Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.

As airborne lidar surveys reveal a growing sample of urbanised tropical landscapes, questions linger about the sampling bias of such research leading to inflated estimates of urban extent and population magnitude. ‘Found’ datasets from remote sensing conducted for non-archaeological purposes and thus not subject to archaeological site bias, provide an opportunity to address these concerns through pseudorandom sampling. Here, the authors present their analysis of an environmental lidar dataset from Campeche, Mexico, which reveals previously unrecorded urbanism and dense regional-scale settlement. Both characteristics, the authors argue, are therefore demonstrably ubiquitous across the central Maya Lowlands.

An increasing number of consumers are expressing concerns about the quality, nutrient content, and safety of the meet products they purchase, alongside animal welfare and the environmental footprint of production systems. Various studies show that grassland-based systems can produce a healthier meat product. In this context, livestock farmers are actively pursuing improvements in their systems focus on sustainability, with regenerative livestock farming emerging as a prominent approach. Most research has focused on showing the differences in the quality of meat comparing pastoral systems and those fed concentrates under controlled environments. However, there are no studies in Chile that evaluate the quality of beef derived from different pastoral systems, particularly those consider adequate data and products sourced directly from livestock sector. This study explores three beef production systems commonly used in southern Chile (conventional, free grazing, and regenerative), evaluating their impact on carcass characteristics, meat quality attributes, and nutritional components. The results show some variations in carcass weight and yield, with free grazing showing better results. Deviations in meat color were observed, with conventional meat being more red and yellow while regenerative meat was less bright. Subcutaneous fat color and water retention capacity were influenced by diet and production methods. Although lipid oxidation showed no differences, 100% grazing-based systems exhibited lower values, suggesting a higher intake of antioxidants. The research highlights the nutritional superiority of beef from grasslands, characterized by a lower intramuscular fat content and higher values of minerals, such as selenium. The complex multifactorial interaction of pastoral systems is also highlighted, impacting the carcass and meat quality. A holistic approach is essential in future research to generate and assess healthy beef.

The aim of this study was to compare the levels of reactive oxygen species (ROS) in Bos taurus and Bos indicus in vitro embryos cryopreserved using either slow freezing or vitrification. Embryos were divided into four groups based on subspecies and freezing method: Bos indicus slow freezing (BiSF; n = 8), Bos indicus vitrification (BiVT; n = 10), Bos taurus slow freezing (BtSF; n = 9), and Bos taurus vitrification (BtVT; n = 6). After thawing, the embryos were incubated with CellRox Green and images were obtained using a confocal microscope. The fluorescence intensity of each cell was measured and expressed as arbitrary units of fluorescence (auf) and compared using a multiple regression and unpaired t-test with α = 0.05. Results showed that subspecies and the freezing method significantly affected auf (P < 0.001; R2 = 0.1213). Bos indicus embryos had higher auf than Bos taurus embryos, whether frozen by slow freezing (67.05 ± 23.18 vs 51.30 ± 16.84, P < 0.001) or vitrification (64.44 ± 23.32 vs 47.86 ± 17.53, P < 0.001). Slow freezing induced higher auf than vitrification in both Bos taurus (51.30 ± 16.84 vs 47.86 ± 17.53, P < 0.001) and Bos indicus (67.05 ± 23.18 vs 64.44 ± 23.32, P < 0.014). In conclusion, Bos taurus embryos had lower ROS levels when frozen using vitrification, while Bos indicus embryos had consistent ROS patterns regardless of the freezing method. However, Bos indicus embryos frozen by slow freezing tended to have a higher number of cells with elevated ROS levels.

Background: Infection prevention and control assessments in healthcare settings serve as a primary resource for obtaining data and providing recommendations based on safety, compliance, and quality assurance guidelines. In Puerto Rico (PR), surgical site infections are underreported in the Epi Info platform used by the Puerto Rico Department of Health (PRDOH), mainly due to the complexity of their identification. By focusing on evaluating Operating Rooms/Sterile Processing and Distribution (OR/SPD) units in acute care facilities (ACFs), our goal is to generate new data within the Healthcare-Associated Infection/Antibiotic Resistance (HAI/AR) Program, specifically related to patient management throughout preoperative, intraoperative, and postoperative phases, as well as reprocessing practices. Methods: Nineteen evaluations of ACFs' OR/SPDs were conducted from May through December 2023. Direct observations, file reviews, and personnel assessments were performed using an infection control assessment and response (ICAR) tool developed collaboratively by a team from an acute facility in PR and the HAI/AR Program staff. This ICAR Tool was customized based on guidelines from the certified Board for Sterile Processing and Distribution (CBSPD), the Association of periOperative Registered Nurses (AORN), and the Association for the Advancement of Medical Instrumentation (AAMI), among other regulatory agencies. The Division of Health Quality Promotion (DHQP) reviewed and approved the tool for use in these evaluations. Results: Key findings indicate that 32% of Sterile Processing Department (SPD) units restrict access to dedicated personnel with available manufacturer’s instructions, yet only 36% of SPD personnel are certified in CBSPD and packaging practices. Only 10% of facilities had a water treatment system for sterilization and Immediate Use Steam Sterilization (IUSS) policies. Notably, 84% of endoscopy areas require additional equipment for cultivating endoscopes, and no facility possessed a borescope for visually inspecting endoscope lumens. Tray inspection occurred in 21%, and only 31% of staff knew the Spaulding Classification and Class V Indicators. Conclusion: These data underscore the necessity of evaluating OR/SPD units in ACFs to provide updated recommendations and mitigate the incidence of surgical site infections (SSI). They offer insight into the structural and functional status of OR/SPD units in Puerto Rico, aligning reporting with OR/SPD practices to enhance patient care and minimize infection risks.

Paquimé (also known as Casas Grandes), situated in northern Chihuahua between Mesoamerican and Ancestral Puebloan groups, was a vibrant multicultural centre during the thirteenth and fourteenth centuries AD. Substantial debate surrounds the social organisation of Paquimé's inhabitants. Here, the authors report on the analysis of ancient DNA from a unique child burial beneath a central support post of a room in the House of the Well. They argue that the close genetic relationship of the child's parents, revealed through this analysis, and the special depositional context of the burial reflect one family's attempts to consolidate and legitimise their social standing in this ancient community.

Several individuals of the sea anemone Telmatactis cricoides (Duchassaing, 1850) (order Actiniaria) were observed in the Mediterranean continental Spanish coast (Almeria) and the Balearic Islands (Mallorca) showing an expansion of the species, possibly related to rising sea water temperatures. This finding contributes to increase the knowledge on the geographical distribution range of this actiniarian in the Mediterranean basin.

Increasing emphasis on the use of real-world evidence (RWE) to support clinical policy and regulatory decision-making has led to a proliferation of guidance, advice, and frameworks from regulatory agencies, academia, professional societies, and industry. A broad spectrum of studies use real-world data (RWD) to produce RWE, ranging from randomized trials with outcomes assessed using RWD to fully observational studies. Yet, many proposals for generating RWE lack sufficient detail, and many analyses of RWD suffer from implausible assumptions, other methodological flaws, or inappropriate interpretations. The Causal Roadmap is an explicit, itemized, iterative process that guides investigators to prespecify study design and analysis plans; it addresses a wide range of guidance within a single framework. By supporting the transparent evaluation of causal assumptions and facilitating objective comparisons of design and analysis choices based on prespecified criteria, the Roadmap can help investigators to evaluate the quality of evidence that a given study is likely to produce, specify a study to generate high-quality RWE, and communicate effectively with regulatory agencies and other stakeholders. This paper aims to disseminate and extend the Causal Roadmap framework for use by clinical and translational researchers; three companion papers demonstrate applications of the Causal Roadmap for specific use cases.

Population connectivity has a fundamental role in metapopulation dynamics with important implications for population persistence in space and time. Oceanic islands, such as Easter Island (EI) and the Salas & Gómez Island (SG), are ideal for the study of population connectivity because they are separated by 415 km and isolated from other islands in the Pacific Ocean by >2000 km. Considering that the dispersal process could play a critical role in the persistence of their populations, we evaluated the connectivity pattern of the endemic gastropod Monetaria caputdraconis between EI and SG using population genetics and biophysical modelling. Eleven microsatellite loci did not show differences in the allelic frequency of individuals located in EI and SG, suggesting the presence of one genetic population. Historical reciprocal migration implies that 0.49% of the recruits in EI come from SG and 0.37% in SG come from EI. Considering year-round larval release and a larval development of 2 weeks in the plankton, a Lagrangian experiment based on a regional oceanic simulation indicated a weak population connectivity with a high rate of self-recruitment. Interestingly, self-recruitment showed both monthly and interannual variation ranging from 1 to 45% of returned larvae, with lower values estimated in SG compared to EI. The results suggest that few larvae/individuals arrive at each other's island, possibly due to stochastic events, such as rafting. Overall, our results indicate that both islands maintain population connectivity despite their distance; these findings have implications for designing conservation strategies in this region.

We analysed the transmission of the human mpox virus in Spain by estimating the effective reproduction number of the disease from official surveillance data. Our computations show that this decreased steadily after an initial burst phase, dropping below 1 on July 12, and thus the outbreak was expected to reduce in the following weeks. Differences in trends were found across geographical regions of the country and across MSM and heterosexual populations.

Over the last two decades, anomalous warming events have been observed in coastal Antarctic regions. While these events have been documented in the Ross Sea sector, the Antarctic interior is believed to have been buffered from warming. In this work, we present data from lakes located near Mt. Heekin and Thanksgiving Valley (~85° S) along the Shackleton Glacier, which are believed to be the southern-most Antarctic dry valley lakes. In 2018, the lakes were characterized, repeat satellite images were examined, and lake water chemistry was measured. Our analysis shows that lake areas recently increased, and the water-soluble ion chemistry indicates a flushing of salts from periglacial soils, likely from increased glacial melt as illustrated by water isotope data. Our results show that high southern latitude ice-free areas have likely been affected by warm pulses over the past 60 years and these pulses may be quasi-synchronous throughout the Transantarctic Mountains.

Antequera in southern Spain is widely recognised as an outstanding example of the European megalithic phenomenon. One of its most remarkable features is the evident relationship between conspicuous natural formations and human-built monuments. Here, the authors report the results of their investigation of a tomb newly discovered at the site of Piedras Blancas at the foot of La Peña de los Enamorados, a limestone massif that dominates the Antequera plain. Excavation and multidisciplinary study, including geological, architectural and archaeoastronomical investigations, have revealed a complex funerary monument that is part natural, part built, part hypogeum, part megalith. The results emphasise the centrality of La Peña in the Neolithic worldview and encourage wider investigation of prehistoric place-making.

Contemporary theories of early development and emerging child psychopathology all posit a major, if not central role for physiological responsiveness. To understand infants’ potential risk for emergent psychopathology, consideration is needed to both autonomic reactivity and environmental contexts (e.g., parent–child interactions). The current study maps infants’ arousal during the face-to-face still-face paradigm using skin conductance (n = 255 ethnically-diverse mother–infant dyads; 52.5% girls, mean infant age = 7.4 months; SD = 0.9 months). A novel statistical approach was designed to model the potential build-up of nonlinear counter electromotive force over the course of the task. Results showed a significant increase in infants’ skin conductance between the Baseline Free-play and the Still-Face phase, and a significant decrease in skin conductance during the Reunion Play when compared to the Still-Face phase. Skin conductance during the Reunion Play phase remained significantly higher than during the Baseline Play phase; indicating that infants had not fully recovered from the mild social stressor. These results further our understanding of infant arousal during dyadic interactions, and the role of caregivers in the development of emotion regulation during infancy.

OBJECTIVES/GOALS: The history of immune suppression, especially CD4 nadir, has been shown to be a strong predictor of HIV-associated neurocognitive disorders (HAND). However, the potential mechanism of this association is not well understood. This study examined the relationship between CD4 nadir and brain atrophy. METHODS/STUDY POPULATION: Fifty-nine people with HIV participated in the cross-sectional study (mean age, 56.5 ± 5.8; age range, 41-69; 15 females; 46 African-Americans). High resolution structural MRI images were obtained using a 3T Siemens scanner. From a comprehensive 7-domain neuropsychological test battery, a global deficit score (GDS) and HAND diagnoses were determined for each participant. The correlation between CD4 nadir (the lowest ever lymphocyte CD4 count) and cortical thickness was investigated using a vertex-wise non-parametric approach with a conservative statistical threshold of p < 0.05 (FWE-corrected). RESULTS/ANTICIPATED RESULTS: Out of the 59 participants, 12 met standard Frascati criteria for asymptomatic neurocognitive impairment (ANI) and two met the criteria for mild neurocognitive disorder (MND). Across all participants, low CD4 nadir was associated with widespread cortical thinning, especially in the frontal and temporal regions. Higher GDS (indicating worse global neurocognitive function) was associated with bilateral frontal cortical thinning, and the association largely persisted in the subset of participants who did not meet HAND criteria. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that the low CD4 nadir may be associated with widespread neural injury in the brain, especially in the frontal and temporal regions. This spatial profile might contribute to the prevalence/phenotypes of HAND in the cART era, such as the frequently observed deficits in the executive domain.