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Active restoration often aims to accelerate ecosystem recovery. However, active restoration may not be worthwhile if its effects are overwhelmed by changes that occur passively. Moreover, it can be challenging to separate the effects of passive processes, such as dispersal and natural succession, from active restoration efforts.We assess the 24‐year impact of actively restoring a Minnesota old‐field grassland via seed addition of native tallgrass prairie species. We compared the abundance of four functional plant groups in actively restored plots against abundances in three reference classes: (1) unrestored plots undergoing passive recovery within the same old field, (2) passively recovering plots in two nearby old fields of similar age and (3) a chronosequence of 21 old fields within the same landscape.Active restoration led to a higher abundance of native grasses and forbs in the 36 m2 treatment plots. Seed addition was more effective if the original vegetation was first removed using herbicide, burning and tilling. However, long‐term conclusions about the efficacy of active restoration varied widely depending on the choice of reference class.In our small‐scale restoration experiment, native abundance was similarly high in both the actively restored and reference plots after 24 years, suggesting either (1) passive recovery or (2) local dispersal of native species from nearby treatment plots (i.e. cross‐contamination). In contrast, a comparison with two nearby reference fields suggested active restoration resulted in much higher native abundance relative to passive recovery. A smaller, positive effect was detected when we compared actively restored plots to the chronosequence of old fields. In the chronosequence, many passively recovering old fields had transitioned to native grass dominance naturally, although active restoration appeared to increase native forb abundance.Synthesis and applications: Our findings highlight the importance of using scale‐appropriate references for assessing the efficacy and need for active restoration. Comparing actively restored plots with the surrounding landscape, we found that active restoration and passive recovery led to similar plant communities after 24 years. Because local dispersal from actively restored sites can nearby references, caution should be exercised when evaluating long‐term restoration projects using only small‐scale experiments. [ABSTRACT FROM AUTHOR]

Future changes in climate, together with rising atmospheric CO2 , may reorganise the functional composition of ecosystems. Without long‐term historical data, predicting how traits will respond to environmental conditions—in particular, water availability—remains a challenge. While eco‐evolutionary optimality theory (EEO) can provide insight into how plants adapt to their environment, EEO approaches to date have been formulated on the assumption that plants maximise carbon gain, which omits the important role of tissue construction and size in determining growth rates and fitness. Here, we show how an expanded optimisation framework, focussed on individual growth rate, enables us to explain shifts in four key traits: leaf mass per area, sapwood area to leaf area ratio (Huber value), wood density and sapwood‐specific conductivity in response to soil moisture, atmospheric aridity, CO2 and light availability. In particular, we predict that as conditions become increasingly dry, height‐growth optimising traits shift from resource‐acquisitive strategies to resource‐conservative strategies, consistent with empirical responses across current environmental gradients of rainfall. These findings can explain both the shift in traits and turnover of species along existing environmental gradients and changing future conditions and highlight the importance of both carbon assimilation and tissue construction in shaping the functional composition of vegetation across climates. Summary Statement: Eco‐evolutionary theory (EEO) can yield insight into how plant traits are likely to adapt to future climatic conditions. However, current implementations typically focus on maximising plant carbon gain while omitting important processes related to tissue construction and relative allocation which are important for understanding plant growth rates, and consequently, fitness. Using a height‐growth based trait optimisation framework incorporating plant hydraulics, we predict how four key traits: leaf mass per area, sapwood area to leaf area ratio (Huber value), wood density and sapwood‐specific conductivity, respond to soil moisture, atmospheric aridity, CO2 and light availability and consider these predictions in light of empirical observations. Finally, we use this framework to explore how simultaneous optimisation of multiple traits can yield species turnover across a soil moisture gradient. The model shows that, when plants maximise height‐growth rate, the optimal value of leaf‐mass‐per‐area, Huber value, wood density and sapwood‐specific conductivity shifts with the environment and through plant ontogeny in line with empirical results. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi‐structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over‐reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery‐based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high‐risk workplace, nurses may also benefit from organisational assistance in this area. [ABSTRACT FROM AUTHOR]

The growth of antimony (Sb) thin films on the fivefold surface of icosahedral Ag−In−Yb quasicrystal has been studied by scanning tunneling microscopy (STM) and x‐ray photoelectron spectroscopy (XPS). At low coverage, the deposited Sb yields a network of pentagons of different sizes and heights. These Sb pentagons can be mapped by a pentagonal tiling of the substrate and thus exhibit quasicrystalline long‐range order. Subsequent deposition of Sb yields a disordered film. XPS observations of the growth mode are consistent with the STM results. [ABSTRACT FROM AUTHOR]

Food safety is crucial to attaining food security and sustainability. Unsafe foods for human and animal consumption lead to product recalls and rejection, negatively impacting the global economy and trade. Similarly, climate change can adversely affect the availability of safe and nutritious food at the table. The changing climatic conditions and global food trade and transport can make the movement of toxic plants possible, resulting in food crops being increasingly invaded by some species of plants that produce toxic secondary metabolites, such as tropane alkaloids (TAs). Datura stramonium from the Solanaceae plant family is an invasive and virulent plant that produces high amounts of two TAs, atropine and scopolamine. Various food poisoning events following accidental or deliberate ingestion of foods contaminated by atropine and scopolamine from seeds of D. stramonium have been recorded in different locations globally. Due to these incidents, regulatory agencies require the development of plant toxin detection methods that can be used in the food chain as early as possible. This systematic review thus focuses on the TA determination techniques in food and feeds published between 2013 and 2023. A particular focus was given to the sample preparation methods, the improvements of each technique claimed, and data to support the performance of each method, especially the ability to measure at or below the maximum level. The review concludes with other technological advancements, including rapid spectroscopy, electrophoresis, and colorimetric methods, as well as the possibility of coupling with smartphones for use in on‐farm detection and the challenges in applying them. [ABSTRACT FROM AUTHOR]

Introduction: Magnetic resonance imaging (MRI) is a rapidly evolving modality, generally considered safe due to lack of ionising radiation. While MRI technology and techniques are improving, many of the safety concerns remain the same as when first established. Patient thermal injuries are the most frequently reported adverse event, accounting for 59% of MRI incidents to the Food and Drug Administration (FDA). Surveys indicate many incidents remain unreported. Patient thermal injuries are preventable and various methods for their mitigation have been published. However, recommendations can be variable, fragmented and confusing. The aim of this systematic review was to synthesise the evidence on MRI safety and associated skin injuries and offer comprehensive recommendations for radiographers to prevent skin thermal injuries. Methods: Four journal databases were searched for sources published January 2010–May 2023, presenting information on MRI safety and thermal injuries. Results: Of 26,801 articles returned, after careful screening and based on the eligibility criteria, only 79 articles and an additional 19 grey literature sources were included (n = 98). Included studies were examined using thematic analysis to determine if holistic recommendations can be provided to assist in preventing skin burns. This resulted in three simplified recommendations: Remove any electrically conductive itemsInsulate the patient to prevent any conductive loops or contact with objectsCommunicate regularly Conclusion: By implementing the above recommendations, it is estimated that 97% of skin burns could be prevented. With thermal injuries continuing to impact MRI safety, strategies to prevent skin burns and heating are essential. Assessing individual risks, rather than blanket policies, will help prevent skin thermal injuries occurring, improving patient care. [ABSTRACT FROM AUTHOR]

Aim: In northern environments, periods of isolation during Pleistocene glaciations and subsequent recolonization and secondary contact have had a significant influence on contemporary diversity of many species. The recent advent of high‐resolution genomic analyses allows unprecedented power to resolve genomic signatures of such events in northern species. Here, we provide the highest resolution genomic characterization of Atlantic salmon in North America to date to infer glacial refugia and the geographic scales of post‐glacial secondary contact. Location: North America. Taxon: Atlantic salmon, Salmo salar. Methods: Samples were collected for 5455 individuals from 148 populations, encompassing the majority of the Atlantic salmon's native range in North America, from Labrador to Maine. Individuals were genotyped using a 220K single nucleotide polymorphism array aligned to the Atlantic salmon (Salmo salar) genome. Spatial genetic structure (principal component analysis, k‐means clustering, admixture) was evaluated in conjunction with genomic comparisons of these identified lineages to infer the refugia during the last glacial maximum and regions of secondary contact following recolonization. Results: Spatial genomic analyses identified three phylogeographic groups, consistent with the northward recolonization from two southern glacial refugia in North America (a western Maritime lineage and an eastern Newfoundland and Labrador lineage), with subsequent differentiation of the eastern lineage into two separate groups. Secondary contact among these North American groups was observed within the northern Gulf of St. Lawrence, and evidence of trans‐Atlantic secondary contact was detected within the eastern Newfoundland and Labrador lineage. Comparison of groups from insular Newfoundland with those from mainland Labrador suggests genomic regions displaying high differentiation were characterized by elevated European admixture, suggesting a possible role of European secondary contact in population divergence. Main Conclusions: These findings present the first evidence suggesting that genomic diversity in extant North American Atlantic salmon populations has resulted from allopatric isolation in two glacial refugia followed by both regional and trans‐Atlantic recolonization and secondary contact and demonstrate the power of genomic tools to resolve historical drivers of diversity in wild populations. [ABSTRACT FROM AUTHOR]

Use of food supplements (FS) by athletes is well characterised but there is little information on 'herbal' or 'botanical' FS beyond 'natural'. This study determined, by questionnaire, whether athletes' main self‐reported reason for using FS was reflective of what was written on product labels or, when these claims were unavailable, was in accordance with the scientific literature. In 217 elite (n = 55) and amateur (n = 162) athletes living on the island of Ireland, 71% (n = 153) consumed any kind of FS, with 16% (n = 34) of the entire cohort deemed botanical consumers. 'Protein' (21%, n = 46), 'vitamin D' (17%, n = 37) and 'vitamin C' (15% n = 32) were most consumed with the top reasons for use being 'to support health', 'to prevent illness/for immunity purposes' and 'recovery'. There was generally good agreement between approved nutrition and health claims for such products and athletes' main reported reasons for use. Only the amateur athletes in our pool described using botanical supplements, with reasons for use stated as 'sleep improvement' (21%), 'recovery' (14%), 'supporting health' (12%) and 'energy' (12%), resulting in poor agreement with either approved claims or scientific evidence. Only half of amateur athletes knew if their botanical FS were third‐party tested. Athletes and practitioners require guidance to avoid consuming supplements for which there is little scientific evidence, and which may risk being contaminated/fraudulent. [ABSTRACT FROM AUTHOR]

If you've listened to the news recently, you may have been struck by a sense of impending doom. This is perhaps especially true for adolescents, who have faced a global pandemic and the constant threat of school shootings and gun violence. Persistent feelings of hopelessness are experienced at alarming rates by adolescents. Hopelessness (defined as the negative expectation toward oneself or the future) has been widely reported to play a major role in the development of depressive symptoms, suicidal ideation, and unsafe behaviors (Berardelli et al., 2022; Stoddard et al., 2011). [ABSTRACT FROM AUTHOR]

Background: Pulmonary vein stenosis (PVS) is a rare condition in which neointimal proliferation leads to venous and arterial hypertension. Little is known about PVS after heart transplant (HTx) in children. We sought to describe the characteristics and outcomes of children who develop PVS after HTx. Methods: We performed a retrospective review of patients ≤18 years old who underwent HTx at two HTx centers between April 2012 and October 2023. Patients with PVS were identified via database queries. Cardiac diagnosis, PVS location and extent, and outcomes were recorded. Results: Over 11.5 years, 422 patients underwent HTx across both centers. Nineteen patients with PVS (10 male) were identified, 15 with de novo PVS. Sixteen had underlying congenital heart disease (CHD), two with anomalous pulmonary venous return. PVS was diagnosed at a median of 2 months (range 2 weeks to 14 years) after HTx. At time of initial diagnosis, 13 patients had one‐vessel PVS. At final follow‐up, 7/19 (37%) had increases in the number of vessels involved. Six patients underwent surgery, and nine patients had stent or balloon angioplasty. Two patients were treated for pulmonary hypertension following PVS diagnosis. Three patients died from right heart failure secondary to PVS. Conclusions: This is the largest study to describe the characteristics of post‐HTx PVS in children. PVS occurs in 4.5% of HTx, and underlying CHD is a strong risk factor. Multiple vessels can be involved and may require catheter‐based or surgical intervention. Clinicians must be vigilant in monitoring the development of PVS in this population. [ABSTRACT FROM AUTHOR]

Introduction: Labor is both a physiological and physical activity that requires energy expenditure by the woman. Despite this, women are often fasted in labor, with hydration requirements addressed predominantly by intravenous therapy. Little is known about how best to manage this in nulliparous women undergoing induction of labor, who can be prone to lengthy labors. Therefore, we undertook a systematic review and meta‐analysis to determine the effects of intravenous hydration regimens on nulliparous women undergoing induction of labor. Material and methods: A systematic review and meta‐analysis were conducted. Databases searched were PubMed, CINAHL, Embase, Cochrane, Scopus, and Web of Science using the search strategy combination of associated key concepts for intravenous therapy and nulliparous laboring women. The primary outcome was excessive neonatal weight loss. Meta‐analyses for categorical outcomes included estimates of odds ratio (OR) and their 95% confidence intervals (CI) calculated; and for continuous outcomes the standardized mean difference, each with its 95% CI. Heterogeneity was assessed visually and by using the χ2 statistic and I2 with significance being set at p < 0.10. Results: A total of 1512 studies were located and following screening, three studies met the eligibility criteria. No studies reported excessive neonatal weight loss. Increased rates of intravenous therapy (250 mL/h vs. 125 mL/h) during labor were not found to reduce the overall length of labor (mean difference −0.07 h, 95% CI −0.27 to 0.13 h) or reduce cesarean sections (OR 0.74, 95% CI 0.45–1.23), when women were not routinely fasted. Conclusions: Our review found no significant improvements for nulliparous women who received higher intravenous fluid volumes when undergoing induction of labor and were not routinely fasted. However, data are limited, and further research is needed. [ABSTRACT FROM AUTHOR]

Problem: Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons. Background: Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored. Aim: The aim of this scoping review was to identify and collate evidence‐based guidelines for intrapartum hydration assessment and management of maternal hydration during labor and birth. Methods: PubMed, Embase, and CINAHL databases were searched, in addition to professional college association websites. Inclusion criteria were intrapartum clinical guidelines in English, published in the last 10 years. Findings: Despite searching all appropriate databases in maternity care, we were unable to identify evidence‐based guidelines specific to hydration assessment and management, therefore resulting in an "empty review." A subsequent review of general intrapartum care guidelines was undertaken. Our adapted review identified 12 guidelines, seven of which referenced the assessment and management of maternal hydration during labor and birth. Three guidelines recommend that "low‐risk" women in spontaneous labor at term should hold determination over what they ingest in labor. No recommendations with respect to assessment and management of hydration for women undergoing induction of labor were found. Discussion: Despite the increasing use of intravenous fluid as an adjunct to oral intake to maintain maternal intrapartum hydration, there is limited evidence and, subsequently, guidelines to determine best practice in this area. How hydration is assessed was also largely absent from general intrapartum care guidelines, further perpetuating potential clinical variation in this area. Conclusion: There is an absence of guidelines specific to the assessment and management of maternal hydration during labor and birth, despite its importance in ensuring labor progress and safe care. [ABSTRACT FROM AUTHOR]

Threatened species monitoring is challenging for small, cryptic endotherms that are most effectively detected at night. Low detectability is a challenge for monitoring programmes, resulting in low statistical power and sparse or zero‐inflated datasets. To advance conservation management programmes, efforts to address this are required. In recent years thermal scanners have emerged as an effective tool for detecting small endotherms, but the diversity of available thermal tools, focal habitats and target species mean that their applicability in many key scenarios remain untested. We directly compared vehicle‐mounted thermal surveys with vehicle‐based spotlighting targeting small endotherms in Australian native grasslands. Our targets included both common species that occur at high densities, and species that are notoriously difficult to detect with spotlights, which may occur at very low densities. We completed paired surveys of roosting grassland birds, and nocturnally active small mammals at 22 sites, once using thermal scanners and once using spotlights. Ultimately, distance sampling was conducted across 136 km of transects. Thermal scanners facilitated greater detection distances and higher total detections for small endotherms when compared with spotlighting. Species of greatest conservation concern, the Plains‐wanderer (Pedionomus torquatus—Pedionomidae) and Fat‐tailed Dunnart (Sminthopsis crassicaudata—Dasyuridae) were only detected using thermal scanners. Detection distances generated for thermal scanners were reduced by higher vegetation density; however, thermal scanners continued to outperform spotlights under this scenario. Observers also detected more stationary animals and fewer birds were flushed upon detection using thermal scanners when compared with spotlighting. Thermal scanners have the potential to improve the quality of monitoring datasets by increasing detection probabilities for small endotherms. We recommend the adoption of thermal scanners as a best‐practice tool for monitoring small endotherms in open grassland habitats at night, offering new opportunities to monitor endotherms where monitoring has historically been challenging, inadequate or impossible. [ABSTRACT FROM AUTHOR]

Complex traits often exhibit complex underlying genetic architectures resulting from a combination of evolution from standing variation, hard and soft sweeps, and alleles of varying effect size. Increasingly, studies implicate both large‐effect loci and polygenic patterns underpinning adaptation, but the extent that common genetic architectures are utilized during repeated adaptation is not well understood. Sea age or age at maturation represents a significant life history trait in Atlantic Salmon (Salmo salar), the genetic basis of which has been studied extensively in European Atlantic populations, with repeated identification of large‐effect loci. However, the genetic basis of sea age within North American Atlantic Salmon populations remains unclear, as does the potential for a parallel trans‐Atlantic genomic basis to sea age. Here, we used a large single‐nucleotide polymorphism (SNP) array and low‐coverage whole‐genome resequencing to explore the genomic basis of sea age variation in North American Atlantic Salmon. We found significant associations at the gene and SNP level with a large‐effect locus (vgll3) previously identified in European populations, indicating genetic parallelism, but found that this pattern varied based on both sex and geographic region. We also identified nonrepeated sets of highly predictive loci associated with sea age among populations and sexes within North America, indicating polygenicity and low rates of genomic parallelism. Despite low genome‐wide parallelism, we uncovered a set of conserved molecular pathways associated with sea age that were consistently enriched among comparisons, including calcium signaling, MapK signaling, focal adhesion, and phosphatidylinositol signaling. Together, our results indicate parallelism of the molecular basis of sea age in North American Atlantic Salmon across large‐effect genes and molecular pathways despite population‐specific patterns of polygenicity. These findings reveal roles for both contingency and repeated adaptation at the molecular level in the evolution of life history variation. [ABSTRACT FROM AUTHOR]

Aim: Neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer facilitates tumour downstaging and complete pathological response (pCR). The goal of neoadjuvant systemic chemotherapy (total neoadjuvant chemotherapy, TNT) is to further improve local and systemic control. While some patients forgo surgery, total mesorectal excision (TME) remains the standard of care. While TNT appears to be noninferior to nCRT with respect to short‐term oncological outcomes few data exist on perioperative outcomes. Perioperative morbidity including anastomotic leaks is associated with a negative effect on oncological outcomes, probably due to a delay in proceeding to adjuvant therapy. Thus, we aimed to compare conversion rates, rates of sphincter‐preserving surgery and anastomosis formation rates in patients undergoing rectal resection after either TNT or standard nCRT. Methods: An institutional colorectal oncology database was searched from January 2018 to July 2023. Inclusion criteria comprised patients with histologically confirmed rectal cancer who had undergone neoadjuvant therapy and TME. Exclusion criteria comprised patients with a noncolorectal primary, those operated on emergently or who had local excision only. Outcomes evaluated included rates of conversion to open, sphincter‐preserving surgery, anastomosis formation and anastomotic leak. Results: A total of 119 patients were eligible for inclusion (60 with standard nCRT, 59 with TNT). There were no differences in rates of sphincter preservation or primary anastomosis formation between the groups. However, a significant increase in conversion to open (p = 0.03) and anastomotic leak (p = 0.03) was observed in the TNT cohort. Conclusion: In this series TNT appears to be associated with higher rates of conversion to open surgery and higher anastomotic leak rates. While larger studies will be required to confirm these findings, these factors should be considered alongside oncological benefits when selecting treatment strategies. [ABSTRACT FROM AUTHOR]

We present a machine learning based emulator of a microphysics scheme for condensation and precipitation processes (Zhao‐Carr) used operationally in a global atmospheric forecast model (FV3GFS). Our tailored emulator architecture achieves high skill (≥94%) in predicting condensate and precipitation amounts and maintains low global‐average bias (≤4%) for 1 year of continuous simulation when replacing the Fortran scheme. The stability and success of this emulator stems from key design decisions. By separating the emulation of condensation and precipitation processes, we can better enforce physical priors such as mass conservation and locality of condensation, and the vertical dependence of precipitation falling downward, using specific network architectures. An activity classifier for condensation imitates the discrete‐continuous nature of the Fortran microphysics outputs (i.e., tendencies are identically zero where the scheme is inactive, and condensate is zero where clouds are fully evaporated). A temperature‐scaled conditional loss function ensures accurate condensate adjustments for a high dynamic range of cloud types (e.g., cold, low‐condensate cirrus clouds or warm, condensate‐rich clouds). Despite excellent overall performance, the emulator exhibits some deficiencies in the uppermost model levels, leading to biases in the stratosphere. The emulator also has short episodic skill dropouts in isolated grid columns and is computationally slower than the original Fortran scheme. Nonetheless, our challenges and strategies should be applicable to the emulation of other microphysical schemes. More broadly, our work demonstrates that with suitable physically motivated architectural choices, ML techniques can accurately emulate complex human‐designed parameterizations of fast physical processes central to weather and climate models. Plain Language Summary: In this study, we create computer code that uses machine learning to mimic a weather model's algorithm for handling how clouds form and rain falls. When used in the weather model to replace this algorithm, our machine learning code is highly accurate in simulations for a whole year. We achieve this by making smart code design choices. We split the code into two parts: one for cloud formation and one for rain and snow. This allows us to better build important aspects of these processes into the machine learning approach. For instance, clouds form where it is moist and evaporate when it gets dry, and rain and snow fall downward. Our code learns cloud behavior based on temperature to ensure it works both for cold, thin clouds high up in the sky and warm, thick clouds closer to the ground. Our work shows a path for suitably designed machine learning code to eventually replace important parts of weather and climate models, but also that this path still requires careful human design respecting known physical principles. Key Points: We build an emulator to replace the Zhao‐Carr Fortran microphysics scheme in FV3GFSThe integrated emulator sustains high skill throughout a 1‐year simulationTailoring the ML architecture to the structure of the underlying scheme greatly improves the online behavior of the emulator [ABSTRACT FROM AUTHOR]

Aim: To gain a greater understanding of how compression therapy affects quality of life, this systematic review appraised existing published studies measuring the impact of compression therapy on health quality of life (HRQoL), and pain, among people with venous leg ulcers (VLU). Method: Five databases were searched, and two authors extracted data and appraised the quality of selected papers using the RevMan risk of bias tool. Due to heterogeneity in the types of compression and instruments used to evaluate HRQoL, meta‐analysis was not appropriate; thus, a narrative synthesis of findings was undertaken. Results: Ten studies were included, 9 RCTs and one before‐after study. The studies employed nine different HRQoL tools to measure the impact of a variety of compression therapy systems, with or without an additional exercise programme, versus other compression systems or usual care, and the results are mixed. With the use of the Cardiff Cardiff Wound Impact Schedule, the SF‐8 and the SF‐12, study authors found no differences in QoL scores between the study groups. This is similar to one study using QUALYs (Iglesias et al., 2004). Conversely, for studies using EuroQol‐5D, VEINES‐QOL, SF‐36 and CIVIQ‐20 differences in QoL scores between the study groups were noted, in favour of the study intervention groups. Two further studies using QUALYs found results that favoured a two‐layer cohesive compression bandage and the TLCCB group, respectively. Results for the five studies that assessed pain are also mixed, with one study finding no difference between study groups, one finding that pain increased over the study period and three studies finding that pain reduced in the intervention groups. All studies were assessed as being at risk of bias in one or more domains. Conclusion: Results were varied, reflecting uncertainty in determining the impact of compression therapy on quality of life and pain among people with a venous leg ulcer. The heterogeneity of the compression systems and the measures used to evaluate HRQoL make it a challenge to interpret the overall evidence. Further studies should strive for homogeneity in design, interventions and comparators to enhance both internal and external validity. [ABSTRACT FROM AUTHOR]

There is growing interest in cannabis use for cancer pain. This commentary aims to discuss the evidence surrounding cannabis use for cancer pain in the context of the long‐racialized landscape of cannabis policies and the disparity in pain control among cancer patients holding minoritized racial identities. Much evidence surrounding both the benefits and harms of cannabis use in cancer patients, and all patients in general, is lacking. Although drawing on the research in cancer that is available, it is also important to illustrate the broader context about how cannabis' deep roots in medical, political, and social history impact patient use and health care policies. There are lessons we can learn from the racialized disparities in opioid risk mitigation strategies, so they are not replicated in the settings of cannabis for cancer symptom management. Additionally, the authors intentionally use the term "cannabis" here rather than "marijuana.: In the early 1900s, the lay press and government popularized the use of the word "marijuana" instead of the more common "cannabis" to tie the drug to anti‐Mexican prejudice. This commentary explores the utilization of cannabis for cancer pain relief, considering historical biases in cannabis policies and disparities in pain management among marginalized racial groups. We emphasize the need for comprehensive research that encompasses diverse patient populations and highlight the significance of inclusive approaches in combating racial disparities. There is a need to prioritize equity and inclusivity in cannabis research and access. [ABSTRACT FROM AUTHOR]

Background: Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. Methods: This manuscript presents and discusses the methodological framework of the ImpPeer‐Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed‐methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. Discussion and Practical Implications: The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. Patient and Public Contribution: The research team of the ImpPeer‐Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation. [ABSTRACT FROM AUTHOR]

Objective: Non‐suicidal self‐injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self‐punishment. Although characterizing moment‐to‐moment associations between shame and NSSI in individuals' real‐world environment and partitioning between‐ and within‐person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. Method: In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. Results: We found that greater between‐person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within‐person increases in NSSI were linked to increased anger at self over and beyond between‐person average levels of NSSI. Conclusions: These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth. [ABSTRACT FROM AUTHOR]

Aims: To determine the impact of a multi‐component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community. Method: A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science), grey literature and reference lists of relevant studies in December 2021– January 2022 and again between January 2023 and February 2023 when no additional new studies were identified. Key inclusion criteria were studies with female older adults above the age of 60, with any type of UI, residing in the community, addressing the effects of a multi‐component exercise intervention combining pelvic floor muscle training (PFMT), strength and balance exercises. The primary outcome of interest was the cure rate of UI in community‐dwelling older women (%). Studies underwent quality appraisal using the RevMan Risk of Bias tool and the Evidence‐based Librarianship tool, identifying significant biases. A narrative synthesis presents results for all outcomes; a meta‐analysis was also performed for secondary outcomes. Results: Following the PRISMA 2020 guidelines, a total of 596 records were identified from the systematic search. Five studies met the inclusion criteria. Participants receiving the intervention had a statistically significant mean cure rate of 44.0% (p < 0.05), which decreased at follow‐up, except for participants with stress UI. Participants receiving the intervention had significantly decreased frequency of UI episodes (p < 0.00001) and increased maximum walking speed (p < 0.0003) at a 3‐month follow‐up. Conclusion: A multi‐component exercise, combining PFMT, strength and balance exercises, is effective in improving and curing UI, especially stress UI, in community‐dwelling older women. [ABSTRACT FROM AUTHOR]

A collection of isolates of the fungi Leptosphaeria maculans and L. biglobosa, which cause blackleg disease on Brassica napus (canola/oilseed rape) and other Brassicaceae species, was assembled to represent the global diversity of these pathogens and a resource for international research. The collection consists of 226 isolates (205 L. maculans and 21 L. biglobosa) from 11 countries. The genomes of all 205 L. maculans isolates were sequenced, and the distribution and identity of avirulence gene alleles were determined based on genotypic information and phenotypic reactions on B. napus lines that hosted specific resistance genes. Whilst the frequencies of some avirulence alleles were consistent across each of the regions, others differed dramatically, potentially reflecting the canola/oilseed rape cultivars grown in those countries. Analyses of the single‐nucleotide polymorphism (SNP) diversity within these L. maculans isolates revealed geographical separation of the populations. This "open access" resource provides a standardized set of isolates that can be used to define the basis for how these fungal pathogens cause disease, and as a tool for discovery of new resistance traits in Brassica species. [ABSTRACT FROM AUTHOR]

Grasslands are one of the most endangered and degraded ecosystems globally. Switches in disturbance type can restore grassland function and improve conservation outcomes for fauna, but land‐use legacies can limit the capacity of biota to respond positively to shifts in disturbance type, making it difficult to predict ecological outcomes. In semi‐arid grasslands of South‐Eastern Australia, habitat for grassland birds is managed using livestock grazing, a practice that has continued for >150 years. It is unknown if outcomes for birds can be improved by a switch in disturbance type as alternatives to livestock grazing have not been explored. We compare the effects of status‐quo livestock grazing with alternative biomass management tools (no management, 'crash' grazing, planned fire) on birds, vegetation structure, and food resources using a BACI design across 3 years (2017–2019). We found crash grazing and fire produced more open, shorter grassy swards, with less exotic grass cover, compared to status‐quo grazing or disturbance exclusion. Preferred habitat structure for the critically endangered plains‐wanderer (Pedionomus torquatus) was maximized by status‐quo grazing. Grassland birds responded in opposing ways to a disturbance switch. Brown songlarks (Megalurus cruralis) and Horsfield's bushlarks (Mirafra javanica) responded positively to disturbance exclusion, while stubble quail (Coturnix pectoralis) responded negatively to crash grazing. Australasian pipits (Anthus novaeseelandiae) were more frequent in response to status‐quo grazing. Our findings suggest that multiple disturbance types should be used if the aim is to promote the spectrum of vegetation structures and food sources required to support a diverse grassland bird community in semi‐arid grasslands of Australia. [ABSTRACT FROM AUTHOR]

Aim. This systematic review aimed to synthesise the relationship between transformational leadership style and staff nurse retention in hospital settings. Background. It is known that globally there is a shortage of nurses. Thus, nurse retention and organisational commitment have never been more critical. Nurse managers are responsible for staff retention. Therefore, nurse managers could reduce staff turnover by adopting the "right leadership style." Methods. Systematic review, following the guidance of PRISMA. Databases CINAHL, MEDLINE, PubMed, PsychInfo, Cochrane Central Register, and Embase were searched between 27th December 2021 and 22nd June 2023 to find relevant publications. Relevant studies were hand searched in January 2022 and June 2023 to source further potential evidence. A total of twelve articles were retrieved. Results. Twelve studies were included in this review, including six cross-sectional studies, two correlational studies, two cross-sectional correlational studies, and two surveys. In relation to retention, the primary outcome, data from eleven of the twelve studies reported statistical significance favouring transformational leadership improving staff retention. One study reported a statistically nonsignificant improvement in retention. Conclusion. There is evidence to suggest that transformational leadership may have a positive and significant relationship with staff nurse retention, job satisfaction, and quality of care. Implications for Nursing Management. Nurse managers should attend leadership and management training programs. This will allow them to understand and practice transformational leadership which may have a positive connection with staff nurse retention. [ABSTRACT FROM AUTHOR]

Tropical convection that overshoots the cold point tropopause can impact the climate by directly influencing water vapor, temperatures, and thin cirrus in the upper troposphere‐lower stratosphere (UTLS) region. The distribution of cold point overshoots between land and ocean may help determine how the overshoots will affect the UTLS in a changing climate. Using 4 years of satellite and reanalysis data, we test a brightness temperature proxy calibrated by radar/lidar data to identify cold point‐overshooting convection across the global tropics. We find evidence of cold point‐overshooting convection throughout the tropics, though other cirrus above the cold point cover an area 100 times larger than overshooting tops. Cold point‐overshooting convection occurs 30%–40% more often over convectively active land areas than over the warmest oceans. This proxy can be generalized to evaluate the fidelity of cold point overshoots simulated by storm‐resolving models. Plain Language Summary: Extremely deep convection in the tropics that overshoots the cold point, the coldest temperature level between the upper troposphere and lower stratosphere, influences the vertical temperature structure of this region and water vapor in the lower stratosphere, where it acts as a greenhouse gas. Overshooting cloud tops appear "cold" in infrared satellite imagery, so they can be identified from the difference between their brightness temperature and the nearby cold point temperature. We calibrate this brightness temperature proxy using satellite measurements of cloud ice. Cold point overshoots occur almost as often over the warmest oceans as over moist tropical land areas. Overshooting tops comprise only 1% of satellite‐detectable cloud above the cold point, most of which is very thin ice cloud. Our proxy can be used as a real‐world observational test of cold point overshoots simulated by the most realistic global atmospheric models, which resolve individual thunderstorm systems. Key Points: We identify likely tropical cold point overshoots using a radar/lidar calibrated cold point‐relative brightness temperature proxyIn a 4‐year climatology, cold point overshoots only modestly favor convectively active land areas over the Indo‐Pacific warm poolThin cirrus above the cold point covers over 100‐fold more tropical area than cold point overshoots [ABSTRACT FROM AUTHOR]

Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of existing publications exploring the prevalence of CVD among health care workers was conducted in July 2022. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were used. A total of 15 papers met the inclusion criteria and these formed the basis of the review. Among health care workers, the mean prevalence of CVD was 58.5% and the mean prevalence for varicose veins was 22.1%. There is an increased prevalence of CVD in health care workers when compared with the general population. Therefore, there is a need for early diagnosis and the use of preventative measures to protect health care workers from CVD and varicose vein development. [ABSTRACT FROM AUTHOR]

Introduction: Predictors of neurodevelopment among children who are HIV‐exposed uninfected (CHEU) are poorly understood. Methods: Mothers with and without HIV and their children were enrolled during 6‐week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1‐year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site. Results: At 1‐year evaluation, CHEU (n = 709) and children who are HIV‐unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate‐to‐severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: −1.38, 95% CI: −2.05, −0.71), food insecurity was associated with lower social scores (adjusted coeff: −0.37, 95% CI: −0.73, −0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: −0.76, 95% CI: −1.40, −0.13) and gross motor scores (adjusted coeff: −1.07, 95% CI: −1.81, −0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: −0.51, 95% CI: −1.01, −0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: −0.45, 95% CI: −0.87, −0.03) or a deceased or absent father (adjusted coeff: −0.81, 95% CI: −1.58, −0.05), respectively. Conclusions: Biologic and social factors were associated with child neurodevelopment. Despite socio‐demographic differences between CHEU and CHUU, 1‐year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU. [ABSTRACT FROM AUTHOR]

Summary: Since its first description by Evans in 1951, this syndrome has been linked to chronic immune thrombocytopenia with the concurrent or delayed onset of autoimmune haemolytic anaemia or neutropenia. For decades, the evolution of Evans syndrome (ES) has carried a poor prognosis and often resulted in chronic steroid exposure, multiple immune suppressing medications directed against T or B lymphocytes, and splenectomy. This paper presents a new view of ES based on recent advances in genomics which begin to classify patients based on their underlying molecular variants in previously described primary immune disorders. This has opened up new avenues of targeted therapy or bone marrow transplant at rather than broad long‐term immune suppression or splenectomy. Importantly, recent studies of the full lifespan of ES suggest that at least 80% of those paediatric patients will progress to various clinical or biological immunopathological manifestations with age despite the resolution of their cytopenias. Those patients merit long‐term follow‐up and monitoring in dedicated transition programs to improve outcome at the adult age. [ABSTRACT FROM AUTHOR]

Introduction: Head and neck cancer (HNC) is the eighth most common cancer in the United Kingdom. Survival rates improve when the cancer is diagnosed at an early stage, highlighting a key need to identify at‐risk patients. This study aimed to explore opportunistic HNC identification and referral by community pharmacists (CPs) using a symptom‐based risk assessment calculator, from the perspective of patients with a diagnosis of HNC. Methods: Purposive sampling was used to recruit patients from the HNC pathway in three large teaching hospitals in Northern England. Qualitative methodology was used to collect data through an iterative series of semistructured telephone interviews. Framework analysis was utilised to identify key themes. Results: Four main themes were constructed through the analytic process: (1) HNC presentation and seeking help; (2) the role of the CP; (3) public perception of HNC and (4) the role of a symptom‐based risk calculator. Participants agreed that CPs could play a role in the identification and referral of suspected HNCs, but there were concerns about access as patients frequently only encounter the medicine counter assistant when they visit the pharmacy. HNC symptoms are frequently attributed to common or minor conditions initially and therefore considered not urgent, leading to delays in seeking help. While there is public promotion for some cancers, there is little known about HNC. Early presentation of HNC can be quite variable, therefore raising awareness would help. The use of a symptom‐based risk calculator was considered beneficial if it enabled earlier referral and diagnosis. Participants suggested that it would also be useful if the public were made aware of it and could self‐assess their symptoms. Conclusion: In principle, CPs could play a role in the identification and referral of HNC, but there was uncertainty as to how the intervention would work. Future research is needed to develop an intervention that would facilitate earlier identification and referral of HNC while not disrupting CP work and that would promote HNC and the risk calculator more widely. Patient or Public Contribution: Patient and public involvement and engagement (PPIE) was integrated throughout the project. Initially, the proposal was discussed during a Cancer Head and Neck Group Experience (CHANGE) PPIE meeting. CHANGE was set up to support HNC research in 2018. The group is composed of seven members (four female, three male) with an age range of 50–71 years, who were diagnosed at Sunderland Royal Hospital. A patient representative from the University of Sunderland PPIE group and a trustee of the Northern HNC Charity were recruited as co‐applicants. They attended project management group meetings and reviewed patient‐facing documentation. [ABSTRACT FROM AUTHOR]

Environmental variation is increasingly recognized as an important driver of diversity in marine species despite the lack of physical barriers to dispersal and the presence of pelagic stages in many taxa. A robust understanding of the genomic and ecological processes involved in structuring populations is lacking for most marine species, often hindering management and conservation action. Cunner (Tautogolabrus adspersus) is a temperate reef fish with both pelagic early life‐history stages and strong site‐associated homing as adults; the species is also of interest for use as a cleaner fish in salmonid aquaculture in Atlantic Canada. We aimed to characterize genomic and geographic differentiation of cunner in the Northwest Atlantic. To achieve this, a chromosome‐level genome assembly for cunner was produced and used to characterize spatial population structure throughout Atlantic Canada using whole‐genome sequencing. The genome assembly spanned 0.72 Gbp and 24 chromosomes; whole‐genome sequencing of 803 individuals from 20 locations from Newfoundland to New Jersey identified approximately 11 million genetic variants. Principal component analysis revealed four regional Atlantic Canadian groups. Pairwise FST and selection scans revealed signals of differentiation and selection at discrete genomic regions, including adjacent peaks on chromosome 10 across multiple pairwise comparisons (i.e. FST 0.5–0.75). Redundancy analysis suggested association of environmental variables related to benthic temperature and oxygen range with genomic structure. Results suggest regional scale diversity in this temperate reef fish and can directly inform the collection and translocation of cunner for aquaculture applications and the conservation of wild populations throughout the Northwest Atlantic. [ABSTRACT FROM AUTHOR]

Lumpfish, Cyclopterus lumpus, have historically been harvested throughout Atlantic Canada and are increasingly in demand as a solution to controlling sea lice in Atlantic salmon farms—a process which involves both the domestication and the transfer of lumpfish between geographic regions. At present, little is known regarding population structure and diversity of wild lumpfish in Atlantic Canada, limiting attempts to assess the potential impacts of escaped lumpfish individuals from salmon pens on currently at‐risk wild populations. Here, we characterize the spatial population structure and genomic‐environmental associations of wild populations of lumpfish throughout the Northwest Atlantic using both 70K SNP array data and whole‐genome re‐sequencing data (WGS). At broad spatial scales, our results reveal a large environmentally associated genetic break between the southern populations (Gulf of Maine and Bay of Fundy) and northern populations (Newfoundland and the Gulf of St. Lawrence), linked to variation in ocean temperature and ice cover. At finer spatial scales, evidence of population structure was also evident in a distinct coastal group in Newfoundland and significant isolation by distance across the northern region. Both evidence of consistent environmental associations and elevated genome‐wide variation in FST values among these three regional groups supports their biological relevance. This study represents the first extensive description of population structure of lumpfish in Atlantic Canada, revealing evidence of broad and fine geographic scale environmentally associated genomic diversity. Our results will facilitate the commercial use of lumpfish as a cleaner fish in Atlantic salmon aquaculture, the identification of lumpfish escapees, and the delineation of conservation units of this at‐risk species throughout Atlantic Canada. [ABSTRACT FROM AUTHOR]

Summary: Despite efforts to curb the rise in Mexico's child and adolescent overweight and obesity rates, prevalence in Mexico has grown by 120% since 1990 to 43.3% in 2022. This investment case identifies policies that will produce the largest returns for Mexico. The investment case model builds beyond a cost‐of‐illness analysis by predicting the health and societal economic impact of implementing child and adolescent overweight and obesity interventions in a cohort aged 0–19 from 2025 to 2090. The Markov model's impacts include healthcare expenditures, years of life lost, and reduced wages and productivity. We projected and compared costs in a status quo scenario to an intervention scenario to estimate cost savings and calculate return‐on‐investment (ROI). Total lifetime health and economic costs amount to USD 1.8 trillion—USD 30 billion on average per year. Implementing five interventions can reduce lifetime costs by approximately 7%. Each intervention has a low cost per disability‐adjusted life year averted over 30‐year, 50‐year, and lifetime horizons. The findings demonstrate that a package of interventions mitigating child and adolescent overweight and obesity offers a strong ROI. The novel investment case methods should be applied to other countries, particularly low‐ and middle‐income countries. [ABSTRACT FROM AUTHOR]

Objective: Assess how historical fragmentation in the form of perched culverts impacts Brook Trout Salvelinus fontinalis genetic diversity and differentiation in the Beebe River watershed (central New Hampshire), the site of a major culvert removal project in 2017. Methods: We collected genetic samples from Brook Trout one year prior to (2016), and two years following (2018 and 2019) culvert removal from six tributaries in the watershed. We used two analytical approaches, STRUCTURE and discriminant analysis of principal components, to determine the degree to which admixture was occurring and the levels of genetic diversity in the sampled populations. We also compared pairwise FST values to measure the genetic differentiation between tributaries. Result: The analysis revealed that the tributaries with impassable culverts (GR1, GR3, and GR5) exhibited a distinct genetic cluster, indicating genetic homogeneity. In contrast, the tributaries without barriers (GR2, ECR1, and GR4) showed a mixture of individuals assigned to multiple genetic clusters, indicating genetic admixture and high diversity. Culvert outlet drop heights correlated with the level of genetic differentiation and diversity. Culvert replacement did not immediately result in significant changes in the genetic composition of the Brook Trout populations. Fish in tributaries with culverts remained genetically distinct from those in other tributaries even two years after culvert removal. Conclusion: The study demonstrates that historical fragmentation caused by culverts has influenced the population genetic structure of Brook Trout in the Beebe River watershed. Culvert replacement did not lead to immediate changes in genetic composition, suggesting that other factors, such as prespawning behavior and geomorphological disturbances, may have limited fish movement and spawning after culvert removal. The findings highlight the importance of considering the specific characteristics of culverts and their interactions with habitat conditions in assessing their impacts on genetic connectivity. Impact statementOur study took advantage of a unique opportunity to assess the popuation level response of Brook Trout to barrier removal. Our findings highlight the importance of monitoring postrestoration to gain insight into the timing and degree of response by different species. [ABSTRACT FROM AUTHOR]

Background: We characterized prescription opioid medication use up to 2 years following the head and neck cancer (HNC) diagnosis and examined associations with moderate or high daily opioid prescription dose. Methods: Using administrative data from Veterans Health Administration, we conducted a retrospective cohort analysis of 5522 Veterans treated for cancers of the upper aerodigestive tract between 2012 and 2019. Data included cancer diagnosis and treatments, pain severity, prescription opioid characteristics, demographics, and other clinical factors. Results: Two years post‐HNC, 7.8% (n = 428) were receiving moderate or high‐dose opioid therapy. Patients with at least moderate pain (18%, n = 996) had 2.48 times higher odds (95% CI = 1.94–3.09, p < 0.001) to be prescribed a moderate opioid dose or higher at 2 years post diagnosis. Conclusions: Survivors of HNC with at least moderate pain were at elevated risk of continued use of moderate and high dose opioids. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149 at risk acute hospital patients took part, 78 treatment, and 71 control. SEM deltas were recorded daily for a maximum of 5 days using the SEM Scanner (Bruin Biometrics LLC, Los Angeles, California), on three sites: the sacrum, the right heel, and the left heel, with enhanced and targeted PU prevention interventions occurring in those with an elevated SEM delta scores in the treatment group. Intention to treat analysis was used to guide the final composition of results. SEM PU represents PU development as identified by 2 days of sustained abnormal SEM delta scores, ≥0.5, after day one. The mean number of days completed by participants was just under 4 days, participants had many different comorbidities, with the most common being: hypertension, cancer, and chronic obstructive pulmonary disease. Results showed that following the introduction of SEM guided targeted treatments, participants in the treatment group yielded a statistically significant reduction in mean SEM delta scores (MD: 0.49; 95% CI: 0.59, 0.39; P <.0001), and in the odds of developing a SEM PU (OR: 0.59, 95% CI: 0.24 to 1.00; P =.05). In the treatment group, none of the participants developed a visual PU, whereas, in the control group, 1.41% (n = 1/71) developed a visual PU. Based on all the results, the following is concluded, (1). There was a greater reduction in mean SEM delta scores among those cared for using SEM measurement and targeted PU prevention, versus those cared for using visual skin assessment and usual care, and (2). the mean SEM delta scores was statistically significantly lower at the study end for those who received targeted treatments based on abnormal SEM scores. More research is now needed in other and larger at‐risk groups to further validate what was found in this study. [ABSTRACT FROM AUTHOR]

Background: EM has been hypothesized to help prevent the development of ICU acquired weakness and may therefore result in positive outcomes for ICU patients. Aim: To establish the impact of Early mobilisation (EM) on adult Intensive Care Unit (ICU) patients in terms of ICU length of stay (LOS), as well as hospital LOS, duration of mechanical ventilation, mortality, and functional independence. Study design: A Systematic Review. EMBASE, MEDLINE, CINAHL, and the Cochrane Library were searched on 24th November 2020. Included studies and other systematic reviews were hand‐searched for further includable studies. The primary outcome was ICU LOS whilst secondary outcomes were duration of MV, mortality, hospital LOS and functional independence. The PRISMA guidelines were utilized to perform the review. Ten randomized controlled trials with a combined total of 1291 patients met inclusion criteria and were scrutinized using the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews. Revman 5.4.1 was used to conduct meta‐analysis were possible. Results: Results were limited by the evidence available for inclusion, in particular small sample sizes. However, a trend towards a shorter duration of ICU LOS and duration of mechanical ventilation emerged. There was also a trend towards higher rates of functional independence for intervention groups. Mortality rates appeared unaffected and results of meta‐analysis were statistically non‐significant (p = 0.90). Conclusion: By applying a stricter time limit than previous systematic reviews a trend emerged that the commencement of EM has a positive effect on patient outcomes, in particular ICU LOS. Relevance to clinical practice: The evidence base surrounding EM remains poor; however on the balance of the available evidence the application of EM should not be delayed. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnoea (OSA) occurs in 15–20% of pregnant women living with obesity. As global obesity prevalence increases, OSA in pregnancy is concurrently increasing, yet remains under‐diagnosed. The effects of treating OSA in pregnancy are under‐investigated. Aim: A systematic review was conducted to determine whether treating pregnant women with OSA using continuous positive airway pressure (CPAP) will improve maternal or fetal outcomes, compared with no treatment or delayed treatment. Materials and Methods: Original studies in English published until May 2022 were included. Searches were conducted in Medline, PubMed, Scopus, the Cochrane Library and clinicaltrials.org. Maternal and neonatal outcome data were extracted, and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach (PROSPERO registration: CRD42019127754). Results: Seven trials met inclusion criteria. Use of CPAP in pregnancy appears to be well tolerated with reasonable adherence. Use of CPAP in pregnancy may be associated with both a reduction in blood pressure and pre‐eclampsia. Birthweight may be increased by maternal CPAP treatment, and preterm birth may be reduced by treatment with CPAP in pregnancy. Conclusion: Treatment of OSA with CPAP in pregnancy may reduce hypertension and, preterm birth, and may increase neonatal birthweight. However, more rigorous definitive trial evidence is required to adequately assess the indication, efficacy, and applications of CPAP treatment in pregnancy. [ABSTRACT FROM AUTHOR]

The negative genetic impacts of gene flow from domestic to wild populations can be dependent on the degree of domestication and exacerbated by the magnitude of pre‐existing genetic differences between wild populations and the domestication source. Recent evidence of European ancestry within North American aquaculture Atlantic salmon (Salmo salar) has elevated the potential impact of escaped farmed salmon on often at‐risk wild North American salmon populations. Here, we compare the ability of single nucleotide polymorphism (SNP) and microsatellite (SSR) marker panels of different sizes (7‐SSR, 100‐SSR and 220K‐SNP) to detect introgression of European genetic information into North American wild and aquaculture populations. Linear regression comparing admixture predictions for a set of individuals common to the three datasets showed that the 100‐SSR panel and 7‐SSR panels replicated the full 220K‐SNP‐based admixture estimates with low accuracy (r2 of .64 and .49, respectively). Additional tests explored the effects of individual sample size and marker number, which revealed that ~300 randomly selected SNPs could replicate the 220K‐SNP admixture predictions with greater than 95% fidelity. We designed a custom SNP panel (301‐SNP) for European admixture detection in future monitoring work and then developed and tested a python package, salmoneuadmix (https://github.com/CNuge/SalmonEuAdmix), which uses a deep neural network to make de novo estimates of individuals' European admixture proportion without the need to conduct complete admixture analysis utilizing baseline samples. The results demonstrate the mobilization of targeted SNP panels and machine learning in support of at‐risk species conservation and management. [ABSTRACT FROM AUTHOR]

Introduction: More than 52.4% of people with a lower extremity amputation (PLEA) will fall at least once each year. Previously established standardized scales that evaluate a concern for falling (CFF) were developed primarily among community‐dwelling older adults. The reliability of commonly used scales to evaluate a CFF among PLEA is needed. Objective: To evaluate test‐retest relative and absolute reliability, and agreement of the Modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), Falls Efficacy Scale ‐ International (FES‐I), Consequences of Falling (COF) Scale, Perceived Control Over Falling (PCOF) Scale, and Perceived Ability to Manage Falls (PAMF) Scale among PLEA. Design: Web‐based cross‐sectional repeated‐measures study. Setting: Rehabilitation hospital. Participants: Adults with a transtibial or transfemoral level amputation, who had completed a prosthetic rehabilitation program, and at minimum of 1 year using a prosthesis for ambulation were recruited after regularly scheduled appointments (N = 22, mean age ± SD, 63.5 ± 12.9 years). Interventions: Not applicable. Main Outcome Measure(s): Initial and re‐test scores on the mSAFFE, FES‐I, COF, PCOF, and PAMF. Results: Intraclass correlation coefficients (ICCs) demonstrated excellent relative reliability of the mSAFFE (ICC = 0.92, 95% confidence interval [CI]: 0.82‐0.97), good relative reliability of the FES‐I (ICC = 0.87, 95% CI: 0.70‐0.94), and fair relative reliability of the COF (ICC = 0.78, 95% CI: 0.53‐0.90) and PAMF (ICC = 0.73, 95% CI: 0.46‐0.88) scales. The ICC value of the PCOF scale could not be validly calculated and was not further analyzed. Calculated standard error of measurement values for the mSAFFE, FES‐I, COF, and PAMF scales were small in magnitude, and Bland‐Altman graphs demonstrated good agreement of initial and re‐test scores for all scales. Conclusion: This study provides initial evidence on the suitability and reliable use of the mSAFFE, FES‐I, COF, and PAMF scales within this population. Further evaluation of the validity of these scales is needed. [ABSTRACT FROM AUTHOR]

Background: Lower urinary tract injury (LUTI) is a serious complication of major gynaecologic surgery. Although intra‐operative cystoscopy can facilitate timely diagnosis and treatment of LUTI, the optimal approach to cystoscopy at the time of benign hysterectomy remains debatable. Aims: To assess whether implementation of a policy of universal cystoscopy at the time of benign hysterectomy was associated with a difference in intra‐operative detection and rates of LUTI. Materials and Methods: Retrospective cohort study at a large regional teaching hospital where a policy of universal cystoscopy at the time of benign hysterectomy was implemented on 30 September 2019. Hysterectomies performed from 1 November 2016 to 31 March 2021 were included and categorised into the 'pre‐policy' and 'post‐policy' groups. Primary outcomes included the intra‐operative detection and overall rates of LUTI. Secondary outcome was the policy adherence rate. Multivariate analysis was used to examine the effect of this policy on the outcomes. Results: There were 584 hysterectomies identified, including 325 in the pre‐policy group and 259 in the post‐policy group. Cystoscopy was performed in 55.1% in the pre‐policy group and 97.7% in the post‐policy group (P < 0.01). Adjusted for age, indication and route of hysterectomy, there were no significant differences in the intra‐operative cystoscopic detection of LUTI (42.9% vs 25.0%, P = 0.55) or the rate of LUTI (2.2% vs 1.5%, P = 0.25) after implementation of the policy. Conclusions: The practice of universal cystoscopy at the time of benign hysterectomy has not been associated with a significant change in the intra‐operative detection and rates of LUTI at our institution. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) affects 1 in 20 reproductive‐aged women and is associated with cardiovascular disease morbidity and mortality. The pathophysiology linking PTSD to cardiovascular disease in nonpregnant adults is proposed to include hypothalamic and autonomic dysregulation; however, the pathways explaining this association in pregnancy are unclear. We examined diurnal cortisol and ambulatory blood pressure (BP) among 254 pregnant women at approximately 12 and 32 gestational weeks. Participants were, on average, 31 years old (SD = 5), 24.4% reported their ethnicity as Hispanic, and 62.2% reported their race as White. PTSD symptoms were measured using the PTSD Checklist for DSM‐5 (PCL‐5). Hierarchical linear regression analyses were performed to examine associations pregnancy between PTSD and cortisol at awakening, 30 min after awakening, and bedtime in early and late pregnancy, as well as associations between PTSD symptoms and daytime and nighttime systolic (SBP) and diastolic BP (DBP) and BP variability. Logistic regression analyses were conducted to test associations between PTSD symptoms and BP dipping. The results showed a positive association between PTSD symptoms and nighttime BP and BP variability at 32 gestational weeks, ∆R2 =.036–.067. PTSD symptoms were negatively associated with awakening cortisol at 12 gestational weeks in unadjusted models. These findings contribute to understanding the associations between PTSD and adverse cardiovascular conditions in pregnancy. More research is needed to replicate these findings and examine whether PTSD interventions are effective at modifying pathways and decreasing the risk for cardiovascular complications in pregnancy. [ABSTRACT FROM AUTHOR]

Background: Maternal preference for warm water immersion (WWI) and waterbirth is increasing, but adoption into obstetric guidelines and clinical practice remains limited. Concerns regarding safety and a paucity of evidence have been cited as reasons for the limited adoption and uptake. Aim: The aim was to investigate maternal and neonatal outcomes after WWI and/or waterbirth compared with land birth. Materials and methods: A prospective cohort study was conducted in an Australian public maternity hospital between 2019 and 2020. Maternal and neonatal outcomes for 1665 women who had a vaginal birth were studied. Primary outcome was admission to the neonatal unit (NNU). Secondary outcomes included neonatal antibiotic administration, maternal intrapartum fever, epidural use and perineal injury. Multivariate logistical regression analyses compared the outcomes between three groups: waterbirth, WWI only and land birth. Results: NNU admissions for a suspected infectious condition were significantly higher in the land birth group (P = 0.035). After accounting for labour duration, epidural use and previous birth mode, no significant difference was detected between groups in the odds of NNU admission (P = 0.167). No babies were admitted to NNU with water inhalation or drowning. Women birthing on land were more likely to be febrile (2 vs 0%; P = 0.007); obstetric anal sphincter injury and postpartum haemorrhage were similar between groups. Regional analgesia use was significantly lower in the WWI group compared to the land birth group (21.02 vs 38.58%; P = <0.001). There was one cord avulsion in the waterbirth group (0.41%). Conclusion: Maternal and neonatal outcomes were similar between groups, with no increased risk evident in the waterbirth and WWI groups. [ABSTRACT FROM AUTHOR]

This meta‐review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR‐2 tool was used for quality appraisal and the certainty of the evidence was appraised using GRADEpro. Data analysis was undertaken using RevMan. We identified 12 systematic reviews published between 1997 and 2021. AMSTAR‐2 assessment identified three as high quality, five as moderate quality, and four as low quality. Seven comparisons were reported, with a meta‐analysis undertaken for five of these comparisons: compression vs no compression (risk ratio [RR]: 1.55; 95% confidence interval [CI] 1.34‐1.78; P <.00001; moderate‐certainty evidence); elastic compression vs inelastic compression (RR: 1.02; 95% CI: 0.96‐1.08; P <.61 moderate‐certainty evidence); four layer vs

In the United States, September marks the return to school, the start of fall, and National Suicide Prevention Awareness Month. Throughout the month, there is a public health push for dissemination of suicide prevention strategies for adolescents, as it is well‐established that suicide is one of the leading causes of death in young people. Experts highlight the importance of safe‐handling protocols for lethal means like gun locks and prescription blister packs, accessible health insurance plans that provide mental health care, increased support for national suicide prevention lifelines and text lines, calls for the overhauls of the juvenile justice and foster care systems... the list goes on. Yet, one topic that we may forget about when talking about suicide and adolescent mental health is access to reproductive and family planning services, including abortions. [ABSTRACT FROM AUTHOR]