Search

A balanced equilibrium between carnivores and their prey is crucial for maintaining ecosystem sustainability. In this study, we applied the predator–prey power law equation to assess the balance between the biomass densities of carnivores and their wild prey within Nepal's lowland protected areas during 2013, 2018, and 2022. The estimated value of the power law exponent k for predator–prey biomass was 0.71 (95% CI = 0.39–1.05), indicating an approximate threefold increase in predator biomass density for every fivefold increase in prey biomass density. Consequently, this creates a systematically bottom‐heavy predator–prey biomass pyramid. This finding, consistent with the k = 3/4 trophic biomass scaling across ecosystems, suggests that predator biomass is proportionally sustained by prey biomass, indicating a balance between top predators and their wild prey in Nepal's lowland protected areas. We further demonstrated it is possible to retain the overall power law exponent while jointly measuring intraguild competition between two predators with canonical correlation analysis. This understanding opens avenues for future research directed toward unraveling the factors that drive these consistent growth patterns in ecological communities. [ABSTRACT FROM AUTHOR]

Implantable medical devices require protective encapsulation to isolate them from the biological environment. Parylene‐C (PaC) is a prevalent encapsulation polymer but is susceptible to cracking, delamination, oxidation, and moisture penetration over time. This study demonstrates that 3D micro‐anchors fabricated by direct laser writing (DLW) greatly enhance PaC lifetime and encapsulation properties. The PaC film is vapor deposited onto these anchor points, followed by ultraviolet radiation (UV)‐curing‐induced shrinkage. Electrochemical impedance spectroscopy (EIS) during accelerated aging tests in reactive solutions (87 °C, 15 mM H2O2) is performed to monitor film degradation over time. Unpatterned PaC films failed before reaching the 3.25 accelerated year benchmark, while 100 µm spaced micro‐anchors extended encapsulation up to 5.5 equivalent years. Subsequent improvements are achieved with a spacing of 50 µm, demonstrating viability up to ≈6 equivalent years. This research demonstrates the benefit of engineering anchor points for preventing delamination of the PaC layer and significantly enhancing encapsulation properties. Printed 3D micro‐anchors are an extremely flexible platform, with many different shapes and sizes possible which can further enhance longevity. The success in increasing coating lifetimes offers a promising direction for improving long‐term implantable medical devices, potentially revolutionizing their longevity and reliability. [ABSTRACT FROM AUTHOR]

Human–wildlife conflict studies of high‐altitude areas are rare due to budget constraints and the challenging nature of research in these remote environments. This study investigates the prevalence and increasing trend of human–wildlife conflict (HWC) in the mountainous Gaurishankar Conservation Area (GCA) of Nepal, with a specific focus on leopard (Panthera pardus) and Himalayan black bear (Ursus thibetanus laniger). The study analyzes a decade of HWC reports and identifies goats as the livestock most targeted by leopards. The Dolakha district of GCA received the highest number of reports, highlighting the need for mitigation measures in the area. In GCA, livestock attacks accounted for 85% of compensation, with the remaining 15% for human injuries. We estimate that the number of reported wildlife attacks grew on average by 33% per year, with an additional increase of 57 reports per year following the implementation of a new compensation policy during BS 2076 (2019 AD). While bear attacks showed no significant change post‐rule alteration, leopard attack reports surged from 1 to 60 annually, indicating improved compensation may have resulted in increased leopard‐attack reporting rates. The findings emphasize the economic impact of HWC on local communities and suggest strategies such as increasing prey populations, promoting community education and awareness, enhancing alternative livelihood options, developing community‐based insurance programs, and implementing secure enclosures (corrals) to minimize conflicts and foster harmonious coexistence. This research addresses a knowledge gap in HWC in high‐altitude conservation areas like the GCA, providing valuable insights for conservation stakeholders and contributing to biodiversity conservation and the well‐being of humans and wildlife. [ABSTRACT FROM AUTHOR]

The article focuses on identifying barriers and facilitators perceived by patients regarding the initiation of naltrexone (NTX) treatment for alcohol use disorder (AUD) in the emergency department (ED). It aims to understand patient perspectives to improve the treatment pathway and address missed opportunities for AUD management in the ED setting.

Proportion variables, also known as compositional data, are very common in ecology. Unfortunately, few scientists are aware of how compositional data, when used as covariates, can adversely impact statistical analysis. We describe here how proportion covariates result in multicollinearity and parameter identifiability problems. Using simulated data on bird species richness as a function of land use, we show how these problems manifest when fitting a wide range of models in R, both in a frequentist and Bayesian framework. In particular, we show that similar models can often generate substantially different parameter estimates, leading to very different conclusions. Dropping a covariate or the intercept from the model can solve the multicollinearity and parameter identifiability problems. Unfortunately, these solutions do not fix the inherent challenges associated with interpreting parameter estimates. To this end, we propose focusing the interpretation on the difference of slope parameters to avoid the inherent unidentifiability of individual parameters. We also propose conditional plots with two x‐axes and marginal plots as visualization techniques that can help users better interpret their modeling results. We illustrate these problems and proposed solutions using empirical data from the North American Breeding Bird Survey. The practical and straightforward approaches suggested in this article will help the fitting of linear models and interpretation of its results when some of the covariates are proportions. [ABSTRACT FROM AUTHOR]

The aim of this perspective is to argue that carbon pricing is not unjust. Two important dimensions of justice are distributive and procedural (sometimes called "participatory") justice. In terms of distributive justice, it is argued that carbon pricing can be made distributionally just through revenue recycling and that it should be expected that even neutral reductions in emissions will generate progressive benefits, both internationally and regionally. In terms of procedural justice, it is argued that carbon pricing is in principle compatible with any procedure; however, there is also a particular morally justifiable procedure, the Citizens' Assembly, which has been implemented in Ireland on this precise question and has generated broad agreement on carbon pricing. It is suggested that this morally matters because such groups are like "ideal advisors" that offer morally important advice. Finally, an independent objection is offered to some ambitious alternatives to carbon pricing like Green New Deal‐type frameworks, frameworks that aim to simultaneously tackle multiple social challenges. The objection is that these will take too long to work in a climate context, both to develop and to iterate. [ABSTRACT FROM AUTHOR]

Ideal carbon tax policy is internationally coordinated, fully internalizes externalities, redistributes revenues to those harmed, and is politically acceptable, generating predictable market signals. Since nonideal circumstances rarely allow all these conditions to be met, moral issues arise. This paper surveys some of the work in moral philosophy responding to several of these issues. First, it discusses the moral drivers for estimates of the social cost of carbon. Second, it explains how national self‐interest can block climate action and suggests international policies—carbon border tax adjustments and carbon clubs—that can help address these concerns. Third, it introduces some of the social science literature about the political acceptability of carbon taxes before addressing a couple common public concerns about carbon taxes. Finally, it introduces four carbon revenue usage options, arguing that redistributive and climate compensation measures are most morally justified. This article is categorized under:Climate, Nature, and Ethics > Ethics and Climate ChangeClimate, Nature, and Ethics > Climate Change and Global JusticeClimate and Development > Social Justice and the Politics of Development [ABSTRACT FROM AUTHOR]

Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD); however, some patients do not improve to the same extent as others. It is important to understand potential factors that can be modified for better patient outcomes. This clinical trial implemented a three‐arm, equipoise‐stratified randomization design to allow for the accommodation of patient preference before randomization to one of three CPT treatment modalities: in‐home, in‐office, or telehealth. This study examined whether satisfaction with the modality, perceived stigma, expectations of therapy, and credibility of the therapist differed between modalities and whether these factors impacted treatment outcomes. We hypothesized that the contributions of these variables would depend upon whether participants opted out of any treatment arms and that these factors would predict treatment outcomes. Participants who endorsed less perceived stigma demonstrated larger reductions in PTSD symptom severity than those with similar levels of perceived stigma in the telehealth and in‐office conditions, η2 =.12–.18. Participants who endorsed lower satisfaction with their treatment modality and were assigned to the in‐home condition experienced larger PTSD symptom reductions than those with similar dissatisfaction in the telehealth and in‐office conditions, η2 =.20. The results show the robustness of evidence‐based therapies for PTSD given that dissatisfaction did not impede treatment success. In addition, they demonstrate that it is important for clinicians to address stigma before initiating evidence‐based therapies for PTSD. Strategies to address these factors are discussed. [ABSTRACT FROM AUTHOR]

Protein glycosylation is critical to the quaternary structure and collagen‐binding activity of the extracellular matrix protein adhesin A (EmaA) associated with Aggregatibacter actinomycetemcomitans. The glycosylation of this large, trimeric autotransporter adhesin is postulated to be mediated by WaaL, an enzyme with the canonical function to ligate the O‐polysaccharide (O‐PS) antigen with a terminal sugar of the lipid A‐core oligosaccharide of lipopolysaccharide (LPS). In this study, we have determined that the Escherichia coli waaL ortholog (rflA) does not restore collagen binding of a waaL mutant strain of A. actinomycetemcomitans but does restore O‐PS ligase activity following transformation of a plasmid expressing waaL. Therefore, a heterologous E. coli expression system was developed constituted of two independently replicating plasmids expressing either waaL or emaA of A. actinomycetemcomitans to directly demonstrate the necessity of ligase activity for EmaA collagen binding. Proper expression of the protein encoded by each plasmid was characterized, and the individually transformed strains did not promote collagen binding. However, coexpression of the two plasmids resulted in a strain with a significant increase in collagen binding activity and a change in the biochemical properties of the protein. These results provide additional data supporting the novel hypothesis that the WaaL ligase of A. actinomycetemcomitans shares a dual role as a ligase in LPS biosynthesis and is required for collagen binding activity of EmaA. [ABSTRACT FROM AUTHOR]

Background: The screening, brief intervention, and referral to treatment (SBIRT) model is recommended by the U.S. Preventive Services Task Force to improve recognition of and intervention for unhealthy alcohol use. How SBIRT implementation differs by demographic characteristics is poorly understood. Methods: We analyzed data from the 2015–2019 National Survey on Drug Use and Health from respondents ≥18 years old who used an outpatient clinic and had at least one alcoholic drink within the past year. Respondents were grouped into one of three mutually exclusive groups: "no binge drinking or alcohol use disorder (AUD)," "binge drinking without AUD," or "AUD." Outcome variables were likelihood of screening, brief intervention (BI), referral to treatment (RT), and AUD treatment. The demographic predictors on which outcomes were regressed included gender, age, race and ethnicity, sexual orientation, insurance status, and history of military involvement. Consistent with SBIRT guidelines, the entire sample was included in the screening model; screened persons with either binge drinking without AUD or with AUD were included in the BI model; screened persons with AUD were included in the RT model, and persons referred to treatment with AUD were included in the AUD treatment model. Results: Analyses included 120,804 respondents. Women were more likely than men to be screened, but less likely to receive BI or RT. When referred to treatment, women were more likely than men to receive it. Persons aged ≥50 were least likely to be screened about alcohol, but most likely to receive BI, while persons aged 18–25 were least likely to receive BI or AUD treatment. Racial and ethnic minorities were less likely than White persons to be screened; Asians were less likely to receive RT, and Black persons were less likely to receive treatment than White persons. Persons identifying as gay, lesbian, or bisexual were equally as likely or more likely to receive SBIRT or AUD treatment as those identifying as heterosexual. Persons without insurance were less likely to be screened than those with insurance. Persons with a history of military involvement were more likely to be screened and receive BI and RT than persons who had not served in the military. Conclusions: Demographic disparities in SBIRT implementation exist. Addressing the sources of these disparities and minimizing attrition from care could improve outcomes for persons with unhealthy alcohol use. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Environmental risk factors for pancreatic cancer include acute and chronic pancreatitis, obesity, and tobacco use. Differentiating a pancreatic neoplasm in a patient with pancreatitis can be challenging due to their similar presentations. A 57‐year‐old African American man with a history of congestive heart failure, pancreatitis, and incomplete pancreas divisum presented with an epigastric abdominal pain that radiated to his back. Imaging showed necrotizing pancreatitis, a developing splenic infarct, and a mass at the pancreas tail. The patient was discharged with pain medications and was recommended follow‐up imaging after resolution of his pancreatitis. He was readmitted to the emergency department 2 weeks later with recurrent acute abdominal pain. Computed tomography scan of abdomen and pelvis followed by magnetic resonance imaging and endoscopic ultrasound revealed an infiltrative pancreatic tail mass. Biopsy of the mass confirmed a locally advanced pancreatic tail adenocarcinoma. Chronic pancreatitis is associated with pancreatic cancer. Practitioners should be aware of the co‐existence of chronic pancreatitis and pancreatic cancer, and the initial steps to evaluate a malignancy in chronic pancreatitis. [ABSTRACT FROM AUTHOR]

In both the literature on inclusive education and in international policy development, there has been considerable interest in the use of sets of indicators for the implementation of inclusive education at national and local levels. Drawing on sets of indicators developed in Europe and the Pacific Islands, this study proposes a set of such indicators for Kuwait. These indicators are then presented in a survey of 161 special education teachers working in public elementary mainstream schools across Kuwait. Analysis of the results is used to explore how such indicators could play a role in promoting policy implementation for inclusive education in Kuwait and more widely in Gulf Cooperation Council (GCC) countries. [ABSTRACT FROM AUTHOR]

Many events that humans and other species experience contain regularities in which certain elements within an event predict certain others. While some of these regularities involve tracking the co‐occurrences between temporally adjacent stimuli, others involve tracking the co‐occurrences between temporally distant stimuli (i.e., nonadjacent dependencies, NADs). Prior research shows robust learning of adjacent dependencies in humans and other species, whereas learning NADs is more difficult, and often requires support from properties of the stimulus to help learners notice the NADs. Here, we report on seven experiments that examined NAD learning from various types of visual stimuli, exploring the effects of dynamic motion on adults' NAD learning from visual sequences involving human and nonhuman agents. We tested adults' NAD learning from visual sequences of human actions, object transformations, static images of human postures, and static images of an object in different postures. We found that dynamic motion aids the acquisition of NADs. We also found that learning NADs in sequences involving human agents is more robust compared to sequences involving nonhuman objects. We propose that dynamic motion and human agents both independently result in richer representations that provide a stronger signal for NAD learning. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Medical treatments for overactive bladder (OAB) have proven efficacy in controlled trials. However, 1‐year treatment persistence is reported to be as low as 25% for anticholinergics and 40% for β3 agonists. Real‐world data on treatment continuation and treatment sequence is limited. Therefore, we aimed to study treatment persistence trends in women initiated on OAB medications. Materials and Methods: We used advanced data‐mining techniques to query the largest regional provider's medication purchase database, dispensing for patients, for all women initiating OAB pharmacotherapy between 2010 and 2020. Treatment persistence was measured as days in which the patient was in possession of medication and nonpersistence was defined as prescription nonrefilling for 90 days. We employed a Sankey diagram to explore trends in OAB medication acquisition and treatment sequence. We compared treatment persistence using Kaplan–Meier survival curves and pairwise log‐rank analysis. Results: Here, 46 079 women made 791 681 unique claims of OAB medications. Only 39% of the patients tried more than one OAB formulation, including dose change. The overall persistence rate for all drugs was 55% in 30 days, 46% in 90 days, and 37% per year. The persistence rate for Mirabegron at 30 days was 54%, 42% at 90 days, and 17% at 1 year. Overall, persistence rates were unchanged when stratifying by the time Mirabegron insurance acceptance into coverage (p > 0.05). Conclusions: Real‐world OAB pharmacotherapy persistence rates are lower than previously reported. The introduction of Mirabegron did not seem to improve these rates or affect the treatment sequence. [ABSTRACT FROM AUTHOR]

As a currently common strategy to treat cancer, surgical resection may cause tumor recurrence and metastasis due to residual postoperative tumors. Herein, an implantable sandwich‐structured dual‐drug depot is developed to trigger a self‐intensified starvation therapy and hypoxia‐induced chemotherapy sequentially. The two outer layers are 3D‐printed using a calcium‐crosslinked mixture ink containing soy protein isolate, polyvinyl alcohol, sodium alginate, and combretastatin A4 phosphate (CA4P). The inner layer is one patch of poly (lactic‐co‐glycolic acid)‐based electrospun fibers loaded with tirapazamine (TPZ). The preferentially released CA4P destroys the preexisting blood vessels and prevents neovascularization, which obstructs the external energy supply to cancer cells but aggravates hypoxic condition. The subsequently released TPZ is bioreduced to cytotoxic benzotriazinyl under hypoxia, further damaging DNA, generating reactive oxygen species, disrupting mitochondria, and downregulating hypoxia‐inducible factor 1α, vascular endothelial growth factor, and matrix metalloproteinase 9. Together these processes induce apoptosis, block the intracellular energy supply, counteract the disadvantage of CA4P in favoring intratumor angiogenesis, and suppress tumor metastasis. The in vivo and in vitro results and the transcriptome analysis demonstrate that the postsurgical adjuvant treatment with the dual‐drug‐loaded sandwich‐like implants efficiently inhibits tumor recurrence and metastasis, showing great potential for clinical translation. [ABSTRACT FROM AUTHOR]

Background and Aims: Skin substitutes, essential tools for helping close full thickness wounds with minimal scarring, are available in both collagen‐based and synthetic polyurethane constructions. Here we explore fundamental differences between two frequently used skin substitutes and discuss how these differences may impact in vivo performance. Methods: Polyurethane‐ and collagen‐based matrices were characterized in vitro for pore size via scanning electron microscopy, hydrophobicity via liquid contact angle, conformability via bending angle, and biocompatibility via fibroblast and keratinocyte adhesion and proliferation. These matrices were then evaluated in a full‐thickness excisional pig wound study followed by histological analysis. Statistical analysis was performed using t‐tests or one‐way analysis of variances with Tukey's multiple post hoc comparisons, where appropriate. Results: Average pore diameter in the tested polyurethane matrix was over four times larger than that of the collagen matrix (589 ± 297 µm vs. 132 ± 91 µm). Through liquid contact angle measurement, the collagen matrix (not measurable) was found to be hydrophilic compared to the hydrophobic polyurethane matrix (>90°). The collagen matrix was significantly more conformable than the polyurethane matrix (9 ± 2° vs. 84 ± 5° bending angle, respectively). Fibroblast and keratinocyte adhesion and proliferation assays elucidated a significantly greater ability of both cell types to attach and proliferate on collagen versus polyurethane. While the porcine study showed minimal contraction of either matrix material, histological findings between the two treatments were markedly different. Collagen matrices were associated with early fibroblast infiltration and fibroplasia, whereas polyurethane matrices elicited a strong multinucleated giant cell response and produced a network of comparatively aligned collagen fibrils. Conclusions: The more favorable in vitro properties of the collagen matrix led to less inflammation and better overall tissue response in vivo. Overall, our findings demonstrate how the choice of biomaterial and its design directly translate to differing in vivo mechanisms of action and overall tissue quality. [ABSTRACT FROM AUTHOR]

Insomnia and nightmares are common in patients with posttraumatic stress disorder (PTSD). They are associated with worse psychological and physical health and worse PTSD treatment outcomes. In addition, they are resistant to PTSD treatments, which do not typically address sleep disorders. Cognitive behavioral therapy for insomnia and nightmares (CBT‐I&N) and cognitive processing therapy (CPT) for PTSD are first‐line treatments, but limited evidence exists guiding the treatment of individuals with all three disorders. The current study randomized U.S. military personnel (N = 93) to one of three conditions: CBT‐I&N delivered before CPT, CBT‐I&N delivered after CPT, or CPT alone; all groups received 18 sessions. Across groups, participants demonstrated significantly improved PTSD symptoms. Because the study was terminated prematurely due to challenges with recruitment and retention, it was underpowered to answer the initially intended research questions. Nonetheless, statistical findings and relevant clinically meaningful changes were observed. Compared to participants who received CPT alone, those who received CBT‐I&N and CPT, regardless of sequencing, demonstrated larger improvements in PTSD symptoms, d = −0.36; insomnia, d = −0.77; sleep efficiency, d = 0.62; and nightmares, d = −.53. Compared to participants who received CBT‐I&N delivered before CPT, those who received CBT‐I&N delivered after CPT demonstrated larger improvements in PTSD symptoms, d = 0.48, and sleep efficiency, d = −0.44. This pilot study suggests that treating comorbid insomnia, nightmares, and PTSD symptoms results in clinically meaningful advantages in improvement for all three concerns compared to treating PTSD alone. [ABSTRACT FROM AUTHOR]

Summary: Background: Curcumin and QingDai (QD, Indigo) have been shown to be effective for treating active ulcerative colitis (UC). Aim: To evaluate the real‐world experience with the Curcumin–QingDai (CurQD) herbal combination to induce remission in active UC. Methods: A retrospec‑tive multicentre adult cohort study from five tertiary academic centres (2018–2022). Active UC was defined as a Simple Clinical Colitis Activity Index (SCCAI) ≥ 3. Patients were induced by CurQD. The primary outcome was clinical remission at weeks 8–12, defined as SCCAI ≤2 and a decrease ≥3 points from baseline. Secondary outcomes were clinical response (SCCAI decrease ≥3 points), corticosteroid‐free remission, faecal calprotectin (FC) response (reduction ≥50%), FC normalisation (FC ≤100 μg/g for patients with FC ≥300 μg/g at baseline), and safety. All outcomes were analysed for patients who were maintaining stable treatment. Results: Eighty‐eight patients were included; 50% were biologics/small molecules experienced, and 36.5% received ≥2 biologics/small molecules. Clinical remission was achieved in 41 (46.5%), and clinical response in 53 (60.2%). Median SCCAI decreased from 7 (IQR:5–9) to 2 (IQR:1–3); p < 0.0001. Of the 26 patients on corticosteroids at baseline, seven achieved corticosteroid‐free remission. Among 43 biologics/small molecules experienced patients, clinical remission was achieved in 39.5% and clinical response in 58.1%. FC normalisation and response were achieved in 17/29 and 27/33, respectively. Median FC decreased from 1000 μg/g (IQR:392–2772) at baseline to 75 μg/g (IQR:12–136) at the end of inductions (n = 30 patients with paired samples); p < 0.0001. No overt safety signals emerged. Conclusion: In this real‐world cohort, CurQD effectively induced clinical and biomarker remission in patients with active UC, including patients who were biologics/small molecules experienced. [ABSTRACT FROM AUTHOR]

Aggregatibacter actinomycetemcomitans is a gram‐negative bacterium associated with periodontal disease and a variety of disseminated extra‐oral infections. Tissue colonization is mediated by fimbriae and non‐fimbriae adhesins resulting in the formation of a sessile bacterial community or biofilm, which confers enhanced resistance to antibiotics and mechanical removal. The environmental changes experienced by A. actinomycetemcomitans during infection are detected and processed by undefined signaling pathways that alter gene expression. In this study, we have characterized the promoter region of the extracellular matrix protein adhesin A (EmaA), which is an important surface adhesin in biofilm biogenesis and disease initiation using a series of deletion constructs consisting of the emaA intergenic region and a promotor‐less lacZ sequence. Two regions of the promoter sequence were found to regulate gene transcription and in silico analysis indicated the presence of multiple transcriptional regulatory binding sequences. Analysis of four regulatory elements, CpxR, ArcA, OxyR, and DeoR, was undertaken in this study. Inactivation of arcA, the regulator moiety of the ArcAB two‐component signaling pathway involved in redox homeostasis, resulted in a decrease in EmaA synthesis and biofilm formation. Analysis of the promoter sequences of other adhesins identified binding sequences for the same regulatory proteins, which suggests that these proteins are involved in the coordinate regulation of adhesins required for colonization and pathogenesis. [ABSTRACT FROM AUTHOR]

Home care is one of the fastest‐growing industries in the United States, providing valuable opportunities for millions of older adults and people with disabilities to live at home rather than in institutional settings. Home care workers assist clients with essential activities of daily living, but their wages and working conditions generally fail to reflect the importance of their work. Drawing on the work of Eva Feder Kittay and other care ethicists, we argue that good care involves attending to the needs of another out of a concern for their well‐being. Such care should be standard in the home care system. Yet, because of the pervasive racial, gender, and economic inequalities that the home care industry perpetuates, home care workers and their clients cannot reasonably be expected to care about each other. We endorse reforms aimed at enabling home care workers and their clients to form and maintain professional relationships that cultivate care.. [ABSTRACT FROM AUTHOR]

Narrative transportation is a state of total immersion that arises when one becomes engaged in a story. In Cohen et al. (2015), participants viewed a suspenseful film either with order of scenes intact or scrambled (out of chronological order). Participants had to remember to raise their hand every time they heard a film character say the word "gun." Results revealed participants were less likely to remember this instruction in the intact condition because their attention shifted away from processing their own goals to the goals of the protagonist. In three studies, we examined the boundary conditions of this effect by including a spoiler by telling participants the film ending (Study 1), having participants view the film individually or in groups (Study 2), and offering a reward incentive (Study 3). Overall, results showed that knowing the ending of the story did not improve performance, however, offering an incentive did boost goal maintenance. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have indicated that intra-articular steroid injections to the hip are beneficial for short-term pain relief. However, recent studies have drawn concerns of rapidly progressive osteoarthritis of the hip (RPOH) following intra-articular steroid injections. The prevalence of RPOH following intra-articular steroid injections varies widely in the literature.Objective: To identify the prevalence of RPOH following intra-articular steroid injections, and to compare baseline characteristics between patients with and without RPOH.Design: Case series.Setting: Tertiary academic hospital.Patients: A total of 924 patients (median [interquartile range; IQR] age: 59 [45-70] years; 579 female) who received an intra-articular hip steroid/anesthetic injection from January 2016 to March 2018 and had available pre- and post-injection imaging (prior to surgical intervention) were included in the study.Interventions: Baseline and injection-related data-including demographics, age, body mass index, medical history, laterality, and steroid type-were collected from electronic medical records.Main Outcome Measures: Post-injection RPOH was determined via imaging review by a physiatry fellow, followed by an attending physiatrist and a musculoskeletal radiologist to confirm findings.Results: The majority of patients received unilateral injections into the hip, and the most common steroids used were triamcinolone and methylprednisolone. Review of pre- and post-injection imaging revealed 26 cases of RPOH, for an overall prevalence of 2.8% (95% confidence interval [CI] 1.9%-4.1%). Compared to those without RPOH, patients with RPOH were significantly older (median age [IQR]: 64 [60-73] vs. 59 [44-70] years, p = .003) and had a shorter duration of symptoms prior to their injections (median [IQR]: 3 vs. 12 [6-36] months, p < .001). Adjusted regression analyses showed that age was associated with greater odds of RPOH (odds ratio [OR], 95% CI: 1.04, 1.01 to 1.07; p = .003).Conclusions: The prevalence of RPOH following intra-articular steroid injections into the hip was lower than previously reported but still clinically relevant. This should be considered when counseling patients prior to intra-articular hip steroid injections. [ABSTRACT FROM AUTHOR]

Objective: To explore whether the association between change in headache management self‐efficacy and posttraumatic headache–related disability is partially mediated by a change in anxiety symptom severity. Background: Many cognitive–behavioral therapy treatments for headache emphasize stress management, which includes anxiety management strategies; however, little is currently known about mechanisms of change in posttraumatic headache–related disability. Increasing our understanding of mechanisms could lead to improvements in treatments for these debilitating headaches. Methods: This study is a secondary analysis of veterans (N = 193) recruited to participate in a randomized clinical trial of cognitive–behavioral therapy, cognitive processing therapy, or treatment as usual for persistent posttraumatic headache. The direct relationship between headache management self‐efficacy and headache‐related disability, along with partial mediation through change in anxiety symptoms was tested. Results: The mediated latent change direct, mediated, and total pathways were statistically significant. The path analysis supported a significant direct pathway between headache management self‐efficacy and headache‐related disability (b = −0.45, p < 0.001; 95% confidence interval [CI: −0.58, −0.33]). The total effect of change of headache management self‐efficacy scores on change in Headache Impact Test‐6 scores was significant with a moderate‐to‐strong effect (b = −0.57, p = 0.001; 95% CI [−0.73, −0.41]). There was also an indirect effect through anxiety symptom severity change (b = −0.12, p = 0.003; 95% CI [−0.20, −0.04]). Conclusions: In this study, most of the improvements in headache‐related disability were related to increased headache management self‐efficacy with mediation occurring through change in anxiety. This indicates that headache management self‐efficacy is a likely mechanism of change of posttraumatic headache–related disability with decreases in anxiety explaining part of the improvement in headache‐related disability. [ABSTRACT FROM AUTHOR]

Objective: Previous research with civilian populations has found strong associations between fibromyalgia (FM) and posttraumatic stress disorder (PTSD). We undertook this study to investigate the prevalence of FM in military service members with and without PTSD. Methods: Participants were active duty military personnel recruited into either an epidemiologic cohort study of service members before a military deployment or 1 of 3 PTSD treatment trials. Instruments used to document FM and PTSD included the PTSD Checklist–Stressor‐Specific Version, the PTSD Symptom Scale‐Interview, and the 2012 American College of Rheumatology FM questionnaire. Results: Across the 4 studies, 4,376 subjects completed surveys. The prevalence of FM was 2.9% in the predeployment cohort, and the prevalence was significantly higher in individuals with PTSD (10.8%) compared with those without PTSD (0.8%). In the treatment trials, all of the participants met criteria for PTSD before starting treatment, and the prevalence of FM was 39.7%. Conclusion: The prevalence of FM in active duty service members preparing to deploy is similar to that reported for the general population of the US but is higher than expected for a predominantly male cohort. Furthermore, the prevalence of FM was significantly higher in service members with comorbid PTSD and was highest among those seeking treatment for PTSD. Further investigation is needed to determine the factors linking PTSD and FM. [ABSTRACT FROM AUTHOR]

Aggregatibacter actinomycetemcomitans, a Gram‐negative oral pathobiont causing aggressive periodontitis and systemic infections, demonstrates serum resistance. We have identified a dsDNA‐tailed bacteriophage, S1249, which was found to convert from this microorganism inducible by human serum into a lytic state to kill the bacterium. This phage demonstrated active transcripts when exposed to human serum: 20% of genes were upregulated more than 10‐fold, and 45% of them were upregulated 5–10‐fold when the bacterium was grown in the presence of human serum compared to without the presence of human serum. Transcriptional activation when grown in equine serum was less pronounced. This phage demonstrated a tail with inner rigid tubes and an outer contractile sheath, features of Myoviridae spp. Further characterization revealed that the lysogenized integration of the phage in the chromosome of A. actinomycetemcomitans occurred between the genes encoding cold‐shock DNA‐binding domain‐containing protein (csp) and glutamyl‐tRNA synthetase (gltX). Both phage DNA integrated lysogeny and nonintegrated pseudolysogeny were identified in the infected bacterium. A newly generated, lysogenized strain using this phage displayed similar attributes, including 63% growth inhibition compared to its isogenic phage‐free strain when in the presence of human serum. Our data suggest that bacteriophage S1249 can be induced in the presence of human serum and enters the lytic cycle, which reduces the viability of infected bacteria in vivo. [ABSTRACT FROM AUTHOR]

This study examined the impact of a history of head injury (HHI) on posttraumatic stress disorder (PTSD) and depression symptoms in active duty military personnel following group and individual cognitive processing therapy (CPT). Data for these secondary analyses were drawn from a clinical trial comparing group and individual CPT. Service members (N = 268, 91.0% male) were randomized to 12 sessions of group (n = 133) or individual (n = 135) CPT. Most participants (57.1%) endorsed a deployment‐related HHI, 92.8% of whom reported currently experiencing symptoms (CES) related to the head injury (i.e., HHI/CES). Patients classified as non‐HHI/CES demonstrated large, significant improvements in PTSD symptom severity in both individual and group therapy, ds = 1.1, p <.001. Patients with HHI/CES status showed similar significant improvements when randomized to individual CPT, d = 1.4, p <.001, but did not demonstrate significant improvements when randomized to group CPT, d = 0.4, p =.060. For participants classified as HHI/CES, individual CPT was significantly superior to group CPT, d = 0.98, p =.003. Symptoms of depression improved following treatment, with no significant differences by treatment delivery format or HHI/CES status. The findings of this clinical trial subgroup study demonstrate evidence that group CPT is less effective than individual CPT for service members classified as HHI/CES. The results suggest that HHI/CES status may be important to consider in selecting patients for group or individual CPT; additional research is needed to confirm the clinical implications of these findings. [ABSTRACT FROM AUTHOR]

Background: Cancer is one of the most common comorbidities in men living with HIV (MLWH). However, little is known about the MLWH subgroups with the highest cancer burden to which cancer prevention efforts should be targeted. Because Medicaid is the most important source of insurance for MLWH, we evaluated the excess cancer prevalence in MLWH on Medicaid relative to their non‐HIV counterparts. Methods: In this cross‐sectional study using 2012 Medicaid Analytic eXtract data nationwide, we flagged the presence of HIV, 13 types of cancer, symptomatic HIV, and viral coinfections using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. The study population included individuals administratively noted to be of male sex (men), aged 18 to 64 years, with (n = 82,495) or without (n = 7,302,523) HIV. We developed log‐binomial models with cancer as the outcome stratified by symptomatic status, age, and race/ethnicity. Results: Cancer prevalence was higher in MLWH than in men without HIV (adjusted prevalence ratio [APR], 1.84; 95% confidence interval [CI], 1.78‐1.90) and was higher among those with symptomatic HIV (APR, 2.74; 95% CI, 2.52‐2.97) than among those with asymptomatic HIV (APR, 1.73; 95% CI, 1.67‐1.79). The highest APRs were observed for anal cancer in younger men, both in the symptomatic and asymptomatic groups: APR, 312.97; 95% CI, 210.27‐465.84, and APR, 482.26; 95% CI, 390.67‐595.32, respectively. In race/ethnicity strata, the highest APRs were among Hispanic men for anal cancer (APR, 198.53; 95% CI, 144.54‐272.68) and for lymphoma (APR, 9.10; 95% CI, 7.80‐10.63). Conclusions: Given the Medicaid program's role in insuring MLWH, the current findings highlight the importance of the program's efforts to promote healthy behaviors and vaccination against human papillomavirus in all children and adolescents and to provide individualized cancer screening for MLWH. The burden of cancer in men living with HIV (MLWH) on Medicaid is substantial. Given the role of the Medicaid program in insuring MLWH, the findings highlight the importance of the program's efforts to promote healthy behaviors and vaccine against human papillomavirus in all children and adolescents and to provide individualized cancer screening for MLWH. [ABSTRACT FROM AUTHOR]

This paper presents a study which has evaluated the extent to which a sample of elementary special education teachers in Kuwait understand and make use of evidence‐informed approaches in the mainstream classroom with children with special educational needs. A questionnaire survey was developed and administered (N = 150), focussing on teacher understanding of and use of two selected evidence‐informed approaches: peer tutoring strategy and the JIGSAW strategy. Results revealed a good degree of understand and use of both strategies. Recommendations are made in relation to further research on the evidence‐informed practice for the effective inclusion of children with special educational needs in Kuwait and internationally. [ABSTRACT FROM AUTHOR]

Online teachers are an under‐researched population, but their perspectives are crucial to the successful implementation of online education. A fully online section of an established face‐to‐face (F2F) two‐semester undergraduate anatomy course with a prosection laboratory commenced in 2012 at The University of Western Ontario, Canada. Professors' lectures for F2F students were broadcast in live and archived format to online students using Blackboard Collaborate (BBC) video conferencing software. Teaching assistants (TAs) delivered online laboratories using BBC and three‐dimensional (3D) anatomical computer models. This study explored the common experiences and issues faced by the course teachers from 2012 to 2014. Transcripts from open‐ended, individual interviews with professors (n = 4) and TAs (n = 5) were coded and analyzed thematically. The teachers' concern for their inability to see the students during sessions to assess class engagement and their teaching effectiveness, and to develop social relationships, was the main finding. However, video conferencing software and email were sufficient communication methods for the students' questions and the teachers' answers. The TAs noted usability challenges and anatomical inaccuracies in the 3D models compared to cadavers. Due to limitations of BBC's screen sharing function, live manipulation for the 3D computer models was not possible; however, the TAs found pedagogical value in using screen captures of the models for drawing activities with the students. Overall, preparation time for teaching online was longer than for F2F. The study's findings provide science educators with issues to consider when preparing for online teaching and recommendations to optimize the teaching experience. [ABSTRACT FROM AUTHOR]

Introduction: Positron emission tomography (PET) imaging for neurofibrillary tau allows investigation of the in vivo spatiotemporal progression of Alzheimer's disease (AD) pathology. We evaluated the suitability of 18F‐MK‐6240 in a clinical sample and determined the relationships among 18F‐MK‐6240 binding, age, cognition, and cerebrospinal fluid (CSF)‐based AD biomarkers. Methods: Participants (n = 101, 72 ± 9 years, 52% women) underwent amyloid PET, tau PET, structural T1‐weighted magnetic resonance imaging, and neuropsychological evaluation. Twenty‐one participants had lumbar puncture for CSF measurement of amyloid beta (Aβ)42, tau, and phosphorylated tau (p‐tau). Results: 18F‐MK‐6240 recapitulated Braak staging and correlated with CSF tau and p‐tau, normalized to Aβ42. 18F‐MK‐6240 negatively correlated with age across Braak regions in amyloid‐positive participants, consistent with greater tau pathology in earlier onset AD. Domain‐specific, regional patterns of 18F‐MK‐6240 binding were associated with reduced memory, executive, and language performance, but only in amyloid‐positive participants. Discussion: 18F‐MK‐6240 can approximate Braak staging across the AD continuum and provide region‐dependent insights into biomarker‐based AD models. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) has demonstrated efficacy for improving PTSD and comorbid symptoms and relationship adjustment. To enhance treatment efficiency and scalability, we developed a 2-day, abbreviated, intensive, multicouple group version of CBCT for PTSD (AIM-CBCT for PTSD). Prior work demonstrated that AIMCBCT for PTSDwasassociated with reductions in PTSD and comorbid symptoms in a sample of 24 post-9/11 active duty military or veteran couples who received the treatment in a retreat format over a single weekend. The current study investigated secondary outcomes regarding trauma-related cognitions, psychosocial impairment, and insomnia. For trauma-related cognitions, reductions were nonsignificant and small at 1-month follow-up, ds = -0.14 to -0.32. However, by 3-month follow-up, there were significant, medium effect size reductions in total trauma-related cognitions, d = -0.68, and negative views of self and others, ds =-0.64 and -0.57, respectively, relative to baseline. There was also a nonsignificant, small-to-medium effect-size reduction in self-blame, d = -0.43, p = .053, by 3-month follow-up. For psychosocial impairment, there were significant and medium-to-large and large effect size reductions by 1- and 3-month follow-ups, ds = -0.73 and -0.81, respectively. There were nonsignificant, small effect size reductions in insomnia at both 1- and 3-month follow-ups relative to baseline, ds = -0.30 and -0.34, respectively. These findings suggest that AIM-CBCT for PTSD is associated with reductions inmaladaptive posttraumatic cognitions and psychosocial impairment but that adjunctive interventions may be needed to address insomnia. [ABSTRACT FROM AUTHOR]