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Abstract Operator learning is a rising field of scientific computing where inputs or outputs of a machine learning model are functions defined in infinite-dimensional spaces. In this paper, we introduce Neon (Neural Epistemic Operator Networks), an architecture for generating predictions with uncertainty using a single operator network backbone, which presents orders of magnitude less trainable parameters than deep ensembles of comparable performance. We showcase the utility of this method for sequential decision-making by examining the problem of composite Bayesian Optimization (BO), where we aim to optimize a function $$f=g\circ h$$ f = g ∘ h , where $$h:X\rightarrow C(\mathscr {Y},{\mathbb {R}}^{d_s})$$ h : X → C ( Y , R d s ) is an unknown map which outputs elements of a function space, and $$g: C(\mathscr {Y},{\mathbb {R}}^{d_s})\rightarrow {\mathbb {R}}$$ g : C ( Y , R d s ) → R is a known and cheap-to-compute functional. By comparing our approach to other state-of-the-art methods on toy and real world scenarios, we demonstrate that Neon achieves state-of-the-art performance while requiring orders of magnitude less trainable parameters.

Abstract Chromosomal inversions have been implicated in a remarkable range of natural phenomena, but it remains unclear how much they contribute to standing genetic variation. Here, we evaluate 64 inversions that segregate within a single natural population of the yellow monkeyflower (Mimulus guttatus). Nucleotide diversity patterns confirm low internal variation for the derived orientation (predicted by recent origin), elevated diversity between orientations (predicted by natural selection), and localized fluctuations (predicted by gene flux). Sequence divergence between orientations varies idiosyncratically by position, not following the suspension bridge pattern predicted if the breakpoints are the targets of selection. Genetic variation in gene expression is not inflated close to inversion breakpoints but is clearly partitioned between orientations. Like sequence variation, the pattern of expression variation suggests that the capture of coadapted alleles is more important than the breakpoints for the fitness effects of inversions. This work confirms several evolutionary predictions for inversion polymorphisms, but clarity emerges only by synthesizing estimates across many loci.

Abstract Due to their position on glomerular capillaries, podocytes are continuously counteracting biomechanical filtration forces. Most therapeutic interventions known to generally slow or prevent the progression of chronic kidney disease appear to lower these biomechanical forces on podocytes, highlighting the critical need to better understand podocyte mechano-signalling pathways. Here we investigated whether the mechanotransducer Piezo is involved in a mechanosensation pathway in Drosophila nephrocytes, the podocyte homologue in the fly. Loss of function analysis in Piezo depleted nephrocytes reveal a severe morphological and functional phenotype. Further, pharmacological activation of endogenous Piezo with Yoda1 causes a significant increase of intracellular Ca++ upon exposure to a mechanical stimulus in nephrocytes, as well as filtration disturbances. Elevated Piezo expression levels also result in a severe nephrocyte phenotype. Interestingly, expression of Piezo which lacks mechanosensitive channel activity, does not result in a severe nephrocyte phenotype, suggesting the observed changes in Piezo wildtype overexpressing cells are caused by the mechanosensitive channel activity. Moreover, blocking Piezo activity using the tarantula toxin GsMTx4 reverses the phenotypes observed in nephrocytes overexpressing Piezo. Taken together, here we provide evidence that Piezo activity levels need to be tightly regulated to maintain normal pericardial nephrocyte morphology and function.

Preterm birth, affecting about 10% of pregnancies, significantly contributes to perinatal morbidity and mortality. Recent research indicates that metabolomics could enhance pregnancy outcomes and reduce costs by identifying biomarkers related to common pregnancy complications. Our team focused on analyzing amniotic fluid collected during the second trimester to identify potential biomarkers for preterm birth using 1H-NMR metabolomic analysis. We compared amniotic fluid samples from women who delivered prematurely with those who delivered at term. Multivariate principal component analysis revealed dimethylglycine, glucose, myo-inositol, and succinic acid as potential biomarkers for preterm birth prognosis and early diagnosis. Further analysis demonstrated distinct regulation patterns of these metabolites in relation to fetal growth centiles. For instance, dimethylglycine and glucose were upregulated in fetuses above the 20th centile, while citrate and succinate were upregulated in those below it. With Area Under the Curve (AUROC) values over 0.75 and p-values less than 0.05, these metabolites show promise as reliable biomarkers for predicting fetal growth restriction. This approach could significantly impact maternal-fetal medicine by facilitating early diagnosis and personalized interventions. Future research should focus on validating these findings in larger populations and exploring the underlying mechanisms of metabolite regulation.

Abstract Background As a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles. Methods This scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups. Results A total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection. Conclusions Most interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.

Just World Beliefs are a tendency to believe the world is inherently fair. The strength of these beliefs correlates with victim derogation, including blaming victims of medical pathology. This cross-sectional study aimed to evaluate whether the strength of belief in a just world predicts beliefs about the etiologies of early pregnancy loss. In total, 911 adults living in the United States were recruited using Amazon Mechanical Turk. Participants completed a web-based assessment of their views on causes of pregnancy loss and a validated measure of just world beliefs. Pearson’s chi-squared test was used to evaluate the association between just world belief strength and beliefs about internal and external causes of spontaneous pregnancy loss. Compared to participants with weak just world beliefs, respondents with strong just world beliefs were more likely to attribute a pregnancy loss to benign reproductive choices (contraception use or a prior abortion) and daily activities (prolonged standing, engaging in an argument) that are within an individual’s control, while minimizing the contribution of factors that cannot be controlled (fetal genetic abnormalities). Understanding belief systems contributing to miscarriage stigma may help to develop stigma-reducing interventions for both patients and the general public.

Abstract Elucidating physical transport phenologies in large lakes can aid understanding of larval recruitment dynamics. Here, we integrate a series of climate, hydrodynamic, biogeochemical, and Lagrangian particle dispersion models to: (1) simulate hatch and transport of fish larvae throughout an illustrative large lake, (2) evaluate patterns of historic and potential future climate‐induced larval transport, and (3) consider consequences for overlap with suitable temperatures and prey. Simulations demonstrate that relative offshore transport increases seasonally, with shifts toward offshore transport occurring earlier during relatively warm historic and future simulations. Intra‐ and inter‐annual trends in transport were robust to assumed pelagic larval duration and precise location and timing of hatching. Larvae retained nearshore generally encountered more favorable temperatures and zooplankton densities compared to larvae transported offshore. Larval exploitation of nearshore resources under climate change may depend on a concomitant shift to earlier spawning and hatch times in advance of earlier offshore transport.

In total, 3274 adults (65.2% females) from six European countries were included in this cross-sectional analysis using data from the baseline assessment of the Feel4Diabetes study. Anthropometric, sociodemographic, dietary and behavioral data were assessed, and the existence of metabolic syndrome (MetS) was recorded. Beverage consumption patterns (BCPs) were derived via principal component analysis. Three BCPs were derived explaining 39.5% of the total variation. BCP1 was labeled as “Alcoholic beverage pattern”, which loaded heavily on high consumption of beer/cider, wine and other spirits; BCP2 was labeled as “High in sugars beverage pattern” that was mainly characterized by high consumption of soft drinks with sugar, juice containing sugar and low consumption of water; and BCP3 was labeled as “Healthy beverage pattern” that was mainly characterized by high consumption of water, tea, fruit juice freshly squeezed or prepacked without sugar and low consumption of soft drinks without sugar. After adjusting for various confounders, BCP2 was positively associated with elevated triglycerides (p = 0.001), elevated blood pressure (p = 0.001) elevated fasting glucose (p = 0.008) and the existence of MetS (p = 0.006), while BCP1 was inversely associated with reduced HDL-C (p = 0.005) and BCP3 was inversely associated with elevated blood pressure (p = 0.047). The establishment of policy actions as well as public health nutritional education can contribute to the promotion of a healthy beverage consumption.

Abstract Sero-monitoring provides context to the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and changes in population immunity following vaccine introduction. Here, we describe results of a cross-sectional hospital-based study of anti-spike seroprevalence in New York City (NYC) from February 2020 to July 2022, and a follow-up period from August 2023 to October 2023. Samples from 55,092 individuals, spanning five epidemiological waves were analyzed. Prevalence ratios (PR) were obtained using Poisson regression. Anti-spike antibody levels increased gradually over the first two waves, with a sharp increase during the 3rd wave coinciding with SARS-CoV-2 vaccination in NYC resulting in seroprevalence levels >90% by July 2022. Our data provide insights into the dynamic changes in immunity occurring in a large and diverse metropolitan community faced with a new viral pathogen and reflects the patterns of antibody responses as the pandemic transitions into an endemic stage.

Abstract Variational image registration methods commonly employ a similarity metric and a regularization term that renders the minimization problem well-posed. However, many frequently used regularizations such as smoothness or curvature do not necessarily reflect the underlying physics that apply to anatomical deformations. This, in turn, can make the accurate estimation of complex deformations particularly challenging. Here, we present a new highly flexible regularization inspired from the physics of fluid dynamics which allows applying independent penalties on the divergence and curl of the deformations and/or their nth order derivative. The complexity of the proposed generalized div-curl regularization renders the problem particularly challenging using conventional optimization techniques. To this end, we develop a transformation model and an optimization scheme that uses the divergence and curl components of the deformation as control parameters for the registration. We demonstrate that the original unconstrained minimization problem reduces to a constrained problem for which we propose the use of the augmented Lagrangian method. Doing this, the equations of motion greatly simplify and become managable. Our experiments indicate that the proposed framework can be applied on a variety of different registration problems and produce highly accurate deformations with the desired physical properties.

Background: Although the current combination of surgery, radiation, and chemotherapy is used in the breast-cancer setting, the administration of the anticancer drugs doxorubicin and trastuzumab is associated with an increased risk of developing heart failure. The aim of this study is to determine whether dietary flaxseed is comparable and/or synergistic with the angiotensin-converting enzyme inhibitor perindopril in the treatment of doxorubicin- and trastuzumab-mediated cardiotoxicity. Methods: In a chronic in vivo murine model (n = 110), doxorubicin and trastuzumab (8 mg/kg and 3 mg/kg, respectively) were administered weekly for 3 weeks. Following this period, the mice were randomized to daily consumption of a 10% flaxseed supplemented diet, administration of perindopril (3 mg/kg) via oral gavage, or a combination of both flaxseed and perindopril for an additional 3 weeks. Results: In mice treated with doxorubicin and trastuzumab, the left ventricular ejection fraction decreased from 74% ± 4% at baseline to 30% ± 2% at week 6. Treatment with either flaxseed or perindopril, or with flaxseed and perindopril improved left ventricular ejection fraction to 52% ± 4%, 54% ± 4%, and 55% ± 3%, respectively (P < 0.05). Although histologic analyses confirmed significant loss of sarcomere integrity and vacuolization in the doxorubicin- and trastuzumab-treated mice, treatment with flaxseed or perindopril, or with flaxseed and perindopril improved myocyte integrity. Finally, the level of Bcl-2 interacting protein 3, high-mobility group box 1 protein expression, and the levels of select oxylipins, were significantly elevated in mice receiving doxorubicin and trastuzumab; these markers were attenuated by treatment with either flaxseed or perindopril, or with flaxseed and perindopril. Conclusions: Flaxseed was equivalent to perindopril at improving cardiovascular remodelling by reducing biomarkers of inflammation, mitochondrial damage, and cell death. Résumé: Contexte: Si l’association actuelle de la chirurgie, de la radiothérapie et de la chimiothérapie est utilisée pour le traitement du cancer du sein, on observe néanmoins que l’administration de la doxorubicine et du trastuzumab, deux anticancéreux, augmente les risques d’insuffisance cardiaque. Cette étude vise à déterminer si les graines de lin alimentaires ont un effet comparable et/ou synergique à celui du périndopril, un inhibiteur de l’enzyme de conversion de l’angiotensine, dans le traitement de la cardiotoxicité liée à la doxorubicine et au trastuzumab. Méthodologie: Dans un modèle murin chronique in vivo (n = 110), la doxorubicine et le trastuzumab (8 mg/kg et 3 mg/kg, respectivement) ont été administrés une fois par semaine pendant trois semaines. Après cette période, les souris ont été réparties de façon aléatoire dans trois groupes : l’un recevant tous les jours un régime alimentaire contenant 10 % de graines de lin, un autre recevant du périndopril (3 mg/kg) par gavage oral et un troisième recevant à la fois des graines de lin et du périndopril pendant trois semaines supplémentaires. Résultats: Chez les souris recevant la doxorubicine et le trastuzumab, la fraction d’éjection ventriculaire gauche est passée de 74 % ± 4 % au départ à 30 % ± 2 % à la semaine 6. Avec le traitement par les graines de lin seules, le périndopril seul ou les graines de lin et le périndopril en association, la fraction d’éjection ventriculaire gauche est passée à 52 % ± 4 %, à 54 % ± 4 % et à 55 % ± 3 %, respectivement (p < 0,05). Bien que les analyses histologiques aient permis de confirmer une perte significative de l’intégrité des sarcomères et une vacuolisation chez les souris recevant la doxorubicine et le trastuzumab, le traitement par les graines de lin seules, le périndopril seul ou les graines de lin et le périndopril en association a amélioré l’intégrité des myocytes. Enfin, les taux de protéine 3 interagissant avec BCL-2, l’expression de la protéine HMGB1 (high-mobility group box 1) et les taux de certaines oxylipines étaient significativement élevés chez les souris recevant la doxorubicine et le trastuzumab. Ces marqueurs ont été atténués par les graines de lin, le périndopril ou l’association des deux. Conclusions: En diminuant les biomarqueurs de l’inflammation, les dommages aux mitochondries et la mort cellulaire, les graines de lin ont un effet équivalant à celui du périndopril quant à l’amélioration du remodelage cardiovasculaire.

This study delves into the Smart Readiness Indicator (SRI), an innovative measure designed to assess and enhance the smart capabilities of buildings across Europe. Addressing the critical question, ‘How can the SRI be effectively documented, made more accessible to European citizens, continuously monitored, and financially supported to enhance its adoption and under-standing?’ This research aims to bridge the gap between the conceptual framework of SRI and its practical implementation for the benefit of European citizens. The study introduces the SRI FAQ Initiative, a pivotal effort aimed at demystifying the SRI through the compilation and dissemination of essential questions and answers. The establishment of the SRI Observatory is another significant outcome, documenting the ongoing development of SRI and providing annual out-looks for future advancements. The research employs a multifaceted methodology, incorporating field research, extensive literature reviews, stakeholder interviews, and both digital and roundtable discussions.

RFID technology is becoming increasingly popular in various industries due to its simplicity, affordability, and adaptability. However, its integration into the construction industry, particularly within the Digital Twin framework, remains limited. This study reviews current research and case studies on RFID in construction, focusing on its potential combination with Digital Twins. It examines the integration of RFID with BIM, sensors and other techniques to monitor building conditions. Using Latent Semantic Analysis, the study identifies key trends and patterns in the literature, revealing a predominant focus on the standalone use of RFID for localisation and tracking, with limited integration into other technologies. The findings highlight persistent barriers to wider adoption and underscore the need for further research to overcome these challenges.

ABSTRACTThermal systems, including those utilising solar energy and waste heat recovery, often have a mismatch between the energy supply and demand. It is crucial to implement a form of Thermal Energy Storage (TES) to effectively utilise the energy source. This study evaluates the thermal performance of a packed bed Latent Heat Thermal Energy Storage (LHTES) unit that is incorporated with a solar flat plate collector. The results show that the time required to charge the tank is reduced by 7% when the porosity is increased from 0.49 to 0.61, and also when the flow rate is raised from 2 to 4 kg/min, the charging time decreases by 2.5%. Additionally, studies were done to investigate the performances of different kinds of paraffin (RT30, RT28HC, WAX, RT58, and P56-58), and compare the heat capacities of each TES tank which resulted in the RT58 TES tank having the highest heat capacity.Abbreviations: BC: boundary conditions; HTF: heat transfer fluid; LHS: latent heat storage; LHTES: latent heat thermal energy storage; PCM: phase change material; SHS: sensible heat storage; TES: thermal energy storage

AbstractBackground Opioid overdoses have continued to increase at higher rates among Black Americans compared to people from other racial groups. Despite demonstrated effectiveness of MOUD in reducing risk of opioid overdose, Black Americans face decreased access to and uptake of MOUD. The current study aimed to examine the knowledge, perceptions, and experiences with MOUD among a sample of Black adults who use prescription opioids nonmedically in order to inform tailored efforts to improve MOUD uptake.Methods Data were derived from a larger study assessing cultural and structural influences on drug use and drug treatment among people who use prescription opioids nonmedically. Semi-structured qualitative interviews were conducted with 34 Black men and women across four generational cohorts: born 1955–1969; 1970–1979; 1980–1994; and 1995–2001. Participant responses were analyzed using thematic analysis.Results Nearly half of participants (44.1%) reported no knowledge or experience with MOUD. Among participants who had any knowledge about MOUD, four major themes regarding their perceptions emerged: MOUD Helps with Recovery; Not Needed for Level of Drug Use; Side Effects and Withdrawal; Equivalence with Illicit Drug Use. The majority reported negative perceptions of MOUD (52.6%), and the youngest cohort (born 1995–2001) had a higher proportion of negative perceptions (80%) relative to other age cohorts (born 1980–1994: 50%; 1970–1979: 75%; 1955–1969: 16.6%).Discussion Findings indicate a significant knowledge gap and clear points of intervention for improving MOUD uptake. Interventions to improve communication of health information in ways that are culturally relevant and tailored by age group can be used in conjunction with efforts to improve MOUD access among Black individuals who use opioids nonmedically.

Background In approaching surgical correction of Hirschsprung disease (HSCR), laparoscopic Swenson endorectal pull-through (Lap-S-ERPT) requires less transanal dissection and sphincter stretch. This may lead to more immediate postoperative obstructive symptoms. While antibiotics and rectal irrigations are mainstays of treatment, there is concern about rectal instrumentation in the setting of recent low anal anastomosis. The purpose of this study was to assess the incidence and safety of early rectal irrigations following Lap-S-ERPT.Methods This is a single-center, retrospective review of all pediatric patients who underwent Lap-S-ERPT for HSCR from January 2018 to October 2023. Irrigations were performed if patients had obstructive symptoms including emesis, obstipation, and dilated colonic loops on radiographs. The primary outcome was need for postoperative rectal irrigation. Secondary outcomes included time from surgery to irrigation, duration of irrigation, and incidence of anastomotic leak.Results A total of 37 patients (62% male) underwent a Lap-S-ERPT at a median age of 3 months (interquartile range (IQR): 0.5, 5.0). Rectosigmoid disease was the most common diagnosis (n=29, 78.4%). There were 11 patients underwent rectal irrigations with a median time to initiation of irrigation of 46 hours (IQR: 32.0, 114.0) postoperatively and a median duration of irrigations of 3 days (IQR: 2.0, 4.5). There was no difference in anastomotic leak rate between patients who received irrigations and those who did not (9.1% v.s. 7.7%, p=0.887).Conclusion Following Lap-S-ERPT, nearly 30% of patients underwent rectal irrigation for postoperative obstructive symptoms. Despite concerns about instrumentation with a recent low anastomosis, there was no increase in leak rate in patients who received rectal irrigations.

This work introduces a comprehensive approach utilizing data-driven methods to elucidate the deposition process regimes in Chemical Vapor Deposition (CVD) reactors and the interplay of physical mechanism that dominate in each one of them. Through this work, we address three key objectives. Firstly, our methodology relies on process outcomes, derived by a detailed CFD model, to identify clusters of “outcomes” corresponding to distinct process regimes, wherein the relative influence of input variables undergoes notable shifts. This phenomenon is experimentally validated through Arrhenius plot analysis, affirming the efficacy of our approach. Secondly, we demonstrate the development of an efficient surrogate model, based on Polynomial Chaos Expansion (PCE), that maintains accuracy, facilitating streamlined computational analyses. Finally, as a result of PCE, sensitivity analysis is made possible by means of Sobol’ indices, that quantify the impact of process inputs across identified regimes.The insights gained from our analysis contribute to the formulation of hypotheses regarding phenomena occurring beyond the transition regime. Notably, the significance of temperature even in the diffusion-limited regime, as evidenced by the Arrhenius plot, suggests activation of gas phase reactions at elevated temperatures. Importantly, our proposed methods yield insights that align with experimental observations and theoretical principles, aiding decision-making in process design and optimization. By circumventing the need for costly and time-consuming experiments, our approach offers a pragmatic pathway toward enhanced process efficiency. Moreover, this study underscores the potential of data-driven computational methods for innovating reactor design paradigms.

Background: Researchers and participants who are members of minoritized populations experience negative psychosocial and wellness outcomes like burnout. Burnout may manifest uniquely for Black women in academia conducting research with Black women participants navigating similar sociocultural contexts. Objectives: This article qualitatively interprets our experiences as 15 Black women scholar-practitioners at a midwestern university conducting community-engaged research. We discuss our experiences of care and burnout while working to reduce opioid use disparities among Black women community members as we simultaneously navigate multilevel challenges in academia. Design: We employ collaborative autoethnography, an autobiographical writing method, using a Black feminist framework and intersectionality methodology. Methods: We are 15 Black women researcher-subjects on the REFOCUS study—a mixed-methods National Institute on Health-funded project examining nonmedical prescription opioid misuse among Black Kentuckians. We examined a series of multigenerational sista circles and individual journal entries we completed to understand the multilevel power dynamics impacting our individual and collective work, burnout, and care. Results: Themes were: (1) “I see me in you”: Research with Black Women, (2) “Pervasive, cellular, and epigenetic”: Burnout Experiences; (3) “Taxing but rewarding”: The Price We Pay to See an Outcome, and (4) “Thank God for the collective”: Complexities of Caring Through the Process. Conclusion: We highlight the importance of continued efforts to address workload inequities among Black women in academia, particularly for those working to combat health disparities among Black women or within Black communities. We make recommendations for structural, institutional, and interpersonal steps to improve the support of Black women across career stages.

Summary:. Although the representation of women and ethnic minority students in the US medical schools has recently increased, discrepancies in representation among plastic surgery residents and faculty continue. The state of sex and ethnic diversity in academic microsurgery remains minimally investigated. We aimed to evaluate the sex, race, and ethnicity demographics among academic microsurgeons and identify underrepresentation along the leadership pathway. The US-based microsurgery fellowship programs provided contact information of fellowship graduates from 2006 to 2020. An anonymous electronic survey was distributed, and demographic, training background, mentorship, and career path data were collected. Program websites were reviewed to collect data on academic microsurgery faculty nationwide. We found that women and non-White surgeons reported similar rates of effective mentorship in training. Compared with White surgeons, non-White surgeons had lower probability of holding an academic position directly after fellowship (odds ratio = 0.28, P = 0.023) and reported fewer perceived opportunities for professional advancement (61% versus 91%, P = 0.007). The majority of academic leadership positions were held by White surgeons (72%). Overall, women faculty were earlier in their careers than men (mean time out of fellowship 7.2 years for women versus 14.8 years for men, P < 0.001), signifying a lack of senior female faculty. Male faculty had higher rates of leadership than female faculty (24.7% versus 8.0%, P = 0.01). Our results demonstrate that women and non-White surgeons are not adequately represented in academic microsurgery faculty and leadership positions. Future interventions seeking to increase diversity can help improve the delivery of equitable reconstructive care.

Summary:. Organized plastic and reconstructive surgery has recognized the importance of diversity for optimal patient care and advancement of the specialty. Initial goals focused on increasing opportunities for underrepresented members of the society: women and Blacks and Hispanic/Latino members. The diversity lens has expanded to not only include race and sex but also diversity of religion, sexual orientation, gender identity, disability, geography, economic status, membership status, and employment type. In response to diversity antagonists who argue that diversity abandons a system based on “excellence,” we counter that diversity efforts demand excellence but realize that success often requires a more level playing field with the elimination of discriminatory barriers.

Background:. Subspecialty fellowship directors are essential to the selection and mentorship of trainees. The purpose of this study is to evaluate the gender and racial/ethnic diversity of fellowship directors across fellowship programs in plastic and reconstructive surgery (PRS). Methods:. In December 2023, listings of fellowship programs/directors were surveyed from respective professional society websites across the 5 primary PRS fellowships: hand (American Society for Surgery of the Hand), craniofacial (American Society of Craniofacial Surgeons), microsurgery (American Society for Reconstructive Microsurgery), aesthetic (The Aesthetic Society), and burn (American Burn Association). Fellowship director demographics from each program were researched and identified. Results:. In total, 248 fellowship directors were identified: 94 hand, 34 craniofacial, 62 microsurgery, 38 aesthetic, and 20 burn. There was a significantly greater percentage of male versus female directors across all fellowships (87.5% versus 12.5%; P < 0.01). Men were noted to have a significantly higher average h-index score (20.4 versus 15.0; P = 0.045) but constituted a lower proportion of assistant professorships (32.3% versus 12.9%; P < 0.01). Relative to directors from racial/ethnic minority backgrounds, White directors constituted a significantly greater percentage of fellowship directors (72.9% versus 27.1%; P < 0.01) and had a greater number of years passed since completing their most recent training (21.7 versus 17.1; P = 0.030). Conclusions:. Across PRS fellowship programs, women and racial/ethnic minorities are disproportionately underrepresented in leadership. Targeted initiatives to promote diversity in PRS fellowship directors should be considered as medicine works toward a surgical workforce more reflective of the patient population.

IntroductionA defining aspect of the Intergovernmental Panel on Climate Change (IPCC) assessment reports (AR) is a formal uncertainty language framework that emphasizes higher certainty issues across the reports, especially in the executive summaries and short summaries for policymakers. As a result, potentially significant risks involving understudied components of the climate system are shielded from view.MethodsHere we seek to address this in the latest, sixth assessment report (AR6) for one such component—the deep ocean—by summarizing major uncertainties (based on discussions of low confidence issues or gaps) regarding its role in our changing climate system. The goal is to identify key research priorities to improve IPCC confidence levels in deep ocean systems and facilitate the dissemination of IPCC results regarding potentially high impact deep ocean processes to decision-makers. This will accelerate improvement of global climate projections and aid in informing efforts to mitigate climate change impacts. An analysis of 3,000 pages across the six selected AR6 reports revealed 219 major science gaps related to the deep ocean. These were categorized by climate stressor and nature of impacts.ResultsHalf of these are biological science gaps, primarily surrounding our understanding of changes in ocean ecosystems, fisheries, and primary productivity. The remaining science gaps are related to uncertainties in the physical (32%) and biogeochemical (15%) ocean states and processes. Model deficiencies are the leading cited cause of low certainty in the physical ocean and ice states, whereas causes of biological uncertainties are most often attributed to limited studies and observations or conflicting results.DiscussionKey areas for coordinated effort within the deep ocean observing and modeling community have emerged, which will improve confidence in the deep ocean state and its ongoing changes for the next assessment report. This list of key “known unknowns” includes meridional overturning circulation, ocean deoxygenation and acidification, primary production, food supply and the ocean carbon cycle, climate change impacts on ocean ecosystems and fisheries, and ocean-based climate interventions. From these findings, we offer recommendations for AR7 to avoid omitting low confidence-high risk changes in the climate system.

During the 2022 Nekton Maldives Mission, we deployed a variety of platforms (snorkelling, remotely-operated vehicles and manned submersibles) to conduct video surveys of the biodiversity and composition of shallow (< 30 m), mesophotic (30-150 m) and deep-sea (> 150 m) benthos found in the Maldives’ central and southern atolls. In total, ~ 80 hrs of stereo-video footage were collected during the benthic transect surveys, which were subsequently processed using annotation software in order to evaluate benthic biodiversity and community composition. Here, we present a photographic guide for the visual, in situ identification of reef benthos encountered, including corals, sponges and other invertebrates that inhabit Maldives’ nearshore habitats. We hope that this identification guide will aid future imagery-based surveys or observations of organisms during fieldwork.A total of 283 morphotypes were identified, including those belonging to Octocorallia (61), Scleractinia (57), Porifera (38), Asteroidea (22), Antipatharia (15), Decapoda (13), Hydrozoa (12), Holothuroidea (10), Actiniaria (9), Echinoidea (8), Annelida (6), Chlorophyta (5), Gastropoda (4), Bivalvia (4), Ascidiacea (3), Crinoidea (3), Bryozoa (2), Cyanobacteria (2), Zoantharia (2), Cephalopoda (1), Ceriantharia (1), Corallimorpharia (1), Ctenophora (1), Ophiuroidea (1), Rhodophyta (1) and to an unknown category (1). Out of these, we identified 40 to species level, 120 to genus, 47 to family, 14 to order and suborder, 58 to class and subclass, two to phylum and one was of unknown phylum. This represents the first attempt to catalogue the mesophotic and deep-sea benthic megafaunal diversity in the Maldives using underwater imagery.

Abstract Background Umbilical cord blood (UCB) cells are a promising treatment for preterm brain injury. Access to allogeneic sources of UCB cells offer the potential for early administration to optimise their therapeutic capacities. As preterm infants often require ventilatory support, which can contribute to preterm brain injury, we investigated the efficacy of early UCB cell administration following ventilation to reduce white matter inflammation and injury. Methods Preterm fetal sheep (0.85 gestation) were randomly allocated to no ventilation (SHAM; n = 5) or 15 min ex utero high tidal volume ventilation. One hour following ventilation, fetuses were randomly allocated to i.v. administration of saline (VENT; n = 7) or allogeneic term-derived UCB cells (24.5 ± 5.0 million cells/kg; VENT + UCB; n = 7). Twenty-four hours after ventilation, lambs were delivered for magnetic resonance imaging and post-mortem brain tissue collected. Arterial plasma was collected throughout the experiment for cytokine analyses. To further investigate the results from the in vivo study, mononuclear cells (MNCs) isolated from human UCB were subjected to in vitro cytokine-spiked culture medium (TNFα and/or IFNγ; 10 ng/mL; n = 3/group) for 16 h then supernatant and cells collected for protein and mRNA assessments respectively. Results In VENT + UCB lambs, systemic IFNγ levels increased and by 24 h, there was white matter neuroglial activation, vascular damage, reduced oligodendrocytes, and increased average, radial and mean diffusivity compared to VENT and SHAM. No evidence of white matter inflammation or injury was present in VENT lambs, except for mRNA downregulation of OCLN and CLDN1 compared to SHAM. In vitro, MNCs subjected to TNFα and/or IFNγ displayed both pro- and anti-inflammatory characteristics indicated by changes in cytokine (IL-18 & IL-10) and growth factor (BDNF & VEGF) gene and protein expression compared to controls. Conclusions UCB cells administered early after brief high tidal volume ventilation in preterm fetal sheep causes white matter injury, and the mechanisms underlying these changes are likely dysregulated responses of the UCB cells to the degree of injury/inflammation already present. If immunomodulatory therapies such as UCB cells are to become a therapeutic strategy for preterm brain injury, especially after ventilation, our study suggests that the inflammatory state of the preterm infant should be considered when timing UCB cells administration.

This article contextualises the participation of Estonian elites in the transnational exchanges of racial and eugenic ideas. The Estonian Nationalist Club (ERK) became a crucial platform where radical nationalist thinkers appropriated ideologies of race and eugenics for the Estonian context. The ERKâs membership, elitist outlook, nationalist anxieties, and geopolitical orientation fostered enthusiastic engagement with racial and eugenic thinking. Inspired by the Swedish and German examples, ERK-affiliated commentators theorised Estoniansâ Nordic racial belonging and expressed ambivalence over racial purity. They skilfully navigated between criticism of German extremism and the drive to advance a racial and eugenic agenda compatible with their radical nationalist beliefs.

As part of two research projects, a small gait analysis device was developed for use inside and outside the home by patients themselves. The project PARMODE aims to record accurate gait measurements in patients with Parkinson’s disease (PD) and proceed with an in-depth analysis of the gait characteristics, while the project CPWATCHER aims to assess the quality of hand movement in cerebral palsy patients. The device was mainly developed to serve the first project with additional offline processing, including machine learning algorithms that could potentially be used for the second aim. A key feature of the device is its small size (36 mm × 46 mm × 16 mm, weight: 14 g), which was designed to meet specific requirements in terms of device consumption restrictions due to the small size of the battery and the need for autonomous operation for more than ten hours. This research work describes, on the one hand, the new device with an emphasis on its functions, and on the other hand, its connection with a web platform for reading and processing data from the devices placed on patients’ feet to record the gait characteristics of patients on a continuous basis.

Nowadays, the explosion of knowledge in the field of epigenetics has revealed new pathways toward the treatment of multifactorial diseases, rendering the key players of the epigenetic machinery the focus of today’s pharmaceutical landscape. Among epigenetic enzymes, DNA methyltransferases (DNMTs) are first studied as inhibition targets for cancer treatment. The increasing clinical interest in DNMTs has led to advanced experimental and computational strategies in the search for novel DNMT inhibitors. Considering the importance of epigenetic targets as a novel and promising pharmaceutical trend, the present study attempted to discover novel inhibitors of natural origin against DNMTs using a combination of structure and ligand-based computational approaches. Particularly, a pharmacophore-based virtual screening was performed, followed by molecular docking and molecular dynamics simulations in order to establish an accurate and robust selection methodology. Our screening protocol prioritized five natural-derived compounds, derivatives of coumarins, flavones, chalcones, benzoic acids, and phenazine, bearing completely diverse chemical scaffolds from FDA-approved “Epi-drugs”. Their total DNMT inhibitory activity was evaluated, revealing promising results for the derived hits with an inhibitory activity ranging within 30–45% at 100 µM of the tested compounds.

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as ?hang ups, let downs, bad breaks, setbacks? that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930?2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954?59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models. Results: Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts. Discussion: These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.

Summary: Systematic approaches to evidence synthesis can improve the rigor, transparency, and replicability of a literature review. However, these systematic approaches are resource intensive. We evaluate the ability of ChatGPT to undertake two stages of evidence syntheses (searching peer-reviewed literature and screening for relevance) and develop a collaborative framework to leverage both human and AI intelligence. Using a scoping review of community-based fisheries management as a case study, we find that with substantial prompting, the AI can provide critical insight into the construction and content of a search string. Thereafter, we evaluate five strategies for synthesizing AI output to screen articles based on predefined inclusion criteria. We find that low omission rates (

Summary: Human genetic studies of critical COVID-19 pneumonia have revealed the essential role of type I interferon-dependent innate immunity to SARS-CoV-2 infection. Conversely, an association between the HLA-B∗15:01 allele and asymptomatic SARS-CoV-2 infection in unvaccinated individuals was recently reported, suggesting a contribution of pre-existing T cell-dependent adaptive immunity. We report a lack of association of classical HLA alleles, including HLA-B∗15:01, with pre-omicron asymptomatic SARS-CoV-2 infection in unvaccinated participants in a prospective population-based study in the United States (191 asymptomatic vs. 945 symptomatic COVID-19 cases). Moreover, we found no such association in the international COVID Human Genetic Effort cohort (206 asymptomatic vs. 574 mild or moderate COVID-19 cases and 1,625 severe or critical COVID-19 cases). Finally, in the Human Challenge Characterisation study, the three HLA-B∗15:01 individuals infected with SARS-CoV-2 developed symptoms. As with other acute primary infections studied, no classical HLA alleles favoring an asymptomatic course of SARS-CoV-2 infection were identified.

IntroductionReceptor activity-modifying proteins (RAMPs) are known to modulate the pharmacology and function of several G-protein-coupled receptors (GPCRs), including the parathyroid hormone 1 receptor (PTH1R). However, the precise effects of different RAMPs on PTH1R signalling and trafficking remain poorly understood. This study investigated the impact of RAMP2 and RAMP3 on PTH1R function using a range of PTH and PTH-related protein (PTHrP)-derived ligands.MethodsWe employed FRET imaging to assess PTH1R interactions with RAMPs. Cell surface expression of PTH1R was evaluated in the presence of RAMPs. PTH1R-mediated cAMP accumulation, β-arrestin recruitment, and calcium signalling were measured in response to various ligands. Antibody-capture scintillation proximity assays were used to examine G-protein activation patterns.ResultsPTH1R preferentially interacted with RAMP2 and, to a lesser extent, RAMP3, but not with RAMP1. RAMP3 co-expression reduced cell surface expression of PTH1R. RAMP2 significantly enhanced PTH1R-mediated signalling responses to PTH (1-34), PTHrP (1-34), PTH (1-84), and PTH (1-17) analogue ZP2307, while RAMP3 co-expression attenuated or abolished these responses. Full-length PTHrP analogues exhibited lower potency and efficacy than PTHrP (1-34) in activating PTH1R. RAMP2 increased the potency and/or efficacy of these analogues, whereas RAMP3 reduced these responses. RAMP2 differentially modulated G-protein activation by PTH1R in a ligand-dependent manner, with PTH (1-34) and PTHrP (1-34) inducing distinct patterns of G-protein subtype activation.DiscussionThese findings highlight the complex role of RAMPs in regulating PTH1R signalling and trafficking, revealing differential effects of RAMP2 and RAMP3 on receptor function. The data suggest that targeting the PTH1R/RAMP2 complex may be a promising strategy for developing novel bone anabolic therapies by leveraging biased agonism and functional selectivity. Further research using physiologically relevant models is needed to elucidate the therapeutic potential of this approach.

BackgroundStroke prevention guidance for patients with atrial fibrillation (AF) uses evidence generated from randomised controlled trials (RCTs). However, applicability to patient groups excluded from trials remains unknown. Real-world patient data provide an opportunity to evaluate outcomes in a trial analogous population of direct oral anticoagulants (DOACs) users and in patients otherwise excluded from RCTs; however, there remains uncertainty on the validity of methods and suitability of the data. Successful reference trial emulation can support the generation of evidence around treatment effects in groups excluded or underrepresented in trials. We used linked United Kingdom primary care data to investigate whether we could emulate the pivotal ARISTOTLE trial (apixaban versus warfarin) and extend the analysis to investigate the impact of warfarin time in therapeutic range (TTR) on results.Methods and findingsPatients with AF in the UK Clinical Practice Research Datalink (CPRD Aurum) prescribed apixaban or warfarin from 1 January 2013 to 31 July 2019 were selected. ARISTOTLE eligibility criteria were applied to this population and matched to the RCT apixaban arm on baseline characteristics creating a trial-analogous apixaban cohort; this was propensity-score matched to warfarin users in the CPRD Aurum. ARISTOTLE outcomes were assessed using Cox proportional hazards regression stratified by prior warfarin exposure status during 2.5 years of patient follow-up and results benchmarked against the trial results before treatment effectiveness was further evaluated based on (warfarin) TTR. The dataset comprised 8,734 apixaban users and propensity-score matched 8,734 warfarin users. Results [hazard ratio (95% confidence interval)] confirmed apixaban noninferiority for stroke or systemic embolism (SE) [CPRD 0.98 (0.82,1.19) versus trial 0.79 (0.66,0.95)] and death from any cause [CPRD 1.03 (0.93,1.14) versus trial 0.89 (0.80,0.998)] but did not indicate apixaban superiority. Absolute event rates for stroke/SE were similar for apixaban in CPRD Aurum and ARISTOTLE (1.27%/year), whereas a lower event rate was observed for warfarin (CPRD Aurum 1.29%/year, ARISTOTLE 1.60%/year). Analysis by TTR suggested similar effectiveness of apixaban compared with poorly controlled warfarin (TTR < 0.75) for stroke/SE [0.91 (0.73, 1.14)], all-cause death [0.94 (0.84, 1.06)], and superiority for major bleeding [0.74 (0.63, 0.86)]. However, when compared with well-controlled warfarin (TTR ≥ 0.75), apixaban was associated with an increased hazard for all-cause death [1.20 (1.04, 1.37)], and there was no significant benefit for major bleeding [1.08 (0.90, 1.30)]. The main limitation of the study's methodology are the risk of residual confounding, channelling bias and attrition bias in the warfarin arm, and selection bias and misclassification in the analysis by TTR.ConclusionsAnalysis of noninterventional data generated results demonstrating noninferiority of apixaban versus warfarin consistent with prespecified benchmarking criteria. Unlike in ARISTOTLE, superiority of apixaban versus warfarin was not seen, possible due to the lower proportion of Asian patients and higher proportion of patients with well-controlled warfarin compared to ARISTOTLE. This methodological template can be used to investigate treatment effects of oral anticoagulants in patient groups excluded from or underrepresented in trials and provides a framework that can be adapted to investigate treatment effects for other conditions.

Background:. A previous study by the authors noted a decline in independent plastic surgery residency programs and rising applicant participation. This study provides updates on match trends and influential predictors, and gathers program leaders’ views on the future of the independent track. Methods:. Match data (2019–2022) were obtained from the San Francisco match after American Council of Educators in Plastic Surgery approval. Variables influencing match success were analyzed, and program leaders were surveyed about desirable applicant traits and program trajectories. Results:. From 2019 to 2022, 243 of 428 applicants matched. Programs and positions declined by 10% and 9.5%, respectively. Applicants rose to 42.3%, but match rates fell from 82% to 56%. Osteopathic graduates doubled, whereas international graduates increased to 53.8%. Successful matches were associated with US allopathic medical school graduates, university-affiliated general surgery residencies, eight or more interviews, United States Medical Licensing Examination scores greater than 230, and high post graduate year (PGY)1–3 American Board of Surgery In-service Training Examination scores (PGY1–64.7%, PGY2–61.2%, PGY3–60.7%; P < 0.05). Of surveyed programs, 55.6% aimed to continue running the independent track in the next year. Conversely, 7.4% planned to discontinue in the next year, 22.2% within 2–5 years, 7.4% within the next decade, and 7.4% were unsure. Conclusions:. Although support for the independent plastic surgery track remains, program participation diminishes as applicant interest increases, intensifying match challenges. Increasing number of interviews improves match potential. Program leaders display varied commitments, with looming plans for some programs to discontinue offering this track. Applicant evaluation pivots on strong recommendations, research, and test scores.

Key Clinical Message Intra‐flap recurrence after reconstruction is a possible complication in oral squamous cell carcinoma (OSCC) after curative resection and reconstruction with a free flap. Abstract This case report describes an intra‐flap recurrence after tumor resection and reconstruction with a latissimus dorsi flap due to OSCC. We report a 58‐year‐old female patient who underwent curative resection of a squamous cell carcinoma in the oral cavity and submental area and reconstruction with a latissimus dorsi free flap. Thirteen months after the operation, the patient presented with lung metastases and, 22 months after the operation, a metastatic lesion in the flap's central area with no sign of recurrence in the primary resection site occurred. The patient died 25 months after the initial operation due to the rapid progression of the disease and further distant metastases. To our knowledge, similar cases do not exist in the literature. This is the first reported case of intra‐flap metastasis after surgical treatment of OSCC.

As power systems integrate increasing quantities of wind, solar and energy storage resources, it is important to revisit power system capacity expansion modeling methods and assumptions that have been utilized in thermal-dominated systems. We conduct a series of case study analyses using a simplified representation of the Electric Reliability Council of Texas (ERCOT) system to demonstrate how least-cost capacity expansion outcomes are impacted by changes in model resolution across two temporal dimensions: 1) the number of considered representative periods, and 2) the system dispatch interval. First, we find that the least-cost generation portfolio can differ significantly for small changes in the number of representative days, but largely converges to the 365-day result once 104 representative days are considered. Furthermore, systems with wind, solar and storage resources were more sensitive to changes in the number of representative days than a thermal-dominated system. Second, we find that considering five-minute dispatch resolution consistently results in least-cost generation portfolios with less solar capacity and more energy storage capacity than corresponding scenarios with hourly dispatch intervals. This suggests that hourly dispatch representation fails to capture the intra-hour volatility of solar generation, and therefore also overlooks opportunities for storage resources to provide system value by balancing this volatility. Collectively these results indicate that capacity expansion modelers should revisit conventional approaches to temporal representation when conducting analyses of deeply decarbonized power systems to ensure that such analyses are robust and actionable. To our knowledge, this is the first study to analyze capacity expansion outcomes with five-minute dispatch resolution in this manner.

Abstract X-ray free-electron lasers are sources of coherent, high-intensity X-rays with numerous applications in ultra-fast measurements and dynamic structural imaging. Due to the stochastic nature of the self-amplified spontaneous emission process and the difficulty in controlling injection of electrons, output pulses exhibit significant noise and limited temporal coherence. Standard measurement techniques used for characterizing two-coloured X-ray pulses are challenging, as they are either invasive or diagnostically expensive. In this work, we employ machine learning methods such as neural networks and decision trees to predict the central photon energies of pairs of attosecond fundamental and second harmonic pulses using parameters that are easily recorded at the high-repetition rate of a single shot. Using real experimental data, we apply a detailed feature analysis on the input parameters while optimizing the training time of the machine learning methods. Our predictive models are able to make predictions of central photon energy for one of the pulses without measuring the other pulse, thereby leveraging the use of the spectrometer without having to extend its detection window. We anticipate applications in X-ray spectroscopy using XFELs, such as in time-resolved X-ray absorption and photoemission spectroscopy, where improved measurement of input spectra will lead to better experimental outcomes.

Abstract Background Cardiac injury is frequently reported in COVID-19 patients, the right ventricle (RV) is mostly affected. We systematically evaluated the cardiac function and longitudinal changes in severe COVID-19 acute respiratory distress syndrome (ARDS) admitted to the intensive care unit (ICU) and assessed the impact on survival. Methods We prospectively performed comprehensive echocardiographic analysis on mechanically ventilated COVID-19 ARDS patients, using 2D/3D echocardiography. We defined left ventricular (LV) systolic dysfunction as ejection fraction (EF) − 18% and right ventricular (RV) dysfunction if two indices among fractional area change (FAC) − 20% were present. RV afterload was assessed from pulmonary artery systolic pressure (PASP), PASP/Velocity Time Integral in the right ventricular outflow tract (VTI RVOT ) and pulmonary acceleration time (PAcT). TAPSE/PASP assessed the right ventriculoarterial coupling (VAC R ). Results Among 176 patients included, RV dysfunction was common (69%) (RV–EF 41.1 ± 1.3%; RV–FAC 36.6 ± 0.9%, TAPSE 20.4 ± 0.4mm, RV–LS:− 14.4 ± 0.4%), usually accompanied by RV dilatation (RVEDA/LVEDA 0.82 ± 0.02). RV afterload was increased in most of the patients (PASP 33 ± 1.1 mmHg, PAcT 65.3 ± 1.5 ms, PASP/VTI RVOT , 2.29 ± 0.1 mmHg/cm). VAC R was 0.8 ± 0.06 mm/mmHg. LV–EF

Abstract The importance of hip adductor strength for injury prevention and performance benefits is well documented. The purpose of this study was to establish the intra‐ and inter‐day variability of peak force (PF) of a groin squeeze protocol using a custom‐designed compression strain gauge device. Sixteen semi‐professional soccer players completed three trials over three separate testing occasions with at least 24‐h rest between each session. The main findings were that the compression strain gauge was a reliable device for measuring PF within and between days. All intraclass correlations were higher than 0.80 and coefficients of variations were below 10% across the different sessions and trials. Due to the information gained through the compression strain gauge, the higher sampling frequency utilized, portability, and the relatively affordable price, this device offers an effective alternative for measuring maximal strength for hip adduction.

Abstract Canine personality and behavioural characteristics have a significant influence on relationships between domestic dogs and humans as well as determining the suitability of dogs for specific working roles. As a result, many researchers have attempted to develop reliable personality assessment tools for dogs. Most previous work has analysed dogs’ behavioural patterns collected via questionnaires using traditional statistical analytic approaches. Artificial Intelligence has been widely and successfully used for predicting human personality types. However, similar approaches have not been applied to data on canine personality. In this research, machine learning techniques were applied to the classification of canine personality types using behavioural data derived from the C-BARQ project. As the dataset was not labelled, in the first step, an unsupervised learning approach was adopted and K-Means algorithm was used to perform clustering and labelling of the data. Five distinct categories of dogs emerged from the K-Means clustering analysis of behavioural data, corresponding to five different personality types. Feature importance analysis was then conducted to identify the relative importance of each behavioural variable’s contribution to each cluster and descriptive labels were generated for each of the personality traits based on these associations. The five personality types identified in this paper were labelled: “Excitable/Hyperattached”, “Anxious/Fearful”, “Aloof/Predatory”, “Reactive/Assertive”, and “Calm/Agreeable”. Four machine learning models including Support Vector Machine (SVM), K-Nearest Neighbour (KNN), Naïve Bayes, and Decision Tree were implemented to predict the personality traits of dogs based on the labelled data. The performance of the models was evaluated using fivefold cross validation method and the results demonstrated that the Decision Tree model provided the best performance with a substantial accuracy of 99%. The novel AI-based methodology in this research may be useful in the future to enhance the selection and training of dogs for specific working and non-working roles.

The continuous growth of urban populations has led to the persistent problem of traffic congestion, which imposes adverse effects on quality of life, such as commute times, road safety, and the local air quality. Advancements in Internet of Things (IoT) sensor technology have contributed to a plethora of new data streams regarding traffic conditions. Therefore, the recognition and prediction of traffic congestion patterns utilizing such data have become crucial. To that end, the integration of Machine Learning (ML) algorithms can further enhance Intelligent Transportation Systems (ITS), contributing to the smart management of transportation systems and effectively tackling traffic congestion in cities. This study seeks to assess a wide range of models as potential solutions for an ML-based multi-step forecasting approach intended to improve traffic congestion prediction, particularly in areas with limited historical data. Various interpretable predictive algorithms, suitable for handling the complexity and spatiotemporal characteristics of urban traffic flow, were tested and eventually shortlisted based on their predictive performance. The forecasting approach selects the optimal model in each step to maximize the accuracy. The findings demonstrate that, in a 24 h step prediction, variating Ensemble Tree-Based (ETB) regressors like the Light Gradient Boosting Machine (LGBM) exhibit superior performances compared to traditional Deep Learning (DL) methods. Our work provides a valuable contribution to short-term traffic congestion predictions and can enable more efficient scheduling of daily urban transportation.

Background and Objectives: Adolescent Idiopathic Scoliosis (AIS) affects individuals aged 10–18 years and is characterized by spinal deformity, three-dimensional axis deformation, and vertebral rotation. Schroth method exercises and braces have been shown to reduce the Cobb angle and halt spinal deformity progression. The aim of this study was to investigate the impact of a 12-month, supervised Schroth exercise program on scoliosis severity and quality of life in adolescents with AIS. Materials and Methods: Eighty adolescents with AIS (aged 10–17 years) were prescribed a brace and were divided into two groups. The intervention group followed a supervised Schroth exercise program three times a week for 12 months in addition to wearing a brace. The control group used only the brace. Outcomes included the Cobb angle of the main curvature and the sum of curves using radiography, the maximum angle of trunk rotation (ATR maximum, using a scoliometer), and quality of life with the Scoliosis Research Society-22 (SRS-22) questionnaire. Evaluations were conducted at baseline, after 12 months, and 6 months post-intervention. A multivariate analysis of covariance (MANCOVA) was used for statistical analysis (p-Value < 0.05). Results: The intervention group showed statistically significant improvement compared to the control group in the 12th month in Cobb angle (mean differences, 95% CI: −3.65 (−5.81, −1.53), p-Value < 0.001, Cohen’s d = 0.30), ATR maximum (mean differences, 95% CI: −3.05 (−3.86, −2.23), p-Value < 0.001, Cohen’s d = 0.74), and SRS-22 score (mean differences, 95% CI: 0.87 (0.60, 1.13), p-Value < 0.001, Cohen’s d = 0.58). Differences in ATR maximum and SRS-22 score remained significant at the 18-month measurement. No significant differences were found between groups in the sum of curves (p-Value > 0.05). Conclusions: A 12-month supervised Schroth exercise program in AIS patients undergoing brace treatment significantly improves scoliosis severity (Cobb angle and ATR maximum) and quality of life. Improvements were greater than those in shorter-duration studies, suggesting a linear dose–response relationship. Further clinical studies are needed to clarify the impact of long-term Schroth programs.

Key Clinical Message We present a case of Cronkhite–Canada syndrome in a patient with decompensated cirrhosis who had successful induction of remission with nutritional supplementation alone. We propose that early institution of high‐protein, high‐energy enteral supplementation should be offered to all patients, especially those with compelling contraindications to immunosuppression.

Las vasculitis de las arterias o vasculitis cerebelosas en el lupus eritematoso sistémico (LES) son extremadamente infrecuentes y podrían estar inmersas o formar parte de los casos de LES neuropsiquiátrico (LESNP), stroke cerebeloso en el LES y grupo de vasculitis del sistema nervioso central (SNC ) por LES. La adición del manejo quirúrgico a esta entidad, mediante descompresión suboccipital, ha sido reportada en muy pocas publicaciones. Se presenta el caso de una paciente mujer de 18 años con LES, LESNP, stroke cerebeloso, con alta sospecha de vasculitis inflamatoria de las arterias cerebelosas a quien, a pesar del manejo médico, se le brindó descompresión suboccipital. La vasculitis inflamatoria de las arterias cerebelosas en el LES es una causa infrecuente de stroke cerebeloso de elevada mortalidad. Existe limitada evidencia científica en la realización de la descompresión suboccipital de esta entidad.

ObjectiveThis study aimed to investigate growth and gut comfort of healthy infants fed with a partially hydrolysed cow's milk protein-based infant formula (pHF) compared to a standard intact cow's milk protein-based formula (IPF).MethodsA double-blind, multi-center, randomized, controlled trial was performed. Healthy full-term, exclusively formula-fed infants (n = 345), aged ≤28 days were allocated to consume either a pHF (n = 173) or an IPF (n = 172) until the age of 17 weeks. The primary outcome was equivalence of weight gain (g/d) until the age of 17 weeks. The secondary outcomes were equivalence of other growth parameters, i.e., infants’ weight, length, head circumference, body mass index (BMI) and anthropometric Z-scores, while tertiary outcomes were gut comfort, formula intake, and adverse events (AEs).ResultsOverall, 288 infants completed the study (pHF group: 138, IPF group: 150). No differences were observed between the two groups in weight gain (g/d) during the three-months intervention [p = 0.915 for the Per Protocol (PP) population]. The 90% CI was [−1.252 to 1.100] being within the pre-defined equivalence margin of ±3.0 g/d. Similar findings were observed in the Full Analysis Set (FAS) and the sensitivity analysis. Regarding the secondary outcomes, no differences over the intervention period were shown between the two groups in both the PP and FAS analysis sets. Average Z-scores were in the normal range based on World Health Organization (WHO) growth standards for both groups at all time points in both analysis sets. Stool consistency, amount, and colour were different in the two groups. No differences were observed in gut comfort, stool frequency, and formula intake, between the two groups. In total 14 AEs and 22 serious adverse events (SAEs) were reported of which 15 (12%) and 1 (5%) were considered as (possibly) related to the study product, respectively.ConclusionsThe study demonstrates that the consumption of pHF results in adequate infant growth, equivalent to that of infants consuming IPF. Furthermore, the overall gut comfort was comparable between the two groups. Therefore, it can be concluded that the pHF is safe for and well tolerated by healthy infants.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT05757323?id=NCT05757323&rank=1, identifier (NCT05757323).

Surgeons are skilled at making complex decisions over invasive procedures that can save lives and alleviate pain and avoid complications in patients. The knowledge to make these decisions is accumulated over years of schooling and practice. Their experience is in turn shared with others, also via peer-reviewed articles, which get published in larger and larger amounts every year. In this work, we review the literature related to the use of Artificial Intelligence (AI) in surgery. We focus on what is currently available and what is likely to come in the near future in both clinical care and research. We show that AI has the potential to be a key tool to elevate the effectiveness of training and decision-making in surgery and the discovery of relevant and valid scientific knowledge in the surgical domain. We also address concerns about AI technology, including the inability for users to interpret algorithms as well as incorrect predictions. A better understanding of AI will allow surgeons to use new tools wisely for the benefit of their patients.

Purpose: Peer mentorship provides professional and personal support between physicians with similar experiences and levels of training. While peer mentorship has shown to benefit academic success and professional growth, little data has examined contextual factors, such as curricular change, that may affect the quality of these relationships. This study aims to explore the impact of a new, nationwide radiation oncology (RO) residency curriculum, known as competence by design (CBD), on peer mentorship experiences between Canadian RO residents. Methods and Materials: A qualitative study, with a social constructivist approach, was conducted with 2 groups of Canadian RO residents. The first were those in the academic year before CBD implementation (non-CBD cohort), and the second were those in the inaugural year of CBD (CBD cohort). Semistructured 1-on-1 interviews were conducted to explore experiences of peer mentorship as it related to curriculum change. Interviews were transcribed and analyzed with deductive and inductive methods until data saturation. Results: Between April and December 2021, 14 participants (6 non-CBD and 8 CBD residents) from 8 out of 10 eligible English-speaking RO training programs across Canada participated. Three major themes were identified: (1) the CBD cohort identified fewer opportunities for peer mentorship, with specific concerns regarding new evaluation processes and uncertainty about the later stages of training; (2) there was minimal impact on specialty-specific learning; and (3) peer mentorship thrived when occurring as spontaneous in-person interactions. Conclusions: Inaugural residents of a CBD curriculum perceived fewer opportunities for peer mentorship. There were specific concerns about new evaluative processes, though this did not affect specialty-specific learning. Peer mentorship was most impactful as informal and in-person interactions. Our findings suggest that unintended consequences of curriculum change may be mitigated by improving communication about new training objectives and increasing opportunities for informal interactions between residents.

Gene expression can be influenced by genetic variants that are closely linked to the expressed gene (cis eQTLs) and variants in other parts of the genome (trans eQTLs). We created a multiparental mapping population by sampling genotypes from a single natural population of Mimulus guttatus and scored gene expression in the leaves of 1,588 plants. We find that nearly every measured gene exhibits cis regulatory variation (91% have FDR < 0.05). cis eQTLs are usually allelic series with three or more functionally distinct alleles. The cis locus explains about two thirds of the standing genetic variance (on average) but varies among genes and tends to be greatest when there is high indel variation in the upstream regulatory region and high nucleotide diversity in the coding sequence. Despite mapping over 10,000 trans eQTL / affected gene pairs, most of the genetic variance generated by trans acting loci remains unexplained. This implies a large reservoir of trans acting genes with subtle or diffuse effects. Mapped trans eQTLs show lower allelic diversity but much higher genetic dominance than cis eQTLs. Several analyses also indicate that trans eQTLs make a substantial contribution to the genetic correlations in expression among different genes. They may thus be essential determinants of "gene expression modules," which has important implications for the evolution of gene expression and how it is studied by geneticists.