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To present a tool and examine the minimum cost of a healthy and diverse diet that meets the daily requirements of essential nutrients for the people of India, using interactive web-based tools.
Design:
Linear-programming algorithms were adapted into two web-based tools: a Food Optimisation for Population (FOP) tool and a Diet Optimisation Tool (DOT). The FOP optimises daily food choices at a population level, considering local food consumption patterns. The DOT focuses on household or individual food selection.
Setting:
India, with consideration of locally produced and consumed foods.
Participants:
The two optimisation tools are demonstrated for the state of Bihar: the FOP tool at the population level, exemplified by diet optimisation for children aged 1–3 years, and DOT at the household level, demonstrated through diet optimisation for a household of four members.
Results:
Both tools provide cost-effective, optimised food plans, respecting cultural preferences. Based on food prices from June 2022, the FOP tool generated optimised diets for 1–3-year-old Bihari children priced at INR 26·8 (USD 0·32 converted as of January 2024 rate)/child/day. By applying a milk subsidy, this cost could drop to INR 23·7 (USD 0·28). The DOT was able to formulate a vegetarian diet for a family of four at INR 204 (USD 2·45)/day.
Conclusions:
These web-based tools offer diet plans optimised to meet macro- and micronutrient requirements at population and/or individual/household levels, at minimum cost. This tool can be used by policymakers to design food-focused strategies that can meet nutritional needs at local price points, while considering food preferences.
Characterizing the structure and composition of clay minerals on the surface of Mars is important for reconstructing past aqueous processes and environments. Data from the CheMin X-ray diffraction (XRD) instrument on the Mars Science Laboratory Curiosity rover demonstrate a ubiquitous presence of collapsed smectite (basal spacing of 10 Å) in ~3.6-billion-year-old lacustrine mudstone in Gale crater, except for expanded smectite (basal spacing of 13.5 Å) at the base of the stratigraphic section in a location called Yellowknife Bay. Hypotheses to explain expanded smectite include partial chloritization by Mg(OH)2 or solvation-shell H2O molecules associated with interlayer Mg2+. The objective of this work is to test these hypotheses by measuring partially chloritized and Mg-saturated smectite using laboratory instruments that are analogous to those on Mars rovers and orbiters. This work presents Mars-analog XRD, evolved gas analysis (EGA), and visible/shortwave-infrared (VSWIR) data from three smectite standards that were Mg-saturated and partially and fully chloritized with Mg(OH)2. Laboratory data are compared with XRD and EGA data collected from Yellowknife Bay by the Curiosity rover to examine whether the expanded smectite can be explained by partial chloritization and what this implies about the diagenetic history of Gale crater. Spectral signatures of partial chloritization by hydroxy-Mg are investigated that may allow the identification of partially chloritized smectite in Martian VSWIR reflectance spectra collected from orbit or in situ by the SuperCam instrument suite on the Mars 2020 Perseverance rover. Laboratory XRD and EGA data of partially chloritized saponite are consistent with data collected from Curiosity. The presence of partially chloritized (with Mg(OH)2) saponite in Gale crater suggests brief interactions between diagenetic alkaline Mg2+-bearing fluids and some of the mudstone exposed at Yellowknife Bay, but not in other parts of the stratigraphic section. The location of Yellowknife Bay at the base of the stratigraphic section may explain the presence of alkaline Mg2+-bearing fluids here but not in other areas of Gale crater investigated by Curiosity. Early diagenetic fluids may have had a sufficiently long residence time in a closed system to equilibrate with basaltic minerals, creating an elevated pH, whereas diagenetic environments higher in the section may have been in an open system, therefore preventing fluid pH from becoming alkaline.
It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
Objectives/Goals: Electronic health record (EHR)-based recruitment can facilitate participation in clinical trials, but is not a panacea to trial accrual challenges. We conducted a root cause analysis to identify EHR-based accrual barriers and facilitators in a pragmatic randomized trial of metformin for those with prostate cancer and glucose intolerance. Methods/Study Population: We quantitatively analyzed enrollment drop-offs among eligible patients who either did not complete a consent (with analysis of EHR-embedded consent process) or who completed a consent but were not enrolled (with analysis of EHR implementation of a Best Practice Alert). We summarized data from the EHR by eligibility, provider encounters, and alerts, and generated CONSORT diagrams and tables to trace the enrollment pathway. We supplemented quantitative findings with a thematic analysis of semi-structured individual interviews with eligible patients (n = 10) and study providers (n = 4) to identify systematic barriers to recruitment and enrollment of eligible patients. Results/Anticipated Results: CONSORT diagram analysis found that 24% of potentially eligible patients (268 of 1130) had an eligible study encounter but were not enrolled. Additionally, BPAs were not triggering for some eligible patients. Interviews revealed that study providers wanted more detailed information about which study arm their patient would be assigned to, and about next steps after enrollment, especially relating to additional lab tests and follow-up care needed. Patient interviews suggested that patients often did not remember completing the consent process and felt overwhelmed with appointments and information; patients expected providers to actively bring up research opportunities during appointments. Discussion/Significance of Impact: While pragmatic EHR-embedded trials are often characterized as lower-burden, these trials still require active engagement by providers, as well as ongoing attention from both research and informatics teams to ensure that EHR-embedded processes are functioning as designed, and that they are effective in recruiting study participants.
Objectives/Goals: The identification of the cascade of molecular and cellular events occurring during the progression of focal segmental glomerulosclerosis in human kidney biopsies from kidney transplant (KTx) recipients (KTR) with normal function or recurrent FSGS to determine potential targets of intervention and therapy. Methods/Study Population: In this study, we evaluate the molecular and cellular events associated with primary FSGS in both native and transplant kidneys. We collected biopsy samples from the native normal kidney (nNK, n = 3), normal functioning allografts (NKTx, n = 3), primary FSGS in the native kidney (nFSGS, n = 1), recurrent FSGS (KTxFSGS, n = 5). KTxFSGS comprises a collection of longitudinal samples with biopsy also collected at the subsequent recurrence. Blood samples were collected during biopsy collection. Biopsies were preserved in RNAlater at the time of collection. 10X genomics chromium single nuclei RNA sequencing (snRNAseq) was performed using isolated nuclei. Data was analyzed using Seurat on R. Conditionally immortalized podocytes were treated with a patient serum to determine the change in expression observed in snRNAseq data. Results/Anticipated Results: Recurrence rates of primary FSGS are high in kidney allograft recipients up to 25–50% in first, and up to 80% in second transplants, often leading to graft loss. Our findings reveal that podocyte detachment is driven by metabolic and structural dysregulation rather than cell death, increasing VEGFA expression and disrupting glomerular endothelial cell growth and permeability. Parietal epithelial cells initially compensate by dedifferentiating toward podocytes but later increase collagen deposition, contributing to glomerular sclerosis. Increased interactions of glomerular cells with B cells exacerbate extracellular matrix deposition and scarring. We also observed tubular sclerosis and disruption of the regenerative potential of proximal tubular cells, with increased interaction with T cells. Discussion/Significance of Impact: These findings offer new insights into the pathogenesis of recurrent FSGS and suggest potential therapeutic targets and establishes a foundation for future studies to further evaluate the role of metabolic dysfunction as the cause of podocyte injury and loss.
Chronic headache after aneurysmal subarachnoid hemorrhage (aSAH) remains an ongoing area of investigation, with uncertainty regarding its prevalence and long-term outcomes.
Methods:
A systematic review was conducted across five databases – Medline (Ovid), the Cochrane Central Register of Controlled Trials (Ovid), PsychInfo (Ovid), Embase (Ovid) and Scopus (Elsevier) – to identify all studies investigating the prevalence of chronic headaches after aSAH. A total of five studies were identified and included in our review.
Results:
There were five observational studies (three cohort and two cross-sectional). The overall prevalence of chronic headaches after aSAH ranged from 16.1% to 41%, albeit across a follow-up time frame of 12 months to 7.5 years. Outcome measurements included quantitative pain scores and opioid usage; however, these were inconsistent across studies, and the studies did not address the long-term impacts of chronic headaches on quality of life or their psychosocial implications.
Conclusion:
The prevalence of chronic headache after aSAH is not well-characterized, and long-term outcomes are seldom studied, highlighting a critical gap in the current literature. Longitudinal cohort studies with standardized approaches to ascertain the psychosocial and physiological burden associated with post-aSAH chronic headaches are urgently needed.
For near-future missions planed for Mars Sample Return (MSR), an international working group organized by the Committee on Space Research (COSPAR) developed the sample safety assessment framework (SSAF). For the SSAF, analytical instruments were selected by taking the practical limitations of hosting them within a facility with the highest level of biosafety precautions (biosafety level 4) and the precious nature of returned samples into account. To prepare for MSR, analytical instruments of high sensitivity need to be tested on effective Mars analogue materials. As an analogue material, we selected a rock core of basalt, a prominent rock type on the Martian surface. Two basalt samples with aqueous alteration cached in Jezero crater by the Perseverance rover are planned to be returned to Earth. Our previously published analytical procedures using destructive but spatially sensitive instruments such as nanoscale secondary ion mass spectrometry (NanoSIMS) and transmission electron microscopy coupled to energy-dispersive spectroscopy revealed microbial colonization at clay-filled fractures. With an aim to test the capability of an analytical instrument listed in SSAF, we now extend that work to conventional Fourier transform infrared (FT-IR) microscopy with a spatial resolution of 10 μm. Although Fe-rich smectite called nontronite was identified after crushing some portion of the rock core sample into powder, the application of conventional FT-IR microscopy is limited to a sample thickness of <30 μm. In order to obtain IR-based spectra without destructive preparation, a new technique called optical-photothermal infrared (O-PTIR) spectroscopy with a spatial resolution of 0.5 μm was applied to a 100 μm thick section of the rock core. By O-PTIR spectroscopic analysis of the clay-filled fracture, we obtained in-situ spectra diagnostic to microbial cells, consistent with our previously published data obtained by NanoSIMS. In addition, nontronite identification was also possible by O-PTIR spectroscopic analysis. From these results, O-PTIR spectroscopy is suggested be superior to deep ultraviolet fluorescence microscopy/μ-Raman spectroscopy, particularly for smectite identification. A simultaneous acquisition of the spatial distribution of structural motifs associated with biomolecules and smectites is critical for distinguishing biological material in samples as well as characterizing an abiotic background.
The Arctic is undergoing increased warming compared to the global mean, with major implications for the mass balance of glaciers. Direct observations of mass balance in the Russian Arctic are sparse and remotely sensed volume changes do not provide information about climatic drivers. Here, we present simulations of the climatic mass balance and meltwater runoff from glaciers in Franz Josef Land and Novaya Zemlya from 1991 to 2022. Based on simulations of glacier climatic mass balance over the period 1991–2022, we present a first detailed view of mass balance evolution in Franz Josef Land and Novaya Zemlya. The simulations are conducted at a 2.5 km resolution using the CryoGrid model forced by the Copernicus Arctic Regional ReAnalysis (CARRA) product. Over the 30 year simulation period, the climatic mass balance of both Franz Josef Land (0.21 m w.e. a−1) and Novaya Zemlya (0.07 m w.e. a−1) is positive on average without a significant trend in annual climatic mass balance. There is still a tendency towards more frequent high-melt years after 2010 and the associated glacier runoff has intensified with record melt years occurring during the model period.
Loneliness has become a major public health issue of the recent decades due to its severe impact on health and mortality. Little is known about the relation between loneliness and social anxiety. This study aimed (1) to explore levels of loneliness and social anxiety in the general population, and (2) to assess whether and how loneliness affects symptoms of social anxiety and vice versa over a period of five years.
Methods
The study combined data from the baseline assessment and the five-year follow-up of the population-based Gutenberg Health Study. Data of N = 15 010 participants at baseline (Mage = 55.01, s.d.age = 11.10) were analyzed. Multiple regression analyses with loneliness and symptoms of social anxiety at follow-up including sociodemographic, physical illnesses, and mental health indicators at baseline were used to test relevant covariates. Effects of loneliness on symptoms of social anxiety over five years and vice versa were analyzed by autoregressive cross-lagged structural equation models.
Results
At baseline, 1076 participants (7.41%) showed symptoms of social anxiety and 1537 (10.48%) participants reported feelings of loneliness. Controlling for relevant covariates, symptoms of social anxiety had a small significant effect on loneliness five years later (standardized estimate of 0.164, p < 0.001). Vice versa, there was no significant effect of loneliness on symptoms of social anxiety taking relevant covariates into account.
Conclusions
Findings provided evidence that symptoms of social anxiety are predictive for loneliness. Thus, prevention and intervention efforts for loneliness need to address symptoms of social anxiety.
By early modern Roman law, persons born deaf, if they could neither speak nor write, could not make their last will and testament. In the event recounted here, thanks to a coordinated effort by her family, her advocates, papal officialdom, her beneficiaries, and Magdalena herself, the formally impossible proved possible. This article, offering a close reading of the unusual document that lays out the complex tests applied to Magdalena to let her act as a legal persona, asks what her story reveals about the attitudes of the papal state, and of Romans, both to this disability and to the personhood of those who struggled successfully to overcome legal discrimination surrounding it.
Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity of clinical and translational science, diminishes uptake of innovations into practice, and restricts access to the potential benefits of participation. Despite efforts to increase diversity in clinical trials, children and adults from Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, and tools demonstrate promise in enhancing recruitment and enrollment in clinical trials. To demonstrate this promise, we draw upon our team’s experience conducting a randomized clinical trial that tests three behavioral interventions designed to promote equity in language and social-emotional skill acquisition among Latino parent–infant dyads from under-resourced communities. The recruitment activities took place during the COVID-19 pandemic, which intensified the need for responsive strategies and procedures. We used the Model for Improvement to achieve our recruitment goals. Across study stages, we engaged strategies such as (1) intentional team formation, (2) participatory approaches to setting goals, monitoring achievement, selecting change strategies, and (3) small iterative tests that informed additional efforts. These strategies helped our team overcome several barriers. These strategies may help other researchers apply quality improvement tools to increase participation in clinical and translational research among people from minoritized groups.
Relative to the numerous studies focused on mammalian schistosomes, fewer include avian schistosomatids particularly in the southern hemisphere. This is changing and current research emerging from the Neotropics shows a remarkable diversity of endemic taxa. To contribute to this effort, nine ducks (Spatula cyanoptera, S.versicolor, Netta peposaca), 12 swans (Cygnus melancoryphus) and 1,400 Physa spp. snails from Chile and Argentina were collected for adults and larval schistosomatids, respectively. Isolated schistosomatids were preserved for morphological and molecular analyses (28S and COI genes). Four different schistosomatid taxa were retrieved from birds: Trichobilharzia sp. in N. peposaca and S. cyanoptera that formed a clade; S.cyanoptera and S. versicolor hosted Trichobilharzia querquedulae; Cygnus melancoryphus hosted the nasal schistosomatid, Nasusbilharzia melancorhypha; and one visceral, Schistosomatidae gen. sp., which formed a clade with furcocercariae from Argentina and Chile from previous work. Of the physid snails, only one from Argentina had schistosomatid furcocercariae that based on molecular analyses grouped with T. querquedulae. This study represents the first description of adult schistosomatids from Chile as well as the elucidation of the life cycles of N.melancorhypha and T. querquedulae in Chile and Neotropics, respectively. Without well-preserved adults, the putative new genus Schistosomatidae gen. sp. could not be described, but its life cycle involves Chilina spp. and C. melancoryphus. Scanning electron microscopy of T. querquedulae revealed additional, undescribed morphological traits, highlighting its diagnostic importance. Authors stress the need for additional surveys of avian schistosomatids from the Neotropics to better understand their evolutionary history.
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego