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Bovine respiratory disease (BRD) is a multifactorial disease and the primary cause of both bovine morbidity and mortality in Ireland. The risk factors associated with a primary necropsy diagnosis of BRD among cattle in the traditional (non-feedlot) husbandry systems prevalent in Ireland have not been investigated previously. The aim of this case-control study was to investigate those risk factors among cattle of all ages over an 8 year period. A total of 3,090 BRD cases and 5,236 controls were matched by submitting veterinary practitioner. Univariable and multivariable analyses were performed to examine the association of selected animallevel, herd-level and environmental risk factors with case or control status using a conditional logistical regression model. Male cattle aged more than 31 days were significantly more likely to record a primary necropsy diagnosis of BRD than female cattle. Older cattle of both sexes were at increased odds of a BRD necropsy diagnosis than younger calves with the exception of female cattle aged greater than 165 days. The risk of a primary necropsy diagnosis of BRD increased with increasing herd size and decreased with increasing time in days since the last animal movement into the submitting herd. There were significantly reduced odds of a primary necropsy diagnosis of BRD in the summer (June to August) when compared with the autumn (September to November). These findings identify significant risk factors for a necropsy diagnosis of BRD under non-feedlot-type husbandry conditions.

Our goal in this paper is to examine the socioecological dynamics of the Early Neolithic period in Iberia in order to test the usefulness of temporal probability curves built from dated sites as a relative proxy for exploring possible links between trends in population patterns and climatic fluctuations. We compare the information for the entire Iberian Peninsula with four Mediterranean regions, investigating the climate–population relationships that emerge when we zoom into particular regions. We evaluate climatic and other possible causes of similarities in the shapes of temporal probability curves across the Peninsula, associated with demographic changes in the Early Neolithic sequence. Changes in subsistence patterns identified in empirical data from sites like Cendres cave (Alicante province), together with computational modeling that simulates long-term socio-ecological processes, suggest key variables that can help account for local dynamics. Theoretical approaches from Complex System Theory and Evolutionary Archaeology can help us to better understand evolutionary processes including the spread of farming.

Background: Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction. Methods: In this 6-month randomized controlled trial, 67 obese (body mass index ≥30 kg/m 2 ) older (≥60 years) adults with a Short Physical Performance Battery score of 4–10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30 g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months. Results: At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (−7.5 ± 6.2 kg) and Protein (−8.7 ± 7.4 kg) groups. Both groups also improved function but the increase in the Protein (+2.4 ± 1.7 units; p < .001) was greater than in the Control (+0.9 ± 1.7 units; p < .01) group (p = .02). Conclusion: Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753).

The hallmark gene expression signatures encapsulate oncogenic and tumor suppressor phenotypes; however, the overview of these phenotypes and their underlying genetic changes, particularly those shared across tumor types, remain unknown. Although a large-scale pan-cancer analysis tends to produce many false discoveries, we can detect reliable relationships by identifying those consistently observed across tumor types with robust statistical methods. Thus, we scored 50 hallmark signatures using single-sample GSEA in approximately 9,000 primary tumors from 33 tumor types in TCGA. To identify the genetic mechanisms underlying tumor phenotypes, we then tested signature scores with and without DNA alterations, including 96 recurrently mutated genes, 1,002 significant focal copy number alterations (CNAs), and 78 arm-level CNAs, confirming hits across multiple tumor types through both a random-effects linear model and a robust permutation framework. First, we confirmed our method by identifying well-described relationships in the mutation analysis, including CTNNB1 mutation with WNT signaling and RB1 mutation with E2F pathway. Then, we identified many significant associations which have not been reported in a large cohort of clinical samples. A considerable proportion of these associations consisted of TP53 mutation with various signatures, including MTORC signaling and glycolysis.Arm-level CNAs also demonstrated previously reported associations, such as 8q gain and MYC activation, as well as a number of novel relationships. The most significant association was 5q deletion and glycolysis signature. Interestingly, although TP53 mutation correlated with a variety of aneuploidies, 5q deletion was the most consistently enriched arm-level alterations in TP53-mutated cases above 17p deletion containing TP53. In addition, the association of TP53 mutation and 5q deletion with glycolysis was shared across five tumor types: breast cancer (BRCA) and various squamous carcinomas. Among BRCA subtypes, these features were most prominent in the basal-like subtype. Clustering of the hallmark signatures by tumor subtypes remarkably showed hormone-negative basal-like BRCA grouping with squamous tumors including esophageal, HPV- head and neck, and lung cancers, far from the hormone-positive BRCA subgroups. This cluster was defined by elevated proliferation, inflammatory signaling, and glycolysis. Our findings provide new evidence of DNA alterations beyond tissue of origin which function to execute parallel oncogenic changes. These results identify common mechanisms in basal-like BRCA with squamous carcinomas across mutations, selected CNAs, and phenotypes. Further investigation is warranted to identify actionable therapeutic target in this aggressive population of tumors. Citation Format: Marni B. McClure, Yasunori Kogure, Yuki Saito, Mariko Tabata, Katherine A. Hoadley, Charles M. Perou, Keisuke Kataoka. TP53 mutation and 5q deletion define common phenotypic changes regardless of tissue of origin [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5904.

[Background] Von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary cancer syndrome attributed to germline VHL mutation. Patients with this disease are at risk of developing multiple independent clear cell renal carcinomas (ccRCCs), which offers a unique opportunity to analyze inter- and intra-tumor heterogeneity of genetic and immune profiles in the same patient. [Method] We selected seven patients with clinically diagnosed VHL disease who underwent one or two surgeries, in each of which two to five ccRCC tumors (total, n = 25) were removed. We harvested one to six regions from each tumor (total, n = 48), and performed whole-exome sequencing on them, together with normal blood (n = 7), cyst (n = 3), and adjacent normal renal tissue (n = 7) specimens from these patients. In addition, we carried out RNA-sequencing (for 20 tumors and 3 adjacent tissues) and digital multiplexed gene expression analysis using the NanoString nCounter system with Human Immunology V2 panel (for 36 tumors and 5 adjacent tissues) to clarify their immune profiles. [Result] Germline VHL mutations were confirmed in all seven patients. A total of 1,141 non-silent somatic mutations (8-44 mutations per patient) were detected, including 22 mutations affecting previously reported driver genes (such as BAP1, PBRM1, PTEN, PIK3CA, and SETD2). In consistent with previous reports, tumors arising in this context are clonally independent and harbor distinct secondary events, including mutations and copy number alterations (as exemplified by loss of heterozygosity of 3p). By contrast, multiple specimens from the same tumor showed almost the same genetic alterations, although several subclonal mutations were observed. Unsupervised hierarchical clustering of gene expression data discovered two robust subsets with distinct immune-related signatures. Particularly, the subset with high immune signature (n = 29) showed increased antigen presentation machinery genes (B2M, TAP1 and TAP2) and cytotoxic T lymphocyte genes (CD8, PRF1, and GZMA) than that with low immune signature (n = 19), suggesting a higher cytolytic activity in the former subset. Pathway analysis revealed the enrichment of cytokine interaction, JAK-STAT signaling and Toll-like receptor signaling. Interestingly, specimens from the same tumor invariably showed a similar immune signature, whereas different tumors frequently exhibit different immune signatures despite the identical immune background, suggesting a greater difference of immune status across tumors than within a tumor. [Conclusion] This study delineates inter- and intra-tumor heterogeneity of genetic and immune profiles in hereditary clear cell renal cell carcinoma. Our findings demonstrate more profound inter-tumor than intra-tumor heterogeneity in immune status, suggesting that tumor factors have a greater impact on immune microenvironment than host factors. Citation Format: Mariko Tabata, Yusuke Sato, Yasunori Kogure, Marni B. McClure, Yuji Kumade, Yuki Saito, Sumito Shingaki, Kota Yoshifuji, Junji Koya, Kazushi Yoshida, Takashi Kohno, Kenichi Chiba, Ai Okada, Yuichi Shiraishi, Haruki Kume, Keisuke Kataoka. Inter- and intra-tumor heterogeneity of genetic and immune profiles in hereditary clear cell renal cell carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1311.

Smokers are at increased risk of oral disease. While routine dental care can help prevent and treat oral health problems, smokers have far lower rates of dental care utilization compared with non-smokers. We sought to better understand which factors may facilitate or hinder dental care utilization among low-income smokers participating in a randomized intervention trial in order to inform future intervention planning. This is a secondary analysis of data collected between 2015 and 2017 as part of the OralHealth4Life trial. Participants were eligible callers to the Louisiana, Nebraska, and Oregon state tobacco quitlines who had no dental appointment in the prior or upcoming six months. We examined the association between participants’ baseline characteristics and their receiving professional dental care between baseline and the 6-month follow-up survey. Participants were racially diverse (42% non-White) and two-thirds had an annual household income under $20,000. Most (86.7%) had not had a dental cleaning in more than one year. Commonly cited barriers to dental care included cost (83.7%) and no dental insurance (78.1%). Those with dental insurance were more likely to see a dentist at follow-up (RR 1.66). Similarly, those reporting a dental insurance barrier to care were less likely to see a dentist at follow-up (RR 0.69); however, there was no significant utilization difference between those reporting a cost barrier vs. those who did not. After controlling for these financial factors, the following baseline characteristics were significantly associated with a higher likelihood of dental care utilization at 6 months: higher motivation (RR 2.16) and self-efficacy (RR 1.80) to visit the dentist, having a disability (RR 1.63), having a higher education level (RR 1.52), and having perceived gum disease (RR 1.49). Factors significantly associated with a lower likelihood of dental care utilization included being married (RR 0.68) and not having a last dental cleaning within the past year (RR 0.47). Our findings provide important insight into factors that may facilitate or deter use of professional dental care among low-income smokers. This information could inform the development of future interventions to promote dental care utilization. ClinicalTrials.gov : NCT02347124 ; registered 27 January 2015.

BackgroundDeleterious recessive alleles can result in reduced economic performance in livestock in multiple ways in homozygous individuals: from early embryonic death, death soon after birth, to being non-lethal but causing reduced viability. While death is an easy phenotype to score, reduced viability is not as easy to identify. However, it can sometimes be observed as reduced artificial insemination (AI) conception rates, longer calving intervals, or higher hazard for live born animals.MethodsIn this paper, we searched for haplotypes carrying putatively recessive lethal alleles in 132,725 genotyped Irish beef cattle from five breeds: Aberdeen Angus, Charolais, Hereford, Limousin, and Simmental. We phased the genotypes in sliding windows along the genome and used five tests to identify haplotypes with absence of or reduced homozygosity. We then corroborated the identified haplotypes with reproduction records, indicating early embryonic death, and postnatal survival records. Finally, we assessed haplotype pleiotropy by estimating substitution effects on national estimates of breeding values for 15 economically important traits in beef production.ResultsWe found support for three haplotypes with carrying putatively recessive lethal alleles. The haplotypes were located on chromosome 14 in Aberdeen Angus, chromosome 19 in Charolais and chromosome 16 in Simmental. Their population frequencies is 15.2%, 14.4%, and 8.8%, respectively. All of the haplotypes showed pleiotropic effects on economically important traits for beef production. Their allele substitution effects are €3.23, €1.47, and €2.30 for the terminal index and -€3.15, -€0.75, and €1.12 for the replacement index, where one standard deviations are €18.32, €22.54, and €22.33 for terminal index and €29.52, €35.62, and €30.97 for the replacement index. We identified ZFAT as the candidate gene for lethality in Aberdeen Angus, several candidate genes for the Simmental haplotype, and no candidate genes for the Charolais haplotype.ConclusionsWe analysed genotype, reproduction, survival, and production data to discover haplotypes carrying putatively recessive lethal alleles in Irish beef cattle. We found support for three haplotypes. All three haplotypes have pleiotropic effects on economically important traits in beef production.

BackgroundThere has been an increase in consumer-facing mobile health (mHealth) apps in recent years. Prior reviews have characterized the availability, usability, or quality of popular mHealth apps targeting a range of health behaviors, but none has examined apps that promote better oral health care. Oral disease affects billions of people worldwide and mobile phone use is on the rise, so the market for well-designed and effective oral health apps is substantial. ObjectiveWe examined the content and usability of popular oral health promotion apps to better understand the current state of these self-help interventions and inform the need and opportunity for future app development. MethodsBetween February and March 2018, we identified oral health-focused apps that were designed for Android or iOS, available in English, and targeted adult consumers (as opposed to children or dental health professionals). The sample was limited to the most popular and highly rated apps on each platform. For each app reviewed, we assessed its basic descriptive characteristics (eg, platform, cost), evidence of a theoretical basis or empirical validation, key program functionality, and the extent to which the app addressed diet and tobacco and alcohol use as risk factors for oral disease. We characterized the framing (ie, gain vs loss) of all persuasive messaging and conducted a heuristic analysis to assess each app’s usability as a persuasive health technology. ResultsThirty-three apps were eligible for review based on the selection criteria. Two-thirds (22/33, 67%) were geared toward the general public as opposed to dental clinic patients, insurance plan members, or owners of specific electric toothbrushes. Most (31/33, 94%) were free to download, and a majority (19/33, 58%) were sponsored by software developers as opposed to oral health experts. None offered any theoretical basis for the content or had been empirically validated. Common program features included tools for tracking or reminding one to brush their teeth and assistance scheduling dental appointments. Nineteen apps (58%) included educational or persuasive content intended to influence oral health behavior. Only 32% (6/19) of these included a larger proportion of gain-framed than loss-framed messaging. Most of the apps did not mention diet, alcohol or tobacco—important risk factors for oral disease. Overall, the apps performed poorly on standard usability heuristics recommended for persuasive health technologies. ConclusionsThe quality of the reviewed apps was generally poor. Important opportunities exist to develop oral health promotion apps that have theoretically grounded content, are empirically validated, and adhere to good design principles for persuasive health technologies.

Background The US Preventive Services Task Force recommends out-of-office blood pressure (BPs) before making a new diagnosis of hypertension, using 24-h ambulatory (ABPM) or home BP monitoring (HBPM), however this is not common in routine clinical practice. Blood Pressure Checks and Diagnosing Hypertension (BP-CHECK) is a randomized controlled diagnostic study assessing the comparability and acceptability of clinic, home, and kiosk-based BP monitoring to ABPM for diagnosing hypertension. Stakeholders including patients, providers, policy makers, and researchers informed the study design and protocols. Methods Adults aged 18–85 without diagnosed hypertension and on no hypertension medication with elevated BPs in clinic and at the baseline research visit are randomized to one of 3 regimens for diagnosing hypertension: (1) clinic BPs, (2) home BPs, or (3) kiosk BPs; all participants subsequently complete ABPM. The primary outcomes are the comparability (with daytime ABPM mean systolic and diastolic BP as the reference standard) and acceptability (e.g., adherence to, patient-reported outcomes) of each method compared to ABPM. Longer-term outcomes are assessed at 6-months including: patient-reported outcomes, primary care providers' diagnosis of hypertension; and BP control. We report challenges experienced and our response to these. Results Enrollment began in May of 2017 with a target of randomizing 510 participants. BP thresholds for diagnosing hypertension in the US changed after the trial started. We discuss the stakeholder process used to assess and respond to these changes. Conclusion and public health impact BP-CHECK will inform which hypertension diagnostic methods are most accurate, acceptable, and feasible to implement in primary care.

Introduction Preliminary trial data suggest group-delivered acceptance and commitment therapy (ACT) might be effective for smoking cessation. If so, this could offer a viable alternative to mainstream behavioral therapies, such as those grounded in cognitive behavioral therapy (CBT). The goal of the current study was to compare the effectiveness of group-delivered ACT versus group-delivered CBT in a rigorous randomized trial design with long-term follow-up. Methods Participants (n = 450) were recruited from the Kaiser Permanente Washington health care system and randomized to either ACT-based group counseling or an attention-matched CBT-based group program. All were prescribed an 8-week course of nicotine patches. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months post-randomization assessed with missing values imputed as smoking. Sensitivity analyses using multiple imputation and complete cases were examined, as were biochemically confirmed and 6-month outcomes. Results Thirty-day point prevalence abstinence rates at the 12-month follow-up did not differ between study arms in the primary analysis (13.8% ACT vs. 18.1% CBT, adjusted odds ratio = 0.68 [95% CI = 0.35 to 1.27], p = .23) or the sensitivity analyses. Conclusions Group-based ACT and CBT had similar long-term quit rates in this methodologically rigorous randomized trial. Group-based ACT is a reasonable alternative to group-based CBT for smoking cessation. Implications This study compared the effectiveness of group-based ACT with group-based CBT for smoking cessation using a rigorous, large-scale, attention-matched, randomized trial with 1-year follow-up. One-year cessation rates did not differ between group-based ACT and CBT, suggesting ACT-based intervention is a reasonable alternative to CBT-based counseling for smoking cessation. The results add to the nascent but growing literature assessing ACT and other mindfulness-based treatments for smoking cessation.

Background Older adults spend more time sitting than any other age group, contributing to poor health outcomes. Effective behavioral interventions are needed to encourage less sitting among older adults, specifically those with obesity, but these programs must be acceptable to the target population. We explored participant acceptance of a theory-based and technology-enhanced sitting reduction intervention designed for older adults (I-STAND). Methods The 12-week I-STAND intervention consisted of 6 health coaching contacts, a study workbook, a Jawbone UP band to remind participants to take breaks from sitting, and feedback on sitting behaviors (generated from wearing an activPAL device for 7 days at the beginning and mid-point of the study). Semi-structured interviews were conducted with 22 participants after they completed the intervention. Interview transcripts were iteratively coded by a team, and thematic analysis was used to identify and refine emerging themes. Results Overall, participants were satisfied with the I-STAND intervention, thought the sedentary behavior goals of the intervention were easy to incorporate, and found the technologies to be helpful additions to (but not substitutes for) health coaching. Barriers to standing more included poor health, ingrained sedentary habits, lack of motivation to change sedentary behavior, and social norms that dictate when it is appropriate to sit/stand. Facilitators to standing more included increased awareness of sitting, a sense of accountability, daily activities that involved standing, social support, and changing ways of interacting in the home environment. Participants reported that the intervention improved physical health, increased energy, increased readiness to engage in physical activity, improved mood, and reduced stress. Conclusions The technology-enhanced sedentary behavior reduction intervention was acceptable, easy to incorporate, and had a positive perceived health impact on older adults with obesity. Trial registration The I-STAND study was registered at clinicaltrials.gov (ID: NCT02692560) February 2016. Electronic supplementary material The online version of this article (10.1186/s12889-018-5616-1) contains supplementary material, which is available to authorized users.

Background The extent to which smokers with bipolar disorder (BD) differ from other smokers on cessation-related characteristics and outcomes is unknown and could improve knowledge of treatment needs for this group. These analyses compared smokers with BD versus smokers with other affective disorders (ADs; anxiety and unipolar depression) and smokers with no mental health conditions (MHCs). Method Participants (n = 2570) were a subsample of those enrolled in a smoking cessation trial comparing two web-delivered intervention approaches: acceptance and commitment therapy (ACT) and cognitive behavioral therapy. Those included in this analysis self-reported having BD (n = 221), other ADs (n = 783) or no major MHCs (n = 1566). Surveys assessed baseline characteristics and self-reported abstinence at 3, 6, and 12-months post-randomization. Treatment utilization was tracked via page views. Results Smokers with BD were distinct from both AD and no MHC smokers on the majority of baseline characteristics. At 12-months, quit rates were lower for smokers with BD (20%) than no MHCs (29%; p = 0.01), but no different than other ADs (20%; p = .467). Interactions between treatment assignment and diagnostic group were non-significant for cessation outcome. The number of logins was higher for smokers with BD than AD in the ACT arm only (p = .001), but this finding was not replicated across other utilization indicators. Conclusions Smokers with BD and other ADs had similar long-term quit rates despite numerous differences in baseline characteristics. Despite being lower than for smokers without MHCs, long-term quit rates from web-based treatment are promising for smokers with BD as well as other ADs.

A major use of genetic data is parentage verification and identification as inaccurate pedigrees negatively affect genetic gain. Since 2012 the international standard for single nucleotide polymorphism (SNP) verification in Bos taurus cattle has been the ISAG SNP panels. While these ISAG panels provide an increased level of parentage accuracy over microsatellite markers (MS), they can validate the wrong parent at ≤1% misconcordance rate levels, indicating that more SNP are needed if a more accurate pedigree is required. With rapidly increasing numbers of cattle being genotyped in Ireland that represent 61 B. taurus breeds from a wide range of farm types: beef/dairy, AI/pedigree/commercial, purebred/crossbred, and large to small herd size the Irish Cattle Breeding Federation (ICBF) analyzed different SNP densities to determine that at a minimum ≥500 SNP are needed to consistently predict only one set of parents at a ≤1% misconcordance rate. For parentage validation and prediction ICBF uses 800 SNP (ICBF800) selected based on SNP clustering quality, ISAG200 inclusion, call rate (CR), and minor allele frequency (MAF) in the Irish cattle population. Large datasets require sample and SNP quality control (QC). Most publications only deal with SNP QC via CR, MAF, parent-progeny conflicts, and Hardy-Weinberg deviation, but not sample QC. We report here parentage, SNP QC, and a genomic sample QC pipelines to deal with the unique challenges of >1 million genotypes from a national herd such as SNP genotype errors from mis-tagging of animals, lab errors, farm errors, and multiple other issues that can arise. We divide the pipeline into two parts: a Genotype QC and an Animal QC pipeline. The Genotype QC identifies samples with low call rate, missing or mixed genotype classes (no BB genotype or ABTG alleles present), and low genotype frequencies. The Animal QC handles situations where the genotype might not belong to the listed individual by identifying: >1 non-matching genotypes per animal, SNP duplicates, sex and breed prediction mismatches, parentage and progeny validation results, and other situations. The Animal QC pipeline make use of ICBF800 SNP set where appropriate to identify errors in a computationally efficient yet still highly accurate method.

BACKGROUND Despite having many advantages, online eHealth trials are not without challenges—notably, participant recruitment, and outcome data retention. Moreover, publications from these trials rarely provide detailed information on the methods used for recruitment and retention or discuss implications of the methods for future studies. OBJECTIVE To address this need for empirical guidance regarding recruitment and outcome data retention planning, we aim to describe the methods and lessons learned from the recruitment and retention procedures used in a large randomized trial of 2 Web-based smoking cessation interventions. METHODS To ensure a demographically and geographically diverse participant sample, we used the recruitment strategies (1) traditional, (2) Web-based, and (3) online survey panel methods and adaptively modified each in response to recruitment success. At baseline, participants indicated how they heard about the study and answered demographic questions. To maximize trial retention at each of the 3-, 6-, and 12-month assessment points, 4 survey modalities (first Web, followed by phone, mail, and postcard) were sequentially timed over a 30-day period. Participants received US $25 for submitting their responses, regardless of modality, and received an additional US $10 bonus for completing the Web survey within 24h of electronic notification. RESULTS We randomized 2637 smokers in 16 months and achieved 88% retention at 12-months. Participants (79.26% female, 72.60% Caucasian) were recruited from all 50 states. The majority of participants were recruited through Facebook (49.43%), followed by the survey panel (20.85%), free internet sources (14.54%), traditional media (11.34%), and Google ads (3.84%). Descriptively, participant demographics varied by recruitment source. Of the completed follow-up surveys, most were completed by Web (92%). Retention rates did not vary by recruitment source. CONCLUSIONS Continuous monitoring and refinement of multiple recruitment methods, particularly of online advertising campaigns, allowed us to maximize the effectiveness of recruitment strategies in recruiting a large, diverse sample of smokers. Likewise, offering multiple follow-up survey modalities in sequential order along with time-dependent bonus incentives enabled us to obtain outcome data from a very high level of enrolled participants for the duration of the trial protocol. These strategies may be similarly useful in other trials. CLINICALTRIAL ClinicalTrials.gov NCT01812278; https://clinicaltrials.gov/ct2/show/NCT01812278 (Archived by WebCite at http://www.webcitation.org/71gy5GLvO)

peer-funded The study objectives were to: 1) evaluate the diagnostic performance of passive immunity tests for classification of failure of passive transfer (FPT) risk, based on their relationships with calf health and performance, and 2) describe the epidemiology of morbidity and mortality in suckler beef and dairy calves under Irish conditions. A total of 1392 suckler beef calves (n = 111 farms) and 2090 dairy calves (84 farms) were included in this observational study. Blood samples were collected by jugular venipuncture. Serum samples were analysed for total IgG concentration using an ELISA assay, total protein concentration by clinical analyser (TP – CA), globulin concentration, zinc sulphate turbidity (ZST) units, total solids percentage by Brix refractometer (TS – BRIX), and total protein concentration by digital refractometer (TP – DR). Crude and cause-specific morbidity, all-cause mortality, and standardised 205-day body weight (BW) were determined. Generalised linear mixed models were used to evaluate associations between suckler beef and dairy calves for morbidity, mortality, growth and passive immunity. Receiver operating characteristic (ROC) curves were constructed to determine optimal test cut-offs for classification of health and growth outcomes. Overall, 20% of suckler beef and 30% of dairy calves were treated for at least one disease event by 6 mo. of age. Suckler beef calves had greater odds of bovine respiratory disease (BRD; odds ratio (OR), 95% confidence interval (CI): 2.8, 1.2–6.5, P = 0.01), navel infection (5.1, 1.9–13.2, P

Background: Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. Objective: The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. Methods: Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. Results: Study enrollment has ended and data processing is underway. Conclusions: Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches Trial Registration: ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

OBJECTIVE:Smokers with bipolar disorder (BD) have low rates of successful quitting, yet no prior studies have evaluated the process of quitting among these smokers in the context of a current quit attempt. To facilitate development of more effective interventions, we conducted a qualitative exploration of challenges and facilitators of quitting in an intervention study for smokers with BD. METHODS:Participants were adult daily smokers with BD (n = 10) who completed a 10-week smoking cessation intervention consisting of Acceptance and Commitment Therapy (ACT) and nicotine patch. We administered semistructured interviews focused on the quitting process at the end of treatment and used inductive content analysis to extract themes. RESULTS:Emergent themes representing challenges of quitting included social impediments, lack of awareness, avoidance, maladaptive beliefs, ambivalence, benefits of smoking, and difficulties with nicotine replacement. Themes representing change facilitators included positive treatment effects (ACT-specific, nonspecific, and nicotine patch-related), coping behaviors, reasons to quit, changes in self-perception, and social benefits. CONCLUSIONS:Results suggest a need for assistance with obtaining social support and handling social impediments, interrupting the automaticity of smoking, expanding the behavioral repertoire to handle aversive internal states that tend to be avoided by smoking, preventing maladaptive beliefs from interfering with quitting, taking meaningful action toward change while experiencing ambivalence, either replacing the benefits of smoking or accepting their loss, and troubleshooting difficulties with nicotine replacement. Findings regarding facilitators of quitting supported previous quantitative findings that the ACT intervention impacted theory-based targets and highlighted the importance of the counseling relationship.

We applied taphonomic analysis combined with geostatistical approaches to investigate the hypothesis that Cocina cave (Eastern Iberia) represents an acculturation context for the appearance of Neolithic Cardial pottery. In the 1970s, Fortea suggested that this important site was a prime example of acculturation because of the presence of early Neolithic pottery in late Mesolithic contexts. Since that time Cocina cave has been heralded as an example of indigenous hunter-gatherers incorporating Neolithic cultural elements into their lifeways. We analyzed the area excavated by Fortea in the 1970s by digitizing archaeological records and testing the spatial distribution of artifacts using geostatistical analysis and high-resolution AMS radiocarbon dating. We contextualized the findings by discussing key issues of archaeological depositions with the goal to better understand the palimpsest that usually occur in prehistoric sequences. Our analysis indicates that the mixture of Mesolithic and Neolithic materials resulted from taphonomic processes rather than acculturation.

Niche construction theory provides a framework to analyze the environmental effects of changing pastoral practices. In Europe, domesticated herd animals facilitated the expansion of farming by extending the spatial framework of early farming communities, produced milk for caloric security of pioneering farmers, and were partners in coevolutionary relationships that resulted in changes in the human genome and the spread of diseases. Domestic herd animal management practices, however, were not uniform during the Neolithic, and variations in livestock management, use, and environment affected the degree of extensive and intensive human niche construction among early farmers. This paper explores the biological and cultural effects of pastoralism for the establishment of new agricultural niches by examining biological and ecological underpinnings of both domesticated animals and their management strategies. It is suggested that strategies varied in their niche outcomes and ecological legacies, highlighting the...

Cigarette smoking is two to three times more prevalent among people with bipolar disorder than among people without psychiatric disorders, and quit rates are one-half that of smokers without psychiatric disorders (1). These substantial differences in smoking prevalence and cessation contribute to numerous tobacco-related health disparities, including a 25-year differential in life expectancy (2) and elevated rates of chronic obstructive pulmonary disease, hypertension, and asthma (3). Treatment as usual has failed to address these disparities. New intervention approaches are needed to assist smokers with bipolar disorder to quit successfully. Very few smoking cessation studies have focused specifically on smokers with bipolar disorder. Extant studies, with sample sizes ranging from five to 60 participants, have tested the safety and efficacy of varenicline (4–6) and bupropion (7). Our prior pilot study (n = 10) of an in-person, individual mood management intervention based on cognitive-behavioral therapy (CBT), combined with nicotine patch, is the only study to date of a targeted behavioral intervention for smokers with bipolar disorder (8). In that study, we determined that the CBT-based mood management intervention combined with transdermal nicotine patch produced a 20% quit rate at the end of the 12-week treatment period, but the counseling was not uniformly acceptable to participants because it lacked the flexibility needed to address heterogeneous reasons for smoking (8). This finding prompted us to change our treatment model and conduct a new series of pilot feasibility studies. We hypothesized that smokers with bipolar disorder might find a new treatment based on Acceptance and Commitment Therapy (ACT) both acceptable and effective for two key reasons. First, the accumulating evidence comparing ACT with standard care smoking cessation counseling in multiple modalities (Internet, telephone, and smartphone application) suggests that this treatment approach holds promise for improving cessation outcomes by 50–150% (9–11). Second, ACT targets a unique mechanism of change—acceptance, defined as willingness to experience discomfort or distress in order to make a meaningful life change (12). For smokers with bipolar disorder, acceptance of mood symptoms as well as other barriers to cessation in this group (13) may be particularly important for sustained efforts to quit. In this study, we evaluated an ACT-based cessation program for adults with bipolar disorder to determine its acceptability, efficacy, and impact on its theory-based change mechanism (i.e., acceptance). Two modes of delivery were examined in sequential, single-arm studies: in-person (because of its depth and the ability to observe face-to-face how participants reacted to the new treatment) and telephone (because of its reach and future dissemination potential through tobacco quitlines, as well as our emerging data suggesting that telephone-delivered ACT for smoking cessation in a general population sample was feasible, well-received, and increased the odds of quitting by 50% as compared to standard tobacco quitline treatment (10)). Recruitment and retention rates were also monitored to inform the feasibility of each modality.

Importance: The US Preventive Services Task Force recommends screening adults for high blood pressure (BP). If BP is high, out-of-office BPs are recommended before making a new diagnosis of hypertension, preferably using 24 hour ambulatory BP monitoring (ABPM), because over 30% have normal BPs outside of clinic or “White coat” hypertension with risk of cardiovascular events and death similar to those without hypertension. Currently few physicians use and few patients have heard of ABPM, which may be less convenient than clinic, home, or kiosk-based monitoring. Objective: The BP Check randomized controlled diagnostic study will compare the accuracy and acceptability of clinic, home, and kiosk-based BP monitoring compared to ABPM for diagnosing hypertension. The study aims, design, protocols, materials, and evaluation described below are informed by patient, health care, policy, and expert stakeholders. Methods: Adults ages 18-85 will be recruited and randomized to routine screening via clinic screening, home BP monitoring over 5 days, or kiosk-based monitoring on 3 separate days. After completion all participants will complete ABPM. Mean BP assessed via each screening method (clinic, home, and kiosk) will be compared with 24 hour APBM to assess the accuracy of each method. We will also assess the acceptability of each method from the patients’ perspective and the impact of the tests longer-term. Finally, a mixed method analysis is planned to explore physician knowledge and beliefs about BP measurement, diagnosing hypertension, and the perceived feasibility of using each of the tested BP strategies in routine clinical practice. Results: Enrollment began in May of 2017 with a target of randomizing 510 participants. Conclusion and Public Health Impact: BP-CHECK will inform which hypertension diagnostic methods are most accurate, acceptable to patients, and feasible to implement in primary care. This evidence-base is critical to compare alternate methods of diagnosing hypertension to ABPM

BACKGROUND Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. OBJECTIVE The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. METHODS Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. RESULTS Study enrollment has ended and data processing is underway. CONCLUSIONS Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches CLINICALTRIAL ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

BACKGROUND AND AIMS: Millions of people worldwide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute’s (NCI) Smokefree.gov website. DESIGN: A two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12-month follow-up. SETTING: USA. PARTICIPANTS: Adults (N = 2637) who currently smoked at least 5 cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean (SD) age of 46.2 (13.4), 79% women, and 73% white. INTERVENTIONS: WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. MEASUREMENTS: The primary outcome was self-reported 30-day point prevalence abstinence at 12 months. FINDINGS: The 12-month follow-up data retention rate was 88% (2309/2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278/1141) for WebQuit.org and 26% (305/1168) for Smokefree.gov (OR = 0.91; 95% CI = 0.76, 1.10); p = 0.334) in the a priori complete case analysis. Abstinence rates were 21% (278/1319) for WebQuit.org and 23% (305/1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07); p = 0.200) when missing cases were imputed as smokers. The Bayes Factor comparing the primary abstinence outcome was 0.17, indicating “substantial” evidence of no difference between groups. CONCLUSIONS: WebQuit.org and Smokefree.gov had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions.

A major use of genetic data is parentage verification and identification as inaccurate pedigrees negatively affect genetic gain. Since 2012 the international standard for single nucleotide polymorphism (SNP) based verification in Bos taurus cattle has been the ISAG 100 and 200 SNP panels. While these SNP sets have provided an increased level of parentage accuracy over microsatellite markers (MS), they can validate the wrong parent for an animal at ≤1% misconcordance rate levels, indicating that more SNP are needed if a more accurate pedigree is required. With rapidly increasing numbers of cattle being genotyped in Ireland that represent 61 Bos taurus breeds from a wide range of farm types: beef/dairy, AI/pedigree/commercial, purebred/crossbred, and large to small herd size the Irish Cattle Breeding Federation (ICBF) analysed different SNP densities to determine that at a minimum ≥500 SNP are needed to consistently predict only one set of parents at a ≤1% misconcordance rate. For parentage validation and prediction ICBF uses 800 SNP selected based on SNP clustering quality, ISAG200 inclusion, call rate (CR), and minor allele frequency (MAF) in the Irish cattle population. Large datasets require sample and SNP quality control (QC). Most publications only deal with SNP QC via CR, MAF, parent-progeny conflicts, and Hardy-Weinberg deviation, but not sample QC. We report here a genomic sample QC pipeline to deal with the unique challenges of >1,000,000 genotypes from a national herd such as SNP genotype errors from mis-tagging of animals, lab errors, farm errors, and multiple other issues that can arise.

Health reminders are integral to self-managing chronic illness. However, to act on these health reminders, patients face many challenges, such as lack of motivation and ability to perform health tasks. As a result, patients experience negative consequences for their health. To investigate the design of health reminders that persuade patients to take action, we conducted six participatory design sessions with two cohorts: mothers of children with asthma, and older adults with type 2 diabetes. Participants used collages, storyboards, and photos to express design ideas for future health reminder systems. From their design artifacts, we identified four types of persuasive reminders for health self-management: introspective, socially supportive, adaptive, and symbolic. We contribute insights into desired features for persuasive reminder systems from the perspectives of patients and informal caregivers, including features that support users to understand why and how to complete health tasks ahead of time, and affordances for intra-familial and patient-provider collaboration.

The spread of farming into the Western Mediterranean is characterized by the appearance of domesticated plants and animals. This chapter summarizes the evidence for domesticated animals (cattle, sheep, goats, pigs, dogs) in the Cardial Neolithic of the Western Mediterranean. The management of these animals is tightly linked to economic, cultural, ecological, and spatial factors, and a variety of data sets such as herd composition, stable isotopic analyses, and culling practices are invoked to determine management strategies. However, the extent of data sets in the region varies, and interpretations span from small-scale household use to more spatially extensive transhumance practices. Comparability is limited due to contextual heterogeneity of samples (e.g., open-air villages or cave/rock shelter sites), differences in analytical procedures and reporting traditions, variation in sample sizes, and issues of taphonomy, chronological resolution, and final interpretations. This summary highlights some of the fundamental issues in assessing domesticated animal management and critically discusses our current understanding of domesticated animal use among the first farmers of the Western Mediterranean.

This article focuses on macroscopic, petrographic and X-ray Diffraction (XRD) analyses of figulina pottery from Middle Neolithic (c. 5500–4900 cal BC) villages on the Dalmatian coast of Croatia. Samples were collected from four sites: Smilčić (Zadar), Krivače and Danilo Bitinj (Šibenik) and Pokrovnik (Drniš) to characterize the degree of variation in figulina production between sites and assess if figulina was produced locally or at a single locale in the region. Figulina is of particular interest because it represents a departure from other Neolithic ceramic technologies in pastes, firing, and decoration. This ware is found in small numbers at Middle Neolithic villages, but has parallels in the northern and western Adriatic. Our analyses suggest that this ware was produced within villages with little exchange between sites. Similarities to other regions (Istria, Italy) may indicate a special function or role of this pottery style within Middle Neolithic societies.

The Western Mediterranean, spanning southern Italy to Portugal, can be considered a single archaeological unit where the diagnostic characteristics of Early Neolithic contexts share common elements, marked by the spread of Cardium-Impressed ceramics. Although some consensus exists regarding the origin of these wares in southern Italy, the debate surrounding its process of expansion to the west remains open. Iberia is a key region for the analysis of the neolithisation process due to its location at the end of the Neolithic Mediterranean expansion. This view includes the problems linked with the mechanism of this spread and the evolutionary dynamics of the early agricultural societies. Our goals are to evaluate the rich archaeological and palaeoenvironmental database produced by recent decades of research in this area in order to address issues related to the Neolithic Transition. We especially deal with the role played by climatic events in the observeddynamics ofthe last Mesolithic and the Early Neolithic (ca. 8500–6900 cal BP).

NC, with renal failure secondary to bilateral dysplastic kidneys, received an LRD renal transplant (tx) at 17 months of age. Her early post-tx course was complicated by persistently elevated blood polyoma BK virus DNA loads. A protocol biopsy at six months post-transplant revealed BKVAN. Blood viral loads did not respond to decreased immunosuppression or treatment with ciprofloxacin and leflunomide. Six months post-tx, her serum creatinine began to rise and we sought experimental therapy to prevent the loss of her graft. At seven months post-tx, with FDA approval under an eIND, the patient was started on a 36-wk course of treatment with the investigational drug. The patient is now more than 24 months after stopping treatment with CMX. BKV viral DNA loads remain at low, but still detectable levels. Urine viral loads have declined, but remain elevated. EBV DNA loads become undetectable. The patient's serum creatinine has declined back to a baseline of 0.5-0.7 mg/dL and has been stable for two yr. Renal function was preserved in association with the use of CMX001 to treat BKV nephropathy in a young pediatric kidney transplant recipient. There were no serious adverse events associated with the use of CMX001. This novel medication may be of value in the treatment of BKVAN in pediatric renal transplant recipients.

Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.

We examine bone samples of known domesticates (sheep, goat, cattle and pig) from five open-air village sites spanning most of the Neolithic period in Dalmatia, Croatia (cal 6000–4700 BC) to characterise diets of domestic animals and address questions of the origin and development of animal husbandry strategies in early farming communities. Carbon and nitrogen stable isotope values are analysed as proxies of diet and local environment that may indicate differences in herding and management practices between domesticated species. Results are compared to those reported for faunal remains found at other Neolithic sites from coastal Croatia and the wider Adriatic region. We find that isotopic values remain stable for cattle and ovicaprids during most of the Neolithic, suggesting that husbandry of these species remained fundamentally the same throughout the period in much of the Adriatic. However, temporal differences identified among pigs indicate changes in associated management practices through time...

Background Pharmacist- or nurse-led team care decreases patient blood pressure (BP) and cardiovascular disease (CVD) risk. Purpose To evaluate whether a Web-based dietitian-led (WD) team care intervention was feasible and resulted in decreased BP, CVD risk, and weight compared to usual care (UC). Methods Electronic health record (EHR) data identified patients aged 30−69 years with BMI >26, elevated BP, and 10%−25% 10-year Framingham CVD risk who were registered patient website users. Patients with uncontrolled BP at screening were randomized to UC or WD, which included a home BP monitor, scale, and dietitian team care. WD participants had a single in-person dietitian visit to obtain baseline information and create a plan to reduce CVD risk. Planned follow-up occurred via secure messaging to report BP, weight, and fruit and vegetable intake and receive ongoing feedback. If needed, dietitians encouraged patients and their physicians to intensify antihypertensive and lipid-lowering medications. Primary outcomes were change in systolic BP and weight loss ≥4 kg at 6 months. Feasibility outcomes included intervention utilization and satisfaction. Results Between 2010 and 2011, a total of 90 of 101 participants completed 6-month follow-ups. The WD group had higher rates of secure messaging utilization and patient satisfaction. The WD group lost significantly more weight than the UC group (adjusted net difference=−3.2 kg, 95% CI=−5.0, −1.5, p adj ]=2.96, 95% CI=1.16, 7.53). BP control and CVD risk reduction were greater in WD than UC, but differences were not statistically significant. Conclusions WD intervention was feasible and resulted in decreased weight, BP, and CVD risk. A larger trial is justified. Trial Registration Number Trial Registration Number: NCT01077388.

Long-distance networks for the transport of exotic goods and the beginnings of specialized craft production first appear in Mesoamerica during the Formative Period. The results of portable X-ray fluorescence (pXRF) analysis of 456 obsidian artefacts imported to the Pacific coast site of La Zanja (Guerrero, Mexico) indicate that long-distance exchange of finished obsidian blades along the coast began during the Early Formative (c.1400–1000 cal bc) and remained constant into the Middle Formative Period (c.800–550 cal bc). Comparisons with sourcing studies from elsewhere in Mesoamerica indicate the development of a major Pacific coast trade network during the Formative Period that linked coastal Guerrero to the central Mexican highlands and the Valley of Oaxaca. Weaker connections existed with Gulf coast obsidian trade networks that traversed the Isthmus of Tehuantepec. As the first obsidian sourcing study from coastal Guerrero, these data contribute to a greater understanding of the development of exchange networks in Mesoamerica during the Formative Period.

Social learning models of addiction hypothesize that situational factors interact with cognitive determinants to influence a person's motivation to use substances. Ecological momentary assessment was used to examine the association between alcohol consumption, smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 113 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants carried a palm-top personal computer for 7 days and were instructed to complete 4 random assessments each day and to initiate an assessment when they were tempted to smoke. Multilevel mediational analyses were used to examine (a) the effects of alcohol consumption before time j and positive smoking outcome expectancies at time j on smoking urge at time j + 1 (Model 1) and (b) the effects of alcohol consumption before time j and smoking urge at time j on positive smoking outcome expectancies at time j + 1 (Model 2). Model 1 found a significant effect of alcohol consumption before time j on smoking urge at time j + 1 (p = .04), and this effect was significantly mediated by positive smoking outcome expectancies at time j (p < .0001). Model 2 failed to find a significant effect of alcohol consumption before time j on positive smoking outcome expectancies at time j + 1. The findings suggest that alcohol consumption is significantly associated with increased positive smoking outcome expectancies that, in turn, are associated with increased smoking urge in women seeking to quit smoking.

The eastern Adriatic is a key area for understanding the mechanisms and effects of the spread of agriculture. This article presents an accelerator mass spectrometry (AMS) radiocarbon chronology for the introduction and subsequent development of farming villages on the eastern shore of the Adriatic (∼6000–1700 cal BC) and evaluates this in comparison with the established pottery chronology based on stylistic data from Pokrovnik (Drniš) on the Dalmatian coast of Croatia. Models for the spread of agriculture rely heavily on changing pottery styles to define cultural groups and trace geographic relationships. Based on AMS 14C dates presented here, Impressed Wares first appear in central Dalmatia by 6000 cal BC and persist until 5300 cal BC, well into what is generally termed the Middle Neolithic. Similarly, a typical Middle Neolithic ware, figulina, appeared earlier than anticipated. These findings stand in contrast to cave and rockshelter assemblages in the eastern Adriatic, but mirror assemblages from farming villages on the Italian Adriatic coast. This study argues that the similarities in ceramic assemblage composition and change through time may have less to do with direct contacts between areas, but more with the nature of ceramic production and consumption at village sites in general. These data shed light on the limitations of regional ceramic chronologies in the eastern Adriatic and highlight the necessity for systematic expansion of 14C chronologies to address the social, economic, and ecological relevance of early farming in the Adriatic for the spread of agriculture in Europe and the Mediterranean.

Introduction Negative affect, alcohol consumption, and presence of others smoking have consistently been implicated as risk factors for smoking lapse and relapse. What is not known, however, is how these factors work together to affect smoking outcomes. This paper uses ecological momentary assessment (EMA) collected during the first 7 days of a smoking cessation attempt to test the individual and combined effects of high-risk triggers on smoking urge and lapse. Methods Participants were 300 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants completed EMA, which recorded negative affect, alcohol consumption, presence of others smoking, smoking urge, and smoking lapse, for 7 days starting on their quit date. Results Alcohol consumption, presence of others smoking, and negative affect were, independently and in combination, associated with increase in smoking urge and lapse. The results also found that the relationship between presence of others smoking and lapse and the relationship between negative affect and lapse were moderated by smoking urge. Conclusions The current study found significant individual effects of alcohol consumption, presence of other smoking, and negative affect on smoking urge and lapse. Combing the triggers increased smoking urge and the risk for lapse to varying degrees, and the presence of all 3 triggers resulted in the highest urge and lapse risk.

The human effects that dominate current ecological and climatic regimes have deep roots. The origins and spread of farming during the Holocene are increasingly viewed as a turning point for human–environmental interaction, health, nutrition, disease, and increasing social complexity. This paper summarizes current evidence for the spread of domesticated animals into the Balkans – the gateway to Europe and a current biodiversity hotspot. The introduction of domesticated plants and animals 8000 years ago was the first documented intentional introduction of new species by humans and initiated a long history of forest clearance, habitat fragmentation, and new ecological relationships that resonate in current discussions of conservation and biodiversity. It is argued that cattle, sheep, goats, and pigs were likely genetically diverse upon introduction and contributed to an initial net increase in animal species biodiversity; that these taxa had distinctive ecological histories of interbreeding with wild species and feralization; and that despite local indicators, the lack of clear evidence for widespread environmental impacts of the grazing animals was likely a result of scale. The historical ecology of the Balkans helps characterize the resiliency and limitations of European landscapes, highlights questions regarding ancient biodiversity, and may prove useful for current understandings of conservation issues. Research into early farming creates baselines for questions of biodiversity, geomorphological change, and the creation of new biota. Studies that focus on ecological histories and human impacts on past environments are becoming more important in order to fully grasp the speed, intensity, and scope of Anthropocene developments today.

To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women's decisions about prophylactic tamoxifen and raloxifene use.Postmenopausal women, age 46-74, with BCRAT 5-year risk ≥ 1.66% and no prior history of breast cancer were randomized to one of three study arms:intervention (n=690), Time 1 control (n=160), or 3-month control (n=162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women's decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively.Intervention participants had significantly lower decisional conflict levels at post-test (p0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p0.001) compared to control participants.GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk.Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients' decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values.

In this paper we present a virtual reconstruction of prehistoric funerary practices in Pastora Cave, a collective burial site in Eastern Spain that dates from the Late Neolithic, Chalcolithic and Bronze Age. Modern data of the cave was captured by 3D laser scanning techniques and added to recorded archaeological data and 3D graphic information. The combination of these data sets allowed us to create a hypothetical reconstruction to analyze the material excavated in the 1940s and 50s in greater spatial context. A 3D model of the current cave was created in order to serve as a basis for modeling the relative stratigraphic information available. We present the methodology employed and the results and implications of the analysis for Pastora Cave with particular emphasis on the spatial and chronological data.

peer-reviewed Background Bovine tuberculosis (bTB) infection in cattle is a significant economic concern in many countries, with annual costs to the UK and Irish governments of approximately €190 million and €63 million, respectively, for bTB control. The existence of host additive and non-additive genetic components to bTB susceptibility has been established. Methods Two approaches i.e. single-SNP (single nucleotide polymorphism) regression and a Bayesian method were applied to genome-wide association studies (GWAS) using high-density SNP genotypes (n = 597,144 SNPs) from 841 dairy artificial insemination (AI) sires. Deregressed estimated breeding values for bTB susceptibility were used as the quantitative dependent variable. Network analysis was performed using the quantitative trait loci (QTL) that were identified as significant in the single-SNP regression and Bayesian analyses separately. In addition, an identity-by-descent analysis was performed on a subset of the most prolific sires in the dataset that showed contrasting prevalences of bTB infection in daughters. Results A significant QTL region was identified on BTA23 (P value >1 × 10−5, Bayes factor >10) across all analyses. Sires with the minor allele (minor allele frequency = 0.136) for this QTL on BTA23 had estimated breeding values that conferred a greater susceptibility to bTB infection than those that were homozygous for the major allele. Imputation of the regions that flank this QTL on BTA23 to full sequence indicated that the most significant associations were located within introns of the FKBP5 gene. Conclusions A genomic region on BTA23 that is strongly associated with host susceptibility to bTB infection was identified. This region contained FKBP5, a gene involved in the TNFα/NFκ-B signalling pathway, which is a major biological pathway associated with immune response. Although there is no study that validates this region in the literature, our approach represents one of the most powerful studies for the analysis of bTB susceptibility to date.

Smokers are at high risk for oral disease. As a result, they represent an important target group for population-level, public oral health promotion efforts. While dental health professionals often address smoking with their patients, no systematic efforts have been made to offer smokers an intervention to improve their use of oral health care. This paper details the rationale, design, and methods of a large, semi-pragmatic, randomized clinical trial designed to address this gap. Participants are recruited via the Oregon, Nebraska and Louisiana state-sponsored tobacco quitlines and randomized to receive standard quitline care versus standard care plus a multi-modal oral health promotion program (Oral Health 4 Life) integrated within the quitline services. All participants are followed for 6 months to assess the impact of the intervention on smoking abstinence and utilization of professional dental care. In addition, the study will assess the cost of the intervention and provide practical guidance to states on whether the intervention is financially feasible to implement, should the intervention be effective. This study protocol may be useful to others interested in promoting oral health among smokers, those interested in partnering with tobacco quitlines to extend standard services to address other high risk health behaviors among smokers, or those interested in semi-pragmatic trial design.

Although social anxiety is associated with higher prevalence of smoking and lower cessation rates, little is known about the underlying mechanisms of these relationships. Research suggests that socially anxious smokers have higher levels of smoking-specific experiential avoidance and are inclined to smoke to avoid internal smoking cues. However, it is unknown which types of internal smoking cues they avoid. Thus, this study aimed to address this gap in the literature.Participants (N = 450) were adult smokers from a group-based trial for smoking cessation. Bivariate correlations and hierarchical linear regression models examined relationships between baseline levels of social anxiety and acceptance of internal smoking cues-physical sensations, emotions, and cognitions.Social anxiety was associated with lower levels of acceptance of thoughts, sensations, and emotions that cue smoking. After controlling for levels of nicotine dependence, depression, generalized anxiety, and posttraumatic stress disorder, social anxiety still explained unique variability in overall acceptance of internal smoking cues and in acceptance of physical sensations and emotions that serve as smoking cues. Social anxiety no longer explained unique variability in acceptance of thoughts that trigger smoking.Smokers with high levels of social anxiety are less accepting of internal smoking cues. For physical and emotional cues, this effect was independent of level of dependence and mental health comorbidity. Results help explain why smokers with social anxiety are less likely to quit and can inform the development of targeted cessation treatments for smokers with social anxiety.

BackgroundMobile health (mHealth) interventions hold great promise for helping smokers quit since these programs can have wide reach and facilitate access to comprehensive, interactive, and adaptive treatment content. However, the feasibility, acceptability, and effectiveness of these programs remain largely untested. ObjectiveTo assess feasibility and acceptability of the My Mobile Advice Program (MyMAP) smoking cessation program and estimate its effects on smoking cessation and medication adherence to inform future research planning. MethodsSixty-six smokers ready to quit were recruited from a large regional health care system and randomized to one of two mHealth programs: (1) standard self-help including psychoeducational materials and guidance how to quit smoking or (2) an adaptive and interactive program consisting of the same standard mHealth self-help content as controls received plus a) real-time, adaptively tailored advice for managing nicotine withdrawal symptoms and medication side-effects and b) asynchronous secure messaging with a cessation counselor. Participants in both arms were also prescribed a 12-week course of varenicline. Follow-up assessments were conducted at 2 weeks post-target quit date (TQD), 3 months post-TQD, and 5 months post-TQD. Indices of program feasibility and acceptability included acceptability ratings, utilization metrics including use of each MyMAP program component (self-help content, secure messaging, and adaptively tailored advice), and open-ended feedback from participants. Smoking abstinence and medication adherence were also assessed to estimate effects on these treatment outcomes. ResultsUtilization data indicated the MyMAP program was actively used, with higher mean program log-ins by experimental than control participants (10.6 vs 2.7, P

Despite clear associations between social anxiety (SA), high prevalence of smoking, and cessation failure, little is known about factors contributing to these relationships. Moreover, the extent to which smokers with moderate SA represent an at-risk group of smokers is also unknown. This study examined the extent to which established risk factors for poor cessation (eg, sociodemographic, smoking history, mental health comorbidity) are prevalent among smokers with low, moderate, and high levels of SA.Participants (N = 2,637) were adult smokers from a web-based smoking cessation trial. Nineteen characteristics considered risk factors for poor cessation outcomes were assessed at baseline. Those associated with social anxiety were subsequently compared by SA level.Regression models indicated that 10/19 risk factors were associated with SA. Compared to smokers with low SA, those with moderate and high SA endorsed 4/10 and 10/10 risk factors as more prevalent or severe, respectively. Compared to smokers with low SA, High SA was associated with greater sociodemographic risk factors, while both moderate and high SA was associated with more severe mental health symptoms.Smokers with moderate and high levels of SA endorse more risk factors for poor cessation outcomes than those with low levels of SA, particularly mental health symptoms. These factors may help explain the differential smoking outcomes of socially anxious smokers. Results suggest that smokers with both moderate and high levels of SA would likely benefit from cessation interventions that address and consider these risk factors. (Am J Addict 2017;26:176-182).