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Background: High dose rate brachytherapy is commonly used in the treatment of prostate cancer. Treatment planning is often performed under transrectal ultrasound (US) guidance, but brachytherapy needles can be challenging to digitize due to the presence of poor US conspicuity and imaging artifacts. The plan accuracy and quality, however, are dependent on the proper visualization of the needles with millimeter accuracy. Purpose: This work describes a technique for generating a color overlay of needle locations atop the grayscale US image. Prototype devices were developed to produce vibrations in the brachytherapy needles that generate a high contrast color Doppler (CD) signal that highlights the needle locations with superior contrast and reduced artifacts. Denoted by the acronym color VISION (Vibrationally Induced Shimmering for Identifying an Object's Nature), the technology has the potential to improve applicator conspicuity and facilitate automated applicator digitization. Methods: Three prototype vibrational devices with frequencies between 200–450 Hz were designed in‐house and evaluated with needle implants in a phantom and cadaveric male pelvis using: (1) an actuator attached to the front of a prostate needle template; (2) an actuator attached to the top of the needle template; and (3) a hand‐held actuator with a stylet, inserted directly into a needle's inner lumen. Acquired images were postprocessed in MATLAB to evaluate the potential for automated digitization. Results: All prototype devices produced localized shimmering in implanted brachytherapy needles in both the axial and sagittal planes. The template mounted actuators provided better vibrational coupling and ease of operation than the stylet prototype. The Michelson contrast, or visibility, of the shimmering CD signal was 100% compared with ≤40% for B‐mode imaging of a single needle. Proof‐of‐principle for automated applicator digitization using only the CD signal was demonstrated. Conclusions: The color VISION prototype devices successfully coupled mechanical vibrations into brachytherapy needles to generate US CD shimmering and accurately highlight brachytherapy needle locations. The high contrast and natively registered signal are promising for future work to automate the needle digitization and provide a real‐time visual overlay of the applicator on the B‐mode US image. [ABSTRACT FROM AUTHOR]

Summary: Background: Data on oral vancomycin for primary sclerosing cholangitis (PSC)‐associated inflammatory bowel disease (IBD) are limited. Aims: Using data from the Paediatric PSC Consortium, to examine the effect of vancomycin on IBD activity. Methods: In this retrospective multi‐centre cohort study, we matched vancomycin‐treated and untreated patients (1:3) based on IBD duration at the time of primary outcome assessment. The primary outcome was Physician Global Assessment (PGA) of IBD clinical activity after 1 year (±6 months) of vancomycin. We used generalised estimating equations (GEE) to examine the association between vancomycin and PGA remission, adjusting for IBD type, severity and medication exposures. Secondary outcomes included serum labs and endoscopic remission (global rating of no activity) among those with available data and also analysed with GEE. Results: 113 PSC‐IBD patients received vancomycin (median age 12.7 years, 63% male). The matched cohort included 70 vancomycin‐treated and 210 untreated patients. Vancomycin was associated with greater odds of IBD clinical remission (odds ratio [OR] 3.52, 95% CI 1.97–6.31; adjusted OR [aOR] 5.24, 95% CI 2.68–10.22). Benefit was maintained in sensitivity analyses restricted to non‐transplanted patients and those with baseline moderate–severe PGA. Vancomycin was associated with increased odds of endoscopic remission (aOR 2.76, 95% CI 1.002–7.62; N = 101 with data), and with lower CRP (p = 0.03) and higher haemoglobin and albumin (both p < 0.01). Conclusion: Vancomycin was associated with greater odds of IBD clinical and endoscopic remission. Additional, preferably randomised, controlled studies are needed to characterise efficacy using objective markers of mucosal inflammation, and to examine safety and define optimal dosing. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has led to unprecedented life disruptions among young adults, including increased job insecurity and financial strain. Mental health problems and substance use have also increased during the pandemic, with young adults particularly vulnerable to experiencing these challenges. This study examines trajectories of financial distress among young adults during the pandemic and their associations with depression, anxiety, and hazardous alcohol and cannabis use. Data from 473 young adults (ages 22–29) recruited in the Northwest United States were collected from April/May 2020 to July/August 2021. Financial distress trajectories were identified using growth mixture modeling. Negative binomial models were used to examine associations between financial distress trajectories and distal outcomes of depression, anxiety, alcohol, and cannabis use. Three distinct trajectories were identified, revealing Low, Moderate, and High financial distress experiences. Individuals with "Moderate" and "High" trajectories showed significantly greater depressive and anxiety symptom scores compared with those in the "Low" financial distress trajectory group. Trajectories were not associated with subsequent levels of alcohol or cannabis use. Young adult mental health remains a priority during periods of economic downturn. Providers must be aware of the psychological challenges imposed by financial distress among young adults to address worsening mental health symptoms. [ABSTRACT FROM AUTHOR]

Background: An important life‐course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. Methods: We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. Results: Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. Conclusions: Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event‐specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday. [ABSTRACT FROM AUTHOR]

Drug development teams must evaluate the risk/benefit profile of new drug candidates that perpetrate drug–drug interactions (DDIs). Real‐world data (RWD) can inform this decision. The purpose of this study was to develop a predicted impact score for DDIs perpetrated by three hypothetical drug candidates via CYP3A, CYP2D6, or CYP2C9 in type 2 diabetes mellitus (T2DM), obesity, or migraine. Optum Market Clarity was analyzed to estimate use of CYP3A, CYP2D6, or CYP2C9 substrates classified in the University of Washington Drug Interaction Database as moderate sensitive, sensitive, narrow therapeutic index, or QT prolongation. Scoring was based on prevalence of exposure to victim substrates and characteristics (age, polypharmacy, duration of exposure, and number of prescribers) of those exposed. The study population of 14,163,271 adults included 1,579,054 with T2DM, 3,117,753 with obesity, and 410,436 with migraine. For T2DM, 71.3% used CYP3A substrates, 44.3% used CYP2D6 substrates, and 44.3% used CYP2C9 substrates. For obesity, 57.1% used CYP3A substrates, 34.6% used CYP2D6 substrates, and 31.0% used CYP2C9 substrates. For migraine, 64.1% used CYP3A substrates, 44.0% used CYP2D6 substrates, and 28.9% used CYP2C9 substrates. In our analyses, the predicted DDI impact scores were highest for DDIs involving CYP3A, followed by CYP2D6, and CYP2C9 substrates, and highest for T2DM, followed by migraine, and obesity. Insights from RWD can be used to estimate a predicted DDI impact score for pharmacokinetic DDIs perpetrated by new drug candidates currently in development. This score can inform the risk/benefit profile of new drug candidates in a target patient population. [ABSTRACT FROM AUTHOR]

Cyanobacterial harmful algal blooms (cyanoHABs) can harm people, animals, and affect consumptive and recreational use of inland waters. Monitoring cyanoHABs is often limited. However, chlorophyll‐a (chl‐a) is a common water quality metric and has been shown to have a relationship with cyanobacteria. The World Health Organization (WHO) recently updated their previous 1999 cyanoHAB guidance values (GVs) to be more practical by basing the GVs on chl‐a concentration rather than cyanobacterial counts. This creates an opportunity for widespread cyanoHAB monitoring based on chl‐a proxies, with satellite remote sensing (SRS) being a potentially powerful tool. We used Sentinel‐2 (S2) and Sentinel‐3 (S3) to map chl‐a and cyanobacteria, respectively, classified chl‐a values according to WHO GVs, and then compared them to cyanotoxin advisories issued by the California Department of Water Resources (DWR) at San Luis Reservoir, key infrastructure in California's water system. We found reasonably high rates of total agreement between advisories by DWR and SRS, however rates of agreement varied for S2 based on algorithm. Total agreement was 83% for S3, and 52%–79% for S2. False positive and false negative rates for S3 were 12% and 23%, respectively. S2 had 12%–80% false positive rate and 0%–38% false negative rate, depending on algorithm. Using SRS‐based chl‐a GVs as an early indicator for possible exposure advisories and as a trigger for in situ sampling may be effective to improve public health warnings. Implementing SRS for cyanoHAB monitoring could fill temporal data gaps and provide greater spatial information not available from in situ measurements alone. Plain Language Summary: Lakes often have algal blooms that create a water quality concern, especially when they contain cyanobacteria, which can be toxic to both humans and animals. These harmful algal blooms are of great concern in areas with limited water supply in states such as California. While it is often difficult and costly to collect and monitor toxin concentrations, monitoring concentrations of chlorophyll‐a (chl‐a) –a measure of how much algae are present—is relatively common and can even be accomplished using satellite remote sensing. There have been multiple studies that have found a relationship between toxins produced by cyanobacteria and chl‐a. The World Health Organization (WHO) has recently released (2021) an updated release of their previous 1999 guidance values for toxin monitoring based on chl‐a concentration. With satellite data, we were able to measure chl‐a concentration in a major reservoir in California, and then classify the chl‐a measurements into the WHO's guidance values for toxins. We compared the satellite‐based guidance values to the public advisory levels currently set by the California Department of Water Resources. Our results indicate that SRS of chl‐a is a reasonable substitute for cyanobacteria toxin advisories, and our framework can be applied to similar cyanobacteria dominated lakes. Key Points: The World Health Organization (WHO) updated cyanobacteria harmful algal blooms (cyanoHABs) guidelines for chlorophyll‐a (chl‐a) as a proxyWith satellite remote sensing (SRS), we estimated and classified chl‐a to compare cyanotoxins advisories used by CaliforniaThis study provides a framework for evaluating public health utility of SRS for enhancing cyanotoxin monitoring globally [ABSTRACT FROM AUTHOR]

Introduction: Exposure to media with alcohol‐related content is a known risk for alcohol use and related harms among young people. The present study used longitudinal self‐report data on exposure to media with alcohol‐related content to examine age trajectories across young adulthood and to estimate associations with heavy episodic drinking (HED) and negative consequences. Method: Participants were 201 high‐risk young adults enrolled in 2‐ and 4‐year colleges (ages 18–25 at screening; 63.7% female). Repeated assessments occurred at four timepoints across a 12‐month period. Results: Self‐reported exposure to both positively and negatively portrayed alcohol‐related media content decreased with age. Between‐persons, controlling for alcohol use frequency, exposure to positive alcohol‐related media content was positively associated with HED, and exposure to negative alcohol‐related media content was inversely associated with HED; no within‐person effects on HED were significant. For negative consequences, controlling for alcohol quantity, exposure to positive media content was associated with more negative consequences both between‐ and within‐persons. Unexpectedly, exposure to negatively portrayed media content was positively associated with negative consequences at the within‐person level. Discussion and Conclusions: Trajectories in exposure to media with alcohol‐related content showed that relatively younger participants reported greater exposure, highlighting the need for policy and prevention efforts to protect this vulnerable demographic. Findings generally indicated that positive portrayals of alcohol use increase alcohol‐related risks. Moreover, increased exposure to negative portrayals in a given assessment was associated with more negative consequences—potentially by normalising or glorifying high‐risk drinking and consequences, though mechanistic/causal research is needed. [ABSTRACT FROM AUTHOR]

Mustn1, a gene expressed exclusively in the musculoskeletal system, was shown in previous in vitro studies to be a key regulator of myogenic differentiation and myofusion. Other studies also showed Mustn1 expression associated with skeletal muscle development and hypertrophy. However, its specific role in skeletal muscle function remains unclear. This study sought to investigate the effects of Mustn1 in a conditional knockout (KO) mouse model in Pax7 positive skeletal muscle satellite cells. Specifically, we investigated the potential effects of Mustn1 on myogenic gene expression, grip strength, alterations in gait, ex vivo investigations of isolated skeletal muscle isometric contractions, and potential changes in the composition of muscle fiber types. Results indicate that Mustn1 KO mice did not present any substantial phenotypic changes or significant variations in genes related to myogenic differentiation and fusion. However, an approximately 10% decrease in overall grip strength was observed in the 2‐month‐old KO mice in comparison to the control wild type (WT), but this decrease was not significant when normalized by weight. KO mice also generated approximately 8% higher vertical force than WT at 4 months in the hindlimb. Ex vivo experiments revealed decreases in about 20 to 50% in skeletal muscle contractions and about 10%–20% fatigue in soleus of both 2‐ and 4‐month‐old KO mice, respectively. Lastly, immunofluorescent analyses showed a persistent increase of Type IIb fibers up to 15‐fold in the KO mice while Type I fibers decreased about 20% and 30% at both 2 and 4 months, respectively. These findings suggest a potential adaptive or compensatory mechanism following Mustn1 loss, as well as hinting at an association between Mustn1 and muscle fiber typing. Collectively, Mustn1's complex roles in skeletal muscle physiology requires further research, particularly in terms of understanding the potential role of Mustn1 in muscle repair and regeneration, as well as with influence of exercise. Collectively, these will offer valuable insights into Mustn1's key biological functions and regulatory pathways. [ABSTRACT FROM AUTHOR]

Imaging spectroscopy is a powerful tool used to support diverse Earth science and applications objectives, ranging from understanding and mitigating widespread impacts of climate change to management of water at farm‐scale. Community studies, such as those deployed by NASA's Surface Biology and Geology and ESA's Copernicus Hyperspectral Imaging Mission for the Environment, have offered new and tangible insights into user needs that are then incorporated into overall mission planning and design. These technologies and tools will be key to develop and consolidate downstream services for users and resource management, given the current pressures on the environment posed by climate change and population growth. This process has highlighted the degree to which planned mission capabilities are responsive to community needs. In this study, we analyze user requirements belonging to the Italian Copernicus User Forum and to the user pool of NASA's Surface Biology and Geology community for the synergic use of hyperspectral imaging technology, providing a reference for the development of earth observation services and the consolidation of existing ones. In addition, potential cross‐mission coordination is analyzed to highlight key benefits—(a) addressing shared community needs around products requiring more frequent temporal revisit and (b) shared resources and community expertise around algorithm development. This paper discusses the critical role of early engagement with users to establish a community of practice ready to work with high spatial resolution imaging spectroscopy data sets. The main outcome is a guide for the synergetic use of hyperspectral mission and data together with the identification of the main gaps between user needs and satellite capabilities influencing the development of key national and trans‐national downstream services. Plain Language Summary: In this research we have analyzed needs of users to understand how to develop and improve earth observation downstream services. Hyperspectral imaging provides information across the electromagnetic spectrum in more detail than multispectral imaging, allowing more specific analysis and accurate identification of materials and substances. The users in this study belong to the Italian Copernicus User Forum and to the NASA Surface Biology and Geology community which provided requirements respectively for ESA's Copernicus Hyperspectral Imaging Mission for the Environment and NASA's Surface Biology and Geology. This work identifies common users and examines the advantages of potential synergy between these hyperspectral satellites for responding to their needs. This analysis shows that the synergy would bring significant advantages in terms of improved revisit time and represents an opportunity to address shared community needs around product and algorithm development. Key Points: Current users' needs for hyperspectral earth observation data suggest future investment in improving spatial and temporal resolutionCoordination between missions can fill this gap especially improving temporal revisitShared community and resources can facilitate the improvement of products from these missions and their use across different sectors [ABSTRACT FROM AUTHOR]

Nodular amyloidosis (NA) is a rare type of primary localized cutaneous amyloidosis in which light chain amyloid deposits in the skin without concurrent systemic involvement. We report a challenging case of NA on the scalp, mimicking primary scarring alopecia, in a relatively young and healthy 36‐year‐old man. In addition to a nonspecific clinical appearance with a broad differential, NA can be a difficult diagnosis because it may require ancillary testing, such as liquid chromatography–tandem mass spectrometry to type the amyloid protein, and hematology–oncology workup to exclude systemic disease. Pathologists can highlight the importance of systemic evaluation in their reports to ensure patients receive appropriate management. [ABSTRACT FROM AUTHOR]

As temperatures rise, it is increasingly important to monitor changes in habitat conditions for aquatic species and mitigate emerging stressors. The ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) instrument provides temperature products at a spatial and temporal scale not previously available. Here, we utilize ECOSTRESS temperature products to assess fluctuations in thermal habitat suitability for an endangered fish species and we also demonstrate the utility of the data set to assess water surface and bulk temperature changes following completion of two tidal wetland restoration efforts in the San Francisco Estuary and Sacramento–San Joaquin River Delta (Bay Delta). During all hours of the day throughout the 2018–2022 study period, key Delta Smelt habitat areas including Honker Bay, West Suisun Bay, and Mid Suisun Bay had greater than 75% of their areas suitable; there were several instances during which less than 25% of the area was thermally suitable generally coinciding with heatwave events. Overall, midday hours are less frequently suitable than morning and evening hours. Early evidence from ECOSTRESS indicates that there may be a decrease in surface water temperature of up to several degrees in tidal restoration areas, but more data is needed to show statistically significant outcomes. The ECOSTRESS record began in summer of 2018, and a longer record is needed to fully capture temperature changes associated with wetland processes and restoration efforts. Future applications of ECOSTRESS products can the capacity to help further understand ecosystem conditions and how restoration efforts affect water temperature, informing decisions that benefit Delta Smelt and other at‐risk aquatic species. Plain Language Summary: Water temperatures are rising in the San Francisco Estuary and Sacramento–San Joaquin River Delta (Bay Delta), negatively affecting endangered fish survivability. An instrument aboard the International Space Station called the ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) can give vital information about Bay Delta water temperatures at a broader scale than field measurements with reasonable spatial resolution and on a more frequent basis than previously available to understand where habitat management efforts would be most useful and even assess the impacts of previous restoration efforts on temperature. Here, we look at how favorable the Bay Delta water temperatures are for endangered Delta Smelt and assess the effects of two completed restoration efforts on water temperature (The Tule Red and Winter Island tidal wetland restoration projects). As managers and decision makers continue to evaluate actions toward protecting endangered aquatic species, ECOSTRESS can provide information to support the decision making process. Key Points: Aquatic thermal habitat conditions vary diurnally and spatiallyMidday periods and inland regions have unsuitable habitat for the Delta Smelt most frequentlyECOsystem Spaceborne Thermal Radiometer Experiment on Space Station shows early evidence of surface water temperature cooling benefits from tidal wetland restoration projects of up to 5.4°C [ABSTRACT FROM AUTHOR]

Background: Simultaneous alcohol and marijuana (SAM) use has been associated with greater alcohol use and consequences at the daily level, but limited research has examined SAM use in relation to marijuana use and its consequences. This study tested daily associations between SAM use and four outcomes: alcohol use (number of drinks), marijuana use (hours high), negative alcohol consequences, and negative marijuana consequences. Methods: A community sample of young adults [ages 18–25, mean (SD) = 21.61 (2.17) years] with recent alcohol and SAM use was recruited (N = 409; 50.9% female; 48.2% non‐Hispanic/Latinx White). Participants completed a baseline survey and six 2‐week bursts of daily surveys (81.1% of morning surveys completed) and reported on substance use and negative substance‐related consequences. Multilevel modeling was used to test the main aims and to explore each specific consequence. Results: Among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total negative alcohol‐related consequences than non‐SAM use days. Among days with any marijuana use, SAM use days were associated with more hours being high than non‐SAM use days. Exploratory models showed that SAM use was related to five specific alcohol‐related consequences and two specific marijuana‐related consequences. Conclusions: These findings build upon prior research by showing that SAM use days are linked to consuming more drinks, reporting more hours being high from marijuana, and experiencing more total alcohol‐related consequences even after controlling for the number of drinks, the number of hours high, any tobacco/nicotine use, and any other substance use. SAM use was also associated with a greater likelihood of experiencing some specific consequences related to alcohol and marijuana. The findings underscore the need for additional research on SAM use and marijuana‐related outcomes. The current study found that, among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total alcohol consequences and also experiencing some specific alcohol consequences. Among days with any marijuana use, SAM use days were associated with more hours high and experiencing some specific marijuana consequences. Findings build on prior research by showing effects of SAM use even after controlling for number of drinks, number of hours high, and other substance use. [ABSTRACT FROM AUTHOR]

We examined patterns of longitudinal trajectories of loneliness during the COVID‐19 pandemic using six time points (January 2020 [pre‐pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most‐likely loneliness trajectory adjusting for pre‐pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre‐pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past‐month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co‐occurring loneliness and cannabis use are needed. [ABSTRACT FROM AUTHOR]

Objective: Inhalational burns frequently lead to dysphonia and airway stenosis. We hypothesize local dexamethasone delivery via a novel drug‐eluting electrospun polymer‐mesh endotracheal tube (ETT) reduces biomechanical and histologic changes in the vocal folds in inhalational burn. Methods: Dexamethasone‐loaded polymer mesh was electrospun onto ETTs trimmed to transglottic endolaryngeal segments and secured in nine Yorkshire Crossbreed swine with directed 150°C inhalation burns. Uncoated ETTs were implanted in nine additional swine with identical burns. ETT segments were maintained for 3 and 7 days. Vocal fold (VF) structural stiffness was measured using automated‐indentation mapping and compared across groups and to four uninjured controls, and matched histologic assessment performed. Statistical analysis was conducted using two‐way ANOVA with Tukey's post hoc test and Wilcoxon rank‐sum test. Results: VF stiffness after burn decreased with longer intubation, from 19.4 (7.6) mN/mm at 3 days to 11.3 (5.2) mN/mm at 7 days (p <.0001). Stiffness similarly decreased with local dexamethasone, from 25.9 (17.2) mN/mm at 3 days to 18.1 (13.0) mN/mm at 7 days (p <.0001). VF stiffness in the dexamethasone group was increased compared to tissues without local dexamethasone (p =.0002), and all groups with ETT placement had higher tissue stiffness at 3 days (p <.001). No significant change in histologic evidence of epithelial ulceration or fibrosis was noted, while an increased degree of inflammation was noted in the dexamethasone group (p =.04). Conclusion: Local dexamethasone delivery increases VF stiffness and degree of inflammation compared to uncoated ETTs in an acute laryngeal burn model, reflected in early biomechanical and histologic changes in an inhalational burn model. [ABSTRACT FROM AUTHOR]

Background: The contexts in which young adults drink alcohol play a salient role in alcohol‐related outcomes and negative consequences at an event‐level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre‐partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within‐person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow‐up timepoint, controlling for baseline AUDIT scores. Method: A community sample of 759 young adults (Mage = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30‐month follow‐up. Multilevel models estimated within‐ and between‐person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol‐related outcomes (weekly consumption, consequences, SAM use). A single‐level negative binomial regression tested associations between drinking context frequency averages across a two‐year period and changes in AUDIT scores from baseline to a follow‐up 2.5 years later. Results: Over 75% of the sample of non‐abstaining young adults reported drinking in each of the three contexts at least once during the 24‐month period. Within‐persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30‐month follow‐up, suggesting that there are potential long‐term risks of drinking in these contexts. Conclusions: Findings suggest that daytime drinking, pregaming, and playing drinking games are high‐risk contexts in terms of month‐to‐month and long‐term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Cat‐scratch disease (CSD) is caused by Bartonella henselae and usually presents with regional lymphadenopathy. Skull base osteomyelitis and cerebral venous sinus thrombosis are rarely reported, particularly in immunocompetent children. CSD should be considered in the differential diagnosis of any patient with persistent headaches in the setting of cat exposure. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) impacts long‐term morbidity in pediatric liver transplant (LT) recipients. The prevalence of estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 (eGFR < 90) at our institution was 25% at 1 year post‐LT; thus, quality improvement (QI) project was initiated, aiming to decrease the prevalence of eGFR < 90 by at least 20% at 1 year‐post LT. Methods: Children post‐LT under 19 years from 2010 to 2018 were included. Three QI interventions were implemented starting 1/2016: documentation of blood pressure percentile (BP%) and eGFR, documentation of a kidney management plan if either was abnormal, and amlodipine initiation prior to hospital discharge after LT. We compared the prevalence of eGFR < 90 at 3, 12, and 24 months after LT in the pre‐ and post‐intervention period. Results: 68 patients in pre‐ and 42 in post‐intervention periods met inclusion criteria. Pre‐intervention BP%, eGFR, and kidney management plan were documented at 25%, 10%, and 22%, compared to 71%, 83%, and 71% post‐intervention, respectively. 22% of patients were started on amlodipine prior to discharge from LT in the pre‐ versus 74% in the post‐intervention period. Prevalence of eGFR < 90 at 3 m post‐LT was 19% in pre‐ versus 14% in the post‐intervention period (p =.31); at 12 months 24% versus 7% (p =.01) and at 24 months 16% versus 6% (p =.13), respectively. Significant non‐modifiable risk factors for eGFR < 90 were malignancy (RR = 4.5, p <.0001), metabolic disorder (RR = 2.6, p =.02), and age at transplant (7% increased risk per year of age, p =.007). Conclusion: By improving documentation of BP%, eGFR, and kidney management plan, the prevalence of eGFR < 90 was decreased by a relative 74% and 60% at 12 and 24 months post‐LT, respectively. [ABSTRACT FROM AUTHOR]

Keywords: featureless melanoma; SDDI; sequential digital dermatoscopic imaging; sequential digital dermoscopic imaging; TBP; total body photography EN featureless melanoma SDDI sequential digital dermatoscopic imaging sequential digital dermoscopic imaging TBP total body photography e193 e196 4 05/12/23 20230501 NES 230501 It is known that dermatoscopy improves diagnostic accuracy for skin lesions whether pigmented or not,[[1]] but it is also known that approximately 10% of melanomas are featureless, lacking diagnostic dermatoscopic criteria.[3] SP (page 620) sp Of relevance, a recent, appropriately powered and controlled study found that 59.2% of monitored lesions did not have dermatoscopic features of malignancy when excised, only being excised because of evident differences when sequential dermatoscopic images were compared side-by-side.[3] SP (page 619) sp Consistent with this, Australian melanoma guidelines highlight the role of both total body photography (TBP) and sequential digital dermatoscopic imaging (SDDI) but recommend as a "Practice Point" that TBP should be the I primary i imaging intervention for early melanoma detection in patients at elevated risk who have high naevus counts.[4] We present two cases of high-risk young patients, whose clinically and dermatoscopically subtle melanomas were first detected by operator-recognition of size-enlargement in sequential TBP images, these changes in both cases I not i being detected by dedicated software. SDDI, sequential digital dermatoscopic imaging, featureless melanoma, sequential digital dermoscopic imaging, TBP, total body photography Semi-automated total body photography can identify subtle melanomas but false-negatives on automated comparison highlight the need for manual side-by-side image comparison. [Extracted from the article]

Glucose homeostasis is closely regulated to maintain energy requirements of vital organs and skeletal muscle plays a crucial role in this process. Mustn1 is expressed during embryonic and postnatal skeletal muscle development and its function has been implicated in myogenic differentiation and myofusion. Whether Mustn1 plays a role in glucose homeostasis in anyway remains largely unknown. As such, we deleted Mustn1 in skeletal muscle using a conditional knockout (KO) mouse approach. KO mice did not reveal any specific gross phenotypic alterations in skeletal muscle. However, intraperitoneal glucose tolerance testing (IPGTT) revealed that 2‐month‐old male KO mice had significantly lower glycemia than their littermate wild type (WT) controls. These findings coincided with mRNA changes in genes known to be involved in glucose metabolism, tolerance, and insulin sensitivity; 2‐month‐old male KO mice had significantly higher expression of GLUT1 and GLUT10 transporters, MUP‐1 while OSTN expression was lower. These differences in glycemia and gene expression were statistically insignificant after 4 months. Identical experiments in female KO and WT control mice did not indicate any differences at any age. Our results suggest a link between Mustn1 expression and glucose homeostasis during a restricted period of skeletal muscle development/maturation. While this is an observational study, Mustn1's relationship to glucose homeostasis appears to be more complex with a possible connection to other key proteins such as GLUTs, MUP‐1, and OSTN. Additionally, our data indicate temporal and sex differences. Lastly, our findings strengthen the notion that Mustn1 plays a role in the metabolic capacity of skeletal muscle. [ABSTRACT FROM AUTHOR]

Background:Applicator conspicuity in ultrasound-guided brachytherapy procedures is commonly impaired by imaging artifacts or non-ideal imaging geometry, which can slow down applicator position digitization and increase the geometric uncertainty of the delivered dose distribution. Purpose: The purpose of this study was to improve the conspicuity of highdose rate (HDR) brachytherapy needles under B-mode ultrasound imaging by applying an echogenic surface coating. Our hypothesis was that an echogenic coating would reduce artifacts and improve needle visualization within regions of signal degradation. Methods: In this study, 17-gauge,25-cm long titanium HDR brachytherapy needles were coated with acoustically reflective microspheres over a 2.5 cm region starting from the needle tip. Three coating thicknesses (27 μm, 40 μm, 64 μm) were compared against an uncoated control needle. The coated and uncoated needles were imaged using B-mode ultrasound in a tissue-equivalent prostate phantom and in a cadaverous male pelvis using a transrectal probe. Needle conspicuity was assessed under multiple conditions: a single needle implant, an implant with multiple needles between the probe and the needle of interest, and an angled needle implant. All images were assessed qualitatively for needle conspicuity and the presence of artifacts and quantitatively using grey-scale image intensity values. Results: The 64 μm echogenic coating reduced the magnitude of reverberation artifacts by 31 ± 14% and comet tail artifacts by 40%–70%.The echogenic coating also improved needle contrast,measured by the relative differences in signal intensity compared with the adjacent environment, when needles were angled up to 30° with respect to the transducer probe in the cadaver. The improvements in conspicuity and artifact reduction increased with increasing coating thickness.The performance of the needles coated with the 64 μmthickness was qualitatively superior and yielded high-contrast,well-circumscribed signals in the cadaverous male pelvis, even under situations where a needle was acoustically shadowed by multiple other needles. Conclusions: An echogenic surface coating reduced imaging artifacts and improved needle conspicuity under realistic clinical conditions for ultrasoundbased prostate or gynecological brachytherapy. The improved conspicuity has the potential to improve the efficiency of needle placement and the accuracy of needle position digitization during brachytherapy procedures. [ABSTRACT FROM AUTHOR]

Observations of planet Earth from space are a critical resource for science and society. Satellite measurements represent very large investments and United States (US) agencies organize their effort to maximize the return on that investment. The US National Research Council conducts a survey of Earth science and applications to prioritize observations for the coming decade. The most recent survey prioritized a visible to shortwave infrared imaging spectrometer and a multispectral thermal infrared imager to meet a range of needs for studying Surface Biology and Geology (SBG). SBG will be the premier integrated observatory for observing the emerging impacts of climate change by characterizing the diversity of plant life and resolving chemical and physiological signatures. It will address wildfire risk, behavior, and recovery as well as responses to hazards such as oil spills, toxic minerals in minelands, harmful algal blooms, landslides, and other geological hazards. The SBG team analyzed needed instrument characteristics (spatial, temporal, and spectral resolutions, measurement uncertainty) and assessed the cost, mass, power, volume, and risk of different architectures. We present an overview of the Research and Applications trade‐study analysis of algorithms, calibration and validation needs, and societal applications with specifics of substudies detailed in other articles in this special collection. We provide a value framework to converge from hundreds down to three candidate architectures recommended for development. The analysis identified valuable opportunities for international collaboration to increase the revisit frequency, adding value for all partners, leading to a clear measurement strategy for an observing system architecture. Plain Language Summary: We present the observing system science, applications, and measurement objectives for studying the Earth's Surface Biology and Geology with a global visible to shortwave infrared imaging spectrometer and a multispectral thermal infrared imager as part of the NASA Earth System Observatory slated for launch in the late 2020s. This mission will enable interdisciplinary science relevant to studying the biology and geology of the Earth's surface unlike any other mission before. Measurements are relevant for studying snow and ice, mineralogy, volcanology, biology, ecology, and components of radiative forcing from the surface such as greenhouse gas emissions. The observations not only have scientific value in studying feedbacks and interactions of surface processes (e.g., wildfire) but also are invaluable to supporting real‐world decision making such as water conservation, agriculture crop classification, forest health, and many others. The work presented here outlines the study conducted over 3 years that informed an architecture study to design a satellite observing system to provide the most value for science and applications as possible. Key Points: Spectroscopic and thermal observations will provide unprecedented information of the Earth's Surface Biology and GeologyAs part of the NASA Earth System Observatory, these observations will transform Earth science and environmental managementThis study informed mission design constraints to provide observations of value for science and decision‐making applications [ABSTRACT FROM AUTHOR]

Aim: Topography, climate and plant water stress influence the spatial patterns of burn severity (damage to soils and vegetation associated with wildfires); however, the relative importance of these predictors remains contested. We hypothesized that high‐resolution pre‐fire vegetation water stress, measured using evapotranspiration (ET), evaporative stress index (ESI) and water use efficiency (WUE), are strong predictors of burn severity. Location: California, USA. Time period: 2019–2020. Major taxa studied: Forests, chaparral, oaks and grasslands. Methods: We used random forest regression modelling with remotely sensed ECOsystem and Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) plant water stress from the spring–summer and year before the fires, predictors to represent spatial autocorrelation, and topography to predict the spatial patterns of burn severity for six fires in the Sierra Nevada and the Southern California Mountains. Results: Plant water stress was the dominant predictor for the Southern California Mountains, and spatial autocorrelation in Sierra Nevada. Elevation was a leading predictor for burn severity for both regions, with greater predictability in higher‐elevation and steeper terrain. Model results varied by vegetation type: for the Southern California Mountains, grasslands had the highest predictability [R2 =.50 (high elevation); R2 =.58 (steep)], followed by savanna and open shrublands, which are typified by chaparral‐type vegetation [R2 =.43 (savanna, high elevation); R2 =.40 (open shrubland, high elevation)]. For grasslands, annual ET was the leading predictor (R2 =.58), consistent with the idea that growing season grassland enhancement increases fuel availability. The predictability of burn severity was also sensitive to the time of day of the ECOSTRESS acquisition and varied by vegetation type. Afternoon ET was the leading predictor for high‐elevation grasslands (R2 =.50), and morning predictors were important for steep‐sloped woody savanna (R2 =.18). Main conclusions Our findings provide insights on how antecedent plant water stress predicts burn severity and can inform pre‐fire season monitoring and fuel management. [ABSTRACT FROM AUTHOR]

Background: Institutional data on initiating and maintaining a low-titer O positive whole blood (LTOWB) inventory for the civilian trauma sector may help other institutions start a LTOWB program. This study from a level 1 trauma center with a hospital-based donor center highlights challenges faced during the collection, maintenance, and utilization of LTOWB.Study Design and Methods: Male O positive donors with low (≤1:100) anti-A and anti-B antibody titers were recruited for LTOWB collection. The daily inventory goal of 4 LTOWB units was kept in the emergency department refrigerator and transfused to adult male trauma patients. Unused units older than 10 days were reprocessed into packed red blood cells.Results: Of 900 donors screened, 61% qualified and 52% of eligible donors provided a collective total of 505 LTOWB units over 2.5 years. The number of collected units directly correlated with the availability of inventory; 42% of the units were transfused, 54% were reprocessed, and 4% were discarded. The inventory goal was maintained for 56% of the year 2018 and 83% of the year 2019. Over these 2 years, 52% of patients had their transfusion needs fully met, 41% had their needs partially met, and 6.5% did not have their needs met.Discussion: Initial challenges to LTOWB implementation were inventory shortages, low utilization rates, and failure to meet clinical demand. Proposed solutions include allowing for a higher yet safe titer, extending shelf life, expanding the donor pool, identifying barriers to utilization, and permitting use in female trauma patients beyond childbearing age. [ABSTRACT FROM AUTHOR]

To provide a comparative meta‐analysis and systematic review of the risk and clinical outcomes of coronavirus 2019 (COVID‐19) infection between fully vaccinated and unvaccinated groups. Eighteen studies of COVID‐19 infections in fully vaccinated ("breakthrough infections") and unvaccinated individuals were reviewed from Medline/PubMed, Scopus, Embase, and Web of Science databases. The meta‐analysis examined the summary effects and between‐study heterogeneity regarding differences in the risk of infection, hospitalization, treatments, and mortality between vaccinated and unvaccinated individuals. he overall risk of infection was lower for the fully vaccinated compared to that of the unvaccinated (relative risk [RR] 0.20, 95% confidence interval [CI]: 0.19−0.21), especially for variants other than Delta (Delta: RR 0.29, 95% CI: 0.13−0.65; other variants: RR 0.06, 95% CI: 0.04−0.08). The risk of asymptomatic infection was not statistically significantly different between fully vaccinated and unvaccinated (RR 0.56, 95% CI: 0.27−1.19). There were neither statistically significant differences in risk of hospitalization (RR 1.06, 95% CI: 0.38−2.93), invasive mechanical ventilation (RR 1.65, 95% CI: 0.90−3.06), or mortality (RR 1.19, 95% CI: 0.79−1.78). Conversely, the risk of supplemental oxygen during hospitalization was significantly higher for the unvaccinated (RR 1.40, 95% CI: 1.08−1.82). Unvaccinated people were more vulnerable to COVID‐19 infection than fully vaccinated for all variants. Once infected, there were no statistically significant differences in the risk of hospitalization, invasive mechanical ventilation, or mortality. Still, unvaccinated showed an increased need for oxygen supplementation. Further prospective analysis, including patients' risk factors, COVID‐19 variants, and the utilized treatment strategies, would be warranted. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has presented young adults with novel challenges and disruptions to several life domains. The current study examined how COVID‐19‐related stressors (i.e., job‐related, financial‐related, social/relational, and illness‐related stressors) relate to young adults' symptoms of depression and anxiety, and satisfaction with life (in the US). In Aim 1, we examined associations between COVID‐19‐related stressors and indices of mental health and well‐being in the initial phase of the pandemic (April/May 2020) while accounting for participants' pre‐pandemic levels of these outcomes in January of 2020 (N = 519; Mage = 25.4; 62.8% women). Social/relational stressors were most strongly associated with increased symptoms of anxiety/depression, and financial stressors were most strongly associated with decreased satisfaction with life. Extending this research longitudinally (Aim 2), we sampled young adults bi‐monthly across a year‐long period (September 2020 to August 2021). Multilevel models revealed within‐person associations between each stressor domain and mental health/well‐being; young adults reported more symptoms of depression/anxiety and lower satisfaction with life in months that stressors were relatively more salient. Interactions between stressors and time revealed associations were generally stronger in earlier months and decreased linearly across the pandemic. Taken together, longitudinal evidence indicates that COVID‐19‐related stressors, especially social/relational stressors, have direct and time‐varying associations with mental health and well‐being. [ABSTRACT FROM AUTHOR]

Basal‐like breast cancer (BLBC) has a greater overlap in molecular features with high‐grade serous ovarian cancer (HGSOC) than with other breast cancer subtypes. Similarities include BRCA1 mutation, high frequency of TP53 mutation, and amplification of CCNE1 (encoding the cyclin E1 protein) in 6–34% of cases, and these features can be used to group patients for targeted therapies in clinical trials. In HGSOC, we previously reported two subsets with high levels of cyclin E1: those in which CCNE1 is amplified, have intact homologous recombination (HR), and very poor prognosis; and a CCNE1 non‐amplified subset, with more prevalent HR defects. Here, we investigate whether similar subsets are identifiable in BLBC that may allow alignment of patient grouping in clinical trials of agents targeting cyclin E1 overexpression. We examined cyclin E1 protein and CCNE1 amplification in a cohort of 76 BLBCs and validated the findings in additional breast cancer datasets. Compared to HGSOC, CCNE1 amplified BLBC had a lower level of amplification (3.5 versus 5.2 copies) and lower relative cyclin E1 protein, a lack of correlation of amplification with expression, and no association with polyploidy. BLBC with elevated cyclin E1 protein also had prevalent HR defects, and high‐level expression of the cyclin E1 deubiquitinase ubiquitin‐specific protease 28 (USP28). Using a meta‐analysis across multiple studies, we determined that cyclin E1 protein overexpression but not amplification is prognostic in BLBC, while both cyclin E1 overexpression and amplification are prognostic in HGSOC. Overall CCNE1 gene amplification is not equivalent between BLBC and HGSOC. However, high cyclin E1 protein expression can co‐occur with HR defects in both BLBC and HGSOC, and is associated with poor prognosis in BLBC. [ABSTRACT FROM AUTHOR]

There are very few true breast emergencies. While infrequent, women do present to emergency departments or urgent care centres with breast‐related concerns. In this case‐based review, both common and uncommon urgent and emergent breast lesions are presented, emphasising ultrasound characteristics and imaging optimisation to improve accurate diagnosis and appropriate recommendations. [ABSTRACT FROM AUTHOR]

The Surface Biology and Geology (SBG) concept is the first National Aeronautics and Space Administration (NASA) Earth mission to develop and implement systematic integration of science application needs at the architecture study stage. Prior NASA mission concept and planning activities presumed that science measurement needs would encompasss application measurement needs and so did not explicitly evaluate and include applications at this stage. However, the effort presented here identified, documented and integrated application needs that would not have been included by considering research science needs only. First, a low latency of no greater than 24 hr was identified as the optimal target to enable the maximum number of applications and was then carried through into all SBG candidate architectures. Second, many applications expressed needs around improved spatial and temporal resolution. While increased spatial resolution would not be possible under current cost and technology considerations, the need for improved resolution for temporal sampling helped drive and bolster discussions with international partners such as the European Space Agency, Italian Space Agency, and Centre National D'Etudes Spatiales. Lastly, we found that the applications and science were synergistic with one another; for example, mission concept decisions to consider additional measurement features were driven by both high relevance application and science priorities, and in particular, evapotranspiration for agriculture and high temperature features for fires and geologic hazards. This paper discusses the process and key contributions originating from the SBG Applications Working Group and how they shaped SBG at the architecture study stage. This stage in the mission planning considers the trade space of spacecraft instruments and architectures, and evaluates which formulations are suitable candidates for SBG. The approach described here may be utilized as a framework for applications and science to inform future NASA satellite mission studies. Plain Language Summary: This is the first instance of integration from the perspective of science applications into mission design, and at the architecture study phase. Mission architectures have traditionally been underpinned by science needs only. This effort demonstrates that not only does the applications community confer unique technical and measurement needs that are feasible to integrate into architecture considerations, but also that the overall process for defining mission requirements is enhanced through science and applications synergy and cohesion. Furthermore, applications feed into other aspects of the mission design process at early stages, such as bolstering discussions with international partners and reinforcing the benefits and need of harmonized data products and mission coordination. Key Points: The Surface Biology and Geology study has shown that science and applications can be considered synergistically, at the start of the satellite mission life cycleApplications and science integration produced a more representative and tailored set of measurement needs driving mission architectureApplications conferred unique technical needs, particularly around latency, that were carried through the architecture study [ABSTRACT FROM AUTHOR]

Background: Norm‐correcting interventions are an effective alcohol harm‐reduction approach, but innovation is needed to increase modest effect sizes. Recent social psychology research shows that individuals may be influenced by social norms that are increasing in prevalence. Contrary to static norms that reflect the current state of normative behavior, dynamic norms reflect behavioral norms that are shifting over time. This proof‐of‐concept study tested the utility of dynamic norms messages within norm‐correcting interventions. Method: Undergraduate student drinkers (N = 461; Mage = 19.97; 64.43% female) were randomly assigned to receive (a) dynamic norms messages highlighting a steady decrease over the past six years in heavy drinking among college students; (b) static norms messaging stating only the current norms; or (c) a control condition without normative information. Proximal outcomes assessed immediately following the experimental paradigm included intentions for total weekly drinks and heavy episodic drinking. Self‐reported information on alcohol use behavior was collected at 1‐month follow‐up. Results: Following the experimental paradigm, participants in the dynamic norms condition estimated that future drinking norms would decrease, while those in the static norms and control groups estimated that future drinking norms would increase. Participants in the dynamic norms condition reported lower intentions for weekly drinks and heavy episodic drinking than those in the static norms and control conditions. No significant differences between conditions were found on alcohol use indices reported at the 1‐month follow‐up. However, dynamic norms messaging had a favorable indirect effect on heavy episodic drinking intentions mediated through lower perceived future drinking norms. Conclusions: These findings provide proof‐of‐concept that dynamic norms messaging may be a prudent strategy for reducing alcohol use intentions, which can be integrated into or used alongside existing norm‐correcting strategies. [ABSTRACT FROM AUTHOR]

This study utilizes satellite data to investigate water quality conditions in the San Francisco Estuary and its upstream delta, the Sacramento--San Joaquin River Delta. To do this, this study derives turbidity from the European Space Agency satellite Sentinel-2 acquired from September 2015 to June 2019 and conducts a rigorous validation with in situ measurements of turbidity from optical sensors at continuous monitoring stations. This validation includes 965 matchup comparisons between satellite and in situ sensor data across 22 stations, yielding R² = 0.63 and 0.75 for Nephelometric Turbidity Unit and Formazin Nephelometric Unit (FNU) stations, respectively. This study then applies remote sensing to evaluate patterns in turbidity during the Suisun Marsh Salinity Control Gates Action ("Gates action"), a pilot study designed to increase habitat access and quality for the endangered Delta Smelt. The basic strategy was to direct more freshwater into Suisun Marsh, creating more low salinity habitat that would then have higher (and more suitable) turbidity than upstream river channels. For all seven acquisitions considered from June 29 to September 27, 2018, turbidity conditions in Bays and Sloughs subregions were consistently higher (and more suitable) (26-47 FNU) than what was observed in the upstream River region (13-25 FNU). This overall pattern was observed when comparing images acquired during similar tidal stages and heights. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenic obesity and its association with nonalcoholic fatty liver disease (NAFLD) is under‐recognized by many healthcare providers in Western medicine due to the lack of awareness and diagnostic guidelines. The result is delayed recognition and treatment, which leads to further health deterioration and increased healthcare costs. Sarcopenic obesity is characterized by the presence of increased fat mass in combination with muscle catabolism related to chronic inflammation and/or inactivity. Previous research has recommended evaluating body composition and physical function performance to adequately diagnose sarcopenic obesity. Body composition analysis can be performed by imaging applications through magnetic resonance imaging, computed tomography, and dual‐energy x‐ray absorptiometry. Due to the cost of each device and radiation exposure for patients as evidenced in all three modalities, bioelectrical impedance analysis offers a noninvasive approach capable of providing quick and reliable estimates of lean body and fat mass. Methods and Results: This review analyzes the current evidence‐based literature, indicating a lower skeletal muscle mass and increased visceral adipose tissue correlation to the advancement of fibrosis in fatty liver disease. Conclusion: Given the substantial promising research conducted in predominantly Asian populations regarding body tissue distribution and NAFLD, additional prospective research is needed to extend these findings in Western populations. [ABSTRACT FROM AUTHOR]

Estuaries worldwide are experiencing stress due to increased droughts, which often prompt intervention by environmental managers and government agencies. Effective management of water resources in estuarine systems can be enhanced by new technologies and methodologies to support decision-making processes. Here, we evaluate the use of high-frequency, high-resolution satellite remote sensing within two managementrelevant case studies in the San Francisco Estuary and the Sacramento--San Joaquin River Delta. We used a remote sensing-derived time series of turbidity maps to (1) identify favorable turbidity conditions for the endangered fish species, delta smelt (Hypomesus transpacificus), during the height of the great California drought in the dry season of 2015, and (2) evaluate changes in turbidity following the installation of an emergency saltwater intrusion barrier. The mapping results indicate several persistent areas of turbidity refugia throughout the summer in the north and west Delta; however, there was infrequent connectivity. A comparison of images captured during ebb tides before and after barrier installation showed a mean increase of 6.6 Nephelometric Turbidity Units (NTU) in the San Joaquin River and 4 NTU in Fisherman's Cut. Our assessment of the barrier supports previous findings, which used field samples to conclude barrier installation may have resulted in increased turbidity near the barrier and enhances these findings by providing spatial context. [ABSTRACT FROM AUTHOR]

Background: Young adulthood is characterized by transitions into and out of social roles in multiple domains. Consistent with self‐medication models of alcohol use, the Transitions Overload Model (J Stud Alcohol Suppl, 14, 2002, 54) hypothesizes that one cause of increased alcohol use during young adulthood may be the stress of navigating simultaneous role transitions. This study examined the simultaneous occurrence of major developmental role transitions in the domains of education, employment, romantic relationships, and residential status and their associations with perceived stress, heavy episodic drinking (HED), and negative alcohol‐related consequences. Further, we extended the Transitions Overload Model to explore whether the number of transitions rated as having a negative impact on one's life was related to perceived stress, HED, and alcohol‐related consequences. Methods: A community sample of young adult drinkers (N = 767, 57% women, ages 18 to 25 years) in the Pacific Northwest provided monthly data across 2 years. Multilevel models were used to assess the average (between‐person) and month‐to‐month (within‐person) associations of role transitions with perceived stress, HED, and negative alcohol‐related consequences. Results: Although having more role transitions was positively associated with HED frequency and alcohol‐related consequences at both the between‐ and within‐person (monthly) levels, it was not associated with increased stress. The number of transitions rated as having a negative impact on one's life, however, was positively associated with stress. Thus, rather than the total number of transitions, it is the number of negatively perceived major developmental role transitions that is associated with perceived stress and increased risk for negative alcohol‐related consequences. Conclusions: Contrary to Transitions Overload Model assumptions, more transitions were not a significant predictor of more perceived stress; rather, the evaluation of the transition as negative was associated with stress and negative alcohol‐related outcomes. This distinction may help elucidate the etiology of stress and subsequent alcohol consequences and identify individuals at‐risk of these effects. [ABSTRACT FROM AUTHOR]

Ultrasound‐guided breast biopsies can be challenging to perform, especially when the target is adjacent to the nipple, skin, or implant or when the target is small and in very posterior, dense fibroglandular tissue. Oftentimes, a slightly modified approach can result in a diagnostic biopsy specimen with minimal complications. After a brief review of basic techniques for ultrasound‐guided breast biopsies that includes a review of conventional breast biopsy devices, a presentation of procedural modifications and techniques to consider for more challenging cases is described. In particular, novel open‐trough and tandem‐needle techniques are detailed. Several cases using these techniques are then presented. [ABSTRACT FROM AUTHOR]

Background: Understanding the nature of the association between cannabis and alcohol use within individuals over time in the era of legalized cannabis is of crucial importance for assessing the public health consequences of increasing cannabis use. An important unanswered question is whether cannabis and alcohol use substitute for one another. Specifically, is greater use of one substance associated with less use of the other substance (i.e., a negative association) or are the substances complementary and their association positive? Methods: We used 24 consecutive months of data on a young adult sample (n = 774; 56% female, age 18–25 during the study) who drank alcohol in the year prior to enrollment. The sample was recruited in Washington State in 2015/2016 (after legalization of nonmedical cannabis) using media advertisements and community flyers and outreach. Using parallel process latent growth curve models, we assessed three types of association between cannabis and alcohol use across the 24‐month period: (1) an association between averagelevels of cannabis and alcohol use; (2) an association between rates of change in cannabis and alcohol use; and (3) correlations between shorter‐term deviations/fluctuations off of longer‐term trajectories of level and change in cannabis and alcohol use. Results: We found a positive association between the average frequency of cannabis and alcohol use; individuals who used cannabis more frequently on average also drank alcohol more frequently on average. Change over time in cannabis use was positively associated with change in alcohol use. There was also a contemporaneous positive association between fluctuations in cannabis and alcohol use. Conclusions: Overall, we found no evidence of substitution. Rather, the results suggest a complementary relationship between cannabis and alcohol use, such that the use of cannabis and alcohol rises and falls together. [ABSTRACT FROM AUTHOR]

According to some recent analyses, the ethnographic encounter takes place between a complicit, colonialist, white discipline and "natives" who are colonized and implicitly nonwhite. But by insisting that anthropology is an inherently white discipline, such binary frameworks ultimately recenter Westernness and whiteness, reinforcing the centrality of Western and white anthropology. In doing so, they conflate phenotypic and structural whiteness, flatten out how anthropological whiteness compels nonwhite bodies to adopt a white habitus, and obfuscate the shifting, unstable role played by phenotype in this process. For anthropologists of color, even those born and trained in the West, the whiteness of anthropology is variable, context‐dependent, and unevenly distributed. This is illustrated with vignettes from ethnographic work in Peru, a country where racialization has typically been framed in terms of a white‐indigenous binary, and as operating like class rather than determined through descent or phenotype. [race, whiteness, ethnography, Asian American, Peru, Andes] [ABSTRACT FROM AUTHOR]

A 3D‐printed array of hollow microneedles (HMNs) is designed and fabricated using a high‐resolution stereolithography 3D printer and assembled with a 3D‐printed reservoir that incorporates a Luer lock mechanism, ensuring standard and secure connection to syringes. The proof‐of‐concept needle designs consist of half‐eccentric and concentric conical tip shapes, each arrayed with two different interspacing values. After the geometrical features of the devices are characterized, the devices are tested ex vivo in porcine skin to evaluate the impact of tip shape and interspacing on the depth of penetration and the efficacy of the devices in delivering fluids (such as tattoo ink) into the dermis. Overall, the 3D‐printed HMNs can deliver fluids into the target layer of skin. Refinement of the design is ongoing with the ultimate aim to provide alternatives for intradermal drug delivery and diagnostic imaging, such as superficial lymphography. [ABSTRACT FROM AUTHOR]

The article discusses the nomadic states in Mongolia that started from the late Bronze Age. Topics discussed include a comparison of the rise and maintenance of nomadic societies, egalitarian nomadic societies, the pattern of social-political development and multiple ethnicities in Central Asian nomadic states.

Objective: Within the UPPS‐P model of impulsive personality, negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking dimensions have been linked to unique etiological mechanisms and outcomes. Yet, additional research is needed exploring direct relations among dimensions to determine how these relations may contribute to the nature of impulsive personality and its correlates. The current study used network analysis to clarify relations among UPPS‐P dimensions and assess global robustness of these relations across young adulthood. Method: Participants included a longitudinal sample of 525 college students (48% male, 18–26 years) who completed the UPPS‐P once per year for three consecutive years. Results: Network structure was globally robust with particularly strong relations emerging between positive and negative urgency, as well as between lack of premeditation and lack of perseverance, across waves. Lack of premeditation consistently emerged as a central dimension. Additional analyses suggested lack of premeditation and sensation seeking as most robustly related with retrospectively reported frequency of alcohol use. Conclusions: Results suggested general robustness in the relations among impulsive personality dimensions, with relations involving lack of premeditation being particularly important for characterizing impulsive personality's nature. Sensation seeking and lack of premeditation may warrant particular focus when linking impulsive personality with frequency of alcohol use. [ABSTRACT FROM AUTHOR]

TE measures liver stiffness to assess fibrosis. Its use in post‐transplant patients was reported in few small pediatric studies. We evaluated TE ability to predict liver graft fibrosis in a large cohort while comparing it to the performance of APRI and FIB‐4. We also investigated the effect of graft type on LSMs. Patients at Boston Children's Hospital who underwent LT and LSM ≤ 1 year from biopsy (2007‐2018) were eligible. Ninety‐four patients (45%M) aged 1‐21 years (89% < 18 years; 13% < 2 years) were eligible. Median time between transplant/biopsy and LSM was 5.1 years and 52 days, respectively. Thirty‐nine percent received whole‐liver grafts, 54% TV grafts, and 6% as part of MV. At LSM, median ALT was 25 [IQR 16‐33] IU/L. Twenty‐one percent had METAVIR ≥ F2. LSM was statistically higher among those with significant fibrosis (METAVIR ≥ F2) compared to those with METAVIR F0/F1 (median [IQR] 7.5 [4.6, 13.6] vs 5.1 [4.0, 6.4] kPa, respectively) (P =.005 by Wilcoxon rank‐sum test). APRI and FIB‐4 distributions were not different across METAVIR stages. The AUROC for LSM was 0.71 (95% CI 0.56‐0.85) with an optimal cut‐point of 6.5 kPa. Graft type had no influence on the AUROC for LSM. TE is useful for assessing significant graft fibrosis in children and young adult LT recipients and performs better than APRI and FIB‐4. TV grafts demonstrate similar correlation with histology as whole‐liver grafts. [ABSTRACT FROM AUTHOR]

A 20‐year‐old male presented 3.5 years after intestinal transplantation with rapidly progressive sensorineural hearing loss. Initial brain imaging was consistent with inflammation and/or demyelination. Lumbar puncture was initially non‐diagnostic and a broad infectious workup was unrevealing. Three months after presentation, a repeat LP detected JC virus for which tests had not earlier been conducted. He continued to deteriorate despite withdrawal of prior immunosuppression and addition of mirtazapine, maraviroc, and steroids. He died of progressive neurologic decompensation 5 months after his initial presentation. This case highlights progressive multifocal leukoencephalopathy (PML) as a rare complication after solid organ transplantation and acute sensorineural hearing loss as an unusual first presenting symptom of PML. JC virus should be considered in the differential diagnosis of acute sensorineural hearing loss in any immunocompromised patient. [ABSTRACT FROM AUTHOR]

Background: Circulating cell-free tumor DNA (ctDNA)-based mutation profiling, if sufficiently sensitive and comprehensive, can efficiently identify genomic targets in advanced lung adenocarcinoma. Therefore, the authors investigated the accuracy and clinical utility of a commercially available digital next-generation sequencing platform in a large series of patients with non-small cell lung cancer (NSCLC).Methods: Plasma-based comprehensive genomic profiling results from 8388 consecutively tested patients with advanced NSCLC were analyzed. Driver and resistance mutations were examined with regard to their distribution, frequency, co-occurrence, and mutual exclusivity.Results: Somatic alterations were detected in 86% of samples. The median variant allele fraction was 0.43% (range, 0.03%-97.62%). Activating alterations in actionable oncogenes were identified in 48% of patients, including EGFR (26.4%), MET (6.1%), and BRAF (2.8%) alterations and fusions (ALK, RET, and ROS1) in 2.3%. Treatment-induced resistance mutations were common in this cohort, including driver-dependent and driver-independent alterations. In the subset of patients who had progressive disease during EGFR therapy, 64% had known or putative resistance alterations detected in plasma. Subset analysis revealed that ctDNA increased the identification of driver mutations by 65% over standard-of-care, tissue-based testing at diagnosis. A pooled data analysis on this plasma-based assay demonstrated that targeted therapy response rates were equivalent to those reported from tissue analysis.Conclusions: Comprehensive ctDNA analysis detected the presence of therapeutically targetable driver and resistance mutations at the frequencies and distributions predicted for the study population. These findings add support for comprehensive ctDNA testing in patients who are incompletely tested at the time of diagnosis and as a primary option at the time of progression on targeted therapies. [ABSTRACT FROM AUTHOR]

Platelets play a critical role in both haemostasis and thrombosis, and it is now evident that not all platelets behave the same when they are called to action. A functionally distinct subpopulation of platelets forms in response to maximal agonist stimulation: the procoagulant platelet. This platelet subpopulation is defined by its ability to expose phosphatidylserine on its surface, allowing for coagulation factor complexes to form and generate bursts of thrombin and fibrin to stabilize platelet clots. Reduced levels of procoagulant platelets have been linked to bleeding in Scott's syndrome and haemophilia A patients, and elevated levels have been demonstrated in many thrombotic disorders, including identifying patients at higher risk for stroke recurrence. One obstacle for incorporating an assay for measuring procoagulant platelets into clinical management algorithms is the lack of consensus on the exact definition and markers for this subpopulation. This review will outline the biological characteristics of procoagulant platelets and the laboratory assays currently used to identify them in research settings. It will summarize the findings of clinical research demonstrating the relevance of measuring the procoagulant platelet levels in patients and will discuss how an appropriate assay can be used to elucidate the mechanism behind the formation of this subpopulation, facilitating novel drug discovery to improve upon current outcomes in cardiovascular and other thrombotic disorders. [ABSTRACT FROM AUTHOR]

Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age‐old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co‐evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations. Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time. [ABSTRACT FROM AUTHOR]