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The attitudes toward genomics and precision medicine (AGPM) measure examines attitudes toward activities such as genetic testing, gene editing, and biobanking. This is a useful tool for research on the ethical, legal, and social implications of genomics, a major program within the National Institutes of Health. We updated the AGPM to explore controversies over mRNA vaccines. This brief report examines the factor structure of the updated AGPM using a sample of 4939 adults in the USA. The updated AGPM’s seven factors include health benefits, knowledge benefits, and concerns about the sacredness of life, privacy, gene editing, mRNA vaccines, and social justice.
We present a novel scheme for rapid quantitative analysis of debris generated during experiments with solid targets following relativistic laser–plasma interaction at high-power laser facilities. Results are supported by standard analysis techniques. Experimental data indicate that predictions by available modelling for non-mass-limited targets are reasonable, with debris of the order of hundreds of μg per shot. We detect for the first time two clearly distinct types of debris emitted from the same interaction. A fraction of the debris is ejected directionally, following the target normal (rear and interaction side). The directional debris ejection towards the interaction side is larger than on the side of the target rear. The second type of debris is characterized by a more spherically uniform ejection, albeit with a small asymmetry that favours ejection towards the target rear side.
Flow generation by colloidal motors activated by external stimuli is an important issue for active matter physics and several nanotechnological or biomedical applications. For instance, flow recirculation generated by rotating magnetic self-assemblies allows effective ‘pumping’ of a thrombolytic drug towards a blood clot along a blocked vessel. However, the physics of the flow generation in this case remains still poorly explored. This study is focused on the generation of a recirculation flow of a magnetic colloid (aqueous suspension of iron oxide nanoparticles with partially screened electrostatic repulsion) within a closed microfluidic channel via application of an external rotating magnetic field. The colloid undergoes reversible phase separation manifested through the appearance of micron-sized elongated aggregates. They synchronously rotate with the magnetic field and can generate macroscopic flows only in the presence of gradients of the aggregate concentration across the channel induced by superposition of a weak magnetic field gradient to the homogeneous rotating field. We achieve recirculation flows with a characteristic speed ${\sim} 5{-}8\;{\rm \mu}\textrm{m}\;{\textrm{s}^{ - \textrm{1}}}$ at low magnetic field amplitude and frequency (${H_0} \approx 3{-}10\;\textrm{kA}\;{\textrm{m}^{ - 1}}$, ${f = 5{-}15\ \textrm{Hz}}$) at low nanoparticle volume fraction ${\varphi _p} = (1.6{-}3.2) \times {10^{ - 3}}$. The concentration and velocity profiles have been assessed experimentally through particle tracking and particle image velocimetry, and have also been computed using the hydrodynamic diffusion approach coupled with the momentum balance equation with a magnetic torque term. The model correctly reproduces the shape of the experimental concentration and velocity fields and explains complex behaviours of the average recirculation speed as a function of governing parameters (${H_0}$, f, ${\varphi _p}$, channel size).
There is limited information on the antibody responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in subjects from developing countries with populations having a high incidence of co-morbidities. Here, we analysed the immunogenicity of homologous schemes using the ChAdOx1-S, Sputnik V, or BNT162b2 vaccines and the effect of a booster dose with ChAdOx1-S in middle-aged adults who were seropositive or seronegative to the SARS-CoV-2 spike protein before vaccination. The study was conducted post-vaccination with a follow-up of 4 months for antibody titre using enzyme-linked immunosorbent assay (ELISA) and pseudovirus (PV) neutralization assays (PNAs). All three vaccines elicited a superior IgG anti-receptor-binding domain (RBD) and neutralization response against the Alpha and Delta variants when administered to individuals with a previous infection by SARS-CoV-2. The booster dose spiked the neutralization activity among individuals with and without a prior SARS-CoV-2 infection. The ChAdOx1-S vaccine induced weaker antibody responses in infection-naive subjects. A follow-up of 4 months post-vaccination showed a drop in antibody titre, with about 20% of the infection-naive and 100% of SARS-CoV-2 pre-exposed participants with detectable neutralization capacity against Alpha pseudovirus (Alpha-PV) and Delta PV (Delta-PV). Our observations support the use of different vaccines in a country with high seroprevalence at the vaccination time.
Satellite data analysis of a compressed gyro-scale current sheet prior to magnetic reconnection in the magnetotail shows that electrostatic lower hybrid waves localized to the region of a transverse ambipolar electric field at the centre of the current sheet are driven by $\boldsymbol{E} \times \boldsymbol{B}$ velocity shear and result from compression. The presence and location of shear-driven waves around the centre of the current sheet, where the magnetic field reverses and the density gradient is minimal, is consistent with our model. This is notable because the free energy source is the curvature of the electron $\boldsymbol{E} \times \boldsymbol{B}$ flow and not the density gradient. Laboratory experiments and particle-in-cell (PIC) simulations have shown that shear-driven lower hybrid fluctuations are capable of producing anomalous cross-field transport (viscosity) and resistivity, which can trigger magnetic reconnection. We estimate the terms in the generalized Ohm's Law directly from MMS data as the spacecraft cross a gyro-scale current sheet. Our analysis shows that the wave effects (resistivity, diffusion and viscosity) and pressure anisotropy effects are comparable. We also find that the quasi-static electric field gradient is correlated with a non-gyrotropic electron distribution function, which is consistent with our model. Furthermore, theoretical arguments suggest agyrotropy is an indicator of the possibility for magnetic reconnection to occur.
State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious wrongdoing by physicians.
We record 392 species or morphospecies of bees (Hymenoptera: Apoidea) for Manitoba, Canada, which is 154 more species than reported in 2015 and includes five new generic records since 2015 (Ashmeadiella, Brachymelecta, Eucera, Neolarra, and Triepeolus). Thirteen new records reported here are new for Canada: Calliopsis (Nomadopsis) australior Cockerell, Perdita (Perdita) tridentata Stevens, Brachymelecta interrupta (Cresson), Diadasia (Dasiapis) ochracea (Cockerell), Melissodes bidentis Cockerell, Nomada crawfordi crawfordi Cockerell, Nomada fuscicincta Swenk, Nomada sphaerogaster Cockerell, Nomada xantholepis Cockerell, Triepeolus cf. grindeliae Cockerell, Dianthidium (Dianthidium) parvum (Cresson), Coelioxys (Xerocoelioxys) nodis Baker, and Megachile (Megachiloides) dakotensis Mitchell. We remove the following species from the list of Manitoba bees based on re-examination of voucher material: Andrena (Ptilandrena) geranii Robertson, Andrena (Rhacandrena) robertsonii Dalla Torre, Andrena (Simandrena) nasonii Robertson, Andrena (Trachandrena) ceanothi Viereck, Andrena (Trachandrena) quintilis Robertson, Lasioglossum (Hemihalictus) pectoraloides (Cockerell), Lasioglossum (Lasioglossum) forbesii (Robertson), and Dianthidium (Dianthidium) concinnum (Cresson). We propose that Nomada alpha paralpha Cockerell, 1921 and N. alpha dialpha Cockerell, 1921 are junior synonyms of N. alpha Cockerell, 1905. Nomada arenicola Swenk, 1912 is considered a junior synonym of N. fervida Smith, 1854. Protandrena albertensis (Cockerell) and Neolarra mallochi Michener are recognised as valid species. We provide additional notes on taxonomy, nomenclature, and behaviour for select species in the list.
Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes.
Methods:
We conducted a 1-year trial with clinical research professionals in the USA (n = 1284) who have trials open to older adults or focus on Alzheimer’s disease. We randomized participants to receive information on ECPs via receiving a toolkit with a social media push (intervention) or receiving an online learning module (active control). Participants completed a baseline survey and a follow-up survey after 1 year. A subset of participants was interviewed (n = 43).
Results:
Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial than participants less engaged with the toolkit or the active control group. However, there were no significant differences in the adoption of ECPs, intention to adopt, or positive attitudes. Participants reported the toolkit and social media push were satisfactory, and participating increased their awareness of ECPs. However, they reported lacking the time needed to engage with the toolkit more fully.
Conclusions:
Using an implementation science approach to increase the use of ECPs was only modestly successful. Data suggest that having institutional review boards recommend or require ECPs may be an effective way to increase their use.
Background: PET imaging of [11C]ABP688 shows reduced hippocampal mGluR5 availability in mesial temporal lobe epilepsy (MTLE) patients, however the relation with post-surgical outcomes is unclear. Here, we tested whether [11C]ABP688 binding in hippocampal subfields vulnerable to glutamate excitotoxicity is related to post-surgical outcome. Methods: [11C]ABP688-PET was obtained from 31 unilateral MTLE patients and 30 controls. Hippocampal subfields were automatically segmented into 1) CA1-3, 2) CA4/dentate gyrus (DG), 3) Subiculum and manually corrected. Partial volume corrected [11C]ABP688 non-displaceable binding potential (BPND) was calculated in the subfields and compared between seizure-free and non-seizure-free patients. Results: [11C]ABP688 BPND was significantly reduced in ipsilateral CA1-3 & CA4/DG (p<0.001) compared to controls. No difference was seen in Subiculum. Ipsilateral CA1-3 [11C]ABP688 BPND was lower in seizure-free (p=0.012; Engel Ia, n=13) vs non-seizure- free (Engel Ic-III, n=10) patients, and this effect was independent of subfield volume. In a subset of patients with [18F]FDG-PET, CA1-3 [11C]ABP688 BPND was significantly lower in seizure-free patients (p=0.03), while no difference was found for [18F]FDG uptake. Conclusions: Reduced CA1-3 mGluR5 availability was associated with post-surgical seizure-freedom independent of atrophy and hypometabolism. Thus, [11C]ABP688-PET may offer a potential biomarker for surgical outcomes and may be particularly relevant for pre-surgical workup in MRI- and [18F]FDG-negative MTLE patients.
Background: PET imaging of [11C]ABP688 shows reduced hippocampal mGluR5 availability in mesial temporal lobe epilepsy (MTLE) patients, however the relation with post-surgical outcomes is unclear. Here, we tested whether [11C]ABP688 binding in hippocampal subfields vulnerable to glutamate excitotoxicity is related to post-surgical outcome. Methods: [11C]ABP688-PET was obtained from 31 unilateral MTLE patients and 30 controls. Hippocampal subfields were automatically segmented into 1) CA1-3, 2) CA4/dentate gyrus (DG), and 3) Subiculum and manually corrected. Partial volume corrected [11C]ABP688 non-displaceable binding potential (BPND) was calculated in the subfields and compared between seizure-free and non-seizure-free patients. Results: [11C]ABP688 BPND was significantly reduced in ipsilateral CA1-3 & CA4/DG (p<0.001) compared to controls. No difference was seen in Subiculum. Ipsilateral CA1-3 [11C]ABP688 BPND was lower in seizure-free (p=0.012; Engel Ia, n=13) vs non-seizure-free (Engel Ic-III, n=10) patients, and this effect was independent of subfield volume. In a subset of patients with [18F]FDG-PET, CA1-3 [11C]ABP688 BPND was significantly lower in seizure-free patients (p=0.03), while no difference was found for [18F]FDG uptake. Conclusions: Reduced CA1-3 mGluR5 availability was associated with post-surgical seizure-freedom independent of atrophy and hypometabolism. Thus, [11C]ABP688-PET may offer a potential biomarker for surgical outcomes and may be particularly relevant for pre-surgical workup in MRI- and [18F]FDG-negative MTLE patients.
Participants and research professionals often overestimate how well participants understand and appreciate consent information for clinical trials, and experts often vary in their determinations of participant’s capacity to consent to research. Past research has developed and validated instruments designed to assess participant understanding and appreciation, but the frequency with which they are utilized is unknown.
Methods:
We administered a survey to clinical researchers working with older adults or those at risk of cognitive impairment (N = 1284), supplemented by qualitative interviews (N = 60).
Results:
We found that using a validated assessment of consent is relatively uncommon, being used by only 44% of researchers who had an opportunity. Factors that predicted adoption of validated assessments included not seeing the study sponsor as a barrier, positive attitudes toward assessments, and being confident that they had the resources needed to implement an assessment. The perceived barriers to adopting validated assessments of consent included lack of awareness, lack of knowledge, being unsure of how to administer such an assessment, and the burden associated with implementing this practice.
Conclusions:
Increasing the use of validated assessments of consent will require educating researchers on the practice and emphasizing very practical assessments, and may require Institutional Review Boards (IRBs) or study sponsors to champion the use of assessments.
This paper reports on a novel measure, attitudes toward genomics and precision medicine (AGPM), which evaluates attitudes toward activities such as genetic testing, collecting information on lifestyle, and genome editing – activities necessary to achieve the goals of precision medicine.
Discussion:
The AGPM will be useful for researchers who want to explore attitudes toward genomics and precision medicine. The association of concerns about precision medicine activities with demographic variables such as religion and politics, as well as higher levels of education, suggests that further education on genomic and precision activities alone is unlikely to shift AGPM scores significantly.
Methods:
We wrote items to represent psychological and health benefits of precision medicine activities, and concerns about privacy, social justice, harm to embryos, and interfering with nature. We validated the measure through factor analysis of its structure, and testing associations with trust in the health information system and demographic variables such as age, sex, education, and religion.
Results:
The AGPM had excellent alpha reliability (.92) and demonstrated good convergent validity with existing measures. Variables most strongly associated with higher levels of concern with precision medicine activities included: regular religious practice, republican political leanings, and higher levels of education.
To describe epidemiologic and genomic characteristics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large skilled-nursing facility (SNF), and the strategies that controlled transmission.
Design, setting, and participants:
This cohort study was conducted during March 22–May 4, 2020, among all staff and residents at a 780-bed SNF in San Francisco, California.
Methods:
Contact tracing and symptom screening guided targeted testing of staff and residents; respiratory specimens were also collected through serial point prevalence surveys (PPSs) in units with confirmed cases. Cases were confirmed by real-time reverse transcription–polymerase chain reaction testing for SARS-CoV-2, and whole-genome sequencing (WGS) was used to characterize viral isolate lineages and relatedness. Infection prevention and control (IPC) interventions included restricting from work any staff who had close contact with a confirmed case; restricting movement between units; implementing surgical face masking facility-wide; and the use of recommended PPE (ie, isolation gown, gloves, N95 respirator and eye protection) for clinical interactions in units with confirmed cases.
Results:
Of 725 staff and residents tested through targeted testing and serial PPSs, 21 (3%) were SARS-CoV-2 positive: 16 (76%) staff and 5 (24%) residents. Fifteen cases (71%) were linked to a single unit. Targeted testing identified 17 cases (81%), and PPSs identified 4 cases (19%). Most cases (71%) were identified before IPC interventions could be implemented. WGS was performed on SARS-CoV-2 isolates from 4 staff and 4 residents: 5 were of Santa Clara County lineage and the 3 others were distinct lineages.
Conclusions:
Early implementation of targeted testing, serial PPSs, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.
Carbon-rich dust is known to form in the atmosphere of the semiregular variable star R Sculptoris. Such stardust, as well as the molecules and gas produced during the lifetime of the star, will be spread into the Galaxy via the mass-loss process. Probing this process is crucial to understand the chemical enrichment of the Galaxy. R Scl was observed using the ESO/VLTI MATISSE instrument in December 2018. Here we show the first images of the star between 3 and 10 R*. Using the complementary MIRA 3D image reconstruction and the RHAPSODY 1D intensity profile reconstruction code, we reveal the location of molecules and dust in the close environment of the star. Indeed, the C2H2 and HCN molecules are spatially located between 1 and 3.4 R* which is much closer to the star than the location of the dust. The R Scl spectrum is fitted by molecules and a dust mixture of 90% of amorphous carbon and 10% of silicone carbide. The inner boundary of the dust envelope is estimated by DUSTY at about 4.6 R*. We derive a mass-loss rate of 1.2 ± 0.4 × 10−6M⊙ yr−1however no clear SiC forming region has been detected in the MATISSE data.
The “Puente project”, rises up the adherence rate with 38% (1). The aim of the study was to analyse the economic impact of this disease management prgramme of patients with a schizophrenic disorder.
Subjects and methods
“Puente” stands for a programme of LAAP with active outreaching of patients with schizophrenia. The details of the data collection and the subjects have been described elsewhere (1).The hospitalisation rate and the length of stay of the 117 case control pairs have been compared. The cost of hospitalisation in Belgium, recently adjusted by De Ridder et al. (2), have been used in order to map the differences.
Results
The number of hospital days totalised by 23 cases, was 2,152 days, in comparison to 6,371 realised by 42 controls,wich gives 18,6 hospital days per year for the cases and 38.9 days for the controls. Given an hospital cost per day in Belgium of 163.8 € per day, a crude saving of 3,328.5 € per case per year can be realised, correespondng with a net diminution of 2,428.5 € per patient year. Enrolling 1,675 cases per year, creates a saving of 4,066,533 € per year, an equivalent of 24,826 hospital days, or the cost of a psychiatric hospital of 85 beds occupied at 80%.
Conclusion
The Puente programme realised a substantial drop in public patient expenditure of 3,328.5 € per patient year. This is a very strong argument to implement, to finance and to support “Puente” like disease programmes in Belgium.
Performance of patients with schizophrenia (n = 15) was compared to that of patients with vascular ischemic lesions of the dorsolateral prefrontal cortex (n= 10) and to age-matched controls (n= 15) in delayed reaction tasks known to be specific markers of the functions of the frontal lobe. The performance of patients with schizophrenia was similar to that of patients with prefrontal lesions in the delayed response task (DR) and the spatial discrimination-reversal task (SD and RV) but not in the delayed alternation task (DA) in which they performed as well as controls. The behavioural profile of responses in delayed reaction tasks for the schizophrenic patients was identical to that of patients with basal ganglia lesions reported in a previous study. These results suggest that in some patients with schizophrenia, a frontal lobe deficit could be indirectly induced by a dysfunction of the basal ganglia. This problem could be due either to the pathological process itself or to the effect of the neuroleptic treatment.
Partial or non-adherence to medication is high amongst patients with schizophrenia. Rates of non-adherence of up to 72% have being reported depending on the method used and the patient population. Adherence is essential for optimal long-term patient outcomes in schizophrenia and failure to adhere to medication can have a major impact on the course of illness and treatment outcomes.
Objectives
The objective of the EMEA (Europe, Middle east and Africa) ADHES survey was to collect psychiatrist's perceptions of the assessment, reasons and management of partial and non-adherence to medication.
Aims
The aim of this poster is to present psychiatrist's perceptions collected in the EMEA ADHES survey.
Methods
The survey was devised to ascertain psychiatrists’ preferred methods of assessing adherence, their perceptions of the level of adherence, reasons for non-adherence and on strategies to improve adherence.
Results
Psychiatrists estimated that during the previous month more than half of their patients (53%) were partially or non-adherent. They estimated that as few as a third of patients who deteriorated after stopping medication was able to attribute this to their non-adherence. 76% of psychiatrists assessed adherence most frequently by asking their patient explicitly. Use of long-acting treatment was the preferred choice to address adherence problems for 62% of respondents.
Discussion
This EMEA-wide survey illustrates that while respondents recognised the relevance and importance of partial and non-adherence to medication, there remains a need for more proactive management of treatment adherence of patients with schizophrenia to reduce the frequency and consequences of relapse.
Partial or non-adherence to medication is high amongst patients with schizophrenia. Many and often overlapping factors are considered to impact on treatment adherence, including: patient-related (lack of insight, psychotic, negative or cognitive symptoms), treatment-related (adverse effects, insufficient efficacy), environmental (living situation, negative attitudes of relatives/friends), and physician-related (patient-healthcare professionals relationship) factors.
Objectives
The objective of the ADHES EMEA (Europe, Middle East and Africa) survey was to collect psychiatrist's perceptions of the assessment, reasons and management of partial and non-adherence to medication.
Aims
To present psychiatrist's opinion through EMEA of potential reasons for partial or non-adherence
Methods
The ADHES survey comprised 20 questions and was conducted in 36 countries across EMEA (over 4500 psychiatrists treating patients with schizophrenia).
Results
Across EMEA 37% of psychiatrists viewed lack of insight as the most important reason for their patients stopping medication. 23% of psychiatrists viewed patient's feeling better and thinking it unnecessary to take medication as the most important reason for their patients stopping medication. 7% or less of psychiatrists viewed undesirable side effects, insufficient efficacy, cognitive impairment or drug/alcohol abuse as the most important reasons for their patients stopping medication.
Discussion
In this survey, psychiatrists estimated that patient’s lack of insight and subjective improvement could constitute the main factors explaining poor adherence. Other factors (i.e., side effects, substance abuse) were regarded as less important. Strategies aimed at raising awareness of maintaining treatment, are warranted within EMEA, with the aim of improving clinical outcomes.