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Introduction: The ~31-km-wide Hiawatha structure, located beneath Hiawatha Glacier in northwestern Greenland, has been proposed as an impact structure that may have formed after the Pleistocene inception of the Greenland Ice Sheet [1]. However, available age constraints for the Hiawatha structure have only been tentative. The bedrock under the structure is likely a continuation of the highly metamorphosed 1.95-1.75 Ga [2] bedrock exposed immediately adjacent to Hiawatha Glacier, providing a maximum constraint on the structure's age [1]. Further age estimates have been based on indirect constraints, such as estimates of erosion rates and the structure's relationship to the Greenland Ice Sheet [1]. Here we dated the structure using detrital materials sampled immediately downstream thereof. We report 40Ar/39Ar analyses of impact-related glaciofluvial sand collected in 2016 and U-Pb analyses of shocked zircon from pebble-sized glaciofluvial clasts of impact melt rock collected in 2019. Results: Of the 50 grains that underwent 40Ar/39Ar step-heating analysis, 29 developed 'U'- or 'saddle'-shaped age spectra, with 23 giving minimum apparent ages in the Paleocene. Two mini-plateaus gave Late Paleocene ages of 58.5 ± 0.3 Ma and 60.2 ± 0.5 Ma, respectively. The 62 U-Pb analysis performed on 43 zircon grains using secondary ion mass spectrometry (SIMS) defined a discordant array in concordia space, spreading between an upper intercept of ~1915 Ma and a Late Paleocene lower intercept. The ~1915 Ma age for the majority of unshocked zircon grains from the impact melt rocks agrees with known geological events and zircon ages from the bedrock adjacent to Hiawatha Glacier [2], supporting a local origin for the samples. Of the 45 analyses performed on shocked zircon grains, the youngest nine data points are statistically indistinguishable, giving a robust concordia age and a weighted mean 206Pb/238U age of 57.99 ± 0.54 Ma (MSWD = 1.18; probability = 0.30; n = 9). We consider this to be the most robust estimate for the age of the impact structure [3]. Discussion: Impact melt rocks collected less than 10 km downstream from the edge of the Hiawatha structure contain unshocked zircon with ages matching that of the bedrock adjacent to Hiawatha Glacier. Shocked zircon in these samples gives a ~58 Ma U-Pb age, which agrees with the younger of two 40Ar/39Ar mini-plateau ages from the sand sample. The samples were thus derived from a Late Paleocene impact structure somewhere upstream but sufficiently proximal that the target geology is indistinguishable geochronologically from that exposed where the samples were recovered. Given existing geomorphic evidence for an eroded complex impact structure beneath Hiawatha Glacier, we suggest this is the source of the samples and thus that the Hiawatha structure is a relatively large impact structure that formed in the Late Paleocene. The new age indicates that the Hiawatha impact structure significantly predates Pleistocene glaciation and is unrelated to either the Paleocene-Eocene Thermal Maximum or flood basalt volcanism in east Greenland. The impact was contemporaneous with the Paleocene Carbon Isotope Maximum, although the impact's exact paleoenvironmental and climatic significance await further investigation. [ABSTRACT FROM AUTHOR]

The platypus ( Ornithorhynchus anatinus ) is an amphibious, egg-laying mammal of high conservation value that is found only in Australia. The zoonotic bacterium Leptospira interrogans serovar Hardjo was discovered in platypuses in prior studies, but little is known about its epidemiology. Samples in the Platypus Serum Bank were tested in 2023 and the results were combined with historical records. Antibodies against L. interrogans serovar Hardjo were found in 50% of 464 serum samples from 411 platypuses collected from 14 river basins in southeastern Australia between 1981 and 2012; prevalence remained high over three decades in the Shoalhaven River population. Seroprevalence increased with age, suggesting environmental exposure. Individual platypuses had persistent titres, some for six years. Seropositive females lactated, juveniles were recruited into the population, and there were no reports of clinical leptospirosis. Three necropsied platypuses were seropositive and had mild nephritis with leptospires in the renal tubules. The high seroprevalence, persistent titres, lack of disease, mild renal lesions, and renal colonisation suggest the platypus may be a maintenance host. Sympatric cattle had L. interrogans serovar Hardjo titres, but the spatial association with seropositive platypuses was statistically weak. Other mammalian wildlife species and sheep also have L. interrogans serovar Hardjo titres; therefore, a complex ecological network must be considered. A landscape-wide study is recommended to properly assess transmission pathways and confirm who is infecting whom.

Background: The aesthetic dimension of transgender experiences involves various aspects linked to the visual representation and expression of one's gender identity. Nonsurgical cosmetic procedures, such as neuromodulators, have consequently become a viable treatment option for patients with gender dysphoria because of the ability to yield significant, although temporary, results with minimal associated risks and downtime., Objective: To comprehensively review literature pertaining to the aesthetic considerations for use of neuromodulators in transgender and nonbinary individuals., Materials and Methods: A literature review of PubMed/MEDLINE for studies was published through January 2024 for nonsurgical facial and body modification using neuromodulators. Searches were conducted with relevant keywords. Peer-reviewed articles and their references published within the past 10 years were given emphasis in the review., Results: Based on the limited publications to date, the authors prepared a comprehensive review on indications for neuromodulator treatment in this population, including brow positioning, lower face contouring, lip eversion, trapezius slimming, and leg contouring., Conclusion: Dermatologists play a crucial role in facilitating the achievement of gender affirmation goals., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Online monitoring of chemical reactions by using analytical chemistry tools is a powerful way to maximize control over these processes. In this paper, we demonstrate the use of molecular rotational resonance, an emerging and extraordinarily selective spectroscopic technique, to perform automated reaction monitoring measurements. An interface using a six-port valve with a calibrated sample loop, coupled to a temperature controlled inlet for analyte volatilization, was developed and tested. Two reactions were chosen for initial characterization: an amine-aldehyde condensation reaction to form an imine product and an isotopic exchange reaction of a β-ketoester with keto-enol tautomerization. The spectrometer was able to provide kinetic information about the reaction and determine reaction completion. In the future, this system can be extended to detect and quantify impurities and characterize reaction selectivity, in addition to the reaction progress., Competing Interests: The authors declare the following competing financial interest(s): Authors A.B., R.E.S., A.V.M., and J.L.N. are currently employed by and have financial interests in BrightSpec, Inc., which is developing commercial instrumentation for MRR spectroscopy., (© 2024 The Authors. Co-published by University of Science and Technology of China and American Chemical Society.)

Background: Active esophageal cooling reduces the incidence of endoscopically identified severe esophageal lesions during radiofrequency (RF) catheter ablation of the left atrium for the treatment of atrial fibrillation. A formal analysis of the atrioesophageal fistula (AEF) rate with active esophageal cooling has not previously been performed., Objectives: The authors aimed to compare AEF rates before and after the adoption of active esophageal cooling., Methods: This institutional review board (IRB)-approved study was a prospective analysis of retrospective data, designed before collecting and analyzing the real-world data. The number of AEFs occurring in equivalent time frames before and after adoption of cooling using a dedicated esophageal cooling device (ensoETM, Attune Medical) were quantified across 25 prespecified hospital systems. AEF rates were then compared using generalized estimating equations robust to cluster correlation., Results: A total of 14,224 patients received active esophageal cooling during RF ablation across the 25 hospital systems, which included a total of 30 separate hospitals. In the time frames before adoption of active cooling, a total of 10,962 patients received primarily luminal esophageal temperature (LET) monitoring during their RF ablations. In the preadoption cohort, a total of 16 AEFs occurred, for an AEF rate of 0.146%, in line with other published estimates for procedures using LET monitoring. In the postadoption cohort, no AEFs were found in the prespecified sites, yielding an AEF rate of 0% (P < 0.0001)., Conclusions: Adoption of active esophageal cooling during RF ablation of the left atrium for the treatment of atrial fibrillation was associated with a significant reduction in AEF rate., Competing Interests: Funding Support and Author Disclosures No specific funding for this research was provided. Some authors are supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, under Award Number R44HL158375 for the evaluation of esophageal cooling (the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health). Academic advisors to—and representatives of—Attune Medical participated in the study design, data collection, analysis, and interpretation and participated in the preparation, review, and approval of the manuscript. Dr Woods has received consulting fees from Abbott and research funding from Biosense Webster; and has equity in Inheart Medical and intellectual property with Attune Medical. Dr Zagrodzky has received consulting fees from Biosense Webster and Attune Medical. Dr Singleton has received consulting fees from Biosense Webster. Dr Brumback has received consulting fees from Attune Medical. Dr Athill has received consultant fees from Abbott, Boston Scientific, Biosense Webster, and Acutus; and speaker fees from Zoll Medical. Dr Joseph has served an internship with Attune Medical. Dr Shah has received consulting fees from Abbott and Janssen Pharmaceuticals. Dr Kulstad holds equity in and has had employment in Attune Medical. Dr Upadhyay has received consulting fees from Abbott, Biotronik, Boston Scientific, Medtronic, Philips BioTel, and Zoll Medical. Dr Cogan has received consulting fees from Abbott and Biosense Webster. Dr Cooper has received support for data acquisition from Attune Medical. Dr Tamirisa has received speaking fees from Abbott and Medtronic; and consultant fees from Sanofi. Dr Patel has received consulting fees from Biosense Webster. Dr Greet has received consulting fees from Medtronic. Dr MacGregor has received research fees from Boston Scientific. Dr Percell has served on Speaker Bureau for Abbott and Janssen. Dr Hao has received consultant fees from Rampart IC. Dr Dewland has received consulting fees from Adagio Medical. Dr Gerstenfeld has received lecture honoraria from Medtronic, Boston Scientific, and Abbott; research funding, scientific advisory board, and compensation from Biosense Webster; has served on a scientific advisory board for Farapulse; and Data and Safety Monitoring Board for trials sponsored by Thermedical Inc and Abbott. Dr Panico has received consulting fees from Abbott and Impulse Dynamics. Dr Mickelsen has received consulting fees from Field Medical, Atraverse Medical, and Attune Medical. Dr Metzl has received consulting fees from Abbott, Biosense Webster, Attune Medical, Medtronic, Sanofi Aventis, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: the Growing Expertise in E-health Knowledge and Skills (GEEKS) program is an applied apprenticeship program that aims to improve informatics capacity at various levels of the national health system and create a sustainable informatics workforce. Nigeria adapted the GEEKS model in 2019 as a mechanism to strengthen data quality and use of routine immunization (RI) and vaccine-preventable disease (VPD) surveillance data among Expanded Programme on Immunization (EPI) staff. Since the start of the GEEKS-EPI program, there has not been a formal assessment conducted to measure the extent to which GEEKS-EPI has been able to build local informatics workforce capacity and strengthen RI and VPD surveillance (VPDS) data quality and use in Nigeria., Methods: we conducted a qualitative assessment to inform the extent to which GEEKS-EPI has been able to build informatics skillsets to enhance local workforce capacity, foster collaboration across government agencies, and create a sustainable informatics workforce in Nigeria. In-Depth Interviews (IDIs) and Focus Group Discussions (FGDs) were held with GEEKS-EPI supervisors, mentors, and mentees from previous GEEKS-EPI cohorts., Results: while there were challenges reported during early implementation of the GEEKS-EPI program in Nigeria, particularly early on in the COVID-19 pandemic, participants and supervisors reported that the fellowship provided a framework for building a sustainable RI and VPDS informatics workforce through regular mentorship, peer-to-peer exchanges and Subject Matter Expert (SME)-led trainings., Conclusion: lessons learned from early implementation of GEEKS-EPI in Nigeria will help to inform its implementation in other countries, where strengthened national RI and VPDS informatics capacity is the primary objective., Competing Interests: The authors declare no competing interests., (Copyright: Audrey Rachlin et al.)

Adolescence is an important time for addressing health, including mental health, obesity, substance use, and food insecurity. As the myriad health and wellness needs of community members expands, it becomes increasingly difficult for one profession alone to address these needs. The park and recreation field was founded to address the health and wellness needs of people, and much of their programming is focused on youth. Thus, municipal park and recreation departments are becoming increasingly involved in collaborative partnerships with other health-serving agencies within their community. This study explored park and recreation directors' experiences in collaborating with health agencies to better address health and wellness factors that affect the youth in their communities. This phenomenological qualitative study employed in-depth interviews with park and recreation directors and used thematic analysis. Nine interviews were conducted from four of the six New England states. The most common health concern seen by the directors was mental health, primarily behavioral health challenges. Parks and recreation collaboration with public health organizations ranged from none to close collaborations; directors regularly spoke about wanting to strengthen their collaborations. Public health and park and recreation staff have similar challenges with staffing and resources; additionally, they have complimentary skills with regard to planning and implementing health-related programs. For that reason, creating purposeful collaborative partnerships between public health agencies and park and recreation departments, focused on measurable outcomes, may increase benefits to the health of youth in a community.