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This study presents a population balance model for the kinetics of nucleation and growth in covalent organic framework (COF) synthesis. The model incorporates second-order nucleation and first-order growth rates, consistent with proposals in the literature. Despite having non-linear terms, an implicit analytic solution is derived and then converted to explicit solutions for the monomer concentration and size distribution of COF flakes as a function of time. For experimental definitions of the induction time and the initial growth rate based on yield (y) vs time (t) curves, the model predicts power-law relationships: t ind = 0.409 k N − 1 / 3 k G − 2 / 3 c A 0 − 1 and d y / d t max = 0.965 k N 1 / 3 k G 2 / 3 c A 0 , respectively. We discuss the implications for the interpretation of Arrhenius plots. We also discuss key discrepancies with experiments, including the predicted attainment of 100% yield instead of 30%–40% as observed and the value of the yield at the inflection point in the yield vs time curve. We suggest extensions to the model, including nucleation and growth kinetics with equilibrium solubility limitations and two-dimensional nucleation for the formation of multilayer COF particles. [ABSTRACT FROM AUTHOR]

Halide perovskites are essential materials for hard radiation detectors at ambient temperature. To improve detector performance, charge transport must be investigated and optimized. Using photoluminescence (PL) and thermally stimulated current (TSC) spectroscopies, we investigate photogenerated charge carriers in Bridgman-grown CsPbBr3 single crystals to understand the nature of charge transport. PL spectroscopy of these halide perovskites revealed the presence of strong emission bands at the band edge, which were attributed to free or bound excitons. It is shown that a wide broadening of the excitonic linewidth in these halide perovskites arises from strong exciton–phonon coupling, which is substantially dominated by longitudinal optical phonons via Fröhlich interaction. An additional contribution due to the presence of ionized impurities was also observed. Crystals with a detectable sensitivity to high-energy gamma radiation are characterized by a higher intensity and a narrower linewidth of the principal PL peak at 2.326 eV. Defect states beyond 2.214 eV have a negative impact on detector sensitivity to high-energy gamma radiation. TSC spectroscopy reveals an array of trap levels spanning 0.15–0.70 eV, attributed to intrinsic point defects and multiple extrinsic defects involving dopants or impurities. Defects identified included Cs and Br vacancies, as well as Pb interstitials with concentrations in the 1011–1016 cm−3 range. Understanding how the synthesis process impacts the types and concentrations of the defects present is currently under investigation. Elimination or suppression of the defect/trap states should result in halide perovskite materials with longer carrier diffusion lengths and improved detector characteristics. [ABSTRACT FROM AUTHOR]

High-temperature annealing (HTA) is one of the most promising techniques to produce high-quality, cost-efficient AlN templates for further epitaxial growth of AlGaN devices. Unfortunately, the yield of this process seems to be limited due to the restricting face-to-face configuration that is typically used, in which contaminations of the template surface can occur easily. A high yield is crucial for process transfer into industry. Indeed, templates that are annealed in open-face configuration suffer from surface degradation due to excessive AlN evaporation during the course of the annealing process. To highlight the physics that are restricting the open-face approach of the process, sublimation behavior of AlN at temperatures and atmospheres typically used in HTA processes has to be examined. In this study, we use the Knudsen effusion mass spectrometry technique to confirm the previously published results on equilibrium partial pressures of species above AlN. Based on the experimentally determined data and further AlN sublimation experiments, the apparent sublimation coefficient of AlN in N2 and Ar atmospheres at HTA process conditions can be derived. Despite N2 having a stabilizing effect on AlN during HTA, the still high decomposition rates of several hundred nanometers per hour can explain the excessive damage that is typically observed if AlN/sapphire templates are annealed in an open-face configuration. Finally, based on theoretical considerations, a strategy to reduce the sublimation of AlN during HTA in open-face configuration is suggested. [ABSTRACT FROM AUTHOR]

The challenges New Zealand faces are stark. Russia's illegal invasion of Ukraine, the utter catastrophe unfolding in Gaza, North Korea's emerging nuclear capability -- all have undermined old certainties in the international order. Three big shifts are apparent: from rules to power, from economics to security and from efficiency to resilience. In response to these shifts, the government has embarked on a foreign policy reset designed to reinvigorate and focus our foreign, defence and trade policy agendas. On the AUKUS issue, it is continuing a process begun by its predecessor Labourled government of considering New Zealand involvement in the arrangement's Pillar 2. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONWheelchair users (WCUs) face additional challenges than non-WCU to multi-tasking (i.e. open doors, cook, use a cell-phone) while navigating their environments. While assistive devices have attempted to provide WCUs with mobility solutions that enable multi-tasking capabilities, current devices have been developed without the input of end-users and have proven to be non-usable. More balanced approaches that integrate the end-users’ voices may improve current assistive technology usability trends. This study sought to empathically understand the lived experience of WCUs, their needs towards a mobility device, and their perceptions towards hands-free mobility. Full-time WCUs and care providers participated in semi-structured interviews examining wheelchair use and perceptions towards current and future mobility devices. Thematic analysis was used to analyze interview data. 9 WCUs (aged 32.1 ± 7.0 years; wheelchair experience 17.9 ± 11.6 years) and five care providers (years caring for WCU 3.75 ± 0.96 years) participated in the study. The most common disability type was spinal cord injury (WCUs: n = 3; care providers: n = 3). Qualitative analysis revealed four key themes: (1) Current wheelchair usage, (2) WCU and care provider perspectives, (3) Future wheelchair, and (4) Hands-free wheelchair. Accordingly, participants desire bespoke, light-weight mobility devices that can through tight spaces, access uneven terrain, and free the hands during navigation. This study provides meaningful insight into the needs of WCUs and care providers that assistive technology innovators can use to develop more usable assistive technologies. Amongst study participants, the concept of a hands-free mobility device appears to be usable and desirable.Integrating end-users’ voices into the development of assistive technology may improve current usability trendsWheelchair users desire access to their hands and the ability to multi-task while navigating their wheelchairsThe development of a hands-free mobility device may profoundly improve the quality of life of wheelchair users.Integrating end-users’ voices into the development of assistive technology may improve current usability trendsWheelchair users desire access to their hands and the ability to multi-task while navigating their wheelchairsThe development of a hands-free mobility device may profoundly improve the quality of life of wheelchair users. [ABSTRACT FROM AUTHOR]

Following the approval of the first antibody–drug conjugates (ADCs) in the early 2000s, development has increased dramatically, with 14 ADCs now approved and >100 in clinical development. In lung cancer, trastuzumab deruxtecan (T-DXd) is approved in human epidermal growth factor receptor 2 (HER2)-mutated, unresectable or metastatic non-small-cell lung cancer, with ADCs targeting HER3 (patritumab deruxtecan), trophoblast cell-surface antigen 2 [datopotamab deruxtecan and sacituzumab govitecan (SG)] and mesenchymal–epithelial transition factor (telisotuzumab vedotin) in late-stage clinical development. In breast cancer, several agents are already approved and widely used, including trastuzumab emtansine, T-DXd and SG, and multiple late-stage trials are ongoing. Thus, in the coming years, we are likely to see significant changes to treatment algorithms. As the number of available ADCs increases, biomarkers (of response and resistance) to better select patients are urgently needed. Biopsy sample collection at the time of treatment selection and incorporation of translational research into clinical trial designs are therefore critical. Biopsy samples taken peri- and post-ADC treatment combined with functional genomics screens could provide insights into response/resistance mechanisms as well as the impact of ADCs on tumour biology and the tumour microenvironment, which could improve understanding of the mechanisms underlying these complex molecules. Many ADCs are undergoing evaluation as combination therapy, but a high bar should be set to progress clinical evaluation of any ADC-based combination, particularly considering the high cost and potential toxicity implications. Efforts to optimise ADC dosing/duration, sequencing and the potential for ADC rechallenge are also important, especially considering sustainability aspects. The ETOP IBCSG Partners Foundation are driving strong collaborations in this field and promoting the generation/sharing of databases, repositories and registries to enable greater access to data. This will allow the most important research questions to be identified and prioritised, which will ultimately accelerate progress and help to improve patient outcomes. • As the number of available ADCs increases, biomarkers are required to optimise treatment algorithms and patient selection. • Combination therapy of ADCs should be scientifically driven and studied in biomarker-driven trials of enriched populations. • Efforts to optimise ADC treatment duration, sequencing and the potential for ADC rechallenge are essential. • In clinical trials, biopsy sample collection and translational research are critical to improve our understanding of ADCs. • Effective collaborations are required to accelerate progress, which will ultimately help improve patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: The diagnosis and management of Superior Canal Dehiscence Syndrome (SCDS) with concomitant otosclerosis can be a challenge. Otosclerosis can mask SCDS symptoms and stapes surgery may reveal or exacerbate vestibular symptoms. Our aim is to present four cases of SCDS with concomitant otosclerosis and thereby informing the reader about the possibility of this dual occurrence and its implications for treatment. Cases: Four patients with SCDS and concomitant otosclerosis are presented. Two patients underwent surgical treatment for both SCDS and otosclerosis and two patients opted for conservative management. Outcomes: The main differences between surgically and non-surgically treated cases are the presence of autophony and pressure-induced vertigo and a more severe experience of symptoms in surgically treated cases. Surgically treated cases achieved a sizeable reduction in postoperative air–bone gap and resolution of vestibular symptoms. Conclusion: The subjective severity of symptoms in combination with shared decision-making is key in determining the appropriate treatment plan for SCDS and concomitant otosclerosis. [ABSTRACT FROM AUTHOR]

Students who are Black or Hispanic have long been disproportionately represented in K–12 gifted and talented services. However, there are schools that have diverged from this trend by identifying atypically high numbers of Black and Hispanic students. In this conceptual replication of Peters and Johnson, we present predictors of whether a school offers gifted services (i.e., access) and representation indices for Black and Hispanic students (i.e., equity) within schools that enroll 10 or more Black or Hispanic students. Our results show that state policy mandates for gifted education are predictive of higher levels of access to and equity within gifted services for these schools. The average achievement and socioeconomic status of the district were positive predictors of access and equity while the district proportion eligible for special education services was a negative predictor of both. Finally, we end with a description of how the top 5% most-equitable schools in the country look different from their peers. [ABSTRACT FROM AUTHOR]

Objective: Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative condition characterized by progressive changes in behavior, cognition, and day-to-day functioning. Progression of the disease usually leads to death 3–5 years after diagnosis. However, there are reports of individuals who are initially diagnosed with bvFTD but fail to progress. These individuals are thought to have what is becoming known as phenocopy bvFTD (phFTD). Methods: This manuscript reviews a single case study of a 68-year-old male Veteran who was diagnosed with bvFTD in 2010, which has not progressed over time. Results: Review of serial neuropsychological evaluations was broadly normal with mild evidence of executive dysfunction with minimal reliable change in his performances from 2015, 2017, and 2022 evaluations. He also has not developed neuroimaging evidence of FTD. Conclusions: This case illustrates the importance of monitoring individuals over time and incorporating neuroimaging data into the diagnosis. We believe this Veteran's presentation is most consistent with what has been described as phFTD. [ABSTRACT FROM AUTHOR]

During times of stress, we look to close others for support. Social support conversations are critical for relationship maintenance and well‐being. Yet, certain ways of talking about problems—such as co‐ruminating—can exacerbate stress. Since social support and co‐rumination are both dyadic processes, it is important to examine physiological responses during these conversations in a dyadic manner. Little research has examined physiological synchrony of the sympathetic nervous system (SNS) during social support conversations or co‐ruminative conversations. The current research capitalizes on an experimental manipulation of co‐rumination using a sample of close friends (147 dyads) and romantic partners (113 dyads) to examine physiological covariation in the context of support. Across both samples, dyads exhibited significant physiological covariation in pre‐ejection period reactivity (PEP). Contrary to our hypothesis, dyads in the co‐rumination condition did not show more covariation. Close friend dyads did, however, exhibit more covariation as compared to romantic dyads. We also found significant variability in physiological covariation across dyads, with a minority of dyads exhibiting negative covariation of PEP reactivity. The homogeneity of the samples limits the generalizability of the findings and highlights the need for more diverse samples in future work. These findings underline the need for further exploration into the mechanisms that contribute to distinct patterns of physiological synchrony, the conditions in which negative synchrony occurs, and what predicts especially strong positive synchrony. This work extends our understanding of physiological synchrony of the sympathetic nervous system during support conversations and emphasizes the importance of considering heterogeneity in physiological processes. Impact statement: This research capitalizes on two dyadic experiments to examine physiological covariation during supportive conversations, examining whether certain ways of providing support affects synchrony. The findings show that not only does physiological covariation of the sympathetic nervous system occur, but it is variable across dyads and stronger for close friends as compared to romantic partners. [ABSTRACT FROM AUTHOR]

Lymphovascular space invasion (LVSI) is an important prognostic parameter in endometrial carcinoma (EC) and has gained increasing interest in recent years due to an expanding body of evidence of its independent prognostic value, especially when the presence of LVSI is quantified. A key strength of LVSI as a prognostic factor is that it can be detected on routine microscopic examination, without ancillary tests, and thus can be used in low‐resource settings. A weakness, however, is the lack of uniformly applied criteria for assessment and quantification of LVSI, resulting in interobserver variation in diagnosis. This is confounded by artefacts and other morphological features that may mimic LVSI (commonly referred to as pseudo‐LVSI). Despite these issues, multiple studies have shown that LVSI is strongly associated with lymph node (LN) metastasis and is an independent risk factor for LN recurrence and distant metastasis. Consequently, the presence of substantial/extensive LVSI has become an important consideration in formulating adjuvant treatment recommendations in patients with EC, and this has been incorporated in the recent International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system. Herein, we review the current literature on LVSI in EC and discuss its role as a prognostic marker, the reproducibility of LVSI assessment and distinction between LVSI and its mimics. We provide illustrations of key diagnostic features and discuss the two‐tiered (none/focal versus substantial) system of LVSI classification. This work is intended to provide guidance to practising pathologists and unify the approach towards LVSI assessment in EC. [ABSTRACT FROM AUTHOR]

The minute marine multicellular heterokont alga originally described as “Giraudyopsis stellifer” by P.J.L. Dangeard, nom. inval., from Atlantic France, was re-isolated by the germling emergence technique and classified according to psaA and psbC sequences. It is genetically similar (99–100 % identity) to Phaeosaccion multiseriatum R.A. Andersen, L. Graf et H.S. Yoon recently described from the NE Pacific, an ephemeral alga of wide geographical distribution. We isolated it also from substratum samples collected in Korea and the Falkland Islands, where it had not been reported previously. Two isolates of similar morphology from the coast of Chile had the same nuclear ribosomal SSU sequence but differed from P. multiseriatum and P. okellyi R.A. Andersen, L. Graf et H.S. Yoon from New Zealand in psaA and psbC sequences (3–4 % genetic distance). These two isolates are here described as Phaeosaccion  westermeieri sp. nov.. Our isolations of P. multiseriatum and P. westermeieri are a further demonstration that the germling emergence technique can reveal microscopic multicellular benthic algae that are easily overlooked in the field. [ABSTRACT FROM AUTHOR]

Background: The Thriving from Work questionnaire is a comprehensive indicator of positive well-being for employees, applicable in both research and practical contexts. Current discussions underline the crucial impact that employment should have in enriching workers' lives positively and meaningfully, along with the necessity for accurate and dependable tools to assess employee well-being. This study investigated the reliability, validity, and dimensionality of the translated German adaptation of the Thriving from Work questionnaire developed by Peters and colleagues [1, 2]. The questionnaire assesses work-related well-being with 30 items clustered in six domains: emotional and psychological well-being, social well-being, work-life integration, physical and mental well-being, basic needs for thriving, and experiences of work. Methods: This study aimed to convert the Thriving at Work Questionnaire from English into German. We assessed the psychometric characteristics of the German version of the questionnaire by using item response theory with a sample of 567 German employees and examined its criterion validity. Results: We found that the long and short German Thriving from Work questionnaire versions are reliable with good construct validity. Criterion validity was demonstrated by relationships with important work and life outcomes, such as life satisfaction, trust in the organizations' management, general well-being, work-related fatigue, and work stress. Conclusions: The current study demonstrated that the German language version of the questionnaire is both a reliable and valid measure of employee well-being. We discuss recommendations for further adaptation and future research. [ABSTRACT FROM AUTHOR]

Social anxiety (SA) is characterized by anxious symptomology and fear during social situations, but recent work suggests that SA may not necessarily be associated with negative interpersonal and intrapersonal outcomes in support contexts. The current research investigates the discrepancies between self‐perceptions, behavior, and physiological responses associated with SA in social support conversations with close friends. Specifically, we examined the associations between SA and positive and negative affect, perceptions of demands and resources, and responsiveness. Additionally, we used the biopsychosocial model of challenge and threat to understand the physiological responses associated with SA. Participants (79.9% White, 9.8% Black or African American, 10.3% Multiple races or other; 78.7% Female), totaling 172 undergraduate friend dyads, completed self‐report measures and had physiological responses recorded while they discussed a problem unrelated to the friendship. Trained coders rated responsive behaviors exhibited during the conversation. Results revealed that greater SA was associated with greater negative perceptions of social interactions (greater negative affect, fewer perceived resources, and greater perceived demands). However, cardiovascular reactivity and behavioral responses within the conversation, as well as perceptions of partners' behavior after the conversation, contrasted with these negative perceptions. Indeed, greater SA was associated with greater sympathetic arousal (indicative of greater task engagement), but not with greater challenge or threat, and SA was not associated with perceived partner responsiveness or responsive behaviors. These results add to the growing body of research that suggests people with greater SA show inconsistencies between their conscious appraisals of social situations and their physiological responses. [ABSTRACT FROM AUTHOR]

Patients with major depression often suffer from excessive interpersonal sensitivity, although it is not typically measured in antidepressant clinical trials. Preliminary evidence suggests selective serotonin reuptake inhibitors have the capacity to reduce interpersonal sensitivity. This was a pooled analysis of data from 1709 patients in three randomized, double-blind, placebo-controlled trials of fluoxetine and paroxetine for acute major depressive disorder. Depressive symptoms were assessed with the Hamilton Depression Rating Scale. A factor from the Symptom Checklist was used to assess interpersonal sensitivity. Our outcome of interest was change from baseline scores at the last assessment (up to 8 or 12 weeks, depending on the trial). Both medications produced significantly greater reductions in interpersonal sensitivity relative to placebo. The effect of medication remained significant after controlling for depression improvement, which explained 18.5% of the variation in interpersonal sensitivity improvement among those treated with active medication. The effect of medication on depressive symptoms, relative to placebo, was not influenced by baseline interpersonal sensitivity. The outcome measured interpersonal sensitivity over the last week, and the results do not necessarily reflect changes in long-standing, trait-like patterns of interpersonal sensitivity. Only two medications were studied. Selective serotonin reuptake inhibitors are effective at treating interpersonal sensitivity in acutely depressed patients. This appears to be a unique drug effect that is not only the result of depression improvement. Future clinical trials might benefit from assessing interpersonal sensitivity more routinely. • Paroxetine and fluoxetine reduced interpersonal sensitivity more than placebo. • This effect could not be fully explained by concurrent depression improvement. • Baseline interpersonal sensitivity did not moderate the depression treatment effect. [ABSTRACT FROM AUTHOR]

The article highlights considerations and practical support for new pharmacy leaders when faced with managing the unexpected. Topics discussed include action that can help new pharmacy leaders detect when actual operations deviate from expected outcomes, role of new pharmacy leaders in the execution of operational and clinical strategies to ensure order across departmental teams, and difficult aspects of leadership for a new pharmacy leader.

The amount of laundry washed by European consumers has grown excessively for reasons that cannot be explained by demographics alone. Initiatives trying to curb this trend have repeatedly failed. Previous studies have largely overlooked the psychological dimensions of laundering behaviour. In three separate studies we investigate how disgust, shame, cleanliness norms and environmental identity, mediated through a set of preceding behaviours, affect washing frequency. Our results highlight how conflicting psychological goals between disgust sensitivity and pro-environmental identity can undermine willingness to change laundry behaviour. Policy recommendations are suggested, and future research challenges are discussed. [ABSTRACT FROM AUTHOR]

Background: Involuntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL. Methods: We conducted a retrospective health records analysis of all involuntarily hospitalised cases in the four psychiatric hospitals of the city of Cologne, Germany, in 2011. Of the 1,773 cases, 87.3% were detained under the MHA of the federal state of North Rhine-Westphalia and 6.4% were hospitalised according to the federal LGL. Another 6.3% of the cases were originally admitted under the MHA, but the legal basis of detention was converted to LGL during the inpatient psychiatric stay (MHA→LGL cases). We compared sociodemographic, clinical, systemic and environmental socioeconomic (ESED) variables of the three groups by means of descriptive statistics. We also trained and tested a machine learning-based algorithm to predict class membership of the involuntary modes of psychiatric inpatient care. Results: Cases with an admission under the premises of LGL lived less often on their own, and they were more often retired compared to MHA cases. They more often had received previous outpatient or inpatient treatment than MHA cases, they were more often diagnosed with a psychotic disorder and they lived in neighbourhoods that were on average more socially advantaged. MHA→LGL cases were on average older and more often retired than MHA cases. More often, they had a main diagnosis of an organic mental disorder compared to both MHA and LGL cases. Also, they less often received previous psychiatric inpatient treatment compared to LGL cases. The reason for detention (self-harm or harm to others) did not differ between the three groups. The proportion of LGL and MHA cases differed between the four hospitals. Effect sizes were mostly small and the balanced accuracy of the Random Forest was low. Conclusion: We found some plausible differences in patient characteristics depending on the legal foundation of the involuntary psychiatric hospitalisation. The differences relate to clinical, sociodemographic and socioeconomical issues. However, the low effect sizes and the limited accuracy of the machine learning models indicate that the investigated variables do not sufficiently explain the respective choice of the legal framework. In addition, we found some indication for possibly different interpretation and handling of the premises of the law in practice. Our findings pose the need for further research in this field. [ABSTRACT FROM AUTHOR]

Despite growing research about asexuality in the field, there is a lack of asexual-centric health communication research. We leverage a communication lens in examining the lives of asexual-spectrum people of color and their experiences with wellness, dis/ability, and/or neurodivergence. Asexuality’s fraught relationship with dis/ability provides a generative location to interrogate co-constitutive systems of oppression. Thus, this article uses poetic inquiry on 33 in-depth interviews with asexual-spectrum people of color. The poems explore the participants’ emotive and experiential dimensions of their stories at the intersections of racism, ableism, and allonormativity and emphasize asexual people of color’s individual and collective pursuits of wellness and healing. Ultimately and looking forward, we recognize allonormativity as a systemic barrier to health and wellness, and aim to instill a commitment to asexual people of color’s wellness, healing, and hope. [ABSTRACT FROM AUTHOR]

Sodium-ion batteries (SiBs) are considered as a serious alternative to the current lithium-ion batteries (LiBs). However, SiBs are an emerging technology in the early stage of development with a wide set of potential cathode material candidates available. Therefore, a major challenge is to identify the most promising and sustainable cathode materials for further research and potential commercialization, simultaneously considering relevant regulations such as the recent new EU Battery Regulation and Europe’s chemicals strategy. Herein, we provide a comprehensive hazard and toxicity screening of promising SIB cathode material, which includes three different toxicity and hazard perspectives: (i) hazard traffic lights (HTL), (ii) total hazard points (THP), and (iii) human toxicity potential (HTox). Over 20 different SiB cathode compositions were screened together with three state-of-the-art LiB-cathodes for comparison. Inputs such as gravimetric energy density and required precursors were based on a comprehensive literature review, laboratory data, and calculations. All cathode active materials were analysed via a bottom-up approach. The results clearly showed that the energy density is one of the most important factors determining the choice of materials for SiBs and their corresponding related impacts. This screening can support a preliminary assessment of cathodes and help substitute selected precursors if they are associated with increased toxic hazards, therefore contributing to the ongoing discussions on more sustainable batteries and their labelling. [ABSTRACT FROM AUTHOR]

Metasurfaces represent a new frontier in materials science paving for unprecedented methods of controlling electromagnetic waves, with a range of applications spanning from sensing to imaging and communications. For pulsed terahertz (THz) generation, metasurfaces offer a gateway to tuneable thin emitters that can be utilized for large‐area imaging, microscopy, and spectroscopy. In literature, THz‐emitting metasurfaces generally exhibit high absorption, being based either on metals or on semiconductors excited in highly resonant regimes. Here, the use of a fully dielectric semiconductor exploiting morphology‐mediated resonances and inherent quadratic nonlinear response is proposed. This system exhibits a remarkable 40‐fold efficiency enhancement compared to the unpatterned at the peak of the optimized wavelength range, demonstrating its potential as a scalable emitter design. [ABSTRACT FROM AUTHOR]

The extremophile Halobacterium salinarum is an aerobic archaeon that has adapted to thrive in high-salt environments such as salted fish, hypersaline lakes, and salterns. Halophiles have garnered significant interest due to their unique interactions with bacteriophages known as haloarchaeophages. Studies have identified and characterized prophages in halophilic archaea, such as Haloferax volcanii, Haloquadratum walsbyi, and Haloarcula marismortui. Still, an investigation has yet to be conducted into the presence of prophage elements on Halobacterium salinarum ATCC 33170. This is of particular interest to us as we are using this strain as a source of archaeol, as one of the components of our sulfated lactosyl archaeol (SLA) archaeosome adjuvant. Genomic contigs of strain 33170 were bioinformatically assessed for prophage-like features using BLAST, PHASTER, InterProScan, and PHYRE2. A 7 kb region encoding six genes was identified as an incomplete prophage, and the proteins were further analyzed, revealing high homology to proteins encoded by bacteria, archaea, and an IS200 transposon. Restricting the BLASTp database to viruses resulted in hits to both myo- and siphoviral proteins, which would be unusual for an intact prophage. Additionally, no known phage structural proteins were identified in the search, suggesting a low chance that H. salinarum ATCC 33170 harbors a latent prophage. [ABSTRACT FROM AUTHOR]

The Omicron variant and its sub-lineages are the only current circulating SARS-CoV-2 viruses worldwide. In this study, the conformational stability of the isolated Receptor Binding Domain (RBD) of Omicron's spike protein is examined in detail. The parent Omicron lineage has over ten mutations in the ACE2 binding region of the RBD that are specifically associated with its β hairpin loop domain. It is demonstrated through biophysical molecular computations that the mutations in the β hairpin loop domain significantly increase the intra-protein interaction energies of intra-loop and loop–RBD interactions. The interaction energy increases include the formation of new hydrogen bonds in the β hairpin loop domain that help stabilize this critical ACE2 binding region. Our results also agree with recent experiments on the stability of Omicron's core β barrel domain, outside of its loop domain, and help demonstrate the overall conformational stability of the Omicron RBD. It is further shown here through dynamic simulations that the unbound state of the Omicron RBD remains closely aligned with the bound state configuration, which was not observed for the wild-type RBD. Overall, these studies demonstrate the significantly increased conformational stability of Omicron over its wild-type configuration and raise a number of questions on whether conformational stability could be a positive selection feature of SARS-CoV-2 viral mutational changes. [ABSTRACT FROM AUTHOR]

Background: The group climate within residential youth care institutions is considered a transactional process, both within a group of youth from various cultural backgrounds and between them and their group workers. The ongoing interaction between the cultural characteristics of these girls may influence the quality of the group climate. This study aimed to provide an in-depth account of the living group climate experiences and perceptions of Dutch girls with a Moroccan cultural background in Dutch residential groups. Method: Interpretative phenomenological analysis was employed to explore the girls' group climate experiences. Result: Three major themes emerged, namely (a) level of involvement of Moroccan girls in their living group, (b) perceptions of Moroccan girls' sense of belonging in a living group, and (c) cultural and religious equality or disparity results in two interaction patterns. The findings revealed that equality or disparity in language, culture, and religion affect Moroccan girls' experiences and perceptions of the living group climate. A crucial finding was that cultural and religious disparity leads to interaction patterns wherein the girls pre-emptively exclude themselves from receiving support from native group workers. Conclusion: Professionals must be aware of the cultural and religious dynamics, including the interplay and impact of cultural and religious equality and disparity, influencing Moroccan girls' group climate experiences. [ABSTRACT FROM AUTHOR]

This review investigated the ability of dual-task tests to predict falls in people with neurological disorders. Databases were searched to identify prospective cohort studies that analyzed dual-task testing and falls in people with neurological disorders. Reviewers screened studies for eligibility and extracted key information like participant characteristics, intervention details, outcome measures, and significant outcomes. Reviewers assessed methodological quality of eligible studies using the Standard Quality Assessment Criteria. Eighteen studies of strong methodological qualified with 1750 participantswere included in the review. Dual-task performances were predictive of future falls in peoplewithHuntington's disease, spinal cord injury, andmoderate cognitive impairment, although only one independent study was included for each disability type. In people with stroke, 37% of eligible studies showed dual-task assessments to be predictive of future falls. No dual-task tests predicted prospective falling in people with Alzheimer's or Parkinson's disease. Complex dual tasks seemed to be more predictive of fall risk than simpler dual tasks. Results suggest that disability type, severity of disability, and task complexity play a role in the predictive ability of dual-task assessments and future falling in neurological disorders. Future studies may benefit from using this review to guide the design of effective dual-task assessments and fall interventions. [ABSTRACT FROM AUTHOR]

Reverse transcriptase (RT) and integrase (IN) are two pivotal enzymes in HIV-1 replication. RT converts the single-stranded viral RNA genome into double-stranded DNA and IN catalyzes the integration of viral double-stranded DNA into host DNA. Currently, dual inhibitors of HIV-1 RT and IN have become a hotspot in new anti-HIV drug research and development. A dual inhibitor of HIV-1 RT/IN does the same thing as the two independent drugs would do. In this paper, we develop a mathematical model comprising a system of nonlinear differential equations describing HIV-1 RT/IN catalyzed biochemical reactions based on Michaelis–Menten enzyme kinetic reaction. In the formulated model we incorporate HIV-1 RT/IN dual inhibitor which simultaneously works as a non-nucleoside RT inhibitor and IN inhibitor. To examine the efficacy of HIV-1 RT/IN dual inhibitor in the treatment of HIV-1 infection, we have introduced a one-dimensional impulsive differential equation model and determined an effective dosing regimen for applying the inhibitor numerically. Furthermore, the exact closed form solution of the impulsive differential equation model is carried out by using the Lambert W function and the local stability of the periodic solution is also obtained analytically. The results obtained from analytical as well as numerical studies provide a basic idea to investigate the minimum dose with the highest efficacy for administering HIV-1 RT/IN dual inhibitors to prevent HIV-1 infection. [ABSTRACT FROM AUTHOR]

Advantages and disadvantages exist for presenting numeric information in science communication. On the one hand, public innumeracy and experts' concerns about providing numbers suggest not always showing them. On the other hand, people often prefer getting them, and their provision can increase comprehension, trust, and healthy behaviors while reducing risk overestimates and supporting decision-making autonomy. Presenting numeric facts without considering their comprehensibility and usability, however, is like throwing good money after bad. We summarize research concerning three theory-based strategies that improve the understanding and use of numbers by decreasing cognitive effort (e.g., doing the math for the audience), being consistent with principles of numeric cognition, and providing affective meaning. [ABSTRACT FROM AUTHOR]

We consider a voting scenario in which the resource to be voted upon may consist of both indivisible and divisible goods. This setting generalizes both the well-studied model of multiwinner voting and the recently introduced model of cake sharing. Under approval votes, we propose two variants of the extended justified representation (EJR) notion from multiwinner voting, a stronger one called EJR for mixed goods (EJR-M) and a weaker one called EJR up to 1 (EJR-1). We extend three multiwinner voting rules to our setting—GreedyEJR, the method of equal shares (MES), and proportional approval voting (PAV)—and show that while all three generalizations satisfy EJR-1, only the first one provides EJR-M. In addition, we derive tight bounds on the proportionality degree implied by EJR-M and EJR-1, and investigate the proportionality degree of our proposed rules. [ABSTRACT FROM AUTHOR]

The Entscheidungsnavi is an open-source decision support system based on multi-attribute utility theory, that offers various methods for dealing with uncertainties. To model decisions with uncertainties, decision-makers can use two categories: Forecast and Parameter Uncertainties. Forecast Uncertainty is modeled with (combined) influence factors using discrete, user-defined probability distributions or predefined 'worst-median-best' distributions. Parameter Uncertainty allows imprecision for utilities, objective weights, and probability distributions. To analyze these uncertainties, the Entscheidungsnavi offers several methods and tools, like a robustness check, based on (Monte Carlo) simulations and a sensitivity analysis. The objective weight analysis provides insights into the effects of different objective weight combinations. Indicator impacts, tornado diagrams, and risk profiles visualize the impact of uncertainties in a decision under risk. Risk profiles also enable a check for stochastic and simulation dominance. This article presents the complete range of methods for dealing with uncertainties in the Entscheidungsnavi using a hypothetical case study. [ABSTRACT FROM AUTHOR]

Within the United States, 1 in 4 women and 1 in 10 men experience intimate partner violence (IPV): psychological aggression, sexual violence, physical violence, and/or stalking from an intimate partner. Although some studies highlight the complexity of post-IPV recovery, the role of communication in post-IPV recovery remains underexplored. This study employs Communication Theory of Identity (CTI) to analyze in-depth interviews with post-IPV adults. Analysis reveals how individuals negotiate post-IPV identity gaps between the personal-personal and personal-relational layers of identity. The forwarded concept of identity veiling explicates how IPV tactics cause the relational layer of identity to eclipse the personal layer in IPV relationships. Therefore, post-IPV recovery involves unveiling the personal layer of identity—communicatively (re)constructing self-image beyond the IPV relationship and the identity gaps it engendered. This study conceptualizes the role of violent communication in the construction of identity gaps and identity gap negotiation. [ABSTRACT FROM AUTHOR]

Summary Multiple sclerosis (MS) affects more than 2.8 million people worldwide but the distribution is not even. Although over 200 gene variants have been associated with susceptibility, studies of genetically identical monozygotic twin pairs suggest that the genetic make‐up is responsible for only about 20%–30% of the risk to develop disease, while the rest is contributed by milieu factors. Recently, a new, unexpected player has entered the ranks of MS‐triggering or facilitating elements: the human gut microbiota. In this review, we summarize the present knowledge of microbial effects on formation of a pathogenic autoreactive immune response targeting the distant central nervous system and delineate the approaches, both in people with MS and in MS animal models, which have led to this concept. Finally, we propose that a tight combination of investigations of human patients with studies of suitable animal models is the best strategy to functionally characterize disease‐associated microbiota and thereby contribute to deciphering pathogenesis of a complex human disease. [ABSTRACT FROM AUTHOR]

Research on the chemoselective metal‐catalyzed hydrogenation of conjugated π‐systems has mostly been focussed on enones. Herein, we communicate the understudied asymmetric hydrogenation of enimines catalyzed by N,P‐iridium complexes and chemoselective toward the alkene. A number of enoxime ethers underwent hydrogenation smoothly to yield the desired products in high yield and stereopurity (up to 99 % yield, up to 99 % ee). No hydrogenation of the C=N π‐bond was observed under the applied reaction conditions (20 bar H2, rt, DCM). It was demonstrated that the chiral oxime ether could be hydrolyzed into the ketone with complete preservation of the installed stereogenity at the α‐carbon. At last, a binding mode of the substrate to the active iridium catalyst and the consequence for the stereoselective outcome was proposed. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONObjective: There is growing evidence that fear of falling (FOF) is common in people who use wheelchairs full-time and negatively influence their performance of daily activities and quality of life. The purpose of this study was to gain an in-depth understanding of perceptions related to FOF among people who use wheelchairs full-time.Methods: Mixed-method analysis was conducted using semi-structured interviews and surveys to gain insight into FOF. Surveys included demographic information; Spinal Cord Injury-Fall Concerns Scale (SCI-FCS); a questionnaire that directly assesses FOF and associated activity curtailment; and Fall Control Scale (FCS).Results: Among 39 participants (age = 43.1 ± 15.6 years, disability duration = 21.2 ± 11.1 years), 27 participants (69%) reported FOF. Participants with less perceived ability to control falls indexed by FCS reported higher SCI-FCS scores, indicating greater FOF (rs = −0.384, p = 0.016). Qualitative findings revealed that participants felt that FOF developed due to sustaining fall-related injuries or limited ability to recover from a fall. Some participants perceived falling as a part of their lives. They believed that it was not the cause of developing FOF.Conclusions: Among people who use wheelchairs full-time, FOF is prevalent and may develop due to fears of sustaining injuries or being unable to get up after falling. Developing an evidenced-based education protocol aimed at managing falls (e.g., establishing a fall recovery strategy and education on techniques to reduce injury during falls) is needed to minimize FOF people who use wheelchairs full-time.Fear of falling and associated activity curtailment are prevalent among people who use wheelchairs full-time.Fear of falling often develops as a result of prior fall-related injuries or the inability to recover from a fall independently.Evidence-based education protocols to reduce fear of falling among people who use wheelchairs full-time should contain content related to fall recovery and injury prevention.Fear of falling and associated activity curtailment are prevalent among people who use wheelchairs full-time.Fear of falling often develops as a result of prior fall-related injuries or the inability to recover from a fall independently.Evidence-based education protocols to reduce fear of falling among people who use wheelchairs full-time should contain content related to fall recovery and injury prevention. [ABSTRACT FROM AUTHOR]

Landslides, resulting from disturbances in slope equilibrium, pose a significant threat to landscapes, infrastructure, and human life. Triggered by factors such as intense precipitation, seismic activities, or volcanic eruptions, these events can cause extensive damage and endanger nearby communities. A comprehensive understanding of landslide characteristics, including spatio-temporal patterns, dimensions, and morphology, is vital for effective landslide disaster management. Existing remote sensing approaches mostly use either optical or synthetic aperture radar sensors. Integrating information from both these types of sensors promises greater accuracy for identifying and locating landslides. This study proposes a novel approach, the ML-LaDeCORsat (Machine Learning-based coseismic Landslide Detection using Combined Optical and Radar Satellite Imagery), that integrates freely available Sentinel-1, Palsar-2, and Sentinel-2 imagery data in Google Earth Engine (GEE). The approach also integrates relevant spectral indices and suitable bands used in a machine learning-based classification of coseismic landslides. The approach includes a robust and reproducible training and validation strategy and allows one to choose between five classifiers (CART, Random Forest, GTB, SVM, and Naive Bayes). Using landslides from four different earthquake case studies, we demonstrate the superiority of our approach over existing solutions in coseismic landslide identification and localization, providing a GTB-based detection accuracy of 87–92%. ML-LaDeCORsat can be adapted to other landslide events (GEE script is provided). Transfer learning experiments proved that our model can be applied to other coseismic landslide events without the need for additional training data. Our novel approach therefore facilitates quick and reliable identification of coseismic landslides, highlighting its potential to contribute towards more effective disaster management. [ABSTRACT FROM AUTHOR]

AbstractForensic mental health professionals are frequently exposed to inpatient aggression, which may negatively affect their physical and mental health. Current studies offer limited insight into how this may affect staff-patient interactions in the aftermath of aggression. A qualitative study was conducted to explore professionals’ experiences with exposure to aggression. Thirteen semi-structured interviews and three focus groups were conducted with 25 professionals working in a high secure forensic mental health unit. A thematic analysis was conducted in consensus among three researchers. Five main themes were generated in the analysis: exposure to different forms of aggression, factors that shape the impact of aggression, emotional reactions, managing emotional reactions, and managing relationships with patients. These themes form a complex interplay. Feelings of anger and fear, intrusive memories, and avoidant or agitated behavior toward patients are frequently reported, affecting both the personal and professional lives of participants. Interpersonal relationships between team members can promote or hinder adequate management of feelings that arise after exposure to aggressive incidents. The tremendous impact that exposure to inpatient aggression may have on professionals, and the way that they care for their patients requires more attention. [ABSTRACT FROM AUTHOR]

The present article revisits threatening discourses from the perspectives of anthropological linguistics, cultural linguistics, speech act theory and pragmatics. On the basis of linguistic data from 11th‐century Britain (Old English), 14th‐century Norway (Old Norse), 19th‐century Ireland (Early Modern Irish English and Modern Irish), 20th‐century Hong Kong (Hong Kong English) as well as 21st century South Africa (Black South African English), the discussion establishes verbal threats as socio‐pragmatic modes of action, that is, commissives that come as both illocutionary and perlocutionary acts. The main aim of the article is to elaborate on the central role that sociocultural norms and conventions play in the enregisterment of threat in a speech community at a given point in time. The article contributes to the development of forensic–linguistic threat assessment through a stronger focus on the sociocultural embeddedness of threatening discourses. [ABSTRACT FROM AUTHOR]

This special issue brings together contributions from leading researchers from Europe, the Middle East, Africa and Asia active in the field of cultural linguistics, with particular reference to English worldwide. The special issue comprises nine substantive research articles together with a comprehensive bibliography dealing with cultural linguistics and world Englishes. It is anticipated that the special issue will provide a very useful reference and starting point for future research in this area. [ABSTRACT FROM AUTHOR]

Peripheral artery disease (PAD) is a common vascular disease that primarily affects the lower limbs and is defined by the constriction or blockage of peripheral arteries and may involve microvascular dysfunction and tissue injury. Patients with diabetes have more prominent disease of microcirculation and develop peripheral neuropathy, autonomic dysfunction, and medial vascular calcification. Early and accurate diagnosis of PAD and disease characterization are essential for personalized management and therapy planning. Magnetic resonance imaging (MRI) provides excellent soft tissue contrast and multiplanar imaging capabilities and is useful as a noninvasive imaging tool in the comprehensive physiological assessment of PAD. This review provides an overview of the current state of the art of MRI in the evaluation and characterization of PAD, including an analysis of the many applicable MR imaging techniques, describing the advantages and disadvantages of each approach. We also present recent developments, future clinical applications, and future MRI directions in assessing PAD. The development of new MR imaging technologies and applications in preclinical models with translation to clinical research holds considerable potential for improving the understanding of the pathophysiology of PAD and clinical applications for improving diagnostic precision, risk stratification, and treatment outcomes in patients with PAD. [ABSTRACT FROM AUTHOR]

An Institutional Review Board-exempt REDCap survey was distributed through the Society of Academic Urologists to all 508 applicants registered for the 2023 Urology Match following the rank list submission deadline on January 10, 2023. The survey closed on February 1, 2023. Responses were anonymized, aggregated, and characterized using descriptive statistics. Thematic mapping of open text comments was performed by 2 reviewers. The response rate was 42% (215/508). Eighty-eight percent of respondents disapproved of the Dobbs ruling. Twenty percent of respondents (15% male/24% female) eliminated programs in states where abortion is illegal. Fifty-nine percent (51% male/70% female) would be concerned for their or their partner's health if they matched in a state where abortion was illegal, and 66% (55% male/82% female) would want their program to assist them or their partner if they required abortion care during residency. Due to the competitive nature of Urology, 68% of applicants reported feeling at least somewhat obligated to apply in states where abortion legislation conflicts with their beliefs. Of the 65 comments provided by respondents, 4 common themes emerged: (1) avoidance of states with restrictive abortion laws; (2) inability to limit applications because of the competitiveness of urology; (3) impacts on personal health care; and (4) desire for advocacy from professional urology organizations. The Dobbs ruling will impact the urology workforce by affecting urology applicants' decision-making regarding residency selection and ranking. Although the competitiveness of the Urology Match pressures applicants to apply broadly, many are taking reproductive health care access into consideration. [ABSTRACT FROM AUTHOR]

Background/Objective: Asthma is a common chronic medical condition among children and the most common diagnosis associated with interfacility transports for pediatric patients. As many as 40% of pediatric transfers may be unnecessary, resulting in potential delays in care and unnecessary costs. Our objective was to identify the patient-related factors associated with potentially unnecessary transfers for pediatric patients with asthma. Methods: We used patient care data from the California Department of Health Care Access and Information patient discharge and emergency department (ED) datasets to capture ED visits where a pediatric patient (age 2-17 years) presented with asthma and was transferred to another ED or acute care hospital. The outcome of interest was a potentially unnecessary transfer, defined as a visit where length of stay after transfer was <24 hours and no advanced services were used, such as respiratory therapy or critical care. Patient-related characteristics were extracted, including age, gender, race/ethnicity, primary language, insurance status, and clinical characteristics. First, we used descriptive statistics to compare necessary vs unnecessary transfers. Second, we used generalized estimating equations accounting for clustering by ED to estimate odds ratios (OR) and identify factors associated with potentially unnecessary transfers. Results: A total of 4,233 pediatric ED patients were transferred with a diagnosis of asthma, including 461 (11%) transfers that met criteria as potentially unnecessary. Median age was 12 years (interquartile range 7-15), and 46% were female. Factors associated with increased odds of potentially unnecessary transfer while controlling for key factors included younger age (eg, 2-5 years, OR 2.0, 95% confidence interval [CI] 1.4-2.9), male gender (OR 1.4, 95% CI 1.1-1.7), and Hispanic ethnicity (OR 1.6, 95% CI 1.2-2.1), while multiple hospitalizations for asthma per year was associated with decreased odds (OR 0.2, 95% CI 0.1-0.4). Conclusion: Several patient-related factors were associated with increased or decreased odds of potentially unnecessary transfers among pediatric patients presenting to the ED with asthma. These factors can be considered in future work to better understand, predict, and reduce unnecessary transfers and their negative consequences. [ABSTRACT FROM AUTHOR]

Mosquitoes are a complex nuisance around the world and tropical countries bear the brunt of the burden of mosquito-borne diseases. Rwanda has had success in reducing malaria and some arboviral diseases over the last few years, but still faces challenges to elimination. By building our understanding of in situ mosquito communities in Rwanda at a disturbed, human-occupied site and at a natural, preserved site, we can build our understanding of natural mosquito microbiomes toward the goal of implementing novel microbial control methods. Here, we examined the composition of collected mosquitoes and their microbiomes at two diverse sites using Cytochrome c Oxidase I sequencing and 16S V4 high-throughput sequencing. The majority (36 of 40 species) of mosquitoes captured and characterized in this study are the first-known record of their species for Rwanda but have been characterized in other nations in East Africa. We found significant differences among mosquito genera and among species, but not between mosquito sexes or catch method. Bacteria of interest for arbovirus control, Asaia, Serratia, and Wolbachia, were found in abundance at both sites and varied greatly by species. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine the influence of dose reduction on a commercially available lung cancer prediction convolutional neuronal network (LCP-CNN). Methods: CT scans from a cohort provided by the local lung cancer center (n = 218) with confirmed pulmonary malignancies and their corresponding reduced dose simulations (25% and 5% dose) were subjected to the LCP-CNN. The resulting LCP scores (scale 1–10, increasing malignancy risk) and the proportion of correctly classified nodules were compared. The cohort was divided into a low-, medium-, and high-risk group based on the respective LCP scores; shifts between the groups were studied to evaluate the potential impact on nodule management. Two different malignancy risk score thresholds were analyzed: a higher threshold of ≥ 9 ("rule-in" approach) and a lower threshold of > 4 ("rule-out" approach). Results: In total, 169 patients with 196 nodules could be included (mean age ± SD, 64.5 ± 9.2 year; 49% females). Mean LCP scores for original, 25% and 5% dose levels were 8.5 ± 1.7, 8.4 ± 1.7 (p > 0.05 vs. original dose) and 8.2 ± 1.9 (p < 0.05 vs. original dose), respectively. The proportion of correctly classified nodules with the "rule-in" approach decreased with simulated dose reduction from 58.2 to 56.1% (p = 0.34) and to 52.0% for the respective dose levels (p = 0.01). For the "rule-out" approach the respective values were 95.9%, 96.4%, and 94.4% (p = 0.12). When reducing the original dose to 25%/5%, eight/twenty-two nodules shifted to a lower, five/seven nodules to a higher malignancy risk group. Conclusion: CT dose reduction may affect the analyzed LCP-CNN regarding the classification of pulmonary malignancies and potentially alter pulmonary nodule management. Clinical relevance statement: Utilization of a "rule-out" approach with a lower malignancy risk threshold prevents underestimation of the nodule malignancy risk for the analyzed software, especially in high-risk cohorts. Key Points: • LCP-CNN may be affected by CT image parameters such as noise resulting from low-dose CT acquisitions. • CT dose reduction can alter pulmonary nodule management recommendations by affecting the outcome of the LCP-CNN. • Utilization of a lower malignancy risk threshold prevents underestimation of pulmonary malignancies in high-risk cohorts. [ABSTRACT FROM AUTHOR]

The objective of the ASPIRE award programme of the International Association for Health Professions Education is to go beyond traditional accreditation processes. Working in partnership with the ASPIRE Academy, the programme aims to encourage and support excellence in health professions education, in part by showcasing and exemplifying best practices. Each year ASPIRE award applications received from institutions across the globe describe their greatest achievements in a variety of areas, one of which is curriculum development, where evaluation of applications is carried out using a framework of six domains. These are described in this paper as key elements of excellence, specifically, Organisational Structure and Curriculum Management; Underlying Educational Strategy; Content Specification and Pedagogy; Teaching and Learning Methods and Environment; Assessment, Monitoring and Evaluation; Scholarship. Using examples from the content of submissions of three medical schools from very different settings that have been successful in the past few years, achievements in education processes and outcomes of institutions around the world are highlighted in ways that are relevant to their local and societal contexts. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance–guided focused ultrasound (MRgFUS) for treatment of essential tremor (ET) traditionally targets the ventral intermediate (Vim) nucleus. Recent strategies include a secondary lesion to the posterior subthalamic area (PSA). Objective: The aim was to compare lesion characteristics, tremor improvement, and adverse events (AE) between patients in whom satisfactory tremor suppression was achieved with lesioning of the Vim alone and patients who required additional lesioning of the PSA. Methods: Retrospective analysis of data collected from ET patients treated with MRgFUS at St Vincent's Hospital Sydney was performed. Clinical Rating Scale for Tremor (CRST), hand tremor score (HTS), and Quality of Life in Essential Tremor Questionnaire (QUEST) were collected pre‐ and posttreatment in addition to the prevalence of AEs. The lesion coordinates and overlap with the dentatorubrothalamic tract (DRTT) were evaluated using magnetic resonance imaging. Results: Twenty‐one patients were treated in Vim only, and 14 were treated with dual Vim–PSA lesions. Clinical data were available for 29 of the 35 patients (19 single target and 10 dual target). At follow‐up (mean: 18.80 months) HTS, CRST, and QUEST in single‐target patients improved by 57.97% (P < 0.001), 36.71% (P < 0.001), and 58.26% (P < 0.001), whereas dual‐target patients improved by 68.34% (P < 0.001), 35.37% (P < 0.003), and 46.97% (P < 0.005), respectively. The Vim lesion of dual‐target patients was further anterior relative to the posterior commissure (PC) (7.84 mm), compared with single‐target patients (6.92 mm), with less DRTT involvement (14.85% vs. 23.21%). Dual‐target patients exhibited a greater proportion of patients with acute motor AEs (100% vs. 58%); however, motor AE prevalence was similar in both groups at long‐term follow‐up (33% vs. 38%). Conclusion: Posterior placement of lesions targeting the Vim may confer greater tremor suppression. The addition of a PSA lesion, in patients with inadequate tremor control despite Vim lesioning, had a trend toward better long‐term tremor suppression; however, this approach was associated with greater prevalence of gait disturbance in the short term. [ABSTRACT FROM AUTHOR]

This article discusses the topic of food allergies, which are adverse reactions to certain foods that involve the immune system. Food allergies can be classified into IgE-mediated forms and non-IgE-mediated forms, and they have a significant impact on patients' quality of life and healthcare systems. The article addresses various unmet needs in the field of pediatric food allergies, including the dietary management of food allergies, psychological support for children and parents, disease prevention strategies, environmental factors, and diagnostic biomarkers. The authors emphasize the importance of further research to improve our understanding of food allergies and address the gaps in knowledge. [Extracted from the article]

Care provision for children with anorexia nervosa is provided by outpatient care teams in hospitals, but the way these teams are organized differs per hospital and hampers the continuity of care. The aim of this study is to explore the organization and continuity of care for children with anorexia nervosa in the Netherlands by using a modular perspective. We conducted a qualitative, exploratory case study and took the healthcare provision for children with anorexia nervosa, provided by outpatient care teams, as our case. We conducted nine interviews with healthcare professionals involved in outpatient care teams from six hospitals. A thematic analysis was used to analyze the data. The modular perspective offered insights into the work practices and working methods of outpatient care teams. We were able to identify modules (i.e. the separate consultations with the various professionals), and components (i.e. elements of these consultations). In addition, communication mechanisms (interfaces) were identified to facilitate information flow and coordination among healthcare professionals. Our modular perspective revealed gaps and overlap in outpatient care provision, consequently providing opportunities to deal with unnecessary duplications and blind spots. Conclusion: A modular perspective can be applied to explore the organization of outpatient care provision for children with anorexia nervosa. We specifically highlight gaps and overlap in healthcare provision, which in turn leads to recommendations on how to support the three essential parts of continuity of care: informational continuity, relational continuity, and management continuity. What is Known: • Care provision for children with anorexia nervosa requires a network of health care professionals from different organizations, as a result the organization and provision of care faces challenges. What is New: • Modular care provision sheds light on the complexity and organization of outpatient care provision and supports the three dimensions of continuity of care as experienced by children with anorexia nervosa and their parents/caregivers. [ABSTRACT FROM AUTHOR]

Within the contemporary evangelical church, there is often little discussion of asceticism despite an emphasis on spiritual disciplines and formation. This article argues that not only does the evangelical church need to embrace and adopt ascetic practices, but these should be based in monastic asceticism, based around the practices of poverty, chastity and obedience. The article first puts forward suggestions as to why the evangelical church does not embrace asceticism, in spite of it being part of its heritage, but then moves to a constructive argument, using an array of ecumenical sources, demonstrating that a monastic asceticism is a biblical asceticism and should be a fundamental feature in evangelical faith and practice. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore and describe current trends in the augmentative and alternative communication (AAC) use and service delivery experiences of people with amyotrophic lateral sclerosis (PALS) in the U.S. Cross-sectional data were collected from 216 PALS via an anonymous online questionnaire in 2021. Over 70% of participants reported at least some detectable speech disturbance, and approximately half used aided communication during face-to-face interactions. Among respondents with severe speech impairment, over 90% reported using speech-generating devices, and just over half reported using low-tech AAC. Most participants had met with an SLP to discuss speech and communication, but varied in both timing of the initial intervention and frequency of ongoing intervention. Fewer than half reported that their family members or other important people had received education or support related to communication for PALS. Participants also shared their use of and experiences with telephone and video calls, access methods, mounting systems, word prediction and stored phrases, and message and voice banking. Results highlight the importance of early referral for AAC intervention, ongoing re-evaluation and treatment, involvement of communication partners and support for multimodal communication and adaptation to changing needs. Most people with amyotrophic lateral sclerosis (PALS) in this sample reported experiencing dysarthria, with 71.3% indicating at least some detectable speech disturbance (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating ≤ 3) and 56.5% reporting reduced intelligibility (ALSFRS-R speech rating ≤ 2). Respondents used a wide variety of communication methods. Among respondents who were unable to meet their communication needs with speech alone, 84.6% used unaided methods (including speech), 52.3% used low-tech augmentative and alternative communication (AAC) and 90.8% used a speech-generating device. Service delivery improvements are needed to ensure timely, ongoing and comprehensive AAC education and intervention for PALS and their families. Communication over video calls (including virtual healthcare visits) is common among PALS and may be an important target for AAC intervention as the COVID-19 pandemic continues to limit in-person gatherings and appointments. [ABSTRACT FROM AUTHOR]