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Targeting the glutamatergic system is posited as a potentially novel therapeutic strategy for psychotic disorders. While studies in subjects indicate that antipsychotic medication reduces brain glutamatergic measures, they were unable to disambiguate clinical changes from drug effects.
Aims
To address this, we investigated the effects of a dopamine D2 receptor partial agonist (aripiprazole) and a dopamine D2 receptor antagonist (amisulpride) on glutamatergic metabolites in the anterior cingulate cortex (ACC), striatum and thalamus in healthy controls.
Method
A double-blind, within-subject, cross-over, placebo-controlled study design with two arms (n = 25 per arm) was conducted. Healthy volunteers received either aripiprazole (up to 10 mg/day) for 7 days or amisulpride (up to 400 mg/day) and a corresponding period of placebo treatment in a pseudo-randomised order. Magnetic resonance spectroscopy (1H-MRS) was used to measure glutamatergic metabolite levels and was carried out at three different time points: baseline, after 1 week of drug and after 1 week of placebo. Values were analysed as a combined measure across the ACC, striatum and thalamus.
Results
Aripiprazole significantly increased glutamate + glutamine (Glx) levels compared with placebo (β = 0.55, 95% CI [0.15, 0.95], P = 0.007). At baseline, the mean Glx level was 8.14 institutional units (s.d. = 2.15); following aripiprazole treatment, the mean Glx level was 8.16 institutional units (s.d. = 2.40) compared with 7.61 institutional units (s.d. = 2.36) for placebo. This effect remained significant after adjusting for plasma parent and active metabolite drug levels. There was an observed increase with amisulpride that did not reach statistical significance.
Conclusions
One week of aripiprazole administration in healthy participants altered brain Glx levels as compared with placebo administration. These findings provide novel insights into the relationship between antipsychotic treatment and brain metabolites in a healthy participant cohort.
Seed dormancy is the key factor determining weed emergence patterns in the field. Alopecurus myosuroides (black grass) is a serious cereal weed in Europe that experiences two emergence peaks affecting winter and spring cereals, respectively. Seedlings that emerge in autumn encounter a period of cold winter temperatures, whereas those that emerge in spring do not. In this work, we investigated the effects of this overwintering during vegetative growth on the primary seed dormancy of the offspring. Alopecurus myosuroides plants were propagated under controlled conditions where a proportion of the population was subjected to a simulated winter period (vernalization) as seedlings. The offspring produced by vernalized plants was significantly more dormant, requiring longer after-ripening and cold stratification treatments to germinate at warm temperatures. However, there was no difference in the range of temperatures under which dormant seeds germinated. We hypothesized that this difference in dormancy was the result of an epigenetic memory of vernalization. Global changes in DNA methylation of seeds were quantified using an ELISA-based approach. Imbibition in dormant seeds produced by vernalized plants was associated with a global demethylation event that was not observed in the offspring of plants that had not been vernalized. Taken together, these results demonstrate the importance of temperature at different stages of the plant lifecycle in determining dormancy levels and consequently weed emergence patterns in the field.
Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Since the early 2000s, the US Government has made purposeful investments to help ensure medical preparedness should a radiological or nuclear incident occur within its borders. This focused support of products to diagnose, mitigate, and treat radiation-induced bodily injuries that would be anticipated during a radiation public health emergency has involved many departments, ranging from multiple agencies within the Department of Health and Human Services to the Department of Defense. The intent of this manuscript is to convey information both on products that have been approved by the US Food and Drug Administration for radiation injuries during a radiation incident, as well as promising approaches under advanced stages of development. These products impact multiple organ systems (e.g., bone marrow, gastrointestinal tract, lungs, kidneys, skin) and have been tested for efficacy in a number of different small and large preclinical animal models. The successful development of these models, methods, products, and devices discussed herein demonstrate the importance of an intentionally collaborative, “one-government” approach to fostering radiation research, while also showcasing the need for critical public-private partnerships – all to ensure the safety of the public should the unthinkable occur.
In April 2023, eighteen scholars from nine different subjects representing the humanities, natural and social sciences came together for a one-day workshop at St John’s College, Durham. Despite our differences, all had one aim: the study of past environmental change and its effects on human societies. Talking across disciplinary divides, we discussed what environmental history is, how it may or may not contribute to tackling the climate crisis, and the problems of sources, scale and temporality. This article collects select conversations into a roundtable format split into four areas: scale, time and space, interdisciplinarity, and the future of environmental history. We argue that environmental history is more usefully understood not as a distinct sub-field of history, but as an interdisciplinary meeting place for innovative collaboration. This also presents a model for future research aimed at tackling the climate crisis at higher education institutions.
Distinguishing early domesticates from their wild progenitors presents a significant obstacle for understanding human-mediated effects in the past. The origin of dogs is particularly controversial because potential early dog remains often lack corroborating evidence that can provide secure links between proposed dog remains and human activity. The Tumat Puppies, two permafrost-preserved Late Pleistocene canids, have been hypothesized to have been littermates and early domesticates due to a physical association with putatively butchered mammoth bones. Through a combination of osteometry, stable isotope analysis, plant macrofossil analysis, and genomic and metagenomic analyses, this study exploits the unique properties of the naturally mummified Tumat Puppies to examine their familial relationship and to determine whether dietary information links them to human activities. The multifaceted analysis reveals that the 14,965–14,046 cal yr BP Tumat Puppies were littermates who inhabited a dry and relatively mild environment with heterogeneous vegetation and consumed a diverse diet, including woolly rhinoceros in their final days. However, because there is no evidence of mammoth consumption, these data do not establish a link between the canids and ancient humans.
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.
In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the authors describe a baby born at 25 weeks gestational age (at a time when survival at that stage was tenuous) to an adolescent mother. The fragile preemie developed necrotizing enterocolitis that was so extensive that definitive surgical resection was impossible. With no definitive treatment and inevitable suffering without it, the recommendation to shift to comfort care was declined and ethics consultants helped to negotiate the conflict.
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
Connectivity and trade dominate discussions of the Mediterranean Bronze and Iron Ages, where artefacts travelled increasing distances by land and sea. Much of the evidence for the means through which such networks operated is necessarily indirect, but shipwrecks offer direct insights into the movement of goods. Here, the authors explore three Iron Age cargoes recently excavated at Tel Dor on the Carmel Coast, the first from this period found in the context of an Iron Age port city in Israel. Spanning the eleventh–seventh centuries BC, these cargoes illuminate cycles of expansion and contraction in Iron Age Mediterranean connectivity and integration.
It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
The Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society represent the core expertise regarding healthcare infection prevention and infectious diseases and have written multisociety statement for healthcare facility leaders, regulatory agencies, payors, and patients to strengthen requirements and expectations around facility infection prevention and control (IPC) programs. Based on a systematic literature search and formal consensus process, the authors advocate raising the expectations for facility IPC programs, moving to effective programs that are:
• Foundational and influential parts of the facility’s operational structure
• Resourced with the correct expertise and leadership
• Prioritized to address all potential infectious harms
This document discusses the IPC program’s leadership—a dyad model that includes both physician and infection preventionist leaders—its reporting structure, expertise, and competencies of its members, and the roles and accountability of partnering groups within the healthcare facility. The document outlines a process for identifying minimum IPC program medical director support. It applies to all types of healthcare settings except post-acute long-term care and focuses on resources for the IPC program. Long-term acute care hospital (LTACH) staffing and antimicrobial stewardship programs will be discussed in subsequent documents.
Inadequate recruitment and retention impede clinical trial goals. Emerging decentralized clinical trials (DCTs) leveraging digital health technologies (DHTs) for remote recruitment and data collection aim to address barriers to participation in traditional trials. The ACTIV-6 trial is a DCT using DHTs, but participants’ experiences of such trials remain largely unknown. This study explored participants’ perspectives of the ACTIV-6 DCT that tested outpatient COVID-19 therapeutics.
Methods:
Participants in the ACTIV-6 study were recruited via email to share their day-to-day trial experiences during 1-hour virtual focus groups. Two human factors researchers guided group discussions through a semi-structured script that probed expectations and perceptions of study activities. Qualitative data analysis was conducted using a grounded theory approach with open coding to identify key themes.
Results:
Twenty-eight ACTIV-6 study participants aged 30+ years completed a virtual focus group including 1–4 participants each. Analysis yielded three major themes: perceptions of the DCT experience, study activity engagement, and trust. Participants perceived the use of remote DCT procedures supported by DHTs as an acceptable and efficient method of organizing and tracking study activities, communicating with study personnel, and managing study medications at home. Use of social media was effective in supporting geographically dispersed participant recruitment but also raised issues with trust and study legitimacy.
Conclusions:
While participants in this qualitative study viewed the DCT-with-DHT approach as reasonably efficient and engaging, they also identified challenges to address. Understanding facilitators and barriers to DCT participation and DHT interaction can help improve future research design.
Objectives/Goals: The University of Minnesota (UMN) CTSI and Medical School sought to increase the diversity of translational research-intensive faculty by recruiting highly promising new-to-UMN tenure track faculty in the Medical School. Increased resources and career development will increase recruitment and address barriers to their promotion and success. Methods/Study Population: In 2019, the Medical School Dean committed to fund 15 Early Career Research Awards (ECRA) Scholars to recruit outstanding new-to-UMN, tenure track faculty. Supplementing usual departmental recruitment packages, ECRA Scholars receive: 75% salary and fringe benefit support for 3 years; an additional $500,000 of research funds; and augmented mentoring and coaching with required participation in the relevant CTSI career development program. Department Chairs propose meritorious candidates for Review Committee consideration based on the Chair nomination letter, scientific plan, mentoring plan, CV, and additional letters of recommendation. To foster community building, there is an annual mini-retreat for the ECRA Scholars and other underrepresented CTSI Scholars with an external visiting professor. Results/Anticipated Results: Fifteen tenure-track faculty have been recruited as ECRA Scholars since 2019 into 9 different departments. One additional Scholar has been accepted and three have completed the program. Three ECRA Scholars were K awardees at the time of recruitment. The CTSI career development programs utilized were the K Accelerator (10), KL2 Scholar (2), and K-R01 (5) Programs, with 3 involved in two programs. The Scholar degrees include 10 PhDs, 3 MD/PhDs, and 2 MDs, with additional MPH/MS (5), MSW (1), and DPT (1) degrees. ECRA Scholars have been awarded multiple NIH R21, Foundation, and internal grants currently under review include Ks and R01s with 5 additional K, 2 new R01, and 1 revised R01 submissions planned for the 2024–2025 academic year. Discussion/Significance of Impact: The ECRA program has successfully augmented recruitment of outstanding underrepresented research-oriented early-stage faculty to the University of Minnesota School of Medicine, contributing to many Departments. The CTSI has provided career development, networking, and a broader community of Scholars, with increased diversity in CTSI programs.
Objectives/Goals: In Fall 2024, we designed a collaborative scholar retreat model to create dialogue among our training programs. The purpose of the retreat was to foster collaboration and provide unique networking opportunity for our KL2, T32, and TL1 scholars to share their research across the translational spectrum and learn more about Clinical and Translational Science Institute (CTSI) resources and tools. Methods/Study Population: The CTSI Fall Scholar Retreat brought together a diverse group of 25 scholars who attended in-person a full-day program. The program included presentations on CTSI resources and Team Science on How to Become a Better Team Member in cross-disciplinary and cross-functional groups. The KL2 Scholars presented motivational talks on their career and professional development journeys. Mentoring roundtable included discussions on subthemes like characteristics of a good mentor/mentee, organizing your mentoring team, different mentor roles, and fears of approaching new mentor/mentee. TL1 and T32 scholars also presented posters describing their ongoing research project from the planning stages to initial observations to completed studies. Results/Anticipated Results: To measure the effectiveness and impact of the CTSI Fall Scholar Retreat, we conducted an evaluation using REDCap survey and received an 88% response rate. On the Likert scale of 1–5 (1 = not at all valuable, 2 = not very valuable, 3 = neutral, 4 = very valuable, and 5 = extremely valuable), 92% of the scholars found the sessions to be valuable. Net Promoter Score of 9.6 (scale of 1–10) was measured to collect the scholar feedback and most of them are likely to recommend the Scholar Retreat to other scholars. Discussion/Significance of Impact: The in-person retreat proved to be a unique platform to interact, collaborate, learn, and grow for all scholars at different levels of their career and research. Inclusion of HRSA-funded T32 post-doctoral program provided cross-level collaboration and helped promote a culture of continuous learning in clinical and translational science.
What problem do today’s circuits address? The very general task of improving performance, through the application of negative feedback, of a great many of the circuits we have met to this point.
In our own version of this course, only a minority of the busy students choose to do projects. But a project can be heaps of fun. To help you conceive of one, here is some information on gadgets and ideas that might inspire a project builder, along with sketches of some great projects of yester-term.
Here, we’d like you to show you how to do one task many ways. This is a favorite device of exam-writers; this kind of question lets the teachers feel that there’s some coherence in the digital material. Students may not feel the same way about these questions.
In this chapter you will configure the Timer/Counter peripheral to interrupt the CPU at a constant rate to output a sampled sine wave from the DAC. On the way, you will land on the Moon.