Miracle-dz/UniFAR-FTUs huggingface dataset:
PrEP Stigma and logistical barriers remain significant challenges in curtailing HIV transmission among Black and Hispanic/Latinx cisgender sexual minority men and transgender women in the US

ABSTRACT Despite advancements in HIV prevention, such as pre-exposure prophylaxis (PrEP), there remain inequities in accessing PrEP among Black and Hispanic/Latinx cisgender sexual minority men and transgender women (SMMTW). Researchers have documented multiple barriers to PrEP uptake, yet the relative impacts of PrEP internalized stigma and logistical barriers (e.g., Cost; time) to PrEP use are understudied. It may be meaningful to investigate potential interactions between internalized stigma and logistical barriers to PrEP use. We utilized data from 827 Black and Hispanic/Latinx SMMTW (M age = 25.09) in the US and found that greater PrEP-related internalized stigma and greater PrEP logistical barriers were independently significantly associated with lower likelihood of current PrEP use, but PrEP-related internalized stigma became a non-significant predictor when included in a multivariable model. We found a significant interaction between PrEP-related internalized stigma and logistical barriers to PrEP use, such that the association between internalized stigma and likelihood of current PrEP use was only significant at lower levels of logistical barriers to PrEP use. Findings highlight the need to reduce logistical barriers to PrEP use, and for clinicians to acknowledge the role of stigma for individuals who otherwise do not report logistical barriers.
Distinct response properties between the FFA to faces and the PPA to houses

The object recognition system involves both selectivity to specific object category and invariance to changes in low‐level visual features. Mounting neuroimaging evidence supports that brain areas in the ventral temporal cortex, such as the FFA and PPA, respond preferentially to faces and houses, respectively. However, how regions in human ventral temporal cortex partitioned and functionally organized to selectively and invariantly respond to different object categories remains unclear. What are the changes of response properties at the intersection of adjacent but distinctively‐selective regions?
Comorbid Chronic Diseases and Survival in Compensated and Decompensated Cirrhosis: A Population-Based Study

INTRODUCTION: The burden of liver disease is substantial and increasing; the impact of comorbid chronic diseases on the clinical course of patients with compensated and decompensated cirrhosis is not well-defined. The aim of this study was to examine the individual and additive impact of comorbid chronic diseases on mortality in patients with cirrhosis. METHODS: In this population-based study, we used Cox proportional hazards modeling with time-dependent covariates to assess the impact of comorbid chronic diseases (diabetes mellitus, chronic kidney disease, and cardiovascular disease [CVD]) on mortality in patients with cirrhosis in a large, diverse Metroplex. RESULTS: There were 35,361 patients with cirrhosis (mean age 59.5 years, 41.8% females, 29.7% non-White, and 17.5% Hispanic ethnicity). Overall, the presence of chronic comorbidities was 1 disease (28.9%), 2 diseases (17.5%), and 3 diseases (12.6%) with a majority having CVD (45%). Adjusted risk of mortality progressively increased with an increase in chronic diseases from 1 (hazard ratio [HR] 2.5, 95% confidence interval [CI] 2.23–2.8) to 2 (HR 3.27.95% CI 2.9–3.69) to 3 (HR 4.52, 95% CI 3.99–5.12) diseases. Survival of patients with compensated cirrhosis and 3 chronic diseases was similar to subsets of decompensated cirrhosis (67.7% as compared with decompensated cirrhosis with 1–3 conditions, 61.9%–63.9%). DISCUSSION: In patients with cirrhosis, a focus on comorbid chronic disease(s) as potential management targets may help avoid premature mortality, regardless of etiology. Multidisciplinary care early in the clinical course of cirrhosis is needed in addition to the current focus on management of complications of portal hypertension.
Serious illness conversations in South Africa

Dear Editor Research conducted by Lawton et al. sheds light on the perspectives of internal medicine residents in having serious illness conversations. Primarily, our lived experiences as a medical doctor, scholar of medical education (LG) and internal medicine registrar (PS) corroborates the findings of Lawton et al. However, as we practice in South Africa, we note that our setting has presented unique communication challenges, which we outline below. As our diverse and resource-constrained setting mimics many others internationally, we present this letter to your global readership for consideration. In a heterogeneous and diverse South African setting, language barriers are a significant challenge in serious illness conversations; the clinician and the patient (or their family) may simply not understand each other. This challenge is further exacerbated in our setting, where communication training is not available for internal medicine registrars (referred to as residents in other parts of the world). As such, rolemodelling, observing and adopting the practice of senior colleagues have been central to our informal communication curriculum. Finally, in our setting, it is not merely that we lack the time for serious illness conversations; we often lack the space. Hospitals are over-burdened. There is limited quiet and private space available to conduct these difficult conversations. While the factors outlined above pose a challenge, they also represent opportunities for research. Additionally, they highlight the dedication of clinicians who continue to engage in serious illness conversations, despite the odds stacked against them.
Behavior of Materials in RADIANCE

R( → P, v) Value of a ray starting at → P in direction v (in watts/sr/mˆ2) → Po Eye ray origin v Eye ray direction → Ps Intersection point of ray with surface n Unperturbed surface normal at intersection an Real argument number n C Material color, {a1, a2, a3} p Material pattern value, {1, 1, 1} if none → d Material texture vector, [0, 0, 0] if none → b Orientation vector given by the string arguments of anisotropic types n1 Index of refraction on eye ray side n2 Index of refraction on opposite side A Indirect irradiance (in watts/mˆ2) At Indirect irradiance from opposite side (in watts/mˆ2) m Mirror direction, which can vary with Monte Carlo sampling ts Specular threshold (set by -st option) Bi Radiance of light source sample i (in watts/sr/mˆ2) qi Direction to source sample i ω i Solid angle of source sample i (in sr)
Structural insights into Pot1-ssDNA, Pot1-Tpz1 and Tpz1-Ccq1 Interactions within fission yeast shelterin complex

The conserved shelterin complex caps chromosome ends to protect telomeres and regulate telomere replication. In fission yeast Schizosaccharomyces pombe, shelterin consists of telomeric single- and double-stranded DNA-binding modules Pot1-Tpz1 and Taz1-Rap1 connected by Poz1, and a specific component Ccq1. While individual structures of the two DNA-binding OB folds of Pot1 (Pot1OB1-GGTTAC and Pot1OB2-GGTTACGGT) are available, structural insight into recognition of telomeric repeats with spacers by the complete DNA-binding domain (Pot1DBD) remains an open question. Moreover, structural information about the Tpz1-Ccq1 interaction requires to be revealed for understanding how the specific component Ccq1 of S. pombe shelterin is recruited to telomeres to function as an interacting hub. Here, we report the crystal structures of Pot1DBD-single-stranded-DNA, Pot1372-555-Tpz1185-212 and Tpz1425-470-Ccq1123-439 complexes and propose an integrated model depicting the assembly mechanism of the shelterin complex at telomeres. The structure of Pot1DBD-DNA unveils how Pot1 recognizes S. pombe degenerate telomeric sequences. Our analyses of Tpz1-Ccq1 reveal structural basis for the essential role of the Tpz1-Ccq1 interaction in telomere recruitment of Ccq1 that is required for telomere maintenance and telomeric heterochromatin formation. Overall, our findings provide valuable structural information regarding interactions within fission yeast shelterin complex at 3’ ss telomeric overhang.
Diagnostic Accuracy of Centrally Restricted Diffusion Sign in Cerebral Metastatic Disease: Differentiating Radiation Necrosis from Tumor Recurrence

Purpose: The centrally restricted diffusion sign of diffusion-weighted imaging (DWI) is associated with radiation necrosis (RN) in treated gliomas. Our goal was to evaluate its diagnostic accuracy to distinguish RN from tumor recurrence (TR) in treated brain metastases. Methods: Retrospective study of consecutive patients with brain metastases who developed a newly centrally necrotic lesion after radiotherapy (RT). One reader placed regions of interest (ROI) in the enhancing solid lesion and the non-enhancing central necrosis on the apparent diffusion coefficient (ADC) map. Two readers qualitatively assessed the presence of the centrally restricted diffusion sign. The final diagnosis was made by histopathology (n = 39) or imaging follow-up (n = 2). Differences between groups were assessed by Fisher’s exact or Mann–Whitney U tests. Diagnostic accuracy and inter-reader agreement were evaluated using receiver operating characteristic (ROC) curve analysis and kappa scores. Results: Forty-one lesions (32 predominant RN; 9 predominant TR) were analyzed. An ADC value ≤ 1220 × 10-6 mm2/s (sensitivity 74%, specificity 89%, area under the curve [AUC] .85 [95% confidence interval {CI}, .70–.94] P < .0001) from the necrosis and an ADC necrosis/enhancement ratio ≤1.37 (sensitivity 74%, specificity 89%, AUC .82 [95% CI, .67–.93] P < .0001) provided the highest performance for RN diagnosis. The qualitative centrally restricted diffusion sign had a sensitivity of 69% (95% CI, .50–.83), specificity of 77% (95% CI, .40–.96), and a moderate (k = .49) inter-reader agreement for RN diagnosis. Conclusions: Radiation necrosis is associated with lower ADC values in the central necrosis than TR. A moderate interobserver agreement might limit the qualitative assessment of the centrally restricted diffusion sign.
Differences in psychotherapy preferences between psychotherapy trainees and laypeople

Abstract Objective: Despite increasing research on psychotherapy preferences, the preferences of psychotherapy trainees are largely unknown. Moreover, differences in preferences between trainees and their patients could (a) hinder symptom improvement and therapy success for patients and (b) represent significant obstacles in the early career and development of future therapists. Method: We compared the preferences of n = 466 psychotherapy trainees to those of n = 969 laypersons using the Cooper-Norcross Inventory of Preferences. Moreover, we compared preferences between trainees in cognitive–behavioural therapy (CBT) and psychodynamic trainees. Results: We found significant differences between both samples in 13 of 18 items, and three of four subscales. Psychotherapy trainees preferred less therapist directiveness (d = 0.58), more emotional intensity (d = 0.74), as well as more focused challenge (d = 0.35) than laypeople. CBT trainees preferred more therapist directiveness (d = 2.00), less emotional intensity (d = 0.51), more present orientation (d = 0.76) and more focused challenge (d = 0.33) than trainees in psychodynamic/psychoanalytic therapy. Conclusion: Overall, the results underline the importance of implementing preference assessment and discussion during psychotherapy training. Moreover, therapists of different orientations seem to cover a large range of preferences for patients, in order to choose the right fit.
A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study

Individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone. There is growing evidence that emphasizing physical and mental wellness is equally crucial for improving functioning among people with RA. The purpose of this formative study is to examine the feasibility of offering the wellness-based intervention (“KickStart30”) in patients with RA. Thirteen individuals with RA on targeted immune modulators (a biologic or JAK inhibitor) enrolled in the KickStart30 program. Participants completed self-report measures of RA-specific disability (eg, pain) and other functional areas (eg, mood) in a pre- versus post- intervention design. Paired samples t-tests (and Related-Samples Wilcoxon Signed Rank Tests for non-normal distributions) detected statistically significant results for 10 of 12 measures, including reductions in pain (M = 4.54 to M = 3.54; p = .025; BPI), functional disability (M = 0.94 to M = 0.73, p = .032; HAQ-II), cognitive and physical dysfunction (M = 25.46 to M = 13.54, p < .001; CPFQ), depressive symptoms (M = 9.31 to M = 5.54, p = .003; PHQ-9), anxiety (M = 5.69 to M = 3.23, p = .005; GAD-7), insomnia (M = 11.62 to M = 17.32, p = .007; Note: higher scores on the SCI indicate less insomnia), stress-related eating (M = 75.46 to M = 84.54, p = .021; Note: higher scores on the EADES indicate less stress-related eating), along with significant increases in mindfulness (M = 62.54 to M = 67.85, p = .040; MAAS), mental wellness (M = 4.46 to M = 5.69; HERO), and well-being (Md = 8.00 to Md = 5.00, p = .004; WHO-5). All significant measures had medium to large effect sizes (Cohen's d). The study gives preliminary support for the possibility that the adjunct intervention may have an effect.
A comparison of nomothetic and individualized alpha frequency approaches to measuring frontal EEG alpha asymmetry.

Frontal alpha asymmetry (FAA) is considered to be a reliable marker of affective processing and psychopathology. Traditionally, the magnitude of alpha is calculated by taking the average over a nomothetic fixed frequency window (e.g., 8 to 13 Hz). Alternatively, methods have been proposed to extract individualized alpha frequency (IAF) peaks and windows in hopes of improving the reliability and validity of signal detection. However, no study has compared the nomothetic to IAF approaches to examine the reliability and validity of resting FAA in a large well-characterized data set. In this study, we assessed the psychometric performance of the standard fixed window approach, a PZ-alpha based IAF approach and a global-alpha based IAF windows detection approach on a previously collected EEG data set (8 recordings per subject collected on four occasions across two weeks). Our results revealed that resting FAA calculated with these three different methods are highly correlated at all frontal regions (mean r = .98). The stability across the 8 recordings over the two weeks also showed no substantial difference between approaches as indicated by intraclass correlations. Moreover, internal-consistency reliability, validity with respect to measures of emotion and emotion-related psychopathology and state-trait Structure equation model (SEM) fitting were evaluated and yielded no significant differences across methods. Our results supported the overall reliability and validity of two different IAF approaches to assessing resting FAA but fail to find any incremental advantage over nomothetic approaches to defining alpha bands. Guidelines for methods selection for future research are provided.
Substance use treatment services for older adults in five states in the Southern United States: a state-by-state comparison of available treatment services

Abstract Objectives: Substance use disorders (SUD) among older adults have become a serious public health concern. The purpose of this study was to assess which states in the Southern U.S. are more responsive to SUD treatment needs of older adults.Methods: This study is a secondary data analysis of the N-SSATS-2019 dataset.Results: There were 1,215 substance treatment facilities in the five states. Kentucky had the highest number of substance use treatment facilities (n = 449, 37%), followed by Georgia (357, 29%), Alabama (153, 13%), Louisiana (146, 12%) and then Mississippi (110, 9%). Out of the 1,215 facilities, only 20% (n = 244) indicated that they had programs specifically tailored for older adults. Kentucky had the largest number of facilities per 1 million older adults while Mississippi had the highest number of facilities per 1 million older adults offering detoxification services. Alabama had the lowest number of services per 1 million adults in all categories examined.Conclusion: Across the U.S., most adults with SUD do not have access to substance use treatment; in the southeastern region of the country, higher rates of poverty, rural geography and stigma, and lack of treatment availability may further complicate individuals’ ability to access substance use-related medical care.
Neural reactivity to affective stimuli and internalizing symptom dimensions in a transdiagnostic patient sample

Internalizing psychopathologies (IPs) are highly comorbid and exhibit substantial overlap, such as aberrant affective reactivity. Neural reactivity to emotional images, measured via the late positive potential (LPP) event‐related potential (ERP) component, has been utilized to index affective reactivity in IPs. The LPP is often examined in isolation with a specific disorder, ignoring overlap between IPs. The current study examined how transdiagnostic IP symptom dimensions relate to neural affective reactivity in a highly comorbid patient sample.
Prevalence of allergic sensitization with vernal keratoconjunctivitis: A systematic review with meta‐analyses

To determine the prevalence of allergic sensitization in patients with vernal keratoconjunctivitis (VKC) and to provide an overview of published studies on this topic. We systematically searched 11 literature databases on 24 May 2021, for studies with cross‐sectional data on the prevalence of positive allergy tests in patients with VKC. Our main outcome of interest was the prevalence of allergic sensitization and the allergens involved. Prevalence meta‐analyses were made to provide summary estimates. We identified 33 eligible studies for qualitative review with 2122 patients with VKC. Studies were predominantly based on patients seen in ophthalmology clinics. Overall, studies reported that the most prevalent positive allergen tests were the inhaled allergens house dust mites and pollen. Twenty‐nine studies were eligible for the quantitative analysis. Here, we calculated the prevalence of allergen‐positive patients to 57.7% (95% confidence interval: 52.5%–62.8%). Subgroup analyses of pooled estimates on sensitization based on specific testing methods found prevalence estimates of 51.4% for conjunctival provocation test, 68.7% for total tear IgE, 58.9% for specific tear IgE, and 58.2% for skin prick test. The prevalence of allergic sensitization in patients with VKC is 57.7%, and mostly towards inhaled allergens. The most frequent positive allergens are house dust mites and pollen. Identifying possible clinically relevant allergens provide information that may aid in managing VKC, such as environmental allergy‐avoidance or allergy‐specific treatment.
Chromosome‐level genome assembly defines female‐biased genes associated with sex determination and differentiation in the human blood fluke Schistosoma japonicum

Schistosomiasis is a neglected tropical disease of humans caused by blood flukes of the genus Schistosoma, the only dioecious parasitic flatworm. Although aspects of sex determination, differentiation and reproduction have been studied in some Schistosoma species, almost nothing is known for Schistosoma japonicum, the causative agent of schistosomiasis japonica. This mainly reflects the lack of high‐quality genomic and transcriptomic resources for this species. As current genomes for S. japonicum are highly fragmented, we assembled and report a chromosome‐level reference genome (seven autosomes, the Z‐chromosome and partial W‐chromosome), achieving a substantially enhanced gene annotation. Utilizing this genome, we discovered that the sex chromosomes of S. japonicum and its congener S. mansoni independently suppressed recombination during evolution, forming five and two evolutionary strata, respectively. By exploring the W‐chromosome and sex‐specific transcriptomes, we identified 35 W‐linked genes and 257 female‐preferentially transcribed genes (FTGs) from our chromosomal assembly and uncovered a signature for sex determination and differentiation in S. japonicum. These FTGs clustering within autosomes or the Z‐chromosome exhibit a highly dynamic transcription profile during the pairing of female and male schistosomula, thereby representing a critical phase for the maturation of the female worms and suggesting distinct layers of regulatory control of gene transcription at this development stage. Collectively, these data provide a valuable resource for further functional genomic characterization of S. japonicum, shed light on the evolution of sex chromosomes in this highly virulent human blood fluke, and provide a pathway to identify novel targets for development of intervention tools against schistosomiasis.
An algebraic p-adic L-function for ordinary families

In this thesis, we construct algebraic p-adic L-functions for families of Galois representations attached to p-adic analytic families of automorphic representations using the formalism of Selmer complexes. This is achieved mainly through making a modification of the Selmer complex to ensure that we deal with perfect complexes and proving a control theorem for the local Euler factors at places not lying above p. The control theorem for local Euler factors is obtained by studying the variation of monodromy under pure specializations of p-adic families of Galois representations restricted to decomposition groups at places of residue characteristic different from p. This allows us to prove a control theorem for the algebraic p-adic L-functions that we construct for Hida families of ordinary cusp forms and ordinary automorphic representations for definite unitary groups. For the Hida family of ordinary cusp forms, we construct a two-variable algebraic p-adic L-function and formulate a conjecture relating it with the analytic p-adic L-function constructed by Emerton, Pollack and Weston. Using results due to Kato, Skinner and Urban, we prove this conjecture in some special cases.
Animal pollination increases stability of crop yield across spatial scales

Abstract The benefits of animal pollination to crop yield are well known. In contrast, the effects of animal pollination on the spatial or temporal stability (the opposite of variability) of crop yield remain poorly understood. We use meta‐analysis to combine variability information from 215 experimental comparisons between animal‐pollinated and wind‐ or self‐pollinated control plants in apple, oilseed rape and faba bean. Animal pollination increased yield stability (by an average of 32% per unit of yield) at between‐flower, ‐plant, ‐plot and ‐field scales. Evidence suggests this occurs because yield benefits of animal pollination become progressively constrained closer to the maximum potential yield in a given context, causing clustering. The increase in yield stability with animal pollination is greatest when yield benefits of animal pollination are greatest, indicating that managing crop pollination to increase yield also increases yield stability. These additional pollination benefits have not yet been included in economic assessments but provide further justification for policies to protect pollinators.