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We study the invariant measure of the transport correlator for a chiral Hamiltonian and analyze its properties. The Jacobian of the invariant measure is a function of random phases. Then we distinguish the invariant measure before and after the phase integration. In the former case we found quantum diffusion of fermions and a uniform zero mode that is associated with particle conservation. After the phase integration the transport correlator reveals two types of evolution processes, namely classical diffusion and back-folded random walks. Which one dominates the other depends on the details of the underlying chiral Hamiltonian and may lead either to classical diffusion or to the suppression of diffusion. [ABSTRACT FROM AUTHOR]

Localization by a broken particleâ€"hole (PH) symmetry in a random system of non-interacting quantum particles is studied on a d -dimensional lattice. Our approach is based on a chiral symmetry argument and the corresponding invariant measure, where the latter is described by a Grassmann functional integral. Within a loop expansion we find for small loops diffusion in the case of PH symmetry. Breaking the PH symmetry results in the creation of random dimers, which suppress diffusion and lead to localization on the scale D / | ÎĽ | , where D is the effective diffusion coefficient at PH symmetry and ÎĽ is the parameter related to PH symmetry breaking. [ABSTRACT FROM AUTHOR]

Introduction: We report here on a recently classified ungrouped pallasite Hassi el Biod 002 (HeB 002) which is a unique type both in terms of olivine composition and oxygen isotopes. Along with Milton, HeB 002 is the only other ungrouped pallasite that is not a pyroxene pallasite (PP), however Milton and HeB 002 are not paired, and do not have olivine compositions and oxygen isotopes that are similar [1]. History and Physical Characteristics: HeB 002 was found near a dry riverbed approximately 50 km northwest of Foggaret Ezzoua in Salah Province, Algeria in 2020. The total known weight of HeB 002 is approximately 10 kg. Saw cut surfaces show angular cm-sized dark-orange olivine grains set in metal (figure 1). There are also smaller scattered olivines set in the host metal. The modal abundances are approximately 60% metal, 38% olivine, 2% troilite and chromite. Petrography, Geochemistry, Oxygen Isotopes: Electron microprobe analysis and imaging reveal the presence of magnesian olivine, kamacite, and minor troilite and chromite. No other phases were detected with both EPMA and SEM searches. Olivine Fa7.6±0.1, Fe/Mn=24±1, Fe/Mg=0.082±0.001, n=12; metal Fe=95.4±0.4, Ni=5.2±0.1 wt%, n=5; chromite Cr2O3=67.9±0.7, Al2O3=1.6±0.3, FeO=18.2±1.8, MgO=8.0±1.2, MnO=1.1±0.3 wt%, n=3. Oxygen isotopes: 6 acid-washed fragments analyzed by laser fluorination gave d18O= 2.820, 3.390, 3.386, 3.186, 2.910, 3.341; δ17O= 0.338, 0.440, 0.650; Δ17O= -1.151, -1.350, -1.138, -1.165, -1.142, -1.161 (linearized, all per mil, TFL slope=0.528) with mean values δ18O=3.172±0.251, δ17O=0.490±0.122, Δ17O= -1.185±0.082. Unique Pallasite Hassi el Biod 002: HeB 002 clearly possesses all the textural characteristics of a pallasite, however it has unique charcteristics that set it distinctly apart from the Pallasite Main Group (PMG), the Eagle Station Group (ESG), as well other ungrouped or anomalous pallasites. For example, its oxygen isotope values occupy a location in triple oxygen isotope space that is different from other known pallasites. Interestingly, HeB 002 oxygen isotope values are coincident with the acapulcoite-lodranite group, suggesting a possible genetic link (figure 2). HeB 002 also has olivine compositions that are more magnesian than any other known pallasite (Fa7.6±0.1, Fe/Mg=0.082±0.001) with the lowest Fe/Mn values (24±1) ever reported in pallasite olivine [2]. These HeB 002 olivine values resemble the more magneisn members of the acapulcoitelodranite group as well as olivines in winonaites. Chromite elemental values in HeB 002 also appear to be anomalous with respect to other pallasites. In particular Fe/Mn and Al/Cr values are among the lowest ever reported in pallasite chromite. Acapulcoite/Lodranite-Like Parent Body for Hassi el Biod 002: Because Main group pallasites have triple oxygen isotope values similar to HED and mesosiderites it has been proposed that PMGs are possibly derived from Vesta-like parent body [3]. Likewise Eagle Station pallasites and some carbonaceous chondrites appear to have a genetic relationship as seen in similar stable isotope values [4]. In the case of HeB 002, as discussed above, an acapulcoite/lodranite-like parent body seems plausible and more work is needed on HeB 002 to further test this hypothesis. [ABSTRACT FROM AUTHOR]

Introduction: Metal-rich achondrites include a variety of types, and likely have a variety of origins. Models range from gravitational mixing at the core-mantle boundaries of differentatiated asteroids, to complex impact mixing scenarios. We describe a new type of metal-rich achondrite that might be the first metal-rich ureilite. Sample: Tin-Essako (TE) 001 (~4.3 kg) was found in Mali in 2020 and purchased by Jay Piatek in 2021. It was classified as a metal-rich ungrouped achondrite, with olivine and oxygen isotope (avg. δ18O=8.281‰, δ17O=3.718 ‰, Δ17O=-0.654‰) compositions suggesting affinity to ureilites [1]. We studied one polished section (~188 mm²). Petrography: TE 001 consists of ~60% metal and 40% silicates, heterogeneously distributed (Fig. 1a). The metal is largely fresh, but iron oxides (presumably terrestrial) occur along one edge and in some patches and veins. The silicates are ≥90% olivine, plus melt-textured areas of plagioclase + Si-rich glass. Minor phases are chromite and carbon. Olivine occurs as rounded grains (≤2.5 mm) in metal, commonly with rims of melt-textured plagioclase + glass. Olivine also occurs in massive areas having a "honeycomb" texture (Fig. 1b), with olivine "cells" surrounded by a network of interstitial reduced olivine (full of tiny metal grains) plus melt-textured plagioclase + Sirich glass (Fig. 1c). Chromite occurs as subhedral to rounded grains (~30-500 μm) included in olivine or metal. A carbon phase occurs as lacy-textured (fibrous) rims around olivine grains or patches within metal. Mineral Compositions: The olivine (excluding interstitial areas) is Fo 73.9±0.5, with 0.25±0.02 wt.% CaO, 0.31±0.01 wt.% Cr2O3, 0.01 wt.% NiO, and molar Fe/Mn=49.8±2.2 (53 analyses). Olivine in interstitial areas has Fo up to at least 91. Smaller chromite grains have Fe# (molar Fe/[Fe+Mg]) = 0.54±0.01, Cr# (molar Cr/[Cr+Al]) = 0.52±0.01, 0.52±0.02 wt.% V2O3 and 0.21±0.04 wt.% ZnO (28 analyses). One larger grain is zoned from Fe# = 0.45, Cr# = 0.52 to Fe# = 0.40, Cr# = 0.57, and contains thin Al-rich lamellae not resolved by EMPA. One irregularly shaped patch of chromite in olivine has Fe# = 0.26 and contains no ZnO. Plagioclase laths are An ~53-60, with ≤0.01 wt.% K2O. Glass contains 75-76 wt.% SiO2 and ~16 wt.% Al2O3. The metal contains 5.2±0.2 wt.% Ni, 0.46±0.02 wt.% Co, and 0.01±0.01 wt.% Cr, with Si and P below detection (168 analyses). Discussion: The olivine + chromite assemblage in TE 001 is suggestive of the most ferroan ureilites (Fo ~75-77 [2]), as are the oxygen isotopes [1]. The presence of a carbon phase supports this, though the identity of this phase (graphite as in ureilites?) remains to be determined. The "honeycomb" textured areas, in particular, the presence of "reduction rims," resemble shock-smelted olivine in ureilites [3], but melt-textured areas of plagioclase laths + glass like those in TE 001 have not been reported in such (or any) ureilites. Olivine in TE 001 is marginally more ferroan than in the most ferroan ureilite, with Fe/Mg-Fe/Mn offset from the trend of olivine + low-Ca pyroxene ureilites (similar to augite-bearing ureilites) [2]. CaO and Cr2O3 contents are in the range of those in ureilite olivine [4], though Cr2O3 is at the extreme low end of the range [5]. Chromites (except the unusual one) have similar Fe# to the most ferroan chromites in ureilites [2], but lower Cr# (0.52 vs. 0.71). Metal compositions are in the range for metal in ureilites [6]. The absence of pyroxene and sulfide, and high abundance of metal, in TE 001, are unlike ureilites. One possibility is that a ferroan, chromite-bearing, pyroxene-poor ureilite was invaded (possibly due to impact) by a metallic liquid (the low S content suggests very high temperature), resulting in complete melting of pyroxene and smelting of olivine, with rapid recrystallization of melted silicate as plagioclase + glass. Alternatively, a preexisting metal-rich ureilite assemblage may have been impact melted. Additional types of data will be obtained to evaluate these and other hypotheses (i.e., is the metal indigenous?) and assess affinity to ureilites. [ABSTRACT FROM AUTHOR]

Introduction: Northwest Africa 12380 (NWA 12380) is an L3 chondrite containing a clast with a unique assemblage of minerals produced by pre-terestrial aqueous alteration [1]. Although the host meteorite has experienced significant terrestrial weathering (W3) [2], preliminary petrography and mineral-chemical analysis suggested that the clast originated as an especially wet L3 chondrite lithology prior to incorporation in the host [1]. Results: Major, minor, and trace element data were obtained using ICPMS on both host and clast (Fig. 1). Given the strong similarity between the host and clast siderophile abundances, we conclude that the host and clast are from the same chemical group. Bulk compositions resemble those in L- or LL-chondrites (Fig. 1), consistent with probable L group membership for both [2]. Both clast and (especially) host show the chemical effects of terrestrial weathering, but only the clast is significantly depleted in soluble alkali elements Na, Rb, and Cs (Fig. 1), consistent with the low amount of feldspathic material in the clast [1] and suggesting break-down of feldspathic glass and open-system removal of alkali elements from the clast by pre-terrestrial and pre-brecciation aqueous alteration. The oxygen isotopic composition of clasr aliquots form a mass-dependent trend from an average L-chondrite value, different from the mass-independent trend shown for the host (Fig. 2), which can be explained by dominant aqueous alteration in the clast, and a shift to higher ẟ18O and lower Δ17O caused by terrestrial weathering in a warm climate for the host. Raman spectroscopy confirms the presence [1] in the clast of a saponite/montmorillonite mixture, jarosite, and cronstedtite, with additional identification of laihunite, hematite, goethite, and abundant macromolecular carbon (MMC) distinct from a few flecks of MMC in the host. The occasional flecks of MMC in the host are found only between chondrules. Two forms of MMC appear to be disseminated throughout the clast, both within and between chondrules. Additionally, a fine-grained MMC-rich lump (Fig. 3) appears to be an exogenous clast. Conclusion: A unique clast in NWA 12380 was aqueously-altered on the L-chondrite parent body prior to becoming incorporated in the host. The source for water could have been also a source of macromolecular carbon. [ABSTRACT FROM AUTHOR]

Responsive nanomaterials that can undergo reversible changes in morphology are interesting for the development of functional materials that interact with and respond to their environment. Amphiphilic block copolymers are well-known for their ability to create a wide range of supramolecular nanostructures in solution. Arylazopyrazoles (AAPs) are versatile molecular photoswitches, which change their configuration and hydrophobicity upon irradiation with UV light (365 nm, Z isomer, less hydrophobic) and green light (520 nm, E isomer, more hydrophobic). In this work, photoswitchable block copolymers containing arylazopyrazole tetraethylene glycol methacrylate (AAPMA) and oligo(ethylene glycol) methacrylate (OEGMA) forming amphiphilic POEGMA- b -PAAPMA with varying block lengths are prepared by RAFT polymerization. The photochemical properties of AAP persist in the polymers. Due to their amphiphilic structure, the polymers self-assemble into supramolecular morphologies in water. Remarkably, photoisomerization results in a reversible change in the self-assembly behavior. Specifically, spherical and cylindrical micelles are observed for POEGMA 33 - b -PAAPMA 47 when illuminated with green or UV light during assembly. Furthermore, the morphology of assembled structures can be reversibly switched by subsequent irradiation with UV and green light.

Background: Empirical evidence has demonstrated associations between pre-pregnancy obesity and perinatal maternal depressive symptoms. Omega-3 is an essential fatty acid derived from dietary sources that is critical for fetal brain development. Pre-pregnancy obesity is associated with higher omega-3 intake, but a weaker association between dietary intake and respective maternal and cord blood omega-3 levels. Further, lower intake of omega-3 during pregnancy has been linked to higher depressive symptoms. Yet, prior studies have not examined the interactive effects of pre-pregnancy overweight or obesity (OWOB) and prenatal maternal mental health symptoms on infant cord blood omega-3 levels., Methods: Participants included 394 maternal-infant dyads from the NIH Environmental influences on Child Health Outcomes (ECHO) - Safe Passage Study in South Dakota. A pre-pregnancy body mass index (BMI) > 25 was used to dichotomize participants as OWOB (54%) vs. non-OWOB (46%). Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and prenatal maternal anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). We implemented linear regression models to examine the interaction term between pre-pregnancy BMI category and prenatal maternal mental health symptoms on cord blood omega-3 levels. Secondary analyses were stratified by pre-pregnancy BMI category., Results: We observed a significant interaction between pre-pregnancy BMI category and prenatal maternal depressive symptoms with cord blood omega-3 (F(4,379) = 6.21, p < .0001, adj. R 2  = 0.05). Stratified models revealed an association between prenatal maternal depressive symptoms with lower cord blood omega-3 levels only among individuals with pre-pregnancy OWOB (β = -0.06, 95% CI = -0.11, -0.02; F (2,208) = 4.00, p < .05, adj R 2  = 0.03). No associations were observed among non-OWOB participants., Conclusions: Findings suggest maternal-placental transfer of omega-3 may represent one pathway by which maternal metabolic and mental health impacts infant development., (© 2024. The Author(s).)

This study investigates unexpected competitive host-guest interactions of β-cyclodextrin (β-CD), which can occur with polymers in aqueous solution, using the examples of the two polymers poly(oligo(ethylene glycol) methyl ether methacrylate) and poly(glycerol mono methacrylate). Systematic structural modifications of the polymer provide insight into the host-guest interaction with β-CD and the competition between side chains and end groups such as hydrophobic end groups remaining from reversible addition fragmentation chain transfer polymerization or intentionally implemented molecular recognition units such as arylazopyrazole photoswitches., (© 2024 Wiley‐VCH GmbH.)

Background: This study examined the efficacy of an interdisciplinary limb preservation service (LPS) in improving surgical outcomes for diabetic foot ulcer (DFU) patients compared to traditional care., Methods: Data from January 1, 2017 to September 30, 2020 were retrospectively reviewed. An interdisciplinary LPS clinic began on August 1, 2018, coexisting with a preexisting single specialty service. Primary outcomes were major/minor amputation rates and ratios and hospital length of stay. Surgical endpoints pre- and post-LPS launch were compared., Results: Among 976 procedures for 731 unique DFU patients, most were male (80.4%) and Hispanic (89.3%). Patient demographics were consistent before and after LPS initiation. Major amputation rates decreased by 45.5% (15.4%-8.4%, p = 0.001), with outpatient procedures increasing over 5-fold (3.3% pre-LPS to 18.7% post-LPS, p < 0.001). Hospital stay reduced from 10.1 to 8.5 days post-LPS (p < 0.001). The major to minor amputation ratio declined from 22.4% to 12.7%., Conclusions: The interdisciplinary LPS improved patient outcomes, marked by fewer major amputations and reduced hospital stays, suggesting the model's potential for broader application., (© 2024 The Authors. Journal of Foot and Ankle Research published by John Wiley & Sons Australia, Ltd on behalf of Australian Podiatry Association and The Royal College of Podiatry.)

A large body of research has established a relation between maternal education and children's neurocognitive functions, such as executive function and language. However, most studies have focused on early childhood and relatively few studies have examined associations with changes in maternal education over time. Consequently, it remains unclear if early maternal education is longitudinally related to neurocognitive functions in children, adolescents, and young adults. In addition, the associations between changes in maternal education across development and more broadly defined neurocognitive outcomes remain relatively untested. The current study leveraged a large multicohort sample to examine the longitudinal relations between perinatal maternal education and changes in maternal education during development with children's, adolescents', and young adults' neurocognitive functions ( N = 2,688; M age = 10.32 years; SD age = 4.26; range = 3-20 years). Moreover, we examined the differential effects of perinatal maternal education and changes in maternal education across development on executive function and language performance. Perinatal maternal education was positively associated with children's later overall neurocognitive function. This longitudinal relation was stronger for language than executive function. In addition, increases in maternal education were related to improved language performance but were not associated with executive functioning performance. Our findings support perinatal maternal education as an important predictor of neurocognitive outcomes later in development. Moreover, our results suggest that examining how maternal education changes across development can provide important insights that can help inform policies and interventions designed to foster neurocognitive development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Graphene oxide nanomaterials are being developed for wide-ranging applications but are associated with potential safety concerns for human health. We conducted a double-blind randomized controlled study to determine how the inhalation of graphene oxide nanosheets affects acute pulmonary and cardiovascular function. Small and ultrasmall graphene oxide nanosheets at a concentration of 200 μg m - 3 or filtered air were inhaled for 2 h by 14 young healthy volunteers in repeated visits. Overall, graphene oxide nanosheet exposure was well tolerated with no adverse effects. Heart rate, blood pressure, lung function and inflammatory markers were unaffected irrespective of graphene oxide particle size. Highly enriched blood proteomics analysis revealed very few differential plasma proteins and thrombus formation was mildly increased in an ex vivo model of arterial injury. Overall, acute inhalation of highly purified and thin nanometre-sized graphene oxide nanosheets was not associated with overt detrimental effects in healthy humans. These findings demonstrate the feasibility of carefully controlled human exposures at a clinical setting for risk assessment of graphene oxide, and lay the foundations for investigating the effects of other two-dimensional nanomaterials in humans. Clinicaltrials.gov ref: NCT03659864., (© 2024. The Author(s).)

Arylazopyrazoles (AAPs) are an important class of molecular photoswitches with high photostationary states (PSS) and long thermal lifetimes. The ultrafast photoisomerization of four water-soluble arylazopyrazoles, all of them featuring an ortho -dimethylated pyrazole ring, is studied by narrowband femtosecond transient absorption spectroscopy and ab initio molecular dynamics simulations. Upon S 1 (nπ*) photoexcitation of the planar E -isomers ( E -AAPs), excited-state bi-exponential decays with time constants τ 1 in the 220-440 fs range and τ 2 in the 1.4-1.8 ps range are observed, comparable to those reported for azobenzene (AB). This is indicative of the same photoisomerization mechanism as has been reported for ABs. In contrast to the planar E -AAPs, a twisted E -AAP with two methyl groups in ortho -position of the phenyl ring displays faster initial photoswitching with τ 1 = 170 ± 10 fs and τ 2 = 1.6 ± 0.1 ps. Our static DFT calculations and ab initio molecular dynamics simulations of E -AAPs on the S 0 and S 1 potential energy surfaces suggest that twisted E -isomer azo photoswitches exhibit faster initial photoisomerization dynamics out of the Franck-Condon region due to a weaker π-coordination of the central CNNC unit to the aromatic ligands.

Background: Terminological problems concerning sedation in palliative care and consequences for research and clinical decision making have been reported frequently. Objectives: To gather data on the application of definitions of sedation practices in palliative care to clinical cases and to analyze implications for high-quality definitions. Design: We conducted an online survey with a convenience sample of international experts involved in the development of guidelines on sedation in palliative care and members of the European Association for Palliative Care (EAPC). Participants were asked to apply four published definitions to four case vignettes. Data were analyzed using descriptive statistics. Results: A total of 32 experts and 271 EAPC members completed the survey. The definitions were applied correctly in n  = 2200/4848 cases (45.4%). The mean number of correct applications of the definitions (4 points max.) was 2.2 ± 1.14 for the definition of the SedPall study group, 1.8 ± 1.03 for the EAPC definition, 1.7 ± 0.98 for the definition of the Norwegian Medical Association, and 1.6 ± 1.01 for the definition of the Japanese Society of Palliative Medicine. The rate of correct applications for the 16 vignette-definition pairs varied between 70/303 (23.1%) and 227/303 (74.9%). The content of definitions and vignettes together with free-text comments explains participants' decisions and misunderstandings. Conclusions: Definitions of sedation in palliative care are frequently incorrectly applied to clinical case scenarios under simplified conditions. This suggests that clinical communication and research might be negatively influenced by misunderstandings and inconsistent labeling or reporting of data. Clinical Trial Registration Number: DRKS00015047.

Parity-time (PT) symmetry has been unveiling new photonic regimes in non-Hermitian systems, with opportunities for lasing, sensing and enhanced light-matter interactions. The most exotic responses emerge at the exceptional point (EP) and in the broken PT-symmetry phase, yet in conventional PT-symmetric systems these regimes require large levels of gain and loss, posing remarkable challenges in practical settings. Floquet PT-symmetry, which may be realized by periodically flipping the effective gain/loss distribution in time, can relax these requirements and tailor the EP and PT-symmetry phases through the modulation period. Here, we explore Floquet PT-symmetry in an integrated photonic waveguide platform, in which the role of time is replaced by the propagation direction. We experimentally demonstrate spontaneous PT-symmetry breaking at small gain/loss levels and efficient control of amplification and suppression through the excitation ports. Our work introduces the advantages of Floquet PT-symmetry in a practical integrated photonic setting, enabling a powerful platform to observe PT-symmetric phenomena and leverage their extreme features, with applications in nanophotonics, coherent control of nanoscale light amplification and routing., (© 2024. The Author(s).)

Importance: Prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) are risk factors associated with adverse neurobehavioral and cognitive outcomes., Objective: To quantify long-term associations of PAE and PTE with brain activity in early and middle childhood via electroencephalography (EEG)., Design, Setting, and Participants: This cohort study included participants enrolled in the Safe Passage Study (August 2007 to January 2015), from which a subset of 649 participants were followed up in the Environmental Influences on Child Health Outcomes Program. From September 2018 through November 2022, EEG recordings were obtained at ages 4, 5, 7, 9, or 11 years. Data were analyzed from November 2022 to November 2023., Exposures: Maternal self-reported consumptions of alcohol and tobacco during pregnancy were captured at the recruitment interview and at up to 3 visits during pregnancy (20-24, 28-32, and ≥34 weeks' gestation). Classifications of PAE (continuous drinking, quit-early drinking, and nondrinking) and PTE (continuous smoking, quit-early smoking, and nonsmoking) were previously obtained., Main Outcomes and Measures: EEG band powers (theta, alpha, beta, gamma) were extracted from the EEG recordings. Linear regression models were used to estimate the associations of PAE and PTE with EEG estimates., Results: The final sample included 649 participants (333 [51.3%] female) aged 4, 5, 7, 9, or 11 years. Children whose mothers were in the quit-early drinking cluster had increased alpha power (0.116 [95% CI, 0.023 to 0.209] μV2; P = .02) compared with individuals without PAE. The magnitude of this increase was approximately double for children exposed to continuous drinking (0.211 [95% CI, 0.005 to 0.417] μV2; P = .04). Children whose mothers were in the continuous smoking cluster had decreased beta power (-0.031 [95% CI, -0.059 to -0.003] μV2; P = .03) and gamma power (-0.020 [95% CI, -0.039 to -0.000] μV2; P = .04) compared with the nonsmoking cluster. In exploratory sex-stratified models, male participants in the quit-early PAE cluster had greater EEG power in the alpha band (0.159 [95% CI, 0.003 to 0.315] μV2; P = .04) compared with those with no PAE, and the difference was approximately double for male participants with continuous PAE (0.354 [95% CI, 0.041 to 0.667] μV2; P = .03). Male participants in the continuous PTE cluster had decreased beta (-0.048 [95% CI, -0.090 to - 0.007] μV2; P = .02) and gamma (-0.032 [95% CI, -0.061 - 0.002] μV2; P = .04) power compared with those with no PTE., Conclusions and Relevance: These findings suggest that even low levels of PAE and PTE were associated with long-term alterations of brain activity.

Introduction: To address the ongoing opioid crisis, states use policy enactment to restrict prescribing by licensed healthcare providers and mandate the use of Prescription Drug Monitoring Programs. There have been mixed results regarding the effectiveness of such state policies. The purpose of this study is to evaluate the impact of Colorado Senate Bill 18-022, which limits opioid prescriptions to ≤7-day supply among patients without an opioid prescription in the previous year (i.e., are opioid naive)., Methods: This is a retrospective interrupted time-series analysis of opioid prescribing to evaluate the weekly percentage of opioid prescriptions consistent with statutory limits for ≤7-day supply among opioid-naive patients before and after enactment using Prescription Drug Monitoring Programs data from May 21, 2017 to May 25, 2019. Statistical analysis was performed in 2021-2022., Results: The weekly percentage of opioid prescriptions ≤7-day supply increased by an average of 0.12% per week (p<0.0001) from 79.7% to 87.4% in the week before enactment. The week after enactment, the average increased by 0.2% (p=0.67). The year after enactment, the average weekly percentage change was 0.07% per week, a 0.05% decrease (p=0.01)., Conclusions: Statutory limits on days' supply among opioid-naive patients had little impact on opioid prescribing in Colorado. Legislating limits on opioid prescribing should be evaluated using Prescription Drug Monitoring Program data and considered for deimplementation when not impactful., (Copyright © 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Parkinson's disease (PD) represents the fastest growing neurodegenerative disease with an increasing prevalence worldwide. It is characterised by complex motor and non-motor symptoms that lead to considerable disability. Specialised physiotherapy has been shown to benefit patients with PD. The Parkinson Netzwerk Therapie (PaNTher) was created to improve access to specialised physiotherapy tailored to care priorities of PD patients. This study aims to evaluate the effectiveness, acceptability and needs of the PaNTher network by neurologists and physiotherapists involved in the network in outpatient care., Methods and Analysis: This is a mixed-method, prospective, pragmatic non-randomised cohort study of parallel groups, with data collection taking place in Bavaria, Germany, between 2020 and 2024. Patients with PD insured by the Allgemeine Ortskrankenkasse Bayern (AOK Bayern) living in Bavaria will be recruited for study participation by network partners. Patients in the intervention group must reside in Munich or the surrounding area to ensure provision of specialised physiotherapy in close proximity to their place of residence. Controls receive care as usual. Six and 12 months after baseline, all patients receive a follow-up questionnaire. Mixed-effect regression models will be used to examine changes in impairment of activities of daily living and quality of life of patients with PD enrolled in the programme over time compared with usual care. Qualitative interviews will investigate the implementation processes and acceptability of the PaNTher network among neurologists and physiotherapists. The study is expected to show that the PaNTher network with an integrative care approach will improve the quality and effectiveness of the management and treatment of patients with PD., Ethics and Dissemination: The study has been approved by the ethics committee at the medical faculty of the Ludwig-Maximilians-University Munich (20-318). Results will be published in scientific, peer-reviewed journals and presented at national and international conferences., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: The effect of prenatal cannabis exposure (PCE) on childhood neurodevelopment remains poorly understood. There is a paucity of studies describing the neurodevelopment impact of PCE in infancy. The Mullen Scale of Early Learning (MSEL) is a cognitive screening tool that can be used from birth to 68 months and includes language and motor domains. Here we aim to explore the association between PCE during pregnancy and neurodevelopmental outcomes at 12 months of age., Methods: Participants were pregnant persons/infant pairs enrolled in The Safe Passage Study, a large prospective cohort study. Inclusion criteria included data available on PCE with associated MSEL scores at 12 months of age. Exposed participants were defined as early exposure (1st trimester only) or late exposure (2nd or 3rd trimester) and were randomly matched with unexposed participants. Multiple linear regression models were performed to test associations between prenatal cannabis exposure and the five Mullen subscales: gross motor, fine motor, expressive language, receptive language, and visual reception., Results: Sixty-nine exposed and 138 randomly matched unexposed infants were included in the analyses. Mothers of children with PCE were younger with the mean age 23.7 years for early exposure ( n  = 51) and 22.8 years for late exposure ( n  = 18). Maternal characteristics with prenatal cannabis use include a high-school education, American Indian or Alaska Native descent, lower socioeconomic status and co-use of tobacco. There were no gestational age or sex difference among the groups. Expressive (95% CI: 2.54-12.76; p  = 0.0036,) and receptive language scores (95% CI: 0.39-8.72; p  = 0.0322) were significantly increased between late-exposed infants compared to unexposed infants following adjustment for covariates. Gross motor scores (95% CI: 1.75-13; p  = 0.0105) were also significantly increased for early-exposed infants with no difference in visual reception scores., Conclusion: Preclinical studies have shown abnormal brain connectivity in offspring exposed to cannabis affecting emotional regulation, hyperactivity, and language development. Results from this study link PCE to altered early language development within the first year of life. Exposed infants demonstrated increased expressive and receptive language scores at 12 months of age, which can translate to better performance in school. However, further research is needed to determine the implications of these results later in childhood., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Talavera-Barber, Morehead, Ziegler, Hockett and Elliott.)

Background: The use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue's great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall ("From anxiolysis to deep continuous sedation - Development of recommendations for sedation in palliative care") with the purpose of developing best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care and obtaining feedback and approval from experts in this area., Design: Our stepwise approach entailed drafting the recommendations, obtaining expert feedback, conducting a single-round Delphi study, and convening a consensus conference. As an interdisciplinary group, we created a set of best practice recommendations based on previously published guidance and empirical and normative analysis, and drawing on feedback from experts, including patient representatives and of public involvement participants. We set the required agreement rate for approval at the single-round Delphi and the consensus conference at ≥80%., Results: Ten experts commented on the recommendations' first draft. The Delphi panel comprised 50 experts and patient and public involvement participants, while 46 participants attended the consensus conference. In total, the participants in these stages of the process approved 66 recommendations, covering the topics "indications", "intent/purpose [of sedation]", "decision-making", "information and consent", "medication and type of sedation", "monitoring", "management of fluids and nutrition", "continuing other measures", "support for relatives", and "team support". The recommendations include suggestions on terminology and comments on legal issues., Conclusion: Further research will be required for evaluating the feasibility of the recommendations' implementation and their effectiveness. The recommendations and the suggested terminology may serve as a resource for healthcare professionals in Germany on the use of sedative drugs and intentional sedation in specialist palliative care and may contribute to discussion on the topic at an international level., Trial Registration: DRKS00015047 (German Clinical Trials Register)., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: To identify and describe requirements, recommendations, and templates for the documentation of sedation in adult palliative care. Introduction: International literature shows inconsistency in clinical practice regarding sedation in palliative care accompanied by legal, ethical, and medical uncertainties. Documentation in general serves as proof for previous treatments. In the context of intentional sedation to relieve suffering at the end of life, documentation provides a clear demarcation against practices of euthanasia. Inclusion Criteria: Articles with full-text version published in English or German since 2000, covering documentation requirements, recommendations, monitoring parameters or templates for sedation in adult palliative care were included. Methods: Scoping review following the JBI methodology. Search in online databases, websites of professional associations in palliative care, reference lists of relevant publications, the archive of the German "Journal of Palliative Medicine" and databases for unpublished literature were used. Search terms included "palliative care,' "sedation," and "documentation." The search was conducted from January 2022 to April 2022 with an initial hand search in November 2021. Data were screened and charted by one reviewer after conducting a pilot test of the criteria. Results: From the initial 390 articles (database search), 22 articles were included. In addition, 15 articles were integrated from the hand search. The results can be clustered in two sets of items, regarding either the documentation before or during sedation. The documentation requirements referred both to inpatient and homecare settings but in many cases, a clear assignment was missing. Conclusions: The guidelines analyzed in this study rarely cover setting-specific differences in documentation and often treat documentation as minor topic. Further research is needed addressing legal and ethical concerns of health care teams and, therefore, help to improve treatment of patients suffering from otherwise intractable burden at the end of life.

The last decade has witnessed growing calls for the return of individual research results. Prior work in genetic studies has shown that individual, contextual, and cultural factors influence participants' preferences for individual research results. There is a gap in knowledge about participants' views about other types of results, specifically those lacking clinical significance. This study investigates the perspectives of 1587 mothers enrolled in the Northern Plains Environmental Influences on Child Health Outcomes (ECHO) Program. Participants were presented with hypothetical scenarios to determine their perceived value of individual research results based on result type and the ability to interpret them within a normative context. Irrespective of the result type, participants attributed higher perceived value to results that were well understood than results of unknown significance.

The primary somatosensory cortex (S1) is a hub for body sensation of both innocuous and noxious signals, yet its role in somatosensation versus pain is debated. Despite known contributions of S1 to sensory gain modulation, its causal involvement in subjective sensory experiences remains elusive. Here, in mouse S1, we reveal the involvement of cortical output neurons in layers 5 (L5) and 6 (L6) in the perception of innocuous and noxious somatosensory signals. We find that L6 activation can drive aversive hypersensitivity and spontaneous nocifensive behavior. Linking behavior to neuronal mechanisms, we find that L6 enhances thalamic somatosensory responses, and in parallel, strongly suppresses L5 neurons. Directly suppressing L5 reproduced the pronociceptive phenotype induced by L6 activation, suggesting an anti-nociceptive function for L5 output. Indeed, L5 activation reduced sensory sensitivity and reversed inflammatory allodynia. Together, these findings reveal a layer-specific and bidirectional role for S1 in modulating subjective sensory experiences., (© 2023. The Author(s).)

The superior colliculus (SC), a conserved midbrain node with extensive long-range connectivity throughout the brain, is a key structure for innate behaviors. Descending cortical pathways are increasingly recognized as central control points for SC-mediated behaviors, but how cortico-collicular pathways coordinate SC activity at the cellular level is poorly understood. Moreover, despite the known role of the SC as a multisensory integrator, the involvement of the SC in the somatosensory system is largely unexplored in comparison to its involvement in the visual and auditory systems. Here, we mapped the connectivity of the whisker-sensitive region of the SC in mice with trans-synaptic and intersectional tracing tools and in vivo electrophysiology. The results reveal a novel trans-collicular connectivity motif in which neurons in motor- and somatosensory cortices impinge onto the brainstem-SC-brainstem sensory-motor arc and onto SC-midbrain output pathways via only one synapse in the SC. Intersectional approaches and optogenetically assisted connectivity quantifications in vivo reveal convergence of motor and somatosensory cortical input on individual SC neurons, providing a new framework for sensory-motor integration in the SC. More than a third of the cortical recipient neurons in the whisker SC are GABAergic neurons, which include a hitherto unknown population of GABAergic projection neurons targeting thalamic nuclei and the zona incerta. These results pinpoint a whisker region in the SC of mice as a node for the integration of somatosensory and motor cortical signals via parallel excitatory and inhibitory trans-collicular pathways, which link cortical and subcortical whisker circuits for somato-motor integration., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Martín-Cortecero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Frequent observations to a quantum system modify its coherent evolution through the Zeno effect and Zeno dynamics. Generally, the measurement process destroys the evolution environment of the monitored system, making repeated observations remain a challenge. Here, using the quantum analogy experiments, we realize and engineer the Zeno effect and Zeno dynamics in optical waveguide arrays, where the optical modes correspond to distinct quantum states, and the temporal evolution is mapped into the spatial propagation. We propose a new, extensible experimental strategy for realizing an optical analog of stroboscopic measurements, which are performed by the build-in, on-demand segmented waveguide portions. The weak-to-strong stroboscopic measurements are realized, where the monitored system undergoes a transition from free evolution to optical Zeno freezing. Setting the measurements in the strong regime, the optical Zeno effect and optical Zeno dynamics are successfully generated, and their relationship is demonstrated in optics. We then propose a novel quantum Zeno slicing approach, which allows us to dynamically engineer the Hilbert space of the monitored system. This generic approach is verified by generating a series of Zeno subspaces with different measurement projectors, based on the quantum-optical analogy. The complexity of light dynamics is largely increased, providing full control of the propagation via steering Zeno dynamics. Our results pave the way for manipulation of quantum states by harnessing Zeno dynamics in integrated photonics.

The chemical modification of aeroallergens by reactive oxygen and nitrogen species (ROS/RNS) may contribute to the growing prevalence of respiratory allergies in industrialized countries. Post-translational modifications can alter the immunological properties of proteins, but the underlying mechanisms and effects are not well understood. In this study, we investigate the Toll-like receptor 4 (TLR4) activation of the major birch and grass pollen allergens Bet v 1 and Phl p 5, and how the physiological oxidant peroxynitrite (ONOO - ) changes the TLR4 activation through protein nitration and the formation of protein dimers and higher oligomers. Of the two allergens, Bet v 1 exhibited no TLR4 activation, but we found TLR4 activation of Phl p 5, which increased after modification with ONOO - and may play a role in the sensitization against this grass pollen allergen. We attribute the TLR4 activation mainly to the two-domain structure of Phl p 5 which may promote TLR4 dimerization and activation. The enhanced TLR4 signaling of the modified allergen indicates that the ONOO - -induced modifications affect relevant protein-receptor interactions. This may lead to increased sensitization to the grass pollen allergen and thus contribute to the increasing prevalence of allergies in the Anthropocene, the present era of globally pervasive anthropogenic influence on the environment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Reinmuth-Selzle, Bellinghausen, Leifke, Backes, Bothen, Ziegler, Weller, Saloga, Schuppan, Lucas, Pöschl and Fröhlich-Nowoisky.)

Background: The multimodal complex treatment for Parkinson's disease (MCT) provides inpatient care by a multi-disciplinary team for people with Parkinson's disease (PwP) in Germany., Objectives: We conducted a 5-year real-world mono-center cohort study to describe the effectiveness of MCT in the full cohort and various subgroups and outcome predictors., Methods: We collected an anonymized dataset between Jan 2015 and Dec 2019, involving N  = 1773. The self-reported MDS-UPDRS part II was used as primary outcome, and clinical routine data for explanatory variables. PwP were categorized as responders or non-responders according to a response of at least 3 points 4 weeks after discharge., Results: N = 591 complete data records were available for statistical analyses. The full group improved by -2.4 points on the MDS-UPDRS II ( P  = <0.0001). 47.7% (n = 282) and 52.3% (n = 309) were coded as responders and non-responders, respectively. A clinically meaningful response was positively associated to age (χ 2  = 11.07, P  = 0.018), as well as baseline-severity of the MDS-UPDRS II (χ 2  = 6.05, P  = 0.048) and negatively associated to the presence of psychiatric disorder (χ 2  = 3.9, P  = 0.048) and cognitive dysfunction (χ 2  = 7.29, P  = 0.007). Logistic regression showed that baseline severity of the MDS-UPDRS II predicted therapy success. PwP with moderate baseline-severity had an about 2fold chance (OR 2.08; 95% CI 1.20-3.61; P  = 0.009) and with severe an about 6fold chance (OR 5.92; 95% CI 2.76-12.68; P  < 0.0001) to benefit clinically meaningful., Discussion: In a naturalistic setting of a specialized Parkinson's center, MCT improved ADL disability of PwP at least 4 weeks after discharge. Moderately and severely impaired patients were more likely to achieve clinically meaningful responses., Competing Interests: K.Z., M.M., M.P., U.M.F., and A.C.B. are all employees of the Schön Klinik München Schwabing. The positions of K.Z. and U.M.F. were supported by an unrestricted educational grant from the Deutsche Parkinson Vereinigung (DPV) and the Deutsche Stiftung Neurologie (DSN). The authors report no other sources of funding for the study., (© 2022 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)

Background: In 1967, concerns about the carcinogenic potential of psychedelics arose after a study reported chromosomal damage in human leukocytes following in vitro lysergic acid (LSD) exposure. Worries were further heightened by subsequent reports of leukemia and other cancers in LSD users. Additional investigations of psychedelics' effects on chromosomes were published over the next decade, with the majority suggesting these concerns were unfounded. However, the relationship between psychedelics and cancer has been explored only minimally from an epidemiological perspective., Aims: To determine whether associations exist between psychedelic use and either lifetime cancer or hematologic cancer diagnoses., Methods: We analyzed data from adult participants in the 2015-2019 administrations of the National Survey on Drug Use and Health for associations between lifetime use of psychedelics and lifetime diagnosis of either any cancer or hematologic cancer., Results: We identified no associations between lifetime psychedelic use and either lifetime cancer diagnosis or hematologic cancer diagnosis. Sub-analyses of lifetime lysergamide, phenethylamine, and tryptamine use also revealed no associations with lifetime cancer or hematologic cancer diagnosis., Conclusions: While laboratory studies and case reports from the 1960s and 1970s generated concerns about psychedelics' carcinogenic potential, this analysis of recent epidemiological data does not support an association between psychedelic use and development of cancer in general or hematologic cancer. Important study limitations to consider include a lack of information about psychedelic dosage, number of lifetime psychedelic exposures, and the temporal relationship between psychedelic use and cancer diagnosis.

Introduction: Bronchiectasis is characterised by excessive neutrophilic inflammation. Lipid mediators such as prostaglandins and leukotrienes have crucial roles in the inflammatory response. Further characterisation of these lipids and understanding the interplay of anti-inflammatory and proinflammatory lipid mediators could lead to the development of novel anti-inflammatory therapies for bronchiectasis., Aim: The aim of our study was to characterise the lipids obtained from serum and airways in patients with bronchiectasis in the stable state., Methods: Six healthy volunteers, 10 patients with mild bronchiectasis, 15 with moderate bronchiectasis and 9 with severe bronchiectasis were recruited. All participants had 60 mL of blood taken and underwent a bronchoscopy while in the stable state. Lipidomics was done on serum and bronchoalveolar lavage fluid (BALF)., Results: In the stable state, in serum there were significantly higher levels of prostaglandin E 2 (PGE 2 ), 15-hydroxyeicosatetranoic acid (15-HETE) and leukotriene B 4 (LTB 4 ) in patients with moderate-severe disease compared with healthy volunteers. There was a significantly lower level of lipoxin A 4 (LXA 4 ) in severe bronchiectasis.In BALF, there were significantly higher levels of PGE 2 , 5-HETE, 15-HETE, 9-hydroxyoctadecadienoic acid and LTB 4 in moderate-severe patients compared with healthy volunteers.In the stable state, there was a negative correlation of PGE 2 and LTB 4 with % predicted forced expiratory volume in 1 s and a positive correlation with antibiotic courses.LXA 4 improved blood and airway neutrophil phagocytosis and bacterial killing in patients with bronchiectasis. Additionally LXA 4 reduced neutrophil activation and degranulation., Conclusion: There is a dysregulation of lipid mediators in bronchiectasis with excess proinflammatory lipids. LXA 4 improves the function of reprogrammed neutrophils. The therapeutic efficacy of LXA 4 in bronchiectasis warrants further studies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Purpose: To analyze long-term results of two multicenter prospective single-arm trials (ARO-2010-01 and ARO-2013-04) investigating adjuvant hypofractionated radiotherapy (HF) with simultaneous integrated boost (SIB) after breast-conserving surgery (BCS)., Methods: Eligible patients had histopathologically confirmed unifocal breast cancer planned for whole breast irradiation plus boost radiotherapy to the tumor bed. In both studies, a total dose of 40 Gy was applied to the whole breast and of 48 Gy to the tumor bed in 16 fractions of 2.5 and 3.0 Gy. Radiotherapy could be given either as three-dimensional conformal radiotherapy (3D-CRT) or as intensity-modulated radiotherapy (IMRT). The primary study objectives were feasibility and security within an observation period of six months. The current investigation focuses on long-term efficacy and toxicities., Results: Between 2011 and 2014, both trials enrolled 300 patients in total. Data from 274 of these patients could be used for the current analysis. The median follow-up time was 60 months and the 5-year disease-free survival 92.1%. Three patients suffered a local recurrence (after 36-72 months) while a regional recurrence occurred in one patient (after 17 months). The 5-year local control rate in the breast was 99.6%. 63.5% of all patients did not report any late radiation-related toxicity, 28.5% reported grade 1 and 7.3% grade 2 toxicities. The highest late toxicity was grade 3 in 2 women (0.7%, telangiectasia and lymphedema of the breast)., Conclusion: Our analysis demonstrates favorable efficacy and low rates of long-term side effects of HF with SIB after BCS. Randomized controlled phase III trials are ongoing., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Fast and accurate determination of the protein content of a sample is an important and non-trivial task of many biochemical, biomedical, food chemical, pharmaceutical, and environmental research activities. Different methods of total protein determination are used for a wide range of proteins with highly variable properties in complex matrices. These methods usually work reasonably well for proteins under controlled conditions, but the results for non-standard and complex samples are often questionable. Here, we compare new and well-established methods, including traditional amino acid analysis (AAA), aromatic amino acid analysis (AAAA) based on the amino acids phenylalanine and tyrosine, reversed-phase liquid chromatography of intact proteins with UV absorbance measurements at 220 and 280 nm (LC-220, LC-280), and colorimetric assays like Coomassie Blue G-250 dye-binding assay (Bradford) and bicinchoninic acid (BCA) assay. We investigated different samples, including proteins with challenging properties, chemical modifications, mixtures, and complex matrices like air particulate matter and pollen extracts. All methods yielded accurate and precise results for the protein and matrix used for calibration. AAA, AAAA with fluorescence detection, and the LC-220 method yielded robust results even under more challenging conditions (variable analytes and matrices). These methods turned out to be well-suited for reliable determination of the protein content in a wide range of samples, such as air particulate matter and pollen., (© 2022. The Author(s).)

Background: Terminology concerning sedation in palliative care is heterogeneous, vague, and difficult to apply with negative impact on the reliability of quantitative data, practice, and ethical discourse. Design: To clarify the concept, we systematically developed definitions of core terms in an interdisciplinary research group comprising palliative care, ethics, law, and philosophy, integrating feedback from external experts. Results: We define terms stepwise, separating matters of terminology (What is the practice?) from matters of good practice (How to use it?). We start with an operational definition of "reduced level of consciousness" (score < 0 on the Richmond Agitation-Sedation Scale modified for palliative care inpatients (RASS-PAL), followed by defining "sedating," "sedation," and "intentional sedation" as the result or process of sedating a patient as a means of achieving a previously defined treatment goal and the terms "light," "deep," "temporary," and "sedation until death." Conclusion: The terminology facilitates the precise phrasing of aims, indications, and rules for good practice. Empirical research on acceptance and feasibility is needed.

We consider s-wave pairing in a double layer of two chiral metals due to interlayer Coulomb interaction and study the Josephson effect near a domain wall, where the sign of the order parameter jumps. The domain wall creates two evanescent modes at the exceptional zero-energy point, whose superposition is associated with currents flowing in different directions in the two layers. Assuming a toroidal geometry, the effective Josephson current winds around the domain walls, whose direction is determined by the phase difference of the complex coefficients of the superimposed zero-energy modes. Thus, the zero-energy mode is directly linked to a macroscopic current. This result can be understood as an interplay of the conventional Josephson current perpendicular and the edge current parallel to a domain wall in a double layer of two chiral metals. As a realization we suggest the surface of a ring-shaped topological insulator. The duality between electron-electron and electron-hole double layers indicates that this effect should also be observable in excitonic double layers.

Background: Effects of the institutional macrocosm on general surgery resident wellbeing have not been well studied. We sought to identify organizational factors that impact resident wellness and burnout., Methods: Using a modified Delphi technique, an open-ended survey and two subsequent iterations were distributed to wellness stakeholders at two institutions to identify and stratify institutional factors in six burnout domains., Results: Response rates for each survey round were 29/106 (27%), 30/46 (65%) and 21/30 (70%). Top factors identified in each domain were: CONCLUSION: A modified Delphi technique prioritized institutional wellness and burnout factors. Top factors identified were compensation, vacation time, and autonomy. These results can direct future scholarship of barriers/facilitators of resident wellbeing., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: Image post-processing corrects for cardiac and respiratory motion (MoCo) during cardiovascular magnetic resonance (CMR) stress perfusion. The study analyzed its influence on visual image evaluation., Materials and Methods: Sixty-two patients with (suspected) coronary artery disease underwent a standard CMR stress perfusion exam during free-breathing. Image post-processing was performed without (non-MoCo) and with MoCo (image intensity normalization; motion extraction with iterative non-rigid registration; motion warping with the combined displacement field). Images were evaluated regarding the perfusion pattern (perfusion deficit, dark rim artifact, uncertain signal loss, and normal perfusion), the general image quality (non-diagnostic, imperfect, good, and excellent), and the reader's subjective confidence to assess the images (not confident, confident, very confident)., Results: Fifty-three (non-MoCo) and 52 (MoCo) myocardial segments were rated as 'perfusion deficit', 113 vs. 109 as 'dark rim artifacts', 9 vs. 7 as 'uncertain signal loss', and 817 vs. 824 as 'normal'. Agreement between non-MoCo and MoCo was high with no diagnostic difference per-patient. The image quality of MoCo was rated more often as 'good' or 'excellent' (92 vs. 63%), and the diagnostic confidence more often as "very confident" (71 vs. 45%) compared to non-MoCo., Conclusions: The comparison of perfusion images acquired during free-breathing and post-processed with and without motion correction demonstrated that both methods led to a consistent evaluation of the perfusion pattern, while the image quality and the reader's subjective confidence to assess the images were rated more favorably for MoCo., (© 2021. European Society for Magnetic Resonance in Medicine and Biology (ESMRMB).)

Mantles of rocky planets are dominantly composed of olivine and its high-pressure polymorphs, according to seismic data of Earth's interior, the mineralogy of natural samples, and modelling results. The missing mantle problem represents the paucity of olivine-rich material among meteorite samples and remote observation of asteroids, given how common differentiated planetesimals were in the early Solar System. Here we report the discovery of new olivine-rich meteorites that have asteroidal origins and are related to V-type asteroids or vestoids. Northwest Africa 12217, 12319, and 12562 are dunites and lherzolite cumulates that have siderophile element abundances consistent with origins on highly differentiated asteroidal bodies that experienced core formation, and with trace element and oxygen and chromium isotopic compositions associated with the howardite-eucrite-diogenite meteorites. These meteorites represent a step towards the end of the shortage of olivine-rich material, allowing for full examination of differentiation processes acting on planetesimals in the earliest epoch of the Solar System., (© 2021. The Author(s).)

Older adults' relationship to information and communications technology (ICT) is often discussed in terms of the digital divide or technology gap. Older persons, those 65 years of age and older, are seen as excluded or marginally represented in the digital sphere, even though data show their use of technology is increasing. Challenges in technology adoption and models for improving digital inclusion are both well-known, but the COVID pandemic and its general shift to digital life have created a critical need to increase digital inclusion of older persons. A case study of Older Adults Technology Services (OATS) and the organization's migration from in-person to virtual programming is used as an example of reframing the way the relationship of older adults to technology is seen in the field and in practice. Policy and programming implications of this new view of technology are discussed in the conclusion.