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Background Patients presenting to the emergency department (ED) following nonfatal opioid overdose represent a high-risk population with 5 % of patients dying within a year of the index visit. Objective To evaluate subsequent overdose and death before and after the implementation of an ED discharge naloxone program. Methods This was a retrospective cohort study of ED patients who presented at the Virginia Commonwealth University Health ED with an Opioid Use Disorder (OUD) chief complaint before and after a discharge naloxone program. The pre-naloxone cohort was consecutive ED OUD patients from August 15, 2021, to August 14, 2022, and the post-naloxone cohort from August 15, 2022, to August 14, 2023. The outcomes were subsequent overdose, ED visit to same hospital (VCU), and death within six months of the index visit. Results In total, 1,053 patients were included, of which 529 were in the pre-naloxone cohort and 524 patients in the post-naloxone cohort. The mean age was 44.2 years (SD = 14.0) and 69 % were males. There was a reduction in overdose requiring ED visiting (subsequent ED overdose) and death (4.6 % vs 9.2 % p = 0.03 and 2.0 % vs 5.6 % p = 0.02 respectively) in the post-naloxone cohort compared to the pre-naloxone cohort. After adjusting for sociodemographic and clinical factors, there was a 48 % reduction in the risk of subsequent ED overdose (RR = 0.52, 95 % CI: 0.27, 1.02) and a 63 % reduction in the risk of death (RR = 0.37, 95 % CI: 0.14, 0.95). Conclusion Implementing an ED take-home naloxone program was associated with a reduction in subsequent overdose and death at six months.

In the United States (US) kindergarten through twelfth-grade public school system, the classroom library has come to be a critical part of literacy instruction within the language arts classroom. This fact is especially true in the middle school grade levels (grades five through eight), where reading volume begins to rapidly increase. Additionally, a developmental norm for students within this age range includes a growing sense of independence and choice, as well as a desire to share and voice opinions. Classroom libraries have come to be tools that are used regularly and are heavily influential on the way that students grow to perceive themselves, the world around them, and the way they fit into that world. However, classroom libraries have remained stagnant and underrepresent the diverse populations of the students in those classrooms. This article aims to connect deep reflective thinking with anti-oppressive and transformative learning theories, exploring how these frameworks can be used to problematize current practices in classroom libraries. Through a content analysis of what is seen as deep and critical thinking practices and reflective thinking practices, anti-oppressive and transformative learning theories can be linked to foster a social justice classroom culture within US public middle school language arts classrooms. © 2025 Common Ground Research Networks. All rights reserved.

We present an investigation into the rotation and stellar activity of four fully convective M dwarf “twin” wide binaries. Components in each pair have (1) astrometry confirming they are common-proper-motion binaries, (2) Gaia BP, RP, and 2MASS J, H, and K s magnitudes matching within 0.10 mag, and (3) presumably the same age and composition. We report long-term photometry, rotation periods, multiepoch Hα equivalent widths, X-ray luminosities, time series radial velocities, and speckle observations for all components. Although it might be expected for the twin components to have matching magnetic attributes, this is not the case. Decade-long photometry of GJ 1183 AB indicates consistently higher spot activity on A than B, a trend matched by A appearing 58% ± 9% stronger in L X and 26% ± 9% stronger in Hα on average—this is despite similar rotation periods of A = 0.86 day and B = 0.68 day, thereby informing the range in activity for otherwise identical and similarly rotating M dwarfs. The young β Pic Moving Group member 2MA 0201+0117 AB displays a consistently more active B component that is 3.6 ± 0.5 times stronger in L X and 52% ± 19% stronger in Hα on average, with distinct rotation at A = 6.01 days and B = 3.30 days. Finally, NLTT 44989 AB displays remarkable differences with implications for spindown evolution—B has sustained Hα emission while A shows absorption, and B is ≥39 ± 4 times stronger in L X, presumably stemming from the surprisingly different rotation periods of A = 38 days and B = 6.55 days. The last system, KX Com, has an unresolved radial velocity companion, and is therefore not a twin system.

Shallow mantle processes such as edge-driven convection are thought to play an important role in shaping the passive margin setting. Previous geophysical investigations of northern New England suggest this process is likely operating beneath this portion of the eastern North American margin today. In western Vermont and eastern New York, USA, Early Cretaceous magmatism dated at ca. 140–130 Ma in the Burlington lobe and at ca. 110–100 Ma in the Taconic lobe of the New England–Quebec igneous province may represent the upper crustal expression of edge-driven convection operating beneath the eastern North American margin in the geologic past. This investigation addresses the potential relationship between these two episodes of magmatism and upper crustal deformation in northern New England through paleostress analysis of Early Cretaceous sheet intrusions and mesoscale normal faults, and geochemical analysis of sheet intrusions. The two episodes of magmatism are geochemically similar, display typical characteristics of intraplate alkaline magmatism, and are likely the product of a common source. Paleostress analysis and crosscutting relationships indicate that Burlington lobe magmatism was associated with a subhorizontal N–S extensional stress field, and Taconic lobe magmatism was associated with a subhorizontal NW–SE extensional stress field. Both stress fields represent short-term perturbations to the regional Early Cretaceous subhorizontal NE–SW extensional stress field. Each perturbation coincided with and likely continued following magmatism. The magmatism, geographic and temporal scale of the stress field changes, and return to regional subhorizontal NE–SW extension following these events are consistent with the periodic nature of edge-driven convection and associated small-scale delamination events. This field-based documentation of intraplate magmatism and its association with short-term changes in the stress field improves our understanding of the upper crustal expression of edge-driven convection at passive margins.

Constructing a personal narrative and consolidating identity is an ongoing process that becomes pressing in the face of mortality. The current pilot study examined the process of life review in a sample of older people, specifically examining the effects of participation in a memoir course on wisdom, identity, and well-being. We hypothesized that wisdom, identity fidelity and coherence, and subjective well-being would increase for those in the memoir group compared to a control. Eighteen elderly individuals from two senior retirement communities were randomly assigned to participate in weekly classes, for four weeks, either to work on a memoir or discuss films (control group). After engaging in the process of organizing their life story and writing about important memories, the nine individuals in the memoir group scored significantly higher on self-report measures of wise reminiscence, identity fidelity, and subjective well-being compared to those in the control group. Furthermore, exploratory analyses found that wise reminiscence statistically mediated relationships between the memoir condition and the outcome measures of identity fidelity, identity coherence, and subjective well-being. These findings point to the benefits of memoir writing for positive aging as well as potential mechanisms underlying its effectiveness.

Do not walk away from this burgeoning hope of heat and dryness.

From a snowbank I watched the squirrel run.

Grey Sparrow Press, in this landmark book, cherishes the voices of national writing treasures published over ten years; Robert Bly, Robert Wexelblatt, Michael C. Keith, Jules Nyquist, Khem Aryal, Marie Sheppard Williams [posthumously,] Doug Holder, Momila Joshi, William Woolfitt, Thomas R. Smith, M.J. Iuppa, LB Chhetri, John Roche, and Bhisma Upreti to name a few. Grey Sparrow Press was formed as a non-profit 501[c]3 on May 11, 2009.

Stock market forecasting is an essential factor in the daily operations of many companies and individuals. However, the complex and nonlinear nature of the stock market and the unpredictable variations in factors affecting stock prices present significant challenges in accurate forecasting. To address this, we employ four model-based metaheuristic search algorithms (MHs), namely the Crow Search Algorithm (CSA), Particle Swarm Optimizer (PSO), Gray Wolf Optimizer (GWO), and Dandelion Optimizer (DO), to estimate the parameters of stock market prices models. The data utilized in our experiments are extracted from the widely recognized stock index of Standard & Poor's 500 (S&P 500), that serves as a representative benchmark for the United States stock market. Our findings demonstrate that the CSA outperforms other MHs by providing the best combination of parameters for modeling stock market prices. The optimized parameters for the CSA model yielded Variance-Account-For (VAF) values of 97.846% in the training set and 93.483% in the testing set. This suggests that CSA offers promising capabilities for enhancing the accuracy and effectiveness of stock market forecasting models. © (2024), (Research Institute of Intelligent Computer Systems). All rights reserved.

Background: Social determinants of health account for racial inequities in breastfeeding rates in the United States. There is a gap in the role of neighborhood socioeconomic status (NSES) as it relates to breastfeeding disparities.Methods: Using longitudinal data from the Black Women’s Health Study, we assessed associations of NSES with breastfeeding initiation and duration in a cohort of primiparous U.S. Black women. We also explored associations within strata of important economic indicators, including education, occupation, and marital status.Results: Breastfeeding initiation (n = 2,705) increased with NSES quartile, from 75.2% in the lowest quartile to 88.3% in the highest quartile (p < 0.0001). Compared with women living in the highest NSES quartile, those in the lowest quartile had a 41% (odds ratio: 0.59 [95% confidence interval: 0.43, 0.81]) decreased odds of initiating breastfeeding. For breastfeeding duration (n = 2,172), women residing in NSES quartiles 1–3 were significantly less likely (p < 0.0001) to breastfeed (44.4%) for 6+ months compared with those living in the highest quartile (62.8%). Adjusted relative risks for those in quartiles 1–3 compared with 4 (highest) were 0.63 (0.45, 0.87), 0.50 (0.37, 0.68), and 0.64 (0.47, 0.86), respectively (p = 0.0001). There was no statistically significant evidence of effect modification by education, occupation, marital status, and region (Pinteraction = >0.05).Conclusion: Living in a lower NSES environment was associated with reduced breastfeeding initiation and duration compared with a higher NSES environment. Research is needed to understand the mechanisms by which neighborhood-level factors influence breastfeeding initiation and duration for Black women in the United States.

We investigated whether more arterial stiffness changes could be induced by fragmentation of Swiss ball balance, and examined the role exercise order played in the modulation of arterial stiffness when on-ball kneeling and sitting were combined. Twenty-three healthy young adults (23.8 ± 0.3 years) performed 7 trials in a randomized crossover fashion: CON (non-exercise control), K (on-ball kneeling, 5 min), fK (fragmented on-ball kneeling, 2 × 2.5 min), S (on-ball sitting, 5 min), fS (fragmented on-ball sitting, 2 × 2.5 min), SK (5-min sitting before 5-min kneeling) and KS (5-min kneeling before 5-min sitting). Arterial stiffness in Cardio-ankle vascular index (CAVI) was measured at baseline (BL), immediately (0 min), and every 10 min after exercise, and its changes from BL (ΔCAVI) were calculated. Area under curve (AUC) of ΔCAVI was calculated for SK and KS. The results showed that relative to CON, ΔCAVI decreased at 0 min and 10 min in K and fK, and remained decreased at 20 min in fK only. However, ΔCAVI in S and fS increased with time similarly, with no difference relative to CON. Though ΔCAVI decreased at 10 min in SK, it decreased at both 0 min and 10 min in KS, relative to CON. AUC of ΔCAVI was greater in KS than in SK. The study indicated that compared to continuous mode, fragmented kneeling results in more arterial stiffness improvements, while fragmented sitting exerts no additional effects. When kneeling and sitting are combined, kneeling before sitting elicits more arterial stiffness improvements than sitting before kneeling. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.

Diabetes, affecting more than 500 million individuals worldwide, is the most widespread non-communicable disease, globally. The early identification and effective management of diabetes are crucial for controlling its spread. Currently, the HbA1c test is the gold standard for the detection of diabetes with high confidence. But this is an invasive, expensive pathology test. Therefore, alternative non-invasive and inexpensive methods have been proposed in the literature for the early detection of diabetes.

Herein, CuO and ZnO nanoparticles (NPs) were biogenically synthesized using plant (Artemisia vulgaris) extracts. The biogenic NPs were subsequently evaluated in vitro for antifungal activity (200 mg/L) against Fusarium virguliforme (FV; the cause of soybean sudden death), and for crop protection (200–500 mg/L) in FV-infested soybean. ZnONPs exhibited 3.8-, 2.5-, and 4.9 -fold greater in vitro antifungal activity, compared to Zn or Cu acetate salt, the Artemisia extract, and a commercial fungicide (Medalion Fludioxon), respectively. The corresponding CuONP values were 1.2-, 1.0-, and 2.2 -fold, respectively. Scanning electron microscopy (SEM) revealed significant morpho-anatomical damage to fungal mycelia and conidia. NP-treated FV lost their hyphal turgidity and uniformity and appeared structurally compromised. ZnONP caused shriveled and broken mycelia lacking conidia, while CuONP caused collapsed mycelia with shriveled and disfigured conidia. In soybean, 200 mg/L of both NPs enhanced growth by 13%, compared to diseased controls, in both soil and foliar exposures. Leaf SEM showed fungal colonization of different infection sites, including the glandular trichome, palisade parenchyma, and vasculature. Foliar application of ZnONP resulted in the deposition of particulate ZnO on the leaf surface and stomatal interiors, likely leading to particle and ion entry via several pathways, including ion diffusion across the cuticle/stomata. SEM also suggested that ZnO/CuO NPs trigger structural reinforcement and anatomical defense responses in both leaves and roots against fungal infection. Collectively, these findings provide important insights into novel and effective mechanisms of crop protection against fungal pathogens by plant-engineered metal oxide nanoparticles, thereby contributing to the sustainability of nano-enabled agriculture.

Introduction: Intimate partner violence (IPV) is an important determinant of poor sexual and reproductive health. One’s sense of sexual autonomy may be an important concept in the context of IPV and sexual and reproductive health outcomes. Compromised sexual autonomy may explain the risk of poor sexual and reproductive health among individuals who experienced IPV; yet few studies have examined the role of sexual autonomy. The current study examined the mediating effects of sexual autonomy on the association between recent IPV, sexual risk and HIV-related worry. Methods: One hundred ninety-eight sexually active women and men involved in past-year romantic partnerships completed an online survey in 2016. Path analysis was used to test the direct and indirect effects of sexual autonomy. Results: Recent IPV predicted lower sexual autonomy (B = −.29, SE =.15, p <.05), unwanted condomless sex (aOR = 3.38, 95% CI 1.63–7.02), coercive sexual risk (aOR = 25.91, 95% CI 5.02–133.75), and HIV-related worry (aOR = 5.44, 95% CI 1.44–20.57). Lower sexual autonomy predicted unwanted condomless sex (aOR =.98, 95% CI.96–.99), coercive sexual risk (aOR =.95, 95% CI.90–.99), and HIV-related worry (aOR =.92, 95% CI.90–.97). Sexual autonomy mediated the association between IPV and HIV-related worry (indirect effect OR = 1.39, 95% CI 1.01–3.63). Conclusions: Recent IPV experiences can weaken one’s sexual autonomy, which in turn creates concerns about acquiring HIV. HIV prevention programming should address the implications of IPV, promote sexual safety strategies, and develop tailored support to increase sexual autonomy among individuals navigating violence. Policy Implications: Findings can inform the integration of trauma-informed policies and IPV screening practices in comprehensive sexual health programmatic initiatives. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.

Climate change analyses and subsequent communications largely focus on the global and continental spatial scales while most individuals experience climate change at the state and local scales. The aggregation of local weather data into broader spatial scales causes local trends to be lost or poorly represented. This study examines climate trends for the New England region of the United States from 1940 to 2019 at the local scale to determine how they match or differ from the trends described for the region from studies at broader spatial scales. An observed increase in precipitation and average minimum temperature matches previous studies when aggregated for the New England region, but mask local variation of the variables. The increase in precipitation is greatest in upland areas and some local areas have not observed increased precipitation. Average minimum temperature has broadly increased in the region, but not universally, and average temperature and maximum temperature show weaker increasing trends along with local variation. The variation of climate trends at the local scale highlights the need for clear communication of climate change that emphasizes the spatial scale of specific statements and the acknowledgment of different observed experiences at different scales.

Epidermolysis bullosa acquisita (EBA) represents a big challenge as a rare skin disorder, with no established markers for early detection for patients. Moreover, as a rare disease, it is extremely difficult to acquire good number of patient sample to diagnose accurately with high confidence. EBA has many biomarkers very similar to other bullosa diseases and needs specific clinical expertise to detect it using immunofluorescence microscopy. In this study, we introduce a deep learningbased method, EBAnet, that leveraged Convolutional Neural Network (CNN) based model for the detection of EBA based on Direct immunofluorescence (DIF) microscopy image. The proposed EfficientNet-based model achieved 97.3% sensitivity, 96.1% precision, and 96.7% accuracy in distinguishing EBA from other class and outperformed the existing model for the same purpose. GradCAM based class activation map also highlighted the important region of the DIF images that was focused by the proposed model leveraging the explainability of the model. We believe, EBAnet will add value in the early and accurate detection of EBA, addressing a critical need in clinical practice.

Meaningful student–teacher relationships form a crucial foundation for teachers to deliver effective interventions leading to better outcomes for students with challenging behavior. By implementing simple recommendations for facilitating genuine and intentional interactions with students and regulating their own emotional responses, teachers can establish, maintain, and reinforce meaningful relationships with students. This article describes and provides school-based examples of recommendations for building and sustaining meaningful student–teacher relationships with students who exhibit challenging behaviors.

Stereotypes about aging and aging anxieties are common and when internalized are related to poor physical and psychological outcomes. As a result, older adults may view themselves as having their best years behind them. The present study investigates ageism and aging anxiety as barriers to positive self-development. Participants (n = 360) between ages of 19 and 77 years old (M = 39, SD = 15.9) were recruited using Amazon Mechanical Turk (MTurk) and completed measures of Ageism, Aging Anxiety, and were asked to identify when they have been or will be their Best Self. With increasing age, adults with more internalized ageism and more aging anxiety, specifically physical appearance and fear of loss, identified their Best Self with a time in the past. These findings support the idea that internalization of ageism and aging anxiety can be counterproductive for expectations for growth as one ages.

Social and behavioral science researchers who use survey data are vigilant about data quality, with an increasing emphasis on avoiding common method variance (CMV) and insufficient effort responding (IER). Each of these errors can inflate and deflate substantive relationships, and there are both a priori and post hoc means to address them. Yet, little research has investigated how both IER and CMV are affected with the use of these different procedural or statistical techniques used to address them. More specifically, if interventions to reduce IER are used, does this affect CMV in data? In an experiment conducted both in and out of the laboratory, we investigate the impact of attentiveness interventions, such as a Factual Manipulation Check (FMC) on both IER and CMV in same-source survey data. In addition to typical IER measures, we also track whether respondents play the instructional video and their mouse movement. The results show that while interventions have some impact on the level of participant attentiveness, these interventions do not appear to lead to differing levels of CMV.