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Sharon J Parish,1 Rossella E Nappi,2 Michael L Krychman,3 Susan Kellogg-Spadt,4 James A Simon,5 Jeffrey A Goldstein,6 Sheryl A Kingsberg7 1Albert Einstein College of Medicine, Bronx, NY, USA; 2Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo University, University of Pavia, Pavia, Italy; 3Southern California Center for Sexual Health and Survivorship Medicine and Clinical Faculty University of California Irvine, Newport Beach and Irvine, CA, USA; 4Pelvic and Sexual Health Institute, Philadelphia, PA, USA; 5Obstetrics and Gynecology, George Washington University, Washington, DC, USA; 6Novo Nordisk Inc, Princeton, NJ, USA; 7Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA Abstract: Several recent, large-scale studies have provided valuable insights into patient perspectives on postmenopausal vulvovaginal health. Symptoms of vulvovaginal atrophy, which include dryness, irritation, itching, dysuria, and dyspareunia, can adversely affect interpersonal relationships, quality of life, and sexual function. While approximately half of postmenopausal women report these symptoms, far fewer seek treatment, often because they are uninformed about hypoestrogenic postmenopausal vulvovaginal changes and the availability of safe, effective, and well-tolerated treatments, particularly local vaginal estrogen therapy. Because women hesitate to seek help for symptoms, a proactive approach to conversations about vulvovaginal discomfort would improve diagnosis and treatment. Keywords: health care professional, hypoactive sexual desire disorder, local vaginal estrogen therapy, quality of life, urinary tract infection, vulvovaginal atrophy

Phenethylamines and phenylisopropylamines of scientific relevance can be prepared with a NaBH4/CuCl2 system in 10 to 30 minutes via reduction of substituted β-nitrostyrenes. This one-pot procedure allows the quick isolation of substituted β-nitrostyrene scaffolds with 62–83% yield under mild conditions, without the need for special precautions, inert atmosphere, and time-consuming purification techniques.

Abstract Background Alcohol use disorder (AUD) is associated with deficits in social cognition and behavior, but why these deficits are acquired is unknown. We hypothesized that a reduced association between actions and outcomes for others, i.e., social reward learning, would explain prevalent social deficiencies in AUD. Methods We conducted one laboratory study (n = 234) and one confirmatory online study (n = 258), comparing young adults with AUD to age-, gender-, and education-matched healthy controls on a standardized reward learning task. In the task, participants learned to maximize reward for another person and for oneself. To elucidate the potential relation between reward learning and social behavior in AUD, we administered two measures: a dictator game task and a self-report measure. Finally, we applied reinforcement learning models to examine the computational properties of learning. Results Social and individual learning, expressed in choice behavior, were comparable in individuals with AUD and healthy controls. Individual differences in learning were not associated with reduced social behavior in AUD. Computational modeling suggested that the learning mechanisms are comparable in AUD and healthy controls and indifferent to whether learning maximizes reward for another person or oneself. Conclusions Individuals with AUD demonstrated preserved reward learning abilities that do not vary with social behavior. Together, these results indicate that reward processes may not be relevant for understanding compromised social behavior in AUD.

Abstract Depression is one of the most common psychiatric conditions. Given its high prevalence and disease burden, accurate diagnostic procedures and valid instruments are warranted to identify those in need of treatment. The Patient Health Questionnaire-9 (PHQ-9) is one of the most widely used self-report measures of depression, and its validity and reliability has been evaluated in several languages. However, the Swedish translation has yet not been subject to psychometric evaluation, and no previous psychometric evaluation of the instrument have used both Rasch analysis and classic test theory. The aim of this study was to investigate validity and reliability of the PHQ-9 in a Swedish sample of individuals with self-reported current or past mental health problems using Rasch analysis and confirmatory factor analysis. A sample of 4958 participants was recruited from an online survey covering different aspects of covid-19 and mental health targeted towards individuals with mental health problems. Results showed that a one-factor solution fit the data after removing one item and that some items had a different response pattern for older respondents. Furthermore, after removing item 2 and merging the two middle response categories for item 9, the Swedish translation of PHQ-9 showed adequate psychometric properties. The findings suggests that the Swedish translation of PHQ-9 may need to be adapted in order to make adequate interpretations of an individual score and to differentiate between populations. Further tests of its validity and reliability in other Swedish samples are needed to fully understand the properties of the Swedish version of PHQ-9.

Abstract Background Resilience is an essential psychological trait that empowers individuals to adapt and thrive in the face of challenges. Although it is acknowledged that health professionals need to possess high levels of resilience, there has been limited research comparing how different groups of health students, particularly school leaver undergraduates and mature age graduate entry students, develop resilience in their coursework. Methods This study combines both objective (academic grades with validated survey results) and subjective data (interviews) to compare how resilience is related to academic coursework performance for two groups of pharmacy students: the mature age graduate entry (GE, N = 64) learners and school leaver undergraduate (UG, N = 208) learners. We employed a sequential explanatory mixed methods design using surveys, academic performance data and semi-structured interviews. The survey tapped constructs related to resilience (burnout, stressors and coping methods) while the interviews elicited a more nuanced understanding of individual and environmental factors. Results Although there was no statistical difference in burnout experience between the two groups, GE students exhibited more positive resilience attitudes than UG when selecting resilience statements on the survey. Both cohorts indicated in the survey that engaging in distraction activities (physical exercise, sleeping, listening to music, anything other than the stressor) was their most preferred method of relieving stress. Within UG student survey responses, those who indicated support from partners, friends and family had better academic performance, while those who did not report coping methods did worse academically. The three key environmental factors we identified that contributed to both undergraduate and graduate entry resilience were workload, feedback provision and psychosocial support. Conclusions Currently, there is still a need for resilience programs geared at academic success to be implemented in higher education. This study provides objective evidence of academic success coupled with exploration into the nuances of resilience amongst different student groups. It not only highlights the differing resilience development strategies and burnout coping mechanisms in emerging health professionals, but showcases the juxtaposition of two different learner groups (UG and GE students) within a discipline. The cross-cohort facilitation of learning as in the discipline-specific strategies identified can help both groups develop resilience and inform future innovations. By comparing mature-age graduate students and younger-in-age undergraduate students, we identified a wider range of strategies and more positive attitudes to burnout in mature-age students. Health and clinical educators in university health degrees, clinical placements and clinical workplaces can develop effective training materials based on findings from this study to 1) assist undergraduate younger-age health students with developing resilience and 2) further refine mature-age health students’ and practicing health professionals’ resilience in today’s fast-paced clinical workplaces.

Abstract Animal age at maturity can be used as a universal and simple predictor of species extinction risk. At present, methods to estimate age at maturity are typically species-specific, limiting comparisons among species, or are infeasible due to practical constraints. To overcome this, here we develop a universal predictor of species-level age at maturity for vertebrates. We show that modelling the frequency of ‘CG’ sequences (CpG sites) in gene promoter regions yields rapid predictions of vertebrate age at maturity. Our models predict age at maturity with remarkable accuracy and generalisability, with median error rates of 30% (less than 1 year) and are robust to genome assemblies of varying quality. We generate predictions for 1912 vertebrate species for which age at maturity estimates were previously absent from public databases. The predictions can be used to help to inform management decisions for the many species for which more detailed population information is currently unavailable.

Abstract Background Traditionally managed semi-natural pastures are recognised for their high biodiversity. One drawback is that these pastures are often low in fodder production and hence rather unprofitable, which may lead to abandonment. Two ways to increase production and profitability and maintain grazing are to (i) offer the grazers supplementary feed, or (ii) co-enclose the semi-natural pasture with an improved pasture. Both practices may transfer nutrients to the semi-natural pasture, with potential negative effects on biodiversity. This systematic review aimed to analyse the available evidence concerning the following primary question: “What is the effect of giving grazers access to additional nutrient sources on biodiversity in semi-natural pastures?” (Q1). We also used two supporting questions: “What is the effect of giving grazers access to additional nutrient sources on nutrient status of the soils of semi-natural pastures?” (Q2) and “How do the grazers of semi-natural pastures behave while having access to additional nutrient sources?” (Q3). Methods Searches for peer-reviewed and grey literature were made using bibliographic databases, search engines, specialist websites, and stakeholder contacts. Literature was screened for relevance according to predefined eligibility criteria, and critical appraisal was performed using the tool CEECAT. A database of the relevant studies was compiled. Descriptive information about the evidence base is presented in tables and an interactive evidence atlas. Because of absent study setup replication, Q1 and Q2 were not analysed quantitatively. However, sample size allowed the use of mixed modelling to quantitatively analyse Q3 regarding the effects of (i) co-enclosing an improved pasture on grazers’ electivity for the improved area, and (ii) supplementary feed on the forage intake of grazers. Review findings A total of 12 articles on the effects of supplementary feeding and 19 on the effects of co-enclosing an improved pasture were included, of which some targeted multiple review questions. Because of the limited literature, it is not possible to draw any conclusions concerning the effects on biodiversity (Q1) or nutritional status (Q2) in semi-natural pastures. For Q3, 28 studies fulfilled our criteria, of which 18 investigated the behaviour of grazers related to co-enclosing an improved pasture, and 10 investigated their forage intake while having access to supplementary fodder. The results show that all grazer species except goats preferred grazing in the improved areas regardless of whether they were grazing together with other grazer species or not. We found no effect of supplementary feeding on forage intake of the grazers. Conclusions We detected a knowledge gap concerning the effects of the two additional nutrient sources on semi-natural pasture biodiversity (Q1) and nutrient status (Q2), which points toward further research needs. Analysis of Q3 showed that grazers prefer to graze improved compared to semi-natural pasture areas. However, how this behaviour subsequently affects nutrient transport and biodiversity is unclear and cannot be translated into management recommendations. To gain better knowledge about the primary question of our review, research focusing specifically on this question is needed. We provide suggestions for how such studies could be designed, including spatio-temporal setup, and key management and environmental conditions to consider.

Abstract Securing a sustainable global food supply for a growing population requires a shift toward a more plant-based diet. The application of plant-based proteins is therefore increasing, but unpleasant off-flavors complicate their use. Here, we screened 97 microorganisms for their potential to remove off-flavors in a process with limiting amounts of fermentable sugar. This allowed the production of a more neutral-tasting, purified food ingredient while limiting microbial growth and the production of typical fermentation end products. We demonstrate that various lactic acid bacteria (LAB) and yeasts remove “green” aldehydes and ketones. This conversion can be carried out in less than one hour in almond, pea, potato, and oat proteins. Heterofermentative LAB was best at aldehyde and ketone neutralization with minimum de novo formation of microbial volatiles such as ethylacetate (sweet, fruity) or alpha-diketones (butter- and cheese-like). While sensory properties were improved, changes in protein solubility, emulsification, foaming, and in vitro digestibility were limited.

This study investigates the effects of adaptive feedback generated by large language models (LLMs), specifically ChatGPT, on performance in a written diagnostic reasoning task among German pre-service teachers (n = 269). Additionally, the study analyzed user evaluations of the feedback and feedback processing time. Diagnostic reasoning, a critical skill for making informed pedagogical decisions, was assessed through a writing task integrated into a teacher preparation course. Participants were randomly assigned to receive either adaptive feedback generated by ChatGPT or static feedback prepared in advance by a human expert, which was identical for all participants in that condition, before completing a second writing task. The findings reveal that ChatGPT-generated adaptive feedback significantly improved the quality of justification in the students’ writing compared to the static feedback written by an expert. However, no significant difference was observed in decision accuracy between the two groups, suggesting that the type and source of feedback did not impact decision-making processes. Additionally, students who had received LLM-generated adaptive feedback spent more time processing the feedback and subsequently wrote longer texts, indicating longer engagement with the feedback and the task. Participants also rated adaptive feedback as more useful and interesting than static feedback, aligning with previous research on the motivational benefits of adaptive feedback. The study highlights the potential of LLMs like ChatGPT as valuable tools in educational settings, particularly in large courses where providing adaptive feedback is challenging.

ABSTRACT There is an increasing interest in environmental DNA (eDNA) as a method to survey marine biota, enhancing traditional survey methods, and a need to ground truth eDNA‐based interpretations with visual surveys to understand biases in both the eDNA and visual datasets. We designed and tested a rapidly deployable, robust method pairing water sampling for eDNA collection and stereo‐video imagery, comparing inferred fish assemblages with interspersed baited remote underwater video (stereo‐BRUV) samples. The system is capable of rapidly collecting simultaneous wide‐field stereo‐video imagery, oceanographic measurements and multiple water samples across a range of habitats and depths (up to 600 m). A platform demonstration was conducted in a no‐take National Park Zone of the Ningaloo Marine Park, Western Australia, with samples being collected whilst the system is resting on the seafloor. Combining simultaneous visual survey data with eDNA species estimates increased the total diversity of the fish assemblage by ca. 6.5% over eDNA estimates alone, whilst the analysis of the assemblage composition sampled by each method revealed significant differences. The platform demonstration highlights the biases of each sampling method and their complementarity to one another. We suggest that these biases will be better understood by advancements that allow eDNA metabarcoding to discriminate the abundance and life stage of marine biota. Furthermore, investigation of the relationship between eDNA metabarcoding data and concomitant imagery‐derived length, age and habitat data is needed.

Background information: Inappropriate disposal of unused antimicrobials can push the environment out of balance, and increase the likelihood of antimicrobial-resistant organisms to grow. We aimed to investigate the recommendations for the disposal of unwanted antibiotics given as advice to consumers by community pharmacists practising in Australia. Methods: A cross-sectional study using mystery shopping explored pharmacists' recommendations for disposing of unwanted antibiotics. Simulated patients called community pharmacies across Australia for advice on disposing of leftover antibiotic mixtures. Findings: Of 1577 pharmacists called across Australia, over 59 % recommended incorrect disposal methods, i.e., putting the leftover antibiotic syrup in the home rubbish bin or down the sink or toilet, 28.4 % recommended putting the unused antibiotic straight into the rubbish bin, and 10 pharmacists recommended throwing the leftover syrup on the grass, soil, or in a street drain. There were 19 pharmacists who did not want to recommend disposal at all; some recommended calling the prescriber to ask. Of the pharmacists who advised consumers to return unwanted antibiotic liquid to their pharmacy, 21 (1.3 % overall) indicated that they would pour it down the sink at the pharmacy upon being returned. Interpretation: Pharmacists' advice on antibiotic disposal varied despite the availability of a national scheme enabling consumers to return unwanted medicines to pharmacies for this purpose. Enhanced education and policies could help pharmacists guide the public on proper disposal.

Abstract Two distemper paint samples taken from decorative boards in Uvdal stave church, Norway, were analysed using palaeoproteomics, with an aim of identifying their binder and possible contaminants. The results point at the use of calfskin to produce hide glue as the original paint binder, and are consistent with the instructions of binder production and resource allocation in the historical records of Norway. Although we did not observe any evidence of prior restoration treatments using protein-based materials, we found abundant traces of human saliva proteins, as well as a few oats and barley peptides, likely deposited together on the boards during their discovery in the 1970s. This work illustrates the need to fully consider contamination sources in palaeoproteomics and to inform those working with such objects about the potential for their contamination.

Current methods for testing water for faecal contamination rely on the culture of faecal indicator bacteria (FIB; Escherichia coli and Enterococci) that take 24–48 h, which leads to delays in taking proactive measures and poses a risk to public health. More rapid methods are therefore required. Here, we have tested a rapid, portable assay (Bacterisk) that detects the bacterial biomarker endotoxin in 30 min to quantify the bacterial biomass present, to evaluate 159 coastal water samples and to compare the results with the traditional culture of FIB. There was a significant correlation between the Bacterisk data given in endotoxin risk (ER) units and FIB culture that could accurately distinguish between poor and sufficient or good quality bathing water using the EU bathing directive values. Receiver operating characteristic analysis was used to determine the optimal ER threshold for coastal water samples, and the area under the curve was 0.9176 with a p-value of

Background: Acquired von Willebrand syndrome (AVWS) is a rare bleeding disorder that usually mimics type 1 or 2A von Willebrand disease (VWD). Key Clinical Question: Can AVWS mimic the phenotype of type 2B VWD? Clinical Approach: A 64-year-old male patient presented with thrombocytopenia, normal routine hemostasis results, and normal VWF antigen and factor VIII levels but reduced von Willebrand factor (VWF) activity (31 IU/dL). The ristocetin-induced platelet aggregation test showed paradoxical aggregation at low doses of ristocetin, suggesting type 2B VWD, but no deleterious sequence variation was found in either the VWF or GP1BA genes, compatible with AVWS. Serum protein electrophoresis revealed a monoclonal immunoglobulin G antibody. Conclusion: This AVWS with a 2B phenotype VWD was probably related to a monoclonal immunoglobulin G antibody causing a VWF conformational change, resulting in increased affinity to platelet glycoprotein-Ib. In the event of surgery or bleeding, treatment with vonicog alfa seems to be the best option for this patient.