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Fusion crusts form during the atmospheric entry heating of meteorites and preserve a record of the conditions that occurred during deceleration in the atmosphere. The fusion crust of the Winchcombe meteorite closely resembles that of other stony meteorites, and in particular CM2 chondrites, since it is dominated by olivine phenocrysts set in a glassy mesostasis with magnetite, and is highly vesicular. Dehydration cracks are unusually abundant in Winchcombe. Failure of this weak layer is an additional ablation mechanism to produce large numbers of particles during deceleration, consistent with the observation of pulses of plasma in videos of the Winchcombe fireball. Calving events might provide an observable phenomenon related to meteorites that are particularly susceptible to dehydration. Oscillatory zoning is observed within olivine phenocrysts in the fusion crust, in contrast to other meteorites, perhaps owing to temperature fluctuations resulting from calving events. Magnetite monolayers are found in the crust, and have also not been previously reported, and form discontinuous strata. These features grade into magnetite rims formed on the external surface of the crust and suggest the trapping of surface magnetite by collapse of melt. Magnetite monolayers may be a feature of meteorites that undergo significant degassing. Silicate warts with dendritic textures were observed and are suggested to be droplets ablated from another stone in the shower. They, therefore, represent the first evidence for intershower transfer of ablation materials and are consistent with the other evidence in the Winchcombe meteorite for unusually intense gas loss and ablation, despite its low entry velocity. [ABSTRACT FROM AUTHOR]

Glucagon‐like peptide 1 receptor agonists (GLP‐1 RAs) reduce elevated blood glucose levels and induce weight loss. Multiple GLP‐1 RAs and one combined GLP‐1/glucose‐dependent insulinotropic polypeptide agonist are currently available. This review was conducted with the aim of summarising direct comparisons between subcutaneous semaglutide and other GLP‐1 RAs in individuals with type 2 diabetes (T2D), particularly with respect to efficacy for inducing weight loss and improving other markers of metabolic health. This systematic review of PubMed and Embase from inception to early 2022 was registered on PROSPERO and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses and Meta‐Analysis of Observational Studies in Epidemiology guidelines. Of the 740 records identified in the search, five studies fulfilled the inclusion criteria. Comparators included liraglutide, exenatide, dulaglutide and tirzepatide. In the identified studies, multiple dosing regimens were utilised for semaglutide. Randomised trials support the superior efficacy of semaglutide over other GLP‐1 RAs with respect to weight loss in T2D, but tirzepatide is more effective than semaglutide. [ABSTRACT FROM AUTHOR]

Proliferative verrucous leukoplakia (PVL) is a rare form of oral leukoplakia with a relatively high transformation rate resulting in oral squamous cell carcinoma (OSCC). Molecular analysis of PVL at the genome level is limited and has only identified molecular similarities between PVL and OSCC. However, the clinical profile of PVL suggests that molecular differences may be more important. Whole exome sequencing of 5 PVL-associated OSCC (PVL-OSCC) and paired blood samples was used to identify somatic mutations common to the tumors. Whole methylome analysis of samples from 4 PVL-associated OSCC and 3 OSCC of non-PVL origin samples was conducted to explore differential methylation. In contrast to conventional OSCC, PVL-associated OSCC showed infrequent TP53 mutation and altered spectra of PIK3CA and NOTCH1 mutations. Unsupervised hierarchical clustering identified 63 probes that discriminated between PVL-associated OSCC and OSCC of non-PVL origin. Differences in methylation were most significant for divalent metal ion transport, particularly calcium movement. Specific differences in mutation and methylation profiles between PVL-derived OSCC and OSCC of non-PVL origin suggest differences in their transformation pathways. Further studies of early PVL lesions may identify markers of transformation that are also applicable to more common oral premalignant disorders such as oral epithelial dysplasia. [ABSTRACT FROM AUTHOR]

Background: Adverse social determinants of health give rise to individual-level social needs that have the potential to negatively impact health. Screening patients to identify unmet social needs is becoming more widespread. A review of the content of currently available screening tools is warranted. The aim of this scoping review was to determine what social needs categories are included in published Social Needs Screening Tools that have been developed for use in primary care settings, and how these social needs are screened. Methods: We pre-registered the study on the Open Science Framework (https://osf. io/dqan2/). We searched MEDLINE and Embase from 01/01/2010 to 3/05/2022 to identify eligible studies reporting tools designed for use in primary healthcare settings. Two reviewers independently screened studies, a single reviewer extracted data. We summarised the characteristics of included studies descriptively and calculated the number of studies that collected data relevant to specific social needs categories. We identified sub-categories to classify the types of questions relevant to each of the main categories. Results: We identified 420 unique citations, and 27 were included. Nine additional studies were retrieved by searching for tools that were used or referred to in excluded studies. Questions relating to food insecurity and the physical environment in which a person lives were the most frequently included items (92-94% of tools), followed by questions relating to economic stability and aspects of social and community context (81%). Seventy-five percent of the screening tools included items that evaluated five or more social needs categories (mean 6.5; standard deviation 1.75). One study reported that the tool had been 'validated'; 16 reported 'partial' validation; 12 reported that the tool was 'not validated' and seven studies did not report validation processes or outcomes. [ABSTRACT FROM AUTHOR]

Predicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patients with lung cancer in the last weeks of life by headspace gas chromatography mass spectrometry. Urine was acidified or alkalinised before analysis. VOC changes in the last weeks of life were identified using univariate, multivariate and linear regression analysis; 12 VOCs increased (11 from the acid dataset, 2 from the alkali dataset) and 25 VOCs decreased (23 from the acid dataset and 3 from the alkali dataset). A Cox Lasso prediction model using 8 VOCs predicted dying with an AUC of 0.77, 0.78 and 0.85 at 30, 20 and 10 days and stratified patients into a low (median 10 days), medium (median 50 days) or high risk of survival. Our data supports the hypothesis there are specific metabolic changes associated with the dying. The VOCs identified are potential biomarkers of dying in lung cancer and could be used as a tool to provide additional prognostic information to inform expert clinician judgement and subsequent decision making. [ABSTRACT FROM AUTHOR]

It is well-established that social determinants of health contribute to health and well-being. Among the social determinants of health, health-related social needs (HRSNs) are unmet needs that can be identified by the health care system and addressed through referral to community services. Despite the importance of identifying patients with HRSNs, none of the few screening tools for HRSNs available internationally have received a comprehensive psychometric validation. This study aims to conduct a qualitative validation of the Social Determinants of Health Screening Tool (SDoHST). This study took place at Lyell McEwin Hospital, a major tertiary hospital located in Adelaide, South Australia. Patient (n = 5) and stakeholder (n = 9) focus groups were conducted face to face, audio recorded, and transcribed verbatim. Inductive content analysis of focus group transcripts was performed to inform tool modifications (e.g. item rewording). The patient focus group recommended the addition of an explanatory paragraph to improve face validity, and highlighted the importance of reliable transport and internet access. The stakeholder focus group recommended using language that carries less stigma to this particular community and incorporating questions surrounding cultural, linguistic, and spiritual needs. The final version of the SDoHST included 12 items (four original items were removed and seven new items were added during the validation process). The SDoHST is the first validated tool to measure social determinants of health (and specifically HRSNs) in Australia, receiving a comprehensive qualitative validation. The instrument is readily available and future studies will further investigate its psychometric properties with quantitative methods. A brief guide to screening tools for social determinants of health and their validation The importance of social context in contributing to overall health is well-established. Social determinants of health (SDoH) are social and environmental factors such as employment, housing security, financial stability, social isolation, and personal safety, which contribute up to 60% of overall health. In recent years, there has been a paradigm shift in how healthcare systems view health and wellbeing. There is a growing call to intervene in adverse SDoH from within the healthcare system. One such intervention involves screening patients for unmet needs, such as housing or food insecurity, and providing appropriate connections to organizations in the community to assist with their needs. The screening tools implemented in this context are multiple and diverse. Some target only one or two factors while others assess multiple SDoH. However, little is reported about the development of these tools. If a screening tool is not thoroughly developed and validated, it is impossible to know whether the data collected with the tool are appropriate or relevant. This study details the development and validation of a screening tool for unmet social needs by community members and healthcare providers at a major metropolitan hospital in South Australia. [ABSTRACT FROM AUTHOR]

The article discusses the translational benefits of space medicine for rural and remote perioperative medicine. Topics include ways high-quality perioperative medicine improves the patient experience of surgery, considerations that need to be made regarding the requirements needed to allow remote perioperative medicine to mirror the advancements in space medicine, and significance of the delivery of high-qualitative perioperative care in Australian rural and remote medicine.

Biomass pyrolysis liquids (also known as bio-oil), are derived from renewable lignocellulosic biomass residues by fast pyrolysis process. These second-generation oxygenated hydrocarbon resources have the potential to partially substitute for petroleum-derived feedstocks and thus enhance the economic and environmental sustainability of our natural resources. However, in contrast to petroleum fuels, biomass-derived pyrolysis liquids contain a large amount of oxygen, usually 40-50% wt% (wet basis). This undesirable high oxygen content in pyrolysis liquids is considered as the primary reason for its high polarity, high acidity, lower stability, lower energy density and very low miscibility with conventional crude refining feedstocks. There are two major pathways for upgrading the pyrolysis liquids. While hydrodeoxygenation route is one of the most explored options, it requires production and supply of large amounts of expensive hydrogen at high pressures, mandating large and centralized upgrading plants, and thus large capital investment. In this paper, we discuss an alternative method of pyrolysis liquid upgrading, using cheap and affordable hydrogen donor additives and catalysts to promote partial deoxygenation at near atmospheric pressure. This approach is preferably to be used as a pre-treatment and stabilizing method for pyrolysis liquids in the close vicinity of remote biomass pyrolysis plants. The pre-treated oil, then can be shipped for further hydrocracking process in a centralized co-processing facility. Preliminary results from the initial proof of concept experiments involving a 200 g/h gas-phase continuous fast catalytic cracking system with continuous coke removal to enhance deoxygenation performance are presented. These results indicate positive impact of catalyst bed on quality and yield of the upgraded bio-oil product in terms of pH, viscosity, degree of deoxygenation, oil yield and concentration of hydrogen in the off gases.

Background The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study has developed predictive risk scores for cardiovascular disease (CVD) and chronic kidney disease (CKD, defined as confirmed estimated glomerular filtration rate [eGFR] [less than or equal to] 60 ml/min/1.73 m.sup.2) events in HIV-positive people. We hypothesized that participants in D:A:D at high (>5%) predicted risk for both CVD and CKD would be at even greater risk for CVD and CKD events. Methods and findings We included all participants with complete risk factor (covariate) data, baseline eGFR > 60 ml/min/1.73 m.sup.2, and a confirmed (>3 months apart) eGFR 1%-5%, >5%) and fitted Poisson models to assess whether CVD and CKD risk group effects were multiplicative. A total of 27,215 participants contributed 202,034 person-years of follow-up: 74% male, median (IQR) age 42 (36, 49) years, median (IQR) baseline year of follow-up 2005 (2004, 2008). D:A:D risk equations predicted 3,560 (13.1%) participants at high CVD risk, 4,996 (18.4%) participants at high CKD risk, and 1,585 (5.8%) participants at both high CKD and high CVD risk. CVD and CKD event rates by predicted risk group were multiplicative. Participants at high CVD risk had a 5.63-fold (95% CI 4.47, 7.09, p < 0.001) increase in CKD events compared to those at low risk; participants at high CKD risk had a 1.31-fold (95% CI 1.09, 1.56, p = 0.005) increase in CVD events compared to those at low risk. Participants' CVD and CKD risk groups had multiplicative predictive effects, with no evidence of an interaction (p = 0.329 and p = 0.291 for CKD and CVD, respectively). The main study limitation is the difference in the ascertainment of the clinically defined CVD endpoints and the laboratory-defined CKD endpoints. Conclusions We found that people at high predicted risk for both CVD and CKD have substantially greater risks for both CVD and CKD events compared with those at low predicted risk for both outcomes, and compared to those at high predicted risk for only CVD or CKD events. This suggests that CVD and CKD risk in HIV-positive persons should be assessed together. The results further encourage clinicians to prioritise addressing modifiable risks for CVD and CKD in HIV-positive people., Author(s): Mark A. Boyd 1,2,*, Amanda Mocroft 3, Lene Ryom 4, Antonella d'Arminio Monforte 5, Caroline Sabin 3, Wafaa M. El-Sadr 6, Camilla Ingrid Hatleberg 4, Stephane De Wit 7, [...]