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Contemporary research has begun to show a strong relationship between movements and the perception of time. More specifically, concurrent movements serve to both bias and enhance time estimates. To explain these effects, we recently proposed a mechanism by which movements provide a secondary channel for estimating duration that is combined optimally with sensory estimates. However, a critical test of this framework is that by introducing noise into movements, sensory estimates of time should similarly become noisier. To accomplish this, we had human participants move a robotic arm while estimating intervals of time in either auditory or visual modalities (n = 24, ea.). Crucially, we introduced an artificial tremor in the arm while subjects were moving, that varied across three levels of amplitude (1-3 N) or frequency (4-12 Hz). The results of both experiments revealed that increasing the frequency of the tremor led to noisier estimates of duration. Further, the effect of noise varied with the base precision of the interval, such that a naturally less precise timing (i.e., visual) was more influenced by the tremor than a naturally more precise modality (i.e., auditory). To explain these findings, we fit the data with a recently developed drift-diffusion model of perceptual decision-making, in which the momentary, within-trial variance was allowed to vary across conditions. Here, we found that the model could recapitulate the observed findings, further supporting the theory that movements influence perception directly. Overall, our findings support the proposed framework, and demonstrate the utility of inducing motor noise via artificial tremors.

Abstract Background African cattle represent a unique resource of genetic diversity in response to adaptation to numerous environmental challenges. Characterising the genetic landscape of indigenous African cattle and identifying genomic regions and genes of functional importance can contribute to targeted breeding and tackle the loss of genetic diversity. However, pinpointing the adaptive variant and determining underlying functional mechanisms of adaptation remains challenging. Results In this study, we use selection signatures from whole-genome sequence data of eight indigenous African cattle breeds in combination with gene expression and quantitative trait loci (QTL) databases to characterise genomic targets of artificial selection and environmental adaptation and to identify the underlying functional candidate genes. In general, the trait-association analyses of selection signatures suggest the innate and adaptive immune system and production traits as important selection targets. For example, a large genomic region, with selection signatures identified for all breeds except N’Dama, was located on BTA27, including multiple defensin DEFB coding-genes. Out of 22 analysed tissues, genes under putative selection were significantly enriched for those overexpressed in adipose tissue, blood, lung, testis and uterus. Our results further suggest that cis-eQTL are themselves selection targets; for most tissues, we found a positive correlation between allele frequency differences and cis-eQTL effect size, suggesting that positive selection acts directly on regulatory variants. Conclusions By combining selection signatures with information on gene expression and QTL, we were able to reveal compelling candidate selection targets that did not stand out from selection signature results alone (e.g. GIMAP8 for tick resistance and NDUFS3 for heat adaptation). Insights from this study will help to inform breeding and maintain diversity of locally adapted, and hence important, breeds.

INTRODUCTION: Lung cancer screening is widely underutilized. Organizational factors, such as readiness for change and belief in the value of change (change valence), may contribute to underutilization. The aim of this study was to evaluate the association between healthcare organizations preparedness and lung cancer screening utilization. METHODS: Investigators cross-sectionally surveyed clinicians, staff, and leaders at10 Veterans Affairs from November 2018 to February 2021 to assess organizational readiness to implement change. In 2022, investigators used simple and multivariable linear regression to evaluate the associations between facility-level organizational readiness to implement change and change valence with lung cancer screening utilization. Organizational readiness to implement change and change valence were calculated from individual surveys. The primary outcome was the proportion of eligible Veterans screened using low-dose computed tomography. Secondary analyses assessed scores by healthcare role. RESULTS: The overall response rate was 27.4% (n=1,049), with 956 complete surveys analyzed: median age of 49 years, 70.3% female, 67.6% White, 34.6% clinicians, 61.1% staff, and 4.3% leaders. For each 1-point increase in median organizational readiness to implement change and change valence, there was an associated 8.4-percentage point (95% CI=0.2, 16.6) and a 6.3-percentage point increase in utilization (95% CI= -3.9, 16.5), respectively. Higher clinician and staff median scores were associated with increased utilization, whereas leader scores were associated with decreased utilization after adjusting for other roles. CONCLUSIONS: Healthcare organizations with higher readiness and change valence utilized more lung cancer screening. These results are hypothesis generating. Future interventions to increase organizations preparedness, especially among clinicians and staff, may increase lung cancer screening utilization.

Abstract Electrospray ionization is widely used to generate vapor phase ions for analysis by mass spectrometry in proteomics research. However, only a small fraction of the analyte enters the mass spectrometer due to losses that are fundamentally linked to the use of a background gas to stimulate the generation of ions from electrosprayed droplets. Here we report a nanopore ion source that delivers ions directly into high vacuum from aqueous solutions. The ion source comprises a pulled quartz pipette with a sub-100 nm opening. Ions escape an electrified meniscus by ion evaporation and travel along collisionless trajectories to the ion detector. We measure mass spectra of 16 different amino acid ions, post-translationally modified variants of glutathione, and the peptide angiotensin II, showing that these analytes can be emitted as desolvated ions. The emitted current is composed of ions rather than charged droplets, and more than 90% of the current can be recovered in a distant collector.

BackgroundCervical cancer oncogenesis starts with human papillomavirus (HPV) cell entry after binding to host cell surface receptors; however, the mechanism is not fully known. We examined polymorphisms in receptor genes hypothesized to be necessary for HPV cell entry and assessed their associations with clinical progression to precancer.MethodsAfrican American women (N = 1,728) from the MACS/WIHS Combined Cohort Study were included. Two case-control study designs were used-cases with histology-based precancer (CIN3+) and controls without; and cases with cytology-based precancer [high-grade squamous intraepithelial lesions (HSIL)] and controls without. SNPs in candidate genes (SDC1, SDC2, SDC3, SDC4, GPC1, GPC2, GPC3, GPC4, GPC5, GPC6, and ITGA6) were genotyped using an Illumina Omni2.5-quad beadchip. Logistic regression was used to assess the associations in all participants and by HPV genotypes, after adjusting for age, human immunodeficiency virus serostatus, CD4 T cells, and three principal components for ancestry.ResultsMinor alleles in SNPs rs77122854 (SDC3), rs73971695, rs79336862 (ITGA6), rs57528020, rs201337456, rs11987725 (SDC2), rs115880588, rs115738853, and rs9301825 (GPC5) were associated with increased odds of both CIN3+ and HSIL, whereas, rs35927186 (GPC5) was found to decrease the odds for both outcomes (P value ≤ 0.01). Among those infected with Alpha-9 HPV types, rs722377 (SDC3), rs16860468, rs2356798 (ITGA6), rs11987725 (SDC2), and rs3848051 (GPC5) were associated with increased odds of both precancer outcomes.ConclusionsPolymorphisms in genes that encode binding receptors for HPV cell entry may play a role in cervical precancer progression.ImpactOur findings are hypothesis generating and support further exploration of mechanisms of HPV entry genes that may help prevent progression to cervical precancer.

ABSTRACTThis work aims to derive a mathematical model that describes the thermal conductivity of the elastic single jersey knitted fabric (SJKF) based on the loop geometry and the yarn and fibers inclination on the direction of heat flow, and to assist the manufactures of elastic SJKF to predict the thermal conductivity from the fabric construction parameters. The main fabric construction parameters in this model are yarn count, loop length, and spandex weight percent. To validate the proposed model, elastic SJKF samples were produced at two different counts and five levels of loop length and spandex weight percent. The thermal conductivity of these samples was measured and compared to the predicted values from the new model rather than the previous three models (Maxwell – Eucken 2, Schuhmeister, Militky models). From the results, it could be concluded that the values of thermal conductivity from the model are very closed to the experimental values; therefore, the new model could be used to predict the thermal conductivity of elastic SJKF.

Background and Objectives It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents’ self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care.Methods Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination.Results Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)).Conclusions An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.

Objectives: Sentinel lymph node (SLN) mapping is a surgical technique with high accuracy in detecting metastases while limiting morbidity associated with full lymphadenectomy in endometrial cancer. Cervical injection of indocyanine green (ICG) dye is associated with very high SLN detection rates; however, iodinated contrast allergy has traditionally been viewed as a contraindication to ICG use. The objective of this study was to describe the use of ICG in a population of patients with iodinated contrast allergies undergoing surgical staging for endometrial cancer. Methods: IRB approval was obtained. All patients with clinically early-stage endometrial cancer who underwent minimally invasive surgical staging with SLN mapping with ICG at a single academic institution from 1/1/2017 to 12/31/2020 were identified retrospectively. Patients with reported iodinated contrast allergies prior to surgery were identified. Data were collected through electronic medical record review and compared using descriptive statistics. Results: 820 patients who underwent minimally invasive surgical staging with SLN mapping with ICG were identified, and 25 had documented iodinated contrast allergies. Documented reactions included rash/hives (n = 10, 40 %), anaphylaxis (n = 6, 24 %), shortness of breath (n = 5, 20 %), diarrhea (n = 1, 4 %), and not specified (n = 3, 12 %). A majority (24/25, 96 %) received 4 mg intravenous dexamethasone during induction of general anesthesia as per the institutional enhanced recovery after surgery (ERAS) protocol. No patients experienced allergic reactions or other adverse events after ICG injection. Conclusions: No patients in this cohort demonstrated an adverse reaction after ICG injection for SLN mapping. This study supports the reasonable safety of ICG in patients with contrast allergies, particularly when routine ERAS protocols containing dexamethasone are utilized.

Summary: Intervertebral disc (IVD) defects heal poorly and can cause back pain and disability. We identified that IVD herniation injury heals regeneratively in neonatal mice until postnatal day 14 (p14) and shifts to fibrotic healing by p28. This age coincides with the shift in expansive IVD growth from cell proliferation to matrix elaboration, implicating collagen crosslinking. β-aminopropionitrile treatment reduced IVD crosslinking and caused fibrotic healing without affecting cell proliferation. Bulk sequencing on naive IVDs was depleted for matrix structural organization from p14 to p28 to validate the importance of crosslinking in regenerative healing. We conclude that matrix changes are key drivers in the shift to fibrotic healing, and a stably crosslinked matrix is needed for IVD regeneration.

OBJECTIVE: This study aims to identify blood biomarkers of postoperative delirium. BACKGROUND: Phosphorylated tau at threonine 217 (Tau-PT217) and 181 (Tau-PT181) are new Alzheimer disease biomarkers. Postoperative delirium is associated with Alzheimer disease. We assessed associations between Tau-PT217 or Tau-PT181 and postoperative delirium. METHODS: Of 491 patients (65 years old or older) who had a knee replacement, hip replacement, or laminectomy, 139 participants were eligible and included in the analysis. Presence and severity of postoperative delirium were assessed in the patients. Preoperative plasma concentrations of Tau-PT217 and Tau-PT181 were determined by a newly established Nanoneedle technology. RESULTS: Of 139 participants (73±6 years old, 55% female), 18 (13%) developed postoperative delirium. Participants who developed postoperative delirium had higher preoperative plasma concentrations of Tau-PT217 and Tau-PT181 than participants who did not. Preoperative plasma concentrations of Tau-PT217 or Tau-PT181 were independently associated with postoperative delirium after adjusting for age, education, and preoperative Mini-Mental State score [odds ratio (OR) per unit change in the biomarker: 2.05, 95% confidence interval (CI):1.61-2.62, P

Relative submergence of macroroughness elements such as boulders and bedrock outcrops, or large bed elements (LBEs), collectively, is a primary control on hydraulics and morphodynamics in steep, coarse-bedded rivers. However, in practice, the property is typically represented by singular, often reach- or cross-section-averaged values that mask bed-surface heterogeneity and joint distributions of local flow depths. By coupling sub-meter resolution two-dimensional (2D) hydrodynamic modeling with spatially explicit mapping of LBEs from a 13.2 km segment of a boulder-bedded mountain river, we present complete distributions of LBE relative submergences at multiple spatial scales and explore their dynamism across discharges. Through distribution fitting and statistical analysis of resultant discharge-dependent LBE relative submergence datasets, it was confirmed that segment- and reach-scale datasets exhibited similar statistical properties and were able to be drawn from the same type of distribution. Further, the rate at which statistical and parametric properties changed between discharge-dependent datasets were statistically equivalent between spatial domains, which we term “process-based similarity”. Commonality in distribution type and the uniform between discharge–scaling relationships suggest mutual self-organizing processes associated with the size-frequency distribution, spatial arrangement, and submergence of LBEs were present between most domains.

Lexical tone languages like Mandarin Chinese require listeners to discriminate among different pitch patterns. A syllable spoken with a rising pitch (e.g. "b[i-acute]" 'nose') carries a different meaning than the same syllable spoken with a falling pitch (e.g. "b[i with grave]" 'arm'). For native speakers (L1) of a non-tonal language, accurate perception of tones in a second language (L2) is notoriously difficult. Musicians, however, have typically shown an aptitude for lexical tone learning due to the unique perceptual demands of music. This study tested whether musical effects can be exploited to improve linguistic abilities in the general population. A pre-test, 8-week training, post-test design was used to measure L1 English participants' sensitivity to tone. Individual Differences Scaling was used to measure participants' weighting of pitch height and movement cues. Participants took part in classroom Mandarin learning only (+L2), musical ear training only (+Music), or classroom learning combined with musical training (+L2+Music). An L1 Mandarin group served as a baseline. At pre-test, mean sensitivity to tone and multidimensional scaling results were similar across all three L1 English groups. After training, all three L1 English groups improved in mean sensitivity, though only the +L2+Music group did so at a significant rate. Multidimensional scaling revealed that all groups increased their weighting of the more informative pitch movement cue at roughly equal rates. Short-term musical training thus affected change in cue weighting of linguistic pitch in a manner comparable to that occurring after a semester of L2 classroom learning. When combined with classroom learning, short-term musical training resulted in even greater sensitivity to pitch movement cues. These results contribute to models of music-language interaction and suggest that focused application of non-linguistic acoustic training can improve phonetic perception in ways that are relevant to language learning.

Introduction: Non-bacterial thrombotic endocarditis is well documented in the literature to occur in patients with known malignancies. It is, however, much less common for patients to be diagnosed with marantic endocarditis as the presenting sign of an unknown primary malignancy. Case Presentation: We discuss a case in which a patient was undergoing routine surveillance for his known heart failure with a transthoracic echocardiogram when an aortic valve vegetation was discovered. After further investigation, he was found to have metastatic adenocarcinoma of the lung. Next-generation sequencing was utilized to identify an EGFR mutation, which led to the patient being treated with osimertinib. Conclusion: Adequate treatment of his primary malignancy, along with anticoagulation, led to overall clinical improvement of the patient.

Abstract Expanded graphite has promising potential environmental applications due to its porous structure and oleophilic nature, which allow it to absorb large quantities of oil. The material is produced by intercalating graphite and applying heat to convert the intercalant into gas to cause expansion between the layers in the graphite. Using different intercalants and temperature conditions results in varying properties of expanded graphite. This work has proven that the sorption properties of commercial expanded graphite differ significantly due to the material’s structural and elemental characteristics, which can be attributed to the intercalation method. This resulted in various degrees of exfoliation of the graphite and possible functionalisation of the graphene sheets within the structure. This affected the material's sorption capacity and its affinity for heavy metal sorption by incorporating selectivity towards the sorption of certain metals. It was found that sample EG3, which underwent a less harsh expansion, exhibited lower porosity than EG1, and thus, the sample absorbed less oil at 37.29 g/g compared to the more expanded samples EG1 and EG2 with 55.16 g/g and 48.82 g/g, respectively. However, it was able to entrap a wider variety of metal particles compared to EG1 and EG2, possibly due to its smaller cavities allowing for a capillary effect between the graphene sheets and greater Van der Waals forces. A second possibility is that ionic or coordination complexes could form with certain metals due to the possible functionalisation of the expanded graphite during the intercalation process. This would be in addition to coordination between the metals and expanded graphite carbon atoms. The findings suggest that there is evidence of functionalisation as determined by XRD and elemental analyses. However, further investigation is necessary to confirm this hypothesis. The findings in this work suggest that the first mechanism of sorption was more likely to be related to the degree of expansion of the expanded graphite. Various metals are present in used oil, and their removal can be challenging. Some metals in oil are not considered heavy since they have a relatively low density but can be associated with heavy metals in terms of toxicity.

Abstract Kawasaki disease (KD) is a multisystem inflammatory illness of infants and young children that can result in acute vasculitis. The mechanism of coronary artery aneurysms (CAA) in KD despite intravenous gamma globulin (IVIG) treatment is not known. We performed a Whole Genome Sequencing (WGS) association analysis in a racially diverse cohort of KD patients treated with IVIG, both using AHA guidelines. We defined coronary aneurysm (CAA) (N = 234) as coronary z ≥ 2.5 and large coronary aneurysm (CAA/L) (N = 92) as z ≥ 5.0. We conducted logistic regression models to examine the association of genetic variants with CAA/L during acute KD and with persistence >6 weeks using an additive model between cases and 238 controls with no CAA. We adjusted for age, gender and three principal components of genetic ancestry. The top significant variants associated with CAA/L were in the intergenic regions (rs62154092 p

Our subjective sense of time is intertwined with a plethora of perceptual, cognitive and motor functions, and likewise, the brain is equipped to expertly filter, weight and combine these signals for seamless interactions with a dynamic world. Until relatively recently, the literature on time perception has excluded the influence of simultaneous motor activity, yet it has been found that motor circuits in the brain are at the core of most timing functions. Several studies have now identified that concurrent movements exert robust effects on perceptual timing estimates, but critically have not assessed how humans consciously judge the duration of their own movements. This creates a gap in our understanding of the mechanisms driving movement-related effects on sensory timing. We sought to address this gap by administering a sensorimotor timing task in which we explicitly compared the timing of isolated auditory tones and arm movements, or both simultaneously. We contextualized our findings within a Bayesian cue combination framework, in which separate sources of temporal information are weighted by their reliability and integrated into a unitary time estimate that is more precise than either unisensory estimate. Our results revealed differences in accuracy between auditory, movement and combined trials, and (crucially) that combined trials were the most accurately timed. Under the Bayesian framework, we found that participants' combined estimates were more precise than isolated estimates, yet were sub-optimal when compared with the model's prediction, on average. These findings elucidate previously unknown qualities of conscious motor timing and propose computational mechanisms that can describe how movements combine with perceptual signals to create unified, multimodal experiences of time.

Flooding is among the costliest and deadliest weather disasters. Moreover, different types of flooding have significant impacts on the transportation network and infrastructure including flash, riverine, urban, coastal, and storm surge. The variety of flooding scenarios makes it challenging to quantify the impacts of flooding on transportation across spatial scales; however, such metrics would be beneficial both prior to and after the event. Pre-flood metrics can promote enhanced impact-based decision-support guidance and hazard communication, while post-flood metrics may include larger regional disruptions located away from the most inundated areas and their associated secondary societal impacts. This study developed a retrospective Roadway Flood-Severity Index (RFSI) from 1982 to 2020 capable of integrating geo-located hydrometeorological data and transportation mobility information across localized and multi-state, sub-national regions to (1) categorize larger-scale, flood-related transportation disruptions, (2) understand the origins of those disruptions, and (3) identify severity risk levels of individual road segments and broader regions of transportation disruption during flood events. The fundamental question is, as flooding events unfold, can past hydrometeorological inundation information be coupled with transportation system network and mobility data to identify the most vulnerable roadway segments and regions? The overall mobility impacts of flooding on transportation were highly variable and relatively uncommon throughout the study period. Given this variability in other mobility data (e.g., vehicle speeds), hydrometeorological parameters were used exclusively as model inputs and crowdsourced Waze flood reports were used as the target response variable. A logistic regression based RFSI was found to best align with the dataset providing a “no flood” or “flood” classification. Eventually, this retrospective analysis will be extended to provide predictive capability as well. The RFSI is intended to provide transportation agencies with a quantitative metric to classify, categorize, and communicate the potential impacts of flood events throughout the transportation network.

BACKGROUND: The number of youth presenting to hospitals with suicidality and/or self-harm has increased substantially in recent years. We implemented a multihospital quality improvement (QI) collaborative from February 1, 2018 to January 31, 2019, aiming for an absolute increase in hospitals mean rate of caregiver lethal means counseling (LMC) of 10 percentage points (from a baseline mean performance of 68% to 78%) by the end of the collaborative, and to evaluate the effectiveness of the collaborative on LMC, adjusting for secular trends. METHODS: This 8 hospital collaborative used a structured process of alternating learning sessions and action periods to improve LMC across hospitals. Electronic medical record documentation of caregiver LMC was evaluated during 3 phases: precollaborative, active QI collaborative, and postcollaborative. We used statistical process control to evaluate changes in LMC monthly. Following collaborative completion, interrupted time series analyses were used to evaluate changes in the level and trend and slope of LMC, adjusting for covariates. RESULTS: In the study, 4208 children and adolescents were included-1314 (31.2%) precollaborative, 1335 (31.7%) during the active QI collaborative, and 1559 (37.0%) postcollaborative. Statistical process control analyses demonstrated that LMC increased from a hospital-level mean of 68% precollaborative to 75% (February 2018) and then 86% (October 2018) during the collaborative. In interrupted time series analyses, there were no significant differences in LMC during and following the collaborative beyond those expected based on pre-collaborative trends. CONCLUSIONS: LMC increased during the collaborative, but the increase did not exceed expected trends. Interventions developed by participating hospitals may be beneficial to others aiming to improve LMC for caregivers of hospitalized youth with suicidality.