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Competing Interests: The authors have declared no conflict of interest.

Aim: This research aimed to uncover elements of a comprehensive, trauma-informed (TI) multidisciplinary health professions simulation framework to improve the delivery of care to traumatized patients., Background: Trauma is a pervasive public health problem requiring a TI approach. Simulation is an evidence-based teaching strategy that advances knowledge and clinical reasoning. There is a lack of scientifically based simulation education models addressing the delivery of TI care for the health professions., Method: A Delphi study utilizing a panel of experts was conducted to identify the most critical elements of a simulation framework., Results: Phase one identified 10 content areas and 111 subcontent areas. Phase two analysis revealed 99 percent of the 111 subcontent areas achieved expert consensus., Conclusion: This Delphi study provides the first scientifically based framework to guide the development of a comprehensive, TI, multidisciplinary simulation framework to recognize trauma survivors and subsequently display concern and respect., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Competing Interests: The authors have declared no conflict of interest.

Background: The change from clinical nurse specialist to nurse practitioner model with emphasis on the biomedical prescriber role significantly affected graduate education/practice., Aim/method: This article reports solutions, lessons learned, and insights from faculty in a four-year Workforce Development Project supported by an academic-practice partnership. Lessons learned that are shared as administrative and clinical practice insights include use of experiential learning platform and interaction process recordings, confirmation of the state of nurse psychotherapy blocks to clinical placements, movement toward a salutogenic psychosocial nursing process, changing student evaluation language of preceptors, and implementation of an Advanced Practice Nursing model for clinical supervision., Results: The educational hypothesis that in-person experiential learning in a workshop format with live simulations is critical to the professional development of psychiatric mental health advanced practice nursing is supported. Resistance to the cultural change operationalized through the curriculum is described. Five student reflections exemplify progress made as a result of this program., Conclusion: This program with its enduring educational frame was an opportunity to regain a historical momentum as nurse leaders in mental health care. There is significant interest and commitment to learning the nurse-psychotherapist and consultation-liaison roles., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: Graduate students are faced with many stressors, including school, work, and home roles. They may not have the self-care skills and support to manage the increased stress from school. Self-care goal setting check-ins were implemented in a graduate course to support students' stress management. Student resilience levels, wellness, and burnout were moderate. Students indicated the check-ins were helpful, yet still found challenges in completing self-care. They also stated less assignments and integrating more wellness into the curriculum would be helpful in supporting their self-care goals. Nursing educators can impact student wellness by providing skills and support in the curriculum., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2024 National League for Nursing.)

Abstract: Prelicensure nursing students manage various stressors, including a rigorous curriculum, physically and psychologically demanding clinical rotations, supplementary work, family responsibilities, and an evolving licensure exam. Because of these stressors, nursing programs must address students' mental health concerns and the potential impact on academic performance. At a private university in the Midwest, a student-centered care plan reflection was implemented to support mental health concerns about the National Council Licensure Examination and promote coping skills. In response, students reported increased motivation, improved stress management, and reduced anxiety., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: The change from a clinical nurse specialist to nurse practitioner model has significantly affected graduate education and practice because of emphasis on the dominant biomedical prescriber role, marginalizing the nurse-psychotherapy and consultation-liaison roles fundamental to quality psychiatric advanced practice nursing practice., Aim/method: We report on a four-year Workforce Development Project supported by an academic-practice partnership to restore formation and skill building of the marginalized roles. Part One focuses on program design, the curriculum for nine specialty courses, and the teaching and learning community approach that promotes engagement, faculty commitment, and preceptor recruitment and retention; the creative faculty staffing model is described., Results: The educational frame described includes highlights of teaching/learning strategies drawn from the history of professional formation curriculum rooted in salutogenesis and belonging science, existentialism, solution-focused therapy, modeling and role modeling theory, and Peplau's Interpersonal Relations ., Conclusion: There is significant interest and commitment to learning the nurse-psychotherapist and consultation-liaison roles., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: An educational innovation centered on mindfulness was developed to support the well-being of first-year nursing students at a large public university. Students participated in a week-long experiential learning program before their first semester. They then enrolled in a one-credit course that fostered well-being through research and evidence-based mindfulness practices. The course was highly ranked because of the quality of learning, environment, and theories presented, indicating that supportive wellness initiatives are acceptable and feasibility for future implementation., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Abstract: The objective structured clinical examination (OSCE) is effective for the evaluation of clinical competence. Studies examining the use of OSCEs in undergraduate mental health nursing education in the United States are limited. A pilot study and a follow-up study were conducted to establish the reliability and validity of a mental health OSCE to evaluate the clinical competence of prelicensure nursing students. International Nursing Association for Clinical Simulation and Learning Standards of Best Practice were used to guide the design and implementation. Results from both studies provide evidence for the use of OSCE in undergraduate mental health nursing education., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Aim: The aim of the study was to explore relationships between perceived faculty support and prevalence of severe/extremely severe depression, anxiety, and stress levels among undergraduate baccalaureate nursing students., Background: Emerging research supports nursing students suffering from extreme psychological distress. Educational success and mental health wellness are influenced by external support., Method: A mixed-methods design was used for this descriptive, cross-sectional study. A national convenience sample of 1,163 undergraduate baccalaureate nursing students completed the Depression, Anxiety and Stress Scale-21, Perceived Faculty Support Scale, and a demographic questionnaire. Emerging themes in the qualitative data were identified., Results: Nearly 54 percent of nursing students suffered from severe/extremely severe depression, anxiety, or stress. Faculty support was critical to nursing student mental health well-being., Conclusion: This multisite study provides a better understanding of the enormity of psychological distress among undergraduate baccalaureate nursing students and emphasizes the immediate need for faculty to provide necessary support to this vulnerable student population., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: With deep historical roots in psychiatry, structural racism persists in psychiatric nursing today. Psychiatric nurses may hold implicit biases and stereotypical beliefs that influence how they perceive, assess, and interact with people from different racial backgrounds, leading to discrimination, poor treatment, and misdiagnosis. To eliminate discrimination in clinical care and diversify the workforce, there is an urgent need to integrate teaching and learning strategies that address influences of racism and racial identity in psychiatric nursing education. This article explores the historical context and proposes antiracist psychiatric nursing teaching and practice interventions to reduce the harms of racism., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: The number of people facing mental health issues continues to grow in the aftermath of COVID-19. Nurses are challenged with providing care for an increasing number of patients, including veterans, with complex mental health needs across healthcare settings. Of concern, many students transitioning into practice feel they lack the necessary confidence, education, and skills to competently care for patients with mental health illness. This article discusses an innovative mental health immersion experience strategically integrated within a new-nurse residency program., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background and Purpose: Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders., Method: Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke's six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data., Results: Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma., Conclusion: Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: Utilizing Healthcare Simulation Standards of Best Practice™, a virtual reality (VR) platform was created to meet American Association of Colleges of Nursing Essential and Quad Council Public Health competencies. The scenario, involving major depressive disorder with suicidal ideation and alcohol dependency, engages learners in assessing suicide risk, recognizing symptoms, and recommending treatment. Eighty-four prelicensure nursing students have taken part in this mental health VR simulation since spring 2023. Although no significant difference was observed between pre-post knowledge, learners appreciated the VR experience. Student ratings were lowest for how physically demanding the task was and highest for their focus and interest in successfully doing the simulation., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: As more patients seek help for acute mental health conditions in all sectors of health care, the demand for nurses trained to care for this population is outpacing the supply. Nursing schools have not been successful in educating students with the knowledge, skills, and attitudes needed to provide care. The purpose of this study was to integrate mental health concepts throughout the entire curriculum in a two-year associate degree nursing program and examine its effects on developing mental health literacy in prelicensure students., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: Emotional exhaustion in online nursing students leads to attrition in educational and professional settings. Few studies have been performed on practicing nurses enrolled in online programs. The purpose of this study was to explore factors contributing to emotional exhaustion in nursing students. Survey methodology targeted licensed practical nurses, registered nurses, and advanced practice registered nurses enrolled in online programs. Data collected from 116 students included demographics and answers to closed- and open-ended questions regarding emotional exhaustion. Participants reported high levels of emotional exhaustion related to multiple factors. Findings from this study will be used to identify at-risk students and interventions to decrease attrition and increase student success., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Aim: The aim of this study was to examine the effects of mentoring programs on undergraduate nursing students' mental health., Background: The study of nursing has been cited as stressful, with negative effects on academic and physical well-being and mental health in nursing students., Method: An integrative review of the literature using the method of Whittemore and Knafl was performed on mentoring programs designed to mitigate student stress. Electronic databases searched included CINAHL, Medline, PubMed, Embase, ERIC, and Scopus., Results: The eight studies included in this review suggest that mentoring has positive impacts on nursing students' mental health, reducing stress and anxiety and enhancing well-being and sense of belonging., Conclusion: Mentoring programs have positive effects on mental health outcomes in undergraduate nursing students. Implementation of structured programs at the start of undergraduate studies can facilitate increased mental and physical well-being and decrease stress and anxiety., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Abstract: The rigors of graduate nursing education create significant stress for nurse anesthesia students. The taxing background of an intensive care nurse, especially during the COVID-19 pandemic, compounds the inherent pressures of doctoral study. Students often experience symptoms of burnout, complicating their ability to learn and retain critical information. We created the Thrive initiative to encourage the development of emotional wellness. Thrive's success is attributed to the blend of relevant information including emotional intelligence skills and racial sensitivity support, engaged student participation, and the desire to help the next generation of graduate nurses develop sustainable emotional health., Competing Interests: The author has declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Objectives: This study aimed to comprehensively investigate the neuroanatomical alterations associated with idiopathic Ménière's disease (MD) using voxel-based morphometry and surface-based morphometry techniques. The primary objective was to explore nuanced changes in gray matter volume, cortical thickness, fractal dimension, gyrification index, and sulcal depth in MD patients compared with healthy controls (HC). Additionally, we sought to develop a machine learning classification model utilizing these neuroimaging features to effectively discriminate between MD patients and HC., Design: A total of 55 patients diagnosed with unilateral MD and 70 HC were enrolled in this study. Voxel-based morphometry and surface-based morphometry were employed to analyze neuroimaging data and identify structural differences between the two groups. The selected neuroimaging features were used to build a machine learning classification model for distinguishing MD patients from HC., Results: Our analysis revealed significant reductions in gray matter volume in MD patients, particularly in frontal and cingulate gyri. Distinctive patterns of alterations in cortical thickness were observed in brain regions associated with emotional processing and sensory integration. Notably, the machine learning classification model achieved an impressive accuracy of 84% in distinguishing MD patients from HC. The model's precision and recall for MD and HC demonstrated robust performance, resulting in balanced F1-scores. Receiver operating characteristic curve analysis further confirmed the discriminative power of the model, supported by an area under the curve value of 0.92., Conclusions: This comprehensive investigation sheds light on the intricate neuroanatomical alterations in MD. The observed gray matter volume reductions and distinct cortical thickness patterns emphasize the disease's impact on neural structure. The high accuracy of our machine learning classification model underscores its diagnostic potential, providing a promising avenue for identifying MD patients. These findings contribute to our understanding of MD's neural underpinnings and offer insights for further research exploring the functional implications of structural changes., Competing Interests: This work was supported by the National Natural Science Foundation of China (Grant No. 82101231, 81701673, 81670930), and the Hubei Provincial Natural Science Foundation of China (Grant No. 2021CFB547, 2019CFB497). There are no conflicts of interest, financial, or otherwise., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

As depressive symptom is considered a prodrome, a risk factor for progression from mild cognitive impairment (MCI) to dementia, improving depressive symptoms should be considered a clinical priority in patients with MCI undergoing transcranial direct current stimulation (tDCS) intervention. We aimed to comprehensively evaluate the efficacy of the home-based and remotely monitored tDCS in patients with both MCI and depression, by integrating cognitive, psychological, and electrophysiological indicators. In a 6-week, randomized, double blind, and sham-controlled study, 37 community-dwelling patients were randomly assigned to either an active or a sham stimulation group, and received 30 home-based sessions of 2 mA tDCS for 30 min with the anode located over the left and cathode over the right dorsolateral prefrontal cortex. We measured depressive symptoms, neurocognitive function, and resting-state electroencephalography. In terms of effects of both depressive symptoms and cognitive functions, active tDCS was not significantly different from sham tDCS. However, compared to sham stimulation, active tDCS decreased and increased the activation of delta and beta frequencies, respectively. Moreover, the increase in beta activity was correlated with the cognitive enhancement only in the active group. It was not possible to reach a definitive conclusion regarding the efficacy of tDCS on depression and cognition in patients with both MCI and depression. Nevertheless, the relationship between the changes of electrophysiology and cognitive performance suggests potential neuroplasticity enhancement implicated in cognitive processes by tDCS., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The relationship between long-term exposure to occupational noise and hearing loss has been extensively documented. We aimed to assess spatial and temporal changes in the burden of occupational noise-induced hearing loss (ONIHL) in 204 countries and territories with varying socio-demographic indexes (SDI) from 1990 to 2019., Design: Temporal and spatial trends in age-standardized disability-adjusted life year rates (ASDR) for ONIHL were estimated by sex, age, SDI level, country, and geographic region from 1990 to 2019. We used the Joinpoint model to calculate annual average percentage changes to assess such trends and projected trends in ASDR for ONIHL globally and across different income regions from 2020 to 2044 using an age-period-cohort model. We fitted the relationship between ASDR and SDI, ASDR and healthcare access and quality index, respectively., Results: Overall, the global burden of ONIHL has decreased since 1990, especially in middle and lower SDI regions. In 2019, the global ASDR for ONIHL was 84.23 (95% confidence interval: 57.46 to 120.52) per 100,000 population. From 1990 to 2019, the global ASDR for ONIHL decreased by 1.72% (annual average percentage change = -0.05, 95% confidence interval: -0.07 to -0.03). Our projections showed a decreasing trend in the global ONIHL burden until 2044. ASDR and SDI ( R = -0.8, p < 0.05), ASDR and healthcare access and quality index ( R = -0.75, p < 0.05) showed significant negative correlations., Conclusions: The global ONIHL burden has decreased over the past three decades, especially in regions with middle and lower SDI levels. However, the global ONIHL burden still remained severe in 2019, notably among males, the middle-aged and elderly, and regions with lower SDI levels., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Food purchasing behaviours are shaped by the choices available to shoppers and the way they are offered for sale. This study tested whether prominent positioning of more sustainable food items online and increasing their relative availability might reduce the environmental impact of foods selected in a 2x2 (availability x position) factorial randomised controlled trial. Participants (n = 1179) selected items in a shopping task in an experimental online supermarket. The availability intervention added lower-impact products to the regular range. The positioning intervention biased product order to give prominence to lower-impact products. The primary outcome was the environmental impact score (ranging from 1 "least impact" to 5 "most impact", of each item in shopping baskets) analysed using Welch's ANOVA. Secondary outcomes included interactions (analysed via linear regression) by gender, age group, education, income and meat consumption and we assessed intervention acceptability (using different frames) in a post-experiment questionnaire. Compared to control (mean = 21.6), mean eco quintile score was significantly reduced when availability & order was altered (-2.30; 95%CI: 3.04; -1.56) and when order only was changed (-1.67; 95%CI: 2.42; -0.92). No significant difference between availability only (-0.02; 95%CI: 0.73; 0.69) and control was found. There were no significant interactions between interventions or by demographic characteristics. Both interventions were acceptable under certain frames (positioning emphasising lower-impact products: 70.3% support; increasing lower-impact items: 74.3% support). Prominent positioning of more sustainable products may be an effective strategy to encourage more sustainable food purchasing. Increasing availability of more sustainable products alone did not significantly alter the environment impact of products selected., Competing Interests: Declaration of Competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Global Cancer Statistics 2020 reported that breast cancer had exceeded lung cancer as the most frequently diagnosed cancer. Surgery is the primary treatment modality for breast cancer, but postoperative upper limb dysfunction often occurs; functional exercise can alleviate this and restore upper limb function. However, exercise compliance is low in postoperative breast cancer patients; thus, many studies have been conducted in recent years to improve patient compliance with exercise., Objective: The aim of this study was to compare the effectiveness of different interventions to improve exercise adherence in postoperative breast cancer patients., Methods: We searched PubMed, Cochrane Library, Web of Science, EMBASE, Wan Fang, CNKI, VIP, and CBM databases for eligible studies. Exercise adherence rate and quality-of-life difference were assessed as outcomes. Sensitivity analysis and inconsistency detection were performed to evaluate whether the exclusion of high-risk studies affected the validity. Risk of bias was assessed using the risk-of-bias table in RevMan 5.4. Surface under the cumulative ranking was used to estimate the rankings among different interventions., Results: Twenty-five randomized controlled trials involving 9 interventions were included, and the network meta-analysis results showed that patients in the pedometer + counseling group had the best exercise adherence., Conclusion: Pedometer + counseling care measures are recommended to improve exercise adherence in postoperative breast cancer patients., Implications for Practice: Oncology nurses can improve patients' exercise compliance through counseling and by giving them pedometers to wear., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Patients with lung cancer experience multiple symptoms requiring self-management. Little is known about how self-management is influenced by interactive health literacy, defined as communicating with healthcare providers to obtain and process information., Objective: This study explored how interactive health literacy relates to symptom self-management among patients with lung cancer. A second aim explored how interactive health literacy might be integrated into the Individual and Family Self-management Theory., Methods: This study used a cross-sectional mixed-methods design. Quantitative data included demographics, the All Aspects of Health Literacy Scale, and the Memorial Symptom Assessment-Short Form. Qualitative data were collected using semistructured interviews. Data analysis followed a critical realist model., Results: Twelve adults who recently received treatment for lung cancer reported an average of 14 symptoms that caused moderate distress. Average interactive health literacy of the sample was in the moderate range. Participants' experiences of self-management differed based on their interactive health literacy. A generative mechanism proposes that those with higher interactive health literacy who accessed online information used this information as a basis for engaging with providers regarding potential symptom self-management strategies., Conclusions: Interactive health literacy skills may play a role in patients' ability and confidence in symptom self-management through interactions with oncology providers. Further research should clarify the relationship between interactive health literacy, self-efficacy, and collaboration with oncology providers., Implications for Practice: The patient-provider relationship is a key factor influencing how patients obtain and process symptom self-management information. Oncology providers should implement patient-centered strategies to engage patients in symptom self-management., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Hypothesis tests for hearing threshold data may be challenging due to the special structure of the response variable, which consists of the measurements from the participant's two ears at multiple frequencies. The commonly-used methods may have inflated type I error rates for the global test that examines whether exposure-hearing threshold associations exist in at least one of the frequencies. We propose using both-ear methods, including all frequencies in the same model for hypothesis testing., Design: We compared the both-ear method to commonly used single-ear methods, such as the worse-ear, better-ear, left/right-ear, average-ear methods, and both-ear methods that evaluate individual audiometric frequencies in separate models, through both theoretical consideration and a simulation study. Differences between the methods were illustrated using hypothesis tests for the associations between the Dietary Approaches to Stop Hypertension adherence score and 3-year change in hearing thresholds among participants in the Conservation of Hearing Study., Results: We found that (1) in the absence of ear-level confounders, the better-ear, worse-ear and left/right-ear methods have less power for frequency-specific tests and for the global test; (2) in the presence of ear-level confounders, the better-ear and worse-ear methods are invalid, and the left/right-ear and average-ear methods have less power, with the power loss in the left/right-ear much greater than the average-ear method, for frequency-specific tests and for the global test; and (3) the both-ear method with separate analyses for individual frequencies is invalid for the global test., Conclusions: For hypothesis testing to evaluate whether there are significant associations between an exposure of interest and audiometric hearing threshold measurements, the both-ear method that includes all frequencies in the same model is the recommended analytic approach., (Copyright © 2024 The Authors. Ear & Hearing is published on behalf of the American Auditory Society, by Wolters Kluwer Health, Inc.)

Rationale and Objective: Cystic fibrosis (CF) is caused by mutations in the CF Transmembrane Conductance Regulator (CFTR) gene. CFTR modulators offer significant improvements, but approximately 10% of patients remain nonresponsive or are intolerant. This study provides an analysis of rSIV.F/HN, a lentiviral vector optimized for lung delivery, including CFTR protein expression, functional correction of CFTR defects and genomic integration site analysis in preparation for a first-in-human clinical trial., Methods: Air-liquid interface cultures of primary human bronchial epithelial cells (HBEC) from CF patients (F508del/F508del), as well as a CFTR-deficient immortalized human lung epithelial cell line mimicking Class I (CFTR-null) homozygous mutations, were used to assess transduction efficiency. Quantification methods included a novel proximity ligation assay (PLA) for CFTR protein expression. For assessment of CFTR channel activity, Ussing chamber studies were conducted. The safety profile was assessed using integration site analysis and in vitro insertional mutagenesis studies., Results: rSIV.F/HN expressed CFTR and restored CFTR-mediated chloride currents to physiological levels in primary F508del/F508del HBECs as well as in a Class I cells. In contrast, the latter could not be achieved by small-molecule CFTR modulators, underscoring the potential of gene therapy for this mutation class. Combination of rSIV.F/HN-CFTR with the potentiator ivacaftor showed a greater than additive effect. The genomic integration pattern showed no site predominance (frequency of occurrence ≤10%), and a low risk of insertional mutagenesis was observed in an in vitro immortalization assay., Conclusions: The results underscore rSIV.F/HN as a promising gene therapy vector for CF, providing a mutation-agnostic treatment option., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)

Abstract: Family nurse practitioners (FNPs) are often gatekeepers and can recognize the warning signs of suicidality yet may lack adequate education or self-confidence in identifying people in crisis. The purpose of this research was to evaluate the effectiveness of an online suicide prevention simulation with 53 FNP students. Pre/post responses were found to be statistically significant across all preparedness and attitudinal items following the Kognito© training (p < .001). Online, avatar-based suicide prevention training with FNP students may be effective in improving participants' perceived preparedness and self-confidence with patients at risk for suicidality., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

During the opening of diplomatic relations in the 1990s, South Africa gifted 20 southern white rhinoceros (Ceratotherium simum simum) to Kenya. The species is not indigenous to Kenya, and management of the introduction was not clearly addressed in the legislation. Responsibility was left to the private sector and local authorities. Ten of the animals were introduced to land contiguous with the Maasai Mara National Reserve, an area with tsetse-trypanosomiasis challenges, and with rare cases of human sleeping sickness. Mortalities had been previously documented when indigenous naïve black rhinoceros were introduced to areas with tsetse; hence there was no consensus on the management of this introduction. Feasibility was only explored once before with the introduction of two animals in a monitored and managed translocation from Lewa Downs, Laikipia in 1992-1994. Ultimately, Kenyan experts were co-opted to address risk after trypanosomiasis occurred in many animals. Unfortunately, this finding was followed by gradual mortalities of most rhinoceros with only a few being saved by removal to highland private sanctuaries. This event was complicated by many factors. Samples were only sporadically collected, and mainly from sick animals. With no clear responsibility by government agencies, a collaboration between veterinarians and researchers resulted in characterization of the disease challenge, and when invited, assessment of health status. Laboratory diagnostics revealed common and sometimes severe infections with Trypanosoma brucei, a normally infrequent trypanosome. Infection was associated with disturbances in erythropoiesis, especially anemia. Symptoms varied from sudden death associated with intestinal atony, to a semiparalyzed animal that was partially responsive to treatment for trypanosomes. This event should be used as a caution to future movements of this species that are planned or ongoing in Africa, for conservation or other purposes., (© Wildlife Disease Association 2024.)

Background: Hair transplantation has become a major method for improving upper facial contour. Hairline contour (HC) and hair growth direction (HGD) are the main factors affecting postoperative aesthetic outcomes. However, studies on natural HC and HGD in Chinese women are scarce., Objective: To summarize the HC and HGD of hairlines in Chinese female participants., Materials and Methods: Standard photographs of the forehead were obtained from healthy Chinese volunteers older than 18 years. Hairline contour features were classified into 5 groups: round, bell-shaped, M-shaped, rectangular, and triangular. Hair growth direction was classified into 5 groups: Type ⅠA, Type ⅠB, Type ⅡA, Type ⅡB1, and Type ⅡB2. The authors performed hairline corrections in female participants., Results: A total of 568 women participated in this study. The proportions of participants with different HC features were as follows: round (8.10%), bell-shaped (15.84%), M-shaped (23.24%), rectangular (44.19%), and triangular (8.63%). The proportions of participants with different HGDs were as follows: Type ⅠA (7.75%), Type ⅠB (27.64%), Type ⅡA (30.81%), Type ⅡB1 (28.34%), and Type ⅡB2 (5.46%)., Conclusion: Both HC and HGD were categorized into 5 types in Chinese women. Shaping the hairline into a round type along with the preexisting direction was suggested in most instances., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Silicosis typically has been classified as a chronic disease that develops after at least 10 years of exposure to silica dust, and often is associated with miners and stone workers. As industries have changed over time, other types of workers (including those in artificial stonework, jewelry polishing, and denim production) have become exposed to high levels of silica, leading to the development of acute and accelerated silicosis. Acute silicosis can develop in as little as a few months, and accelerated silicosis can develop in as little as 2 years. No cure exists for any form of silicosis, and lung transplantation is the only lifesaving treatment. Primary care clinicians must understand when patients are at risk for developing silicosis and not assume that a short time of exposure precludes the development of silicosis., (Copyright © 2024 Wolters Kluwer Health | Lippincott Williams & Wilkins.)

Purpose: Mentorship has many notable benefits. Research about mentorship for physician associates/assistants (PAs) is limited. This study sought to uncover more detailed information on mentorship and its effect on PAs., Methods: A survey was sent via email to all PAs and advanced practice registered nurses at our institution. Subgroup analysis was performed on PA respondents, including satisfaction and independent predictors associated with mentorship., Results: Of the 295 PAs, 63 (21.4%) identified having a mentor. Those with a mentor were statistically more likely to function as a mentor (OR 2.7 [95% CI 1.5-4.9], P = .001), have an academic rank of assistant professor or higher (OR 2.7 [95% CI 1.3-5.5], P = .007), be under age 45 years (OR 6.1 [95% CI 2.1-17.4], P = .008), be less than 10 years into their career (OR 3.1 [95% CI 1.7-5.7], P = .002), and be satisfied with mentorship (88.9% versus 23.9%, P < .001)., Conclusions: Mentorship for PAs is crucial and can boost academic promotion and career satisfaction., (Copyright © 2024 Wolters Kluwer Health | Lippincott Williams & Wilkins.)

Abstract: Serotonin syndrome is a rare, life-threatening toxidrome caused by serotonergic agents. This syndrome classically presents with a combination of mental status changes, autonomic hyperactivity, and neuromuscular abnormalities. However, diagnosing the condition is difficult because of its variable symptoms at presentation. As a result, serotonin syndrome often is underreported, making it harder to understand, recognize, and treat. Patients with this condition may present to primary or urgent care or an ED, and may become acutely symptomatic during an inpatient admission. Clinicians must be able to identify at-risk patients and intervene to prevent potentially lethal complications., (Copyright © 2024 Wolters Kluwer Health | Lippincott Williams & Wilkins.)

Dextromethorphan toxicity in young children (especially those with age 4 years or younger) can have an extremely poor prognosis if untreated. However, if timely recognized and optimally managed, it can have a good clinical outcome despite significant initial insult. We present 3 pediatric cases (< 5 years old) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in cerebellar hemispheres on MR brain, with diffusion restricting foci in supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, the POUNCE syndrome (Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema). Hence, we name this entity "DANCE" (Dextromethorphan Associated Neurotoxicity with Cerebellar Edema) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.ABBREVIATIONS: POUNCE= Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema; DANCE= Dextromethorphan Associated Neurotoxicity with Cerebellar Edema., (© 2024 by American Journal of Neuroradiology.)

Abstract: The human body possesses the unique ability to repair itself after injury through complex, sequential phases. Current development of advanced wound care therapies generally focuses on addressing a single aspect of this biological process that can result in delayed or ineffective wound healing. When patients present with further systemic and local confounding pathologies it can result in painful, chronic wounds that are especially challenging to treat.In this case report, the authors demonstrate how treatment with a novel multimodal wound matrix expedited healing and decreased pain in two patients who had each been unresponsive to treatment with advanced modalities for more than 7 months. The first patient had factor V Leiden and the second patient had sickle cell disease. Use of a once-weekly treatment protocol with the multimodal wound matrix, combined with sharp debridement when deemed clinically necessary, resulted in elimination of pain and expedited wound healing to closure. The wound matrix's omega fatty acid-based formulation is designed to target multiple factors common among hard-to-heal wounds that when not addressed, can adversely inhibit the wound-healing cascade., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: The diagnosis, severity assessment, and development of therapeutic strategies for asthma are crucial aspects of disease management. Since biomarkers are reliable tools in disease management, we aimed to identify and explore asthma-associated biomarkers and investigate their mechanisms., Methods: Lipidomics was used to profile serum glycerophospholipids in asthmatic patients and controls. The absolute concentration of lysophosphatidylglycerol (LPG) 18:0 was quantified in various asthma subtypes. Mouse asthma models were used to confirm its potential as a biomarker and investigate its mechanisms in vivo. The effects of LPG 18:0 on CD4 + T cell differentiation, proliferation, and apoptosis were assessed in vitro by flow cytometry, while mitochondrial dysfunction was evaluated through mitochondrial membrane potential, reactive oxygen species, and ATP production measurements. The intracellular mechanism of LPG 18:0 in Tregs was investigated using small molecule inhibitors., Results: The serum glycerophospholipid profile varied between asthmatic patients and control group, with LPG 18:0 levels being notably higher in asthmatic patients, correlating with asthma severity and control level. In vivo and in vitro studies revealed that LPG18:0 impaired naïve CD4 + T cell differentiation into Tregs and compromised their suppressive function. Further investigation demonstrated that LPG18:0 treatment reduced the FOXP3 protein level via SIRT1-mediated deacetylation during Treg differentiation., Conclusions: This study identifies that serum levels of LPG 18:0 are generally elevated in asthmatics and serve as a biomarker for asthma. LPG 18:0 impairs Treg function via the NAD + /SIRT1/FOXP3 pathway. Our research reveals the potential of LPG18:0 as a biomarker for asthma, elucidating its role in asthma diagnosis and treatment., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)

Emphysema, the progressive destruction of gas exchange surfaces in the lungs, is a hallmark of chronic obstructive pulmonary disease (COPD) that is presently incurable. This therapeutic gap is largely due to a poor understanding of potential drivers of impaired tissue regeneration, such as abnormal lung epithelial progenitor cells, including alveolar type II (ATII) and airway club cells. We discovered an emphysema-specific sub-population of ATII cells located in enlarged distal alveolar sacs, termed asATII cells. Single cell RNA-seq and in situ localisation revealed that asATII cells co-express the alveolar marker surfactant protein C (SPC) and the club cell marker secretaglobin-3A2 (SCGB3A2). A similar ATII sub-population derived from club cells was also identified in mouse COPD models using lineage labeling. Human and mouse ATII sub-populations formed 80-90% fewer alveolar organoids than healthy controls, indicating reduced progenitor function. Targeting asATII cells or their progenitor club cells could reveal novel COPD treatment strategies., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)

Rationale: The inflammasome is a key regulatory complex of the inflammatory response leading to interleukin-1β (IL-1β) release and activation. IL-1β amplifies inflammatory responses and induces mucus secretion and hyperconcentration in other diseases. The role of IL-1β in bronchiectasis has not been investigated., Objectives: To characterise the role of airway IL-1β in bronchiectasis, including the association with mucus properties, ciliary function, airway inflammation, microbiome and disease severity., Methods: Stable bronchiectasis patients were enrolled in an international cohort study (n=269). IL-1β was measured in sputum supernatant. A validation cohort also had sputum rheology and hydration measured (n=53). For analysis, patients were stratified according to the median value of IL-1β in the population (high versus low) to compare disease severity, airway infection, microbiome (16S rRNA sequencing), inflammation and caspase-1 activity. Primary human nasal epithelial cells grown in air-liquid interface culture were used to study the effect of IL-1β on cilia function., Results: Patients with high sputum IL-1β had more severe disease, increased caspase-1 activity and an increased T-helper type 1, T-helper type 2 and neutrophil inflammatory response compared with patients with low IL-1β. The active-dominant form of IL-1β was associated with increased disease severity. High IL-1β was related to higher relative abundance of Proteobacteria in the microbiome and increased mucus solid content and viscoelastic properties. Chronic IL-1β treatment reduced the functionality of cilia and tight junctions of epithelial cells in vitro ., Conclusions: A subset of stable bronchiectasis patients show increased airway IL-1β, suggesting pulmonary inflammasome activation is linked with more severe disease, airway infection, mucus dehydration and epithelial dysfunction., Competing Interests: Conflict of interest: M. Shteinberg reports consulting fees from GSK, Boehringer Ingelheim, Kamada and Zambon; payment or honoraria for lectures, presentations, manuscript writing or educational events from Insmed, Boehringer Ingelheim, GSK, AstraZeneca, Teva, Novartis, Kamada and Sanofi; support for attending meetings and/or travel from Novartis, Actelion, Boehringer Ingelheim, GSK and Rafa; participation on a data safety monitoring board or advisory board for Bonus Therapeutics, Israel; leadership roles for EMBARC Management, Israel Pulmonology Society Board, Israel Society for TB and Mycobacterial Diseases; receipt of equipment, materials, drugs, medical writing, gifts or other services from Trudell Medical Int; and is an associate editor of the American Journal of Respiratory and Critical Care Medicine. P.C. Goeminne reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Insmed, GSK and Chiesi; support for attending meetings and/or travel from Chiesi; and participation on a data safety monitoring board or advisory board for Boehringer, GSK and Pfizer. E. Polverino reports grants or contracts from Grifols; consulting fees from Insmed, Bayer, Chiesi and Zambon; payment or honoraria for lectures, presentations, manuscript writing or educational events from Bayer, Chiesi, Grifols, GSK, Insmed, Menarini and Zambon; and support for attending meetings and/or travel from Insmed, Pfizer and Moderna. F. Blasi reports grants or contracts from AstraZeneca, Chiesi and Insmed; consulting fees from Menarini; and payment or honoraria for lectures, presentations, manuscript writing or educational events from AstraZeneca, Chiesi, GSK, Guidotti, Grifols, Insmed, Menarini, Novartis, OM Pharma, Pfizer, Sanofi, Viatris, Vertex and Zambon. S. Aliberti reports grants or contracts from Insmed Incorporated, Chiesi, Fisher and Paykel and GSK; royalties or licences from McGraw Hill; consulting fees from Insmed Incorporated, Insmed Italy, Insmed Ireland Ltd, Zambon Spa, AstraZeneca UK Ltd, AstraZeneca Pharmaceutical LP, CSL Behring GmbH, Grifols, Fondazione Internazionale Menarini, Moderna, Chiesi, MCD Italis SrL, Brahms, Physioassist SAS and GSK SpA; payment or honoraria for lectures, presentations, manuscript writing or educational events from GSK SpA, Thermofisher Scientific, Insmed Italy, Insmed Ireland, Zambon and Fondazione Internazionale Menarini; and participation on a data safety monitoring board or advisory board for Insmed Incorporated, Insmed Italy, AstraZeneca UK Ltd and MSD Italia SrL. J.D. Chalmers reports grants or contracts from AstraZeneca, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Grifols, Insmed, LifeArc and Novartis; and consulting fees from AstraZeneca, Chiesi, GSK, Insmed, Grifols, Novartis, Boehringer Ingelheim, Pfizer, Janssen, Antabio and Zambon. A. Shoemark reports consulting fees from Spirovant and Translate Bio; payment or honoraria for lectures, presentations, manuscript writing or educational events from Translate Bio, Ethris and Insmed; and a leadership role in European Respiratory Society Clinical Research Collaborations (EMBARC, BEATPCD, AMR). The remaining authors have no potential conflicts of interest to disclose., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)

Euglenids have long been studied due to their unique physiology and versatile metabolism, providing underpinnings for much of our understanding of photosynthesis and biochemistry, and a growing opportunity in biotechnology. Until recently there has been a lack of genetic studies due to their large and complex genomes, but recently new technologies have begun to unveil their genetic capabilities. Whilst much research has focused on the model organism Euglena gracilis, other members of the euglenids have now started to receive due attention. Currently only poor nuclear genome assemblies of E. gracilis and Rhabdomonas costata are available, but there are many more plastid genome sequences and an increasing number of transcriptomes. As more assemblies become available, there are great opportunities to understand the fundamental biology of these organisms and to exploit them for biotechnology., Competing Interests: Declaration of interests The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Abstract: Sarcoptes scabiei mites and skin lesions consistent with severe sarcoptic mange were identified in a Tasmanian devil (Sarcophilus harrisii) and Bennett's wallaby (Notamacropus rufogriseus) from Tasmania, Australia. The devil and wallaby both had severe hyperkeratotic skin lesions. All stages of mite development were identified in the devil, suggesting parasite reproduction on the host. The devil was also affected by devil facial tumor disease and several other parasites. This expands the global host range of species susceptible to this panzootic mange disease., (© Wildlife Disease Association 2024.)

Background: COVID-19 remains a challenge to individual health and healthcare resources worldwide. Telemedical surveillance might minimise hospitalisation and direct patient-physician contacts. Yet, randomised clinical trials evaluating telemedical management of COVID-19 patients are lacking., Methods: COVID-SMART is a randomised, open-label, controlled clinical trial investigating whether telemedicine reduces the primary end-point of hospitalisation or any unscheduled utilisation of an emergency medical service within 30 days of follow-up. Key secondary end-points included mortality and primary end-point components. We enrolled acutely infected SARS-CoV-2 patients suitable for outpatient care. All presented with ≥1 risk factor for an adverse COVID-19 course. Patients were randomised 1:1 into a control group receiving standard of care and an intervention group receiving smartphone-based assessment of oxygen saturation, heart rate and electrocardiogram, and telemedical counselling via a 24/7 emergency hotline., Results: Of 607 enrolled patients (mean±sd age 46.7±13.5 years), 304 were randomised into the intervention and 303 into the control group. The primary end-point occurred in 6.9% (n=21) of the intervention and in 9.6% (n=29) of the control group (hazard ratio (HR) 0.72, 95% confidence interval (CI) 0.41-1.26; p=0.24). No deaths occurred during follow-up. Fewer intervention group participants utilised outpatient-based emergency medical services (HR 0.43, 95% CI 0.20-0.90; p=0.03)., Conclusions: COVID-SMART is the first randomised clinical trial assessing the benefit of telemedicine in an acute respiratory infectious disease. Whereas telemedical management did not reduce the primary end-point of hospitalisation, fewer intervention group patients used outpatient-based emergency services, suggesting a potential benefit for less-acutely infected individuals., Competing Interests: Conflict of interest: A.S. von Falkenhausen declares to be granted support from the German Research Foundation. Conflict of interest: C. Scherer reports speaker honoraria from AstraZeneca outside the submitted work. Conflict of interest: P. de Villèle reports being an employee of Withings, the manufacturer of Scanwatch, the smart watch that was used in this trial. Conflict of interest: M.F. Sinner declares being granted support from the German Centre for Cardiovascular Research and with travel support from Biotronik. Conflict of interest: All other authors declare no potential conflict of interest., (Copyright ©The authors 2024.)

Importance: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the postresuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover IHCA study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort., Objectives: Our study collects granular data on post-IHCA treatment practices, focusing on temperature control and prognostication, with the objective of describing variation in current post-IHCA practices., Design, Setting, and Participants: This is a multicenter, prospectively collected, observational cohort study of patients who have suffered IHCA and have been successfully resuscitated (achieved ROSC). There are 24 enrolling hospital systems (23 in the United States) with 69 individuals enrolling in hospitals (39 in the United States). We developed a standardized data dictionary, and data collection began in October 2023, with a projected 1000 total enrollments. Discover IHCA is endorsed by the Society of Critical Care Medicine., Main Outcomes and Measures: The study collects data on patient characteristics, including prearrest frailty, arrest characteristics, and detailed information on postarrest practices and outcomes. Data collection on post-IHCA practice was structured around current American Heart Association and European Resuscitation Council guidelines. Among other data elements, the study captures postarrest temperature control interventions and postarrest prognostication methods., Results: The majority of participating hospital systems are large, academic, tertiary care centers serving urban populations. The analysis will evaluate variations in practice and their association with mortality and neurologic function., Conclusions and Relevance: We expect this study, Discover IHCA, to identify variability in practice and outcomes following IHCA and be a vital resource for future investigations into best practices for managing patients after IHCA., Competing Interests: Dr. Moskowitz is funded by a grant from the National Institutes of Health/National Heart, Lung, and Blood Institute (4R33HL162980). The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Centrosomes rely upon proteins within the pericentriolar material to nucleate and organize microtubules. Several mRNAs also reside at centrosomes, although less is known about how and why they accumulate there. We previously showed that local Centrocortin ( Cen ) mRNA supports centrosome separation, microtubule organization, and viability in Drosophila embryos. Here, using Cen mRNA as a model, we examine mechanisms of centrosomal mRNA localization. We find that while the Cen N'-terminus is sufficient for protein enrichment at centrosomes, multiple domains cooperate to concentrate Cen mRNA at this location. We further identify an N'-terminal motif within Cen that is conserved among dynein cargo adaptor proteins and test its contribution to RNA localization. Our results support a model whereby Cen protein enables the accumulation of its own mRNA to centrosomes through a mechanism requiring active translation, microtubules, and the dynein motor complex. Taken together, our data uncover the basis of translation-dependent localization of a centrosomal RNA required for mitotic integrity., Competing Interests: The authors declare no competing financial interests.

River water in Kosovo is exposed to various discharges from industrial and agricultural activities as well as to urban wastewater. Rivers Sitnica and Drenica are among the most affected ones and water samples drawn from these rivers show the presence of various toxic substances. Genotoxic effects are seen in fish living in these rivers indicating a cytotoxic and mutagenic potential of the river water. Aiming at substantiating these observations, we assessed cyto- and genotoxic effects of water samples collected at different locations from Drenica and Sitnica river. Samples drawn from Lake Badovc served for comparison. To address seasonal effects, samples were collected at different seasons/time points during the period summer 2016 - spring 2018. The water samples were analyzed employing primary rat hepatocytes as reliable in vitro cell model for the assessment of cytotoxic effects (mitotic arrest and cell death) and DNA damage/genotoxicity (micronucleus assay, Comet assay). The results do not account for significant effects associated with specific locations but demonstrate seasonal differences of the genotoxic potential of the water samples collected along both rivers, which are accompanied by a limited cytotoxic potential. Our data provide substantial support to earlier observations and strongly warrant the need for continuous chemical as well as biological monitoring of the river water in Kosovo, focusing on an improved toxicant profiling of the river water and investigations addressing the observed seasonal variations., (© The Author(s) 2024. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society. 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.)

Characterizing the transcriptional and translational gene expression patterns at the single-cell level within their three-dimensional (3D) tissue context is essential for revealing how genes shape tissue structure and function in health and disease. However, most existing spatial profiling techniques are limited to 5-20 μm thin tissue sections. Here, we developed Deep-STARmap and Deep-RIBOmap, which enable 3D in situ quantification of thousands of gene transcripts and their corresponding translation activities, respectively, within 200-μm thick tissue blocks. This is achieved through scalable probe synthesis, hydrogel embedding with efficient probe anchoring, and robust cDNA crosslinking. We first utilized Deep-STARmap in combination with multicolor fluorescent protein imaging for simultaneous molecular cell typing and 3D neuron morphology tracing in the mouse brain. We also demonstrate that 3D spatial profiling facilitates comprehensive and quantitative analysis of tumor-immune interactions in human skin cancer., Competing Interests: Competing interests X.W. and X.S. are inventors on pending patent applications related to Deep-STARmap and Deep-RIBOmap. X.W. is a scientific co-founder and consultant of Stellaromics. Other authors declare no competing interests.

Starting October 2022, the Boston Public Health Commission implemented a neighborhood-level wastewater-based epidemiology program to inform strategies to reduce COVID-19 inequities. We collected samples twice weekly at 11 neighborhood sites, covering approximately 18% of Boston, Massachusetts's population. Results from the program's first year revealed inequities unobservable in regional wastewater data both between the City of Boston and the greater Boston area and between Boston neighborhoods. We report program results and neighborhood-specific recommendations and resources to help residents interpret and use our findings. ( Am J Public Health . Published online ahead of print August 8, 2024:e1-e5. https://doi.org/10.2105/AJPH.2024.307749).

Objective: Cognitive impairment is a common nonmotor symptom in Parkinson's disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance., Methods: Data were obtained from the Parkinson's Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall., Results: Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group., Conclusions: These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities., Competing Interests: The authors report no financial relationships with commercial interests.