Objectives/Goals: The goals of this research are to 1) determine the prevalence of perinatal doula services use in Virginia, with a focus on individuals with substance use disorders (SUD), 2) evaluate awareness of doulas among pregnant and postpartum people with SUD, and 3) assess provider knowledge and interaction with doulas for the care of this population. Methods/Study Population: Both quantitative and qualitative methods will be used to evaluate patient and healthcare provider knowledge regarding doula services and the patient–doula–healthcare provider relationship. Surveys and semi-structured interviews will be administered to doulas, pregnant and postpartum women, and healthcare providers in this mixed-methods approach. Information from the Centers for Medicare and Medicaid Services National Provider Identifier (NPI) Registry, and doula training programs will be utilized to recruit doulas for participation. Paper and online recruitment materials will be posted to engage pregnant and postpartum individuals. Healthcare provider recruitment will occur via the NPI Registry along with contacting physicians’ practices. SAS 9.4 and NVivo will be utilized for analysis. Results/Anticipated Results: This proposed research will be an initial assessment of the current state of doula services utilization, mothers’ knowledge of doulas and their purpose, and healthcare providers’ awareness of and partnership with doulas to provide optimal birthing and postpartum experiences to the pregnant and parenting population with and without SUD. Results from this study will be disseminated to community doulas, pregnant people and mothers with substance use disorders, and relevant healthcare providers to decrease barriers to doula care and advocate for consistent, systematic documentation of doula services in the medical record and in public health surveillance systems. Discussion/Significance of Impact: This study will be the first study to assess doula services utilization in Virginia, with a specific focus on pregnant and postpartum women with substance use disorders. This work will support advocacy for improved data capture and utilization regarding doula services in order to reduce barriers to care and improve perinatal outcomes.

The 7th edition of the Canadian Stroke Best Practice Recommendations (CSBPR) is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners, and intended to drive healthcare excellence, improved outcomes and more integrated health systems. This edition includes a new module on the management of cerebral venous thrombosis (CVT). Cerebral venous thrombosis is defined as thrombosis of the veins of the brain, including the dural venous sinuses and/or cortical or deep veins. Cerebral venous thrombosis is a rare but potentially life-threatening type of stroke, representing 0.5–1.0% of all stroke admissions. The reported rates of CVT are approximately 10–20 per million and appear to be increasing over time. The risk of CVT is higher in women and often associated with oral contraceptive use and with pregnancy and the puerperium. This guideline addresses care for adult individuals who present to the healthcare system with current or recent symptoms of CVT. The recommendations cover the continuum of care from diagnosis and initial clinical assessment of symptomatic CVT, to acute treatment of symptomatic CVT, post-acute management, person-centered care, special considerations in the long-term management of CVT, including pregnancy and considerations related to CVT in special circumstances such as trauma and vaccination. This module also includes supporting materials such as implementation resources to facilitate the adoption of evidence into practice and performance measures to enable monitoring of uptake and effectiveness of recommendations.

In September 2023, the UK Health Security Agency identified cases of Salmonella Saintpaul distributed across England, Scotland, and Wales, all with very low genetic diversity. Additional cases were identified in Portugal following an alert raised by the United Kingdom. Ninety-eight cases with a similar genetic sequence were identified, 93 in the United Kingdom and 5 in Portugal, of which 46% were aged under 10 years. Cases formed a phylogenetic cluster with a maximum distance of six single nucleotide polymorphisms (SNPs) and average of less than one SNP between isolates. An outbreak investigation was undertaken, including a case–control study. Among the 25 UK cases included in this study, 13 reported blood in stool and 5 were hospitalized. One hundred controls were recruited via a market research panel using frequency matching for age. Multivariable logistic regression analysis of food exposures in cases and controls identified a strong association with cantaloupe consumption (adjusted odds ratio: 14.22; 95% confidence interval: 2.83–71.43; p-value: 0.001). This outbreak, together with other recent national and international incidents, points to an increase in identifications of large outbreaks of Salmonella linked to melon consumption. We recommend detailed questioning and triangulation of information sources to delineate consumption of specific fruit varieties during Salmonella outbreaks.

Multistate methodology proves effective in analyzing hospitalized coronavirus disease 2019 (COVID-19) patients with emerging variants in real time. An analysis of 2,548 admissions in Freiburg, Germany, showed reduced severity over time in terms of shorter hospital stays and higher discharge rates when comparing more recent phases with earlier phases of the pandemic.

Previous research has revealed that intuitive confidence is an important predictor of how people choose between an intuitive and non-intuitive alternative when faced with information that opposes the intuitive response. In the current study, we investigated the speed of intuition generation as a predictor of intuitive confidence and participant choice in choice conflict situations. Participants predicted the outcomes of several National Basketball Association games, both with and without reference to a point spread. As hypothesized, the faster participants were to predict the outright winner of a game (i.e., generate an intuition) the more likely they were to predict the favourite against the point spread for that game (i.e., endorse the intuitive response). Overall, our findings are consistent with the notion that the speed of intuition generation acts as a determinant of intuitive confidence and a predictor of choice in situations featuring equally valid intuitive and non-intuitive alternatives.

While they usually should, people do not revise their beliefs more to expert (economist) opinion than to lay opinion. The present research sought to better understand the factors that make it more likely for an individual to change their mind when faced with the opinions of expert economists versus the general public. Across five studies we examined the role that overestimation of knowledge plays in this behavior. We replicated the finding that people fail to privilege the opinion of experts over the public across two different (Study 1) and five different (Study 5) economic issues. We further find that undermining an illusion of both topic-relevant (Studies 2–4) and -irrelevant knowledge (Studies 3 and 4) leads to greater normative belief revision in response to expert rather than lay opinion. We suggest one reason that people fail to revise their beliefs more in response to experts is because people think they know more than they really do.

Previous research has demonstrated a link between illusory pattern perception and various irrational beliefs. On this basis, we hypothesized that participants who displayed greater degrees of illusory pattern perception would also be more likely to rate pseudo-profound bullshit statements as profound. We find support for this prediction across three experiments (N = 627) and four distinct measures of pattern perception. We further demonstrate that this observed relation is restricted to illusory pattern perception, with participants displaying greater endorsement of non-illusory patterns being no more likely to rate pseudo-profound bullshit statements as profound. Additionally, this relation is not a product of a general proclivity to rate all statements as profound and is not accounted for by individual differences in analytic thinking. Overall, we demonstrate that individuals with a tendency to go beyond the available data such that they uncritically endorse patterns where no patterns exist are also more likely to create and endorse false-meaning in meaningless pseudo-profound statements. These findings are discussed in the context of a proposed framework that views individuals’ receptivity to pseudo-profound bullshit as, in part, an unfortunate consequence of an otherwise adaptive process: that of pattern perception.

In 2012, the authors undertook a radiocarbon dating programme to explore the chronology of southern Iberian megalithic societies. Thirty new radiocarbon dates were obtained for two tholos-type tombs, Loma de Belmonte and Loma del Campo 2, and analysed within a Bayesian framework. Results are discussed in the context of the prehistoric societies of the region and four main conclusions were reached: i) in both tombs, mortuary activity started in the last century of the fourth millennium although with significant differences in their timespan; ii) funerary rituals ended in Loma de Belmonte at least five centuries later than in Loma del Campo 2; iii) the tholoi can be considered the most recent type of tomb compared to other megalithic monuments with mortuary activity beginning in the first centuries of the fourth millennium; iv) the largest and most prominent settlement of the region, Las Pilas, was closely associated with this funerary and sacred landscape.

The date of unique symbolic carvings, from various contexts across north and east Scotland, has been debated for over a century. Excavations at key sites and direct dating of engraved bone artefacts have allowed for a more precise chronology, extending from the third/fourth centuries AD, broadly contemporaneous with other non-vernacular scripts developed beyond the frontiers of the Roman Empire, to the ninth century AD. These symbols were probably an elaborate, non-alphabetic writing system, a Pictish response to broader European changes in power and identity during the transition from the Roman Empire to the early medieval period.

Hydraulic fracturing is a widely used method for well stimulation to enhance hydrocarbon recovery. Permeability, or fluid conductivity, of the hydraulic fracture is a key parameter to determine the fluid production rate, and is principally conditioned by fracture geometry and the distribution of the encased proppant. A numerical model is developed to describe proppant transport within a propagating blade-shaped fracture towards defining the fracture conductivity and reservoir production after fracture closure. Fracture propagation is formulated based on the PKN-formalism coupled with advective transport of an equivalent slurry representing a proppant-laden fluid. Empirical constitutive relations are incorporated to define rheology of the slurry, proppant transport with bulk slurry flow, proppant gravitational settling, and finally the transition from Poiseuille (fracture) flow to Darcy (proppant pack) flow. At the maximum extent of the fluid-driven fracture, as driving pressure is released, a fracture closure model is employed to follow the evolution of fracture conductivity with the decreasing fluid pressure. This model is capable of accommodating the mechanical response of the proppant pack, fracture closure of potentially contacting rough surfaces, proppant embedment into fracture walls, and most importantly flexural displacement of the unsupported spans of the fracture. Results show that reduced fluid viscosity increases the length of the resulting fracture, while rapid leak-off decreases it, with both characteristics minimizing fracture width over converse conditions. Proppant density and size do not significantly influence fracture propagation. Proppant settling ensues throughout fracture advance, and is accelerated by a lower viscosity fluid or greater proppant density or size, resulting in accumulation of a proppant bed at the fracture base. ‘Screen-out’ of proppant at the fracture tip can occur where the fracture aperture is only several times the diameter of the individual proppant particles. After fracture closure, proppant packs comprising larger particles exhibit higher conductivity. More importantly, high-conductivity flow channels are necessarily formed around proppant banks due to the flexural displacement of the fracture walls, which offer preferential flow pathways and significantly influence the distribution of fluid transport. Higher compacting stresses are observed around the edge of proppant banks, resulting in greater depths of proppant embedment into the fracture walls and/or an increased potential for proppant crushing.

The anti-inflammatory mechanisms of low-fat dairy product consumption are largely unknown. The objective of this study was to determine whether low-fat yogurt reduces biomarkers of chronic inflammation and endotoxin exposure in women. Premenopausal women (BMI 18·5–27 and 30–40 kg/m2) were randomised to consume 339 g of low-fat yogurt (yogurt non-obese (YN); yogurt obese (YO)) or 324 g of soya pudding (control non-obese; control obese (CO)) daily for 9 weeks (n 30/group). Fasting blood samples were analysed for IL-6, TNF-α/soluble TNF II (sTNF-RII), high-sensitivity C-reactive protein, 2-arachidonoyl glycerol, anandamide, monocyte gene expression, soluble CD14 (sCD14), lipopolysaccharide (LPS), LPS binding protein (LBP), IgM endotoxin-core antibody (IgM EndoCAb), and zonulin. BMI, waist circumference and blood pressure were also determined. After 9-week yogurt consumption, YO and YN had decreased TNF-α/sTNFR-RII. Yogurt consumption increased plasma IgM EndoCAb regardless of obesity status. sCD14 was not affected by diet, but LBP/sCD14 was lowered by yogurt consumption in both YN and YO. Yogurt intervention increased plasma 2-arachidonoylglycerol in YO but not YN. YO peripheral blood mononuclear cells expression of NF-κB inhibitor α and transforming growth factor β1 increased relative to CO at 9 weeks. Other biomarkers were unchanged by diet. CO and YO gained approximately 0·9 kg in body weight. YO had 3·6 % lower diastolic blood pressure at week 3. Low-fat yogurt for 9 weeks reduced biomarkers of chronic inflammation and endotoxin exposure in premenopausal women compared with a non-dairy control food. This trial was registered as NCT01686204.

The benzoylcyclohexane-1,3-diones, the triketones, are potent bleaching herbicides whose structure-activity relationships and physical properties are substantially different from classical bleaching herbicides, which affect phytoene desaturase. The first clue to their unique mechanism of action was the discovery that rats treated with a triketone were found to be tyrosinemic. Additionally, examination of the rat urine revealed the accumulation of p-hydroxyphenylpyruvate (HPP) and p-hydroxyphenyllactate. These results suggested that this chemically induced tyrosinemia was the result of the inhibition of p-hydroxyphenylpyruvate dioxygenase (HPPD, EC 1.13.11.27), and this suggestion was confirmed when a triketone was shown to be a potent inhibitor of rat liver HPPD. In plants, HPPD is a component of the biosynthetic pathway to plastoquinone (PQ), which in turn is a key cofactor of phytoene desaturase. The expectation that triketone-treated plants should accumulate tyrosine while having reduced PQ levels was dramatically demonstrated in the meristematic tissue of ivyleaf morningglory. Plant HPPD, like the mammalian enzyme, was inhibited in vitro by triketones. These biochemical effects provide evidence that the triketone herbicidal mechanism of action is HPPD inhibition leading to a deficiency of PQ, a key cofactor for carotenoid biosynthesis. Other chemical classes of bleaching herbicides were also examined for their ability to elevate tyrosine and deplete PQ as a definitive means of establishing their mode of action and for delineating the structural and physical chemical requirements for an HPPD herbicide. Evidence is provided to support the claim that a 2-benzoylethen-1-ol substructure is the minimum substructure required for a potent HPPD inhibitor.

Reconciliation of unpaid care and employment is an increasingly important societal, economic and policy issue, both in the UK and internationally. Previous research shows the effectiveness of formal social care services in enabling carers to remain in employment. Using quantitative and qualitative data collected from carers and the person they care for in 2013 and 2015, during a period of cuts to adult social care in England, we explore barriers experienced to receipt of social care services. The main barriers to receipt of services identified in our study were availability, characteristics of services such as quality, and attitudes of carer and care-recipient to receiving services. These barriers have particular implications for carers' ability to reconcile care and employment.

Based on findings from the literature on campaign effects on the one hand, and the literature on European Parliament elections on the other, we propose a model of European Parliamentary elections in which the campaign shift the calculus of electoral support, making differences in national political allegiances less important and attitudes about the European project more important by informing voters of and getting them interested in European politics. In effect, we argue that the political campaign leading up to the election makes European Parliament elections less second order. While previous studies have demonstrated that EU issues can matter for voting behavior in European Parliament elections, existing research has drawn on post-election surveys that do not enable us to capture campaign effects. Our contribution is to assess the impact of a campaign by utilizing a rolling cross-sectional survey that enables us to track how voters were affected by the campaign. Our findings show that campaigns do have an effect on European Parliament election outcomes, in that they provide information that enables voters to make decisions based on their attitude on European issues, making voter decision-making more dominated by EU issue voting.

Agricultural production systems that reduce the use of in-crop herbicidescould greatly reduce risks of environmental damage and the development ofherbicide-resistant weeds. Few studies have investigated the long-termeffects of in-crop herbicide omissions on weed seedbank community size andstructure. A crop-rotation study was sampled 10 yr after a strictly annualrotation and an annual/perennial rotation were exposed to different in-cropherbicide omission treatments. In-crop herbicides were applied either in allannual crops (control), omitted from oats only, or omitted from both flaxand oats. Seedbank densities were greatest when in-crop herbicides wereomitted from flax and oats, and this treatment also reduced crop yield.Shannon-Wiener diversity differed among crops in the annual crop rotationand among herbicide omission treatments in the perennial rotation. Herbicideomissions changed the weed-community structure in flax and in wheat andcanola crops in the annual rotation enough to warrant alternate controlmethods in some treatments. The magnitude of the effects on the seedbankparameters depended largely on the competitive ability of the crop in whichherbicides were omitted. No yield response to omitting herbicides in oatsindicated that standard weed management practices have reduced weedpopulations below yield-loss thresholds.