University of Florida

Objective As the number of individuals diagnosed with dementia increases, so does the need to understand the preferences of persons living with dementia (PLWD) and caregivers for how clinicians can deliver a dementia diagnosis effectively, which can be a difficult process. This study describes the diagnostic communication preferences of PLWD and caregivers. Methods We conducted semi-structured individual phone interviews with two groups: PLWD who were diagnosed in the past two years (n = 11) and family caregivers of PLWD (n = 19) living in Florida. PLWD and caregivers were not recruited/enrolled as dyads. Results The groups' communication preferences were largely similar. Data were analyzed thematically into five themes: communicate the diagnosis clearly, meet information needs, discuss PLWD/caregiver resources, prepare for continued care, and communicate to establish and maintain relationships. Conclusion Participants wanted clear communication, information, and support, but differed in some details (e.g. the language used to describe the diagnosis and the amount/type of desired information). Clinicians can apply general principles but will need to tailor them to individual preferences of PLWD and caregivers. Innovation Limited research has elicited PLWD and caregivers' communication preferences for receiving dementia diagnoses, particularly through an individualized data collection method allowing for richer descriptions and deeper understanding.

KEY POINTS There is no single set of accepted patient selection criteria for outpatient TSA. Here, the authors identify and systematically review available literature to propose evidence-based criteria that merit postoperative admission. The surveyed literature indicates that patients with a limited ability to ambulate independently or a history of congestive heart failure should be admitted postoperatively for monitoring unless otherwise cleared for discharge. In addition, age 85+, renal insufficiency, poorly controlled diabetes mellitus, and a positive smoking status were identified as risk factors with varying levels of significance for increased LOS or early adverse events.

The ease and inexpensive setup of injecting timing faults in a hardware design make it vulnerable to adversaries, resulting in confidentiality or integrity violations. The state-of-the-art fault-injection attack assessment frameworks do not consider significant timing variations during layout generation from a gate-level design when assessing security threats of timing faults. Additionally, existing mitigation methods focus on higher design abstractions (e.g., register transfer level (RTL) and gate level), resulting in substantial area, power consumption, and latency overhead. To address these limitations, we propose our layout-aware and security property-assisted timing fault-injection attack assessment (FLAT) framework that automatically assesses the feasibility of injecting controlled timing faults into the layout of a design using clock glitches and quantifies its vulnerability concerning security properties. If the design is vulnerable, FLAT modifies the layout to tune the fan-in path delays of the security-critical registers as local countermeasures. Unlike system-wide mitigation approaches, these countermeasures incur minimal overheads at an IP or system-on-chip (SoC) design regarding power, performance, and area while ensuring security against timing faults. To demonstrate the effectiveness of FLAT, we perform security assessments on the postlayout designs of various benchmarks e.g., advanced encryption standard (AES), rivest-shamir-adleman (RSA), and floating-point unit (FPU) by targeting major fault injection attack vectors and deploying local countermeasures. These assessments indicate that the FLAT framework adeptly evaluates each design’s susceptibility to timing faults and implements the countermeasures to mitigate this susceptibility to the desired level.

The aim of this study was to experimentally test the effects of different electromyographic-based prosthetic control modes on user task performance, cognitive workload, and perceived usability to inform further human-centered design and application of these prosthetic control interfaces. We recruited 30 able-bodied participants for a between-subjects comparison of three control modes: direct control (DC), pattern recognition (PR), and continuous control (CC). Multiple human-centered evaluations were used, including task performance, cognitive workload, and usability assessments. To ensure that the results were not task-dependent, this study used two different test tasks, including the clothespin relocation task and Southampton hand assessment procedure-door handle task. Results revealed performance with each control mode to vary among tasks. When the task had high-angle adjustment accuracy requirements, the PR control outperformed DC. For cognitive workload, the CC mode was superior to DC in reducing user load across tasks. Both CC and PR control appear to be effective alternatives to DC in terms of task performance and cognitive load. Furthermore, we observed that, when comparing control modes, multitask testing and multifaceted evaluations are critical to avoid task-induced or method-induced evaluation bias. Hence, future studies with larger samples and different designs will be needed to expand the understanding of prosthetic device features and workload relationships.

Chromium (Cr) contamination in agricultural soils poses a risk to crop productivity and quality. Emerging nano-enabled strategies show great promise in remediating soils contaminated with heavy metals and enhancing crop production. The present study was aimed to investigate the efficacy of nano silicon (nSi) in promoting wheat growth and mitigating adverse effects of Cr-induced toxicity. Wheat seedlings exposed to Cr (K2Cr2O7) at a concentration of 100 mg kg−1 showed significant reductions in plant height (29.56%), fresh weight (35.60%), and dry weight (38.92%) along with enhanced Cr accumulation in roots and shoots as compared to the control plants. However, the application of nSi at a concentration of 150 mg kg−1 showcased substantial mitigation of Cr toxicity, leading to a decrease in Cr accumulation by 27.30% in roots and 35.46% in shoots of wheat seedlings. Moreover, nSi exhibited the capability to scavenge oxidative stressors, such as hydrogen peroxide (H2O2), and malondialdehyde (MDA) and electrolyte leakage, while significantly enhancing gas exchange parameters, total chlorophyll content, and antioxidant activities (enzymatic and nonenzymatic) in plants grown in Cr-contaminated soil. This study further found that the reduced Cr uptake by nSi application was due to downregulating the expression of HMs transporter genes (TaHMA2 and TaHMA3), alongwith upregulating the expression of antioxidant-responsive genes (TaSOD and TaSOD). The findings of this investigation highlight the remarkable potential of nSi in ameliorating Cr toxicity. This enhanced efficacy could be ascribed to the distinctive size and structure of nSi, which augment its ability to counteract Cr stress. Thus, the application of nSi could serve as a viable solution for production of crops in metal contaminated soils, offering an effective alternative to time-consuming and costly remediation techniques.

BCL‐2, a member of the BCL‐2 protein family, is an antiapoptotic factor that regulates the intrinsic pathway of apoptosis. Due to its aberrant activity, it is frequently implicated in haematopoietic cancers and represents an attractive target for the development of therapeutics that antagonize its activity. A selective BCL‐2 inhibitor, venetoclax, was approved for treating chronic lymphocytic leukaemia, acute myeloid leukemia, and other hematologic malignancies, validating BCL‐2 as an anticancer target. Since then, alternative therapeutic approaches to modulate the activity of BCL‐2 have been explored, such as antibody‐drug conjugates and proteolysis‐targeting chimeras. Despite numerous research groups focusing on developing degraders of BCL‐2 family member proteins, selective BCL‐2 PROTACs remain elusive, as disclosed compounds only show dual BCL‐xL/BCL‐2 degradation. Herein, we report our efforts to develop BCL‐2 degraders by incorporating two BCL‐2 binding moieties into chimeric compounds that aim to hijack one of three E3 ligases: CRBN, VHL, and IAPs. Even though our project did not result in obtaining a potent and selective BCL‐2 PROTAC, our research will aid in understanding the narrow chemical space of BCL‐2 degraders.

Microbes inhabiting and evolving in aquatic ecosystems at the base of polar ice sheets subsist under energy-limited conditions while in relative isolation from surface gene pools and their common ancestral populations of origin. Samples recently obtained from the base of West Antarctic Ice Sheet (WAIS) allowed us to examine evolutionary relationships of and identify metabolic pathways in microbial genomes recovered from the Mercer Subglacial Lake (SLM) ecosystem. We obtained 1,374 single-cell amplified genomes from individual bacterial and archaeal cells that were isolated from samples of SLM’s water column and sediments. Genome-based taxonomic classification coherently identified nearly all of the subglacial microorganisms as new species or novel taxonomic groups, and phylogenomic analyses showed evidence for genetically isolation of the microbial populations from marine and surface biomes. Comparative genomic analysis revealed a lake ecosystem exhibiting a range of metabolisms to oxidize various organic and inorganic compounds via aerobic or anerobic respiration. Network construction identified two distinct organotrophic and chemolithotrophic metabolic guilds that may operate alternatively depending on oxygen availability. Our SAG data imply substantial metabolic flexibility in the microbial assemblage characterized, reveal key energy generating strategies in the subglacial ecosystem, and provide a framework to assess microbial evolution beneath WAIS.

Background HIV remains a global public health concern, and women continue to be disproportionately affected. Understanding the factors associated with pre-exposure prophylaxis awareness among women is crucial as an effective HIV prevention strategy. Objectives We investigated the prevalence and associated factors of pre-exposure prophylaxis awareness among women in Burkina Faso. Design This was a cross-section study that used population-based data. Methods A total of 17,659 women of reproductive age (15–49 years) from the 2021 Burkina Faso Demographic and Health Survey were analyzed. Percentage and multivariable logistic regression model were used to examine the prevalence and factors associated with pre-exposure prophylaxis awareness. Results The prevalence of pre-exposure prophylaxis awareness was 8.2% (95% confidence interval = 7.8%–8.6%). Women’s age was positively associated pre-exposure prophylaxis awareness. Women with primary and secondary education had 39% and 48% higher odds of pre-exposure prophylaxis awareness, when compared with women with no formal education. The odds of pre-exposure prophylaxis awareness were 1.40 (95% confidence interval = 1.19–1.66) times higher among Christians when compared with the Muslims. Women who were exposed to mass media including newspaper or magazine, radio, TV, and Internet had higher odds of pre-exposure prophylaxis awareness, when compared with those without exposure to mass media channels. Women who have previously tested for HIV had 37% higher odds of pre-exposure prophylaxis awareness, when compared with those who have not been tested (adjusted odds ratio = 1.37; 95% confidence interval = 1.09–1.72). Conclusion This study found women’s age, geographical region, education, religion, exposure to mass media channels, employment, and HIV testing to be associated with pre-exposure prophylaxis awareness. These findings can inform the development of targeted interventions and public health campaigns to increase awareness and practice to pre-exposure prophylaxis, particularly among key population.

Purpose The overall goal of this review was to identify what is known about triadic (clinician–patient–caregiver) communication in mild cognitive impairment (MCI) and dementia care settings throughout the care continuum. Methods Using a structured search, we conducted a systematic scoping review of relevant published journal articles across 5 databases. Study titles/abstracts and selected full-text articles were screened by 2 investigators in Covidence systematic review software. Articles were excluded if they were not about clinical communication, focused only on caregiver–patient communication or communication in residential care, were interventional, lacked empirical data, or were not in English. Extracted data were documented using Google Forms. Results The study team screened 3426 article titles and abstracts and 112 full-text articles. Forty-four articles were included in the final review. Results were categorized by 3 communication scenarios: diagnostic communication (n=22), general communication (n=16), and advanced care planning communication (n=6). Conclusions and Relevance Across the included articles, the conceptualization and assessment of communication lacked homogeneity. Future directions include addressing these research gaps, establishing recommendations for clinicians to effectively communicate with individuals with dementia and caregivers, and creating and testing communication skills trainings for caregivers/family members, clinicians, and/or individuals with dementia to facilitate effective communication.

BACKGROUND Pulmonary hypertension (PH) represents an important phenotype in heart failure with preserved ejection fraction (HFpEF). However, management of PH-HFpEF is challenging because mechanisms involved in the regulation of PH-HFpEF remain unclear. METHODS We used a mass spectrometry–based comparative plasma proteomics approach as a sensitive and comprehensive hypothesis-generating discovery technique to profile proteins in patients with PH-HFpEF and control subjects. We then validated and investigated the role of one of the identified proteins using in vitro cell cultures, in vivo animal models, and independent cohort of human samples. RESULTS Plasma proteomics identified high protein abundance levels of B2M (β2-microglobulin) in patients with PH-HFpEF. Interestingly, both circulating and skeletal muscle levels of B2M were increased in mice with skeletal muscle SIRT3 (sirtuin-3) deficiency or high-fat diet–induced PH-HFpEF. Plasma and muscle biopsies from a validation cohort of PH-HFpEF patients were found to have increased B2M levels, which positively correlated with disease severity, especially pulmonary capillary wedge pressure and right atrial pressure at rest. Not only did the administration of exogenous B2M promote migration/proliferation in pulmonary arterial vascular endothelial cells but it also increased PCNA (proliferating cell nuclear antigen) expression and cell proliferation in pulmonary arterial vascular smooth muscle cells. Finally, B2m deletion improved glucose intolerance, reduced pulmonary vascular remodeling, lowered PH, and attenuated RV hypertrophy in mice with high-fat diet–induced PH-HFpEF. CONCLUSIONS Patients with PH-HFpEF display higher circulating and skeletal muscle expression levels of B2M, the magnitude of which correlates with disease severity. Our findings also reveal a previously unknown pathogenic role of B2M in the regulation of pulmonary vascular proliferative remodeling and PH-HFpEF. These data suggest that circulating and skeletal muscle B2M can be promising targets for the management of PH-HFpEF.

Phenolic compounds are a group of non-essential dietary compounds that are widely recognized for their beneficial health effects, primarily due to their bioactive properties. These compounds which found in a variety of plant-based foods, including fruits, vegetables, and grains are known to possess antimicrobial, antioxidant, anti-inflammatory, and anti-carcinogenic properties. However, the health effects of these compounds depend on their bioaccessibility and bioavailability. In recent years, there has been growing interest in the use of probiotics for promoting human health. Saccharomyces cerevisiae is a yeast with potential probiotic properties and beneficial health effects. Biosorption of phenolic compounds on Saccharomyces cerevisiae cell walls improves their bioaccessibility. This characteristic has also allowed the use of this yeast as a biosorbent in the biosorption process due to its low cost, safety, and easy availability. S. cerevisiae enhances the bioaccessibility of phenolic compounds as a delivery system under in vitro digestion conditions. The reason for this phenomenon is the protective effects of yeast on various phenolic compounds under digestion conditions. This article shows the role of S. cerevisiae yeast on the bioaccessibility of various phenolic compounds and contributes to our understanding of the potential impact of yeasts in human health.

Background: Gait speed or 6-minute walk test are frequently used to project community ambulation abilities post-stroke by categorizing individuals as household ambulators, limited, or unlimited community ambulators. However, whether improved clinically-assessed gait outcomes truly translate into enhanced real-world community ambulation remains uncertain. Objective This cross-sectional study aimed to examine differences in home and community ambulation between established categories of speed- and endurance-based classification systems of community ambulation post-stroke and compare these with healthy controls. Methods: Sixty stroke survivors and 18 healthy controls participated. Stroke survivors were categorized into low-speed, medium-speed, or high-speed groups based on speed-based classifications and into low-endurance, medium-endurance, or high-endurance groups based on the endurance-based classification. Home and community steps/day were quantified using Global Positioning System and accelerometer devices over 7 days. Results: The low-speed groups exhibited fewer home and community steps/day than their medium- and high-speed counterparts (P < .05). The low-endurance group took fewer community steps/day than the high-endurance group (P < .05). Despite vast differences in clinical measures of gait speed and endurance, the medium-speed/endurance groups did not differ in their home and community steps/day from the high-speed/endurance groups, respectively. Stroke survivors took 48% fewer home steps/day and 77% fewer community steps/day than healthy controls. Conclusions: Clinical classification systems may only distinguish home ambulators from community ambulators, but not between levels of community ambulation, especially beyond certain thresholds of gait speed and endurance. Clinicians should use caution when predicting community ambulation status through clinical measures, due to the limited translation of these classification systems into the real world.

Introduction 3D-printed temporal bone models enable the training and rehearsal of complex otological procedures. To date, there has been no consolidation of the literature regarding the developmental process of 3D-printed temporal bone models. A brief review of the current literature shows that many of the key surgical landmarks of the temporal bone are poorly represented in models. This study aims to propose a novel design and production workflow to produce high-fidelity 3D-printed temporal bone models for surgical simulation. Methods Developmental phases for data extraction, 3D segmentation and Computer Aided Design (CAD), and fabrication are outlined. The design and fabrication considerations for key anatomical regions, such as the mastoid air cells and course of the facial nerve, are expounded on with the associated strategy and design methods employed. To validate the model, radiological measurements were compared and a senior otolaryngologist performed various surgical procedures on the model. Results Measurements between the original scans and scans of the model demonstrate sub-millimetre accuracy of the model. Assessment by the senior otologist found that the model was satisfactory in simulating multiple surgical procedures. Conclusion This study offers a systematic method for creating accurate 3D-printed temporal bone models for surgical training. Results show high accuracy and effectiveness in simulating surgical procedures, promising improved training and patient outcomes.

Plant diseases significantly impact food security and food safety. It was estimated that food production needs to increase by 50% to feed the projected 9.3 billion people by 2050. Yet, plant pathogens and pests are documented to cause up to 40% yield losses in major crops, including maize, rice, and wheat, resulting in annual worldwide economic losses of approximately US$220 billion. Yield losses due to plant diseases and pests are estimated to be 21.5% (10.1 to 28.1%) in wheat, 30.3% (24.6 to 40.9%) in rice, and 22.6% (19.5 to 41.4%) in maize. In March 2023, The American Phytopathological Society (APS) conducted a survey to identify and rank key challenges in plant pathology in the next decade. Phytopathology subsequently invited papers that address those key challenges in plant pathology, and these were published as a special issue. The key challenges identified include climate change effect on the disease triangle and outbreaks, plant disease resistance mechanisms and its applications, and specific diseases including those caused by Candidatus Liberibacter spp. and Xylella fastidiosa. Additionally, disease detection, natural and man-made disasters, and plant disease control strategies were explored in issue articles. Finally, aspects of open access and how to publish articles to maximize the Findability, Accessibility, Interoperability, and Reuse of digital assets in plant pathology were described. Only by identifying the challenges and tracking progress in developing solutions for them will we be able to resolve the issues in plant pathology and ultimately ensure plant health, food security, and food safety.

Insects often exhibit irruptive population dynamics determined by environmental conditions. We examine if populations of the Culex tarsalis mosquito, a West Nile virus (WNV) vector, fluctuate synchronously over broad spatial extents and multiple timescales and whether climate drives synchrony in Cx. tarsalis, especially at annual timescales, due to the synchronous influence of temperature, precipitation, and/or humidity. We leveraged mosquito collections across 9 National Ecological Observatory Network (NEON) sites distributed in the interior West and Great Plains region USA over a 45-month period, and associated gridMET climate data. We utilized wavelet phasor mean fields and wavelet linear models to quantify spatial synchrony for mosquitoes and climate and to calculate the importance of climate in explaining Cx. tarsalis synchrony. We also tested whether the strength of spatial synchrony may vary directionally across years. We found significant annual synchrony in Cx. tarsalis, and short-term synchrony during a single period in 2018. Mean minimum temperature was a significant predictor of annual Cx. tarsalis spatial synchrony, and we found a marginally significant decrease in annual Cx. tarsalis synchrony. Significant Cx. tarsalis synchrony during 2018 coincided with an anomalous increase in precipitation. This work provides a valuable step toward understanding broadscale synchrony in a WNV vector.

Circadian rhythms have been shown in the subthalamic nucleus (STN) in Parkinson’s disease (PD), but only a few studies have focused on the globus pallidus internus (GPi). This retrospective study investigates GPi circadian rhythms in a large cohort of subjects with PD (130 recordings from 93 subjects) with GPi activity chronically recorded in their home environment. We found a significant change in GPi activity between daytime and nighttime in most subjects (82.4%), with a reduction in GPi activity at nighttime in 56.2% of recordings and an increase in activity in 26.2%. GPi activity in higher frequency bands ( > 20 Hz) was more likely to decrease at night and in patients taking extended-release levodopa medication. Our results suggest that circadian fluctuations in the GPi vary across individuals and that increased power at night might be due to the reemergence of pathological neural activity. These findings should be considered to ensure successful implementation of adaptive neurostimulation paradigms in the real-world.

Despite recent therapeutic advancements, outcomes for advanced hepatocellular carcinoma (HCC) remain unsatisfactory, highlighting the need for novel treatments. The CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) gene-editing technology offers innovative treatment approaches, involving genetic manipulation of either cancer cells or adoptive T cells to combat HCC. This review comprehensively assesses the applications of CRISPR systems in HCC treatment, focusing on in vivo targeting of cancer cells and the development of chimeric antigen receptor (CAR) T cells and T cell receptor (TCR)-engineered T cells. We explore potential synergies between CRISPR-based cancer therapeutics and existing treatment options, discussing ongoing clinical trials and the role of CRISPR technology in improving HCC treatment outcomes with advanced safety measures. In summary, this review provides insights into the promising prospects and current challenges of using CRISPR technology in HCC treatment, with the ultimate goal of improving patient outcomes and revolutionizing the landscape of HCC therapeutics.