Common outputs of software programs for network estimation include association matrices containing the edge weights between pairs of symptoms and a plot of the symptom network. Although such outputs are useful, it is sometimes difficult to ascertain structural relationships among symptoms from these types of output alone. We propose that matrix permutation provides a simple, yet effective, approach for clarifying the order relationships among the symptoms based on the edge weights of the network. For directed symptom networks, we use a permutation criterion that has classic applications in electrical circuit theory and economics. This criterion can be used to place symptoms that strongly predict other symptoms at the beginning of the ordering, and symptoms that are strongly predicted by other symptoms at the end. For undirected symptom networks, we recommend a permutation criterion that is based on location theory in the field of operations research. When using this criterion, symptoms with many strong ties tend to be placed centrally in the ordering, whereas weakly-tied symptoms are placed at the ends. The permutation optimization problems are solved using dynamic programming. We also make use of branch-search algorithms for extracting maximum cardinality subsets of symptoms that have perfect structure with respect to a selected criterion. Software for implementing the dynamic programming algorithms is available in MATLAB and R. Two networks from the literature are used to demonstrate the matrix permutation algorithms.

In epidemiological investigations, pathogen genomics can provide insights and test epidemiological hypotheses that would not have been possible through traditional epidemiology. Tools to synthesize genomic analysis with other types of data are a key requirement of genomic epidemiology. We propose a new ‘phylepic’ visualization that combines a phylogenomic tree with an epidemic curve. The combination visually links the molecular time represented in the tree to the calendar time in the epidemic curve, a correspondence that is not easily represented by existing tools. Using an example derived from a foodborne bacterial outbreak, we demonstrated that the phylepic chart communicates that what appeared to be a point-source outbreak was in fact composed of cases associated with two genetically distinct clades of bacteria. We provide an R package implementing the chart. We expect that visualizations that place genomic analyses within the epidemiological context will become increasingly important for outbreak investigations and public health surveillance of infectious diseases.

Adequate energy intake (EI) is essential for adolescent athletes to support health, performance, and growth(1). Rowing is a physically demanding sport where intense training begins in adolescence. Research is needed to assess whether current EI is sufficient to support healthy physiological functions and training in adolescent rowers. The aim of this study was to evaluate the energy status (energy availability (EA) or energy balance (EB)) including EI and exercise energy expenditure (EEE) of adolescent rowers in New Zealand. A total of 35 rowers (23 females, 16.8yrs ± 1.9yrs; 12 males, 17.3yrs ± 1.6yrs) who had been rowing for at least one season participated. A bioimpedance analyser measured body composition in 11 participants (8 females, weight 63.0±7.0kg, fat free mass (FFM) 50.8 ± 6.5kg; 3 males, weight 78.5 ± 15.9kg, FFM 70.7 ± 12.2kg) enabling calculation of EA. Due to COVID-19 restrictions, the remaining 24 participants (15 females, 9 males) provided estimated body weight (74.7 ± 9.2kg) and EB was then used to evaluate energy status. All participants completed four days of food and training diaries, two ‘recovery’ and two ‘hard’ training days. EI was determined in FoodWorks10 software using the New Zealand Food Composition Database. For training, metabolic equivalent of tasks (MET)(2) were assigned using bodyweight, heart rate, and rating of perceived effort to estimate EEE. Paired sample t-tests or Wilcoxon Signed Rank test (non-parametric data) was used to determine differences between EI, EEE, EA, and EB on the high and low training days for each gender. Significance was set at p< 0.05. The average EI for females on hard and recovery days was 10837 ± 3304kJ and 10461 ± 2882kJ respectively, and for males was 15293 ± 3971kJ and 13319 ± 4943kJ, respectively. No significant differences were found between EI on hard vs. recovery days in both genders. Significant differences between average EEE on hard vs. recovery days were found in both genders (females, hard day 4609 ± 2446kJ, recovery day 3146 ± 1905kJ, p<0.001; males, hard day 6589 ± 1575kJ, recovery day 3326 ± 2890kJ, p = 0.001). EA on hard and recovery training days was classified as suboptimal at 142 ± 80kJ/FFMkg/day and 167 ± 79kJ/FFMkg/day respectively with no significant difference in EA between hard and recovery days (p = 0.092). Average EB on hard training days was −484 ± 4267kJ and on recovery training days was 572 ± 3265kJ, with no significant difference between training days (p = 0.177). Both genders showed no significant difference in EB between hard and recovery training days (females p = 0.221, males p = 0.978). The results suggest that adolescent rowers do not adjust their nutritional intake to match EEE. This may increase the risk of adolescent rowers presenting with suboptimal EB or EA, with females being at a greater risk than males.

Dietary intake plays a key role in athletic performance in rowing(1). Suboptimal nutrition within the adolescent rowing population may negatively affect performance, normal growth and development, professional athlete development, and career longevity. Previous research has indicated that suboptimal carbohydrate intakes are a common issue in rowing(2). The quality of nutritional intake in adolescent rowers has seldom been explored. During moderate training, adolescent athletes should aim for 5-7g.kg-1 of carbohydrates, 1.3-1.8g.kg-1 of protein, and 20-35% energy from fat(3). This study aimed to examine the dietary intake of adolescent rowers in New Zealand and compare it with nutritional guidelines for normal growth, development, and sports performance. A cross-sectional study design involved data collection on two ‘hard’ training days, and two ‘recovery’ days from rowers (14-21 years) recruited from clubs and secondary schools around New Zealand. Participants completed four 24-hour collection periods, recording food intake, training duration and intensity. The food records were verified for accuracy, and dietary data was entered into Foodworks software for nutritional analysis. IBM SPSS software was used to calculate mean intakes for carbohydrate, protein, fat, and standard deviations. Independent t-tests were used to compare carbohydrate and protein intakes between males and females. Of the initial 40 participants, 35 fully (n = 23 females, 16.8 ± 1.9 years and n = 12 males, 17.3 ± 1.6 years) completed the study. Participants consumed 319 ± 116g (4.5 ± 1.7g.kg-1/day) of carbohydrates, 121 ± 56 g (1.7 ± 0.7 g.kg-1/day) of protein and 113 ± 46 g (1.6 ± 0.6g.kg-1/day) of fat per day. Females consumed 290 ± 80g (4.4 ± 1.3g.kg-1/day) of carbohydrates and males consumed 400 ± 78 g (5.0 ± 1.4g.kg-1/day) per day, with no significant difference between males and females intake per kilogram of bodyweight per day (p = 0.165). Minimum carbohydrate levels of 5g.kg-1 per day were only achieved by 7 females (30.4%) and 4 (33.3%) males. Females consumed significantly less protein per day, 106 ± 38g (1.6 ± 0.6 g.kg-1/day), in comparison to males who consumed 164 ± 46 grams (2.0 ± 0.5 g.kg-1/day) per day (p = 0.04). Fourteen females (60.9%) and 10 males (83.3%) consumed more than the minimum requirement of 1.3g.kg-1 of protein per day. The findings suggest that 2 out of 3 adolescent rowers in New Zealand fail to reach the minimum recommendations for carbohydrate intake(3), and males more readily meet the recommended intakes of protein when compared to females. Nutrition education for adolescent rowers in New Zealand should emphasise adequate carbohydrate and protein intakes that meet sports nutrition guidelines in order to support normal growth, development and optimised performance for these athletes.

Commentaries on the target article offer diverse perspectives on integrative experiment design. Our responses engage three themes: (1) Disputes of our characterization of the problem, (2) skepticism toward our proposed solution, and (3) endorsement of the solution, with accompanying discussions of its implementation in existing work and its potential for other domains. Collectively, the commentaries enhance our confidence in the promise and viability of integrative experiment design, while highlighting important considerations about how it is used.

Background: Although palliative care (PC) is recommended for patients with amyotrophic lateral sclerosis (ALS), many patients receive PC very late or not at all. Our study goals included 1) determing the feasibility of early PC 2) describing patient/caregiver satisfaction with early PC and 3) measuring the impact of early PC on quality of life (QOL) and mood. Methods: Patients followed at the multidisciplinary ALS clinic in Ottawa, Canada and their caregivers were eligible for the study irrespective of duration or severity of disease. All participants completed questionnaires tracking QOL and mood and all were offered a palliative care consultation. Participants completed a satisfaction survey post-PC consultation. Results: 32 patients and 20 caregivers received a PC consultation, conducted virtually. All of them found the consult beneficial and none of the patients reported preferring the consultation later in their illness. The PC consultations were most highly rated by patients with high levels of anxiety and worse bulbar function, and by caregivers of patients with low function. There was no statistically significant change in mood or QOL compared to the 7 participants who declined PC consultation. Conclusions: PC consultations are feasible and beneficial at all stages of illness. Patients with anxiety and bulbar dysfunction may benefit most.

Sipping, an early form of alcohol initiation, is associated with aspects of psychopathology and personality that reflect long-term risk for harmful alcohol use. In the Adolescent Brain and Cognitive Development cohort (N = 11,872), sipping by age 9–10 was concurrently associated with impulsivity, other aspects of externalizing, and prodromal schizophrenia symptoms. Still, these associations were cross-sectional in nature, leaving open the possibility that these features of psychopathology and personality might not reflect long-term risk for alcohol consumption and related harm across development. Here, we attempted to replicate baseline concurrent associations across three waves of data to extend concurrent associations to prospective ones. Most cross-sectional associations replicated across waves, such that impulsivity, other aspects of externalizing, reward sensitivity (e.g., surgency, sensation seeking), and prodromal schizophrenia symptoms were associated with increased odds of having sipped alcohol by the age of 12. Nevertheless, not all concurrent associations replicated prospectively; impulsigenic features did not reflect long-term risk for sipping. Thus, some psychopathology features appeared to reflect stable risk factors, whereas others appeared to reflect state-dependent risk factors. All told, sipping might not reflect long-term risk for harmful alcohol use, and the nature of sipping may change across development.

A machine learning model was created to predict the electron spectrum generated by a GeV-class laser wakefield accelerator. The model was constructed from variational convolutional neural networks, which mapped the results of secondary laser and plasma diagnostics to the generated electron spectrum. An ensemble of trained networks was used to predict the electron spectrum and to provide an estimation of the uncertainty of that prediction. It is anticipated that this approach will be useful for inferring the electron spectrum prior to undergoing any process that can alter or destroy the beam. In addition, the model provides insight into the scaling of electron beam properties due to stochastic fluctuations in the laser energy and plasma electron density.

Many popular books and articles that purport to explain how people, companies, orideas succeed highlight a few successes chosen to fit a particular narrative. Weinvestigate what effect these highly selected “success narratives”have on readers’ beliefs and decisions. We conducted a large, randomized,pre-registered experiment, showing participants successful firms with foundersthat all either dropped out of or graduated college, and asked them to makeincentive-compatible bets on a new firm. Despite acknowledging biases in theexamples, participants’ decisions were very strongly influenced by them.People shown dropout founders were 55 percentage points more likely to bet on adropout-founded company than people who were shown graduate founders. Mostreported medium to high confidence in their bets, and many wrote causalexplanations justifying their decision. In light of recent concerns about falseinformation, our findings demonstrate how true but biased information canstrongly alter beliefs and decisions.

In this paper it is demonstrated that the measurable costs of the sustained high rate of unemployment in Australia are substantially higher than the alleged gains from neo-liberal (microeconomic) reforms. In addition, significant individual and social costs can be identified. Consequently macroeconomic intervention to reduce unemployment should be viewed as a priority, rather than the imposition of market reform with its uncertain impact. The paper concludes with a brief outline of a Job Guarantee Program, advocated by Mitchell (1998) that utilises the principles of the buffer stock mechanism to reduce unemployment. It is argued that the net increase in government outlays is modest and could be offset by a reduction in the level of annual corporate welfare.

The dominant paradigm of experiments in the social and behavioral sciences views an experiment as a test of a theory, where the theory is assumed to generalize beyond the experiment's specific conditions. According to this view, which Alan Newell once characterized as “playing twenty questions with nature,” theory is advanced one experiment at a time, and the integration of disparate findings is assumed to happen via the scientific publishing process. In this article, we argue that the process of integration is at best inefficient, and at worst it does not, in fact, occur. We further show that the challenge of integration cannot be adequately addressed by recently proposed reforms that focus on the reliability and replicability of individual findings, nor simply by conducting more or larger experiments. Rather, the problem arises from the imprecise nature of social and behavioral theories and, consequently, a lack of commensurability across experiments conducted under different conditions. Therefore, researchers must fundamentally rethink how they design experiments and how the experiments relate to theory. We specifically describe an alternative framework, integrative experiment design, which intrinsically promotes commensurability and continuous integration of knowledge. In this paradigm, researchers explicitly map the design space of possible experiments associated with a given research question, embracing many potentially relevant theories rather than focusing on just one. Researchers then iteratively generate theories and test them with experiments explicitly sampled from the design space, allowing results to be integrated across experiments. Given recent methodological and technological developments, we conclude that this approach is feasible and would generate more-reliable, more-cumulative empirical and theoretical knowledge than the current paradigm – and with far greater efficiency.

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide. Oral medications for control of motor symptoms are the mainstay of treatment however, as the disease progresses, patients with PD may develop dysphagia or other medical illnesses that prohibit them from safely taking oral medications. Currently there are no clinical guidelines for managing distressing motor symptoms in patients with PD and severe dysphagia, which can therefore be quite challenging. Methods: A scoping review using MEDLINE, EMBASE, CENTRAL, CINAHL, AgeLine and Psyc INFO databases (1946-2021) was conducted. Articles examining PD with dysphagia in palliative care or at end-of-life were included. Studies that included patients who were also on oral PD medications or received device-aided therapy were excluded. Results: Of 3836 articles screened for title and abstract, 274 were selected for full text review, and 20 articles were finally selected for data extraction. These included five case reports, one retrospective cohort study, one book chapter and 13 narrative reviews. Conclusions: There are very few articles addressing the issue of treatment of patients with advanced PD who are unable to take oral medications. Although rotigotine patch and apormorphine injections are most frequently recommended, there are no clinical trials in this patient population to support those recommendations.

Historically, access to contraception has been supported in a bipartisan way, best exemplified by consistent congressional funding of Title X—the only federal program specifically focused on providing affordable reproductive health care to American residents. However, in an era of partisan polarization, Title X has become a political and symbolic pawn, in part because of its connection to family planning organizations like Planned Parenthood. The conflicts around Title X highlight the effects of intertwining abortion politics and contraception policy, particularly as they relate to reproductive justice and gendered policy making. Family planning organizations like Planned Parenthood have responded to these battles by bowing out of the Title X network. To what extent have contraception deserts—places characterized by inequitable access to Title X—developed or expanded in response to policy changes related to contraception and reproductive health? What is the demographic makeup of these spaces of inequality? We leverage data from the Office of Population Affairs and the U.S. Census Bureau and use the integrated two-step floating catchment area method to illustrate the effects of a major change in the Title X network in 10 states. Our results reveal the widespread human ramifications of increasing constraints on family planning organizations as a result of quiet but insidious federal bureaucratic rule changes.

A patchwork of policies exists across the United States. While citizens’ policy preferences in domains such as the criminal legal system, gun regulations/rights, immigration, and welfare are informed by their political predispositions, they are also shaped by the extent to which policy targets are viewed as deserving. This article centres the idea that collective evaluations matter in policymaking, and it ascertains whether subnational levels of deservingness evaluations of several target groups differ across space to illuminate the link between these judgements and state policy design. We leverage original survey data and multilevel regression and poststratification to create state-level estimates of deservingness evaluations. The analyses elucidate the heterogeneity in state-level deservingness evaluations of several politically relevant groups, and they pinpoint a link between these social reputations and policy design. The article also delivers a useful methodological tool and measures for scholars of state policy design to employ in future research.