We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To evaluate the impact of receptive vocabulary versus years of education on neuropsychological performance of Black and White older adults.
Method:
A community-based prospectively enrolled cohort (n = 1,007; 130 Black, 877 White) in the Emory Healthy Brain Study were administered the NIH Toolbox Picture Vocabulary Test and neuropsychological measures. Group differences were evaluated with age, sex, and education or age, sex, and Toolbox Vocabulary scores as covariates to determine whether performance differences between Black versus White participants were attenuated or eliminated.
Results:
With vocabulary as a covariate, the main effect of race was no longer significant for the MoCA, Phonemic Fluency, Rey Auditory Verbal Learning Test, and Rey Complex Figure Test immediate and delayed recall. Although still significantly different between groups, the effect sizes for Animal Fluency, Trails B-A, Symbol Digit Modalities Test, and Rey Copy were attenuated, with the greatest reductions occurring for the Multilingual Naming Test and Judgment of Line Orientation.
Conclusions:
Findings support the value of using receptive vocabulary as a proxy for premorbid ability level when comparing the cognitive performance of Black and White older adults. The results extend investigations using measures of single word reading to encompass measures assessing word meaning.
There is a growing awareness that diversity, health equity, and inclusion play a significant role in improving patient outcomes and advancing knowledge. The Pediatric Heart Network launched an initiative to incorporate diversity, health equity, and inclusion into its 2021 Scholar Award Funding Opportunity Announcement. This manuscript describes the process of incorporating diversity, health equity, and inclusion into the Pediatric Heart Network Scholar Award and the lessons learned. Recommendations for future Pediatric Heart Network grant application cycles are made which could be replicated by other funding agencies.
We prove the existence of solutions to the Kuramoto–Sivashinsky equation with low regularity data in function spaces based on the Wiener algebra and in pseudomeasure spaces. In any spatial dimension, we allow the data to have its antiderivative in the Wiener algebra. In one spatial dimension, we also allow data that are in a pseudomeasure space of negative order. In two spatial dimensions, we also allow data that are in a pseudomeasure space one derivative more regular than in the one-dimensional case. In the course of carrying out the existence arguments, we show a parabolic gain of regularity of the solutions as compared to the data. Subsequently, we show that the solutions are in fact analytic at any positive time in the interval of existence.
The record of mammal declines and extinctions in Australia raises concerns regarding geographically restricted and poorly known taxa. For many taxa, the existing data are insufficient to assess their conservation status and inform appropriate management. Concerns regarding the persistence of the subspecies of yellow-footed rock-wallaby Petrogale xanthopus celeris, which is endemic to Queensland, have been expressed since the 1970s because of red fox Vulpes vulpes predation, competition with feral goats Capra hircus and land clearing. This rock-wallaby is rarely observed, occupies rugged mountain ranges and, prior to our surveys, had not been surveyed for 25 years. We surveyed 138 sites across the range of this rock-wallaby during 2010–2023, including revisiting sites surveyed in the 1970s–1980s and locations of historical records. We examined occurrence in relation to habitat variables and threats. Occupancy and abundance remained similar over time at most sites. However, by 2023 the subspecies had recolonized areas in the north-east of its range where it had disappeared between surveys in the 1980s and 2010s, and three south-western subpopulations that were considered extinct in the 1980s were rediscovered. Recolonization and increases in abundance at numerous sites between the 2010s and 2020s are associated with declines in feral goat abundance, indicating dietary and habitat competition are major threats. Exclusion fences erected since 2010 could limit genetic exchange between rock-wallaby subpopulations whilst allowing domestic goats to be commercially grazed. Petrogale xanthopus celeris should remain categorized as Vulnerable based on these ongoing threats. Repeated monitoring approximately every decade should underpin management of this endemic taxon.
Identifying persons with HIV (PWH) at increased risk for Alzheimer’s disease (AD) is complicated because memory deficits are common in HIV-associated neurocognitive disorders (HAND) and a defining feature of amnestic mild cognitive impairment (aMCI; a precursor to AD). Recognition memory deficits may be useful in differentiating these etiologies. Therefore, neuroimaging correlates of different memory deficits (i.e., recall, recognition) and their longitudinal trajectories in PWH were examined.
Design:
We examined 92 PWH from the CHARTER Program, ages 45–68, without severe comorbid conditions, who received baseline structural MRI and baseline and longitudinal neuropsychological testing. Linear and logistic regression examined neuroanatomical correlates (i.e., cortical thickness and volumes of regions associated with HAND and/or AD) of memory performance at baseline and multilevel modeling examined neuroanatomical correlates of memory decline (average follow-up = 6.5 years).
Results:
At baseline, thinner pars opercularis cortex was associated with impaired recognition (p = 0.012; p = 0.060 after correcting for multiple comparisons). Worse delayed recall was associated with thinner pars opercularis (p = 0.001) and thinner rostral middle frontal cortex (p = 0.006) cross sectionally even after correcting for multiple comparisons. Delayed recall and recognition were not associated with medial temporal lobe (MTL), basal ganglia, or other prefrontal structures. Recognition impairment was variable over time, and there was little decline in delayed recall. Baseline MTL and prefrontal structures were not associated with delayed recall.
Conclusions:
Episodic memory was associated with prefrontal structures, and MTL and prefrontal structures did not predict memory decline. There was relative stability in memory over time. Findings suggest that episodic memory is more related to frontal structures, rather than encroaching AD pathology, in middle-aged PWH. Additional research should clarify if recognition is useful clinically to differentiate aMCI and HAND.
To introduce the Emory 10-element Complex Figure (CF) scoring system and recognition task. We evaluated the relationship between Emory CF scoring and traditional Osterrieth CF scoring approach in cognitively healthy volunteers. Additionally, a cohort of patients undergoing deep brain stimulation (DBS) evaluation was assessed to compare the scoring methods in a clinical population.
Method:
The study included 315 volunteers from the Emory Healthy Brain Study (EHBS) with Montreal Cognitive Assessment (MoCA) scores of 24/30 or higher. The clinical group consisted of 84 DBS candidates. Scoring time differences were analyzed in a subset of 48 DBS candidates.
Results:
High correlations between scoring methods were present for non-recognition components in both cohorts (EHBS: Copy r = 0.76, Immediate r = 0.86, Delayed r = 0.85, Recognition r = 47; DBS: Copy r = 0.80, Immediate r = 0.84, Delayed Recall r = 0.85, Recognition r = 0.37). Emory CF scoring times were significantly shorter than Osterrieth times across non-recognition conditions (all p < 0.00001, individual Cohen’s d: 1.4–2.4), resulting in an average time savings of 57%. DBS patients scored lower than EHBS participants across CF memory measures, with larger effect sizes for Emory CF scoring (Cohen’s d range = 1.0–1.2). Emory CF scoring demonstrated better group classification in logistic regression models, improving DBS candidate classification from 16.7% to 32.1% compared to Osterrieth scoring.
Conclusions:
Emory CF scoring yields results that are highly correlated with traditional Osterrieth scoring, significantly reduces scoring time burden, and demonstrates greater sensitivity to memory decline in DBS candidates. Its efficiency and sensitivity make Emory CF scoring well-suited for broader implementation in clinical research.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
Mandatory folic acid fortification of enriched grains has reduced neural tube defect prevalence in several countries. We examined salt as an additional vehicle for folic acid fortification. The primary objective was to examine the change in serum folate concentration after 1 month of consumption of fortified iodised salt with folic acid (FISFA) among women of reproductive age. The secondary objectives were to examine (1) the feasibility of implementing FISFA intervention and (2) the acceptability of FISFA.
Design:
We conducted a pre–post intervention study (January–April 2023). Participants received a FISFA saltshaker with the study salt (1 g of sodium chloride salt fortified with 100 mcg of folic acid) to use instead of regular table salt for 1 month. Serum folate was measured using the Elecsys Folate-III immunoassay method at baseline and 1-month endpoint. Change in serum folate was assessed using a two-tailed Wilcoxon signed rank test for paired samples.
Setting:
Metropolitan city, Southern USA.
Participants:
Non-pregnant, 18–40-year-old women who lived alone/with a partner.
Results:
Thirty-two eligible women consented to participate, including eleven non-Hispanic-White, eleven non-Hispanic-Black and ten Hispanic. Post-intervention, there was a significant increase in median serum folate concentration of 1·40 nmol/l (IQR 0·74–2·05; P < 0·001) from 24·08 nmol/l to 25·96 nmol/l in an analytical sample of n 29. An increase was seen in 28/29 (93 %) participants. Feasibility: 100 % study consent and compliance. FISFA acceptability: 25 d average use; 1·28 g average daily intake; 96·7 % and 90 % reported taste and colour of FISFA as highly acceptable, respectively.
Conclusions:
FISFA is an effective approach to increasing serum folate concentrations among women of reproductive age. Findings should be replicated in a larger study.
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.
During the past 30 yr an impasse has developed in the discovery and commercialization of synthetic herbicides with new molecular targets and novel chemistries. Similarly, there has been little success with bioherbicides, both microbial and chemical. These bioherbicides are needed to combat fast-growing herbicide resistance and to fulfill the need for more environmentally and toxicologically safe herbicides. In response to this substantial and growing opportunity, numerous start-up companies are utilizing novel approaches to provide new tools for weed management. These diverse new tools broaden the scope of discovery, encompassing advanced computational, bioinformatic, and imaging platforms; plant genome–editing and targeted protein degradation technologies; and machine learning and artificial intelligence (AI)-based strategies. This review contains summaries of the presentations of 10 such companies that took part in a symposium held at the WSSA annual meeting in 2024. Four of the companies are developing microbial bioherbicides or natural product–based herbicides, and the other six are using advanced technologies, such as AI, to accelerate the discovery of herbicides with novel molecular target sites or to develop non-GMO, herbicide-resistant crops.
Breastfeeding represents a strong selective factor for shaping the infant gut microbiota. Besides providing nutritional requirements for the infant, human milk is a key source of oligosaccharides, human milk oligosaccharides (HMOs), and diverse microbes in early life. This study aimed to evaluate the influence of human milk microbiota and oligosaccharides on the composition of infant faecal microbiota at one, three, and nine months postpartum. We profiled milk microbiota, HMOs, and infant faecal microbiota from 23 mother–infant pairs at these time points. The predominant genera in milk samples were Streptococcus, Staphylococcus, and an unclassified Enterobacteriaceae genus-level taxon (Enterobacteriaceae uncl.), whereas the infant faecal microbiota was predominated by Bifidobacterium, Bacteroides, and Enterobacteriaceae uncl. Mother–infant dyads frequently shared bacterial amplicon sequence variants (ASVs) belonging to the genera Bifidobacterium, Streptococcus, Enterobacteriaceae uncl., Veillonella, Bacteroides, and Haemophilus. The individual HMO concentrations in the milk showed either no change or decreased over the lactation period, except for 3-fucosyllactose (3-FL), which increased. Neither maternal secretor status nor HMO concentrations were significantly associated with microbiota composition at the different ages or the bacterial ASVs of maternal milk and infant faeces. This study suggests an age-dependent role of milk microbes in shaping the gut microbiota, while variations in HMO concentrations show limited influence.
Wild oat is a long-standing weed problem in Australian grain cropping systems, potentially reducing the yield and quality of winter grain crops significantly. The effective management of wild oat requires an integrated approach comprising diverse control techniques that suit specific crops and cropping situations. This research aimed to construct and validate a bioeconomic model that enables the simulation and integration of weed control technologies for wild oat in grain production systems. The Avena spp. integrated management (AIM) model was developed with a simple interface to provide outputs of biological and economic data (crop yields, weed control costs, emerged weeds, weed seedbank, gross margins) on wild oat management data in a cropping rotation. Uniquely, AIM was validated against real-world data on wild oat management in a wheat and sorghum cropping rotation, where the model was able to reproduce the patterns of wild oat population changes as influenced by weed control and agronomic practices. Correlation coefficients for 12 comparison scenarios ranged between 0.55 and 0.96. With accurate parameterization, AIM is thus able to make useful predictions of the effectiveness of individual and integrated weed management tactics for wild oat control in grain cropping systems.
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
The U.S. Department of Veterans Affairs is actively transitioning away from a disease-centric model of healthcare to one that prioritizes disease prevention and the promotion of overall health and well-being. Described as Whole Health, this initiative aims to provide personalized, values-centered care that optimizes physical, behavioral, spiritual, and socioeconomic well-being. To inform this initiative, we analyzed cross-sectional data from a nationally representative sample of primarily older U.S. military veterans to estimate levels of well-being across these domains, and identify sociodemographic, military, and potentially modifiable health and psychosocial correlates of them. Results revealed that, overall, veterans reported high domain-specific well-being (average scores ranging from 6.7 to 8.3 out of 10), with the highest levels in the socioeconomic domain and lowest in the physical domain. Several modifiable factors, including purpose in life, resilience, and social support, were strongly associated with the examined well-being domains. Interventions targeting these constructs may help promote well-being among U.S. veterans.
Type 2 diabetes (T2DM) poses a significant public health challenge, with pronounced disparities in control and outcomes. Social determinants of health (SDoH) significantly contribute to these disparities, affecting healthcare access, neighborhood environments, and social context. We discuss the design, development, and use of an innovative web-based application integrating real-world data (electronic health record and geospatial files), to enhance comprehension of the impact of SDoH on T2 DM health disparities.
Methods:
We identified a patient cohort with diabetes from the institutional Diabetes Registry (N = 67,699) within the Duke University Health System. Patient-level information (demographics, comorbidities, service utilization, laboratory results, and medications) was extracted to Tableau. Neighborhood-level socioeconomic status was assessed via the Area Deprivation Index (ADI), and geospatial files incorporated additional data related to points of interest (i.e., parks/green space). Interactive Tableau dashboards were developed to understand risk and contextual factors affecting diabetes management at the individual, group, neighborhood, and population levels.
Results:
The Tableau-powered digital health tool offers dynamic visualizations, identifying T2DM-related disparities. The dashboard allows for the exploration of contextual factors affecting diabetes management (e.g., food insecurity, built environment) and possesses capabilities to generate targeted patient lists for personalized diabetes care planning.
Conclusion:
As part of a broader health equity initiative, this application meets the needs of a diverse range of users. The interactive dashboard, incorporating clinical, sociodemographic, and environmental factors, enhances understanding at various levels and facilitates targeted interventions to address disparities in diabetes care and outcomes. Ultimately, this transformative approach aims to manage SDoH and improve patient care.
We argue that proxy failure contributes to poor measurement practices in psychological science and that a tradeoff exists between the legibility and fidelity of proxies whereby increasing legibility can result in decreased fidelity.
Sculpins (coastrange and slimy) and sticklebacks (ninespine and threespine) are widely distributed fishes cohabiting 2 south-central Alaskan lakes (Aleknagik and Iliamna), and all these species are parasitized by cryptic diphyllobothriidean cestodes in the genus Schistocephalus. The goal of this investigation was to test for host-specific parasitic relationships between sculpins and sticklebacks based upon morphological traits (segment counts) and sequence variation across the NADH1 gene. A total of 446 plerocercoids was examined. Large, significant differences in mean segment counts were found between cestodes in sculpin (mean = 112; standard deviation [s.d.] = 15) and stickleback (mean = 86; s.d. = 9) hosts within and between lakes. Nucleotide sequence divergence between parasites from sculpin and stickleback hosts was 20.5%, and Bayesian phylogenetic analysis recovered 2 well-supported clades of cestodes reflecting intermediate host family (i.e. sculpin, Cottidae vs stickleback, Gasterosteidae). Our findings point to the presence of a distinct lineage of cryptic Schistocephalus in sculpins from Aleknagik and Iliamna lakes that warrants further investigation to determine appropriate evolutionary and taxonomic recognition.
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.
In decision-making, especially for sustainability, choosing the right assessment tools is crucial but challenging due to the abundance of options. A new method is introduced to streamline this process, aiding policymakers and managers. This method involves four phases: scoping, cataloging, selection, and validation, combining data analysis with stakeholder engagement. Using the food system as an example, the approach demonstrates how practitioners can select tools effectively based on input variables and desired outcomes to address sustainability risks. This method can be applied across various sectors, offering a systematic way to enhance decision-making and manage sustainability effectively.
Technical Summary
Decision making frequently entails the selection and application of assessment tools. For sustainability decisions there are a plethora of tools available for environmental assessment, yet no established and clear approach to determine which tools are appropriate and resource efficient for application. Here we present an extensive inventory of tools and a novel taxonomic method which enables efficient, effective tool selection to improve decision making for policymakers and managers. The tool selection methodology follows four main phases based on the divergence-convergence logic; a scoping phase, cataloging phase, selection phase and validation phase. This approach combines elements of data-driven analysis with participatory techniques for stakeholder engagement to achieve buy-in and to ensure efficient management of progress and agile course correction when needed. It builds on the current limited range and scope of approaches to tool selection, and is flexible and Artificial Intelligence-ready in order to facilitate more rapid integration and uptake. Using the food system as a case study, we demonstrate how practitioners can use available input variables and desired output metrics to select the most appropriate tools to manage sustainability risks, with the approach having wide applicability to other sectors.
Social Media Summary
New method simplifies tool selection for sustainable decisions, aiding policymakers & managers. #Sustainability #DecisionMaking