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Objectives. To propose a novel Bayesian spatial–temporal approach to identify and quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing disparities for small area estimation. Methods. In step 1, we used a Bayesian inseparable space–time model framework to estimate the testing positivity rate (TPR) at geographically granular areas of the census block groups (CBGs). In step 2, we adopted a rank-based approach to compare the estimated TPR and the testing rate to identify areas with testing deficiency and quantify the number of needed tests. We used weekly SARS-CoV-2 infection and testing surveillance data from Cameron County, Texas, between March 2020 and February 2022 to demonstrate the usefulness of our proposed approach. Results. We identified the CBGs that had experienced substantial testing deficiency, quantified the number of tests that should have been conducted in these areas, and evaluated the short- and long-term testing disparities. Conclusions. Our proposed analytical framework offers policymakers and public health practitioners a tool for understanding SARS-CoV-2 testing disparities in geographically small communities. It could also aid COVID-19 response planning and inform intervention programs to improve goal setting and strategy implementation in SARS-CoV-2 testing uptake. (Am J Public Health. 2023;113(1):40–48. https://doi.org/10.2105/AJPH.2022.307127 )

Locally derived endothelial nitric oxide (NO) contributes to the full expression of cutaneous vasodilation responses. Acute ultraviolet radiation (UVR) exposure attenuates NO-mediated vasodilation of the cutaneous microvasculature. Our findings suggest that in constitutively lightly pigmented skin, variation in skin melanin due to seasonal exposure to UVR does not alter the NO contribution to cutaneous vasodilation. Seasonal UVR exposure does not impact the NO-mediated cutaneous microvascular function.

Hypertension remains a significant global health problem. Although hypertension research and therapies are keenly focused on the heart and arterial circulation, the venous circulation has been neglected comparatively. We determined whether hypoxia, known to cause peripheral chemoreflex activation, evoked more pronounced changes in lower limb venous capacity and compliance in hypertensives (HTN) than in age-matched normotensives (NT). We found that hypoxia reduced venous capacity in the great saphenous vein in HTN and increased its compliance twofold. However, hypoxia did not affect venous function in NT. Our data indicate the venomotor response to hypoxia is enhanced in hypertension, and this may contribute to the hypertensive state.

Muscle O2 saturation (%SmO2) rate can be used to not only identify sustainable from unsustainable exercise intensities but also delineate the transition from heavy to severe exercise domains. This report is the first to identify, and then validate, that the highest steady-state metabolic rate is related to a zero-slope muscle O2 saturation and is therefore dependent on muscle oxygen supply-demand balance.

Background: Cerebral cavernous malformations, also known as cavernous angiomas, are blood vessel abnormalities comprised of clusters of grossly enlarged and hemorrhage-prone capillaries. The prevalence in the general population, including asymptomatic cases, is estimated to be 0.5%. Some patients develop severe symptoms, including seizures and focal neurological deficits, whereas others remain asymptomatic. The causes of this remarkable presentation heterogeneity within a primarily monogenic disease remain poorly understood. Methods: We established a chronic mouse model of cerebral cavernous malformations, induced by postnatal ablation of Krit1 with Pdgfb-CreERT2 , and examined lesion progression in these mice with T2-weighted 7T magnetic resonance imaging (MRI). We also established a modified protocol for dynamic contrast-enhanced MRI and produced quantitative maps of gadolinium tracer gadobenate dimeglumine. After terminal imaging, brain slices were stained with antibodies against microglia, astrocytes, and endothelial cells. Results: These mice develop cerebral cavernous malformations lesions gradually over 4 to 5 months of age throughout the brain. Precise volumetric analysis of individual lesions revealed nonmonotonous behavior, with some lesions temporarily growing smaller. However, the cumulative lesional volume invariably increased over time and after about 2 months followed a power trend. Using dynamic contrast-enhanced MRI, we produced quantitative maps of gadolinium in the lesions, indicating a high degree of heterogeneity in lesional permeability. MRI properties of the lesions were correlated with cellular markers for endothelial cells, astrocytes, and microglia. Multivariate comparisons of MRI properties of the lesions with cellular markers for endothelial and glial cells revealed that increased cell density surrounding lesions correlates with stability, whereas denser vasculature within and surrounding the lesions may correlate with high permeability. Conclusions: Our results lay a foundation for better understanding individual lesion properties and provide a comprehensive preclinical platform for testing new drug and gene therapies for controlling cerebral cavernous malformations.

Funding: This work was supported by a University of Kent 50th Anniversary Scholarship, and a Cotutelle de thèse grant from swissuniversities to J.V. Optimal foraging theory has guided much of the research on foraging behaviour in the past five decades, with the notion of optimality deeply embedded in most models today. However, assuming that all foragers strive to maximize a certain predefined currency, such as amount of food per unit time, restricts what can be learned about the factors influencing foraging decisions. Here we applied a different approach: the discrete-choice model, which does not assume an optimal strategy as the starting point, but instead examines foraging decisions directly, modelling interpatch movements as the consequence of a choice of destination from a limited set of options. We analysed a set of foraging decisions by both adult male and female chimpanzees, Pan troglodytes, from two habituated communities in the Budongo forest, Uganda, to investigate the influence of foraging variables including food patch characteristics and interpatch distance on patch choice, with a view to identifying the strategy underlying these decisions. Despite differences in habitat between communities, we found that foraging strategies were remarkably similar across both communities and sexes, with chimpanzees exhibiting a clear preference for closer and novel (not previously visited) food patches. Individuals of both communities frequently chose to forage on food patches providing young leaves, highlighting the importance of this food type in their diet. Contrary to expectation, patch size did not predict foraging decisions, except for adult males of one community that chose larger patches, while both sexes aimed to minimize travel distance between consecutive patches. This study provides the first direct evidence that chimpanzees consider travel distance and whether they have recently visited a patch when choosing between potential foraging sites and demonstrates that new insights can be gained (even in a well-studied system) from integrating several important variables describing feeding ecology into a coherent model of patch choice. Publisher PDF

This historical review explores a descriptive-informative overview of cuisine as a component of gastro-tourism and travel. The paper reports on contemporary culinary innovation offerings in a South African context, analysing the links – or absence thereof – between academia and the gastro-tourism industry, to illustrate the ambiguity between research and practice in culinary innovation and its effects on the gastro-tourism industry. The qualitative methodology employed was informed by the historically oriented systematic literature review process. This was guided by a structured approach to determine relevant source material that would be useful for the historical literature review purpose. Evidence searches for literature from various sources such as scholarly journals and professional magazines, grey literature and personal reviews within the industry were undertaken. The examples in this paper highlight the potential unstructured innovation taking place within the South African food service environment without supported evidence from academic research. Role-players in both research and the gastro-tourism fields could apply properly researched food heritage and gastro-nationalism interventions to draw tourists and allow them to experience innovative use of local indigenous produce and food heritage innovations. Examples include Wild Peach (Landolphia kirkii) or Sand Apricot Vine (Umkuzi in Zulu) fruit leather disk covering a cheese and fruit plate, or swirls of fruit leather used to decorate a carrot and Marula Bundt cake, made from bright Umnumbela or Transvaal Milk-plum purée, and Marula (Sclerocarya birrea) pulp in the carrot cake batter. The research highlights the limited available data, to establish a viable link between academia and the gastro-tourism industry. Despite this limitation, the paper foregrounds the efforts being made towards culinary innovation within the South African culinary industry. Simultaneously it also illustrates the originality of this research and the importance of improved collaboration.

Funding: This study was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) (Grant BB/M010996/1) via EASTBIO Doctoral Training Partnership studentships to G.F. and B.J.R., and by the University of St Andrews via a StARIS summer research bursary to S.K.L. The bifunctional enzyme phosphoribosyl-ATP pyrophosphohydrolase/phosphoribosyl-AMP cyclohydrolase (HisIE) catalyzes the second and third steps of histidine biosynthesis: pyrophosphohydrolysis of N1-(5-phospho-β-D-ribosyl)-ATP (PRATP) to N1-(5-phospho-β-D-ribosyl)-AMP (PRAMP) and pyrophosphate in the C-terminal HisE-like domain, and cyclohydrolysis of PRAMP to N-(5′-phospho-D-ribosylformimino)-5-amino-1-(5″-phospho-D-ribosyl)-4-imidazolecarboxamide (ProFAR) in the N-terminal HisI-like domain. Here we use UV–VIS spectroscopy and LC–MS to show Acinetobacter baumannii putative HisIE produces ProFAR from PRATP. Employing an assay to detect pyrophosphate and another to detect ProFAR, we established the pyrophosphohydrolase reaction rate is higher than the overall reaction rate. We produced a truncated version of the enzyme-containing only the C-terminal (HisE) domain. This truncated HisIE was catalytically active, which allowed the synthesis of PRAMP, the substrate for the cyclohydrolysis reaction. PRAMP was kinetically competent for HisIE-catalyzed ProFAR production, demonstrating PRAMP can bind the HisI-like domain from bulk water, and suggesting that the cyclohydrolase reaction is rate-limiting for the overall bifunctional enzyme. The overall kcat increased with increasing pH, while the solvent deuterium kinetic isotope effect decreased at more basic pH but was still large at pH 7.5. The lack of solvent viscosity effects on kcat and kcat/KM ruled out diffusional steps limiting the rates of substrate binding and product release. Rapid kinetics with excess PRATP demonstrated a lag time followed by a burst in ProFAR formation. These observations are consistent with a rate-limiting unimolecular step involving a proton transfer following adenine ring opening. We synthesized N1-(5-phospho-β-D-ribosyl)-ADP (PRADP), which could not be processed by HisIE. PRADP inhibited HisIE-catalyzed ProFAR formation from PRATP but not from PRAMP, suggesting that it binds to the phosphohydrolase active site while still permitting unobstructed access of PRAMP to the cyclohydrolase active site. The kinetics data are incompatible with a build-up of PRAMP in bulk solvent, indicating HisIE catalysis involves preferential channeling of PRAMP, albeit not via a protein tunnel. Publisher PDF

The aim of this study was to develop and validate risk prediction models for deep surgical site infection (SSI) caused by specific bacterial pathogens after fracture fixation. A retrospective case-control study was conducted at a level I trauma center. Fifteen candidate predictors of the bacterial pathogens in deep SSI were evaluated to develop models of bacterial risk. The study included 441 patients with orthopedic trauma with deep SSI after fracture fixation and 576 control patients. The main outcome measurement was deep SSI cultures positive for methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S aureus (MRSA), gram-negative rods (GNRs), anaerobes, or polymicrobial infection within 1 year of injury. Prognostic models were developed for five bacterial pathogen outcomes. Mean area under the curve ranged from 0.70 (GNRs) to 0.74 (polymicrobial). Strong predictors of MRSA were American Society of Anesthesiologists (ASA) classification of III or greater (odds ratio [OR], 3.4; 95% CI, 1.6–8.0) and time to fixation greater than 7 days (OR, 3.4; 95% CI, 1.9–5.9). Gustilo type III fracture was the strongest predictor of MSSA (OR, 2.5; 95% CI, 1.6–3.9) and GNRs (OR, 3.4; 95% CI, 2.3–5.0). ASA classification of III or greater was the strongest predictor of polymicrobial infection (OR, 5.9; 95% CI, 2.7–15.5) and was associated with increased odds of GNRs (OR, 2.7; 95% CI, 1.5–5.5). Our models predict the risk of MRSA, MSSA, GNR, anaerobe, and polymicrobial infections in patients with fractures. The models might allow for modification of preoperative antibiotic selection based on the particular pathogen posing greatest risk for this patient population. [ Orthopedics . 202x;4x(x):xx–xx.]

The Republic of Turkey continues to grapple with a foundational tension between isolationist impulses steeped in a nationalist, sovereigntist, i.e., realist outlook on the world, and what I call the “embedded liberalism” of the republican project. Yet, neither realism nor liberalism are sufficient, I show, to explain Turkey’s trajectory. Invoking three visions of the international system as envisaged in realism (billiard balls), liberalism (concentric circles), and global IR (which I conceptualize as a Venn diagram), I argue that the last best captures (Turkey’s) challenges and opportunities. My contention is that global IR incorporates constructivist claims regarding historical and social forces in world politics, but also decenters Eurocentric notions of history and society. A timely way to read multipolarity, the approach supports relational learning regarding our overlapping challenges as humanity. Scholars in and of Turkey arguably have a comparative advantage in this space. This is due to their ability, albeit not always actualized, to read the world in plural terms — the epistemological equivalent of Turkey’s proverbial bridging role in world politics.

Despite the well-established benefits of antenatal education (ANE) and breastfeeding for mothers, there is a paucity of evidence about the uptake of ANE and breastfeeding amongst women from refugee backgrounds or its associations with sociodemographic factors. The current study is a cross-sectional survey at two time points examining the prevalence of ANE attendance, breastfeeding, and intimate partner violence (IPV) amongst 583 women refugees resettled in Australia and a control group of 528 Australian-born women. Multi-logistic regression was used to explore bivariate associations between ANE attendance, breastfeeding, IPV, and sociodemographic characteristics (parity, maternal employment, and education). Refugee-background women compared to Australian-born women have lower ANE utilization (20.4% vs. 24.1%), higher rates of breastfeeding on hospital discharge (89.3% vs. 81.7%), and more IPV reports (43.4% vs. 25.9%). Factors such as nulliparity, higher level of education, and employment predict higher rates of ANE and breastfeeding adoption. In contrast, IPV is a risk factor for ANE underutilization. Further, of the women from refugee backgrounds who accessed ANE services, 70% attended clinics designed for women from non-English-speaking backgrounds. These findings support the need to ensure effective screening and interventions for IPV during antenatal care and to better understand the role of culture as a protective or risk factor for breastfeeding initiation.

Complex human–environmental processes form identifiable, lasting features on the landscape that can illuminate past human behavior and human–environment interactions. We examine the anthropogenic landscape of the ancient port of Macurany, located along the middle Amazon River in Parintins, Brazil, and identify four classes of anthropogenic landscape features at the site: wharfs, middens, terra preta (dark or black earths), and cultural forests. Middens, terra preta, and cultural forests have been found at archaeological sites in regions surrounding Macurany, but wharfs have not previously been reported in Amazonian contexts predating European contact. Taken together, these features are clearly the result of anthropogenesis and represent a range of subsistence, settlement, and infrastructure-building activities pointing to an ancient society that was actively engaged in modifying the surrounding landscape for purposes beyond settlement and subsistence. Evidence for a permanent, extensive, continuously settled society practicing intensive landscape engineering in this region of Amazonia reinforces findings of dense habitation, infrastructure, and early urbanization in Amazonia prior to European contact. This research helps expand our understanding of human–environment interactions, landscape formation processes, and settlement organization in ancient Amazonia.

A promising way to mitigate inequality is by addressing students’ worries about belonging. But where and with whom is this social-belonging intervention effective? Here we report a team-science randomized controlled experiment with 26,911 students at 22 diverse institutions. Results showed that the social-belonging intervention, administered online before college (in under 30 minutes), increased the rate at which students completed the first year as full-time students, especially among students in groups that had historically progressed at lower rates. The college context also mattered: The intervention was effective only when students’ groups were afforded opportunities to belong. This study develops methods for understanding how student identities and contexts interact with interventions. It also shows that a low-cost, scalable intervention generalizes its effects to 749 4-year institutions in the United States.

AimsObesity is associated with an increased risk of hip osteoarthritis, resulting in an increased number of total hip arthroplasties (THAs) performed annually. This study examines the peri- and postoperative outcomes of morbidly obese (MO) patients (BMI ≥ 40 kg/m2) compared to healthy weight (HW) patients (BMI 18.5 to < 25 kg/m2) who underwent a THA using the anterior-based muscle-sparing (ABMS) approach.MethodsThis retrospective cohort study observes peri- and postoperative outcomes of MO and HW patients who underwent a primary, unilateral THA with the ABMS approach. Data from surgeries performed by three surgeons at a single institution was collected from January 2013 to August 2020 and analyzed using Microsoft Excel and Stata 17.0.ResultsThis study compares 341 MO to 1,140 HW patients. Anaesthesia, surgery duration, and length of hospital stay was significantly lower in HW patients compared to MO. There was no difference in incidence of pulmonary embolism, periprosthetic fracture, or dislocation between the two groups. The rate of infection in MO patients (1.47%) was significantly higher than HW patients (0.14%). Preoperative patient-reported outcome measures (PROMs) show a significantly higher pain level in MO patients and a significantly lower score in functional abilities. Overall, six-week and one-year postoperative data show higher levels of pain, lower levels of functional improvement, and lower satisfaction scores in the MO group.ConclusionThe comorbidities of obesity are well studied; however, the implications of THA using the ABMS approach have not been studied. Our peri- and postoperative results demonstrate significant improvements in PROMs in MO patients undergoing THA. However, the incidence of deep infection was significantly higher in this group compared with HW patients.Cite this article: Bone Jt Open 2023;4(5):299–305.

Abstract: Introduction: The purpose of this study was to compare the structural validity of Holland’s circular/hexagonal model in two versions of a commonly used Realistic, Investigative, Artistic, Social, Enterprising, Conventional (RIASEC) occupational interest measure – one that used items with a neutral response option ( unsure) and one that used items without a neutral response option. Method: These comparisons were made using a sample of 1,025 undergraduate university business majors. A two-group Cosine Function Model (CFM) implemented in standard structural equation modeling software was used to investigate the circumplex fit across the two versions of the assessment. Results: CFM analyses suggested a high level of equivalence across versions such that (1) the correlation matrix of each group shows a good fit to the RIASEC circumplex, and (2) the two correlation matrices are essentially identical. Conclusion: The neutral response option (or lack thereof) did not seem to affect model fit. The generalizability of these results should be explored in future studies.

Biological sex, gender and race are important considerations in patients with interstitial lung diseases (ILD).Do patient's sex assigned at birth and race influence ILD treatment initiation?Patients with ILD from three longitudinal prospective registries were compared in this observational study. ILD-related medications included antifibrotics and immunomodulating medications. Race was dichotomized as "White" vs non-White". Time to treatment initiation was determined from the date of initial ILD registry visit to the date of first medication initiation. Proportions of treated patients were compared between groups using Chi2 test. Cox proportional analysis was used to determine how sex and race was associated with time to treatment initiation stratified by ILD diagnosis.A total of 4572 patients were included across all cohorts. The proportion of men who received treatment was higher than for women in the Canadian cohort (47 vs 40%, p,0.001), and the proportion of White patients who received treatment was also higher compared to non-Whites (46 vs 36%, p0.001). In contrast, the proportion of treated men in the Chicago cohort was lower compared to women (56 vs 64%, p=0.005), and that of White patients was lower compared to non-Whites (56 vs 69%, p0.001). No sex- or race-based differences in proportions of patients treated were found in the Australasian cohort. White race was significantly associated with earlier treatment initiation compared to non-White patients across diagnoses in the Canadian cohort, while the opposite association was found in the Australasian cohort.Sex- and racial-based differences exist in the initiation of ILD treatment, with variability across different cohorts in different countries. Reasons for these differences need to be further explored in future studies.

This study explored associations between exposure to other people's gambling and the prevalence of gambling in the last month, engagement in hard gambling activities (defined as those which occur more frequently, with a quicker determination of outcomes, and/or high payout ratios), and the prevalence of at risk and problem gambling, among a large sample of Australian adolescent school students.In 2017, 6,377 students from Victoria and Queensland answered gambling questions as part of the cross-sectional triennial Australian Secondary Students' Alcohol and Drug Survey. Students reported on gambling behaviors (gambling in the last month, types of gambling activities), were assessed for problem gambling using the Diagnostic Statistical Manual IV adapted for Juveniles (DSM-IV-[MR]-J), and reported whether people they knew (parents, siblings, other relatives, best friend, or someone else) had gambled in the last month. Logistic regressions explored the relationship between other people's gambling and student gambling behaviors in the last month.Approximately, one in five students reported that someone from their household gambled in the last month. Overall, 6% of students reported they had gambled, and 4% gambled on a hard gambling activity, in the previous month; 10% were classified as potentially at risk or problem gamblers. Having a parent, sibling, best friend, another relative, or someone else who gambled in the last month were each significantly associated with the three gambling outcomes.There is a need to address the modeling of gambling behaviors by young people's friends, family, and others, in order to reduce gambling behaviors and problem gambling among Australian adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Problem definition: How to use social media to predict style color and jeans fit sales for a retailer. Academic/practical relevance: Neither retail practice nor the academic literature provides a method for using social media to predict style color and jeans fit sales for a retailer. We present and validate a systematic approach for doing that. Methodology: Demand forecasting in the fashion industry is challenging due to short product lifetimes, long manufacturing lead times, and constant innovation of fashion products. We investigate the value of social media information for color trends and jeans fit forecasting. We partner with three multinational retailers, two apparel and one footwear, and combine their proprietary data sets with web-crawled publicly available data on Twitter and the Google Search Volume Index. We implement a variety of machine learning models to develop forecasts that can be used in setting the initial shipment quantity for an item, arguably the most important decision for fashion retailers. Results: Our findings show that fine-grained social media information has significant predictive power in forecasting color and fit demands months in advance of the sales season, and therefore greatly helps in making the initial shipment quantity decision. The predictive power of including social media features, measured by the improvement of the out-of-sample mean absolute deviation over current practice ranges from 24% to 57%. Managerial implications: To our knowledge, this study is the first to explore and demonstrate the value of social media information in fashion demand forecasting in a way that is practical and operable for fashion retailers. With consistent results across all three retailers, we demonstrate the robustness of our findings over market and geographic heterogeneity, and different forecast horizons. Moreover, we discuss potential mechanisms that might be driving this significant predictive power. Our results suggest that changes in fashion demand are driven more by “bottom-up” changes in consumer preferences than by “top-down” influence from the fashion industry. Funding: This work was supported by Wharton School Fishman-Davidson Center for Service and Operations Management, the Wharton School Baker Retailing Center, and the Wharton School Risk Management Center Russell Ackoff Doctoral Student Fellowship. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.1193 .

The coexistence of psoriasis and hidradenitis suppurativa (HS) has been described, but the association between these conditions is yet to be firmly established.To study the association between psoriasis and HS using a large-scale real-life computerized database.A cross-sectional study was conducted comparing the prevalence of HS among patients with psoriasis and among age-, sex- and ethnicity-matched control subjects.A total of 68,836 patients with psoriasis and 68,836 controls were included in the study. The prevalence of HS was increased in patients with psoriasis as compared to the control group (0.3% vs. 0.2%, respectively; OR, 1.8; 95% CI, 1.5-2.3; P0.001). In a multivariate analysis adjusting for smoking, obesity, and other comorbidities, psoriasis was still associated with HS (OR, 1.8; 95% CI, 1.4-2.2; P0.001). Patients with coexistent psoriasis and HS were significantly younger (39.0±15.7 vs. 42.6±21.2 years; P=0.015) and had a higher prevalence of obesity (35.1% vs. 25.3%; P=0.001) and smoking (58.5% vs. 37.3%; P0.001) as compared to patients with psoriasis alone.Retrospective data collection.A positive association was observed between HS and psoriasis. Further longitudinal observational studies are necessary to establish these findings in other study populations.