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The Solid Oxide Fuel Cell (SOFC) Program at the National Energy Technology Laboratory (NETL) managed by the U.S. Department of Energy (DOE) Office of Fossil Energy and Carbon Management (FECM) is currently developing low-cost SOFC and Solid Oxide Electrolysis Cell (SOEC) systems. This paper develops the Total Energy (TE) (kilowatt-hours per kilogram hydrogen, kWh/kgH2 ) for the SOEC and SOFC. The Total Energy includes heat input, exergetic flows, enthalpy of vaporization, pressurization, heat loss, area specific resistance, etc. The SOEC Total Energy developed at NETL, as it would happen, correlates well with the Idaho National Laboratory (INL) proven SOEC performance of forty-five kilowatt-hours per kilogram hydrogen at twenty bars, 1.3 volt and 725oC. Total Energy is necessary for designing, predicting, and planning for SOEC and SOFC performance and cost.

A growing consensus among concussion experts is that a formal gait assessment is an essential component in return-to-play decisions. Concussion research illustrates that gait variables follow a pattern of recovery that may be more protracted than cognitive recovery, suggesting that gait dynamics may be more sensitive to the sequelae of concussion, and accelerometer data may enhance that sensitivity. However, pediatric neuropsychologists have few available options for quantitatively assessing gait. We here introduce a novel gait technology, the BioKinetoGraph (BKG), that provides multiple metrics for assessing gait, including within the domains of power, stride, balance (stability), and symmetry. We demonstrate how BKG data can be collected using a mobile application called SportGait, which is available for use on any smartphone. We present data illustrating the test–retest reliability of the mobile BKG in a sample of 4150 ostensibly healthy individuals, with an overall mean correlation coefficient of .79 between two walks across the assessed domains. We also provide quantitative and qualitative data to illustrate recovery, including a presentation of norm- and self-referenced comparisons. Additional recovery data is presented using qualitative information in the form of stabilogram and displacement graphs. Because the BKG is broadly available, reliable, valid, and does not require extensive or costly equipment (i.e., only requiring a mobile device and the App), it represents a significant advancement in quantifying gait in a wide range of settings.

Major regional gaps exist in the reporting and accessibility of naturalized plant species distribution data, especially within Southeast Asia. Here, we present the Malesian Naturalized Alien Flora database (MalNAF), the first standardized island-group level checklist of naturalized vascular plant species for the Malesian phytogeographical region. We used MalNAF to investigate the composition, origins, and habitat preferences of the naturalized flora. The naturalized vascular flora of Malesia consists of at least 1177 species. Richness is highest in the Philippines (539 spp.) and lowest in the Maluku Islands (87 spp.). But, the Lesser Sunda Islands had the highest naturalized species richness relative to native richness and Singapore has a higher naturalized plant species richness than would be expected given its size. When comparing the data for Malesia with a global dataset, we found that naturalized richness increased with area for islands but not for continental regions. Across the archipelago, 31 species are widespread, occurring in every island group, but the majority have a limited distribution of 2.4 ± 2.3 (mean ± SD) island groups per naturalized species. The naturalized plant species are representatives of 150 families, twenty of which are newly introduced to the region. Families richest in naturalized plant species in Malesia were Fabaceae (= Leguminosae) (160 spp.), Poaceae (= Gramineae) (138 spp.), and Asteraceae (= Compositae) (96 spp.). Most of these have a native range that includes tropical Asia, closely followed by those from Southern America (inclusive of the Caribbean, Central and South America), although at the island-group level, most have a higher proportion with a Southern American native range. Most naturalized species occur in anthropogenic habitats, but many are present in “natural” habitats with fewer species, such as Leucaena leucocephala, reported from specialized habitats like drylands. MalNAF provides a baseline for future studies of naturalized plant species distributions in the region.

BACKGROUND: Lower back pain (LBP) is a principal cause of disability worldwide and is associated with a variety of spinal conditions. Individuals presenting with LBP may display changes in spinal motion. Despite this, the ability to measure lumbar segmental range of motion (ROM) non-invasively remains a challenge. OBJECTIVE: To review the reliability of four non-invasive modalities: Video Fluoroscopy (VF), Ultrasound imaging (US), Magnetic Resonance Imaging (MRI) and Radiography used for measuring segmental ROM in the lumbar spine in-vivo. METHODS: The methodological quality of seventeen eligible studies, identified through a systematic literature search, were appraised. RESULTS: The intra-rater reliability for VF is excellent in recumbent and upright positions but errors are larger for intra-rater repeated movements and inter-rater reliability shows larger variation. Excellent results for intra- and inter-rater reliability are seen in US studies and there is good reliability within- and between-day. There is a large degree of heterogeneity in MRI and radiography methodologies but reliable results are seen. CONCLUSIONS: Excellent reliability is seen across all modalities. However, VF and radiography are limited by radiation exposure and MRI is expensive. US offers a non-invasive, risk free method but further research must determine whether it yields truly consistent measurements.

Patient-specific, additively manufactured (printed) titanium reconstruction plates have been widely used to improve accuracy and efficiency of fibular flap reconstruction of the mandible. Miniplates possess some potential advantages over single-piece reconstruction plates, however multiple-miniplate fixation can be more technically demanding and may lengthen the duration of surgery. Furthermore, incremental angulation errors in screw placement for each miniplate could compromise overall dimensional accuracy of the neomandibular reconstruction. This preliminary article reports the first clinical use of a new patient-specific, printed titanium miniplate-jig system in a patient undergoing hemimandibulectomy for osteoradionecrosis of the mandible withfibular flap reconstruction. Our initial experience with the new deviceand technique demonstratesa quick, user friendly, and precise method for the placement and fixation of multiple miniplates in fibular-flap reconstruction of the mandible.

Hospitals not only provide access to healthcare services in rural areas; they also serve as major employers and economic drivers. The goal of this pilot study was to improve our understanding of how a rural healthcare system in Appalachian Kentucky could be leveraged to expand access to fresh fruits and vegetables. We conducted 11 semi-structured interviews with food system and healthcare stakeholders in Hazard, Kentucky, to (1) improve our understanding of key barriers to accessing and utilizing fresh produce for healthcare worker and patient populations, (2) identify models for direct-to-consumer market channels and farm-to-institution programming in collaboration with a local hospital, and (3) explore the potential of those models to foster greater consumption of fruit and vegetables among community members. Stakeholders emphasized the need for staff support and funding during program development and discussed the difficulty in maintaining prior local food and health promotion efforts when pilot funding expired. Other considerations included the importance of community ownership, robust communication and coordination among stakeholders, and attunement to the opportunities and challenges of a hospital-based approach. Direct farm-to-consumer models were considered feasible but would require accommodation for low-income consumers, such as vouchers, sliding-scale payment methods, or “double dollar” programs. Farm-to-hospital initiatives were discussed in the context of the COVID-19 pandemic and reduced hospital cafeteria usage, which may limit the success of some events but highlights the potential for to-go options such as pre-prepared salads, lightly processed snacks, and medically tailored meal kits. Results of this study illustrate the challenges and opportunities of leveraging a rural hospital as an anchor institution for expanding local food system development in rural Appalachia. This study also offers insights into the intersections of health, culture, and economy in an Appalachian community, and provides a framework for expanding local food system initiatives.

Background: Anterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability. Methods: We did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367. Findings: Between Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications. Interpretation: Surgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management. Funding: The UK National Institute for Health Research Health Technology Assessment Programme.

Democratic cooperation is a particularly complex type of arrangement that requires attendant institutions to ensure that the problems inherent in collective action do not subvert the public good. It is perhaps due to this complexity that historians, political scientists, and others generally associate the birth of democracy with the emergence of so-called states and center it geographically in the “West,” where it then diffused to the rest of the world. We argue that the archaeological record of the American Southeast provides a case to examine the emergence of democratic institutions and to highlight the distinctive ways in which such long-lived institutions were—and continue to be—expressed by Native Americans. Our research at the Cold Springs site in northern Georgia, USA, provides important insight into the earliest documented council houses in the American Southeast. We present new radiocarbon dating of these structures along with dates for the associated early platform mounds that place their use as early as cal AD 500. This new dating makes the institution of the Muskogean council, whose active participants have always included both men and women, at least 1,500 years old, and therefore one of the most enduring and inclusive democratic institutions in world history.

There are many potential improvement opportunities in corporate or industry learning to enable better and faster decisions. 'Lessons Learned' has long been a respected mechanism for ensuring mistakes of the past aren’t repeated. This may lead to operational improvements, business excellence as well as reduced health, safety and environment incidents. In the collective experience of the authors in the energy industry, as consultants and software developers working in the Lessons Learned area, although there is general approval of the Lessons Learned concept and a desire to leverage expertise, companies are not achieving their desired value and assurance of continuous improvement. To truly learn lessons, they need to have become inherently amalgamated into the processes. This may be through policies/procedures ranging from governing documentation to short-form checklists. Too often, a Lesson Learned process goes no further than airing frustrations from imperfect execution, and lessons are lost beyond the personnel directly involved or, at best, they become a repository of infrequently accessed and poorly categorised lessons of reduced value. In order to maximise knowledge transfer, workshop methodology and categorisation are key. Actions must be assigned and a prioritisation system put in place based on the level of concern and the potential opportunity for improvement. The well-accepted Risk Matrix can be applied to prioritise areas using filtering and to allow different areas of the business to focus on their speciality as well as grouping action types to aid the continuous improvement cycle. This paper provides insights into a new system of Lessons Learned, which allows accelerated execution, increased collaboration and innovation, thereby capturing company knowledge and empowering employees.

Sociologists have long been interested in the meaning workers derive from their jobs. The issue has garnered increasing academic and policy attention in recent years with the concept of "meaningful work," yet little is known about how social stratification relates to access to it. This paper addresses this issue by exploring how the meaningfulness of jobs-as rated by their incumbents-is stratified across classes and occupations in a national survey of 14,000 working adults in the United Kingdom. It finds modest differentials between classes, with those in routine and manual occupations reporting the lowest levels of meaningfulness and those in managerial and professional occupations and small employers and own account workers reporting the highest levels. Detailed job attributes (e.g., job complexity and development opportunities) explain much of the differences in meaningfulness between classes and occupations, and much of the overall variance in meaningfulness. The main exception is the specific case of how useful workers perceive their jobs to be for society: A handful of occupations relating to health, social care, and protective services which cut across classes stand out from all other occupations. The paper concludes that the modest stratification between classes and occupations in meaningful work is largely due to disparities in underlying job complexity and development opportunities. The extent to which these aspects of work can be improved, and so meaningfulness, especially in routine and manual occupations, is an open, yet urgent, question.

The human species has deeply impacted the geology of our planet, our current environmental conditions now being very different from the stable interglacial conditions of the Holocene Epoch, in which human civilization flowered. Hence, a new epoch has been proposed, the Anthropocene, starting in tandem with the mid-20th-century Great Acceleration of population, industrialization, and globalization. One of the clearest measures of human impact on our planet is energy use, as reflected by rapidly increasing atmospheric carbon dioxide levels. Through this lens, the large-scale historical patterns of human activity show not gradual change but sudden and massive linked changes to geology and ecosystems. This has been driven by growth of the technosphere, a quasi-autonomous and emergent sphere of human-driven processes that interacts with the other Earth spheres. Consequences include the rapid accumulation of unrecycled waste, increasingly threatening the success of this development and hence of humans too.

Africa has undergone a progressive aridification during the last 20 My that presumably impacted organisms and fostered the evolution of life history adaptations. We test the hypothesis that shift to living in ant nests and feeding on ant brood by larvae of phyto-predaceous Lepidochrysops butterflies was an adaptive response to the aridification of Africa that facilitated the subsequent radiation of butterflies in this genus. Using anchored hybrid enrichment we constructed a time-calibrated phylogeny for Lepidochrysops and its closest, non-parasitic relatives in the Euchrysops section (Poloyommatini). We estimated ancestral areas across the phylogeny with process-based biogeographical models and diversification rates relying on time-variable and clade-heterogeneous birth-death models. The Euchrysops section originated with the emerging Miombo woodlands about 22 million years ago (Mya) and spread to drier biomes as they became available in the late Miocene. The diversification of the non-parasitic lineages decreased as aridification intensified around 10 Mya, culminating in diversity decline. In contrast, the diversification of the phyto-predaceous Lepidochrysops lineage proceeded rapidly from about 6.5 Mya when this unusual life history likely first evolved. The Miombo woodlands were the cradle for diversification of the Euchrysops section, and our findings are consistent with the hypothesis that aridification during the Miocene selected for a phyto-predaceous life history in species of Lepidochrysops, with ant nests likely providing caterpillars a safe refuge from fire and a source of food when vegetation was scarce., This work was funded by the Research Council of Norway (# 204308), the German Research Foundation (ES 522/1-1), Synthesys (GB-TAF-6197), the Putnam Exploration Fund of the Museum of Comparative Zoology, and the Hintelmann Prize for Zoological systematics to ME, and NSF DEB-0447244 and a Wetmore-Colles grant from the Museum of Comparative Zoology to NEP. ERC-EMARES (# 250325) funded fieldwork by DJL in Madagascar. Open Access funding enabled and organized by Projekt DEAL., 1 INTRODUCTION 2 MATERIALS AND METHODS Taxon sampling Probe design 2.2.1 Selection of AHE target loci 2.2.2 Selection of anonymous target loci 2.2.3 Incorporation of legacy loci 2.2.4 Probe generation Molecular methods, data cleaning, and assembly Molecular data, phylogeny, and dating Historical biogeography Diversification dynamics 3 RESULTS AND DISCUSSION Diversification during the aridification of Africa Increasing occupation of drier biomes Extinction and rise of phyto-predation Aphytophagy: A rare and risky life history strategy in Lepidoptera Ant association and adaptation to the aridification of Africa 4 CONCLUSIONS AUTHOR CONTRIBUTIONS ACKNOWLEDGMENTS CONFLICT OF INTEREST STATEMENT

This file contains supplementary information referenced in the Journal of the ASABE peer-reviewed article “Can woodchip bioreactors be used at a catchment scale? Nitrate performance and sediment considerations.” The information is of three general types: Written method, tables, and figures. The first page consists of text and equations describing the methods used to determine V-notch weir discharge in the article. Pages 2 through 13 contain ten tables of detailed data documenting duration of flow events, discharge, hydraulic residence time, nitrate-N removal rate, water temperature, nutrient loads, and woodchip ash and sediment contents. Pages 14 through 21 contain seven figures; four figures contain photographs from the experimental site, two are data graphs, and one is a diagram showing the location of woodchip sampling.

Preprints enable new forms of peer review that have the potential to be more thorough, inclusive, and collegial. In December 2022, 80 researchers and representatives of funders, institutions, preprint servers, journals, indexers, and review services were invited to gather online and at the Janelia Research Campus for a workshop on Recognizing Preprint Peer Review. Sponsored by HHMI, ASAPbio, and EMBO, this meeting aimed to catalyze community consensus and support for preprint peer review and to create model funder, institutional, and journal policies that recognize both preprints with reviews, and reviews of preprints. Here, we make a call to action to stakeholders in the community to help capture the growing momentum of preprint sharing and empower researchers to provide open and constructive peer review for preprints.

The structuring of time in the early modern period has traditionally been associated with a broad, European-led shift towards ‘accuracy’, and with it connotations of ‘modernity’. Yet, a fuller examination of the temporal world of early modern merchants challenges such a teleology. Taking as its focus the English East India Company (EIC), this article situates concerns for accuracy in the management of time (and with it profit) within a broader spectrum of temporal influences, including seasonal, indigenous, and embodied time. It draws upon the experiences of the merchant Isaac Lawrence (1639–79), whose trade began around the Mediterranean Sea but ended in the service of the EIC in Persia. Like many of his contemporaries in the Company, Lawrence died relatively young and in obscure circumstances; however, the survival of his personal papers through his brother William Lawrence affords vital insights into how time was observed, measured, and felt within mobile early modern lives. Read alongside Company records, Lawrence's experience makes clear the necessity of reading subjective temporalities into historical understandings of time within global frameworks.

Despite the increasing availability of pre-exposure prophylaxis (PrEP), Latinx men who have sex with men (LMSM) are not receiving PrEP-related information. To understand the influence of LMSM sexual networks on PrEP-related conversations and encouragement to use PrEP, this cross-sectional egocentric network study characterized the PrEP-related communication of 130 LMSM egos with 507 sexual partners (alters). Participants were recruited using respondent-driven sampling methods from a Miami-Dade County community-health organization. Egocentric-level data were collected from 2018-2019 and analyzed using multilevel modeling. Of egos, 30% reported using PrEP. Closeness between participants and sexual partners played a role in PrEP conversation and encouragement. Participants believed they would have less success convincing sexual partners to use PrEP if partners were older. Participants perceived higher likelihood to talk about PrEP or success in encouraging alters to use PrEP if, relative to meeting sexual partners on Grindr, they met at a friend's party, gay-centric community event, or school/work. Given that increased closeness and in-person sexual partner meeting venues are associated with PrEP information dissemination and encouragement, social network-based interventions can capitalize on PrEP navigators who run network visualizations, and with this information develop a longitudinal plan to increase PrEP conversation and encouragement as needed for each network.

We administered a survey during the fifteen-minute wait time after the COVID-19 vaccine was given (N = 1475) to examine attitudes towards COVID-19 vaccines among adults who were vaccinated in Arkansas between April 22nd and July 6th, 2021. We found 60% of those who had just been vaccinated reported some level of hesitancy, including 10% who reported being "very hesitant." Hesitancy was not evenly distributed across sociodemographic groups (age, sex, race/ethnicity, and education) and was associated with whether a non-English language is spoken in the home, health care coverage, and flu vaccination over the past five years in bivariate analysis. Generalized ordered logistic regression results reveal associations between the log-ordered odds of COVID-19 vaccine hesitancy and age, sex, race/ethnicity, health care coverage, health literacy, and flu vaccination over the past five years. Surprisingly, a prior COVID-19 diagnosis was not significantly associated with COVID-19 vaccine hesitancy. These results can inform health care and communication strategies. Further attention to "hesitant adopters" can provide insights into the process of overcoming vaccine hesitancy that are critical to vaccine uptake.

This essay will realize an intersectional historiographic approach to the career of Ina Ray Hutton, one of the most important band leaders during the rise and fall of the swing era. Hutton was known as the “blonde bombshell of rhythm,” an appellation that was critical not only to her popular notoriety but also to her success performing a sustained act of racial passing, the full public awareness of which has arrived in a belated and untimely fashion (absent from her obituaries). Although her passing was likely known within certain delimited communities, it was hidden from the larger dominant white culture of the day and from the popular memory of her trans-media audience. This study will focus on the contexts of her work at the beginning of her career, and end with her late career on local and network television as sites that provide new speculative interventions to recognize the significance of this singular performer.

CCR Translation for This Article from Plectin-1 as a Novel Biomarker for Pancreatic Cancer

Purpose: We are in great need of specific biomarkers to detect pancreatic ductal adenocarcinoma (PDAC) at an early stage, ideally before invasion. Plectin-1 (Plec1) was recently identified as one such biomarker. However, its suitability as a specific biomarker for human pancreatic cancer, and its usability as an imaging target, remain to be assessed.Experimental Design: Specimens of human PDAC, chronic pancreatitis, and normal pancreata were evaluated by immunohistochemistry and Western blot analysis. To validate Plec1 as an imaging target, Plec1-targeting peptides (tPTP) were used as a contrast agent for single photon emission computed tomography in an orthotopic and liver metastasis murine model of PDAC.Results: Plec1 expression was noted to be positive in all PDACs but negative in benign tissues. Plec1 expression increases during pancreatic carcinogenesis. It was found to be misexpressed in only 0% to 3.85% of early PDAC precursor lesions (PanIN I/II) but in 60% of PanIN III lesions. Plec1 expression was further noted to be retained in all metastatic foci assayed and clearly highlighted these metastatic deposits in lymph nodes, liver, and peritoneum. In vivo imaging using tPTP specifically highlighted the primary and metastatic tumors. Biodistribution studies performed after imaging show that the primary pancreatic tumors and liver metastases retained 1.9- to 2.9-fold of tPTP over normal pancreas and 1.7-fold over normal liver.Conclusions: Plec1 is the first biomarker to identify primary and metastatic PDAC by imaging and may also detect preinvasive PanIN III lesions. Strategies designed to image Plec1 could therefore improve detection and staging. Clin Cancer Res; 17(2); 302–9. ©2010 AACR.

Commercially developed monoclonal antibodies (mAb) have been effective in the prevention or treatment of SARS-CoV-2 infection1-3 but the rapid antigenic evolution of the Omicron sub-lineages has reduced their activity4-8 and they are no longer licensed for use in many countries. Here, we isolate spike binding monoclonal antibodies from vaccinees who suffered vaccine break-through infections with Omicron sublineages BA.4/5. We find that it is possible for antibodies targeting highly mutated regions to recover broad activity through allosteric effects (mAb BA.4/5-35) and characterise a pair of potent mAbs with extremely broad neutralization against current and historical SARS-CoV-2 variants. One, mAb BA.4/5-2, binds at the back of the left shoulder of the receptor binding domain (RBD) in an area which has resisted mutational change to date. The second, mAb BA.4/5-5, binds a conserved epitope in sub-domain 1 (SD1). The isolation of this pair of antibodies with non-overlapping epitopes shows that potent and extremely broadly neutralizing antibodies are still generated following infection and SD1 directed mAbs may increase the resilience of mAb therapeutics/prophylactics against SARS-CoV-2.

An uncooled 800Gb/s-DR8 silicon photonics transmitter PIC with fully integrated lasers and 1.0 Vpp drive swing modulators in an open market platform is demonstrated for data center applications.

We propose a simple algorithm for automatic transfer of facial expressions, from videos to a 3D character, as well as between distinct 3D characters through their rendered animations. Our method begins by learning a common, semantically-consistent latent representation for the different input image domains using an unsupervised image-to-image translation model. It subsequently learns, in a supervised manner, a linear mapping from the character images' encoded representation to the animation coefficients. At inference time, given the source domain (i.e., actor footage), it regresses the corresponding animation coefficients for the target character. Expressions are automatically remapped between the source and target identities despite differences in physiognomy. We show how our technique can be used in the context of markerless motion capture with controlled lighting conditions, for one actor and for multiple actors. Additionally, we show how it can be used to automatically transfer facial animation between distinct characters without consistent mesh parameterization and without engineered geometric priors. We compare our method with standard approaches used in production and with recent state-of-the-art models on single camera face tracking.

Despite the wide availability of PrEP, Latino men who have sex with men (LMSM) continue to experience access barriers. Novel HIV prevention research strategies to increase PrEP uptake and adherence among the high incidence populations, such as LMSM who misuse drugs, include social network analyses. This study identified the associations of drug use homophily within LMSM friendship networks and PrEP promotion conversations and described the physical overlap between geographic drug risk areas with conversations of PrEP promotion. Respondent-driven sampling was used to recruit 10 sociocentric networks. Quadratic assignment procedure (QAP) correlations and multiple regression QAPs were used to identify influences of drug use homophily, and geocoding and visualizations to describe drug use polygons and PrEP conversations. Friendship relationships in which both friends used cocaine or marijuana were more likely to report PrEP-related conversations in the past six months. The likelihood of talking about PrEP in the next six months was higher among dyads with cocaine use homophily and ecstasy use homophily, while lower among dyads with marijuana use homophily. Participants reported using marijuana and cocaine throughout Miami-Dade County while ecstasy polygons were mostly in urban areas. The majority of drug polygons associated with PrEP conversations were located in north and central Miami. Future interventions can consider enrolling entire sociocentric friendship groups, configuring friendship networks to connect those without PrEP information to those with information, and incorporating peer leaders.

Background The COVID-19 pandemic has led to pervasive social and economic disruptions. This cross-sectional investigation aimed to evaluate associations between religious/spiritual factors and mental health symptoms among community residents in a southern US state. In particular, we focused on perceptions of God's distance, a salient aspect of religious/spiritual struggle that has received little scrutiny in health research. Methods Participants included 551 respondents assessed during a period of gradual reopening but rising infection rates. Mental health outcomes were assessed using standardized measures of generalized anxiety, depression, and trauma symptoms. Perceptions of an affirming relationship with God, anger at God, and disappointment at God's distance were evaluated using an adapted version of the Attitudes-Toward-God Scale-9. Results In multivariate analyses that accounted for pandemic-related and demographic factors, positive relationships with God were related to diminished symptoms on all three mental heatlh indices (all p's ≤.003), whereas disappointment with God's distance was associated with more pronounced difficulties (all p's ≤.014). Limtations The cross-sectional design precludes causal conclusions. Conclusions Findings suggest that perceived relationships with God are tied to clinically relevant mental health outcomes during periods of major upheaval. Disappointment with God's distance may be an important, understudied dimension of religious/spiritual struggle meriting further investigation.