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Synthetic cannabinoids (SCs) make up a class of novel psychoactive substances (NPS), used predominantly in prisons and homeless communities in the U.K. SCs can have severe side effects, including psychosis, stroke, and seizures, with numerous reported deaths associated with their use. The chemical diversity of SCs presents the major challenge to their detection since approaches relying on specific molecular recognition become outdated almost immediately. Ideally one would have a generic approach to detecting SCs in portable settings. The problem of SC detection is more challenging still because the majority of SCs enter the prison estate adsorbed onto physical matrices such as paper, fabric, or herb materials. That is, regardless of the detection modality used, the necessary extraction step reduces the effectiveness and ability to rapidly screen materials on-site. Herein, we demonstrate a truly instant generic test for SCs, tested against real-world drug seizures. The test is based on two advances. First, we identify a spectrally silent region in the emission spectrum of most physical matrices. Second, the finding that background signals (including from autofluorescence) can be accurately predicted is based on tracking the fraction of absorbed light from the irradiation source. Finally, we demonstrate that the intrinsic fluorescence of a large range of physical substrates can be leveraged to track the presence of other drugs of interest, including the most recent iterations of benzodiazepines and opioids. We demonstrate the implementation of our presumptive test in a portable, pocket-sized device that will find immediate utility in prisons and law enforcement agencies around the world.

Methionine synthases (MetH) catalyse the methylation of homocysteine (Hcy) with 5-methyl-tetrahydrofolate (5, methyl-THF) acting as methyl donor, to form methionine (Met) and tetrahydrofolate (THF). This function is performed by two unrelated classes of enzymes that differ significantly in both their structures and mechanisms of action. The genomes of plants and many fungi exclusively encode cobalamin-independent enzymes (EC.2.1.1.14), while some fungi also possess proteins from the cobalamin-dependent (EC.2.1.1.13) family utilised by humans. Methionine synthase’s function connects the methionine and folate cycles, making it a crucial node in primary metabolism, with impacts on important cellular processes such as anabolism, growth and synthesis of proteins, polyamines, nucleotides and lipids. As a result, MetHs are vital for the viability or virulence of numerous prominent human and plant pathogenic fungi and have been proposed as promising broad-spectrum antifungal drug targets. This review provides a summary of the relevance of methionine synthases to fungal metabolism, their potential as antifungal drug targets and insights into the structures of both classes of MetH.

Environmental exposures transported across air, land and water can affect our health making us more susceptible to developing a disease. Therefore, researchers need to face the complex task of integrating environmental exposures and linking them to health events with the relevant spatiotemporal and health context for individuals or populations. We present a usability evaluation approach and study of a semantic framework (i.e. Knowledge Graph, Methodology and User Interface) to enable Health Data Researchers (HDR) to link particular health events with environmental data for rare disease research. The usability study includes 17 HDRs with expertise in health data related to Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis (AAV) in Ireland and Kawasaki Disease in Japan, and with no previous practical experience in using Semantic Web (SW) technologies. The evaluation results are promising in that they indicate that the framework is useful in allowing researchers themselves to link health and environmental data whilst hiding the complexities of SW technologies. As a result of this work, we also discuss the limitations of the approach together with the applicability to other domains. Beyond the direct impact on environmental health studies, the description of the evaluation approach can guide researchers in making SW technologies more accessible to domain experts through usability studies.

This article from Psychotherapy Networker Magazine explores the author's personal journey with anxiety and how they found empowerment through practicing Krav Maga, an Israeli self-defense style of combat. The author shares their experiences of feeling anxious and fearful in various situations, from childhood to adulthood. Eventually, they decide to challenge themselves and join their husband and daughter in taking Krav Maga classes. Through this practice, the author gains confidence, learns self-defense techniques, and finds a sense of empowerment. They reflect on how their anxiety and bravery can coexist and how facing their fears has been a transformative experience. [Extracted from the article]

With synthetic cannabinoid receptor agonist (SCRA) use still prevalent across Europe and structurally advanced generations emerging, it is imperative that drug detection methods advance in parallel. SCRAs are a chemically diverse and evolving group, which makes rapid detection challenging. We have previously shown that fluorescence spectral fingerprinting (FSF) has the potential to provide rapid assessment of SCRA presence directly from street material with minimal processing and in saliva. Enhancing the sensitivity and discriminatory ability of this approach has high potential to accelerate the delivery of a point-of-care technology that can be used confidently by a range of stakeholders, from medical to prison staff. We demonstrate that a range of structurally distinct SCRAs are photochemically active and give rise to distinct FSFs after irradiation. To explore this in detail, we have synthesized a model series of compounds which mimic specific structural features of AM-694. Our data show that FSFs are sensitive to chemically conservative changes, with evidence that this relates to shifts in the electronic structure and cross-conjugation. Crucially, we find that the photochemical degradation rate is sensitive to individual structures and gives rise to a specific major product, the mechanism and identification of which we elucidate through density-functional theory (DFT) and time-dependent DFT. We test the potential of our hybrid “photochemical fingerprinting” approach to discriminate SCRAs by demonstrating SCRA detection from a simulated smoking apparatus in saliva. Our study shows the potential of tracking photochemical reactivity via FSFs for enhanced discrimination of SCRAs, with successful integration into a portable device.

ABSTRACTIn recent years, immigrant family apprehensions at the United States southern border have more than doubled. Those wishing to stay enter a complex legal process as they either fight for lawful status or remain unauthorized. The trauma many experienced may inhibit their ability to articulate claims to legal status. Yet several relief options are only available to applicants who have suffered trauma. Social worker-lawyer collaboration can enhance advocacy on such cases. Social work educators can train practitioners to engage in effective interprofessional partnerships. We developed an interprofessional training tailored to social worker–lawyer collaborations supporting immigrant clients. We present the curriculum structure and post-training survey results, and offer suggestions for social work education on interprofessional collaborations in immigrant client advocacy.

We consider the problem of solving large-scale linear least squares problems that have one or more linear constraints that must be satisfied exactly. While some classical approaches are theoretically well founded, they can face difficulties when the matrix of constraints contains dense rows or if an algorithmic transformation used in the solution process results in a modified problem that is much denser than the original one. We propose modifications with an emphasis on requiring that the constraints be satisfied with a small residual. We examine combining the null-space method with our recently developed algorithm for computing a null-space basis matrix for a “wide” matrix. We further show that a direct elimination approach enhanced by careful pivoting can be effective in transforming the problem to an unconstrained sparse-dense least squares problem that can be solved with existing direct or iterative methods. We also present a number of solution variants that employ an augmented system formulation, which can be attractive for solving a sequence of related problems. Numerical experiments on problems coming from practical applications are used throughout to demonstrate the effectiveness of the different approaches.

Transitioning the energy source dependencies to create sustainable portfolios entails decreasing the share of fossil fuels and increasing the share of renewable energies. For many countries this leads to required consideration of impact for long-term development plans. In Iran, a resource-based economy where fossil fuel energies have historically contributed to large portions of the energy portfolio, restructuring this portfolio becomes complicated with respect to the interactions of energy systems with sustainable development areas: economic, social, and environmental systems. Using Iran as a case study, this paper presents the development, validation, and use of a system dynamics model to consider future outcomes of diversifying the country's energy portfolio. Five scenarios demonstrate how the model can support decision-making for restructuring the energy portfolio to improve the country's sustainable development indicators. The paper suggests such modelling could provide clarity and confidence for decision and policymakers to progress development plans for sustainable energy portfolios.

Early COVID-19 pandemic data suggested racial/ethnic minority and low-income earning people bore the greatest burden of infection. Structural racism, the reinforcement of racial and ethnic discrimination via policy, provides a framework for understanding disparities in health outcomes like COVID-19 infection. Residential racial and economic segregation is one indicator of structural racism. Little attention has been paid to the relationship of infection to relative overall concentrations of risk (i.e., segregation of the most privileged from the most disadvantaged). We used ordinary least squares and geographically weighted regression models to evaluate the relationship between racial and economic segregation, measured by the Index of Concentration at the Extremes, and COVID-19 cases in Louisiana. We found a significant global association between racial segregation and cumulative COVID-19 case rate in Louisiana and variation across the state during the study period. The northwest and central regions exhibited a strong negative relationship indicating greater risk in areas with high concentrations of Black residents. On the other hand, the southeastern part of the state exhibited more neutral or positive relationships indicating greater risk in areas with high concentrations of White residents. Our findings that the relationship between racial segregation and COVID-19 cases varied within a state further support evidence that social and political determinants, not biological, drive racial disparities. Small area measures and measures of polarization provide localized information better suited to tailoring public health policy according to the dynamics of communities at the census tract level, which may lead to better health outcomes.

Admission to high-acuity ICUs has been associated with improved outcomes compared with outcomes in low-acuity ICUs, although the mechanism for these findings is unclear.

Although working more than one job to avoid economic hardship is not a new strategy for U.S. workers, official estimates suggest it is infrequent. These may not, however, include new conceptualizations of work like “side hustles.” To understand who works multiple jobs and its effect on economic well-being, we expanded the definition and used the Survey of Income and Program Participation to estimate (a) prevalence and (b) the effect of secondary earnings on household poverty. We found that 18.2% of households held multiple jobs and that secondary earnings reduced household poverty, and more effectively for consistent multiple jobholders. Integrating this understanding into economic well-being practice and policy interventions that expand employee benefits could better support multiple jobholding as a poverty reduction strategy.

Many women choose behavioral interventions as a first-line treatment for urinary incontinence. We developed a 20-minute abbreviated video, which proved to be similar to a 2-hour in-person class in a randomized trial. This study examines economic end points for the 20-minute video relative to the 2-hour class.

ABSTRACTThe study discusses the insertion of experimental course materials into a general education political science course in an effort to increase female student success. The experimental materials highlighted women serving in political office, with a goal of combatting stereotype threat. Stereotype threat occurs when a person is aware of a negative performance stereotype and the awareness causes anxiety, resulting in poor performance; this phenomenon occurs in fields where gender stereotypes exist. This study uses documented methods of stereotype threat-mitigation from the fields of science, math, and psychology and applies them to the political science classroom. The experiment used materials that were already slated for update, and simple statistics were used to evaluate impact on success.

The Pediatric Emergency Care Applied Research Network (PECARN) Head Injury/Trauma Algorithm is a well-validated decision rule used to identify patients at low risk of clinically important traumatic brain injuries who may not need head CT. In adult patients with mild head trauma, elevated serum glucose and white cell count (WCC) have been associated with abnormal head CT findings. Currently, glucose or WCC is not considered in pediatric patients. The objective of this study was to determine if elevations in glucose or WCC could be used as additional tools to risk-stratify pediatric trauma patients for intracranial injury (ICI). Data were abstracted from the Maryland Trauma Registry and from electronic medical records for patients at the Johns Hopkins Children's Center from 2017 to 2020. We evaluated 145 encounters that met the inclusion criteria. There were 33 cases of ICI on CT. In addition to higher median glucose and WCC, we found that patients with ICI had a younger median age and were less likely to have other clinically significant injuries than patients without ICI. Following multiple logistic regression analysis, WCC (OR 1.113, 95% CI 1.02 to 1.21), younger age (OR 0.89, 95% CI 0.8 to 0.98), and absence of other injuries (OR 0.41, 95% CI 0.23 to 0.73) were found to be associated with risk of ICI. The area under the curve for our model was 0.79. When used with the PECARN algorithm, our model could help determine which patients may avoid head CT or undergo a shorter observation period.

The Pediatric Emergency Care Applied Research Network (PECARN) Head Injury/Trauma Algorithm is a well-validated decision rule used to identify patients at low risk of clinically important traumatic brain injuries who may not need head CT. In adult patients with mild head trauma, elevated serum glucose and white cell count (WCC) have been associated with abnormal head CT findings. Currently, glucose or WCC is not considered in pediatric patients. The objective of this study was to determine if elevations in glucose or WCC could be used as additional tools to risk-stratify pediatric trauma patients for intracranial injury (ICI). Data were abstracted from the Maryland Trauma Registry and from electronic medical records for patients at the Johns Hopkins Children’s Center from 2017 to 2020. We evaluated 145 encounters that met the inclusion criteria. There were 33 cases of ICI on CT. In addition to higher median glucose and WCC, we found that patients with ICI had a younger median age and were less likely to have other clinically significant injuries than patients without ICI. Following multiple logistic regression analysis, WCC (OR 1.113, 95% CI 1.02 to 1.21), younger age (OR 0.89, 95% CI 0.8 to 0.98), and absence of other injuries (OR 0.41, 95% CI 0.23 to 0.73) were found to be associated with risk of ICI. The area under the curve for our model was 0.79. When used with the PECARN algorithm, our model could help determine which patients may avoid head CT or undergo a shorter observation period.

Abstract:While faculty are often treated as a homogenous group in literature discussing student learning outcomes assessment, this should not be the case. Drawing on responses to a national survey, we show that full-time faculty, both tenure-line and non-tenure-line, are likely to be invited to help design and give feedback on assessments implemented in disciplines, institutions, and classes. Full-time faculty are also likely to be invited to interpret the assessment results and offer feedback on how to use the results to close the loop. Part-time faculty members are not as likely as their full-time colleagues to be invited to participate in the various stages of the assessment loop. The implications of these findings are discussed. Keywords: assessment, part-time faculty, student learning outcomes, success, retention

Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher’s attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university’s Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder’s experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.

Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher's attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university's Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder's experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.

Research rarely considers the origin or history of a cancer patient’s anxiety and/or depression, instead assuming that these illnesses are related to the cancer experience. The aim of this study was to compare differences in the support needs of people who have experienced anxiety/depression as part of the cancer experience and people who have not, as well as between people who have experienced episodic anxiety/depression and people who have experienced long-term anxiety/depression. Twenty-one semi-structured interviews were conducted with people with a current or previous diagnosis of cancer, and a current or previous experience with anxiety and/or depression. Participants were split into four groups based on their history with cancer and anxiety/depression, and an inductive thematic analysis was conducted to identify themes across groups. Two superordinate themes (with three and two subordinate themes respectively) were found: ‘coping with cancer’ and ‘health care system support provision’. Important differences were found across groups, with participants who had a history of anxiety/depression that was unrelated to their cancer diagnosis coping better with the combined burden of cancer and anxiety/depression, experiencing less fear of cancer recurrence, and highlighting more positive hospital and support service related experiences, than those whose anxiety/depression was cancer related. The origin and history of a person’s anxiety/depression is important to consider when determining how they might cope with cancer, what their support needs are, and how much support they may require.

A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country’s health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda. In this Article, the authors describe how U.S. academic institutions (focusing on the seven Harvard-affiliated institutions participating in the HRH Program—Harvard Medical School, Brigham and Women’s Hospital, Harvard School of Dental Medicine, Boston Children’s Hospital, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, and Massachusetts Eye and Ear Infirmary) have also benefited: (1) by providing opportunities to their faculty and trainees to engage in global health activities; (2) by establishing long-term, academic partnerships and collaborations with Rwandan academic institutions; and (3) by building the administrative and mentorship capacity to support global health initiatives beyond the HRH Program. In doing this, the authors describe the seven Harvard-affiliated institutions’ contributions to the HRH Program, summarize the benefits accrued by these institutions as a result of their participation in the program, describe the challenges they encountered in implementing the program, and outline potential solutions to these challenges that may inform similar future health professional training initiatives.

Background: The aetiology of ANCA-associated vasculitis (AAV) and triggers of relapse are poorly understood. Vitamin D (vitD) is an important immunomodulator, potentially responsible for the observed latitudinal differences between granulomatous and non-granulomatous AAV phenotypes. A narrow ultraviolet B spectrum induces vitD synthesis (vitD-UVB) via the skin. We hypothesised that prolonged periods of low ambient UVB (and by extension vitD deficiency) are associated with the granulomatous form of the disease and an increased risk of AAV relapse. Methods: Patients with AAV recruited to the Irish Rare Kidney Disease (RKD) (n= 439) and UKIVAS (n= 1961) registries were studied. Exposure variables comprised latitude and measures of ambient vitD-UVB, including cumulative weighted UVB dose (CW-D-UVB), a well-validated vitD proxy. An n-of-1 study design was used to examine the relapse risk using only the RKD dataset. Multi-level models and logistic regression were used to examine the effect of predictors on AAV relapse risk, phenotype and serotype. Results: Residential latitude was positively correlated (OR 1.41, 95% CI 1.14–1.74, p= 0.002) and average vitD-UVB negatively correlated (0.82, 0.70–0.99, p= 0.04) with relapse risk, with a stronger effect when restricting to winter measurements (0.71, 0.57–0.89, p= 0.002). However, these associations were not restricted to granulomatous phenotypes. We observed no clear relationship between latitude, vitD-UVB or CW-D-UVB and AAV phenotype or serotype. Conclusion: Our findings suggest that low winter ambient UVB and prolonged vitD status contribute to AAV relapse risk across all phenotypes. However, the development of a granulomatous phenotype does not appear to be directly vitD-mediated. Further research is needed to determine whether sufficient vitD status would reduce relapse propensity in AAV.

How can a historic house museum speak to communities experiencing complex urban change and social ills in the twenty-first century? Weeksville Heritage Center (WHC), a post-emancipation site based in residential Brooklyn, interprets a free black, intentional, land-owning community, which established its own schools, churches, and anti-slavery organizations, and operated as a safe space for African Americans in the greater New York area throughout the nineteenth century. The museum is a direct result of more than a generation of community activism begun in the late 1960s to reclaim a forgotten history. WHC radically attempts to redefine ideas of freedom and emancipation in contemporary and self-determined ways. Drawing on Weeksville’s histories, WHC explores interpretations that highlight agency, independence, and activism and that resonate with contemporary concerns.

Tick species worldwide are implicated in transmission of pathogens that cause mild to severe diseases in humans and livestock. Although tick population densities are often highly correlated with tick-borne disease rates, we currently know little about which factors underlie annual changes in those tick population densities. We used a 25-year dataset of Ixodes scapularisdrag-sampling surveys at two locations in CT, USA, to investigate the relationship between average nymphal density from mid-May to mid-August and monthly, lagged regional weather variables. The dataset was randomly split into two data subsets, one for hypothesis development and one for hypothesis testing. Nymphal density showed the strongest association with the Standardized Precipitation Index for January of the same year that density data were collected in the analysis based on the hypothesis development data subset. This association was positive; nymphal tick density increased with regional winter precipitation. Nymphal density was positively associated with this same weather variable in the hypothesis testing data subset. Weather conditions during the coldest months of the year may serve as a bottleneck to tick populations, thereby functioning as an important correlate of not only annual blacklegged tick nymphal densities the following summer, but also entomological risk associated with tick-borne pathogens transmitted by this species.