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Objectives: There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs. Method: Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians. Results: The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts. Conclusion: All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience. [ABSTRACT FROM AUTHOR]

Socio‐scientific issues (SSI) instruction positions the understanding and practice of science in the context of issues that are informed by science but require reasoning about their societal dimensions to respond to those issues effectively. For this reason, instruction in the context of SSI has been considered the gateway to contemporary visions of scientific literacy. SSI instruction is often framed in line with the Socio‐Scientific Issues Teaching and Learning (SSI‐TL) framework, which is prominent in the literature and well‐used by researchers to frame professional development but potentially less familiar to classroom teachers. Given that teachers are likely familiar with the 5E learning cycle, they might experience an easier transition to developing and facilitating SSI instruction using the SSI‐TL model if framed through a lens of 5E. In this article, we unpack the SSI‐TL model of instruction through a 5E lens, then provide an exemplary prototype of the new SSI‐TL infused 5E instruction in the context of a globally relevant SSI to highlight the overlap between engagement in essential science practices and socio‐scientific reasoning. We hope that teachers become more comfortable developing science literacy by addressing both science and societal dimensions of contemporary SSI by considering the SSI‐TL Framework through a 5E lens. [ABSTRACT FROM AUTHOR]

Introduction: To compare responses to basal insulin glargine 300 U/ml (IGlar‐300) and 100 U/ml (IGlar‐100) in newly defined subphenotypes of type 2 diabetes. Methods: Insulin‐naive participants (n = 858) from the EDITION 3 trial were assigned to subphenotypes 'Mild Age‐Related Diabetes (MARD)', 'Mild Obesity Diabetes (MOD)', 'Severe Insulin Resistant Diabetes (SIRD)' and 'Severe Insulin Deficient Diabetes (SIDD)'. Key variables were analysed at baseline and 26 weeks. Results: Participants were comprised of MOD 56.1% (n = 481), SIDD 22.1% (n = 190), MARD 18.2% (n = 156) and SIRD 3.0% (n = 26). After 26 weeks a similar decrease in glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) of 16‐19 mmol/mol and 1.4‐1.7 mmol/L, respectively, occurred in MARD and MOD with both insulins. SIDD had the most elevated HbA1c and FPG (80‐83 mmol/mol/11.1‐11.4 mmol/L) and reduction in both HbA1c and FPG was greater with IGlar‐100 than with IGlar‐300 (−18 vs. −15 mmol/mol and −1.6 vs. −1.3 mmol/L, respectively; each p =.03). In SIDD, despite receiving the highest basal insulin doses, HbA1c decline (57‐60 mmol/mol/7.3‐7.6%) was suboptimal at week 26. In MOD and SIDD lower incidences with IGlar‐300 were found for level 1 nocturnal hypoglycaemia [odds ratio (OR) 0.59, 95% confidence intervals (CI) 0.36‐0.97; OR 0.49, 95% CI 0.24‐0.99]. In addition, fewer level 2 hypoglycaemia episodes occurred at any time with IGlar‐300 in SIDD (OR 0.31, 95% CI 0.13‐0.77). Conclusion: Both insulins produce comparable outcomes in type 2 diabetes subphenotypes, but in SIDD, add‐on treatment to basal insulin is required to achieve glycaemic targets. [ABSTRACT FROM AUTHOR]

Although argumentation is a critical historical component of scientific literacy, the recent coronavirus pandemic and associated issues have highlighted the importance of argumentation in science practice. Argumentation that aligns with functional scientific literacy requires gathering evidence and reasoning to support or refute claims related to socioscientific issues (SSI)--those informed by science but also affected by society. In this article, we present a 5E module that models argumentation instruction while scaffolding preservice elementary teachers' argumentation practice in the context of SSI. To do so, we introduced the claim-evidence-reasoning argumentation framework. In this approach, students responded to potential solutions to SSI related to the coronavirus (claim), supported their responses with data (evidence), and justified how the evidence they provided supported their responses (reasoning). Specifically, preservice elementary teachers completed diverse argumentation tasks--starting with more traditional scientific argumentation and building toward recognizing and addressing nonscientific, cross-curricular issues--to develop effective argumentation practice concerning contemporary SSI. [ABSTRACT FROM AUTHOR]

Kids are drawn to dolls and dump trucks, and crashing the two together might just be a child's favorite pastime. Who knew such a simple pleasure could serve as an accessible, compelling phenomenon for instigating investigations of force and motion. With a few inexpensive materials straight out of the toy box (literally, a doll, a dump truck, a ramp, and some weights), teachers can set up and facilitate a whole suite of Crash Test Physics investigations that are easily adaptable, and that have been effectively piloted in classrooms, festivals, and outreach events alike with student populations that range from preschool to pre-service elementary teachers. [ABSTRACT FROM AUTHOR]

The article discusses Roots of Normativity (Roots) is the last work Joseph Raz published before his death in May 2022. Like many of his books it is a collection of papers. Some focus on issues that will likely be of most interest to philosophers of mind and ethics, topics such as the nature of intention, the binding force of a promise, the components of human well-being and the theoretical significance of the notion of a reason.

Introduction: This study aimed to evaluate glycemic outcomes in subphenotypes of type 2 diabetes (T2D) with HbA1c > 7.0%, previously on basal insulin (pre-BI) alone (≥ 42 U/day) or on basal-bolus therapy (pre-BB), and who were switched to either basal insulin glargine 300 U/mL (IGlar-300) or 100 U/mL (IGlar-100), with or without pre-prandial insulin.Participants from EDITION 2 (pre-BI, n = 785), and EDITION 1 (pre-BB, n = 792) trials were assigned retrospectively to subphenotypes of T2D: severe insulin deficient diabetes (SIDD), mild age-related diabetes (MARD), mild obesity diabetes (MOD), and severe insulin resistant diabetes (SIRD). Key efficacy and safety parameters were analyzed at baseline, and after 26 weeks, for IGlar-300 and IGlar-100 pooled groups according to subphenotypes. Outcomes were also compared with insulin-naïve subphenotypes on oral antihyperglycemic drugs (OADs) from the EDITION 3 trial (pre-OAD, n = 858).Pre-BI and pre-BB treated subphenotypes with SIDD had a higher mean HbA1c (8.9% and 9.1%) at baseline compared to those of MARD (7.7% and 7.8%) and MOD (8.1% and 8.2%) and after 26 weeks remained above target HbA1c (7.7% and 8.0%) despite mean glargine doses of 0.7 to 1.0 U/kg/day and pre-prandial insulin use in the pre-BB SIDD subgroup. Pre-BB treated individuals with MARD and MOD achieved lower HbA1c levels (6.9% and 7.2%) than the pre-BI groups (7.3% and 7.5%) despite similar mean FPG levels (123–130 mg/dL). Only 19–22% of participants with SIDD achieved HbA1c < 7.0% compared to 33–51% with MARD and MOD, respectively. Pre-BI and pre-BB treated subphenotypes experienced more hypoglycemia than pre-OAD treated subphenotypes.Individuals with T2D assigned post hoc to the SIDD subphenotype achieved suboptimal glycemic control with glargine regimens including basal-bolus therapy, alerting clinicians to improve further diabetes treatment, particularly post-prandial glycemic control, in individuals with SIDD.Methods: This study aimed to evaluate glycemic outcomes in subphenotypes of type 2 diabetes (T2D) with HbA1c > 7.0%, previously on basal insulin (pre-BI) alone (≥ 42 U/day) or on basal-bolus therapy (pre-BB), and who were switched to either basal insulin glargine 300 U/mL (IGlar-300) or 100 U/mL (IGlar-100), with or without pre-prandial insulin.Participants from EDITION 2 (pre-BI, n = 785), and EDITION 1 (pre-BB, n = 792) trials were assigned retrospectively to subphenotypes of T2D: severe insulin deficient diabetes (SIDD), mild age-related diabetes (MARD), mild obesity diabetes (MOD), and severe insulin resistant diabetes (SIRD). Key efficacy and safety parameters were analyzed at baseline, and after 26 weeks, for IGlar-300 and IGlar-100 pooled groups according to subphenotypes. Outcomes were also compared with insulin-naïve subphenotypes on oral antihyperglycemic drugs (OADs) from the EDITION 3 trial (pre-OAD, n = 858).Pre-BI and pre-BB treated subphenotypes with SIDD had a higher mean HbA1c (8.9% and 9.1%) at baseline compared to those of MARD (7.7% and 7.8%) and MOD (8.1% and 8.2%) and after 26 weeks remained above target HbA1c (7.7% and 8.0%) despite mean glargine doses of 0.7 to 1.0 U/kg/day and pre-prandial insulin use in the pre-BB SIDD subgroup. Pre-BB treated individuals with MARD and MOD achieved lower HbA1c levels (6.9% and 7.2%) than the pre-BI groups (7.3% and 7.5%) despite similar mean FPG levels (123–130 mg/dL). Only 19–22% of participants with SIDD achieved HbA1c < 7.0% compared to 33–51% with MARD and MOD, respectively. Pre-BI and pre-BB treated subphenotypes experienced more hypoglycemia than pre-OAD treated subphenotypes.Individuals with T2D assigned post hoc to the SIDD subphenotype achieved suboptimal glycemic control with glargine regimens including basal-bolus therapy, alerting clinicians to improve further diabetes treatment, particularly post-prandial glycemic control, in individuals with SIDD.Results: This study aimed to evaluate glycemic outcomes in subphenotypes of type 2 diabetes (T2D) with HbA1c > 7.0%, previously on basal insulin (pre-BI) alone (≥ 42 U/day) or on basal-bolus therapy (pre-BB), and who were switched to either basal insulin glargine 300 U/mL (IGlar-300) or 100 U/mL (IGlar-100), with or without pre-prandial insulin.Participants from EDITION 2 (pre-BI, n = 785), and EDITION 1 (pre-BB, n = 792) trials were assigned retrospectively to subphenotypes of T2D: severe insulin deficient diabetes (SIDD), mild age-related diabetes (MARD), mild obesity diabetes (MOD), and severe insulin resistant diabetes (SIRD). Key efficacy and safety parameters were analyzed at baseline, and after 26 weeks, for IGlar-300 and IGlar-100 pooled groups according to subphenotypes. Outcomes were also compared with insulin-naïve subphenotypes on oral antihyperglycemic drugs (OADs) from the EDITION 3 trial (pre-OAD, n = 858).Pre-BI and pre-BB treated subphenotypes with SIDD had a higher mean HbA1c (8.9% and 9.1%) at baseline compared to those of MARD (7.7% and 7.8%) and MOD (8.1% and 8.2%) and after 26 weeks remained above target HbA1c (7.7% and 8.0%) despite mean glargine doses of 0.7 to 1.0 U/kg/day and pre-prandial insulin use in the pre-BB SIDD subgroup. Pre-BB treated individuals with MARD and MOD achieved lower HbA1c levels (6.9% and 7.2%) than the pre-BI groups (7.3% and 7.5%) despite similar mean FPG levels (123–130 mg/dL). Only 19–22% of participants with SIDD achieved HbA1c < 7.0% compared to 33–51% with MARD and MOD, respectively. Pre-BI and pre-BB treated subphenotypes experienced more hypoglycemia than pre-OAD treated subphenotypes.Individuals with T2D assigned post hoc to the SIDD subphenotype achieved suboptimal glycemic control with glargine regimens including basal-bolus therapy, alerting clinicians to improve further diabetes treatment, particularly post-prandial glycemic control, in individuals with SIDD.Conclusion: This study aimed to evaluate glycemic outcomes in subphenotypes of type 2 diabetes (T2D) with HbA1c > 7.0%, previously on basal insulin (pre-BI) alone (≥ 42 U/day) or on basal-bolus therapy (pre-BB), and who were switched to either basal insulin glargine 300 U/mL (IGlar-300) or 100 U/mL (IGlar-100), with or without pre-prandial insulin.Participants from EDITION 2 (pre-BI, n = 785), and EDITION 1 (pre-BB, n = 792) trials were assigned retrospectively to subphenotypes of T2D: severe insulin deficient diabetes (SIDD), mild age-related diabetes (MARD), mild obesity diabetes (MOD), and severe insulin resistant diabetes (SIRD). Key efficacy and safety parameters were analyzed at baseline, and after 26 weeks, for IGlar-300 and IGlar-100 pooled groups according to subphenotypes. Outcomes were also compared with insulin-naïve subphenotypes on oral antihyperglycemic drugs (OADs) from the EDITION 3 trial (pre-OAD, n = 858).Pre-BI and pre-BB treated subphenotypes with SIDD had a higher mean HbA1c (8.9% and 9.1%) at baseline compared to those of MARD (7.7% and 7.8%) and MOD (8.1% and 8.2%) and after 26 weeks remained above target HbA1c (7.7% and 8.0%) despite mean glargine doses of 0.7 to 1.0 U/kg/day and pre-prandial insulin use in the pre-BB SIDD subgroup. Pre-BB treated individuals with MARD and MOD achieved lower HbA1c levels (6.9% and 7.2%) than the pre-BI groups (7.3% and 7.5%) despite similar mean FPG levels (123–130 mg/dL). Only 19–22% of participants with SIDD achieved HbA1c < 7.0% compared to 33–51% with MARD and MOD, respectively. Pre-BI and pre-BB treated subphenotypes experienced more hypoglycemia than pre-OAD treated subphenotypes.Individuals with T2D assigned post hoc to the SIDD subphenotype achieved suboptimal glycemic control with glargine regimens including basal-bolus therapy, alerting clinicians to improve further diabetes treatment, particularly post-prandial glycemic control, in individuals with SIDD. [ABSTRACT FROM AUTHOR]

During 1921 to 1922, a team effort by Banting, Macleod, Collip and Best isolated and purified insulin and demonstrated its life‐giving properties, giving rise to the birth of insulin therapy. In the early years (1922‐1950), priorities revolved around the manufacture of insulin to meet demand, improving purity to avoid allergic reactions, establishing insulin standards and increasing its duration of action to avoid multiple daily injections. Shortly after the emergence of insulin, Joslin and Allen advocated the need to achieve and maintain good glycaemic control to realize its full potential. Although this view was opposed by some during a dark period in the history of insulin, it was subsequently endorsed some 60 years later endorsed by the Diabetes Control and Complications Trial and United Kingdom Prospective Diabetes Study. Major scientific advances by the Nobel Laureates Sanger, Hodgkin, Yalow and Gilbert and also by Steiner have revolutionized the understanding of diabetes and facilitated major advances in insulin therapy. The more recent advent of recombinant technology over the last 40 years has provided the potential for unlimited source of insulin, and the ability to generate various insulin 'analogues', in an attempt to better replicate normal insulin secretory patterns. The emerging biosimilars now provide the opportunity to improve availability at a lower cost. [ABSTRACT FROM AUTHOR]

Background: Declining vaginal hysterectomy numbers in obstetrics and gynecology training programs highlights the need for innovative methods to teach vaginal surgical skills. We describe our experience with a vaginal hysterectomy skills simulation curriculum.Instrument: A low-fidelity bench model was constructed to simulate four vaginal hysterectomy suturing tasks. A polyvinyl chloride downspout adapter and low-cost materials simulate the Heaney pedicle stitch, simple pedicle stitch, double ligature, and continuous running stitch.Experience: Faculty expert vaginal surgeons established proficiency levels for each task. Resident (N=30) pass rates for tasks 1, 2, and 3 were 1 of 30 (3.3%), 7 of 30 (23.3%), and 4 of 30 (13.3%), respectively, for the left side, and 3 of 30 (10%), 9 of 30 (30%), and 10 of 30 (33.3%), respectively, for the right side. For task 4, the pass rate was 14 of 30 (46.7%). The majority of residents felt that the model simulates the technical skills required for vaginal hysterectomy and agreed that vaginal skills laboratory training would improve their ability to perform procedures in the operating room. Ninety-two percent of residents felt that a vaginal surgery skills curriculum would be a useful addition to their simulation education.Conclusion: A proficiency-based vaginal hysterectomy skills simulation curriculum using a low-fidelity model may be an important training and evaluation tool for vaginal surgical skills training. [ABSTRACT FROM AUTHOR]

We investigated pre-service elementary teachers' engagement in science and English language arts (ELA) instruction integrated in the context of a children's book. Teachers developed models and conducted a compare- and-contrast analysis after exposure to different accounts of the butterfly life cycle: a popular children's book, The Very Hungry Caterpillar, and a scientific account from National Geographic called "Butterfly: A Life." The mixed-methods research was guided by the following question: What are the affordances and limitations of children's literature toward engendering an understanding of the butterfly life cycle for pre-service elementary teachers? Content analysis indicated that pre-service elementary teachers' abilities to compare and contrast the two accounts were not exceptional, as they failed to discriminate between ideas offered in the accounts and missed details of the key aspect of the butterfly life-cycle phenomenon: metamorphosis. However, the quality of participants' butterfly life-cycle models significantly increased after exposure to the scientific account. We suggest the potential for an additional ELA standard, asking and answering such questions as who, what, where, when, why, and how to demonstrate understanding of key details in a text, as a means for enhancing compare-and-contrast skills following these activities. [ABSTRACT FROM AUTHOR]

Although climate change gamers the bull: of headlines, ocean acidification is an equally important issue that also results from our increasing consumption offossilfuels. As atmospheric (02 dissolves into the ocean, the oceanji pH decreases, making it increasingly difficult for organisms that build calcium carbonate skeletons to grow and thrive, Given that thesc marine calcifiers - such as corals, snails, shelljish, crustaccans, acidificaand plankton - often form the base of occanic food wcbs and are habitat and food resources for larger oceanic plants and animals (including humans), ocean acidijication poses a serious threat. In this article, we present a series of investigations that provide evidence that increases in anthropogenic sources of COz contribute to the acidification oj the ocean, and that an increasingly acidic ocean can negatively impact marine calcijiers. [ABSTRACT FROM AUTHOR]

In this article author focuses on promises that allows to convert might into right, escaping the lawless state of nature. Topics include examines that Seana Shiffrin rejects the Hobbesian view that all obligation originates in contract as she does maintain that some coerced promises enable decent forms of human interaction and that this fact explains why such promises bind.

The class of rapid‐acting insulin analogues were introduced more than 20 years ago to control postprandial plasma glucose (PPG) excursions better than unmodified regular human insulin. Insulins, lispro, aspart and glulisine all achieved an earlier onset of action, greater peak effect and shorter duration of action resulting in lower PPG levels and a reduced risk of late postprandial hypoglycaemia. However, the subcutaneous absorption rate of these analogues still fails to match the physiological profile of insulin in the systemic circulation following a meal. Recent reformulations of aspart and lispro have generated a second generation of more rapid‐acting insulin analogue candidates, including fast‐acting aspart (faster aspart), ultra‐rapid lispro and BioChaperone Lispro. These modifications have the potential to mimic physiological prandial insulin secretion better with an even earlier onset of action with improved PPG control, shorter duration of effect and reduced risk of hypoglycaemia. Recent phase 3 trials in type 1 and type 2 diabetes show that faster aspart and ultra‐rapid lispro compared with conventional aspart and lispro, achieved fewer PPG excursions with a small increase in post‐meal hypoglycaemia but similar or marginally superior glycated haemoglobin levels, and suggest the need for parallel optimization of basal insulin replacement. Phase 1 trials for BioChaperone Lispro are equally encouraging with phase 3 trials yet to be initiated. Comparative analysis of the clinical and pharmacological evidence for these new prandial insulin candidates in the treatment of type 1 and type 2 diabetes is the main focus of this review. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between baseline fasting C‐peptide (FCP) and outcomes in insulin‐naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL (Gla‐100). Materials and methods: Post hoc pooled analysis of nine randomized, treat‐to‐target trials in patients with type 2 diabetes inadequately controlled on oral antihyperglycaemic drugs initiating once‐daily Gla‐100. Participants (n = 2165) were stratified at baseline according to FCP (≤0.40, >0.40–1.20, >1.20–2.00, >2.00 nmol/L). Glycaemic control, body weight, insulin dose and hypoglycaemia were determined at 24 weeks. Results: At baseline low FCP levels were associated with longer known diabetes duration, lower body mass index and higher fasting plasma glucose (FPG). Following Gla‐100 introduction, the mean HbA1c reduction at week 24 was similar in all four FCP groups, albeit fewer people in the lowest FCP group achieved HbA1c <7.0% versus FCP groups >0.40 nmol/L. By contrast, FPG reduction and proportion reaching FPG ≤5.6 mmol/L were greatest in the lowest FCP group, diminishing at higher FCP levels. Gla‐100 dose at week 24 was lowest in the ≤0.40 nmol/L FCP group and highest in the >1.20 nmol/L FCP group. Incidence and event rate of overall, nocturnal and severe hypoglycaemia were higher at week 24 in groups with lower FCP levels. In multivariable regression analysis baseline FCP, concomitant sulphonylurea use and endpoint HbA1c were strong predictors of hypoglycaemia. Conclusions: FCP levels identified patients with type 2 diabetes experiencing different responses to basal insulin Gla‐100. A low FCP identifies a markedly insulin‐deficient, insulin‐sensitive subgroup/phenotype with an enhanced risk of hypoglycaemia, which requires a low initial basal insulin dose, cautious titration and earlier addition of prandial glucose‐lowering therapy. [ABSTRACT FROM AUTHOR]

Background: Term babies born smaller than expected for a given gestation are at greater risk of short- and long-term health conditions. Breastmilk is the optimum nutrition for all babies and offers specific protection from the risks that follow from being born small for gestational age. Aim: To explore breastfeeding outcomes for babies born with a birthweight below the 10th centile. Methods: Data were collected on all women giving birth in one maternity unit in the north of England over a year. Method of feeding at three time points was compared between small-for-gestational-age and appropriately grown babies. Findings: Small-for-gestational-age babies were significantly less likely to be breastfeeding at discharge from hospital and community services compared to larger babies. Conclusion: This study suggests that small-for-gestational-age babies are disadvantaged in establishing breastfeeding. [ABSTRACT FROM AUTHOR]

Almost all human societies recognize property in some form and in most of them that includes personal property, property owned by individuals. Here is our first conjecture:The Control Interest Hypothesis (CIH): Personal property rights exist (at least in part) to serve the right holder's interest in controlling things. It usually matters that property rights also serve other interests (they are rarely grounded in personal control interests alone), but what distinguishes personal property rights from other rights over things is (a) that they do serve the control interests of individuals and (b) that this (partially) explains their normative significance. I shall defend the following hypothesis:The Authority Interest Hypothesis (AIH): Personal property rights exist, at least in part, to serve the right holder's interest in having authority over things. This article outlined two accounts of personal property rights, one of which grounds them partly in our control interests, the other partly in our authority interests, and it highlighted two crucial features of personal property that can be explained only by appeal to our authority interests. [Extracted from the article]

Invasive ambrosia beetles in the Euwallacea nr. fornicatus species complex (Coleoptera: Curculionidae: Scolytinae) threaten avocado production in multiple countries. These pests are currently monitored with lures containing quercivorol; α‐copaene was also recently discovered to be an effective attractant.We investigated dispersal behaviour of female E. nr. fornicatus in two Florida avocado groves using mark–release–recapture experiments and laboratory flight mills. Additionally, we estimated the sampling range of quercivorol and α‐copaene lures deployed alone and in tandem.The two‐component lure recaptured 31.2% of marked beetles, which was significantly more than quercivorol (11.2%) or α‐copaene (8.8%) alone. Contour analysis indicated that wind speed and direction can influence the number of females that disperse, as well as the direction and distance of their flight.Two methods were used to estimate sampling range and both of them indicated comparable effective ranges for the three lure treatments, with 80% of marked beetles being recaptured within 30–35 m of the release point. Average total flight distance in laboratory tests was 81.0 m in 24 h, with a maximum distance recorded at 400 m.The combination of quercivorol and α‐copaene lures provides the best detection of pest E. nr. fornicatus in Florida, with a recommended trap spacing of approximately 30 m in surveillance programmes for this pest in avocado groves. [ABSTRACT FROM AUTHOR]

Fecal contamination by human and animal pathogens, including viruses, bacteria, and protozoa, is a potential human health hazard, especially with regards to drinking water. Pathogen occurrence in groundwater varies considerably in space and time, which can be difficult to characterize as sampling typically requires hundreds of liters of water to be passed through a filter. Here we describe the design and deployment of an automated sampler suited for hydrogeologically and chemically dynamic groundwater systems. Our design focused on a compact form to facilitate transport and quick deployment to municipal and domestic water supplies. We deployed a sampler to characterize water quality from a household well tapping a shallow fractured dolomite aquifer in northeast Wisconsin. The sampler was deployed from January to April 2017, and monitored temperature, nitrate, chloride, specific conductance, and fluorescent dissolved organic matter on a minute time step; water was directed to sequential microbial filters during three recharge periods that ranged from 5 to 20 days. Results from the automated sampler demonstrate the dynamic nature of the household water quality, especially with regard to microbial targets, which were shown to vary 1 to 2 orders of magnitude during a single sampling event. We believe assessments of pathogen occurrence and concentration, and related assessments of drinking well vulnerability, would be improved by the time‐integrated characterization provided by this sampler. Article impact statement: Using the automated sampler described here, microbial concentrations in groundwater are shown to vary significantly over short time periods. [ABSTRACT FROM AUTHOR]

The development of rational treatments for tardive dyskinesia has been held back by limitations to our understanding of its aetiology, which even now does not extend far beyond its association with centrally acting dopamine-blocking drugs. This article reviews briefly the major aetiological theories and addresses general management and specific treatment options. Primary prevention and early recognition remain the crucial management issues because, once the condition is established, there are no satisfactory treatments. The article considers two newly developed drugs, valbenazine and deutetrabenazine, in some detail as, although they are not yet licensed in Europe, they have largely been responsible for an upsurge in interest in tardive dyskinesia in the North American literature and are likely to be widely promoted in the future. Although possessed of undoubted benefits, the evidence suggests that these represent small steps rather than large leaps forward in treatment. [ABSTRACT FROM AUTHOR]

Aims: To identify factors associated with achievement of glycated haemoglobin A1c (HbA1c) target at 24 weeks after commencing basal insulin therapy in individuals with type 2 diabetes mellitus (T2DM). Materials and methods: Post‐hoc pooled analysis of 16 randomized, treat‐to‐target trials involving individuals with T2DM inadequately controlled with oral anti‐hyperglycaemic drugs (n = 3415) initiated on once‐daily insulin glargine 100 U/mL (Gla‐100). Clinical outcomes were assessed by HbA1c response at 24 weeks and individuals were classified as "good responders" with HbA1c <7.0% (<53 mmol/mol) or as "poor responders" with HbA1c ≥7.0% (≥53 mmol/mol). Univariable and multivariable stepwise logistic regression analyses were performed to identify predictive factors for attaining HbA1c <7.0%. Results: Lower levels of baseline HbA1c, fasting plasma glucose (FPG) and post‐prandial plasma glucose (PPG), higher body mass index (BMI), shorter diabetes duration and male sex were associated with a good glycaemic response, but not age or baseline C‐peptide levels. Gla‐100 dose (U/kg) was highest in the poor‐responder group, which had the fewest hypoglycaemia episodes. Univariable analysis for achievement of HbA1c <7.0% confirmed these observations. Multivariable analysis retained baseline HbA1c, body weight, BMI, sex, 2‐hours PPG and diabetes duration as predictors of a good response. Continued use of sulfonylureas, hypoglycaemia and change in body weight were indicative of poor response. Conclusions: Baseline HbA1c was the strongest determinant for achieving target HbA1c <7.0% by supplementary Gla‐100 therapy, while sex and BMI were also useful indicators. However, age and C‐peptide levels at baseline did not predict glycaemic response to the introduction of basal insulin. [ABSTRACT FROM AUTHOR]

Tardive dyskinesia is a common iatrogenic neurological and neurobehavioural syndrome associated with the use of antidopaminergic medication, especially antipsychotics. Prior to the introduction of the newer antipsychotics in the 1990s, it was one of the major areas of psychiatric research but interest waned as the new drugs were reputed to have a reduced liability to extrapyramidal adverse effects in general, a claim now discredited by numerous pragmatic research studies. Early small-scale short-term prevalence studies were presented as evidence to support the assumption that patients on the newer drugs did indeed have a lower prevalence of tardive dyskinesia but recent large-scale review of studies with patients exposed for longer suggest that things have not changed. This article presents a clinical overview of a complex and varied syndrome in terms of its phenomenology, epidemiology and risk factors; a companion article will consider treatment. This overview aims to highlight tardive dyskinesia once again, especially to practitioners who have trained in an environment where this was considered mainly in historical terms. [ABSTRACT FROM AUTHOR]

Ambrosia beetles in the cryptic species complex Euwallacea nr. fornicatus vector a fungal pathogen responsible for Fusarium dieback, a disease that impacts avocado (Persea americana), woody ornamentals, and numerous native trees in the USA (California, Florida), Israel, and other countries. Currently, these pests are detected with quercivorol lures (containing p-menth-2-en-1-ol isomers), but recent research identified an essential oil enriched in (-)-α-copaene as a new attractant. In this study, lure longevity and efficacy were assessed in three 12-week field tests conducted in Florida by deploying traps baited with quercivorol, α-copaene, and a combination of the two. A fourth test compared different formulations of quercivorol. Concurrent with field experiments, gas chromatographic analyses were conducted to quantify initial lure contents as well as volatile emissions from lures field-aged for 12 weeks. In all tests, the lure combination captured significantly more E. nr. fornicatus than the individual lures; and in two trials, synergistic attraction was observed. Field life of the combination lure was 12 weeks; longevity of single lures varied from 9 to 12 weeks. Twelve terpenoids were detected from the α-copaene-enriched oil, suggesting there may be additional attractants. Analysis of the quercivorol lure showed it contained 88% trans- and 9% cis-p-menth-2-en-1-ol. Results indicate that the combination of quercivorol and α-copaene provides a long-lasting, effective lure for early detection of E. nr. fornicatus in Florida. Further research is needed to determine which isomer of p-menth-2-en-1-ol is attractive to Florida E. nr. fornicatus, and if other members of the species complex are attracted to (-)-α-copaene. [ABSTRACT FROM AUTHOR]

While much is known about the characteristics that researchers deem valuable for professional development (PD), teachers' perceptions of their PD needs are less understood. In this study, we sought to explore teachers' perceptions of their PD needs, including PD format, time frame, and topics covered, and how those perceptions varied by teachers' district size, grade level, subject area, and years of experience. Participants included a statewide representative sample of 800 elementary and secondary STEM teachers with a wide range of teaching experience and from small to large school districts across Missouri. Each participant responded to the MO‐STEM PD Needs Assessment, a 61‐item Likert scale survey. We found teachers to be most interested in learning about real‐world issues and problem‐based learning to teach STEM content. Teachers' participation in PD positively correlated with district size and the manner in which PD is valued in their community of practice, while years of teaching experience was negatively correlated with interest in virtually all categories of the survey, including formats of PD delivery and the majority of PD topics. We conclude with a discussion of the ways in which teachers' expressed preferences for PD ran contrary to what the literature suggests as best practices for PD. [ABSTRACT FROM AUTHOR]

Restricted range, and subsequently small population size, render Kemp's ridley sea turtles (Lepidochelys kempii) the most globally endangered sea turtle species. For at least two decades preceding conservation, high egg harvest rates reduced annual cohort recruitment. Despite > 50 years of dedicated conservation, annual nest counts remain well below a landmark 1947 level. Prior studies attribute less robust than anticipated nest count rebound to multiple contemporary concerns; however, analyses herein convey optimistic interpretation. In objective 1, improved analysis of the ratio of hatchlings to nests since 1966 suggested age structure stabilization as a more likely basis for nest count trends after 2005 than density-dependent effects. In objective 2, multiple regression revealed a lagged (≤ 13 years prior) climate influence on nests (adj. r2 = 0.82) and hatchlings per nest (adj. r2 = 0.94) during 2006–2022. In objectives 3 and 4, a simulator modeled population response to changes in a suite of demographic rates including survival. Across 32 models, high survival and dynamic cohort sex ratio, sexual maturity age, and the ratio of clutch frequency to remigration interval best explained nesting trends during 1966–2022. These novel findings provide alternative perspective for evaluating species recovery criteria and in turn refine future nest trend expectations. [ABSTRACT FROM AUTHOR]

Ambrosia beetles in the Euwallacea nr. fornicatus complex (Coleoptera: Curculionidae) vector Fusarium spp. fungi pathogenic to susceptible hosts, including avocado, Persea americana Mill., (Lauraceae). Previous survey traps in Florida avocado groves indicated significant beetle populations in several groves with minimal observed beetle activity, suggesting an external beetle source. A natural area near one such grove revealed E. nr. fornicatus colonization of wild tamarind, Lysiloma latisiliquum (L.) Bentham (Fabaceae). A survey of the natural area was conducted to understand the role that natural areas might play in E. nr. fornicatus ecology in southern Florida. Headspace volatiles from rasped avocado and L. latisiliquum bark were analyzed by gas chromatography-mass spectroscopy (GC-MS) to identify potential attractants. Genetic analysis confirmed that these beetles and their symbiotic fungi are of the same complex that attacks Florida avocado. Gas chromatography-mass spectroscopy analysis indicated that avocado is high in α-copaene (a known attractant of E. nr. fornicatus), but this kairomone is lacking in L. latisiliquum. Host diam and ht were examined for potential influence on colonization behavior. Albizia lebbeck (L.) Bentham (Fabaceae) and an unknown shrub also were observed to be suitable hosts. Concurrent with this study, a nearby grove of soursop, Annona muricata L. (Annonaceae), was found to have infestations of E. nr. fornicatus. Euwallacea nr. fornicatus populations are increasing in Florida and other cultivated and native trees are potentially at risk. Further research is warranted to better understand the ecology of this emerging pest and the chemical cues used for host location. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus ( T2DM) is an independent risk factor for cardiovascular ( CV) comorbidities, with CV disease being the most common cause of death in adults with T2DM. Although glucocentric therapies may improve glycaemic control (as determined by glycated haemoglobin levels), evidence suggests that this approach alone has limited beneficial effects on CV outcomes relative to improvements in lipid and blood pressure control. This may be explained in part by the fact that current antidiabetic treatment regimens primarily address overall glycaemia and/or fasting plasma glucose, but not the postprandial plasma glucose ( PPG) excursions that have a fundamental causative role in increasing CV risk. This literature review evaluates the relationship between PPG and the risk of CV disease, discusses the treatment of T2DM with glucagon-like peptide-1 receptor agonists ( GLP-1 RAs) and examines the associated CV outcomes. The literature analysis suggests that exaggerated PPG excursions are a risk factor for CV disease because of their adverse pathophysiologic effects on the vasculature, resulting in increased all-cause and CV-related mortality. Although GLP-1 RAs are well established in the current T2DM treatment paradigm, a subgroup of these compounds has a particularly pronounced, persistent and short-lived effect on gastric emptying and, hence, lower PPG substantially. However, current long-term data on CV outcomes with GLP-1 RAs are contradictory, with both beneficial and adverse effects having been reported. This review explores the opportunity to direct treatment towards controlling PPG excursions, thereby improving not only overall glycaemic control but also CV outcomes. [ABSTRACT FROM AUTHOR]

Aims To analyse the effects of patient characteristics and different oral antidiabetes drug (OAD) use on standardised clinical outcomes in type 2 diabetes patients initiating insulin glargine 100 U/mL ( Gla-100). Materials and methods Patient-level data from 16 randomized, treat-to-target clinical trials that added Gla-100 to existing metformin ( MET), sulfonylurea ( SU) or metformin plus sulfonylurea ( MET+ SU) treatment in insulin-naïve patients inadequately controlled by oral therapy were analysed and patients were followed for ≥24 weeks. Change in glycated haemoglobin A1c ( HbA1c) from baseline to week 24, other glycaemic endpoints and incidence of hypoglycaemia (overall, nocturnal, and severe) were analysed by age (<65 vs ≥65 years), gender (male vs female), body mass index ( BMI; <25 vs ≥25 to <30 vs >30 kg/m2) and concomitant OAD ( MET vs SU vs MET+ SU). Results At baseline, the overall population ( N = 3188) had a mean age of 57.7 years, BMI of 30.5 kg/m2, HbA1c of 8.7%, fasting plasma glucose of 192 mg/dL, and 52.7% were male. Younger and older patients had similar HbA1c reductions with Gla-100 and a similar risk of hypoglycaemia. Females and patients with BMI <25 kg/m2 were less likely to achieve HbA1c targets and more likely to experience hypoglycaemia, regardless of concomitant OAD. Adding Gla-100 to SU therapy (alone or in combination with MET) increased hypoglycaemia risk across all analyses. Conclusions Our data suggest that female patients with type 2 diabetes and normal-weight patients treated with Gla-100 and MET ± SU are less likely to achieve glycaemic targets and, therefore, may require more clinical attention. Addition of Gla-100 to SU regimens may increase hypoglycaemia risk irrespective of age, gender, or BMI. [ABSTRACT FROM AUTHOR]

An introductory undergraduate biology laboratory session about vertebrate tissues was gamified to elucidate the effects of gameful learning on students' perceptions of their own learning and motivation. Student groups were randomly assigned a vertebrate tissue, including corresponding slides and content from the laboratory manual, and tasked with developing higher level questions from the content and compelling responses to answer them. After each group presented their questions and answers, an audience of their peers provided both written and verbal feedback. On completion of the activity, each group used their feedback sheets to score their peers' groups on the basis of predetermined criteria. The average of scores was used to rank each team and determine a winner, as well as the allotment of points each team received. All students reported enhanced motivation in this environment compared with their motivation in the traditional learning environments they had previously encountered in the course. Several students perceived the development, presentation, and critique of higher level questions to enhance their understanding. All but a few of the higher achieving students preferred the gameful learning environment. [ABSTRACT FROM AUTHOR]

Restricted range, and subsequently small population size, render Kemp's ridley sea turtles (Lepidochelys kempii) the most globally endangered sea turtle species. For at least two decades preceding conservation, high egg harvest rates reduced annual cohort recruitment. Despite > 50 years of dedicated conservation, annual nest counts remain well below a landmark 1947 level. Prior studies attribute less robust than anticipated nest count rebound to multiple contemporary concerns; however, analyses herein convey optimistic interpretation. In objective 1, improved analysis of the ratio of hatchlings to nests since 1966 suggested age structure stabilization as a more likely basis for nest count trends after 2005 than density-dependent effects. In objective 2, multiple regression revealed a lagged (≤ 13 years prior) climate influence on nests (adj. r2 = 0.82) and hatchlings per nest (adj. r2 = 0.94) during 2006–2022. In objectives 3 and 4, a simulator modeled population response to changes in a suite of demographic rates including survival. Across 32 models, high survival and dynamic cohort sex ratio, sexual maturity age, and the ratio of clutch frequency to remigration interval best explained nesting trends during 1966–2022. These novel findings provide alternative perspective for evaluating species recovery criteria and in turn refine future nest trend expectations. [ABSTRACT FROM AUTHOR]

The tea shot-hole borer, Euwallacea fornicatus Eichhoff, is an ambrosia beetle endemic to Asia and a pest of commercial tea, Camellia sinensis (L.) Kuntze. Recently, a complex of species morphologically similar to E. fornicatus has been recognized, which includes new pests established in Israel and the USA, both in California and Florida. Collectively termed E. nr. fornicatus, these cryptic species carry symbiotic Fusarium spp. fungi, some of which cause dieback disease in susceptible hosts, which include avocado, Persea americana Miller. Due to the threat to this economically important crop, research was initiated to evaluate efficacy of kairomone-based lures for detection of the beetle in Florida (termed the Florida tea shot hole borer, FL-TSHB). A series of field tests were conducted in 2016 in commercial avocado groves known to have FL-TSHB at various population levels. All tests evaluated lures containing quercivorol (p-menth-2-en-1-ol) and α-copaene, presented separately and in combination; and one test evaluated effect of trap type on beetle captures. In addition, electroantennography (EAG) was used to quantify female olfactory responses to lure emissions. This study identified (-)-α-copaene as a new attractant for FL-TSHB, equivalent in efficacy to quercivorol (the standard lure for Euwallacea detection in the USA); however, the combination of lures captured significantly more FL-TSHB than either lure alone. This combination resulted in synergistic attraction at two field sites and additive attraction at a third site. Sticky panel traps captured more FL-TSHB than comparably-baited Lindgren funnel traps. Females engaged in host-seeking flight from 11:00 to 16:00 hr (EST), with peak numbers observed between 12:00 and 13:00 hr. EAG analyses confirmed olfactory chemoreception of both kairomones, with a higher response elicited with the combination of volatiles. Results indicate that detection of pest E. nr. fornicatus in Florida can be improved by using a two-component lure consisting of p-menth-2-en-1-ol and (-)-α-copaene. [ABSTRACT FROM AUTHOR]

It is often maintained that practical freedom is a capacity to act on our view of what we ought to do and in particular on our view of what it would be best to do. Here, I discuss an important exception to that claim, namely habitual agency. Acting out of habit is widely regarded as a form of reflex or even as compulsive behaviour but much habitual agency is both intentional and free. Still it is true that, in so far as we act out of habit, we have no capacity to determine what we do by making a judgement about whether we ought to be doing it. Habitual agency is nonetheless free because we have the capacity to determine whether we act out of habit by making a judgement about whether or not the habit is a virtue. I develop this view of habit by contrasting habitual agency with action on policy and I argue that much virtuous agency is best understood as a form of habitual agency rather than as a form of action on policy. [ABSTRACT FROM PUBLISHER]

Sweet corn grown in Florida that is not well protected by insecticides often becomes heavily infested by maggots of picture-winged flies (Diptera: Ulidiidae). Additionally, after marketable ears are harvested, remaining ears are left unprotected and can be exploited by female flies. Larvae leave the ears to pupate in the soil. Occasionally, crop residue removal is delayed, sometimes for several weeks. Sweet corn plots were established in Fall 2015 and Spring 2016 to determine how various crop destruction techniques might impact the successful completion of the corn-infesting picture-winged fly life cycle. After harvest maturity, untreated sweet corn plots were partially mowed, disked once, disked twice, or left standing in the fall. In the spring, plots were partially plowed, disked twice, or left standing. Emergence cages were erected over the soil to intercept newly emerging adults. In the fall, crop destruction did not reduce adult emergence compared with the standing corn plots. In the spring, both plowing and disking significantly reduced adult fly emergence from the soil. The species complex emerging from the soil in the spring after crop destruction differed from the adult species complex present earlier during the spring corn's reproductive stages. Seasonal differences may have contributed to this inconsistency. Crop destruction does not initially appear to be a reliable method to reduce 1st generation adult fly emergence from ears post-harvest, highlighting the importance of timely crop destruction to deny females an unprotected host in which to oviposit. [ABSTRACT FROM AUTHOR]

Several morphologically similar species of picture-winged flies (the silk fly complex, Diptera: Ulidiidae) are severe primary pests of sweet corn ( Zea mays L.; Poaceae) in Florida. Monitoring traps for these pests may aid threshold development and species complex determination in the field. This study evaluated floral lures, some previously used to monitor pest Lepidoptera, and liquid protein baits, used for other pest Diptera, for efficacy in attraction of silk flies. Baited universal moth traps were deployed for several weeks and placed in a summer fallow field (field trial 1), a fall sweet corn field (field trial 2), and a spring sweet corn field (field trial 3). Flies were removed weekly during each experiment. In field trial 1, traps baited with 1,4-dimethoxybenzene captured the most flies. The majority of flies captured were Chaetopsis massyla Walker. In field trial 2, aged torula yeast-baited traps captured more flies than other treatments, (1,4-dimethoxybenzene, geraniol, phenylacetaldehyde, and fresh torula yeast). The majority of captured flies were Euxesta stigmatias Loew. In field trial 3, the aged torula yeast treatment resulted in greater fly capture than all other treatments (1,4-dimethoxybenzene, acetoin, anisole, and benzaldehyde). Euxesta eluta Loew was the dominant species captured in the spring. More females than males were captured from all 3 experiments and all treatments. These experiments demonstrate that all 3 silk fly species can be captured in traps currently used for pest monitoring. Torula yeast was the best attractant evaluated, and further semiochemical investigations of torula yeast are warranted. [ABSTRACT FROM AUTHOR]

Some acts (mala in se) are wrong prior to any social prohibition (e.g., murder). Other acts (mala prohibita) are wrong only once socially prohibited (e.g., traffic violations). This article considers certain obligations of care that parents owe to their children and children to their parents. Violations of these familial obligations are like paradigm mala prohibita in that they are wrongs created by social convention. But, it is argued, they are unlike paradigm mala prohibita in that their prohibition is not justified merely by the desirable consequences of prohibiting them but also by the value of the prohibition itself. [ABSTRACT FROM AUTHOR]

Aims: Evaluate efficacy and hypoglycaemia according to concomitant oral antidiabetes drug (OAD) in people with type 2 diabetes initiating insulin glargine 100U/mL (Gla-100) or neutral protamine Hagedorn (NPH) insulin once daily.Methods: Four studies (target fasting plasma glucose [FPG] ⩽100mg/dL [⩽5.6mmol/L]; duration ⩾24weeks) were included. Standardised data from 2091 subjects (Gla-100, n=1024; NPH insulin, n=1067) were analysed. Endpoints included glycated haemoglobin (HbA1c) and FPG change, glycaemic target achievement, hypoglycaemia, weight change, and insulin dose.Results: Mean HbA1c and FPG reductions were similar with Gla-100 and NPH insulin regardless of concomitant OAD (P=0.184 and P=0.553, respectively) and similar proportions of subjects achieved HbA1c <7.0% (P=0.603). There was a trend for more subjects treated with Gla-100 achieving FPG ⩽100mg/dL versus NPH insulin (relative risk [RR] 1.09 [95% confidence interval (CI) 0.97-1.23]; P=0.135). Plasma glucose confirmed (<70mg/dL) overall and nocturnal hypoglycaemia incidences and rates were lower with Gla-100 versus NPH insulin (overall RR 0.93 [95% CI 0.87-1.00]; P=0.041; nocturnal RR 0.73 [95% CI 0.65-0.83]; P<0.001). After 24weeks, weight gain and insulin doses were higher with Gla-100 versus NPH insulin (2.7kg vs 2.3kg, P=0.009 and 0.42U/kg vs 0.39U/kg; P=0.003, respectively). Insulin doses were higher when either insulin was added to sulfonylurea alone.Conclusions: Pooled results from treat-to-target trials in insulin-naïve people with type 2 diabetes demonstrate a significantly lower overall and nocturnal hypoglycaemia risk across different plasma glucose definitions with Gla-100 versus NPH insulin at similar glycaemic control. OAD therapy co-administered with Gla-100 or NPH insulin impacts glycaemic control and overall nocturnal hypoglycaemia risk. [ABSTRACT FROM AUTHOR]

Background: Although pancreatic rests have characteristic endoscopic features, confirming a histological diagnosis may be desirable to exclude other significant pathology.Aims: The aim of this study was to assess the efficacy and safety of endoscopic band ligation snare polypectomy (EBLSP) for removal of suspected pancreatic rests and to compare the diagnostic yield to other endoscopic tissue sampling methods.Methods: An electronic endoscopic report database was searched for patients referred for evaluation of incidentally found gastric antral subepithelial lesions. Tissue sampling technique, pathology, and complications were recorded.Results: Removal of suspected pancreatic rests with EBLSP was successful in all 21 cases without complications. Nineteen of 21 (90%) who underwent EBLSP had a histological diagnosis of heterotopic pancreas compared with 5 of 14 (36%) who underwent tissue sampling with biopsy and/or snare (P = 0.001). The endoscopic characteristics of the histology proven pancreatic rests were an antral subepithelial mass with central umbilication measuring 6-10 mm in diameter and located 2-6 cm from the pylorus in the 3-7 o'clock position.Conclusions: Endoscopic band ligation snare polypectomy resection of gastric antral lesions suspected to be pancreatic rests had a diagnostic yield superior to standard biopsy forceps and snare polypectomy techniques. However, because all pathologically confirmed pancreatic rests had typical endoscopic appearances of pancreatic rests, it may not be necessary to obtain histologic diagnosis for every suspected gastric antral heterotopic pancreas. [ABSTRACT FROM AUTHOR]

Exercise recommendations for those who have Marfan syndrome or other genetic predisposition for thoracic aortic disease remain controversial and at times ambiguous. There are no outcomes studies to help guide recommendations. In this review, we examine the guidelines regarding exercise and inherited aortic conditions, the theoretical reasoning and circumstantial evidence that support the guidelines, as well as the knowledge gaps that continue to exist. [ABSTRACT FROM AUTHOR]

Exercise recommendations for those who have Marfan syndrome or other genetic predisposition for thoracic aortic disease remain controversial and at times ambiguous. There are no outcomes studies to help guide recommendations. In this review, we examine the guidelines regarding exercise and inherited aortic conditions, the theoretical reasoning and circumstantial evidence that support the guidelines, as well as the knowledge gaps that continue to exist. [ABSTRACT FROM AUTHOR]

Phosphoinositide-dependent kinase-1 (PDK1) is a key signaling molecule downstream of the phosphatidylinositol 3-kinase pathway and is a master regulator of multiple kinases in cells of epithelial and hematopoietic lineages. The physiological role of PDK1 in regulating skin and immune homeostasis is not known. Here we developed a mouse model in which PDK1 is conditionally ablated in activated CD4 T cells, regulatory T cells, and mature keratinocytes through OX40-Cre recombinase expression. The resultant mice (PDK1-CKO) spontaneously developed severe dermatitis, skin fibrosis, and systemic T helper type 2 immunity, succumbing by 11 weeks of age. Through a series of T-cell transfers, bone marrow reconstitutions, and crossing to lymphocyte-deficient backgrounds, we demonstrate that ablation of PDK1 in keratinocytes is the major driver of disease pathogenesis. PDK1-deficient keratinocytes exhibit intrinsic defects in the expression of key structural proteins including cytokeratin-10 and loricrin, resulting in increased keratinocyte turnover, which in turn triggers inflammation, T-cell recruitment, and immune-mediated destruction. Our results reveal PDK1 as a central regulator of keratinocyte homeostasis that prevents skin immune infiltration and inflammation. [ABSTRACT FROM AUTHOR]

The article discusses author David Owens reply to commentators Daniel Markovits, Christopher Bennett and Stan Husi for offering their views, exposition and claims about his book "Shaping". According to the article, Daniel Markovits makes Evaluative Claim and Explanatory Claim, Bennett claims that normative interests can be only thought of and Stan Husi talks about breach of promise and social obligation.

Background Self-poisoning and self-injury have widely differing incidences in hospitals and in the community, which has led to confusion about the concept of self-harm. Categorising self-harm simply by a method may be clinically misleading because many hospital-attending patients switch from one method of harm to another on subsequent episodes. The study set out to determine the frequency, pattern, determinants and characteristics of method-switching in self-harm episodes presenting to the general hospital. Methods The pattern of repeated self-harm was established from over 33,000 consecutive self-harm episodes in a multicentre English cohort, categorising self-harm methods as poisoning, cutting, other injury, and combined methods. Results Over an average of 30 months of follow-up, 23% of people repeated self-harm and one-third of them switched method, often rapidly, and especially where the person was male, younger, or had self-harmed previously. Self-poisoning was far less likely than other methods to lead on to switching. Limitations Self-harm episodes that do not lead to hospital attendance are not included in these findings but people who self-harmed and went to hospital but were not admitted from the emergency department to the general hospital, or did not receive designated psychosocial assessment are included. People in the study were a mix of prevalent as well as incident cases. Conclusions Method of self-harm is fluctuating and unpredictable. Clinicians should avoid false assumptions about people׳s risks or needs based simply on the method of harm. [ABSTRACT FROM AUTHOR]

Exercise recommendations for those who have Marfan syndrome or other genetic predisposition for thoracic aortic disease remain controversial and at times ambiguous. There are no outcomes studies to help guide recommendations. In this review, we examine the guidelines regarding exercise and inherited aortic conditions, the theoretical reasoning and circumstantial evidence that support the guidelines, as well as the knowledge gaps that continue to exist. [ABSTRACT FROM AUTHOR]

Euxesta annonae Fabricius, E. eluta Loew, E. stigmatias Loew, and Chaetopsis massyla Walker (Diptera: Ulidiidae) are primary sweet corn pests in Florida. Few natural enemies of these flies are known. The pupal parasitoid Pachycrepoideus vindemmiae Rondani (Hymenoptera: Pteromalidae) was discovered in a laboratory colony of E. eluta and E. stigmatias, and its potential as a biological control agent was studied. Development times in fresh, chilled, and frozen E. eluta pupae were recorded. Fly larvae were allowed to dig into soil to pupate, and pupae covered by 2.5 cm of soil were presented to wasps to determine if P. vindemmiae could locate them. Finally, to evaluate susceptibility to insecticides commercially used in ear-stage sweet corn, adult parasitoids were caged on maize leaves treated with chlorpyrifos, methomyl, or zeta cypermethrin for 24 h. Pachycrepoideus vindemmiae completed development in normal, chilled, and frozen fly pupae in 15-17 days. None of the fly pupae covered by soil were parasitized. Chlorpyrifos and methomyl residues killed >95% of P. vindemmiae within 24 h. Zeta cypermethrin was slower acting, but resulted in 50% mortality after 24 h. Therefore, P. vindemmiae does not appear to be well suited as an effective biological control agent of maize-infesting Ulidiidae in sweet corn fields. This is the first known account of this cosmopolitan parasitoid attacking maize-infesting ulidiids. [ABSTRACT FROM AUTHOR]

Aim Evaluate early (0–12 weeks) and later (12–24 weeks) treatment outcomes in subjects with type 2 diabetes not achieving glycaemic control with oral antidiabetes drugs (OADs). Methods Selected data were pooled from 15 randomised, controlled treat-to-target (fasting plasma glucose < 100 mg/dL [<5.6 mmol/L]) trials adding insulin glargine to metformin, a sulphonylurea, or both. Glycaemic and hypoglycaemia parameters, insulin dose, and body weight at weeks 12 and 24 were assessed using individualised subject-level data. Results Data from 2837 subjects were analysed. HbA1c decreased from 8.8% (73 mmol/mol) at baseline by 1.4% (15 mmol/mol) at Week 12, and a further 0.2% (2 mmol/mol) at Week 24 in the pooled population. Similar reductions were observed across the different treatment groups. HbA1c < 7.0% (<53 mmol/mol) was reached by 34.8% of participants at Week 12 and an additional 24.3% by Week 24. Hypoglycaemia incidence and rates were similar during the early and continued treatment periods across all treatment combinations, but were markedly lower for insulin glargine plus metformin versus the other 2 regimens. Conclusions Early and sustained glycaemic benefits with a low-risk of hypoglycaemia are observed after initiation of insulin glargine in a pooled type 2 diabetes cohort previously uncontrolled on OADs. [ABSTRACT FROM AUTHOR]

Motivated by the commonly encountered problem in which tracking is only required at selected intermediate points within the time interval, a general optimisation-based iterative learning control (ILC) algorithm is derived that ensures convergence of tracking errors to zero whilst simultaneously minimising a specified quadratic objective function of the input signals and chosen auxiliary (state) variables. In practice, the proposed solutions enable a repeated tracking task to be accurately completed whilst simultaneously reducing undesirable effects such as payload spillage, vibration tendencies and actuator wear. The theory is developed using the well-known norm optimal ILC (NOILC) framework, using general linear, functional operators between real Hilbert spaces. Solutions are derived using feedforward action, convergence is proved and robustness bounds are presented using both norm bounds and positivity conditions. Algorithms are specified for both continuous and discrete-time state-space representations, with the latter including application to multi-rate sampled systems. Experimental results using a robotic manipulator confirm the practical utility of the algorithms and the closeness with which observed results match theoretical predictions. [ABSTRACT FROM AUTHOR]

Background Around 150,000 people each year attend hospitals in England due to self-harm, many of them more than once. Over 5,000 people die by suicide each year in the UK, a quarter of them having attended hospital in the previous year because of self-harm. Self-harm is a major identifiable risk factor for suicide. People receive variable care at hospital; many are not assessed for their psychological needs and little psychological therapy is offered. Despite its frequent occurrence, we have no clear research evidence about how to reduce the repetition of self-harm. Some people who have self-harmed show less active ways of solving problems, and brief problem-solving therapies are considered the most promising psychological treatments. Methods/Design This is a pragmatic, individually randomised, controlled, feasibility study comparing interpersonal problem-solving therapy plus treatment-as-usual with treatment-as-usual alone, for adults attending a general hospital following self-harm. A total of 60 participants will be randomised equally between the treatment arms, which will be balanced with respect to the type of most recent self-harm event, number of previous self-harm events, gender and age. Feasibility objectives are as follows: a) To establish and field test procedures for implementing the problem-solving intervention; b) To determine the feasibility and best method of participant recruitment and follow up; c) To assess therapeutic delivery; d) To assess the feasibility of obtaining the definitive trial's primary and secondary outcomes; e) To assess the perceived burden and acceptability of obtaining the trial's self-reported outcome data; f) To inform the sample size calculation for the definitive trial. Discussion The results of this feasibility study will be used to determine the appropriateness of proceeding to a definitive trial and will allow us to design an achievable trial of interpersonal problem-solving therapy for adults who self-harm. Trial registration Current Controlled Trials (ISRCTN54036115) [ABSTRACT FROM AUTHOR]