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Introduction Methods and Results Conclusion It remains unclear if pacing induced cardiomyopathy (PICM) may be minimized by standard pacing of the right ventricle (RV) at sites other than the RV apex. The purpose of this study is to compare the relative frequency of PICM in a population of patients paced at either the superficial RV mid septum (RVMS) or RV apex (RVA), and other outcomes that may differ between these sites.A retrospective evaluation was performed on all patients undergoing pacemaker implantation between 2011 and 2022. Potential study patients were those with Medtronic 3830 superficial RVMS leads placed with septal specific guidance catheters, and any with RVA leads. Patients were included if they had ≥20% RV pacing, available baseline and follow‐up measurements of left ventricular ejection fraction (LVEF) at least 6 months postimplantation, and a baseline LVEF ≥50%. PICM was defined as a decline in the LVEF of at least 10%, resulting in LVEF <50%. Patients were excluded for Biventricular devices, and for alternative causes of cardiomyopathy. The study criteria were met in 324 patients, with 220 RVMS and 104 RVA paced patients. PICM occurred in 4.5% of RVMS patients, and 22.1% of RVA patients (p < .001). Additional differences were demonstrated in paced QRS duration (144 ± 15.5 ms in RVMS, 166 ± 19.4 ms in RVA; p < .001); QRS axis (2.3 ± 64.9 in RVMS, −65.2 ± 49.5 in RVA; p < .001), and various qualitative QRS morphologic characteristics.Patients with normal LVEF experienced significantly less PICM with superficial RVMS pacing performed via septal specific guidance catheters than similar counterparts with RVA pacing. Narrower paced QRS duration and less left axis deviation was also demonstrated. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3–18 using a diotic and antiphasic digits‐in‐noise (DIN) tablet‐based test using existing adult cut‐off criteria. Methods: A blinded multi‐institutional prospective cohort of 64 children aged 3–18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same‐day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same‐phased stimuli) and antiphasic (out‐of‐phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over‐the‐ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult "cut off criteria." Results: A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p‐value of.753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p‐value of.373. Otologic pathology and age were not predictive of outcome. Conclusion: This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3–18 when using the adult cut‐off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut‐off values. [ABSTRACT FROM AUTHOR]

The across‐shore transport of meroplanktonic larvae is predominantly driven by coastal physical processes, resulting in episodic recruitment of benthic species. Historically, due to the sampling challenges associated with resolving these advective mechanisms across the continental shelf, relevant components of larval transport have been difficult to isolate and understand. We use three‐dimensional temperature and velocity data from an array of 29 moorings to identify fundamental physical processes that could have generated successful across‐shore transport and settlement of meroplankton. The dense spatial and temporal sampling from this array allows us to use Lagrangian particle tracking to estimate the influences of wind conditions and the internal tide on the across‐shore transport of planktonic larvae. Settlement was found to be episodic at all depths studied. Above mid‐water, modeled larvae were successfully transported onshore by the internal tide during wind relaxations. Surprisingly, abundant pulses of shallow‐water larvae were supplied to the coast on occasions when strong, upwelling‐favorable winds (> 4 m s−1) drove offshore‐flowing surface waters, revealing a complex, potentially topographically influenced flow. These intense upwelling‐favorable winds also contributed to subsurface onshore flows that created large pulses of larval settlement in deeper waters (> 20 m). Our analyses from this highly resolved data set provide novel insights into the interactions of physical drivers in creating episodic pulses of coastal larval recruitment. [ABSTRACT FROM AUTHOR]

Annual bluegrass (Poa annua L.) and creeping bentgrass (Agrostis stolonifera L.) commonly coexist in turfgrass ecosystems but differ in drought tolerance, contributing to uneven turf quality. This study was conducted to examine the physiological and metabolic responses of P. annua and A. stolonifera to drought stress and rewatering and identify major metabolites associated with the interspecific variation in drought tolerance and recovery. Plants grown in controlled‐environment chambers were well irrigated (non‐stress control) or subjected to drought stress by withholding irrigation for 21 days. For the evaluation of post‐stress recovery, drought‐stressed plants were rewatered for an additional 21 days. Leaf relative water content, visual turf quality, green canopy cover, and leaf electrolyte leakage were measured weekly. Metabolomic analysis was performed with leaf tissue collected at 21 days of drought stress and 21 days of rewatering. Poa annua demonstrated lower drought tolerance and post‐stress recovery compared to A. stolonifera when drought‐stressed plants were compared to their respective control across physiological parameters. Metabolomic analysis identified a relatively greater upregulation of sugars and amino acids in A. stolonifera and downregulation of more carbon intermediates and nucleic acids in P. annua in response to drought stress. Upon rewatering, both species had declined sugar content and increased carbon intermediates and nucleic acids. The differential response to drought stress and recovery between A. stolonifera and P. annua could be attributed to a greater accumulation of sugars and amino acids involved in osmotic adjustment during drought stress and their utilization upon rewatering to stimulate post‐stress recovery in A. stolonifera. [ABSTRACT FROM AUTHOR]

COVID‐19 response offers a model to guide research and preventive interventions targeting adolescents, their families, and communities. My 2022 SRA Presidential Address posed: What if the COVID‐19 Response Served as a Guidepost for Future Research on Adolescence? Solution versus Problem‐Focused Agenda. Several “pandemics” were already underway, emerging from historic and contemporary events that threaten the safety and survival of human lives. The Multi‐Transgenerational Life Course Theoretical model was selected to demonstrate pathways through which the transmission of generational exposure to crisis and trauma impact adolescents' developmental trajectories. Recommendations to inform and guide an adolescent research rapid response agenda are proposed minds to advance equity and social justice can become realities. [ABSTRACT FROM AUTHOR]

While previous research has documented the unique aspects of Chinese dyslexia as compared to dyslexia in alphabetic scripts, it remains unclear whether the difference in Chinese literacy experiences influences the manifestation of Chinese dyslexia. The present article first reviews the characteristics of Chinese languages and scripts, including important cognitive‐linguistic correlates (rapid automatized naming, phonological, orthographic, and morphological awareness) of Chinese reading development and impairment. The diversity in Chinese literacy experiences of scripts, languages, and instructional practices, and consequently their impact on Chinese literacy acquisition across different Chinese societies are also reviewed. Using an equivalent Chinese assessment battery administered to 91 children with dyslexia from Hong Kong, Beijing, and Taipei, we examined the subtypes of Chinese dyslexia across these three societies concurrently. With the four cognitive‐linguistic skills included as the clustering variable, the hierarchical cluster analysis revealed four cognitive subtypes of dyslexia: 38% mild orthographic deficit subtype (OD), 33% phonological deficit subtype (PD), 18% morphological deficit subtype (MD), and 11% global deficit subtype (GD)—each with their own set of cognitive‐linguistic deficit profiles. Interestingly, all four subtypes of dyslexia manifested poorer orthographic skills as compared to the control group. Bayesian Analysis of Contingency Table further showed that the distribution of dyslexia subtypes remains similar across the three Chinese societies, suggesting invariance of the Chinese dyslexia construct. Findings highlight the importance of assessment in orthographic processing, rapid automatized naming, phonological awareness, and morphological awareness in order to understand Chinese dyslexia, both in a within and cross‐cultural Chinese perspective. [ABSTRACT FROM AUTHOR]

Despite recent breakthroughs in understanding how protein sequence relates to structure and function, considerably less attention has been paid to the general features of protein surfaces beyond those regions involved in binding and catalysis. This article provides a systematic survey of the universe of protein surfaces and quantifies the sizes, shapes, and curvatures of the positively/negatively charged and hydrophobic/hydrophilic surface patches as well as correlations between such patches. It then compares these statistics with the metrics characterizing nanoparticles functionalized with ligands terminated with positively and negatively charged ligands. These particles are of particular interest because they are also surface patchy and have been shown to exhibit both antibiotic and anticancer activities—via selective interactions against various cellular structures—prompting loose analogies to proteins. The analyses support such analogies in several respects (e.g., patterns of charged protrusions and hydrophobic niches similar to those observed in proteins), although there are also significant differences. Looking forward, this work provides a blueprint for the rational design of synthetic nano‐objects with further enhanced mimicry of proteins' surface properties. [ABSTRACT FROM AUTHOR]

Effective video resources are assumed to promote learner engagement, but the extent to which this occurs is unclear. This study examines learners' engagement with instructor‐generated video. It contributes an analytical synthesis of qualitative and quantitative data that provides the basis for investigating the extent to which, and how, learners engage with video resources provided in their courses. Specifically, three dimensions of learner engagement with video are studied: behavioural, cognitive and affective. The study contributes to educational technology research by identifying distinctive patterns of learner control over the use of video which diverges from instructors' assumptions. It shows the complex and nuanced features of cognitive and affective engagement. Videos can have positive effects, but inappropriate use of technical features results in learner disengagement. This study contributes a novel use of signalling theory, suggesting the importance of instructor signals concerning relevance, focus and utility as a feature of video generation, as a prerequisite of cognitive engagement. A research and theory development agenda is developed, locating video‐based learning in student contexts as a basis for explaining both engagement and disengagement with video technology affordances. Practitioner notesWhat is already known about this topic Higher education tutors are increasingly expected to generate video content as a feature of their course delivery.Although effective video resources are assumed to promote learner engagement, the extent to which this occurs is unclear.Video technology affordances rarely feature in academic professional development programmes leaving tutors ill‐equipped to understand how and in what ways students engage with video resources as a part of their courses.What this paper adds A novel use of signalling theory to explain different patterns of learner engagement and disengagement.Learner agency and control results in video technology affordances being fitted and 'flexed' around factors that instructors rarely consider in the video generation process.A new model to describe factors that affect student engagement with instructor‐generated video.Implications for practice and/or policy Raise awareness for instructors about patterns of student engagement with video technology affordances that affect learning experience and outcomes.Implement professional development programmes to equip instructors to design and generate video content that takes account of patterns of behavioural, cognitive and affective engagement and signals relevance, focus and utility.Develop clear policies regarding technical features of video generation to avoid learner disengagement. [ABSTRACT FROM AUTHOR]

Background: Prior work documented circadian rhythm impacts on efficacy and toxicity of cancer therapies. Methods: Secondary analysis of prospective, phase II trial of metastatic HNSCC randomized to nivolumab+/−SBRT. Used cutoffs of 1100 and 1630. Timing classified by first infusion or majority of SBRT (e.g., PM SBRT defined by two or three fractions after 1630). Results: Of 62 patients, there was no significant difference in median PFS between AM nivolumab (n = 7, 175 days), PM nivolumab (n = 21, 58 days), or Mid‐Day nivolumab (n = 34, 67 days; p = 0.8). There was no significant difference in median PFS with AM SBRT (n = 4, 78 days), PM SBRT (n = 13, 111 days), or Mid‐Day SBRT (n = 15, 63 days; p = 0.8). There was no significant difference in Grade 3–4 toxicity or ORR. Sensitivity analyses with other timepoints were negative. Conclusions: Further work may elucidate circadian impacts on select patients, tumors, and therapies; however, we found no significant effect in this study. [ABSTRACT FROM AUTHOR]

Background: Mental distress is on the rise for young people, and there are high levels of unmet need for support. Increasingly, young people are engaging with online mechanisms of support to avoid cost and wait times; however, online support does have its limitations. We surveyed young people, 15–30 years of age, in Aotearoa New Zealand to explore their views of digital support for mental health. The aim of this study was to find out from young people what they thought about various types of online support and perceived benefits and drawbacks. Methods: A cross‐sectional online survey promoted through social media advertising was used. Participants included anyone aged 15–30 years living in Aotearoa New Zealand. The survey ran for 10 weeks between February and May 2022. It included demographic questions and asked about (i) use of digital support for mental health; (ii) what digital support is best used for; (iii) best ways of publicising mental health supports to young people; and (iv) where they would choose to get information about mental health support. Questions were a mix of forced choice and free text. Participants could opt to take part in a follow‐up interview. Results: Surveys were completed by 1471 participants; two respondents participated in an interview. A total of 641 participants had used digital support before (44%). The most used forms of digital support were websites (n = 324) and watching videos (n = 260), although these were not necessarily rated as the most helpful. Alternatives that people most wanted to try were podcasts and phone or video consultations with a counsellor or therapist. Drawbacks of digital support included privacy concerns, technical issues, lack of quality and motivation requirements. Benefits included ease of access, anonymity and a non‐threatening starting point. Conclusions: Digital support has a place in mental health care, but strong sentiment was expressed in favour of real‐life support. It may also be worth investing in more innovative types of digital support such as online performing arts and podcasts. Patient or Public Contribution: A group of young people were recruited as co‐researchers, had input into survey design, data analysis and interpretation and are co‐authors (list of co‐authors). Survey respondents also included young people with lived experience who are members of the general public. [ABSTRACT FROM AUTHOR]

Fatherhood interventions have emerged as significant tools for strengthening father identity and parenting skills. Despite the growing evidence of the effectiveness and benefits of these interventions for fathers and their families, there are limited studies on fathers' and providers' perspectives and experiences with the implementation of father‐based interventions. To fill this gap, we explore the unique experiences of the Black and Latino programme staff and fathers in the implementation of the 24/7 Dad® intervention. Qualitative data were collected between October 2021 and February 2022 from all programme staff (n = 7) and selected Dad 24/7 fathers (n = 20) from the English (n = 10) and Spanish (n = 10) intervention groups. All programme staff completed a semi‐structured interview via phone and/or video conferencing. A qualitative descriptive approach was used for analysis. Average age of staff was 53 years; mean age of fathers was 43 years. Among staff, 43% were Black, and 57% were Latino. Fathers self‐identified as Black (30%) and Latino (70%). Three key staff themes were benefits to fathers, impact on fathers and facilitators, and ways to strengthen fatherhood interventions. Three key father themes were intervention benefits, intervention impact (what 'made it work') and ways to strengthen intervention services. Fathering is a key component in maintaining healthy families and communities. Fatherhood interventions have great potential for empowering fathers and strengthening families. Finding ways to a relational approach, allocating more time for robust participation and building on facilitators' experiences and assets can help strengthen the impact of fatherhood interventions. [ABSTRACT FROM AUTHOR]

Background: Whilst both mental illness comorbidity and the delivery of emergency surgery are commonplace in Australia, there is little evidence investigating any link between them. As such, this study examines the emergency surgical outcomes for patients with mental illness compared to other surgical patients within the Australian public surgical system. Methods: Retrospective cohort study involving adult emergency and elective surgical patients treated at three public hospitals in Sydney, Australia between 2018 and 2019. Patients were identified using ICD‐10 diagnosis codes, and grouped by those with decompensated mental illness, chronic depression, or those without mental illness. Outcome measures included those within the emergency department (ED), along with in‐hospital mortality and surgical outcomes. Results: Of 48 338 total patients, 31 890 (66.0%) had elective and 16 448 (34.0%) had emergency surgery. For patients with decompensated mental illness, only 228 (0.7%) had elective whilst 425 (2.6%) had emergency surgery. Their outcomes for this surgery type included being triaged significantly higher (Cat 1 or 2, 34% vs. 15%) and longer ED stays (8.3 vs. 6.6 h). They also had significantly more post‐operative complications (26% vs. 8%) and total days in hospital (33.8 vs. 8.5 days). There was no significant difference for in‐hospital mortality. Conclusion: Patients with mental illness are significantly more likely to have emergency surgery including presenting to the ED with more acute physical illness and to experience worse surgical outcomes compared to other surgical patients for every measure analyzed except mortality. There is considerable opportunity to further investigate how these differences might be improved. [ABSTRACT FROM AUTHOR]

Background: Prevention and early intervention of alcohol use disorder (AUD) is a public health priority, yet there are gaps in our understanding of how AUD emerges, which symptoms of AUD come first, and whether there are modifiable risk factors that forecast the development of the disorder. This study investigated potential early‐warning‐sign symptoms for the development of AUD. Methods: Data were from the RADAR study, a prospective cohort study of contemporary emerging adults across Australia (n = 565, mean age = 18.9, range = 18–21 at baseline, 48% female). Participants were interviewed five times across a 2.5‐year period. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) AUD criteria and diagnoses were assessed by clinical psychologists using the Structured Clinical Interview for DSM‐IV (SCID‐IV), modified to cover DSM‐5 criteria. Hazard analyses modeled the time from first alcoholic drink to the emergence of any AUD criteria and determined which first‐emergent AUD criteria were associated with a faster transition to disorder. Results: By the final time point, 54.8% of the sample had experienced at least one DSM‐5 AUD criterion and 26.1% met criteria for DSM‐5 AUD. The median time from first AUD criterion to a diagnosis of AUD was 4 years. Social problems from drinking (hazard ratio [HR] = 3.24, CI95 = 2.14, 4.92, p < 0.001), major role (HR = 2.53, CI95 = 1.58, 4.06, p < 0.001), and drinking larger amounts/for longer than intended (HR = 2.04, CI95 = 1.20, 3.46, p = 0.008) were first‐onset criteria associated with a faster transition to AUD. Conclusion: In the context of a prospective general population cohort study of the temporal development of AUD, alcohol‐related social problems, major role problems, and using more or for longer than intended are key risk factors that may be targeted for early intervention. [ABSTRACT FROM AUTHOR]

Children with pulmonary hypertension (PH) often demonstrate limited exercise capacity. Data support exercise as an effective nonpharmacologic intervention among adults with PH. However, data on exercise training in children and adolescents are limited, and characteristics of the optimal exercise program in pediatric PH have not been identified. Exercise programs may have multiple targets, including muscle deficits which are associated with exercise limitations in both adult and pediatric PH. Wearable accelerometer sensors measure physical activity volume and intensity in the naturalistic setting and can facilitate near continuous data transfer and bidirectional communication between patients and the study team when paired with informatics tools during exercise interventions. To address the knowledge gaps in exercise training in pediatric PH, we designed a prospective, single arm, nonrandomized pilot study to determine feasibility and preliminary estimates of efficacy of a 16‐week home exercise intervention, targeting lower extremity muscle mass and enriched by wearable mobile health technology. The exercIse Training in pulmONary hypertEnsion (iTONE) trial includes (1) semistructured exercise prescriptions tailored to the participant's baseline level of activity and access to resources; (2) interval goal setting fostering self‐efficacy; (3) real time monitoring of activity via wearable devices; (4) a digital platform enabling communication and feedback between participant and study team; (5) multiple avenues to assess participant safety. This pilot intervention will provide information on the digital infrastructure needed to conduct home‐based exercise interventions in PH and will generate important preliminary data on the effect of exercise interventions in youth with chronic cardiorespiratory conditions to power larger studies in the future. [ABSTRACT FROM AUTHOR]

Rapidly developing technological advances have raised new questions about what makes us uniquely human. As data and generative AI become more powerful, what does it mean to learn, teach, create, make meaning, and express ourselves, even as machines are trained to take care of these tasks for us? With youth, and in the context of literacy and media education, we embrace this moment to broaden our social imaginations. Our collaboration with journalists ages 14–25 from 2019 to 2023 has yielded a corpus of over 30 multimodal compositions constructed with and/or about AI reaching audiences in the millions. On the basis of these youth texts – produced within our participatory research at YR Media, a national STEAM learning center and platform for emerging BIPOC content creators – we developed the conceptual framework presented here: Humanizing Data Expression (HDE). The key role of expression in HDE distinguishes the human from the machine through the lens of storytelling. Analysis of this corpus (podcasts, web‐based interactives, videos, radio features, online posts, social media assets) revealed four literacy practices of YR Media authors as they made sense of AI: (1) contextualize: try out AI‐powered features, reveal how it works; (2) unveil authorship: introduce AI creators and processes; (3) grapple: explore tensions and paradoxes; (4) play: hack, mess with, outsmart, exaggerate AI. From these insights, we end with implications of HDE as a framework for learning and teaching AI literacy, including its potential for critically transforming data literacy practice and pedagogy across schools, teaching, and teacher education. [ABSTRACT FROM AUTHOR]

Background and aims: Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use. Design: Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states. Setting and participants: Adolescent‐parent dyads (n = 1927; adolescents in grade 7, age ≈13 years) were recruited from Australian schools during 2010/11 (Wave 1). Adolescents were surveyed annually until 2016/17 (n = 1503; age ≈19 years; Wave 7) and parents were surveyed annually until 2014/15 (Wave 5). Measurements Alcohol, tobacco, cannabis and 3,4‐methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3–7. Potential confounders were collected at Waves 1–6 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status. Findings Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5–7: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (<9%) adolescents transitioning out. More externalizing problems (odds ratio [OR] = 1.10; 99.6% confidence interval [CI] = 1.07–1.14), parental heavy episodic drinking (OR = 1.22; 99.6% CI = 1.07–1.40), parental illicit substance use (OR = 3.56; 99.6% CI = 1.43–8.86), peer alcohol use (OR = 5.68; 99.6% CI = 1.59–20.50) and peer smoking (OR = 4.18; 99.6% CI = 1.95–8.81) were associated with transitioning to polysubstance use. Conclusions: Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets. [ABSTRACT FROM AUTHOR]

Ongoing legislative responses to the impacts of the pandemic have prompted many countries to evaluate whether their bankruptcy systems remain fit for purpose. Moreover, the current climate highlights the importance of data‐driven policy, which the literature identifies as a deficiency of bankruptcy regimes. In Australia, the 2015 reform proposals to reduce the default discharge period from 3 years to 1 year are currently being revised amidst stakeholder concern about potential abuse and repeat bankrupts. Although an extensive body of literature exists on 'repeat filers' in the USA, there has been no equivalent study in Australia. Using our data of 153,526 bankruptcies between 2007 and 2021, we conducted a novel application of survival analysis to predict the probability of a repeat bankruptcy comparing business and non‐business groups. The results show that this probability peaked in both male and females with non‐business‐related administrations irrespective of client's age, employment and relationship status. These findings are important as they identify the prospects that certain bankrupt groups have higher rates of repeat bankruptcy, which can inform strategies to improve their survival rate. A significance of our study is the development of a high‐quality longitudinal dataset that facilitates the extension of the data models and allows easy updates about targeted questions involving bankruptcy‐related policy shifts and impacts on sub‐populations. This methodological approach will enable regulators and insolvency experts to address concerns of repeat bankruptcy to guide policy, evaluate reform and extend the evidence base in other jurisdictions. [ABSTRACT FROM AUTHOR]

Summary: Background: Early entry into nonparental care (NPC) and introduction to solid foods (ITS) have been linked to elevated weight, however, little research exists on the combined influence of these transitions on child weight over time. Objectives: Identify groups of children based on early NPC and ITS timing and examine whether NPC‐ITS groups differentially affect child weight over time. Method: Data were drawn from STRONG Kids2 (n = 468). Primary predictors include NPC (by 3M)‐ITS (< or ≥6M) groups; outcome variables include child weight‐for‐length/height z‐scores (WFL/WFHz) (3, 12, 18, and 24 months). Multilevel regression was used to examine the NPC‐ITS groups as predictors of child WFL/WFHz. Results: Six groups were identified: 27% Parental Care‐ITS before 6M, 31% Parental Care‐ITS after 6M, 12% Daycare‐ITS before 6M, 14% Daycare‐ITS after 6M, 10% Kincare‐ITS before 6M, and 7% Kincare‐ITS after 6M. Children who were in daycare (regardless of ITS) or kincare‐ITS before 6M demonstrated the highest WFL/WFHz over time, compared to their parental care counterparts. Conclusions: NPC‐ITS combinations on child WFL/WFHz across the first 2 years of life highlight the need for a partnership approach among parental and nonparental caregivers to support the feeding of infants throughout the transition to solid foods. [ABSTRACT FROM AUTHOR]

Background: Malrotation and volvulus classically present with bilious vomiting. It is more common earlier in life, but there are other causes of bile‐stained vomiting. This leads some clinicians to 'watch and wait'. In the presence of a volvulus, this is potentially a fatal decision. It is not clear from the literature if there is a safe time window in which children can be observed in the hope of avoiding transfers or radiological investigations. Aim: To determine whether time to identification and management of midgut volvulus correlated with morbidity and mortality; and whether there were patterns to transition of care. Methods: Multicentre, retrospective review of all children with malrotation ± volvulus at two tertiary children's hospitals in Brisbane from 2000 to 2012. Data collected included age at presentation, timing between symptom onset and presentation, radiological findings, and definitive surgical management. Outcomes included patient length of stay (LOS), total parenteral nutrition (TPN) duration, re‐operations and death. Results: There were 96 cases of malrotation identified, with 23 excluded (elective operation, insufficient data). Neonates made up 66% of included cases. Only 14% of cases were over 12 months old. Bilious vomiting or bile‐stained aspirates were the presenting symptoms in 71% (52). Overall mortality was 5.56%. Time from symptom onset to presentation or management was not significantly associated with morbidity or mortality. More than half (53%, 39/73) of patients received total parenteral nutrition; 20/39 for more than 10 days. Neonates and infants had a significantly higher rate of TPN compared with older children (P < 0.001). Those requiring TPN post‐operatively had a significantly higher mortality compared with those who did not (P = 0.02). Time from symptom onset to presentation or definitive management was not significantly associated with LOS, TPN duration, or need for re‐operation. Conclusion: Malrotation remains a time‐critical diagnosis to secure and treat. Even a short duration of symptoms can be associated with high morbidity or mortality. There is no place for 'watch and wait' for such patients, and malrotation/volvulus should be emergently actively excluded with contrast studies. [ABSTRACT FROM AUTHOR]

Aims: Swine are a mixing vessel for the emergence of novel reassortant influenza A viruses (IAV). Interspecies transmission of swine‐origin IAV poses a public health and pandemic risk. In the United States, the majority of zoonotic IAV transmission events have occurred in association with swine exposure at agricultural fairs. Accordingly, this human‐animal interface necessitates mitigation strategies informed by understanding of interspecies transmission mechanisms in exhibition swine. Likewise, the diversity of IAV in swine can be a source for novel reassortant or mutated viruses that pose a risk to both swine and human health. Methods and Results: In an effort to better understand those risks, here we investigated the epidemiology of IAV in exhibition swine and subsequent transmission to humans by performing phylogenetic analyses using full genome sequences from 272 IAV isolates collected from exhibition swine and 23 A(H3N2)v viruses from human hosts during 2013–2015. Sixty‐seven fairs (24.2%) had at least one pig test positive for IAV with an overall estimated prevalence of 8.9% (95% CI: 8.3–9.6, Clopper‐Pearson). Of the 19 genotypes found in swine, 5 were also identified in humans. There was a positive correlation between the number of human cases of a genotype and its prevalence in exhibition swine. Additionally, we demonstrated that A(H3N2)v viruses clustered tightly with exhibition swine viruses that were prevalent in the same year. Conclusions: These data indicate that multiple genotypes of swine‐lineage IAV have infected humans, and highly prevalent IAV genotypes in exhibition swine during a given year are also the strains detected most frequently in human cases of variant IAV. Continued surveillance and rapid characterization of IAVs in exhibition swine can facilitate timely phenotypic evaluation and matching of candidate vaccine strains to those viruses present at the human‐animal interface which are most likely to spillover into humans. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effectiveness of a school‐based multiple health behaviour change e‐health intervention for modifying risk factors for chronic disease (secondary outcomes). Study design: Cluster randomised controlled trial. Setting, participants: Students (at baseline [2019]: year 7, 11–14 years old) at 71 Australian public, independent, and Catholic schools. Intervention: Health4Life: an e‐health school‐based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. Main outcome measures: Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol‐related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). Results: A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow‐up survey, 5698 (85.8%) two or more follow‐up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57–2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64–1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72–1.38); tobacco use frequency: relative difference, 0.03 (95% CI, –0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, –0.34 (95% CI, –1.16 to 0.49) days per 30 days; device use time: relative difference, –0.07 (95% CI, –0.29 to 0.16) hours per day. Conclusions: Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e‐health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective). [ABSTRACT FROM AUTHOR]

Mitogen‐activated protein kinase (MPK) cascades play central signalling roles in plant immunity and stress response. The soybean orthologue of MPK kinase2 (GmMKK2) was recently identified as a potential signalling node whose expression is upregulated in the feeding site induced by soybean cyst nematode (SCN, Heterodera glycines). To investigate the role of GmMKK2 in soybean–SCN interactions, we overexpressed a catabolically inactive variant referred to as kinase‐dead variant (KD‐GmMKK2) using transgenic hairy roots. KD‐GmMKK2 overexpression caused significant reduction in soybean susceptibility to SCN, while overexpression of the wild‐type variant (WT‐GmMKK2) exhibited no effect on susceptibility. Transcriptome analysis indicated that KD‐GmMKK2 overexpressing plants are primed for SCN resistance via constitutive activation of defence signalling, particularly those related to chitin, respiratory burst, hydrogen peroxide and salicylic acid. Phosphoproteomic profiling of the WT‐GmMKK2 and KD‐GmMKK2 root samples upon SCN infection resulted in the identification of 391 potential targets of GmMKK2. These targets are involved in a broad range of biological processes, including defence signalling, vesicle fusion, chromatin remodelling and nuclear organization among others. Furthermore, GmMKK2 mediates phosphorylation of numerous transcriptional and translational regulators, pointing to the presence of signalling shortcuts besides the canonical MAPK cascades to initiate downstream signalling that eventually regulates gene expression and translation initiation. Finally, the functional requirement of specific phosphorylation sites for soybean response to SCN infection was validated by overexpressing phospho‐mimic and phospho‐dead variants of two differentially phosphorylated proteins SUN1 and IDD4. Together, our analyses identify GmMKK2 impacts on signalling modules that regulate soybean response to SCN infection. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Traditional exercise is often difficult for individuals with Friedreich ataxia (FRDA), and evidence is limited regarding how to measure exercise performance in this population. We evaluated the feasibility, reliability, and natural history of adaptive cardiopulmonary exercise test (CPET) performance in children and adults with FRDA. Methods: Participants underwent CPET on either an arm cycle ergometer (ACE) or recumbent leg cycle ergometer (RLCE) at up to four visits (baseline, 2 weeks, 4 weeks, and 1 year). Maximum work, oxygen consumption (peak VO2), oxygen (O2) pulse, and anaerobic threshold (AT) were measured in those who reached maximal volition. Test–retest reliability was assessed with intraclass coefficients, and longitudinal change was assessed using regression analysis. Results: In our cohort (N = 23), median age was 18 years (interquartile range [IQR], 14–23), median age of FRDA onset was 8 years (IQR 6–13), median Friedreich Ataxia Rating Scale score was 58 (IQR 54–62), and GAA repeat length on the shorter FXN allele (GAA1) was 766 (IQR, 650–900). Twenty‐one (91%) completed a maximal CPET (n = 8, ACE and n = 13, RLCE). Age, sex, and GAA1 repeat length were each associated with peak VO2. Preliminary estimates demonstrated reasonable agreement between visits 2 and 3 for peak work by both ACE and RLCE, and for peak VO2, O2 pulse, and AT by RLCE. We did not detect significant performance changes over 1 year. Discussion: Adaptive CPET is feasible in FRDA, a relevant clinical trial outcome for interventions that impact exercise performance and will increase access to participation as well as generalizability of findings. [ABSTRACT FROM AUTHOR]

Anthropogenic pressure, such as urbanization and habitat loss, can wield many effects on wildlife that radiate through ecosystems. Large carnivores tend to experience these effects more severely than other species, diminishing their viability and altering ecosystem function by suppressing their role as an apex predator. Yet opportunistic carnivores that rely on an omnivorous diet can sometimes take advantage of anthropogenic food and improve their fitness prospects. We quantified the effect of phenotypic and ecological factors on female body mass of the American black bear (Ursus americanus) in New Jersey, USA. Habitat and reliable mast crops in New Jersey keep adult female black bear body mass and reproduction higher than many parts of the United States, and historically, female black bears in the mid‐Atlantic states tend to be larger than in other parts of their range. We used data collected from den surveys (n = 317) in northern New Jersey from 1984 to 2019 to examine the shared roles of climate, anthropogenic pressure (human food subsidies, harvest), habitat composition and configuration, natural food availability (hard mast production), and bear characteristics (age, history of human–black bear conflict) on female black bear body mass using generalized linear mixed models. Adult female body mass was heaviest with increased availability of cultivated crop and within low‐intensity developed land covers, suggesting anthropogenic food subsidies found in these 2 land cover types are contributing to female overall body mass. A history of conflict with humans explained heavier females, and a quadratic effect of age on body mass supported a senescent decline in adult female body mass later in life. Our results suggest that access to specific land cover types (i.e., crops, low‐intensity developments) that provide a diversity of food (e.g., corn, soft and hard mast) and support low human densities, explains female black bear body mass in a fragmented landscape. [ABSTRACT FROM AUTHOR]

The nonmigratory and endemic Florida mottled duck (Anas fulvigula fulvigula) is facing conservation threats from the combined effects of urbanization and introgressive hybridization with feral mallards (Anas platyrhynchos) and mallard x mottled duck hybrids. In the past, the status of the Florida mottled duck population was assessed during annual aerial surveys and most brown ducks (mottled ducks, mallards, and hybrids of them) detected during the survey would have been mottled ducks. But the release of domesticated mallards for aesthetic purposes has led to increases in the prevalence of mallards-hybrids (mallards or mallard x mottled duck hybrids) throughout peninsular Florida, USA, and because it is impossible to differentiate among mottled ducks, female mallards, and hybrids during aerial surveys, helicopter surveys were halted in 2009 until state researchers could conduct a range-wide study to determine what proportion of brown ducks are mottled ducks versus mallards-hybrids. We used plumage keys and high-resolution photography to categorize brown ducks from 557 wetland grid points as either mottled ducks or mallards-hybrids. Of the 5,179 brown ducks categorized, 40.1% were mottled ducks and 59.9% were mallardshybrids. We used logistic regression analysis to model the interactive effect of a site's latitude and level of urbanization (urban gradient value within a 2-km buffer) to generate a predictive raster surface (1-km resolution) of the study area with values corresponding to the probability that a brown duck observed within a cell is a pure mottled duck. Predicted values will be used as correction factors when estimating final mottled duck population abundance from brown-duck survey data. Additionally, the predictive raster surface will be used to identify wetlands where mottled ducks remain predominant so that these sites can be targeted for preservation. Overall, mallards-hybrids outnumbered mottled ducks throughout most of peninsular Florida, especially in more urbanized regions, and their current prevalence rate presents a serious conservation threat, via hybridization, to extant mottled duck populations. [ABSTRACT FROM AUTHOR]

Background: This study describes surgical and quality of life outcomes in patients with peritoneal malignancy treated by cytoreductive surgery (CRS) alone compared with a subgroup treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: Peritoneal malignancy patients undergoing surgery between 2017 and 2023 were included. The cohort was divided into patients treated by CRS and HIPEC and those treated by CRS without HIPEC (including CRS only or maximal tumour debulking (MTB)). Main outcomes included surgical outcomes, survival, and quality of life. Groups were compared using non‐parametric tests and log‐rank test was used to compare survival curves. Results: 403 had CRS and HIPEC, 25 CRS only and 15 MTB. CRS and HIPEC patients had a lower peritoneal carcinomatosis index (12.0 vs. 17.0 vs. 35.0; P < 0.001) and longer surgical operative time (9.3 vs. 8.3 vs. 5.2 h; P < 0.001), when compared to CRS only and MTB, respectively. No other significant difference between groups was observed. Conclusions: The optimal management of selected patients with resectable peritoneal malignancy incorporates a combined strategy of CRS and HIPEC. When HIPEC is not utilized, due to significant residual disease or comorbidity precluding safe delivery, CRS alone is associated with good outcomes. Hospital stay and complications are acceptable but not significantly different to the CRS and HIPEC group. CRS alone is a complex intervention requiring comparable resources with good outcomes. In view of our findings 'intention to treat' with CRS and HIPEC should be the basis for resource allocation and funding. [ABSTRACT FROM AUTHOR]

Background: Day‐only emergency surgery for abscess drainage is poorly implemented in Australia. This study assessed the feasibility, outcomes, cost, and impact of an acute day‐only surgery (ADOS) program. Method: A retrospective pre‐post implementation study of patients requiring abscess drainage in theatre was performed. Following implementation of an ADOS program for abscess management, eligible patients were discharged from the emergency department and prioritized first on the following day's emergency list. Outcomes from the first 12 months of the ADOS era were compared with those of the preceding 6 months (pre‐ADOS). Primary outcome was length of hospital stay (LOS). Secondary outcomes included 30‐day complications, admission costs, and impact on overall emergency theatre workflow (measured by emergency appendicectomy metrics). Results: Overall, 266 patients during the ADOS era (including 95 eligible for the ADOS pathway) were compared with 115 patients during the pre‐ADOS era. Baseline characteristics were comparable. Median LOS was shorter during the ADOS era (21.9 h (IQR 11.8–43.3) vs. 30.1 h (IQR 24.7–48.8), P < 0.001). Median LOS was 10.2 h (IQR 8.9–13.1) for patients on the ADOS pathway. There were no significant differences in 30‐day complications (9.3% vs. 9.5%), emergency department re‐presentations (7.4% vs. 5.1%), or abscess recurrence (5.6% vs. 5.7%). Average cost per patient was lower during the ADOS era ($4155 vs. $4916, p = 0.005). ADOS did not appear to materially impact other emergency procedures. Conclusion: ADOS for abscess drainage is feasible, safe, and produces cost savings, while being implemented without significant additional resources. [ABSTRACT FROM AUTHOR]

Background: Perinatal mental health disorders affect up to 20% of all women. Women of refugee background are likely to be at increased risk, yet little research has explored this. This study aimed to assess if women of refugee background are more likely to screen risk positive for depression and anxiety than non‐refugee women, using the Edinburgh Postnatal Depression Scale (EPDS); and if screening in pregnancy using the EPDS enables better detection of depression and anxiety symptoms in women of refugee background than routine care. Methods: This implementation study was conducted at an antenatal clinic in Melbourne, Australia. Women of refugee and non‐refugee backgrounds were screened for depression using English or translated versions of the EPDS and a psychosocial assessment on a digital platform. The psychosocial assessment records of 34 women of refugee background receiving routine care (no screening) were audited. Results: Overall, 274 women completed the EPDS; 43% of refugee background. A similar proportion of women of refugee and non‐refugee backgrounds had EPDS scores of ≥9 (39% vs. 40% p = 0.93). Women receiving the combined EPDS and psychosocial screening were more likely to receive a referral for further support than women receiving routine care (41% vs. 18%, p = 0.012). Conclusion: Similarly, high proportions of women of refugee and non‐refugee backgrounds were at increased risk of experiencing a current depressive disorder in early pregnancy, suggesting pregnancy care systems should acknowledge and respond to the mental health needs of these women. Screening appeared to facilitate the identification and referral of women compared to routine care. [ABSTRACT FROM AUTHOR]

Background: As individuals age, they may need new strategies to manage exacerbations of chronic disease to maintain their dignity and independence. Many end up in a revolving cycle of emergency department visits, hospitalizations, and post‐acute care. Support to stay at home, which is often their preference, becomes a challenge and varies with insurance coverage, location, and financial status. There are few home‐based options sufficiently agile enough to respond when acute conditions arise particularly with exacerbations of chronic disease. Methods: In 2018, Integra designed a home‐based option to treat acute exacerbations of chronic illness. A partnership with community paramedicine enabled faster response times and provided additional treatment tools. Using process improvement methodology, we developed "Integra at Home" workflows and team‐based care. We counted averted emergency visits and hospitalizations, patient and staff satisfaction, and evidence of financial sustainability as a result of our program. Results: Integra successfully developed a suite of home‐based services, including responses to acute problems, to address beneficiaries' fluctuating medical needs. Following responses to 415 acute events, 74% (N = 307) resulted in averted emergency department visits. Based on InterQual® criteria, 34% (N = 103) of averted visits would have qualified as an averted hospitalization. All 64 respondents to patient surveys (N = 170) stated they would recommend our program. The staff indicated the model is a better way of caring for patients with higher rewards than traditional settings. The average length of stay in hospice for patients referred from the program (N = 22) was 4 weeks. Conclusions: Home‐based care continuums are feasible, yet resources to manage acute exacerbations remain inadequate. To fill this gap, we created higher acuity services to respond to urgent needs and monitor symptoms between episodes. Amid successes and challenges, we are serving higher acuity older adults in Integra's home‐based continuum model. We encourage further spread of longitudinal home‐based acute care models. [ABSTRACT FROM AUTHOR]

Objective: Fragile X‐associated tremor/ataxia syndrome (FXTAS) is a late‐onset progressive genetic neurodegenerative disorder that occurs in FMR1 premutation carriers. The temporal, spatial, and cell‐type specific patterns of neurodegeneration in the FXTAS brain remain incompletely characterized. Intranuclear inclusion bodies are the neuropathological hallmark of FXTAS, which are largest and occur most frequently in astrocytes, glial cells that maintain brain homeostasis. Here, we characterized neuropathological alterations in astrocytes in multiple regions of the FXTAS brain. Methods: Striatal and cerebellar sections from FXTAS cases (n = 12) and controls (n = 12) were stained for the astrocyte markers glial fibrillary acidic protein (GFAP) and aldehyde dehydrogenase 1L1 (ALDH1L1) using immunohistochemistry. Reactive astrogliosis severity, the prevalence of GFAP+ fragments, and astrocyte density were scored. Double label immunofluorescence was utilized to detect co‐localization of GFAP and cleaved caspase‐3. Results: FXTAS cases showed widespread reactive gliosis in both grey and white matter. GFAP staining also revealed remarkably severe astrocyte pathology in FXTAS white matter – characterized by a significant and visible reduction in astrocyte density (−38.7% in striatum and − 32.2% in cerebellum) and the widespread presence of GFAP+ fragments reminiscent of apoptotic bodies. White matter specific reductions in astrocyte density were confirmed with ALDH1L1 staining. GFAP+ astrocytes and fragments in white matter were positive for cleaved caspase‐3, suggesting that apoptosis‐mediated degeneration is responsible for reduced astrocyte counts. Interpretation: We have established that FXTAS neuropathology includes robust degeneration of astrocytes, which is specific to white matter. Because astrocytes are essential for maintaining homeostasis within the central nervous system, a loss of astrocytes likely further exacerbates neuropathological progression of other cell types in the FXTAS brain. ANN NEUROL 2024;95:558–575 [ABSTRACT FROM AUTHOR]

The airborne fraction of atmospheric CO2 (AF), defined as the annual global CO2 growth rate (dCO2/dt) divided by the total emission of CO2 from combustion of fossil fuels and land use change (LUC), has a long‐term average of ∼0.44 over the past six decades. When quantifying trends in AF it is important to account for inter‐annual variability in dCO2/dt due to natural factors such as the El Niño Southern Oscillation (ENSO) and major volcanic eruptions, as well as assumptions regarding LUC. Here, a multiple linear regression model is used to compute dCO2/dt as a function of anthropogenic CO2 emissions, ENSO indices, and stratospheric aerosol optical depth (a proxy for major volcanic eruptions), for numerous time series of the emission of CO2 due to LUC (ELUC). For 20 out of 21 previously published ELUC time series, the trend in AF adjusted for natural variability (AFADJ) over 1959 to 2021 exhibits a trend that is statistically indistinguishable from zero and lacks statistical significance at the 95% confidence interval. Therefore, it is most likely that the relative efficacy of the combined global terrestrial biosphere and oceanic carbon sinks has been fairly constant on a global scale over the past six decades. Since the trend in AF exhibits considerable variability depending on which ELUC time series is used, more precise knowledge of the actual value of the AF trend will require resolving the current large differences in various estimates of ELUC. Plain Language Summary: The term airborne fraction (AF) refers to the annual rise in globally averaged atmospheric CO2 divided by the total annual anthropogenic emissions of CO2. There is considerable interest in determining whether AF is changing over time because a rise in AF would imply the existence of a feedback between climate change and the global carbon cycle. Such a feedback might inhibit society's ability to limit global warming to a particular threshold, such as the 1.5°C target and 2°C goal of the Paris Agreement. Here, we analyze trends in AF by accounting for variations in the annual growth rate of atmospheric CO2 induced by ENSO events and major volcanic eruptions. We examine trends in AF over various time periods and for 21 previously published estimates of the global, annual emission of CO2 due to land use change (ELUC). For 20 out of these 21 estimates of ELUC, we find that AF has not changed in a statistically significant manner over the past six decades. Our study also highlights the importance of resolving large differences in previously published estimates of ELUC to better determine the true value of the trend in AF. Key Points: 77% of the variability in the CO2 growth rate is caused by anthropogenic carbon emissions, El Niño Southern Oscillation, and stratospheric aerosols from volcanoesTrends in the airborne fraction of CO2 (AF) are sensitive to natural variability and the emission of CO2 from land use change (ELUC)After accounting for natural variability, we find no statistically significant trend in AF over 1959–2021 for 20 of 21 estimates of ELUC [ABSTRACT FROM AUTHOR]

Objective: Class 3 obesity (severe obesity) is defined by a body mass index ≥40 kg/m2. Tertiary weight‐management programs (WMPs) are hospital‐based multidisciplinary services that aim to support individuals with severe obesity. Severe shortage of WMPs has led to waitlists and pressure on clinicians to discharge patients. Community obesity management often fails to support patients in maintaining weight loss/health gains. This study aimed to explore the needs of patients for community‐based obesity care. Methods: A qualitative study was undertaken via a tertiary WMP in Sydney, Australia. Semi‐structured interviews/focus groups explored perceptions of purposively sampled patients and their clinicians on the community‐based support needs of people with severe obesity. Data were audio‐recorded, transcribed verbatim, and then thematically analyzed. Results: Eleven patients and seven clinicians were interviewed. Four themes were identified: the importance of accountability and motivation to maintain weight‐loss/health gains; limitations within community‐based obesity management for those with severe obesity; perspectives on structured community programs for patients transitioning into/out of tertiary WMPs; and impact of mental health, stigma, and social isolation on engagement with community‐based services. Conclusions: Community‐based programs are needed to support those awaiting access to tertiary WMPs and to help maintain health gains once discharged. Such programs should address issues of social isolation and integrate with current models of tertiary metabolic and primary health care. [ABSTRACT FROM AUTHOR]

Objective: Psychological distress after testing positive for human papillomavirus (HPV) at cervical cancer screening is well documented in the general population. However, little is known about the impact of an HPV‐positive result on those with pre‐existing mental health conditions, who may be at higher risk of experiencing clinically significant distress. This study explored the psychosocial impact of HPV in women with co‐morbid mental health conditions, as well as their experience of cervical screening during the COVID‐19 pandemic. Methods: Semi‐structured telephone interviews were conducted with 22 women aged 27–54 who had tested positive for HPV at routine cervical screening in England, and who reported having at least one mental health condition. Data were analysed using thematic analysis. Results: Being informed of an HPV‐positive result increased distress and heightened pre‐existing psychological challenges. Psychosocial response and duration of HPV‐related distress appeared to be influenced by the ability to regulate emotions, number of consecutive HPV‐positive results, interactions with health care professionals, and other life stressors. The experience added further complexity to many women's perceptions of self and self‐esteem. Women who had received psychological treatment for their mental health condition were best able to self‐manage HPV‐related distress by applying learned coping skills. Conclusions: Receiving an HPV‐positive result at cervical screening appears to be a distressing experience for women with co‐morbid mental health conditions. Future hypothesis‐driven research is needed to confirm findings and develop effective interventions to reduce psychosocial burden. [ABSTRACT FROM AUTHOR]

Following the 2016 EU referendum on Britain's membership in the European Union, many people described themselves as "Leavers" or "Remainers." Here, we examine the emotional responses associated with Brexit identities using survey data collected from two nationally representative samples of the British public in 2019 (N = 638) and 2021 (N = 2,058). Confirmatory factor analysis indicated that many in both samples had coherent Leave or Remain identities. Remain and, to a lesser extent, Leave identities (regardless of how people actually voted in the referendum) predicted distress about Brexit‐related events and clinical symptoms of depression and anxiety at both time points. Structural equation models suggested that the effect of identities on symptoms was largely mediated by distress about Brexit‐related events. We demonstrate a lasting impact of Brexit on the mental health of UK citizens and show that the formation of novel political identities has been more important in this process than voting behavior. [ABSTRACT FROM AUTHOR]

Objectives: To determine platelet function and assess fibrinolysis in dogs following trauma using multiple electrical impedance aggregometry and a modified thromboelastographic (TEG) technique. To determine if the severity of trauma, as assessed by the Animal Trauma Triage (ATT) score and clinicopathological markers of shock, is associated with a greater degree of platelet dysfunction and fibrinolysis. Setting: University teaching hospital. Animals: Twenty client‐owned dogs with trauma (occurring <24 h prior to admission and blood sampling) and ATT score of >4 were prospectively recruited. A control group of 10 healthy dogs was included. Interventions: None. Measurements and Main Results: Platelet function was measured using multiple electrode platelet aggregometry (MEPA) utilizing arachidonic acid, ADP, and collagen agonists. Fibrinolysis was assessed in citrated whole blood with the addition of tissue plasminogen activator (tPA; 50 U/mL) using kaolin‐activated TEG. Conventional statistical analysis was performed to compare coagulation parameters between the groups and assess linear correlations. Median (interquartile range) ATT score was 5 (5–7), and 65% (n = 13) of dogs suffered polytrauma. Mean (± SD) time from trauma to blood sampling was 9 hours (± 6). Median (interquartile range) shock index and plasma lactate concentration were 1.1 (0.7–2.0, n = 16) and 2.9 mmol/L (0.9–16.0, n = 18), respectively. Four dogs did not survive to discharge (20%). There were no differences between the trauma and control group coagulation variables. A moderate negative correlation between ATT score and area under the curve for ADP was found (P = 0.043, r2 = −0.496). Conclusions: Preliminary evaluation of platelet function measured by MEPA, and fibrinolysis measured by tPA‐modified TEG, is not significantly different in this population of dogs with traumatic injury compared to healthy dogs. [ABSTRACT FROM AUTHOR]

Anthropogenic warming is altering species abundance, distribution, physiology, and more. How changes observed at the species level alter emergent community properties is an active and urgent area of research. Trait‐based ecology and regime shift theory provide complementary ways to understand climate change impacts on communities, but these two bodies of work are only rarely integrated. Lack of integration handicaps our ability to understand community responses to warming, at a time when such understanding is critical. Therefore, we advocate for merging trait‐based ecology with regime shift theory. We propose a general set of principles to guide this merger and apply these principles to research on marine communities in the rapidly warming North Atlantic. In our example, combining trait distribution and regime shift analyses at the community level yields greater insight than either alone. Looking forward, we identify a clear need for expanding quantitative approaches to collecting and merging trait‐based and resilience metrics in order to advance our understanding of climate‐driven community change. [ABSTRACT FROM AUTHOR]

Exercise training prevents age‐related decline in muscle function. Targeting epigenetic aging is a promising actionable mechanism and late‐life exercise mitigates epigenetic aging in rodent muscle. Whether exercise training can decelerate, or reverse epigenetic aging in humans is unknown. Here, we performed a powerful meta‐analysis of the methylome and transcriptome of an unprecedented number of human skeletal muscle samples (n = 3176). We show that: (1) individuals with higher baseline aerobic fitness have younger epigenetic and transcriptomic profiles, (2) exercise training leads to significant shifts of epigenetic and transcriptomic patterns toward a younger profile, and (3) muscle disuse "ages" the transcriptome. Higher fitness levels were associated with attenuated differential methylation and transcription during aging. Furthermore, both epigenetic and transcriptomic profiles shifted toward a younger state after exercise training interventions, while the transcriptome shifted toward an older state after forced muscle disuse. We demonstrate that exercise training targets many of the age‐related transcripts and DNA methylation loci to maintain younger methylome and transcriptome profiles, specifically in genes related to muscle structure, metabolism, and mitochondrial function. Our comprehensive analysis will inform future studies aiming to identify the best combination of therapeutics and exercise regimes to optimize longevity. [ABSTRACT FROM AUTHOR]

Background: Supination resistance is a clinical outcome that estimates the amount of external force required to supinate the foot. A greater supination resistance may indicate greater loads on structures responsible for generating internal supination moments across the subtalar joint during static and dynamic tasks. As such, greater supination resistance may be an expected finding in medial foot and ankle musculoskeletal disorders, such as plantar fasciopathy (PF) and posterior tibial tendon dysfunction (PTTD), whereas reduced supination resistance may be present in lateral ankle disorders, such as chronic ankle instability (CAI). However, no studies have yet investigated the changes in supination resistance across these foot and ankle musculoskeletal disorders. This study aimed to quantify supination resistance in individuals with PF, PTTD and CAI compared to healthy controls. Additionally, this study aimed to explore the changes in supination resistance following the simulation of varus and valgus wedges, which are commonly used interventions for these disorders. Methods: Fourteen participants with PF, fourteen with PTTD, fourteen with CAI and fourteen healthy controls were recruited. Supination resistance was quantified on a level surface and on a 10-degree inclined surface with varus and valgus positions. Results: Supination resistance was lower for the injured foot for CAI (p < 0.001) and greater for PTTD (p < 0.001) compared to the healthy foot. There was no significant between-foot difference observed for PF (p = 0.275) and controls (p = 0.970). In the injured foot, CAI exhibited lower supination resistance compared to controls (p < 0.001), PF (p = 0.012) and PTTD (p = 0.014). Regardless of the groups, supination resistance increased when tested on a surface with valgus inclination (p < 0.001) and decreased when tested on a surface with varus inclination (p < 0.001). Conclusions: Varus and valgus inclinations to the surface were effective in modifying supination resistance in PTTD and CAI, respectively. Supination resistance seemed unchanged in PF, and thus inclining the standing surface leads to greater between-feet asymmetries. This study also highlights the potential of wedged insoles as a mean to customise treatments and modify tissue stresses in these disorders. The findings contribute to the understanding of foot and ankle biomechanics and may aid in the development of more effective management and rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Mitochondrial and peroxisomal anchored protein ligase (MAPL) is a dual ubiquitin and small ubiquitin‐like modifier (SUMO) ligase with roles in mitochondrial quality control, cell death and inflammation in cultured cells. Here, we show that MAPL function in the organismal context converges on metabolic control, as knockout mice are viable, insulin‐sensitive, and protected from diet‐induced obesity. MAPL loss leads to liver‐specific activation of the integrated stress response, inducing secretion of stress hormone FGF21. MAPL knockout mice develop fully penetrant spontaneous hepatocellular carcinoma. Mechanistically, the peroxisomal bile acid transporter ABCD3 is a primary MAPL interacting partner and SUMOylated in a MAPL‐dependent manner. MAPL knockout leads to increased bile acid production coupled with defective regulatory feedback in liver in vivo and in isolated primary hepatocytes, suggesting cell‐autonomous function. Together, our findings establish MAPL function as a regulator of bile acid synthesis whose loss leads to the disruption of bile acid feedback mechanisms. The consequences of MAPL loss in liver, along with evidence of tumor suppression through regulation of cell survival pathways, ultimately lead to hepatocellular carcinogenesis. Synopsis: Mitochondrial and peroxisomal anchored protein ligase (MAPL) deficiency in mice leads to loss of SUMOylation of the peroxisomal bile acid transporter ABCD3 and defects in the bile acid metabolism. MAPL knockout mice develop liver stress and spontaneous hepatocellular carcinoma.ABCD3 is SUMOylated by MAPL.MAPL knockout mice exhibit increased bile flux and secretion from the liver.MAPL deficiency leads to liver‐specific activation of the integrated stress response.MAPL‐deficient hepatocytes are protected from genotoxic stress‐induced cell death.MAPL knockout mice develop fully penetrant spontaneous hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Scholars and policy makers alike frequently promote drinking water system consolidation as a solution to the longstanding struggles of small water systems and the related consequences of service fragmentation, including vulnerability to climate change and persistent racial and economic inequalities in access to safe and affordable drinking water. Despite enthusiasm for the concept, however, our understanding of how, why, and where consolidations occur has remained stubbornly limited such that the promise of drinking water system consolidation remains theoretical at best. This study analyzes all known water system consolidations (n = 206) in the state of California over a 7‐year period (2015–2021). We find empirical support for certain theoretical claims about consolidation, including an overall reduction in the number of regulated systems, with the largest reductions occurring among particularly underperforming, climate‐vulnerable, and unrepresentative system types. Other findings, however, do not align with the literature on the subject. We find limited evidence of either water service privatization or remunicipalization trends and seemingly limited prospects for economies of scale benefits through consolidations. Moreover, roughly half of consolidations during the study period involve non‐residential water systems. Among the consolidated community water systems, systems serving higher‐resourced communities are overrepresented compared to those serving lower‐resourced communities by a margin of two‐to‐one. It is time to move beyond the blanket assumption of positive consolidation benefits toward a more nuanced understanding of the associated opportunities and limitations. Depending on their goals, policymakers may need to support more specific types of consolidation. Key Points: Consolidations are reducing the number of regulated systems including among underperforming and unrepresentative system typesConsolidations occur across institutional types and typically involve very small/nonresidential systems, reducing prospects for economies of scale benefitsResidents served by consolidating and receiving systems tend to be similar but among consolidated systems, low‐resource communities are underrepresented [ABSTRACT FROM AUTHOR]

In the process of developing a complicated, community‐driven evaluation initiative, Dr. Stafford Hood indicated the importance of allowing the project to "unfold as it should." This indication of emergence is too often missing in the dialogue of what it means to do Culturally Responsive Evaluation. This chapter explores and elucidates the concept of emergence and presents two examples of how it has influenced evaluation practice and enhanced the ongoing application of culturally responsive frameworks. The authors provide examples rooted in Dr. Hood's childhood home community while showcasing the power of simple interactions, fluidity, and attending to contextual and human nuances. [ABSTRACT FROM AUTHOR]

Laterite weathering profile (LWP) thicknesses are functions of precipitation rate and time, but their exact dependence on them is uncertain. We investigate LWP development on ground surfaces in Hawai'i that are neither aggrading nor eroding across substrates from 0.01 to 4 Ma and rainfall rates of <250 to >3000 mm/a. The Hawaiian Islands provide an excellent opportunity for LWP studies across climates and over millions of years on a single rock type, basalt. LWP weathering rates are usually determined by geochemical approaches. We present a geophysical method once bedrock ages and precipitation rates are known. We employed multichannel analysis of surface waves and horizontal‐to‐vertical spectral ratio methods. Results indicate that >70% of the variability in LWP thickness is due to precipitation and bedrock age. The remainder is attributed to measurement uncertainty and heterogeneity in the permeability of basalt. LWPs develop by two paths. Dry (<1000 mm/a) areas have a negative water balance with evapotranspiration exceeding rainfall. LWPs thicken until they reach a steady state where the storage capacity of the saprolite precludes the percolation of water into subjacent lava. In wetter areas, downslope interflow produces thick laterite wedges near coastlines that migrate upslope over ~1 Ma. Subsequently, they thicken and reach a steady state where precipitation cannot deliver water through the vadose zone. LWPs' thickness (T) increases as a function of time (t) and precipitation (P) according to the expression (95% confidence): T=log10t+10.934±0.126×log10P+13.890±0.085. The first partial derivative, or weathering rate, is ∂T∂tP=0.406t+1×log10P+13.890. Weathering rates decrease with time and are strong functions of t and P. These expressions add considerable insight into the rates and processes driving weathering at large scales and can also be solved for t, giving a rough estimate of the time of landscape formation of eroded surfaces. [ABSTRACT FROM AUTHOR]

This article presents a collaborative reflective‐thinking‐writing project that draws from the authors' experiences of co‐productive and critical inquiry with children in the field of gender, sexualities and education. Integrating our collective concerns regarding how childhood can be negatively framed and policed within/through RSE, we explore how these ontological boundaries might be queered through a collective engagement with the possibilities for/of RSE that is affirmative, playful and co‐produced with, rather than for, children. [ABSTRACT FROM AUTHOR]

Background: Neurogenic bowel is a dysmotility disorder following spinal cord injury (SCI) that negatively impacts quality of life, social integration, and physical health. Colonic transit is directly modulated by the enteric nervous system. Interstitial Cells of Cajal (ICC) distributed throughout the small intestine and colon serve as specialized pacemaker cells, generating rhythmic electrical slow waves within intestinal smooth muscle, or serve as an interface between smooth muscle cells and enteric motor neurons of the myenteric plexus. Interstitial Cells of Cajal loss has been reported for other preclinical models of dysmotility, and our previous experimental SCI study provided evidence of reduced excitatory and inhibitory enteric neuronal count and smooth muscle neural control. Methods: Immunohistochemistry for the ICC‐specific marker c‐Kit was utilized to examine neuromuscular remodeling of the distal colon in male and female rats with experimental SCI. Key Results: Myenteric plexus ICC (ICC‐MP) exhibited increased cell counts 3 days following SCI in male rats, but did not significantly increase in females until 3 weeks after SCI. On average, ICC‐MP total primary arborization length increased significantly in male rats at 3‐day, 3‐week, and 6‐week time points, whereas in females, this increase occurred most frequently at 6 weeks post‐SCI. Conversely, circular muscle ICC (ICC‐CM) did not demonstrate post‐SCI changes. Conclusions and Inferences: These data demonstrate resiliency of the ICC‐MP in neurogenic bowel following SCI, unlike seen in other related disease states. This plasticity underscores the need to further understand neuromuscular changes driving colonic dysmotility after SCI in order to advance therapeutic targets for neurogenic bowel treatment. [ABSTRACT FROM AUTHOR]