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Leah L Zullig,1,2 Valerie A Smith,1,2 Jennifer H Lindquist,1 Christina D Williams,3,4 Morris Weinberger,1,5 Dawn Provenzale,1,4 George L Jackson,1,2 Michael J Kelley,6–8 Susanne Danus,1 Hayden B Bosworth1,2,91Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA; 2Department of Population Health Sciences, Duke University, Durham, NC, USA; 3Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA; 4Cooperative Studies Program Epidemiology Center, Durham, NC, USA; 5Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA; 6Office of Specialty Care Services, Department of Veterans Affairs, Washington, DC, USA; 7Hematology-Oncology Service, Durham Veterans Affairs Medical Center, Durham, NC, USA; 8Department of Medicine, Duke University, Durham, NC, USA; 9Departments of Psychiatry and School of Nursing, Duke University, Durham, NC, USAPurpose: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing nonmetastatic CRC survivors and matched noncancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with cardiovascular disease (CVD)-related chronic conditions and their likelihood of control during the year after CRC diagnosis.Patients and methods: We retrospectively identified patients diagnosed with nonmetastatic CRC in the Veterans Affairs health care system from fiscal years 2009 to 2012 and matched each with up to 3 noncancer control patients. We used logistic regression to assess differences in the likelihood of being diagnosed with CVD-related chronic conditions and control between nonmetastatic CRC survivors and noncancer controls.Results: We identified 9,758 nonmetastatic CRC patients and matched them to 29,066 noncancer controls. At baseline, 69.4% of CRC survivors and their matched controls were diagnosed with hypertension, 52.4% with hyperlipidemia, and 36.7% with diabetes. Compared to matched noncancer controls, CRC survivors had 57% higher odds of being diagnosed with hypertension (OR=1.57, 95% CI=1.49–1.64) and 7% higher odds of controlled blood pressure (OR=1.07, 95% CI 1.02, 1.13) in the subsequent year. Compared to matched noncancer control patients, CRC survivors had half the odds of being diagnosed with hyperlipidemia (OR=0.50, 95% CI=0.48–0.52) and lower odds of low-density lipoprotein (LDL) control (OR 0.88, 95% CI 0.81–0.94). There were no significant differences between groups for diabetes diagnoses or control.Conclusion: Compared to noncancer controls, nonmetastatic CRC survivors have 1) greater likelihood of being diagnosed with hypertension and worse blood pressure control in the year following diagnosis; 2) lower likelihood of being diagnosed with hyperlipidemia or LDL control; and 3) comparable diabetes diagnoses and control. There may be a need for hypertension control interventions targeting cancer survivors.Keywords: Veterans Affairs, colorectal neoplasms, cancer survivors, cardiovascular disease, comorbidity, chronic disease management

Leah L Zullig,1,2 Christina D Williams,3,4 Alice G Fortune-Britt1,51Center for Health Services Research and Development in Primary Care, Durham Veterans Affairs Medical Center, 2Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, 3Medical Service, Division of Hematology-Oncology, Durham Veterans Affairs Medical Center, 4Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, 5Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USAAbstract: Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans' health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes.Keywords: colorectal neoplasms, health services research, lung neoplasms, outcome assessment (health care), review, United States Department of Veterans Affairs

Background: Risk for colorectal cancer may accumulate through multiple environmental factors. Understanding their effects, along with genetics, age, and family history, could allow improvements in clinical decisions for screening protocols. We aimed to extend the previous work by recalibrating an environmental risk score (e-Score) for colorectal cancer among a sample of US veteran participants of the Million Veteran Program., Methods: Demographic, lifestyle, and colorectal cancer data from 2011 to 2022 were abstracted from survey responses and health records of 227,504 male Million Veteran Program participants. Weighting for each environmental factor's effect size was recalculated using Veterans Affairs training data to create a recalibrated e-Score. This recalibrated score was compared with the original weighted e-Score in a validation sample of 113,752 (n cases = 590). Nested multiple logistic regression models tested associations between quintiles for recalibrated and original e-Scores. Likelihood ratio tests were used to compare model performance., Results: Age (P < 0.0001), education (P < 0.0001), diabetes (P < 0.0001), physical activity (P < 0.0001), smoking (P < 0.0001), NSAID use (P < 0.0001), calcium (P = 0.015), folate (P = 0.020), and fruit consumption (P = 0.019) were significantly different between colorectal cancer case and control groups. In the validation sample, the recalibrated e-Score model significantly improved the base model performance (P < 0.001), but the original e-Score model did not (P = 0.07). The recalibrated e-Score model quintile 5 was associated with significantly higher odds for colorectal cancer compared with quintile 1 (Q5 vs. Q1: 1.79; 95% CI, 1.38-2.33)., Conclusions: Multiple environmental factors and the recalibrated e-Score quintiles were significantly associated with colorectal cancer cases., Impact: A recalibrated, veteran-specific e-Score could be used to help personalize colorectal cancer screening and prevention strategies., (©2024 The Authors; Published by the American Association for Cancer Research.)

The goal of therapeutic cancer vaccines and immune checkpoint therapy (ICT) is to promote T cells with anti-tumor capabilities. Here, we compared mutant neoantigen (neoAg) peptide-based vaccines with ICT in preclinical models. NeoAg vaccines induce the most robust expansion of proliferating and stem-like PD-1 + TCF-1 + neoAg-specific CD8 T cells in tumors. Anti-CTLA-4 and/or anti-PD-1 ICT promotes intratumoral TCF-1 - neoAg-specific CD8 T cells, although their phenotype depends in part on the specific ICT used. Anti-CTLA-4 also prompts substantial changes to CD4 T cells, including induction of ICOS + Bhlhe40 + T helper 1 (Th1)-like cells. Although neoAg vaccines or ICTs expand iNOS + macrophages, neoAg vaccines maintain CX3CR1 + CD206 + macrophages expressing the TREM2 receptor, unlike ICT, which suppresses them. TREM2 blockade enhances neoAg vaccine efficacy and is associated with fewer CX3CR1 + CD206 + macrophages and induction of neoAg-specific CD8 T cells. Our findings highlight different mechanisms underlying neoAg vaccines and different forms of ICT and identify combinatorial therapies to enhance neoAg vaccine efficacy., Competing Interests: Declaration of interests A.M.H. is currently employed by Lifecycle Biotechnologies, and her employment does not pose any direct conflict of interest with the research presented in this article. M.M.G. reports a personal honorarium of US $1,000.00 per year from Springer Nature Ltd (as an associate editor for Nature Precision Oncology) and served as a paid consultant for Merck. M. Colonna reports that they are a member of the scientific advisory board of Vigil Neuro and Cell Signaling Technology, received research grants from Vigil Neuro during the conduct of the study, and has a patent related to TREM2 modulation pending (PCT/US2021/019914). K.E.P. reports an advising relationship with Guardant Health that will result in advising fees., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The flow of water confined in nanosize capillaries is subject of intense research due to its relevance in the fabrication of nanofluidic devices and in the development of theories for fluid transport in porous media. Here, using molecular dynamics simulations carried out on 2D capillaries made up of graphite, hexagonal boron nitride (hBN) and a mix of the two, and of sizes from subnanometer to few nanometers, we investigate the relationship between the wettability of the wall capillary, the water diffusion, and its flow rate. We find that the water diffusion is decoupled from its flow properties as the former is not affected either by the height or chemistry of the capillary (except for the subnanometer slits), while the latter is dependent on both. The capillaries containing hBN show a reduced flow rate compared to those that are purely graphitic, likely due to the high friction coefficient between water and hBN. Such resistance to the flow is, however, at its maximum in the smallest capillary and lower for larger ones. Finally, we show that the flow rate values obtained from the Hagen-Poiseuille theory are almost always smaller than those obtained from simulations, indicating that either the slip length or the viscosity of nanoconfined water could be substantially different from the bulk values.

The current study tested a longitudinal mediation model throughout the COVID-19 pandemic focused on whether students' housing instability stress and food/financial instability stress at the beginning of the pandemic in spring 2020 (T1) informed sleep dissatisfaction and duration in fall 2020 (T2) and, in turn, physical and mental health in spring 2021 (T3). Further, we tested whether relations varied based on students' ethnic-racial backgrounds. Participants included 879 Asian, Black, Latine, Multiracial, and White emerging adult college students (Mage = 19.95, SD = 0.33) from a large public university in the mid-Atlantic region of the United States who attended college during the COVID-19 pandemic and completed surveys about their experiences. Findings indicated a significant mediation process, such that T1 housing instability stress predicted greater T2 sleep dissatisfaction and, in turn, less physical health, greater depressive symptoms, and greater anxiety symptoms at T3. Additionally, T1 food/financial instability stress was significantly associated with less T2 sleep duration but was not, in turn, associated with any T3 outcomes. Findings did not vary by students' ethnicity/race. Results highlight that sleep dissatisfaction is an important factor that accounts for relations between COVID-19 stressors predicting mental and physical health outcomes throughout the pandemic., (© 2024 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Patients with chronic lymphocytic leukemia (CLL) respond well to initial treatment with the Bcell lymphoma 2 (BCL2) inhibitor venetoclax. Upon relapse, they often retain sensitivity to BCL2 targeting, but durability of response remains a concern. We hypothesize that targeting both BCL2 and B-cell lymphoma-extra large (BCLXL) will be a successful strategy to treat CLL, including for patients who relapse on venetoclax. To test this hypothesis, we conducted a pre-clinical investigation of LP-118, a highly potent inhibitor of BCL2 with moderate BCLXL inhibition to minimize platelet toxicity. This study demonstrated that LP-118 induces efficient BAK activation, cytochrome C release, and apoptosis in both venetoclax naïve and resistant CLL cells. Significantly, LP-118 is effective in cell lines expressing the BCL2 G101V mutation and in cells expressing BCLXL but lacking BCL2 dependence. Using an immunocompetent mouse model, Eμ-TCL1, LP-118 demonstrates low platelet toxicity, which hampered earlier BCLXL inhibitors. Finally, LP-118 in the RS4;11 and OSU-CLL xenograft models results in decreases in tumor burden and survival advantage, respectively. These results provide a mechanistic rationale for the evaluation of LP-118 for the treatment of venetoclax responsive and relapsed CLL.

Computational simulation methods based on machine learned potentials (MLPs) promise to revolutionise shape prediction of flexible molecules in solution, but their widespread adoption has been limited by the way in which training data is generated. Here, we present an approach which allows the key conformational degrees of freedom to be properly represented in reference molecular datasets. MLPs trained on these datasets using a global descriptor scheme are generalisable in conformational space, providing quantum chemical accuracy for all conformers. These MLPs are capable of propagating long, stable molecular dynamics trajectories, an attribute that has remained a challenge. We deploy the MLPs in obtaining converged conformational free energy surfaces for flexible molecules via well-tempered metadynamics simulations; this approach provides a hitherto inaccessible route to accurately computing the structural, dynamical and thermodynamical properties of a wide variety of flexible molecular systems. It is further demonstrated that MLPs must be trained on reference datasets with complete coverage of conformational space, including in barrier regions, to achieve stable molecular dynamics trajectories., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Introduction: The objectives of the current study were the following: (1) to explore multidimensional profiles of Latinx cultural orientation using Spanish language use, familismo, and ethnic-racial identity (ERI) affirmation among Latinx adolescents, (2) to test how Latinx cultural orientation profiles were associated with adolescents' internalizing symptoms (i.e., depressive symptoms and anxiety symptoms), and (3) to test whether associations between profiles and internalizing symptoms were moderated by adolescents' ethnic-racial discrimination experiences., Methods: The study was conducted among a sample of 204 Latinx adolescents (52.4% female; M age  = 14.35, SD age  = 1.75)., Results: Latent profile analysis indicated four profiles of Latinx cultural orientation: higher affirmation and lower Spanish (HALS), higher Spanish (HS), lower familismo and affirmation (LFA), and higher familismo/lower Spanish and affirmation (HFLSA). Latinx adolescents who reported lower levels on more than one Latinx cultural orientation dimension (e.g. LFA or HFSLA) also reported worse health when compared to adolescents who reported higher levels of more than one Latinx cultural orientation dimension (e.g., HSA). The associations between Latinx cultural orientation profiles and internalizing symptoms were not moderated by adolescents' ethnic-racial discrimination., Conclusion: Findings provide researchers and practitioners with an understanding of the various ways in which Latinx adolescents remain connected to their Latinx culture and implications for their outcomes., (© 2024 Foundation for Professionals in Services to Adolescents.)

Objectives: The present study examined whether teen mothers' adaptive cultural characteristics (i.e., familism values, language competency pressures, and involvement in Mexican culture and U.S. mainstream culture) when children were 3 years old (i.e., Wave 4; W4) informed mothers' Spanish language use with their children when children were 4 years old (W5) and, in turn, children's subsequent Spanish receptive vocabulary when children were 5 years old (W6)., Method: The present study included 204 Mexican-origin children (58% male) and their mothers who entered parenthood during adolescence ( M = 16.24, SD = .99 at W1)., Results: Five mediational processes were significant, such that mothers' higher familism values (i.e., emphasizing family support and obligations), Spanish competency pressure (i.e., stress associated with Spanish language competency), and involvement in U.S. mainstream culture at W4 were associated with mothers' lower Spanish language use with children at W5 and, in turn, children's lower levels of Spanish receptive vocabulary at W6. Mothers' greater involvement in Mexican culture and English competency pressure (i.e., stress associated with English language competency) at W4 were associated with mothers' greater Spanish language use with children at W5 and, in turn, children's greater Spanish receptive vocabulary at W6. Additionally, mothers' greater involvement in U.S. mainstream culture at W4 was directly associated with children's lower Spanish language abilities at W6., Conclusions: Findings highlight the importance of the family context in Mexican-origin children's Spanish language skills over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: The study examined the associations between familial cultural values of familismo (familism) and respeto (respect), parental monitoring, and Mexican adolescents' sexual behaviors., Method: The sample consisted of 1,024 Mexican adolescents (12-18 years) from two urban schools in Puebla, Mexico., Results: Findings indicated that respeto was associated with paternal and maternal monitoring, sexual responsibility, sexual intention, and sexual behavior. Further, through indirect effects, among males, respeto was associated with paternal monitoring, which was, in turn, associated with sexual intentions., Conclusions: Findings highlight the relevance of caregivers and cultural values in Mexican adolescents' sexual health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Molecular simulations have become a key tool in molecular and materials design. Machine learning (ML)-based potential energy functions offer the prospect of simulating complex molecular systems efficiently at quantum chemical accuracy. In previous work, we have introduced the ML-based PairF-Net approach to neural network potentials, that adopts a pairwise interatomic scheme to predicting forces within a molecular system. Here, we further develop the PairF-Net model to intrinsically incorporate energy conservation and couple the model to a molecular mechanical (MM) environment within the OpenMM package. The updated PairF-Net model yields energy and force predictions and dynamical distributions in good agreement with the rMD17 dataset of ten small organic molecules in the gas-phase. We further show that these in vacuo ML models of small molecules can be applied to force predictions in aqueous solution via hybrid ML/MM simulations. We present a new benchmark dataset for these ten molecules in solution, obtained from QM/MM simulations, which we denote as rMD17-aq (https://zenodo.org/records/10048644); and assess the ability of PairF-Net to reproduce the molecular energy, atomic forces and dynamical distributions of these solution conformations via ML/MM simulations., (© 2024 The Authors. Journal of Computational Chemistry published by Wiley Periodicals LLC.)

Introduction: Lung cancer survival is improving in the United States. We investigated whether there was a similar trend within the Veterans Health Administration (VHA), the largest integrated healthcare system in the United States., Materials and Methods: Data from the Veterans Affairs Central Cancer Registry were analyzed for temporal survival trends using Kaplan-Meier estimates and linear regression., Results: A total number of 54,922 Veterans were identified with lung cancer diagnosed from 2010 to 2017. Histologies were classified as non-small-cell lung cancer (NSCLC) (64.2%), small cell lung cancer (SCLC) (12.9%), and 'other' (22.9%). The proportion with stage I increased from 18.1% to 30.4%, while stage IV decreased from 38.9% to 34.6% (both P < .001). The 3-year overall survival (OS) improved for stage I (58.6% to 68.4%, P < .001), stage II (35.5% to 48.4%, P < .001), stage III (18.7% to 29.4%, P < .001), and stage IV (3.4% to 7.8%, P < .001). For NSCLC, the median OS increased from 12 to 21 months (P < .001), and the 3-year OS increased from 24.1% to 38.3% (P < .001). For SCLC, the median OS remained unchanged (8 to 9 months, P = .10), while the 3-year OS increased from 9.1% to 12.3% (P = .014). Compared to White Veterans, Black Veterans with NSCLC had similar OS (P = .81), and those with SCLC had higher OS (P = .003)., Conclusion: Lung cancer survival is improving within the VHA. Compared to White Veterans, Black Veterans had similar or higher survival rates. The observed racial equity in outcomes within a geographically and socioeconomically diverse population warrants further investigation to better understand and replicate this achievement in other healthcare systems., Competing Interests: Disclosure DM is a consultant and/or advisor for AstraZeneca, Delfi Diagnostics, Viewray, and Merck; is a scientific advisor for Lungevity Foundation and GO2 Foundation for Lung Cancer; is co-director of the VA Greater Los Angeles Lung Precision Oncology Program; is on the scientific advisory board and owns stock options in Lung Life AI. DG is a founder of SwitchboardMD, is on the advisory board of Histowiz LLC, and owns stock in PortalBurner LLC, Histowiz LLC, and SwitchboardMD. JL is a board member of Rescue Lung Rescue Life and is Co-director of the Tennessee Valley Healthcare System Lung Cancer Screening Program. LS is a member of the Tennessee Valley Healthcare System Lung Cancer Screening Steering Committee and Vice Chair of Health Equity at Vanderbilt University Medical Center Radiology. CS is a Medical Director of the VAPORHCS lung nodule surveillance system, Director for the VISN 20 Centralized Lung Cancer Screening Program, and Chief Consultant for the VA National Center for Lung Cancer Screening. He does not receive additional remuneration for this role. He has a grant from the Oregon Health and Science University Knight Cancer Institute (KCI) to develop a nodule/lung cancer risk prediction model that includes working with a for-profit company, Optellum, Ltd. Neither he nor the KCI receive remuneration for this collaboration. All other authors declare no conflicts of interest., (Published by Elsevier Inc.)

Objective: To broadly assess the efficacy of medroxyprogesterone acetate (MPA) for ovulatory suppression during in vitro stimulation compared with gonadotropin-releasing hormone (GnRH) antagonist cycles., Design: Cohort trial., Setting: A single academic-affiliated private fertility practice., Patients: Patients of all diagnoses aged 18-44 years undergoing autologous in vitro fertilization (IVF) for fertility treatment between 2020 and 2023., Interventions: Comparison of MPA vs. antagonist IVF stimulation cycles., Main Outcome Measures: Rates of premature ovulation, oocyte and embryo yield, embryo quality, pregnancy rates, and logistical benefits., Results: Prospective data was collected on 418 patients who underwent MPA protocol ovarian stimulation (MPA group), which was compared with 419 historical control gonadotropin hormone-releasing hormone antagonist cycles (control group). Age was similar between groups (35.6 ± 4.6 vs. 35.7 ± 4.8 years; P = .75). There were no cases of premature ovulation in the MPA group compared with a total of five cases in the control group (0% vs. 1.2%; risk ratio [RR] = 0.09; 95% confidence interval [CI], 0.01, 1.66). No differences were seen between number of oocytes retrieved (14.3 ± 10.2 vs. 14.3 ± 9.7; P = .83), blastocysts (4.9 ± 4.6 vs. 5.0 ± 4.6; P = .89), or euploid blastocysts (2.4 ± 2.6 vs. 2.2 ± 2.4; P = .18) in the MPA vs. control group respectively. Clinical pregnancy rate was similar between groups (70.4% vs. 64.2%; RR = 0.92; 95% CI, 0.72, 1.18). There was no difference in length of IVF stimulation or dose of stimulation medications. Patients in the MPA group saved an average of $491 ± $119 on medications, had an average of one less monitoring visit (4.4 ± 0.9 vs. 5.6 ± 1.1; P<.01), and 5.0 ± 1.2 less injections per cycle. When adjusting for age and ovarian reserve, protocol group (MPA vs. control) did not influence having an embryo available for transfer (76.6% vs. 73.4%; adjusted RR = 1.05; 95% CI, 0.94, 1.14)., Conclusion: For ovulatory suppression during IVF cycles, MPA was effective at preventing ovulation while demonstrating similar cycle and reproductive outcomes, with the additional benefits of patient cost savings, increased convenience with decreased number of visits, and fewer injections., Competing Interests: Declaration of interests A.M.W. has nothing to disclose. C.D.W. has nothing to disclose. L.P.S. has nothing to disclose. S.P. is on the Scientific Advisory Board of PS Fertility (Charlottesville, Virginia) outside the submitted work. L.R.G. is a Consultant to LiNA Medical for research and development of hysteroscopy equipment outside the submitted work., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

The death of a parent can have profound effects on child development. Yet, little is known about the individual and environmental processes that contribute to heterogeneity in child bereavement outcomes. A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3-22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Individual processes (i.e., how children manage stressors and think about themselves/their environment) included child coping and perception of themselves and/or their environment. Environmental processes (i.e., contextual resources) included family, mentorship, and stress exposure. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.

Objectives: To examine whether severe Gulf War illness (SGWI) case status was associated with longitudinal multimorbidity patterns. Methods: Participants were users of the Veteran Health Administration Health Care System drawn from the Gulf War Era Cohort and Biorepository ( n = 840). Longitudinal measures of multimorbidity were constructed using (1) electronic health records (Charlson Comorbidity Index; Elixhauser; and Veterans Affairs Frailty Index) from 10/1/1999 to 6/30/2023 and (2) self-reported medical conditions (Deficit Accumulation Index) since the war until the survey date. Accelerated failure time models examined SGWI case status as a predictor of time until threshold level of multimorbidity was reached, adjusted for age and sociodemographic and military characteristics. Results: Models, adjusted for covariates, revealed that (1) relative to the SWGI- group, the SGWI+ group was associated with an accelerated time for reaching each threshold and (2) the relationship between SGWI and each threshold was not moderated by age. Discussion: Findings suggest that veterans with SGWI experienced accelerated aging., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The Veterans Health Administration (VHA) is a leader in generating transformational research across the cancer care continuum. Given the extensive body of cancer-related literature utilizing VHA data, our objectives are to: (1) describe the VHA data sources available for conducting cancer-related research, and (2) discuss examples of published cancer research using each data source., Methods: We identified commonly used data sources within the VHA and reviewed previously published cancer-related research that utilized these data sources. In addition, we reviewed VHA clinical and health services research web pages and consulted with a multidisciplinary group of cancer researchers that included hematologist/oncologists, health services researchers, and epidemiologists., Results: Commonly used VHA cancer data sources include the Veterans Affairs (VA) Cancer Registry System, the VA Central Cancer Registry (VACCR), the Corporate Data Warehouse (CDW)-Oncology Raw Domain (subset of data within the CDW), and the VA Cancer Care Cube (Cube). While no reference standard exists for cancer case ascertainment, the VACCR provides a systematic approach to ensure the complete capture of clinical history, cancer diagnosis, and treatment. Like many population-based cancer registries, a significant time lag exists due to constrained resources, which may make it best suited for historical epidemiologic studies. The CDW-Oncology Raw Domain and the Cube contain national information on incident cancers which may be useful for case ascertainment and prospective recruitment; however, additional resources may be needed for data cleaning., Conclusions: The VHA has a wealth of data sources available for cancer-related research. It is imperative that researchers recognize the advantages and disadvantages of each data source to ensure their research questions are addressed appropriately., (© 2024 National Cancer Registrars Association.)

HLA-DQA1*05:101 differs from HLA-DQA1*05:01:01:02 by one nucleotide substitution at codon 221 (CGT>TGT) in exon 4., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Adverse childhood experiences (ACES) negatively impact mental, physical, and behavioral health of adults. To develop empirically supported interventions to reduce the impact of ACES, we need to have a strong empirical base of research on modifiable protective factors that reduce the link between ACES and health outcomes. The current review is focused on assessing the state of the literature on modifiable protective factors on the ACE-health outcome relationship in adults., Method: We conducted a scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic search for peer-reviewed literature published in English was conducted in Medline, Embase, PsycINFO, CINAHL, and Web of Science from inception of the databases to January 5, 2023. We then constructed an evidence gap map to provide an innovative, visual approach to guide research prioritization., Results: Seventy-seven articles met inclusion criteria. Findings indicated that the majority focused on mental health outcomes (59%), and investigated individual (52%) and general social support (23%) protective factors. Also, the majority of the work was done in North America (65%) with predominantly female samples., Conclusions: Future studies should focus on addressing gaps in our understanding of what factors may buffer the influence of ACES on physical health outcomes and risky health behaviors and our understanding of family and nonfamily relationships and community and cultural protective factors on the ACE-health outcome relationship in adults. Additionally, research is needed that focuses on samples that are more gender diverse and from countries outside of North America. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Multiracial individuals are exposed to many forms of interpersonal racial discrimination, including general discrimination against their monoracial groups and discrimination against being multiracial. Because their families include members of different racial groups, multiracial people may also be exposed to various forms of discrimination from within the family. In the present study, we leverage recent advances in latent profile analysis to identify distinct patterns of family-based and external (i.e., from outside the family unit) discrimination experienced by multiracial college students, the differential impacts of these discrimination patterns on depressive and anxiety symptoms, and whether parental support of participants' multiracial experiences and identity impacts their exposure to different forms of discrimination. In a sample of 635 diverse multiracial college students ( M age = 21.2, SD = 5.3, range = 18-57, 74.0% female) from three U.S. universities, we identified three distinct discrimination profiles: High External and Familial Discrimination (43.2%) , Average External Low Familial Discrimination (32.1%) , and Low External and Familial Discrimination (24.7%). Profiles differed in depressive and anxiety symptomatology, with those in the High External and Familial Discrimination profile displaying the worst outcomes. Parental support of multiracial experiences was associated with lower levels of family-based discrimination. The complex relations between parental support, family-based discrimination, and multiracial participants' internalizing symptomology are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Gulf War illness (GWI) is a chronic multisymptom disorder of unknown etiology that is believed to be caused by neurotoxicant exposure experienced during deployment to the Gulf War. Posttraumatic stress disorder (PTSD) covaries with GWI and is believed to play a role in GWI symptoms. The present study examined the association between self-reported military exposures and GWI, stratified by PTSD status, in veterans from the Gulf War Era Cohort and Biorepository who were deployed to the Persian Gulf during the war. Participants self-reported current GWI and PTSD symptoms as well as military exposures (e.g., pyridostigmine [PB] pills, pesticides/insecticides, combat, chemical attacks, and oil well fires) experienced during the Gulf War. Deployed veterans' (N = 921) GWI status was ascertained using the Centers for Disease Control and Prevention definition. Individuals who met the GWI criteria were stratified by PTSD status, yielding three groups: GWI-, GWI+/PTSD-, and GWI+/PTSD+. Multivariable logistic regression, adjusted for covariates, was used to examine associations between GWI/PTSD groups and military exposures. Apart from insect bait use, the GWI+/PTSD+ group had higher odds of reporting military exposures than the GWI+/PTSD- group, adjusted odds ratio (aOR) = 2.15, 95% CI [1.30, 3.56]-aOR = 6.91, 95% CI [3.39, 14.08]. Except for PB pills, the GWI+/PTSD- group had a higher likelihood of reporting military exposures than the GWI- group, aOR = 2.03, 95% CI [1.26, 3.26]-aOR = 4.01, 95% CI [1.57, 10.25]. These findings are consistent with roles for both PTSD and military exposures in the etiology of GWI., (© 2023 International Society for Traumatic Stress Studies.)

Background: Veterans of the first Gulf War (1990-1991) are reaching middle and older adulthood in differing degrees of health and biological age. Many Gulf War veterans report myriad negative symptoms classified as Gulf War illness (GWI), a chronic multi-symptom illness., Objectives: To describe and analyze deficit accumulation, among veterans with Severe GWI (SGWI+) and those without Severe GWI (SGWI-), to assess the association between a medically unexplained illness and aging., Design: This study uses a retrospective cohort design with quasi-longitudinal data., Setting: The recruitment sample included 10,042 Gulf War era veterans across all four US Census regions., Participants: The analytic sample included 1,054 participants of the GWECB for whom SGWI case status could be determined and who had valid responses for at least 90% of the deficits included in the deficit accumulation index., Measurements: Chronic health conditions were retroactively reported, including year of diagnosis, enabling us to create a longitudinal measure of deficit accumulation. This deficit accumulation index (DAI) ranged from 0-1 for each respondent in each year between 1991-2013. We compare veterans with SGWI+ to those with SGWI- using the CDC case definition., Results: Most veterans in our sample could expect to spend more years with moderate or substantial deficits than without deficits. SGWI+ was associated with spending more years with substantial deficits than those with SGWI-. Veterans in middle age (age 35-65) experienced more years with substantial deficits than younger veterans. Individuals with SGWI+ had 13 times the hazard of accumulating substantial deficits than those without., Conclusions: This study demonstrated that veterans with SGWI+, even those in midlife, experienced aging as measured by accumulating deficits. Practitioners should consider patients with multi-symptom illnesses as at risk of accelerated aging, tailoring treatments to address patients' holistic needs., Competing Interests: On behalf of all authors, the corresponding author states that there is no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Racial discrimination is associated with adverse mental health outcomes among Students of Color. In order to address racial tensions, it is important to consider students' dialogues about race. The current study tested whether having positive and negative conversations about one's ethnic-racial group mediated the relation between racial discrimination at T1 and depressive symptoms 5 months later at T2 among 94 college Students of Color. Findings indicated that greater racial discrimination at T1 was associated with more frequent negative conversations about race at T2 ( b  = .38, p  = .00), which was, in turn, associated with greater depressive symptoms at T2 ( b  = 2.73, p  = .04); this pathway demonstrated significant mediation. However, positive conversations about race was not a significant mediator in this association. The current study highlights the importance of focusing on racial conversations after racial discrimination in order to minimize adverse effects on mental health among Students of Color.

The current study examined associations between Black adolescents' (M age  = 15.55, SD = 1.23) racial discrimination and suicide behaviors (i.e., suicide ideation, suicide plan, and suicide attempts), and whether perceived school safety was a protective moderator. Furthermore, we tested gender differences in relations, which were not significant. Racial discrimination predicted greater suicide behaviors, and school safety informed less suicide behaviors. School safety moderated the relation between discrimination and suicide plan, such that at low school safety, discrimination predicted having a suicide plan but was not significant at high school safety. Furthermore, school safety moderated the relation between discrimination and suicide attempts. At low school safety, discrimination predicted more suicide attempts, but was not significant at high school safety., (© 2023 Society for Research on Adolescence.)

We present a genome assembly from an individual male Tetanocera ferruginea (the common buff snailkiller; Arthropoda; Insecta; Diptera; Sciomyzidae). The genome sequence is 790.4 megabases in span. Most of the assembly is scaffolded into 7 chromosomal pseudomolecules, including the X and Y sex chromosomes. The mitochondrial genome has also been assembled and is 17.07 kilobases in length., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Crowley LM et al.)

Graphene oxide (GO) membranes are known to have a complex morphology that depends on the degree of oxidation of the graphene flake and the membrane preparation technique. In this study, using Grand Canonical Monte Carlo simulations, we investigate the mechanism of swelling of GO membranes exposed to different relative humidity (RH) values and show how this is intimately related to the graphene surface chemistry. We show that the structure of the GO membrane changes while the membrane adsorbs water from the environment and that graphene oxide flakes become charged as the membrane is loaded with water and swells. A detailed comparison between simulation and experimental adsorption data reveals that the flake surface charge drives the water adsorption mechanism at low RH when the membrane topology is still disordered and the internal pores are small and asymmetric. As the membrane is exposed to higher RH (80%), the flake acquires more surface charge as more oxide groups deprotonate, and the pores grow in size, yet maintain their disordered geometry. Only for very high relative humidity (98%) does the membrane undergo structural changes. At this level of humidity, the pores in the membrane become slit-like but the flake surface charge remains constant. Our results unveil a very complex mechanism of swelling and show that a single molecular model cannot fully capture the ever-changing chemistry and morphology of the membrane as it swells. Our computational procedure provides the first atomically resolved insight into the GO membrane structure of experimental samples.

Background and Aims: Colorectal cancer (CRC) polygenic risk scores (PRS) may help personalize CRC prevention strategies. We investigated whether an existing PRS was associated with advanced neoplasia (AN) in a population undergoing screening and follow-up colonoscopy., Methods: We evaluated 10-year outcomes in the Cooperative Studies Program #380 screening colonoscopy cohort, which includes a biorepository of selected individuals with baseline AN (defined as CRC or adenoma ≥10 mm or villous histology, or high-grade dysplasia) and matched individuals without AN. A PRS was constructed from 136 prespecified CRC-risk single nucleotide polymorphisms. Multivariate logistic regression was used to evaluate the PRS for associations with AN prevalence at baseline screening colonoscopy or incident AN in participants with at least one follow-up colonoscopy., Results: The PRS was associated with AN risk at baseline screening colonoscopy ( P  = .004). Participants in the lowest PRS quintile had more than a 70% decreased risk of AN at baseline (odds ratio 0.29, 95% confidence interval 0.14-0.58; P < .001) compared to participants with a PRS in the middle quintile. Using a PRS cut-off of more than the first quintile to indicate need for colonoscopy as primary screening, the sensitivity for detecting AN at baseline is 91.8%. We did not observe a relationship between the PRS and incident AN during follow-up ( P  = .28)., Conclusion: A PRS could identify individuals at low risk for prevalent AN. Ongoing work will determine whether this PRS can identify a subset of individuals at sufficiently low risk who could safely delay or be reassured about noninvasive screening. Otherwise, more research is needed to augment these genetic tools to predict incident AN during long-term follow-up.

Objectives: The present study examined whether sociocultural risk factors (i.e., mothers' risky behaviors, mothers' and grandmothers' ethnic discrimination, and family economic hardship) predicted children's internalizing behaviors. We also tested whether sociocultural protective factors, including children's positive ethnic-racial identity (ERI) attitudes and mothers' cultural socialization, moderated relations., Method: Participants were 182 5-year-old Mexican-origin children, their mothers, and grandmothers., Results: Findings indicated that children's positive ERI attitudes were protective, such that grandmothers' discrimination predicted children's greater internalizing at low levels of children's positive ERI attitudes, but this relation was not significant at high levels of children's positive ERI attitudes. Mothers' cultural socialization was also protective, such that mothers' risky behaviors predicted children's greater internalizing at low levels of mothers' cultural socialization, but this relation was not significant at high levels of mothers' cultural socialization. Economic hardship predicted children's greater internalizing and no variables moderated this relation., Conclusions: Findings highlight that mothers' engagement in risky behaviors, grandmothers' ethnic discrimination experiences, and family economic hardship contribute to children's greater internalizing behaviors. However, in some of these relations, children's positive ERI attitudes and mothers' cultural socialization are protective. In future research and programming, a consideration of the role of individual, family, and cultural factors will be important for addressing and reducing children's internalizing behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults., (© 2022. W. Montague Cobb-NMA Health Institute.)

The adsorption of a cationic dye, Methylene blue (MB), and a zwitterionic dye, 8-Hydroxyquinoline (8-HQ), onto zeolites synthesized from different clays has been investigated. The presence of certain metals and the Si/Al ratio of the parent clay has an overall effect on the type of zeolites produced. Zeolites LTA and FAU Y were obtained using the hydrothermal method. X-ray diffraction and Fourier transform infrared spectroscopy (FTIR) spectral analysis was used to study the adsorption phenomena of the adsorbates on the adsorbents. The adsorption profile of MB (Topological Polar Surface Area (TPSA) 43.9 Å 2 and 8-HQ (TPSA 33.1 Å 2 ) compared favourably with a Freundlich isotherm with R 2  > 0.9 for all the zeolitic materials synthesized. Adsorption capacities of zeolite FAU was significantly different from zeolite LTA for MB removal. The higher adsorption capacity of zeolite FAU was attributed to geometric effects resulting in greater shrinkage in the inter lattice spacing of zeolite LTA leading to a reduction in surface area. Adsorption of the relatively smaller 8-HQ however, did not show significant difference in the two zeolite types. Surface and structural characterization showed that adsorbates/adsorbents interactions were driven by both geometric (inter lattice spacing which imparts higher surface area of the adsorbent) and electronic (electrostatic repulsions through electron back donation from metals in the zeolitic structure) considerations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

The present study tested whether family home disruptions during the COVID-19 pandemic in the Spring 2020 (Time 1; T1) informed mental health (i.e., posttraumatic stress disorder [PTSD], depressive, and anxiety symptoms) 7 months later in Fall 2020 at T2 and whether family relationship quality moderated relations. Multigroup path analysis models were used to test whether there were significant differences in relations by emerging adults' ethnic-racial backgrounds. Participants were 811 Black, Asian American, Latine, and White emerging adult college students ( M age = 19.95, SD = .33), and the majority (79.6%) who reported their gender identified as cisgender women. Results indicated that across all individuals, T1 family relationship quality moderated relations between T1 family home disruptions and T2 anxiety and depressive symptoms. At lower levels of T1 family relationship quality, family home disruptions predicted greater T2 depressive and anxiety symptoms. At higher levels of T1 family relationship quality, these relations were not significant. Findings highlight that family relationship quality is an important protective factor for diverse emerging adult college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Gulf War Illness (GWI) is a chronic, multi-symptom disorder affecting 25%-32% of Gulf War veterans. Veterans with GWI disproportionately suffer from gastrointestinal (GI) disorders. Given the increasing evidence supporting a gut-brain axis, we explore the relationship between post-traumatic stress disorder (PTSD), GWI, and self-reported GI disorders among GW veterans., Methods: Veterans from the Gulf War Era Cohort and Biorepository responded to a mail-based survey (N = 1058). They were stratified by GWI (Centers for Disease Control definition) and PTSD status. This yielded three groups: GWI-, GWI+/PTSD-, and GWI+/PTSD+. Multivariable logistic regression adjusting for demographic and military characteristics examined associations between GWI/PTSD groups and GI disorders. Results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI)., Key Results: The most frequently reported GI disorders were irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and colon polyps (CP). The GWI+/PTSD+ group had a higher odds of these disorders than the GWI+/PTSD- group (aOR IBS  = 3.12, 95% CI: 1.93-5.05; aOR GERD  = 2.04, 95% CI: 1.44-2.90; aOR CP  = 1.85, 95% CI: 1.23-2.80), which had a higher odds of these disorders than the GWI- group (aOR IBS  = 4.38, 95% CI: 1.55-12.36; aOR GERD  = 2.51 95% CI: 1.63-3.87; aOR CP  = 2.57, 95% CI: 1.53-4.32)., Conclusions & Inferences: GW veterans with GWI and PTSD have significantly higher odds of specific self-reported GI disorders than the other groups. Given the known bidirectional influences of the gut and brain, these veterans may benefit from a holistic healthcare approach that considers biopsychosocial contributors to the assessment and management of disease., (© 2023 John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Low-density lipoprotein (LDL) contributes to atherogenesis and cardiovascular disease through interactions with peripheral blood cells, especially platelets. However, mechanisms by which LDL affects platelet activation and atherothrombosis, and how to best therapeutically target and safely prevent such responses remain unclear. Here, we investigate how oxidized low-density lipoprotein (oxLDL) enhances glycoprotein VI (GPVI)-mediated platelet hemostatic and procoagulant responses, and how traditional and emerging antiplatelet therapies affect oxLDL-enhanced platelet procoagulant activity ex vivo. Human platelets were treated with oxLDL and the GPVI-specific agonist, crosslinked collagen-related peptide, and assayed for hemostatic and procoagulant responses in the presence of inhibitors of purinergic receptors (P2YR), cyclooxygenase (COX), and tyrosine kinases. Ex vivo, oxLDL enhanced GPVI-mediated platelet dense granule secretion, α-granule secretion, integrin activation, thromboxane generation and aggregation, as well as procoagulant phosphatidylserine exposure and fibrin generation. Studies of washed human platelets, as well as platelets from mouse and nonhuman primate models of hyperlipidemia, further determined that P2YR antagonists (eg, ticagrelor) and Bruton tyrosine kinase inhibitors (eg, ibrutinib) reduced oxLDL-mediated platelet responses and procoagulant activity, whereas COX inhibitors (eg, aspirin) had no significant effect. Together, our results demonstrate that oxLDL enhances GPVI-mediated platelet procoagulant activity in a manner that may be more effectively reduced by P2YR antagonists and tyrosine kinase inhibitors compared with COX inhibitors., (Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution.)

Animals' gut microbiomes affect a wide array of biological processes including immunity and protection from pathogens. However, how the microbiome changes due to infection by parasites is still largely unknown, as is how the microbiome changes in hosts that differ in their susceptibility to parasites. To investigate this, we exposed two slug species of differing susceptibility to the parasitic nematode Phasmarhabditis hermaphrodita (Deroceras reticulatum is highly susceptible and Ambigolimax valentianus resistant to the nematode) and profiled the gut microbiota after 7 and 14 days. Before infection, both slug species' microbiota was dominated by similar bacterial genera: Pseudomonas (by far the most abundant), Sphingobacterium, Pedobacter, Chryseobacterium, and Flavobacterium. In the resistant host A. valentianus, there was no significant change in the bacterial genera after infection, but in D. reticulatum, the bacterial profile changed, with a decrease in the abundance of Pseudomonadaceae and an increase in the abundance of Flavobacteriaceae and Sphingobacteriaceae after 7 days postinfection. This suggests nematode infection causes dysbiosis in hosts that are susceptible to infection, but the microbiome of resistant species remains unaltered. In summary, the regulation of the immune system is tightly linked with host survival, and nematode infection can alter the microbiome structure., (© 2023 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

There is an ever-increasing body of evidence that metallic complexes involving amphiliphic ligands do not form normal solutions in organic solvents. Instead, they form complex fluids with intricate structures. For example, the metallic complexes may aggregate into clusters, and these clusters themselves may aggregate into superclusters. To gain a deeper insight into the mechanisms at play, we have used an improved force field to conduct extensive molecular dynamics simulations of a system composed of zirconium nitrate, water, nitric acid, tri- n -butyl phosphate, and n -octane. The important new finding is that a dynamic equilibrium between the cis and trans isomers of the metal complex is likely to play a key role in the aggregation behavior. The isolated cis and trans isomers have similar energies, but simulation indicates that the clusters consist predominantly of cis isomers. With increasing metal concentration, we hypothesize that more clustering occurs and the chemical equilibrium shifts toward the cis isomer. It is possible that such isomeric effects play a role in the liquid-liquid extraction of other species and the inclusion of such effects in flow sheet modeling may lead to a better description of the process.

Entomology is key to understanding terrestrial and freshwater ecosystems at a time of unprecedented anthropogenic environmental change and offers substantial untapped potential to benefit humanity in a variety of ways, from improving agricultural practices to managing vector-borne diseases and inspiring technological advances.We identified high priority challenges for entomology using an inclusive, open, and democratic four-stage prioritisation approach, conducted among the membership and affiliates (hereafter 'members') of the UK-based Royal Entomological Society (RES).A list of 710 challenges was gathered from 189 RES members. Thematic analysis was used to group suggestions, followed by an online vote to determine initial priorities, which were subsequently ranked during an online workshop involving 37 participants.The outcome was a set of 61 priority challenges within four groupings of related themes: (i) 'Fundamental Research' (themes: Taxonomy, 'Blue Skies' [defined as research ideas without immediate practical application], Methods and Techniques); (ii) 'Anthropogenic Impacts and Conservation' (themes: Anthropogenic Impacts, Conservation Options); (iii) 'Uses, Ecosystem Services and Disservices' (themes: Ecosystem Benefits, Technology and Resources [use of insects as a resource, or as inspiration], Pests); (iv) 'Collaboration, Engagement and Training' (themes: Knowledge Access, Training and Collaboration, Societal Engagement).Priority challenges encompass research questions, funding objectives, new technologies, and priorities for outreach and engagement. Examples include training taxonomists, establishing a global network of insect monitoring sites, understanding the extent of insect declines, exploring roles of cultivated insects in food supply chains, and connecting professional with amateur entomologists. Responses to different challenges could be led by amateur and professional entomologists, at all career stages.Overall, the challenges provide a diverse array of options to inspire and initiate entomological activities and reveal the potential of entomology to contribute to addressing global challenges related to human health and well-being, and environmental change., Competing Interests: Luke A. N. Tilley, Sajidha Mohammed, and Francisca Sconce are employed by the Royal Entomological Society (RES); Helen E. Roy, Chris D. Thomas, Simon Ward, Allan Watt, Lynn V. Dicks and Jane K. Hill play senior roles in the management of the RES, including as trustees, president, or former president; and the majority of co‐authors are members of the RES., (© 2023 The Authors. Insect Conservation and Diversity published by John Wiley & Sons Ltd on behalf of Royal Entomological Society.)

Background: Until recently, multi-agent chemotherapy (CT) was the standard of care for patients with advanced non-small cell lung cancer (NSCLC). Clinical trials have confirmed benefits in overall survival (OS) and progression-free survival with immunotherapy (IO) compared to CT. This study compares real-world treatment patterns and outcomes between CT and IO administrations in second-line (2L) settings for patients with stage IV NSCLC., Materials and Methods: This retrospective study included patients in the United States Department of Veterans Affairs healthcare system diagnosed with stage IV NSCLC during 2012-2017 and receiving IO or CT in the 2L. Patient demographics and clinical characteristics, healthcare resource utilization (HCRU), and adverse events (AEs) were compared between treatment groups. Logistic regression was used to examine differences in baseline characteristics between groups, and inverse probability weighting multivariable Cox proportional hazard regression was used to analyze OS., Results: Among 4,609 Veterans who received first-line (1L) therapy for stage IV NSCLC, 96% received 1L CT alone. A total of 1,630 (35%) were administered 2L systemic therapy, with 695 (43%) receiving IO and 935 (57%) receiving CT. Median age was 67 years (IO group) and 65 years (CT group); most patients were male (97%) and white (76-77%). Patients administered 2L IO had a higher Charlson Comorbidity Index than those administered CT (p = 0.0002). 2L IO was associated with significantly longer OS compared with CT (hazard ratio 0.84, 95% CI 0.75-0.94). IO was more frequently prescribed during the study period (p < 0.0001). No difference in rate of hospitalizations was observed between the two groups., Conclusions: Overall, the proportion of advanced NSCLC patients receiving 2L systemic therapy is low. Among patients treated with 1L CT and without IO contraindications, 2L IO should be considered, as this supports potential benefit of IO for advanced NSCLC. The increasing availability and indications for IO will likely increase the administration of 2L therapy to NSCLC patients., Competing Interests: This study was supported by Bristol-Myers Squibb Company (BMS). Dr. Allo was affiliated with BMS. BMS did not have access to underlying data and did not contribute to any data analysis. This commercial affiliation does not alter the adherence to PLOS ONE policies on sharing data and materials. The authors declare no other competing interests., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: Despite recent focus on improving health care in care homes, it is unclear what role general practitioners (GPs) should play. To provide evidence for future practice we set out to explore how GPs have been involved in such improvements., Methods: Realist review incorporated theory-driven literature searches and stakeholder interviews, supplemented by focussed searches on GP-led medication reviews and end-of-life care. Medline, Embase, CINAHL, PsycInfo, Web of Science, and the Cochrane library were searched. Grey literature was identified through internet searches and professional networks. Studies were included based upon relevance. Data were coded to develop and test contexts, mechanisms, and outcomes for improvements involving GPs., Results: Evidence was synthesized from 30 articles. Programme theories described: (i) "negotiated working with GPs," where other professionals led improvement and GPs provided expertise; and (ii) "GP involvement in national/regional improvement programmes." The expertise of GPs was vital to many improvement programmes, with their medical expertise or role as coordinators of primary care proving pivotal. GPs had limited training in quality improvement (QI) and care home improvement work had to be negotiated in the context of wider primary care commitments., Conclusions: GPs are central to QI in health care in care homes. Their contributions relate to their specialist expertise and recognition as leaders of primary care but are challenged by available time and resources to develop this role., (© The Author(s) 2022. Published by Oxford University Press.)

The summer of 2020 marked a shift in public perception of police brutality and racism in the United States. Following the police murder of George Floyd and ensuing social unrest, the appropriate role and function of the police in communities have been a frequent topic of debate. Of particular concern is the intersection of policing and mental health where we see a pattern of police using excessive force disproportionately against persons with disabilities, especially mental health disabilities (Autistic Self Advocacy Network, 2017). The introduction of race only exacerbates this disparity (Saleh et al., 2018). Given the realities of these mental health inequities, the aim of this scoping review is to explore first response models/programs that emphasize a therapeutic intervention as an alternative to policing. Seventeen articles were selected for inclusion in the review, six exploratory or experimental studies and 11 review or discussion articles. Using findings from the review, we offer recommendations to help reimagine this country's approach to emergency response. We urge psychologists and other health care providers to step out of the clinic and engage the community in the development of crisis responses for mental health emergencies that are therapeutic rather than inflammatory, healing rather than harming. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: The present study examined whether ethnic-racial identity (ERI) exploration, resolution, and affirmation informed individuals' beliefs about virginity (ie, virginity as a gift, stigma, process) and first coital affective reactions (FCAR; ie, positive and negative), and whether these relations varied by biological sex. Participants and method: The sample consisted of 184 Black college students ( M age = 19.79, SD  = 2.08) enrolled in a large Southern university. Participants completed a virginity beliefs measure, first coital affective reaction measure, and an ethnic-racial identity measure. Results: Findings indicated that for Black females, greater ERI exploration was associated with decreased virginity as a gift beliefs; and ERI resolution was associated with increased virginity as a gift beliefs. Additionally, for Black males and females, ERI affirmation resulted in more positive FCAR, less negative FCAR, and less views of virginity as a stigma. Conclusion: Finding implications are presented in the context of future research.

Use of the gabapentinoids for pain continues to increase. In 2018, the US Food and Drug Administration (FDA) strengthened the warnings for both gabapentin and pregabalin to emphasize the central nervous system side effects and the risk of respiratory depression, especially when combined with other centrally acting drugs. We reviewed the published comparative effectiveness literature for gabapentinoids for pain as well as all trials (published and unpublished) used by the FDA for the approval of the five pain indications for these agents (one for gabapentin, four for pregabalin). Among the findings of interest are the fact that the FDA rejected the application for gabapentin for diabetic peripheral neuropathy based on the risk versus benefit profile of that drug in the clinical trials that were submitted by the manufacturer. Additionally, both the comparative effectiveness trials as well as the studies used by the FDA tend to be short in duration and show only modest pain benefits for the gabapentinoids. The placebo response in these trials was frequently one-third to one-half as great as the pain benefit demonstrated by the gabapentinoid. Based on the available clinical trial evidence, we feel prescribers should be cautious when using gabapentinoids for pain, particularly when using these agents for a prolonged period or when combined with other, centrally acting agents., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Many severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive patients take commonly prescribed medications with properties which may affect mortality., Objective: Assess if common medications postulated to affect clinical outcomes are associated with mortality in SARS-CoV-2 positive patients in the Veterans Health Administration (VHA)., Design: Observational national cohort analysis., Participants: Consecutive 26,508 SARS-CoV-2 positive Veterans (7% of 399,290 tested from March 1 to September 10, 2020) constitute the study cohort., Main Measures: The primary outcome was 30-day mortality from the first positive SARS-CoV-2 test date. In patients receiving medications or drug pairs within 2 weeks post-SARS-CoV-2 positive test, 30-day mortality was estimated as relative risk (RR) on the log-binomial scale or using multinomial models with and without adjusting for covariates., Key Results: The 26,508 SARS-CoV-2 positive patients were predominantly male (89%) and White (59%), and 82% were overweight/obese. Medications associated with decreased 30-day mortality risk included the following: metformin (aRR, 0.33; 95% CI, 0.25-0.43), colchicine, angiotensin-converting-enzyme inhibitors (ACEi), angiotensin II receptor blockers, statins, vitamin D, antihistamines, alpha-blockers, anti-androgens, and nonsteroidal anti-inflammatory drugs (aRR, 0.69; 95% CI, 0.61-0.78). The effect of co-prescribed medications on 30-day mortality risk revealed the lowest risk for combined statins and metformin (aRR, 0.21; 95% CI, 0.15-0.31), followed by ACEi and statins (aRR, 0.25; 95% CI, 0.18-0.35), ACEi and metformin (aRR, 0.26; 95% CI, 0.17-0.40), antihistamines and NSAIDs (aRR, 0.41; 95% CI, 0.32-0.52), and in men, combined alpha-blockers and anti-androgens (aRR, 0.51; 95% CI, 0.42-0.64)., Conclusions: In this large national cohort, treatment of SARS-CoV-2 positive patients with individual or co-prescribed metformin and statins, ACEi and statins (or metformin) and other medications was associated with a markedly decreased 30-day mortality and can likely be continued safely. Clinical trials may assess their therapeutic benefit., (© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)