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Abstract Background 2022 survey data showed 29% of Veterans utilized Veterans Affairs (VA) paid health care at a non-VA facility, 6% higher than in 2021. Despite an increase in the number of Veterans accessing care in the community via the MISSION Act Community Care Program (CCP), there is limited information on the quality of mental health care delivered to Veterans in these settings. Further, Veterans report barriers to quality care, including poor communication between CCP and VA providers, which can result in negative patient outcomes. We aimed to evaluate the feasibility and acceptability of using electronic screening, eScreening, as part of a process involving remote symptom screening, symptom monitoring, and clinically driven communication from VA to CCP providers, for Veterans accessing mental health treatment in CCP settings. Methods Veterans (n = 150) diagnosed with major depressive disorder, an anxiety disorder, post-traumatic stress disorder, and/or an adjustment disorder referred to mental health care in CCP between August-November 2021 were eligible to participate. Veterans received an eScreening link to complete an initial web-based assessment and three follow-up assessments spaced 4–6 weeks apart over the course of their treatment. Quantitative assessment data was largely characterized using descriptive statistics and included patient-reported outcome (PRO) measures (PTSD and depression), health-related quality of life/functioning, community care information (e.g., number of sessions attended), and satisfaction with the eScreening technology. Qualitative interview data was also collected from participating Veterans and CCP providers to better understand experiences with eScreening. Results Findings support the feasibility and acceptability of using eScreening to administer and monitor PROs for Veterans accessing mental health treatment in CCP. Of the Veterans who provided eScreening satisfaction ratings (Ns = 45–55), 89% had no technical difficulties; 78% felt comfortable entering personal information; and 83% were neutral or positive about ease of use. Focus group interviews revealed strong support from Veterans, who stated the software was easy to use; they felt comfortable completing PRO measures; and they appreciated having their symptoms monitored. Similarly, providers indicated eScreening had a positive impact on communication, collaboration of care, and transparency. Conclusions Technologies like eScreening represent a promising tool to support the mental health care Veterans receive when they access CCP.

The effects of land use type (LUT) on the physicochemical properties of the soils of mango plantations (MPs), Neem plantations (NPs), arable farms (AFs), vegetable farms (FFs), flood plains (FPs), and residential areas (RAs) were evaluated from NovemberDecember 2022. Soil samples were collected from the ecological zone of Nigeria Sudan, which is Borno. To understand the drastic changes in land use types and their effects on ecosystems, investigations are required to explore the extent to which LUT affects soil properties in arid environments. Samples were collected at predetermined depths of 0-20 and 20-40 cm in all the LUTs. The samples were subjected to laboratory analysis and statistical tools such as Factorial (ANOVA) and Means Separations using (LSD) at a 0.05% probability level. Analysis of the effects of LUT and depth on soil particle size revealed that VFs had more sand and fewer FPs, with values of 70.30% and 55.30%, respectively; FPs had more silt and fewer AFs, with values of 30.833% and 14.583%, respectively; and AFs had more clay and fewer VFs, with values of 18.033% and 11.783%, respectively. There were no differences in the soil characteristics, and the soil textures were sandy loam for all the LUTs. BD, TP, WHC, MWD, θ, PR, and MC ranged from 1.37–1.46 g/cm2 , 44.67–48.5%, 21.23– 29.70%, 0.077–0.1515 mm, 26.733–36.017°C, 20.833–29.333 N/cm and 0.1543–0.3303 cm3/cm3, respectively, with the greatest ranges found for VF-AF, AF-VF, MP-FP, RA-VF, VF-RA, VF-AF and RA-VF, respectively. Based on these findings, the 20-40 cm soil layer was best for all the LUTs. This study showed that land use type can affect soil physical properties. Therefore, vegetable farms and Neem plantations at depths of 20-40 cm were recommended for the study area.

Abstract Background SHANK3, a gene encoding a synaptic scaffolding protein, is implicated in autism spectrum disorder (ASD) and is disrupted in Phelan-McDermid syndrome (PMS). Despite evidence of regression or worsening of ASD-like symptoms in individuals with PMS, the underlying mechanisms remain unclear. Although Shank3 is highly expressed in the cerebellar cortical granule cells, its role in cerebellar function and contribution to behavioral deficits in ASD models are unknown. This study investigates behavioral changes and cerebellar synaptic alterations in Shank3 Δex4–22 mice at two developmental stages. Methods Shank3 Δex4–22 wildtype, heterozygous, and homozygous knockout mice lacking exons 4–22 (all functional isoforms) were subjected to a behavioral battery in both juvenile (5–7 weeks old) and adult (3–5 months old) mouse cohorts of both sexes. Immunostaining was used to show the expression of Shank3 in the cerebellar cortex. Spontaneous excitatory postsynaptic currents (sEPSCs) from cerebellar granule cells (CGCs) were recorded by whole-cell patch-clamp electrophysiology. Results Deletion of Shank3 caused deficits in motor function, heightened anxiety, and repetitive behaviors. These genotype-dependent behavioral alterations were more prominent in adult mice than in juveniles. Reduced social preference was only identified in adult Shank3 Δex4–22 knockout male mice, while self-grooming was uniquely elevated in males across both age groups. Heterozygous mice showed little to no changes in behavioral phenotypes in most behavioral tests. Immunofluorescence staining indicated the presence of Shank3 predominantly in the dendrite-containing rosette-like structures in CGCs, colocalizing with presynaptic markers of glutamatergic mossy fiber. Electrophysiological findings identified a parallel relationship between the age-related exacerbation of behavioral impairments and the enhancement of sEPSC amplitude in CGCs. Limitations Other behavioral tests of muscle strength (grip strength test), memory (Barnes/water maze), and communication (ultrasonic vocalization), were not performed. Further study is necessary to elucidate how Shank3 modulates synaptic function at the mossy fiber-granule cell synapse in the cerebellum and whether these changes shape the behavioral phenotype. Conclusions Our findings reveal an age-related exacerbation of behavioral impairments in Shank3 Δex4–22 mutant mice. These results suggest that Shank3 may alter the function of glutamatergic receptors at the mossy fiber-cerebellar granule cell synapse as a potential mechanism causing cerebellar disruption in ASD.

Summary: Background: Large-scale multicentre studies are needed to understand complex relationships between the gut microbiota, health and disease. Interrogating the mucosal microbiota may identify important biology not captured by stool analysis. Gold standard tissue cryopreservation (‘flash freezing’) limits large-scale study feasibility. We aimed to compare gut microbiota in gold standard and pragmatic mucosal biopsy storage conditions. Methods: We collected endoscopic recto-sigmoid biopsies from 20 adults with inflammatory bowel disease. Biopsies were preserved using three methods: (i) flash freezing (most proximal and distal biopsy sites); (ii) nucleic acid preservative reagents (QIAGEN Allprotect®, Invitrogen RNAlater™, and Zymo DNA/RNA Shield™); and (iii) formalin fixation with paraffin embedding (FFPE), which is used to preserve tissue for clinical histopathology within healthcare settings. Microbiota were sequenced on the MiSeq platform (V4 region, 16S rRNA gene). Findings: Tissue microbiota were consistent between most proximal and distal tissue suggesting any within-patient variation observed reflected storage condition, not biopsy location. There was no significant difference in alpha-diversity or microbial community profiles of reagent-preserved versus gold standard tissue. FFPE community structure was significantly dissimilar to other tissue samples, driven by differential relative abundance of obligate gut anaerobes; Faecalibacterium, Anaerostipes and Lachnospiraceae. Despite these differences, tissue microbiota grouped by participant regardless of preservation and storage conditions. Interpretation: Preservative reagents offer a convenient alternative to flash freezing tissue in prospective large-scale mucosal microbiota studies. Whilst less comparable, FFPE provides potential for retrospective microbiota studies using historical samples. Funding: Medical Research Council (MR/T032162/1) and The Leona M. and Harry B. Helmsley Charitable Trust (G-2002-04255).

Like many other low- and middle-income countries, Botswana has struggled to address the shortage of doctors, particularly specialists. In 2009, the country’s first medical school offering an undergraduate medical program was established. A needs and feasibility assessment was conducted with relevant stakeholders to explore the need for specialty training programs in all medical school departments. As a result, three residency programs were established a year after the undergraduate program, but psychiatry was not included in this first crop of residency programs. Existing strengths in the university and healthcare systems were leveraged to successfully establish a four-year Master of Medicine residency program in psychiatry, which began in January 2020. The program aims to produce psychiatrists who are familiar with the local mental health needs. The first batch of students completed their training in December 2023. This paper reflects on and describes the development of a psychiatry residency program in Botswana and contributes a process grounded in educational program development models and educational theories that others can utilize. Botswana’s experience may be helpful to other low- and middle-income countries, particularly in sub-Saharan Africa, that want to establish and run a locally developed residency program in psychiatry.

ABSTRACT Objective While weight status and clinical laboratory measures are important in assessing obesity‐related disease severity and chronic disease risk, including a broader range of emotional, psychosocial, and behavioral factors would provide greater context of an individual's overall state of wellness and could be used to better guide treatment decisions. The purpose of this research was to develop a comprehensive Lifestyle Wellness assessment for use in lifestyle‐based wellness interventions and programs. Methods A cross‐sectional exploratory factor analysis (EFA) was conducted using baseline data from N = 138 adults participating in behavioral weight loss trials. An unweighted least squares extraction method with oblique rotation was used. Twenty‐one putative measures spanning constructs related to metabolic health, emotional health/wellbeing, body weight and composition, diet quality, and fitness were analyzed for retention. Results Mean body mass index (BMI) was 38.0 ± 6.6 kg/m2, mean age was 57.3 ± 11.1 years, and 77.5% of participants were female. The EFA produced a five‐factor model with 13 items that explained 80.3% of the variance. The retained factors included: (1) Psychosocial State: mindfulness, resilience, quality of life, and happiness; (2) Blood Pressure State: systolic and diastolic blood pressure; (3) Lipid State: total cholesterol and LDL‐cholesterol; (4) Fitness State: grip strength, jump height, and percent body fat; and (5) Body State: BMI and waist circumference. Conclusions Lifestyle Wellness is a comprehensive assessment that enables innovative wellness‐related research such as metabolically healthy obese phenotypes and weight‐neutral interventions. Future research should include investigations in additional populations with greater age, sex/gender, and body size diversity.

ABSTRACT Alterations to lipid storage, and the consequent effects on liver structure, need to be considered when replacing wild‐derived fish meal (wd‐FM) with alternative ingredients in formulated diets for commercially aquacultured species. The replacement of wd‐FM is likely to alter the available level of precursors for bile acid production, potentially impacting the absorption of dietary lipids and fat‐soluble vitamins. In this 252‐day study, Yellowtail Kingfish, Seriola lalandi (2.52 ± 0.25 kg; 546 ± 20 mm [fork length; mean ± standard deviation]) were fed five different diets. A 30% wd‐FM diet served as a control. Dietary wd‐FM inclusions were reduced to 20% and 10%, replaced with FM by‐product meal. In addition, dietary wd‐FM levels were reduced to 20% and replaced with poultry meal (PM) or soy protein concentrate (SPC) in two other separate diets. Fat deposition in the liver was similar amongst all treatment groups with bile duct proliferation and periductular fibrosis observed in the livers of fish fed diets with wd‐FM replacement with 10% PM or 10% SPC. Fish fed FM by‐product meal at 10% and 20% replacement displayed similar liver structures to control fish. Yellowtail Kingfish fed a 30% wd‐FM diet may have the FM replaced by up to 66.67% FM by‐product, 33.3% PM or 33.3% SPC without any significant impact on total bile acid synthesis, storage and excretion and liver lipid storage. This research expands our ability to deliver cost‐effective nutritional solutions in support of Yellowtail Kingfish culture.

The convergence of Artificial Intelligence (AI) and nanotechnology is a transformative frontier, holding vast potential for scientific and technological advancements. This review explores the integration of AI and nanotechnology, aiming to uncover current trends, challenges, and future directions across various domains. A scientometric approach was employed, gathering and analyzing existing literature and research in the fields of AI and nanotechnology. Through a systematic examination of recent studies and developments, we identified key trends, challenges, and potential pathways for future research and applications. Findings from this review highlight the significant impact of AI-driven nanotechnology in materials discovery and design, healthcare, environmental monitoring, energy conversion, and quantum computing. These areas have witnessed remarkable advancements, such as the development of novel nanomaterials, precise drug delivery systems, advanced nanosensors, and efficient energy storage solutions. However, challenges persist, including insufficient interdisciplinary collaboration, data quality, ethical concerns, and regulatory frameworks. While challenges require careful consideration and mitigation, the potential for innovation and progress in diverse domains is undeniable. This review underscores the importance of responsible AI use and ongoing research to unlock the full potential of this convergence, ultimately shaping the future of science and technology.

Abstract High-density electromyography (HD-EMG) can provide a natural interface to enhance human–computer interaction (HCI). This study aims to demonstrate the capability of a novel HD-EMG forearm sleeve equipped with up to 150 electrodes to capture high-resolution muscle activity, decode complex hand gestures, and estimate continuous hand position via joint angle predictions. Ten able-bodied participants performed 37 hand movements and grasps while EMG was recorded using the HD-EMG sleeve. Simultaneously, an 18-sensor motion capture glove calculated 23 joint angles from the hand and fingers across all movements for training regression models. For classifying across the 37 gestures, our decoding algorithm was able to differentiate between sequential movements with $$97.3 \pm 0.3\%$$ 97.3 ± 0.3 % accuracy calculated on a 100 ms bin-by-bin basis. In a separate mixed dataset consisting of 19 movements randomly interspersed, decoding performance achieved an average bin-wise accuracy of $$92.8 \pm 0.8\%$$ 92.8 ± 0.8 % . When evaluating decoders for use in real-time scenarios, we found that decoders can reliably decode both movements and movement transitions, achieving an average accuracy of $$93.3 \pm 0.9\%$$ 93.3 ± 0.9 % on the sequential set and $$88.5 \pm 0.9\%$$ 88.5 ± 0.9 % on the mixed set. Furthermore, we estimated continuous joint angles from the EMG sleeve data, achieving a $$R^2$$ R 2 of $$0.884 \pm 0.003$$ 0.884 ± 0.003 in the sequential set and $$0.750 \pm 0.008$$ 0.750 ± 0.008 in the mixed set. Median absolute error (MAE) was kept below 10° across all joints, with a grand average MAE of $$1.8 \pm 0.04^\circ$$ 1.8 ± 0 . 04 ∘ and $$3.4 \pm 0.07^\circ$$ 3.4 ± 0 . 07 ∘ for the sequential and mixed datasets, respectively. We also assessed two algorithm modifications to address specific challenges for EMG-driven HCI applications. To minimize decoder latency, we used a method that accounts for reaction time by dynamically shifting cue labels in time. To reduce training requirements, we show that pretraining models with historical data provided an increase in decoding performance compared with models that were not pretrained when reducing the in-session training data to only one attempt of each movement. The HD-EMG sleeve, combined with sophisticated machine learning algorithms, can be a powerful tool for hand gesture recognition and joint angle estimation. This technology holds significant promise for applications in HCI, such as prosthetics, assistive technology, rehabilitation, and human–robot collaboration.

Abstract Background Clinical imaging tools to probe aggressiveness of renal masses are lacking, and T2-weighted imaging as an integral part of magnetic resonance imaging protocol only provides qualitative information. We developed high-resolution and accelerated T2 mapping methods based on echo merging and using k-t undersampling and reduced flip angles (TEMPURA) and tested their potential to quantify differences between renal tumour subtypes and grades. Methods Twenty-four patients with treatment-naïve renal tumours were imaged: seven renal oncocytomas (RO); one eosinophilic/oncocytic renal cell carcinoma; two chromophobe RCCs (chRCC); three papillary RCCs (pRCC); and twelve clear cell RCCs (ccRCC). Median, kurtosis, and skewness of T2 were quantified in tumours and in the normal-adjacent kidney cortex and were compared across renal tumour subtypes and between ccRCC grades. Results High-resolution TEMPURA depicted the tumour structure at improved resolution compared to conventional T2-weighted imaging. The lowest median T2 values were present in pRCC (high-resolution, 51 ms; accelerated, 45 ms), which was significantly lower than RO (high-resolution; accelerated, p = 0.012) and ccRCC (high-resolution, p = 0.019; accelerated, p = 0.008). ROs showed the lowest kurtosis (high-resolution, 3.4; accelerated, 4.0), suggestive of low intratumoural heterogeneity. Lower T2 values were observed in higher compared to lower grade ccRCCs (grades 2, 3 and 4 on high-resolution, 209 ms, 151 ms, and 106 ms; on accelerated, 172 ms, 160 ms, and 102 ms, respectively), with accelerated TEMPURA showing statistical significance in comparison (p = 0.037). Conclusions Both high-resolution and accelerated TEMPURA showed marked potential to quantify differences across renal tumour subtypes and between ccRCC grades. Trial registration ClinicalTrials.gov, NCT03741426 . Registered on 13 November 2018. Relevance statement The newly developed T2 mapping methods have improved resolution, shorter acquisition times, and promising quantifiable readouts to characterise incidental renal masses. Graphical Abstract

Pesticide was considered complex substances intended for preventing, destroying, or controlling any pest including vectors of human or animal diseases. They are specific chemicals, which contain both “active” or energetic and “inactive” or inert ingredients. The term pesticide includes herbicide, insecticide, nematicide, sanitizer, bactericide, insect repellent, animal repellent, antimicrobial, fungicide, disinfectant, molluiscide, and avicide among others. They are classified based on the mode of entry, mode of function and action, and their chemical composition. These pesticides played a key role in controlling and mitigating variety of agricultural pest and diseases in farm, garden. They contrary, affect soil functional service and great biological biodiversity including human and his environment. Many factors and processes are involved in the transfer, transport and degradation or biochemical conversation of pesticides in soil. The soil factors are the soil organic matter, soil pH, temperature, nutrients, moisture, infiltration rate, aerobic and anaerobic, soil texture and structure. The combined processes are physical, biological, and chemical with great conversion on weathering, hydrolysis, oxidation-reduction, photolysis humification, cheluviation, organic sorting, translocation, eluviations, illuviation, calcification, podsolisation, gleying, and leaching. Seven important subjects have been treated in a synopsis manner – major groups of pesticides, pesticide toxicity (acute and chronic effects), processes affecting pesticides in soil, pesticides and its ecological effects (soil, crop, biota and human), step by step procedure and soil sampling, techniques involving analysis of pesticides residues in soil, and bioremediation and biodegradation approaches.

Abstract Background Pathogenic Leptospira species are globally important zoonotic pathogens capable of infecting a wide range of host species. In marine mammals, reports of Leptospira have predominantly been in pinnipeds, with isolated reports of infections in cetaceans. Case presentation On 28 June 2021, a 150.5 cm long female, short-beaked common dolphin (Delphinus delphis delphis) stranded alive on the coast of southern California and subsequently died. Gross necropsy revealed multifocal cortical pallor within the reniculi of the kidney, and lymphoplasmacytic tubulointerstitial nephritis was observed histologically. Immunohistochemistry confirmed Leptospira infection, and PCR followed by lfb1 gene amplicon sequencing suggested that the infecting organism was L. kirschneri. Leptospira DNA capture and enrichment allowed for whole-genome sequencing to be conducted. Phylogenetic analyses confirmed the causative agent was a previously undescribed, divergent lineage of L. kirschneri. Conclusions We report the first detection of pathogenic Leptospira in a short-beaked common dolphin, and the first detection in any cetacean in the northeastern Pacific Ocean. Renal lesions were consistent with leptospirosis in other host species, including marine mammals, and were the most significant lesions detected overall, suggesting leptospirosis as the likely cause of death. We identified the cause of the infection as L. kirschneri, a species detected only once before in a marine mammal – a northern elephant seal (Mirounga angustirostris) of the northeastern Pacific. These findings raise questions about the mechanism of transmission, given the obligate marine lifestyle of cetaceans (in contrast to pinnipeds, which spend time on land) and the commonly accepted view that Leptospira are quickly killed by salt water. They also raise important questions regarding the source of infection, and whether it arose from transmission among marine mammals or from terrestrial-to-marine spillover. Moving forward, surveillance and sampling must be expanded to better understand the extent to which Leptospira infections occur in the marine ecosystem and possible epidemiological linkages between and among marine and terrestrial host species. Generating Leptospira genomes from different host species will yield crucial information about possible transmission links, and our study highlights the power of new techniques such as DNA enrichment to illuminate the complex ecology of this important zoonotic pathogen.

The modern zoo relies on the persistence of genetically and physiologically healthy populations of endangered species, which is enabled through breeding programmes globally and regionally. Many species commonly held in zoos are poorly studied in the wild, leading to a lack of in-depth knowledge surrounding breeding behaviours and subsequent parental behaviours and early life development of young. Knowledge of this information is critical to make informed management decisions which promote successful rearing of young in zoos. While the critically endangered Sumatran tiger is popular in zoos, rates of cub survival in the first 5 months are lower than 50%, highlighting the need for scientific evidence driving management decisions. This study monitors nursing and cub grooming behaviours in a first-time mother Sumatran tiger (Panthera tigris sumatrae) and her cubs throughout four stages of cub development. The social proximity of cubs and dam were recorded to describe social interactions within the group throughout cub aging. A series of Friedman tests and post-hoc tests found significant decreases in both cub grooming (χ2 (3, N = 96) = 14.20, p < 0.01) and nursing (χ2 (3, N = 96) = 25.77, p < 0.001) behaviours between the birth and weaning of the cubs, as well as within different phases of cub development between those times. Cub-to-cub proximity was maintained from birth to weaning, with cubs spending significant amounts of time in close proximity (within one adult body length) of each other (χ2 (3, N = 96) = 15.231, p = 0.001) throughout the study. The dam was found to spend significantly less time with the cubs as they reached weaning age (χ2 (3, N = 96) = 27.88, p < 0.001). These results are thought to be the first of their kind to detail timings of cub development and early life socialisation, providing evidence for timing of first food provision to young and promote the provision of space for the dam to spend time away from the cubs, while allowing the cubs to become confident, mobile, and independent.

Despite the growing emphasis on workplace diversity and inclusion, ageism remains prevalent in various industries, including construction. Through an extensive review of literature and a United States national-level survey, this paper investigates the adverse impacts of ageism on the overall well-being of the construction workforce, focusing on their mental and physical health. The questionnaire was distributed among individuals working in the construction industry sector who were randomly selected and received 72 responses. The data obtained were analyzed statistically using binomial logistic regression in modeling the relationship between ageism, and mental and physical health of the construction workforce. The research results indicate that ageism has a statistically significant (p < .001) positive relationship between both the mental and physical health of the construction workforce. The results, therefore, show that ageism has an impact on the mental and physical well-being of workers in the construction industry. Furthermore, the results show that individuals in the construction workforce who experience ageism are more likely to have their mental health and physical well-being impacted compared to those who don’t experience ageism. Consequently, the results highlight the need for proactive measures to combat age discrimination and promote a healthier and more inclusive work environment for construction workers of all ages.

Abstract Background Socioecological factors are associated with key health behaviors that are critical for weight management, and major life events may disrupt engagement in these behaviors. However, the influence of socioecological factors on health behaviors in the midst of major life events is not clear and is difficult to study due to the random and sporadic nature of their occurrence. The COVID‐19 pandemic provided a unique opportunity to study a major life event and its impacts on diet, physical activity, and body weight. Objective This cross‐sectional study aimed to investigate associations between socioecological factors (environmental, interpersonal, and individual) and self‐reported weight change during a major life event using data collected during the COVID‐19 pandemic, and whether the associations were mediated through self‐reported changes in eating and physical activity behaviors. Methods Participants self‐reported socioecological factors, weight change, and changes in eating behaviors (EB) and physical activity (PA) via online questionnaires between December 2020 and October 2021. Changes in EB and PA were measured using scales with higher scores reflecting more positive changes during the COVID‐19 pandemic. Results Participants (n = 1283) were mostly female (84.9%) with age 52.1 ± 14.1 years (mean ± SD) and BMI of 32.9 ± 8.2 kg/m2. Stronger healthy eater and exercise identities (individual factors) were associated with higher EB scores (EBS) and PA scores (PAS), respectively (p's

There is a global movement to implement a One Health approach across sectors to holistically address emerging issues that have implications for public, animal, and environmental health. The operationalization of a One Health model can support knowledge sharing and build an evidence base for designing research programs and decision-making tools to evaluate and mitigate intersectoral health challenges. In late 2021, the highly pathogenic avian influenza virus (HPAIV) H5N1 2.3.4.4b was detected in eastern Canada, and subsequently spread throughout the flyways of North America. Given the multiyear persistence of the current HPAIV in Europe and the continued detections in North America, Environment and Climate Change Canada and partners recognized the need to prioritize HPAIV-related information needs to inform future decision-making and management. In early 2023, we carried out an expert opinion exercise with partners from across One Health domains and expertise to prioritize information needs related to the conservation and management of migratory birds in Canada. The results informed on-the-ground programming for migratory bird activities in 2023 and onwards. The process illustrates how a One Health lens can be applied with a conservation focal point, using dedicated facilitation to synthesize expert opinions across groups with non-overlapping mandates.

Abstract This trial assessed the feasibility and acceptability of Kidney BEAM, a physical activity and emotional well-being self-management digital health intervention (DHI) for people with chronic kidney disease (CKD), which offers live and on-demand physical activity sessions, educational blogs and videos, and peer support. In this mixed-methods, multicentre randomised waitlist-controlled internal pilot, adults with established CKD were recruited from five NHS hospitals and randomised 1:1 to Kidney BEAM or waitlist control. Feasibility outcomes were based upon a priori progression criteria. Acceptability was primarily explored via individual semi-structured interviews (n = 15). Of 763 individuals screened, n = 519 (68%, 95% CI 65 to 71%) were eligible. Of those eligible, n = 303 (58%, 95% CI 54–63%) did not respond to an invitation to participate by the end of the pilot period. Of the 216 responders, 50 (23%, 95% CI 18–29%) consented. Of the 42 randomised, n = 22 (10 (45%) male; 49 ± 16 years; 14 (64%) White British) were allocated to Kidney BEAM and n = 20 (12 (55%) male; 56 ± 11 years; 15 (68%) White British) to the waitlist control group. Overall, n = 15 (30%, 95% CI 18–45%) withdrew during the pilot phase. Participants completed a median of 14 (IQR 5–21) sessions. At baseline, 90–100% of outcome data (patient reported outcome measures and a remotely conducted physical function test) were completed and 62–83% completed at 12 weeks follow-up. Interview data revealed that remote trial procedures were acceptable. Participants’ reported that Kidney BEAM increased their opportunity and motivation to be physically active, however, lack of time remained an ongoing barrier to engagement with the DHI. An randomised controlled trial of Kidney BEAM is feasible and acceptable, with adaptations to increase recruitment, retention and engagement. Trial registration NCT04872933. Date of first registration 05/05/2021.

Abstract Lightning strikes, snow, and wind are common causes of power system failures. Their frequency of occurrence varies depending on weather patterns and seasons. Here, we analyse the occurrence of thirty pre-defined daily weather patterns along with nearly 70,000 power system failures in the United Kingdom between 2010 and 2019 to investigate the predictability of weather-induced power outages. We identify high-risk weather patterns and pattern transitions for all seasons. Winter weather patterns characterized by high wind speeds and high precipitation volumes are responsible for many instances of power outages caused by wind, gale, and lightning strikes. Weather patterns with moderate to high snowfall are often linked to power outages caused by snow and ice. Because high-risk weather patterns can be forecast reliably with valuable lead time, clear links between specific patterns and transitions can significantly improve the preparedness of the United Kingdom and broader European distribution network operators for adverse weather conditions.

Abstract Background Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes. Methods The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases. Results In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p

Background: Indomethacin has analgesic and antipyretic properties. It is a common treatment for pain and rheumatoid diseases, but it has many side effects. We speculate that the natural antioxidants of Moringa oleifera could be a remedy for the long list of side effects. This study aimed to determine the possible protective effect of Moringa oleifera leaf extract on the indomethacin-induced degenerated testes and uterus in albino rat. Methods: Forty-eight white albino rats were assigned randomly into six groups consisting of eight rats. Group, I was the Normal control. Group II was animals induced with indomethacin but not treated. Group III was dosed with 500 mg/kg Moringa oleifera leaf extract while Groups IV-VI were induced with indomethacin and treated with 100, 250, and 500 mg/kg Moringa oleifera leaf extract respectively for 28 days. Animals were euthanized after the treatment period. The uterus and testes were excised and processed using the paraffin wax method and stained with haematoxylin and eosin. Results: Animals exposed to indomethacin became drowsy and lethargic with deep red teary eyes. The first mortality was recorded among animals administered with indomethacin without treatment. Histopathology of the testes showed that indomethacin caused degeneration of the seminiferous tubules and diminished the spermatozoa. The histology of the uterus was distorted, the endometrium and myometrium layers of the uterus were disintegrated. However, animals treated with Moringa oleifera showed dose-related improvements in the histology of the testes and uterus compared to the control group. Conclusion: Moringa oleifera leaf extract improved the histology of indomethacin-induced toxicity of the testes and uterine in white albino rats.

While native grass and shrub restoration is often promoted for bird conservation, evaluations are necessary to understand the effects of habitat change on songbird vital rates and migratory stopover use. We evaluated the effects of native vegetation restoration on the species richness, productivity, and capture rate of breeding and fall migrating songbirds at the Shaker Village of Pleasant Hill, in central Kentucky, USA. From 2009 to 2022, we conducted constant effort mist netting, resulting in 8418 captures of 110 bird species. In 2012–2013, we implemented management in the study area, which began as an old field, to restore native grasses, forbs, and shrubs. Effects on the vital rates of breeding species included higher Spizella pusilla (field sparrow) and Spinus tristis (American goldfinch) productivity post restoration. Restoration of native vegetation also led to significantly higher fall capture rates for pooled cohorts of both long-distance and medium-distance migrants. Our results demonstrate that the restoration and management of native vegetation can enhance stopover habitats for fall migrating songbirds including neotropical migrants and the field sparrow, a common bird in steep decline. We recommend prioritizing areas for native grass and shrub restoration that initially lack structural heterogeneity (a well-developed grass component with diverse forbs and interspersed shrubs).

Abstract Background Treatments currently available for ceruminous gland tumors include surgery and radiation therapy, which come with high financial costs and frequent complication and recurrence rates. Hypothesis To evaluate the treatment, response, complication, and recurrence of ceruminous gland tumors confirmed with biopsy and ablated using CO2 laser. Methods Retrospective review of medical records from Iowa State University and the University of Illinois between January 1, 2016 and December 31, 2021. Electronic medical records were evaluated for a histopathologically confirmed ceruminous gland tumor via video‐otoscopic aided biopsy and subsequent CO2 laser ablation. Signalment, tumor type, size, location within the ear canal, length of time tumor was present before presentation, advanced imaging, and follow‐up including recurrence were assessed. Results Fourteen ceruminous gland adenomas (4 dogs, 10 cats) and 12 ceruminous gland adenocarcinomas (7 dogs, 5 cats) were identified. Bacterial otitis externa was present in 4/26 (15%) animals. Recurrence was identified in 1/14 (7%) ceruminous gland adenomas and 1/12 (8%) ceruminous gland adenocarcinomas. Conclusions and Clinical Importance Video‐otoscopic aided biopsy and CO2 laser ablation of ceruminous gland tumors in dogs and cats is a viable treatment option with low recurrence and complication rates with CO2 laser ablation.

An outbreak of human mpox infection in nonendemic countries appears to have been driven largely by transmission through body fluids or skin-to-skin contact during sexual activity. We evaluated the stability of monkeypox virus (MPXV) in different environments and specific body fluids and tested the effectiveness of decontamination methodologies. MPXV decayed faster at higher temperatures, and rates varied considerably depending on the medium in which virus was suspended, both in solution and on surfaces. More proteinaceous fluids supported greater persistence. Chlorination was an effective decontamination technique, but only at higher concentrations. Wastewater was more difficult to decontaminate than plain deionized water; testing for infectious MPXV could be a helpful addition to PCR-based wastewater surveillance when high levels of viral DNA are detected. Our findings suggest that, because virus stability is sufficient to support environmental MPXV transmission in healthcare settings, exposure and dose-response will be limiting factors for those transmission routes.

Abstract Studies of infectious disease ecology would benefit greatly from knowing when individuals were infected, but estimating this time of infection can be challenging, especially in wildlife. Time of infection can be estimated from various types of data, with antibody‐level data being one of the most promising sources of information. The use of antibody levels to back‐calculate infection time requires the development of a host‐pathogen system‐specific model of antibody dynamics, and a leading challenge in such quantitative serology approaches is how to model antibody dynamics in the absence of experimental infection data. We present a way to model antibody dynamics in a Bayesian framework that facilitates the incorporation of all available information about potential infection times and apply the model to estimate infection times of Channel Island foxes infected with Leptospira interrogans. Using simulated data, we show that the approach works well across a broad range of parameter settings and can lead to major improvements in infection time estimates that depend on system characteristics such as antibody decay rate and variation in peak antibody levels after exposure. When applied to field data we saw reductions up to 83% in the window of possible infection times. The method substantially simplifies the challenge of modelling antibody dynamics in the absence of individuals with known infection times, opens up new opportunities in wildlife disease ecology and can even be applied to cross‐sectional data once the model is trained.

Abstract Large placebo-controlled trials have demonstrated kidney and cardiovascular clinical benefits of SGLT-2 inhibitors. Data from the EMPA-KIDNEY and DELIVER trials and associated meta-analyses triggered an update to the UK Kidney Association Clinical Practice Guideline on Sodium-Glucose Co-transporter-2 (SGLT-2) Inhibition in Adults with Kidney Disease. We provide a summary of the full guideline and highlight the rationale for recent updates. The use of SGLT-2 inhibitors in people with specific medical conditions, including type 1 diabetes, kidney transplants, and people admitted to hospital with heart failure is also considered, along with Recommendations for future research and Recommendations for implementation. A full “lay” summary of the guidelines is provided as an appendix to ensure that these guidelines are accessible and understandable to people who are not medical professionals.

Abstract Leptospirosis, the most widespread zoonotic disease in the world, is broadly understudied in multi-host wildlife systems. Knowledge gaps regarding Leptospira circulation in wildlife, particularly in densely populated areas, contribute to frequent misdiagnoses in humans and domestic animals. We assessed Leptospira prevalence levels and risk factors in five target wildlife species across the greater Los Angeles region: striped skunks (Mephitis mephitis), raccoons (Procyon lotor), coyotes (Canis latrans), Virginia opossums (Didelphis virginiana), and fox squirrels (Sciurus niger). We sampled more than 960 individual animals, including over 700 from target species in the greater Los Angeles region, and an additional 266 sampled opportunistically from other California regions and species. In the five target species seroprevalences ranged from 5 to 60%, and infection prevalences ranged from 0.8 to 15.2% in all except fox squirrels (0%). Leptospira phylogenomics and patterns of serologic reactivity suggest that mainland terrestrial wildlife, particularly mesocarnivores, could be the source of repeated observed introductions of Leptospira into local marine and island ecosystems. Overall, we found evidence of widespread Leptospira exposure in wildlife across Los Angeles and surrounding regions. This indicates exposure risk for humans and domestic animals and highlights that this pathogen can circulate endemically in many wildlife species even in densely populated urban areas.

Tissue-resident memory T cells (TRM) are long-lived memory lymphocytes that persist in non-lymphoid tissues and provide the first line of defence against invading pathogens. They adapt to their environment in a tissue-specific manner, exerting effective pathogen control through a diverse T cell receptor (TCR) repertoire and the expression of proinflammatory cytokines and cytolytic proteins. More recently, several studies have indicated that TRM can egress from the tissue into the blood as so-called “ex-TRM”, or “circulating cells with a TRM phenotype”. The numerically small ex-TRM population can re-differentiate in the circulation, giving rise to new memory and effector T cells. Following their egress, ex-TRM in the blood and secondary lymphoid organs can be identified based on their continued expression of the residency marker CD103, alongside other TRM-like features. Currently, it is unclear whether exit is a stochastic process, or is actively triggered in response to unknown factors. Also, it is not known whether a subset or all TRM are able to egress. Ex-TRM may be beneficial in health, as mobilisation of specialised TRM and their recruitment to both their site of origin as well as distant tissues results in an efficient distribution of the immune response. However, there is emerging evidence of a pathogenic role for ex-TRM, with a suggestion that they may perpetuate both local and distant tissue inflammation. Here, we review the evidence for the existence of ex-TRM and examine their potential involvement in disease pathogenesis.

Abstract Numerous policy and international frameworks consider that “destructive fishing” hampers efforts to reach sustainability goals. Though ubiquitous, “destructive fishing” is undefined and therefore currently immeasurable. Here we propose a definition developed through expert consultation: “Destructive fishing is any fishing practice that causes irrecoverable habitat degradation, or which causes significant adverse environmental impacts, results in long‐term declines in target or nontarget species beyond biologically safe limits and has negative livelihood impacts.” We show strong stakeholder support for a definition, consensus on many biological and ecological dimensions, and no clustering of respondents from different sectors. Our consensus definition is a significant step toward defining sustainable fisheries goals and will help interpret and implement global political commitments which utilize the term “destructive fishing.” Our definition and results will help reinforce the Food and Agricultural Organization's Code of Conduct and meaningfully support member countries to prohibit destructive fishing practices.

IntroductionContinuous recognition tasks (CRTs) assess episodic memory (EM), the central functional disturbance in Alzheimer’s disease and several related disorders. The online MemTrax computerized CRT provides a platform for screening and assessment that is engaging and can be repeated frequently. MemTrax presents complex visual stimuli, which require complex involvement of the lateral and medial temporal lobes and can be completed in less than 2 min. Results include number of correct recognitions (HITs), recognition failures (MISSes = 1-HITs), correct rejections (CRs), false alarms (FAs = 1-CRs), total correct (TC = HITs + CRs), and response times (RTs) for each HIT and FA. Prior analyses of MemTrax CRT data show no effects of sex but an effect of age on performance. The number of HITs corresponds to faster RT-HITs more closely than TC, and CRs do not relate to RT-HITs. RT-HITs show a typical skewed distribution, and cumulative RT-HITs fit a negative survival curve (RevEx). Thus, this study aimed to define precisely the effects of sex and age on HITS, CRs, RT-HITs, and the dynamics of RTs in an engaged population.MethodsMemTrax CRT online data on 18,255 individuals was analyzed for sex, age, and distributions of HITs, CRs, MISSes, FAs, TC, and relationships to both RT-HITs and RT-FAs.ResultsHITs corresponded more closely to RT-HITs than did TC because CRs did not relate to RT-HITs. RT-FAs had a broader distribution than RT-HITs and were faster than RT-HITs in about half of the sample, slower in the other half. Performance metrics for men and women were the same. HITs declined with age as RT-HITs increased. CRs also decreased with age and RT-FAs increased, but with no correlation. The group over aged 50 years had RT-HITs distributions slower than under 50 years. For both age ranges, the RevEx model explained more than 99% of the variance in RT-HITs.DiscussionThe dichotomy of HITs and CRs suggests opposing cognitive strategies: (1) less certainty about recognitions, in association with slower RT-HITs and lower HIT percentages suggests recognition difficulty, leading to more MISSes, and (2) decreased CRs (more FAs) but faster RTs to HITs and FAs, suggesting overly quick decisions leading to errors. MemTrax CRT performance provides an indication of EM (HITs and RT-HITs may relate to function of the temporal lobe), executive function (FAs may relate to function of the frontal lobe), processing speed (RTs), cognitive ability, and age-related changes. This CRT provides potential clinical screening utility for early Alzheimer’s disease and other conditions affecting EM, other cognitive functions, and more accurate impairment assessment to track changes over time.

Introduction/Purpose: Infection of an ankle fracture is a devastating complication that can lead to chronic pain, limited motion or amputation. Traditional treatment strategies after infection involve aggressive surgical debridement, implant removal and prolonged antibiotic therapy. Non-anatomic cement spacers for the tibiotalar joint have previously been described with mixed results. Articulating spacers have shown improved outcomes and may be used as definitive treatment. Currently, there are no prefabricated TAR spacers on the market. The use of 3D printing to create custom implants is emerging, however, there is a paucity of literature regarding their use. We present a case of post-infectious ankle arthritis in 14 year old patient treated with a 3D printed total ankle replacement with built in antibiotic spacer (TAR-AS). Methods: A CT scan was performed in accordance with computer aided design (CAD) parameters. Bilateral lower extremities were scanned to allow the unaffected side to be mirrored and be the basis for implant design. Slice spacing less than 1.25mm with pixel size of 0.5mm. The studies were in DICOM files and within a timeframe where no significant change in patient anatomy had occurred. The implants were fabricated by selective laser melting (SLM) of cobalt chrome alloy (CoCrMo) by Restor3d (Durham, NC). Our design incorporated a stacked gyroid component to facilitate antibiotic cement impregnation. In terms of surgical technique, the custom TAR-AS followed a similar approach to a patient specific TAR procedure. Prior to implantation, the gyroid component of the TAR-AS was filled with Simplex bone cement with tobramycin (Stryker). Results: At six months postoperatively, our patient reported no limitation in activities. AOFAS scores improved from 46/100 preoperatively to 83/100 at six months postoperatively. Radiographic parameters showed no signs of implant failure, loosening or change in alignment. Intraoperative cultures remained negative. Conclusion: We present a case demonstrating the utilization of 3D generated prostheses for treatment of post-infection ankle arthritis. The TAR-AS represents a significant advancement in the management of ankle infections. This innovative approach combines the benefits of joint replacement and continued antibiotic elution. With further research and continued technological advancements, the TAR-AS has the potential to become the gold standard for the treatment of infected TAR. Despite the promising results, challenges remain in the implementation of TAR-AS. Long term follow up studies are needed to evaluate the durability and longevity of the implant. Total ankle with built in antibiotic spacer Superior view of tibial tray with antibiotic cement packed in gyroid

Abstract Background People with physical disabilities (PWD) have a higher prevalence of obesity than populations without disability, but most evidence‐based weight loss programs have not included this population. The State of Slim (SOS) program is an evidence‐based weight loss program that has demonstrated success in producing weight loss in populations without disability, but it has not been adapted for or evaluated in PWD. Methods The SOS program was systematically adapted using the evidence‐informed Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. A total of 35 participants enrolled in the State of Slim Everybody program. The program was offered entirely online. Body weight, attendance, and food log completion were also tracked weekly. The program length was 16.5 h and included weekly group instruction, with optional one‐on‐one sessions provided upon request. Following completion, participants completed post‐evaluation surveys on overall satisfaction with the program. The primary outcomes were program effectiveness (i.e., body weight), usability, and feasibility. Results Thirty‐two out of 35 participants completed the program, representing a retention rate of 91.4%. Average weight loss was 10.9% (9.9 ± 0.7 kg (t (31) = −13.3, p =< 0.0001)). On a 1 (dissatisfied/completely useless) to 5 (very satisfied/completely helpful) Likert scale, the average score for overall program satisfaction was 4.8 ± 0.1 and program helpfulness 4.6 ± 0.1. Conclusion The State of Slim Everybody program demonstrated significant weight loss and good usability and feasibility in PWD. Existing adaptation frameworks can be used to create inclusive health promotion programs for adults with physical disabilities.

Background: Knowledge regarding the use of ethnoveterinary products in the control of chicken diseases in Uganda is hardly documented. Aim: The study documented the ideas of controlling chicken diseases using herbal remedies as shared by chicken owners. Setting: The study was conducted among backyard and free-ranging chicken owners. Methods: Mixed methods of focus group discussions (FGDs) and farmer questionnaires were used. Results: Most respondents, 91% (71/78), were using ethnoveterinary medicine (EVM) and 96.2% (75/78) knew others who were also using them. Of the respondents, 82% (64/78) were convinced that EVMs are effective alternative to conventional treatments. Ethnoveterinary medicines are acceptable and promoted during informal and formal training. The sources of EVM were home gardens, wild sources and markets. Most respondents had their planted EVM materials and acquired knowledge from neighbours and friends. About 37.2% (29/78) of the respondents affirmed that they could not freely share their EVM knowledge with others. Conclusion: The participants of the FGDs and the respondents of the questionnaires knew the acceptable opportunities of alternative drugs of unproven efficacy and safety. The practices pose risks to chickens and the possible development of antimicrobial resistance (AMR) in chickens and humans. The study shows the need for claim validations to guide the safe use of EVM in chicken. Contribution: The study documents plant materials for treating various chicken diseases. The information is essential in the era of AMR and among communities that cannot afford drugs.

Vestibular hair cells (HCs) are mechanoreceptors that sense head motions by modulating the firing rate of vestibular ganglion neurons (VGNs), whose central processes project to vestibular nucleus neurons (VNNs) and cerebellar neurons. We explored vestibular function after HC destruction in adult Pou4f3+/DTR (DTR) mice, in which injections of high-dose (50 ng/g) diphtheria toxin (DT) destroyed most vestibular HCs within 2 weeks. At that time, DTR mice had lost the horizontal vestibulo-ocular reflex (aVORH), and their VNNs failed to upregulate nuclear cFos expression in response to a vestibular stimulus (centrifugation). Five months later, 21 and 14% of HCs were regenerated in utricles and horizontal ampullae, respectively. The vast majority of HCs present were type II. This degree of HC regeneration did not restore the aVORH or centrifugation-evoked cFos expression in VNNs. The failure to regain vestibular pathway function was not due to degeneration of VGNs or VNNs because normal neuron numbers were maintained after HC destruction. Furthermore, sinusoidal galvanic stimulation at the mastoid process evoked cFos protein expression in VNNs, indicating that VGNs were able to regulate VNN activity after HC loss. aVORH and cFos responses in VNNs were robust after low-dose (25 ng/g) DT, which compared to high-dose DT resulted in a similar degree of type II HC death and regeneration but spared more type I HCs in both organs. These findings demonstrate that having more type I HCs is correlated with stronger responses to vestibular stimulation and suggest that regenerating type I HCs may improve vestibular function after HC loss.

Agricultural land use shapes biodiversity patterns. In the literature, land use and land cover at both local and landscape scales has been shown to be important to understanding variation in biodiversity in agricultural systems including measures of occupancy, abundance, and diversity, with landscape scale processes moderating local patterns. The relative role of these processes in explaining variation in acoustic indices, an increasingly frequent measure of biological and environmental change, remains unknown. To address this gap, we recorded acoustic data by passive sampling for two months across 39 farms in central Kansas, USA with automated recording units. We used these data to calculate eight different acoustic indices. We found that acoustic indices were associated with local land use composition (within 100 m) but not landscape composition (within 1000 m). These data suggest that passive acoustic monitoring may be used explain how local land use shapes the soundscape and perhaps biodiversity, but future research should seek to understand the lack of response to landscape variation.

Abstract Aberrant enhancer activation is a key mechanism driving oncogene expression in many cancers. While much is known about the regulation of larger chromosome domains in eukaryotes, the details of enhancer-promoter interactions remain poorly understood. Recent work suggests co-activators like BRD4 and Mediator have little impact on enhancer-promoter interactions. In leukemias controlled by the MLL-AF4 fusion protein, we use the ultra-high resolution technique Micro-Capture-C (MCC) to show that MLL-AF4 binding promotes broad, high-density regions of enhancer-promoter interactions at a subset of key targets. These enhancers are enriched for transcription elongation factors like PAF1C and FACT, and the loss of these factors abolishes enhancer-promoter contact. This work not only provides an additional model for how MLL-AF4 is able to drive high levels of transcription at key genes in leukemia but also suggests a more general model linking enhancer-promoter crosstalk and transcription elongation.

Abstract Background In-centre nocturnal haemodialysis (INHD) offers extended-hours haemodialysis, 6 to 8 h thrice-weekly overnight, with the support of dialysis specialist nurses. There is increasing observational data demonstrating potential benefits of INHD on health-related quality of life (HRQoL). There is a lack of randomised controlled trial (RCT) data to confirm these benefits and assess safety. Methods The NightLife study is a pragmatic, two-arm, multicentre RCT comparing the impact of 6 months INHD to conventional haemodialysis (thrice-weekly daytime in-centre haemodialysis, 3.5–5 h per session). The primary outcome is the total score from the Kidney Disease Quality of Life tool at 6 months. Secondary outcomes include sleep and cognitive function, measures of safety, adherence to dialysis and impact on clinical parameters. There is an embedded Process Evaluation to assess implementation, health economic modelling and a QuinteT Recruitment Intervention to understand factors that influence recruitment and retention. Adults (≥ 18 years old) who have been established on haemodialysis for > 3 months are eligible to participate. Discussion There are 68,000 adults in the UK that need kidney replacement therapy (KRT), with in-centre haemodialysis the treatment modality for over a third of cases. HRQoL is an independent predictor of hospitalisation and mortality in individuals on maintenance dialysis. Haemodialysis is associated with poor HRQoL in comparison to the general population. INHD has the potential to improve HRQoL. Vigorous RCT evidence of effectiveness is lacking. The NightLife study is an essential step in the understanding of dialysis therapies and will guide patient-centred decisions regarding KRT in the future. Trial registration Trial registration number: ISRCTN87042063. Registered: 14/07/2020.

Abstract Background Anemia is associated with impaired physical performance and adverse perioperative outcomes. Iron-deficiency anemia is increasingly treated with intravenous iron before elective surgery. We explored the relationship between exercise capacity, anemia, and total hemoglobin mass (tHb-mass) and the response to intravenous iron in anemic patients prior to surgery. Methods A prospective clinical study was undertaken in patients having routine cardiopulmonary exercise testing (CPET) with a hemoglobin concentration ([Hb])

Abstract Initiatives designed to reduce the disease burden and improve the health of the US population that focus on increasing access to health care have been disappointing. Progress requires multifaceted change. We must first acknowledge that the healthcare system is focused on reversing or modifying disease, not enhancing health. Our conceptualization of the development of ill health and disease must also change. Scientific advances are clarifying the complex interactions among the development of ill health and disease and an individual's behaviors, their microbiota, and their physical, social, and emotional environments. A person's genetic makeup predisposes them to a wide array of disease conditions but is rarely deterministic in and of itself. Factors extrinsic to the individual, including the social determinants of health, play a major role in disease development, often decades later. The complexity of health and disease requires a “team” accountable for the health of our populations, and these teams must be expanded beyond the medical professions. Governmental officials, architects, business leaders, civic organizations, social and neighborhood groups are among the key stakeholders on the health side of the equation. If and when disease does become manifest, then the care part of the healthcare system assumes the larger role. This has major implications for the education of our clinically focused health science students, but also of professional disciplines previously deemed peripheral to health. Simply redoubling our efforts and focusing on our current healthcare system is insufficient to make progress in the health of the populace. One example of a multipronged approach in Allentown, PA is explored in depth.

There are some persistent basic questions pertaining to the bedrock schist of New York City (NYC). How many mappable schist formations are exposed in NYC, and what was the sedimentary protolith of the Manhattan schists? Our proposed answers are based in part on a blending of published paleontological and radiometric dating results that constrain the timing of Taconic subduction and the best choice of a pelitic protolith for the schists of NYC. We have chemically analyzed some samples of schist and shales at key locations to evaluate the plausibility of our proposals. The compelling published evidence indicates that the Taconic Orogeny began about 475 Ma, when peri-Laurentian plates began the process of east-dipping subduction under the Moretown Terrane, resulting in a magmatic flareup of the Shelburne Falls arc that carried the Moretown Terrane west across NYC. East-dipping subduction accounts for early Ordovician metamorphism until an oceanic slab break-off event at about 466 Ma. Our review of the biostratigraphic data indicates a continuation of subduction and the deposition of pelitic sediments until about 455 Ma, during the transition to deep-water turbiditic sediment deposition. This disqualifies all post-455 Ma turbidites as viable protoliths for the NYC Manhattan schists but does include the Late Cambrian to lowermost Late Ordovician pelites of the Jutland Sequence that are exposed directly west of NYC in New Jersey. Our new chemical analyses of Jutland sediments and each of the three named schists from the NYC plot as a single geochemical population. We, therefore, propose that the schists of NYC could collectively be referred to as the Manhattan schist of the Late Cambrian to lower Late Ordovician.

Abstract Digestive enzyme activities are known to fluctuate in abalone grown under different environmental conditions however the effects of different dietary regimes are less clear. Therefore, in a 12‐week study, the effects of water temperature and dietary protein levels on digestive enzyme activity in postweaned (6‐month‐old) greenlip abalone (Haliotis laevigata) were investigated. The abalone were fed diets with crude protein levels that ranged from 27% to 36% and cultured at 14°C, 17°C and 20°C. Diets were formulated to be isoenergetic (12.5 MJ kg−1 digestible energy) and isolipidic (3.6% crude lipid). Trypsin, α‐amylase and lipase activities were measured in the gastrointestinal region. Trypsin, α‐amylase and lipase activities significantly increased as water temperatures were raised. In addition, significantly higher α‐amylase activities were observed as protein levels increased, potentially indicating a compensatory effect to increase carbohydrate utilisation for energy metabolism when in short supply. However, abalone fed high dietary protein levels may also utilise protein for energy metabolism. Further research investigating the dietary carbohydrate source for greenlip abalone is recommended. This study provides useful information on the digestive enzyme activity in postweaned greenlip abalone to improve diet strategies for sustainable production. Abbreviated abstract: Post‐weaned greenlip abalone digestive enzyme activity was examined after feeding four dietary protein levels at three different temperatures for a 12‐week period. Enzyme activities were significantly increased with increasing water temperature. Additionally, significantly higher α‐amylase activities were observed as protein levels increased.

Abstract Background People with physical disabilities (PWD) have an increased risk of obesity and related comorbidities compared with people without physical disabilities (PWoD). Previously identified contributors to weight loss maintenance pose challenges to PWD. However, it is not known if PWD experience less success in weight management. Methods Six hundred and nine participants in the International Weight Control Registry (IWCR) were eligible for this analysis (PWD, n = 174; PWoD, n = 435). Self‐reported weight history metrics were compared using general linear models. Perceived weight history category was compared using Chi‐squared tests. Importance of diet and physical activity strategies for weight management were compared using Wilcoxon rank‐signed tests. Results PWD reported higher current body mass index (BMI) (36.1 ± 0.7 vs. 31.0 ± 0.5; p

Respiratory syncytial virus (RSV) is the leading viral cause of childhood bronchiolitis and pneumonia causing over 3 million hospitalizations and 100,000 deaths in children under 5 years of age annually. Wastewater-based surveillance (WBS) has proven an effective early warning system for high-consequence pathogens, including SARS-CoV-2, polio, mpox, and influenza, but has yet to be fully leveraged for RSV surveillance. A model predicated on the Canadian province of Ontario demonstrates that implementation of a WBS system can potentially result in significant cost savings and clinical benefits when guiding an RSV preventive program with a long-acting monoclonal antibody. A network of integrated WBS initiatives offers the opportunity to help minimize the devastating global burden of RSV in children by optimizing the timing of preventive measures and we strongly advocate that its benefits continue to be explored.

Only a handful of massive starless core candidates have been discovered so far, but none of them have been fully confirmed. Within the MM1 clump in the filamentary infrared dark cloud G34.43+0.24 that was covered by the Atacama Large Millimeter/submillimeter Array (ALMA) ATOMS survey at Band 3 (∼2″, 6000 au) and the ALMA-QUARKS survey at Band 6 (∼0.″3, 900 au), two prestellar core candidates MM1-C and E1 with masses of 71 and 20 M _⊙ and radii of 2100–4400 au were discovered. The two cores show no obvious sign of star formation activities. In particular, MM1-C is a very promising massive prestellar core candidate with a total gas mass of 71 M _⊙ . Within MM1-C, we detected two extremely dense substructures, C1 and C2, as characterized by their high densities of ${n}_{{{\rm{H}}}_{2}}\sim {10}^{8\mbox{--}9}\,{\mathrm{cm}}^{-3}$ . Moreover, evidence of further fragmentation in C2 was also revealed. We have detected the primordial fragmentation in the earliest stage of massive star formation, and we speculate that MM1-C would be the birthplace of a massive multiple system. However, we cannot fully rule out the possibility that the massive prestellar core MM1-C will just form a cluster of low-mass stars if it undergoes further fragmentation.

Using new continuum and molecular line data from the Atacama Large Millimeter/submillimeter Array Three-millimeter Observations of Massive Star-forming Regions (ATOMS) survey and archival Very Large Array, 4.86 GHz data, we present direct observational evidence of hierarchical triggering relating three epochs of massive star formation in a ringlike H ii region, G24.47+0.49. We find from radio flux analysis that it is excited by a massive star(s) of spectral type O8.5V–O8V from the first epoch of star formation. The swept-up ionized ring structure shows evidence of secondary collapse, and within this ring, a burst of massive star formation is observed in different evolutionary phases, which constitutes the second epoch. ATOMS spectral line (e.g., HCO ^+ (1–0)) observations reveal an outer concentric molecular gas ring expanding at a velocity of ∼9 km s ^−1 , constituting the direct and unambiguous detection of an expanding molecular ring. It harbors twelve dense molecular cores with surface mass density greater than 0.05 g cm ^−2 , a threshold typical of massive star formation. Half of them are found to be subvirial and thus in gravitational collapse making them the third epoch of potential massive star-forming sites.

First measurements of the emission of lava worlds with the James Webb Space Telescope (JWST) probe the conditions on worlds so hot that their surfaces are likely molten or partially molten. These observations provide a unique opportunity to explore rocky planets’ evolution. Surfaces of lava world exoplanets can give insights into their composition and their interior workings. However, data of spectral emissivity of a wide range of potential exoplanet surface compositions and temperatures is required to understand JWST data. Here, we chose eight synthetic, potential exoplanet surfaces that span a wide range of chemical compositions to provide observers with a tool for the interpretation of JWST data for the exploration of lava worlds. We present the measured infrared emissivity spectra (2.5–20 μ m) of these materials for temperatures between 800° C and 1350° C. Our data comprise the first spectral library of possible high-temperature exoplanet surfaces. From these measurements, we establish the link between composition and a strong spectral feature at around 9 μ m, the Christiansen frequency (CF) for different temperatures. Additionally, we report that the shift in the CF associated with the bulk composition of the material is significantly more important than its temperature. This provides a critical tool to aid in interpreting future spectra of lava worlds that will be collected by the JWST and future missions.

Conclusion: Leaf extract from Moringa oleifera reduces blood sugar and lessens the damage caused by hyperglycemia in the pancreas and liver.