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The kappa opioid receptor (KOR) system is implicated in dysphoria and as an “anti-reward system” during withdrawal from opioids. However, no clear consensus has been made in the field, as mixed findings have been reported regarding the relationship between the KOR system and opioid use. This review summarizes the studies to date on the KOR system and opioids. A systematic scoping review was reported following PRISMA guidelines and conducted based on the published protocol. Comprehensive searches of several databases were done in the following databases: MEDLINE, Embase, PsycINFO, Web of Science, Scopus, and Cochrane. We included preclinical and clinical studies that tested the administration of KOR agonists/antagonists or dynorphin and/or measured dynorphin levels or KOR expression during opioid intoxication or withdrawal from opioids. One hundred studies were included in the final analysis. Preclinical administration of KOR agonists decreased drug-seeking/taking behaviors and opioid withdrawal symptoms. KOR antagonists showed mixed findings, depending on the agent and/or type of withdrawal symptom. Administration of dynorphins attenuated opioid withdrawal symptoms both in preclinical and clinical studies. In the limited number of available studies, dynorphin levels were found to increase in cerebrospinal fluid (CSF) and peripheral blood lymphocytes (PBL) of opioid use disorder subjects (OUD). In animals, dynorphin levels and/or KOR expression showed mixed findings during opioid use. The KOR/dynorphin system appears to have a multifaceted and complex nature rather than simply functioning as an anti-reward system. Future research in well-controlled study settings is necessary to better understand the clinical role of the KOR system in opioid use.

Counselor educators and supervisors have a vital role in promoting legislative professional advocacy (LPA). An interpretative qualitative analysis study of counseling graduate students involved in state-level LPA was conducted. Findings revealed six distinct themes: (1) professional counselor identity, (2) knowledge, attitudes and skills, (3) professional support, (4) power of the group, (5) social justice, and (6) personal impact. Study findings may help counselor educators and supervisors educate, guide, and mentor students, thereby increasing the likelihood of professional counselor LPA. © 2024 Chi Sigma Iota.

Purpose: This qualitative study explored the practices of hospital-based speech-language pathologists (SLPs) conducting modified barium swallow studies (MBS) for infants at risk for dysphagia. Specifically, this research aimed to determine whether or not SLPs use side-lying position during MBS, to examine possible differences in the use of positioning, and to better understand SLPs' perceptions and experiences in this practice. Using a constructivist view, research questions guiding this inquiry were as follows: What is the current practice of hospital-based pediatric SLPs in regard to the use of side-lying position during infant MBS? What is the experience of the hospital-based SLP in their use of side-lying position during MBS? How do SLPs report perceived barriers or benefits to using side-lying position during MBS? Method: Employing a purposive-convenience sampling technique, data were collected using semistructured interviews of SLPs serving at-risk infants with dysphagia. All participants were practicing in Level-III or -IV neonatal intensive care units. Interviews were recorded, transcribed, loaded into NVivo, and coded using initial and consensus coding. Themes achieved saturation following six interviews. Results: Three themes emerged from the analysis: (a) variations in practice patterns, (b) factors influencing clinical practice, and (c) items that SLPs identified as needs to facilitate change in their clinical practice. Conclusions: Although SLPs acknowledged the importance of MBS replicating an infant's typical feeding, some SLPs who consistently use side-lying position during feeding do not assess feeding in side-lying position during MBS. This inconsistency in practice results from SLPs' perceived barriers, including lack of experience, concern over interdisciplinary conflict, need for MBS protocols, and lack of research on the potential impacts of side-lying positioning on swallowing. Participants reported the need for research to determine whether side-lying position alters, possibly improves, swallow functions and safety (e.g., airway protection) for at-risk infants.

In the United States, many actors are pushing for the use of grade point average (GPA) as the main placement tool for gatekeeper math and English courses for community college students (Quarles, 2022; Scott-Clayton, 2018; Turk, 2017). One community college system (pseudonymously, SXCC) in a New England state has begun placing students in initial math and English classes based on self-reported GPA. There have been studies on the effects of placement changes of this type (Belfield & Crosta, 2012; Hodara & Cox, 2016; Ngo & Kwon, 2014; Scott-Clayton, 2012). However, studies have not included the effects of these changes on multilingual learners (MLLs).Using a census of every MLL placed in SXCC in the summer and fall of 2020 and the spring of 2021 (N = 12,603), a MANOVA found that MLL students in the SXCC system who were placed using previous placement methods had a higher overall GPA than students placed using self-reported GPA (M = 3.32, SD = 0.740; M = 2.01, SD = 1.27, respectively) and had higher satisfactory academic progress (SAP) (M = 102.98, SD = 51.52; M = 57.66, SD = 55.53, respectively), and took longer to enroll in English 101 (M = 5.11, SD = 3.55; M = 2.36, SD = 1.76, respectively).

First published in 1990, Neptune’s Domain is organized around one unifying theme: the geographic aspects of the new Law of the Sea as expressed primarily in the United Nations Convention on the Law of the Sea. The first two chapters provide essential background information. Chapters 3 through 9 explain relevant provisions of the Convention. The next two chapters cover topics excluded from the Convention, and the last three chapters are more analytical and future-oriented. All students and scholars concerned with the human use of the marine environment will welcome this book, whether they be geographers, political scientists or lawyers. © Martin Ira Glassner 1990. All rights reserved.

Theropods are obligate bipedal dinosaurs that appeared 230 Ma and are still extant as birds. Their history is characterized by extreme variations in body mass, with gigantism evolving convergently between many lineages. However, no quantification of hindlimb functional morphology has shown whether these body mass increases led to similar specializations between distinct lineages. Here we studied femoral shape variation across 41 species of theropods (n = 68 specimens) using a high-density 3D geometric morphometric approach. We demonstrated that the heaviest theropods evolved wider epiphyses and a more distally located fourth trochanter, as previously demonstrated in early archosaurs, along with an upturned femoral head and a mediodistal crest that extended proximally along the shaft. Phylogenetically informed analyses highlighted that these traits evolved convergently within six major theropod lineages, regardless of their maximum body mass. Conversely, the most gracile femora were distinct from the rest of the dataset, which we interpret as a femoral specialization to “miniaturization” evolving close to Avialae (bird lineage). Our results support a gradual evolution of known “avian” features, such as the fusion between lesser and greater trochanters and a reduction of the epiphyseal offset, independent from body mass variations, which may relate to a more “avian” type of locomotion (more knee than hip driven). The distinction between body mass variations and a more “avian” locomotion is represented by a decoupling in the mediodistal crest morphology, whose biomechanical nature should be studied to better understand the importance of its functional role in gigantism, miniaturization, and higher parasagittal abilities.

Context: Authors of previous research at a public university in New England, where the current study takes place, showed that approximately one-third of undergraduate students have experienced some aspect of food insecurity. More recent investigators at this university revealed that students who were members of a sport team were 4 times more likely to be food insecure than their peers who were not on a sport team. The estimated prevalence of student-athlete food insecurity from other previous research studies ranged from 14% to 32%. Objective: To understand the contributing factors to food insecurity among collegiate athletes. Design: Qualitative study. Setting: A public university in New England. Patients or Other Participants: Data are presented for 10 collegiate athletes who experienced some level of food insecurity according to the United States Department of Agriculture Six-Item Short Form. Data Collection and Analysis: Data were collected using a brief demographic questionnaire and semistructured interviews. Results: Contributing factors were a lack of time, special dietary needs, limited campus dining options, and limited access to transportation or kitchens. Coping strategies were managing time and resources, buying cheaper foods, and skipping meals. Food insecurity negatively affected students' athletic performance. The athletes struggled to balance their athletic and academic schedules and obtain a diet that allowed them to meet their performance goals. Conclusions: Additional and innovative programming is needed to support food-insecure student-athletes. © by the National Athletic Trainers' Association, Inc.

We measure triangular flow relative to the reaction plane at 3 GeV center-of-mass energy in Au+Au collisions at the BNL Relativistic Heavy Ion Collider. A significant v3 signal for protons is observed, which increases for higher rapidity, higher transverse momentum, and more peripheral collisions. The triangular flow is essentially rapidity-odd with a slope at midrapidity, dv3/dy|(y=0), opposite in sign compared to the slope for directed flow. No significant v3 signal is observed for charged pions and kaons. Comparisons with models suggest that a mean field potential is required to describe these results, and that the triangular shape of the participant nucleons is the result of stopping and nuclear geometry.

Background: Perceptions of the US healthcare system can impact individuals' healthcare utilization, including vaccination intentions. This study examined the association between perceived racial-ethnic inequities in COVID-19 healthcare and willingness to receive the COVID-19 vaccine. Methods: This study used data from REACH-US, a nationally representative online survey of a large, diverse sample of U.S. adults (N=5145 January 26, 2021-March 3, 2021). Confirmatory factor and regression analyses examined a latent factor of perceived racial-ethnic inequities in COVID-19 healthcare, whether the factor was associated with willingness to receive the COVID-19 vaccine, and whether associations varied across racial-ethnic groups reported as probit estimates (B) and 95% confidence intervals (CIs). Results: Perceived racial-ethnic inequities in COVID-19 healthcare were highest among Black/African American adults (mean latent factor score: 0.65 ± 0.43) and lowest among White adults (mean latent factor score: 0.04 ± 0.67). Black/African American (B = -0.08; 95% CI = -0.19, 0.03) and Native Hawaiian/Pacific Islander (B = -0.08; 95% CI = -0.23, 0.07) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were less willing than participants who perceived lower inequities. In contrast, American Indian/Alaska Native (B = 0.15; 95% CI = -0.01, 0.30), Asian (B = 0.20; 95% CI = 0.08, 0.31), Hispanic/Latino (English language preference) (B = 0.22; 95% CI = 0.01, 0.43), Multiracial (B = 0.23; 95% CI = 0.09, 0.36), and White (B = 0.31; 95% CI = 0.19, 0.43) adults who perceived greater racial-ethnic inequities in COVID-19 healthcare were more willing to receive the COVID-19 vaccine than participants perceiving higher inequities. Conclusions: Greater perceived racial-ethnic inequities in COVID-19 healthcare were associated with less willingness to receive the COVID-19 vaccine among Black/African American and Native Hawaiian/Pacific Islander adults. © 2024 Lippincott Williams and Wilkins. All rights reserved.

Convolutional neural network (CNN) based deep learning is used to analyze spectral data collected by visible resonance Raman (VRR) spectroscopy to distinguish human glioma tumors from healthy brain tissues using binary classification and identify the cancer grades of the glioma tumors using multi-class classification. Classification was performed using both raw spectral data and baseline-subtracted data for comparison. The classification using both datasets yielded high accuracy, with the results obtained from baseline subtracted spectra slightly better than that obtained from raw spectra. The study showed VRR combined with deep learning provides a robust molecular diagnostic tool for accurately distinguishing glioma tumors from normal tissues and glioma tumor tissues at different cancer grades. Deep learning aided VRR technique may be used for in-situ intraoperative diagnosis of brain cancer. It may help a surgeon to identify cancer margins and even cancer grades during surgery. © COPYRIGHT SPIE. Downloading of the abstract is permitted for personal use only.

Human impacts on wild populations are numerous and extensive, degrading habitats and causing population declines across taxa. Though these impacts are often studied individually, wild populations typically face suites of stressors acting concomitantly, compromising the fitness of individuals and populations in ways poorly understood and not easily predicted by the effects of any single stressor. Developing understanding of the effects of multiple stressors and their potential interactions remains a critical challenge in environmental biology. Here, we focus on assessing the impacts of two prominent stressors associated with anthropogenic activities that affect many organisms across the planet – elevated salinity (e.g., from road de-icing salt) and temperature (e.g. from climate change). We examined a suite of physiological traits and components of fitness across populations of wood frogs originating from ponds that differ in their proximity to roads and thus their legacy of exposure to pollution from road salt. When experimentally exposed to road salt, wood frogs showed reduced survival (especially those from ponds adjacent to roads), divergent developmental rates, and reduced longevity. Family-level effects mediated these outcomes, but high salinity generally eroded family-level variance. When combined, exposure to both temperature and salt resulted in very low survival, and this effect was strongest in roadside populations. Taken together, these results suggest that temperature is an important stressor capable of exacerbating impacts from a prominent contaminant confronting many freshwater organisms in salinized habitats. More broadly, it appears likely that toxicity might often be underestimated in the absence of multi-stressor approaches. © 2024 Elsevier Ltd

Alumni from an Assistive Technology (AT) graduate program were invited to complete a survey and participate in focus groups to share how they are using the knowledge gained from their graduate degree and its impact on their professional careers. The sample of 27 alumni spanned seven years and a variety of professional backgrounds. This qualitative single-case study revealed impacts on careers, professional skill development, and technology skills after graduation. Participants also connected this later skill development to their concrete learning experiences within the graduate program.

The impact of trauma on mental health has led to the increased development of trauma-informed organizations. Little is known, however, about the benefits of using a trauma-informed care perspective within a faith-based setting, particularly among Latino communities. This article reviews the literature and identifies gaps suggesting the problem of a lack of mental health and trauma-informed awareness among places of worship. The need for developing trauma-informed ministries within places of worship is recommended to assist in promoting the psychological, emotional, and spiritual well-being of congregants and community members within faith-based settings. © 2024 Taylor & Francis.

Drug waste poses a real threat to human health and the environment. Therefore, recycling and sustainability scholars have recently sought practical solutions to the drug waste problem. Furthermore, several governments have made significant efforts to reduce the negative effects of waste, such as establishing programs to take back unwanted drugs (expired and unused) for recycling (i.e., drug reuse or drug redispersing). However, many of these programs have failed to achieve their goals. In this context, it is expected that creating green start-ups to collect unwanted drugs will contribute to solving this problem. Accordingly, this study aims to investigate the antecedents of intentions to create green start-ups for collecting unwanted drugs. To this end, the authors integrate start-up self-efficacy and drug waste collection-related knowledge constructs into the theory of planned behavior (TPB). Using a self-administered paper questionnaire and relying on a convenience sample, data were collected from 328 students in six Algerian universities. A hierarchical multiple regression was conducted to test the proposed study model. Theresults revealed that perceived behavioral control (PBC) (β = 0.187, p < 0.001), attitudes (β = 0.182, p = 0.002), start-up self-efficacy (β = 0.169, p = 0.001), drug waste collection-related knowledge (β = 0.161, p < 0.001), and subjective norms (β = 0.088, p < 0.05) have a positive significant effect on the intention to create a start-up to collect unwanted drugs. In conclusion, this paper contributes to reducing drug waste by investigating the drivers of intention to create green start-ups for collecting unwanted drugs. Therefore, our study is expected to provide valuable insights for hospitals, pharmacies, pharmaceutical manufacturers, environmental protection associations, and stakeholders interested in reverse logistics. © 2024 by the authors.

Background: Limited research has been done on nursing students’ awareness of racial disparities and their readiness to address bias and racism in clinical practice. Purpose: This study investigated nursing students' perceptions of how racial disparities affect health outcomes, including maternal outcomes, in the United States. Methods: Interpretive description was used and supported by the critical race theory as a framework to guide the data collection, analysis, and interpretation to understand participants’ perceptions surrounding racism and health disparities. Discussion: Nurse educators should guide students to look beyond individual behavioral and risk factors and consider systemic issues as a leading contributors to health disparities. Conclusion: The most critical finding was the lack of participants’ understanding of systemic racism and its impact on health disparities. While they often attributed racial disparities to low socioeconomic status and lack of education, they did not understand the relationships between social determinants of health and systemic racism. © 2024

This chapter presents Hybrid Whale Optimization Algorithm (HWOA) to tackle the stubborn problems of local optima traps and initialization sensitivity of the K-means clustering technique. This work was inspired by the popularity and robustness of meta-heuristic algorithms in providing compelling solutions, which sparked several effective approaches and computational tools to address challenging real-world problems. The Chameleon Swarm Algorithm (CSA) is embedded with the bubble-net mechanism of WOA to help the search agents of HWOA effectively explore and exploit each potential area of the search space, enhancing the capability of both exploitation and exploration aspects of the classic WOA. Additionally, the search agents of HWOA use a rotation mechanism to relocate to new spots outside of nearby areas to conduct global exploration. This process increases the search efficiency of WOA while also enhancing the diversity and intensity behavior of the search agents. These improvements to HWOA increase its capacity for exploitation and broaden the range of search scopes and directions in performing clustering tasks. To assess the effectiveness of the proposed HWOA on clustering activities, a total of ten distinct datasets from the UCI are used, each with a different level of complexity. According to the experimental findings, the proposed HWOA outperforms eight meta-heuristic algorithms-based clustering and the conventional K-means clustering technique by a statistically significant margin in terms of performance distance metric.

Diabetes mellitus is a chronic disease affecting over 38.4 million adults worldwide. Unfortunately, 8.7 million were undiagnosed. Early detection and diagnosis of diabetes can save millions of people’s lives. Significant benefits can be achieved if we have the means and tools for the early diagnosis and treatment of diabetes since it can reduce the ratio of cardiovascular disease and mortality rate. It is urgently necessary to explore computational methods and machine learning for possible assistance in the diagnosis of diabetes to support physician decisions. This research utilizes machine learning to diagnose diabetes based on several selected features collected from patients. This research provides a complete process for data handling and pre-processing, feature selection, model development, and evaluation. Among the models tested, our results reveal that Random Forest performs best in accuracy (i.e., 0.945%). This emphasizes Random Forest’s efficiency in precisely helping diagnose and reduce the risk of diabetes.

The nostos, the return home in Greek mythology, is most often a journey over the sea, and it is the god Poseidon who rules the sea, both ensuring the safe passage of fishermen and sailors and causing disasters to individuals like Ajax son of Oileus, sometimes through obstacles like his daughter Charybdis. Most famously, he uses his power to hinder the nostos of Odysseus, all the while knowing he cannot prevent him from reaching home. This example illustrates how a god who may once have been the most powerful deity can no longer control ultimate results. As his power declines over the centuries, that of Zeus increases. It is also by sea that we see the ships in Isaiah 23, attempting to return to their homes in Sidon and Tyre on the eastern Mediterranean coast. In this Biblical passage from the eighth century BCE, the ships wail when they see that their seaport homes have been destroyed; there are no homes to which they can return. The great god of the Sea and the epichoric gods have failed to protect the cities which are considered their progeny. The Israelite prophet mocks their powerlessness and celebrates the power of his One God. There is no nostos, no homecoming for ships because they no longer have homes. Just as Poseidon could not prevent Odysseus from his nostos, the so-called Averter of Disaster has not prevented the disaster that has befallen his children. © 2023 Akadémiai Kiadó, Budapest.