Search

An experimental method was developed to examine the dynamic compression properties of structured polyurethane composites used as press belts within a shoe press of a paper machine. The objective was to investigate the influences of the geometrical surface structure and the matrix material composition on the compression properties. Two polyurethane formulations were tested under varying specimen conditions. The results show that the dynamic compression modulus increases with the applied load rate and that temperature and water saturation reduce the influence of dynamic effects on the compression modulus. Furthermore, it was observed that modifications of the matrix material have a more significant impact on the dynamic compression modulus than adaptions in the geometrical structure. This is addressed to the relatively small variations in possible surface designs. Finally, a rate-sensitivity index is introduced to quantify the tested specimens’ rate-sensitive behaviour.

Phylogenetic tree diagrams are commonly found in introductory biology curricula and represent the evolutionary relationships of organisms. Tree-thinking, or the ability to accurately interpret, use, and generate these phylogenetic representations, involves a challenging set of skills for students to learn. Although many introductory biology courses incorporate tree-thinking instruction, few studies have identified which instructional methods provide the best learning gains for students. We gathered data from 884 introductory biology students using the Basic Evolutionary Tree-Thinking Skills Inventory (BETTSI) to measure tree-thinking learning gains. We measured tree-thinking differences across five sections of introductory biology, each offering a different instructional intervention, and compared differences among STEM majors and non-STEM majors. After calculating paired differences, we performed a two-way repeated measure analysis of variance (ANOVA) and Scheffe's post hoc test to identify significant differences among and between the different interventions. We found that students who engaged in active tree-thinking instruction had significantly higher tree-thinking learning gains than students who participated in passive or no instruction. Furthermore, these learning gains became even more significant as active-learning became more multifaceted. These active-learning approaches also removed knowledge gaps between STEM majors and non-majors. Instructors must select explicit and active pedagogical approaches to support student tree-thinking to accomplish positive learning gains for all students.

Cellulose is a natural polymer with great properties such as high optical transparency and mechanical strength, flexibility, and biodegradability. Hence, cellulose‐based foils are suitable for the replacement of synthetic polymers as substrate materials in organic electronics. This article reports the fabrication of ultrathin, free‐standing cellulose foils by spraying aqueous 2,2,6,6‐tetramethylpiperidine‐1‐oxyl‐nanocellulose (TEMPO) fibrils ink layer‐by‐layer on a hot substrate using a movable spray nozzle. The resulting foils are only 2 ± 1 µm in thickness with an average basis weight of 1.9 g m−2, which ranges in the same scale as the world's thinnest paper. The suitability of these ultra‐thin nanocellulose foils as a sustainable substrate material for organic electronic applications is demonstrated by testing the foils resistance against organic solvents. Furthermore, silver nanowires (AgNWs) and the blend poly(3,4‐ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) are integrated into the foils, and the foils are molded into 3D paper structures in order to create conductive, paper‐based building blocks for organic electronics. [ABSTRACT FROM AUTHOR]

An extensive body of demographic literature has described Jews as 'long-lifers'. From the mid-nineteenth century onwards, this pattern affected all age groups and was particularly well expressed among Jewish males but was also present among Jewish females. It held good independently of the Jews' socio-economic position. This became known as 'Jewish pattern of mortality'. This paper has two aims. The first aim is to show the impact of COVID-19 on Jewish mortality. This is a study of a global pandemic in the Jewish population which is, to the best of our knowledge, unique in its scope and quality. The second aim is to settle the finding of relatively high mortality from COVID-19 in certain Jewish communities ('Jewish penalty' in relation to COVID-19) with the notion of 'Jewish pattern of mortality'. The author proceeds to show that the status of Jews as a low mortality group under a Western epidemiological regime, when mortality and morbidity are dominated by non-communicable diseases, does not stand in contradiction to a higher vulnerability among Jews to coronavirus. Thus, the paper further develops understanding of mortality of Jews and serves as a contribution to ethnic and religious demography and epidemiology. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to evaluate a modern combined video laryngoscopy and flexible fiberoptic bronchoscope approach to placement of a double lumen endobronchial tube and further characterize potential strengths and weaknesses of this approach. Methods Retrospective chart review was conducted at our single institution, academic medical center, tertiary-care hospital. Patients aged 18 years of age or older were evaluated who underwent thoracic surgery and one-lung ventilation with placement of a double lumen endobronchial tube using a novel combined video laryngoscopy and flexible fiberoptic bronchoscope approach. No interventions were performed. Results Demographics and induction and intubation documentation were reviewed for 21 patients who underwent thoracic surgery and one-lung ventilation with placement of a double lumen endobronchial tube using a novel combined video laryngoscopy and flexible fiberoptic bronchoscope approach. First pass success using the combined approach was 86% (18/21). The five patients with an anticipated difficult airway had successful double lumen endobronchial tube placement on the first attempt. There were no instances of desaturation during double lumen endobronchial tube placement. No airway complications related to double lumen endobronchial tube placement were recorded. Conclusion Use of a combined approach employing video laryngoscopy and a flexible fiberoptic bronchoscope may represent a reliable alternative approach to placement of double lumen endobronchial tubes.

Abstract Catheter-based embolization has become a widely adopted minimally-invasive treatment for a broad range of applications. However, assessment of embolization endpoints requires x-ray fluoroscopic monitoring, exposing patients and physicians performing embolization procedures to harmful ionizing radiation. Moreover, x-ray fluoroscopy assessment of embolization endpoints is low sensitivity, subjective, and may not reflect the actual physiology of blood flow reduction, thus providing little oversight of the embolization procedure. Inspired by the observation that the dielectric properties of blood differ from those of fluids injected during the embolization procedure, a customized angiographic catheter was created with embedded electrodes for catheter-based electrochemical impedance spectroscopy as a way to monitor embolization. Real-time electrochemical impedance spectroscopy was performed in a phantom and compared to visual and videographic monitoring. Electrochemical impedance spectroscopy was able to sense endpoints of embolization, including stasis, reflux, and persistent flow. This new technique offers a label-free method of sensing embolization progress with potentially higher sensitivity and reproducibility compared to x-ray, as well as offer substantial reduction in x-ray exposure to patients and physicians.

Abstract Purpose To evaluate the relationship between delivered radiation (RT) and post-RT inversion-recovery ultrashort-echo-time (IR-UTE) MRI signal-intensity (SI) in gynecologic cancer patients treated with high-dose-rate (HDR) brachytherapy (BT). Methods Seven patients underwent whole-pelvis RT (WPRT) followed by BT to the high-risk clinical target volume (HR-CTV). MR images were acquired at three time-points; pre-RT, post-WPRT/pre-BT, and 3–6 months post-BT. Diffuse-fibrosis (FDiffuse) was imaged with a non-contrast dual-echo IR (inversion time [TI] = 60 ms) UTE research application, with image-subtraction of the later echo, only retaining the ultrashort-echo SI. Dense-fibrosis (FDense) imaging utilized single-echo Late-Gadolinium-Enhanced IR-UTE, acquired ∼ 15 min post-Gadavist injection. Resulting FDiffuse and FDense SI were normalized to the corresponding gluteal-muscle SI. Images were deformably registered between time-points based on normal tissue anatomy. The remnant tumor at both time-points was segmented using multi-parametric MRI. Contours corresponding to the 50%, 100%, 150%, and 200% isodose lines (IDLs) of the prescription BT-dose were created. Mean FDiffuse and FDense SI within (i) each IDL contour and (ii) the remnant tumor were calculated. Post-BT FDiffuse and FDense SI were correlated with prescribed BT-dose. To determine the relationship between BT-dose and IR-UTE SI, the differences in the post-BT FDense across IDLs was determined using paired t-tests with Bonferroni correction. Results FDense was higher in regions of higher dose for 6/7 patients, with mean ± SD values of 357 ± 103% and 331 ± 97% (p = .03) in the 100% and 50% IDL, respectively. FDense was higher in regions of higher dose in the responsive regions with mean ± SD values of 380 ± 122% and 356 ± 135% (p = .03) in the 150% and 50% IDL, respectively. Within the segmented remnant tumor, an increase in prescribed dose correlated with an increase in FDense post-BT (n = 5, r = .89, p = .04). Post-BT FDiffuse inversely correlated (n = 7, r = -.83, p = .02) with prescribed BT-dose within the 100% IDL. Conclusions Results suggest that FDense SI 3–6 months post-BT is a sensitive measure of tissue response to heterogeneous BT radiation-dose. Future studies will validate whether FDiffuse and FDense are accurate biomarkers of fibrotic radiation response.

Freshwater snails that act as intermediate host and some abiotic environmental factors plays a prominent roles in these infections. The objective of this paper as to assess the composition and distribution of the snail fauna in water bodies around irrigation schemes in the Benue River Valley, Yola area of Adamawa state, Nigeria using appropriate techniques. Data obtained reveals that the distribution of freshwater snails species, showed that a total of 1,620 snails were sampled, Njoboliyo had the highest number of snails with 373, followed by Lake Geriyo with 287, Dasin Hausa with 266, Rugange with 255, Dasin Bwattiye with 235, while Boronji had the least with 204 freshwater snails. The species include B. globosus, P. ovata, B. truncatus and B. reticulatus. The diversity index showed that H fell below the 1.5-3.5 range while the Evenness E showed a potential evenness between freshwater snail species in all sites of the communities with no exception.

Abstract Polygenic variation unrelated to disease contributes to interindividual variation in baseline white blood cell (WBC) counts, but its clinical significance is uncharacterized. We investigated the clinical consequences of a genetic predisposition toward lower WBC counts among 89,559 biobank participants from tertiary care centers using a polygenic score for WBC count (PGSWBC) comprising single nucleotide polymorphisms not associated with disease. A predisposition to lower WBC counts was associated with a decreased risk of identifying pathology on a bone marrow biopsy performed for a low WBC count (odds-ratio = 0.55 per standard deviation increase in PGSWBC [95%CI, 0.30−0.94], p = 0.04), an increased risk of leukopenia (a low WBC count) when treated with a chemotherapeutic (n = 1724, hazard ratio [HR] = 0.78 [0.69−0.88], p = 4.0 × 10−5) or immunosuppressant (n = 354, HR = 0.61 [0.38–0.99], p = 0.04). A predisposition to benign lower WBC counts was associated with an increased risk of discontinuing azathioprine treatment (n = 1,466, HR = 0.62 [0.44−0.87], p = 0.006). Collectively, these findings suggest that there are genetically predisposed individuals who are susceptible to escalations or alterations in clinical care that may be harmful or of little benefit.

Summary:. We introduce a novel technique using augmented reality (AR) on smartphones and tablets, making it possible for surgeons to review perforator anatomy in three dimensions on the go. Autologous breast reconstruction with abdominal flaps remains challenging due to the highly variable anatomy of the deep inferior epigastric artery. Computed tomography angiography has mitigated some but not all challenges. Previously, volume rendering and different headsets were used to enable better three-dimensional (3D) review for surgeons. However, surgeons have been dependent on others to provide 3D imaging data. Leveraging the ubiquity of Apple devices, our approach permits surgeons to review 3D models of deep inferior epigastric artery anatomy segmented from abdominal computed tomography angiography directly on their iPhone/iPad. Segmentation can be performed in common radiology software. The models are converted to the universal scene description zipped format, which allows immediate use on Apple devices without third-party software. They can be easily shared using secure, Health Insurance Portability and Accountability Act–compliant sharing services already provided by most hospitals. Surgeons can simply open the file on their mobile device to explore the images in 3D using “object mode” natively without additional applications or can switch to AR mode to pin the model in their real-world surroundings for intuitive exploration. We believe patient-specific 3D anatomy models are a powerful tool for intuitive understanding and communication of complex perforator anatomy and would be a valuable addition in routine clinical practice and education. Using this one-click solution on existing devices that is simple to implement, we hope to streamline the adoption of AR models by plastic surgeons.

Summary:. Preoperative vascular imaging has become standard practice in the planning of microsurgical breast reconstruction. Currently, translating perforator locations from radiological findings to a patient’s abdomen is often not easy or intuitive. Techniques using three-dimensional printing or patient-specific guides have been introduced to superimpose anatomy onto the abdomen for reference. Augmented and mixed reality is currently actively investigated for perforator mapping by superimposing virtual models directly onto the patient. Most techniques have found only limited adoption due to complexity and price. Additionally, a critical step is aligning virtual models to patients. We propose repurposing suture packaging as an image tracking marker. Tracking markers allow quick and easy alignment of virtual models to the individual patient’s anatomy. Current techniques are often complicated or expensive and limit intraoperative use of augmented reality models. Suture packs are sterile, readily available, and can be used to align abdominal models on the patients. Using an iPad, the augmented reality models automatically align in the correct position by using a suture pack as a tracking marker. Given the ubiquity of iPads, the combination of these devices with readily available suture packs will predictably lower the barrier to entry and utilization of this technology. Here, our workflow is presented along with its intraoperative utilization. Additionally, we investigated the accuracy of this technology.

In this work, hybrid materials within the polydimethylsiloxane–silica (PDMS–SiO2) system, synthesized via the sol–gel method, were developed and characterized for their potential to incorporate and release the bioactive compound resveratrol (RES). RES was incorporated into the materials with a high loading efficiency (>75%) using the rotary evaporator technique. This incorporation induced the amorphization of RES, resulting in enhanced solubility and in vitro release when compared to the free polyphenolic compound. The release profiles displayed pH dependence, exhibiting notably faster release at pH 5.2 compared to pH 7.4. The gradual release of RES over time demonstrated an initial time lag of approximately 4 h, being well described by the Weibull model. In vitro cytotoxicity studies were conducted on human osteosarcoma cells (MG-63), revealing a concentration-dependent decrease in cell viability for RES-loaded samples (for concentrations >50 µg mL−1).

Physiological regulation strategies can be effective in reducing anxiety. However, while these strategies are often learned and practised under low-stress conditions, they are more likely to be required under conditions of high stress. We created virtual reality (VR) biofeedback games to both teach participants a breathing technique and then practise that technique under stress. We present two studies: the first provides a proof of concept, demonstrating that participants can apply the breathing technique during stress, with a significant lowering of both respiration rate and increase in heart rate variability (HRV) under stress (p < .001). The second study explicitly evaluated the effectiveness of training by comparing trained and untrained groups. Training was associated with a significantly greater HRV (p = .008) under stress. In within-group comparisons of HRV during stress compared to a baseline stressor presented before training, the trained group showed a significantly greater increase compared to untrained controls (p = .025). Our results show the feasibility and potential effectiveness of VR-based games for biofeedback training under experimentally applied stress. This may offer the opportunity for clinical techniques to more closely reflect the circumstances under which those techniques will be required., (© 2024 The Author(s). Psychophysiology published by Wiley Periodicals LLC on behalf of Society for Psychophysiological Research.)

Background: The posterior tibial tendon (PTT), deltoid ligament, and spring ligament are often torn or attenuated in patients with progressive collapsing foot deformity. The goal of this pilot study was to measure the ultrasound shear wave velocity (SWV) of these arch-supporting structures in feet with varying degrees of deformity to improve our understanding of their role in the progression of deformity., Methods: Two observers measured the SWV of the supramalleolar and inframalleolar PTT in long and short axes, in the tibiospring portion of the deltoid ligament, and in the superomedial band of the spring ligament in 8 neutrally aligned feet, 5 asymptomatic flatfeet, and 7 symptomatic flatfeet. Each measurement was repeated 3 times both with and without an applied eversion stress., Results: Average SWV was lower at all locations in the symptomatic flatfeet compared with normal feet, but these differences were statistically significant only for the inframalleolar PTT and the spring ligament. Externally applied stress led to an increase in the SWV of the ligaments but a paradoxical decrease in the SWV in the supramalleolar PTT. The SWV of the PTT was lower along the short axis compared with the long axis., Conclusion: SWV may be useful in evaluating the severity of degenerative disease of arch-supporting structures, but further study is needed before this technique can be applied clinically., Level of Evidence: Level III, case-control study., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Disclosure forms for all authors are available online., (© The Author(s) 2024.)

The diffusion and interaction dynamics of charged nanoparticles (NPs) within charged polymer networks are crucial for understanding various biological and biomedical applications. Using a combination of coarse-grained molecular dynamics simulations and experimental diffusion studies, we investigate the effects of the NP size, relative surface charge density (ζ), and concentration on the NP permeation length and time. We propose a scaling law for the relative diffusion of NPs with respect to concentration and ζ, highlighting how these factors influence the NP movement within the network. The analyses reveal that concentration and ζ significantly affect NP permeation length and time, with ζ being critical, as critical as concentration. This finding is corroborated by controlled release experiments. Further, we categorize NP dynamics into sticking, sliding, and bouncing regimes, demonstrating how variations in ζ, concentration, and NP size control these behaviors. Through normalized attachment time (NAT) analyses, we elucidate the roles of electrostatic interactions, steric hindrance, and hydrodynamic forces in governing NP dynamics. These insights provide guidance for optimizing NP design in targeted drug delivery and advanced material applications, enhancing our understanding of NP behavior in complex environments.

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

To ascertain the bioinorganic chemistry of metals conjugated with quinones, the complexes [Ag(ATV)(PPh 3 ) 2 ] ( 1 ), [Au(ATV)(PPh 3 )]·2H 2 O ( 2 ), and [Cu(ATV)(PPh 3 ) 2 ] ( 3 ) were synthesized by the coordination of the antimalarial naphthoquinone atovaquone (ATV) to the starting materials [Ag(PPh 3)2 ]NO 3 , [Au(PPh 3 )Cl], and [Cu(PPh 3 ) 2 NO 3 ], respectively. These complexes were characterized by analytical and spectroscopical techniques. X-ray diffraction of single crystals precisely confirmed the coordination mode of ATV to the metals, which was monodentate or bidentate, depending on the metal center. Both coordination modes showed high stability in the solid state and in solution. All three complexes showed negative log D values at pH 5, but at pH 7.4, while complex 2 continued to have a negative log D value, complexes 1 and 3 displayed positive values, indicating a more hydrophilic character. ATV and complexes 1 - 3 could bind to ferriprotoporphyrin IX (FePPIX); however, only complexes 1 - 3 could inhibit β-hematin crystal formation. Phenotype-based activity revealed that all three metal complexes are able to inhibit the growth of P. falciparum with potency and selectivity comparable to those of ATV, while the starting materials lack this activity. The outcomes of this chemical design may provide significant insights into structure-activity relationships for the development of new antimalarial agents.

Purpose: Postinjury multiple organ failure (MOF) is the sequela to the disease of polytrauma. We aimed to describe the contemporary population-based epidemiology of MOF within a mature trauma system, to analyse the time taken for MOF to develop, and to evaluate the temporal patterns and contributions of the individual constituent organ failures., Methods: Prospective observational study conducted across five Level-1 trauma centers in New South Wales, Australia. Trauma patients at-risk of MOF (Denver > 3 from 48 h post-admission), aged > 16 years, ISS > 15, and who stayed in ICU for ≥ 48 h were eligible for inclusion., Results: From May 2018-February 2021, 600 at-risk polytrauma patients were prospectively enrolled (mean(SD)age = 49(21)years, males = 453/600(76%),median(IQR)ISS = 26(20,34)). MOF incidence was 136/600(23%) among at-risk patients, 142/6248(2%) among major trauma patients (ISS > 12 per Australian definition), and 0.8/100,000 in the general population. The mortality rate was 55/600(11%) in the overall study population, and 34/136(25%) in MOF patients. 82/136(60%) of MOF patients developed MOF on day-3. No patients developed MOF after day-13. Among MOF patients, 60/136(44%) had cardiac failures (mortality = 37%), 39/136(29%) had respiratory failures (mortality = 23%), 24/136(18%) had renal failures (mortality = 63%), and 12/136(9%) had hepatic failures (mortality = 50%)., Conclusion: Although a rare syndrome in the general population, MOF occurred in 23% of the most severely injured polytrauma patients. When compared to previous risk-matched cohorts, MOF become more common, but not more lethal, despite a decade older cohort. The heart has superseded the lungs as the most common organ to fail. Cardiac and respiratory failures occurred earlier and were associated with lower mortality than renal and hepatic failures., (© 2024. The Author(s).)

Traumatic brain injury (TBI) is a disabling neurotraumatic condition and the leading cause of injury-related deaths and disability in the United States. Attenuation of neuroinflammation early after TBI is considered an important treatment target; however, while these inflammatory responses can induce secondary brain injury, they are also involved in the repair of the nervous system. Pioglitazone, which activates peroxisome proliferator-activated receptor gamma, has been shown to decrease inflammation acutely after TBI, but the long-term consequences of its use remain unknown. For this reason, the impacts of treatment with pioglitazone during the acute/subacute phase (30 min after injury and each subsequent 24 h for 5 days) after TBI were interrogated during the chronic phase (30- and 274-days post-injury (DPI)) in mice using the controlled cortical impact model of experimental TBI. Acute/subacute pioglitazone treatment after TBI results in long-term deleterious consequences, including disruption of tau homeostasis, chronic glial cell activation, neuronal pathology, and worsened injury severity particularly at 274 DPI, with male mice being more susceptible than female mice. Further, male pioglitazone-treated TBI mice exhibited increased dominant and offensive-like behavior while having a decreased non-social exploring behavior at 274 DPI. After TBI, both sexes exhibited glial activation at 30 DPI when treated with pioglitazone; however, while injury severity was increased in females it was not impacted in male mice. This work reveals that although pioglitazone has been shown to lead to attenuated TBI outcomes acutely, sex-based differences, timing and long-term consequences of treatment with glitazones must be considered and further studied prior to their clinical use for TBI therapy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The in vitro anti-proliferative activity of MA ( 5,7-dihydroxy-8-(3-methylbut-2-enyl)-6-(3-methyl-1-oxobutyl)-4-phenyl[1]2H-[1]benzopyran-2-one) on a variety of cancer cells was previously demonstrated. This work strives to understand the mechanisms by which MA exerts this biological activity. Thereafter, the binding of MA to calf thymus DNA was studied by monitoring the change in the UV-visible absorbance of MA . It was found that, the response of MA to binding with calf thymus DNA is characterised by an increase in the A S /A L ratio of the absorbance of the longest wavelength absorption band to the shortest one, and the appearance of a new band at about 377 nm assigned to S0→S1 transition, which is red shifted as compared to free MA . From the bands ratio, the binding constant is found to be 4.3x10 5 M -1 , indicating strong binding. The deduced binding free energy, enthalpy and entropy are -7.7 kcal/mol, -10.89 ± 0.28 kcal/mol and -54.46 ± 4 J/K, respectively, indicating that MA binds to DNA by a non-bonding Van der Waals type interactions and hydrogen bonds. Further study with classical molecular dynamics shows that MA binds to DNA by intercalation, where it is positioned between two AT base pairs. Unlike isolated MA , TDDFT calculations on ten images extracted from the MD trajectory show that, the frontier molecular orbitals of the complex are distributed over the DNA and MA . This indicates a strong stacking interaction and then explains the hypochromism and the red shift of the S0→S1 transition. The present work demonstrates the potency of MA as antitumor compound and as absorbance-based molecular probe.Communicated by Ramaswamy H. Sarma.

In the context of global climate change, the demand for new functional materials that are sustainable and environmentally friendly is rapidly increasing. Cellulose and lignin are the two most abundant raw materials in nature, and are ideal components for functional materials. The hydrophilic interface and easy film-forming properties of cellulose nanofibrils make them excellent candidates for natural biopolymer templates and network structures. Lignin is a natural UV-shielding material, as it contains a large number of phenolic groups. In this work, we have applied two routes for spray deposition of hybrid films with different laminar structures using surface-charged cellulose nanofibrils and water-based colloidal lignin particles. As the first route, we prepare stacked colloidal lignin particles and cellulose nanofibrils hybrid film through a layer-by-layer deposition. As the second route, we spray-deposite premixed colloidal lignin particles and cellulose nanofibrils dispersion to prepare a mixed hybrid film. We find that cellulose nanofibrils act as a directing agent to dominate the arrangement of the colloidal lignin particles in a mixed system. Additionally, cellulose nanofibrils eliminate the agglomerations and thus increase the visible light transparency while retaining the UV shielding ability. Our research on these colloidal lignin and cellulose nanofibril hybrid films provides a fundamental understanding of using colloidal lignin nanoparticles as functional material on porous cellulose-based materials, for example on fabrics., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objectives. To examine the accessibility of hospital facilities with maternity care services in 1 rural county in Alabama in preparation for the initiation of prenatal care services at a federally qualified health center. Methods. We analyzed driving distance (in miles) from maternal city of residence in Conecuh County, Alabama to hospital of delivery, using 2019-2021 vital statistics data and geographic information system (GIS) software. Results. A total of 370 births to mothers who have home addresses in Conecuh County were reported, and 368 of those were in hospital facilities. The majority of deliveries were less than 30 miles (median = 23 miles) from the maternal city of residence. Some women traveled more than 70 miles for obstetrical care. Conclusions. Pregnant patients in Conecuh County experience significant geographic barriers related to perinatal care access. Using GIS for this analysis is a promising approach to better understand the unique challenges of pregnant individuals in this rural population. Public health policy efforts need to be geographically tailored to address these disparities. ( Am J Public Health . 2024;114(S4):S330-S333. https://doi.org/10.2105/AJPH.2024.307692).

Background: Timely vaccination is the practice of administering the vaccine within the first birthday of the child. Not vaccinating the child at the appropriate age is the cause of improper protection of diseases and can be a possible factor in death. The problem of not completing the vaccine in the scheduled period is a globally distributed problem, but especially in sub-Saharan African countries, it is a bottleneck to child health. Even if timely vaccination is crucial for reducing the impact of VPDs, there are no current national-level studies to generate conclusive and tangible evidence in Ethiopia., Objective: To assess spatial variations and determinants of timely completion of vaccination in Ethiopia using further analysis of EDHS 2019 data., Method: The secondary data analysis of a community-based cross-sectional study design was employed among 3094 participants. Stata-14 software was used for data cleaning, recording, and analysis. Arc GIS version 10.3 and Kuldorff SAT scan version 9.6 software are used for spatial and SAT scan statistics. A multilevel mixed-effect binary logistic regression analysis was used to identify the predictors of timely vaccination. The clustering effect was also evaluated by Moran's I statistics and intra class correlation., Results: The timely completion of vaccination among Ethiopian women who had a child aged 12-35 months was 19.5% (95%CI: 18.2-20.8), and the spatial distribution of timely completion of vaccinations in Ethiopia was non-randomly distributed. A statistically significant high proportion of timely completion areas were clustered in the eastern part of Amhara, the south part of Afar, Addis Ababa, and Oromia. The primary cluster was located at a 13.11 km radius in Diredawa, which was 3.68 times higher than outside the window (RR = 3.68, LLR = 68.76, p-value < 0.001). History of antenatal care follow-up (AOR = 1.63, 95% CI: 1.3-2.04), giving birth at health facilities (AOR = 1.63, 95% CI: 1.25-2.13), age ≥ 35 years (AOR = 186, 95% CI: 1.35-2.63), age 25-34 years (AOR = 1.72, 95% CI: 1.33-2.21), and being richest (AOR = 2.71, 95% CI: 1.86-3.94) were the factors contributing to the timely completion of vaccination., Conclusion: The prevalence of timely completion of vaccination was low in Ethiopia, and the spatial distribution of timely completion of vaccination in Ethiopia was non-randomly distributed across the regions. The factors associated with the timely completion of vaccinations were ANC follow-up, place of delivery, age of the participant, and wealth index. We recommend expanding facility delivery, antenatal care services, and empowering women to scale up timely vaccination in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Agimas 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.)

Across-task binding is defined as the stimulus/response of one task being linked to the response of another task. The purpose of the present experiment was to determine across-task binding in a continuous movement sequence task with an auditory task of high and low pitch tones and the development of a movement sequence representation. According to the two systems theory of sequence learning, we expected that the developed representation in the across-task binding context relies on the multi-dimensional system rather than on the unidimensional system which is restricted to a set of modules where each module processed information along one task/dimension. An inter-manual transfer design was used to disentangle the sequence representations. The mirror transfer test required the same pattern of muscle activation and joint angles (motor coordinates) in the contralateral limb as experienced during the acquisition phase, while in the non-mirror transfer test, the visual-spatial locations (spatial coordinates) of the target waveform were reinstated. The main finding was that consistently combining visual-spatial positions in a sequence and auditory dimensions such as the tone pitch does not rely on a multidimensional system as predicted by the two-systems theory., Competing Interests: Declaration of competing interest The authors have no competing interests to declare. The first author declares that he has no conflict of interest. The second author declares that she has no conflict of interest. The third author declares that he has no conflict of interest. The fourth author declares that he has no conflict of interest. The fifth author declares that she has no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The histopathological lesions, minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are entities without immune complex deposits which can cause podocyte injury, thus are frequently grouped under the umbrella of podocytopathies. Whether MCD and FSGS may represent a spectrum of the same disease remains a matter of conjecture. Both frequently require repeated high-dose glucocorticoid therapy with alternative immunosuppressive treatments reserved for relapsing or resistant cases and response rates are variable. There is an unmet need to identify patients who should receive immunosuppressive therapies as opposed to those who would benefit from supportive strategies. Therapeutic trials focusing on MCD are scarce, and the evidence used for the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) guideline for the management of glomerular diseases largely stems from observational and pediatric trials. In FSGS, the differentiation between primary forms and those with underlying genetic variants or secondary forms further complicates trial design. This article provides a perspective of the Immunonephrology Working Group (IWG) of the European Renal Association (ERA) and discusses the KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases focusing on the management of MCD and primary forms of FSGS in the context of recently published evidence, with a special emphasis on the role of rituximab, cyclophosphamide, supportive treatment options and ongoing clinical trials in the field., (© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)

Transgender and nonbinary patients face unique healthcare challenges, such as harassment, discrimination, and/or prejudice, at higher rates than their cisgender counterparts. These experiences, or even the fear of these experiences, may push patients to delay or forego medical treatment, thus compounding any existing conditions. Such extraneous issues can be combatted through cultural sensitivity. The authors designed blended education consisting of an online module followed by a live simulation to educate and promote sensitivity. Internal medicine (IM) residents (n = 94) completed the module, which introduced them to transgender community terminology and medical disparities, and ways to incorporate affirming behaviors into their practice. Afterward, they engaged in a simulation with true transgender-simulated patients (SPs) - either trans-masculine, trans-feminine, or non-binary. Residents were expected to conduct a patient interview mirroring an intake appointment. Residents then engaged in a debriefing session with the lead investigator and the SP to reflect on the experience, receive feedback and constructive criticism, and ask questions. After the education, the residents' knowledge significantly increased, t(66) = 3.69, p ≤ 0.00, d = 0.45, and their attitude toward members of the transgender community also increased significantly, t(62) = 7.57, p ≤ 0.00, d = 0.95. Furthermore, nearly all residents (99%) reported the training allowed them to practice relevant skills and was a worthy investment of their time. Nearly half (45%) of the residents who listed changes they will make to their practice pledged to ask patients for their preferred name and pronouns. Most comments were positive (75%), praising the education's effectiveness, expressing gratitude, and reporting increased confidence. Results provided evidence that the education was effective in increasing IM residents' knowledge and attitudes. Further research is needed to investigate the longitudinal effects of this education and to extend the education to a broader audience. The investigators plan to adapt and expand the research to other specialties such as gynecology and emergency medicine., (© 2024. The Author(s).)

The present paper deals with the problem of elastic wave generation mechanisms (WGMs) by an electromagnetic-acoustic transducer (EMAT) in ferromagnetic materials. The paper seeks to prove that taking into account all the WGMs must be a general rule to quantitatively predict the elastic waves generated by an EMAT in such materials. Existing models of the various physical phenomena involved, namely magnetic and magnetostrictive, electromagnetic, and ultrasonic, are combined to solve the multiphysics wave generation problem. The resulting model shows that WGMs (i.e., electromagnetic force, magnetostrictive strain, and magnetic traction) strongly depend on material properties and EMAT design and excitation. To illustrate this, four magnetic materials (nickel, AISI410, Z20C13, and low carbon steel) with similar elastic but contrasting electromagnetic properties are studied. A given EMAT of fixed excitation and geometry yields WGMs with highly different amplitudes in these materials, with a WGM dominant in one material being negligible in another. Experimental results make it possible to validate the accuracy of certain predictions of the model developed. In summary, the present work shows that considering all WGMs is the general rule when working with ferromagnetic materials. Furthermore, it offers a generic model that can be integrated into various numerical tools to help optimize EMAT design and give reliable data interpretation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To report on the oncological outcomes of active surveillance (AS) in low-grade prostate cancer (PCa) patients using the French SurACaP protocol, with a focus on long-term outcomes., Methods: This multicenter study recruited patients with low-grade PCa between 2007 and 2013 in four referral centers in France. The cohort included patients meeting the SurACaP inclusion criteria, i.e., aged ≤75years, with low-grade PCa (i.e., ISUP 1), clinical stage T1c/T2a, PSA ≤10ng/mL and ≤3 positive cores and tumor length ≤3mm per core. The SurACaP protocol included a digital rectal examination every six months, PSA level measurement every three months for the first two years after inclusion and twice a year thereafter, a confirmatory biopsy in the first year after inclusion, and then follow-up biopsy every two years or if disease progression was suspected. Multiparametric magnetic resonance imaging (mpMRI) was progressively included over the study period., Results: A total of 86 consecutive patients were included, with a median follow-up of 10.6 years. Only one patient developed metastases and died of PCa. The estimated rates of grade reclassification and treatment-free survival at 15 years were 53.4% and 21.2%, respectively. A negative mpMRI at baseline and a negative confirmatory biopsy were significantly associated with a lower risk of disease progression (P<0.05)., Conclusions: AS using the French SurACaP protocol is a safe and valuable strategy for patients with low-risk PCa, with excellent oncological outcomes after more than 10 years' follow-up. Future studies are crucial to broaden the inclusion criteria and develop a personalized, risk based AS protocol with the aim of de-escalating follow-up examinations., Level of Evidence: Grade 4., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Congenital cytomegalovirus (cCMV) is the most common intrauterine infection, leading to infant neurodevelopmental disabilities. An improved knowledge of correlates of protection against cCMV is needed to guide prevention strategies. Here, we employ an ex vivo model of human CMV (HCMV) infection in decidual tissues of women with and without preconception immunity against CMV, recapitulating nonprimary vs. primary infection at the authentic maternofetal transmission site. We show that decidual tissues of women with preconception immunity against CMV exhibit intrinsic resistance to HCMV, mounting a rapid activation of tissue-resident memory CD8 + and CD4 + T cells upon HCMV reinfection. We further reveal the role of HCMV-specific decidual-tissue-resident CD8 + T cells in local protection against nonprimary HCMV infection. The findings could inform the development of a vaccine against cCMV and provide insights for further studies of the integrity of immune defense against HCMV and other pathogens at the human maternal-fetal interface., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

To date, much of the health focus of environmental policy has been on preventing physical health impacts of environmental exposures. Recent research has however highlighted increasingly concurrent mental health effects and its consideration is an emerging requirement for many governments and their agencies, yet there are limited universal mental health assessment tools for environmental exposures. This paper details the findings of a scoping review that evaluated assessment tools used to measure psychological impacts from environmental exposures and pollution, as reported in recent peer-reviewed literature (2000-2022). Across the 126 papers identified in our review, a wide range of tools to assess mental health impact were identified. We document a clear recent upswing of research interest in the mental and psychological impacts of environmental exposures, and an overarching concern for air pollution from industry, traffic, and fires. A majority of studies utilised standardised assessment instruments, but there was little consistency in the way that these were combined or deployed. The dominant mental health outcomes of interest in these studies were depression, anxiety, and mental and psychiatric health. The findings of the review identify a need and opportunity to develop a best-practice approach to consistently assess the mental health impacts arising from environmental exposures. Future work is needed to define the most appropriate choice and application of assessment tools to evaluate adverse mental health impacts from environmental exposures. This will support a more universal, coordinated and cross-jurisdiction approach for the assessment, quantification and targeted response to addressing mental health impacts arising from environmental exposures., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Emma Baker reports financial support was provided by The University of Adelaide. Mark Patrick Taylor reports financial support was provided by EPA Victoria., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Population screening for risk of type 1 diabetes (T1D) has been proposed to identify those with islet autoimmunity (presence of islet autoantibodies). As islet autoantibodies can be transient, screening with a genetic risk score has been proposed as an entry into autoantibody testing., Methods: Children were recruited from eight general pediatric and specialty clinics across Virginia with diverse community settings. Recruiters in each clinic obtained informed consent/assent, a medical history, and a saliva sample for DNA extraction in children with and without a history of T1D. A custom genotyping panel was used to define T1D genetic risk based upon associated SNPs in European- and African-genetic ancestry. Subjects at "high genetic risk" were offered a separate blood collection for screening four islet autoantibodies. A follow-up contact (email, mail, and telephone) in one half of the participants determined interest and occurrence of subsequent T1D., Results: A total of 3818 children aged 2-16 years were recruited, with 14.2% (n = 542) having a "high genetic risk." Of children with "high genetic risk" and without pre-existing T1D (n = 494), 7.0% (34/494) consented for autoantibody screening; 82.4% (28/34) who consented also completed the blood collection, and 7.1% (2/28) of them tested positive for multiple autoantibodies. Among children with pre-existing T1D (n = 91), 52% (n = 48) had a "high genetic risk." In the sample of children with existing T1D, there was no relationship between genetic risk and age at T1D onset. A major factor in obtaining islet autoantibody testing was concern over SARS-CoV-2 exposure., Conclusions: Minimally invasive saliva sampling implemented using a genetic risk score can identify children at genetic risk of T1D. Consent for autoantibody screening, however, was limited largely due to the SARS-CoV-2 pandemic and need for blood collection., (© 2024. The Author(s).)

The purpose of this study was to explore U.S. parents' and caregivers' understanding about children's bullying-what bullying is and how to address it. We analyzed 2017, 2018, and 2019 Fall ConsumerStyles online panel survey data from U.S. parents/caregivers of children ages 10 to 17 years ( N  = 1,516), including 20 items representing statements consistent or inconsistent with the bullying prevention evidence and best practices. Percentage of endorsement for each item and a summary measure of understanding about bullying were calculated. The association between low overall understanding about bullying and sociodemographic characteristics was explored. Most parents identified bullying as harmful (77%), repetitive (63%), and involving power imbalance (51%). At least half of parents answered 13 or more items (20 total) consistent with the bullying prevention evidence or best practices. Being male, non-Hispanic Black or Hispanic, having high school or less education, and small household size were associated with higher odds of low overall understanding about bullying. Awareness of parents' understanding about bullying and how to appropriately address it is vital for bullying prevention. Findings can inform the strategic development of bullying prevention health messages for parents., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Economic stress, broadly defined, is associated with an increased likelihood of multiple forms of violence. Food insecurity is a distinct economic stressor and material hardship that is amenable to programmatic and policy intervention. To inform intervention and identify gaps in the current evidence base, we conducted a systematic review to synthesize and critically evaluate the existing literature regarding the association between food insecurity and five forms of interpersonal and self-directed violence: intimate partner violence (IPV), suicidality, peer violence and bullying, youth dating violence, and child maltreatment, in high-income countries. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and searched six electronic databases from their start date through February of 2022. We included studies that examined food insecurity as the exposure and an outcome measure of IPV, suicide, suicidality, peer violence, bullying, youth dating violence, or child maltreatment; were peer-reviewed and published in English; reported quantitative data; and took place in a high-income country. We identified 20 relevant studies. Nineteen studies found that food insecurity was associated with an increased likelihood of these forms of violence. Results highlight the potential for programs and policies that address food insecurity to function as primary prevention strategies for multiple forms of violence and underscore the importance of trauma-informed approaches in organizations providing food assistance. Additional theory-driven research with validated measures of food insecurity and clearly established temporality between measures of food insecurity and violence is needed to strengthen the existing evidence base., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To report the long-term oncological outcomes of active surveillance (AS) in selected patients with favorable intermediate-risk (IR) prostate cancer (PCa)., Methods: A retrospective database review of two academic centers was conducted to identify favorable IR PCa patients initially managed by AS between 2014 and 2022. Favorable IR PCa was defined by the presence of one single element of IR disease (i.e., PSA 10-20ng/mL, Gleason Grade Group [GG] 2, or cT2b). All patients were diagnosed and followed up according to a contemporary scheme, including MRI and image-guided biopsies. The primary endpoint was metastasis-free survival., Results: A total of 57 patients met our inclusion criteria and the median follow-up was 56months. During follow-up, there were no cases of metastasis or death due to PCa, but 6 deaths due to competing causes. A total of 25 (44%) and 6 patients (11%) had definitive treatment and GG 3 reclassification during follow-up, respectively. In multivariable Cox hazard regression analysis, the risk of undergoing definitive treatment was significantly associated with PSA density>0.15 (HR: 4.82, 95% CI: 1.47 to 15; P=0.01) and PI-RADS 4-5 lesions on mpMRI (HR: 2.48, 95% CI: 1.06 to 5.19; P=0.006). Interestingly, tumor burden (P=0.3) and GG (P=0.7) on biopsy were not associated with definitive treatment., Conclusions: AS is a safe and valuable strategy for well-selected patients with favorable IR prostate cancer, with excellent oncological outcomes after five years' follow-up., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)