Search

Artificial intelligence (AI) text generators, such as ChatGPT and Copilot, have been used for various purposes such as creating written content, writing or debugging computer code, answering questions, providing information, and improving written communication. This robust functionality of AI text generators along with the high rate of use reported by college students highlights the need for instructors in special education teacher preparation programs to contend with the impact of AI on teaching and learning. The purpose of this article is to provide examples of how teacher educators might reimagine assignments and activities in the era of AI text generators. Specifically, the authors explore ways that AI applications might be intentionally incorporated or, conversely, intentionally restricted in the design of course assignments and activities.

Professionals and communication partners report experiencing challenges with regard to developing the knowledge and skills needed to support individuals with complex communication needs who use augmentative and alternative communication (AAC). These challenges can be exacerbated in rural and remote areas where access to resources and training may be limited. This practitioner-focused article provides evidence-based strategies for addressing the knowledge and skill needs experienced by professionals and communication partners in rural communities, including strategies for (a) identifying AAC knowledge and skill needs, (b) accessing AAC resources, (c) using principles of instructional design and instructional coaching to address identified areas of need, (d) considering contexts for instruction, and (e) examining contextual fit.

Critical thinking is recognised as instrumental for positive, personal and professional, long-term outlooks. It is also widely accepted that the development of students' critical thinking skills can be achieved through explicit interventions. This paper documents the outcomes of a pilot study that investigated the value and impact of an instructional model for guiding critical thinking skills. The model was implemented as an explicit framework, with pre-tertiary students, at a regional campus of an Australian university. Student participants were tasked with using the Review, Connect, Extend, Apply (RCEA) Framework (James, 2015) to support their analysis and critical reflection on the concepts explored in a unit of study. Data revealed that students exhibited limited critical thinking skills prior to participation in the pilot program and evidenced improvement after engaging with the RCEA framework. However, some students struggled with expressing their reflections, evaluations, and applications of knowledge, which resulted in considerations about the importance of vocabulary. The findings directed the authors to note the importance of qualifying the notion of explicit interventions for teaching critical thinking. Accordingly, they propose the use of an explicit teaching model for enabling students' critical thinking, which encompasses a structured format, a thinking framework, and pedagogy that incorporates the modelling of metacognition and metalanguage for critical thinking.

Depression in type 2 diabetes (T2D) is estimated at 50% vs 18% among US adults, and markers of inflammation, which are tightly linked to hyperglycemia, are 5- to 50-fold higher in adults with T2D. Although lifestyle modifications are recommended for managing diabetes, resistance training (RT) is not commonly considered. This case report examined the practicality of implementing a structured RT protocol in a highly sedentary woman with T2D and depressive symptomology and assessed changes in strength, fitness, depression, and inflammation. The 59-year-old participant (body mass index: 38.1 kg/m2) was diagnosed in 2015. She had hypertension and bronchial asthma, was highly sedentary, and was clinically depressed based on validated measures: The Center for Epidemiological Studies Depression (CES-D) questionnaire and the Profile of Mood States (POMS) questionnaire. She had quit smoking 6 months earlier. The estimated 1RM guided the exercise prescription that used progressive overload to improve strength and promote the accretion of lean body mass. All exercise sessions (~45 minutes duration; 3× weekly) were supervised by trained personnel. After 8 weeks, total strength improved 135%. Heart rate was reduced by 14%, and depression symptomology fell into normal ranges. Although RT improved strength, fitness, and depressive symptomology, RT did not improve HbA1c, HOMA-IR, or inflammation emphasizing the need for a comprehensive treatment strategy. Simple assessments can be performed to determine the fitness and mental health of individuals with T2D, and incorporating an exercise prescription to standard care to address these key health determinants will empower patients to actively engage in their health care.

Abstract Background Scholarship on how fentanyl affects the complexities of correctional settings is limited in Canada, as scholars have focused on the prevalence of opioid use and overdose in prisons, as well as community treatment and access following release. Fentanyl constitutes a continuing challenge both in prisons and broader society. Results The current qualitative, interview-based empirical study examines how fentanyl is interpreted by correctional officers (COs, n = 99) across federal prisons in Canada, some of whom have worked in institutions with a high presence of fentanyl, while others have less exposure to the drug. We found that while many COs had responded to an overdose during their first or second year on the job, most COs who had did not perceive the event to be psychologically traumatic nor were concerned about the presence and availability fentanyl in their work environment, or they were indifferent. Yet this finding competes with the 41.4% of officers who did express concern about the presence of fentanyl – suggesting both a “normalization” of fentanyl as a workplace hazard as well as an underpinning social concern. Conclusions We discuss the implications of these complicated findings in relation to reducing workplace stressors and countering misinformation that, in addition to other potential occupational factors, may be responsible for the concerns of COs tied to the presence of fentanyl.

Introduction: Obesity has arisen as a prominent risk factor for COVID-19 severity and long COVID, potentially owed in part to the obesity-induced proinflammatory state. This study aimed to examine relationships among circulating inflammatory biomarkers and body mass index in nonhospitalized adults recently diagnosed with COVID-19. Methods: This analysis included participants who completed a randomized placebo-controlled trial conducted in October 2020–March 2021. Participants (19–53 years) were unvaccinated and enrolled following COVID-19 diagnosis as allowed by CDC return-to-work guidance. Anthropometrics and biomarkers were assessed at study baseline and week four. We examined the associations between body mass index (BMI) and inflammatory biomarkers via multiple regression models. Results: At study baseline (i.e., the point of enrollment following COVID-19 diagnosis) across all participants (N = 60), a higher BMI was associated with elevations in several inflammatory biomarkers including IL-6 (β = 7.63, 95% CI = 3.54, 11.89, p = 0.0004), ferritin (β = 6.31, 95% CI = 1.97, 10.83, p = 0.0047), high sensitivity C-reactive protein (β = 13.1, 95% CI = 8.03, 18.42, p = < 0.0001), tumor necrosis factor-α (β = 3.23, 95% CI = 0.91, 5.60, p = 0.0069), IL-12p40 (β = 3.69, 95% CI = 0.93, 6.52, p = 0.0094), IL-13 (β = 5.11, 95% CI = 1.00, 9.40, p = 0.0154), and IL-1Ra (β = 7.57, 95% CI = 3.61, 11.70, p = 0.0003). In control group participants (n = 30) after 4 weeks, a higher BMI was associated with elevations in IL-4 (β = 17.8, 95% CI = 0.84, 37.6, p = 0.0397) and sP-selectin (β = 1.16, 95% CI = 0.22, 2.11, p = 0.0182), controlling for baseline and covariates. Conclusions: Here, BMI was positively associated with circulating biomarkers of platelet activation and inflammation in adults recently diagnosed with COVID-19 after 4 weeks. The shift in post-acute COVID-19 inflammatory biomarkers associated with an increasing BMI noted here shares similarities to biomarkers of LC reported in the literature.

Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a new disease entity occurring in the pediatric population two to six weeks after coronavirus exposure due to a systemic arteritis. We investigated post-hospital-discharge arterial function at short- and mid-term intervals using pulse wave velocity. We assessed associations between arterial function, left ventricular diastolic and systolic function and left ventricular mass. Materials and methods: Retrospective data collection was carried out on 28 patients with MIS-C with at least two outpatient pediatric cardiology clinic visits post hospital admission. The patients underwent assessment of systemic arterial function and cardiac function. Data included pulse wave velocity between carotid and femoral arteries and echocardiographic assessment of left ventricular systolic function (shortening and ejection fraction, longitudinal strain), diastolic function and left ventricular mass. Results: Pulse wave velocity significantly decreased from visit 1 to visit 2 (5.29 ± 1.34 m/s vs. 4.51 ± 0.91 m/s, p = 0.009). Left ventricular mass significantly decreased from visit 1 to visit 2 (42 ± 9 g/m2.7 vs. 38 ± 7 g/m2.7, p = 0.02). There was a significant negative correlation between the pulse wave velocity and E/A mitral inflow (−0.41, p < 0.05). Conclusions: Children have elevated pulse wave velocity and left ventricular mass in the short-term relative to mid-term values after hospital discharge. These results suggest that MIS-C is associated with transient systemic arterial dysfunction, which, in turn, may play a role in cardiac changes.

Recent longitudinal evidence reveals how sustaining a traumatic brain injury (TBI) increases risk for criminal justice involvement, including incarceration for serious or chronic offending (i.e., violent crime). In 2016, researchers from Correctional Service Canada (CSC) found between 01 July 1997 and 31 March 2011, the incidence of incarceration was higher among federally sentenced incarcerated people with prior TBI; in their sample, both men and women with TBI were approximately 2.5 times more likely to be incarcerated than men and women without TBI. More research is needed to understand how TBI may be related to neurodiversity and shape pathways to criminal justice system involvement, particularly among men who do not identify as White; for example, in 2020/2021, Indigenous men made up 32% of male admissions to federal custody in Canada. Engaging 11 reports produced by CSC which examine rates of TBI and other related factors among incarcerated people, as well as select international literature on TBI and the criminal justice system, our rapid report seeks to explicate the potential relationship between TBI, neurodiversity, and men as evidenced among federally incarcerated men in Canada. Policy, training, education, future areas of inquiry and practical implications for correctional services are discussed.

Abstract Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.

Abstract Magnetic van der Waals (vdW) materials have opened new frontiers for realizing novel many-body phenomena. Recently NiPS3 has received intense interest since it hosts an excitonic quasiparticle whose properties appear to be intimately linked to the magnetic state of the lattice. Despite extensive studies, the electronic character, mobility, and magnetic interactions of the exciton remain unresolved. Here we address these issues by measuring NiPS3 with ultra-high energy resolution resonant inelastic x-ray scattering (RIXS). We find that Hund’s exchange interactions are primarily responsible for the energy of formation of the exciton. Measuring the dispersion of the Hund’s exciton reveals that it propagates in a way that is analogous to a double-magnon. We trace this unique behavior to fundamental similarities between the NiPS3 exciton hopping and spin exchange processes, underlining the unique magnetic characteristics of this novel quasiparticle.

COVID-19 and the subsequent public health responses disrupted the routines and lives of people globally. The impact was felt by correctional workers who navigated rapidly changing public health policies and many disruptions to operations within both institutional and community correctional services. In the current study, we unpack qualitative findings emerging from an online mental health and well-being survey, during COVID-19, of 571 correctional workers employed in the Canadian province of Alberta. Results emphasize how correctional work was strained by the on-set of the COVID-19 pandemic, creating other risks and vulnerabilities for both staff and incarcerated people. Respondents highlighted impacts to their workload, routine, personal and institutional security, relationships with colleagues and incarcerated people, and their competing perspectives on the enforcement and ethics of ensuing public health measures intended to contain the spread of the virus. We discuss the empirical implications of these findings and areas for future research post pandemic.

Abstract Background People with amyotrophic lateral sclerosis (ALS) face disability- and travel-related barriers to research participation. We investigate the usefulness and acceptability of asynchronous, online focus groups (AOFGs) for research involving people affected by ALS (patients and family caregivers) and outline lessons learned. Methods The ALS Talk Project, consisting of seven AOFGs and 100 participants affected by ALS, provided context for this investigation. Hosted on the secure itracks Board™ platform, participants interacted in a threaded web forum structure. Moderators posted weekly discussion questions and facilitated discussion. Data pertaining to methodology, participant interaction and experience, and moderator technique were analyzed using itracks and NVivo 12 analytics (quantitative) and conventional content analysis and the constant-comparative approach (qualitative). Results There was active engagement within groups, with post lengths averaging 111.48 words and a complex network of branching interactions between participants. One third of participant responses included individual reflections without further interaction. Participants affirmed their co-group members, offered practical advice, and discussed shared and differing perspectives. Moderators responded to all posts, indicating presence and probing answers. AOFGs facilitated qualitative and quantitative data-gathering and flexible response to unanticipated events. Although total participation fell below 50% after 10–12 weeks, participants valued interacting with peers in an inclusive, confidential forum. Participants used a variety of personal devices, browsers, and operating systems when interacting on the online platform. Conclusions This methodological examination of AOFGs for patient-centred investigations involving people affected by ALS demonstrates their usefulness and acceptability, and advances knowledge of online research methodologies. Lessons learned include: early identification of research goals and participant needs is critical to selecting an AOFG platform; although duration longer than 10–12 weeks may be burdensome in this population, participants were positive about AOFGs; AOFGs offer real world flexibility enabling response to research challenges and opportunities; and, AOGFs can effectively foster safe spaces for sharing personal perspectives and discussing sensitive topics. With moderators playing an important role in fostering engagement, AOFGs facilitated rich data gathering and promoted reciprocity by fostering the exchange of ideas and interaction between peers. Findings may have implications for research involving other neurologically impaired and/or medically vulnerable populations.

Abstract Mounting evidence highlights the high prevalence of posttraumatic stress disorder (PTSD) among correctional workers. The current analysis draws on survey response data to present a social profile of correctional workers in the province of Manitoba (n = 580), Canada, who screened positive for PTSD (n = 196). We examined demographic information, professional history information, and adverse work exposure experiences, as well as treatment and support patterns. The analysis was not intended to identify correlates of PTSD development among correctional workers, but did identify the characteristics, professional and personal situations, and treatment experiences of correctional workers who screened positive for PTSD. The results highlight the multidimensional nature of work stressors, the pronounced problem of work–life conflict, and variations in seeking supports and treatments. Generally, participants screening positive for PTSD reported higher exposure to potentially psychologically traumatic events, higher environmental or occupational stressors at work, and many had prior work experience as public safety personnel. Correctional workers who screened positive for PTSD appeared more likely to access mental health supports. Promoting proactive support seeking for mental health treatment may help to mitigate the severity, frequency, stigma, and length of mental health challenges among correctional workers.

Urban green spaces can be important habitats for soil, plant, and pollinator diversity and the complementary ecosystem functions they confer. Most studies tend to investigate the relationships between plant diversity with either soil or pollinator diversity, but establishing their relationship across habitat types could be important for optimising ecosystem service provision via alternative management (for instance, urban meadows in place of short amenity grass). Here, we investigate soil–plant–pollinator relationships across urban grass and meadow habitats through a range of measured biodiversity (soil mesofauna and macrofauna, plants, aboveground invertebrates, and pollinators) and edaphic variables. We found significant effects of habitat type on available nutrients (plant and soil C:N ratios) but less clear relationships were observed between habitat type and diversity metrics. Soil–plant–pollinator interactions across habitat types and sites showed an interconnection, whereby flowering plant abundance increased alongside soil macrofauna abundance. Site characteristics that showed strong effects on plant and invertebrate diversity metrics were C:N ratios (plant and soil) and soil pH, suggesting a potential role of nutrient availability on soil–plant–pollinator associations. Our results suggest that a combination of short-mown grass, tall grass, and sown flowers can provide greater benefits for soil and pollination services as each habitat type benefits different taxa due to differing sensitivities to management practices. For example, pollinators benefit from sown flowers but soil fauna are sensitive to annual sowing. Our results also indicate that sown flowers may not optimise overall biodiversity as expected due to disturbance and the depleting role of tall, flowering plants on soil nutrient availability. Future research across a greater range of sites in urban landscapes would resolve the potential role of nutrient availability in modulating soil–plant–pollinator interactions in urban green spaces.

IntroductionThe inherent nature of work in correctional services can have negative effects on correctional worker mental health and well-being.MethodsThe current study, a replication, analyzes survey data collected from provincial and territorial correctional workers staffed in six regions across Canada (n = 192). Specifically, participants were asked at the end of an extensive mental health and well-being survey an open-ended question requesting any additional feedback or information.ResultsFour predominant themes were identified in the data: (1) stigma pertaining to a need to recognize mental health concerns within correctional services; (2) the idea that correctional services wear on the mind and body; (3) a need for better relationships with and support from correctional supervisors, upper management, and ministerial leadership; and (4) suggestions to improve correctional services to help the sector realize its full potential and maximize workplace health.DiscussionWe discuss the implications of these findings, with an emphasis on finding ways to promote positive organizational and cultural change in correctional services.

IntroductionPrevalence rates for vitamin B12 deficiency in U.S. adult vegetarians may exceed 30%, which is concerning given the role for this vitamin in numerous nervous system functions, including the synthesis of myelin sheaths. Defective myelin synthesis and repair are directly linked to peripheral neuropathy; yet, few investigations have examined how physical indicators of peripheral neuropathy (e.g., hand dexterity, vibration sensitivity and balance) are impacted in individuals adhering to vegetarian diets. This feasibility research explored the relationships between peripheral neuropathy and vitamin B12 status using a cross-sectional study design. In addition, a small pilot trial was conducted for limited-efficacy testing of vitamin B12 supplementation for reducing peripheral neuropathy.MethodsHealthy, able-bodied adults (n = 38; 19–40 years of age) reported exclusive adherence to a vegetarian or vegan diet for 3 years. Peripheral neuropathy was measured using a force plate for assessing balance, and a vibration sensitivity tester and pegboard tests to assess hand dexterity. Serum vitamin B12 and folate were measured using standard radioimmunoassay techniques.ResultsTwenty-six percent of the sample displayed deficient or marginal vitamin B12 status (serum vitamin B12

Summary: HIV gp120 engineered outer domain germline-targeting version 8 (eOD-GT8) was designed specifically to engage naive B cell precursors of VRC01-class antibodies. However, the frequency and affinity of naive B cell precursors able to recognize eOD-GT8 have been evaluated only in U.S. populations. HIV infection is disproportionally concentrated in sub-Saharan Africa, so we seek to characterize naive B cells able to recognize eOD-GT8 in sub-Saharan cohorts. We demonstrate that people from sub-Saharan Africa have a higher or equivalent frequency of naive B cells able to engage eOD-GT8 compared with people from the U.S. Genetically, the higher frequency of eOD-GT8-positive cells is accompanied by a higher level of naive B cells with gene signatures characteristic of the VRC01 class, as well as other CD4bs-directed antibodies. Our study demonstrates that vaccination with eOD-GT8 in sub-Saharan Africa could be successful at expanding and establishing a pool of CD4bs-directed memory B cells from naive precursors.

Abstract Ruddlesden-Popper and reduced Ruddlesden-Popper nickelates are intriguing candidates for mimicking the properties of high-temperature superconducting cuprates. The degree of similarity between these nickelates and cuprates has been the subject of considerable debate. Resonant inelastic x-ray scattering (RIXS) has played an important role in exploring their electronic and magnetic excitations, but these efforts have been stymied by inconsistencies between different samples and the lack of publicly available data for detailed comparison. To address this issue, we present open RIXS data on La4Ni3O10 and La4Ni3O8.

Multisystem inflammatory syndrome in children (MIS-C) is a rare but life-threatening hyperinflammatory condition induced by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes pediatric COVID-19 (pCOVID-19). The relationship of the systemic tissue injury to the pathophysiology of MIS-C is poorly defined. We leveraged the high sensitivity of epigenomics analyses of plasma cell-free DNA (cfDNA) and plasma cytokine measurements to identify the spectrum of tissue injury and glean mechanistic insights. Compared with pediatric healthy controls (pHCs) and patients with pCOVID-19, patients with MIS-C had higher levels of cfDNA primarily derived from innate immune cells, megakaryocyte-erythroid precursor cells, and nonhematopoietic tissues such as hepatocytes, cardiac myocytes, and kidney cells. Nonhematopoietic tissue cfDNA levels demonstrated significant interindividual variability, consistent with the heterogenous clinical presentation of MIS-C. In contrast, adaptive immune cell–derived cfDNA levels were comparable in MIS-C and pCOVID-19 patients. Indeed, the cfDNA of innate immune cells in patients with MIS-C correlated with the levels of innate immune inflammatory cytokines and nonhematopoietic tissue–derived cfDNA, suggesting a primarily innate immunity–mediated response to account for the multisystem pathology. These data provide insight into the pathogenesis of MIS-C and support the value of cfDNA as a sensitive biomarker to map tissue injury in MIS-C and likely other multiorgan inflammatory conditions.

Abstract Background Mental health frameworks, best practices, and the well-being of public safety personnel in Canada are topics of increasing interest to both researchers and organizations. To protect and improve worker mental health, different training programs have been implemented to serve this population. The Road to Mental Readiness (R2MR) training regimen is one such program specialized to build cultural awareness of mental health, reduce stigma, and mitigate the cumulative impacts of exposures to potentially psychologically traumatic events among public safety personnel. However, limited research has been conducted to evaluate the effectiveness of R2MR, especially among correctional workers. Methods The current study analyzed 307 open-ended survey responses to four (4) questions about R2MR garnered from 124 Canadian provincial and territorial correctional workers between 2018–2020 to reveal their understandings and perceptions of R2MR training, and to identify what learned skills they found challenging or easy to implement. Results The results suggest that R2MR training plays a significant role in decreasing stigma and increasing mental health awareness. Across jurisdictions, R2MR creates a supportive space for open dialogue around mental health meant to shift cultural and individual barriers that often hinder treatment-seeking. Some respondents also indicated that R2MR was a starting point for intervention. Conclusions Further research is necessary to understand how R2MR and other programs could support the mental health and well-being of correctional workers.

Vaccines against the WA1 SARS-CoV2 strain confer protection against other variants. However, the mechanisms underlying cross-protection are not fully understood. Here, the authors develop a method for rapid analysis of single B cells from patient samples and show that infection with a variant elicits convergent, public B cell responses to other variants.

Background: Small changes in deltoid tension and moment arm due to glenosphere lateralization may be associated with an increase in acromion or scapular spine strain in reverse shoulder arthroplasty (RSA), which can lead to stress fracture. The coracoacromial ligament (CAL) may be protective and lower the strain seen on the acromion or scapular spine. This biomechanical study investigated the impact of glenosphere lateralization and CAL integrity on acromion and scapular spine strain after RSA. Methods: Ten cadaveric specimens were tested on a custom dynamic shoulder frame. Acromial and scapular spine strain were measured at 0°, 30°, and 60° of abduction using strain rosettes fixed to the acromion (Levy Type 2) and the scapular spine (Levy Type 3). Specimens were first tested with a standard commercially available RSA implant with zero lateralization and then subsequently with the +3 and +6 lateralizing glenospheres for that implant. The CAL was then cut in each specimen and testing was repeated with the 0, +3, and +6 glenospheres. Maximal strain was recorded at both the acromion and scapular spine and analysis of variance compared strain across various abduction angles and glenospheres with and without CAL transection. Results: In the intact CAL group, maximal strain decreased significantly at the acromion with abduction from 0° to 30° and 0° to 60°, however, at the scapular spine abduction did not significantly impact strain. Maximal strain decreased significantly with increasing abduction from 0 to 30 and 0 to 60 at both the acromion and scapular spine in the cut CAL group. Average strain at the acromion was significantly higher in the cut group (844.7 με) versus the intact group (580.3 με), a difference of 31.3% (P = .0493). Average strain at the scapular spine, did not differ in the cut group (725 με) compared with the intact group (787 με) (P = .3666). There were no statistically significant differences in acromial or scapular spine strain between various levels of glenosphere lateralization in either the cut or intact state. Conclusion: In this biomechanical study, arm abduction decreased acromial and scapular spine strain following RSA. Cutting the CAL significantly increased strain at the acromion, and did not significantly alter strain at the scapular spine for all angles of abduction, differing from prior literature. Glenosphere lateralization did not have a significant effect on strain at the levels studied regardless of CAL status. Continued study of the complexion relationship between surgical and implant factors on strain following RSA is needed.

Abstract We studied the magnetic excitations in the quasi-one-dimensional (q-1D) ladder subsystem of Sr14−xCaxCu24O41 (SCCO) using Cu L 3-edge resonant inelastic X-ray scattering (RIXS). By comparing momentum-resolved RIXS spectra with high (x = 12.2) and without (x = 0) Ca content, we track the evolution of the magnetic excitations from collective two-triplon (2 T) excitations (x = 0) to weakly-dispersive gapped modes at an energy of 280 meV (x = 12.2). Density matrix renormalization group (DMRG) calculations of the RIXS response in the doped ladders suggest that the flat magnetic dispersion and damped excitation profile observed at x = 12.2 originates from enhanced hole localization. This interpretation is supported by polarization-dependent RIXS measurements, where we disentangle the spin-conserving ΔS = 0 scattering from the predominant ΔS = 1 spin-flip signal in the RIXS spectra. The results show that the low-energy weight in the ΔS = 0 channel is depleted when Sr is replaced by Ca, consistent with a reduced carrier mobility. Our results demonstrate that off-ladder impurities can affect both the low-energy magnetic excitations and superconducting correlations in the CuO4 plaquettes. Finally, our study characterizes the magnetic and charge fluctuations in the phase from which superconductivity emerges in SCCO at elevated pressures.

Abstract Background Komagataella phaffii is a commonly used alternative host for manufacturing therapeutic proteins, in part because of its ability to secrete recombinant proteins into the extracellular space. Incorrect processing of secreted proteins by cells can, however, cause non-functional product-related variants, which are expensive to remove in purification and lower overall process yields. The secretion signal peptide, attached to the N-terminus of the recombinant protein, is a major determinant of the quality of the protein sequence and yield. In K. phaffii, the signal peptide from the Saccharomyces cerevisiae alpha mating factor often yields the highest secreted titer of recombinant proteins, but the quality of secreted protein can vary highly. Results We determined that an aggregated product-related variant of the SARS-CoV-2 receptor binding domain is caused by N-terminal extension from incomplete cleavage of the signal peptide. We eliminated this variant and improved secreted protein titer up to 76% by extension of the N-terminus with a short, functional peptide moiety or with the EAEA residues from the native signal peptide. We then applied this strategy to three other recombinant subunit vaccine antigens and observed consistent elimination of the same aggregated product-related variant. Finally, we demonstrated that this benefit in quality and secreted titer can be achieved with addition of a single amino acid to the N-terminus of the recombinant protein. Conclusions Our observations suggest that steric hindrance of proteases in the Golgi that cleave the signal peptide can cause unwanted N-terminal extension and related product variants. We demonstrated that this phenomenon occurs for multiple recombinant proteins, and can be addressed by minimal modification of the N-terminus to improve steric accessibility. This strategy may enable consistent secretion of a broad range of recombinant proteins with the highly productive alpha mating factor secretion signal peptide.

Drawing on 5090 English reviews of 486 psychiatrists working in Canada posted on ratemds.com, this study explores how mental health service users refuse to become subjectivized by psychiatric discourse and power. We interrogate how digital mediums provide mental health service users with a community of critique to regain control over settings where there are many power imbalances. We argue that websites like ratemds.com act as a digital agora in which people are afforded the ability to make the personal political. Through critiquing their own doctors, mental health service users invert the question of what is “wrong” with them to what is “wrong” with agents of the psychiatric apparatus. By regaining a say over their treatment/conditions and insisting doctors are asking the wrong questions to better control their identities, service users refuse to accept the diagnoses, pathologies, and practices imposed on them. We discuss how their transgression in this forum provides new insights into psychiatric resistance that is of special interest to scholars and service users positioned in the Mad Studies movement.

Rotating radio transients (RRATs) are neutron stars that emit sporadic radio bursts. We detected 1955 single pulses from RRAT J1913+1330 using the 19 beam receiver of the Five-hundred-meter Aperture Spherical radio Telescope. These pulses were detected in 19 distinct clusters, with 49.4% of them occurring with a waiting time of one rotation period. The energy distribution of these individual pulses exhibited a wide range, spanning 3 orders of magnitude, reminiscent of repeating fast radio bursts (FRBs). Furthermore, we observed abrupt variations in pulse profile, width, peak flux, and fluence between adjacent sequential pulses. These findings suggest that this RRAT could be interpreted as a pulsar with extreme pulse-to-pulse modulation. The presence of sequential pulse trains during active phases, along with significant pulse variations in profile, fluence, flux, and width, should be intrinsic to a subset of RRATs. Our results indicate that J1913+1330 represents a peculiar source that shares certain properties with populations of nulling pulsars, giant pulses, and FRBs from different perspectives. The dramatic pulse-to-pulse variation observed in J1913+1330 could be attributed to unstable pair creation above the polar cap region and the variation of the site where streaming pairs emit coherently. Exploring a larger sample of RRATs exhibiting similar properties to J1913+1330 has the potential to significantly advance our understanding of pulsars, RRATs, and FRBs.

We present a detailed study of the X-ray emission from PSR B1055–52 using XMM-Newton observations from 2019 and 2000. The phase-integrated X-ray emission from this pulsar is poorly described by existing models of neutron star atmospheres. Instead, we confirm that, similar to other middle-aged pulsars, the best-fitting spectral model consists of two blackbody components, with substantially different temperatures and emitting areas, and a nonthermal component characterized by a power law. Our phase-resolved X-ray spectral analysis using this three-component model reveals variations in the thermal emission parameters with the pulsar’s rotational phase. These variations suggest a nonuniform temperature distribution across the neutron star’s surface, including the cold thermal component and probable hot spot(s). Such a temperature distribution can be caused by external and internal heating processes, likely a combination thereof. We observe very high pulse fractions, 60%–80% in the 0.7–1.5 keV range, dominated by the hot blackbody component. This could be related to temperature nonuniformity and potential beaming effects in an atmosphere. We find indication of a second hot spot that appears at lower energies (0.15–0.3 keV) than the first hot spot (0.5–1.5 keV) in the X-ray light curves and is offset by about half a rotation period. This finding aligns with the nearly orthogonal rotator geometry suggested by radio observations of this interpulse pulsar. If the hot spots are associated with polar caps, a possible explanation for their temperature asymmetry could be an offset magnetic dipole and/or an additional toroidal magnetic field component in the neutron star crust.

Abstract Background To compare clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape (2OPMT) versus conventional absorbable sutures plus waterproof wound dressings (CSWWD). Methods Retrospective study using the Premier Healthcare Database. Patients undergoing a cardiac surgery requiring sternotomy with 2OPMT or CSWWD were included. Primary outcome was 60-day cumulative incidence of diagnosis for wound complications (infection, dehiscence). Secondary outcomes were index admission hospital length of stay (LOS), total hospital-borne costs, discharge status, and 60-day cumulative incidences of inpatient readmission and reoperation. After propensity score matching, outcomes were compared between the 2OPMT and CSWWD groups using bivariate multilevel mixed-effects generalized linear models. Results Overall, 7,901 2OPMT patients and 10,775 CSWWD patients were eligible for study. After propensity score matching on 68 variables, each group comprised 5,338 patients (total study N = 10,676). The 2OPMT and CSWWD groups did not differ significantly in terms of the 60-day cumulative incidences of wound complication (3.47% vs 3.47%, p = 0.996), inpatient readmission (12.6% vs. 13.6%, p = 0.354), and reoperation (10.3% vs 10.1%, p = 0.808), as well as discharge to home versus non-home setting (77.2% vs. 75.1%), p = 0.254. However, the 2OPMT group had significantly lower LOS (9.2 days vs 10.6 days, p

Background The SARS-CoV-2 Omicron BA.5 subvariant escapes vaccination-induced neutralizing antibodies because of mutations in the spike (S) protein. Solid organ transplant recipients (SOTRs) develop high COVID-19 morbidity and poor Omicron variant recognition after COVID-19 vaccination. T cell responses may provide a second line of defense. Therefore, understanding which vaccine regimens induce robust, conserved T cell responses is critical.Methods We evaluated anti-S IgG titers, subvariant pseudo-neutralization, and S-specific CD4+ and CD8+ T cell responses from SOTRs in a national, prospective, observational trial (n = 75). Participants were selected if they received 3 doses of mRNA (homologous boosting) or 2 doses of mRNA followed by Ad26.COV2.S (heterologous boosting).Results Homologous boosting with 3 mRNA doses induced the highest anti-S IgG titers. However, antibodies induced by both vaccine regimens demonstrated lower pseudo-neutralization against BA.5 compared with the ancestral strain. In contrast, vaccine-induced S-specific T cells maintained cross-reactivity against BA.5 compared with ancestral recognition. Homologous boosting induced higher frequencies of activated polyfunctional CD4+ T cell responses, with polyfunctional IL-21+ peripheral T follicular helper cells increased in mRNA-1273 compared with BNT162b2. IL-21+ cells correlated with antibody titers. Heterologous boosting with Ad26.COV2.S did not increase CD8+ responses compared to homologous boosting.Conclusion Boosting with the ancestral strain can induce cross-reactive T cell responses against emerging variants in SOTRs, but alternative vaccine strategies are required to induce robust CD8+ T cell responses.Funding Ben-Dov Family; NIH National Institute of Allergy and Infectious Diseases (NIAID) K24AI144954, NIAID K08AI156021, NIAID K23AI157893, NIAID U01AI138897, National Institute of Diabetes and Digestive and Kidney Diseases T32DK007713, and National Cancer Institute 1U54CA260492; Johns Hopkins Vice Dean of Research Support for COVID-19 Research in Immunopathogenesis; and Emory COVID-19 research repository.

Background: Although the global protein bar market is rapidly escalating, there is a scarcity of controlled trials examining their dietary impact. This cross-over study examined the impact of protein bar ingestion (with or without added fibre) on energy intake. Methods: Adults (n = 21; 21.9 ± 2.6 y) recorded food and beverage consumption using a smartphone application and appetite ratings using 100-mm VAS scales. Body composition was recorded at baseline and following each one-week feeding phase. Results: Average 24-hour energy intakes during the weeks bars were consumed were elevated significantly (7–13%) from control weeks with no difference between bars. Postprandial appetite scores were significantly below fasting scores but did not differ between bars. Body fat mass was significantly elevated (+3%) at the end of each feeding period compared to the control week. Conclusion: These results suggest that the daily ingestion of protein bars increased overall energy intakes and may impact body mass over time.

Abstract Background People with amyotrophic lateral sclerosis (ALS) are at high risk for severe outcomes from Covid-19 infection. Researchers exploring ALS and Covid-19 have focused primarily on system response and adaptation. Using Protection Motivation Theory, we investigated how people with ALS and family caregivers appraised and responded to Covid-19 threat, the ‘costs’ associated with pandemic response, and how health professionals and systems can better support people affected by ALS who are facing public health emergencies. Methods Data were drawn from the ‘ALS Talk Project,’ an asynchronous, moderated focus group study. Participants were recruited from regions across Canada. Seven groups met online over 14 weeks between January and July 2020. Fifty-three participants contributed to Covid-19 discussions. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach. Results Participants learned about the Covid-19 pandemic from the media. They rapidly assessed their vulnerability and responded to Covid-19 threat by following recommendations from health authorities, information monitoring, and preparing for worst-case scenarios. Adopting protective behaviors had substantial response costs, including adaptations for medical care and home support workers, threatened access to advance care, and increased caregiver burden. Participants expressed need for ALS-specific, pandemic information from trusted health professionals and/or ALS health charities. Telemedicine introduced both conveniences and costs. Prior experience with ALS provided tools for coping with Covid-19. Threat and coping appraisal was a dynamic process involving ongoing vigilance and adaptation. Findings draw attention to the lack of emergency preparedness among participants and within health systems. Conclusions Clinicians should engage ALS patients and families in ongoing discussions about pandemic coping, strategies to mitigate response costs, care pathways in the event of Covid-19 infection, and changing information about Covid-19 variants and vaccines. Healthcare systems should incorporate flexible approaches for medical care, leveraging the benefits of telemedicine and facilitating in-person interaction as needed and where possible. Research is needed to identify strategies to mitigate response costs and to further explore the interaction between prior experience and coping. Further study is also needed to determine how communication about emergency preparedness might be effectively incorporated into clinical care for those with ALS and other medically vulnerable populations.

Multipolar magnetic excitations are challenging to measure as most experimental probes are sensitive to dipolar processes. Here, Nag et al. show the existence of dispersing quadrupolar components to the spin excitations in an antiferromagnet, highlighting the importance of higher order magnetic excitations.

Abstract Objective Arterial stiffness is a strong predictor of cardiovascular mortality, and often precedes elevations in blood pressure. This cross-sectional pilot study examined differences in arterial stiffness, blood pressure, cardiometabolic markers, anthropometric outcomes, and inflammation in vegetarians and matched omnivores. Participants were healthy, non-smoking adults (18–65 years old) adhering to either a vegetarian/vegan or omnivore diet. Omnivores were matched to vegetarians using broad body mass index (BMI) categories. Results Arterial stiffness trended higher in omnivores versus vegetarians (7.0 ± 1.5 and 6.8 ± 1.1 m/s, respectively; p = 0.073). This trend was mainly driven by the male omnivores (p = 0.006 for gender effect and p = 0.294 for eating pattern effect). Omnivores displayed higher HDL concentrations compared to vegetarians, 63.8 ± 18.5 and 55.2 ± 16.9 mg/dL; however, total cholesterol/HDL ratio did not vary significantly between groups; p = 0.310. In men, a vegetarian eating pattern may reduce arterial stiffness; however, this benefit may be limited in women, particularly those who are premenopausal. Future research should examine arterial stiffness and cardiometabolic health outcomes in younger versus older female vegetarians, as these data can provide valuable insights on the role of plant-based eating patterns on arterial stiffness and cardiometabolic health.

ABSTRACT The impact of preexisting antibodies to the four endemic human coronaviruses (ehCoV) (229E, OC43, NL63, and HKU1) on severe (hospitalization) coronavirus disease 2019 (COVID-19) outcomes has been described in small cohorts. Many studies have measured ehCoV 229E, OC43, NL63, and HKU1 antibody levels weeks after recovery rather than in the first weeks of illness, which is more relevant to early hospitalizations. Antibody levels to the spike protein of the four coronaviruses (229E, OC43, NL63, and HKU1), as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were measured both before and immediately after convalescent or control plasma transfusion in 51 participants who were hospitalized and 250 who were not hospitalized, as well as in 71 convalescent and 50 control plasma donors as a subset from a completed randomized controlled trial. In COVID-19 convalescent plasma donors, the ehCoV spike antibodies were 1.2 to 2 times greater than the control donor unit levels, while donor COVID-19 convalescent plasma (CCP) SARS-CoV-2 spike antibodies were more than 600 times the control plasma units. Plasma transfusion, whether COVID-19 convalescent or control, did not alter the post-transfusion antibody levels for the endemic human coronaviruses (229E, OC43, NL63, and HKU1) in those hospitalized and not hospitalized, despite the 1.2- to 2-fold elevation in donor COVID-19 convalescent plasma. There was no influence of prior antibody levels to 229E, OC43, NL63, and HKU1 or post-transfusion antibody levels on subsequent hospitalization. These data, from a well-controlled prospective randomized clinical trial, add evidence that antibodies to ehCoV do not significantly impact COVID-19 outcomes, despite the apparent back-boosting of some ehCoV after SARS-CoV-2 infection. IMPORTANCE The relevance of preexisting immunity to the four endemic human coronaviruses in the first week of COVID-19 illness on the outcome of COVID-19 progression stems from the high prevalence of the ehCoV and SARS-CoV-2 coronaviruses. The question has been raised of whether therapeutic convalescent plasma or control plasma containing ehCoV antibodies might alter the outcome of COVID-19 progression to hospitalization. Here, we observed that plasma transfusion did not significantly change the preexisting ehCoV antibody levels. In over 50 hospitalized participants and 250 nonhospitalized participants, ehCoV antibody levels were comparable, without statistical differences. Antibody levels were stable over the more than 12 months of the intervention trial, with individual heterogeneity similar in hospitalized and nonhospitalized participants. The ehCoV antibodies in plasma transfusion did not alter the recipient preexisting antibody levels nor hasten the COVID-19 progression to hospitalization in this clinical trial data.

Background: The Prison Needle Exchange Program (PNEP) is a harm reduction initiative which involves providing people who are incarcerated (PWAI) with sterile injection equipment to avoid harms associated with unsterilized needle use, such as the spread of infectious diseases. While current evidence strongly supports the implementation and monitoring of PNEP, the program's success requires institutional support along with staff and prisoner commitment. Methods: The current study draws on interview data to examine policies surrounding PNEP and correctional officers’ (COs) (n = 134) perceptions and attitudes toward PNEP. Results: The COs in our sample were strongly in opposition to PNEP, with only a handful supporting PNEP. Emergent themes underpinning their opposition related to a sense of injustice and an inherent tension between introducing needles into the prison versus how they understand their occupational role and responsibilities. Conclusion: We conclude with a discussion of policy recommendations aimed at implementing PNEP collaboratively with staff to ensure the benefits of harm reduction are fostered and realized.

Public safety personnel are at an elevated risk for suicidal thoughts and behaviors relative to the general public. Correctional workers in particular report some of the highest prevalence of suicidal thoughts and behaviors. To better understand this phenomenon, the current study draws on qualitative, open-ended survey response data (n = 94) that explores three distinct themes (occupational environment, lack of support, social silence) and how entrenched notions of mental health stigma and occupational culture inform how Canadian correctional workers understand their experiences with suicidal thoughts and behaviors. We conclude with a brief discussion of the research and policy implications, with an emphasis on mobilizing efforts to normalize mental health discussion in correctional workplaces, bolstering peer support resources, and collaboration, and assessing the limited organizational supports available to struggling staff.

Low-cost, refrigerator-stable COVID-19 vaccines will facilitate global access and improve vaccine coverage in low- and middle-income countries. To this end, subunit-based approaches targeting the receptor-binding domain (RBD) of SARS-CoV-2 Spike protein remain attractive. Antibodies against RBD neutralize SARS-CoV-2 by blocking viral attachment to the host cell receptor, ACE2. Here, a yeast-produced recombinant RBD antigen (RBD-L452K-F490W or RBD-J) was formulated with various combinations of aluminum-salt (Alhydrogel®, AH; AdjuPhos®, AP) and CpG 1018 adjuvants. We assessed the effect of antigen-adjuvant interactions on the stability and mouse immunogenicity of various RBD-J preparations. While RBD-J was 50% adsorbed to AH and

Growing numbers of Americans are adopting vegetarian or vegan diets. While risk for some chronic conditions may be lower when following these diets, concern remains over the ability to consume adequate amounts of various nutrients, notably, protein. Knowing that serum creatinine is a reliable marker of muscle mass, this study examined the relationships between serum creatinine, lean body mass (LBM), handgrip strength, and protein intake in healthy vegetarian (n = 55) and omnivorous (n = 27) adults. Significantly higher protein intakes (+31%), LBM (+7%), serum creatinine (+12%) and handgrip strength (+14%) were observed for the omnivore participants compared to vegetarian participants. Positive correlations (p < 0.001) were noted between creatinine and LBM (R2 = 0.42), creatinine and handgrip strength (R2 = 0.41), protein intake and LBM (R2 = 0.29), and handgrip strength and LBM (R2 = 0.69). These data show that serum creatinine concentrations were lower in vegetarian women and men in comparison to their omnivorous counterparts and that serum creatinine concentrations correlate with LBM and strength in healthy adults, regardless of diet.

Erythrocyte fragility is amplified by oxidative stress and linked to diabetes-specific microvascular disease. Vitamin C supplementation improves glycemic indices in adults with type 2 diabetes (T2D) by improving antioxidant status. This cross-sectional study examined the relationships between vitamin C status and erythrocyte osmotic fragility in adults with or without T2D. Participants provided a fasting blood sample for erythrocyte osmotic fragility testing as a function of hypotonic NaCl concentrations. Additionally, plasma was stabilized with metaphosphoric acid prior to vitamin C analysis using isocratic reverse-phase UV-HPLC separation. Participants were grouped as diagnosed T2D (n = 14; 36% female; 55.5 ± 8.2 y; 31.5 ± 9.0 kg/m2; HbA1c: 7.4 ± 1.9%; plasma vitamin C: 36.0 ± 12.2 μM) or no diabetes (n = 16; 69% female; 38.7 ± 13.5 y; 26.8 ± 6.6 kg/m2; HbA1c: 5.4 ± 0.3%; plasma vitamin C: 34.8 ± 10.9 μM). Participant characteristics differed between groups only for age and hemoglobin A1c (HbA1c; p < 0.05). All hemolysis parameters were in normal ranges for the participants with T2D, and no significant differences in hemolysis parameters were noted between those with or without T2D. However, among participants with T2D, the NaCl concentration eliciting 50% hemolysis was higher for those with low (7%) HbA1c values (p = 0.037) indicating a slightly higher erythrocyte fragility in the former group. Vitamin C status did not impact any of the hemolysis parameters in adults with or without T2D. Thus, erythrocyte fragility was not elevated in T2D, and vitamin C nutriture was not related to erythrocyte fragility in adults with well-controlled T2D.

ABSTRACT The ongoing COVID-19 pandemic has contributed largely to the global vaccine disparity. Development of protein subunit vaccines can help alleviate shortages of COVID-19 vaccines delivered to low-income countries. Here, we evaluated the efficacy of a three-dose virus-like particle (VLP) vaccine composed of hepatitis B surface antigen (HBsAg) decorated with the receptor binding domain (RBD) from the Wuhan or Beta SARS-CoV-2 strain adjuvanted with either aluminum hydroxide (alum) or squalene in water emulsion (SWE). RBD HBsAg vaccines were compared to the standard two doses of Pfizer mRNA vaccine. Alum-adjuvanted vaccines were composed of either HBsAg conjugated with Beta RBD alone (β RBD HBsAg+Al) or a combination of both Beta RBD HBsAg and Wuhan RBD HBsAg (β/Wu RBD HBsAg+Al). RBD vaccines adjuvanted with SWE were formulated with Beta RBD HBsAg (β RBD HBsAg+SWE) or without HBsAg (β RBD+SWE). Both alum-adjuvanted RBD HBsAg vaccines generated functional RBD IgG against multiple SARS-CoV-2 variants of concern (VOC), decreased viral RNA burden, and lowered inflammation in the lung against Alpha or Beta challenge in K18-hACE2 mice. However, only β/Wu RBD HBsAg+Al was able to afford 100% survival to mice challenged with Alpha or Beta VOC. Furthermore, mice immunized with β RBD HBsAg+SWE induced cross-reactive neutralizing antibodies against major VOC of SARS-CoV-2, lowered viral RNA burden in the lung and brain, and protected mice from Alpha or Beta challenge similarly to mice immunized with Pfizer mRNA. However, RBD+SWE immunization failed to protect mice from VOC challenge. Our findings demonstrate that RBD HBsAg VLP vaccines provided similar protection profiles to the approved Pfizer mRNA vaccines used worldwide and may offer protection against SARS-CoV-2 VOC. IMPORTANCE Global COVID-19 vaccine distribution to low-income countries has been a major challenge of the pandemic. To address supply chain issues, RBD virus-like particle (VLP) vaccines that are cost-effective and capable of large-scale production were developed and evaluated for efficacy in preclinical mouse studies. We demonstrated that RBD-VLP vaccines protected K18-hACE2 mice against Alpha or Beta challenge similarly to Pfizer mRNA vaccination. Our findings showed that the VLP platform can be utilized to formulate immunogenic and efficacious COVID-19 vaccines.

Abstract Background Cardinality matching (CM), a novel matching technique, finds the largest matched sample meeting prespecified balance criteria thereby overcoming limitations of propensity score matching (PSM) associated with limited covariate overlap, which are especially pronounced in studies with small sample sizes. The current study proposes a framework for large-scale CM (LS-CM); and compares large-scale PSM (LS-PSM) and LS-CM in terms of post-match sample size, covariate balance and residual confounding at progressively smaller sample sizes. Methods Evaluation of LS-PSM and LS-CM within a comparative cohort study of new users of angiotensin-converting enzyme inhibitor (ACEI) and thiazide or thiazide-like diuretic monotherapy identified from a U.S. insurance claims database. Candidate covariates included patient demographics, and all observed prior conditions, drug exposures and procedures. Propensity scores were calculated using LASSO regression, and candidate covariates with non-zero beta coefficients in the propensity model were defined as matching covariates for use in LS-CM. One-to-one matching was performed using progressively tighter parameter settings. Covariate balance was assessed using standardized mean differences. Hazard ratios for negative control outcomes perceived as unassociated with treatment (i.e., true hazard ratio of 1) were estimated using unconditional Cox models. Residual confounding was assessed using the expected systematic error of the empirical null distribution of negative control effect estimates compared to the ground truth. To simulate diverse research conditions, analyses were repeated within 10 %, 1 and 0.5 % subsample groups with increasingly limited covariate overlap. Results A total of 172,117 patients (ACEI: 129,078; thiazide: 43,039) met the study criteria. As compared to LS-PSM, LS-CM was associated with increased sample retention. Although LS-PSM achieved balance across all matching covariates within the full study population, substantial matching covariate imbalance was observed within the 1 and 0.5 % subsample groups. Meanwhile, LS-CM achieved matching covariate balance across all analyses. LS-PSM was associated with better candidate covariate balance within the full study population. Otherwise, both matching techniques achieved comparable candidate covariate balance and expected systematic error. Conclusions LS-CM found the largest matched sample meeting prespecified balance criteria while achieving comparable candidate covariate balance and residual confounding. We recommend LS-CM as an alternative to LS-PSM in studies with small sample sizes or limited covariate overlap.

Abstract Investigations of magnetically ordered phases on the femtosecond timescale have provided significant insights into the influence of charge and lattice degrees of freedom on the magnetic sub-system. However, short-range magnetic correlations occurring in the absence of long-range order, for example in spin-frustrated systems, are inaccessible to many ultrafast techniques. Here, we show how time-resolved resonant inelastic X-ray scattering (trRIXS) is capable of probing such short-ranged magnetic dynamics in a charge-transfer insulator through the detection of a Zhang–Rice singlet exciton. Utilizing trRIXS measurements at the O K-edge, and in combination with model calculations, we probe the short-range spin correlations in the frustrated spin chain material CuGeO3 following photo-excitation, revealing a strong coupling between the local lattice and spin sub-systems.