Université Saint-Louis

The Mississippi–Atchafalaya River Basin (MARB) drains approximately 40% of the continental United States and discharges into the Northern Gulf of Mexico, where a large area of benthic hypoxia forms in late summer, largely in response to N loads from the MARB. Trend analysis revealed changes in nitrate-N (NO 3 -N) loads in MARB subbasins from 2000 to 2020, although causes are uncertain. Net anthropogenic N inputs (NANI), the net of estimated N inputs and outputs from human activities, has been correlated with riverine N loads in many regions worldwide. Here, we incorporate reported changes in crop N content and biological N fixation into NANI estimates and investigate correlations with flow-normalized (FN) riverine N yields from 217 watersheds in the MARB. Reductions in crop N content in corn and soybean influenced values of NANI but had little influence on NANI correlations with riverine FN NO 3 -N, which generally ranged from 0.5 to 0.7. In the late 1990s and early 2000s, NANI values and FN NO 3 -N yields were generally high for watersheds with a high percentage of cultivated cropland and tile drainage; by 2020, both NANI and FN NO 3 -N yields from these watersheds had declined. The magnitude of the decline in FN NO 3 -N yields from watersheds with greater than 20% tile drainage averaged 552 kg N km −2 year −1 . In these watersheds, the largest reductions in NANI were due to greater N harvest in maize and wheat with little change in N fertilizer, and a reduction in atmospheric N deposition.

Project Northstar is a variable-impulse hybrid rocket engine under development at Saint Louis University’s Rocket Propulsion Lab (SLURPL) for use in sounding rocket research. The engine is designed for seamless integration with rockets for the International Rocketry and Engineering Challenge (IREC). Northstar is classified as an O4200 hybrid engine, utilizing solid PMMA fuel and liquid nitrous oxide as the oxidizer. It is designed to deliver a total impulse of 5,000 lbf·s with an average thrust of 1,000 lbf. Hybrids allow for throttleable engines which allow for better flight control and safety. The project focuses on two objectives which are to provide the experience and infrastructure for SLURPL’s hybrid program and to have altitude control enabled by a throttleable hybrid engine. Additionally, the program is structured into two iterative development cycles: Northstar V1, emphasizing foundational hybrid engine capabilities, and Northstar V2, which serves as the final flight article for the 2026 IREC.

Abstract Background Cardiovascular disease (CVD) and cancer are the leading causes of mortality in the U.S., with significant overlap in risk factors and outcomes. This study examines the burden of CVD in cancer-related deaths using the Reporting Odds Ratio (ROR) to identify disparities by sex, race, region, and urbanization from 1999 to 2020. Methods A disproportionality analysis was conducted to calculate ROR of CVD burden in cancer patients compared to non-cancer population across age groups 15–85 years. A ROR greater than 1 indicated a higher burden of CVD in cancer patients. Average Annual Percentage Changes (AAPCs) were calculated to evaluate trends, with p-values determining significance. Results The highest ROR across age groups was in the 15–24 group at 1.83, declining to 0.34 in ages 55–64, and rising to 0.56 in ages 85+. The yearly trends showed ROR increased in all groups, with the highest increase in 55–64 group (AAPC: 1.69). Males exhibited higher RORs than females, with the steepest increase in middle-aged females (AAPC: 2.59). Young Hispanics had the highest ROR among racial groups (15–24: 2.558), while the Midwest showed the highest regional ROR (15–24: 2.311). Urban areas had higher RORs than rural areas, with medical facilities reporting the highest RORs. Conclusion This study highlights significant disparities in CVD burden among cancer patients, with younger individuals, males, Hispanics, and urban residents at higher risk. The trends underscore the need for targeted cardio-oncological interventions, to mitigate the increasing burden of CVD and cancer. Addressing systemic disparities in healthcare access and delivery is critical to improving outcomes.

Correction to: Nature Communicationshttps://doi.org/10.1038/s41467-025-62319-3, published online 7 August 2025 In this article the author name Adele Mitrotti was incorrectly written as Adele Mittrori. In addition, several affiliations were incorrect: the affiliation for Monika Miklaszewska and Katarzyna Zachwieja should have been ‘Department of Pediatric Nephrology and Hypertension, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland’; for Isabella Pisani, ‘Nephrology Unit, Parma University Hospital, Parma, Italy’; for Valeria Grandinetti, ‘Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy’; and for Olga Baraldi, ‘Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.’ The original article has been corrected.

Key Home Message: Ectopic esophageal sebaceous glands are rare, benign lesions that may mimic more serious pathology. Recognition of this condition can prevent unnecessary interventions, guide management focused on symptom control, and provide reassur

Abstract Background Trust in health insurance plays a crucial role in shaping individuals’ engagement with healthcare services, particularly as insurers assume more proactive roles in care delivery. However, limited research has examined which factors influence trust in health insurance plans and companies at the national level. Methods We used data from 7,702 adults in the 2021 Health Reform Monitoring Survey (HRMS) to assess factors associated with trust in health insurance. The primary outcome was a binary indicator of trust, derived from agreement with the statement: “I trust my health insurance plan and company.” Weighted bivariate analyses were employed to assess the relationships between trust and sociodemographic, health-related, and insurance-related characteristics. Variables significantly associated with trust in bivariate analyses were included in a multivariate logistic regression model to assess their independent effects. All analyses accounted for the survey’s probability weights. Results Among the 7,702 respondents, 69.1% reported trusting their health insurance provider. In bivariate analyses, trust varied significantly by age, race, education, income, self-rated health, usual source of care, type of insurance, perceived respect from the insurer, and perceived affordability of care (all p < 0.01). In the multivariate logistic regression model, individuals with better health status, lower income, lower education, a usual source of care, or non-private insurance had higher odds of trusting their insurance. Notably, respondents who felt respected by their insurer had substantially higher odds of reporting trust (adjusted odds ratio (OR) = 67.41; 95% confidence interval (CI): 52.25–86.97). Perceived affordability of care was also positively associated with trust (adjusted OR = 1.21 per unit increase in score; 95% CI: 1.11–1.31). Race and age were not independently associated with trust after adjusting for other variables. Conclusions Both access-related experiences and perceived interpersonal respect from insurers shape conclusions about trust in health insurance. These findings underscore the importance of fostering dignity and responsiveness in insurance interactions, as well as addressing affordability barriers to strengthen beneficiaries’ trust, particularly as insurers assume a greater role in population health and care coordination.

General chemistry lectures and laboratories provide an essential foundation for students pursuing careers in science, technology, engineering, mathematics (STEM), and other fields that require a foundational understanding of chemistry. However, traditional general chemistry lab curricula often rely on “cookbook-style” procedures, which limit critical thinking due to minimal opportunities for experimental design or connections to real-world applications. While various laboratory curriculum reforms have been proposed to foster active engagement and critical thinking, many of these are logistically challenging and difficult to implement in large enrollment courses. In response, we present an alternative approach for transforming a traditional “cookbook-style” laboratory curriculum, which incorporates targeted curriculum enhancements aimed at achieving two key objectives: first, to create value in students’ learning experiences, and second, to establish meaningful connections between chemistry and real-world applications. After implementation of these changes, we observed statistically significant, positive changes in student responses to survey questions evaluating their perceptions of course value. Students who took the course after curriculum enhancements indicated that the course had more real-world value, the concepts and techniques they learned were more important, and they enjoyed the course more than students who took the course prior to enhancements.

Background: Health equity remains an enduring global challenge, with social determinants of health (SDOH)—such as income, education, housing, and employment—playing a pivotal role in shaping health outcomes. Despite advances in healthcare interventions, systemic inequities persist worldwide. Policy reforms targeting these determinants are increasingly recognized as critical to reducing disparities and achieving sustainable health improvements. Objective: This systematic review aimed to synthesize and critically evaluate global policy reforms addressing SDOH and promoting health equity across diverse populations. Methods: Adhering to PRISMA guidelines, a comprehensive search was conducted across five academic databases and relevant grey literature sources between January and March 2024. Out of 243 initially identified studies, 43 met the inclusion criteria following title/abstract screening and full-text review. Eligibility required: (i) national or subnational policy reforms targeting SDOH, (ii) explicit evaluation of health equity outcomes, and (iii) publication in English from 2010 to 2024. Key data on policy type, targeted determinants, equity outcomes, and evaluation methods were systematically extracted and thematically analyzed using established frameworks. Results: The included studies represented reforms from six global regions, with a majority based in high-income countries but notable examples from low- and middle-income settings. Successful policies shared common features: multisectoral collaboration, equity-centered design, community engagement, and robust monitoring and evaluation frameworks. Policy types encompassed universal healthcare, conditional cash transfers, education, and housing reforms. Common equity indicators included income, geographic location, race/ethnicity, and gender. Among the studies included, 70% reported quantifiable improvements in equity outcomes, while 30% lacked rigorous evaluation frameworks, limiting assessment of long-term impact. Conclusion: Policy reforms addressing upstream SDOH are essential for advancing health equity. Integrating equity considerations across all sectors, fostering intersectoral governance, and investing in robust monitoring systems offer promising pathways to reduce health disparities globally. However, persistent gaps in evaluation, particularly in low- and middle-income countries, highlight the need for sustained research and investment in comprehensive policy assessment.

BackgroundTandem lesions pose unique challenges in the endovascular treatment of acute ischemic stroke. We aimed to compare the clinical and procedural outcomes of patients with tandem lesions and extracranial internal carotid artery (ICA) complete occlusion versus those with moderate to severe stenosis.MethodsThis is a subanalysis of a multicenter cohort of patients with acute anterior circulation tandem lesions treated with intracranial mechanical thrombectomy and carotid artery stenting, between January 2015 and December 2020. The patients were categorized into 2 groups: extracranial ICA stenosis >70% to 99% and complete occlusion. Outcomes included successful and excellent recanalization, functional independence, symptomatic intracranial hemorrhage, and puncture‐to‐recanalization time. Sensitivity analyses were conducted based on varying degrees of stenosis, and we explored interactions with age, Alberta Stroke Program Early CT [Computed Tomography] Score, National Institutes of Health Stroke Scale, procedural antiplatelets, ICA treatment approach, ICA lesion etiology, Intravenous thrombolysis, and use of a balloon‐guide catheter.ResultsThe study included 323 patients; 166 (51.4%) of whom presented with ICA occlusion and 157 (48.6%) with severe stenosis. Patients with ICA occlusion had significantly higher rates of previous stroke/transient ischemic attack, and antegrade ICA treatment approach. The comparison between both groups in univariable and multivariable analysis revealed no significant differences in the rates of successful and excellent recanalization, functional independence, symptomatic intracranial hemorrhage, and additional outcomes. The median puncture‐to‐recanalization time was longer in the occlusion group (adjusted coefficient, 1.21 [95% CI 1.01–1.46], P = 0.05). When categorized into 3 groups (occlusion, severe, and moderate stenosis), median puncture‐to‐recanalization time was significantly higher in patients with occlusion (adjusted coefficient, 1.34 [95% CI, 1.04–1.71], P = 0.022), and a trend toward statistical significance was observed in patients with severe stenosis (adjusted coefficient, 1.29 [95% CI, 0.98–1.71], P = 0.068), compared with patients with moderate stenosis. Interaction analysis did not yield significant differences.ConclusionIn patients with tandem lesions, those with ICA occlusion presented longer puncture‐to‐recanalization time than patients with cervical stenosis. This observation might be linked to higher rates of an antegrade approach in patients with ICA occlusion.