bluuebunny/crossref_metadata_2025 huggingface dataset:
Highly contiguous genome assembly of Drosophila prolongata—a model for evolution of sexual dimorphism and male-specific innovations
Authors: Luecke David , Luo Yige , Krzystek Halina , Jones Corbin , Kopp Artyom
Published: July 2024

Drosophila prolongata is a member of the melanogaster species group and rhopaloa subgroup native to the subtropical highlands of Southeast Asia. This species exhibits an array of recently evolved male-specific morphological, physiological, and behavioral traits that distinguish it from its closest relatives, making it an attractive model for studying the evolution of sexual dimorphism and testing theories of sexual selection. The lack of genomic resources has impeded the dissection of the molecular basis of sex-specific development and behavior in this species. To address this, we assembled the genome of D. prolongata using long-read sequencing and Hi–C scaffolding, resulting in a highly complete and contiguous (scaffold N50 2.2 Mb) genome assembly of 220 Mb. The repetitive content of the genome is 24.6%, the plurality of which are long terminal repeats retrotransposons (33.2%). Annotations based on RNA-seq data and homology to related species revealed a total of 19,330 genes, of which 16,170 are protein-coding. The assembly includes 98.5% of Diptera BUSCO genes, including 93.8% present as a single copy. Despite some likely regional duplications, the completeness of this genome suggests that it can be readily used for gene expression, genome-wide association studies (GWAS), and other genomic analyses.
Comparative transcriptomics provides insights into molecular mechanisms of zinc tolerance in the ectomycorrhizal fungus Suillus luteus
Authors: Smith Alexander , Fletcher Jessica , Swinnen Janne , Jonckheere Karl , Bazzicalupo Anna , Liao Hui-Ling , Ragland Greg , Colpaert Jan , Lipzen Anna , Tejomurthula Sravanthi , Barry Kerrie , V. Grigoriev Igor , Ruytinx Joske , Branco Sara
Published: July 2024

Zinc (Zn) is a major soil contaminant and high Zn levels can disrupt growth, survival, and reproduction of fungi. Some fungal species evolved Zn tolerance through cell processes mitigating Zn toxicity, although the genes and detailed mechanisms underlying mycorrhizal fungal Zn tolerance remain unexplored. To fill this gap in knowledge, we investigated the gene expression of Zn tolerance in the ectomycorrhizal fungus Suillus luteus. We found that Zn tolerance in this species is mainly a constitutive trait that can also be environmentally dependent. Zinc tolerance in S. luteus is associated with differences in the expression of genes involved in metal exclusion and immobilization, as well as recognition and mitigation of metal-induced oxidative stress. Differentially expressed genes were predicted to be involved in transmembrane transport, metal chelation, oxidoreductase activity, and signal transduction. Some of these genes were previously reported as candidates for S. luteus Zn tolerance, while others are reported here for the first time. Our results contribute to understanding the mechanisms of fungal metal tolerance and pave the way for further research on the role of fungal metal tolerance in mycorrhizal associations.
Selection with two alleles of X-linkage and its application to the fitness component analysis of OdsH in Drosophila
Authors: Sun Sha , Ting Chau-Ti , Wu Chung-I
Published: July 2024

In organisms with the XY sex-determination system, there is an imbalance in the inheritance and transmission of the X chromosome between males and females. Unlike an autosomal allele, an X-linked recessive allele in a female will have phenotypic effects on its male counterpart. Thus, genes located on the X chromosome are of particular interest to researchers in molecular evolution and genetics. Here we present a model for selection with two alleles of X-linkage to understand fitness components associated with genes on the X chromosome. We apply this model to the fitness analysis of an X-linked gene, OdsH (16D), in the fruit fly Drosophila melanogaster. The function of OdsH is involved in sperm production and the gene is rapidly evolving under positive selection. Using site-directed gene targeting, we generated functional and defective OdsH variants tagged with the eye-color marker gene white. We compare the allele frequency changes of the two OdsH variants, each directly competing against a wild-type OdsH allele in concurrent but separate experimental populations. After 20 generations, the two genetically modified OdsH variants displayed a 40% difference in allele frequencies, with the functional OdsH variant demonstrating an advantage over the defective variant. Using maximum likelihood estimation, we determined the fitness components associated with the OdsH alleles in males and females. Our analysis revealed functional aspects of the fitness determinants associated with OdsH, and that sex-specific fertility and viability consequences both contribute to selection on an X-linked gene.
People-centered primary care measures in health equity: a perspective of urban–rural comparison in Beijing, China
Authors: Peng Yingchun , Zhai Shaoqi , Zhang Zhiying , Zhang Ruyi , Zhang Jiaying , Jin Qilin , Zhou Jiaojiao , Chen Jingjing
Published: July 2024

Person-centered primary care measures (PCPCM) facilitate high-quality and culturally appropriate primary care. Access to PCPCM remains unequal between rural and urban areas, and the available evidence on rural PCPCM is still lacking. A cross-sectional survey was conducted with stratified sampling by regions, and four districts (Xicheng, Fengtai, Huairou, and Daxing) in Beijing were selected to test the performance of PCPCM in both urban and rural areas. Descriptive statistical methods were used to compare the urban–rural differences in the demographic characteristics of PCPCM. Correlation and regression analyses were performed to determine the associations between PCPCM in demographics and utilization of primary care. The PCPCM showed good reliability and validity in both urban and rural areas (P < .001), slightly lower in rural areas, but scores of rural PCPCM (R-PCPCM) in all items were lower than urban PCPCM (U-PCPCM). Patients in either the preferred urban or rural health centers all showed the highest PCPCM scores, with U-PCPCM= 3.31 for CHCs and R-PCPCM= 3.10 for RHCs, respectively. Patients in urban areas were more likely to receive higher-quality primary care than in rural areas (P < .001). Patients who preferred hospitals (β = 2.61, P < .001) or CHCs (β = 0.71, P = .003) as providers was a significant positive predictor of U-PCPCM but it was the preference for hospitals (β = 2.95, P < .001) for R-PCPCM. Urban–rural differences existed in the performance of PCPCM, with rural areas typically more difficult to access better PCPCM. To promote health equity in rural areas, healthcare providers should strive to minimize urban–rural differences in the quality and utilization of primary care services as much as feasible.
Christian Addiction: The Metaphor of Debt-Bondage in Roman Theology
Authors: McCracken Lucas
Published: July 2024

What exactly is addiction? Scholars, clinicians, and addicts themselves consistently arrive at a fork in the road in their respective quests for the meaning of addiction: choice or compulsion, crime or disease? Despite these many inquiries, one important aspect of addiction’s past remains unexamined—its deep theological history. Christian theologians writing in Latin from the second to the seventeenth century used the term addiction metaphorically to describe the sinful human condition. In this article, I uncover the genesis and development of the Christian addiction metaphor in the writings of Roman theologians Tertullian, Ambrose, and Augustine. I analyze their theologies of addiction to show how the language and logic of Roman pecuniary jurisprudence structures their thinking about sin, salvation, and free will. To conclude, I suggest that the disease-crime ambivalence constitutive of our contemporary understanding of addiction originated in their oxymoronic definition of sin as both generational enslavement and willful servitude.
Rationalizing irrational prescribing—infection-related attitudes and practices across paediatric surgery specialties in a hospital in South India
Authors: Surendran Surya , Nampoothiri Vrinda , Dhar Puneet , Holmes Alison , Singh Sanjeev , Charani Esmita
Published: July 2024

Background and objectives

Antibiotic use in paediatric surgical specialties is understudied. We investigated the antibiotic prescribing practices of paediatric general and cardiovascular surgical teams in a tertiary hospital in South India.

Methods

Mixed-methods study including observations from ward rounds, semi-structured interviews, and review of antibiotic prescribing. Field notes from observations and interview transcripts were coded using NVivo and thematically analysed. Data collection and analysis were iterative and continued until thematic saturation. Quantitative data were analysed using descriptive statistics.

Results

Data included 62 h of observation, 24 interviews, one case study and 200 patient chart reviews (100/specialty). Senior surgeons make key decisions, referring to their own experience when prescribing antibiotics. Being outcome-driven, the doctors often prescribe antibiotics at the earliest indication of infection with a reluctance to de-escalate, even when an infection is not diagnosed. This practice is more acute among surgeons who consider themselves responsible for their patients’ health and attribute the consistently low surgical site infection rates to this practice.

In general surgery, 83.3% (80/96; 4 lost to follow-up) of patients were prescribed antibiotics for the duration of their stay with oral antibiotics prescribed at discharge. The surgeons use antibiotics prophylactically for patients who may be vulnerable to infection. The antimicrobial stewardship team was considered to have limited influence in the decision-making process.

Conclusions

Outcome-driven decision-making in surgery leads to overprescription of antibiotics and prolonged surgical prophylaxis. The rationale for suboptimal practices is complicated by the surgeons’ beliefs about the contextual determinants of health in India.
Performance Evaluation of 2 FDA-Approved Fentanyl Immunoassays against LC-MS/MS Reference
Authors: Militello Leah , Gqamana Putuma P , McLean Betty , Laurey Jesse , Rudy Daniel , McMaster Jeffrey M , Zhang Y Victoria
Published: July 2024

Background

Fentanyl, a synthetic opioid, has caused many recent overdose deaths. Diagnosis of fentanyl abuse is not served by traditional opiate assays due to differences in chemical structure between synthetics and natural opioids. To our knowledge, this is the first study that uses liquid chromatography-tandem mass spectrometry (LC-MS/MS) as the reference method to evaluate and compare the ARK Fentanyl II Assay (ARK II) and the Fentanyl II Enzyme Immunoassay by Roche (FEN2). The ARK II is designed to detect fentanyl in urine samples, whereas the FEN2 is designed to detect norfentanyl, which is the major metabolite.

Methods

Two hundred patient urine samples including 100 positive and 100 negative samples according to an in-house LC-MS/MS assay were selected for the study. These samples were tested using the ARK II and the FEN2 to determine their performances relative to LC-MS/MS results.

Results

The FEN2 showed a positive and negative predictive value of 100% and 97% and a concordance with LC-MS/MS of 98.5% (kappa 0.97). The ARK II showed a positive and negative predictive value of 100% and 95% and a concordance with LC-MS/MS of 97.5% (kappa 0.95). Additionally, the FEN2 accurately identified 9 positive samples with a range of fentanyl concentrations from 0 to 18 ng/mL for which norfentanyl levels were less than the cutoff of 5 ng/mL, indicating potentially greater sensitivity than otherwise stated.

Conclusions

The FEN2 and the ARK II were evaluated to be similar in terms of positive and negative predictive value during the analysis of 200 patient samples, as well as equally concordant with the LC-MS/MS reference, despite differences in design.
Measuring cognitive effort using tabular transformer-based language models of electronic health record-based audit log action sequences
Authors: Kim Seunghwan , Warner Benjamin C , Lew Daphne , Lou Sunny S , Kannampallil Thomas
Published: July 2024

Objectives

To develop and validate a novel measure, action entropy, for assessing the cognitive effort associated with electronic health record (EHR)-based work activities.

Materials and Methods

EHR-based audit logs of attending physicians and advanced practice providers (APPs) from four surgical intensive care units in 2019 were included. Neural language models (LMs) were trained and validated separately for attendings’ and APPs’ action sequences. Action entropy was calculated as the cross-entropy associated with the predicted probability of the next action, based on prior actions. To validate the measure, a matched pairs study was conducted to assess the difference in action entropy during known high cognitive effort scenarios, namely, attention switching between patients and to or from the EHR inbox.

Results

Sixty-five clinicians performing 5 904 429 EHR-based audit log actions on 8956 unique patients were included. All attention switching scenarios were associated with a higher action entropy compared to non-switching scenarios (P < .001), except for the from-inbox switching scenario among APPs. The highest difference among attendings was for the from-inbox attention switching: Action entropy was 1.288 (95% CI, 1.256-1.320) standard deviations (SDs) higher for switching compared to non-switching scenarios. For APPs, the highest difference was for the to-inbox switching, where action entropy was 2.354 (95% CI, 2.311-2.397) SDs higher for switching compared to non-switching scenarios.

Discussion

We developed a LM-based metric, action entropy, for assessing cognitive burden associated with EHR-based actions. The metric showed discriminant validity and statistical significance when evaluated against known situations of high cognitive effort (ie, attention switching). With additional validation, this metric can potentially be used as a screening tool for assessing behavioral action phenotypes that are associated with higher cognitive burden.

Conclusion

An LM-based action entropy metric—relying on sequences of EHR actions—offers opportunities for assessing cognitive effort in EHR-based workflows.
Telemedicine appointments are more likely to be completed than in-person healthcare appointments: a retrospective cohort study
Authors: Cummins Mollie R , Tsalatsanis Athanasios , Chaphalkar Chaitanya , Ivanova Julia , Ong Triton , Soni Hiral , Barrera Janelle F , Wilczewski Hattie , Welch Brandon M , Bunnell Brian E
Published: July 2024

Objectives

Missed appointments can lead to treatment delays and adverse outcomes. Telemedicine may improve appointment completion because it addresses barriers to in-person visits, such as childcare and transportation. This study compared appointment completion for appointments using telemedicine versus in-person care in a large cohort of patients at an urban academic health sciences center.

Materials and Methods

We conducted a retrospective cohort study of electronic health record data to determine whether telemedicine appointments have higher odds of completion compared to in-person care appointments, January 1, 2021, and April 30, 2023. The data were obtained from the University of South Florida (USF), a large academic health sciences center serving Tampa, FL, and surrounding communities. We implemented 1:1 propensity score matching based on age, gender, race, visit type, and Charlson Comorbidity Index (CCI).

Results

The matched cohort included 87 376 appointments, with diverse patient demographics. The percentage of completed telemedicine appointments exceeded that of completed in-person care appointments by 9.2 points (73.4% vs 64.2%, P < .001). The adjusted odds ratio for telemedicine versus in-person care in relation to appointment completion was 1.64 (95% CI, 1.59-1.69, P < .001), indicating that telemedicine appointments are associated with 64% higher odds of completion than in-person care appointments when controlling for other factors.

Discussion

This cohort study indicated that telemedicine appointments are more likely to be completed than in-person care appointments, regardless of demographics, comorbidity, payment type, or distance.

Conclusion

Telemedicine appointments are more likely to be completed than in-person healthcare appointments.
Smart Chemometric-Assisted Spectrophotometric Approaches for Simultaneous Quantification of Tertiary Combination Recommended for COVID-19 Supportive Treatments With Their Greenness Assessment
Authors: Soliman Rabab M , Tantawy Mahmoud A , Mostafa Nadia M , Fayez Yasmin M , Monir Hany H , Rostom Yasmin
Published: July 2024

Background

There is an increasing interest of the scientific community in developing innovative methodologies for their analysis needs within a green analytical chemistry framework. UV spectrophotometry is one of the most promising eco-friendly methods, which is integrated with advanced chemometric tools to enhance the selectivity of the analysis of complex mixtures with severe overlapped signals.

Objective

Simultaneous determination of a triple-combination of pseudoephedrine hydrochloride (PSE), carbinoxamine maleate (CRX), and paracetamol (PAR) using an artificial intelligence system and multivariate calibration methods. This combination has been recently recommended for COVID-19 home-treated patients as part of a symptomatic treatment.

Methods

Namely, the suggested models are artificial neural networks, partial least-squares, and principal component regression. The proposed algorithms were optimized and developed with the aid of a five-level, three-factor experimental design.

Results

The investigated methods were applied over the concentration range of 100–180 μg/mL, 18–16 μg/mL, and 4–12 μg/mL for PSE, CRX, and PAR, respectively. The models’ validation results demonstrated excellent recoveries (around 98 to 102%), signaling the approaches’ outstanding resolution capacity for the cited compounds in the presence of common excipients. The outcomes of the studied methods were statistically compared to the official approaches, and no significant difference was found.

Conclusions

The suggested models were efficiently employed to determine the selected drugs in their combined tablets without any initial separation steps. The impact of these methods on the environment was evaluated via greenness tools: namely, the National Environmental Method Index, Raynie and Driver’s green assessment method, Analytical Eco-Scale, Green Analytical Procedure Index, and Analytical Greenness Metric.

Highlights

Green chemometric quality assessment of PSE, CRX, and PAR in their pure and pharmaceutical dosage forms. The established approaches are innovative, sustainable, smart, fast, selective, and cost-effective. These models are potential green nominees for routine analysis of the investigated mixture in quality control laboratories.
Effect of cordyceps militaris on growth performance, antioxidant capacity, and intestinal epithelium functions in weaned pigs
Authors: Li YanPing , Lu Yang , Yu Bing , Huang Zhiqing , Luo Yuheng , Zheng Ping , Mao Xiangbing , Yu Jie , Luo Junqiu , Yan Hui , He Jun
Published: July 2024

To explore the effects of cordyceps militaris (CM) on growth performance and intestinal epithelium functions, 180 weaned pigs were randomly assigned into 5 treatments with 6 replicate pens per treatment (6 pigs per pen). Pigs were fed with basal diet (control) or basal diet supplemented with 100, 200, 400, and 800 mg/kg CM. The trial lasted for 42 d, and pigs from the control and optimal-dose groups (based on growth performance) were picked for blood and tissue collection (n = 6). Results showed that CM elevated the average daily gain (ADG) and decreased the ratio of feed intake to gain (F:G) in the weaned pigs (P < 0.05). CM supplementation at 100 mg/kg improved the digestibilities of dry matter (DM), crude protein (CP), and gross energy (GE) (P < 0.05). CM not only increased the activities of superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT) but also increased the concentration of interleukin-10 (IL-10) in serum (P < 0.05). The serum concentrations of malondialdehyde (MDA), d-lactate, and diamine oxidase (DAO) were reduced by CM (P < 0.05). Interestingly, CM elevated the villus height and the ratio of villus height to crypt depth in the duodenum and jejunum and increased the activities of duodenal sucrase and maltase (P < 0.05). Moreover, CM elevated the expression levels of tight-junction proteins ZO-1, claudin-1, and occluding, as well as critical functional genes such as the fatty acid transport protein (FATP1), cationic amino acid transporter 1 (CAT1), and NF-E2-related factor 2 (Nrf2) in the duodenum and jejunum (P < 0.05). Importantly, CM increased the concentrations of acetic acid and butyric acid, and elevated the abundances of Bacillus and Lactobacillus in the cecum and colon, respectively (P < 0.05). These results indicated potential benefits of CM in improving the growth of weaned pigs, and such effect may be tightly associated with improvement in antioxidant capacity and intestinal epithelium functions.
Carboxyfullerene C60 preserves porcine sperm by enhancing antioxidant capacity and inhibiting apoptosis and harmful bacteria
Authors: Li Yuqing , Xiao Haoqi , Qin Xue , Zhang Haize , Zheng Yi , Cai Rui , Pang Weijun
Published: July 2024

This study used a porcine model to systematically investigate whether carboxyfullerene C60(CF-C60) can be used for sperm preservation. The results indicated that CF-C60 supplementation can preserve porcine sperm quality during storage at 17 °C. This effect was attributable to an improvement in the antioxidant capacity of sperm through a decrease in the reactive oxygen species (ROS) level. Additionally, CF-C60 can maintain mitochondrial function, inhibit sperm apoptosis through the ROS/Cytochrome C (Cyt C)/Caspase 3 signaling pathway, and mediate suppression of bacterial growth through the effects of ROS. Finally, the results of artificial insemination experiments indicated that insemination with CF-C60-treated sperm can increase the total number of offspring born and reduce the number of deformed piglets. Thus, CF-C60 is safe for use as a component of semen diluent for sperm storage.
Qualitative and quantitative determination of xylazine in oral fluid
Authors: Levitas Matthew , Thomas Christopher , Widman Corey , DeColumna Joseph , Allgaier Brandi , Conley Eric , deHagen Troy , Freitas Isabela , Horvath Hannah , Lemberg Bridget , Lemberg Dave
Published: July 2024

Xylazine has emerged in recent years as a dangerous adulterant in illicit fentanyl use, and methods for the detection of xylazine in toxicology panels are still lagging. We developed methods for the screening and quantitation of xylazine in oral fluid (OF), a popular testing medium due to its ease of collection and reflection of presence in blood for many classes of drugs. Enzyme-linked immunosorbent assays were employed for the rapid screening of xylazine directly from the collection device buffer with a cutoff of 1 ng/mL. Solid-phase extraction coupled with liquid chromatography–tandem mass spectrometry facilitated the confirmation and quantification of xylazine as low as 0.1 ng/mL and a dynamic range of 0.1–25 ng/mL. Selectivity, ionization suppression, processed sample stability, and dilution effect were also assessed. The method was validated through the American National Standards Institute/American Academy of Forensic Sciences Standards Board (ANSI/ASB) Standard 036, first edition from 2019, and found to be accurate, precise, and robust. Living human subject OF samples collected within substance use disorder and therapeutic drug monitoring clinics received between September 2023 and January 2024, with the specific request to test for xylazine (n = 57), were screened. Presumptive positive samples were confirmed using the validated method. Xylazine confirmed living human subject OF sample concentrations ranged from 1.2 to 23.3 ng/mL.
Soybean aphid management and perception of insecticide resistance by farmers
Authors: Lozano Rosa E , Hurley Terrance M , Knodel Janet J , Andow David A , Koch Robert L
Published: July 2024

In the Midwest United States, soybean aphids can cause significant economic losses in soybean production. The repeated use of insecticides within the same family has led to the development of insecticide resistance in soybean aphids. Implementing integrated pest management (IPM) and insecticide-resistance management (IRM) strategies can help farmers reduce the frequency of insecticide applications and delay the evolution of soybean aphid resistance while reducing production costs, maintaining yields, and protecting the environment. Farmers play a crucial role in implementing such practices; therefore, to understand farmers’ practices for management of soybean aphids and their perceptions of insecticide resistance, a survey of soybean farmers in Minnesota and North Dakota was conducted in 2021. Overall, the reported decision-making sources were similar for both farmers who changed and those who did not change their aphid management due to insecticide resistance; these were crop consultants and agricultural retailers. The threshold used by farmers in both groups to determine whether to use a foliar insecticide was lower than the research-based threshold for soybean aphids, and farmers were aware that this could contribute to insecticide resistance. In addition, farmers who changed soybean aphid management were more concerned than farmers who did not change about insecticide resistance and were implementing good practices such as scouting, using labeled application rates, and rotating insecticide modes of action. The results of this research can inform the refinement of IPM and IRM programs as well as extension education efforts.
Quantifying the Variability of “Fixed-Width” Buffers on Harvested Lands in Western Oregon and Washington
Authors: Swartz Allison G , Coble Ashley A , Thaler Evan A , Warren Dana R
Published: July 2024

In contemporary forest management, buffers of unharvested trees are left along streams to protect riparian and aquatic ecosystems. Buffer regulations often focus on specific minimum width requirements, which aid in straightforward regulation and application, but minimum widths also suggest buffered edges are uniform and contain little variability. Conceptual papers suggest that alternative buffer configurations may offer greater flexibility in landscape-level protection, increase forest complexity, and enhance aquatic and riparian biodiversity. However, before considering alternatives to fixed-width buffers, it is necessary to quantify the inherent variability in current buffer practices present on the landscape. In this study, we used aerial imagery to quantify variability of buffer widths in two hundred randomly selected recently harvested units on managed land in Oregon and Washington with both fish-bearing and non-fish-bearing sections of stream. Wider buffers on larger streams had a greater magnitude of variability, but when normalized by stream size, variation was greater in smaller streams, and overall, variation ranged from 25% to 50% of the mean width. Despite local variability, buffer widths rarely fell below 9.14 m (30 ft). The variation quantified here provides an initial measure of variability to inform future management, given emerging interest in variable retention buffers.

Study Implications: In contemporary forest management, riparian and aquatic habitat protection usually relies on minimum buffer width regulations. Minimum requirements create the perception that buffered edges are uniform distances from streams containing little variability, so conceptual papers have suggested alternative buffer configurations with variable retention edges to enhance ecological benefits. However, there are several reasons why, in practice, buffer widths may vary substantially from minimum sizes within and across harvest units under current forest management, but this potential variation has not been quantified. Before considering alternative riparian management options, it is necessary to quantify and understand the inherent variability in current practices. By utilizing high-resolution aerial imagery and digital elevation models, we quantified buffer width variation. Using a set of two hundred recently harvested units, we demonstrate notable buffer width variation across managed Pacific Northwest forests. We attribute the variation in buffer widths to the presence of road crossings, tributary junctions, underlying valley slope and slope variation, and flexibility in regulations that may be overlooked in broad evaluations of strict minimum widths. Understanding fundamental information about buffer width variability provides information about current practices and provides a standard against which proposed increases in variability may be compared.
White Matter Hyperintensities and Mild TBI in Post-9/11 Veterans and Service Members
Authors: Tate David F , Bigler Erin D , York Gerald E , Newsome Mary R , Taylor Brian A , Mayer Andrew R , Pugh Mary Jo , Presson Angela P , Ou Zhining , Hovenden Elizabeth S , Dimanche Josephine , Abildskov Tracy J , Agarwal Rajan , Belanger Heather G , Betts Aaron M , Duncan Timothy , Eapen Blessen C , Jaramillo Carlos A , Lennon Michael , Nathan Jennifer E , Scheibel Randall S , Spruiell Matthew B , Walker William C , Wilde Elisabeth A
Published: July 2024

Introduction

The neurobehavioral significance of white matter hyperintensities (WMHs) seen on magnetic resonance imaging after traumatic brain injury (TBI) remains unclear, especially in Veterans and Service Members with a history of mild TBI (mTBI). In this study, we investigate the relation between WMH, mTBI, age, and cognitive performance in a large multisite cohort from the Long-term Impact of Military-relevant Brain Injury Consortium—Chronic Effects of Neurotrauma Consortium.

Materials and Methods

The neuroimaging and neurobehavioral assessments for 1,011 combat-exposed, post-9/11 Veterans and Service Members (age range 22-69 years), including those with a history of at least 1 mTBI (n = 813; median postinjury interval of 8 years) or negative mTBI history (n = 198), were examined.

Results

White matter hyperintensities were present in both mTBI and comparison groups at similar rates (39% and 37%, respectively). There was an age-by-diagnostic group interaction, such that older Veterans and Service Members with a history of mTBI demonstrated a significant increase in the number of WMHs present compared to those without a history of mTBI. Additional associations between an increase in the number of WMHs and service-connected disability, insulin-like growth factor-1 levels, and worse performance on tests of episodic memory and executive functioning-processing speed were found.

Conclusions

Subtle but important clinical relationships are identified when larger samples of mTBI participants are used to examine the relationship between history of head injury and radiological findings. Future studies should use follow-up magnetic resonance imaging and longitudinal neurobehavioral assessments to evaluate the long-term implications of WMHs following mTBI.
Reversible Increased Anxiety Following Left-Sided Stellate Ganglion Block to Treat Posttraumatic Stress Disorder: A Case Report
Authors: Mulvaney Sean W , Lynch James H , Means Gary E , Dineen Kyle J , Mahadevan Sanjay
Published: July 2024

Describe a 2-patient case report of a rare occurrence of significantly increased anxiety after a left-sided stellate ganglion block (SGB) and the subsequent improvement of that anxiety through a right-sided SGB. Right-sided SGB to treat post-traumatic stress disorder (PTSD) has over 23 supporting publications in the peer-reviewed medical literature, including level 1 evidence. A published case series of 285 patients showed that two-level SGB may improve anxiety-related symptoms in patients. However, a recently published study indicates that some patients only respond to a left-sided SGB. The patients had an ultrasound-guided right-sided SGB for the treatment of PTSD and experienced a reduction in anxiety symptoms based on Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) scores. Later, a left-sided SGB was performed. Clinically, the addition of a left-sided SGB is typically associated with further anxiety reduction, but in these 2 cases, the patients had a significant reversal of the improvements experienced after a right-sided SGB. Following this unusual response to a left-sided SGB, these patients were offered another right-sided SGB, after which, they experienced a significant and durable improvement in anxiety symptoms beyond the original baseline PCL-score. In rare cases and for unknown reasons, a left-sided SGB may result in acute worsening of anxiety symptoms, which can be addressed and significantly improved with the application of a subsequent right-sided SGB.
Examining the Psychological Measures and Feasibility of Recreational Trail Rides in Reducing Cravings for Addictive Substances among Veterans: A Replication Pilot Study
Authors: Pahlke Makenna L , Hoopes Karl H , Black Heather F , Connelly Heather , Klinger William R , Joubert Katryna , Nazarenko Elena E , Marchand William R , Sheppard Stephen R
Published: July 2024

Introduction

Equine-assisted services have been gaining popularity as complementary therapies for a variety of populations with a diversity of diagnoses. Interventions using equines might benefit the military Veteran population through building therapeutic alliance as well as reducing symptoms. This pilot observational study is primarily aimed to investigate safety, feasibility, and acceptability of equine-assisted services for Veterans with substance abuse disorders. It is the second pilot observational study, the first being completed in 2022. Secondary outcomes included recording the impact of trail riding on psychological measures among Veterans at a large Veterans Administration medical center.

Methods

The study included a total of 32 Veterans who participated in trail riding sessions from May 4, 2022 to August 31, 2022. The study utilized the Positive and Negative Affect Scale, Adult Hope Scale, and Craving Experience Questionnaire to assess changes in positive affect, negative affect, hope components, and substance craving.

Results

The results indicated significant reductions in negative affect and substance craving after the first session, with positive effects observed in subsequent sessions. However, demographic and diagnostic variables did not predict significant changes in psychological instruments.

Conclusion

Overall, the study demonstrated that trail riding was a safe and feasible intervention and may have potential benefits for improving emotional well-being and reducing substance cravings among Veterans. It is recommended that future studies research mechanisms of action, as well as conduct more rigorous investigations, including controlled trials using larger sample sizes and longitudinal research, to best determine lasting effects of these types of complementary therapies.
Impact of an Integrated Human Performance Support Group: Evaluation of Air Force Special Warfare Candidate Training and Musculoskeletal Injury Outcomes Over Eight Fiscal Years
Authors: Haydu Lauren E , Hogan Kathleen K , Merseal Courtney , Feldbrugge Chase M , Johnson Andrew S , Smolka Michael T , Buse George J , Carr Wesley , Butler Cody R
Published: July 2024

Introduction

The Special Warfare Training Wing and Special Warfare Human Performance Support Group (HPSG; all-co-authors) were established in fiscal year (FY) 2019 to consolidate and oversee all Air Force Special Warfare (AFSPECWAR) training and provide embedded medical and human performance support to candidates with the goal of improving graduation rates and the longevity of the AFSPECWAR operator. The purpose of this manuscript is to assess the impact of the HPSG on AFSPECWAR graduation rates, musculoskeletal injury (MSKI) incidence, and cost.

Materials and Methods

Graduation rates, MSKI incidence (including incidence density and cumulative incidence probability), and MSKI-related health care costs were assessed across all AFSPECWAR training pipelines spanning 8 FYs 2015–22, including Indoctrination, Assessment, and Selection Courses (Selection); Tactical Air Control Party (TACP); Special Tactics (ST), and Guardian Angel (GA).

Results

A total of 5,728 distinct candidates were assessed over the time frame. There were significant decreases in attrition when comparing the HPSG era (FY 19–22) with the prior 4-year period for the ST (47% vs. 82% graduates) and TACP (34% vs. 41% graduates) training pipelines. The corresponding Selection (36% graduates) and GA (80% graduates) pipeline attrition rates remained stable. MSKI incidence rates (both incidence density and cumulative incidence probability) overall were not significantly different when comparing the pre-HPSG and HPSG time frames; however, they varied between the two time frames by course. GA candidates had a decrease in MSKI during the apprentice course in the HPSG era compared with the pre-HPSG era (2.4–1.0 cases per 100 trainee weeks; P < .001), which corresponds to a nearly 20% reduction in the cumulative incidence probability (i.e., proportion of trainees injured) after 10 weeks of course. For ST and TACP courses, however, significantly increased incidence of MSKI was observed when comparing the two time frames (P < .001), while for Selection courses, the rates remained stable. A significant reduction in the cost of MSKI-related management (62% total relative value units, 83% total costs) was observed.

Conclusion

The impact of the HPSG on attrition, MSKI incidence, and cost-of-care was not consistent across all training pipelines; however, taken together, there were no increases in attrition, and the cost of MSKI management was significantly lower.
High contrast at small separation – III. Impact on the dark hole of MEMS deformable mirror control electronics
Authors: Martinez P , Beaulieu M , Abe L , Baudoz P , Gouvret C , Spang A , Marcotto A
Published: July 2024

The creation of a dark hole (DH) region in the science image for exoplanet direct detection depends on deformable mirrors (DMs), where the imperfect control of DM limits the achievable contrast. The mirror surface height resolution is set by the DM drive electronics, and the quantization errors in DM impact the contrast in the DH. Consequently, determining the optimal voltage value for the flattening map of DM is essential, as it involves balancing dynamic and accuracy considerations. We conduct a numerical study to examine the impact of these parameters on microelectromechanical DM within the high-contrast field of view of several DHs with various characteristics and optical configurations. Our analysis includes an exploration of their influence on both small and moderate angular separations. We compare our numerical results with a formula available in the literature that aims to capture the dependence of contrast on DM quantization errors. We show that the formula accuracy to predict the contrast limit when the DM deflection curves follow the as-manufactured quadratic power law is dependent on the DM flattening map voltage domain, regardless of DH size and angular separations. Further these results appear to be insensitive to factors such as actuator number, coronagraph type, set-up architecture, and science objective (small or moderate angular separations). We provide guidelines for determining the optimal voltage for the DM flattening map, discuss the domain validity of the formula used to predict DM quantization errors on the contrast, and provide insights into balancing DM actuator density and mirror surface height resolution.
Directionally non-rotating electric field therapy delivered through implanted electrodes as a glioblastoma treatment platform: A proof-of-principle study
Authors: Ma Jun , Singh Shilpi , Li Ming , Seelig Davis , Molnar Gregory F , Wong Eric T , Dhawan Sanjay , Kim Stefan , Helland Logan , Chen David , Tapinos Nikos , Lawler Sean , Singh Gatikrushna , Chen Clark C
Published: July 2024

Background

While directionally rotating tumor-treating fields (TTF) therapy has garnered considerable clinical interest in recent years, there has been comparatively less focus on directionally non-rotating electric field therapy (dnEFT).

Methods

We explored dnEFT generated through customized electrodes as a glioblastoma therapy in in vitro and in vivo preclinical models. The effects of dnEFT on tumor apoptosis and microglia/macrophages in the tumor microenvironment were tested using flow-cytometric and qPCR assays.

Results

In vitro, dnEFT generated using a clinical-grade spinal cord stimulator showed antineoplastic activity against independent glioblastoma cell lines. In support of the results obtained using the clinical-grade electrode, dnEFT delivered through a customized, 2-electrode array induced glioblastoma apoptosis. To characterize this effect in vivo, a custom-designed 4-electrode array was fabricated such that tumor cells can be implanted into murine cerebrum through a center channel equidistant from the electrodes. After implantation with this array and luciferase-expressing murine GL261 glioblastoma cells, mice were randomized to dnEFT or placebo. Relative to placebo-treated mice, dnEFT reduced tumor growth (measured by bioluminescence) and prolonged survival (median survival gain of 6.5 days). Analysis of brain sections following dnEFT showed a notable increase in the accumulation of peritumoral macrophage/microglia with increased expression of M1 genes (IFNγ, TNFα, and IL-6) and decreased expression of M2 genes (CD206, Arg, and IL-10) relative to placebo-treated tumors.

Conclusions

Our results suggest therapeutic potential in glioblastoma for dnEFT delivered through implanted electrodes, supporting the development of a proof-of-principle clinical trial using commercially available deep brain stimulator electrodes.
Pathogen-Agnostic Advanced Molecular Diagnostic Testing for Difficult-to-Diagnose Clinical Syndromes—Results of an Emerging Infections Network Survey of Frontline US Infectious Disease Clinicians, May 2023
Authors: Rao Preetika S , Downie Diane L , David-Ferdon Corinne , Beekmann Susan E , Santibanez Scott , Polgreen Philip M , Kuehnert Matthew , Courtney Sean , Lee Justin S , Chaitram Jasmine , Salerno Reynolds M , Gundlapalli Adi V
Published: July 2024

During routine clinical practice, infectious disease physicians encounter patients with difficult-to-diagnose clinical syndromes and may order advanced molecular testing to detect pathogens. These tests may identify potential infectious causes for illness and allow clinicians to adapt treatments or stop unnecessary antimicrobials. Cases of pathogen-agnostic disease testing also provide an important window into known, emerging, and reemerging pathogens and may be leveraged as part of national sentinel surveillance. A survey of Emerging Infections Network members, a group of infectious disease providers in North America, was conducted in May 2023. The objective of the survey was to gain insight into how and when infectious disease physicians use advanced molecular testing for patients with difficult-to-diagnose infectious diseases, as well as to explore the usefulness of advanced molecular testing and barriers to use. Overall, 643 providers answered at least some of the survey questions; 478 (74%) of those who completed the survey had ordered advanced molecular testing in the last two years, and formed the basis for this study. Respondents indicated that they most often ordered broad-range 16S rRNA gene sequencing, followed by metagenomic next-generation sequencing and whole genome sequencing; and commented that in clinical practice, some, but not all tests were useful. Many physicians also noted several barriers to use, including a lack of national guidelines and cost, while others commented that whole genome sequencing had potential for use in outbreak surveillance. Improving frontline physician access, availability, affordability, and developing clear national guidelines for interpretation and use of advanced molecular testing could potentially support clinical practice and public health surveillance.
Collective Knowledge and the Limits of the Expanded Identification Doctrine
Authors: Sarch Alexander
Published: July 2024

The Economic Crime and Corporate Transparency Act 2023 expanded the identification doctrine in welcome ways, but, I argue, does not go far enough. Specifically, I contend that the Act’s reforms do not sufficiently respond to the threat of senior managers who culpably interfere in the proper flow of information within the company to orchestrate harmful or risky practices by others, all while seeking to avoid liability by preventing any individual from forming the full mens rea of any economic crime. How should the criminal law respond to this gap? I argue it would be problematic to respond by extending individual liability even further—say, by expanding the already ‘disturbingly wide’ inchoate offences in the Serious Crime Act 2007. Instead, the collective knowledge doctrine provides a tailor-made solution to these scenarios. This doctrine would permit courts (in narrow circumstances) to aggregate individuals’ mental states within the company to construct a distinct corporate mens rea. I argue that section 196 of the 2023 Act, which expands the identification doctrine, could be read to incorporate a narrow version of the collective knowledge doctrine—at least if courts are willing to adopt a purposivist orientation aimed at giving effect to the wider aims of Parliament. A restricted version of the collective knowledge doctrine would have normative benefits and so, I suggest, is worth putting to the courts through test litigation.
Quantum Error Correction Realized by the Renormalization Group in Scalar Field Theories
Authors: Kuwahara Takaaki , Nasu Ryota , Tanaka Gota , Tsuchiya Asato
Published: July 2024

We demonstrate that quantum error correction is realized by the renormalization group in scalar field theories. We construct q-level states by using coherent states in the IR region. By acting on them the inverse of the unitary operator U that describes the renormalization group flow of the ground state, we encode them into states in the UV region. We find the situations in which the Knill–Laflamme condition is satisfied for operators that create coherent states. We verify this to the first order in the perturbation theory. This result suggests a general relationship between the renormalization group and quantum error correction and should give insights into understanding the role played by them in the gauge/gravity correspondence.