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Abstract This article presents the results of the research on real coal charges of different compositions intended for coking with loading into the chamber by the stamping method. The results of the study established that with an increase in the content of coal at a low stage of metamorphism and a decrease in the content of coal at a high stage of metamorphism in the charges, a decrease in the quality indicators of the coke obtained from them leads to a decrease in the yield of coke. At the same time, there is a gradual decrease in the compaction of the charges from 22.5 to 21.1 kPa; their expansion pressure decreases from 6.8 to 5.9 kPa; and the work of stamping decreases from 8966 to 6822 J. It was also discovered that with the increase in the degree of grinding of the charge, and, accordingly, with the decrease in the average diameter of its particles, the work of stamping coal charges decreases from 7407 to 6238 J. The results can be used in the manufacturing of blast furnace coke by stamping coal charges.

Abstract The count of mitotic figures (MFs) observed in hematoxylin and eosin (H&E)-stained slides is an important prognostic marker, as it is a measure for tumor cell proliferation. However, the identification of MFs has a known low inter-rater agreement. In a computer-aided setting, deep learning algorithms can help to mitigate this, but they require large amounts of annotated data for training and validation. Furthermore, label noise introduced during the annotation process may impede the algorithms’ performance. Unlike H&E, where identification of MFs is based mainly on morphological features, the mitosis-specific antibody phospho-histone H3 (PHH3) specifically highlights MFs. Counting MFs on slides stained against PHH3 leads to higher agreement among raters and has therefore recently been used as a ground truth for the annotation of MFs in H&E. However, as PHH3 facilitates the recognition of cells indistinguishable from H&E staining alone, the use of this ground truth could potentially introduce an interpretation shift and even label noise into the H&E-related dataset, impacting model performance. This study analyzes the impact of PHH3-assisted MF annotation on inter-rater reliability and object level agreement through an extensive multi-rater experiment. Subsequently, MF detectors, including a novel dual-stain detector, were evaluated on the resulting datasets to investigate the influence of PHH3-assisted labeling on the models’ performance. We found that the annotators’ object-level agreement significantly increased when using PHH3-assisted labeling (F1: 0.53 to 0.74). However, this enhancement in label consistency did not translate to improved performance for H&E-based detectors, neither during the training phase nor the evaluation phase. Conversely, the dual-stain detector was able to benefit from the higher consistency. This reveals an information mismatch between the H&E and PHH3-stained images as the cause of this effect, which renders PHH3-assisted annotations not well-aligned for use with H&E-based detectors. Based on our findings, we propose an improved PHH3-assisted labeling procedure.

Abstract Our ability to predict, control, or design biological function is fundamentally limited by poorly annotated gene function. This can be particularly challenging in non-model systems. Accordingly, there is motivation for new high-throughput methods for accurate functional annotation. Here, we used complementation of auxotrophs and DNA barcode sequencing (Coaux-Seq) to enable high-throughput characterization of protein function. Fragment libraries from eleven genetically diverse bacteria were tested in twenty different auxotrophic strains of Escherichia coli to identify genes that complement missing biochemical activity. We recovered 41% of expected hits, with effectiveness ranging per source genome, and observed success even with distant E. coli relatives like Bacillus subtilis and Bacteroides thetaiotaomicron. Coaux-Seq provided the first experimental validation for 53 proteins, of which 11 are less than 40% identical to an experimentally characterized protein. Among the unexpected function identified was a sulfate uptake transporter, an O-succinylhomoserine sulfhydrylase for methionine synthesis, and an aminotransferase. We also identified instances of cross-feeding wherein protein overexpression and nearby non-auxotrophic strains enabled growth. Altogether, Coaux-Seq’s utility is demonstrated, with future applications in ecology, health, and engineering.

Abstract Contrary to expert readers, children learning to read have limited ability to preprocess letters in parafoveal vision. Parafoveal letters induce crowding cost: the features of neighboring letters interfere with target letter identification. We longitudinally studied the weight of parafoveal cost and benefit in two group of children (N = 42), during their first school year (Group 1) and at the end of second school year (Groupe 2). Using a novel digit-tracking method, a blurred text was presented and rendered unblurred by touching the screen, allowing the user to discover a window of visible text as the finger moved along it. We compared two conditions: (1) a large window, where crowding was enhanced by the presence of parafoveal information; (2) a small window, where crowding was suppressed by blurred parafoveal information. Finger kinematics were simultaneously recorded. We found that at the beginning of first-grade, digital fixations - brief slowing or stopping of the finger on a specific point - are significantly longer in the large compared to the small window condition, as parafoveal crowding increases text processing difficulty. This effect diminishes and disappears at the end of second-grade as reading performance improves. In the large window condition, longer digital saccades - rapid movements of the finger changing position - appear by the end of first grade suggesting that parafoveal exposure become more beneficial than harmful when children acquire basic reading skills. Our results show that in beginning readers, crowding has a cognitive cost that interfere with the speed of the learning reading process. Our findings are relevant to the field of education by showing that visual crowding in first grade should not be underestimated.

Abstract MandibuloAcral Dysplasia associated to MTX2 gene (MADaM) is a recently described progeroid syndrome (accelerated aging disease) whose clinical manifestations include skin abnormalities, growth retardation, and cardiovascular diseases. We previously proposed that mtx-2-deficient C. elegans could be used as a model for MADaM and to support this, we present here our comprehensive phenotypic characterization of these worms using atomic force microscopy (AFM), transcriptomic, and oxygen consumption rate analyses. AFM analysis showed that young mtx-2-less worms had a significantly rougher, less elastic cuticle which becomes significantly rougher and less elastic as they age, and abnormal mitochondrial morphology. mtx-2 C. elegans displayed slightly delayed development, decreased pharyngeal pumping, significantly reduced mitochondrial respiratory capacities, and transcriptomic analysis identified perturbations in the aging, TOR, and WNT-signaling pathways. The phenotypic characteristics of mtx-2 worms shown here are analogous to many of the human clinical presentations of MADaM and we believe this validates their use as a model which will allow us to uncover the molecular details of the disease and develop new therapeutics and treatments.

Latar belakang. Stunting merupakan kondisi gagal tumbuh akibat kekurangan gizi secara kronis. Di Indonesia, prevalensi stunting pada tahun 2021 adalah 24,4 persen. Kondisi prevalensi stunting di Sumatera Utara juga sangat memprihatinkan. Sebanyak 13 dari 33 kabupaten/kota yang berada di Sumatera Utara memiliki prevalensi stunting di atas 30%. Kecamatan Medan Denai adalah salah satu kecamatan di Kota Medan dengan kasus gizi buruk anak tertinggi. Salah satu faktor risiko kejadian stunting adalah tingkat pendidikan ibu. Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan tingkat pendidikan dengan tingkat pengetahuan ibu tentang stunting. Metode. Penelitian analitik observasional dengan desain cross-sectional dengan sampel penelitian terdiri dari 96 responden yaitu ibu anak balita yang berdomisili dan menyekolahkan anaknya di TK/PAUD di Kecamatan Medan Denai yang memenuhi kriteria inklusi dan eksklusi. Analisis data menggunakan uji statistik chi-square. Hasil. Pada 96 responden ditemukan tingkat pengetahuan tentang stunting yang sedang (60,4%), rendah (30,2%), dan tinggi (9,4%). Hasil analisis menunjukkan terdapat hubungan yang signifikan antara tingkat pendidikan dengan tingkat pengetahuan ibu tentang stunting dengan nilai p=0,035 (p

This study aims to explore the impact of green accounting and audit quality on company performance in property and real estate companies listed in 2021–2022. This study used the purposive sampling method, observing 138 observations from 69 companies. This study uses 91 GRI G4 Framework criteria statements to assess the level of green accounting disclosure. Corporate performance in this study is measured by ROA, ROE, and NPM. The results of this study, based on statistical data, show that green accounting only has a significant positive effect on NPM. The results of the audit quality effect on ROA, ROE, and NPM indicate that the effect was positive and insignificant. Based on this study indicates that the effect of green accounting is only seen in NPM, for that in the future there should be more companies that voluntarily make corporate sustainability reports.

Megalithic stones are a remnant of the ancient people. An intriguing megalithic stone legacy ought to emphasize the context in which it fits. Consequently, it is necessary to ascertain each megalithic stone’s historical context. This is significant for the archaeologist to obtain true and valid information. In Tambunan, there are numerous myths about megalithic stones. As a result, it is impossible to verify the story’s validity. These days, remote sensing has emerged as a crucial technical instrument for archaeologists to gather spatial data in both broad and localized locations. Prior research has demonstrated the efficacy of remote sensing in identifying archaeological site remnants. Nevertheless, there have never been any investigations utilizing remote sensing in relation to small-sized megalithic stones. Thus, this study employs spectral signature techniques and remote sensing to identify the original source of the megalithic stones discovered in Tambunan. This study carries out the spectral signature of megalithic stones in Tambunan using Sentinel-2A satellite image data with a 5-meter resolution using the SNAP application. Before that, the coordinates and measurements for each megalithic stone were obtained from the ground. The spectral signature of all the megalithic stones was then compared with the spectral signature of the stones near the river or near the hill. The study’s findings demonstrate that the spectral signature of the megalithic stones in question is identical to the stone found in the river near its location. As a result, this study was successful in providing scientific evidence that the river is the source of the megalithic stones in Tambunan, despite the stones’ considerable distance from their site.

Abstract We report the case of an acute cerebellitis following COVID-19 in 32-year-old man who presented with a life-threatening critical cerebellar syndrome contrasting with normal paraclinical findings. Despite this fulminant critical presentation, the patient fully recovered in 37 days after early treatment with high-dose steroids and intravenous immunoglobulins. This case highlights the need for clinicians to be aware of acute cerebellitis following COVID-19, despite normal laboratory, imaging and electroencephalography findings and the importance to start appropriate treatment as soon as possible.

Abstract Background Kidney transplantation is the definitive treatment option for chronic kidney failure, offering improved quality of life and extended survival. Access to kidney transplantation is limited in the Sub-Saharan Africa (SSA) region, with only a few countries with established services. Tanzania started its program five years ago, for the sustainability of the program it is important to understand the outcome. Therefore, this study was conducted to determine the clinical outcomes and survival rates of kidney transplant recipients at Muhimbili National Hospital in Tanzania, in the absence of a national transplant registry, since the inception of the program. Methods This was a retrospective study conducted among kidney transplant recipients from live donors at Muhimbili National Hospital (MNH) between November 2017 and February 2022. Analyses were performed to assess baseline characteristics, post-transplant complications, and patient and graft survival. Results In our study of 68 kidney transplant recipients, the majority of recipients were male (63.2%) with a mean age of 45.8 years and under medical insurance (88.2%). The predominant cause of CKD was hypertension (58.2%) with recipients undergoing dialysis for a mean duration of 14.4 months, and basiliximab being the most commonly used induction medication (57.3%). The majority of donors were males (64.7%) and had first-degree relationships with recipients (76.5%). Haploid HLA mismatch was observed in 36.8% of cases. One-year patient and graft survival rates were 91.2% and 96.7%, respectively, with infection being the primary cause of death (n = 5), and more than half of deceased patients died with a functioning graft (n = 4). Conclusion Our study underscores favorable one-year patient and graft outcomes among kidney transplant recipients at Muhimbili National Hospital, Tanzania. However, challenges persist, notably with infections posing ongoing difficulties for this cohort.

Educational outcomes for Black & brown students are the result of well-functioning school systems overwrought with top-down bureaucracy that stifle school-based leaders from generating school-based solutions. The dominant explanation is the growing power and influence of politically-driven school board members cut off from local, national, and international best practices. Previous research has centered on the power of school boards and what can be done by school board officials with more power. The article explores the impact of school boards ceding power and giving more autonomy to school based leaders through three case studies. Findings indicate that the school districts making the greatest gains for Black & brown students are those that introduce innovation schools or schools that provide more autonomy in return for more accountability.

Much attention has been paid to the contributions of media literacy to children and adolescent development in most developed countries. This study adopted a non-equivalent control type of quasi-experimental research design involving the experimental and control groups. The sample size for the study was 90 learners drawn from all public adult and vocational education centres across Nigeria. The Entrepreneurial Development Test" (EDT) was the data collecting instrument. Data gathered were analysed using mean, standard deviation and analysis of covariance. Findings show that learners exposed to media literacy had a higher positive effect on entrepreneurial development than basic literacy. Furthermore, the cooperative learning style adopted gained a higher entrepreneurial development mean score than solitary. On interaction effect, the study shows that basic literacy had a more positive effect than media literacy, hence, the advocacy for providing necessary facilities to promote media literacy skills.

Previous studies tend to not only assess principals' demographic variables but also use other dependent variables, such as administrative effectiveness, job performance, and student achievement. In the literature, principals' demographic qualities and the misuse of material capital have been under-assessed. This study used a quantitative approach to investigate the demographic attributes of principals and the abuse of school material capital in secondary schools. Using a questionnaire, data were gathered from 667 secondary school administrators in Cross River State, Nigeria. The findings revealed significant differences in the misuse of school material capital by principals of different ages, professional qualifications, and years of experience. However, major disparities between male and female principals were not identified. More specifically, principals who were older, seasoned, and possessed bachelor's and Master of Education degrees were efficient managers of school material capital. A high rate of misuse was found among principals who were younger and inexperienced than their counterparts who were young, less experienced, and possessed a postgraduate diploma in education, as well as other professional academic qualifications unrelated to the field of education (e.g., HND, BSc, BA, and MSc). Based on these findings, key implications for quality service delivery and administrative effectiveness were discussed.

This study estimated the direct and indirect contributions of mentorship and institutional support (IS) to academic staff's research productivity (RP) at a public university in Cross River State. Two mediator variables--collaboration and institutional culture (IC), were introduced to determine their roles in the nexus between the predictors and the criterion variables. The quantitative research method was adopted following the correlational research design. "Career Empowerment and Research Productivity Questionnaire (CERPQ)" was used for data collection after validation by experts and reliability test. Three hundred twenty-seven copies of the CERPQ were administered, but 303 were retrieved. Mediation-based analysis was performed using structural equation modelling following the research questions and hypotheses. Amongst others, findings revealed that mentorship had a non-significant negative contribution to the RP of academic staff; mentorship only promoted RP among academic staff when it was followed by positive IC and collaboration. IS had a non-significant positive contribution to the RP of academic staff. The joint mediation of collaboration and IC was significant in the nexus between mentorship and RP and between IS and RP of academic staff in the public university. Collaboration was the most important factor directly associated with the RP of academic staff and also partially mediated the contributions of other variables (such as mentorship and IS) to the RP of academic staff. The results of this study can be useful for universities seeking to enhance the research productivity of their academic staff. The study highlights the importance of considering multiple factors that may influence research productivity and suggests that institutions should prioritise fostering a supportive and collaborative environment for academic staff to maximise their research productivity. The study can also inform the development of mentorship programmes and the creation of institutional policies that support and promote research productivity.

Service animals can play an integral role in the lives and education of students with disabilities. In addition to assisting with physical tasks, service animals can improve confidence, independence and quality of life for students, as well as help them to meet their educational goals. Teachers, coaches and administrators should have the knowledge and skills necessary to support and collaborate with students as they engage with their service animals in and outside of school. The purpose of this article is to educate school personnel about service animals and to help facilitate the successful integration of service animals into schools. Specifically, the article defines service animals and outlines the rights of students with disabilities and their service animals. It also provides recommendations for teachers and coaches to help promote inclusion in physical education and athletics.

Modals (e.g., "can," "must") vary along two dimensions of meaning: "force" (i.e., possibility or necessity), and "flavor" (i.e., possibilities relative to knowledge [epistemic], goals [teleological], or rules [deontic] …). Comprehension studies show that children struggle with both force and flavor dimensions of modals. However, given the complex one-to-many mappings from forms to meanings, it is not clear what force or flavor children assign to the modals being tested. In this study, we use a sentence-repair task to test which modals 3- and 4-year-old children themselves prefer to produce in teleological (goal-oriented) and epistemic (knowledge-based) possibility and necessity contexts, and how these preferences differ from those of adults. Our results provide a first controlled look at which modals children use to express the major flavor and force dimensions of modal verb meanings. We shed new light on children's modal systems, and show that learners generally distinguish modal flavors but struggle distinguishing forces.

The authors present a scientometric procedure comparing engineering education (EE) publication output in different countries. Selected European countries were compared using a snapshot of authors published in EE journals during a two-year period - 895 in all. The entire publication careers of these authors - 39,322 publications - were analysed to determine the breakdown of educational and non-educational publications. Spain and the UK produced the most publications, and we propose explanations based on relevant national policies. France, Germany, and Italy had notably fewer EE publications relative to their general engineering and science research outputs, whereas Portugal, Ireland, and three Nordic countries were the opposite. Countries varied widely in the ratio of educational to non-educational publications. Non-educational publications typically had a greater impact on authors' h-index values. We believe this procedure can longitudinally map and compare EE publication output in and across Europe, providing a valuable resource for policy-makers and researchers in the region.

Young children's voices have been nearly absent in the study of belonging during the early years. In this article, we propose a more inclusive understanding about "how" to study belonging, as well as "what else" must be studied in early childhood education. The importance of conducting research "with" young children rather than on them is provided, and factors contributing to a sense of belonging or (un)belonging in early childhood are examined. With a commitment to understanding first-hand from young children's own perspectives, research agendas can be more authentically and inclusively achieved.

Published studies of intervention effects probably report effect sizes that are larger than the true effect size. There are probably many reasons for this, but one can be thought of as a "winner's curse." In this essay, I discuss evidence from two recent studies that highlight how evidence clearinghouses might inadvertently expose themselves to the winner's curse, describe reasonable and unreasonable expectations for evidence clearinghouses, then suggest strategies clearinghouses might adopt to reduce their exposure to the winner's curse.

Although children learn more when teachers gesture, it is not clear "how" gesture supports learning. Here, we sought to investigate the nature of the memory processes that underlie the observed benefits of gesture on lasting learning. We hypothesized that instruction with gesture might create memory representations that are particularly resistant to interference. We investigated this possibility in a classroom study with 402 second- and third-grade children. Participants received classroom-level instruction in mathematical equivalence using videos with or without accompanying gesture. After instruction, children solved problems that were either visually similar to the problems that were taught, and consistent with an operational interpretation of the equal sign (interference), or visually distinct from equivalence problems and without an equal sign (control) in order to assess the role of gesture in resisting interference after learning. Gesture facilitated learning, but the effects of gesture and interference varied depending on type of problem being solved and the strategies that children used to solve problems prior to instruction. Some children benefitted from gesture, while others did not. These findings have implications for understanding the mechanisms underlying the beneficial effect of gesture on mathematical learning, revealing that gesture does not work via a general mechanism like enhancing attention or engagement that would apply to children with all forms of prior knowledge.

The global climate emergency raises important questions for the future of fieldtrips in geographical education. Building on a longer history of these debates in the discipline, geography educators are paying increased attention to the environmental impacts of field-based education, as demonstrated by the Royal Geographical Society-Institute of British Geographers' (RGS-IBG) recent Principles for Undergraduate Field Courses. However, as important as these steps are, there is relatively little study of student engagement with discussions on the environmental sustainability of geographical fieldtrips. Reporting on a research project involving a survey, learning intervention and semi-structured interviews with undergraduate geographers based at an East Midlands university in the UK, specifically exploring these students' perspectives on geography fieldtrips and environmental sustainability, we argue that participatory and collaborative dialogue between teachers, students and other geographical stakeholders is crucial as geographers continue to grapple with the ethical, political, and environmental implications of these debates.

The Research Sprints program offers faculty partners the opportunity to collaborate intensively and exclusively for one week with a team of librarians to achieve significant progress on research or teaching projects. This longitudinal study extends previous immediate and short-term assessments by interviewing Research Sprints participants at two research-intensive institutions 2-4 years after their concentrated week. The authors evaluate the enduring impact of the program on the participants' projects, research/teaching practices, and relationships with the library. Participants report achieving project goals, improved skills and student success, and greater awareness and appreciation of librarians' work.

Introduction: Effective medical education must balance clinical service demands for institutions and learning needs of trainees. The question of whether these are competing demands or can serve complementary roles has profound impacts on graduate medical education, ranging from funding decisions to the willingness of community-based hospitals and physicians to include learners at their clinical sites. Our objective in this article was to systematically review the evidence on the impact of medical trainees on productivity and efficiency in the emergency department (ED). Methods: We queried PubMed, Embase, Scopus, and Web of Science from earliest available dates to March 2023. We identified all studies evaluating the impact of medical students and/or residents in the ED on commonly used productivity and efficiency metrics. Only studies in EDs in the United States were included. No additional filters were used. We assessed the risk of bias of included studies using the Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool. Certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study findings were combined in a narrative synthesis and reported according to PRISMA guidelines. Results: The literature search yielded 3,390 unique articles for abstract screening. Eighty-one abstracts were identified as relevant to our PICO question (population, intervention, control, and outcomes), 76 of which had retrievable full-text articles and the themes of which were discussed in a narrative synthesis. We selected 13 of the full-text articles for final inclusion in a systematic review. Studies were roughly split between observational (6) and quasi-experimental (7) designs. The majority of studies (11) were single-site studies. Only two studies could be graded as low risk of bias per the ROBINS-I tool. Conclusion: Low-GRADE evidence suggests that students and residents decrease ED efficiency by a statistically small effect size of debatable clinical importance. Residents provide a moderate boost to ED productivity. Students do not produce a statistically or clinically significant impact on ED productivity. Residents increase emergency department relative value units revenue by $26.30 an hour, while students have no impact. Both types of learners decrease efficiency.

Objective: The study objective was to determine if intraoperative peritoneal catheter placement is associated with improved outcomes in neonates undergoing high-risk cardiac surgery with cardiopulmonary bypass. Methods: This propensity score–matched retrospective study used data from 22 academic pediatric cardiac intensive care units. Consecutive neonates undergoing Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery category 3 to 5 cardiac surgery with cardiopulmonary bypass at centers participating in the NEonatal and Pediatric Heart Renal Outcomes Network collaborative were studied to determine the association of the use of an intraoperative placed peritoneal catheter for dialysis or passive drainage with clinical outcomes, including the duration of mechanical ventilation. Results: Among 1490 eligible neonates in the NEonatal and Pediatric Heart Renal Outcomes Network dataset, a propensity-matched analysis was used to compare 395 patients with peritoneal catheter placement with 628 patients without peritoneal catheter placement. Time to extubation and most clinical outcomes were similar. Postoperative length of stay was 5 days longer in the peritoneal catheter placement cohort (17 vs 22 days, P = .001). There was a 50% higher incidence of moderate to severe acute kidney injury in the no-peritoneal catheter cohort (12% vs 18%, P = .02). Subgroup analyses between specific treatments and in highest risk patients yielded similar associations. Conclusions: This study does not demonstrate improved outcomes among neonates with placement of a peritoneal catheter during cardiac surgery. Outcomes were similar apart from longer hospital stay in the peritoneal catheter cohort. The no-peritoneal catheter cohort had a 50% higher incidence of moderate to severe acute kidney injury (12% vs 18%). This analysis does not support indiscriminate peritoneal catheter use, although it may support the utility for postoperative fluid removal among neonates at risk for acute kidney injury. A multicenter controlled trial may better elucidate peritoneal catheter effects.

BACKGROUND: Despite a rising interest in the diversity and ecology of fungi in marine environments, there are few published genomes of fungi isolated from the ocean. The basidiomycetous yeast (unicellular fungus) genus Rhodotorula are prevalent and abundant in the open ocean, and they have been isolated from a wide range of other environments. Many of these environments are nutrient poor, such as the Antarctica and the Atacama deserts, raising the question as to how Rhodotorula yeasts may have adapted their metabolic strategies to optimize survival under low nutrient conditions. In order to understand their adaptive strategies in the ocean, the genome of R. sphaerocarpa ETNP2018 was compared to that of fourteen representative Rhodotorula yeasts, isolated from a variety of environments. RESULTS: Rhodotorula sphaerocarpa ETNP2018, a strain isolated from the oligotrophic part of the eastern tropical North Pacific (ETNP) oxygen minimum zone (OMZ), hosts the smallest of the fifteen genomes and yet the number of protein-coding genes it possesses is on par with the other strains. Its genome exhibits a distinct reduction in genes dedicated to Major Facilitator Superfamily transporters as well as biosynthetic enzymes. However, its core metabolic pathways are fully conserved. Our research indicates that the selective pressures of the ETNP OMZ favor a streamlined genome with reduced overall biosynthetic potential balanced by a stable set of core metabolisms and an expansion of mechanisms for nutrient acquisition. CONCLUSIONS: In summary, this study offers insights into the adaptation of fungi to the oligotrophic ocean and provides valuable information for understanding the ecological roles of fungi in the ocean.

Introduction: Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction. Patients suffering SCAD are often young women without typical risk factors for atherosclerotic heart disease. Clinicians should maintain a high index of suspicion for SCAD.Case series: We report three cases of patients with SCAD from a single physician in a six-month period. Each case is unique and highlights the varied presentations and epidemiological risk factors associated with this condition.Discussion: We believe these cases are unique in that they provide insights into the variable presentations and conditions frequently associated with SCAD and will help clinicians maintain a high index of suspicion for this difficult to diagnose and rare cause of type 2 myocardial infarction. We discuss differences in interventional techniques and medical management.

CONTEXT: Given the impact of environmental pollution on health and health inequity, there may be substantial value in integrating assessment and response to pollution into nonprofit hospital community benefit processes. Such hospital engagement has not yet been studied. OBJECTIVES: We take a preliminary step of inquiry in investigating if nonprofit hospitals in New York State (NYS) assess, identify, or respond to environmental pollution as part of community benefit processes. DESIGN: This study is of retrospective, observational design. Data were abstracted from community health needs reports (2015-2017), associated implementation plans, and related IRS (Internal Revenue Service) filings from a randomly geographically stratified selection of NYS nonprofit hospitals. PARTICIPANTS: The sample includes 53 hospitals from 23 counties. The sampling frame consists of NYS nonspecialty private nonprofit hospitals. MAIN OUTCOME MEASURES: Dichotomous findings for the following: (1) engagement of environmental pollution in the process of assessment of community health needs; (2) environmental pollution concern identified as a priority community health need; (3) strategic planning present to address pollution identified as community health need; and (4) action taken on same. RESULTS: We found that 60.5% (95% confidence interval [CI], 0.46-0.74) of hospitals evidenced some form of assessment of environmental pollution and 18.9% (95% CI, 0.09-0.32) identified pollution as a priority community health need. However, no hospital went on to take independent or collaborative planning or action to address pollution. In additional analysis, we found that social justice in hospital mission was a positive predictor of assessment of environmental pollution. CONCLUSIONS: For NYS hospitals, we found a substantial presence of assessment and identification of pollution as a community health concern. Our finding of the absence of response to environmental pollution represents a gap in community benefit implementation. This indicates a yet untaken opportunity to address racial and economic environmental health injustices and to improve population health.