Blood-Brain Barrier Dysfunction and Exposure to Head Impacts in University Football Players.

OBJECTIVE: To investigate the link between dysfunction of the blood-brain barrier (BBB) and exposure to head impacts in concussed football athletes. DESIGN: This was a prospective, observational pilot study. SETTING: Canadian university football. PARTICIPANTS: The study population consisted of 60 university football players, aged 18 to 25. Athletes who sustained a clinically diagnosed concussion over the course of a single football season were invited to undergo an assessment of BBB leakage. INDEPENDENT VARIABLES: Head impacts detected using impact-sensing helmets were the measured variables. MAIN OUTCOME MEASURES: Clinical diagnosis of concussion and BBB leakage assessed using dynamic contrast-enhanced MRI (DCE-MRI) within 1 week of concussion were the outcome measures. RESULTS: Eight athletes were diagnosed with a concussion throughout the season. These athletes sustained a significantly higher number of head impacts than nonconcussed athletes. Athletes playing in the defensive back position were significantly more likely to sustain a concussion than remain concussion free. Five of the concussed athletes underwent an assessment of BBB leakage. Logistic regression analysis indicated that region-specific BBB leakage in these 5 athletes was best predicted by impacts sustained in all games and practices leading up to the concussion-as opposed to the last preconcussion impact or the impacts sustained during the game when concussion occurred. CONCLUSIONS: These preliminary findings raise the potential for the hypothesis that repeated exposure to head impacts may contribute to the development of BBB pathology. Further research is needed to validate this hypothesis and to test whether BBB pathology plays a role in the sequela of repeated head trauma.

Direct measurement of internal temperatures of commercially-available 18650 lithium-ion batteries.

Direct access to internal temperature readings in lithium-ion batteries provides the opportunity to infer physical information to study the effects of increased heating, degradation, and thermal runaway. In this context, a method to insert temperature sensors into commercial 18650 cells to determine the short- and long-term effects through characterization testing is developed. Results show that sensor insertion only causes a decrease in capacity of 0.5-2.3%, and an increase in DC resistance of approximately 15 mΩ. The temperatures of the modified cells are approximately 0.5 °C higher than the control cells, the difference between the internal and external temperature readings of the modified cells is approximately 0.4 °C, and the modified cells exhibit the same temperature behavior and trend during cycling as the control cells. The cells are able to operate and collect data for 100-150 cycles before their capacities fade and resistances increase beyond what is observed in the control cells. The results of the testing show that cells modified with internal temperature sensors provide useful internal temperature data for cells that have experienced little or no cyclic aging.

An Intersectional Approach to Understanding Barriers to Healthcare for Women.

Access to health care depends on multiple sociodemographic factors such as race/ethnicity, marital status, education, income, and insurance status. However, a paucity of research has examined access to healthcare disparities as they uniquely affect women, specifically women of color. National data were analyzed from the Medical Expenditure Panel Survey (MEPS) utilizing an 11-year sample (2005-2015) of women ages 18-74 (N = 128,355). More recent data were not included due to changes in how sampling was conducted after 2015. Predictor variables included race/ethnicity cross-classified with marital status, education, income, or insurance status, controlling for age. A dichotomous outcome variable called "any barriers to healthcare" was created based on usual source of care, delayed medical care, delayed dental care and delayed prescription care. Multivariate logistic regression models were used to identify associations with barriers to care. The foundation of this methodology is intersectionality and how it impacts access to care for women across social identities. Hispanic women (OR 1.08, 95% CI 1.02-1.14) had higher odds of having a barrier to care compared to White women. However, Black women (OR 0.92, 95% CI 0.87-0.97) had lower odds of having a barrier to care compared to White women. Race/ethnicity also significantly moderated the relationship between socioeconomic variables (marital status, income, education and insurance status) and having a barrier to care. To achieve a healthy community, addressing these racial/ethnic and socioeconomic inequalities helps to support the people who live and work within these communities.

Microbiome differential abundance methods produce different results across 38 datasets.

Identifying differentially abundant microbes is a common goal of microbiome studies. Multiple methods are used interchangeably for this purpose in the literature. Yet, there are few large-scale studies systematically exploring the appropriateness of using these tools interchangeably, and the scale and significance of the differences between them. Here, we compare the performance of 14 differential abundance testing methods on 38 16S rRNA gene datasets with two sample groups. We test for differences in amplicon sequence variants and operational taxonomic units (ASVs) between these groups. Our findings confirm that these tools identified drastically different numbers and sets of significant ASVs, and that results depend on data pre-processing. For many tools the number of features identified correlate with aspects of the data, such as sample size, sequencing depth, and effect size of community differences. ALDEx2 and ANCOM-II produce the most consistent results across studies and agree best with the intersect of results from different approaches. Nevertheless, we recommend that researchers should use a consensus approach based on multiple differential abundance methods to help ensure robust biological interpretations.

"Land is everything, land is us": Exploring the connections between climate change, land, and health in Fort William First Nation.

The myriad and cumulative impacts of climate change on land, communities, and health are increasingly evident worldwide. Throughout 2019 and 2020, Fort William First Nation and researchers at Lakehead University conducted a project to document and understand connections among climate change, land, and health from the perspective of Elders, knowledge keepers, and community members with close ties to the land. Fort William First Nation is an Anishinaabe community located on the shores of Lake Superior/Kitchigami in Northern Ontario and within Robinson-Superior Treaty territory. This paper describes the analysis of interviews with 22 community members. Two-Eyed Seeing, an approach that centers the working together of Indigenous and non-Indigenous knowledges and peoples and demands respectful relationship building, guided our project and analysis. Our analysis identified five themes: 1) observations and experiences of changes on the land, 2) lack of care and respect for Mother Earth as the root cause of climate change, 3) healthy land, healthy people, 4) youth and future generations, and 5) (re-)connecting with land and culture. 'All our Relations' is a thread woven across these themes emphasizing that climate change is understood and experienced through relationships and relationality. As concluding thoughts and reflections, we share three specific offerings of particular relevance to those engaging in climate change and health research and action with Indigenous peoples and communities. First, this research has highlighted the importance of explicitly centering land when exploring the links between climate change and health. Second, we reflect on the value of both the Two-Eyed Seeing approach and the Medicine Wheel in guiding climate change and health research. Third, we argue for an explicit focus on relationships and relationality in efforts aimed at understanding and addressing climate change.

Concussion susceptibility is mediated by spreading depolarization-induced neurovascular dysfunction.

The mechanisms underlying the complications of mild traumatic brain injury, including post-concussion syndrome, post-impact catastrophic death, and delayed neurodegeneration remain poorly understood. This limited pathophysiological understanding has hindered the development of diagnostic and prognostic biomarkers and has prevented the advancement of treatments for the sequelae of mild traumatic brain injury. We aimed to characterize the early electrophysiological and neurovascular alterations following repetitive mild traumatic brain injury and sought to identify new targets for the diagnosis and treatment of individuals at risk of severe post-impact complications. We combined behavioural, electrophysiological, molecular, and neuroimaging techniques in a rodent model of repetitive mild traumatic brain injury. In humans, we used dynamic contrast-enhanced MRI to quantify blood-brain barrier dysfunction after exposure to sport-related concussive mild traumatic brain injury. Rats could clearly be classified based on their susceptibility to neurological complications, including life-threatening outcomes, following repetitive injury. Susceptible animals showed greater neurological complications and had higher levels of blood-brain barrier dysfunction, transforming growth factor ß (TGFß) signalling, and neuroinflammation compared to resilient animals. Cortical spreading depolarizations were the most common electrophysiological events immediately following mild traumatic brain injury and were associated with longer recovery from impact. Triggering cortical spreading depolarizations in mild traumatic brain injured rats (but not in controls) induced blood-brain barrier dysfunction. Treatment with a selective TGFß receptor inhibitor prevented blood-brain barrier opening and reduced injury complications. Consistent with the rodent model, blood-brain barrier dysfunction was found in a subset of human athletes following concussive mild traumatic brain injury. We provide evidence that cortical spreading depolarization, blood-brain barrier dysfunction, and pro-inflammatory TGFß signalling are associated with severe, potentially life-threatening outcomes following repetitive mild traumatic brain injury. Diagnostic-coupled targeting of TGFß signalling may be a novel strategy in treating mild traumatic brain injury.

Dynamic Interconversion of Metal Active Site Ensembles in Zeolite Catalysis.

Catalysis science is founded on understanding the structure, number, and reactivity of active sites. Kinetic models that consider active sites to be static and noninteracting entities are routinely successful in describing the behavior of heterogeneous catalysts. Yet, active site ensembles often restructure in response to their external environment and even during steady-state catalytic turnover, sometimes requiring non-mean-field kinetic treatments to describe distance-dependent interactions among sites. Such behavior is being recognized more frequently in modern catalysis research, with the advent of experimental methods to quantify turnover rates with increasing precision, an expanding arsenal of operando characterization tools, and computational descriptions of atomic structure and motion at chemical potentials and timescales increasingly relevant to reaction conditions. This review focuses on dynamic changes to metal active site ensembles on zeolite supports, which are silica-based crystalline materials substituted with Al that generate binding sites for isolated and low-nuclearity metal site ensembles. Metal sites can become solvated and mobilized during reaction, facilitating interactions among sites that change their nuclearity and function. Such intersite communication can be regulated by the zeolite support, resulting in non-single-site and potentially non-mean-field kinetic behavior arising from mechanisms of catalytic action that combine elements of those canonically associated with homogeneous and heterogeneous catalysis.We discuss recent literature examples that document dynamic active site behavior in metal-zeolites and outline methodologies to identify and interpret such behavior. We conclude with our outlook on future research directions to develop this evolving branch of catalysis science and harness it for practical applications.

Clinical teaching of university-degree nursing students: are the nurses in practice in Uganda ready?

BACKGROUND: Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several low-resource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and may not have the necessary skills to facilitate clinical learning as expected at degree level. A university in Uganda established a bachelor's degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of university-degree nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students. METHODS: A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from Arua Regional Referral Hospital (ARRH) who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis. RESULTS: The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; "Willingness to teach undergraduate students" "Perceived attributes of undergraduate students", and "The clinical practice environment". CONCLUSION: The nurses in practice need support in the execution of the clinical teaching role of university-degree nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.

Development of a rigid suspended micro-island device and robust measurement method for thermal transport measurements.

One of the most versatile techniques to study thermal transport in low dimensional materials utilizes a suspended micro-island device integrated with resistance thermometers. Advancements in experimental techniques with suspended micro-island devices resulted in increasing capabilities such as enhancing temperature resolution and expanding a measurable range of sample thermal conductance. In this work, we further improve the suspended micro-island based technique. Specifically, we present a rigid structure of the suspended micro-island device and robust measurement method for sequential heating. The rigid structure enabled by T-shaped beams prevents the displacement of suspended micro-islands, thus increasing the success rates of sample transfer especially for samples with a large cross-sectional area and short length. Besides, thermal isolation of micro-islands is maintained at a similar level through the T-shaped beams compared to conventional flat beams. Next, we introduce an advanced experimental approach that enables sequential heating to measure sample thermal conductance. Sequential heating in micro-islands can be used either to measure accurate sample thermal conductance even under unexpected asymmetric supporting beam configuration or to study thermal transport dependence on heat flow directions. Using a switch matrix for sequential heating eliminates the need for experimental reconfigurations during the experiment. We demonstrate the experimental method with thermal conductivity measurements of the Si nanowire under both the ideal symmetric beam configuration and replicated asymmetric beam configuration scenarios. The results show that the developed experimental method effectively eliminates potential experimental errors that can arise from the asymmetry in beam configurations.

Combining Kinetics and Operando Spectroscopy to Interrogate the Mechanism and Active Site Requirements of NOx Selective Catalytic Reduction with NH3 on Cu-Zeolites.

NOx selective catalytic reduction (SCR) with NH3 on Cu-zeolites is a commercial emissions control technology for diesel and lean-burn engines. Mitigating low-temperature emissions remains an outstanding challenge, motivating an improved understanding of the reaction mechanism, active site requirements, and rate-determining processes at low temperatures (<523 K). In this Perspective, we discuss how operando spectroscopy provides crucial information about how the structures, coordination environments, and oxidation states of Cu active sites depend on reaction conditions and sample composition; when combined with kinetic measurements, such operando data provide insights into the Cu site and spatial density requirements for reduction and oxidation steps relevant to the Cu(II)/Cu(I) SCR redox cycle. Isolated Cu ions coordinated to zeolite oxygen atoms ex situ become coordinated to NH3 in situ and dynamically interconvert between mononuclear and binuclear NH3-solvated Cu complexes to catalyze SCR turnovers. We conclude with future research directions that can benefit from combining quantitative kinetic measurements with operando spectroscopy.

Cooperative and Competitive Occlusion of Organic and Inorganic Structure-Directing Agents within Chabazite Zeolites Influences Their Aluminum Arrangement.

We combine experiment and theory to investigate the cooperation or competition between organic and inorganic structure-directing agents (SDAs) for occupancy within microporous voids of chabazite (CHA) zeolites and to rationalize the effects of SDA siting on biasing the framework Al arrangement (Al-O(-Si-O)x-Al, x = 1-3) among CHA zeolites of essentially fixed composition (Si/Al = 15). CHA zeolites crystallized using mixtures of TMAda+ and Na+ contain one TMAda+ occluded per cage and Na+ co-occluded in an amount linearly proportional to the number of 6-MR paired Al sites, quantified by Co2+ titration. In contrast, CHA zeolites crystallized using mixtures of TMAda+ and K+ provide evidence that three K+ cations, on average, displace one TMAda+ from occupying a cage and contain predominantly 6-MR isolated Al sites. Moreover, CHA crystallizes from synthesis media containing more than 10-fold higher inorganic-to-organic ratios with K+ than with Na+ before competing crystalline phases form, providing a route to decrease the amount of organic SDA needed to crystallize high-silica CHA. Density functional theory calculations show that differences in the ionic radii of Na+ and K+ determine their preferences for siting in different CHA rings, which influences their energy to co-occlude with TMAda+ and stabilize different Al configurations. Monte Carlo models confirm that energy differences resulting from Na+ or K+ co-occlusion promote the formation of 6-MR and 8-MR paired Al arrangements, respectively. These results highlight opportunities to exploit using mixtures of organic and inorganic SDAs during zeolite crystallization in order to more efficiently use organic SDAs and influence framework Al arrangements.

Bacterial Taxa and Functions Are Predictive of Sustained Remission Following Exclusive Enteral Nutrition in Pediatric Crohn's Disease.

BACKGROUND: The gut microbiome is extensively involved in induction of remission in pediatric Crohn's disease (CD) patients by exclusive enteral nutrition (EEN). In this follow-up study of pediatric CD patients undergoing treatment with EEN, we employ machine learning models trained on baseline gut microbiome data to distinguish patients who achieved and sustained remission (SR) from those who did not achieve remission nor relapse (non-SR) by 24 weeks. METHODS: A total of 139 fecal samples were obtained from 22 patients (8-15 years of age) for up to 96 weeks. Gut microbiome taxonomy was assessed by 16S rRNA gene sequencing, and functional capacity was assessed by metagenomic sequencing. We used standard metrics of diversity and taxonomy to quantify differences between SR and non-SR patients and to associate gut microbial shifts with fecal calprotectin (FCP), and disease severity as defined by weighted Pediatric Crohn's Disease Activity Index. We used microbial data sets in addition to clinical metadata in random forests (RFs) models to classify treatment response and predict FCP levels. RESULTS: Microbial diversity did not change after EEN, but species richness was lower in low-FCP samples (<250 µg/g). An RF model using microbial abundances, species richness, and Paris disease classification was the best at classifying treatment response (area under the curve [AUC] = 0.9). KEGG Pathways also significantly classified treatment response with the addition of the same clinical data (AUC = 0.8). Top features of the RF model are consistent with previously identified IBD taxa, such as Ruminococcaceae and Ruminococcus gnavus. CONCLUSIONS: Our machine learning approach is able to distinguish SR and non-SR samples using baseline microbiome and clinical data.

Covalent attachment of resveratrol to stainless steel toward the development of a resveratrol-releasing bare-metal stent.

Herein, we describe the covalent attachment of resveratrol, a naturally occurring antioxidant, to the surface of stainless-steel as a model for designing a novel bare-metal stent to treat coronary artery disease. Resveratrol has been shown to reduce oxidative stress in dysfunctional endothelial cells, and stimulate arterial healing. Resveratrol treatments, however, are limited by low water solubility, such that a localized delivery to the site of arterial narrowing via a coated stent presents a promising strategy for improving stent outcomes. Our attachment strategy utilizes zirconium vapor deposition to lay down a thin layer of zirconium oxide with labile hydrocarbon groups at the surface. Resveratrol can displace these hydrocarbons in aprotic solvent to afford a covalently attached layer of resveratrol. We evaluated the release of resveratrol under a range of pH levels, including physiological conditions (pH = 7.4 and 37 °C). Furthermore, we established that endothelial cells grown on a resveratrol-bound surface release elevated nitric oxide levels compared to controls, a key endothelial signaling molecule responsible for arterial health. These results are promising toward the development of a resveratrol-coated bare-metal stent to improve patient outcomes.

Chemical facility risks to natural flooding hazards in the United States.

Toxic release inventory (TRI) facilities contain chemicals, most must be kept in process equipment, otherwise leaks are possible. An analysis of the National Flood Hazard Layer and TRI facilities within ArcGIS. The national analysis included TRI facilities intersecting the 100-year floodplain based on the National Flood Hazard Layer. The frequency which TRI facilities are impacted by flooding was analyzed with federal declarations data. We were able to determine what percentage of each state's facilities fall into the floodplain and calculate and assign a risk number to each state.

Mapping the Solastalgia Literature: A Scoping Review Study.

Solastalgia is a relatively new concept for understanding the links between human and ecosystem health, specifically, the cumulative impacts of climatic and environmental change on mental, emotional, and spiritual health. Given the speed and scale of climate change alongside biodiversity loss, pollution, deforestation, unbridled resource extraction, and other environmental challenges, more and more people will experience solastalgia. This study reviewed 15 years of scholarly literature on solastalgia using a scoping review process. Our goal was to advance conceptual clarity, synthesize the literature, and identify priorities for future research. Four specific questions guided the review process: (1) How is solastalgia conceptualized and applied in the literature?; (2) How is solastalgia experienced and measured in the literature?; (3) How is 'place' understood in the solastalgia literature?; and (4) Does the current body of literature on solastalgia engage with Indigenous worldviews and experiences? Overall, we find there is a need for additional research employing diverse methodologies, across a greater diversity of people and places, and conducted in collaboration with affected populations and potential knowledge, alongside greater attention to the practical implications and applications of solastalgia research. We also call for continued efforts to advance conceptual clarity and theoretical foundations. Key outcomes of this study include our use of the landscape construct in relation to solastalgia and a call to better understand Indigenous peoples' lived experiences of landscape transformation and degradation in the context of historical traumas.

Phytobiomes are compositionally nested from the ground up.

Plant-associated microbes are critical players in host health, fitness and productivity. Despite microbes' importance in plants, seeds are mostly sterile, and most plant microbes are recruited from an environmental pool. Surprisingly little is known about the processes that govern how environmental microbes assemble on plants in nature. In this study we examine how bacteria are distributed across plant parts, and how these distributions interact with spatial gradients. We sequenced amplicons of bacteria from the surfaces of six plant parts and adjacent soil of Scaevola taccada, a common beach shrub, along a 60 km transect spanning O'ahu island's windward coast, as well as within a single intensively-sampled site. Bacteria are more strongly partitioned by plant part as compared with location. Within S. taccada plants, microbial communities are highly nested: soil and rhizosphere communities contain much of the diversity found elsewhere, whereas reproductive parts fall at the bottom of the nestedness hierarchy. Nestedness patterns suggest either that microbes follow a source/sink gradient from the ground up, or else that assembly processes correlate with other traits, such as tissue persistence, that are vertically stratified. Our work shines light on the origins and determinants of plant-associated microbes across plant and landscape scales.

Family Members' Experiences With Bereavement in the Intensive Care Unit.

BACKGROUND: Losing a loved one in the intensive care unit can be challenging for families. Providing bereavement support may assist in the grieving process. OBJECTIVE: To describe family members' experiences with bereavement after the death of a loved one in the intensive care unit. METHODS: This secondary analysis used an exploratory, descriptive design to study family members' experiences with bereavement. Family members of patients from 2 intensive care units in a tertiary medical center in the western United States participated. Audiotaped telephone interviews using a semistructured questionnaire were conducted. A qualitative, descriptive technique was used for data analysis. Two independent raters coded transcripts of audiotaped interviews with family members about their bereavement experiences. RESULTS: Seventeen family members participated in the study. Most participants were female (n = 12; 71%) and spouses of deceased patients (n = 14; 82%), and their mean (SD) age was 62.4 (10.0) years. Three themes emerged: (1) bereavement was an individual experience; (2) situations occurring during the intensive care unit encounter remained significant for family members beyond a year after the death; and (3) social, cultural, spiritual, and religious events after the death hold importance for families of patients in the intensive care unit. CONCLUSIONS: Bereavement is a challenging experience for families of deceased intensive care unit patients. The themes identified in this study add insight into the experiences of these family members. The results of this study may guide future interventions to help support bereaved families of intensive care unit patients.