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Strawberries in California are grown in specific coastal areas where land is scarce and climate change threatens future production. Strawberry growers are under pressure to adopt sustainable production strategies such as crop rotation, but this practice requires more land than back-to-back planting. The objectives of this research were to quantify the rate of crop rotation across the three main strawberry producing regions in California (Ventura, Santa Maria, and Monterey Bay), and evaluate geographic and edaphic influences on crop rotation. All strawberry fields in the main strawberry producing regions of California were identified by satellite imagery and manual inspection for the years 2017 through 2022. ArcGIS Pro was used to outline each strawberry field and compare among years to determine the period between successive strawberry plantings. Edaphic characteristics and shapefiles for surrounding fields were retrieved from public datasets. The three regions significantly differed in their rates of crop rotation. On average, 95, 52, and 25% of strawberry hectares were rotated each year in the Monterey Bay, Santa Maria, and Ventura regions, respectively. Shorter rotation lengths were associated with reduced distance from the ocean and soil with a higher percentage of sand. Based on 2 years of disease surveys, fields infested with Macrophomina phaseolina tended to be further inland than fields infested with Fusarium oxysporum f. sp. fragariae in the Monterey Bay region. This study determined that distance from the ocean and soil texture are associated with crop rotation lengths in California strawberry production. Enough land may be available in the Santa Maria and Monterey Bay regions for growers to lengthen crop rotations, but water quality, social networks, and financial considerations that were outside the scope of this study are likely to limit the ability for strawberry growers to maximize the duration of crop rotations.

BACKGROUND: In severely affected patients with catecholaminergic polymorphic ventricular tachycardia, beta-blockers are often insufficiently protective. The purpose of this study was to evaluate whether flecainide is associated with a lower incidence of arrhythmic events (AEs) when added to beta-blockers in a large cohort of patients with catecholaminergic polymorphic ventricular tachycardia. METHODS: From 2 international registries, this multicenter case cross-over study included patients with a clinical or genetic diagnosis of catecholaminergic polymorphic ventricular tachycardia in whom flecainide was added to beta-blocker therapy. The study period was defined as the period in which background therapy (ie, beta-blocker type [beta1-selective or nonselective]), left cardiac sympathetic denervation, and implantable cardioverter defibrillator treatment status, remained unchanged within individual patients and was divided into pre-flecainide and on-flecainide periods. The primary end point was AEs, defined as sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter defibrillator shock, and arrhythmic syncope. The association of flecainide with AE rates was assessed using a generalized linear mixed model assuming negative binomial distribution and random effects for patients. RESULTS: A total of 247 patients (123 [50%] females; median age at start of flecainide, 18 years [interquartile range, 14-29]; median flecainide dose, 2.2 mg/kg per day [interquartile range, 1.7-3.1]) were included. At baseline, all patients used a beta-blocker, 70 (28%) had an implantable cardioverter defibrillator, and 21 (9%) had a left cardiac sympathetic denervation. During a median pre-flecainide follow-up of 2.1 years (interquartile range, 0.4-7.2), 41 patients (17%) experienced 58 AEs (annual event rate, 5.6%). During a median on-flecainide follow-up of 2.9 years (interquartile range, 1.0-6.0), 23 patients (9%) experienced 38 AEs (annual event rate, 4.0%). There were significantly fewer AEs after initiation of flecainide (incidence rate ratio, 0.55 [95% CI, 0.38-0.83]; P=0.007). Among patients who were symptomatic before diagnosis or during the pre-flecainide period (n=167), flecainide was associated with significantly fewer AEs (incidence rate ratio, 0.49 [95% CI, 0.31-0.77]; P=0.002). Among patients with ≥1 AE on beta-blocker therapy (n=41), adding flecainide was also associated with significantly fewer AEs (incidence rate ratio, 0.25 [95% CI, 0.14-0.45]; P

Abstract Differences in brain size between the sexes are consistently reported. However, the consequences of this anatomical difference on sex differences in intrinsic brain function remain unclear. In the current study, we investigate whether sex differences in intrinsic cortical functional organization may be associated with differences in cortical morphometry, namely different measures of brain size, microstructure, and the geodesic distance of connectivity profiles. For this, we compute a low dimensional representation of functional cortical organization, the sensory-association axis, and identify widespread sex differences. Contrary to our expectations, sex differences in functional organization do not appear to be systematically associated with differences in total surface area, microstructural organization, or geodesic distance, despite these morphometric properties being per se associated with functional organization and differing between sexes. Instead, functional sex differences in the sensory-association axis are associated with differences in functional connectivity profiles and network topology. Collectively, our findings suggest that sex differences in functional cortical organization extend beyond sex differences in cortical morphometry.

In advanced non-squamous non-small-cell lung cancer (NSCLC), routine testing with next-generation sequencing (NGS) is recommended to identify actionable genomic alterations (AGAs). The therapeutic implications of repeated NGS testing on synchronous and metachronous tumors are unclear. Between February 2017 and October 2020, NSCLC samples from a single institution were reflex-tested using a targeted 15-gene NGS panel (TruSight Tumor 15, Illumina). Thirty-eight patients were identified with multiple NGS results from 82 samples: 11% were from single unifocal, 51% were from synchronous, and 38% were from metachronous tumors. Changes in EGFR, KRAS, PI3KCA, and TP53 variants were found in 22 patients’ samples (58%). No changes were seen with longitudinal testing of multiple samples from single unifocal tumors, while changes were observed in 60% of synchronous and 71% of metachronous tumors. Of these, 26% of patients had AGA differences between samples. Acknowledging the limited sample size, a significant difference in overall survival was observed between synchronous separate primaries and metastasis. Repeat NGS testing of synchronous and metachronous NSCLC tumors may identify differing variants in >50% of patients. These changes may reflect separate primary lung carcinomas, tumor heterogeneity among intrapulmonary metastases, and clonal evolution. NGS testing of multiple tumors may enhance the identification of therapeutic targets for treatment decisions.

Abstract Determining sex-bias in brain structure is of great societal interest to improve diagnostics and treatment of brain-related disorders. So far, studies on sex-bias in brain structure predominantly focus on macro-scale measures, and often ignore factors determining this bias. Here we study sex-bias in cortical and hippocampal microstructure in relation to sex hormones. Investigating quantitative intracortical profiling in-vivo using the T1w/T2w ratio in 1093 healthy females and males of the cross-sectional Human Connectome Project young adult sample, we find that regional cortical and hippocampal microstructure differs between males and females and that the effect size of this sex-bias varies depending on self-reported hormonal status in females. Microstructural sex-bias and expression of sex hormone genes, based on an independent post-mortem sample, are spatially coupled. Lastly, sex-bias is most pronounced in paralimbic areas, with low laminar complexity, which are predicted to be most plastic based on their cytoarchitectural properties. Albeit correlative, our study underscores the importance of incorporating sex hormone variables into the investigation of brain structure and plasticity.

Abstract We have designed, fabricated, and characterized implantable silicon neural probes with nanophotonic grating emitters that focus the emitted light at a specified distance above the surface of the probe for spatially precise optogenetic targeting of neurons. Using the holographic principle, we designed gratings for wavelengths of 488 and 594 nm, targeting the excitation spectra of the optogenetic actuators Channelrhodopsin-2 and Chrimson, respectively. The measured optical emission pattern of these emitters in non-scattering medium and tissue matched well with simulations. To our knowledge, this is the first report of focused spots with the size scale of a neuron soma in brain tissue formed from implantable neural probes.

Background: We evaluated outcomes in non-small cell lung cancer (NSCLC) patients who presented with brain-only metastatic (BOM) disease overall and by EGFR/ALK mutation status. Methods: We analyzed clinico-demographic, treatment and survival data for all NSCLC patients who presented to our center between 2014 and 2016 with BOM as their first presentation of metastatic disease. Differences in overall survival (OS) were evaluated using log-rank tests for NSCLC wildtype (NSCLCwt) versus NSCLC with an ALK-rearrangement/EGFR-mutation (NSCLCmut+). Results: Of 109 patients with BOM, median age was 68 years; 51 % were female; 69 % Caucasian; 76 % ever-smoker; 76 % adenocarcinoma; and 25 % NSCLCmut+. While 41 patients (38 %) had subsequent brain-only progressive disease (PD), 22 (20 %) developed extracranial metastases. A higher proportion of NSCLCmut+ (vs –wt) subsequently progressed outside the brain (37 % vs 15 %, p = 0.03). Median time-to-first-extracranial-metastases was 8.5 (NSCLCmut+) vs 21.0 months (NSCLCwt; p = 0.23).With 17.7 months median follow-up, median-OS was 15.9 months [95%CI: 11.5–21.3; all patients]; 12.3 [7.4–18.4; NSCLCwt] and 38.9 [21.3-not reached (NR); NSCLCmut+] (p = 0.09). In 33 of 80 patients with de novo BOM, the primary tumor was treated with surgery or radiotherapy. In patients with NSCLCwt, there was no OS benefit associated with local lung tumor treatment (p = 0.68), whereas in NSCLCmut + pts, local lung tumor treatment correlated with greater OS (median-OS NR vs 21.5 months; p = 0.05). Conclusion: In patients with NSCLCwt with BOM, we observed a -predominant pattern of brain-only secondary progression, however patients with NSCLCmut + more often progressed extracranially. In patients with NSCLCmut+ and BOM, definitive primary tumor treatment correlated with improved survival.

Background: Heart disease is one of the leading causes of death in the United States. Increased education and utilization of BLS by first responders have had a significant impact, but certain populations remain high risk, such as African Americans. Raising awareness among at-risk populations may lead to more bystander CPR performed, improving mortality rates. The influence of celebrity deaths and illnesses is an important driver of public awareness. Therefore, the cardiac arrests of both Bronny James and Damar Hamlin may have influenced cardiac arrest awareness. Methods: Google Trends data was pulled for the following search terms from 8/21/2022–8/14/2023: Cardiac arrest (disease), Cardiopulmonary Resuscitation (topic), Basic Life Support (topic), Myocardial Infarction (disease), Defibrillation (topic) and Automatic External Defibrillator (topic). The average relative search volume (RSV) for each search term was taken for a three-week period encompassing the week of and two weeks following the cardiac arrests of Damar Hamlin and Lebron James Jr., respectively. We used one-way ANOVA and independent sample t-tests to compare the average values of Damar Hamlin's and LeBron James Jr.'s incidents with their respective 12-month averages. Results: RSV was significantly higher surrounding Hamlin's cardiac arrest compared to James Jr.'s for Cardiopulmonary Resuscitation and Automatic External Defibrillator. RSV for Basic Life Support was increased in LeBron James Jr.'s time compared to the 12-month average and Damar Hamlin's incident. Compared to the 12-month average, Cardiac arrest, Cardiopulmonary Resuscitation, Defibrillation, and Automatic External Defibrillator during Hamlin's incident. Myocardial infarction RSV was higher during James Jr.'s incident compared to baseline. Over the long term, the search terms showed a significant increase after Damar Hamlin's incident when compared to before.RSV was significantly higher surrounding Hamlin's cardiac arrest compared to James Jr.'s for “Cardiopulmonary Resuscitation” (23.56 vs. 22.0, p

Abstract The exploration of neural circuitry is paramount for comprehending the computational mechanisms and physiology of the brain. Despite significant advances in materials and fabrication techniques, controlling neuronal connectivity and response in 3D remains a formidable challenge. Here, we introduce a method for engineering the growth of 3D neural circuits with the capability for optical stimulation. We fabricate bioactive interfaces by melt electrospinning writing (MEW) 3D polycaprolactone (PCL) scaffolds followed by coating with titanium carbide (Ti3C2Tx MXene). Beyond enhancing hydrophilicity, cell adhesion, and electrical conductivity, the Ti3C2Tx MXene coating enables optocapacitance-based neuronal stimulation, induced by localized temperature increases upon illumination. This approach offers a pathway for additive manufacturing of neural tissues endowed with optical control, facilitating functional tissue engineering and neural circuit computation.

Real-world evidence for patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC) in Canada is limited. This study’s objective was to use previously validated DARWENTM artificial intelligence (AI) to extract data from electronic heath records of patients with non-squamous NSCLC at University Health Network (UHN) to describe EGFR mutation prevalence, treatment patterns, and outcomes. Of 2154 patients with NSCLC, 613 had advanced disease. Of these, 136 (22%) had common sensitizing EGFR mutations (cEGFRm; ex19del, L858R), 8 (1%) had exon 20 insertions (ex20ins), and 338 (55%) had EGFR wild type. One-year overall survival (OS) (95% CI) for patients with cEGFRm, ex20ins, and EGFR wild type tumours was 88% (83, 94), 100% (100, 100), and 59% (53, 65), respectively. In total, 38% patients with ex20ins received experimental ex20ins targeting treatment as their first-line therapy. A total of 57 patients (36%) with cEGFRm received osimertinib as their first-line treatment, and 61 (39%) received it as their second-line treatment. One-year OS (95% CI) following the discontinuation of osimertinib was 35% (17, 75) post-first-line and 20% (9, 44) post-second-line. In this real-world AI-generated dataset, survival post-osimertinib was poor in patients with cEGFR mutations. Patients with ex20ins in this cohort had improved outcomes, possibly due to ex20ins targeting treatment, highlighting the need for more effective treatments for patients with advanced EGFRm NSCLC.

A challenge in optical phased arrays (OPAs) is to achieve single-lobe emission using densely spaced emitters without incurring inter-waveguide optical crosstalk. Here, we propose to heuristically optimize the amplitude and phase of each grating antenna in an OPA to correct for optical non-idealities, including fabrication variations and inter-waveguide crosstalk. This method was applied to a silicon photonic integrated circuit with 1 mm-long gratings at 775 nm spacing for operation in a wavelength range of 1450–1650 nm. We achieved a wide two-dimensional beam-steering range of 110° × 28°, evaluated over a 127° × 47° field-of-view (FOV). Within this FOV, we measured an average sidelobe suppression of 8.2 dB and focused on average, 34.5 % of the emitted power into the main lobe. We achieved a peak sidelobe suppression of 14.5 dB and 50 % of the power concentrated in the main lobe. The approach is suitable for applications that require alias-free out-of-plane emission.

Strawberries in California are grown in specific coastal areas where land is scarce and climate change threatens future production. Strawberry growers are under pressure to adopt sustainable production strategies such as crop rotation, but this practice requires more land than back-to-back planting. The objectives of this research were to quantify the rate of crop rotation across the three main strawberry producing regions in California (Ventura, Santa Maria, and Monterey Bay), and evaluate geographic and edaphic influences on crop rotation. All strawberry fields in the main strawberry producing regions of California were identified by satellite imagery and manual inspection for the years 2017 through 2022. ArcGIS Pro was used to outline each strawberry field and compare among years to determine the period between successive strawberry plantings. Edaphic characteristics and shapefiles for surrounding fields were retrieved from public datasets. The three regions significantly differed in their rates of crop rotation. On average, 95, 52, and 25% of strawberry hectares were rotated each year in the Monterey Bay, Santa Maria, and Ventura regions, respectively. Shorter rotation lengths were associated with reduced distance from the ocean and soil with a higher percentage of sand. Based on 2 years of disease surveys, fields infested with Macrophomina phaseolina tended to be further inland than fields infested with Fusarium oxysporum f. sp. fragariae in the Monterey Bay region. This study determined that distance from the ocean and soil texture are associated with crop rotation lengths in California strawberry production. Enough land may be available in the Santa Maria and Monterey Bay regions for growers to lengthen crop rotations, but water quality, social networks, and financial considerations that were outside the scope of this study are likely to limit the ability for strawberry growers to maximize the duration of crop rotations.

BackgroundDigital health interventions show promise for weight management. However, few text-based behavior change interventions have been designed to support patients receiving intragastric balloons, and none have simultaneously evaluated weight loss, psychological well-being, and behavior change despite the crucial interplay of these factors in weight management. ObjectiveThis study aims to assess whether a health coach–led, asynchronous, text-based digital behavior change coaching intervention (DBCCI) delivered to participants receiving an intragastric balloon and its aftercare program was feasible and acceptable to participants and supported improved outcomes, including weight loss, psychological well-being, and lifestyle behavior change conducive to weight loss maintenance. MethodsThis 12-month, single-arm prospective study enrolled adults aged 21 to 65 years with BMI ≥27 kg/m2 receiving a procedureless intragastric balloon (PIGB) at 5 bariatric clinics in the United Kingdom and the Netherlands. Participants received the DBCCI and the clinic-led PIGB aftercare program (remotely delivered) for 6 months after PIGB placement and then no intervention for an additional 6 months. The DBCCI was an evidence-based, personalized intervention wherein health coaches supported participants via exchanged asynchronous in-app text-based messages. Over the 12-month study, we assessed percentage of total body weight loss and psychological well-being via self-administered validated questionnaires (Warwick-Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder Scale, Impact of Weight on Quality of Life–Lite–Clinical Trials Version, Loss of Control Over Eating Scale–Brief, Weight Efficacy Lifestyle Questionnaire–Short Form, and Barriers to Being Active Quiz). Participant engagement with and acceptability of the intervention were assessed via self-reported surveys. ResultsOverall, 107 participants (n=96, 89.7% female; mean baseline BMI 35.4, SD 5.4 kg/m2) were included in the analysis. Mean total body weight loss was 13.5% (SEM 2.3%) at the end of the DBCCI and 11.22% (SEM 2.3%) at the 12-month follow-up (P

Background Patients with advanced non-small-cell lung cancer (NSCLC) with activating mutations in the epidermal growth factor receptor (EGFR) gene are a heterogeneous population who often develop brain metastases (BM). The optimal management of patients with asymptomatic brain metastases is unclear given the activity of newer-generation targeted therapies in the central nervous system. We present a protocol for an individual patient data (IPD) prospective meta-analysis to evaluate whether the addition of stereotactic radiosurgery (SRS) before osimertinib treatment will lead to better control of intracranial metastatic disease. This is a clinically relevant question that will inform practice.Methods Randomised controlled trials will be eligible if they include participants with BM arising from EGFR-mutant NSCLC and suitable to receive osimertinib both in the first-line and second-line settings (P); comparisons of SRS followed by osimertinib versus osimertinib alone (I, C) and intracranial disease control included as an endpoint (O). Systematic searches of Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), PsychInfo, ClinicalTrials.gov and the WHO’s International Clinical Trials Registry Platform’s Search Portal will be undertaken. An IPD meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome is intracranial progression-free survival, as determined by response assessment in neuro-oncology-BM criteria. Secondary outcomes include overall survival, time to whole brain radiotherapy, quality of life, and adverse events of special interest. Effect differences will be explored among prespecified subgroups.Ethics and dissemination Approved by each trial’s ethics committee. Results will be relevant to clinicians, researchers, policymakers and patients, and will be disseminated via publications, presentations and media releases.Prospero registration CRD42022330532.