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We have studied the use of polymethyl methacrylate (PMMA) as an alternative biopsy marker that is readily detectable with ultrasound Doppler twinkling in cases of in vitro, ex vivo , or limited duration in vivo settings. This study investigates the long-term safety and ultrasound Doppler twinkling detectability of a PMMA breast biopsy marker following local perturbations and different dwell times in a 6-mo animal experiment. This study, which was approved by our Institutional Animal Care and Use Committee, involved three pigs and utilized various markers, including PMMA (Zimmer Biomet), 3D-printed, and Tumark Q markers. Markers were implanted at different times for each pig. Mesh material or ethanol was used to induce a local inflammatory reaction near certain markers. A semiquantitative twinkling score assessed twinkling for actionable localization during monthly ultrasounds. At the primary endpoint, ultrasound-guided localization of lymph nodes with detectable markers was performed. Following surgical resection of the localized nodes, histomorphometric analysis was conducted to evaluate for tissue ingrowth and the formation of a tissue rind around the markers. No adverse events occurred. Twinkling scores of all markers for all three pigs decreased gradually over time. The Q marker exhibited the highest mean twinkling score followed by the PMMA marker, PMMA with mesh, and Q with ethanol. The 3D-printed marker with mesh and PMMA with ethanol had the lowest scores. All wire-localized lymph nodes were successfully resected. Despite varying percentages of tissue rind around the markers and a significant reduction in overall twinkling (p < 0.001) over time, mean PMMA twinkling scores remained clinically actionable at 6 and 5 mo using a General Electric C1-6 probe and 9L-probe, respectively. In this porcine model, the PMMA marker demonstrates an acceptable safety profile. Clinically actionable twinkling aids PMMA marker detection even after 6 mo of dwell time in porcine lymph nodes. The Q marker maintained the greatest twinkling over time compared to all the other markers studied. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess associations between distal symmetric polyneuropathy (DSPN) and Diabetes Prevention Program (DPP) treatment groups, diabetes status or duration, and cumulative glycemic exposure approximately 21 years after DPP randomization. RESEARCH DESIGN AND METHODS: In the DPP, 3,234 adults ≥25 years old at high risk for diabetes were randomized to an intensive lifestyle (ILS), metformin, or placebo intervention to prevent diabetes. After the DPP ended, 2,779 joined the Diabetes Prevention Program Outcomes Study (DPPOS). Open-label metformin was continued, placebo was discontinued, ILS was provided in the form of semiannual group-based classes, and all participants were offered quarterly lifestyle classes. Symptoms and signs of DSPN were assessed in 1,792 participants at DPPOS year 17. Multivariable logistic regression models were used to evaluate DSPN associations with treatment group, diabetes status/duration, and cumulative glycemic exposure. RESULTS: At 21 years after DPP randomization, 66% of subjects had diabetes. DSPN prevalence did not differ by initial DPP treatment assignment (ILS 21.5%, metformin 21.5%, and placebo 21.9%). There was a significant interaction between treatment assignment to ILS and age (P < 0.05) on DSPN. At DPPOS year 17, the odds ratio for DSPN in comparison with ILS with placebo was 17.4% (95% CI 3.0, 29.3) lower with increasing 5-year age intervals. DSPN prevalence was slightly lower for those at risk for diabetes (19.6%) versus those with diabetes (22.7%) and was associated with longer diabetes duration and time-weighted HbA1c (P values <0.001). CONCLUSIONS: The likelihood of DSPN was similar across DPP treatment groups but higher for those with diabetes, longer diabetes duration, and higher cumulative glycemic exposure. ILS may have long-term benefits on DSPN for older adults. [ABSTRACT FROM AUTHOR]

Drug development teams must evaluate the risk/benefit profile of new drug candidates that perpetrate drug–drug interactions (DDIs). Real‐world data (RWD) can inform this decision. The purpose of this study was to develop a predicted impact score for DDIs perpetrated by three hypothetical drug candidates via CYP3A, CYP2D6, or CYP2C9 in type 2 diabetes mellitus (T2DM), obesity, or migraine. Optum Market Clarity was analyzed to estimate use of CYP3A, CYP2D6, or CYP2C9 substrates classified in the University of Washington Drug Interaction Database as moderate sensitive, sensitive, narrow therapeutic index, or QT prolongation. Scoring was based on prevalence of exposure to victim substrates and characteristics (age, polypharmacy, duration of exposure, and number of prescribers) of those exposed. The study population of 14,163,271 adults included 1,579,054 with T2DM, 3,117,753 with obesity, and 410,436 with migraine. For T2DM, 71.3% used CYP3A substrates, 44.3% used CYP2D6 substrates, and 44.3% used CYP2C9 substrates. For obesity, 57.1% used CYP3A substrates, 34.6% used CYP2D6 substrates, and 31.0% used CYP2C9 substrates. For migraine, 64.1% used CYP3A substrates, 44.0% used CYP2D6 substrates, and 28.9% used CYP2C9 substrates. In our analyses, the predicted DDI impact scores were highest for DDIs involving CYP3A, followed by CYP2D6, and CYP2C9 substrates, and highest for T2DM, followed by migraine, and obesity. Insights from RWD can be used to estimate a predicted DDI impact score for pharmacokinetic DDIs perpetrated by new drug candidates currently in development. This score can inform the risk/benefit profile of new drug candidates in a target patient population. [ABSTRACT FROM AUTHOR]

This article, titled "Cavernous Sinus Exenteration for Invasive Mucormycosis," discusses a case study of a 61-year-old woman with HIV and diabetes mellitus who experienced vision loss due to invasive rhino-orbito-cerebral mucormycosis. Despite initial surgery and antifungal therapy, the disease progressed into the cavernous sinus and trigeminal nerve branches. The authors performed a STA-to-MCA bypass and a middle fossa approach for cavernous sinus exenteration, which successfully controlled the disease. The article highlights the technical aspects of cavernous sinus exenteration. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, explores the pterygoid-sphenoidal fissure (PSF) as a key landmark for accessing the foramen lacerum in pediatric endoscopic endonasal surgery. The study evaluates the morphometry and developmental variations of the PSF in a general pediatric population using computed tomography scans. The results show that the length, width, and morphology of the PSF vary significantly across different age groups. Understanding these radiological findings is important for preoperative planning and intraoperative guidance in pediatric endoscopic endonasal surgery. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, explores the surgical anatomy and variations of the inferior hypophyseal artery (IHA), which is closely related to pituitary lesions and lesions in the cavernous sinus. The study used anatomical specimens to investigate the origin, course, branching, and relations of the IHA. The findings reveal that the IHA usually arises from the meningohypophyseal trunk (MHT) and runs in an anterior, medial direction to the medial wall of the cavernous sinus. Understanding the surgical anatomy of the IHA and its variations can assist surgeons in approaching challenging lesions in the cavernous sinus. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses the use of repeat endoscopic transcavernous surgery for patients with residual growth hormone producing tumors and persistent acromegaly. The study analyzed 28 patients who had previously undergone pituitary tumor surgery and found that a transcavernous approach resulted in positive outcomes, with 80% of patients achieving biochemical remission with surgery alone and 90% with surgery and adjuvant therapy. The study concludes that repeat surgery with a transcavernous approach is safe and effective in achieving biochemical remission for patients with active disease who have undergone traditional transsphenoidal surgery. [Extracted from the article]

This article discusses the outcomes of endoscopic endonasal transcavernous surgery for pituitary adenomas. The study analyzed data from patients who underwent this surgery between 2018 and 2023. The results showed that transcavernous surgery was more common in repeat surgery patients and those with functioning adenomas. The study also examined the invasion patterns of the cavernous sinus compartments and found that the medial wall was the most frequently involved. The authors concluded that the outcomes of transcavernous surgery can vary depending on the specific compartments involved. [Extracted from the article]

This article discusses the surgical management and outcomes of pituitary adenomas with subarachnoid invasion. The study analyzed data from 321 patients who underwent an endoscopic endonasal approach for pituitary adenoma resection, and identified 13 patients with subarachnoid invasion. The surgical approach for these tumors involved careful dissection from surrounding neurovascular structures to achieve safe resection. Patients with subarachnoid invasion were more likely to have subtotal tumor resection and require additional treatment, such as medical therapy, radiation, or repeat resection. They also experienced higher rates of intra-operative CSF leak, postoperative diabetes insipidus, post-operative hematomas, and the need for adjuvant interventions. Overall, pituitary adenomas with subarachnoid invasion present unique challenges and require specialized surgical techniques. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, explores the microsurgical anatomy of the "true" petrous apex and the feasibility of accessing it through the endoscopic endonasal approach. The study conducted detailed dissections of post-mortem human specimens and identified key anatomical landmarks and neurovascular structures. The authors found that the endoscopic endonasal petrosectomy approach provides access to the "true" petrous apex, with two variants based on its relationship with the internal carotid artery. The study concludes that this approach is an effective surgical alternative for accessing lesions in this region. [Extracted from the article]

The article discusses the extreme lateral supracerebellar infratentorial and transtentorial (ELSIT) approach for accessing lesions in the ambient cistern, a challenging area due to its deep location and vital neurovascular structures. The study conducted a systematic dissection on post-mortem human specimens to investigate the anatomical landmarks and measurements of this approach. The ELSIT approach provides a narrow corridor leading to the ambient cistern, with specific landmarks such as the superior petrous vein and posterior root of the trigeminal nerve. Understanding these anatomical nuances is crucial for optimizing surgical outcomes and minimizing complications. [Extracted from the article]

Major depressive disorder (MDD) is a heterogeneous disorder whose possible symptom combinations have not been well delineated. The aim of this study was to explore the heterogeneity of symptoms experienced by those with MDD to characterize phenotypic presentations. Cross-sectional data (N = 10,158) from a large telemental health platform were used to identify subtypes of MDD. Symptom data, gathered from both clinically-validated surveys and intake questions, were analyzed via polychoric correlations, principal component analysis, and cluster analysis. Principal components analysis (PCA) of baseline symptom data revealed 5 components, including anxious distress, core emotional, agitation/irritability, insomnia, and anergic/apathy components. PCA-based cluster analysis resulted in four MDD phenotypes, the largest of which was characterized by a prominent elevation on the anergic/apathy component, but also core emotional. The four clusters differed on demographic and clinical characteristics. The primary limitation of this study is that the phenotypes uncovered are limited by the questions asked. These phenotypes will need to be cross validated with other samples, potentially expanded to include biological/genetic variables, and followed longitudinally. The heterogeneity in MDD, as illustrated by the phenotypes in this sample, may explain the heterogeneity of treatment response in large-scale treatment trials. These phenotypes can be used to study varying rates of recovery following treatment and to develop clinical decision support tools and artificial intelligence algorithms. Strengths of this study include its size, breadth of included symptoms, and novel use of a telehealth platform. • This study was first to use PCA and cluster analysis on the PHQ-9 and the GAD-7 to discover phenotypes among those with MDD. • Data from depression and anxiety measures can be reduced to 5 components. • The five components can be described as anxious distress, core emotional, agitation/irritability, insomnia, and anergic/apathy. • Cluster analysis resulted in four MDD phenotypes, one characterized by prominent elevation on the anergic/apathy component. • The four clusters differed on demographic and clinical characteristics. [ABSTRACT FROM AUTHOR]

Inositols are a class of biologically active compounds which can be used as precursors for the synthesis of a wide range of bioactive products. Lately, there is growing awareness on the importance of developing chiral compounds in the pharmaceutical and nutraceutical industries. This new emphasis on chiral compounds boils down to safety matters, with an aim to select the right enantiomer for desired biological activities. Natural rubber serum (NRS) has the advantage as it possesses a significant percentage of naturally occurring bioactive inositol compounds. For this study, considerable amounts of quebrachitol (2-O-methyl-l-chiro-inositol) were isolated from NRS using membrane separation technology and converted to l-chiro-inositol crystals. Characterisations of the resulting inositol compounds were performed using Fourier transform infrared spectroscopy (FTIR), high-performance liquid chromatography–mass spectrometry (LCMS) and liquid-state nuclear magnetic resonance (NMR) spectroscopy methods. FTIR and NMR results for the l-chiro-inositol compound obtained showed similar spectrums as the commercial control, while LCMS mass spectra was demonstrated to be at m/z 179.03 (M–H)− in the negative ionisation mode, confirming the compound to be l-chiro-inositol. Thus, it can be concluded that quebrachitol from NRS obtained via membrane separation technology and its modified inositol derivatives have high potential market value to be used as building blocks for pharmaceutical and nutraceutical applications. Quebrachitol already exists naturally as an enantiomer and chiral compound in the rubber tree, and instead of being treated as a waste product, its usage can actively contribute to tackling environmental pollution from rubber processing effluents. [ABSTRACT FROM AUTHOR]

Christian, especially Protestant, identity is often framed through the lens of belief, particularly belief understood as an interior orientation. Through an examination of the non-denominational Protestant group, the 'Little Flock', founded by Watchman Nee in the early 20th century, we trace enduring aspects of Little Flock theology in contemporary Chinese Protestant practice. In particular, we attend to conceptions of and debates surrounding belief and how to determine the quality of one's faith—whether or not one might be considered not just a Christian, but a 'good' one. [ABSTRACT FROM AUTHOR]

Background: Microbiota-based treatments reduce the incidence of recurrent Clostridioides difficile infections (rCDIs), but prospectively collected safety data needed to broaden patient access and protect public health have been limited. Objectives: We provide cumulative safety data from five prospective clinical trials evaluating fecal microbiota, live-jslm (RBL) – the first microbiota-based live biotherapeutic product approved by the US Food and Drug Administration – for preventing rCDI in adults. Design: Integrated safety analysis includes three phase II trials (PUNCH CD, PUNCH CD2, PUNCH Open-Label) and two phase III trials (PUNCH CD3, PUNCH CD3-OLS) of RBL. Methods: Trial participants were at least 18 years of age with documented rCDI who completed standard-of-care antibiotic therapy before treatment with RBL. Assigned study treatment regimen was one or two doses of RBL (or placebo) administered rectally, depending on the trial design. In four of the five trials, participants with CDI recurrence within 8 weeks after RBL or placebo administration were eligible for treatment with open-label RBL. Treatment-emergent adverse events (TEAEs) were recorded for at least 6 months following last study treatment; in PUNCH CD2 and PUNCH Open-Label trials, TEAEs and serious TEAEs were collected through 12 and 24 months, respectively. Results: Among the five trials, 978 participants received at least one dose of RBL (assigned treatment or after recurrence) and 83 participants received placebo only. TEAEs were reported in 60.2% of Placebo Only participants and 66.4% of RBL Only participants. Only abdominal pain, nausea, and flatulence were significantly higher in the RBL Only group compared with the Placebo Only group. Most TEAEs were mild or moderate in severity and were most frequently related to preexisting conditions. There were no reported infections for which the causative pathogen was traced to RBL. Potentially life-threatening TEAEs were infrequent (3.0% of participants). Conclusion: Across five clinical trials, RBL was well tolerated in adults with rCDI. In aggregate, these data consistently demonstrated the safety of RBL. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Cat‐scratch disease (CSD) is caused by Bartonella henselae and usually presents with regional lymphadenopathy. Skull base osteomyelitis and cerebral venous sinus thrombosis are rarely reported, particularly in immunocompetent children. CSD should be considered in the differential diagnosis of any patient with persistent headaches in the setting of cat exposure. [ABSTRACT FROM AUTHOR]

Keywords: featureless melanoma; SDDI; sequential digital dermatoscopic imaging; sequential digital dermoscopic imaging; TBP; total body photography EN featureless melanoma SDDI sequential digital dermatoscopic imaging sequential digital dermoscopic imaging TBP total body photography e193 e196 4 05/12/23 20230501 NES 230501 It is known that dermatoscopy improves diagnostic accuracy for skin lesions whether pigmented or not,[[1]] but it is also known that approximately 10% of melanomas are featureless, lacking diagnostic dermatoscopic criteria.[3] SP (page 620) sp Of relevance, a recent, appropriately powered and controlled study found that 59.2% of monitored lesions did not have dermatoscopic features of malignancy when excised, only being excised because of evident differences when sequential dermatoscopic images were compared side-by-side.[3] SP (page 619) sp Consistent with this, Australian melanoma guidelines highlight the role of both total body photography (TBP) and sequential digital dermatoscopic imaging (SDDI) but recommend as a "Practice Point" that TBP should be the I primary i imaging intervention for early melanoma detection in patients at elevated risk who have high naevus counts.[4] We present two cases of high-risk young patients, whose clinically and dermatoscopically subtle melanomas were first detected by operator-recognition of size-enlargement in sequential TBP images, these changes in both cases I not i being detected by dedicated software. SDDI, sequential digital dermatoscopic imaging, featureless melanoma, sequential digital dermoscopic imaging, TBP, total body photography Semi-automated total body photography can identify subtle melanomas but false-negatives on automated comparison highlight the need for manual side-by-side image comparison. [Extracted from the article]

Sexual minority women and gender diverse (SMWGD) individuals are at elevated risk for alcohol and cannabis use disorders compared with cisgender, heterosexual women. This has been attributed to the unique stressors that SMWGD experience (i.e., sexual minority stress); however, recent studies have found mixed evidence for a link between sexual minority stress and substance use. The current manuscript introduces and tests a novel theoretical model derived from integrating minority stress theory and the multistage model of drug addiction to explain these mixed findings. We used data from a 30-day ecological momentary assessment (EMA) study of substance use among SMWGD to determine whether event-level associations between enacted stigma (bias from others) and same-/next-day alcohol and cannabis use are dependent on an individual's typical pattern of substance use (e.g., frequency, quantity, motives, and substance use disorder [SUD] symptoms). Findings indicate that enacted stigma predicted an increased likelihood of alcohol and cannabis use among those who used frequently and those who had a probable alcohol or cannabis use disorder and predicted a decreased likelihood of use among those who used less frequently. Enacted stigma also predicted cannabis (but not alcohol) use among those who reported high coping motives for use. Findings provide initial evidence in support of an integrated model of minority stress theory and the multistage model of drug addiction. Findings suggest that alcohol and cannabis use disorder interventions for SMWGD would benefit from addressing sexual minority stress and coping skill-building. General Scientific Summary: The results of this study suggest that discrimination and microaggressions are risk factors for same/next-day alcohol and cannabis use among LGBTQ+ individuals who use alcohol and/or cannabis frequently or have an SUD. However, discrimination and microaggressions do not appear to be risk factors for same/next-day alcohol and cannabis use among LGBTQ+ individuals who use alcohol or cannabis less frequently or do not have an SUD. [ABSTRACT FROM AUTHOR]

The extent to which vaccinated persons who become infected with SARS-CoV-2 contribute to transmission is unclear. During a SARS-CoV-2 Delta variant outbreak among incarcerated persons with high vaccination rates in a federal prison, we assessed markers of viral shedding in vaccinated and unvaccinated persons. Consenting incarcerated persons with confirmed SARS-CoV-2 infection provided mid-turbinate nasal specimens daily for 10 consecutive days and reported symptom data via questionnaire. Real-time reverse transcription-polymerase chain reaction (RT-PCR), viral whole genome sequencing, and viral culture was performed on these nasal specimens. Duration of RT-PCR positivity and viral culture positivity was assessed using survival analysis. A total of 957 specimens were provided by 93 participants, of whom 78 (84 %) were vaccinated and 17 (16 %) were unvaccinated. No significant differences were detected in duration of RT-PCR positivity among vaccinated participants (median: 13 days) versus those unvaccinated (median: 13 days; p = 0.50), or in duration of culture positivity (medians: 5 days and 5 days; p = 0.29). Among vaccinated participants, overall duration of culture positivity was shorter among Moderna vaccine recipients versus Pfizer (p = 0.048) or Janssen (p = 0.003) vaccine recipients. In post-hoc analyses, Moderna vaccine recipients demonstrated significantly shorter duration of culture positivity compared to unvaccinated participants (p = 0.02). When restricted to participants without reported prior infection, the difference between Moderna vaccine recipients and unvaccinated participants was more pronounced (medians: 3 days and 6 days, p = 0.002). Infectious periods for vaccinated and unvaccinated persons who become infected with SARS-CoV-2 are similar and can be highly variable, though some vaccinated persons are likely infectious for shorter durations. These findings are critically important, especially in congregate settings where viral transmission can lead to large outbreaks. In such settings, clinicians and public health practitioners should consider vaccinated, infected persons to be no less infectious than unvaccinated, infected persons. [ABSTRACT FROM AUTHOR]

Platelet-specific collagen receptor glycoprotein (GP)VI is stable on the surface of circulating platelets but undergoes ectodomain cleavage on activated platelets. Activation-dependent GPVI metalloproteolysis is primarily mediated by A Disintegrin And Metalloproteinase (ADAM) 10. Regulation of platelet ADAMs activity is not well-defined however Tissue Inhibitors of Metalloproteinases (TIMPs) may play a role. As levels of TIMPs on platelets and the control of ADAMs-mediated shedding by TIMPs has not been evaluated, we quantified the levels of TIMPs on the surface of resting and activated platelets from healthy donors by flow cytometry and multiplex ELISA. Variable levels of all TIMPs could be detected on platelets. Plasma contained significant quantities of TIMP1 and TIMP2, but only trace amounts of TIMP3 and TIMP4. Recombinant TIMP3 strongly ablated resting and activated platelet ADAM10 activity, when monitored using a quenched fluorogenic peptide substrate with ADAM10 specificity. Whilst ADAM10-specific inhibitor GI254023X or ethylenediamine tetraacetic acid (EDTA) could modulate ligand-initiated shedding of GPVI, only recombinant TIMP2 achieved a modest (~20%) inhibition. We conclude that some platelet TIMPs are able to modulate platelet ADAM10 activity but none strongly regulate ligand-dependent shedding of GPVI. Our findings provide new insights into the regulation of platelet receptor sheddase activity. What do we know? Platelet receptor GPVI initiates platelet adhesion and aggregation and is proteolytically cleaved from the activated platelet surface The metalloproteinases responsible belong to the ADAMs family of enzymes which are inhibited by TIMPs What did we discover? Plasma contains significant amounts of TIMP1 and TIMP2 Circulating platelets bear significant amounts of TIMPs 1, 2, and 3 Recombinant TIMP3 strongly inhibits resting and activated platelet ADAM10 activity Exogenous addition of TIMP2 mildly blocked ligand-initiated shedding of GPVI What is the impact? TIMPs may modulate ADAM10 activity under resting conditions and stabilize GPVI levels in response to platelet activation Anti-GPVI agents are being evaluated as anti-thrombotic agents, however, acute loss of GPVI in trauma or settings of thrombocytopenia is linked with clinical bleeding Understanding how GPVI levels are regulated is important as agents that modulate GPVI function are emerging as important therapeutics for clinical applications in Thrombosis and Hemostasis fields [ABSTRACT FROM AUTHOR]

Background: Microbiota-based treatments reduce the incidence of recurrent Clostridioides difficile infections (rCDIs), but prospectively collected safety data needed to broaden patient access and protect public health have been limited. Objectives: We provide cumulative safety data from five prospective clinical trials evaluating fecal microbiota, live-jslm (RBL) – the first microbiota-based live biotherapeutic product approved by the US Food and Drug Administration – for preventing rCDI in adults. Design: Integrated safety analysis includes three phase II trials (PUNCH CD, PUNCH CD2, PUNCH Open-Label) and two phase III trials (PUNCH CD3, PUNCH CD3-OLS) of RBL. Methods: Trial participants were at least 18 years of age with documented rCDI who completed standard-of-care antibiotic therapy before treatment with RBL. Assigned study treatment regimen was one or two doses of RBL (or placebo) administered rectally, depending on the trial design. In four of the five trials, participants with CDI recurrence within 8 weeks after RBL or placebo administration were eligible for treatment with open-label RBL. Treatment-emergent adverse events (TEAEs) were recorded for at least 6 months following last study treatment; in PUNCH CD2 and PUNCH Open-Label trials, TEAEs and serious TEAEs were collected through 12 and 24 months, respectively. Results: Among the five trials, 978 participants received at least one dose of RBL (assigned treatment or after recurrence) and 83 participants received placebo only. TEAEs were reported in 60.2% of Placebo Only participants and 66.4% of RBL Only participants. Only abdominal pain, nausea, and flatulence were significantly higher in the RBL Only group compared with the Placebo Only group. Most TEAEs were mild or moderate in severity and were most frequently related to preexisting conditions. There were no reported infections for which the causative pathogen was traced to RBL. Potentially life-threatening TEAEs were infrequent (3.0% of participants). Conclusion: Across five clinical trials, RBL was well tolerated in adults with rCDI. In aggregate, these data consistently demonstrated the safety of RBL. [ABSTRACT FROM AUTHOR]

Aim: Topography, climate and plant water stress influence the spatial patterns of burn severity (damage to soils and vegetation associated with wildfires); however, the relative importance of these predictors remains contested. We hypothesized that high‐resolution pre‐fire vegetation water stress, measured using evapotranspiration (ET), evaporative stress index (ESI) and water use efficiency (WUE), are strong predictors of burn severity. Location: California, USA. Time period: 2019–2020. Major taxa studied: Forests, chaparral, oaks and grasslands. Methods: We used random forest regression modelling with remotely sensed ECOsystem and Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) plant water stress from the spring–summer and year before the fires, predictors to represent spatial autocorrelation, and topography to predict the spatial patterns of burn severity for six fires in the Sierra Nevada and the Southern California Mountains. Results: Plant water stress was the dominant predictor for the Southern California Mountains, and spatial autocorrelation in Sierra Nevada. Elevation was a leading predictor for burn severity for both regions, with greater predictability in higher‐elevation and steeper terrain. Model results varied by vegetation type: for the Southern California Mountains, grasslands had the highest predictability [R2 =.50 (high elevation); R2 =.58 (steep)], followed by savanna and open shrublands, which are typified by chaparral‐type vegetation [R2 =.43 (savanna, high elevation); R2 =.40 (open shrubland, high elevation)]. For grasslands, annual ET was the leading predictor (R2 =.58), consistent with the idea that growing season grassland enhancement increases fuel availability. The predictability of burn severity was also sensitive to the time of day of the ECOSTRESS acquisition and varied by vegetation type. Afternoon ET was the leading predictor for high‐elevation grasslands (R2 =.50), and morning predictors were important for steep‐sloped woody savanna (R2 =.18). Main conclusions Our findings provide insights on how antecedent plant water stress predicts burn severity and can inform pre‐fire season monitoring and fuel management. [ABSTRACT FROM AUTHOR]

Background: Institutional data on initiating and maintaining a low-titer O positive whole blood (LTOWB) inventory for the civilian trauma sector may help other institutions start a LTOWB program. This study from a level 1 trauma center with a hospital-based donor center highlights challenges faced during the collection, maintenance, and utilization of LTOWB.Study Design and Methods: Male O positive donors with low (≤1:100) anti-A and anti-B antibody titers were recruited for LTOWB collection. The daily inventory goal of 4 LTOWB units was kept in the emergency department refrigerator and transfused to adult male trauma patients. Unused units older than 10 days were reprocessed into packed red blood cells.Results: Of 900 donors screened, 61% qualified and 52% of eligible donors provided a collective total of 505 LTOWB units over 2.5 years. The number of collected units directly correlated with the availability of inventory; 42% of the units were transfused, 54% were reprocessed, and 4% were discarded. The inventory goal was maintained for 56% of the year 2018 and 83% of the year 2019. Over these 2 years, 52% of patients had their transfusion needs fully met, 41% had their needs partially met, and 6.5% did not have their needs met.Discussion: Initial challenges to LTOWB implementation were inventory shortages, low utilization rates, and failure to meet clinical demand. Proposed solutions include allowing for a higher yet safe titer, extending shelf life, expanding the donor pool, identifying barriers to utilization, and permitting use in female trauma patients beyond childbearing age. [ABSTRACT FROM AUTHOR]

• We designed a text message program, ASPIRE, aimed at coaching individuals to engage with peers to assist in meeting context-specific drinking limits. • Among a geographically diverse sample of non-collegiate young adults, we found high program engagement but suboptimal usability ratings. • Pilot trial results suggest the intervention reduces peer pressure and boosts peer support and goal confidence but needs to be further optimized to reduce drinking episodes. Scalable interventions attempting to nurture peer outreach to help young adults meet drinking limit goals remain under-developed. To address this gap, we developed ASPIRE, a text message intervention focused on coaching individuals to engage with close peers to assist them in meeting drinking limit goals. Non-collegiate young adults who had reported one or more heavy drinking days in the preceding month and were at least contemplating change were recruited through social media. Participants were randomly assigned to one of three 6-week text message interventions: Control, Goal Support, or ASPIRE. All groups completed baseline assessments and received weekly text message assessments on Thursdays and Sundays. Control and ASPIRE groups were prompted to complete web-based outcome assessments at 6- and 12-weeks. We enrolled 92 young adults from 31 US states (65% female; 73% White). All groups had high text response rates but intervention usability was sub-optimal. Follow-up rates were 87% at 6-weeks and 79% at 12-weeks. Compared to Control, ASPIRE participants reported significantly more peer support and less peer pressure to drink. ASPIRE exhibited higher goal confidence compared to the Goal Support group. Using multiple imputation, there were no significant differences in drinking outcomes between groups. Preliminary findings from this pilot study suggest that a text message intervention focused on nurturing peer outreach to help meet drinking limit goals holds promise in altering peer support and pressure as well as boosting drinking limit goal confidence. Design improvements are needed to reduce alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Young adults are prolific media users and tend to use substances, such as alcohol, more than people of other ages. Despite much research on young adults' exposure to alcohol advertisements and portrayals of alcohol use in the media, much is still unknown about the nuances of young adults' exposure to and engagement with alcohol-related media content. The present paper examined how college students' media exposure differed for messages portraying positive and negative alcohol effects, how exposure to alcohol-related content differed across media sources, which themes of alcoholrelated content were seen most, and whether exposure to alcohol-related content was associated with hazardous/harmful drinking. Method: Participants (N=500) were two- and four-year college students (Mage=20.90, SDage=1.70, 63.2% female) recruited for a longitudinal study examining the efficacy of a mobile app intervention for high-risk drinking college students. The data used here comes from the baseline survey. Results: Participants reported the greatest exposure to alcohol-related messages in movies/TV/on-demand streaming shows followed by in social media, and they reported greater exposure to messages portraying positive than negative effects of alcohol. Findings from linear regressions indicated that exposure to messages portraying positive or negative effects of alcohol generally did not predict hazardous/harmful drinking. Conclusion: This sample of high-risk college student drinkers reported seeing alcohol-related content through a variety of media sources, with most content portraying alcohol in a positive light. Future research should assess the effects that messages of different types and from different sources have on use, expectancies, norms, and other outcomes. [ABSTRACT FROM AUTHOR]

Any mechanical instability associated with total hip replacement (THR) excites elastic waves with different frequencies and propagates through the surrounding biological layers. Using the acoustic emission (AE) technique as a THR monitoring tool provides valuable information on structural degradations associated with these implants. However, several factors can compromise the reliability of the signals detected by AE sensors, such as attenuation of the detected signal due to the presence of biological layers in the human body between prosthesis (THR) and AE sensor. The main objective of this study is to develop a numerical model of THR that evaluates the impact of biological layer thicknesses on AE signal propagation. Adipose tissue thickness, which varies the most between patients, was modeled at two different thicknesses 40 mm and 70 mm, while the muscle and skin thicknesses were kept to a constant value. The proposed models were tested at different micromotions of 2 µm, 15–20 µm at modular junctions, and different frequencies of 10–60 kHz. Attenuation of signal is observed to be more with an increase in the selected boundary conditions along with an increase in distance the signals propagate through. Thereby, the numerical observations drawn on each interface helped to simulate the effect of tissue thicknesses and their impact on the attenuation of elastic wave propagation to the AE receiver sensor. [ABSTRACT FROM AUTHOR]

Background: To improve understanding of the antibody response to SARS-CoV-2 infection, we examined seroprevalence, incidence of infection, and seroconversion among a cohort of young adults living on university campuses during the fall of 2020. Methods: At the beginning (semester start) and end (semester end) of an 11-week period, serum collected from 107 students was tested using the qualitative Abbott Architect SARS-CoV-2 IgG and AdviseDx SARS-CoV-2 IgG II assays. Results were matched to interim weekly surveillance viral testing and symptom data. Results: With the SARS-CoV-2 IgG assay, 15 (14.0%) students were seropositive at semester start; 29 (27.1%) students were seropositive at semester end; 10 (9.3%) were seropositive at both times. With the AdviseDx SARS-CoV-2 IgG II assay, 17 (16.3%) students were seropositive at semester start, 37 (35.6%) were seropositive at semester end, and 16 (15.3%) were seropositive at both times. Overall, 23 students (21.5%) had positive viral tests during the semester. Infection was identified by serial testing in a large majority of individuals who seroconverted using both assays. Those seropositive at semester end more frequently reported symptomatic infections (56.5%) than asymptomatic infections (30.4%). Conclusion: Differences between antibody targets were observed, with more declines in antibody index values below the threshold of positivity with the anti-nucleocapsid assay compared to the anti-spike assay. Serology testing, combined with serial viral testing, can detect seroconversions, and help understand the potential correlates of protection provided by antibodies to SARS-CoV-2. [ABSTRACT FROM AUTHOR]

The San Francisco Estuary and Sacramento–San Joaquin River Delta (Bay Delta) is a highly sensitive and critical habitat for the Delta Smelt, an endangered endemic fish, with water temperature being a key determinant of habitat suitability. This study investigates the relationship between open water surface and subsurface conditions from spaceborne thermal measurements (ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) and Landsat-8) and in situ sensor data from the California Data Exchange Center (CDEC) to produce estimates of spatially continuous bulk temperature in the Bay Delta. We found that ECOSTRESS and Landsat-8 surface temperature measurements are well-correlated with bulk water temperatures ($N =236$ and $r = 0.907$ and $N = 226$ and $r = 0.976$ , respectively). For the ECOSTRESS-in situ comparison, accounting for time of day improved the correlation between surface and subsurface conditions ($r = 0.946$ , 0.881, and 0.944 for morning, midday, and evening, respectively). We found that ECOSTRESS surface temperatures were warmer than bulk temperatures in the midday period (2 °C peak at 2 P.M.) and cooler in the morning and evening periods (−1°C peak at 6 A.M.). We also found that a simple harmonic regression model can capture the diurnal variability of the skin effect to predict bulk water temperature (root-mean-square error (RMSE) = 0.809°C). With ECOSTRESS, we found that across the Bay Delta, including open waters and pelagic bays, temperature conditions causing stress and mortality for the Delta Smelt were persistent throughout the day during summer months. ECOSTRESS is a unique dataset capable of informing conservation efforts in the Bay Delta. [ABSTRACT FROM AUTHOR]

BACKGROUND: Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use. OBJECTIVES: This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use. ELIGIBILITY CRITERIA: This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded. SOURCES OF EVIDENCE: PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist. CHARTING METHODS: A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use. RESULTS: A total of 1,282 papers were identified through initial search terms. Through double-blind title/ abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models. CONCLUSIONS: The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention. [ABSTRACT FROM AUTHOR]

Objective: To determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.Research Design and Methods: From 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively.Results: Over a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death (n = 170), followed by cardiovascular disease (n = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality.Conclusions: Cancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates. [ABSTRACT FROM AUTHOR]

Background: Norm‐correcting interventions are an effective alcohol harm‐reduction approach, but innovation is needed to increase modest effect sizes. Recent social psychology research shows that individuals may be influenced by social norms that are increasing in prevalence. Contrary to static norms that reflect the current state of normative behavior, dynamic norms reflect behavioral norms that are shifting over time. This proof‐of‐concept study tested the utility of dynamic norms messages within norm‐correcting interventions. Method: Undergraduate student drinkers (N = 461; Mage = 19.97; 64.43% female) were randomly assigned to receive (a) dynamic norms messages highlighting a steady decrease over the past six years in heavy drinking among college students; (b) static norms messaging stating only the current norms; or (c) a control condition without normative information. Proximal outcomes assessed immediately following the experimental paradigm included intentions for total weekly drinks and heavy episodic drinking. Self‐reported information on alcohol use behavior was collected at 1‐month follow‐up. Results: Following the experimental paradigm, participants in the dynamic norms condition estimated that future drinking norms would decrease, while those in the static norms and control groups estimated that future drinking norms would increase. Participants in the dynamic norms condition reported lower intentions for weekly drinks and heavy episodic drinking than those in the static norms and control conditions. No significant differences between conditions were found on alcohol use indices reported at the 1‐month follow‐up. However, dynamic norms messaging had a favorable indirect effect on heavy episodic drinking intentions mediated through lower perceived future drinking norms. Conclusions: These findings provide proof‐of‐concept that dynamic norms messaging may be a prudent strategy for reducing alcohol use intentions, which can be integrated into or used alongside existing norm‐correcting strategies. [ABSTRACT FROM AUTHOR]

In breast radiology, ultrasound detection of biopsy markers or clips for localization purposes is often challenging, especially in the axilla. The purpose of this research was to test the hypothesis that the surface roughness of biopsy clips would elicit a twinkling signature on color Doppler, making them more readily identifiable by ultrasound. Ultrasound color Doppler imaging of 12 biopsy markers was performed and consensus scoring of the degree of twinkling (0 [no twinkling] to 4 [exuberant twinkling]) was obtained for each of the markers. The surface roughness characteristics of the markers were measured using 3-D coherence scanning interferometry. The 3 markers scoring at least 3 for twinkling in vitro were cork, Q and Vision. Of these 3 markers, only the cork marker scored a 4 ex vivo and in cadaveric tissue. Surface roughness metrics demonstrated a positive estimated correlation with the twinkling scores (rho = 0.33, 95% CI = [-0.48 to 0.84]). Of the 12 markers tested, the markers that twinkled corresponded to surface roughness measured with non-contact 3-D optical imaging. Qualitatively, lower color scales and color frequencies optimized twinkling, but the most specific qualitative predictor of confidence in twinkling was insensitivity to changes in color scale and color frequency values. [ABSTRACT FROM AUTHOR]

Introduction: Dog bites are a significant health concern in the pediatric population. Few studies published to date have stratified the injuries caused by dog bites based on surgical severity to elucidate the contributing risk factors. Methods: We used an electronic hospital database to identify all patients ≤17 years of age treated for dog bites from 2013-2018. Data related to patient demographics, injury type, intervention, dog breed, and payer source were collected. We extracted socioeconomic data from the American Community Survey. Data related to dog breed was obtained from public records on dog licenses. We calculated descriptive statistics as well as relative risk of dog bite by breed. Results: Of 1,252 injuries identified in 967 pediatric patients, 17.1% required consultation with a surgical specialist for repair. Bites affecting the head/neck region were most common (61.7%) and most likely to require operating room intervention (P = 0.002). The relative risk of a patient being bitten in a low-income area was 2.24, compared with 0.46 in a high-income area. Among cases where the breed of dog responsible for the bite was known, the dog breed most commonly associated with severe bites was the pit bull (relative risk vs German shepherd 8.53, relative risk vs unknown, 3.28). Conclusion: The majority of injuries did not require repair and were sufficiently handled by an emergency physician. Repair by a surgical specialist was required <20% of the time, usually for bites affecting the head/neck region. Disparities in the frequency and characteristics of dog bites across socioeconomic levels and dog breeds suggest that public education efforts may decrease the incidence of pediatric dog bites. [ABSTRACT FROM AUTHOR]

This study utilizes satellite data to investigate water quality conditions in the San Francisco Estuary and its upstream delta, the Sacramento--San Joaquin River Delta. To do this, this study derives turbidity from the European Space Agency satellite Sentinel-2 acquired from September 2015 to June 2019 and conducts a rigorous validation with in situ measurements of turbidity from optical sensors at continuous monitoring stations. This validation includes 965 matchup comparisons between satellite and in situ sensor data across 22 stations, yielding R² = 0.63 and 0.75 for Nephelometric Turbidity Unit and Formazin Nephelometric Unit (FNU) stations, respectively. This study then applies remote sensing to evaluate patterns in turbidity during the Suisun Marsh Salinity Control Gates Action ("Gates action"), a pilot study designed to increase habitat access and quality for the endangered Delta Smelt. The basic strategy was to direct more freshwater into Suisun Marsh, creating more low salinity habitat that would then have higher (and more suitable) turbidity than upstream river channels. For all seven acquisitions considered from June 29 to September 27, 2018, turbidity conditions in Bays and Sloughs subregions were consistently higher (and more suitable) (26-47 FNU) than what was observed in the upstream River region (13-25 FNU). This overall pattern was observed when comparing images acquired during similar tidal stages and heights. [ABSTRACT FROM AUTHOR]

Background Real-time reverse transcription polymerase chain reaction (rRT-PCR) and antigen tests are important diagnostics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sensitivity of antigen tests has been shown to be lower than that of rRT-PCR; however, data to evaluate epidemiologic characteristics that affect test performance are limited. Methods Paired mid-turbinate nasal swabs were collected from university students and staff and tested for SARS-CoV-2 using both Quidel Sofia SARS Antigen Fluorescent Immunoassay (FIA) and rRT-PCR assay. Specimens positive by either rRT-PCR or antigen FIA were placed in viral culture and tested for subgenomic RNA (sgRNA). Logistic regression models were used to evaluate characteristics associated with antigen results, rRT-PCR cycle threshold (Ct) values, sgRNA, and viral culture. Results Antigen FIA sensitivity was 78.9% and 43.8% among symptomatic and asymptomatic participants, respectively. Among rRT-PCR positive participants, negative antigen results were more likely among asymptomatic participants (odds ratio [OR] 4.6, 95% confidence interval [CI]: 1.3–15.4) and less likely among participants reporting nasal congestion (OR 0.1, 95% CI:.03–.8). rRT-PCR-positive specimens with higher Ct values (OR 0.5, 95% CI:.4–.8) were less likely, and specimens positive for sgRNA (OR 10.2, 95% CI: 1.6–65.0) more likely, to yield positive virus isolation. Antigen testing was >90% positive in specimens with Ct values < 29. Positive predictive value of antigen test for positive viral culture (57.7%) was similar to that of rRT-PCR (59.3%). Conclusions SARS-CoV-2 antigen test advantages include low cost, wide availability and rapid turnaround time, making them important screening tests. The performance of antigen tests may vary with patient characteristics, so performance characteristics should be accounted for when designing testing strategies and interpreting results. [ABSTRACT FROM AUTHOR]

Measures assessing marijuana-related consequences or problems experienced by young adults have typically been adapted from measures assessing alcohol consequences. These measures may not fully reflect the specific unwanted or perceived "not so good" effects of marijuana that are experienced by young adults. Thus, using these measures may present a gap, which needs to be addressed, given that reports of consequences are often utilized in brief motivational personalized feedback interventions. Data from three different studies of young adults were used to (1) examine self-reported "not so good" effects or consequences of marijuana use among frequent marijuana-using college students (Study 1), (2) create a new version of a marijuana consequences list and compare it to an existing marijuana consequences measure (Study 2), and (3) assess convergent and divergent validity between a finalized Marijuana Consequences Checklist (MCC, 26-items) and marijuana use and risk for cannabis use disorder (Study 3). The most frequently endorsed self-reported effects of marijuana included the impact on eating (the "munchies"), dry mouth, trouble concentrating, and acting foolish or goofy. Higher scores on the MCC were associated with more frequent use and a higher probability of meeting criteria for cannabis use disorder. The MCC represents a range of negative consequences of marijuana use derived from frequent users' own accounts and includes consequences not assessed by other measures. The MCC captures marijuana-specific negative consequences relevant for young adults, which can be incorporated in brief motivational personalized feedback interventions. [ABSTRACT FROM AUTHOR]

How did khipus—knotted cords that encode information—function within the economic systems of the postcolonial Andes? Best known as the method by which the Incas recorded administrative data, khipu use continued into the nineteenth and twentieth centuries. Few studies of modern khipus, however, have analyzed how khipu cords were integrated with the institutions of the modern state, such as the hacienda. This article examines a set of modern khipus from the Island of the Sun in Bolivia. These khipus, which contain dried potatoes and beans, are the first ever known to include agricultural produce. Our analysis demonstrates how the circulation of khipu styles within the Island of the Sun was linked to hacienda production, underscoring the intimate relationship between khipus and hacienda culture. Modern herding and crop khipus did not arise out of a generalized Andean consciousness but were products of specific historical and economic circumstances. [ABSTRACT FROM AUTHOR]

A 3D‐printed array of hollow microneedles (HMNs) is designed and fabricated using a high‐resolution stereolithography 3D printer and assembled with a 3D‐printed reservoir that incorporates a Luer lock mechanism, ensuring standard and secure connection to syringes. The proof‐of‐concept needle designs consist of half‐eccentric and concentric conical tip shapes, each arrayed with two different interspacing values. After the geometrical features of the devices are characterized, the devices are tested ex vivo in porcine skin to evaluate the impact of tip shape and interspacing on the depth of penetration and the efficacy of the devices in delivering fluids (such as tattoo ink) into the dermis. Overall, the 3D‐printed HMNs can deliver fluids into the target layer of skin. Refinement of the design is ongoing with the ultimate aim to provide alternatives for intradermal drug delivery and diagnostic imaging, such as superficial lymphography. [ABSTRACT FROM AUTHOR]

For the first time within living memory, the rural Roman Catholic parish of Talavera in the southcentral Peruvian Andes features only native clergy. By placing the Talaveran Catholic priests in theological and historical context, this article shows how this current generation of Catholic priests in Talavera must be understood within the context of the post–Vatican II Catholic Church in Latin America, which explicitly encouraged the training of native clergy and recast the relationship between the sacramental and the human as mutually compatible and constitutive. Although such initiatives are generally associated with liberal parishes unlike Talavera, the nouvelle theology that shaped Vatican II nevertheless meant that the dual nature of the Roman Catholic priesthood—as concretely human but also ineffably sacramental—fundamentally shapes the lay relationship with the Catholic priests in Talavera, too. The resulting tension between the priest as a sacramental mediator to the divine and the priest as a human man is continually renegotiated by laity and clergy alike, and is essential to understanding Catholic priests in Latin America and how lay parishioners experience the Catholic priesthood. [ABSTRACT FROM AUTHOR]

According to some recent analyses, the ethnographic encounter takes place between a complicit, colonialist, white discipline and "natives" who are colonized and implicitly nonwhite. But by insisting that anthropology is an inherently white discipline, such binary frameworks ultimately recenter Westernness and whiteness, reinforcing the centrality of Western and white anthropology. In doing so, they conflate phenotypic and structural whiteness, flatten out how anthropological whiteness compels nonwhite bodies to adopt a white habitus, and obfuscate the shifting, unstable role played by phenotype in this process. For anthropologists of color, even those born and trained in the West, the whiteness of anthropology is variable, context‐dependent, and unevenly distributed. This is illustrated with vignettes from ethnographic work in Peru, a country where racialization has typically been framed in terms of a white‐indigenous binary, and as operating like class rather than determined through descent or phenotype. [race, whiteness, ethnography, Asian American, Peru, Andes] [ABSTRACT FROM AUTHOR]

• Treatment of refractory granulomatous mastitis can be approached with targeted aspirations, intralesional corticosteroid injections, and clinical and sonographic breast diagrams for longitudinal follow-up. Literature on how to perform intralesional steroid injections, a valuable therapy for idiopathic granulomatous mastitis (IGM), is limited. This technical note offers a detailed technical guide on intralesional steroid injections for IGM and provides a framework for long-term follow-up. Ultrasound characterization of IGM severity considering breadth, depth, and ancillary findings was used to guide steroid dosing and injection frequency. Clinical and sonographic breast diagrams were designed for accurate longitudinal tracking of IGM. A step-by-step guide for ultrasound-guided IGM aspirations and intralesional steroid injections was developed. A detailed approach for ultrasound-guided IGM interventions with clinical and sonographic breast diagrams for longitudinal follow-up is now in practice. The treatment approach described provides a framework for multidisciplinary treatment of IGM and offers insights that may contribute to the ongoing development and improvement of management strategies for this challenging disease. [ABSTRACT FROM AUTHOR]

While research on embodied learning sheds light on the body's role during science learning, there is a lack of understanding of how the body is drawn upon in subsequent learning interactions. We seek to understand how the body supports cognition and learning during and after embodiment. We elaborate upon the liminal blends framework (Enyedy, N., Danish, J. A., & DeLiema, D. (2015). Constructing liminal blends in a collaborative augmented-reality learning environment. International Journal of Computer-Supported Collaborative Learning, 10(1), 7–34.) to understand how many resources are taken up, blended together, and progressively refined towards canonical scientific understanding. By tracing the body, we demonstrate that embodied experiences are never 'erased.' Instead, although students find ways to articulate understanding that do not require movement, they nonetheless derive meaning from prior embodied activity. Young children exceed expected grade level understanding in part because their capability as embodied reasoners is privileged for learning. In addition to expanding liminal blends theory, we suggest implications for designing technology-enhanced environments and science learning. Across all audiences, findings suggest the importance of privileging an array of sensemaking resources often excluded from classrooms, and the importance of students mapping multiple representational forms to develop conceptual understanding of science phenomena [ABSTRACT FROM AUTHOR]

The article discusses the nomadic states in Mongolia that started from the late Bronze Age. Topics discussed include a comparison of the rise and maintenance of nomadic societies, egalitarian nomadic societies, the pattern of social-political development and multiple ethnicities in Central Asian nomadic states.

Objective: Within the UPPS‐P model of impulsive personality, negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking dimensions have been linked to unique etiological mechanisms and outcomes. Yet, additional research is needed exploring direct relations among dimensions to determine how these relations may contribute to the nature of impulsive personality and its correlates. The current study used network analysis to clarify relations among UPPS‐P dimensions and assess global robustness of these relations across young adulthood. Method: Participants included a longitudinal sample of 525 college students (48% male, 18–26 years) who completed the UPPS‐P once per year for three consecutive years. Results: Network structure was globally robust with particularly strong relations emerging between positive and negative urgency, as well as between lack of premeditation and lack of perseverance, across waves. Lack of premeditation consistently emerged as a central dimension. Additional analyses suggested lack of premeditation and sensation seeking as most robustly related with retrospectively reported frequency of alcohol use. Conclusions: Results suggested general robustness in the relations among impulsive personality dimensions, with relations involving lack of premeditation being particularly important for characterizing impulsive personality's nature. Sensation seeking and lack of premeditation may warrant particular focus when linking impulsive personality with frequency of alcohol use. [ABSTRACT FROM AUTHOR]