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Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years. The resultant regression equation predicts expected TEE from easily acquired variables, such as body weight, age and sex, with 95% predictive limits that can be used to screen for misreporting by participants in dietary studies. We applied the equation to two large datasets (National Diet and Nutrition Survey and National Health and Nutrition Examination Survey) and found that the level of misreporting was >50%. The macronutrient composition from dietary reports in these studies was systematically biased as the level of misreporting increased, leading to potentially spurious associations between diet components and body mass index.

This article provides a comprehensive literature review examining virtual learning in the Aotearoa New Zealand schools sector, with a specific focus on understanding and addressing the needs of Maori learners in these online environments. It begins by tracing the historical development of virtual learning in Aotearoa New Zealand -- from early correspondence courses to the emergence of e-learning clusters and increasing digital technology use. The authors highlight the differences between teaching and learning virtually compared with traditional face-to-face classrooms, exploring unique pedagogical approaches, challenges, and the support structures required for effective online instruction and student engagement. Emphasis is placed on the crucial role of fostering strong teacher--student relationships in virtual settings. The article then reviews culturally responsive pedagogies and strategies identified as effective for engaging and supporting Maori learners, and discusses potential frameworks for translating these approaches to online learning environments. The potential of virtual learning to provide more equitable educational opportunities for Maori students, particularly in rural areas, is examined. However, pre-existing socioeconomic inequalities and the digital divide exacerbated by COVID-19 are noted as barriers. Overall, the author underscores the scarcity of research specifically examining Maori students' experiences and needs in virtual learning contexts. They call for further investigation to better understand and address these gaps, striving to ensure culturally responsive and equitable virtual education opportunities for Maori learners. The paper provides a valuable synthesis of literature and insights into this important issue in Aotearoa New Zealand education.

The personnel preparation of early intervention/early childhood special educator (EI/ECSE) candidates is a pivotal stage in supporting the development of professionals who can effectively work with young children with and at-risk of developmental disabilities, their families, and other service providers. This process encompasses a multifaceted approach to equip candidates with knowledge, skills, and attitudes/dispositions to successfully work within the field. This compilation article includes multiple authors of each section who share strategies, assignments, tools, and experiences to center the Initial Practice-Based Standards for Early Interventionists/Early Childhood Special Educators (Division for Early Childhood [DEC] of the Council for Exceptional Children [CEC], 2020; hereafter referred to as the EI/ECSE Standards) and DEC's Recommended Practices (RPs). These strategies are shared through a "spiraling curriculum" framework, and progress from an awareness level to reflection of candidates' own practice. In addition, this article shares related resources to consider in planning for innovative coursework and practicum/student teaching opportunities. Specific examples of spiraling experiences to deepen learning through opportunities to introduce content aligned to RPs and EI/ECSE Standards are included.

Sex trafficking of minors is a significant problem across North America, with sizeable numbers of youth being directly or indirectly manipulated into being exploited or trafficked. Identification of these youth remains difficult, in part because of a lack of knowledge about common characteristics and in part because of victims' reluctance engaging with and trusting law enforcement enough to disclose their experiences. Given that many youth are trafficked during school-aged years, school settings may represent an ideal location to target prevention and identification efforts, especially by health-related school professionals, whose training, professional duties, and often positive relationships with youth may make the professionals trustworthy disclosure recipients. Whether such professionals are effective, though, depends on their knowledge of who is at risk for trafficking, characteristics that distinguish trafficking from other forms of harm, and effective questioning approaches to elicit disclosures from victimized youth. To document whether this knowledge exists, we surveyed 361 school-based professionals concerning their ability to identify trafficking and knowledge of trafficking, adolescent development, and interviewing youth. Although nearly all (97%) school professionals recognized general student risk in the vignettes, only 18% identified that risk as trafficking. Professionals who had prior experience with trafficked youth were more likely to recognize trafficking than those without such experience. Finally, professionals evidenced some general knowledge about the existence of trafficking, adolescent development, and interviewing, but demonstrated more limited knowledge in the most common characteristics of trafficked minors and nuanced aspects of best-practice questioning approaches. Results highlight important directions for training of school-based professionals to improve prevention and identification of a highly vulnerable and often overlooked population of victims, namely trafficked minors.

Predictive high-fidelity modeling of wind turbines with computational fluid dynamics, wherein turbine geometry is resolved in an atmospheric boundary layer, is important to understanding complex flow accounting for design strategies and operational phenomena such as blade erosion, pitch-control, stall/vortex-induced vibrations, and aftermarket add-ons. The biggest challenge with high-fidelity modeling is the realization of numerical algorithms that can capture the relevant physics in detail through effective use of high-performance computing. For modern supercomputers, that means relying on GPUs for acceleration. In this paper, we present ExaWind, a GPU-enabled open-source incompressible-flow hybrid-computational fluid dynamics framework, comprising the near-body unstructured grid solver Nalu-Wind, and the off-body block-structured-grid solver AMR-Wind, which are coupled using the Topology Independent Overset Grid Assembler. Turbine simulations employ either a pure Reynolds-averaged Navier–Stokes turbulence model or hybrid turbulence modeling wherein Reynolds-averaged Navier–Stokes is used for near-body flow and large eddy simulation is used for off-body flow. Being two-way coupled through overset grids, the two solvers enable simulation of flows across a huge range of length scales, for example, 10 orders of magnitude going from O(μm) boundary layers along the blades to O(10 km) across a wind farm. In this paper, we describe the numerical algorithms for geometry-resolved turbine simulations in atmospheric boundary layers using ExaWind. We present verification studies using canonical flow problems. Validation studies are presented using megawatt-scale turbines established in literature. Additionally presented are demonstration simulations of a small wind farm under atmospheric inflow with different stability states.

Surgery is the mainstay of treatment for meningioma, the most common primary intracranial tumor, but improvements in meningioma risk stratification are needed and indications for postoperative radiotherapy are controversial. Here we develop a targeted gene expression biomarker that predicts meningioma outcomes and radiotherapy responses. Using a discovery cohort of 173 meningiomas, we developed a 34-gene expression risk score and performed clinical and analytical validation of this biomarker on independent meningiomas from 12 institutions across 3 continents (N = 1,856), including 103 meningiomas from a prospective clinical trial. The gene expression biomarker improved discrimination of outcomes compared with all other systems tested (N = 9) in the clinical validation cohort for local recurrence (5-year area under the curve (AUC) 0.81) and overall survival (5-year AUC 0.80). The increase in AUC compared with the standard of care, World Health Organization 2021 grade, was 0.11 for local recurrence (95% confidence interval 0.07 to 0.17, P

There is considerably greater variation in metabolic rates between men than between women, in terms of basal, activity and total (daily) energy expenditure (EE). One possible explanation is that EE is associated with male sexual characteristics (which are known to vary more than other traits) such as musculature and athletic capacity. Such traits might be predicted to be most prominent during periods of adolescence and young adulthood, when sexual behaviour develops and peaks. We tested this hypothesis on a large dataset by comparing the amount of male variation and female variation in total EE, activity EE and basal EE, at different life stages, along with several morphological traits: height, fat free mass and fat mass. Total EE, and to some degree also activity EE, exhibit considerable greater male variation (GMV) in young adults, and then a decreasing GMV in progressively older individuals. Arguably, basal EE, and also morphometrics, do not exhibit this pattern. These findings suggest that single male sexual characteristics may not exhibit peak GMV in young adulthood, however total and perhaps also activity EE, associated with many morphological and physiological traits combined, do exhibit GMV most prominently during the reproductive life stages.

Reducing dietary saturated fatty acids (SFA) intake results in a clinically significant lowering of low-density lipoprotein cholesterol (LDL-C) across ethnicities. In contrast, dietary SFA's role in modulating emerging cardiovascular risk factors in different ethnicities remains poorly understood. Elevated levels of lipoprotein(a) [Lp(a)], an independent cardiovascular risk factor, disproportionally affect individuals of African descent. Here, we assessed the responses in Lp(a) levels to dietary SFA reduction in 166 African Americans enrolled in GET-READI (The Gene-Environment Trial on Response in African Americans to Dietary Intervention), a randomized controlled feeding trial. Participants were fed two diets in random order for 5 weeks each: 1) an average American diet (AAD) (37% total fat: 16% SFA), and 2) a diet similar to the Dietary Approaches to Stop Hypertension (DASH) diet (25% total fat: 6% SFA). The participants' mean age was 35 years, 70% were women, the mean BMI was 28 kg/m2, and the mean LDL-C was 116 mg/dl. Compared to the AAD diet, LDL-C was reduced by the DASH-type diet (mean change: -12 mg/dl) as were total cholesterol (-16 mg/dl), HDL-C (-5 mg/dl), apoA-1 (-9 mg/dl) and apoB-100 (-5 mg/dl) (all P < 0.0001). In contrast, Lp(a) levels increased following the DASH-type diet compared with AAD (median: 58 vs. 44 mg/dl, P < 0.0001). In conclusion, in a large cohort of African Americans, reductions in SFA intake significantly increased Lp(a) levels while reducing LDL-C. Future studies are warranted to elucidate the mechanism(s) underlying the SFA reduction-induced increase in Lp(a) levels and its role in cardiovascular risk across populations.

Cash transfers are increasingly used to motivate adherence to HIV care. However, evidence on cash transfers and intimate partner violence (IPV) is mixed and little is known about their safety for women living with HIV. We conducted in-depth interviews with women living with HIV who participated in a randomized trial providing 6 months of cash transfers (~$4.5 or $11 USD) conditional on HIV clinic attendance in Shinyanga, Tanzania to assess how receiving cash affects IPV and relationship dynamics. Eligible participants were 18-49 years, received cash transfers, and in a partnership at baseline. Data were analyzed in Dedoose using a combined inductive-deductive coding approach. 25 interviews were conducted between November 2019-February 2020. Women's employment was found to be a source of household tension and violence. None of the participants reported physical or sexual IPV in relation to cash transfers, however, some women experienced controlling behaviors or emotional violence including accusations and withholding of money, particularly those who were unemployed. Cash transfers were predominantly used for small household expenses and were not viewed as being substantial enough to shift the financial dynamic or balance of power within relationships. Our findings suggest that small, short-term cash transfers do not increase physical or sexual IPV for women living with HIV however can exacerbate controlling behaviors or emotional violence. Modest incentives used as a behavioral nudge to improve health outcomes may affect women differently than employment or larger cash transfers. Nonetheless, consultations with beneficiaries should be prioritized to protect women from potential IPV risks.

Pediatric brain and spinal cancers are collectively the leading disease-related cause of death in children; thus, we urgently need curative therapeutic strategies for these tumors. To accelerate such discoveries, the Childrens Brain Tumor Network (CBTN) and Pacific Pediatric Neuro-Oncology Consortium (PNOC) created a systematic process for tumor biobanking, model generation, and sequencing with immediate access to harmonized data. We leverage these data to establish OpenPBTA, an open collaborative project with over 40 scalable analysis modules that genomically characterize 1,074 pediatric brain tumors. Transcriptomic classification reveals universal TP53 dysregulation in mismatch repair-deficient hypermutant high-grade gliomas and TP53 loss as a significant marker for poor overall survival in ependymomas and H3 K28-mutant diffuse midline gliomas. Already being actively applied to other pediatric cancers and PNOC molecular tumor board decision-making, OpenPBTA is an invaluable resource to the pediatric oncology community.

Type D enterotoxemia, caused by Clostridium perfringens epsilon toxin (ETX), is one of the most economically important clostridial diseases of sheep. Acute type D enterotoxemia is characterized by well-documented lesions in the nervous, cardiocirculatory, and pulmonary systems. However, discrepancies and confusion exist as to whether renal lesions are part of the spectrum of lesions of this condition, which is controversial considering that for many decades it has been colloquially referred to as pulpy kidney disease. Here, the authors assess renal changes in an experimental model of acute type D enterotoxemia in sheep and evaluate the possible role of ETX in their genesis. Four groups of 6 sheep each were intraduodenally inoculated with either a wild-type virulent C. perfringens type D strain, an etx knockout mutant unable to produce ETX, the etx mutant strain complemented with the wild-type etx gene that regains the ETX toxin production, or sterile culture medium (control group). All sheep were autopsied less than 24 hours after inoculation; none of them developed gross lesions in the kidneys. Ten predefined histologic renal changes were scored in each sheep. The proportion of sheep with microscopic changes and their severity scores did not differ significantly between groups. Mild intratubular medullary hemorrhage was observed in only 2 of the 12 sheep inoculated with the wild-type or etx-complemented bacterial strains, but not in the 12 sheep of the other 2 groups. The authors conclude that no specific gross or histologic renal lesions are observed in sheep with experimental acute type D enterotoxemia.

BACKGROUND: Recent 3-dimensional optical (3DO) imaging advancements have provided more accessible, affordable, and self-operating opportunities for assessing body composition. 3DO is accurate and precise in clinical measures made by DXA. However, the sensitivity for monitoring body composition change over time with 3DO body shape imaging is unknown. OBJECTIVES: This study aimed to evaluate the ability of 3DO in monitoring body composition changes across multiple intervention studies. METHODS: A retrospective analysis was performed using intervention studies on healthy adults that were complimentary to the cross-sectional study, Shape Up! Adults. Each participant received a DXA (Hologic Discovery/A system) and 3DO (Fit3D ProScanner) scan at the baseline and follow-up. 3DO meshes were digitally registered and reposed using Meshcapade to standardize the vertices and pose. Using an established statistical shape model, each 3DO mesh was transformed into principal components, which were used to predict whole-body and regional body composition values using published equations. Body composition changes (follow-up minus the baseline) were compared with those of DXA using a linear regression analysis. RESULTS: The analysis included 133 participants (45 females) in 6 studies. The mean (SD) length of follow-up was 13 (5) wk (range: 3-23 wk). Agreement between 3DO and DXA (R2) for changes in total FM, total FFM, and appendicular lean mass were 0.86, 0.73, and 0.70, with root mean squared errors (RMSEs) of 1.98 kg, 1.58 kg, and 0.37 kg, in females and 0.75, 0.75, and 0.52 with RMSEs of 2.31 kg, 1.77 kg, and 0.52 kg, in males, respectively. Further adjustment with demographic descriptors improved the 3DO change agreement to changes observed with DXA. CONCLUSIONS: Compared with DXA, 3DO was highly sensitive in detecting body shape changes over time. The 3DO method was sensitive enough to detect even small changes in body composition during intervention studies. The safety and accessibility of 3DO allows users to self-monitor on a frequent basis throughout interventions. This trial was registered at clinicaltrials.gov as NCT03637855 (Shape Up! Adults; https://clinicaltrials.gov/ct2/show/NCT03637855); NCT03394664 (Macronutrients and Body Fat Accumulation: A Mechanistic Feeding Study; https://clinicaltrials.gov/ct2/show/NCT03394664); NCT03771417 (Resistance Exercise and Low-Intensity Physical Activity Breaks in Sedentary Time to Improve Muscle and Cardiometabolic Health; https://clinicaltrials.gov/ct2/show/NCT03771417); NCT03393195 (Time Restricted Eating on Weight Loss; https://clinicaltrials.gov/ct2/show/NCT03393195), and NCT04120363 (Trial of Testosterone Undecanoate for Optimizing Performance During Military Operations; https://clinicaltrials.gov/ct2/show/NCT04120363).

Obesity is caused by a prolonged positive energy balance1,2. Whether reduced energy expenditure stemming from reduced activity levels contributes is debated3,4. Here we show that in both sexes, total energy expenditure (TEE) adjusted for body composition and age declined since the late 1980s, while adjusted activity energy expenditure increased over time. We use the International Atomic Energy Agency Doubly Labelled Water database on energy expenditure of adults in the United States and Europe (n = 4,799) to explore patterns in total (TEE: n = 4,799), basal (BEE: n = 1,432) and physical activity energy expenditure (n = 1,432) over time. In males, adjusted BEE decreased significantly, but in females this did not reach significance. A larger dataset of basal metabolic rate (equivalent to BEE) measurements of 9,912 adults across 163 studies spanning 100 years replicates the decline in BEE in both sexes. We conclude that increasing obesity in the United States/Europe has probably not been fuelled by reduced physical activity leading to lowered TEE. We identify here a decline in adjusted BEE as a previously unrecognized factor.

Reacting flow simulations for combustion applications require extensive computing capabilities. Leveraging the AMReX library, the Pele suite of combustion simulation tools targets the largest supercomputers available and future exascale machines. We introduce PeleC, the compressible solver in the Pele suite, and detail its capabilities, including complex geometry representation, chemistry integration, and discretization. We present a comparison of development efforts using both OpenACC and AMReX’s C++ performance portability framework for execution on multiple GPU architectures. We discuss relevant details that have allowed PeleC to achieve high performance and scalability. PeleC’s performance characteristics are measured through relevant simulations on multiple supercomputers. The success of PeleC’s design for exascale is exhibited through demonstration of a 160 billion cell simulation and weak scaling onto 100% of Summit, an NVIDIA-based GPU supercomputer at Oak Ridge National Laboratory. Our results provide confidence that PeleC will enable future combustion science simulations with unprecedented fidelity.