Mapping Ixodes pacificus and Borrelia burgdorferi Habitat Suitability Under Current and Mid-Century Climate in the Pacific Northwest (BC and WA).

Introduction: Lyme disease is the most common vector-borne disease in the United States and Canada. The primary vector for the causative agent of Lyme disease, Borrelia burgdorferi, in the Pacific Northwest is the western blacklegged tick, Ixodes pacificus. Materials and Methods: Using active tick surveillance data from British Columbia, Canada, and Washington State, USA, habitat suitability models using MaxEnt (maximum entropy) were developed for I. pacificus to predict its current and mid-century geographic distributions. Passive surveillance data both from BC and WA were also visualized. Results: According to the constructed models, the number of frost-free days during the winter is the most relevant predictor of its habitat suitability, followed by summer climate moisture, ecoregion, and mean minimum fall temperature. The ensemble geographic distribution map predicts that the coastal regions and inland valleys of British Columbia and the Puget Lowlands of Washington State provide the most suitable habitats for I. pacificus. The density map of ticks submitted from passive surveillance data was overlaid on the current distribution map and demonstrates the correlation between numbers of submissions and habitat suitability. Mid-century projections, based on current climate change predictions, indicate a range expansion, especially of low and moderate suitability, from current distribution. Regarding Lyme disease risk, I. pacificus identified from both active and passive surveillance and tested positive for B. burgdorferi were found to be in areas of moderate to very high suitability for I. pacificus. Conclusion: According to developed models, the total suitable habitat area for I. pacificus will expand in the interior regions of British Columbia and Washington State. However, the risk remains small given relatively low infection rates among I. pacificus. Further studies are required to better understand how this might change in the future.

Range dynamics of Anopheles mosquitoes in Africa suggest a significant increase in the malaria transmission risk.

Despite a more than 100-year effort to combat malaria, it remains one of the most malignant infectious diseases globally, especially in Africa. Malaria is transmitted by several Anopheles mosquitoes. However, until now few studies have investigated future range dynamics of major An. mosquitoes in Africa through a unified scheme. Through a unified scheme, we developed 21 species distribution models to predict the range dynamics of 21 major An. species in Africa under future scenarios and also examined their overall range dynamic patterns mainly through suitability overlap index and range overlap index. Although future range dynamics varied substantially among the 21 An. species, we predicted large future range expansions for all 21 An. species, and increases in suitability overlap index were detected in more than 90% of the African continent for all future scenarios. Additionally, we predicted high range overlap index in West Africa, East Africa, South Sudan, Angola, and the Democratic Republic of the Congo under future scenarios. Although the relative impacts of land use, topography and climate variables on the range dynamics depended on species and spatial scale, climate played the strongest roles in the range dynamics of most species. Africa might face an increasing risk of malaria transmissions in the future, and better strategies are required to address this problem. Mitigating climate change and human disturbance of natural ecosystems might be essential to reduce the proliferation of An. species and the risk of malaria transmissions in Africa in the future. Our strategies against their impacts should be species-specific.

Reflecting back - 10 years of the Future Hospital Programme.

A decade ago, The Future Hospital Programme was created following the publication of the Future Hospital Commission (FHC), to demonstrate how Future Hospital (FH) principles could be implemented and embedded within the NHS. Ten years on, we reflect back on each of the development sites and the programme itself. What were the successes and what are the current challenges? Indeed, in the current NHS, is it feasible to deliver in 'real world environments' the FH principles and make sure that patient care is safe and effective? The last decade has seen financial constraints and inevitable (albeit often short-term) changes to manage the COVID pandemic. How have these affected each of the development sites and what else do we need to do to ensure that we get care right for our patients within our future hospitals?

Life as a chief of medicine-Taking future hospital guidance to the front line.

The Future Hospital Commission developed a comprehensive and ambitious proposal of how hospitals should be run, with clinical leadership at its heart. A medical division led by the chief of medicine was integral to the vision and these senior physicians would be central to the running of hospitals alongside managers. The real-world experiences over 8 years of one chief of medicine are explored and compared to the guidance set out by the Future Hospital Commission, with an emphasis on interdisciplinary triumvirate working, values, behaviours, quality improvement and the impact of crises like the COVID pandemic. The chief of medicine role can play an important part in delivering the outcomes promoted by the Future Hospital Commission, but the role is likely to vary throughout the NHS dependent on local factors. Future guidance could focus on equipping the leaders of the future to design and improve services, and to develop the multiprofessional teams that meet the needs of their specific challenges that they face.

Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis.

Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.

Tackling the future in hospital pharmacy: Training as a pillar of success. / Conquistando el futuro en farmacia hospitalaria: la formación como pilar del éxito.

The training of hospital pharmacists in the coming years must adapt and respond to constant current and future social and technological challenges, without neglecting the basic areas of the profession. It is necessary to acquire knowledge in what is known as digital comprehensive health: Artificial intelligence, technology and automation, digital skills, and new forms of communication with patients, such as telemedicine and telepharmacy that are already a reality in many hospitals. We must provide knowledge in automated systems for the distribution and dispensing of medicines, robots for preparing sterile preparations, traceability systems, the use of drones in clinical care, etc., as well as including training in the application of technology in pharmaceutical care, through devices and applications that help identify patients who require specific care early and effectively. In this digital scenario, new risks and challenges must be faced, such as cybersecurity and cyber-resilience, which makes the training and education of healthcare professionals in general, and hospital pharmacists in particular, essential. On the other hand, the appearance of increasingly complex and innovative therapies has a great impact not only on health population but also on economic and environmental issues, which makes new competencies and skills essential to develop and implement disruptive and competent financing, equity, and sustainability strategies. In this demanding and hyper-connected environment, it is understandable that the well-known "burned out worker syndrome" appears, which prevents the correct personal and professional development of the team and highlights the importance of quality training for its prevention and management. In short, in the next decade, the training of hospital pharmacists must be aimed at providing knowledge in innovation and in basic skills needed to adapt and succeed to current demands and changes.

[Translated article] Conquering the future in hospital pharmacy: Training as a pillar of success.

The training of hospital pharmacists in the coming years must adapt and respond to constant current and future social and technological challenges, without neglecting the basic areas of the profession. It is necessary to acquire knowledge in what is known as digital comprehensive health: artificial intelligence, technology and automation, digital skills, and new forms of communication with patients, such as telemedicine and telepharmacy that are already a reality in many hospitals. We must provide knowledge in automated systems for the distribution and dispensing of medicines, robots for preparing sterile preparations, traceability systems, the use of drones in clinical care, etc. as well as training in the application of technology in pharmaceutical care, through devices and applications that help identify patients who require specific care early and effectively. In this digital scenario, new risks and challenges must be faced, such as cybersecurity and cyber resilience, which makes the training and education of healthcare professionals in general, and hospital pharmacists in particular, inexcusable. On the other hand, the appearance of increasingly complex and innovative therapies has a great impact not only on health population but also on economic and environmental issues, which makes new competencies and skills essential to develop and implement disruptive and competent financing, equity, and sustainability strategies. In this demanding and hyper-connected environment, it is understandable that the well-known "burned out worker syndrome" appears, which prevents the correct personal and professional development of the team and highlights the importance of quality training for its prevention and management. In short, in the next decade, the training of hospital pharmacists must be aimed at providing knowledge in innovation and in basic skills needed to adapt and succeed to current demands and changes.

Limitations of homologous recombination status testing and poly (ADP-ribose) polymerase inhibitor treatment in the current management of ovarian cancer.

Homologous recombination (HR) is a highly conserved DNA repair system, in which aberrations can lead to the accumulation of DNA damage and genomic scars known as homologous recombination deficiency (HRD). The identification of mutations in key genes (i.e., BRCA1, and BRCA2 (BRCA)) and the quantification of large-scale structural variants (e.g., loss of heterozygosity) are indicators of the HRD phenotype. HRD is a stable biomarker and remains unchanged during recurrence, but fails to reveal the molecular profile of tumor progression. Moreover, interpretation of the current HRD score lacks comprehensiveness, especially for the HR-proficient group. Poly (ADP-ribose) polymerase (PARP) enzymes play an important role in the repair of DNA single-strand breaks, the blockage of which using PARP inhibitors (PARPi) can generate synthetic lethality in cancer cells with HRD. Although numerous studies have demonstrated that the benefit of PARPi is substantial in ovarian cancer (OC) patients, the efficacy is limited by the development of resistance, and seems to be irrespective of HR and/or BRCA mutation status. Moreover, in addition to improving progression-free survival, long-term benefit as overall survival brought by PARPi for advanced, recurrent and refractory OC patients remains unclear. Therefore, further investigations are needed to uncover the role of HR genes beyond BRCA and their interactions with other oncogenic pathways, to determine the value of HRD in the recurrent setting, and to identify alternative strategies for the precise management of advanced, refractory OC patients.

Rethinking clinical trials in restless legs syndrome: A roadmap.

The number of large clinical trials of restless legs syndrome (RLS) have decreased in recent years, this coincides with reduced interest in developing and testing novel pharmaceuticals. Therefore, the International Restless Legs Syndrome Study Group (IRLSSG) formed a task force of global experts to examine the causes of these trends and make recommendations to facilitate new clinical trials. In our article, we delve into potential complications linked to the diagnostic definition of RLS, identify subpopulations necessitating more attention, and highlight issues pertaining to endpoints and study frameworks. In particular, we recommend developing alternative scoring methods for more accurate RLS diagnosis, thereby improving clinical trial specificity. Furthermore, enhancing the precision of endpoints will increase study effect sizes and mitigate study costs. Suggestions to achieve this include developing online, real-time sleep diaries with high-frequency sampling of nightly sleep latency and the use of PLMs as surrogate markers. Furthermore, to reduce the placebo response, strategies should be adopted that include placebo run-in periods. As RLS is frequently a chronic condition, priority should be given to long-term studies, using a randomized, placebo-controlled, withdrawal design. Lastly, new populations should be investigated to develop targeted treatments such as mild RLS, pregnancy, hemodialysis, or iron-deficient anemia.

Perceptions of the Future and Health Behavior in Adulthood.

Engagement in healthier lifestyle behaviors often is motivated by a focus on the future. However, there is limited research on the associations between health behavior and future time perspective, defined as people's tendency to perceive their future as expansive or as limited. Data came from a survey of U.S. adults (N = 805, 49.3% female; M = 50 years, range: 19 to 85 years). Participants completed measures of perceptions of future opportunities and time and health behavior. Opportunities and time factors were uniquely associated with health behavior. While the perceived opportunities factor was strongly associated with better health behavior, the time factor was associated with poorer health behavior. However, this latter association was dependent on individual demographic and health status differences. These findings suggest that perceptions of future opportunities can play an important role in health behavior engagement and thus represent an important target for health promotion.

Specificity of Episodic Future Thinking in Adolescents: Comparing Childhood Maltreatment, Autism Spectrum, and Typical Development.

Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.

Ongoing and Future Clinical Trials of Device Therapies for Patients with Heart Failure.

Heart failure continues to pose a significant burden in terms of morbidity, mortality, and healthcare costs worldwide despite the implementation of guideline-directed medical therapy. Addressing this challenge and improving clinical outcomes for this patient population remains an urgent priority. Recognizing the limitations in current medical approaches and exploring strategies to overcome these limitations are crucial steps toward improving future outcomes. Various device-based interventions, such as Cardiac Resynchronization Therapy devices and Left Ventricular Assist Devices, have demonstrated notable benefits for individuals with heart failure. Our review is aimed at summarizing the ongoing research into new device therapies for heart failure, emphasizing their potential to overcome the current challenges in treatment. By utilizing Clinicaltrials.gov, an online repository, we conducted a comprehensive search for trials investigating emerging device therapies for patients dealing with heart failure.

Data-driven identification of environmental variables influencing phenotypic plasticity to facilitate breeding for future climates.

Phenotypic plasticity describes a genotype's ability to produce different phenotypes in response to different environments. Breeding crops that exhibit appropriate levels of plasticity for future climates will be crucial to meeting global demand, but knowledge of the critical environmental factors is limited to a handful of well-studied major crops. Using 727 maize (Zea mays L.) hybrids phenotyped for grain yield in 45 environments, we investigated the ability of a genetic algorithm and two other methods to identify environmental determinants of grain yield from a large set of candidate environmental variables constructed using minimal assumptions. The genetic algorithm identified pre- and postanthesis maximum temperature, mid-season solar radiation, and whole season net evapotranspiration as the four most important variables from a candidate set of 9150. Importantly, these four variables are supported by previous literature. After calculating reaction norms for each environmental variable, candidate genes were identified and gene annotations investigated to demonstrate how this method can generate insights into phenotypic plasticity. The genetic algorithm successfully identified known environmental determinants of hybrid maize grain yield. This demonstrates that the methodology could be applied to other less well-studied phenotypes and crops to improve understanding of phenotypic plasticity and facilitate breeding crops for future climates.

Causal diagnostic model and governance strategies to reduce pollution from ship accidents in Chinese waters.

Ship transportation is a primary mode for global trade and cargo transport, yet even minor discrepancies can lead to ship accidents, causing severe secondary environmental pollution. Maritime accidents involve complex and numerous factors. Formal Concept Analysis (FCA) can identify the key contributing factors and their impact levels by eliminating homogenization factors in maritime accidents. This study constructs an innovative FCA model of ship accidents in Chinese waters, utilizing 172 ship accident reports released by the China Maritime Safety Administration. The analysis reveals seven reduced sets and 23 diagnostic rules of ship accidents. Results show that failed ship registration/security inspection, deficient nautical data and instruments, and management issues are the most critical factors. Three accident chains are identified and corresponding mitigation strategies are proposed to reduce potential pollution from ship accidents. These strategies offer significant reference value for preventing ship accidents and reducing their environmental impact in China and globally.

The association between perceived social support and future decent work perception: A moderated mediation model.

This study examined the relationship between perceived social support, career exploration, and future decent work perception among undergraduate teacher education students in Fujian Province, China. The research focused mainly on the moderating role of proactive personality in these relationships. Data from 542 valid questionnaires revealed that perceived social support significantly influenced career exploration, impacting students' perceptions of future decent work. More importantly, our analysis showed that proactive personality intensified the positive effects of social support on career exploration activities, enhancing students' outlook on their future careers. These findings confirmed social cognitive theory's relevance in understanding career development processes and highlighted the potential of proactive personality traits to leverage social resources more effectively. Given the evolving educational demands and the current socio-economic conditions in China, our study suggested that educational programs should emphasize nurturing proactive behaviors and strengthening social support systems to better prepare students for future professional challenges. These insights were crucial for educators aiming to enhance the quality and effectiveness of teacher education programs, promoting a more robust entry into the workforce for future educators.

Does real option value influence oncologists' treatment recommendations? A survey of U.S. oncologists.

OBJECTIVES: Survival benefit from anticancer treatments, even if modest, improves a patient's chances of accessing future innovations, thereby creating real option value (ROV). There is no empirical evidence on the impact of potential future innovations on oncologists' treatment recommendations. METHODS: We conducted a national online survey of practicing medical and hematological oncologists. We presented a hypothetical metastatic cancer patient with median survival of 6 months under four decision-making scenarios with varying expected efficacy and time to arrival of future innovations. We assessed the likelihood of discussing future innovations with their patients and the likelihood that future innovations would influence their current treatment recommendation, as well as factors associated with these 2 outcomes using multivariate logistic regressions. RESULTS: 201 oncologists completed the survey. When future innovations were expected to improve survival by 6 months and be available in 6 months, 76% of oncologists were likely or very likely to discuss the innovations with their patients, and 68% reported they would influence their current treatment recommendations. A one-month increase in the expected survival improvement of future innovation was associated with a 1.17 (95% CI: 1.1-1.25) greater odds of reporting likely or very likely to discuss future innovations with their patients, while a one-month increase in the expected time to arrival was associated with a 0.91 (95% CI: 0.88-0.94) lower odds. CONCLUSIONS: As potential future innovations appear to influence oncologists' treatments recommendations, evidence to inform clinical guidelines and value assessments should consider data on ROV impacts to support informed treatment decision-making.

Italian university students' future time perspective and well-being during the COVID-19 pandemic.

Introduction: During the COVID-19 pandemic, young adults worldwide showed signs of distress as they were affected in their specific developmental tasks, including the construction of personal and professional futures. Methods: The present study aimed to assess the situational future time perspective of Italian university students during the second pandemic wave, as measured by an ad hoc constructed instrument, to explore its interaction with some dispositional traits relevant in future construction, such as optimism, sense of life, aggression, and dispositional future time perspective, and to test their effect on psychological well-being. The total sample consisted of 389 subjects (18-35 years, M = 23.5, SD = 4.4). Results and discussion: The results indicated that the pandemic experience, assessed by surveying specific indicators, negatively affected the future time perspective of students, particularly those dispositionally optimistic and convinced that life has meaning. However, awareness of the negative impact that the pandemic brought to the vision of the future seems to have dampened the levels of depression and stress, while anxiety was found to be related only to dispositional traits. The results also suggested the need for educational and economic policies that help young adults develop confidence in the future and in their ability to build it.

Episodic future thinking and psychopathology: A focus on depression and suicide risk.

Episodic future thinking (EFT), the ability to imagine future autobiographical events, is both an everyday and clinically significant cognitive process. With a focus on depression and suicidality, here we discuss evidence connecting EFT with psychopathology. Emotional valence of imagined future events has emerged as the most widely established feature of EFT detected to date, with less positive EFT being associated with depressive symptoms and suicidal thoughts and behaviors. This pattern may not be merely a byproduct of sadness or anhedonia. Promising directions for future research include clarifying the temporal association between EFT and clinical outcomes, investigating the potential benefits and drawbacks of positive EFT, and refining assessments for youth to measure EFT either preceding or soon after onset of psychopathology.

Recent progress in microbial biosurfactants production strategies: Applications, technological bottlenecks, and future outlook.

Biosurfactants are surface-active compounds produced by numerous microorganisms. They have gained significant attention due to their wide applications in food, pharmaceuticals, cosmetics, agriculture, and environmental remediation. The production efficiency and yield of microbial biosurfactants have improved significantly through the development and optimization of different process parameters. This review aims to provide an in-depth analysis of recent trends and developments in microbial biosurfactant production strategies, including submerged, solid-state, and co-culture fermentation. Additionally, review discusses biosurfactants' applications, challenges, and future perspectives. It highlights their advantages over chemical surfactants, emphasizing their biodegradability, low toxicity, and diverse chemical structures. However, the critical challenges in commercializing include high production costs and low yield. Strategies like genetic engineering, process optimization, and downstream processing, have been employed to address these challenges. The review provides insights into current commercial producers and highlights future perspectives such as novel bioprocesses, efficient microbial strains, and exploring their applications in emerging industries.

Longitudinal effects of peer victimization on adolescents' future educational and work expectations: Depressive symptoms as a mechanism.

Leveraging six waves of data, this study examined the effects of ninth-grade peer victimization on adolescents' future work and education expectations 2 years later, testing depressive symptoms as a mechanism. Participants (N = 388, Mage = 14.05; 61% female, 35% male, 3% non-binary, trans, or other gender; 46% White, 19% Black, 17% Asian, 6% AMENA, 6% Multiracial, 6% other race) completed surveys from ninth through 11th grade. Results indicated that adolescents who experienced more frequent relational, but not overt, peer victimization in ninth grade were subsequently more pessimistic about their educational and occupational prospects beyond high school; depressive symptoms mediated this link. The findings suggest that relational victimization and its psychological harm may undermine adolescents' confidence in achieving postsecondary success.