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Anorexia nervosa (AN) is associated with food restriction and significantly low body weight, but the neurobiology of food avoidance in AN is unknown. Animal research suggests that food avoidance can be triggered by conditioned fear that engages the anterior cingulate and nucleus accumbens. We hypothesized that the neural activation during food avoidance in AN could be modeled based on aversive goal value processing. Nineteen females with AN and thirty healthy controls matched for age underwent functional magnetic resonance brain imaging while conducting a food avoidance task. During active control free-bid and computer-generated forced-bid trials, participants bid money to avoid eating food items. Brain activation was parametrically modulated with the trial-by-trial placed bids. During free-bid trials, the AN group engaged the caudate nucleus, nucleus accumbens, ventral anterior cingulate, and inferior and medial orbitofrontal cortex more than the control group. High- versus low-bid trials in the AN group were associated with higher caudate nucleus response. Emotion dysregulation and intolerance of uncertainty scores were inversely associated with nucleus accumbens free-bid trial brain response in AN. This study supports the idea that food avoidance behavior in AN involves aversive goal value computation in the nucleus accumbens, caudate nucleus, anterior cingulate, and orbitofrontal cortex.

This perspective highlights the experiences and observations of an early care and education researcher reentering the field after the lifting of COVID-19 restrictions in the USA. Specifically, this perspective highlights the struggles of children, teachers, early care and education leaders, and the system itself as early care and education attempts to return to normal post COVID-19. Children exhibit behavioral, social, cognitive, and physical challenges. Teachers are burned out from grueling cleaning and safety protocols and caring for children who have missed the benefits of early care and education socialization during the pandemic. Leaders are struggling to keep a stable workforce and fill many roles in the childcare site. This perspective details firsthand experiences and recent relevant literature to describe these struggles.

This singular holistic case study examined the experience of a Black pregnant mother pursuing doctoral studies in a science, technology, engineering, and math (STEM) field at a predominantly white flagship institution in the southern United States. We employed the tenets of critical race feminism in this study to demonstrate the ways in which structural racism and pervasive gender stereotypes, specifically as they relate to Black women, present obstacles to successful completion of doctoral STEM studies. We narrate her story to highlight the insight inherent within her intersecting identities that challenges dominant narratives about a Black pregnant doctoral student. In bringing to the fore four themes surfaced: the triple consciousness of layered Blackness, the pregnant Black tax, Chemical imbalance: mapping a white man's reality onto a Black mother's body, and internal struggles and the complex intra-actions that birthed them -- we present a counternarrative to the dominant white-male centred STEM discourse that permeates the field. We conclude by extrapolating, from this case, considerations for faculty and institutions to understand better and act to comprehensively support Black students, in general, and Black mothers.

Day to day energy production is shifting towards renewable energy sources as these sources become more economically viable while being less polluting to operate; solar energy has become one of the major sources of renewable energy. However, it currently relies on ultra-pure silicon ingots to produce commercial silicon photovoltaics, which prevents the cost of electricity being produced to compete with non-renewable energy production. A viable low-cost alternative for silicon based cells would be dye-sensitized solar cells (DSSCs), which are easier and cheaper to manufacture as they do not require expensive and delicate raw materials to make. Moreover, they could be made semi-flexible which allows for a greater variety of applications. A DSSC consists of three components, a photo-electrode, an electrolyte and a counter-electrode. When exposed to incident light, the complex photosensitizers in the photoelectrode release electrons which are transported to the external load, leaving the photoelectrode in an oxidized state. The electrons are collected by the counter electrode and used to reduce the electrolyte. This charged electrolyte then reduces the positively charged photoelectrode, allowing the process to begin again. To improve the efficiency of this process, we explore the use of bismuth sulfide (Bi2S3) and titanium oxide (TiO2) composite as photoelectrode material and investigate their impact on the efficiency of DSSC.

Entrepreneurial minded learning (EML) is a pedagogical technique that gives students the tools to identify opportunities, focus on impact, and to create value through their solutions. The entrepreneurial mindset builds upon three key elements: curiosity, connections, and creating value (3 Cs). A biomedical engineering course was developed using EML. EML was infused into every class session through learning objectives, content, reading, and activities. The course culminated in a project in which students used EML to define a problem in bioengineering and propose solutions that incorporated polymers. Activities gave the students the opportunity to experience EML, teamwork, and entrepreneurship, and to work through the stages of their project. Assessments incorporated at least one question tied to EML. Questions on two direct assessments were scored by a set of established EML objectives and associated rubrics. Students participated in anonymous pre- and post-surveys to assess understanding and acquisition of EML skills. There have been two offerings with participation from undergraduate and graduate students. Over two offerings, 38% of students had invention disclosures related to their projects. Survey results indicated significant increases across many areas of EML, with the largest increases related to defining EML and the 3 Cs; identifying opportunity; identifying social, economic, and environmental value; and considering intellectual property. Survey results were corroborated by students demonstrating emerging or accomplished scores on several EML objectives on final exams and final project submissions. By the end of the course, most students appreciated learning the entrepreneurial mindset and saw opportunities to apply these techniques to both their research projects and future careers. EML promoted innovative and creative thinking, problem solving, assessment of user needs, and teamwork. This work demonstrates approaches and examples of assessments and activities that can be used to incorporate entrepreneurial skills into a course.

IntroductionClinicians are the conduits of high-quality care delivery. Clinicians have driven advancements in pharmacotherapeutics, devices, and related interventions and improved morbidity and mortality in patients with congestive heart failure over the past decade. Yet, the management of congestive heart failure has become extraordinarily complex and has fueled recommendations from the American Heart Association and the American College of Cardiology to optimize the composition of the care team to reduce the health, economic, and the health system burden of high lengths of stay and hospital charges. Therefore, the purpose of this study was to identify the extent to which specific care team configurations were associated with high length of stay and high-charge hospitalizations of patients with congestive heart failure.MethodsThis study performed a retrospective analysis of data extracted from the electronic health records of 3,099 patients and their hospitalizations from the Arkansas Clinical Data Repository. The data was analyzed using binomial logistic regression in which adjusted odds ratios reflected the association of specific care team configurations (i.e., combination of care roles) with length of stay and hospital charges.ResultsTeam configurations that included a nurse practitioner, registered nurse, care manager, and social worker were generally above the median length of stay and median charges when compared to team configurations that did not collectively include all of these roles. Patients with larger configurations (i.e., four or more different care roles) had higher length of stays and charges than smaller configurations (i.e., two to three different care roles). The results also validated the Van Walraven Elixhauser Comorbidity Score by finding that its quartiles were associated with length of stay and charges, an indicator of care demand based on patient morbidity.ConclusionsCardiologists, alone, cannot shoulder the burden of improving patient outcomes. Care team configuration data within electronic health record systems of hospitals could be an effective method of isolating and tracking high-risk patients. Registered nurses may be particularly effective in advancing real-time risk stratification by applying the Van Walraven Elixhauser Comorbidity Score at the point of care, improving the ability of health systems to match care demand with workforce availability.

Anxious traits are elevated in eating disorders (EDs), are considered risk factors for ED development, and trait anxiety has been linked to ED psychopathology. How trait anxiety relates to ED neurobiology is not well understood. In this study 197 individuals across the ED spectrum (anorexia nervosa n = 91; other specified EDs n = 34; bulimia nervosa n = 56; binge ED n = 16), and 120 healthy controls were assessed for anxious traits and learned to expect and receive caloric or neutral taste stimuli during brain imaging. Amygdala sucrose expectation response differed across groups (Wilk's lambda = 0.945, p = 0.023), and was higher on the left in anorexia nervosa compared to healthy controls (p = 0.002). Expected sucrose receipt response across taste reward regions was not different between groups. In the ED sample, trait anxiety negatively moderated the relationship between amygdala expectation and right dorsal (p = 0.0062) and ventral (p = 0.0046) anterior insula receipt response. A subgroup analysis showed similar results for anorexia nervosa, and partially in bulimia nervosa. Across EDs, appetitive motivation correlated positively with bilateral orbitofrontal cortex, caudate head, and ventral striatal sucrose receipt response (r = 0.215 to 0.179, p = 0.002 to 0.012). Across the study sample, trait anxiety showed an inverted-U-shaped relationship with right (r = 0.147, p = 0.034) and left (r = 0.162, p = 0.016) amygdala expectation response. Amygdala sucrose expectation response is elevated in anorexia nervosa, correlates with sucrose receipt response, and this relationship is negatively moderated by trait anxiety across EDs. Trait anxiety may have an important role in how expectation drives taste stimulus receipt brain response and perhaps food approach in individuals with EDs.

OBJECTIVE: Anorexia nervosa (AN) is a severe psychiatric illness with complex etiology. Recently, we found elevated striatal brain response to sweet taste stimuli in adolescents and young adults with AN. Here, we tested the hypothesis that nutritional rehabilitation normalizes prediction error activation, a measure for dopamine-related reward circuit response, to salient caloric taste stimuli in AN. METHODS: A total of 28 individuals with AN (age = 16 ± 2 years; body mass index [BMI] = 16 ± 1) who previously underwent brain imaging while performing a taste prediction error task using sucrose as salient caloric stimulus, participated in a second brain imaging scan (BMI = 18 ± 1) after intensive specialized eating disorder treatment (41 ± 15 days). A total of 31 healthy controls (age = 16 ± 3 years; BMI = 21 ± 2) were also studied on two occasions. RESULTS: At baseline, individuals with AN demonstrated an elevated salience response in bilateral caudate head and nucleus accumbens, and right ventral striatum. At the second scan, elevated response was only found in the right nucleus accumbens. A moderator analysis indicated that greater increase in BMI and greater decrease in sweetness perception predicted lesser prediction error response at the second scan in AN. CONCLUSION: Consistent with the previously reported monetary stimulus-response, elevated taste prediction error response in AN was largely absent after weight restoration. This study indicates that changes in BMI and sweet taste perception are independent moderators of change of brain salience response in adolescents and young adults with AN. The study points toward dynamic changes in the brain reward circuitry in AN and highlights the importance of nutrition and weight restoration in that process. PUBLIC SIGNIFICANCE STATEMENT: AN is a severe psychiatric illness. Biological factors that integrate neurobiology and behavior could become important targets to improve treatment outcome. This study highlights the importance of weight normalization and taste perception the normalization of brain function, and food type or taste-specific interventions could help in the recovery process. Furthermore, the study suggests that food-related and nonfood-related reward processing adapts to illness state in AN.

This case study research, informed by an Indigenous Research Paradigm, sought to ascertain the impact of a university's decentralised health faculty Aboriginal engagement program. It involved analysis of health faculty and other faculties' 2016-2020 student commencement, enrolment, completion, and retention data. The health faculty was more likely to have Aboriginal commencements in 2017 and 2018 due to a more equitable student selection process focused on applicant success factors and inclusive of Aboriginal epistemology. Other faculties' Aboriginal commencement improved when a similar process was adopted. Excepting 2018, the health faculty was more likely to have Aboriginal completions and from 2017 onwards, Aboriginal enrolments. An increasing faculty retention pattern existed likely relating to earlier student engagement and planning. The decentralised model, led by Aboriginal people and supported by faculty and university, also provided processes for Aboriginal students, to crucially be, belong, and further grow as, Aboriginal people. With this presumably better positioning of graduates' standpoints as Aboriginal health professionals to engage with healthcare cultural safety. This is important as health professions education is predominantly conceived by colonial paradigms which can promote assimilation. Despite improvements, inequities remained. Higher education should aim to graduate as many Aboriginal health professional graduates as possible to address healthcare inequities.

Abstract Background Knowledge translation (KT) strategies are widely used to facilitate the implementation of EBIs into healthcare practices. However, it is unknown what and how KT strategies are used to facilitate the sustainability of EBIs in institutional healthcare settings. Objectives This scoping review aimed to consolidate the current evidence on (i) what and how KT strategies are being used for the sustainability of EBIs in institutional healthcare settings; (ii) the reported KT strategy outcomes (e.g., acceptability) for EBI sustainability, and (iii) the reported EBI sustainability outcomes (e.g., EBI activities or component of the intervention continue). Methods We conducted a scoping review of five electronic databases. We included studies describing the use of specific KT strategies to facilitate the sustainability of EBIs (more than 1-year post-implementation). We coded KT strategies using the clustered ERIC taxonomy and AIMD framework, we coded KT strategy outcomes using Tierney et al.’s measures, and EBI sustainability outcomes using Scheirer and Dearing’s and Lennox’s taxonomy. We conducted descriptive numerical summaries and a narrative synthesis to analyze the results. Results The search identified 3776 studies for review. Following the screening, 25 studies (reported in 27 papers due to two companion reports) met the final inclusion criteria. Most studies used multi-component KT strategies for EBI sustainability (n = 24). The most common ERIC KT strategy clusters were to train and educate stakeholders (n = 38) and develop stakeholder interrelationships (n = 34). Education was the most widely used KT strategy (n = 17). Many studies (n = 11) did not clearly report whether they used different or the same KT strategies between EBI implementation and sustainability. Seven studies adapted KT strategies from implementation to sustainability efforts. Only two studies reported using a new KT strategy for EBI sustainability. The most reported KT strategy outcomes were acceptability (n = 10), sustainability (n = 5); and adoption (n = 4). The most commonly measured EBI sustainability outcome was the continuation of EBI activities or components (n = 23), followed by continued benefits for patients, staff, and stakeholders (n = 22). Conclusions Our review provides insight into a conceptual problem where initial EBI implementation and sustainability are considered as two discrete time periods. Our findings show we need to consider EBI implementation and sustainability as a continuum and design and select KT strategies with this in mind. Our review has emphasized areas that require further research (e.g., KT strategy adaptation for EBI sustainability). To advance understanding of how to employ KT strategies for EBI sustainability, we recommend clearly reporting the dose, frequency, adaptations, fidelity, and cost of KT strategies. Advancing our understanding in this area would facilitate better design, selection, tailored, and adapted use of KT strategies for EBI sustainability, thereby contributing to improved patient, provider, and health system outcomes.

ImportanceEating disorders are severe psychiatric disorders; however, disease models that cross subtypes and integrate behavior and neurobiologic factors are lacking.ObjectiveTo assess brain response during unexpected receipt or omission of a salient sweet stimulus across a large sample of individuals with eating disorders and healthy controls and test for evidence of whether this brain response is associated with the ventral striatal-hypothalamic circuitry, which has been associated with food intake control, and whether salient stimulus response and eating disorder related behaviors are associated.Design, setting, and participantsIn this cross-sectional functional brain imaging study, young adults across the eating disorder spectrum were matched with healthy controls at a university brain imaging facility and eating disorder treatment program. During a sucrose taste classic conditioning paradigm, violations of learned associations between conditioned visual and unconditioned taste stimuli evoked the dopamine-related prediction error. Dynamic effective connectivity during expected sweet taste receipt was studied to investigate hierarchical brain activation between food intake relevant brain regions. The study was conducted from June 2014 to November 2019. Data were analyzed from December 2019 to February 2020.Main outcomes and measuresPrediction error brain reward response across insula and striatum; dynamic effective connectivity between hypothalamus and ventral striatum; and demographic and behavior variables and their correlations with prediction error brain response and connectivity edge coefficients.ResultsOf 317 female participants (197 with eating disorders and 120 healthy controls), the mean (SD) age was 23.8 (5.6) years and mean (SD) body mass index was 20.8 (5.4). Prediction error response was elevated in participants with anorexia nervosa (Wilks λ, 0.843; P = .001) and in participants with eating disorders inversely correlated with body mass index (left nucleus accumbens: r = -0.291; 95% CI, -0.413 to -0.167; P

In our consensual qualitative research investigation of teaching development, beginning counselor educators' (N = 13) grew in transitioning from teacher-centeredness to student-centered learning approaches, as well as in student engagement, adaptation to student needs, and confidence. They felt challenged by setting boundaries with students and managing time.

Administration of oxygen microbubbles (OMBs) has been shown to increase oxygen and decrease carbon dioxide in systemic circulation, as well as reduce lung inflammation and promote survival in preclinical models of hypoxia caused by lung injury. However, their impact on microenvironmental oxygenation remains unexplored. Herein, we investigated the effects of intraperitoneal administration of OMBs in anesthetized rats exposed to hypoxic ventilation (FiO2 = 0.14). Blood oxygenation and hemodynamics were evaluated over a 2 h time frame, and then organ and tissue samples were collected for hypoxic and metabolic analyses. Data showed that OMBs improved blood SaO2 (~14%) and alleviated tissue hypoxia within the microenvironment of the kidney and intestine at 2 h of hypoxia. Metabolomic analysis revealed OMBs induced metabolic differences in the cecum, liver, kidney, heart, red blood cells and plasma. Within the spleen and lung, principal component analysis showed a metabolic phenotype more comparable to the normoxic group than the hypoxic group. In the spleen, this shift was characterized by reduced levels of fatty acids and 2-hydroxygluterate, alongside increased expression of antioxidant enzymes such as glutathione and hypoxanthine. Interestingly, there was also a shuttle effect within the metabolism of the spleen from the tricarboxylic acid cycle to the glycolysis and pentose phosphate pathways. In the lung, metabolomic analysis revealed upregulation of phosphatidylethanolamine and phosphatidylcholine synthesis, indicating a potential indirect mechanism through which OMB administration may improve lung surfactant secretion and prevent alveolar collapse. In addition, cell-protective purine salvage was increased within the lung. In summary, oxygenation with intraperitoneal OMBs improves systemic blood and local tissue oxygenation, thereby shifting metabolomic profiles of the lung and spleen toward a healthier normoxic state.

Spectroscopic analysis of radiological materials has been historically limited to radiological labs with older or less advanced scientific instrumentation. The development of double-walled cells (DWCs) at the Savannah River National Laboratory (SRNL) has enabled Pu-bearing compounds to be removed from radiological laboratories and studied in our radiologically clean spectroscopy laboratory with state-of-the-art instrumentation. In this manuscript, we discuss the contributions of DWCs that have allowed the application of Raman spectroscopy, diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS), diffuse reflectance spectroscopy (DRS) in the shortwave infrared, and gamma spectroscopy at SRNL. Significant advances have been made in the understanding of the thermal decomposition of Pu(III) and Pu(IV) oxalates, alpha-induced damage to the PuO2 crystal lattice, and the effect of calcination temperatures on the quality of PuO2. These techniques have enabled methods to conduct PuO2 age dating since last calcination and estimate the calcination temperature with Raman spectroscopy and DRS. Additional spectroscopic information measured with DRIFTS has enabled the observation of the evolution of carbon species with calcination temperature, while gamma spectroscopy provides information on age dating since last purification.