ptx3a+ fibroblast/epicardial cells provide a transient macrophage niche to promote heart regeneration.

Macrophages conduct critical roles in heart repair, but the niche required to nurture and anchor them is poorly studied. Here, we investigated the macrophage niche in the regenerating heart. We analyzed cell-cell interactions through published single-cell RNA sequencing datasets and identified a strong interaction between fibroblast/epicardial (Fb/Epi) cells and macrophages. We further visualized the association of macrophages with Fb/Epi cells and the blockage of macrophage response without Fb/Epi cells in the regenerating zebrafish heart. Moreover, we found that ptx3a+ epicardial cells associate with reparative macrophages, and their depletion resulted in fewer reparative macrophages. Further, we identified csf1a expression in ptx3a+ cells and determined that pharmacological inhibition of the csf1a pathway or csf1a knockout blocked the reparative macrophage response. Moreover, we found that genetic overexpression of csf1a enhanced the reparative macrophage response with or without heart injury. Altogether, our studies illuminate a cardiac Fb/Epi niche, which mediates a beneficial macrophage response after heart injury.

Neutrophils facilitate the epicardial regenerative response after zebrafish heart injury.

Despite extensive studies on endogenous heart regeneration within the past 20 years, the players involved in initiating early regeneration events are far from clear. Here, we assessed the function of neutrophils, the first-responder cells to tissue damage, during zebrafish heart regeneration. We detected rapid neutrophil mobilization to the injury site after ventricular amputation, peaking at 1-day post-amputation (dpa) and resolving by 3 dpa. Further analyses indicated neutrophil mobilization coincides with peak epicardial cell proliferation, and recruited neutrophils associated with activated, expanding epicardial cells at 1 dpa. Neutrophil depletion inhibited myocardial regeneration and significantly reduced epicardial cell expansion, proliferation, and activation. To explore the molecular mechanism of neutrophils on the epicardial regenerative response, we performed scRNA-seq analysis of 1 dpa neutrophils and identified enrichment of the FGF and MAPK/ERK signaling pathways. Pharmacological inhibition of FGF signaling indicated its' requirement for epicardial expansion, while neutrophil depletion blocked MAPK/ERK signaling activation in epicardial cells. Ligand-receptor analysis indicated the EGF ligand, hbegfa, is released from neutrophils and synergizes with other FGF and MAPK/ERK factors for induction of epicardial regeneration. Altogether, our studies revealed that neutrophils quickly motivate epicardial cells, which later accumulate at the injury site and contribute to heart regeneration.

Exploring differences in and factors influencing self-efficacy for competence in interprofessional collaborative practice among health professions students.

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. The study data were collected between 2015 and 2019 from students from 13 different health professions programmes (N = 3,497) before an annual institutional interprofessional programme. Students completed the IPECC-SET-27, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of, the role of different health professions. Students in different health professions education programmes were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programmes (p < .05). Specifically, health information management/health informatics, dentistry, medicine, and nursing students expressed relatively higher SE, whereas physical therapy and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health professions (p < .01) and gender (p < .01) contributed significantly to predicting perceived SE for competence in ICP, while the amount of previous contact with other health professions did not (p = .42). The findings highlight the value of designing IPE with consideration of specific learner needs.

Reducing fall injuries with better data.

BACKGROUND: Fall deaths in the USA almost tripled in the twenty-first century. While various interventions have been effective in reducing fall deaths, they have failed to make a substantial impact at a population level. MAIN BODY: An overarching factor that has been relatively neglected in fall injury prevention is the need for more and better data. We need better data on the causes and circumstances of older adult fall deaths. While there are excellent national surveillance systems on the circumstances of other injury deaths (e.g., motor vehicle crashes, suicides, and homicides), such a system is lacking for fall deaths. These other data systems have been instrumental in indicating and evaluating policies that will reduce injury. It is also important to provide consumers with better information concerning the many products that affect the likelihood of fall injury (e.g., flooring, hip protectors, footwear). Automotive buyers are provided with relevant up-to-date make-model safety information from crash tests and real-world performance. Such information not only helps protect buyers from purchasing dangerous products, but it provides producers with the incentive to make ever safer products over time. CONCLUSION: We believe that creation of a national surveillance system on the circumstances of fall deaths, and increased testing/certifying of fall-related products, are two steps that would help create the conditions for continuous reductions in fall fatalities. Fall prevention should apply some of the same basic strategies that have proved effective in addressing other injuries.

Effects of Lead (Pb) from Smelter Operations in an Urban Terrestrial Food Chain at a Colorado Superfund Site.

Lead (Pb) is ubiquitous in urban environments, and it is a risk factor for wildlife. But wildlife are particularly at risk for exposure near smelters in urban areas where higher than safe Pb levels in the soil have the potential to transfer to the food chain. Therefore, we investigated whether wildlife are at risk of Pb exposure and differences in Pb bioaccumulation in trophic levels at a Superfund site in an urban area of Colorado. We sampled soil, vegetation, arthropods, and birds at four sites: two contaminated sites (one at the Superfund site and one near the Superfund site) and two reference sites with low predicted Pb contamination. We found significantly higher Pb levels in the soil at the contaminated Slag pile at the Superfund site, compared to the other sites. At the Slag pile, Pb levels were the highest in vegetation and both arthropods and birds accumulated Pb. However, Pb did not increase between trophic levels in the terrestrial food web at the site. We concluded that smelter operations at the Superfund site resulted in significantly higher levels of Pb in the soil and sublethal accumulation in all taxa studied. This research can be used to mitigate the risks to vulnerable wildlife populations exposed to Pb at the Superfund site. Further examination of Pb toxicity in vulnerable taxa is critical to conserving wild populations and ecosystems near contamination zones.

Maternal depressive symptoms and child language development: Exploring potential pathways through observed and self-reported mother-child verbal interactions.

Maternal depressive symptoms (MDS) in the postnatal period may impact children's later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.

Maternal reminiscing during middle childhood: Associations with maternal personality and child temperament from the Growing Up in New Zealand cohort study.

The way that mothers talk about the past (reminisce) with young children is linked to key memory, language, and socioemotional outcomes. The present research explored the role of a range of child, maternal, socioeconomic, and cultural factors that predict maternal reminiscing style, with a particular focus on maternal personality and child temperament. A total of 1,404 mother-child dyads from the prebirth longitudinal cohort study Growing Up in New Zealand (https://www.growingup.co.nz) participated in a reminiscing task about a negative event when children were 8 years old. This broader cohort is broadly representative of the New Zealand population in terms of maternal ethnicity and socioeconomic status. Conversations were scored using a revised version of the Elaborative Reminiscing Scale. Child temperament during infancy, but not childhood, uniquely predicted maternal reminiscing style. Maternal extraversion also predicted a more elaborative reminiscing style. Other maternal factors, including education, ethnicity, and age, were also identified as unique predictors of maternal reminiscing style. These findings fit well with an ecological systems view of maternal reminiscing as a function of child, maternal, and cultural factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Proximal Processes and Contextual Factors Associated with Early Socio-emotional Competence Development.

There is growing interest in child socio-emotional competence from parents, educators, employers and policy makers, with emphasis on developing it as early as possible. The aim of the present study was to examine contextual and proximal factors that influence socio-emotional competence development across the first five years of a child's life. We used data from 3200 mothers and their children drawn mostly from four major data collection waves (antenatal, 9 months, 2 years and 4.5 years) of the population-based longitudinal study, Growing Up in New Zealand. Regression analyses were carried out to identify the predictors of socio-emotional competence after controlling for demographics and prior score(s) of socio-emotional competence. We found that specific maternal behaviours, such as playing games and playing with toys with children, singing songs or telling stories to them, reading books with them, having rules around viewing TV, DVDs and videos, and praising children have a positive effect on socio-emotional competence. Parental relationship warmth and less family stress at 9 months also made positive contributions to socio-emotional competence at 9 months and 2 years. In contrast, attending childcare and having more siblings at home negatively predicted socio-emotional competence at 9 months. Mother's unemployment, living in neighbourhoods perceived as negative and being in contact with family and social services were negatively associated with concurrent socio-emotional competence at 2 years. Overall, more and/or stronger contemporaneous effects were found suggesting that negative effects of contextual factors may not have lasting impact on socio-emotional competence. In addition, the results showed that maternal behaviours need to be practised regularly to have positive impact on child's socio-emotional development.

Carotid-Cavernous Fistula in a Patient With Unilateral Periorbital Swelling and Proptosis Initially Attributed to Possible Immunoglobulin G4-Related (IgG4-Related) Disease.

The differential diagnosis for proptosis and periorbital swelling is broad and includes infectious, malignant, vascular, and rheumatologic etiologies. In this study, we report a case of carotid-cavernous fistula as the cause of acute-onset unilateral proptosis and periorbital swelling of the right eye in a 44-year-old female patient whose symptoms were initially attributed to possible immunoglobulin G4-related disease (IgG4-RD). The patient initially received antibiotics for presumed cellulitis and steroid treatment for a possible autoimmune cause, however; her autoimmune work-up was negative. Radiologic imaging later confirmed that she had a direct spontaneous carotid-cavernous fistula. She experienced significant improvement in her symptoms and vision after embolization treatment. Due to the risk that a carotid-cavernous fistula will progress quickly and cause neurological damage, this is a key diagnosis that should not be missed in patients with acute-onset periorbital and visual symptoms. Rheumatologists should include this condition in the differential for any patient who presents with periorbital swelling and vision disturbances.

Behavioural outcomes of children exposed to antidepressants and unmedicated depression during pregnancy.

BACKGROUND: Antenatal exposure to both antidepressants and maternal depression has been associated with child behavioural difficulties. However, previous research has not adequately distinguished between the effects of the antidepressants and the underlying maternal depression. METHODS: Child behavioural difficulties were assessed using the Strengths and Difficulties Questionnaire at 2-, 4.5-, and 8-years of age by mothers in the Growing Up in New Zealand study (N = 6233 at 2-years; N = 6066 at 4.5-years; N = 4632 at 8-years). Mothers were classified as either on antidepressants, unmedicated depression, or neither based on self-reported antidepressant intake during pregnancy and the Edinburgh Postnatal Depression Scale. Hierarchical multiple logistic regressions were used to examine whether antenatal exposure to antidepressants and unmedicated depression had a differential association with child behavioural outcomes relative to no exposure. RESULTS: When later life depression in the mother and a range of birth and sociodemographic variables were accounted for, neither antenatal exposure to unmedicated depression or antidepressants remained associated with an increased risk of behavioural difficulties at the ages investigated. However, maternal later life depression was associated with behavioural difficulties in the fully adjusted analyses at all three ages investigated. LIMITATIONS: The current study relied on mother-report of child behaviour which may be susceptible to bias due to maternal mental health problems. CONCLUSIONS: Adjusted results did not show an adverse association between antenatal antidepressant exposure or unmedicated depression in relation to child behaviour. Findings also suggest that efforts to improve child behaviour need to include more family-based approaches that support maternal wellbeing.

hapln1a+ cells guide coronary growth during heart morphogenesis and regeneration.

Although several tissues and chemokines orchestrate coronary formation, the guidance cues for coronary growth remain unclear. Here, we profile the juvenile zebrafish epicardium during coronary vascularization and identify hapln1a+ cells enriched with vascular-regulating genes. hapln1a+ cells not only envelop vessels but also form linear structures ahead of coronary sprouts. Live-imaging demonstrates that coronary growth occurs along these pre-formed structures, with depletion of hapln1a+ cells blocking this growth. hapln1a+ cells also pre-lead coronary sprouts during regeneration and hapln1a+ cell loss inhibits revascularization. Further, we identify serpine1 expression in hapln1a+ cells adjacent to coronary sprouts, and serpine1 inhibition blocks vascularization and revascularization. Moreover, we observe the hapln1a substrate, hyaluronan, forming linear structures along and preceding coronary vessels. Depletion of hapln1a+ cells or serpine1 activity inhibition disrupts hyaluronan structure. Our studies reveal that hapln1a+ cells and serpine1 are required for coronary production by establishing a microenvironment to facilitate guided coronary growth.

Online Delivery of the Individualized Reduction of Falls Intervention for Persons With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-time: A Pilot Study.

BACKGROUND: People with multiple sclerosis (MS) who use a wheelchair or scooter full-time fall frequently; however, fall prevention programming that meets the unique needs of this population is limited. This study examined the preliminary efficacy of a group-based online fall prevention and management intervention designed specifically for people with MS. METHODS: This pre/post intervention, mixed-methods study included people with MS who used a wheelchair or scooter full-time, experienced at least 1 fall within the past year, and transferred independently or with minimal or moderate assistance. Participants engaged in a 6-week, online, individualized, multicomponent fall prevention and management intervention: Individualized Reduction of Falls-Online (iROLL-O). RESULTS: No statistically significant change in fall incidence occurred after iROLL-O. However, fear of falling significantly decreased (P < .01) and knowledge related to fall management (P = .04) and fall prevention and management (P = .03) significantly improved. Qualitative results indicated that participants valued the opportunity for peer learning and iROLL-O's attention to diverse influences on fall risk. CONCLUSIONS: This study is the first to examine the preliminary efficacy of an online fall prevention and management intervention for people with MS who use a wheelchair or scooter full-time. iROLL-O has promise, and participants found it valuable. Further efforts are needed to retain iROLL-O participants with lower confidence and functional mobility, and more research is needed to investigate the impact of the intervention on key outcomes over time.

Characteristics and consequences of falls among people with multiple sclerosis who use wheelchairs or scooters: Differences between injurious and non-injurious falls.

BACKGROUND: Falls are common among people living with multiple sclerosis (MS) who use wheelchairs or scooters. Falls may lead to severe consequences including physical injuries. However, very little is known about the circumstances associated with injurious falls in this population. Therefore, we aimed to explore the differences in fall-related characteristics between injurious and non-injurious falls among people with MS who use wheelchairs or scooters. METHODS: A convenience sample of 48 people with MS (age = 62.0 [13.0] years, gender = 81.3% female, primary mobility aid = power wheelchair) completed a fall-history survey that examined the characteristics and consequences of their most recent fall. Participants also completed standard questionnaires on quality of life, community participation, and fear of falling. RESULTS: Most falls (85.4%) reported by participants occurred inside the house. Twelve (25.0%) participants reported experiencing fall-related injuries such as bruises, cuts, muscle strains, and fractures. People who reported being injured after a fall had a higher proportion of falls that occurred during transfers compared to those who were not injured (n = 10, 83.3% vs n = 17, 47.2%). Most participants (45.8%) did not receive any information from healthcare professionals on how to manage their fall-risk after their fall experience. No differences between injurious and non-injurious fallers in quality of life, community participation, and fear of falling were observed. CONCLUSIONS: This cross-sectional investigation provides compelling evidence that people with MS who use wheelchairs or scooters are at high risk of fall-related injuries. The study findings underscore the importance of increasing health care providers' awareness about the frequency and consequences of falls. Further, it demonstrates the critical need for evidence-based interventions specifically designed to minimize fall-related injuries in this vulnerable population.

Developing online fall prevention program: Older adult recommendations.

Falls are a critical public health problem for older adults making expanded access of evidence-based fall prevention programs to this population a priority. Online delivery could improve the reach of these needed programs, however associated benefits and challenges remain poorly explored. This focus group study was undertaken to gather older adults' perceptions regarding the transition of face-to-face fall prevention programs to online formats. Content analysis was used to identify their opinions and suggestions. Older adults had concerns related to technology, engagement, and interaction with peers that they valued during face-to-face programs. They provided suggestions they felt would improve the success of online fall prevention programs, especially including synchronous sessions and getting input during program development from older adults.

Self-management of falls in people with multiple sclerosis: A scoping review.

OBJECTIVE: Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. DATA SOURCES: A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. REVIEW METHODS: Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. RESULTS: Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. CONCLUSION: The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed.

Bidirectional phonon emission in two-dimensional heterostructures triggered by ultrafast charge transfer.

Photoinduced charge transfer in van der Waals heterostructures occurs on the 100 fs timescale despite weak interlayer coupling and momentum mismatch. However, little is understood about the microscopic mechanism behind this ultrafast process and the role of the lattice in mediating it. Here, using femtosecond electron diffraction, we directly visualize lattice dynamics in photoexcited heterostructures of WSe2/WS2 monolayers. Following the selective excitation of WSe2, we measure the concurrent heating of both WSe2 and WS2 on a picosecond timescale-an observation that is not explained by phonon transport across the interface. Using first-principles calculations, we identify a fast channel involving an electronic state hybridized across the heterostructure, enabling phonon-assisted interlayer transfer of photoexcited electrons. Phonons are emitted in both layers on the femtosecond timescale via this channel, consistent with the simultaneous lattice heating observed experimentally. Taken together, our work indicates strong electron-phonon coupling via layer-hybridized electronic states-a novel route to control energy transport across atomic junctions.

A process evaluation of an on-line fall prevention and management program for individuals who use wheelchairs or scooters living with multiple sclerosis.

Background: Falls and resulting injury are a significant concern for individuals living with multiple sclerosis (MS) that use a wheelchair and/or scooter to support mobility. Effective fall prevention efforts are vital to support the health, wellbeing, and participation for these individuals. Aims: This study reports the findings from the process evaluation conducted in association with a pilot study evaluating the efficacy of Individualized Reduction of FaLLs-Online (iROLL-O), an online, group fall prevention, and management program specifically designed for community-based people living with multiple sclerosis (pwMS) who are full-time wheelchair or scooter users. Methods: A mixed-methods process evaluation was conducted, with specific attention to the impact of online delivery on intervention implementation, participant satisfaction, and mechanisms of change (MOC). Multiple data sources were utilized, including post-session and post-intervention participant and trainer feedback forms and participant qualitative interview data. Descriptive analysis was conducted using Microsoft Excel. Close-ended questions were analyzed by examining five-point Likert scale responses. Qualitative interview data was explored using thematic analysis. Results: Twelve participants and three trainers (one occupational therapist and two physical therapists) contributed to the study. Online delivery did not compromise session fidelity, which averaged 95%. No significant adaptations to the intervention were made during delivery. Participant satisfaction was high at 4.6/5.0. Post-course Trainer Feedback Forms indicate trainer satisfaction with the group dynamic, ability to address unique group needs, and program content. Reach improved with online delivery as transportation barriers were removed and recruitment from a broader geographic area was enabled. Three themes reflecting key MOC emerged from the analysis: group context, motivation for participant engagement, and the multifaceted nature of the program. The COVID-19 pandemic was identified as a contextual factor impacting community participation. Both participants and trainers identified the group dynamic as a strength. The trainers valued the program's flexibility in allowing them to address individual and/or group-specific fall prevention needs. Conclusion: Feedback from key stakeholders was essential to a meaningful process evaluation. Online delivery supported program implementation, including reach, and resulted in high levels of satisfaction among participants and trainers. Future iterations should aim to uphold the positive group context, recruit, and train skilled interventionists who are licensed as occupational or physical therapists and continue to provide the program's diverse approach to fall prevention and management.

Pilot Study of a Fall Prevention and Management Intervention Program for People With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-Time.

Objective: To examine the efficacy of a fall prevention/management intervention among persons with multiple sclerosis (PwMS) who use a wheelchair (WC) or scooter full-time. Design: Pre-post/follow-up trial. Setting: Community and research laboratory. Participants: Twenty-one PwMS who used a WC or scooter full-time, self-reported at least 1 fall/12 months, and could transfer independently or with minimal/moderate assistance (N=21). Intervention: Six-week, group and community-based fall prevention and management intervention. The intervention included six 2-hour in-person weekly sessions led by a physical or occupational therapist featuring interactive group discussions, skill practice, and action planning opportunities. Main Outcome Measures: Fall frequency tracked 12 weeks pre- and 24 weeks post intervention. Outcomes were assessed pre- and post intervention and 12 weeks post intervention. Measures included surveys to examine fear of falling (FOF), fall prevention/management, quality of life, community participation, and assessment of functional mobility skills. Semistructured interviews were administered post intervention to ascertain overall experiences with the program and effect on daily life. A Friedman test with signed-rank post hoc analysis was run to determine differences across the 3 study visits. Results: After the intervention, fall incidence did not significantly change, but fall management strategies (P=.01-0.05), importance of community participation (P=.01), and transfer quality (P=.02) significantly improved. Moderate effect sizes were noted among concerns about falling, activity curtailment because of to FOF, and WC skills. Qualitative results indicate that participants found the intervention beneficial and applied intervention content in their daily lives. Conclusions: This study is the first to describe the effect of a multicomponent fall prevention/management intervention designed specifically for PwMS who use a WC or scooter full-time. Results indicate the program has potential to reduce fall risk; however, further testing is needed to fully examine the effect of the program.

The Association Between Persistence and Change in Behavioral Difficulties During Early to Middle Childhood and Cognitive Abilities at Age 8.

We investigated the association between persistence and change in behavioral difficulties during early to middle childhood and several cognitive outcomes. We observed 3904 8-year-olds enrolled in the longitudinal study Growing Up in New Zealand (50% male/female; 23% Maori, 9% Pacific Peoples, 13% Asian, 2% Middle Eastern/Latin American/African, 9% Other, 43% European). The NIH Toolbox Cognition Battery was used to assess cognitive functioning at 8 years and the Strengths and Difficulties Questionnaire for behavioral difficulties at 4.5 and 8 years. Multivariate logistic regression analyses were conducted, controlling for well-known sociodemographic confounders. Children with persistent or later onset of behavioral difficulties were at higher risk for poorer vocabulary, reading, inhibitory control/attention, episodic memory, working memory and processing speed at age 8 compared to children with no or improved difficulties. Our study supports the importance of addressing both cognitive and behavioral aspects when planning educational programmes and interventions in early and middle childhood.