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Complete replacement of inorganic trace minerals (ITM) with proteinated organic trace minerals (PTM) at equal or lower inclusion rates was evaluated. One thousand and eight, one-d-old male chicks were divided into 24 pens containing 42 chicks, and randomly allocated to one of the following: T1: control group with ITM supplied at the standard commercial level in Ecuador; T2: PTM at 100% T1; T3: PTM at 66% TI; and T4: PTM at 33% T1. The 42-d experiment employed a three-phase feeding programme (1-14, 15-28 and 29-42 d). Restricted feeding was used to prevent the development of ascites associated with high altitude. At 21 and 42 d of age, Cu, Mn and Zn retention were measured in tibial bone, and Fe in whole blood. Lymphoid organ weights were at 21 and 42 d of age. Antibody titres were measured by ELISA at 42 d of age. Weight gain, feed consumption, feed conversion and mortality were similar among treatments, although were below breed expectations due to feed restriction practices. Blood Fe was not affected by treatment (P

Abstract Individuals’ access to sport and physical activity has been hampered due to COVID-19 lockdown restrictions. In Australia participation in community sport was cancelled during lockdowns. There is limited research on the impact of sport participation restrictions on the health and wellbeing of adults. Aim The aim of this study was to investigate the perceived health and wellbeing of a sample of predominantly active Australian adults, both during COVID-19 and in comparison with one year earlier (pre COVID-19). Methods A survey was conducted during the first COVID-19 restrictions and lockdowns in Australia in May–June 2020. It was distributed by national and state sporting organisations and through researchers’ social media accounts. This particular paper focuses on adults aged 18–59 years. The survey collected information on participant demographics, the sport and physical activity patterns pre- COVID-19, and health and wellbeing outcomes during COVID-19 lockdown and compared to one year earlier. The health measures were cross-tabulated against the demographic and sport and physical activity variables, and group profiles compared with chi-square tests. Scales were derived from three wellbeing questions, and group differences were analysed by t-tests and F-tests. Results The survey sample included 1279 men and 868 women aged 18–59 years. Most (67%) resided in metropolitan cities. The great majority (83%) were sport participants. During COVID-19 lockdown men were significantly more likely than women to report worse or much worse general (p = 0.014), physical (p = 0.015) and mental health (p = 0.038) and lower life satisfaction (p = 0.016). The inactive adults were significantly more likely to report poorer general health (p = 0.001) and physical health (p = 0.001) compared to active adults. The younger age cohort (18–29 years) were significantly more likely to report poorer general wellbeing (p

Background: Health disparities disproportionately affect minority groups across the United States with respect to care access, quality, and outcomes. The aim of this study is to examine existing disparities between white and African American (AA) patients regarding postoperative outcomes following total joint arthroplasty and provide insight into disparity trends over a 9-year period. Methods: A retrospective review of 16,779 total joint arthroplasty patients at a single institution between January 2013 and December 2021 was performed. Patients were grouped by race as AA or white. Outcomes of interest included length of stay (LOS), home discharge, 30-day emergency department return, and 30-day readmission. Univariate statistics and multivariate regressions were utilized to analyze results. Results: Significant improvements in LOS and rates of home discharge occurred for both white and AA patients at our institution over a 9-year period, while rates of 30-day emergency department returns and readmissions demonstrated a downward but non–statistically significant trend. Despite these trends, AA patients continued to experience longer lengths of stay, less likelihood of 0- or 1-day LOS, and higher risk of nonhome discharge for most years examined. However, after controlling for demographic and comorbidity differences, the differences between groups narrowed over time resulting in no significant differences in the aforementioned 3 measures by 2021. Conclusions: Although racial disparities in outcomes are still apparent, over time, the differences in resource utilization between AA and white patients have narrowed. Initiatives aimed at creating healthier communities with increased access to care and the ultimate goal of equitable care must continue to be pursued.

Indicators are key tools used to assess the ecological status of the environment for ecosystem based management. Anthropogenic disturbances produce changes to habitat condition, which include modifications in species composition and their functions. Monitoring a group of sentinel species (from a taxonomic and functional point of view) provides useful insights into benthic habitat condition. Here, a new indicator, Sentinels of the Seabed (SoS) is proposed to assess state of benthic habitats using “sentinel” species (species which are characteristic of a habitat and sensitive to a given pressure). The selection of these sentinel species has two stages. First, a ‘typical species set’ is computed using intra-habitat similarity and frequency under reference conditions. Second, the ‘sentinel species set’ is generated by selecting the most sensitive species from the typical species set. This selection is made using specific indexes able to assess species sensitivity to a particular pressure. The SoS indicator method was tested on six case studies and two different pressure types (trawling disturbance and pollution), using data from otter trawl, box-corer and Remote Operate Vehicle images. In each scenario, the SoS indicator was compared to the Shannon-Wiener diversity index, Margalef index and total biomass, being the only metric, which showed the expected significant negative response to pressure in all cases. Our results shows that SoS was highly effective in assessing benthic habitats status under both physical and chemical pressures, regardless of the sampling gear, the habitat, or the case study, showing a great potential to be a useful tool in the management of marine ecosystems.

Summary: Background: COVID-19 has the potential to cause outbreaks in hospitals. Given the comorbid and elderly cohort of patients hospitalized, hospital-acquired COVID-19 infection is often fatal. Pathogen genome sequencing is becoming increasingly important in infection prevention and control (IPC). Aim: To inform the understanding of in-hospital SARS-CoV-2 transmission in order to improve IPC practices and to inform the future development of virological testing for IPC. Methods: Patients detected COVID-19 positive by polymerase chain reaction on Ward A in April and May 2020 were included with contact tracing to identify other potential cases. Genome sequencing was undertaken for a subgroup of cases. Epidemiological, genomic, and cluster analyses were performed to describe the epidemiology and to identify factors contributing to the outbreak. Findings: Fourteen cases were identified on Ward A. Contact tracing identified 16 further patient cases; in addition, eight healthcare workers (HCWs) were identified as being COVID-19 positive through a round of asymptomatic testing. Genome sequencing of 16 of these cases identified viral genomes differing by two single nucleotide polymorphisms or fewer, with further cluster analysis identifying two groups of infection (a five-person group and a six-person group). Conclusion: Despite the temporal relationship of cases, genome sequencing identified that not all cases shared transmission events. However, 11 samples were found to be closely related and these likely represented in-hospital transmission. This included three HCWs, thereby confirming transmission between patients and HCWs.

Abstract Artificial intelligence (AI) readers of mammograms compare favourably to individual radiologists in detecting breast cancer. However, AI readers cannot perform at the level of multi-reader systems used by screening programs in countries such as Australia, Sweden, and the UK. Therefore, implementation demands human-AI collaboration. Here, we use a large, high-quality retrospective mammography dataset from Victoria, Australia to conduct detailed simulations of five potential AI-integrated screening pathways, and examine human-AI interaction effects to explore automation bias. Operating an AI reader as a second reader or as a high confidence filter improves current screening outcomes by 1.9–2.5% in sensitivity and up to 0.6% in specificity, achieving 4.6–10.9% reduction in assessments and 48–80.7% reduction in human reads. Automation bias degrades performance in multi-reader settings but improves it for single-readers. This study provides insight into feasible approaches for AI-integrated screening pathways and prospective studies necessary prior to clinical adoption.

Abstract Juno conducted two close Io flybys on 30 December 2023 and 03 February 2024, both at a minimum altitude of 1,500 km. Filamentary structures in the electric and magnetic field spectra indicate Juno crossed the Alfvén wing, the magnetic structure connecting Io to Jupiter's polar ionosphere. We show that the first pass took Juno diametrically through the northern Alfvén wing, while the second pass had Juno graze the southern Alfvén wing boundary, enabling extended measurements of the transition region between Io's vicinity and the Jovian magnetosphere. Of note, evidence of local electron beams is inferred from whistler‐mode emissions. We demonstrate that their energies are sub‐keV, are sourced from Io's ionosphere or local torus, and are part of a distributed current system connecting Io to Jupiter. Finally, upper hybrid resonances indicate electron densities are significantly elevated in Io's polar region (∼28,000 cm−3) compared to the local Io torus (∼2,000 cm−3).

The college years represent a crucial developmental period in which unhealthy behaviors, including smoking, alcohol consumption, inadequate physical activity (PA), poor sleep quality, and unhealthy nutrition habits are often acquired, influencing the onset or exacerbation of pre-existing mental disturbances such as anxiety, depression, or difficulties in emotion regulation. Our aim was to analyze the effect of the intensity of physical activity (PA) on the emotional, behavioral, and cognitive variables in a sample of young people. We recruited 103 participants (19.85 ± 0.25) who completed several online questionnaires (IPAQ-SF, STAI-t, DERS, UPPS-P, ISP-20, and Mini-IPIP). Subsequently, face-to-face sessions were conducted to assess the cognitive variables and to collect more details about their lifestyle habits, including drug use, sleep quality, and leisure activities. Based on the IPAQ-SF results, we categorized the sample into three groups: light PA (n = 47), moderate PA (n = 29), and vigorous PA (n = 27). Vigorous PA group showed better emotional regulation, lower impulsivity, fewer prefrontal symptoms and unhealthy behaviors, better sleep quality, and more leisure activities. No significant cognitive differences were found. It seems that young people are a vulnerable group with emotional and impulsivity traits and engaging in intense PA appears to be a promising avenue for managing these symptoms. In conclusion, our study suggests that young people are a vulnerable group with emotional and impulsivity traits that may precipitate in future mental disorders. Nevertheless, engaging in PA, particularly at high intensity, appears to be a promising avenue for reducing and managing these symptoms during this critical period of life.

To advance environmentally friendly technologies in the aquaculture of Atractoscion nobilis, and simultaneously to diversify seafood production, a 79-day trial was conducted to assess the performance of Ulva lactuca and Devaleraea mollis cultured in the effluent from A. nobilis in a land-based integrated multi-trophic aquaculture (IMTA) system in southern California, USA. Water quality and performance of macroalgae were measured weekly. The impacted factors on the growth of macroalgae and nutrient uptake rate of macroalgae were assessed. The specific growth rate of juvenile A. nobilis was 0.47–0.52%/d. Total ammonia nitrogen in effluents of A. nobilis tanks ranged from 0.03 to 0.19 mg/L. Ulva lactuca and D. mollis achieved an average productivity of 24.53 and 14.40 g dry weight (DW)/m2/d. The average nitrogen content was 3.48 and 4.89% DW, and accordingly, the average nitrogen uptake rate was 0.88 and 0.71 g/m2/d, respectively. Temperature and nutrient concentration were key factors impacting macroalgae growth, and light intensity also impacted the growth of D. mollis. The high protein content of U. lactuca and D. mollis would make them good for use as human or animal food, or for use in other industries. Research on the interaction effects between seawater exchange rates and aeration rates on the performance and nutrient uptake rates of macroalgae will be conducted in future studies.

The COVID-19 pandemic has presented the importance of vaccination as a pivotal strategy for controlling its spread. However, vaccine hesitancy poses a significant barrier to achieving widespread immunization in the United States. This systematic review utilizes the 5C model to examine the factors contributing to hesitancy, which include confidence in vaccines, complacency about disease risk, calculations of individual benefit, convenience of vaccination, and collective responsibility for the protection of others. Methods: We conducted a comprehensive search across several relevant databases and the gray literature, identifying 544 studies that used quantitative and qualitative methods to explore COVID-19 vaccine hesitancy in the general U.S. population. Results: This review identifies a complex interplay of factors affecting hesitancy, such as concerns over vaccine safety and efficacy, misinformation and conspiracy theories, demographic variables, and socioeconomic conditions. Key strategies for increasing vaccine uptake include transparent and effective communication along with proactive community engagement. Conclusions: To effectively mitigate vaccine hesitancy, it is crucial to understand its multifaceted causes. Tailored interventions that consider socioeconomic and cultural contexts and prioritize clear communication, community involvement, and specific strategies to address unique concerns can enhance vaccine acceptance.

Background:. Facial cancer surgery involving the midface (comprising the lower eyelids, nose, cheeks, and upper lip) can have debilitating life-changing functional, social, and psychological impacts on the patient. Midface symptoms are inadequately captured by existing patient-reported outcome measures (PROMs). PROMs are increasingly used for individual patient care, quality improvement, and standardized reporting of treatment outcomes. This study aimed to present our findings from the first phase of the development of a midface, specifically periocular and nasal, PROM. Methods:. After international guidance for PROM development, the first phase comprised identification of salient issues and item generation. Fifteen patients who had midface surgery and 10 clinicians from various specialties with more than 5 years’ experience treating these patients were recruited. Semi-structured interviews explored aesthetic, functional, social, and psychological outcomes, with specific attention to deficiencies in current PROMs. Thematic analysis was used to develop an item pool, and group interviews with clinicians were carried out to create and refine PROM scales. Results:. Qualitative data from patient interviews were grouped into aesthetic, functional, and psychosocial domains for the eyelids and nose. Ninety-nine draft items were generated across these domains. Following focus group discussions, the final version of the midface-specific PROM contained 31 items (13 eye-specific, 10-nose-specific, eight general midface items). Conclusions:. This midface-specific PROM is valuable in assessing and comparing patient-reported outcomes in those who have undergone complex resection and reconstruction of the midface. This PROM is currently undergoing field testing.

IntroductionThe COVID-19 pandemic prompted healthcare professionals to implement service delivery adaptations to remain in compliance with safety regulations. Though many adaptations in service delivery were reported throughout the literature, a wide variety of terminology and definitions were used.MethodsTo address this, we conducted a PRISMA review to identify service delivery adaptations across behavioral healthcare services in the United States from March 2020 to May 2022 and to identify variations in terminology used to describe these adaptations. We identified 445 initial articles for our review across eight databases using predetermined keywords. Using a two-round screening process, authors used a team approach to identify the most appropriate articles for this review.ResultsOur results suggested that a total of 14 different terms were used to describe service modality changes, with the most frequent term being telehealth (63%). Each term found in our review and the frequency of use across identified articles is described in detail.DiscussionImplications of this review such as understanding modality changes during the COVID-19 pandemic and beyond are discussed. Our findings illustrate the importance of standardizing terminology to enhance communication and understanding among professionals.

Abstract Human milk is essential for infant nutrition and immunity, providing protection against infections and other immune-mediated diseases during the lactation period and beyond in later childhood. Milk contains a broad range of bioactive factors such as nutrients, hormones, enzymes, immunoglobulins, growth factors, cytokines, and antimicrobial factors, as well as heterogeneous populations of maternal cells. The soluble and cellular components of milk are dynamic over time to meet the needs of the growing infant. In this study, we utilize systems-approaches to define and characterize 62 analytes of the soluble component, including immunoglobulin isotypes, as well as the cellular component of human milk during the first two weeks postpartum from 36 mothers. We identify soluble immune and growth factors that are dynamic over time and could be utilized to classify milk into different phenotypic groups. We identify 24 distinct populations of both epithelial and immune cells by single-cell transcriptome analysis of 128,016 human milk cells. We found that macrophage populations have shifting inflammatory profiles during the first two weeks of lactation. This analysis provides key insights into the soluble and cellular components of human milk and serves as a substantial resource for future studies of human milk.

The effectiveness of COVID-19 vaccines depends on widespread vaccine uptake. Employing a telephone-administered weighted survey with 19,502 participants, we examined the determinants of COVID-19 vaccine acceptance among adults in Texas. We used multiple regression analysis with LASSO-selected variables to identify factors associated with COVID-19 vaccine uptake and intentions to receive the vaccine among the unvaccinated. The prevalence of unvaccinated individuals (22%) was higher among those aged 18–39, males, White respondents, English speakers, uninsured individuals, those facing financial challenges, and individuals expressing no concern about contracting the illness. In a fully adjusted regression model, higher odds of being unvaccinated were observed among males (aOR 1.11), the uninsured (aOR 1.38), smokers (aOR 1.56), and those facing financial struggles (aOR 1.62). Conversely, Asians, Blacks, and Hispanics were less likely to be unvaccinated compared to Whites. Among the unvaccinated, factors associated with stronger intent to receive the vaccine included age (over 65 years), Black and Hispanic ethnicity, and perceived risk of infection. Hispanic individuals, the uninsured, those covered by public insurance, and those facing financial challenges were more likely to encounter barriers to vaccine receipt. These findings underscore the importance of devising tailored strategies, emphasizing nuanced approaches that account for demographic, socioeconomic, and attitudinal factors in vaccine distribution and public health interventions.

Abstract. Objectives:. To determine the rate of erectile dysfunction in male patients who have sustained an acetabular fracture with no previously identified urogenital injury. Design:. Cross-sectional survey. Setting:. Level 1 Trauma Center. Patients/Participants:. All male patients treated for acetabular fracture without urogenital injury. Intervention:. The International Index of Erectile Function (IIEF), a validated patient-reported outcome measure for male sexual function, was administered to all patients. Main Outcome Measurements:. Patients were asked to complete the International Index of Erectile Function score for both preinjury and current sexual function, and the erectile function (EF) domain was used to quantify the degree of erectile dysfunction. Fractures were classified according the OTA/AO classification schema, fracture classification, injury severity score, race, and treatment details, including surgical approach were collected from the database. Results:. Ninety-two men with acetabular fractures without previously diagnosed urogenital injury responded to the survey at a minimum of 12 months and an average of 43 ± 21 months postinjury. The mean age was 53 ± 15 years. 39.8% of patients developed moderate-to-severe erectile dysfunction after injury. The mean EF domain score decreased 5.02 ± 1.73 points, which is greater than the minimum clinically important difference of 4. Increased injury severity score and associated fracture pattern were predictive of decreased EF score. Conclusion:. Patients with acetabular fractures have an increased rate of erectile dysfunction at intermediate-term follow-up. The orthopaedic trauma surgeon treating these injuries should be aware of this as a potential associated injury, ask their patients about their function, and make appropriate referrals. Level of Evidence:. III.

Emelia Quinn, Reading Veganism: The Monstrous Vegan, 1818 to Present. Oxford English Monographs. Oxford: Oxford University Press, 2021. ix, 188 pp. £65.00 (hb).

A three-dimensional, transient computational fluid dynamics analysis was conducted on an idealised geometry of a coronary artery fitted with representative geometries of an Absorb bioresorbable vascular scaffold (BVS) or a Xience drug-eluting stent (DES) in order to identify and compare areas of disturbed flow and potential risk sites. A non-Newtonian viscosity model was used with a transient velocity boundary condition programmed with user-defined functions. At-risk areas were quantified in terms of several parameters linked to restenosis: wall shear stress, time-averaged wall shear stress, oscillatory shear index, particle residence time, and shear rate. Results indicated that 71% of the BVS stented surface area had time-averaged wall shear stress values under 0.4 Pa compared to 45% of the DES area. Additionally, high particle residence times were present in 23% and 8% of the BVS and DES areas, respectively, with risk areas identified as being more prominent in close proximity to crowns and link struts. These results suggest an increased risk for thrombosis and neointimal hyperplasia for the BVS compared to the DES, which is in agreement with the outcomes of clinical trials. It is intended that the results of this study may be used as a pre-clinical tool to aid in the design of bioresorbable coronary stents.

Background: The prevalence, indications, and preferred methods for gastrocnemius recession and tendo-Achilles lengthening—grouped as triceps surae lengthening (TSL) procedures—in foot and ankle trauma are supported by a scarcity of clinical evidence. We hypothesize that injury, practice environment, and training heritage are significantly associated with probability of performing adjunctive TSL in the operative management of foot and ankle trauma. Methods: A survey was distributed to members of the American Orthopaedic Foot & Ankle Society and the Orthopaedic Trauma Association. Participants rated how likely they would be to perform TSL at initial management, definitive fixation, and after weightbearing in the presence and absence of a positive Silfverskiöld test in 10 clinical scenarios of closed foot and ankle trauma. Results: A total of 258 surgeons with median 14 years’ experience responded. Eighty-five percent reported foot and ankle fellowship training, 24% reported traumatology fellowship training, 13% both, and 4% no fellowship. Ninety-nine percent reported performing TSL with a median 25 TSL procedures per year, 72% open gastrocnemius recession, and 17% percutaneous tendo-Achilles lengthening). Across all scenarios, we observed low overall 8% probability with fair agreement (κ = 0.246) of performing TSL (range, 1% at initial management of an unstable Weber B bimalleolar ankle fracture with negative contralateral Silfverskiöld test to 29% at definitive fixation of tongue-type calcaneus fracture with positive contralateral Silfverskiöld test). Silfverskiöld testing significantly influenced TSL probability at all time points. University of Washington training (β = 1.5, P = .007) but not trauma vs foot fellowship training, years in practice, academic practice, urban setting, or facility trauma designation were significantly associated with likelihood of performing TSL. Conclusion: Orthopaedic traumatology and foot and ankle surgeons report similar indications, methods, and low perceived propensity to use TSL in the management of foot and ankle trauma. We found that graduates of 1 fellowship training site were more likely to perform TSL in the setting of acute trauma potentially indicating the need for better scientific data to support this practice. Level of Evidence: Level V, therapeutic.