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Biochar derived from abundant waste biomass has emerged as an eco-friendly alternative to conventional adsorbents. In this study, biochar produced from golden snail shells through a simple pyrolysis process was applied for phosphorus adsorption. The effects of pyrolysis temperature and time on adsorption capacity were investigated. The biochar pyrolyzed at 800 °C for 90 min (B800) exhibited the best adsorption performance. Optimal adsorption conditions were determined to be a pH of 4.0 and an adsorbent dose of 1.6 g L–1. The adsorption of phosphorus onto B800 could be well described by the Langmuir model and the pseudo-first-order model, achieving a maximum adsorption capacity of 63.5 mg g–1 and a rate constant of 0.029 min–1. This study highlights the potential of biochar derived from agricultural waste as a highly efficient and environmentally friendly adsorbent for phosphorus removal. Furthermore, the adsorption mechanism, driven by the electrostatic interaction occurring prior to Ca-P precipitation, was elucidated. The phosphorus adsorbed onto biochar can potentially be recycled as a soil fertilizer.

The callipodidan genus Sinocallipus Zhang, 1993 (Callipodida, Sinocallipodidae) is reviewed within the scope of the Vietnamese fauna. A total of three species are recorded in Vietnam including a new one, Sinocallipus similis sp. nov. All three species are confirmed by morphological and molecular data. An existing identification key of Sinocallipus species is amended to include the new species.

Two new species of the dragon millipede genus Hylomus Cook & Loomis, 1924 are described from mountainous areas in northern Vietnam, namely Hylomus piccolo sp. nov. and Hylomus borealis sp. nov. The COI barcodes are provided for these species, and an identification key is presented to all Vietnamese Hylomus species.

Labronema Thorne, 1939 is a large and diverse dorylaimid genus with complicated taxonomy. Two new species, Labronema porosum sp. nov. and Labronema bidoupense sp. nov. from natural habitats in Vietnam were characterised both morphologically and molecularly (18S rDNA and 28 rDNA), and line drawings and microphotographs are provided. Phylogenetic analyses showed that the new species clustered together with Labronema ferox Thorne, 1939, the type species of the genus. The two new taxa belong to a group of Labronema species with medium body (L = 1.5–2.5 mm) and odontostyle (31–39 μm) length, and a lip region offset by a constriction. Based on morphological and molecular evidence, this study shows that the populations from Vietnam previously identified as L. glandosum Rahman, Jairajpuri, Ahmad & Ahmad, 1986 in fact represent L. porosum sp. nov. Evolutionary relationships of Labronema species are discussed. A key to the species of Labronema with a medium-sized odontostyle (31–39 μm) is provided as well as a list of the species of the genus considered valid.

Abstract Background Addressing mental health disparities following COVID-19 requires adaptive, multi-sectoral, equity-focused, and community-based approaches. Mental health task-sharing in gateway settings has been found to address mental health care gaps in low- and middle-income countries, but is not a common practice in the U.S., especially in non-medical settings, such as low-income housing developments (LIH). This research study will evaluate the effectiveness of a multisectoral community-engaged collaborative for task-sharing mental health care on consumer, provider, and implementation outcomes, as well as identify barriers and facilitators for implementation. Methods In this stepped-wedge randomized controlled trial with technology supplementation, LIH and primary care sites will be randomly assigned to one of five sequences of three implementation strategies: (1) Education and Resources (E&R), which involves online training and resources on basic mental health task-sharing skills, (2) Multisectoral Community Collaborative Care (MCC), which consists of all E&R resources plus additional community responsive implementation supports and participation in a multisectoral coalition and (3) MCC + Technology, which combines the MCC condition resources with a community crowdsourced technology solution to support implementation. The primary outcome is the effectiveness in meeting consumers’ needs through direct service (e.g., adequately addressing depression and anxiety symptoms), and through implementation to increase access to mental health care (reach). The secondary outcome examines additional consumer outcomes including health functioning and social risks, as well as implementation outcomes including provider skills, program adoption, and factors related to barriers and facilitators of quality implementation. A total of 700 consumers receiving mental health care at 20 sites will be surveyed at baseline, 6-, and 12-month follow-ups. Additionally, 100 providers will be evaluated at baseline, 6-, 12-, and 24-month follow-ups before training and after randomization. Discussion We hypothesize that MCC and MCC + Technology conditions will demonstrate significantly higher efficacy in changing primary outcomes compared to E&R, and the MCC + Technology supplement will show significantly higher levels of reach of mental health tasks compared to the MCC condition alone. These findings will demonstrate the feasibility of mental health integration into accessible, non-medical community settings such as LIH. Moreover, it will help establish a multilevel system solution based on community engagement and planning with a multisectoral collaboration that can be sustained community-wide. Trial registration NCT05833555 on Clinicaltrials.gov. Registered April 26, 2023

This study examines the correlation between youngsters' media literacy and their trust in government, support for anti-pandemic regulations, and vaccine readiness during the COVID-19 pandemic in Vietnam. The findings show a statistically significant positive correlation between youngsters' media literacy and their trust in government, support for anti-pandemic regulations, and vaccine readiness. The more media literacy youngsters have, the more likely they trust the government, comply with anti-pandemic regulations, and take the COVID-19 vaccines. The findings emphasize the importance of media literacy and media literacy education as the core solution to construct a media-literate society, in which youngsters use media for their personal growth and social development. In such aspect, media literacy can be an effective tool to manage the pandemic and a type of social vaccine to end the infodemic.

The Red River originating from Yunnan province, China is the second largest river in Vietnam in terms of length and discharge. Combination of water chemistry monitoring data of 4 years (2018–2022) from different sub-basins of the Red River (the Da, Lo, Thao, Tra Ly, and Day) with historical datasets indicates a decline in pH from 8.1 in 2000 to 7.7 in 2021, greater CO2 concentrations and a shift from waters naturally dominated by carbonate weathering to waters dominated by evaporite weathering. Such changes were most apparent in the delta area where heavy human activities have increased influxes of most dissolved chemicals, except SiO2. Evaporite weathering is particularly enhanced by mining and deforestation occurring in upstream regions of both China and Vietnam. Pyrite oxidation, alongside silicate weathering, is enhanced along the Red River Fault Zone but reduced in tributaries with a higher proportion of hydropower reservoirs. Longer water residence times in these large reservoirs (total volume > 2.7x1010 m3) located in the Da and Lo sub-basins have also increased primary productivity, leading to higher evasion/uptake of CO2 and SiO2, lower total dissolved solids (TDS), and higher pH. The total physical and chemical denudation rates of upstream mountain tributaries ranged between 0.107 ± 0.108 and 0.139 ± 0.137 mm yr−1, mainly due to reservoir implementation and instream aquatic biogeochemistry changes. Our findings demonstrate that anthropogenic activities are profound factors impacting the water chemistry of the Red River system.

Climate and other shocks threaten the livelihoods of rice farmers in Vietnam, forcing them to diversify their livelihoods. This study investigates the diversification strategies of rice farmers in the Mekong Delta of Vietnam. Based on 405 rice farming households in Tien Giang, Dong Thap, and Can Tho provinces, the results of the Hausman test showed that the four strategies, namely rice farming only, on-farm activities (rice farming and other farming activities), rice and non-farm activities, and on-farm and non-farm activities, were used in this study. A multinomial logit regression was used to measure the influence of rice farmers’ livelihood capital on their adaptive strategies. The results show that human capital (gender, household size, dependency ratio), social capital (extension visits, cooperatives’ membership), natural capital (farm size, land rent, access to water for farming), physical capital (distance to markets, distance to district capital), and financial capital (fixed asset, access to credit, and government support) are significant factors affecting households’ diversification decisions. Intervention programs should encourage farmers, especially women, to participate in cooperative and extension visits to improve their skills, access to credit, and income opportunities.

Abstract The study of muscle mass as an imaging-derived phenotype (IDP) may yield new insights into determining the normal and pathologic variations in muscle mass in the population. This can be done by determining 3D abdominal muscle mass from 12 distinct abdominal muscle regions and groups using computed tomography (CT) in a racially diverse medical biobank. To develop a fully automatic technique for assessment of CT abdominal muscle IDPs and preliminarily determine abdominal muscle IDP variations with age and sex in a clinically and racially diverse medical biobank. This retrospective study was conducted using the Penn Medicine BioBank (PMBB), a research protocol that recruits adult participants during outpatient visits at hospitals in the Penn Medicine network. We developed a deep residual U-Net (ResUNet) to segment 12 abdominal muscle groups including the left and right psoas, quadratus lumborum, erector spinae, gluteus medius, rectus abdominis, and lateral abdominals. 110 CT studies were randomly selected for training, validation, and testing. 44 of the 110 CT studies were selected to enrich the dataset with representative cases of intra-abdominal and abdominal wall pathology. The studies were divided into non-overlapping training, validation and testing sets. Model performance was evaluated using the Sørensen–Dice coefficient. Volumes of individual muscle groups were plotted to distribution curves. To investigate associations between muscle IDPs, age, and sex, deep learning model segmentations were performed on a larger abdominal CT dataset from PMBB consisting of 295 studies. Multivariable models were used to determine relationships between muscle mass, age and sex. The model's performance (Dice scores) on the test data was the following: psoas: 0.85 ± 0.12, quadratus lumborum: 0.72 ± 0.14, erector spinae: 0.92 ± 0.07, gluteus medius: 0.90 ± 0.08, rectus abdominis: 0.85 ± 0.08, lateral abdominals: 0.85 ± 0.09. The average Dice score across all muscle groups was 0.86 ± 0.11. Average total muscle mass for females was 2041 ± 560.7 g with a high of 2256 ± 560.1 g (41–50 year old cohort) and a change of − 0.96 g/year, declining to an average mass of 1579 ± 408.8 g (81–100 year old cohort). Average total muscle mass for males was 3086 ± 769.1 g with a high of 3385 ± 819.3 g (51–60 year old cohort) and a change of − 1.73 g/year, declining to an average mass of 2629 ± 536.7 g (81–100 year old cohort). Quadratus lumborum was most highly correlated with age for both sexes (correlation coefficient of − 0.5). Gluteus medius mass in females was positively correlated with age with a coefficient of 0.22. These preliminary findings show that our CNN can automate detailed abdominal muscle volume measurement. Unlike prior efforts, this technique provides 3D muscle segmentations of individual muscles. This technique will dramatically impact sarcopenia diagnosis and research, elucidating its clinical and public health implications. Our results suggest a peak age range for muscle mass and an expected rate of decline, both of which vary between genders. Future goals are to investigate genetic variants for sarcopenia and malnutrition, while describing genotype–phenotype associations of muscle mass in healthy humans using imaging-derived phenotypes. It is feasible to obtain 3D abdominal muscle IDPs with high accuracy from patients in a medical biobank using fully automated machine learning methods. Abdominal muscle IDPs showed significant variations in lean mass by age and sex. In the future, this tool can be leveraged to perform a genome-wide association study across the medical biobank and determine genetic variants associated with early or accelerated muscle wasting.

Functional magnetic resonance imaging (fMRI) allows studying human brain function non-invasively up to the spatial resolution of cortical columns and layers. Most fMRI acquisitions rely on the blood oxygenation level dependent (BOLD) contrast employing T2* weighted 2D multi-slice echo-planar imaging (EPI). At ultra-high magnetic field (i.e. 7 T and above), it has been shown experimentally and by simulation, that T2 weighted acquisitions yield a signal that is spatially more specific to the site of neuronal activity at the cost of functional sensitivity. This study compared two T2 weighted imaging sequences, inner-volume 3D Gradient-and-Spin-Echo (3D-GRASE) and 2D Spin-Echo EPI (SE-EPI), with evaluation of their imaging point-spread function, functional specificity, and functional sensitivity at sub-millimeter resolution. Simulations and measurements of the imaging point-spread function revealed that the strongest anisotropic blurring in 3D-GRASE (along the second phase-encoding direction) was about 60 % higher than the strongest anisotropic blurring in 2D SE-EPI (along the phase-encoding direction) In a visual paradigm, the BOLD sensitivity of 3D-GRASE was found to be superior due to its higher temporal signal-to-noise ratio. High resolution cortical depth profiles suggested that the contrast mechanisms are similar between the two sequences, however, 2D SE-EPI had a higher surface bias owing to the higher T2* contribution of the longer in-plane EPI echo-train for full field of view compared to the reduced field of view of zoomed 3D-GRASE.

Digestive health is an overlooked but vital component of the success of Western honey bee (Apis mellifera) colonies. Viral, bacterial, fungal, and protozoal infections can inhibit nutrient uptake and waste elimination by the honey bee digestive tract. Active management requires monitoring honey bee health on an individual and colony basis, providing adequate nutrition, and controlling for other pests and diseases. One organism that has gained recent attention is Malpighamoeba mellificae. This publication describes how to detect M. mellificae in A. mellifera colonies.

In this paper a very compact design of a dual-band band pass filter (D-BPF) using dual composite right-/left-handed (D-CRLH) and open-loop ring (OLR) resonators is presented. To overcome the frequency ratio limitations of D-CLRH resonators technique, the D-BPF design combines D-CRLH and OLR resonators to finally perform a D-BPF. The filter covers the 2.6 and 3.5 GHz spectrums for 4G and 5G applications, respectively. The reported D-BPF is designed and optimized using ADS software, and is implemented on a Rogers RO5880 substrate with a relative dielectric constant of 2.2 and thickness of 0.787 mm. The overall compact size is 8×8×0.787 mm^3. To our knowledge, this design is considered as the most compact and smallest size dual-bandpass filters.

The mechanism underlying the preferential and cooperative binding of cofilin and the expansion of clusters toward the pointed-end side of actin filaments remains poorly understood. To address this, we conducted a principal component analysis based on available filamentous actin (F-actin) and C-actin (cofilins were excluded from cofilactin) structures and compared to monomeric G-actin. The results strongly suggest that C-actin, rather than F-ADP-actin, represented the favourable structure for binding preference of cofilin. High-speed atomic force microscopy explored that the shortened bare half helix adjacent to the cofilin clusters on the pointed end side included fewer actin protomers than normal helices. The mean axial distance (MAD) between two adjacent actin protomers along the same long-pitch strand within shortened bare half helices was longer (5.0–6.3 nm) than the MAD within typical helices (4.3–5.6 nm). The inhibition of torsional motion during helical twisting, achieved through stronger attachment to the lipid membrane, led to more pronounced inhibition of cofilin binding and cluster formation than the presence of inorganic phosphate (Pi) in solution. F-ADP-actin exhibited more naturally supertwisted half helices than F-ADP.Pi-actin, explaining how Pi inhibits cofilin binding to F-actin with variable helical twists. We propose that protomers within the shorter bare helical twists, either influenced by thermal fluctuation or induced allosterically by cofilin clusters, exhibit characteristics of C-actin-like structures with an elongated MAD, leading to preferential and cooperative binding of cofilin.

Objective Diabetes mellitus is an important chronic disease that is prevalent around the world. Different countries and diverse cultures use varying approaches to dealing with this chronic condition. Also, with the advancement of computation and automated decision-making, many tools and technologies are now available to patients suffering from this disease. In this work, the investigators attempt to analyze approaches taken towards managing this illness in India and the United States. Methods In this work, the investigators have used available literature and data to compare the use of artificial intelligence in diabetes management. Findings The article provides key insights to comparison of diabetes management in terms of the nature of the healthcare system, availability, electronic health records, cultural factors, data privacy, affordability, and other important variables. Interestingly, variables such as quality of electronic health records, and cultural factors are key impediments in implementing an efficiency-driven management system for dealing with this chronic disease. Conclusion The article adds to the body of knowledge associated with the management of this disease, establishing a critical need for using artificial intelligence in diabetes care management.

Two known species of the genus Sporonchulus, namely S. ibitiensis and S. vagabundus, collected from natural areas of Vietnam, are characterized, including descriptions and illustrations of both species, as well as SEM observations and molecular (18S-, 28S rDNA) analyses of S. ibitiensis. The identity of the two species is discussed, with detailed comparison with previously known populations. The taxonomy of the genus is updated, presenting a diagnosis, list of species, key to their identification, and a compendium of their main morphometrics. An integrative analysis, combining morphological data with a cladistic approach and the first molecular study for a representative of Sporonchulus, better supports a narrow relationship of this genus with Mononchidae than with Mylonchulidae members, however further research should be conducted to elucidate its phylogeny.

Abstract Power system dynamics are generally modeled by high dimensional non‐linear differential‐algebraic equations (DAEs) given a large number of components forming the network. These DAEs' complexity can grow exponentially due to the increasing penetration of distributed energy resources, whereas their computation time becomes sensitive due to the increasing interconnection of the power grid with other energy systems. This paper demonstrates the use of quantum computing algorithms to solve DAEs for power system dynamic analysis. We leverage a symbolic programming framework to equivalently convert the power system's DAEs into ordinary differential equations (ODEs) using index reduction methods and then encode their data into qubits using amplitude encoding. The system non‐linearity is captured by Hamiltonian simulation with truncated Taylor expansion so that state variables can be updated by a quantum linear equation solver. Our results show that quantum computing can solve the power system's DAEs accurately with a computational complexity polynomial in the logarithm of the system dimension. We also illustrate the use of recent advanced tools in scientific machine learning for implementing complex computing concepts, that is, Taylor expansion, DAEs/ODEs transformation, and quantum computing solver with abstract representation for power engineering applications.

The millipede family Polydesmidae Leach, 1816 is reviewed in the scope of the Vietnamese fauna. The distribution of the species, Polydesmus vietnamicus Nguyen, 2009 is extended northward to Ha Giang Province. A new cavernicolous polydesmid, Pacidesmus tuachua sp. nov., is described from two caves in northwestern Vietnam, representing the first record of the genus from Vietnam. Extensive illustrations and DNA barcodes are provided for both species, a revised key is presented to all 12 species of Pacidesmus Golovatch, 1991, as well as a key to all eight genera of Asian Polydesmidae.

Abstract Background and Aim We aimed to evaluate the application of Peptest, a novel technique to detect pepsin in the saliva, and identify its threshold level for the diagnosis of gastroesophageal reflux disease (GERD) with extraesophageal symptoms. Methods A cross‐sectional study was conducted in two groups: patients with extraesophageal GERD symptoms (symptomatic group divided into GERD and non‐GERD groups according to 24‐h esophageal pH‐impedance monitoring [pH‐I] results) and healthy controls. For the symptomatic group, endoscopy, pH 24 h, high‐resolution manometry (HRM), and salivary Peptest were performed. For the healthy control group, only Peptest was done. The accuracy of Peptest was compared with that of pH‐I by the Lyon consensus criteria. Results Chronic laryngitis was the most frequent extraesophageal symptom. On saliva testing, the GERD group had a higher prevalence of positive samples and pepsin concentration than the control group. Between GERD and non‐GERD groups, the optimal threshold level was 31.2 ng/mL, with a sensitivity of 86.7% and specificity of 27.5%. The optimal threshold level was 31.4 ng/mL to differentiate GERD from healthy controls, with a sensitivity of 86.7% and specificity of 66.0%. Age, number of total refluxes, DeMeester score, post‐reflux swallow‐induced peristaltic wave (PSPW) index, and mean nocturnal baseline impedence (MNBI) were associated with pepsin concentration. Regarding HRM metrics, there was no significant difference of pepsin concentration between low/normal upper esophageal sphincter (UES) resting pressure, low/normal lower esophageal sphincter (LES) resting pressure, low/normal 4‐s integrated relaxation pressure (IRP4s), and hypomotility/normal motility. Conclusion Patients with extraesophageal symptoms had a higher prevalence of positive Peptest. The optimum threshold level of 31.4 ng/mL had high sensitivity and moderate specificity to differentiate between patients with GERD and healthy controls.

Background/Objectives: In Vietnam, COVID-19 vaccination campaigns for children have encountered numerous challenges due to acceptance issues among parents. This study aimed to assess parental decision-making and identify factors influencing their decision to vaccinate their children against COVID-19. Methods: This was a cross-sectional online survey conducted between April and May 2023 among parents of children aged 6–17 years enrolled in urban and rural schools in Thai Nguyen province, Vietnam. Data on parental and child demographics, vaccination decision-making, COVID-19 experiences, and health beliefs based on the Health Belief Model were collected and analyzed, using univariate and multivariable multinomial regression analyses. Results: Among 4235 respondents (median age 41 years, 80.4% female), 81.3% had accepted all vaccine doses for their children, 9.7% had accepted some doses, 4.6% had rejected all doses, and 4.5% had not vaccinated their children for reasons unrelated to vaccine acceptance. Factors influencing parental decision-making included parental age, educational status, area of residence, health beliefs, prior experience with COVID-19 vaccination, and their child’s age and health status. Conclusions: We found overall high levels of parental acceptance for COVID-19 vaccination for children in Thai Nguyen province. To enhance COVID-19 vaccination acceptance, targeted communication strategies should focus on younger parents, those living in urban areas, parents with higher educational levels, and those with children who are younger or have underlying medical conditions. Trusted sources such as healthcare workers, teachers, and official health websites are essential for disseminating accurate information and fostering trust in vaccination programs.

Abstract This study examined the relationship between uncontrolled diabetes and periodontal disease (PD) among adults in the United States. We used data from the 2009–2014 National Health and Nutrition Examination Survey (NHANES) with a sample of 6108 adults ages 30 and over. To measure PD status, we used the Centers for Disease Control and Prevention/American Academy of Periodontology’s standards. To classify DM status (no DM, DM with HbA1c 50 years). In conclusion, uncontrolled DM was significantly associated with higher odds of PD among adults in the US.

Background: The World Health Organization (WHO) warns that vaccine hesitancy is an ongoing major global health threat. While vaccination against severe acute respiratory syndrome coronavirus (SARS-CoV-2) proves to be an effective strategy in protecting against the disease, vaccine hesitancy represents a major barrier to stopping the spread of the virus. Willingness for vaccination can be influenced by several factors, including education level and health literacy. Although several studies demonstrate the value of video educational programs in improving coronavirus disease 2019 (COVID-19) vaccine knowledge and acceptance, no studies to date have evaluated if race, gender, and other demographic factors impact the influence of an educational video on COVID-19 vaccine knowledge and hesitancy among university students in the United States (U.S.). Aims: This study was conducted to determine the impact of an educational video on U.S. university undergraduate students’ COVID-19 vaccine perception and acceptance. It also aims to evaluate whether demographic factors affect the influence of the video. Methods: An online survey was used to measure perceived understanding and acceptance of COVID-19 vaccines before and after viewing a video regarding the effectiveness and safety of COVID-19 vaccinations. The impact of demographic factors on the Video Influence Score was analyzed. Key results: After viewing the video, respondents’ (n = 285) perceived awareness and acceptance of COVID-19 vaccines significantly increased (p < 0.05). In addition, gender, political party affiliation, age, study major, and influenza vaccination history did not significantly impact the Video Influence Score (p > 0.05). However, African American/Black respondents (3.81 ± 4.24) were significantly more influenced by the video compared to respondents of other races (p < 0.05), such as White/Caucasian (1.91 ± 3.75), Hispanic/Latino (0.17 ± 3.67), Asian (0.29 ± 1.53), and Indigenous American (0.64 ± 2.52). Conclusions: This study suggests the potential impact of an educational video on COVID-19 vaccine perception and acceptance among university students. Despite limitations such as a modest survey response rate, this study provides valuable insight concerning the influential factors affecting vaccine acceptance in diverse student populations. Future studies are warranted to explore how student response to vaccine educational videos may vary depending on students’ racial and cultural backgrounds. Implications: A targeted educational video to promote vaccine acceptance is a valuable tool for public health campaigns to combat vaccine hesitancy. The study also highlights the importance of tailoring interventions to specific demographic groups such as considering racial factors to maximize the impact of educational interventions on vaccine attitudes.

Abstract Based on the fact that many water reservoirs built in headwater catchments receive no water input during dry season, we modified the Craig‐Gordon model and proposed an approach to calculate kinetic fractionation factors in open‐water evaporation taking into account isotopic compositions of precipitation and of lake water, lake volume, and land‐based meteorological data. The approach is centered around the determination of lake water isotope enrichment rate over time during dry periods. We then applied this approach for calculating kinetic fractionation factors, turbulence index, and open‐water evaporation for a small reservoir located in a sub‐tropical monsoonal climate. We found that the kinetic fractionation factors, εK,H and εK,O are, respectively 3.11‰ ± 0.41‰ and 2.50‰ ± 2.15‰, corresponding to the turbulence index of 0.43 ± 0.19. Evaporation rates in open‐water estimated by our approach is 1.55 times of the land‐based evaporation gauged in the nearby meteorological station. Wind speed, represented by turbulence index, is proved as an important climatic factor influencing kinetic fractionation. This study confirms that wind and surface area factors, which have been neglected in several isotope mass balance models, should be included into calculation process.

Introduction: Hemolytic uremic syndrome (HUS) usually presents with mild gastrointestinal symptoms, typically managed medically. We describe 3 patients with challenging clinical presentations diagnosed with colonic perforation, review the literature, and discuss lessons learned. Case presentation: Case 1: A 5-year-old girl presented with symptoms of HUS. Three weeks later, with new fevers and tachycardia, computerized tomography (CT) revealed pneumoperitoneum. She underwent resection of necrotic small bowel and sigmoid, with a second look resection and creation of multiple stomas. After 5 months, she was discharged on total parenteral nutrition (TPN) and hemodialysis. She later had restoration of intestinal continuity and renal transplantation. Case 2: A 2-year-old boy with HUS underwent, over 3-weeks, 9 ultrasounds, percutaneous ascites aspiration, and 2 CT scans before diagnosis of colonic necrosis and perforation. A laparotomy revealed necrotic colon with a thick rind encasing the bowel, rendering full exploration and stoma creation impossible. Drains were placed, and he was discharged on TPN after 2 months. He underwent colo-colonic anastomosis and a TPN wean after one year with full renal recovery. Case 3: A 3-year-old boy with HUS developed worsening distension. After one week, he suffered cardiopulmonary arrest and CT showed bowel hypoenhancement. He underwent resection of necrotic colon with transverse colostomy creation. After 4 months, he was discharged on hemodialysis. He underwent subsequent colostomy closure and renal transplantation. Conclusion: Bowel ischemia is difficult to diagnose in HUS. CT with intravenous contrast is critical for diagnostic accuracy. Frequent re-evaluation by pediatric surgery is important to avoid missing a surgical emergency.

Scientific inquiry skills (e.g., observation, critical analysis, hypothesis generation) are the cornerstone of scientific training, yet these skills are seldom taught. Consequently, an inquiry-based course was created at McMaster University, Science of Fictional Characters, that facilitates students to develop scientific inquiry skills. By analysing the feasibility of fictional characters in the real world, students apply and understand concepts in various scientific disciplines (e.g., biology, psychology, physics). This course embeds a variety of active learning strategies to foster the development of skills relevant to the scientific process, including group projects, written reflections, and Socratic discussions and debates. To gather student opinions about the effectiveness of the course, we administered an end-of-term survey, a modified version of the Course Interest Survey (CIS). This self-reported CIS included five subscales: student attention, relevance, confidence, satisfaction, and scientific inquiry skill development. Of the 17 surveys completed, on average the subscales scored above four on a five-point scale. Additionally, we performed a thematic analysis on 15 reflective assignments. Qualitatively, 10 codes were extracted from the student testimonies, which were grouped into four themes: student satisfaction, perceived applicability, course flexibility, and barriers to learning. Both data types revealed that students were engaged with the course and felt they improved their scientific inquiry skills. Our data further suggest the course would benefit from additional foundational scientific content. Nevertheless, the study provides an example of how fiction and an active learning model can create an engaging, skills-based learning environment in a science course.

High baseline clearance of immune checkpoint inhibitors (ICIs), independent of dose or systemic exposure, is associated with cachexia and poor outcomes in cancer patients. Mechanisms linking ICI clearance, cachexia and ICI therapy failure are unknown. Here, we evaluate in four murine models and across multiple antibodies whether altered baseline catabolic clearance of administered antibody requires a tumor and/or cachexia and whether medical reversal of cachexia phenotype can alleviate altered clearance. Key findings include mild cachexia phenotype and lack of elevated pembrolizumab clearance in the MC38 tumor-bearing model. We also observed severe cachexia and decreased, instead of increased, baseline pembrolizumab clearance in the tumor-free cisplatin-induced cachexia model. Liver Fcgrt expression correlated with altered baseline catabolic clearance, though elevated clearance was still observed with antibodies having no (human IgA) or reduced (human H310Q IgG1) FcRn binding. We conclude cachexia phenotype coincides with altered antibody clearance, though tumor presence is neither sufficient nor necessary for altered clearance in immunocompetent mice. Magnitude and direction of clearance alteration correlated with hepatic Fcgrt, suggesting changes in FcRn expression and/or recycling function may be partially responsible, though factors beyond FcRn also contribute to altered clearance in cachexia.

BackgroundNew drugs targeting antimicrobial resistant pathogens, including Pseudomonas aeruginosa, have been challenging to evaluate in clinical trials, particularly for the non-ventilated hospital-acquired pneumonia and ventilator-associated pneumonia indications. Development of new antibacterial drugs is facilitated by preclinical animal models that could predict clinical efficacy in patients with these infections.MethodsWe report here an FDA-funded study to develop a rabbit model of non-ventilated pneumonia with Pseudomonas aeruginosa by determining the extent to which the natural history of animal disease reproduced human pathophysiology and conducting validation studies to evaluate whether humanized dosing regimens of two antibiotics, meropenem and tobramycin, can halt or reverse disease progression.ResultsIn a rabbit model of non-ventilated pneumonia, endobronchial challenge with live P. aeruginosa strain 6206, but not with UV-killed Pa6206, caused acute respiratory distress syndrome, as evidenced by acute lung inflammation, pulmonary edema, hemorrhage, severe hypoxemia, hyperlactatemia, neutropenia, thrombocytopenia, and hypoglycemia, which preceded respiratory failure and death. Pa6206 increased >100-fold in the lungs and then disseminated from there to infect distal organs, including spleen and kidneys. At 5 h post-infection, 67% of Pa6206-challenged rabbits had PaO2 MIC, resulting in 75% microbiological clearance rate of Pa6206 from the lungs. For tobramycin which exhibits concentration-dependent killing, rabbits treated with a humanized tobramycin dosing regimen of 8 mg/kg q8h for 24 h achieved Cmax/MIC of 9.8 ± 1.4 at 60 min post-dose, resulting in 50% lung microbiological clearance rate. In contrast, rabbits treated with a single tobramycin dose of 2.5 mg/kg had Cmax/MIC of 7.8 ± 0.8 and 8% (1/12) microbiological clearance rate, indicating that this rabbit model can detect dose-response effects.ConclusionThe rabbit model may be used to help predict clinical efficacy of new antibacterial drugs for the treatment of non-ventilated P. aeruginosa pneumonia.

The increasing global population accelerates environmental degradation, contributes to global warming, reduces agricultural land, and causes food shortages. Developing products that can reduce dependence on animal husbandry and ensure global carbon neutrality is necessary. This study aimed to create TVP (Textured Vegetable Proteins) meatballs with Polydextrose (PDX) supplementation. The fixed ingredient composition per 100 g was as follows: 70 g ISP (Soy Protein Isolate), 26 g soybean powder, 5 g HVP (Hydrolyzed Vegetable Protein), 4 g soybean oil, and 2 g salt. Added water content was 200 % (by weight). Additives and structural components used include PDX and wheat gluten. Structural properties such as texture, moisture, and water absorption capacity of the formulations have been performed. With 16 % gluten content and 0.9 % polydextrose, the TVP meatballs have a stable structure. This study provided knowledge on how to process alternative meat products that can reduce the burden on animal husbandry and protect the environment.

Nerve injury requiring surgical repair often results in poor functional recovery due to the inability of host axons to re-grow long distances and reform meaningful connections with the target muscle. While surgeons can re-route local axon fascicles to the target muscle, there are no technologies to provide an exogenous source of axons without sacrificing healthy nerves. Accordingly, we have developed tissue engineered neuromuscular interfaces (TE-NMIs) as the first injectable microtissue containing motor and sensory neurons in an anatomically-inspired architecture. TE-NMIs provide axon tracts that are intended to integrate with denervated distal structures and preserve regenerative capacity during prolonged periods without host innervation. Following implant, we found that TE-NMI axons promoted Schwann cell maintenance, integrated with distal muscle, and preserved an evoked muscle response out to 20-weeks post nerve transection in absence of innervation from host axons. By repopulating the distal sheath with exogenous axons, TE-NMIs also enabled putative delayed fusion with proximal host axons, a phenomenon previously not achievable in delayed repair scenarios due to distal axon degeneration. Here, we found immediate electrophysiological recovery after fusion with proximal host axons and improved axon maturation and muscle reinnervation at 24-weeks post-transection (4-weeks following delayed nerve fusion). These findings show that TE-NMIs provide the potential to improve functional recovery following delayed nerve repair.

IntroductionDuring the coronavirus disease 2019 pandemic, high levels of burnout were reported among healthcare workers. This study examines the association of work absenteeism and frequency of thoughts in leaving current job with burnout among a cohort of healthcare workers during the COVID-19 pandemic.MethodsA cross-sectional survey of healthcare workers was conducted from April-May, 2022 on healthcare workers from 10 hospitals, 18 immediate care centers, and 325 outpatient practices in the Chicago area and surrounding Illinois suburbs. Logistic regression models were used to assess the association of burnout scores (Oldenburg Burnout Inventory—OLBI) and its sub-scores (exhaustion and disengagement scores) with work absenteeism and thoughts of leaving work.ResultsOne-fifth and 60% of respondents (n = 1,825) reported unplanned absenteeism and thoughts of leaving their job, respectively. After adjusting for covariates, higher burnout scores, especially exhaustion scores, were associated with increased odds of unplanned absenteeism (OR = 1.04, 95% CI: 1.01–1.08). Burnout scores and both sub-scores were also positively associated with the frequency of thoughts of leaving work, e.g., each unit increase in the OLBI burnout score was associated with 1.39 (95% CI: 1.34–1.43) times higher odds of thinking about leaving work “a lot/constantly” vs. “never”.DiscussionOverall, this study cohort showed a positive association between burnout scores and unplanned work absenteeism (and frequency of thoughts in leaving job) during the COVID-19 pandemic. More research is needed to support healthcare worker well-being during times of stress and direct solutions to addressing unplanned absenteeism in the light of a pandemic.

Introduction Cognitive dysfunction, a leading cause of mortality and morbidity in the USA and globally, has been shown to disproportionately affect the socioeconomically disadvantaged and those who identify as black or Hispanic/Latinx. Poor sleep is strongly associated with the development of vascular and metabolic diseases, which correlate with cognitive dysfunction. Therefore, sleep may contribute to observed disparities in cognitive disorders. The Epidemiologic Study of Disparities in Sleep and Cognition in Older Adults (DISCO) is a longitudinal, observational cohort study that focuses on gathering data to better understand racial/ethnic sleep disparities and illuminate the relationship among sleep, race and ethnicity and changes in cognitive function. This investigation may help inform targeted interventions to minimise disparities in cognitive health among ageing adults.Methods and analysis The DISCO study will examine up to 495 individuals aged 55 and older at two time points over 24 months. An equal number of black, white and Hispanic/Latinx individuals will be recruited using methods aimed for adults traditionally under-represented in research. Study procedures at each time point will include cognitive tests, gait speed measurement, wrist actigraphy, a type 2 home polysomnography and a clinical examination. Participants will also complete self-identified assessments and questionnaires on cognitive ability, sleep, medication use, quality of life, sociodemographic characteristics, diet, substance use, and psychological and social health.Ethics and dissemination This study was approved by the Northwestern University Feinberg School of Medicine Institutional Review Board. Deidentified datasets will be shared via the BioLINCC repository following the completion of the project. Biospecimen samples from the study that are not being analysed can be made available to qualified investigators on review and approval by study investigators. Requests that do not lead to participant burden or that conflict with the primary aims of the study will be reviewed by the study investigators.

Several international non-governmental organizations (INGOs) function as boundary organizations and try to promote ecosystem-based adaptation (EbA) as a pivotal climate change adaptation strategy for coastal areas. This is being done in Vietnam. Few studies, however, have investigated how these INGOs operate, what challenges they face, and what conditions support them to successfully promote the implementation of EbA. To address this knowledge gap, the literature on international boundary work and boundary organizations was first reviewed, deriving four categories of conditions for a successful promotion of EbA: knowledge, networks, resources, and context. Next, we applied this framework in a case study of the International Union for Conservation (IUCN) and the Foundation of Netherlands Volunteers (SNV) led EbA project on the restoration and sustainable use of mangroves in two provinces, Ca Mau and Ben Tre, which are located in the Vietnamese Mekong Delta. We interviewed 25 key informants representing INGOs, Vietnamese governmental agencies, farmers, scientists, and market parties. Our case study not only revealed how most literature-based success conditions were met but also found some additional conditions. We found that INGOs will have a greater chance of successfully promoting the implementation of the EbA in cases in which they can act as a knowledge broker, have a strong international network, can supply enough resources, and use context-specific strategies. A supportive context appeared to be essential.