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Polydiacetylenes (PDAs) are conjugated polymers that are well known for their colorimetric transition from blue to red with the application of energetic stimulus. Sensing platforms based on polymerized diacetylene surfactant vesicles and other structures have been widely demonstrated for various colorimetric biosensing applications. Although less studied and utilized, the transition also results in a change from a non-fluorescent to a highly fluorescent state, making polydiacetylenes useful for both colorimetric and fluorogenic sensing applications. Here, we focus on the characterization and optimization of polydiacetylene vesicles to tune their sensitivity for fluorogenic sensing applications. Particularly, we look at how the structure of the diacetylene (DA) hydrocarbon tail and headgroup affect the self-assembled vesicle size and stability, polymerization kinetics, and the fluorogenic, blue to red phase transition. Longer DA acyl tails generally resulted in smaller and more stable vesicles. The polymerization kinetics and the blue to red transition were a function of both the DA acyl tail length and structure of the headgroup. Decreasing the acyl tail length generally led to vesicles that were more sensitive to energetic stimuli. Headgroup modifications had different effects depending on the structure of the headgroup. Ethanolamine headgroups resulted in vesicles with potentially increased stimuli responsivity. The lower energy stimulus to induce the chromatic transition was attributed to an increase in headgroup hydrogen bonding and polymer backbone strain. Boronic-acid headgroup functionalization led to vesicles that were generally unstable, only weakly polymerized, and unable to fully transform to the red phase due to strong polar, aromatic headgroup interactions. This work presents the design of PDA vesicles in the context of biosensing platforms and includes a discussion of the past, present, and future of PDA biosensing.

Large-scale restoration projects are an exciting and often untapped opportunity to use an experimental approach to inform ecosystem management and test ecological theory. In our $10M tidal marsh restoration project, we installed over 17,000 high marsh plants to increase cover and diversity, using these plantings in a large-scale experiment to test the benefits of clustering and soil amendments across a stress gradient. Clustered plantings have the potential to outperform widely spaced ones if plants alter conditions in ways that decrease stress for close neighbors. Here, we test whether intraspecific facilitation improves restoration outcomes using a suite of seven high marsh species native to central California salt marshes. We also applied a biochar treatment to test whether soil amendment boosts restoration success. We compared the performance of clustered and uniform plantings across the high marsh elevation gradient for 3 years. There was a strong effect of elevation on plant performance and clear signs of plant stress related to soil conditions. Clustering slightly improved the survival of one species out of seven, although clustering did not benefit that species in a follow-up experiment under more stressful conditions. By contrast, clustering had strong negative effects on the growth and/or cover of all species tested. The stressors in this system-likely related to compaction and soil salinity-were not mitigated by neighbors or biochar. The prevailing negative effect on seven species from distinct evolutionary lineages lends strong generality to our findings. We therefore conclude that for this and similar high marsh systems, intraspecific facilitation confers no benefits and practitioners should space plants widely to minimize competition. To take full advantage of the learning opportunities provided by large-scale restoration projects, we recommend including experimental treatments and monitoring the response of multiple species across years to refine best practices and inform adaptive management.

Aims: The aim of this study was to evaluate the radiological outcome of patients with large bone defects in the femur and tibia who were treated according to the guidelines of the diamond concept in our department (Centre for Orthopedics, Trauma Surgery, and Paraplegiology). Methods: The following retrospective, descriptive analysis consists of patients treated in our department between January 2010 and December 2021. In total, 628 patients were registered, of whom 108 presented with a large-sized defect (≥ 5 cm). A total of 70 patients met the inclusion criteria. The primary endpoint was radiological consolidation of nonunions after one and two years via a modified Lane-Sandhu Score, including only radiological parameters. Results: The mean defect size was 6.77 cm (SD 1.86), with the largest defect being 12.6 cm. Within two years after surgical treatment, 45 patients (64.3%) presented consolidation of the previous nonunion. After one year, six patients (8.6%) showed complete consolidation and 23 patients (32.9%) showed a considerable callus formation, whereas 41 patients (58.6%) showed a Lane-Sandhu score of 2 or below. Two years after surgery, 24 patients (34.3%) were categorized as Lane-Sandhu score 4, another 23 patients (32.9%) reached a score of 3, while 14 patients (20.0%) remained without final consolidation (score ≤ 2). A total of nine patients (12.9%) missed the two-year follow-up. The mean follow-up was 44.40 months (SD 32.00). The mean time period from nonunion surgery to consolidation was 16.42 months (SD 9.73) Conclusion: Patients with presentation of a large-sized nonunion require a structured and sufficiently long follow-up to secure the consolidation of the former nonunion. Furthermore, a follow-up of at least two years is required in order to declare a nonunion as consolidated, given that a significant part of the nonunions declared as not consolidated at one year showed consolidation within the second year. Moreover, the proven “gold standard” of a two-step procedure, so called Masquelet technique, shows effectiveness. Cite this article: Bone Jt Open 2024;6(1):26–34.

Abstract Recent research has identified sex-dependent links between risk taking behaviors, approach-avoidance bias and alcohol intake. However, preclinical studies have typically assessed alcohol drinking using a singular dimension of intake (i.e. drinking level), failing to capture the multidimensional pattern of aberrant alcohol-seeking observed in alcohol use disorder. In this study, we sought to further explore individual and sex differences in the relationship between approach-avoidance bias, frontloading (bingeing and onset skew) and multiple addiction-like indices of ethanol seeking that included motivation for ethanol, persistence despite its absence (extinction), and ethanol-taking in the face of mild footshock. We found that female rats displayed more addiction-like phenotypes than males overall, and that frontloading patterns differed by sex, with females outdrinking males in the early part of access sessions (bingeing), but males strongly concentrating their lever pressing for ethanol in that period (onset skew). Multiple regression analyses revealed that bingeing was a strong positive predictor and onset skew a negative predictor of motivational breakpoint. Cued-conflict preference – a measure of approach-avoidance bias towards a mixed-valence conflict cue – was predictive of both extinction and footshock in males, but not females. Our data highlight key sex differences, and the relevance of both frontloading patterns and conflict preference in predicting future addiction-like phenotypes.

Abstract Background Animated short videos used to explain a concept or project are often called animated explainer videos (AEVs). AEVs can supplement or provide an alternative to participant information sheets as a means of giving information about clinical research to potential participants. Current use of AEVs tends to focus on the specifics of a particular trial, yet there are many common aspects of clinical research regardless of the interventions being investigated that can be poorly covered in current trial materials. The EXPLAIN initiative aimed to determine the top generic clinical trial topics considered most important by different UK trial stakeholders. The top three topics were then turned into AEVs and have been made freely available for use. Method A list of generic clinical trial topics which often need explaining to potential trial participants when they are approached to take part in research was developed. Using a two-round Delphi survey of stakeholder groups (trial participants, patients, members of the public, site staff and clinical trials unit staff), the list of topics was expanded and prioritised to identify the topics most in need of clear explanation. The top three topics formed the basis of three AEVs, co-developed with patient and public partners. Results Two hundred twenty-eight responses were received to the first round of the Delphi survey, and 167 of these respondents also completed the second round of the survey. The three topics prioritised for creation of animated explainer videos were as follows: (1) What is consent? (2) Who decides what treatment I get/What is randomisation? (3) Is it safe to take part in a trial/How do you know a trial is safe? Following virtual meetings with patient and public partners recruited from the Delphi respondents, a script for each AEV was co-produced before being developed into an AEV by a company specialising in animated video production. Conclusion There are a wide range of generic concepts in which the use of animated explainer videos could be useful to improve participant understanding of clinical research. Via consensus survey across multiple stakeholders, we have determined a hierarchy of the importance of explaining these concepts. We envisage that the three AEVs created from this project will form the basis of a readily accessible library of animations to be utilised by trialists.

Analysis of thermal infrared satellite measurements of umbrella clouds generated by volcanic eruptions suggests that asymptotic gravity current models of the temporal (t) radial (r) spreading (r ~tf, f < 1) of the umbrella-shaped intrusion do not adequately explain the observations. Umbrella clouds from 13 volcanic eruptions are studied using satellite data that have spatial resolutions of ~4–25 km2 and temporal resolutions of 1–60 minutes. The umbrella cloud morphology is evaluated using digital image processing tools in a Lagrangian frame of reference. At the onset of neutral buoyancy, the radial spreading is better explained by a stronger dependence on time of r ~ t, rather than t2/3, t3/4, or t2/9. This flow regime exists on the order of minutes and has not been observed previously in satellite data. This may be of significance as it provides a means to rapidly (within the first 2–3 observations) determine the volumetric eruption rate. A hyperbolic tangent model, r ~ tanh(t) is presented that matches the entire radial spreading time history and has a conserved torus-shaped volume in which the intrusion depth is proportional to sech(t). This model also predicts the observed radial velocities. The data and the model estimates of the volumetric flow rate for the 15 January 2022 Hunga eruption are found to be 3.6–5 × 1011 m3s−1, the largest ever measured.

Abstract Background We developed the FORCETM platform to overcome limitations of oligonucleotide delivery to muscle and enable their applicability to neuromuscular disorders. The platform consists of an antigen-binding fragment, highly specific for the human transferrin receptor 1 (TfR1), conjugated to an oligonucleotide via a cleavable valine-citrulline linker. Myotonic dystrophy type 1 (DM1) is a neuromuscular disorder caused by expanded CUG triplets in the DMPK RNA, which sequester splicing proteins in the nucleus, lead to spliceopathy, and drive disease progression. Methods Multiple surrogate conjugates were generated to characterize the FORCE platform. DYNE-101 is the conjugate designed to target DMPK and correct spliceopathy for the treatment of DM1. HSALR and TfR1 hu/mu ;DMSXL Tg/Tg mice were used as models of myotonic dystrophy, the latter expresses human TfR1 and a human DMPK RNA with >1,000 CUG repeats. Cynomolgus monkeys were used to determine translatability of DYNE-101 pharmacology to higher species. Results In HSALR mice, a surrogate FORCE conjugate achieves durable correction of spliceopathy and improves myotonia to a greater extent than unconjugated ASO. In patient-derived myoblasts, DYNE-101 reduces DMPK RNA and nuclear foci, consequently improving spliceopathy. In TfR1 hu/mu ;DMSXL Tg/Tg mice, DYNE-101 reduces mutant DMPK RNA in muscle, thereby correcting splicing. Reduction of DMPK foci in cardiomyocyte nuclei accompanies these effects. Low monthly dosing of DYNE-101 in TfR1 hu/mu ;DMSXL WT/Tg mice or cynomolgus monkeys leads to a profound reduction of DMPK expression in muscle. Conclusions These data validate FORCE as a drug delivery platform and support the notion that DM1 may be treatable with low and infrequent dosing of DYNE-101.

Abstract Background College students who are in recovery from substance use disorders face challenges related to abstaining from substance use, finding supportive social networks, and achieving their academic goals. These students may therefore seek out various recovery supports at their institutions to meet their needs and goals. Methods This study analyzed previously collected data to explore themes related to students’ experiences of recovery, including their recovery needs and challenges while also attending college. We conducted qualitative thematic analysis of written responses to open-ended prompts posed to 92 college students from one university (47% female; M age = 21.5 years, SD = 5.6) who participated in a larger parent study of Collegiate Recovery Programs in the United States. We used a phenomenological approach to guide the current study, to characterize the meaning and experience within the shared phenomenon of recovery processes among college students. Results Two broad categories emerged, representing nine total themes that were coded: (a) intrapersonal factors: recovery-specific challenges, self-care and coping, mental and behavioral health, life challenges, and personal motivations and attributes; and (b) interpersonal/social factors: 12-step recovery supports, external supports and community, college environment, and relationships with others. Conclusions Findings offer insight into barriers and facilitators to recovery among colleges students and are discussed in terms of their implications for primary stakeholders at institutions of higher education to support college students in substance use recovery.

Luminescence lifetime is a crucial parameter in photophysical studies that bears essential physical and chemical information and that is used to quantify a variety of phenomena, from the determination of quenching mechanisms to temperature sensing and bioimaging. The current perception of lifetime measurement is that it is a trivial and fast experiment. However, despite this apparent simplicity, measuring luminescence decay and fitting the obtained data to a suitable model can be far more intricate. In this perspective, the influence of experimental parameters and fitting procedures on the determination of lifetimes are investigated and, through carefully chosen examples, it is shown that large variations, up to 10%, can be induced by varying parameters such as the data acquisition time, the baseline evaluation, or the mathematical fitting model. In order to present to a wider audience, detailed mathematical descriptions are kept out of the manuscript.

Introduction Elevated glycosylated hemoglobin (HbA1c) in individuals with type 2 diabetes is associated with increased risk of hospitalization and death after acute COVID-19, however the effect of HbA1c on Long COVID is unclear.Objective Evaluate the association of glycemic control with the development of Long COVID in patients with type 2 diabetes (T2D).Research design and methods We conducted a retrospective cohort study using electronic health record data from the National COVID Cohort Collaborative. Our cohort included individuals with T2D from eight sites with longitudinal natural language processing (NLP) data. The primary outcome was death or new-onset recurrent Long COVID symptoms within 30–180 days after COVID-19. Symptoms were identified as keywords from clinical notes using NLP in respiratory, brain fog, fatigue, loss of smell/taste, cough, cardiovascular and musculoskeletal symptom categories. Logistic regression was used to evaluate the risk of Long COVID by HbA1c range, adjusting for demographics, body mass index, comorbidities, and diabetes medication. A COVID-negative group was used as a control.Results Among 7430 COVID-positive patients, 1491 (20.1%) developed symptomatic Long COVID, and 380 (5.1%) died. The primary outcome of death or Long COVID was increased in patients with HbA1c 8% to

Abstract. Introduction:. Factors contributing to individual differences in knee osteoarthritis remain elusive. Dispositional traits and socioeconomic status are independent predictors of mental and physical health, although significant variability remains. Dispositional traits serve as the biological interface for life experiences. Objectives:. We investigate group differences based on dispositional traits and poverty status, specific to (1) pain intensity and functional limitations and (2) biological measures, a clinical composite and brain age. Methods:. Adults aged 45 to 85 years with knee pain associated with chronic musculoskeletal pain provided information on demographics, socioeconomic and psychosocial factors, pain, and physical function. Kellgren–Lawrence scores were determined from knee radiographs, the clinical composite from fasting blood draws, and brain age from MRI data. Results:. One hundred seventy-three individuals participated in the study. Of those, 117 had protective dispositional traits (81 above poverty/36 in poverty), and 56 had vulnerable dispositional traits (24 above poverty/32 in poverty). With sex, study site, Kellgren–Lawrence score, and age/or image quality as covariates, significant group differences were observed across clinical pain (P < 0.001), functional limitations (P ≤ 0.001), and brain age (P ≤ 0.002) measures. Although not significant, the clinical composite measure aligned with the other outcome measures and demonstrated the hormesis inverted U pattern. Conclusions:. Groups based on dispositional traits and socioeconomic status explain differing clinical outcomes. Consistent with the allostatic load and hormesis inverted U models, one group was in an adaptive health status, 2 groups were showing signs of developing load, and the fourth group showing signs of overload, at risk of worse health outcomes.

Summary: Background: Despite the recent rise in depressive symptoms among adolescents, trends in at-risk groups remain poorly understood. This study estimated national trends in depressive symptoms among high school students with and without health-risk behaviors. Methods: Data were analyzed from the 2007 to 2021 Youth Risk Behavior Survey (YRBS), a biennial cross-sectional survey of US high school students (n = 119,654). Depressive symptoms were defined as past-year feelings of sadness/hopelessness almost every day for ≥2 weeks impacting usual activities. 24 health-risk behaviors across five categories (violence, substance use, sexual, physical/sedentary, and weight-related) were considered. Multivariable-adjusted logistic regression identified health-risk behaviors independently associated with depressive symptoms. National trends in depressive symptoms among students with and without these health-risk behaviors were estimated. National trends in health-risk behaviors were also estimated among those with depressive symptoms. Findings: Among 119,654 students (mean age, 16.0 [SD = 1.2] years; 50.1% females; and 45.3% non-Hispanic White), depressive symptoms increased from 28.4% (2007) to 42.3% (2021) (biennial average percent change (BAPC), 3.0% [95% confidence interval (CI), 2.6–3.4%]). The largest increases occurred among females (BAPC, 3.3% [2.9–3.8%]) and non-Hispanic White students (BAPC, 3.6% [3.0–4.1%]). Depressive symptoms increased more among students engaging in ≤1 risk category (BAPC = 4.6% [3.6–5.7%]) than students engaging in 4–5 risk categories (BAPC = 2.9% [2.4–3.3%]) (interaction, p = 0.037) and there was a general trend toward decreasing engagement in risk behaviors among students with depressive symptoms. In subgroup analyses, there was a disproportionately large increase in depressive symptoms among students reporting cannabis use, high-risk screen time, shorter sleep hours, and unhealthy weight perception. Interpretation: Depressive symptoms increased faster among high school students without than with multiple behavioral risk factors. A broadening of the depression risk profile underscores the potential value of universal depression screening to identify students who may otherwise go undetected by targeted screening. Funding: The study was not funded.

Research from the Australian Human Rights Commission (2017) and the National Student Safety Survey (Heywood et al., 2022) revealed the prevalence of sexual harm experienced by students during internships and placements, with perpetrators often being colleagues and clients outside the university. The Action Plan Addressing Gender-Based Violence in Higher Education (Department of Education, 2024a) identifies placements as high-risk environments, prompting action to address this issue. Over several years, Deakin University’s sexual harm prevention and response teams have partnered with Work Integrated Learning staff to enhance awareness of support and report services. This has included the implementation of a university-wide module to educate students on their rights, responsibilities, and personal safety during internships and placements. This paper provides an overview of the design, development, and initial launch of the module with discussion of future directions. --- Empowering respectful and inclusive placement experiences by Laura Burge, Alicea Yu, Rhiannon Tanner, Thanura Ediri, Alisha Stewart and Mary Rabahi is licensed under CC BY 4.0

Objectives To explore patients’ and carers’ preferences for postdischarge surgical wound monitoring.Design Explanatory mixed methods study with an online survey followed by online interviews.Setting The online survey was distributed via the Cardiothoracic Interdisciplinary Research Network and cardiac surgery patient and public involvement groups in London and Leicester, UK. Participants were invited to share the survey link with other patients and carers. Interviewees were recruited through the survey.Participants Seventy participants completed the survey: 74% patients and 26% carers. A range of ages, sex, ethnicities and geographical locations were represented. Six survey patient participants volunteered to be interviewed.Findings Themes identified were the impact on patients of having a surgical site infection, patients’ preferences for postdischarge surgical wound follow-up, access to specialist support, wound monitoring using digital technology and receiving information from the hospital about wounds and wound care. Interviewees described feeling isolated after discharge from hospital and 10% of survey patient respondents, including four of the six interviewees, reported hospital readmissions. Survey respondents’ preferred routes for providing hospitals with wound information were over the telephone (30%), emails (24%), text messages (16%) and photos sent securely (14%). All six interviewees’ preference was for digital approaches using images. Survey respondents were least likely (50%) to reply to questionnaires that required software to be downloaded and installed. Interviewees considered digital wound monitoring to be convenient and the best use of patient and staff resources. A new theme was identified where patients wanted to become more involved in treating their surgical wounds at home.Conclusion Experiences described by participants suggests there is a need to improve post-discharge wound monitoring. A new approach should be proactive, ongoing and provide easy access to healthcare services. Digital surgical wound monitoring offers these benefits and is acceptable to patients.Trial registration number ISRCTN13950775; Post-results.

A growing body of research highlights digital platforms like TikTok’s pivotal role in shaping meaning for their users, particularly regarding gender perceptions. With TikTok increasingly serving as a search engine for teens, understanding how opinions are formed necessitates examining online content and interactions. Our article focuses on the construction of masculinity and gender dynamics with sigma videos on TikTok, emphasizing the digital practices that foster toxic communication. We define toxic communication as the deliberate framing and intensification of gender relations through the lens of male control and domination, alongside the denigration, devaluation, or defamation of feminine and non-binary identities associated with hegemonic masculinity. Adopting a socio-technical approach, we utilize a digital qualitative method of immersive observation to collect and analyze videos, posts, hashtags, and gender-related content. Our findings reveal that sigma toxic communication manifests in a spectrum ranging from subtle humor to explicit violence. This diversity of content functions as a “ready-to-think” framework, potentially appealing to a wide range of men across varying tastes, ages, and attitudes toward gender while perpetuating narratives that reflect and reinforce entrenched patterns of male dominance.

Despite the acknowledged merits of precision oncology (PO) and its increasing global implementation, its full potential for advancing care and prevention remains unrealized. The benefits are currently accessible to only limited patient segments because of multifaceted barriers. Successful implementation hinges on various factors—scientific complexities not limited to technical, clinical, regulatory, economic, administrative, and health care policy–related challenges. From building infrastructure to the associated costs, including research and development, testing, processing, and trained personnel, a lack of alignment persists. Administrative alignment with regulatory and payor acceptance is crucial. Health care policy must adapt to the ongoing shift from a one-size-fits-all treatment to a personalized approach. Without official endorsement of long-term gains over short-term costs and the health establishment's readiness for innovation, PO prospects, even in prosperous economies, may stagnate. Lower-income countries face exacerbated challenges, intensifying barriers to adoption. Nevertheless, growing awareness and utilization, driven by recognized potential for patients and public health, along with successful examples and advocacy, are progressively influencing policy for a more inclusive and beneficial approach to PO adoption.

BackgroundParkinson’s disease (PD) is often characterized by altered rates and patterns of neuronal activity in the sensorimotor regions of the basal ganglia thalamocortical network. Little is known, however, regarding how neuronal activity in the executive control network of the brain changes in the parkinsonian condition.ObjectiveInvestigate the impact of parkinsonism on neuronal activity in the dorsolateral prefrontal cortex (DLPFC), a key region in executive control, during a go/nogo reaching task.MethodsUsing a within-subject design, single and multi-unit neuronal activity was recorded in the DLPFC of a nonhuman primate (n = 1) before and after the induction of mild parkinsonism using the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP).ResultsCoincident with development of mild parkinsonian motor signs, there was a marked reduction in the percentage of DLPFC cells with significant task-related firing rate modulation during go and nogo conditions.ConclusionThese results suggest that DLPFC dysfunction may occur early in parkinsonism and contribute to cognitive impairments and disrupted executive function often observed in PD patients.

Objective: Smoking cessation remains a significant challenge in the care of patients with vascular disease. This pilot study aims to evaluate the efficacy of a multidisciplinary inpatient smoking cessation intervention that leverages surgery as a teachable moment and the postoperative inpatient recovery period to initiate smoking cessation counseling and pharmacotherapy. Methods: Adult smokers with occlusive or aneurysmal arterial disease admitted after vascular surgery in a tertiary care center were enrolled. Patients received brief counselling sessions regarding smoking cessation from specialties including vascular surgery, cardiology, neurology, and the smoking cessation program during the hospitalization using the gain-frame approach. Subjects completed surveys related to smoking habits and mental health, including the Fagerstrom test for nicotine dependence and Patient-Reported Outcomes Measurement Information System questionnaire, respectively. Patients were provided free nicotine replacement therapy for 4 weeks. Any additional medication deemed necessary for quitting was prescribed upon discharge. Patients were given appointments for a smoking cessation program visit and routine provider follow-up was scheduled. The primary end points were smoking cessation rates at 3 months and 1 year. Results: A total of 48 patients were enrolled. The mean number of cigarettes consumed before enrollment was 17 ± 9 per day over a mean period of 40 ± 11 years. All patients had previously attempted to quit smoking and 97% had received advice from their surgeons or interventionalists to quit smoking in the prior year. Most patients (94%) had tried to stop smoking before and 50% had more than three attempts at smoking cessation before enrollment. The mean quitting period was 9 months (range, 4-20 months) before relapse. Stress was the most common reason for relapse and continued smoking in 50% of patients. A minority of patients knew that smoking was taking years off their life (42%), made them worry about developing heart disease (34%), and reduced their quality of life (31%). At 1 year, the smoking cessation rate was 45% (n = 19/42) with 59% (n = 25/42) reduced smoking quantity. The carbon monoxide breath test was not conducted owing to the coronavirus disease 2019 pandemic. Conclusions: This pilot study demonstrates that an inpatient, multidisciplinary approach to smoking cessation is effective with a durable impact up to 1 year. Inpatient strategies leveraging multidisciplinary teams and teachable moments should be incorporated into smoking cessation programs.

Objective To identify patient and provider factors associated with lower rates of follow-up for positive depression screens in outpatient settings.Design Retrospective cohort study with electronic health record analysis investigating factors associated with follow-up care for patients with moderate-to-severe depressive symptoms. Patient and provider variables were associated with rates of follow-up for positive depression screens.Setting University of Utah and University of Utah Health-affiliated primary care and specialty clinics.Participants Adults who screened positive for depressive symptoms (score≥10) on the Patient Health Questionnaire (PHQ-9) at an ambulatory visit between 1 January 2021 and 31 January 2022. A total of 17 651 patients were included in the study.Outcome measures Follow-up for positive depression screens was defined as a new antidepressant prescription or completed mental health visit. Variables associated with follow-up included patient demographic data, anthropometric measures, geographical classification, primary language, comorbidities and socioeconomic factors as well as provider demographics, level of training and clinic type.Results 5396 patients (30.6%) did not receive follow-up care for a positive PHQ-9 screen. Factors associated with lower rates of follow-up included male patients (gender; p=0.013), older patients (age group; p=0.016), non-White patients (ethnicity; p

IntroductionGuided by a communications-focused framework developed by an interdisciplinary team of authors, this paper presents data from a survey of health science faculty members to better understand how research collaborations are established and maintained.MethodsAn electronic survey was distributed to faculty in six colleges at a Research 1 institution. Quantitative data were downloaded into Excel and then RStudio for descriptive analysis. Open-ended, qualitative responses were coded and analyzed for themes.ResultsMost respondents were in public health (44.0%) or medicine (25.3%); 40.0% were tenured. A grant deadline was the main impetus reported for initiating research collaborations (86.1%). Most respondents (76.5%) sought federal research funding. Establishing roles at the start of collaborations was considered either extremely (74.4%) or somewhat (25.6%) valuable; most (78.0%) decided on roles in a collaborative manner. Women were significantly more likely than men to publish with community members (p

PURPOSEStigma contributes to fear and shame, resulting in delays in care-seeking behavior among individuals with cancer. As a social construct, stigma is affected by language, religion, culture, and local norms. This study explored pediatric cancer stigma at the time of diagnosis across diverse settings through the adaptation of two stigma measures.METHODSThis study was conducted with adolescents and caregivers of children with osteosarcoma and retinoblastoma at three centers in Jordan, Guatemala, and Zimbabwe. The Stigma-related Social Problems (SSP) and the eight-item Stigma Scale for Chronic Illness (SSCI-8) measures were translated into Arabic, Spanish, and Shona and contextually adapted for use with adolescents and caregiver proxies. Adapted measures were pilot-tested and iteratively revised.RESULTSExtensive adaptations were made to both measures to make them relevant to the local pediatric contexts. The final measures were used in nine patients and 28 caregivers. The exploratory analysis found that domain-specific and overall scale scores for both measures indicate a higher level of stigma than those found in previous studies (SSP: patient [51.23], caregiver [40.74]; SSCI-8: patient [50.41], caregiver [49.78]). Paired, patient-caregiver proxy responses were analyzed, with disagreement between the pairs for both scales.CONCLUSIONAdapted measures detected high levels of stigma among patients with pediatric cancer and their caregiver proxies and demonstrated a lack of concordance in the reports. This suggests the importance of studying stigma in this population and the need to ask patients about their stigma without using proxy measures. The required adaptations suggest a need for stigma measures developed specifically for pediatric cancer.

Background Hypoxic pulmonary vasoconstriction leads to an increase in pulmonary artery pressure (PAP) and potentially right heart failure in healthy individuals and patients with respiratory diseases. Previous studies in patients with chronic obstructive pulmonary disease (COPD) exposed to hypobaric hypoxia have shown an increase in PAP, while traditional echocardiographic parameters revealed only minimal changes at high altitude. Speckle-tracking-derived analysis is potentially more sensitive to assess right ventricular (RV) function and we used this method to investigate the impact on RV function of patients with COPD ascending to high altitude and compared the results with the traditional echocardiographic parameters.Methods This post hoc analysis evaluates echocardiographic RV free wall strain (RVFWS) in patients with COPD GOLD grade 1–3 travelling from 760 m to 3100 m for a 2-day stay. An RVFWS over −20% was considered as an indicator of RV dysfunction.Results A total of 54 patients (57% men, mean±SD age 58±9 years, forced expiratory volume in 1 s (FEV1 % predicted 77.3±22.5)) with echocardiographs of sufficient quality were included. The mean RVFWS worsened significantly from −26.0±4.9% at 760 m to −23.9±5.4% at 3100 m (p=0.02). The number of patients with relevant RV dysfunction based on RVFWS increased from 7.4% at 760 m to 25.9% at 3100 m (p=0.02), whereas the prevalence of RV dysfunction assessed by traditional indices remained unchanged.Conclusion Exposure to hypoxia led to RVFWS impairment in more than one quarter of patients with COPD. Strain analysis is a promising, non-invasive method for evaluating RV dysfunction, even in subclinical cases and might be prognostically relevant in patients with lung diseases.Trial registration numbers NCT02450968 and NCT03173508.

Extant literature and common marketing practices converge around the idea that stronger self-links to a brand and its products lead to increased brand loyalty. In this article, we challenge this conventional notion by revealing situations where the preference for self-linked brands diminishes, despite the self-links remaining unchanged. We introduce a key distinction between two types of consumer identities based on whether identity expression relies on specific products: product-dependent (e.g. chef) and product-independent (e.g. foodie). Our theory posits that self-links to products exert less influence on preference when a product-independent identity is prominent. Across five studies examining consumer leisure identities, we find that priming a product-independent (vs. product-dependent) identity reduces preference for self-linked products/brands. Interestingly, it can also enhance preference for negatively self-linked (dissociative) products/brands among materialistic consumers. In a sixth experiment and a real-world Facebook study, we illustrate that the extent to which consumers' identity is chronically product-independent can be assessed either directly or indirectly from social media interests, allowing for more effective targeting of brand-switching appeals. Adding to the literature on the symbolic role of products in identity expression, our research uniquely investigates the functional role of products in identity expression and its profound impact on product/brand preference. [ABSTRACT FROM AUTHOR]