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Abstract Clonal tracking of cells using somatic mutations permits exploration of clonal dynamics in human disease. Here, we perform whole genome sequencing of 323 haematopoietic colonies from 10 individuals with the inherited ribosomopathy Shwachman-Diamond syndrome to reconstruct haematopoietic phylogenies. In ~30% of colonies, we identify mutually exclusive mutations in TP53, EIF6, RPL5, RPL22, PRPF8, plus chromosome 7 and 15 aberrations that increase SBDS and EFL1 gene dosage, respectively. Target gene mutations commence in utero, resulting in a profusion of clonal expansions, with only a few haematopoietic stem cell lineages (mean 8, range 1-24) contributing ~50% of haematopoietic colonies across 8 individuals (range 4-100% clonality) by young adulthood. Rapid clonal expansion during disease transformation is associated with biallelic TP53 mutations and increased mutation burden. Our study highlights how convergent somatic mutation of the p53-dependent nucleolar surveillance pathway offsets the deleterious effects of germline ribosomopathy but increases opportunity for TP53-mutated cancer evolution.

Key Clinical Message We highlight the rare case of an atraumatic, intra‐articular ganglion cyst of the lateral knee deep to the iliotibial band that was successfully treated nonoperatively, a pathology yet to be reported in orthopedic literature. Abstract Ganglion cysts are mucin‐filled synovial cysts commonly found on the dorsal surface of the hands and feet. Intra‐articular ganglion cysts of the knee are rare, and when they present clinically, are typically treated operatively through arthroscopic surgery. We present the first reported case of an atraumatic intraarticular, extra‐synovial ganglion cyst of the lateral knee located deep to the iliotibial band that was successfully treated without operative intervention through repeated intra‐articular aspirations of the knee.

Ulnar collateral ligament (UCL) injuries commonly occur in overhead athletes as a result of excess valgus stress on the elbow and can be functionally debilitating, requiring surgical intervention. Since the advent of the first initial UCL reconstruction technique pioneered by Dr. Frank Jobe performed on professional baseball player Tommy John, UCL, or Tommy John Ligament reconstruction has successfully returned athletes to sport following injury and shown enhanced clinical outcomes with minimal complication rates. Tommy John surgery continues to evolve with the development of various techniques over recent years. This technical note describes a UCL repair with an internal brace using knotless suture anchors and aims to contribute to the current literature a technique that is efficacious and reproducible and offers satisfactory stability, functionality, and return to play.

Purpose: To examine trends of population-level semen quality over a 20-year period. Materials and Methods: We performed a retrospective review of data from the andrology lab of a high volume tertiary hospital. All men with semen samples between 2000 and 2019 were included and men with azoospermia were excluded. Semen parameters were reported using the World Health Organization (WHO) 4th edition. The primary outcome of interest was changes in semen parameters over time. Generalized least squares (GLS) with restricted cubic splines were used to estimate average-monthly measurements, adjusting for age and abstinence period. Contrasts of the estimated averages based on GLS between the first and last months of collection were calculated. Results: A total of 8,990 semen samples from subfertile non-azoospermic men were included in our study. Semen volume decreased over time and estimate average at the beginning and end were statistically different (p

Abstract Background Clinical trials evaluating immune checkpoint inhibition (ICI) in recurrent high‐grade gliomas (rHGG) report 7%–20% 6‐month progression‐free survival (PFS), while re‐irradiation demonstrates 28%–39% 6‐month PFS. Aims We evaluate outcomes of patients treated with ICI and concurrent re‐irradiation utilizing stereotactic body radiotherapy/fractionated stereotactic radiosurgery (SBRT) compared to ICI monotherapy. Methods and Results Patients ≥18‐years‐old with rHGG (WHO grade III and IV) receiving ICI + SBRT or ICI monotherapy between January 1, 2016 and January 1, 2019 were included. Adverse events, 6‐month PFS and overall survival (OS) were assessed. Log‐rank tests were used to evaluate PFS and OS. Histogram analyses of apparent diffusion coefficient maps and dynamic contrast‐enhanced magnetic resonance perfusion metrics were performed. Twenty‐one patients with rHGG (ICI + SBRT: 16; ICI: 5) were included. The ICI + SBRT and ICI groups received a mean 7.25 and 6.2 ICI cycles, respectively. There were five grade 1, one grade 2 and no grade 3–5 AEs in the ICI + SBRT group, and four grade 1 and no grade 2–5 AEs in the ICI group. Median PFS was 2.85 and 1 month for the ICI + SBRT and ICI groups; median OS was 7 and 6 months among ICI + SBRT and ICI groups, respectively. There were significant differences in pre and posttreatment tumor volume in the cohort (12.35 vs. 20.51; p = .03), but not between treatment groups. Conclusions In this heavily pretreated cohort, ICI with re‐irradiation utilizing SBRT was well tolerated. Prospective studies are warranted to evaluate potential therapeutic benefits to re‐irradiation with ICI + SBRT in rHGG.

Background: Primary care physicians (PCPs) are often gatekeepers to specialist care. This study assessed the relationship between PCP density and total knee (TKA) and total hip arthroplasty (THA) outcomes. Methods: We obtained patient-level data from an institutional registry on patients undergoing elective primary TKA and THA for osteoarthritis, including Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at baseline and 2 years. Using geocoding, we identified the number of PCPs in the patient’s census tract (communities). We used Augmented Inverse Probability Weighting and Cross-validated Targeted Minimum Loss-Based Estimation to compare provider density and outcomes adjusting for potential confounders. Results: Our sample included 3606 TKA and 4295 THA cases. The median number of PCPs in each community was similar for both procedures: TKA 2 (interquartile range 1, 6) and for THA 2 (interquartile range 1, 7). Baseline and 2-year follow-up WOMAC pain, function, and stiffness scores were not statistically significantly different comparing communities with more than median number of PCPs to those with less than median number of PCPs. In sensitivity analyses, adding 1 PCP to a community with zero PCPs would not have statistically significantly improved baseline or 2-year follow-up WOMAC pain, function, and stiffness scores. Conclusions: In this sample of patients who underwent elective TKA or THA for osteoarthritis, we found no statistically significant association between PCP density and pain, function, or stiffness outcomes at baseline or 2 years. Further studies should examine what other provider factors affect access and outcomes in THA and TKA.

Abstract Dysregulation of the immune system can initiate chronic inflammatory responses that exacerbate disease pathology. Multipotent adult progenitor cells (MAPC cells), an adult adherent bone-marrow derived stromal cell, have been observed to promote the resolution of uncontrolled inflammatory responses in a variety of clinical conditions including acute ischemic stroke, acute myocardial infarction (AMI), graft vs host disease (GvHD), and acute respiratory distress syndrome (ARDS). One of the proposed mechanisms by which MAPC cells modulate immune responses is via the induction of regulatory T cells (Tregs), however, the mechanism(s) involved remains to be fully elucidated. Herein, we demonstrate that, in an in vitro setting, MAPC cells increase Treg frequencies by promoting Treg proliferation and CD4+ T cell differentiation into Tregs. Moreover, MAPC cell-induced Tregs (miTregs) have a more suppressive phenotype characterized by increased expression of CTLA-4, HLA-DR, and PD-L1 and T cell suppression capacity. MAPC cells also promoted Treg activation by inducing CD45RA+ CD45RO+ transitional Tregs. Additionally, we identify transforming growth factor beta (TGFβ) as an essential factor for Treg induction secreted by MAPC cells. Furthermore, inhibition of indoleamine 2, 3-dioxygenase (IDO) resulted in decreased Treg induction by MAPC cells demonstrating IDO involvement. Our studies also show that CD14+ monocytes play a critical role in Treg induction by MAPC cells. Our study describes MAPC cell dependent Treg phenotypic changes and provides evidence of potential mechanisms by which MAPC cells promote Treg differentiation.

This article analyzes the use of several response particles in face-to-face interaction in Wa’ikhana, an East Tukano language of northwestern Amazonia. Adopting a Conversation Analysis approach, we explore details of each particle, considering their prosodic shapes, the action contexts in which they occur, and their sequential positioning, all crucial to understanding their meanings in interaction. Our analysis shows that Wa’ikhana response particles exhibit both universal and language-particular properties, thus demonstrating the contributions of data from lesser-studied languages to research on language in social interaction, and the value of an interactional approach in the study of under-described, and often endangered, indigenous languages. --------------------------------------------------------------------------------- ANALISANDO PARTÍCULAS EM WA’IKHANA Este artigo analisa o uso de um conjunto de partículas responsivas em interação cotidiana em Wa’ikhana, língua da família Tukano Oriental, falada no noroeste amazônico. Adotando a abordagem da Análise de Conversação, exploramos detalhes de cada partícula, considerando sua forma prosódica, o contexto de ação em que ocorre e sua posição sequencial, todos cruciais para o entendimento do seu significado em interação. Nossa análise mostra que partículas responsivas em Wa’ikhana exibem propriedades universais e próprias, demonstrando a contribuição de dados provindos de línguas pouco conhecidas à pesquisa sobre linguagem e interação social, bem como o valor da abordagem interacional no estudo de línguas indígenas pouco estudadas e muitas vezes ameaçadas. --- Original em inglês.

Background: The primary objective was to compare the overall diagnostic performance, presented as detection rate of 68Ga-PSMA-HBED-CC positron emission tomography/magnetic resonance imaging (PSMA PET/MRI) versus conventional, multiparametric MRI (mpMRI) in a population of patients with biochemically recurrent prostate cancer. In conjunction with this analysis, secondary objectives included the evaluation of the detection rate stratified by PSA levels and primary treatment modality. Methods: A total of 165 PSMA PET MRI were performed from April 2018 to May 2021, of whom 108 were presenting for biochemical recurrent disease. The PSMA PET vertex to thigh were read by two different board-certified nuclear medicine physicians while the MRI head and neck, chest, abdomen, and pelvis (with dedicated, PI-RADS compliant multiparametric prostate MRI) were read by two board certified diagnostic radiologists. Analysis: PSMA PET/MRI had a higher detection rate than mpMRI when evaluating patients with biochemical recurrence (BCR) with similar results demonstrated when sub-analysis was performed using PSA levels, primary treatment modality, and time since androgen deprivation therapy. Our study also showed PSMA PET/MRI had a higher sensitivity than mpMRI. Discussion: Our findings demonstrate that PSMA PET/MRI is a better imaging modality in the detection of disease in the setting of BCR when compared to MRI alone. Combined utility with PSMA PET/MRI is a powerful tool which can aid in not only the detection of disease, but also guide in treatment planning for prostate cancer patients.

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: Surgical correction of the collapsing flatfoot deformity has been well studied in the literature, with the average patient being a female in her 50s. While reconstruction of the flexible, symptomatic flatfoot in children and adolescents has been described, assessment of outcomes across age groups is limited. Therefore, the purpose of our study is to compare the clinical and radiographic outcomes in younger patients 30 years or less undergoing flatfoot reconstruction with that of older patients. In addition, the procedures performed for reconstruction and the incidence of subsequent reoperations were compared between the two groups. Methods: Ninety-four feet (51 left, 43 right) in 87 patients who underwent reconstruction for flexible collapsing flatfoot deformity were divided into 2 groups based on age: 30 years (n=72). Exclusion criteria included tarsal coalition or neuromuscular disease. Average age and BMI was 20.8 years (range, 13 to 30) and 26.8 (range, 18 to 38) in the younger cohort, and 57.5 years (range, 35 to 81) and 29.8 (range, 18 to 46) in the older cohort. Preoperative and minimum 2-year postoperative PROMIS scores were compared. Average follow-up was 30.6 and 27 months in the younger and older cohorts, respectively. We assessed five radiographic parameters both preoperatively and postoperatively, including talonavicular (TN) coverage angle, lateral talo-first metatarsal angle (Meary’s), lateral talocalcaneal angle, calcaneal pitch, and hindfoot moment arm (HMA). Operative reports and hospital records were reviewed to compare procedures performed for reconstruction as well as subsequent reoperations. Results: Younger patients demonstrated significant preoperative to postoperative improvements in Physical Function (p=0.01), Pain Interference (p

Category: Midfoot/Forefoot; Other Introduction/Purpose: Severe adult-acquired flatfoot deformity (AAFD) is often associated with painful medial column collapse at the naviculocuneiform (NC) joint. The purpose of this study was to examine the role of first tarsometatarsal (1st TMT) fusion combined with subtalar fusion in correcting deformity at this joint. Methods: We retrospectively analyzed 40 patients (41 feet) who underwent 1st TMT and subtalar (ST) fusion as part of a flatfoot reconstructive procedure. We assessed six radiographic parameters both preoperatively and at a minimum of 6 months postoperatively, including talonavicular (TN) coverage angle, lateral talo-first metatarsal angle, lateral talocalcaneal angle, calcaneal pitch, hindfoot moment arm, and a newly defined navicular-cuneiform incongruency angle (NCIA). Patient-Reported Outcomes Measurement Information System (PROMIS) clinical outcomes were assessed preoperatively and at a minimum 1 year follow-up. Results: The NCIA demonstrated excellent interobserver reliability, with no significant change between pre- and postoperative measurements. All other radiographic parameters, except calcaneal pitch, demonstrated statistically significant improvement postoperatively (p

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Hallux valgus can alter load bearing in the foot and may result in secondary pathologies such as hammertoes of the second ray. However, there has been little research on the development of second ray pathology in patients with pre-existing hallux valgus. Additionally, most research examining these three-dimensional foot deformities relies on two- dimensional plain radiographs. The goal of this study was to determine if hallux valgus is associated with second ray hammertoes using three-dimensional weightbearing CT scans. Methods: 71 patients who underwent a modified Lapidus procedure for hallux valgus and had preoperative weightbearing CT scans were separated into 2 outcome groups: (1) hallux valgus only (47 feet), and (2) hallux valgus with second ray hammertoe (29 feet). Preoperative age, BMI, sex, hallux valgus angle (HVA), intermetatarsal angle (IMA), absolute and effective first, second, and third metatarsal lengths, the ratios between metatarsal lengths, Meary’s angle, metatarsus adductus angle (MAA), and pronation were measured. Mean values of continuous variables were compared using one-way ANOVA tests or Kruskal-Wallis tests. Simple logistic regression models were created to evaluate associations between variables and hammertoe occurrence: (1) comparing hammertoe to hallux valgus only, (2) comparing hammertoe to hallux valgus with mild hammertoe removed, and (3) comparing hammertoe to hallux valgus with severe hammertoe removed. Multivariable logistic regression models were generated to evaluate potential risk factors for hammertoe after adjusting for patient age and BMI. Results: Patients in the hammertoe group were found to be significantly older and have significantly higher BMIs, HVAs, effective second MT lengths, IMAs, and more apex plantar Meary’s angles (all P-values < 0.05). BMI and HVA were also found to be significant predictors of second ray hammertoe in simple logistic regression models (OR=5.66 (95% CI: 1.67-22.79) and OR=4.5 (95% CI: 1.13-21.06), respectively). The multivariable analysis demonstrated that higher IMA and a more apex plantar Meary’s angle were the only significant predictors of second ray hammertoe risk (P= 0.03 and P = 0.01, respectively) once corrected for age and BMI. Conclusion: Significant associations were found between older age, higher BMI, and more severe deformity and the occurrence of hammertoe in hallux valgus patients. These relationships may aid in determining which patients are at a greater risk of progressing to secondary pathologies and which patients could potentially benefit from earlier surgical intervention to correct hallux valgus.

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Lapidus procedure and Scarf osteotomy are indicated for treatment of mild to moderate hallux valgus. Advantages of modified Lapidus procedure include ability to address severe deformity, first tarsometatarsal arthritis, and first ray hypermobility. Advantages of Scarf osteotomy include greater correction of the distal metatarsal articular angle (DMAA) and greater fixation stability than other techniques. Both procedures have shown good radiographic and clinical outcomes; however, no prior studies have compared these outcomes between the procedures. The aim of this study was to compare clinical and radiographic outcomes between patients with hallux valgus treated with the modified Lapidus procedure or Scarf osteotomy. Methods: This retrospective cohort study included patients treated by one of seven fellowship-trained foot and ankle surgeons were identified. Inclusion criteria were age greater than 18 years, primary modified Lapidus procedure or Scarf osteotomy for hallux valgus, minimum 1-year postoperative PROMIS scores, and minimum 3-month postoperative radiographs. Revision cases were excluded. Clinical outcomes were assessed using six PROMIS domains: Pain Interference, Pain Intensity, Physical Function, Global Mental Health, Global Physical Health, and Depression. Pre- and postoperative radiographic parameters were measured on AP (HVA, IMA, DMAA, tibial sesamoid position), and lateral (talo-1st-metatarsal angle (Meary’s), Horton index, Seiberg index, sagittal IMA) x-rays. Statistical analysis utilized targeted maximum likelihood estimation controls for confounding of bunion severity by including covariates for baseline HVA and IMA. Statistics were also analyzed in a restricted cohort of mild to moderate severity bunions (HVA

Background: Operative correction of flatfoot deformity has been well studied in the older population. There is a subset of younger patients without congenital foot deformity that also develop a collapsing flatfoot. However, assessment of outcomes across age groups is limited, especially in the young demographic. The purpose of our study was to compare operative outcomes of flatfoot reconstruction between these 2 age groups. Methods: Seventy-six feet (41 left, 35 right) in 71 patients who underwent flexible flatfoot reconstruction were divided into 2 groups based on age: ≤30 years (n = 22) and >30 years (n = 54). Exclusion criteria included congenital causes of flatfoot (tarsal coalition, vertical talus, overcorrected clubfoot). Average age was 20.8 years (range, 14-30) and 55.4 years (range, 35-74) in the younger and older cohorts, respectively. Preoperative and minimum 2-year postoperative Patient-Reported Outcomes Measurement Information Systems (PROMIS) scores were compared. Five radiographic parameters were assessed pre- and postoperatively: talonavicular coverage angle, lateral talo–first metatarsal angle, lateral talocalcaneal angle, calcaneal pitch, and hindfoot moment arm. Procedures performed and incidence of minor (removal of symptomatic hardware) and major (revision) reoperations were compared. Results: Younger patients were less likely to undergo flexor digitorum longus transfer, first tarsometatarsal fusion, spring ligament repair, and posterior tibial tendon repair (all P < .05). Both younger and older cohorts demonstrated significant improvement in multiple PROMIS domains at an average follow-up of 30.6 (range, 24-44) and 26.8 (range, 24-45) months, respectively ( P = .07). Younger patients demonstrated significantly higher pre- and postoperative Physical Function (mean difference postoperatively, 4.6; 95% confidence interval, 1.5-7.8; P = .03). There were no differences in radiographic parameters postoperatively. There were 8 (36.4%) reoperations (all minor) in the younger group, and 21 (38.9%) reoperations (6 major, 15 minor) in the older group ( P = .84). Conclusion: Our data suggest that age may play a role in clinical outcomes, procedures indicated, and subsequent corrective reoperations. Younger patients maintained greater physical function with comparable radiographic correction, with less frequent indication for tendon transfers, arthrodesis, and additional corrective surgeries. Level of Evidence: Level III, retrospective comparative study.

While heterogeneous catalysts can act as tangible, efficient materials for energy conversion, understanding the active catalytic sites is challenging. Here, authors engineer specific catalytic sites into molybdenum sulfide to improve and elucidate hydrogen evolution electrocatalysis.

Context: Multiple angles of the craniocervical junction (CCJ) are associated with pathological conditions and surgical outcomes, including the clivo-axial angle (CXA), clival slope (CS), and sagittal axis (XS). However, there are varying normative ranges reported and a paucity of data analyzing the effects of imaging modality, age, and gender on these angles. Setting and Design: A retrospective review of computed tomographic (CT) and magnetic resonance imaging (MRI) scans in fifty adults without CCJ pathology from 2014 to 2019. Methods: Age, gender, indication, and hours between scans were recorded. Two-blinded observers measured all angles. Analysis between angles from the same patient was performed using the Wilcoxon signed-rank test. Multivariable linear regression was used to test for associations between average angles and age or gender. Results: Average age and time between scans were 41.3 and 14.3 h, respectively, with 94% performed due to trauma. On CT, average CXA, CS, and XS were 162.1°, 118.4°, and 81.3°, respectively. On MRI, they were 159.8°, 117.2°, 85.3°, respectively. There were statistically significant differences between CXA and XS (P < 0.01) based on imaging modality. On CT, there was a significant increase in XS by 1.93°° and decrease in CS by 1.88°° and on MRI, there was a significant increase in CXA by 1.93°° and decrease in CS by 2.75°° corresponding with a 10-year advancement of age. Gender did not have an effect. Conclusion: There are significant differences in angular measurements of the CCJ between CT and MRI from the same patient, as well as changes in normative values based on age.

Negative capacitance (NC) field-effect transistors (FETs) with 2-D semiconducting channels have become increasingly attractive due to their ability to produce sub-60 mV/dec switching behavior in a physically scalable device. However, it has yet to be determined how gate control, including threshold voltage, of 2-D NC-FETs is impacted by gate dielectric composition, along with dielectric and ferroelectric layer thicknesses. Here, we show the threshold voltage shifts positively under increasing ferroelectric thickness and negatively with increasing dielectric thickness. This shifting behavior is observed in devices without an interfacial metal layer between the ferroelectric hafnium zirconium oxide (HfZrO2 or HZO) and dielectric. Because the interface between the ferroelectric and dielectric is critical in driving NC behavior, we also study 2-D NC-FETs with 4 nm HZO paired with different dielectrics. These results reveal that the HZO/Al2O3 interface is more favorable than either the HZO/ZrO2 or HZO/HfO2 interfaces. Finally, the impact of an interfacial metal layer is discussed by comparing the 2-D NC-FET performance of similar devices with and without this layer.

Background: Hallux valgus can alter load bearing in the foot leading to abnormal forces on the second toe. The purpose of this study was to determine demographic and radiographic factors associated with second ray hammertoes in hallux valgus using 3-dimensional weightbearing CT scans. Methods: Seventy-one patients who underwent a modified Lapidus procedure for hallux valgus with preoperative weightbearing CT scans were separated into 2 groups: (1) hallux valgus only (47 feet) and (2) hallux valgus with second ray hammertoe (29 feet). Preoperative age, body mass index (BMI), sex, hallux valgus angle (HVA), intermetatarsal angle (IMA), absolute and effective metatarsal (MT) lengths, ratios between metatarsal lengths, Meary angle, metatarsus adductus angle (MAA), and pronation were measured. Mean values of continuous variables were compared and both simple and multivariable logistic regression models were used to evaluate associations between variables and hammertoe occurrence. Results: Patients in the hammertoe group were found to be significantly older and have higher BMIs, HVAs, effective second MT lengths, IMAs, and more apex plantar Meary angles (all P < .05). The multivariable analysis demonstrated that a higher IMA and a more apex plantar Meary angle were the only significant predictors of second ray hammertoe risk ( P = .03 and P = .01, respectively) once corrected for age and BMI. Conclusion: Significant associations were found between older age, higher BMI, and more severe deformity and the occurrence of hammertoe in hallux valgus patients. These results may help clinicians counsel hallux valgus patients about the risk of developing an advanced hammertoe deformity. Level of Evidence: Level III, retrospective comparative series

Many cities are grappling with how to regulate new shared mobility modes, including dockless e-scooters and bikes (i.e., “micromobility”). Transportation planners in these cities are particularly concerned about micromobility parking regulations, which have implications for the safety and mobility of riders and the general public. In this research, we investigate the parking practices as well as the frequency and types of parking violations of three types of vehicles operating on city sidewalks and streets: e-scooters, bikes, and motor vehicles. We collected original data on 3666 e-scooters, bikes, motor vehicles, and sidewalk objects in Austin, TX, Portland, OR, San Francisco, CA, Santa Monica, CA, and Washington, DC, to examine micromobility and motor vehicle parking practices. We find that motor vehicles impede access far more (24.7%) than bikes (0.3%) and e-scooters (1.7%). Ride-hail and food delivery drivers disproportionately impede access. Motor vehicles often impeded other travelers' access when dropping off or picking up people or food while double parking, parking in “No Parking” areas, or blocking driveways. Our findings suggest that micromobility companies are just one of several technology-enabled transportation services that should motivate cities to rethink parking policies.

San alt seo cuirtear síos ar na hainmneacha éagsúla Gaeilge atá ar ‘goosegrass’ (Galium aparine) agus pléitear an t‑ainm athabha (Oenanthe crocata) freisin. Tá ‘goosegrass’ flúirseach in Éirinn agus tá níos mó ná ainm amháin Gaeilge air. Tagraíonn na hainmneacha do ghairbhe an phlanda agus don chaoi a ngreamaíonn idir phlanda agus shíolta d’fhionnadh ainmhithe agus d’éadach daoine. Is tagairt an t‑ainm is spéisiúla don úsáid a bhaintí as G. aparine chun bainne a scagadh, feidhm a bhí le fáil de réir cosúlachta i measc na Sean-Ghréagach. Tá O. crocata ar cheann de na plandaí dúchasacha is nimhiúla in Éirinn. Cé go ndealraíonn sé go dtugtaí an t‑ainm athabha agus a sheachfhoirmeacha dathabha agus tathabha ar phlandaí eile, is léir nach mbaintí feidhm as an ainm ach le tagairt do phlandaí fíornimhiúla. Ar an ábhar sin, moltar an t‑ainm athabha, ar tagairt é dá chontúirtí is atá an planda, agus an tsanasaíocht á cíoradh san alt seo.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

How does a revolution such as the Cuban one arrive at the rural backwaters of the country? How do the citizens in a destitute area relate to a national, revolutionary process, given that “national” and “revolutionary” were hardly concepts that used to apply to their everyday lives? The Sierra del Rosario is today a UNESCO biosphere reserve with the model community of Las Terrazas inside it but prior to the revolution, it was a particularly poverty-stricken area. I would therefore like to suggest a few arguments, based on oral histories recorded in Las Terrazas in 2007 and 2008, as well as further interview sources, to sketch its remarkable development. In short, the argument put forward here is that the development scheme for the Sierra del Rosario, which transformed the landscape and (re)created a community in Las Terrazas, meant that the revolution finally arrived in the Sierra del Rosario, and today its living standards and economic and social success even outperform that of Cuba as a whole. The examples used and the arguments put forward are by no means exhaustive but should serve as part of a debate and hopefully/maybe even spark off further research into the question. All interviews (unless where otherwise stated) were recorded by the author in 2007 and 2008.

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency. Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums. Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status. Conclusion: Lessons learned from these state-wide community health forums can be applied to improve the overall process of gathering data for a comprehensive CHA throughout Georgia or other areas interested in pursuing public health agency accreditation.

Background: Public Health for Young Adults Day (PHYA Day) is a one-day program designed to educate high school-age students about the principles and values of the five core areas of public health. The goal of PHYA Day is to foster interest and ultimately increase recruitment into the field of public health. This goal is essential due to the impact of the economic recession of 2008. It was estimated that the local public health workforce decreased from 191,000 to 168,000 across the nation between 2008 and 2013. In spite of 2008’s recession, a well-trained, competent public health workforce remains an imperative component of effective public health service delivery. The researchers believe that PHYA Day encourages young people to explore the idea of a public health-focused career by increasing their knowledge of the field as a whole. Methods: A pre- and post-test survey was used to evaluate this program, determine if participants gained an interest in joining the public health workforce, and measure the learning outcomes of those participants. After gaining proper Institutional Review Board approval the evaluation was completed in April 2015. Results: When the averages of the post-test were compared to those of the pre-test the results showed that there was a significant gain in knowledge among participants. Conclusions: Based off of their findings the researchers were able to conclude that PHYA Day is effective in educating high school age students about the options that the public health field have to offer and therefore may increase the number of young adults choosing public health as a career.

Los esfuerzos para construir una Identidad Europea de Seguridad y Defensa (IESD)recibieron un impulso importante tras la experiencia yugoslava, que revitalizó la OTAN y mostró a los países europeos sus limitaciones. Estas se evidenciaron especialmente tras la decisión, adoptada en 1996 en Berlín por los ministros de asuntos exteriores delos países de la Alianza, de construir la IESD dentro del marco OTAN. Williams revisa los futuros retos de la IESD a la luz de la ampliación de la OTAN, el fortalecimiento del Partenariado para la Paz y el Acta Fundacional firmada por Rusia. También repasa la iniciativa de diálogo entre la OTAN y algunos países del Mediterráneo, señalando al menos tres factores que pueden afectar su evolución: el propio mensaje de la OTAN, que indica a la vez la voluntad de cooperar con esos países y la amenaza que representala proliferación de armas de destrucción masiva en el Mediterráneo; la apariencia de que la OTAN está construyendo estructuras militares en su flanco sur; y la evidente triplicidad entre la UEO, la UE y la OTAN en el debate sobre acuerdos de seguridad en el Mediterráneo.