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The World Health Organization (WHO) has a global initiative to eliminate industrially produced trans fatty acids (iTFAs) from the food supply (1). Formed via the partial hydrogenation of vegetable oils to create hardened vegetable fat, iTFAs can be found in processed foods including fried foods and baked goods. Even small amounts of iTFAs can increase the risk of coronary heart disease. These can be successfully eliminated from the food supply with the WHO recommending a ban on partially hydrogenated oils or to limit iTFA in food to a maximum of 2% of total fat (1). As of June 2024, over 50 countries had one of these regulatory measures in place. The trans-Tasman Food Regulation System is considering policy options to ensure iTFAs are eliminated or reduced as much as possible from the food supply in Australia and New Zealand. Up to date data on the presence of iTFAs in the New Zealand food supply is needed to inform this work as this was last measured in New Zealand in 2007/09 for packaged food and 2013 for fast food. The aim of this survey was to determine the presence and levels of iTFAs in the New Zealand food supply. Since it is not possible to analytically quantify iTFA separately from trans-fats that occur naturally in food products of ruminant origin, such as dairy, beef and lamb products, the sampling plan was designed to target products likely to contain predominately iTFA and adapted from the WHO global protocol for measuring trans fatty acid profiles of foods(2) to the New Zealand context. The survey analysed the trans-fat content of 627 products across national supermarkets (275 products), international supermarkets specialising in imported foods (149 products) and ready-to-eat food outlets (203 products from three regions). One hundred and six products (16.9%) contained trans-fat that exceeded 2% of total fat. Twenty-five (4%) of these products were likely to contain predominately iTFA. The 25 products predominately containing iTFA included eight products from national supermarkets (mostly bakery products), nine products from international supermarkets (mostly curry pastes and biscuits) and eight products from ready-to-eat food outlets (all fried foods). The median trans-fat content of these 25 products was 3.2% of total fat (assumed to be all iTFA). Over a third of these products contained more than double the recommended WHO limit, with five products containing over four times the limit and one product containing more than 16 times the WHO limit. The remaining 81 products may contain some iTFA, but we were unable to quantify the amount. The results from this survey will be used by New Zealand Food Safety to inform the consideration of regulatory options for reducing iTFAs in foods in New Zealand.
Multicenter clinical trials are essential for evaluating interventions but often face significant challenges in study design, site coordination, participant recruitment, and regulatory compliance. To address these issues, the National Institutes of Health’s National Center for Advancing Translational Sciences established the Trial Innovation Network (TIN). The TIN offers a scientific consultation process, providing access to clinical trial and disease experts who provide input and recommendations throughout the trial’s duration, at no cost to investigators. This approach aims to improve trial design, accelerate implementation, foster interdisciplinary teamwork, and spur innovations that enhance multicenter trial quality and efficiency. The TIN leverages resources of the Clinical and Translational Science Awards (CTSA) program, complementing local capabilities at the investigator’s institution. The Initial Consultation process focuses on the study’s scientific premise, design, site development, recruitment and retention strategies, funding feasibility, and other support areas. As of 6/1/2024, the TIN has provided 431 Initial Consultations to increase efficiency and accelerate trial implementation by delivering customized support and tailored recommendations. Across a range of clinical trials, the TIN has developed standardized, streamlined, and adaptable processes. We describe these processes, provide operational metrics, and include a set of lessons learned for consideration by other trial support and innovation networks.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
The description and delineation of trematode species is a major ongoing task. Across the field there has been, and currently still is, great variation in the standard of this work and in the sophistication of the proposal of taxonomic hypotheses. Although most species are relatively unambiguously distinct from their congeners, many are either morphologically very similar, including the major and rapidly growing component of cryptic species, or are highly variable morphologically despite little to no molecular variation for standard DNA markers. Here we review challenges in species delineation in the context provided to us by the historical literature, and the use of morphological, geographical, host, and molecular data. We observe that there are potential challenges associated with all these information sources. As a result, we encourage careful proposal of taxonomic hypotheses with consideration for underlying species concepts and frank acknowledgement of weaknesses or conflict in the data. It seems clear that there is no single source of data that provides a wholly reliable answer to our taxonomic challenges but that nuanced consideration of information from multiple sources (the ‘integrated approach’) provides the best possibility of developing hypotheses that will stand the test of time.
Vascular rings represent a heterogeneous set of aberrant great vessel anatomic configurations which can cause respiratory symptoms or dysphagia due to tracheal or oesophageal compression. These symptoms can be subtle and may present at varied ages. More recently, many have been identified in patients without symptoms, including fetal echocardiogram, resulting in a conundrum for practitioners when attempting to determine who will benefit from surgical correction. Here, we provide a review of vascular rings and a guide to the practitioner on when to consider additional imaging or referral. Additionally, we discuss the changing landscape regarding asymptomatic patients and fetal echocardiogram.
The opportunity to increase soybean yield has prompted Illinois farmers to plant soybean earlier than historical norms. Extending the growing season with an earlier planting date might alter the relationship between soybean growth and weed emergence timings, potentially altering the optimal herbicide application timings to minimize crop yield loss due to weed interference and ensure minimal weed seed production. The objective of this research was to examine various herbicide treatments applied at different timings and rates to assess the effect on weed control and yield in early-planted soybean. Field experiments were conducted in 2021 at three locations across central Illinois to determine effective chemical strategies for weed management in early-planted soybean. PRE treatments consisted of a S-metolachlor + metribuzin premix applied at planting or just prior to soybean emergence at 0.5X (883 + 210 g ai ha−1) or 1X (1,766 + 420 g ai ha−1) label-recommended rates. POST treatments were applied when weeds reached 10 cm tall and consisted of 1X rates of glufosinate (655 g ai ha−1) + glyphosate (1,260 g ae ha−1) + ammonium sulfate, without or with pyroxasulfone at a 0.5X (63 g ai ha−1) or 1X (126 g ai ha−1) rate. Treatments comprising both a full rate of PRE followed by a POST resulted in the greatest and most consistent weed control at the final evaluation timing. The addition of pyroxasulfone to POST treatments did not consistently reduce late-season weed emergence. The lack of a consistent effect by pyroxasulfone could be attributed to suppression of weeds by soybean canopy closure due to earlier soybean development. The full rate of PRE extended the timing of POST application 2 to 3 wk for all treatments at all locations except Urbana. Full-rate PRE treatments also reduced the time between the POST application and soybean canopy closure. Overall, a full-rate PRE reduced early-season weed interference and minimized soybean yield loss due to weed interference.
This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.
Methods
Two separate surveys were sent to USA-based DM program directors and alumni. The surveys gathered information regarding current training characteristics, career trajectories, and the outlook of DM training.
Results
The study had a 57% response rate among PDs, and 42% response rate from alumni. Most programs are 1-year and accept 1-2 fellows per class. More than 60% of the programs offer additional advanced degrees. Half of the respondents accept international medical graduates (IMGs). Only 25% accept non-MD/DO/MBBs trained applicants. Most of the alumni hold academic and governmental positions post-training. Furthermore, many alumni report that fellowship training offered an advantage in the job market and allowed them to expand their clinical practice.
Conclusions
The field of disaster medicine is continuously evolving owing to the increased recognition of the important roles DM specialists play in healthcare. The fellowship training programs are experiencing a similar evolution with an increasing trend toward standardization. Furthermore, graduates from these programs see their training as a worthwhile investment in career opportunities.
The global population and status of Snowy Owls Bubo scandiacus are particularly challenging to assess because individuals are irruptive and nomadic, and the breeding range is restricted to the remote circumpolar Arctic tundra. The International Union for Conservation of Nature (IUCN) uplisted the Snowy Owl to “Vulnerable” in 2017 because the suggested population estimates appeared considerably lower than historical estimates, and it recommended actions to clarify the population size, structure, and trends. Here we present a broad review and status assessment, an effort led by the International Snowy Owl Working Group (ISOWG) and researchers from around the world, to estimate population trends and the current global status of the Snowy Owl. We use long-term breeding data, genetic studies, satellite-GPS tracking, and survival estimates to assess current population trends at several monitoring sites in the Arctic and we review the ecology and threats throughout the Snowy Owl range. An assessment of the available data suggests that current estimates of a worldwide population of 14,000–28,000 breeding adults are plausible. Our assessment of population trends at five long-term monitoring sites suggests that breeding populations of Snowy Owls in the Arctic have decreased by more than 30% over the past three generations and the species should continue to be categorised as Vulnerable under the IUCN Red List Criterion A2. We offer research recommendations to improve our understanding of Snowy Owl biology and future population assessments in a changing world.
The Magellanic Stream (MS), a tail of diffuse gas formed from tidal and ram pressure interactions between the Small and Large Magellanic Clouds (SMC and LMC) and the Halo of the Milky Way, is primarily composed of neutral atomic hydrogen (HI). The deficiency of dust and the diffuse nature of the present gas make molecular formation rare and difficult, but if present, could lead to regions potentially suitable for star formation, thereby allowing us to probe conditions of star formation similar to those at high redshifts. We search for $\text{HCO}^{+}$, HCN, HNC, and C$_2$H using the highest sensitivity observations of molecular absorption data from the Atacama Large Millimeter Array (ALMA) to trace these regions, comparing with HI archival data from the Galactic Arecibo L-Band Feed Array (GALFA) HI Survey and the Galactic All Sky Survey (GASS) to compare these environments in the MS to the HI column density threshold for molecular formation in the Milky Way. We also compare the line of sight locations with confirmed locations of stars, molecular hydrogen, and OI detections, though at higher sensitivities than the observations presented here.
We find no detections to a 3$\sigma$ significance, despite four sightlines having column densities surpassing the threshold for molecular formation in the diffuse regions of the Milky Way. Here we present our calculations for the upper limits of the column densities of each of these molecular absorption lines, ranging from $3 \times 10^{10}$ to $1 \times 10^{13}$ cm$^{-2}$. The non-detection of $\text{HCO}^{+}$ suggests that at least one of the following is true: (i) $X_{\text{HCO}^{+}{}, \mathrm{MS}}$ is significantly lower than the Milky Way value; (ii) that the widespread diffuse molecular gas observed by Rybarczyk (2022b, ApJ, 928, 79) in the Milky Way’s diffuse interstellar medium (ISM) does not have a direct analogue in the MS; (iii) the HI-to-$\text{H}_{2}$ transition occurs in the MS at a higher surface density in the MS than in the LMC or SMC; or (iv) molecular gas exists in the MS, but only in small, dense clumps.
Black and Latino individuals are underrepresented in COVID-19 treatment and vaccine clinical trials, calling for an examination of factors that may predict willingness to participate in trials.
Methods:
We administered the Common Survey 2.0 developed by the Community Engagement Alliance (CEAL) Against COVID-19 Disparities to 600 Black and Latino adults in Baltimore City, Prince George’s County, Maryland, Montgomery County, Maryland, and Washington, DC, between October and December 2021. We examined the relationship between awareness of clinical trials, social determinants of health challenges, trust in COVID-19 clinical trial information sources, and willingness to participate in COVID-19 treatment and vaccine trials using multinomial regression analysis.
Results:
Approximately half of Black and Latino respondents were unwilling to participate in COVID-19 treatment or vaccine clinical trials. Results showed that increased trust in COVID-19 clinical trial information sources and trial awareness were associated with greater willingness to participate in COVID-19 treatment and vaccine trials among Black and Latino individuals. For Latino respondents, having recently experienced more challenges related to social determinants of health was associated with a decreased likelihood of willingness to participate in COVID-19 vaccine trials.
Conclusions:
The willingness of Black and Latino adults to participate in COVID-19 treatment and vaccine clinical trials is influenced by trial awareness and trust in trial information sources. Ensuring the inclusion of these communities in clinical trials will require approaches that build greater awareness and trust.
Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients.
Methods:
There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol.
Results:
There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males.
Conclusions:
Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.
Educational attainment (EduA) is correlated with life outcomes, and EduA itself is influenced by both cognitive and non-cognitive factors. A recent study performed a ‘genome-wide association study (GWAS) by subtraction,’ subtracting genetic effects for cognitive performance from an educational attainment GWAS to create orthogonal ‘cognitive’ and ‘non-cognitive’ factors. These cognitive and non-cognitive factors showed associations with behavioral health outcomes in adults; however, whether these correlations are present during childhood is unclear.
Methods
Using data from up to 5517 youth (ages 9–11) of European ancestry from the ongoing Adolescent Brain Cognitive DevelopmentSM Study, we examined associations between polygenic scores (PGS) for cognitive and non-cognitive factors and cognition, risk tolerance, decision-making & personality, substance initiation, psychopathology, and brain structure (e.g. volume, fractional anisotropy [FA]). Within-sibling analyses estimated whether observed genetic associations may be consistent with direct genetic effects.
Results
Both PGSs were associated with greater cognition and lower impulsivity, drive, and severity of psychotic-like experiences. The cognitive PGS was also associated with greater risk tolerance, increased odds of choosing delayed reward, and decreased likelihood of ADHD and bipolar disorder; the non-cognitive PGS was associated with lack of perseverance and reward responsiveness. Cognitive PGS were more strongly associated with larger regional cortical volumes; non-cognitive PGS were more strongly associated with higher FA. All associations were characterized by small effects.
Conclusions
While the small sizes of these associations suggest that they are not effective for prediction within individuals, cognitive and non-cognitive PGS show unique associations with phenotypes in childhood at the population level.
BrighT STAR was a diagnostic stewardship collaborative of 14 pediatric intensive care units (PICUs) across the United States designed to standardize and reduce unnecessary blood cultures and study the impact on patient outcomes and broad-spectrum antibiotic use. We now examine the implementation process in detail to understand how sites facilitated this diagnostic stewardship program in their PICUs.
Design:
A multi-center electronic survey of the 14 BrighT STAR sites, based on qualitative data about the implementation process collected during the primary phase of BrighT STAR.
Setting:
14 PICUs enrolled in BrighT STAR.
Participants:
Site leads at each enrolled site.
Methods:
An electronic survey guided by implementation science literature and based on data collected during BrighT STAR was administered to all 14 sites after completion of the primary phase of the collaborative.
Results:
10 specific tasks appear critical to implementing blood culture diagnostic stewardship, with variability in site-level strategies employed to accomplish those tasks. Sites rated certain tasks and strategies as highly important. Strategies used in top-performing sites were distinct from those used in lower-performing sites. Certain strategies may link to drivers of culture overuse and represent key targets for changing clinician behavior.
Conclusions:
BrighT STAR offers important insights into the tasks and strategies used to facilitate successful diagnostic stewardship in the PICU. More work is needed to compare specific strategies and optimize stewardship outcomes in this complex environment.
Panic disorder (PD) and agoraphobia (AG) are highly comorbid anxiety disorders with an increasing prevalence that have a significant clinical and public health impact but are not adequately recognized and treated. Although the current functional neuroimaging literature has documented a range of neural abnormalities in these disorders, primary studies are often not sufficiently powered and their findings have been inconsistent.
Objectives
This meta-analysis aims to advance our understanding of the neural underpinnings of PD and AG by identifying the most robust patterns of differential neural activation that differentiate individuals diagnosed with one of or both these disorders from age-matched healthy controls.
Methods
We conducted a comprehensive literature search in the PubMed database for all peer-reviewed, whole-brain, task-based functional magnetic resonance imaging (fMRI) activation studies that compared adults diagnosed with PD and/or AG with age-matched healthy controls. Each of these articles was screened by two independent coding teams using formal inclusion criteria and according to current PRISMA guidelines. We then performed a voxelwise, whole-brain, meta-analytic comparison of PD/AG participants with age-matched healthy controls using multilevel kernel density analysis (MKDA) with ensemble thresholding (p<0.05-0.0001) to minimize cluster size detection bias and 10,000 Monte Carlo simulations to correct for multiple comparisons.
Results
With data from 34 primary studies and a substantial sample size (N=2138), PD/AG participants, relative to age-matched healthy controls, exhibited a reliable pattern of statistically significant, (p<.05-0.0001; FWE-corrected) abnormal neural activation in multiple brain regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.
Conclusions
In this meta-analysis we found robust patterns of differential neural activation in participants diagnosed with PD/AG relative to age-matched healthy controls. These findings advance our understanding of the neural underpinnings of PD and AG and inform the development of brain-based clinical interventions such as non-invasive brain stimulation (NIBS) and treatment prediction and matching algorithms. Future studies should also investigate the neural similarities and differences between PD and AG to increase our understanding of possible differences in their etiology, diagnosis, and treatment.
Amid resurgent geopolitical fissures and in the aftermath of the Covid-19 pandemic, there is a growing awareness in the sector of the need for, and concern about, national and international collaboration in archaeological projects. This article reflects on present-day challenges for international collaboration in central Eurasian archaeology and furthers a much-needed discussion about (re)integrating local narratives with inter-regional trends in future research. Responsible and practical proposals for bridging collaborator differences in institutional or publishing obligations, language capacities and access to resources are discussed.
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
Methods
Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.
Results
Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).
Conclusions
Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
Our institution sought to evaluate our antimicrobial stewardship empiric treatment recommendations for Salmonella. Results from 36 isolates demonstrated reduced susceptibilities to fluoroquinolones with 1 isolate susceptible only to ceftriaxone. Analysis supports the current recommendation of empiric ceftriaxone therapy for severe infection and updated recommendation for sulfamethoxazole-trimethoprim in non-severe infections.
Two independent temporal-spatial clusters of hospital-onset Rhizopus infections were evaluated using whole-genome sequencing (WGS). Phylogenetic analysis confirmed that isolates within each cluster were unrelated despite epidemiological suspicion of outbreaks. The ITS1 region alone was insufficient for accurate analysis. WGS has utility for rapid rule-out of suspected nosocomial Rhizopus outbreaks.
Children with congenital heart disease (CHD) can face neurodevelopmental, psychological, and behavioural difficulties beginning in infancy and continuing through adulthood. Despite overall improvements in medical care and a growing focus on neurodevelopmental screening and evaluation in recent years, neurodevelopmental disabilities, delays, and deficits remain a concern. The Cardiac Neurodevelopmental Outcome Collaborative was founded in 2016 with the goal of improving neurodevelopmental outcomes for individuals with CHD and pediatric heart disease. This paper describes the establishment of a centralised clinical data registry to standardize data collection across member institutions of the Cardiac Neurodevelopmental Outcome Collaborative. The goal of this registry is to foster collaboration for large, multi-centre research and quality improvement initiatives that will benefit individuals and families with CHD and improve their quality of life. We describe the components of the registry, initial research projects proposed using data from the registry, and lessons learned in the development of the registry.