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Mitochondrial transplantation has been used to treat various diseases associated with mitochondrial dysfunction. Here, we highlight the considerations in quality control mechanisms that should be considered in the context of mitochondrial transplantation.

Regular monitoring and inspection of military railroad tracks are necessary to ensure the safe transportation of military freight. Manual railroad inspection has drawbacks and limitations that can impact accuracy and efficiency. This study introduces a novel tool designed to automate Ground Penetrating Radar (GPR) imaging interpretation for railroad ballast condition assessment, aiming to reduce human intervention in inspections. The tool uses advanced signal processing techniques, such as the Short-Time Fourier Transform (STFT) and Wavelet Transform (WT), to quantify ballast fouling levels accurately, enhancing maintenance and safety protocols for railroad tracks. Validation through comprehensive testing, including two case studies, demonstrates the tool’s superior efficacy over traditional manual inspection methods. This research represents a pivotal step towards more efficient and reliable infrastructure management, ensuring critical railroad systems’ safety and operational integrity.

Abstract High-grade serous ovarian carcinoma (HGSOC) is genetically unstable and characterised by the presence of subclones with distinct genotypes. Intratumoural heterogeneity is linked to recurrence, chemotherapy resistance, and poor prognosis. Here, we use spatial transcriptomics to identify HGSOC subclones and study their association with infiltrating cell populations. Visium spatial transcriptomics reveals multiple tumour subclones with different copy number alterations present within individual tumour sections. These subclones differentially express various ligands and receptors and are predicted to differentially associate with different stromal and immune cell populations. In one sample, CosMx single molecule imaging reveals subclones differentially associating with immune cell populations, fibroblasts, and endothelial cells. Cell-to-cell communication analysis identifies subclone-specific signalling to stromal and immune cells and multiple subclone-specific autocrine loops. Our study highlights the high degree of subclonal heterogeneity in HGSOC and suggests that subclone-specific ligand and receptor expression patterns likely modulate how HGSOC cells interact with their local microenvironment.

Objective: The purpose of this analysis was to explore adolescent and adult women's interest in public health messaging around bladder health and perceptions of its usefulness. Materials and Methods: Directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health across the life course. This article reports an analysis of the "Public Health Messaging" code, which included participants' desire or need for information about bladder health and recommendations for appropriate priority audiences. Results: Forty-four focus groups were conducted with 360 participants organized into six age groups (11-93 years). There was consensus across age groups that more information about the bladder is wanted and needed throughout the life course, as there is currently a lack of reliable educational resources. Information on bladder health was seen as useful and important because it enables people to anticipate negative changes in bladder health and act to prevent these. Several priority audiences were identified based on their risk of developing symptoms, but participants also saw value in educating the general public regardless of risk status. They also recommended education for parents and teachers who are in positions to control bathroom access. Conclusions: Results indicate a uniform desire for information on women's bladder health and a need for more research to develop individual prevention strategies and public health messaging for women of all ages, as well as guidance for organizations with a role in supporting bladder health.

Summary: Abdominal and thoracic aortic aneurysms (AAAs, TAAs) remain a major cause of deaths worldwide, in part due to the lack of reliable prognostic markers or early warning signs. Sox6 has been found to regulate renin controlling blood pressure. We hypothesized that Sox6 may serve as an important regulator of the mechanisms contributing to hypertension-induced aortic aneurysms. Phenotype and laboratory-wide association scans in a clinical cohort found that SOX6 gene expression is associated with aortic aneurysm in subjects of European ancestry. Sox6 and tumor necrosis factor alpha (TNF-α) expression were upregulated in aortic tissues from patients affected by either AAA or TAA. In Sox6 knockout mice with angiotensin-II-induced AAA, we found that Sox6 plays critical role in the development and progression of AAA. Our data support a regulatory role of SOX6 in the development of hypertension-induced AAA, suggesting that Sox6 may be a therapeutic target for the treatment of aortic aneurysms.

The evolving role of the sideline physician in sports medicine frequently involves comprehensive responsibilities beyond direct medical care. We outline important aspects of sideline preparedness and management, including the development and rehearsal of Emergency Action Plans (EAPs), initial approaches to assessing injured athletes, equipment removal strategies, and return-to-play decision-making processes. Epidemiological insights into sports injuries, particularly catastrophic events, underscore the importance of venue-specific planning within EAPs. We also provide guidance and recommendations for nuanced medical procedures such as IV fluid administration, anesthetic joint injections, and Toradol use, addressing current controversies and evidence-based recommendations. Medicolegal and ethical considerations emphasize the necessity of navigating legal statutes and maintaining patient confidentiality while adhering to ethical principles. Overall, this concept review underscores the multifaceted nature of the sideline physician's role, emphasizing evidence-based practice, transparent communication, and collaboration with stakeholders for optimal athlete care across all levels of play. Key Concepts: (1) Evolution of sideline physician role: the manuscript explores the expanded responsibilities of sideline physicians beyond direct medical care, encompassing aspects such as emergency action plan development and return-to-play decisions. (2) Importance of emergency preparedness: emphasizes the crucial role of rehearsed emergency action plans in effectively managing on-field emergencies and optimizing patient outcomes. (3) Nuanced medical procedures: discusses controversies and evidence-based recommendations surrounding procedures like IV fluid administration, anesthetic joint injections, and Toradol use. (4) Medicolegal and ethical considerations: addresses the necessity for navigating legal statutes, maintaining patient confidentiality, and adhering to ethical principles in sports medicine practice. (5) Collaborative care approach: underscores the significance of evidence-based practice, transparent communication, and collaboration with stakeholders for providing optimal athlete care across all levels of play.

Background: In New Zealand a progressive increase in budesonide/formoterol dispensing, accompanied by a reduction in dispensing of short-acting β2-agonists (SABAs), inhaled corticosteroids (ICSs), and other ICS/long-acting β2-agonists (ICSs/LABAs), occurred in the 18-month period following publication of the 2020 New Zealand asthma guidelines, which recommended budesonide/formoterol anti-inflammatory reliever therapy. Objective: Our aim was to investigate more recent trends in asthma medication use and asthma hospital discharges in New Zealand. Methods: New Zealand national dispensing data for inhalers for the period from January 2010 to December 2022 were reviewed for patients aged 12 years and older. Monthly rates of dispensing of budesonide/formoterol, ICSs, other ICS/LABAs, and SABAs were displayed graphically by locally weighted scatterplot smoother plots. The rates of dispensing and hospital discharge for asthma were compared between the past 6 months for which dispensing data were available (July-December 2022) and the corresponding period from July to December 2019. Results: There has been a progressive increase in dispensing of budesonide/formoterol since 2019, with a 108% increase between the period from July to December 2019 and the period from July to December 2022 in adolescents and adults. In contrast, there was a reduction in rates of dispensing of other ICS/LABAs, ICSs, and SABAs by 3%, 18%, and 5%, respectively. During this period, there was a 17% reduction in hospital discharges for asthma. Conclusion: There has been a further widespread uptake of ICS/formoterol reliever and/or maintenance therapy in adolescents and adults with asthma in New Zealand. The changes in prescribing practice have been temporally associated with a reduction in hospital admissions for asthma.

This research explores the predictive capabilities of random forests algorithm on datasets coming from standard experiments on crop management systems in soybeans. This is a secondary analysis of a dataset from a project evaluating the relationship of cover crop systems to soybean yield prediction. The purpose of this paper is to compare a random forest algorithm to standard statistical techniques such as linear regression on a clean information rich agronomic experiment. The main findings include an estimate of the hyperparameters for optimal predictions using random forests, a threshold for data for optimal results and a general description of comparison methodologies for AI based techniques.

Background The optimal target oxygen saturation (SpO2) range for hospital inpatients not at risk of hypercapnia is unknown. The objective of this study was to assess the impact on oxygen usage and National Early Warning Score 2 (NEWS2) of changing the standard SpO2 target range from 94–98% to 92–96%.Methods In a metropolitan UK hospital, a database of electronic bedside SpO2 measurements, oxygen prescriptions and NEWS2 records was reviewed. Logistic regression was used to compare the proportion of hypoxaemic SpO2 values (

School counselors often experience high levels of stress that may result from a variety of factors including multiple job responsibilities, role ambiguity, high caseloads, limited clinical supervision, and exposure to students who have experienced trauma (DeMato & Curcio, 2004; Lambie, 2007; McCarthy et al., 2010; Rumsey, 2017; Mullen & Gutierrez, 2016). This article reports findings from a pilot study that further explored the relationship between counselor activities and demographic variables on school counselors' (N=55) levels of secondary traumatic stress after controlling for burnout and years of experience. Findings indicate that overall secondary traumatic stress was low to moderate with Coordination and Other activities significantly influencing the outcome. This brings attention to the contributing factors of secondary traumatic stress in school counselors that can inform educational training, wellness interventions, and environmental supports for school counselors. This pilot study resulted in encouraging findings and future implications are discussed.

Raising the Voice of the Environmental Health Workforce The National Environmental Health Association's (NEHA) 86th Annual Educational Conference (AEC) & Exhibition continued our longstanding tradition of providing innovative content to [...]

Abstract Pediatric Crohn’s disease (CD) is characterized by a severe disease course with frequent complications. We sought to apply machine learning-based models to predict risk of developing future complications in pediatric CD using ileal and colonic gene expression. Gene expression data was generated from 101 formalin-fixed, paraffin-embedded (FFPE) ileal and colonic biopsies obtained from treatment-naïve CD patients and controls. Clinical outcomes including development of strictures or fistulas and progression to surgery were analyzed using differential expression and modeled using machine learning. Differential expression analysis revealed downregulation of pathways related to inflammation and extra-cellular matrix production in patients with strictures. Machine learning-based models were able to incorporate colonic gene expression and clinical characteristics to predict outcomes with high accuracy. Models showed an area under the receiver operating characteristic curve (AUROC) of 0.84 for strictures, 0.83 for remission, and 0.75 for surgery. Genes with potential prognostic importance for strictures (REG1A, MMP3, and DUOX2) were not identified in single gene differential analysis but were found to have strong contributions to predictive models. Our findings in FFPE tissue support the importance of colonic gene expression and the potential for machine learning-based models in predicting outcomes for pediatric CD.

Background and Aims: Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions influenced heavily by environmental factors. DNA methylation is a form of epigenetic regulation linking environmental stimuli to gene expression changes and inflammation. Here, we investigated how DNA methylation of the tumor necrosis factor (TNF) promoter differs between inflamed and uninflamed mucosa of IBD patients, including anti-TNF responders and nonresponders. Methods: We obtained mucosal biopsies from 200 participants (133 IBDs and 67 controls) and analyzed TNF promoter methylation using bisulfite sequencing, comparing inflamed with uninflamed segments, in addition to paired inflamed/uninflamed samples from individual patients. We conducted similar analyses on purified intestinal epithelial cells from bowel resections. We also compared TNF methylation levels of inflamed and uninflamed mucosa from a separate cohort of 15 anti-TNF responders and 17 nonresponders. Finally, we sequenced DNA methyltransferase genes to identify rare variants in IBD patients and functionally tested them using rescue experiments in a zebrafish genetic model of DNA methylation deficiency. Results: TNF promoter methylation levels were decreased in inflamed mucosa of IBD patients and correlated with disease severity. Isolated intestinal epithelial cells from inflamed tissue showed proportional decreases in TNF methylation. Anti-TNF nonresponders showed lower levels of TNF methylation than responders in uninflamed mucosa. Our sequencing analysis revealed 2 missense variants in DNA methyltransferase 1, 1 of which had reduced function in vivo. Conclusion: Our study reveals an association of TNF promoter hypomethylation with mucosal inflammation, suggesting that IBD patients may be particularly sensitive to inflammatory environmental insults affecting DNA methylation. Together, our analyses indicate that TNF promoter methylation analysis may aid in the characterization of IBD status and evaluation of anti-TNF therapy response.

Abstract Manipulative behaviour that consists of touching or close contact with ears or tails of pen mates is common in pigs and can become damaging. Manipulative behaviour was analysed from video recordings of 45-day-old pigs, and 15 manipulator-control pairs (n = 30) were formed. Controls neither received nor performed manipulative behaviour. Rectal faecal samples of manipulators and controls were compared. 16S PCR was used to identify Lactobacillaceae species and 16S amplicon sequencing to determine faecal microbiota composition. Seven culturable Lactobacillaceae species were identified in control pigs and four in manipulator pigs. Manipulators (p = 0.02) and females (p = 0.005) expressed higher Lactobacillus amylovorus, and a significant interaction was seen (sex * status: p = 0.005) with this sex difference being more marked in controls. Females (p = 0.08) and manipulator pigs (p = 0.07) tended to express higher total Lactobacillaceae. A tendency for an interaction was seen in Limosilactobacillus reuteri (sex * status: p = 0.09). Results suggest a link between observed low diversity in Lactobacillaceae and the development of manipulative behaviour.

Abstract Background The field of point-of-care ultrasound (POCUS) has advanced in recent decades due to the benefits it holds for medical providers. However, aspiring POCUS practitioners require adequate training. Unfortunately, there remains a paucity of resources to deliver this training, particularly in rural and underserved areas. Despite these barriers, calls for POCUS training in undergraduate medical education are growing, and many medical schools now deliver some form of POCUS education. Our program lacked POCUS training; therefore, we developed and implemented a POCUS curriculum for our first-year medical students. Methods We developed a POCUS curriculum for first year medical students in a rural medically underserved region of the United States. To evaluate our course, we measured learning outcomes, self-reported confidence in a variety of POCUS domains, and gathered feedback on the course with a multi-modal approach: an original written pre- and post-test, survey tool, and semi-structured interview protocol, respectively. Results Student (n=24) knowledge of POCUS significantly increased (pre-test average score = 55%, post-test average score = 79%, P

Abstract 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.