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We present a 1000 km transect of phase-sensitive radar measurements of ice thickness, basal reflection strength, basal melting and ice-column deformation across the Ross Ice Shelf (RIS). Measurements were gathered at varying intervals in austral summer between 2015 and 2020, connecting the grounding line with the distant ice shelf front. We identified changing basal reflection strengths revealing a variety of basal conditions influenced by ice flow and by ice–ocean interaction at the ice base. Reflection strength is lower across the central RIS, while strong reflections in the near-front and near-grounding line regions correspond with higher basal melt rates, up to 0.47 ± 0.02 m a−1 in the north. Melting from atmospherically warmed surface water extends 150–170 km south of the RIS front. Melt rates up to 0.29 ± 0.03 m a−1 and 0.15 ± 0.03 m a−1 are observed near the grounding lines of the Whillans and Kamb Ice Stream, respectively. Although troublesome to compare directly, our surface-based observations generally agree with the basal melt pattern provided by satellite-based methods but provide a distinctly smoother pattern. Our work delivers a precise measurement of basal melt rates across the RIS, a rare insight that also provides an early 21st-century baseline.
The excavation of a stratified sequence of deposits spanning the Initial Late Formative period (250 BC–AD 120) at Iruhito, in the upper Desaguadero Valley of Bolivia, provides insight into this previously unrecognized, four-century period separating the well-documented Middle Formative (800–250 BC) from the Late Formative (~AD 120–590) period. By tracking subtle shifts in ceramic, architectural, lithic, and faunal data, we can explore tempos of change in social life during this dynamic time. These data lead us to suggest that, rather than being a “transitional” period or a “hiatus” in regional occupation, the Initial Late Formative period was a distinct mode of sociality characterized by the realignment and expansion of interaction networks, on the one hand, and rejection of the decorative aesthetics, monumentality, and public-oriented performances of earlier periods, on the other. We argue that the Late Formative period centers emerging after ~AD 120 intentionally cited architecture and aesthetics that were distant in time and space, constituting a sophisticated political strategy. Finally, these data suggest that the chronological schemata we use to build regional histories often obscure social variability.
The recent ONS survey reported that 92% of students had been affected by the cost-of-living crisis with 46% revealing their overall mental health and well-being had worsened(1). London Metropolitan University has a unique diverse student population: in 2020-21, 82% of students were mature, 64% of students identified as female, 55% of students were from a minoritised background and 13% had a known disability(2). Furthermore, at least 50% of our students, many of whom have caring responsibilities, reside in the most deprived wards of Islington or other impoverished London boroughs. It has been documented that those students with families, who come from a low income and a minority background are more vulnerable(3) and are more likely to be disproportionately affected by the cost-of-living crisis and at risk of food insecurity. We sought to ease the burden of the cost-of-living crisis with a recipe box scheme, BRITE Box (4) and evaluate its acceptance.
BRITE Box provides a complete set of pre-weighed ingredients for a healthy nutritious meal with an easy-to-follow recipe guide. Each box typically contains two servings of vegetables, meat, bread and dairy, as well as spices, dried and tinned goods to feed a family of five people. We distributed 300 boxes over a period of five months to students primarily with families who had accessed the university hardship fund. Student volunteers and the academic staff pre-weighed the ingredients, prepared and distributed the boxes. The scheme was advertised through Student Services who administer the hardship fund, the Student Union and the intranet. The recipients of the boxes were provided with a QR code linking to a 20-item online survey on demographic characteristics, number of children, acceptability of the box and perceived advantages and disadvantages of the scheme. Ethics was approved by London Metropolitan University.
Thirty-three participants completed the survey, 42% of the recipients identified as female, 55% were from a minority background and 30% had children. The responses showed that students agreed and strongly agreed that the recipe box introduced them to new flavours (52%), and new foods (42%). The majority followed the recipe and will use again (67%). Most importantly, 73% students agreed and or strongly agreed that it helped with the food budget and helped foster a sense of belonging to the university (85%).
The scheme has proved to be popular among the students: “a really cool concept”, “it helped me cook”, “the box provided food for 3 days” and created a buzz around campus on distribution days. It has enhanced the feeling of community and belonging within the university, whilst also alleviating food insecurity and tackling the cost-of-living crisis.
In Michigan, the COVID-19 pandemic severely impacted Black and Latinx communities. These communities experienced higher rates of exposure, hospitalizations, and deaths compared to Whites. We examine the impact of the pandemic and reasons for the higher burden on communities of color from the perspectives of Black and Latinx community members across four Michigan counties and discuss recommendations to better prepare for future public health emergencies.
Methods:
Using a community-based participatory research approach, we conducted semi-structured interviews (n = 40) with Black and Latinx individuals across the four counties. Interviews focused on knowledge related to the pandemic, the impact of the pandemic on their lives, sources of information, attitudes toward vaccination and participation in vaccine trials, and perspectives on the pandemic’s higher impact on communities of color.
Results:
Participants reported overwhelming effects of the pandemic in terms of worsened physical and mental health, financial difficulties, and lifestyle changes. They also reported some unexpected positive effects. They expressed awareness of the disproportionate burden among Black and Latinx populations and attributed this to a wide range of disparities in Social Determinants of Health. These included racism and systemic inequities, lack of access to information and language support, cultural practices, medical mistrust, and varied individual responses to the pandemic.
Conclusion:
Examining perspectives and experiences of those most impacted by the pandemic is essential for preparing for and effectively responding to public health emergencies in the future. Public health messaging and crisis response strategies must acknowledge the concerns and cultural needs of underrepresented populations.
This study documents several correlations observed during the first run of the plasma wakefield acceleration experiment E300 conducted at FACET-II, using a single drive electron bunch. The established correlations include those between the measured maximum energy loss of the drive electron beam and the integrated betatron X-ray signal, the calculated total beam energy deposited in the plasma and the integrated X-ray signal, among three visible light emission measuring cameras and between the visible plasma light and X-ray signal. The integrated X-ray signal correlates almost linearly with both the maximum energy loss of the drive beam and the energy deposited into the plasma, demonstrating its usability as a measure of energy transfer from the drive beam to the plasma. Visible plasma light is found to be a useful indicator of the presence of a wake at three locations that overall are two metres apart. Despite the complex dynamics and vastly different time scales, the X-ray radiation from the drive bunch and visible light emission from the plasma may prove to be effective non-invasive diagnostics for monitoring the energy transfer from the beam to the plasma in future high-repetition-rate experiments.
Ice tongues are unconfined by land on their lateral margins and are sensitive to external forcing from the ocean. They are found sporadically around the Antarctic coast but are common in the western Ross Sea. Lateral flexure creates bending stresses within these ice tongues which is likely to contribute to their fragility and may restrict their spatial distribution. A three-year time series (2017–2020) of synthetic aperture radar interferometry (InSAR) and differential interferometry (DInSAR) is used to observe the lateral flexure of the 10 km long Erebus Ice Tongue as a result of ocean currents. The fast ice area around the ice tongue was mapped during the same period. It was found that when fast ice was absent (34.7% of the time), the average lateral movement of the ice tongue was twice as high (0.44 m) as when it was embedded in fast ice (0.19 m). A significant correlation (0.45) between flexure and tidal currents was found when fast ice was absent. An analytical model tuned to observations suggests that even without sea ice for stabilisation, the lateral bending stresses induced by the ocean are insufficient to cause calving without additional amplifying factors.
There is a paucity of data guiding treatment duration of oral vancomycin for Clostridiodes difficile infection (CDI) in patients requiring concomitant systemic antibiotics.
Objectives:
To evaluate prescribing practices of vancomycin for CDI in patients that required concurrent systemic antibiotics and to determine whether a prolonged duration of vancomycin (>14 days), compared to a standard duration (10–14 days), decreased CDI recurrence.
Methods:
In this retrospective cohort study, we evaluated adult hospitalized patients with an initial episode of CDI who were treated with vancomycin and who received overlapping systemic antibiotics for >72 hours. Outcomes of interest included CDI recurrence and isolation of vancomycin-resistant Enterococcus (VRE).
Results:
Among the 218 patients included, 36% received a standard duration and 64% received a prolonged duration of treatment for a median of 13 days (11–14) and 20 days (16–26), respectively. Patients who received a prolonged duration had a longer median duration of systemic antibiotic overlap with vancomycin (11 vs 8 days; P < .001) and significantly more carbapenem use and infectious disease consultation. Recurrence at 8 weeks (12% standard duration vs 8% prolonged duration; P = .367), recurrence at 6 months (15% standard duration vs 10% prolonged duration; P = .240), and VRE isolation (3% standard duration vs 9% prolonged duration; P = .083) were not significantly different between groups. Discontinuation of vancomycin prior to completion of antibiotics was an independent predictor of 8-week recurrence on multivariable logistic regression (OR, 4.8; 95% CI, 1.3–18.1).
Conclusions:
Oral vancomycin prescribing relative to the systemic antibiotic end date may affect CDI recurrence to a greater extent than total vancomycin duration alone. Further studies are needed to confirm these findings.
Journal editors can promote gender equality in various ways. The main ones are consideration of gender when inviting editorial board members, peer reviewers, and authors of solicited opinion pieces or reviews. As in many areas, the problem can be that the pool of suitable women is perceived to be small and the same women are asked to perform multiple tasks in addition to their academic and clinical duties. Journal editors need to seek women who are less well known but competent for the task required. To increase the pool of qualified candidates, editors should promote training using existing resources, such as online peer reviewer courses, or develop in-house initiatives, such as The Lancet Psychiatry’s Editorial Board Development Programme. It is important to make public commitments to gender balance, for example as part of a diversity pledge, with specific targets, and to collect and report data with regular updates. Gender balance should be an integral part of information templates in manuscript handling systems, such as asking authors and peer reviewers to consider women when recommending alternative peer reviewers. Where relevant, journal editors can also consider gender balance in their use of images, cover art, podcast or interview subjects, profiles, news and features, and social media content.
OBJECTIVES/GOALS: To identify insights and challenges in community engaged research for the academy and community. To develop an online platform to match academic and community partners; promote networking; and provision of key resources. METHODS/STUDY POPULATION: Using a human-centered design approach, 19 interviews were conducted with academics, community organizations and members, and other CTSAs. The interviews focused on understanding CEnR challenges and processes in partnership formation. RESULTS/ANTICIPATED RESULTS: Findings revealed the following 10 challenges to and insights about CEnR: (1) time intensive; (2) lack of knowledge; (3) differing motivations; (4) connections occur through networking; (5) topic area, proximity, and readiness influence partnerships; (6) organizational turnover; (7) promotion pressure; (8) collaboration throughout; (9) navigator for partnership; and (10) lack of shared language. Also, a CEnR system flowchart revealed the following five phases of an effective partnership: 1) generating interest; 2) learning process; 3) connecting with the right partner; 4). Defining the research question; and 5) implementing research as a partnership. DISCUSSION/SIGNIFICANCE: In conclusion, input from academicians and community members support the need for an online platform like M-REACH to facilitate CEnR partnerships, networking, and resources to address significant public health issues through translational research.
OBJECTIVES/GOALS: During earlier periods of the pandemic, Black and Latinx populations in Michigan have suffered higher rates of infection, hospitalization, and deaths when compared to Whites. We conducted this study to understand how Black and Latinx residents perceived this disproportionate burden. METHODS/STUDY POPULATION: In 2021, 40 semi-structured interviews were conducted virtually in English or Spanish with Black (n=24) and Latinx (n=16) residents in Michigan areas highly impacted by COVID-19: Genesee, Kent, Washtenaw, and Wayne counties. Using a Community-Based Participatory Research (CBPR) approach, we partnered with leaders from 15 community-based organizations and health and human service agencies to develop research questions, an interview protocol, and to interpret the data. We used the data analysis software Dedoose (ver 4.12) for inductive coding (IRR=0.81). This study is a part of the NIH Community Engagement Alliance (CEAL) Against COVID-19 initiative. RESULTS/ANTICIPATED RESULTS: Participants described the significant impact of the pandemic in terms of physical and mental health, job security, and the sheer number of deaths among loved ones. They attributed the impact to comorbidities and social determinants of health disparities exacerbated by the pandemic, including income, housing, access to healthcare, as well as systemic racism. They noted being overrepresented among frontline workers with higher exposure to COVID-19, limited or misinformation about the virus, language barriers, and difficulty with social distancing. Cultural norms that promote being in close proximity, such as intergenerational households, and loss of trusted community leaders were also noted. DISCUSSION/SIGNIFICANCE: Findings reflect the needs of Black and Latinx community members in Michigan and the discussions they feel are important to highlight. We must work strategically with partners and the community to provide transparency and effective leadership, and prioritize addressing systemic disparities in SDoH.
OBJECTIVES/GOALS: COVID-19 vaccines were met with both public excitement and concern. Our goal was to understand individual’s attitudes about COVID-19 vaccines within Black and Latino communities deeply impacted by COVID-19, in an effort to highlight their potential similarities and differences. METHODS/STUDY POPULATION: Using a community-based participatory approach, we partnered with 16 leaders from community-based organizations to conduct a mixed-methods study examining the perspectives of Black and Latino communities regarding their vaccine acceptance or hesitancy. We focused on Michigan counties highly impacted by COVID-19 infection and deaths. In 2021, we interviewed 24 Black and 16 Latino residents in English or Spanish. We combined this with survey data on vaccine attitudes and behavior from the Detroit Metro Area Communities Study (n=1,800). This research is part of the NIH Community Engagement Alliance Against COVID-19. RESULTS/ANTICIPATED RESULTS: Qualitative and quantitative analysis highlight that Black participants expressed greater mistrust and hesitance around vaccines and less willingness to get vaccinated, often citing historical mistreatment as a contributing factor. The desire to keep themselves, their families and community safe was cited as the most important factor shaping vaccine decisions among both groups. Trust in information and in science was rated as a stronger reason for vaccination among Latinx participants; however, they also appeared to highlight the issue of vaccine access more often than Black participants. Fear of side effects and risks were equally cited as factors that influenced their vaccine hesitancy. DISCUSSION/SIGNIFICANCE: Despite being labeled as minority communities, these two groups have important differences regarding their perspective of COVID-19 vaccines. Our results suggest that public health interventions must be tailored to address the concerns, differences in attitudes, and beliefs among Blacks and Latinos.
Adolescents with emotional and behavioural disorders (EBD) continue to struggle in the school environment. They may have difficulty connecting to their school environment as their engagement in challenging behaviour may have led to frequent school removal and high rates of school dropout, resulting in a breakdown of their school connectedness. The purpose of this study was to evaluate levels of school connectedness for adolescents with EBD attending self-contained classrooms and compare them to adolescents in general education. The School Connectedness Questionnaire (SCQ), measuring school bonding, school attachment, school engagement, and school climate, was administered to 50 students with EBD and to 50 general education students (n = 100). A multivariate analysis of variance (MANOVA) was conducted. The results indicated that of the four domains of school connectedness, students with EBD reported significantly higher levels of school climate. These youth also reported significant differences on four specific items representing three of the four construct domains. The results indicate that adolescents with EBD may experience school differently. Researchers should continue to examine specially designed programs for students with EBD that emphasise explicit behavioural and academic expectations and social and emotional skill development and its impact on school connectedness for adolescents with EBD.
The effectiveness of community-based participatory research (CBPR) partnerships to address health inequities is well documented. CBPR integrates knowledge and perspectives of diverse communities throughout the research process, following principles that emphasize trust, power sharing, co-learning, and mutual benefits. However, institutions and funders seldom provide the time and resources needed for the critical stage of equitable partnership formation and development.
Methods:
Since 2011, the Detroit Urban Research Center, collaborating with other entities, has promoted the development of new community–academic research partnerships through two grant programs that combine seed funding with capacity building support from community and academic instructors/mentors experienced in CBPR. Process and outcomes were evaluated using mixed methods.
Results:
From 2011 to 2021, 50 partnerships received grants ranging from $2,500 to $30,000, totaling $605,000. Outcomes included equitable partnership infrastructure and processes, innovative pilot research, translation of findings to interventions and policy change, dissemination to multiple audiences, new proposals and projects, and sustained community–academic research partnerships. All partnerships continued beyond the program; over half secured additional funding.
Conclusions:
Keys to success included participation as community–academic teams, dedicated time for partnership/relationship development, workshops to develop equity-based skills, relationships, and projects, expert community–academic instructor guidance, and connection to additional resources. Findings demonstrate that small amounts of seed funding for newly forming community–academic partnerships, paired with capacity building support, can provide essential time and resources needed to develop diverse, inclusive, equity-focused CBPR partnerships. Building such support into funding initiatives and through academic institutions can enhance impact and sustainability of translational research toward advancing health equity.
We aimed to describe the clinical characteristics of female patients presenting with premenstrual disorders to a tertiary service in the UK. We conducted a retrospective case-note review of referrals to the National Female Hormone Clinic from April 2014 to August 2020. Based on clinical assessment, we determined whether the patient met criteria for premenstrual dysphoric disorder or premenstrual exacerbation of an underlying psychiatric disorder.
Results
Of 146 patients seen in clinic for premenstrual disorders, an ICD-10 psychiatric diagnosis was made in 130 (89.0%); a minority 16 (11.0%) did not have a psychiatric diagnosis. Following assessment, 94 patients (64.4%) met criteria for premenstrual dysphoric disorder and 67 (45.6%) had exacerbation of a psychiatric disorder.
Clinical implications
Patients presenting to this specialist service had complex psychiatric comorbidity; almost half presented with exacerbation of a psychiatric disorder.
Non-archosaur archosauromorphs are a paraphyletic group of diapsid reptiles that were important members of global Middle and Late Triassic continental ecosystems. Included in this group are the azendohsaurids, a clade of allokotosaurians (kuehneosaurids and Azendohsauridae + Trilophosauridae) that retain the plesiomorphic archosauromorph postcranial body plan but evolved disparate cranial features that converge on later dinosaurian anatomy, including sauropodomorph-like marginal dentition and ceratopsian-like postorbital horns. Here we describe a new malerisaurine azendohsaurid from two monodominant bonebeds in the Blue Mesa Member, Chinle Formation (Late Triassic, ca. 218–220 Ma); the first occurs at Petrified Forest National Park and preserves a minimum of eight individuals of varying sizes, and the second occurs near St. Johns, Arizona. Puercosuchus traverorum n. gen. n. sp. is a carnivorous malerisaurine that is closely related to Malerisaurus robinsonae from the Maleri Formation of India and to Malerisaurus langstoni from the Dockum Group of western Texas. Dentigerous elements from Puercosuchus traverorum n. gen. n. sp. confirm that some Late Triassic tooth morphotypes thought to represent early dinosaurs cannot be differentiated from, and likely pertain to, Puercosuchus-like malerisaurine taxa. These bonebeds from northern Arizona support the hypothesis that non-archosauriform archosauromorphs were locally diverse near the middle Norian and experienced an extinction event prior to the end-Triassic mass extinction coincidental with the Adamanian-Revueltian boundary recognized at Petrified Forest National Park. The relatively late age of this early-diverging taxon (Norian) suggests that the diversity of azendohsaurids is underrepresented in Middle and Late Triassic fossil records around the world.
Whole-genome sequencing (WGS) has traditionally been used in infection prevention to confirm or refute the presence of an outbreak after it has occurred. Due to decreasing costs of WGS, an increasing number of institutions have been utilizing WGS-based surveillance. Additionally, machine learning or statistical modeling to supplement infection prevention practice have also been used. We systematically reviewed the use of WGS surveillance and machine learning to detect and investigate outbreaks in healthcare settings.
Methods:
We performed a PubMed search using separate terms for WGS surveillance and/or machine-learning technologies for infection prevention through March 15, 2021.
Results:
Of 767 studies returned using the WGS search terms, 42 articles were included for review. Only 2 studies (4.8%) were performed in real time, and 39 (92.9%) studied only 1 pathogen. Nearly all studies (n = 41, 97.6%) found genetic relatedness between some isolates collected. Across all studies, 525 outbreaks were detected among 2,837 related isolates (average, 5.4 isolates per outbreak). Also, 35 studies (83.3%) only utilized geotemporal clustering to identify outbreak transmission routes. Of 21 studies identified using the machine-learning search terms, 4 were included for review. In each study, machine learning aided outbreak investigations by complementing methods to gather epidemiologic data and automating identification of transmission pathways.
Conclusions:
WGS surveillance is an emerging method that can enhance outbreak detection. Machine learning has the potential to identify novel routes of pathogen transmission. Broader incorporation of WGS surveillance into infection prevention practice has the potential to transform the detection and control of healthcare outbreaks.
Research has shown that 20–30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders.
Aims
To estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD.
Method
We conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16–25 years) meeting the DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8 weeks, using the investigator-rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression.
Results
In the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks was estimated to be reduced by 0.57 points relative to the placebo arm (95% CI −2.41 to 3.56), and non-significant. The responder rate, defined as a 20% reduction in CAARS-O score, was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm.
Conclusions
ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multi-modal treatments and preventative interventions in the community.
The sense of ‘loss of control’ (LOC), or a feeling of being unable to stop eating or control what or how much one is eating, is the most salient aspect of binge eating. However, the neural alterations that may contribute to this experience and eating behavior remain poorly understood.
Methods
We used functional near-infrared spectroscopy (fNIRS) to measure activation in the prefrontal cortices of 23 women with bulimia nervosa (BN) and 23 healthy controls (HC) during two tasks: a novel go/no-go task requiring inhibition of eating responses, and a standard go/no-go task requiring inhibition of button-pressing responses.
Results
Women with BN made more commission errors on both tasks. BN subgroups with the most severe LOC eating (n = 12) and those who felt most strongly that they binge ate during the task (n = 12) showed abnormally reduced bilateral ventromedial prefrontal cortex (vmPFC) and right ventrolateral prefrontal cortex (vlPFC) activation associated with eating-response inhibition. In the entire BN sample, lower eating-task activation in right vlPFC was related to more frequent and severe LOC eating, but no group differences in activation were detected on either task when this full sample was compared with HC. BN severity was unrelated to standard-task activation.
Conclusions
Results provide initial evidence that diminished PFC activation may directly contribute to more severe eating-specific control deficits in BN. Our findings support vmPFC and vlPFC dysfunction as promising treatment targets, and indicate that eating-specific tasks and fNIRS may be useful tools for identifying neural mechanisms underlying dysregulated eating.