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This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9-13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood.

The cross-shell excited states of Si34 have been investigated via β decays of the 4- ground state and the 1+ isomeric state of Al34. Since the valence protons and valence neutrons occupy different major shells in the ground state as well as the intruder 1+ isomeric state of Al34, intruder levels of Si34 are populated via allowed β decays. Spin assignments to such intruder levels of Si34 were established through γ-γ angular correlation analysis for the negative-parity states with dominant configurations (νd3/2)-1⊗ - (νf7/2)1 as well as the positive-parity states with dominant configurations (νsd)-2⊗ - (νf7/2p3/2)2. The configurations of such intruder states play crucial roles in our understanding of the N=20 shell gap evolution. A configuration interaction model derived from the FSU Hamiltonian was utilized in order to interpret the intruder states in Si34. Shell model interaction derived from a more fundamental theory with the valence space in medium similarity renormalization group method was also employed to interpret the structure of Si34.

Objective: A national survey was conducted to determine the extent of use of compounded hormone therapy(C-HT) and to characterize the differences between C-HT users and users of hormone therapy approved by the USFood and Drug Administration (FDA-HT users).Methods: This Internet survey enrolled 3,725 women aged 40 to 84 years who were postmenopausal orexperiencing the menopause transition. The sample was weighted slightly by age, region, education, and race toreflect population attributes based on US Census data.Results: Overall, 9% of women were current users of HT, and 28% of all respondents were ever-users of HT.C-HT users represented 31% of ever-users of HT, 35% of current users of HT, and 41% of ever-users aged 40 to 49years. Approximately 13% of ever-users indicated current or past use of testosterone. The most cited reason forusing HT was vasomotor symptoms ( 70%). Nonapproved indications for using HT were selected more often byC-HT users. There were four reports of endometrial cancer among the 326 C-HT users compared with none reportedamong the 738 FDA-HT users. Significance was not determined because of small numbers.Conclusions: This survey indicates substantial use of C-HT across the country and the possibility of higher ratesof endometrial side effects with such products. There is a need for standardized data collection on the extent of use ofcompounded hormones and their potential risks.

BackgroundWe aimed to understand the association between maternal stress in the first year of life and childhood body mass index (BMI) from 2 to 4 years of age in a large, prospective United States-based consortium of cohorts.MethodsWe used data from the Environmental influences on Child Health Outcomes program. The main exposure was maternal stress in the first year of life measured with the Perceived Stress Scale (PSS). The main outcome was the first childhood BMI percentile after age 2 until age 4 years. We used an adjusted linear mixed effects model to examine associations between BMI and PSS quartile.ResultsThe mean BMI percentile in children was 59.8 (SD 30) measured at 3.0 years (SD 1) on average. In both crude models and models adjusted for maternal BMI, age, race, ethnicity, infant birthweight, and health insurance status, no linear associations were observed between maternal stress and child BMI.ConclusionsAmong 1694 maternal-infant dyads, we found no statistically significant relationships between maternal perceived stress in the first year of life and child BMI after 2 through 4 years.ImpactAlthough existing literature suggests relationships between parental stress and childhood BMI, we found no linear associations between maternal stress in the first year of life and childhood BMI at 2-4 years of age among participants in ECHO cohorts. Higher maternal stress was significantly associated with Hispanic ethnicity, Black race, and public health insurance. Our analysis of a large, nationally representative sample challenges assumptions that maternal stress in the first year of life, as measured by a widely used scale, is associated with offspring BMI.

^{180m}Ta is a rare nuclear isomer whose decay has never been observed. Its remarkably long lifetime surpasses the half-lives of all other known β and electron capture decays due to the large K-spin differences and small energy differences between the isomeric and lower-energy states. Detecting its decay presents a significant experimental challenge but could shed light on neutrino-induced nucleosynthesis mechanisms, the nature of dark matter, and K-spin violation. For this study, we repurposed the Majorana Demonstrator, an experimental search for the neutrinoless double-beta decay of ^{76}Ge using an array of high-purity germanium detectors, to search for the decay of ^{180m}Ta. More than 17 kg, the largest amount of tantalum metal ever used for such a search, was installed within the ultralow-background detector array. In this Letter, we present results from the first year of Ta data taking and provide an updated limit for the ^{180m}Ta half-life on the different decay channels. With new limits up to 1.5×10^{19}  yr, we improved existing limits by 1-2 orders of magnitude which are the most sensitive searches for a single β and electron capture decay ever achieved. Over all channels, the decay can be excluded for T_{1/2}

Ferroelectricity, a spontaneous and reversible electric polarization, is found in certain classes of van der Waals (vdW) materials. The discovery of ferroelectricity in twisted vdW layers provides new opportunities to engineer spatially dependent electric and optical properties associated with the configuration of moiré superlattice domains and the network of domain walls. Here, we employ near-field infrared nano-imaging and nano-photocurrent measurements to study ferroelectricity in minimally twisted WSe2. The ferroelectric domains are visualized through the imaging of the plasmonic response in a graphene monolayer adjacent to the moiré WSe2 bilayers. Specifically, we find that the ferroelectric polarization in moiré domains is imprinted on the plasmonic response of the graphene. Complementary nano-photocurrent measurements demonstrate that the optoelectronic properties of graphene are also modulated by the proximal ferroelectric domains. Our approach represents an alternative strategy for studying moiré ferroelectricity at native length scales and opens promising prospects for (opto)electronic devices.

Siew Lian Chong,1,* Asral Wirda Ahmad Asnawi,1,2,* Tengku Amatullah Madeehah Tengku Mohd,2,* Sen Mui Tan1,* 1Department of Hematology, Hospital Ampang, Ampang Jaya, Selangor, Malaysia; 2Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia*These authors contributed equally to this workCorrespondence: Siew Lian Chong, Department of Hematology, Hospital Ampang, Jalan Mewah Utara, Taman Pandan Mewah, Ampang, Selangor, 68000, Malaysia, Email swian_@hotmail.com Asral Wirda Ahmad Asnawi, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Putra Nilai, Nilai, Negeri Sembilan, 71800, Malaysia, Email wirda@usim.edu.myIntroduction: The CD34+ hematopoietic cell count was used to define cell harvest goals. Successful peripheral blood stem cell transplantation depends on infusion of an appropriate number of HPCs to achieve rapid and durable hematologic recovery.Purpose: In this study, we evaluated the use of the Hematopoietic Progenitor Cell count program on the Sysmex XN-3000 hematology analyzer as an effective parameter for enumerating CD34+ cells.Patients and Methods: Whole blood samples from 144 subjects who are either healthy donors or patients scheduled to undergo peripheral blood stem cell collection were collected and hemopoietic stem cells were quantified using CD34 cell enumeration by flow cytometry and XN-HPC by hematology analyzer.Results: The correlation between the two methods was high (r = 0.766; 95% CI: 0.702– 0.818). Passing–Bablok showed an intercept at 3.45 (2.54 to 4.74) with a slope of 0.78 (95% CI 0.69 to 0.89). Residual analysis of this model indicated no significant deviation from linearity (p = 0.360). The receiver operating characteristic curve demonstrated an area under curve to be 0.88 (0.82 to 0.92), with a positive predictive value of 80.3%. The correlation between CD34+ and XN-HPC showed a strong relationship and good agreement with minimal bias.Conclusion: The XN-HPC showed good analytical performance. With the increasing requirements for stem cell transplantation, a technically simple and rapid alternative for stem cell enumeration that is sustainable is highly useful.Keywords: XN-HPC, CD34+, progenitor, leukemia, allogeneic, autologous

Yuan-Jie Liu,1,* Jing-Xiao Li,1,* Jie-Pin Li,1 Yi-Dou Hu,2 Zhi-Bin Ma,3 Wei Huang,1 Shen-Lin Liu,1 Xi Zou1 1Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, People’s Republic of China; 2Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu, 215600, People’s Republic of China; 3Nanjing YOUMENG Biology Science and Technology Co. Ltd, Nanjing, Jiangsu, 210029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xi Zou; Shen-lin Liu, Email fsyy00670@njucm.edu.cn; lsljsszyy@126.comBackground: Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality, underscoring the need for novel therapeutic targets. This study aimed to elucidate the role of endoplasmic reticulum membrane protein complex subunit 1 (EMC1) in HCC progression and its therapeutic potential.Methods: Publicly available sequencing data and biopsy specimens were analyzed to assess EMC’s clinical value and functions in HCC. In vitro experiments validated EMC functions, and multiplex immunofluorescence analysis examined EMC-associated sorafenib resistance mechanisms. EMC1 expression was knocked down in HCC cell lines, followed by cell viability, wound healing, and transwell migration assays. Tumor growth and response to sorafenib treatment were evaluated in mouse models. Metabolomic analysis assessed changes in the TCA cycle.Results: EMC genes were aberrantly expressed in HCC, and high EMC1 expression correlated with poorer survival rates. EMC1 disruption enhanced HCC cells’ sensitivity to sorafenib, reducing cell viability, increasing apoptosis, and decreasing tumor size and weight. EMC1 maintained cancer cell stemness and promoted M2 macrophage infiltration. Metabolomic analysis revealed significant changes in the TCA cycle, indicating EMC1’s role in HCC metabolic reprogramming. Importantly, EMC1 is highly associated with sorafenib resistance, potentially linked to CTNNB1 mutation or activation.Conclusion: EMC1 plays a critical role in regulating the sorafenib resistance in HCC. Targeting EMC1 may improve HCC treatment efficacy.Keywords: endoplasmic reticulum membrane complex subunit 1, catenin beta 1, tumor stemness, M2 macrophage, sorafenib resistance

Olawale Razaq Ajuwon,1 Fleury Augustine Nsole-Biteghe,2 Jean Delacroix Ndong,3 Lester Merlin Davids,4 Basiru Olaitan Ajiboye,1 Bartholomew Brai,1 Fisayo Abraham Bamisaye,1 John Adeolu Falode,1 Ikenna Maximillian Odoh,1,5 Kabirat Iyabode Adegbite,6 Bosede Oluwasayo Adegoke,7 Monde Ntwasa,8 Sogolo Lucky Lebelo,8 Ademola Olabode Ayeleso8,9 1Department of Biochemistry, Federal University, Oye-Ekiti, Ekiti State, Nigeria; 2Department of Radiation Oncology and Biomedical Sciences, Cedars-Sinai Medical, Los Angeles, CA, USA; 3School of Arts and Science, Rutgers University, New Brunswick, NJ, 08901, USA; 4Graduate School of Business, University of Cape Town, Cape Town, South Africa; 5Medical Center, Federal University, Oye-Ekiti, Ekiti-State, Nigeria; 6Department of Environmental Health Science, College of Basic Medical and Health Sciences, Fountain University, Osogbo, Osun State, Nigeria; 7Department of Chemical Pathology, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria; 8Department of Life and Consumer Sciences, University of South Africa, Florida Park 1709, Roodeport, South Africa; 9Biochemistry Programme, Bowen University, Iwo, Osun State, NigeriaCorrespondence: Olawale Razaq Ajuwon, Department of Biochemistry, Federal University OyeEkiti, Ekiti State, Nigeria, Tel +2348054127724, Email olawale.ajuwon@fuoye.edu.ngAbstract: Photodynamic therapy (PDT) is a groundbreaking approach involving the induction of cytotoxic reactive oxygen species (ROS) within tumors through visible light activation of photosensitizers (PS) in the presence of molecular oxygen. This innovative therapy has demonstrated success in treating various cancers. While PDT proves highly effective in most solid tumors, there are indications that certain cancers exhibit resistance, and some initially responsive cancers may develop intrinsic or acquired resistance to PDT. The molecular mechanisms underlying this resistance are not fully understood. Recent evidence suggests that, akin to other traditional cancer treatments, the activation of survival pathways, such as the KEAP1/Nrf2 signaling pathway, is emerging as an important mechanism of post-PDT resistance in many cancers. This article explores the dual role of Nrf2, highlighting evidence linking aberrant Nrf2 expression to treatment resistance across a range of cancers. Additionally, it delves into the specific role of Nrf2 in the context of photodynamic therapy for cancers, emphasizing evidence that suggests Nrf2-mediated upregulation of antioxidant responses and induction of drug efflux transporters are potential mechanisms of resistance to PDT in diverse cancer types. Therefore, understanding the specific role(s) of Nrf2 in PDT resistance may pave the way for the development of more effective cancer treatments using PDT.Keywords: photodynamic therapy, oxidative stress, antioxidant response, tumor resistance, Nrf2

Zhi-Hang Chen,1,&ast; Qian Zhou,2,&ast; Ze-Bin Chen,1,&ast; Wen-Xuan Xie,1 Zi-Min Song,1 Shui-Rong Lin,1 Wei Wang,3 Shun-Li Shen,1 Ming Kuang1 1Department of Liver Surgery, Center of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China; 2Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China; 3Division of Interventional Ultrasound, Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shun-Li Shen; Ming Kuang, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China, Tel +86 20-87755766, Email shenshli@mail.sysu.edu.cn; kuangm@mail.sysu.edu.cnPurpose: Liver resection and ablation remain the most common therapeutic options for Barcelona Clinic Liver Cancer (BCLC) stage 0-A hepatocellular carcinoma (HCC), but there is a lack of evidence to show which is the most suitable therapy. This study aimed to make concurrent multi-arm comparisons of the short-term and long-term outcomes of percutaneous ablation (PA), open (OLR) or laparoscopic liver resection (LLR) for these patients.Patients and Methods: This was a retrospective observational cohort study. A series of generalized propensity score methods for multiple treatment groups were performed to concurrently compare the clinical outcomes of these three treatment options to balance potential confounders. Regression standardization was used to account for hazard of all-cause mortality and recurrence of intergroup differences.Results: Of the 1778 patients included, 1237, 307 and 234 underwent OLR, LLR and PA, respectively. After overlap weighting, which was the optimal adjustment strategy, patients in the minimally invasive group (LLR and PA groups) had few postoperative complications and short postoperative hospital stays (both P < 0.001). The 5-year recurrence-free survival (RFS) rate and 5-year overall survival (OS) rate were significantly higher in the LLR group when compared with the OLR and PA groups (RFS: 55.6% vs 48.0% vs 30.2%, P < 0.001; OS: 89.1% vs 79.7% vs 84.0%, P = 0.020). Multivariable Cox analysis and regression standardization showed that LLR was an independent factor for better RFS when compared with OLR and PA. In subgroup analysis, the long-term outcomes of patients with BCLC stage A HCC were consistent with the whole population.Conclusion: In the observational study using various covariate adjustment analysis with excellent balance, LLR is not only minimally invasive, but also provides better RFS and equivalent OS for patients with BCLC stage 0-A HCC when compared with OLR and PA.Keywords: hepatocellular carcinoma, laparoscopic liver resection, generalized propensity score analysis, overlap weighting, clinical outcome

Jaimee K Miller, Simon L Evans School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UKCorrespondence: Jaimee K Miller, Email jaimeekmiller@outlook.comObjective: Poor sleep among young adults is prevalent, yet the mediating variables are largely understudied, and there is limited relevant work utilizing objective sleep measures. The present study investigated the mediating effects of perceived stress and rumination in the relationship between trait mindfulness and subjective and objective sleep quality in young adults.Methods: A total of 170 healthy adults (aged 18– 37, M = 20.8, SD = 2.9) self-reported on trait mindfulness, perceived stress, and rumination. The primary (N = 140) and secondary (N = 30) samples both completed the Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The secondary sample (N = 30) additionally provided sleep diaries, as well as wrist-worn actigraphy data for assessing objective sleep quality. A mediation analysis was conducted to assess the effect of trait mindfulness on sleep quality with perceived stress and rumination as mediators.Results: Trait mindfulness was positively associated with better subjective sleep quality; this was fully mediated by perceived stress, b = − 0.08, 95% CI [− .12, − 0.06]. Rumination was negatively associated with subjective sleep quality but did not mediate the relationship between trait mindfulness and sleep quality, b = − 0.01, 95% CI [− .03, 0.02]. Only trait mindfulness was correlated with diary-based sleep ratings, and none of the measures were associated with actigraphy-based sleep quality.Conclusion: This study indicates that perceived stress is an important mediator in the relationship between trait mindfulness and subjective sleep quality among young adults, rather than rumination. These findings have implications for mindfulness-based therapeutic approaches to address the high prevalence of sleep disorders among young adults, adding mechanistic detail to the literature.Keywords: mindfulness, perceived stress, rumination, sleep

Danielle Soares Rocha Vieira,1 Cintia Vieira Del Moro,1 Sabrina Leal Pscheidt,1 Maíra Junkes-Cunha,2 Marcio Mesquita Judice,3 Livia Arcencio,1 Abebaw Mengistu Yohannes4,5 1Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Araranguá, SC, Brazil; 2Department of Gymnastics and Health, Federal University of Pelotas, Pelotas, RS, Brazil; 3Pulmonology Department, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil; 4Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA; 5Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Abebaw Mengistu Yohannes, 372 School of Health Professions Department of Physical Therapy, 1720 2nd Avenue South, Birmingham, AL, 35294, USA, Tel +1 205 996 1579, Email amyohann@uab.eduBackground: Most instruments available to screen for anxiety in people with chronic obstructive pulmonary disease (COPD) are not disease specific. Therefore, the Anxiety Inventory for Respiratory Disease (AIR) was developed to measure anxiety for this patient group; however, it requires cross-cultural adaptation for use in non-English speaking countries.Purpose: To carry out cross-cultural adaptation of the AIR scale for Brazilian patients with COPD and to analyze its semantic validity.Patients and Methods: This methodological study followed six stages: 1) Initial translation by two independent translators fluent in English; 2) Synthesis of translations; 3) Back translation by two English first language translators; 4) Expert committee review (eight healthcare professionals, a methodologist, the translators, and back-translators); 5) Pre-final version evaluation with 30 patients with COPD through a cognitive interview; and 6) Submission of documents. Semantic validity was analyzed by agreement rate and content validity index (CVI) for the committee equivalence assessments.Results: 1) Initial translation: the two translated versions presented eight divergences; 2) Synthesis of translations: the differences were discussed to reach consensus; 3) Back-translation: there were no important inconsistencies; 4) Expert Committee: the experts proposed eight and the instrument developer proposed three changes, which were analyzed and voted on, resulting in the pre-final version; 5) Evaluation of the pre-final version: data collection allowed for other changes and the formulation of instructions by applying the adapted instrument in an interview format. Patients rated the questions as clear or very clear; 6) The expert committee and the developer approved the final documents. The agreement rate and CVI were ≥ 0.80 for all items of the scale final version.Conclusion: The process of cross-cultural adaptation followed all necessary stages and the semantic validity results were adequate, providing the Brazilian version of the AIR to assess anxiety symptoms in patients with COPD.Keywords: COPD, AIR scale, surveys and questionnaires, Anxiety

Natalia A Warren,1,2,&ast; Steven L Maskin,3,&ast; Varadraj Gurupur,4,&ast; Deidre A Rector,1,&ast; Diana Adelman,1,&ast; Susan Howell,1,&ast; John McAree,1,&ast; Ruthie Dibble,1,&ast; Celia Carlisano,1,&ast; David P Maconi,1,&ast; Dirk Schrotenboer,5,&ast; Maria Jaimes,3,&ast; Nancy Marte,3,&ast; Theresa Carlisano,1,&ast; Claire Toland,3,&ast; Jongik Chung,6,&ast; Sandra L Cremers,7 Glenn S Corbin8 1Not A Dry Eye Foundation, Daytona Beach, FL, USA; 2School of Modeling, Simulation, and Training, University of Central Florida, Orlando, FL, USA; 3Dry Eye and Cornea Treatment Center, Tampa, FL, USA; 4Department of Health Management and Informatics, University of Central Florida, Orlando, FL, USA; 5Dry Eye Spa of West Michigan, Holland, MI, USA; 6Department of Statistics and Data Science, University of Central Florida, Orlando, FL, USA; 7Johns Hopkins Medical Institution, Baltimore, MD, USA; 8Wyomissing Optometric Center, Inc, Wyomissing, PA, USA&ast;These authors contributed equally to this workCorrespondence: Natalia A Warren, Not A Dry Eye Foundation, 1019 Sea Shell Court, Daytona Beach, FL, 32124, Tel +1 855-544-6553, Email Natalia.warren@notadryeye.orgIntroduction: Although affecting an estimated 35% of the population, Dry Eye is not well understood by patients and the medical community. As a result, both in research and clinical settings, diagnostic and treatment protocols tend to be non-specific, ad hoc, and inadequate, with a narrow industry-driven focus. The purpose of this convening was to propose a research roadmap that orients Dry Eye researchers toward a comprehensive patient-centered approach to diagnosing and treating Dry Eye, Meibomian gland dysfunction (MGD), and related comorbidities with a goal of improving clinical outcomes for Dry Eye/MGD patients.Methods: Sixteen participants, including Dry Eye/MGD patients, caregivers, and patient advocates together with a group of experts in Dry Eye, MGD and other fields identified gaps in research on Dry Eye and MGD diagnostic and treatment approaches (age range 20– 80; male to female ratio of 7:11; patients: 7). During a 2-day virtual convening, participants were assigned to topic-specific focus-group sessions to discuss and develop research questions pertaining to Dry Eye and MGD. The research questions were compiled into a proposed patient-centered roadmap for Dry Eye and MGD research. Two additional participants contributed to the proposed roadmap following the convening.Results: The focus groups identified over 80 patient-centered research questions important to patients and other stakeholders and compiled these into a proposed research roadmap.Conclusion: The convened stakeholders aim to establish a cohesive and comprehensive patient-centered approach to treating Dry Eye, Meibomian Gland Dysfunction, and comorbidities. The research roadmap will serve as a reference for researchers, educational institutions, clinicians, and others evaluating diagnostic and treatment protocols in Dry Eye and MGD.Keywords: dry eye disease, Meibomian gland dysfunction, patient-centered research, patient advocacy, ocular surface disease, patient care

The efficacy of marine protected areas (MPAs) may be reduced when climate change disrupts the ecosystems and human communities around which they are designed. The effects of ocean warming on MPA functioning have received attention but less is known about how multiple climatic stressors may influence MPAs efficacy. Using a novel dataset incorporating 8.8 million oceanographic observations, we assess exposure to potentially stressful temperatures, dissolved oxygen concentrations, and pH levels across the California MPA network. This dataset covers more than two-thirds of California's 124 MPAs and multiple biogeographic domains. However, spatial-temporal and methodological patchiness constrains the extent to which systematic evaluation of exposure is possible across the network. Across a set of nine well-monitored MPAs, the most frequently observed combination of stressful conditions was hypoxic conditions (

We report on new measurements of elliptic flow (v2) of electrons from heavy-flavor hadron decays at mid-rapidity (|y|

The level structure of Al36 has been studied via β decay of Mg36 at the Facility for Rare Isotope Beams (FRIB) and the National Superconducting Cyclotron Laboratory (NSCL). A long-lived isomer in Al36 was identified which decays by β to an excited state of Si36. The ground state and the isomeric state of Al36 were found to populate different energy levels of Si36. The results from the two data sets in the present work complement each other. Configuration interaction calculations performed with the FSU shell-model Hamiltonians provide reasonable descriptions to the experimental observations and offer insight into future improvements of the theoretical interpretation.

A portable monoenergetic 24 keV neutron source based on the 124Sb-9Be photoneutron reaction and an iron filter has been constructed and characterized. The coincidence of the neutron energy from SbBe and the low interaction cross-section with iron (mean free path up to 29 cm) makes pure iron specially suited to shield against gamma rays from 124Sb decays while letting through the neutrons. To increase the 124Sb activity and thus the neutron flux, a >1 GBq 124Sb source was produced by irradiating a natural Sb metal pellet with a high flux of thermal neutrons in a nuclear reactor. The design of the source shielding structure makes for easy transportation and deployment. A hydrogen gas proportional counter is used to characterize the neutrons emitted by the source and a NaI detector is used for gamma background characterization. At the exit opening of the neutron beam, the characterization determined the neutron flux in the energy range 20-25 keV to be 6.00±0.30 neutrons per cm2 per second and the total gamma flux to be 245±8 gammas per cm2 per second (numbers scaled to 1 GBq activity of the 124Sb source). A liquid scintillator detector is demonstrated to be sensitive to neutrons with incident kinetic energies from 8 to 17 keV, so it can be paired with the source as a backing detector for neutron scattering calibration experiments. This photoneutron source provides a good tool for in-situ low energy nuclear recoil calibration for dark matter experiments and coherent elastic neutrino-nucleus scattering experiments.

Ji-Rong Yang,1 Ying-Yuan Li,2 Tao-Jia Ran,1 Xiao-Yu Lin,1 Jin-Yan Xu,1 Shao-Li Zhou,1 Pin-Jie Huang1 1Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 2Department of Anesthesiology, Huadu District People’s Hospital, Guangzhou, Guangdong Province, People’s Republic of ChinaCorrespondence: Pin-Jie Huang; Shao-Li Zhou, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, Guangdong Province, People’s Republic of China, Email hpjie@126.com; 13610272308@139.comPurpose: We aimed to evaluate the effect of intravenous esketamine combined with dexmedetomidine as supplemental analgesia in reducing intraoperative visceral pain during elective cesarean section under combined spinal-epidural anesthesia (CSEA).Patients and Methods: A total of 269 parturients scheduled for elective cesarean section under CSEA between May 2023 and August 2023 were assessed. The parturients were randomly allocated to receiving either intravenous infusion of 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine (group ED, n=76), 0.5-μg/kg dexmedetomidine (group D, n=76), or normal saline (group C, n=76) after umbilical cord clamping. The primary outcome was intraoperative visceral pain. Secondary outcomes included the visual analog scale (VAS) score for pain evaluation and other intraoperative complications.Results: The incidence of visceral pain was lower in group ED [9 (12.7%)] than in group D [32 (43.8%)] and group C [36 (48.6%), P < 0.0001]. The VAS score was also lower in group ED when exploring abdominal cavity [0 (0), P < 0.0001] and suturing the muscle layer [0 (0), P =0.036]. The mean arterial pressure was higher in group D [83 (9) mmHg] and group ED [81 (11) mmHg] than in group C [75 (10) mmHg, P < 0.0001] after solution infusion. The heart rate after infusion of the solution was lower in group D [80 (12) bpm] than in group C [86 (14) bpm] and group ED [85 (12) bpm, P = 0.016]. The incidence of transient neurologic or mental symptoms was higher in group ED compared to group C and group D (76.1% vs 18.9% vs 23.3%, P< 0.0001).Conclusion: During cesarean section, 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine can alleviate visceral traction pain and provide stable hemodynamics. Parturients receiving this regimen may experience transient neurologic or mental symptoms that can spontaneously resolve at the end of the surgery.Plain language summary: Some parturients endure experience indescribable pain and discomfort during fetal delivery. Esketamine combined with dexmedetomidine can alleviate this pain during cesarean section under combined spinal-epidural anesthesia. However, after intravenous injection of esketamine and dexmedetomidine, the parturients may experience nightmares, dizziness, hallucinations, and drowsiness, etc.Keywords: cesarean section, dexmedetomidine, esketamine, CSEA, visceral pain

Abstract Vaccine-related myocarditis associated with the BNT162b2 vaccine is a rare complication, with a higher risk observed in male adolescents. However, the contribution of genetic factors to this condition remains uncertain. In this study, we conducted a comprehensive genetic association analysis in a cohort of 43 Hong Kong Chinese adolescents who were diagnosed with myocarditis shortly after receiving the BNT162b2 mRNA COVID-19 vaccine. A comparison of whole-genome sequencing data was performed between the confirmed myocarditis cases and a control group of 481 healthy individuals. To narrow down potential genomic regions of interest, we employed a novel clustering approach called ClusterAnalyzer, which prioritised 2,182 genomic regions overlapping with 1,499 genes for further investigation. Our pathway analysis revealed significant enrichment of these genes in functions related to cardiac conduction, ion channel activity, plasma membrane adhesion, and axonogenesis. These findings suggest a potential genetic predisposition in these specific functional areas that may contribute to the observed side effect of the vaccine. Nevertheless, further validation through larger-scale studies is imperative to confirm these findings. Given the increasing prominence of mRNA vaccines as a promising strategy for disease prevention and treatment, understanding the genetic factors associated with vaccine-related myocarditis assumes paramount importance. Our study provides valuable insights that significantly advance our understanding in this regard and serve as a valuable foundation for future research endeavours in this field.

Sheri L Rowen,1 Tom Tooma,1 Ngoc Trieu,1 Brad Hall2 1Nvision Eye Centers, Newport Beach, CA, USA; 2Sengi, Penniac, NB, CanadaCorrespondence: Sheri L Rowen, Nvision Eye Centers, 4220 Von Karman &num;100, Newport Beach, CA, 92660, USA, Tel +1-877-455-9942, Email srowen10@gmail.comPurpose: To compare visual outcomes of eyes that had laser refractive surgery with the Contoura Phorcides treatment plan and eyes that had laser refractive surgery with the wavefront-optimized treatment plan using the same laser.Methods: Retrospective chart review of clinical outcomes of eyes that had either Contoura with Phorcides (CP) or wavefront-optimized (WFO) corneal refractive procedures using the Wavelight EX500 (Alcon Vision, LLC). Data were collected and compared for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, change in postoperative UDVA compared to preoperative CDVA, and change in postoperative CDVA compared to preoperative CDVA.Results: Total eyes included were 348, with 227 in the CP Group and 121 in the WFO Group. Post-operatively, there was a significantly higher percentage of eyes in the CP Group that were 20/16 or better compared to the WFO Group (57%, 129 eyes, and 17%, 21 eyes, respectively; p < 0.001). The percentage of eyes that gained 1 or more Snellen lines of UDVA compared to preoperative CDVA was higher in the CP Group (47%; 107 eyes) compared to the WFO Group (12%; 14 eyes), which was statistically significant (p < 0.001). Differences in refraction were statistically significant.Conclusion: Topography-guided and wavefront-optimized treatment profiles both provided excellent refractive results. A higher percentage of eyes that were treated using Contoura with Phorcides achieved 20/16 or better unaided distance vision compared to eyes receiving a wavefront-optimized treatment plan.Plain Language Summary: Laser in situ keratomileusis (LASIK) is a common procedure performed to reshape the cornea (transparent part of the eye) and provide clear, spectacle-free vision. There are many different technologies available for surgeons to choose a treatment plan. One of the most popular is called wavefront-optimized LASIK (WFO), which takes into account the curvature of the cornea. Recently, topography-guided LASIK treatment plans that incorporate a proprietary planning software (Contoura Phorcides) have been available that can factor in the individualized surface elevation characteristics of the cornea. The purpose of this study was to compare visual outcomes in patients that had LASIK with the Contoura Phorcides treatment plan to patients that had LASIK with the WFO treatment plan. The results of this study suggest that both treatment profiles both provided excellent refractive results. In addition, a higher percentage of eyes that were treated using Contoura with Phorcides achieved 20/16 or better unaided distance vision compared to eyes receiving a WFO treatment plan.Keywords: topography-guided LASIK, wavefront-optimized LASIK, Phorcides, Contoura

Hard substrate and vertical relief are limited habitat resources for reef-associated species in many regions. On the West Florida Shelf (WFS) of the Gulf of Mexico, red grouper Epinephelus morio act as ecosystem engineers by excavating sediments to expose limestone bedrock. Excavations can exceed 25 m in diameter and 2 m in depth and are among the most abundant WFS seafloor features at depths between 40 and 110 m. As part of a survey of hard-bottom habitats and associated reef fish assemblages, 1203 excavations were identified in WFS waters along the Florida Panhandle between 2014 and 2019. These excavations often contained subsided artificial reef material within their interior and infrequently included E. morio among observed fishes. We video-identified red snapper Lutjanus campechanus excavating sediments around 2 subsided artificial reefs in 2015 and 2017 for a total of approximately 56 min of excavation activity. A total of 24 excavation events were documented around a tire pile in 2015, and 5 were documented around a pyramid-shaped reef module in 2017. These observations help to explain the subsidence of artificial reefs and apparent excavation around their bases despite the scarcity of previously known excavating species. This suggests that L. campechanus might be ecosystem engineers on the WFS.

Pumudu Weerasekara,1 Nadeeka Chandraratne,2 Sunil Lakshman Perera3 1Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka; 2Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, 00800, Sri Lanka; 3Department of Neurosurgery, Asiri Central Brain & Spine Neurosurgical Group, Colombo, 01000, Sri LankaCorrespondence: Pumudu Weerasekara, Faculty of Medicine, University of Colombo, No. 25 Kynsey Road, Colombo, Western Province, 00800, Sri Lanka, Email w.pumudu@gmail.comBackground: Giant Clinically Non-Functioning Pituitary Adenomas (GCNFPA) are pituitary neuroendocrine tumours spanning beyond 4 cm in diameter without clinically apparent secretory function. They elicit insidious growth pertaining to its asymptomatic nature and present at large sizes from mass effect. Certain clinical features such as headache and visual disturbances are common presentations of GCNFPAs owing to their size, while others such as seizures are extremely rare.Case Report: A 63-year-old woman presented with back-to-back generalized tonic clonic seizures to the A&E and was treated with Levetiracetam. Following initial normal blood investigations, a visual field analysis revealed a bitemporal upper quadrantanopia and further evaluation using MRI found a giant pituitary lesion with suprasellar extension through the third ventricle into the lateral ventricles with significant mass effect. She underwent neuro-navigation guided endonasal transsphenoidal subtotal resection 2 weeks later. The histological diagnosis of null cell adenoma with a Ki67 of 3% was made. At 3 months of follow-up, she is symptom free and monitored with serial MRIs.Conclusion: Seizures are an uncommon presentation of GCNFPAs limited to a few case reports. This illustrates the importance of careful evaluation of patient presentations to correctly diagnose pituitary neoplasms and prioritizing symptom relief in choosing surgical approaches.Keywords: pituitary neuroendocrine tumour, giant pituitary macroadenoma, case report

Rebecca Hui Shan Ong,1 Milawaty Nurjono,1 Hong Choon Oh,1– 3 Christopher Tsung Chien Lien,4 Junisha Jumala,5 Raymond Choon Chye Teo,6 Peiying Gan,7 Karen Lai Ming Kan,8 Lina Farhana Rosle,8 Moi Kim Wee,8 Shou Lin Low4 1Health Services Research, Changi General Hospital, Singapore; 2Centre for Population Health Research and Implementation, Singapore Health Services, Singapore; 3Health Services & Systems Research, Duke-NUS Medical School, Singapore; 4Geriatric Medicine, Changi General Hospital, Singapore; 5Rehabilitative Services, Changi General Hospital, Singapore; 6Singapore Sport & Exercise Medicine Centre, Changi General Hospital, Singapore; 7Community Nursing, Changi General Hospital, Singapore; 8Community and Mental Health, Changi General Hospital, SingaporeCorrespondence: Rebecca Hui Shan Ong, Health Services Research, Changi General Hospital, 2 Simei Street 3, 529889, Singapore, Tel +65 6788 8833, Fax +65 67826049, Email Rebecca.ong.h.s@singhealth.com.sgPurpose: Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of “Steady Feet” (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore.Material and Methods: This study utilized purposive sampling to recruit two participant groups: (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors.Results: Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation.Conclusion: Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers’ capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.Keywords: falls prevention, community-dwelling, older adults, exercise, qualitative, precede-proceed

Abstract Anthropometric characteristics in a subject are a good indication of their body-weight status and diagnosis of overweight and obesity. O and O multifactorial, so today the curiosity arises to investigate new risk factors that predispose to increased body weight, including chronotype. The objective of this study is to evaluate the anthropometric characteristics and caloric intake according to the chronotype in sick Ecuadorian adults. This cross-sectional study consisted of 400 men and women aged between 18 and 63 years, who were hospitalized at the Enrique Garcés General Hospital in the city of Quito. Anthropometric measurements were taken using ISAK techniques. Calorie intake was measured by a 24-hour recall and food frequency, and the Horne and Osttberg questionnaire was applied to measure the chronotype of the subjects. Statistical analyses were performed in R and R studio software. The study subjects were classified into 4 groups depending on their chronotype: moderate morning, extreme morning, intermediate, and moderate evening. It was observed that moderate evening subjects had higher values of body weight, high waist circumference, high triceps skinfold, high percentage of fat mass, visceral fat, and caloric intake than the other groups (p < 0.05). Evening chronotype appears to be related to overweight and obesity and caloric intake.

María Dolores Mondéjar Barrios,1 Matilde Anais Matos Inga,1 Karem Justhin Rodas Trujillo,1 Sandra Lisseth Mori Díaz,1 Juana Olga Espíritu Aguirre,2 Luis Alberto Cabanillas-Chirinos1 1La Libertad, Universidad César Vallejo, Trujillo, Perú; 2Áncash, Universidad Nacional del Santa, Chimbote, PerúCorrespondence: María Dolores Mondéjar Barrios, La Libertad, Universidad César Vallejo, Avenida Antenor Orrego W3 lote 16. Urbanización Covicorti, Trujillo, Perú, Email mmondejarba@ucvvirtual.edu.peIntroduction: Obesity has increased steadily in recent decades, becoming a worldwide pandemic.Objective: To determine the effect of the “Healthy Dish” method to reduce waist circumference in teachers with abdominal obesity in a Peruvian University.Methods: Quasi-experimental, prospective study in 43 teachers, divided into 21 in the control group and 22 in the experimental group, who received a two-session workshop on abdominal obesity and the “Healthy Dish” method. The latter was applied for 2 months, monitored 5 days a week, the waist circumference of both groups was measured at one month and at two months and compared. For the statistical analysis, descriptive and inferential statistics or nonparametric statistics were applied (Mann–Whitney U-test, according to the assumption of normality).Results: The predominant age range was 40 to 49 years, women, married, overweight, with a family history of hypertension, cancer and diabetes mellitus. After the intervention, 40.9% of teachers in the experimental group decreased their waist circumference and 54.5% normalized it, while the control group decreased it by 23.8% and 47.6% normalized it. Only 4.54% of teachers in the experimental group showed no change in their waist circumference, compared to 19.0% in the control group, and 9.52% of teachers in the control group increased their waist circumference.Conclusion: The healthy dish method has a positive effect on decreasing waist circumference in teachers with abdominal obesity.Keywords: healthy eating, abdominal obesity, teachers, waist circumference

Shi-Li Cheng,1 Azlina Yusuf,1 Ying-Yu He,2,3 Wen-Zhen Tang,1 Nur Adibah Binti Solihin Sulaiman1 1School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 3Guangxi University Key Laboratory of Breast Cancer Diagnosis and Treatment, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of ChinaCorrespondence: Azlina Yusuf, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia, Tel + 60 97677567, Email azlinayusuf@usm.my Ying-Yu He, Department of Breast Surgery, Guangxi Medical University Cancer Hospital, No. 71 Hedi Road, Nanning, 530021, People’s Republic of China, Tel + 86 13517886919, Email 864354195@qq.comPurpose: The purpose of the study was to determine the status of spiritual needs and influencing factors of postoperative breast cancer (BC) women undergoing chemotherapy.Participants and Methods: This study is a cross-sectional study. A total of 173 participants completed a general information questionnaire and a Chinese version of the Spiritual Needs Scale at the Guangxi Medical University Cancer Hospital. Data were collected by purposive sampling from December 2022 to April 2023. Data were analyzed by descriptive statistics, independent t-test, ANOVA, non-parametric test, and logistic regression analysis.Results: The spiritual needs of postoperative BC women undergoing chemotherapy were at a high level (84.20 ± 12.86). The need for “hope and peace” was considered paramount and the need for a “relationship with transcendence” was considered the least important. Significant differences were found in the following: spiritual needs total score (P=0.040) and “hope and peace” (P=0.021) in education level; “love and connection” in disease stage (P=0.021); “meaning and purpose” in education level (P=0.013), household income (P=0.012), and payment method (P=0.015); “relationship with transcendence” in religion (P< 0.001); and “acceptance of dying” in marital status (P=0.023). The level of education was the influencing factor of spiritual needs (OR=1.50, P=0.005), especially for “hope and peace” (OR=1.50, P=0.012).Conclusion: The spiritual need of postoperative BC Chinese women undergoing chemotherapy is at a high level and should receive more attention. In clinical work, nurses should fully assess the spiritual needs of patients and meet their specific needs. Results may help nurses to develop targeted and comprehensive spiritual intervention strategies according to the characteristics of patients.Keywords: breast neoplasms, spirituality, oncology nursing, nursing care, needs assessment

The field of radionuclide therapy (RNT) for prostate cancer (PC) is growing rapidly, with recent Food and Drug Administration approval of the first 177Lu-PSMA ligand. We aimed to develop the first patient-reported outcome (PRO) measure for PC patients receiving RNT. Methods: We identified relevant symptoms and toxicities by reviewing published trials and interviews with PC patients receiving RNT (n = 29), caregivers (n = 14), and clinicians (n = 11). Second, we selected items for measure inclusion. Third, we refined the item list with input from experts in RNTs and PROs. Fourth, we finalized the Functional Assessment of Cancer Therapy-Radionuclide Therapy (FACT-RNT) with patient input. Results: This multistep process yielded a brief 15-item measure deemed by key stakeholders to be relevant and useful in the context of RNT for PC. Conclusion: The FACT-RNT is a new standardized tool to monitor relevant symptoms and toxicities among PC patients in RNT trials and real-world settings.

Abstract: Importance: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. Methods: RECOVER-Adult is a combined prospective/retrospective cohort currently planned to enroll 14,880 adults aged ≥18 years. Eligible participants either must meet WHO criteria for suspected, probable, or confirmed infection; or must have evidence of no prior infection. Recruitment occurs at 86 sites in 33 U.S. states, Washington, DC and Puerto Rico, via facility– and community-based outreach. Participants complete quarterly questionnaires about symptoms, social determinants, vaccination status, and interim SARS-CoV-2 infections. In addition, participants contribute biospecimens and undergo physical and laboratory examinations at approximately 0, 90 and 180 days from infection or negative test date, and yearly thereafter. Some participants undergo additional testing based on specific criteria or random sampling. Patient representatives provide input on all study processes. The primary study outcome is onset of PASC, measured by signs and symptoms. A paradigm for identifying PASC cases will be defined and updated using supervised and unsupervised learning approaches with cross– validation. Logistic regression and proportional hazards regression will be conducted to investigate associations between risk factors, onset, and resolution of PASC symptoms. Discussion: RECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options.

The NASA Ionospheric Connection Explorer (ICON) was launched in October 2019 and has been observing the upper atmosphere and ionosphere to understand the sources of their strong variability, to understand the energy and momentum transfer, and to determine how the solar wind and magnetospheric effects modify the internally-driven atmosphere-space system. The Far Ultraviolet Instrument (FUV) supports these goals by observing the ultraviolet airglow in day and night, determining the atmospheric and ionospheric composition and density distribution. Based on the combination of ground calibration and flight data, this paper describes how major instrument parameters have been verified or refined since launch, how science data are collected, and how the instrument has performed over the first 3 years of the science mission. It also provides a brief summary of science results obtained so far.