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It is unknown to what extent medical researchers generalize study findings beyond their samples when their sample size, sample diversity, or knowledge of conditions that support external validity do not warrant it. It is also unknown to what extent medical researchers describe their results with precise quantifications or unquantified generalizations, i.e., generics, that can obscure variations between individuals. We therefore systematically reviewed all prospective studies (n = 533) published in the top four highest ranking medical journals, Lancet, New England Journal of Medicine (NEJM), Journal of the American Medical Association (JAMA), and the British Medical Journal (BMJ), from January 2022 to May 2023. We additionally reviewed all NEJM Journal Watch clinical research summaries (n = 143) published during the same time. Of all research articles reporting prospective studies, 52.5% included generalizations beyond specific national study populations, with the numbers of articles with generics varying significantly between journals (JAMA = 12%; Lancet = 77%) (p < 0.001, V = 0.48). There was no evidence that articles containing broader generalizations or generics were correlated with larger or more nationally diverse samples. Moreover, only 10.2% of articles with generalizations beyond specific national populations reported external validity strengthening factors that could potentially support such extrapolations. There was no evidence that original research articles and NEJM Journal Watch summaries intended for practitioners differed in their use of broad generalizations, including generics. Finally, from the journal with the highest citation impact, articles containing broader conclusions were correlated with more citations. Since there was no evidence that studies with generalizations beyond specific national study populations or with generics were associated with larger, more nationally diverse samples, or with reports of population similarity that may permit extensions of conclusions, our findings suggest that the generalizations in many articles were insufficiently supported. Caution against overly broad generalizations in medical research is warranted. [ABSTRACT FROM AUTHOR]

The challenges New Zealand faces are stark. Russia's illegal invasion of Ukraine, the utter catastrophe unfolding in Gaza, North Korea's emerging nuclear capability -- all have undermined old certainties in the international order. Three big shifts are apparent: from rules to power, from economics to security and from efficiency to resilience. In response to these shifts, the government has embarked on a foreign policy reset designed to reinvigorate and focus our foreign, defence and trade policy agendas. On the AUKUS issue, it is continuing a process begun by its predecessor Labourled government of considering New Zealand involvement in the arrangement's Pillar 2. [ABSTRACT FROM AUTHOR]

Background: The Thriving from Work questionnaire is a comprehensive indicator of positive well-being for employees, applicable in both research and practical contexts. Current discussions underline the crucial impact that employment should have in enriching workers' lives positively and meaningfully, along with the necessity for accurate and dependable tools to assess employee well-being. This study investigated the reliability, validity, and dimensionality of the translated German adaptation of the Thriving from Work questionnaire developed by Peters and colleagues [1, 2]. The questionnaire assesses work-related well-being with 30 items clustered in six domains: emotional and psychological well-being, social well-being, work-life integration, physical and mental well-being, basic needs for thriving, and experiences of work. Methods: This study aimed to convert the Thriving at Work Questionnaire from English into German. We assessed the psychometric characteristics of the German version of the questionnaire by using item response theory with a sample of 567 German employees and examined its criterion validity. Results: We found that the long and short German Thriving from Work questionnaire versions are reliable with good construct validity. Criterion validity was demonstrated by relationships with important work and life outcomes, such as life satisfaction, trust in the organizations' management, general well-being, work-related fatigue, and work stress. Conclusions: The current study demonstrated that the German language version of the questionnaire is both a reliable and valid measure of employee well-being. We discuss recommendations for further adaptation and future research. [ABSTRACT FROM AUTHOR]

The amount of laundry washed by European consumers has grown excessively for reasons that cannot be explained by demographics alone. Initiatives trying to curb this trend have repeatedly failed. Previous studies have largely overlooked the psychological dimensions of laundering behaviour. In three separate studies we investigate how disgust, shame, cleanliness norms and environmental identity, mediated through a set of preceding behaviours, affect washing frequency. Our results highlight how conflicting psychological goals between disgust sensitivity and pro-environmental identity can undermine willingness to change laundry behaviour. Policy recommendations are suggested, and future research challenges are discussed. [ABSTRACT FROM AUTHOR]

Background: Involuntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL. Methods: We conducted a retrospective health records analysis of all involuntarily hospitalised cases in the four psychiatric hospitals of the city of Cologne, Germany, in 2011. Of the 1,773 cases, 87.3% were detained under the MHA of the federal state of North Rhine-Westphalia and 6.4% were hospitalised according to the federal LGL. Another 6.3% of the cases were originally admitted under the MHA, but the legal basis of detention was converted to LGL during the inpatient psychiatric stay (MHA→LGL cases). We compared sociodemographic, clinical, systemic and environmental socioeconomic (ESED) variables of the three groups by means of descriptive statistics. We also trained and tested a machine learning-based algorithm to predict class membership of the involuntary modes of psychiatric inpatient care. Results: Cases with an admission under the premises of LGL lived less often on their own, and they were more often retired compared to MHA cases. They more often had received previous outpatient or inpatient treatment than MHA cases, they were more often diagnosed with a psychotic disorder and they lived in neighbourhoods that were on average more socially advantaged. MHA→LGL cases were on average older and more often retired than MHA cases. More often, they had a main diagnosis of an organic mental disorder compared to both MHA and LGL cases. Also, they less often received previous psychiatric inpatient treatment compared to LGL cases. The reason for detention (self-harm or harm to others) did not differ between the three groups. The proportion of LGL and MHA cases differed between the four hospitals. Effect sizes were mostly small and the balanced accuracy of the Random Forest was low. Conclusion: We found some plausible differences in patient characteristics depending on the legal foundation of the involuntary psychiatric hospitalisation. The differences relate to clinical, sociodemographic and socioeconomical issues. However, the low effect sizes and the limited accuracy of the machine learning models indicate that the investigated variables do not sufficiently explain the respective choice of the legal framework. In addition, we found some indication for possibly different interpretation and handling of the premises of the law in practice. Our findings pose the need for further research in this field. [ABSTRACT FROM AUTHOR]

Background While use of some older antiretroviral drugs (ARVs) is associated with chronic liver enzyme elevation (cLEE), the impact of newer ARVs remains unknown. Methods People with HIV enrolled in the RESPOND cohort who started an ARV after January 1, 2012 were included (baseline). The primary outcome was first cLEE individuals were censored at first of cLEE, last visit, death, or December 31, 2021. Incidence rates (IRs; events/1000 person-years) were calculated for each ARV overall and by ARV exposure (6–12 months, 1–2 years, and 2+ years). Poisson regression was used to estimate the incidence rate ratio (IRR) of cLEE and its association with individual ARVs and ARV class. Results Of 17 106 individuals included contributing 87 924 person-years of follow-up, 1932 (11.3%) experienced cLEE (incidence rate [IR], 22.0; 95% CI, 21.0–23.0). There was no evidence of a cumulative ARV effect on cLEE incidence, (6–12 months: IR, 45.8; 95% CI, 41.4–50.19; 1–2 years: IR, 34.3; 95% CI, 31.5–37.4; and 2+ years: IR, 18.5; 95% CI, 17.4–19.7). Any use (vs no prior use) of non-nucleoside reverse transcriptase inhibitors (NNRTIs) as a class and tenofovir disoproxil fumarate (TDF) was independently associated with an increased IRR of cLEE, and any use of darunavir (DRV) was associated with a decreased risk of cLEE. Conclusions cLEE is common and more frequent during the first year after initiating new ARVs. With a >5-year median follow-up, we found no short-term liver safety concerns with the use of INSTIs. Use of NNRTIs and TDF was associated with an increased cLEE risk, while DRV was associated with lower risk. [ABSTRACT FROM AUTHOR]

The extremophile Halobacterium salinarum is an aerobic archaeon that has adapted to thrive in high-salt environments such as salted fish, hypersaline lakes, and salterns. Halophiles have garnered significant interest due to their unique interactions with bacteriophages known as haloarchaeophages. Studies have identified and characterized prophages in halophilic archaea, such as Haloferax volcanii, Haloquadratum walsbyi, and Haloarcula marismortui. Still, an investigation has yet to be conducted into the presence of prophage elements on Halobacterium salinarum ATCC 33170. This is of particular interest to us as we are using this strain as a source of archaeol, as one of the components of our sulfated lactosyl archaeol (SLA) archaeosome adjuvant. Genomic contigs of strain 33170 were bioinformatically assessed for prophage-like features using BLAST, PHASTER, InterProScan, and PHYRE2. A 7 kb region encoding six genes was identified as an incomplete prophage, and the proteins were further analyzed, revealing high homology to proteins encoded by bacteria, archaea, and an IS200 transposon. Restricting the BLASTp database to viruses resulted in hits to both myo- and siphoviral proteins, which would be unusual for an intact prophage. Additionally, no known phage structural proteins were identified in the search, suggesting a low chance that H. salinarum ATCC 33170 harbors a latent prophage. [ABSTRACT FROM AUTHOR]

The Omicron variant and its sub-lineages are the only current circulating SARS-CoV-2 viruses worldwide. In this study, the conformational stability of the isolated Receptor Binding Domain (RBD) of Omicron's spike protein is examined in detail. The parent Omicron lineage has over ten mutations in the ACE2 binding region of the RBD that are specifically associated with its β hairpin loop domain. It is demonstrated through biophysical molecular computations that the mutations in the β hairpin loop domain significantly increase the intra-protein interaction energies of intra-loop and loop–RBD interactions. The interaction energy increases include the formation of new hydrogen bonds in the β hairpin loop domain that help stabilize this critical ACE2 binding region. Our results also agree with recent experiments on the stability of Omicron's core β barrel domain, outside of its loop domain, and help demonstrate the overall conformational stability of the Omicron RBD. It is further shown here through dynamic simulations that the unbound state of the Omicron RBD remains closely aligned with the bound state configuration, which was not observed for the wild-type RBD. Overall, these studies demonstrate the significantly increased conformational stability of Omicron over its wild-type configuration and raise a number of questions on whether conformational stability could be a positive selection feature of SARS-CoV-2 viral mutational changes. [ABSTRACT FROM AUTHOR]

Background: The group climate within residential youth care institutions is considered a transactional process, both within a group of youth from various cultural backgrounds and between them and their group workers. The ongoing interaction between the cultural characteristics of these girls may influence the quality of the group climate. This study aimed to provide an in-depth account of the living group climate experiences and perceptions of Dutch girls with a Moroccan cultural background in Dutch residential groups. Method: Interpretative phenomenological analysis was employed to explore the girls' group climate experiences. Result: Three major themes emerged, namely (a) level of involvement of Moroccan girls in their living group, (b) perceptions of Moroccan girls' sense of belonging in a living group, and (c) cultural and religious equality or disparity results in two interaction patterns. The findings revealed that equality or disparity in language, culture, and religion affect Moroccan girls' experiences and perceptions of the living group climate. A crucial finding was that cultural and religious disparity leads to interaction patterns wherein the girls pre-emptively exclude themselves from receiving support from native group workers. Conclusion: Professionals must be aware of the cultural and religious dynamics, including the interplay and impact of cultural and religious equality and disparity, influencing Moroccan girls' group climate experiences. [ABSTRACT FROM AUTHOR]

The Entscheidungsnavi is an open-source decision support system based on multi-attribute utility theory, that offers various methods for dealing with uncertainties. To model decisions with uncertainties, decision-makers can use two categories: Forecast and Parameter Uncertainties. Forecast Uncertainty is modeled with (combined) influence factors using discrete, user-defined probability distributions or predefined 'worst-median-best' distributions. Parameter Uncertainty allows imprecision for utilities, objective weights, and probability distributions. To analyze these uncertainties, the Entscheidungsnavi offers several methods and tools, like a robustness check, based on (Monte Carlo) simulations and a sensitivity analysis. The objective weight analysis provides insights into the effects of different objective weight combinations. Indicator impacts, tornado diagrams, and risk profiles visualize the impact of uncertainties in a decision under risk. Risk profiles also enable a check for stochastic and simulation dominance. This article presents the complete range of methods for dealing with uncertainties in the Entscheidungsnavi using a hypothetical case study. [ABSTRACT FROM AUTHOR]

Landslides, resulting from disturbances in slope equilibrium, pose a significant threat to landscapes, infrastructure, and human life. Triggered by factors such as intense precipitation, seismic activities, or volcanic eruptions, these events can cause extensive damage and endanger nearby communities. A comprehensive understanding of landslide characteristics, including spatio-temporal patterns, dimensions, and morphology, is vital for effective landslide disaster management. Existing remote sensing approaches mostly use either optical or synthetic aperture radar sensors. Integrating information from both these types of sensors promises greater accuracy for identifying and locating landslides. This study proposes a novel approach, the ML-LaDeCORsat (Machine Learning-based coseismic Landslide Detection using Combined Optical and Radar Satellite Imagery), that integrates freely available Sentinel-1, Palsar-2, and Sentinel-2 imagery data in Google Earth Engine (GEE). The approach also integrates relevant spectral indices and suitable bands used in a machine learning-based classification of coseismic landslides. The approach includes a robust and reproducible training and validation strategy and allows one to choose between five classifiers (CART, Random Forest, GTB, SVM, and Naive Bayes). Using landslides from four different earthquake case studies, we demonstrate the superiority of our approach over existing solutions in coseismic landslide identification and localization, providing a GTB-based detection accuracy of 87–92%. ML-LaDeCORsat can be adapted to other landslide events (GEE script is provided). Transfer learning experiments proved that our model can be applied to other coseismic landslide events without the need for additional training data. Our novel approach therefore facilitates quick and reliable identification of coseismic landslides, highlighting its potential to contribute towards more effective disaster management. [ABSTRACT FROM AUTHOR]

Background/Objective: Asthma is a common chronic medical condition among children and the most common diagnosis associated with interfacility transports for pediatric patients. As many as 40% of pediatric transfers may be unnecessary, resulting in potential delays in care and unnecessary costs. Our objective was to identify the patient-related factors associated with potentially unnecessary transfers for pediatric patients with asthma. Methods: We used patient care data from the California Department of Health Care Access and Information patient discharge and emergency department (ED) datasets to capture ED visits where a pediatric patient (age 2-17 years) presented with asthma and was transferred to another ED or acute care hospital. The outcome of interest was a potentially unnecessary transfer, defined as a visit where length of stay after transfer was <24 hours and no advanced services were used, such as respiratory therapy or critical care. Patient-related characteristics were extracted, including age, gender, race/ethnicity, primary language, insurance status, and clinical characteristics. First, we used descriptive statistics to compare necessary vs unnecessary transfers. Second, we used generalized estimating equations accounting for clustering by ED to estimate odds ratios (OR) and identify factors associated with potentially unnecessary transfers. Results: A total of 4,233 pediatric ED patients were transferred with a diagnosis of asthma, including 461 (11%) transfers that met criteria as potentially unnecessary. Median age was 12 years (interquartile range 7-15), and 46% were female. Factors associated with increased odds of potentially unnecessary transfer while controlling for key factors included younger age (eg, 2-5 years, OR 2.0, 95% confidence interval [CI] 1.4-2.9), male gender (OR 1.4, 95% CI 1.1-1.7), and Hispanic ethnicity (OR 1.6, 95% CI 1.2-2.1), while multiple hospitalizations for asthma per year was associated with decreased odds (OR 0.2, 95% CI 0.1-0.4). Conclusion: Several patient-related factors were associated with increased or decreased odds of potentially unnecessary transfers among pediatric patients presenting to the ED with asthma. These factors can be considered in future work to better understand, predict, and reduce unnecessary transfers and their negative consequences. [ABSTRACT FROM AUTHOR]

The carotid body paraganglioma is a rare benign neoplasm arising from the chemoreceptor cells of the carotid bulb. The carotid body has the largest collection of paraganglia in the head and neck with 60–70% of head and neck paraganglioma. Paraganglia are clusters of cells originating from the neural crest with histological and cytochemical characteristics of neuroendocrine cells. It is mostly asymptomatic in early presentation but become symptomatic and difficult to manage when the tumor is large. We present a case of a 26-year-old male who presented with a painless, pulsatile, progressively increasing left lateral neck swelling of 5 years duration with Shamblin IIIa. The diagnosis of the tumor was confirmed based on clinical features, histology, and radiological findings. We had difficult surgical dissection of the tumor with neurovascular damage. [ABSTRACT FROM AUTHOR]

Background: Thriving from Work is a construct that has been highlighted as an important integrative positive worker well-being indicator that can be used in both research and practice. Recent public discourse emphasizes the important contributions that work should have on workers' lives in positive and meaningful ways and the importance of valid and reliable instruments to measure worker well-being. The Thriving from Work Questionnaire measures how workers' experiences of their work and conditions of work contributes in positive ways to their thriving both at and outside of work. Methods: The purpose of this study was to translate the Thriving from Work Questionnaire from English to Spanish, and then validate the translated questionnaire in a sample of 8,795 finance workers in Peru and Mexico. We used item response theory models replicating methods that were used for the original validation studies. We conducted a differential item functioning analysis to evaluate any differences in the performance of models between Peru and Mexico. We evaluated criterion validity with organizational leadership, flourishing, vitality, community well-being, and worker's home location socio-economic position. Results: The current study demonstrates that the Spanish (Peru/Mexico) questionnaire was found to be a reliable and valid measure of workers' thriving from work. One item was dropped from the long-form version of the original U.S. questionnaire. Both the long and short form versions of the questionnaire had similar psychometric properties. Empirical reliability was high. Criterion validity was established as hypothesized relationships between constructs was supported. There were no differences in the performance of the model between countries suggesting utility across Latin American countries. Conclusions: The current study demonstrated that the Spanish (Peru and Mexico) version of the questionnaire is both a reliable and valid measure of worker well-being in Latin America. Specific recommendations are made for the adaptation of the questionnaire and directions of future research. [ABSTRACT FROM AUTHOR]

Background: Gut dysbiosis has been linked with both HIV infection and diabetes, but its interplay with metabolic and inflammatory responses in diabetes, particularly in the context of HIV infection, remains unclear. Methods: We first conducted a cross-sectional association analysis to characterize the gut microbial, circulating metabolite, and immune/inflammatory protein features associated with diabetes in up to 493 women (~ 146 with prevalent diabetes with 69.9% HIV +) of the Women's Interagency HIV Study. Prospective analyses were then conducted to determine associations of identified metabolites with incident diabetes over 12 years of follow-up in 694 participants (391 women from WIHS and 303 men from the Multicenter AIDS Cohort Study; 166 incident cases were recorded) with and without HIV infection. Mediation analyses were conducted to explore whether gut bacteria–diabetes associations are explained by altered metabolites and proteins. Results: Seven gut bacterial genera were identified to be associated with diabetes (FDR-q < 0.1), with positive associations for Shigella, Escherichia, Megasphaera, and Lactobacillus, and inverse associations for Adlercreutzia, Ruminococcus, and Intestinibacter. Importantly, the associations of most species, especially Adlercreutzia and Ruminococcus, were largely independent of antidiabetic medications use. Meanwhile, 18 proteins and 76 metabolites, including 3 microbially derived metabolites (trimethylamine N-oxide, phenylacetylglutamine (PAGln), imidazolepropionic acid (IMP)), 50 lipids (e.g., diradylglycerols (DGs) and triradylglycerols (TGs)) and 23 non-lipid metabolites, were associated with diabetes (FDR-q < 0.1), with the majority showing positive associations and more than half of them (59/76) associated with incident diabetes. In mediation analyses, several proteins, especially interleukin-18 receptor 1 and osteoprotegerin, IMP and PAGln partially mediate the observed bacterial genera–diabetes associations, particularly for those of Adlercreutzia and Escherichia. Many diabetes-associated metabolites and proteins were altered in HIV, but no effect modification on their associations with diabetes was observed by HIV. Conclusion: Among individuals with and without HIV, multiple gut bacterial genera, blood metabolites, and proinflammatory proteins were associated with diabetes. The observed mediated effects by metabolites and proteins in genera–diabetes associations highlighted the potential involvement of inflammatory and metabolic perturbations in the link between gut dysbiosis and diabetes in the context of HIV infection. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether patients with basal ganglia calcifications (BGC) should undergo infectious disease testing as part of their diagnostic work-up. We investigated the occurrence of possibly associated infections in patients with BGC diagnosed with Fahr's disease or syndrome and consecutively performed a systematic review of published infectious diseases associated with BGC. Methods: In a cross-sectional study, we evaluated infections in non-immunocompromised patients aged ≥ 18 years with BGC in the Netherlands, who were diagnosed with Fahr's disease or syndrome after an extensive multidisciplinary diagnostic work-up. Pathogens that were assessed included the following: Brucella sp., cytomegalovirus, human herpesvirus type 6/8, human immunodeficiency virus (HIV), Mycobacterium tuberculosis, rubella virus, and Toxoplasma gondii. Next, a systematic review was performed using MEDLINE and Embase (2002–2023). Results: The cross-sectional study included 54 patients (median age 65 years). We did not observe any possible related infections to the BGC in this population. Prior infection with Toxoplasma gondii occurred in 28%, and in 94%, IgG rubella antibodies were present. The positive tests were considered to be incidental findings by the multidisciplinary team since these infections are only associated with BGC when congenitally contracted and all patients presented with adult-onset symptoms. The systematic search yielded 47 articles, including 24 narrative reviews/textbooks and 23 original studies (11 case series, 6 cross-sectional and 4 cohort studies, and 2 systematic reviews). Most studies reported congenital infections associated with BGC (cytomegalovirus, HIV, rubella virus, Zika virus). Only two studies reported acquired pathogens (chronic active Epstein–Barr virus and Mycobacterium tuberculosis). The quality of evidence was low. Conclusions: In our cross-sectional study and systematic review, we found no convincing evidence that acquired infections are causing BGC in adults. Therefore, we argue against routine testing for infections in non-immunocompromised adults with BGC in Western countries. [ABSTRACT FROM AUTHOR]

In this work we seek to enhance the frameworks practitioners in asset management and wealth management may adopt to asses how different screening rules may influence the diversification benefits of portfolios. The problem arises naturally in the area of Environmental, Social, and Governance (ESG) based investing practices as practitioners often need to select subsets of the total available assets based on some ESG screening rule. Once a screening rule is identified, one constructs a dynamic portfolio which is usually compared with another dynamic portfolio to check if it satisfies or outperforms the risk and return profile set by the company. Our study proposes a novel method that tackles the problem of comparing diversification benefits of portfolios constructed under different screening rules. Each screening rule produces a sequence of graphs, where the nodes are assets and edges are partial correlations. To compare the diversification benefits of screening rules, we propose to compare the obtained graph sequences. The method proposed is based on a machine learning hypothesis testing framework called the kernel two-sample test whose objective is to determine whether the graphs come from the same distribution. If they come from the same distribution, then the risk and return profiles should be the same. The fact that the sample data points are graphs means that one needs to use graph testing frameworks. The problem is natural for kernel two-sample testing as one can use so-called graph kernels to work with samples of graphs. The null hypothesis of the two-sample graph kernel test is that the graph sequences were generated from the same distribution, while the alternative is that the distributions are different. A failure to reject the null hypothesis would indicate that ESG screening does not affect diversification while rejection would indicate that ESG screening does have an effect. The article describes the graph kernel two-sample testing framework, and further provides a brief overview of different graph kernels. We then demonstrate the power of the graph two-sample testing framework under different realistic scenarios. Finally, the proposed methodology is applied to data within the SnP500 to demonstrate the workflow one can use in asset management to test for structural differences in diversification of portfolios under different ESG screening rules. [ABSTRACT FROM AUTHOR]

Future transport systems will rely on new electrified drives utilizing batteries and hydrogen-powered fuel cells or combustion engines with sustainable fuels. These systems must complement each other and should not be viewed as competing. Properties such as efficiency, range, as well as transport and storage properties will determine their use cases. This article looks at the usability of liquid electro-fuels in freight transport and analyzes the production capacities that will be necessary through 2050 in Germany. Different scenarios with varying market shares of electro-fuels are considered. A scenario with a focus on fuel cells foresees a quantity of 220 PJ of electro-fuels, i.e., 5.1 million tons, which reduces 80% of carbon dioxide emissions in LDV and HDV transport. A further scenario achieves carbon-neutrality and leads to a demand for nearly 17 million tons of e-fuel, corresponding to 640 PJ. Considering a final production rate of 5.1 million tons of electro-fuels per year leads to maximum investment costs of around EUR 350 million/year in 2036 during the ramp-up phase. The total investment costs for synthesis plants amount to EUR 4.02 billion. A carbon-neutrality scenario requires more than a factor 3 for investment for the production facilities of electro-fuels alone. [ABSTRACT FROM AUTHOR]

This paper reviews the impact of replications published as comments in the American Economic Review between 2010 and 2020. We examine their citations and influence on the original papers' (OPs) subsequent citations. Our results show that comments are barely cited, and they do not affect the OP's citations—even if the comment diagnoses substantive problems. Furthermore, we conduct an opinion survey among replicators and authors and find that there often is no consensus on whether the OP's contribution sustains. We conclude that the economics literature does not self‐correct, and that robustness and replicability are hard to define in economics. [ABSTRACT FROM AUTHOR]

The fundamental goal of a rare plant translocation is to create self‐sustaining populations with the evolutionary resilience to persist in the long term. Yet, most plant translocation syntheses focus on a few factors influencing short‐term benchmarks of success (e.g., survival and reproduction). Short‐term benchmarks can be misleading when trying to infer future growth and viability because the factors that promote establishment may differ from those required for long‐term persistence. We assembled a large (n = 275) and broadly representative data set of well‐documented and monitored (7.9 years on average) at‐risk plant translocations to identify the most important site attributes, management techniques, and species' traits for six life‐cycle benchmarks and population metrics of translocation success. We used the random forest algorithm to quantify the relative importance of 29 predictor variables for each metric of success. Drivers of translocation outcomes varied across time frames and success metrics. Management techniques had the greatest relative influence on the attainment of life‐cycle benchmarks and short‐term population trends, whereas site attributes and species' traits were more important for population persistence and long‐term trends. Specifically, large founder sizes increased the potential for reproduction and recruitment into the next generation, whereas declining habitat quality and the outplanting of species with low seed production led to increased extinction risks and a reduction in potential reproductive output in the long‐term, respectively. We also detected novel interactions between some of the most important drivers, such as an increased probability of next‐generation recruitment in species with greater seed production rates, but only when coupled with large founder sizes. Because most significant barriers to plant translocation success can be overcome by improving techniques or resolving site‐level issues through early intervention and management, we suggest that by combining long‐term monitoring with adaptive management, translocation programs can enhance the prospects of achieving long‐term success. [ABSTRACT FROM AUTHOR]

The second law of thermodynamics and the concept of positive entropy generation are analyzed following classical statistical mechanics methods. Previously, using the generalized Boltzmann–Gibbs entropy and its associated general entropy conservation relation, positive entropy generation expressions were obtained in agreement with phenomenological results and the work of Boltzmann and Gibbs. In this study, using the general approach, we formally and explicitly trace the specific entropy generation expressions to truncations in the full N-body description of the entropy state to a lower s-body description. Using higher-order superposition approximations, it is formally shown that the generalized Boltzmann–Gibbs entropy in the s-order state is always less than the corresponding Boltzmann–Gibbs entropy in the lower (s − 1)-order state. Using the general form of the entropy conservation equation, entropy generation is shown to be a required compensatory effect to ensure that all physical variables and physical processes associated with heat, work, temperature, etc., are independent of the particular entropy definition state. [ABSTRACT FROM AUTHOR]

Simple Summary: The vaginal microbiome may play a role in racial disparities in ovarian cancer; there is evidence suggesting that it differs according to race and contributes to inflammation by producing or consuming compounds that can shape how ovarian cancer progresses. Our cross-sectional study aimed to investigate the extent to which chemical compounds, or metabolites, from vaginal fluid, also differ by race, and whether these metabolites are linked to systemic inflammation. Our study of 20 White and 16 Black patients identified 1 out of 99 metabolites, arachidonoylcarnitine (C20:4), as occurring at lower levels in Black and higher levels in White patients with ovarian cancer. More than one-third of vaginal fluid metabolites considered showed correlations with biomarkers of systemic inflammation. Our findings suggest that vaginal fluid metabolites likely differ by race, and may play an important role in inflammatory processes, which may be relevant to racial differences in ovarian cancer outcomes. These pilot findings have the potential to improve our understanding of biological mechanisms underlying racial disparities in ovarian cancer but need verification with larger sample sizes. The vaginal microbiome differs by race and contributes to inflammation by directly producing or consuming metabolites or by indirectly inducing host immune response, but its potential contributions to ovarian cancer (OC) disparities remain unclear. In this exploratory cross-sectional study, we examine whether vaginal fluid metabolites differ by race among patients with OC, if they are associated with systemic inflammation, and if such associations differ by race. Study participants were recruited from the Ovarian Cancer Epidemiology, Healthcare Access, and Disparities Study between March 2021 and September 2022. Our study included 36 study participants with ovarian cancer who provided biospecimens; 20 randomly selected White patients and all 16 eligible Black patients, aged 50–70 years. Acylcarnitines (n = 45 species), sphingomyelins (n = 34), and ceramides (n = 21) were assayed on cervicovaginal fluid, while four cytokines (IL-1β, IL-10, TNF-α, and IL-6) were assayed on saliva. Seven metabolites showed >2-fold differences, two showed significant differences using the Wilcoxon rank-sum test (p < 0.05; False Discovery Rate > 0.05), and 30 metabolites had coefficients > ±0.1 in a Penalized Discriminant Analysis that achieved two distinct clusters by race. Arachidonoylcarnitine, the carnitine adduct of arachidonic acid, appeared to be consistently different by race. Thirty-eight vaginal fluid metabolites were significantly correlated with systemic inflammation biomarkers, irrespective of race. These findings suggest that vaginal fluid metabolites may differ by race, are linked with systemic inflammation, and hint at a potential role for mitochondrial dysfunction and sphingolipid metabolism in OC disparities. Larger studies are needed to verify these findings and further establish specific biological mechanisms that may link the vaginal microbiome with OC racial disparities. [ABSTRACT FROM AUTHOR]

Introduction: Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties. Methods: A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents. Results: A total of 272/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women 'agreed' or 'strongly agreed' that surgeons have higher pregnancy complication rates than the general population (p<0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p<0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias. Conclusion: Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees. [ABSTRACT FROM AUTHOR]

Recent work has suggested that feedforward residual neural networks (ResNets) approximate iterative recurrent computations. Iterative computations are useful in many domains, so they might provide good solutions for neural networks to learn. However, principled methods for measuring and manipulating iterative convergence in neural networks remain lacking. Here we address this gap by 1) quantifying the degree to which ResNets learn iterative solutions and 2) introducing a regularization approach that encourages the learning of iterative solutions. Iterative methods are characterized by two properties: iteration and convergence. To quantify these properties, we define three indices of iterative convergence. Consistent with previous work, we show that, even though ResNets can express iterative solutions, they do not learn them when trained conventionally on computer-vision tasks. We then introduce regularizations to encourage iterative convergent computation and test whether this provides a useful inductive bias. To make the networks more iterative, we manipulate the degree of weight sharing across layers using soft gradient coupling. This new method provides a form of recurrence regularization and can interpolate smoothly between an ordinary ResNet and a "recurrent" ResNet (i.e., one that uses identical weights across layers and thus could be physically implemented with a recurrent network computing the successive stages iteratively across time). To make the networks more convergent we impose a Lipschitz constraint on the residual functions using spectral normalization. The three indices of iterative convergence reveal that the gradient coupling and the Lipschitz constraint succeed at making the networks iterative and convergent, respectively. To showcase the practicality of our approach, we study how iterative convergence impacts generalization on standard visual recognition tasks (MNIST, CIFAR-10, CIFAR-100) or challenging recognition tasks with partial occlusions (Digitclutter). We find that iterative convergent computation, in these tasks, does not provide a useful inductive bias for ResNets. Importantly, our approach may be useful for investigating other network architectures and tasks as well and we hope that our study provides a useful starting point for investigating the broader question of whether iterative convergence can help neural networks in their generalization. [ABSTRACT FROM AUTHOR]

Introduction: In Nigeria, breast cancer (BC), a disorder marked by the unchecked growth of breast cells, has been the commonest cancer among women in Nigeria. Breast self-examination (BSE) is one of the suggested methods for screening for the early diagnosis of breast cancer. However, studies have reported inadequate knowledge, negative attitudes and poor practices of BSE among undergraduate female students. The study was designed as an interventional study to examine the effect of educational intervention on knowledge, attitude and practice of breast self-examination among female students in a private university in southern Nigeria. Methods: This pretest posttest design study was carried out on 103 students of Novena University at baseline in 2022, which were chosen through the use of simple random sampling. A validated questionnaire with components on demographics, knowledge, attitude, and BSE practice was used to gather the data. After that, the students participated in three hourly sessions of an educational intervention for two weeks. A month later, the students' data were once again collected, and SPSS 20 software was used to evaluate the results using the mean, paired t test, and logistic regression at the P < 0.05 level of significance. Results: The mean age of the respondents was 22.37 ± 1.92 years. Only 53 (51.3%) were aware of BSE. The mean knowledge, attitude and practice of BSE at pretest significantly increased at posttest after the educational intervention (1.58 ± 1.48 vs. 4.31 ± 1.15, 2.37 ± 1.27 vs. 4.80 ± 0.49 and 1.97 ± 0.09 vs. 5.81 ± 3.26, respectively). Furthermore, age and family history of BC were predictors of knowledge (OR = 4.00 95% CI = 0.29–41.99, OR = 141, 95% CI = 0.15–13.18), attitude (OR = 2.39, 95% CI = 0.28–12.32, OR = 1.15, 95% CI = 0.24–8.34) and practice of BSE (OR = 2.66, 95% CI = 0.38–18.41, OR = 1.44, 95% CI = 0.24–8.34) respectively. Conclusion: The findings showed that using an educational intervention strategy will improve the knowledge, attitude and practice of BSE among undergraduate students. [ABSTRACT FROM AUTHOR]

Background The Illumina family of Infnium Methylation BeadChip microarrays has been widely used over the last 15 years for genome-wide DNA methylation profling, including large-scale and population-based studies, due to their ease of use and cost efectiveness. Succeeding the popular HumanMethylationEPIC BeadChip (EPICv1), the recently released Infnium MethylationEPIC v2.0 BeadChip (EPICv2) claims to extend genomic coverage to more than 935,000 CpG sites. Here, we comprehensively characterise the reproducibility, reliability and annotation of the EPICv2 array, based on bioinformatic analysis of both manifest data and new EPICv2 data from diverse biologi‑ cal samples. Results We fnd a high degree of reproducibility with EPICv1, evidenced by comparable sensitivity and precision from empirical cross-platform comparison incorporating whole genome bisulphite sequencing (WGBS), and high correlation between technical sample replicates, including between samples with DNA input levels below the manu‑ facturer’s recommendation. We provide a full assessment of probe content, evaluating genomic distribution and changes from previous array versions. We characterise EPICv2’s new feature of replicated probes and provide recommendations as to the superior probes. In silico analysis of probe sequences demonstrates that probe crosshybridisation remains a signifcant problem in EPICv2. By mapping the of-target sites at single nucleotide resolution and comparing with WGBS we show empirical evidence for preferential of-target binding. Conclusions Overall, we fnd EPICv2 a worthy successor to the previous Infnium methylation microarrays, however some technical issues remain. To support optimal EPICv2 data analysis we provide an expanded version of the EPICv2 manifest to aid researchers in understanding probe design, data processing, choosing appropriate probes for analysis and for integration with methylation datasets from previous versions of the Infnium Methylation BeadChip. [ABSTRACT FROM AUTHOR]

(1) Background: Dog-assisted therapy (DAT) is an experiential intervention to promote psychological, physical, and social functioning in children and adults. Only few studies have been conducted on DAT in adults with a mild intellectual disability or borderline intellectual functioning (MID-BIF). The purpose of this study was to explore the experiences of patients with MID-BIF undergoing DAT in a mental health care facility. (2) Method: Seven patients completed 13 to 15 sessions of DAT. Within two weeks of completing the program, they were interviewed using a semi-structured interview. The transcripts of the interviews were analysed using interpretational phenomenological analysis. In addition, the patients' relatives and the DAT therapist were interviewed, and a focus group discussion took place with each patient's treatment team. (3) Results: The patients' experiences were predominantly positive. Physical contact with the dog calmed them down. The dog offered them emotional support and helped them to make contact inside and outside the therapy and the setting where they lived. The patients also liked the fact that DAT focused on the dog rather than their problems, that the therapy was experiential and using a positive approach, and that, during the therapy, they did not feel like a patient but a human being. DAT is a promising therapy for patients with MID-BIF in mental health care facilities, but more research into its effectiveness and cost-effectiveness and ways to implement DAT in clinical practice is needed to make more definitive statements. [ABSTRACT FROM AUTHOR]

ABSTRACT--Recent developments at the U.S. Supreme Court have rekindled debates over textualism. Missing from the conversation is a discussion of the courts that decide the vast majority of statutory interpretation cases in the United States--state courts. This Article uses supervised machine learning to conduct the first-ever empirical study of the statutory interpretation methods used by state supreme courts. In total, this study analyzes over 44,000 opinions from all fifty states from 1980 to 2019. This Article establishes several key descriptive findings. First, since the 1980s, textualism has risen rapidly in state supreme court opinions. Second, this rise is primarily attributable to increased reliance on the statute's plain meaning. Third, state supreme courts use tools of statutory interpretation often associated with textualism--plain meaning, dictionaries, and linguistic canons--much more often than legislative history or consequences. And fourth, there is dramatic variation in textualism use across states. This Article also conducts several exploratory analyses investigating whether ideology and judicial selection are associated with the use of textualist tools. I find that conservative justices invoke textualist reasoning slightly more often. And, while the estimates are noisy, the findings also indicate this ideological gap is primarily explained by conservatives' heightened tendency to invoke the plain meaning rule. As for judicial selection, cross-state evidence suggests that justices appointed by governors and legislatures use textualism more frequently than those selected via election or merit commission. These findings add empirical discipline to ongoing debates about ideology and textualism. They also reframe priorities for future research on the plain meaning rule, textualism in general, and judicial selection's relationship to statutory interpretation. More broadly, they illustrate how natural language processing methods can help statutory interpretation scholarship expand its focus and study state courts. [ABSTRACT FROM AUTHOR]

Orientation is a fundamental cognitive faculty and the bedrock of the neurologic examination. Orientation is defined as the alignment between an individual's internal representation and the external world in the spatial, temporal, and social domains. While spatial disorientation is a recognized hallmark of Alzheimer's disease (AD), little is known about disorientation beyond space in AD. This study aimed to explore disorientation in spatial, temporal, and social domains along the AD continuum. Fifty‐one participants along the AD continuum performed an ecological orientation task in the spatial, temporal, and social domains while undergoing functional MRI. Disorientation in AD followed a three‐way association between orientation domain, brain region, and disease stage. Specifically, patients with early amnestic mild cognitive impairment exhibited spatio‐temporal disorientation and reduced brain activity in temporoparietal regions, while patients with AD dementia showed additional social disorientation and reduced brain activity in frontoparietal regions. Furthermore, patterns of hypoactivation overlapped different subnetworks of the default mode network, patterns of fluorodeoxyglucose hypometabolism, and cortical atrophy characteristic of AD. Our results suggest that AD may encompass a disorder of orientation, characterized by a biphasic process manifesting as early spatio‐temporal and late social disorientation. As such, disorientation may offer a unique window into the clinicopathological progression of AD. Significance statement: Despite extensive research into Alzheimer's disease (AD), its core cognitive deficit remains a matter of debate. In this study, we investigated whether orientation, defined as the ability to align internal representations with the external world in spatial, temporal, and social domains, constitutes a core cognitive deficit in AD. To do so, we used PET‐fMRI imaging to collect behavioral, functional, and metabolic data from 51 participants along the AD continuum. Our findings suggest that AD may constitute a disorder of orientation, characterized by an early spatio‐temporal disorientation and followed by late social disorientation, manifesting in task‐evoked and neurodegenerative changes. We propose that a profile of disorientation across multiple domains offers a unique window into the progression of AD and as such could greatly benefit disease diagnosis, monitoring, and evaluation of treatment response. [ABSTRACT FROM AUTHOR]

Microfluidic 3D cell culture devices that enable the recapitulation of key aspects of organ structures and functions in vivo represent a promising preclinical platform to improve translational success during drug discovery. Essential to these engineered devices is the spatial patterning of cells from different tissue types within a confined microenvironment. Traditional fabrication strategies lack the scalability, cost‐effectiveness, and rapid prototyping capabilities required for industrial applications, especially for processes involving thermoplastic materials. Here, an approach to pattern fluid guides inside microchannels is introduced by establishing differential hydrophilicity using pressure‐sensitive adhesives as masks and a subsequent selective coating with a biocompatible polymer. Optimal coating conditions are identified using polyvinylpyrrolidone, which resulted in rapid and consistent hydrogel flow in both the open‐chip prototype and the fully bonded device containing additional features for medium perfusion. The suitability of the device for dynamic 3D cell culture is tested by growing human hepatocytes in the device under controlled fluid flow for a 14‐day period. Additionally, the study demonstrated the potential of using the device for pharmaceutical high‐throughput screening applications, such as predicting drug‐induced liver injury. The approach offers a facile strategy of rapid prototyping thermoplastic microfluidic organ chips with varying geometries, microstructures, and substrate materials. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups. Methods: Between April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants' physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions. Results: Out of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO's physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI:.117;.126) while engaging in more sedentary behavior (M = 0.24; 95% CI:.240;.247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines. Conclusions: Mobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the association between cardiorespiratory fitness (CRF) and long-term survival in United States (US) Veterans undergoing CABG. We identified 14,550 US Veterans who underwent CABG at least six months after completing a symptom-limited exercise treadmill test (ETT) with no evidence of cardiovascular disease. During a mean follow-up period of 10.0 ± 5.4 years, 6502 (43.0%) died. To assess the association between CRF and risk of mortality, we formed the following five fitness categories based on peak workload achieved (metabolic equivalents or METs) prior to CABG: Least-Fit (4.3 ± 1.0 METs (n = 4722)), Low-Fit (6.8 ± 0.9 METs (n = 3788)), Moderate-Fit (8.3 ± 1.1 METs (n = 2608)), Fit (10.2 ± 0.8 METs (n = 2613)), and High-Fit (13.0 ± 1.5 METs (n = 819)). Cox proportional hazard models were used to calculate risk across CRF categories. The models were adjusted for age, body mass index, race, cardiovascular disease, percutaneous coronary intervention prior to ETT, cardiovascular medications, and cardiovascular disease risk factors. P-values < 0.05 using two-sided tests were considered statistically significant. The association between cardiorespiratory fitness and mortality was inverse and graded. For every 1-MET increase in exercise capacity, the mortality risk was 11% lower (HR = 0.89; CI: 0.88–0.90; p < 0.001). When compared to the Least-Fit category (referent), mortality risk was 22% lower in Low-Fit individuals (HR = 0.78; CI: 0.73–0.82; p < 0.001), 31% lower in Moderate-Fit individuals (HR = 0.69; CI: 0.64–0.74; p < 0.001), 52% lower in Fit individuals (HR = 0.48; CI: 0.44–0.52; p < 0.001), and 66% lower in High-Fit individuals (HR = 0.34; CI: 0.29–0.40; p < 0.001). Cardiorespiratory fitness is inversely and independently associated with long-term mortality after CABG in Veterans referred for exercise testing. [ABSTRACT FROM AUTHOR]

Ideas are important as a foundation for public policy, but they can also become 'zombie ideas' which survive even though they have been proven to be ineffective. Both the political right and the political left have their own zombie ideas, and when there is a change in government old ideas may return. This article presents the concept of zombie ideas and discusses its relevance for policy in New Zealand. [ABSTRACT FROM AUTHOR]

In the US, 3 rescue treatment options are approved for patients with seizure clusters (ie, acute repetitive seizures), which are intermittent increases of seizure activity. This narrative PubMed review of these 3 treatments examines newer intranasal options that are well suited for adolescent and adult patients who may desire a transition from rectal treatment. Diazepam rectal gel is indicated for patients ≥ 2 years, diazepam nasal spray for those ≥ 6 years, and midazolam nasal spray for those ≥ 12 years. Approvals for diazepam rectal gel and midazolam nasal spray were based on safety and efficacy comparisons with placebo. Approval for diazepam nasal spray was based on results from long-term safety and tolerability studies in addition to its comparable bioavailability to diazepam rectal gel, while also showing less interpatient variability. The safety profiles of diazepam rectal gel and nasal spray are similar, and the medications share safety, warning, and precaution labeling. Thus, patients ≥ 6 years could be introduced to intranasal diazepam, allowing for continuity of familiar treatment while improving access and comfort. Intranasal midazolam also has a well-characterized safety profile. A proxy for effectiveness is the number of seizure clusters that were treated with a single dose, and these differed in separate, noncomparative studies. The safety and effectiveness of diazepam nasal spray have been examined in multiple subpopulations, whereas patient/caregiver experiences with both approved intranasal formulations have been characterized. Users may prefer nasal administration because it is noninvasive and effective, and provides social advantages, comfort, ease of use, and less variability compared with rectal gel. Nasal sprays are portable and convenient for use in the community (school, work, travel), and self-administration was reported in one study, with patients as young as 11 years old self-administering diazepam nasal spray. These newer, intranasal rescue treatments for seizure clusters provide an alternative to the rectal route. Plain Language Summary: Some people with epilepsy may have seizure clusters, which are often defined as 2 or more seizures in a day that are not part of their normal seizure pattern. Rescue treatments approved in the United States are diazepam rectal gel, diazepam nasal spray, and midazolam nasal spray. These rescue drugs can help stop seizure clusters at home, school, or work. Diazepam rectal gel is for adults and children ages 2 years or older. To give a rectal dose, the caregiver must pull down the patient's underwear. Spraying nasal treatment into the nose may be less embarrassing. Because some patients may want to switch their treatment, we looked for articles about how to use these treatments and summarized what we found. Diazepam nasal spray is for patients ages 6 years or older and midazolam nasal spray is for patients 12 years or older. Diazepam rectal gel and nasal spray use the same drug, and dosing is based on patient age and weight. Midazolam nasal spray uses a different drug, and everyone uses the same dose. Some drugs may be more likely than others to need a second dose for a seizure. Patients and caregivers (care partners) felt that diazepam nasal spray was easier to use than rectal gel. They were also more comfortable using diazepam nasal spray in public. Patients as young as 11 years have used diazepam nasal spray by themselves. In all, patients may prefer nasal treatment and now have options to change from rectal treatment of seizure clusters. [ABSTRACT FROM AUTHOR]

This paper presents new methodologies for modeling static VAr compensators (SVCs) in the power flow problem. The proposed formulations utilize sigmoid functions to model the control equations that describe the steady-state behavior of SVCs. The first methodology introduces reactive power injection as a new state variable, while the second methodology utilizes the thyristor firing angle. These steady-state SVC methodologies were applied to the power flow problem using the full Newton formulation, which incorporates the control equations into the system of nonlinear equations. One of the main contributions of these proposed methodologies is that they eliminate the need for alternating adjustments concerning the operational limits of the SVC during the iterative power flow process. The implementation of a power flow program was tested on both small-scale tutorial systems and the medium-scale IEEE Nordic system. The presented results validate and demonstrate the effectiveness of the proposed methodology. [ABSTRACT FROM AUTHOR]

Aims: To increase our understanding of which factors contribute to long‐term benzodiazepine receptor agonist (BZRA) use for insomnia in primary care, from a patients', general practitioners' (GP) and pharmacists' perspective. Design: Qualitative research following a grounded theory approach. Setting: Primary care in Belgium. Participants: Twenty‐four participants were interviewed, including nine patients, six GPs and nine pharmacists. Measurements: In‐depth, semistructured interviews with iterative cycles of data collection and analysis. Transcripts were analysed using the framework method. Thematic findings were interpreted in the context of the Theoretical Domains Framework. Findings: A reflexive relation was identified between views about hypnotic use at the level of society, healthcare and patients. Behaviour change appeared to depend strongly on context and social influence, including a need for supporting relationships by all stakeholders. Six key messages captured factors that contribute to long‐term BZRA use for insomnia in primary care: societal beliefs as a game changer, the opportunity of nonpharmacological treatment, collaborative primary care, patient‐centred goals, informed consent and self‐management. Conclusions: Long‐term BZRA use for insomnia is a complex and multifaceted public health problem that is not adequately addressed in primary care at this time. Although primary care professionals in this study found discontinuation of long‐term BZRA use relevant to the patient's health, many organisational and personal barriers were reported. Moreover, the current social and healthcare context is not empowering patients and professionals to reduce long‐term BZRA use for insomnia. Specifically, for primary care, all stakeholders reported the need for a nonmedicalised relationship between the patient and GP to lower prescribing rates. Patient or Public Contribution: The Flemish Patient Platform, a patient representative organisation, assisted with recruitment by launching a call for participants in their newsletter and volunteered to disseminate the results. The call for recruitment was also published online in social media groups regarding insomnia and via posters in public pharmacies. Patients or public were not involved in designing or conducting the interview study. [ABSTRACT FROM AUTHOR]

Reducing the heat demand of existing buildings is an essential prerequisite for achieving a greenhouse gas-neutral energy supply. Numerous studies and open-source tools deal with heat demand mapping. It is not uncommon that estimated heat demands deviate from real heat consumption, so existing approaches should be improved by including in-depth building information. Some tools have recognised this problem and offer built-in functions for factoring various parameters into their assessments. Nevertheless, the necessary information is usually missing and should be obtained first. In this paper, we analyse the impact of thermal refurbishment and climate on building heat demand; hence, generate public datasets with corresponding key figures for each building type in different efficiency states and years. Accounting for already performed refurbishments in methodologies for assessing the actual state heat demand for cities will result in a reduction of at least 8% up to more than 21%, depending on whether conventional or passive house components were installed. As a result of climatic differences within Germany, a building's heat demand can be up to 39% higher or up to 21% lower than the heat demand of an identical building in the reference climate of Germany. By further developing the approaches of the tools Hotmaps and Heat Cadastre Hamburg, we could improve the estimated heat demand of Hamburg to a value approximating the real consumption. [ABSTRACT FROM AUTHOR]

Driver mutations are considered the cornerstone of cancer initiation. They are defined as mutations that convey a competitive fitness advantage, and hence, their mutation frequency in premalignant tissue is expected to exceed the basal mutation rate. In old terms, that translates to "the survival of the fittest" and implies that a selective process underlies the frequency of cancer driver mutations. In that sense, each tissue is its own niche that creates a molecular selective pressure that may favor the propagation of a mutation or not. At the heart of this stands one of the biggest riddles in cancer biology: the tissue-predisposition to cancer driver mutations. The frequency of cancer driver mutations among tissues is non-uniform: for instance, mutations in APC are particularly frequent in colorectal cancer, and 99% of chronic myeloid leukemia patients harbor the driver BCR-ABL1 fusion mutation, which is rarely found in solid tumors. Here, we provide a mechanistic framework that aims to explain how tissue-specific features, ranging from epigenetic underpinnings to the expression of viral transposable elements, establish a molecular basis for selecting cancer driver mutations in a tissue-specific manner. [ABSTRACT FROM AUTHOR]

Proteomic fingerprinting using MALDI-TOF mass spectrometry is a well-established tool for identifying microorganisms and has shown promising results for identification of animal species, particularly disease vectors and marine organisms. And thus can be a vital tool for biodiversity assessments in ecological studies. However, few studies have tested species identification across different orders and classes. In this study, we collected data from 1246 specimens and 198 species to test species identification in a diverse dataset. We also evaluated different specimen preparation and data processing approaches for machine learning and developed a workflow to optimize classification using random forest. Our results showed high success rates of over 90%, but we also found that the size of the reference library affects classification error. Additionally, we demonstrated the ability of the method to differentiate marine cryptic-species complexes and to distinguish sexes within species. [ABSTRACT FROM AUTHOR]

One problem highlighted by intersectional and Black feminist theory is that not all oppressed agents are oppressed in the same ways and to the same degree. One of the implications of this for responsibility practices is that social practices of exculpation will not apply equally across all agents. This article explores two false social narratives about far-right women and evaluates them according to the standard view of moral responsibility. The first narrative of misogyny as exculpation holds that far-right women are themselves victims of oppression (of the misogyny of their own movements) and thus not blameworthy for their actions, as misogyny undermines their control and knowledge on the standard view of moral responsibility. The second narrative of infantilization as exculpation also proposes that women lack both knowledge and control on the standard view. The narrative tells us that (White) women, unable to protect themselves, must be protected and avenged by (White) men. If we assume the standard view of moral responsibility, both of these narratives impede our ability to hold far-right women responsible. By instead proposing the adoption of the rational relations view of Angela Smith, this article seeks to demonstrate how a nonvolitionalist account of responsibility can itself become a feminist response to far-right women's extremism with larger implications for our responsibility practices as a whole. [ABSTRACT FROM AUTHOR]

Monitoring the spatial distribution and trends in surface greenhouse gas (GHG) fluxes, as well as flux attribution to natural and anthropogenic processes, is essential to track progress under the Paris Agreement and to inform its Global Stocktake. This study updates earlier syntheses (Petrescu et al., 2020, 2021, 2023) and provides a consolidated synthesis of CH4 emissions using bottom-up (BU) and top-down (TD) approaches for the European Union (EU) and seven additional countries with large anthropogenic and/or natural emissions (USA, Brazil, China, India, Indonesia, Russia, and the Democratic Republic of Congo (DR Congo)). The work utilizes updated National GHG Inventories (NGHGIs) reported by Annex I Parties under the United Nations Framework Convention on Climate Change (UNFCCC) in 2023 and the latest available Biennial Update Reports (BURs) reported by non-Annex I Parties. The NGHGIs are considered in an integrated analysis that also relies on independent flux estimates from global inventory datasets, process-based models, inverse modeling and, when available, respective uncertainties. Whenever possible, it extends the period to 2021. Comparing NGHGIs with other approaches reveals that differences in the emission sources that are included in the estimate is a key source of divergence between approaches. A key system boundary difference is whether both anthropogenic and natural fluxes are included and, if they are, how fluxes belonging to these two sources are grouped/partitioned. Additionally, the natural fluxes are sensitive to the prior geospatial distribution of emissions in atmospheric inversions. Over the studied period, the total CH4 emissions in the EU, USA, and Russia show a steady decreasing trend since 1990, while for the non-EU emitters analyzed in this study, Brazil, China, India, Indonesia, and DR Congo, CH4 emissions have generally increased. In the EU, the anthropogenic BU approaches are reporting relatively similar mean emissions over 2015 to 2020 of 18.5 ± 2.7 Tg CH4 yr-1 for EDGAR v7.0, 16 Tg CH4 yr-1 for GAINS and 19 Tg CH4 yr-1 for FAOSTAT, with the NGHGI estimates of 15 ± 1.8 Tg CH4 yr-1. Inversions give higher emission estimates as they include natural emissions. Over the same period, the three high-resolution regional inversions report a mean emission of 21 (19-25) Tg CH4 yr-1, while the mean of six coarser-resolution global inversions results in emission estimates of 24 (23-25) Tg CH4 yr-1. The magnitude of BU natural emissions (peatland and mineral soils, lakes and reservoirs, geological and biomass burning) accounts for 6.6 Tg CH4 yr-1 (Petrescu et al., 2023a) and explains the differences between the TD inversions and the BU estimates of anthropogenic emissions (including NGHGIs). For the other Annex I Parties in this study (USA and Russia), over 2015 to 2020, the mean of the four anthropogenic BU approaches reports 18.5 (13-27.9) Tg CH4 yr-1 for Russia and 29.1 (23.5- Tg CH4 yr-1 for the USA, against total TD mean estimates of 37 (30-43) Tg CH4 yr-1 and 43.4 (42-48) Tg CH4 yr-1, respectively. The averaged BU and TD natural emissions account for 16.2 Tg CH4 yr-1 for Russia and 14.6 Tg CH4 yr-1 for the USA, partly explaining the gap between the BU anthropogenic and total TD emissions. For the non-Annex I Parties, anthropogenic CH4 estimates from UNFCCC BURs show large differences with the other global inventory-based estimates and even more with atmospheric-based ones. This poses an important potential challenge to monitoring the progress of the global CH4 pledge and the Global Stocktake, not only from the availability of data but also its accuracy. By systematically comparing the BU with TD methods, this study provides recommendations for more robust comparisons of available data sources and hopes to steadily engage more Parties in using observational methods to complement their UNFCCC inventories, as well as considering their natural emissions. With anticipated improvements in atmospheric modeling and observations, as well as modeling of natural fluxes, future development needs to resolve knowledge gaps in both BU and TD approaches and to better quantify remaining uncertainty. Consequently, TD methods may emerge as a powerful tool for verifying emission inventories for CH4, and other GHGs and informing international climate policy. The referenced datasets related to figures are available at https://doi.org/10.5281/zenodo.10276087 (Petrescu et al., 2023b). [ABSTRACT FROM AUTHOR]

INTRODUCTION Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic. METHODS We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms. RESULTS We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts. CONCLUSIONS The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use. [ABSTRACT FROM AUTHOR]

In this study, two surrogate modeling approaches will be investigated for their ability to predict store surface pressure distributions as a store is launched from a rotorcraft in hover. To generate these surrogate models, three computational fluid dynamics (CFD) simulations were completed while varying the propulsive force assigned to the store. Once the surrogate models were generated, an additional CFD simulation with a new propulsive force was assigned to the store. The results of this validation indicate that although the proper orthogonal decomposition (POD) surrogate model struggled to provide detailed predictions of store-distributed loads, mean load variations could be modeled well. The results further indicated that by leveraging the convolutional neural network (CNN)-based surrogate model, a significant improvement in distributed load modeling could be obtained. It was further identified that once distributed loads were integrated, both POD- and CNN-based surrogate models provided a viable path for the generation of a trajectory prediction-based surrogate model for rotorcraft applications. Both POD- and CNN-based surrogate models provided significantly reduced computational costs. For each rotorcraft store separation CFD simulation, the computational cost required 10 days of simulation time across 880 central processing unit cores. While using the surrogate model, comparable predictions could be produced in under 3 min on a single core. [ABSTRACT FROM AUTHOR]

A fundamental challenge in the practical implementation of multistatic radar systems (MSRS) is the requirement for precise time and frequency synchronisation between the spatially separated radar nodes. The authors evaluate the performance of different classes of commercially available Global Navigation Satellite Systems (GNSS) timing receivers, Local Oscillators (LO) and GNSS Disciplined Oscillators (GNSSDOs) to determine the limitations of using one‐way GNSS Time and Frequency Transfer (TFT) in this application. From evaluating the performance of three pairs of GNSSDOs, it is concluded that one‐way GNSS TFT will likely be suitable only for the synchronisation of fully spatially coherent MSRS with carrier frequencies up to 100 MHz and waveform bandwidths up to 20 MHz. Whereas, in the case of short‐term spatially coherent MSRS, synchronisation of systems with carrier frequencies up to a few GHz and waveform bandwidths of over 100 MHz will likely be possible. The performance of the different classes of GNSSDOs during GNSS denial (holdover) are evaluated, where it is concluded that frequency offsets between LOs at the point of GNSS denial will often significantly contribute, or even dominate, the holdover performance. Analysis of two practical multistatic radar measurements verifies the function of using the GNSSDOs for wireless synchronisation of the ARESTOR MSRS. [ABSTRACT FROM AUTHOR]

Background: Sex-specific trends over time with respect to kidney graft survival have scarcely been described in earlier studies. The present study aimed to examine whether kidney graft survival differs between women and men over time. Methods: This study was based on prospectively collected data extracted from a quality registry including all kidney transplant patients between January 1965 and September 2017 at the transplantation center of a university hospital in Sweden. The transplantation center serves a population of approximately 3.5 million inhabitants. Only the first graft for each patient was included in the study resulting in 4698 transplantations from unique patients (37% women, 63% men). Patients were followed-up until graft failure, death, or the end of the study. Death-censored graft survival analysis after kidney transplantation (KT) was performed using Kaplan-Meier analysis with log-rank test, and analysis adjusted for confounders was performed using multivariable Cox regression analysis. Results: Median age at transplantation was 48 years (quartiles 36-57 years) and was similar for women and men. Graft survival was analyzed separately in four transplantation periods that represented various immunosuppressive regimes (1965-1985, 1986-1995, 1996-2005, and 2006-2017). Sex differences in graft survival varied over time (sex-by-period interaction, p = 0.026). During the three first periods, there were no significant sex differences in graft survival. However, during the last period, women had shorter graft survival (p = 0.022, hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.1-2.7, adjusted for covariates). Biopsy-proven rejections were more common in women. Conclusions: In this registry-based study, women had shorter graft survival than men during the last observation period (years 2006-2017). [ABSTRACT FROM AUTHOR]

Groundwater discharge into streams influences the biodiversity and health of groundwater-dependent stream ecosystems. These localized upwelling zones may act as biodiversity hotspots, or areas with a heightened amount of endemic species richness and abundance when compared to the surrounding locality. This input water creates environments with unique chemical compositions and water temperatures that serve as ideal habitat for various species within the ecosystem. Although difficult to identify and sample, these underwater groundwater–surface water interaction zones are important for fish spawning, benthic macroinvertebrate biodiversity, microbial communities, and aquatic and riparian vegetation. In this review, we highlight the groundwater characteristics that influence stream biodiversity and community structure. We argue for the importance of increased research on biodiversity indicators of groundwater upwelling zones as well as more public involvement through citizen science practices on the indirect and direct relationships between groundwater and dependent stream ecosystems. The unique characteristics that differentiate groundwater from surface water in a stream environment can be ideal conditions for fish, benthic macroinvertebrates, vegetation, and bacteria. Groundwater upwelling zones act as biodiversity hotspots that may have a key role in the overall health of a stream community. Research that revolves around groundwater-stream interactions is limited and difficult to accomplish, with no standardized hydrologic or ecological methods of measurement. It is crucial to not only make measurement collection practices and data interpretation commonplace but increase awareness of the relationship between groundwater-stream interactions and biodiversity hotspots. [ABSTRACT FROM AUTHOR]