Bridging and breaking silos: Transformational governance of the migration-sustainability nexus.

Sustainability and migration are typically treated as discrete policy spheres in international, national, and local fora, separated in governance structures and institutions. This results in policy incoherence that hinders just transitions toward more sustainable societies cognizant of mobile realities. This explorative effort identifies the (dis)connections between policy domains using data collected on how the sustainability-migration nexus is governed in four countries with a special emphasis on urban areas: Belgium, the Netherlands, Sweden, and the United States. Results of 73 interviews show that migration and sustainability actors find it challenging to see how they could be working together and that migrants are rarely conceived of as sustainability actors and/or targeted populations of sustainability policy. Despite the cross-sectoral nature of sustainability, it appears that migration and sustainability are sequestered into silos that hinder collaborative actions. Lamenting the existence of silos is not enough to encourage new lines of thinking or practice in how sustainability is governed; therefore, we examine the evidence to ascertain current barriers blocking synergetic governance and the opportunities for change perceived by respondents via three critical elements of transformations toward sustainability: structural, systemic, and enabling conditions. We argue that for sustainability transitions to happen, a wider set of societal actors needs to be included from policy intention to action, but that this transformation may require more than policy integration via horizontal coordination. It demands reflexivity and pluralistic pathways that close vertical gaps between national and municipal levels and diminish structural inequalities as they intersect with migration type and status.

Optimizing remote access to urinary incontinence treatments for women veterans (PRACTICAL): Study protocol for a pragmatic clinical trial comparing two virtual care options.

OBJECTIVES: In this pragmatic clinical trial, the primary objective is to increase access to behavioral treatment of urinary incontinence (UI) for women Veterans by comparing the effectiveness of two virtual care delivery modalities. METHODS: Veterans Affairs (VA) clinical sites in AL, GA, NC will virtually randomize 286 women Veterans with UI (ie, stress, urge, or mixed). We will compare the effectiveness of our mHealth UI application (MyHealtheBladder) to a single VA Video Connect (VVC) session delivered by trained UI providers. Women without improvement after 8 weeks will receive an optimization VVC visit using a sequential, multiple assignment, randomized trial (SMART) design. The primary outcome is UI symptom improvement at 12-weeks with or without optimization; secondary outcomes include improvements in lower urinary tract symptoms, adherence, retention rates, perceptions of improvement, and visit-related miles saved. Sample size needed to identify a 2.5-point change (range 0-21) in the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) from baseline to 12-weeks post-randomization is 200 participants. Allowing for an attrition rate of 25%, 286 participants are required. KEY RESULTS: Study team initiated remote recruitment on April 2020. Recruitment is on target with a 75% retention rate. We expect completion in fall of 2023 (clinicaltrials.govNCT04237753). DISCUSSION/CONCLUSION: Engaging women Veterans with virtual modalities for initial UI treatment may increase access to UI care while also improving symptoms. After assessing efficacy, adherence, and retention, the next step is to implement the most effective option for remote delivery of evidence-based behavioral UI treatment for women Veterans. TRIAL REGISTRATION: ClinicalTrials.gov number NCT04237753.

PACSIN2 regulates platelet integrin ß1 hemostatic function.

BACKGROUND: Upon vessel injury, platelets adhere to exposed matrix constituents via specific membrane receptors, including the von Willebrand factor receptor glycoprotein (GP)Ib-IX-V complex and integrins ß1 and ß3. In platelets, the Fes/CIP4-homology Bin-Amphiphysin-Rvs protein PACSIN2 associates with the cytoskeletal and scaffolding protein filamin A (FlnA), linking GPIbα and integrins to the cytoskeleton. OBJECTIVES: Here we investigated the role of PACSIN2 in platelet function. METHODS: Platelet parameters were evaluated in mice lacking PACSIN2 and platelet integrin ß1. RESULTS: Pacsin2-/- mice displayed mild thrombocytopenia, prolonged bleeding time, and delayed thrombus formation in a ferric chloride-mediated carotid artery injury model, which was normalized by injection of control platelets. Pacsin2-/- platelets formed unstable thrombi that embolized abruptly in a laser-induced cremaster muscle injury model. Pacsin2-/- platelets had hyperactive integrin ß1, as evidenced by increased spreading onto surfaces coated with the collagen receptor α2ß1-specific peptide GFOGER and increased binding of the antibody 9EG7 directed against active integrin ß1. By contrast, Pacsin2-/- platelets had normal integrin αIIbß3 function and expressed P-selectin normally following stimulation through the collagen receptor GPVI or with thrombin. Deletion of platelet integrin ß1 in Pacsin2-/- mice normalized platelet count, hemostasis, and thrombus formation. A PACSIN2 peptide mimicking the FlnA-binding site mediated the pull-down of a FlnA rod 2 construct by integrin ß7, a model for integrin ß-subunits. CONCLUSIONS: Pacsin2-/- mice displayed severe thrombus formation defects due to hyperactive platelet integrin ß1. The data suggest that PACSIN2 binding to FlnA negatively regulates platelet integrin ß1 hemostatic function.

Highly Selective Fe-Catalyzed Nitrogen Fixation to Hydrazine Enabled by Sm(II) Reagents with Tailored Redox Potential and pKa.

Controlling product selectivity in multiproton, multielectron reductions of unsaturated small molecules is of fundamental interest in catalysis. For the N2 reduction reaction (N2RR) in particular, parameters that dictate selectivity for either the 6H+/6e- product ammonia (NH3) or the 4H+/4e- product hydrazine (N2H4) are poorly understood. To probe this issue, we have developed conditions to invert the selectivity of a tris(phosphino)borane iron catalyst (Fe), with which NH3 is typically the major product of N2R, to instead favor N2H4 as the sole observed fixed-N product (>99:1). This dramatic shift is achieved by replacing moderate reductants and strong acids with a very strongly reducing but weakly acidic SmII-(2-pyrrolidone) core supported by a hexadentate dianionic macrocyclic ligand (SmII-PH) as the net hydrogen-atom donor. The activity and efficiency of the catalyst with this reagent remain high (up to 69 equiv of N2H4 per Fe and 67% fixed-N yield per H+). However, by generating N2H4 as the kinetic product, the overpotential of this Sm-driven reaction is 700 mV lower than that of the mildest reported set of NH3-selective conditions with Fe. Mechanistic data support assignment of iron hydrazido(2-) species FeNNH2 as selectivity-determining: we infer that protonation of FeNNH2 at Nß, favored by strong acids, releases NH3, whereas one-electron reduction to FeNNH2-, favored by strong reductants such as SmII-PH, produces N2H4 via reactivity initiated at Nα. Spectroscopic data also implicate a role for SmIII-binding to anionic FeN2- (via an Fe-N2- -SmIII species) with respect to catalytic efficacy.

COVID-19 responses restricted abilities and aspirations for mobility and migration: insights from diverse cities in four continents.

Research on the impacts of COVID-19 on mobility has focused primarily on the increased health vulnerabilities of involuntary migrant and displaced populations. But virtually all migration flows have been truncated and altered because of reduced economic and mobility opportunities of migrants. Here we use a well-established framework of migration decision-making, whereby individual decisions combine the aspiration and ability to migrate, to explain how public responses to the COVID-19 pandemic alter migration patterns among urban populations across the world. The principal responses to COVID-19 pandemic that affected migration are: 1) through travel restrictions and border closures, 2) by affecting abilities to move through economic and other means, and 3) by affecting aspirations to move. Using in-depth qualitative data collected in six cities in four continents (Accra, Amsterdam, Brussels, Dhaka, Maputo, and Worcester), we explore how populations with diverse levels of education and occupations were affected in their current and future mobility decisions. We use data from interviews with sample of internal and international migrants and non-migrants during the 2020 COVID-19 pandemic outbreak to identify the mechanisms through which the pandemic affected their mobility decisions. The results show common processes across the different geographical contexts: individuals perceived increased risks associated with further migration, which affected their migration aspirations, and had reduced abilities to migrate, all of which affected their migration decision-making processes. The results also reveal stark differences in perceived and experienced migration decision-making across precarious migrant groups compared to high-skilled and formally employed international migrants in all settings. This precarity of place is particularly evident in low-income marginalised populations.

A diagnosis fifteen years in the making.

A 52-year-old male with a diagnosis of non-alcoholic fatty liver disease re-engages with the medical system and is found to have an unexpected diagnosis.

Sm(II)-Mediated Proton-Coupled Electron Transfer: Quantifying Very Weak N-H and O-H Homolytic Bond Strengths and Factors Controlling Them.

Coordination of alcohols to the single-electron reductant samarium diiodide (SmI2) results in substantial O-H bond weakening, affording potent proton-coupled electron transfer (PCET) reagents. However, poorly defined speciation of SmI2 in tetrahydrofuran (THF)/alcohol mixtures limits reliable thermodynamic analyses of such systems. Rigorous determination of bond dissociation free energy (BDFE) values in such Sm systems, important to evaluating their reactivity profiles, motivates studies of model Sm systems where contributing factors can be teased apart. Here, a bulky and strongly chelating macrocyclic ligand ((tBu2ArOH)2Me2cyclam) maintains solubility, eliminates dimerization pathways, and facilitates clean electrochemical behavior in a well-defined functional model for the PCET reactivity of SmII with coordinating proton sources. Direct measurement of thermodynamic parameters enables reliable experimental estimation of the BDFEs in 2-pyrrolidone and MeOH complexes of ((tBu2ArO)2Me2cyclam)SmII, thereby revealing exceptionally weak N-H and O-H BDFEs of 27.2 and <24.1 kcal mol-1, respectively. Expanded thermochemical cycles reveal that this bond weakening stems from the very strongly reducing SmII center and the formation of strong SmIII-alkoxide (and -pyrrolidonate) interactions in the PCET products. We provide a detailed analysis comparing these BDFE values with those that have been put forward for SmI2 in THF in the presence of related proton donors. We suggest that BDFE values for the latter systems may in fact be appreciably higher than the system described herein. Finally, protonation and electrochemical reduction steps necessary for the regeneration of the PCET donors from SmIII-alkoxides are demonstrated, pointing to future strategies aimed at achieving (electro)catalytic turnover using SmII-based PCET reagents.

Association between vessels that encapsulate tumour clusters vascular pattern and hepatocellular carcinoma recurrence following liver transplantation.

Background: Vessels that encapsulate tumor clusters (VETC) is a novel vascular pattern seen on hepatocellular carcinoma (HCC) histology which has been shown to independently predict tumor recurrence and survival after liver resection. Its prognostic value in HCC patients receiving liver transplantation (LT) is unclear. Methods: We retrospectively studied consecutive adults who underwent deceased-donor LT with active HCC found on explant between 2010-2019. Tumor tissue was stained for CD34 and quantified for VETC. Primary and secondary endpoints were time to recurrence (TTR) and recurrence-free survival (RFS). Results: During the study period, 158 patients received LT where HCC was present on explant. VETC pattern was seen in 76.5% of explants. Patients with VETC-positive tumors spent longer on the waitlist (6.4 vs. 4.1 months, P=0.048), had higher median tumor numbers (2 vs. 1, P=0.001) and larger tumor sizes (20mm vs. 13mm, P<0.001) on explant pathology compared to those with VETC-negative tumors. Correspondingly, VETC-positive patients were more likely to be outside of accepted LT criteria for HCC. After 56.4 months median follow-up, 8.2% of patients developed HCC recurrence post-LT. On multivariable Cox regression, presence of VETC pattern did not predict TTR or RFS. However, the number of VETC-positive tumors on explant was an independent predictor of TTR (hazard ratio [HR] 1.411, P=0.001) and RFS (HR 1.267, P=0.014) after adjusting for other significant variables. Conclusion: VETC pattern is commonly observed in HCC patients undergoing LT. The number of VETC-positive tumors, but not its presence, is an independent risk factor for TTR and RFS post-LT.

Catalytic transfer hydrogenation of N2 to NH3 via a photoredox catalysis strategy.

Inspired by momentum in applications of reductive photoredox catalysis to organic synthesis, photodriven transfer hydrogenations toward deep (>2 e-) reductions of small molecules are attractive compared to using harsh chemical reagents. Noteworthy in this context is the nitrogen reduction reaction (N2RR), where a synthetic photocatalyst system had yet to be developed. Noting that a reduced Hantzsch ester (HEH2) and related organic structures can behave as 2 e-/2 H+ photoreductants, we show here that, when partnered with a suitable catalyst (Mo) under blue light irradiation, HEH2 facilitates delivery of successive H2 equivalents for the 6 e-/6 H+ catalytic reduction of N2 to NH3; this catalysis is enhanced by addition of a photoredox catalyst (Ir). Reductions of additional substrates (nitrate and acetylene) are also described.

Endocytosis of the thrombopoietin receptor Mpl regulates megakaryocyte and erythroid maturation in mice.

Dnm2fl/fl Pf4-Cre (Dnm2Plt-/- ) mice lacking the endocytic GTPase dynamin 2 (DNM2) in platelets and megakaryocytes (MKs) develop hallmarks of myelofibrosis. At the cellular level, the tyrosine kinase JAK2 is constitutively active but decreased in expression in Dnm2Plt-/- platelets. Additionally, Dnm2Plt-/- platelets cannot endocytose the thrombopoietin (TPO) receptor Mpl, leading to elevated circulating TPO levels. Here, we assessed whether the hyperproliferative phenotype of Dnm2Plt-/- mice was due to JAK2 constitutive activation or to elevated circulating TPO levels. In unstimulated Dnm2Plt-/- platelets, STAT3 and, to a lower extent, STAT5 were phosphorylated, but their phosphorylation was slowed and diminished upon TPO stimulation. We further crossed Dnm2Plt-/- mice in the Mpl-/- background to generate Mpl-/-Dnm2Plt-/- mice lacking Mpl ubiquitously and DNM2 in platelets and MKs. Mpl-/- Dnm2Plt-/- platelets had severely reduced JAK2 and STAT3 but normal STAT5 expression. Mpl-/- Dnm2Plt-/- mice had severely reduced bone marrow MK and hematopoietic stem and progenitor cell numbers. Additionally, Mpl-/- Dnm2Plt-/- mice had severe erythroblast (EB) maturation defects, decreased expression of hemoglobin and heme homeostasis genes and increased expression of ribosome biogenesis and protein translation genes in spleen EBs, and developed anemia with grossly elevated plasma erythropoietin (EPO) levels, leading to early fatality by postnatal day 25. Mpl-/- Dnm2Plt+/+ mice had impaired EB development at three weeks of age, which normalized with adulthood. Together, the data shows that DNM2-dependent Mpl-mediated endocytosis in platelets and MKs is required for steady-state hematopoiesis and provides novel insights into a developmentally controlled role for Mpl in normal erythropoiesis, regulating hemoglobin and heme production.

Relationship Building Interventions for Caregivers of Adults With Traumatic Brain Injury (2013-2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions for caregivers of persons with traumatic brain injury (TBI) that facilitate participation in the caregiver role.

Education and Skill-Building Interventions for Caregivers of Adults With Traumatic Brain Injury (2013-2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions for caregivers of persons with traumatic brain injury that facilitate participation in the caregiver role.

Health and Well-Being Interventions for Caregivers of Adults With Traumatic Brain Injury (2013-2020).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions for caregivers of persons with traumatic brain injury that facilitate participation in the caregiver role.

Critical social science perspectives on transformations to sustainability.

This article introduces a special issue on the contribution of social science to addressing transformations to sustainability. Articles underline the importance of embracing theoretically rooted, empirically informed, and collaboratively generated knowledge to address sustainability challenges and transformative change. Emphasis is placed on the role of the social sciences in elaborating on the politicisation and pluralisation of transformation processes and outcomes, helping situate, frame, reflect and generate societal action, while acknowledging the complexity of societal transformation in different contexts.

Evidence-based strategies to advance BSN student diversity.

BACKGROUND: Minoritized nurses understand the cultural and contextual circumstances that lead to health disparities, yet they are underrepresented in the RN workforce. This underrepresentation can have serious health consequences. However, to have more representation, it must be understood the pipeline for diversity begins with the admission of diverse students into baccalaureate nursing education programs. PURPOSE: This manuscript describes an Initiative that increased the enrollment of students from underrepresented backgrounds and provided the students with the support necessary for retention through graduation. METHOD: The Initiative incorporated five evidence-based strategies that created a culturally responsive academic environment and enabled diverse students to succeed. RESULTS: Forty-two students were admitted to the baccalaureate nursing program. Thirty-six of the 42 remain in the program resulting in a retention rate of 86%. Six of the thirty-six recently graduated and the remaining 30 students are on track to graduate in their respective years. CONCLUSION: Through the use of the five-prong evidence-based strategies, the School was able to establish the infrastructure to support the academic advancement and achievement of students from diverse backgrounds. The impact is yet to be determined, but more diverse individuals will graduate, suggestive of a more diverse workforce which will hopefully advance the nation toward health equity.

Remote Oxidative Activation of a [Cp*Rh] Monohydride.

Half-sandwich rhodium monohydrides are often proposed as intermediates in catalysis, but little is known regarding the redox-induced reactivity accessible to these species. Herein, the bis(diphenylphosphino)ferrocene (dppf) ligand has been used to explore the reactivity that can be induced when a [Cp*Rh] monohydride undergoes remote (dppf-centered) oxidation by 1e- . Chemical and electrochemical studies show that one-electron redox chemistry is accessible to Cp*Rh(dppf), including a unique quasi-reversible RhII/I process at -0.96 V vs. ferrocenium/ferrocene (Fc+/0 ). This redox manifold was confirmed by isolation of an uncommon RhII species, [Cp*Rh(dppf)]+ , that was characterized by electron paramagnetic resonance (EPR) spectroscopy. Protonation of Cp*Rh(dppf) with anilinium triflate yielded an isolable and inert monohydride, [Cp*Rh(dppf)H]+ , and this species was found to undergo a quasireversible electrochemical oxidation at +0.41 V vs. Fc+/0 that corresponds to iron-centered oxidation in the dppf backbone. Thermochemical analysis predicts that this dppf-centered oxidation drives a dramatic increase in acidity of the Rh-H moiety by 23 pKa units, a reactivity pattern confirmed by in situ 1 H NMR studies. Taken together, these results show that remote oxidation can effectively induce M-H activation and suggest that ligand-centered redox activity could be an attractive feature for the design of new systems relying on hydride intermediates.

Intracranial mesenchymal tumors with FET-CREB fusion are composed of at least two epigenetic subgroups distinct from meningioma and extracranial sarcomas.

'Intracranial mesenchymal tumor, FET-CREB fusion-positive' occurs primarily in children and young adults and has previously been termed intracranial angiomatoid fibrous histiocytoma (AFH) or intracranial myxoid mesenchymal tumor (IMMT). Here we performed genome-wide DNA methylation array profiling of 20 primary intracranial mesenchymal tumors with FET-CREB fusion to further study their ontology. These tumors resolved into two distinct epigenetic subgroups that were both divergent from all other analyzed intracranial neoplasms and soft tissue sarcomas, including meningioma, clear cell sarcoma of soft tissue (CCS), and AFH of extracranial soft tissue. The first subgroup (Group A, 16 tumors) clustered nearest to but independent of solitary fibrous tumor and AFH of extracranial soft tissue, whereas the second epigenetic subgroup (Group B, 4 tumors) clustered nearest to but independent of CCS and also lacked expression of melanocytic markers (HMB45, Melan A, or MITF) characteristic of CCS. Group A tumors most often occurred in adolescence or early adulthood, arose throughout the neuroaxis, and contained mostly EWSR1-ATF1 and EWSR1-CREB1 fusions. Group B tumors arose most often in early childhood, were located along the cerebral convexities or spinal cord, and demonstrated an enrichment for tumors with CREM as the fusion partner (either EWSR1-CREM or FUS-CREM). Group A tumors more often demonstrated stellate/spindle cell morphology and hemangioma-like vasculature, whereas Group B tumors more often demonstrated round cell or epithelioid/rhabdoid morphology without hemangioma-like vasculature, although robust comparison of these clinical and histologic features requires future study. Patients with Group B tumors had inferior progression-free survival relative to Group A tumors (median 4.5 vs. 49 months, p = 0.001). Together, these findings confirm that intracranial AFH-like neoplasms and IMMT represent histologic variants of a single tumor type ('intracranial mesenchymal tumor, FET-CREB fusion-positive') that is distinct from meningioma and extracranial sarcomas. Additionally, epigenomic evaluation may provide important prognostic subtyping for this unique tumor entity.

Evaluation of a Brief Mindfulness Intervention on Examination Anxiety and Stress.

BACKGROUND: Nursing students report increasing levels of stress and anxiety related to academic performance. Mindfulness programs have been found to reduce stress, yet such programs have been identified as a time-burden for students. This study evaluated the integration of a brief preexamination mindfulness reflective intervention for nursing students. Perceived stress, anxiety, resilience, and acceptability were evaluated. METHOD: A mixed-methods experimental design with random assignment was used. Forty-nine nursing students were randomized to either an intervention group (N = 25) who participated in the brief preexamination mindfulness intervention or a control group (N = 24) who took their examinations without any intervention. Self-report tools measured stress, resilience, and mindfulness. Qualitative responses were collected. RESULTS: Outcomes revealed decreased feelings of helplessness and anxiety in the intervention group. Although students had positive views of mindfulness, barriers were indicated. CONCLUSION: Brief preexamination mindfulness interventions provide students with anxiety-reducing options. [J Nurs Educ. 2021;60(11):625-628.].