-day to a 0-day global period. This study reviews a tertiary referral center's experience with hernia coding comparing the work relative value units (wRVUs) generated for ventral hernia repair pre-2023 compared to post-2023., Study Design: CPT codes were analyzed for patients undergoing open or laparoscopic VHR before updates to the CPT hernia codes (January 2022-September 2022) and following CPT change (January 2023-September 2023). Work RVU values were assigned based on nationally published values. CPT codes in 2022, CPT codes in 2023, 8 inpatient E&M codes, and 5 outpatient E&M codes were evaluated., Results: 299 patients underwent VHR, 143 in 2022 and 156 in 2023. Average procedural VHR wRVUs increased from 9.6 in 2022 to 11.6 in 2023 (p<0.001). Procedures involving myofascial advancement flaps/component separation techniques (53.8% vs. 48.7%, p = 0.419) and wRVUs for the component separation procedures were similar between 2022 and 2023, respectively 17.7 vs 16.1 (p=0.419)]. The wRVUs associated with adjunctive procedures (mesh removal/placement) decreased from 3.3 to 0.6 (p<0.001) in the post-2023 era. Postoperative E&M wRVUs increased in 2023 for postoperative inpatient (0.48) and postoperative outpatient (0.39) services, compared to 0 wRVUs in 2022. Overall, the total management including follow-up clinic visit adjusted wRVUs for hernia repair was similar between 2022 and 2023, respectively 30.7 vs 29.2 (p=0.409)., Conclusion: Procedural wRVUs for anterior abdominal hernia repair increased from 2022 to 2023 (p<0.001) at a tertiary referral medical center. However, total wRVUs, including the operation and postoperative visits, remained unchanged., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Surgical coronary bypass has evolved continually, and most analyses currently favor performing coronary grafts with autologous living arterial conduits to obtain better long-term patencies and clinical outcomes. With bilateral internal mammary artery grafts and both radial arteries, 4 excellent arterial conduits exist for creating "all-arterial" revascularization in the majority of multivessel disease patients, including those with valve disorders. Using contemporary surgical techniques, it is possible to obtain greater than 95% overall early graft patencies that translate into better late outcomes, including improved survival, freedom from myocardial infarction, fewer percutaneous coronary interventions, and redo coronary bypass procedures. The overall goal is to revascularize the 2 most important coronary systems with internal mammary artery grafts, and the rest with radial arteries, depending on the anatomy, experience, and choice of the surgeon. Using highly validated management strategies, early postoperative complications, including the incidence of sternal infections, are extremely uncommon, and in many practices, multi-arterial grafts currently are used in the majority of multivessel patients, including those with concomitant valve disease. Because patencies and outcomes are significantly better than with saphenous vein bypass or percutaneous coronary interventions, referring physicians frequently favor multi-arterial bypass procedures as the primary therapy for patients with prognostically serious multivessel disease. Thus, coronary bypass using predominantly autologous arterial conduits should play an increasingly important role in the future management of severe coronary atherosclerosis., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Comparing time series of unequal length requires data processing procedures that may introduce biases. This article describes, validates, and applies Cross-Recurrence Quantification Analysis (CRQA) to detect and quantify correlation and coupling among time series of unequal length without prior data processing. We illustrate and validate this application using continuous and discrete data from a model system (study 1). Then we use the method to re-analyze the Sleep Heart Health Study (SHHS), a rare large dataset comprising detailed physiological sleep measurements acquired by in-home polysomnography. We investigate whether recurrence patterns of ultradian NREM/REM sleep cycles (USC) predict mortality (study 2). CRQA exhibits better performance compared with traditional approaches that require trimming, stretching or compression to bring two time series to the same length. Application to the SHHS indicates that recurrence patterns linked to stability of USCs are associated with all-cause mortality even after controlling for other sleep parameters, health, and sociodemographics. We suggest that CRQA is a useful tool for analyzing categorical time series, where the underlying structure of the data is unlikely to result in matching data points-such as ultradian sleep cycles., (© 2024. The Author(s).)

Environmental factors amplified by climate change contribute significantly to the global burden of disease, disproportionately impacting vulnerable populations, such as individuals with rare diseases. Researchers require innovative, dynamic data linkage methods to enable the development of risk prediction models, particularly for diseases like vasculitis with unknown aetiology but potential environmental triggers. In response, we present the Semantic Environmental and Rare Disease Data Integration Framework (SERDIF). SERDIF was evaluated with researchers studying climate-related health hazards of vasculitis disease activity across European countries (N P1  = 10, N P2  = 17, N P3  = 23). Usability metrics consistently improved, indicating SERDIF's effectiveness in linking complex environmental and health datasets. Furthermore, SERDIF-enabled epidemiologists to study environmental factors in a pregnancy cohort in Lombardy, showcasing its versatility beyond rare diseases. This framework offers for the first time a user-friendly, FAIR-compliant design for environment-health data linkage with export capabilities enabling data analysis to mitigate health risks posed by climate change., (© 2024. The Author(s).)

This paper outlines the process by which a medical gamma camera can be utilised to support assessment of internal radionuclides for the public. While hospital based gamma cameras are able to detect photopeaks, they are often limited to an energy range of 40-540 keV. However, radionuclides with photopeak energies above 540 keV can still be detected as the partial collection of photon energy increases the count rate at lower energies. By combining extensive mathematical modelling with empirical calibration of multiple gamma cameras it is possible to develop a linear correlation between the efficiency of counting point sources and the overall counting efficiency for the camera. Once established, a simple protocol can be used to characterise any gamma camera, using optimal system settings, and hence generate a system efficiency with sufficient accuracy to allow the camera to be used in a triage process to committed effective doses of 2 mSv.&#xD., (Creative Commons Attribution license.)

Persons with germline variants in the tumor suppressor gene phosphatase and tensin homolog, PTEN, are molecularly diagnosed with PTEN hamartoma tumor syndrome (PHTS). PHTS confers high risks of specific malignancies, and up to 23% of the patients are diagnosed with autism spectrum disorder (ASD) and/or developmental delay (DD). The accurate prediction of these two seemingly disparate phenotypes (cancer vs. ASD/DD) for PHTS at the individual level remains elusive despite the available statistical prevalence of specific phenotypes of the syndrome at the population level. The pleiotropy of the syndrome may, in part, be due to the alterations of the key multi-functions of PTEN. Maintenance of genome integrity is one of the key biological functions of PTEN, but no integrative studies have been conducted to quantify the DNA damage response (DDR) in individuals with PHTS and to relate to phenotypes and genotypes. In this study, we used 43 PHTS patient-derived lymphoblastoid cell lines (LCLs) to investigate the associations between DDR and PTEN genotypes and/or clinical phenotypes ASD/DD vs. cancer. The dynamics of DDR of γ-irradiated LCLs were analyzed using the exponential decay mathematical model to fit temporal changes in γH2AX levels which report the degree of DNA damage. We found that PTEN nonsense variants are associated with less efficient DNA damage repair ability resulting in higher DNA damage levels at 24 hours after irradiation compared to PTEN missense variants. Regarding PHTS phenotypes, LCLs from PHTS individuals with ASD/DD showed faster DNA damage repairing rate than those from patients without ASD/DD or cancer. We also applied the reaction-diffusion partial differential equation (PDE) mathematical model, a cell growth model with a DNA damage term, to accurately describe the DDR process in the LCLs. For each LCL, we can derive parameters of the PDE. Then we averaged the numerical results by PHTS phenotypes. By performing simple subtraction of two subgroup average results, we found that PHTS-ASD/DD is associated with higher live cell density at lower DNA damage level but lower cell density level at higher DNA damage level compared to LCLs from individuals with PHTS-cancer and PHTS-neither., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) developed consensus-based generic competencies in antimicrobial prescribing and stewardship. These may be useful in structuring and evaluating antimicrobial prescribing education to veterinary students, but their applicability has not been evaluated. We aimed to evaluate whether the ESCMID competencies are currently taught and how relevant they are to veterinary prescribing in veterinary schools globally. A multi-center, cross-sectional survey was performed by administering an online questionnaire to academics teaching antimicrobial prescribing to veterinary students. Targeted recruitment was undertaken to ensure the representation of diverse geographical locations. Responses (48) were received from veterinary schools in Europe (26), North America (7), Asia (6), Australia (3), Central and South America (3), and Africa (3). Of the 37 ESCMID prescribing competencies, only 6 were considered only "slightly" or "not at all" relevant by more than 10% of respondents. Of the 37 competencies, 25 of the competencies were taught in more than 90% of schools and another 6 were taught in 80%-89% of schools. Time spent teaching was "too little" or "far too little" for five competencies according to more than 50% of the respondents. Additional competencies to address extra-label drug use; the use of compounded antimicrobials; the use of antimicrobials for metaphylaxis, prophylaxis, and growth promotion; and the importance rating of antimicrobials were suggested. The ESCMID antimicrobial prescribing competencies had broad relevance and were widely covered in the veterinary curriculum globally.

Growth-promoting antibiotics have been used in cattle, but concern about antimicrobial overuse has prompted a re-evaluation of this practice. To evaluate changes in the ruminal microbiota of feedlot cattle by virginiamycin, a total of 76 crossbreed beef cattle from 2 batches of cattle at different sampling periods (B1 and B2) were divided into 2 groups: one receiving virginiamycin in their diet (ATB) and the other receiving the same diet without any growth promoter (CON). The use of virginiamycin was associated with significant changes in the diversity and composition of the ruminal microbiota of cattle in B1, but not in cattle in B2. Several bacterial taxa were significantly more abundant in samples from CON, e.g ., an unclassified genus of the TM7 phylum, whereas others were associated with the use of virginiamycin, e.g., Holdemania and Selenomonas spp. In conclusion, virginiamycin can affect bacterial diversity and composition in the rumen of feedlot cattle, but its effect is inconsistent in different seasons of the year., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

The similarity of current definitions of 'cross-resistance' and 'co-resistance' continues to cause confusion both in the scientific community as well as in understanding policies and in particular when looking at resistance from a risk assessment perspective. Further, lack of harmonized definitions of these terms in the regulatory space is challenging for interpretation. The purpose of this article is to: (i) provide an overview of the ambiguity in existing terminology related to cross-resistance, co-resistance and co-selection; (ii) emphasize the challenges created by the use of poor terminology in research and scientific literature; and (iii) propose a clear set of harmonized definitions that could be put into use through international regulatory agencies and institutions, such as the World Health Organization, Food and Drug Administration, European Medicines Agency, Center for Disease Control, Committee for Veterinary Medicinal Products, World Organization for Animal Health/Office International des Epizooties and the Food and Agriculture Organization of the United Nations., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: US Hispanics have several health disparities, greater tobacco/nicotine-related illnesses, lower access to smoking cessation, and lower rates of cessation. Understanding cultural constructs linked to tobacco/nicotine use may provide a greater understanding of future cultural adaptations of cessation interventions. This study used a multidimensional acculturation framework, with cultural practices, identity, and values, to test links between measures of acculturation stress, multidimensional acculturation (language-based enculturation and acculturation, cultural identity, familism), and tobacco/nicotine use, and interactions with gender., Design: Participants were 391 adult Latin American immigrants (69% women); 12% self-reported tobacco/nicotine use in the past six months., Results: Path analysis showed acculturative stress, β  = .16, and acculturation, β  = .20, were positively related to tobacco/nicotine use. Enculturation, familism, and Hispanic cultural identity were not related to tobacco/nicotine use. There were no significant acculturation by enculturation or gender interactions, but women were less likely to use tobacco/nicotine than men, β  = -.36., Conclusion: Findings suggest that tobacco/nicotine cessation interventions for Latino immigrants may be enhanced with an emphasis on the mitigation of acculturative stress, attention to the adoption of US cultural practices, and gender. Future research should examine specific sources of acculturative stress or social norms related to tobacco/nicotine use.

Abstract: Infection of wounds delays healing, increases treatment costs, and leads to major complications. Current methods to manage such infections include antibiotic ointments and antimicrobial wound dressings, both of which have significant drawbacks, including frequent reapplication and contribution to antimicrobial resistance. In this work, we developed wound dressings fabricated with a medical-grade polyurethane coating composed of natural plant secondary metabolites, cinnamaldehyde, and alpha-terpineol. Our wound dressings are easy to change and do not adhere to the wound bed. They kill gram-positive and -negative microbes in infected wounds due to the Food and Drug Administration-approved for human consumption components. The wound dressings were fabricated by dip coating. Antimicrobial efficacy was determined by quantifying the bacteria colonies after a 24 h of immersion. Wound healing and bacterial reduction were assessed in an in vivo full-thickness porcine burn model. Our antimicrobial wound dressings showed a > 5-log reduction (99.999%) of different gram-positive and gram-negative bacteria, while maintaining absorbency. In the in vivo porcine burn model, our wound dressings were superior to bacitracin in decreasing bacterial burden during daily changes, without interfering with wound healing. Additionally, the dressings had a significantly lower adhesion to the wound bed. Our antimicrobial wound dressings reduced the burden of clinically relevant bacteria more than commercial antimicrobial wound dressings. In an in vivo infected burn wound model, our coatings performed as well or better than bacitracin. We anticipate that our wound dressings would be useful for the treatment of various types of acute and chronic wounds., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by the Shock Society.)

Photocatalytic solar hydrogen generation, encompassing both overall water splitting and organic reforming, presents a promising avenue for green hydrogen production. This technology holds the potential for reduced capital costs in comparison to competing methods like photovoltaic-electrocatalysis and photoelectrocatalysis, owing to its simplicity and fewer auxiliary components. However, the current solar-to-hydrogen efficiency of photocatalytic solar hydrogen production has predominantly remained low at ≈1-2% or lower, mainly due to curtailed access to the entire solar spectrum, thus impeding practical application of photocatalytic solar hydrogen production. This review offers an integrated, multidisciplinary perspective on photocatalytic solar hydrogen production. Specifically, the review presents the existing approaches in photocatalyst and system designs aimed at significantly boosting the solar-to-hydrogen efficiency, while also considering factors of cost and scalability of each approach. In-depth discussions extending beyond the efficacy of material and system design strategies are particularly vital to identify potential hurdles in translating photocatalysis research to large-scale applications. Ultimately, this review aims to provide understanding and perspective of feasible pathways for commercializing photocatalytic solar hydrogen production technology, considering both engineering and economic standpoints., (© 2024 The Author(s). Advanced Materials published by Wiley‐VCH GmbH.)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Objective: The purpose of this study was to further the understanding of reported patient safety events at the interface between hospital and care home including what active failings and latent conditions were present and how reporting helped learning., Methods: Two care home organizations, one in the North East and one in the South West of England, participated in the study. Reports relating to a transition and where a patient safety event had occurred were sought during the COVID-19 (SARS-CoV-2) virus prepandemic and intrapandemic periods. All reports were screened for eligibility and analyzed using content analysis., Results: Seventeen South West England care homes and 15 North East England care homes sent 114 safety incident reports and after screening 91 were eligible for review. A hospital discharge transition (n = 78, 86%) was most common. Pressure damage (n = 29, 32%), medication errors (n = 26, 29%) and premature discharge (n = 21, 23%) contributed to 84% of the total reporting. Many 'active failings' (n = 340) were identified with fewer latent conditions (failings) (n = 14, 15%) being reported. No examples of individual learning were identified. Organization and systems learning were identified in 12 reports (n = 12, 13%)., Conclusions: The findings highlight potentially high levels of underreporting. The most common safety incidents reported were pressure damage, medication errors, and premature discharge. Many active failings causing numerous staff actions were identified emphasizing the cost to patients and services. Additionally, latent conditions (failings) were not emphasized; similarly, evidence of learning from safety incidents was not addressed., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Intimate partner violence (IPV) is a significant, global public health concern. Women, individuals with historically underrepresented identities, and disabilities are at high risk for IPV and tend to experience severe injuries. There has been growing concern about the risk of exposure to IPV-related head trauma, resulting in IPV-related brain injury (IPV-BI), and its health consequences. Past work suggests that a significant proportion of women exposed to IPV experience IPV-BI, likely representing a distinct phenotype compared with BI of other etiologies. An IPV-BI often co-occurs with psychological trauma and mental health complaints, leading to unique issues related to identifying, prognosticating, and managing IPV-BI outcomes. The goal of this review is to identify important gaps in research and clinical practice in IPV-BI and suggest potential solutions to address them. We summarize IPV research in five key priority areas: (1) unique considerations for IPV-BI study design; (2) understanding non-fatal strangulation as a form of BI; (3) identifying objective biomarkers of IPV-BI; (4) consideration of the chronicity, cumulative and late effects of IPV-BI; and (5) BI as a risk factor for IPV engagement. Our review concludes with a call to action to help investigators develop ecologically valid research studies addressing the identified clinical-research knowledge gaps and strategies to improve care in individuals exposed to IPV-BI. By reducing the current gaps and answering these calls to action, we will approach IPV-BI in a trauma-informed manner, ultimately improving outcomes and quality of life for those impacted by IPV-BI.

The study of complex phases in nuclear fuels is necessary to understand the physicochemical properties of the fuel. Na 6 Mo 7 O 24 ⋅14H 2 O (1) was prepared via a simplified method and the crystal structure was improved. Upon thermal degradation, 1 decomposes into Na 2 Mo 2 O 7 and MoO 3 . Additionally, novel Ba 3 Mo 7 O 24 ⋅12H 2 O (2) was isolated via an aqueous synthetic route and characterized via FTIR and elemental analysis. PXRD pattern of 2 was determined. Thermal degradation of 2 indicates formation of BaMoO 4 , BaMo 3 O 10 , MoO 3 , and an unidentified phase., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: This study compares patient-reported functional and aesthetic outcomes of split-thickness skin graft (STSG) versus hatchet flap closure of radial forearm free flap (RFFF) donor site., Methods: Patients with RFFF (2015-2020) were retrospectively identified. Those willing to participate in patient-reported outcomes (PRO) filled out Patient-Observer Scar Assessment Scale (POSAS) and Michigan Hand Outcome Questionnaire (MHOQ)., Results: 198 patients met our inclusion criteria and 81 participated in PRO. There was a higher rate of tendon exposure in STSG versus hatchet flap (11 vs. 1, p = 0.0019), but a lower rate of skin necrosis (5 vs. 16, p = 0.0190) and epidermolysis (1 vs. 12, p = 0.0028). Scar quality in STSG was superior to hatchet flap in all domains of POSAS. MHOQ scores were similar between both groups with no statistical difference in overall scores (p = 0.2165)., Conclusions: STSG appeared to have less compromise in activities of daily living, better satisfaction and improved scar quality than hatchet flap, but a higher rate of tendon exposure., Level of Evidence: 3 Laryngoscope, 134:4266-4273, 2024., (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

The effect of acidic media on the formation of the 3,4-dihydro-2H-3-phenyl-1,3-benzoxazine Bz is evaluated, focusing on the differentiation of intermediates and products formed by the distinct pathways observed in the presence and absence of acid. The use of real-time mass spectrometry (PSI-ESI-MS) coupled to tandem mass spectrometry and infrared multiple photon dissociation (IRMPD) allowed the differentiation of the species observed during the synthesis of benzoxazines in these different conditions. The results suggest that formic acid promotes the formation of aniline and phenol condensation products (IC and IIC) by protecting the aniline amino group and enhancing the formaldehyde electrophilicity. The results also suggest that although the presence of acid allow a more efficient potential energy landscape to be accessed, the last cyclization step for the formation of benzoxazines cannot be mediated by the protonation route intermediate (ROP Bz). Overall, the conclusions presented here provide important information about the synthesis of benzoxazines under acidic conditions, allowing the development of optimal reaction conditions., (© 2024 Wiley-VCH GmbH.)

Purpose: The effects of low-intensity exercise, heat-induced hypo-hydration and rehydration on maximal strength and the underlying neurophysiological mechanisms are not well understood., Methods: To assess this, 12 participants took part in a randomised crossover study, in a prolonged (3 h) submaximal (60 W) cycling protocol under 3 conditions: (i) in 45 °C (achieving ~ 5% body mass reduction), with post-exercise rehydration in 2 h (RHY2), (ii) with rehydration across 24 h (RHY24), and (iii) a euhydrated trial in 25 °C (CON). Dependent variables included maximal voluntary contractions (MVC), maximum motor unit potential (M MAX ), motor evoked potential (MEP RAW ) amplitude and cortical silent period (cSP) duration. Blood-brain-barrier integrity was also assessed by serum Ubiquitin Carboxyl-terminal Hydrolase (UCH-L1) concentrations. All measures were obtained immediately pre, post, post 2 h and 24 h., Results: During both dehydration trials, MVC (RHY2: p < 0.001, RHY24: p = 0.001) and MEP RAW (RHY2: p = 0.025, RHY24: p = 0.045) decreased from pre- to post-exercise. MEP RAW returned to baseline during RHY2 and CON, but not RHY24 (p = 0.020). MEP/M MAX ratio decreased across time for all trials (p = 0.009) and returned to baseline, except RHY24 (p < 0.026). Increased cSP (p = 0.011) was observed during CON post-exercise, but not during RHY2 and RHY24. Serum UCH-L1 increased across time for all conditions (p < 0.001) but was not significantly different between conditions., Conclusion: Our findings demonstrate an increase in corticospinal inhibition after exercise with fluid ingestion, but a decrease in corticospinal excitability after heat-induced hypo-hydration. In addition, low-intensity exercise increases peripheral markers of blood-brain-barrier permeability.Kindly check and confirm inserted city name correctly identified in affiliation 7This is correct., (© 2024. The Author(s).)

The significant surge of ionic liquids (ILs) research over the past decade has led to the formation of various novel ionic liquid compounds and their diverse applications. Enhanced geothermal systems (EGS) for geothermal power generation are an emerging IL application as a heat extraction fluid. The once widely held belief in the environmentally friendly characteristics of ionic liquids, mainly due to their insignificant vapor pressure, is now being scrutinized. It has become apparent that while ILs do not readily evaporate into the atmosphere, they are not guaranteed to remain entirely isolated from the environment. Recent attention has been directed toward toxicological studies, including ecotoxicity impacts, with the long-accepted assumption of ILs having low toxicity being invalid. This paper aims to shed light on the toxicity of hexylepyradinium bromide (HPyBr) IL and a deep eutectic solvent (DES) comprising choline chloride with magnesium chloride hexahydrate (ChCl:MgCl 2 ·6H 2 O) to five test species, an algal species ( Raphidocelis subcapitata ), the water flea ( Ceriodaphnia dubia and Daphina magna) , the fathead minnow ( Pimephales promelas ), and the earthworm ( Eisenia fetida ), to measure acute and chronic toxicity. Additionally, new approach methods (NAMs) are presented using the fathead minnow embryo and the rainbow trout ( Oncorhynchus mykiss ) gill cell line and the RTgill-W1 assay to compare sensitivity across species. Overall, ChCl:MgCl 2 ·6H 2 O displayed lower toxicity, while HPyBr demonstrated higher toxicity, highlighting the need for caution in handling it to prevent harm to aquatic ecosystems. Comparative analysis underscored the potential threat of ChCl:MgCl 2 ·6H 2 O to aquatic life, highlighting the cumulative effects of the environmental components., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Many literature reviews or other types of reviews (e.g., meta-analyses, scoping reviews) in deaf education research are focused upon primarily or exclusively research that is performed in U.S. contexts or English-speaking contexts only. However, research that is conducted in non-English-speaking, non-U.S. settings that may be more likely to be multilingual, has value for our understanding of how deaf students using multiple languages may develop literacy skills. The objective of this review was to explore the literature on literacy development with deaf learners conducted outside of English-speaking contexts that has been published in English, Portuguese, or Spanish. We identified 13 English-language articles, 9 Portuguese-language articles, and 0 Spanish articles that met inclusion criteria. From these articles, we glean important insights into the reading process, including the teaching of subskills of reading, writing instruction, early literacy experiences, and the potential relationship between signed languages and literacy. We also note the need for multiple, converging sources of evidence and the value of an asset-driven approach to understanding deaf learners., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Introduction: Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic., Material and Methods: A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect data regarding knowledge of barriers to effective COVID-19 risk mitigation, recovery, and chronic disease self-management. This included nurses, physicians, COVID-19 survivors and their carepartners, public health, and community leaders connected with the healthcare systems in rural counties of South Carolina., Results: Five major themes were identified across the subgroups. The themes: The COVID-19 Illness Trajectory Added Major Health Challenges and Stressors, Access to Care Is Lacking, Support is Needed for COVID-19 Survivors and Care Partners, Support Must be Distributed Equitably, and Racism and Structural Issues Affect Stress reflect the strengths, opportunities, and inequities perceived within these groups., Conclusion: This research is the first qualitative study focused on COVID-19 survivor-carepartner dyads that consider the intersectionality of race/ ethnicity, geography, and health that is known to occur when engaging healthcare systems. The themes illustrate the need for infectious disease prevention at all socioecological levels: structural/ systemic, community, organizational/ institutional, interpersonal, and individual., Competing Interests: Dr Gayenell Magwood reports honorarium from University of Mississippi Medical Center; personal fees from American Heart Association, NIH, and AHEC, outside the submitted work. The authors report no other conflicts of interest in this work., (© 2024 Magwood et al.)

Introduction: Persons with non-ambulatory spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have marked loss of bone mineral density below the level of lesion that is directly associated with increased risk of long-bone fractures. There is a paucity of research that has successfully implemented rehabilitation and/or exercise training interventions to mitigate bone loss after acute SCI or reverse bone loss that has already occurred in chronic SCI. This paper describes a research protocol to compare the effect of exoskeletal-assisted walking (EAW) alone versus EAW plus transcutaneous spinal cord stimulation (EAW+tSCS) on bone density, geometry and strength in a cohort of chronic SCI participants., Methods and Analysis: After meeting eligibility criteria and completing baseline testing, sixteen participants will be block randomised into the EAW alone group or the EAW+tSCS combined group (n=8 each group). Each group will receive a total of 108 overground training sessions (60 min sessions, 3 times a week, for 36 weeks) for the 9-month training period. Imaging for bone density and geometry by dual-energy X-ray absorptiometry and peripheral quantitative CT will be performed prior to starting the intervention (baseline), after 72 training sessions, and again after 108 sessions in each of the intervention arms. CT imaging of both lower extremities will be performed at baseline and at the 9-month time point in each of the intervention arms. Finite element models of bone loading will be generated based on three-dimensional (3D) reconstruction of bone architecture from CT imaging prior to and 9 months after the intervention., Ethics and Dissemination: This study is currently approved by the Kessler Foundation and James J. Peters VA Medical Center Institutional Review Board. A member of the research team will review and explain the study consent form and will have all eligible participants sign prior to participation in the study. Results from this study will be disseminated to clinicians and researchers in the SCI community at national and international conferences., Trial Registration Number: NCT03096197., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)