Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Objectives/Goals: Digital recruitment can improve participant engagement in medical research, but its potential to introduce demographic and socioeconomic biases is unclear. This study investigates pathways participants took during a digital recruitment workflow in neurology, examining potential associations with socioeconomic and demographic factors. Methods/Study Population: As part of an ongoing study aiming to remotely capture speech from patients with neurologic disease, most participants seen in neurology on our campus are invited to complete a self-administered speech examination. We exported participant data from Epic (semi-automated identification and invitation), Qualtrics (eligibility screening), the participant tracking database (consent), and the recording platform (completion) for March to July 2024. Data visualization was performed using a Sankey diagram. Socioeconomic status was assessed using the housing-based socioeconomic status (HOUSES) index and area deprivation index (ADI) national rank. Kruskal–Wallis and Wilcoxon rank-sum tests were used to compare the median age, socioeconomic indices, and time taken to reach different steps of the study. Results/Anticipated Results: Of the 5846 invited participants, 57% were from urban areas, 23% from rural areas, and 20% from urban clusters. Most did not read/respond (2739) or declined (1749) the initial invitation via Epic. Of the 1358 interested participants, 415 completed the study. Participants from urban areas completed enrollment steps faster than those from rural areas and urban clusters, though the variance was large (42.6 ± 41.4 days vs. 50.6 ± 42.2 days and 50 ± 43.9 days, respectively; p  =  0.030). Female participants took longer to complete enrollment than males (48.7 ± 44 days vs. 40.5 ± 38.8 days; p  =  0.026). Participants who successfully finished the study had significantly lower ADI national ranks compared to other common pathways (40.6 ± 19; p  =  0.0021). No associations were found with the HOUSES indices. Discussion/Significance of Impact: Our findings support differences in participant engagement, with urban participants and males more likely to complete enrollment steps. Those who finished the study were less disadvantaged suggesting potential bias in digital recruitment. These findings can inform strategies to improve digital recruitment in neurology research.

An online survey was distributed to South Dakota stakeholders to understand how noxious weeds are currently being managed. The response rate was 26%; 129 stakeholders completed the survey of the 491 stakeholders who opened the survey. Eighty percent of respondents stated noxious weeds were a problem. Canada thistle [Cirsium arvense (L.) Scop.], leafy spurge (Euphorbia esula L.), and absinth wormwood (Artemisia absinthium L.) were the most common and troublesome, but all statewide noxious weeds were reported. The most common singular response to manage noxious weeds was herbicides alone (25%), but respondents utilized two (27%) to three (24%) other tactics as well. Most respondents (47%) were somewhat satisfied with management tactics, while others were completely satisfied (9%), neither satisfied nor dissatisfied (20%), somewhat unsatisfied (11%), or very unsatisfied (15%). A covariate analysis showed that the more management tactics individual stakeholders utilized, the less satisfied they were with control (P < 0.0001). The most common barrier of adopting new tactics was effectiveness (26%) followed by a combination of effectiveness + current production practices + cost + labor (13%). An additional covariate analysis showed that the increase in management tactics increased the barriers of adoption (P = 0.04) and increasing the number of barriers of adoption resulted in stakeholders being dissatisfied with control (P = 0.0003). Overall, the results of the survey suggest that statewide noxious weeds remain a problem, and multiple tactics are used to manage these weeds. However, Cooperative extension efforts need to address how to use current management and implement new management strategies to increase effectiveness.

Sea ice is a mushy layer, a porous material whose properties depend on the relative proportions of solid and liquid. The growth of sea ice is governed by heat transfer through the ice together with appropriate boundary conditions at the interfaces with the atmosphere and ocean. The salinity of sea ice has a major effect on its thermal properties so might naïvely be expected to have a major effect on its growth rate. However, previous studies observed a low sensitivity throughout the winter growth season. The goal of this study is to identify the controlling physical mechanisms that explain this observation. We develop a simplified quasi-static framework by applying a similarity transformation to the underlying heat equation and neglecting the explicit time dependence. We find three key processes controlling the sensitivity of growth rate to salinity. First, the trade-off between thermal conductivity and (latent) heat capacity leads to low sensitivity to salinity even at moderately high salinity and brine volume fraction. Second, the feedback on the temperature profile reduces the sensitivity relative to models that assume a linear profile, such as zero-layer Semtner models. Third, thicker ice has the opposite sensitivity of growth rate to salinity compared with thinner ice, sensitivities that counteract each other as the ice grows. Beyond its use in diagnosing these sensitivities, we show that the quasi-static approach offers a valuable sea-ice model of intermediate complexity between zero-layer Semtner models and full partial-differential-equation-based models such as Maykut–Untersteiner/Bitz–Lipscomb and mushy-layer models.

Outdoor studies were conducted to determine the extent of leafy spurge biomass reduction resulting from broadcast application of 2,4-D (2,244 g ae ha−1) with and without wiper-applied glyphosate. Glyphosate (575 g ae L−1) was applied at 0%, 33%, 50%, and 75% diluted concentrate with a wiper 24 h after 2,4-D was broadcast-applied. Injury estimates and shoot biomass did not differ between plants treated with 2,4-D only or when glyphosate was wiper-applied 21 d after treatment. Shoot regrowth biomass of plants treated with 2,4-D only was approximately 560% greater than nontreated plants 3 mo after treatment. Plants treated with wiper-applied glyphosate exhibited shoot regrowth biomass of less than 10% compared with nontreated plants 3 mo after treatment. Root biomass of plants treated with 2,4-D only (160% of nontreated plants) exhibited a similar pattern of shoot regrowth biomass. Root biomass of plants treated with wiper-applied glyphosate exhibited approximately 50% reductions compared with nontreated plants. All vegetative metrics were equally reduced with all tested concentrations of glyphosate; therefore, all labeled concentrations should be effective. The results of the experiment indicate that broadcast-applied 2,4-D is more effective at reducing leafy spurge biomass with the addition of wiper-applied glyphosate.

Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.

Garbarino et al. (J Econ Sci Assoc. https://doi.org/10.1007/s40881-018-0055-4, 2018) describe a new method to calculate the probability distribution of the proportion of lies told in “coin flip” style experiments. I show that their estimates and confidence intervals are flawed. I demonstrate two better ways to estimate the probability distribution of what we really care about—the proportion of liars—and I provide R software to do this.

Several methods used to examine differential item functioning (DIF) in Patient-Reported Outcomes Measurement Information System (PROMIS®) measures are presented, including effect size estimation. A summary of factors that may affect DIF detection and challenges encountered in PROMIS DIF analyses, e.g., anchor item selection, is provided. An issue in PROMIS was the potential for inadequately modeled multidimensionality to result in false DIF detection. Section 1 is a presentation of the unidimensional models used by most PROMIS investigators for DIF detection, as well as their multidimensional expansions. Section 2 is an illustration that builds on previous unidimensional analyses of depression and anxiety short-forms to examine DIF detection using a multidimensional item response theory (MIRT) model. The Item Response Theory-Log-likelihood Ratio Test (IRT-LRT) method was used for a real data illustration with gender as the grouping variable. The IRT-LRT DIF detection method is a flexible approach to handle group differences in trait distributions, known as impact in the DIF literature, and was studied with both real data and in simulations to compare the performance of the IRT-LRT method within the unidimensional IRT (UIRT) and MIRT contexts. Additionally, different effect size measures were compared for the data presented in Section 2. A finding from the real data illustration was that using the IRT-LRT method within a MIRT context resulted in more flagged items as compared to using the IRT-LRT method within a UIRT context. The simulations provided some evidence that while unidimensional and multidimensional approaches were similar in terms of Type I error rates, power for DIF detection was greater for the multidimensional approach. Effect size measures presented in Section 1 and applied in Section 2 varied in terms of estimation methods, choice of density function, methods of equating, and anchor item selection. Despite these differences, there was considerable consistency in results, especially for the items showing the largest values. Future work is needed to examine DIF detection in the context of polytomous, multidimensional data. PROMIS standards included incorporation of effect size measures in determining salient DIF. Integrated methods for examining effect size measures in the context of IRT-based DIF detection procedures are still in early stages of development.

Galba truncatula is one of the most distributed intermediate hosts of Fasciola hepatica across Europe, North Africa and South America. Therefore, understanding the environmental preferences of this species is vital for developing control strategies for fascioliasis and other trematodes such as Calicophoron daubneyi. This systematic literature review evaluates the current understanding of the snail's environmental preferences to identify factors which might aid control and areas where further research is needed. Searches were conducted using Google Scholar and PubMed and included papers published up to August 2023. After filtration, 198 papers with data from 64 countries were evaluated, and data regarding habitat type and habitat pH were noted, along with any other information pertaining to the snail's environmental preferences. The results show that G. truncatula can survive in a diverse range of climates and habitats, generally favours shallow slow-moving water or moist bare mud surfaces, temperatures between 10 and 25°C and was found in habitats with a water pH ranging from 5.0 to 9.4. However, there is limited understanding of the impact of several factors, such as the true optimum pH and temperature preferences within the respective tolerance limits or the reason for the snail's apparent aversion to peatland. Further research is needed to clarify the impact of biotic and abiotic factors on the snail to create robust risk assessments of fluke infection and assess opportunities for environmental control strategies, and for predicting how the snail and fluke transmission may be impacted by climate change.

This editorial considers the value and nature of academic psychiatry by asking what defines the specialty and psychiatrists as academics. We frame academic psychiatry as a way of thinking that benefits clinical services and discuss how to inspire the next generation of academics.

Hypertension and depression are increasingly common noncommunicable diseases in Ghana and worldwide, yet both are poorly controlled. We sought to understand how healthcare workers in rural Ghana conceptualize the interaction between hypertension and depression, and how care for these two conditions might best be integrated. We conducted a qualitative descriptive study involving in-depth interviews with 34 healthcare workers in the Kassena-Nankana districts of the Upper East Region of Ghana. We used conventional content analysis to systematically review interview transcripts, code the data content and analyze codes for salient themes. Respondents detailed three discrete conceptual models. Most emphasized depression as causing hypertension: through both emotional distress and unhealthy behavior. Others posited a bidirectional relationship, where cardiovascular morbidity worsened mood, or described a single set of underlying causes for both conditions. Nearly all proposed health interventions targeted their favored root cause of these disorders. In this representative rural Ghanaian community, healthcare workers widely agreed that cardiovascular disease and mental illness are physiologically linked and warrant an integrated care response, but held diverse views regarding precisely how and why. There was widespread support for a single primary care intervention to treat both conditions through counseling and medication.

Tidal flooding occurs when coastal water levels exceed impact-based flood thresholds due to tides alone, under average weather conditions. Transitions to tidal flood regimes are already underway for nuisance flood severities in harbours and bays and expected for higher severities in coming decades. In the first such regional assessment, we show that the same transition to tidally forced floods can also be expected to occur in Australian estuaries with less than 0.1 m further sea-level rise. Flood thresholds that historically used to only be exceeded under the combined effects of riverine (freshwater) and coastal (salt water) influences will then occur due to high tides alone. Once this tidal flooding emerges, it is projected to become chronic within two decades. Locations most at-risk of the emergence of tidal flooding and subsequent establishment of chronic flood regimes are those just inside estuary entrances. These locations are exemplified by low freeboard, the vertical distance between a flood threshold and a typical high tide level. We use a freeboard-based analysis to estimate the sea-level rise required for impacts associated with official flood thresholds to occur due to tides alone. The resultant tide-only flood frequency estimates provide a lower bound for future flood rates.

Background: The Clinical & Laboratory Standards Institute (CLSI) recommends use of annual antibiograms to help guide empiric antibiotic therapy. Because CLSI periodically updates minimum inhibitory concentration (MIC) breakpoints, we assessed the impact of these updates on longitudinal trends in antibiotic susceptibility rates for Escherichia coli and Klebsiella pneumoniae at a single academic medical center in Atlanta, GA. Methods: Susceptibilities for cefepime, ceftazidime, and levofloxacin in E. coli and K. pneumoniae were extracted from hospital antibiograms from 1988 to 2022. Starting in 1995, intensive care units (ICUs) and wards had separate annual antibiograms, which we combined using weighted averages to create annual overall hospital antibiograms. After summarizing the frequency of isolates tested and susceptibilities using medians and interquartile ranges (IQR), we conducted an interrupted time series analysis using linear segmented regression models, to evaluate the level changes and trends in susceptibility, before and after CLSI MIC breakpoints were updated for ceftazidime (2010 and 2017), cefepime (2014 and 2017), and levofloxacin (2013). Results: Among 21,214 E. coli, there was a median of 291 [IQR: 104, 555] isolates tested annually. Similarly, among 8,686 K. pneumoniae isolates, the median was 125 per year (IQR: 76, 178). Prior to the MIC breakpoint changes, baseline susceptibility trends of both organisms to all 3 antibiotics significantly declined at a rate between 0.2% to 2.4% per year (Table 1). For cefepime (Figure 1), susceptibility decreased annually during 1988 – 2013 for both E. coli (-0.5%) and K. pneumoniae (-1.2%). There were no significant level changes but there were trend changes after 2018, for E. coli (+2.1%) and K. pneumoniae (– 5.5%). For ceftazidime (Figure 2), significant level changes occurred after 2010 for both organisms (E. coli: -5.7%; K. pneumoniae: -5.2%). For levofloxacin (Figure 3), the breakpoint update in 2013 lead to significant level change in susceptibility (E. coli: +8.4%; K. pneumoniae: +11.4%). Conclusion: Overall, we observed a consistent decrease in antibiotic susceptibility in E. coli and K. pneumoniae over three decades, with immediate increases in the level change of susceptibility when MIC breakpoints were changed, followed by a decreasing trend. These findings highlight the importance of longitudinal surveillance and MIC breakpoint changes to inform antimicrobial stewardship strategies.