The scientific manuscript review process can often seem daunting and mysterious to authors. Frequently, medical journals do not describe the peer-review process in detail, which can further lead to frustration for authors, peer reviewers, and readers. This editorial describes the updated manuscript review process for Prehospital and Disaster Medicine. It is hoped that this editorial will lead to increased clarity and transparency in the review process.

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious wrongdoing by physicians.

Cattle feed yards routinely track and collect data for individual calves throughout the feeding period. Using such operational data from nine U.S. feed yards for the years 2016–2019, we evaluated the scalability and economic viability of using machine learning classifier predicted mortality as a culling decision aid. The expected change in net return per head when using the classifier predictions as a culling aid as compared to the status quo culling protocol for calves having been pulled at least once for bovine respiratory disease was simulated. This simulated change in net return ranged from −$1.61 to $19.46/head. Average change in net return and standard deviation for the nine feed yards in this study was $6.31/head and $7.75/head, respectively.

In October 2017, the National Poll on Healthy Aging surveyed a nationally representative sample of 2,007 adults aged 50–80 years to assess attitudes toward influenza (flu) vaccination policies in long-term care facilities. Support for requiring vaccinations was lowest for visitors. Policy makers can use these findings to develop sustainable vaccination strategies.

Rapid whole genome sequencing (rapid WGS) is a powerful diagnostic tool that is becoming increasingly practical for widespread clinical use. However, protocols for its use are challenging to implement. A significant obstacle to clinical adoption is that laboratory certification requires an initial research development phase, which is constrained by regulations from returning results. Regulations preventing return of results have ethical implications in cases which might impact patient outcomes. Here, we describe our experience with the development of a rapid WGS research protocol, that balanced the requirements for laboratory-validated test development with the ethical needs of clinically relevant return of results.

Rapid Access Ice Drill is a new drilling technology capable of quickly accessing the glacial bed of Antarctic ice sheets, retrieving ice core and rock core samples, and providing boreholes for downhole logging of physical properties. Scientific goals include searching for old ice near the glacial bed and sampling subglacial bedrock. During field trials near McMurdo Station on a piedmont glacier at Minna Bluff in the 2019–20 austral summer, we successfully completed a ‘top-to-bottom’ operational sequence in three boreholes by (1) augering through firn, (2) creating a borehole packer seal in non-porous ice, (3) establishing fluid circulation, (4) quickly drilling a borehole in ice at penetration rates up to 1.2 m min−1, (5) acquiring a short ice core at depth, (6) penetrating the glacial bed at a depth of ~677 m, (7) recovering a 3.2 m core of ice, basal till and subglacial bedrock, (8) optically logging the borehole on wireline, (9) testing hydrofracture potential by overpressuring the borehole fluid and (10) operating in an environmentally benign yet rapid field mode. Minna Bluff testing, therefore, demonstrates the effectiveness of this integrated system to drill rapidly through thick ice and penetrate across the glacial bed to take cores of bedrock.

Studies examining associations between fetal serotonin reuptake inhibitor (SRI) exposure and child autism spectrum disorder (ASD) diagnoses or delayed language remain mixed and rarely prospectively follow children or employ gold-standard assessments. We prospectively followed a cohort of mother–child dyads from pregnancy through early elementary school (N = 178), and obtained maternal and alternate–caregiver ratings of behaviors related to ASD (N = 137), as well as direct, gold-standard assessments of child ASD symptoms and pragmatic language among dyads who experienced prenatal depression and either took SRIs or were medication free during pregnancy (N = 44). Prenatal SRI exposure was related to maternal ratings of ASD-related behaviors (β = 0.24 95% confidence interval; CI [0.07, 0.48]), and, among boys, alternative caregiver ratings (males-only β = 0.28 95% CI [0.02, 0.55], females-only β = −0.21 95% CI [–0.63, 0.08]). However, results of our direct assessments suggest an association between SRI exposure and reduced pragmatic language scores (β = –0.27, 95% CI [–0.53, –0.01], but not ASD (Autism Diagnostic Observation Schedule β = 0.14 95% CI [–0.15, 0.41]; Social Responsiveness Scale β = 0.08 95% CI [–0.25, 0.40]). These discrepancies point to issues regarding how ASD is assessed, and the possibility that SRIs may be more strongly associated with language or other broader behaviors that coincide with ASD. Larger prospective studies that incorporate thorough, gold-standard assessments of ASD, language, and other ASD-related behaviors are needed.

OBJECTIVES/SPECIFIC AIMS: Exposure to theatrical performances holds promise for addressing bioethical issues, but there has been little empirical examination of the impact of dramatic presentation on audiences’ attitudes. This study assessed the short-term impact of the play, Informed Consent, on perceptions of trust, willingness to donate biospecimens, attitudes toward harm and privacy among the general public and in faculty, medical and undergraduate students within an academic medical center in the intermountain west. METHODS/STUDY POPULATION: Surveys were administered before and after a staged reading of the play by professional actors. Pre and post survey responses were linked for each participant. Survey items included the short form Trust in Medical Researchers, and single item questions about group identity, of genetic testing in children, and willingness to donate biospecimens. In total, 3 additional questions about harm, consent, and ethical investigator behavior as represented in the play were asked in the post survey. In addition, respondents were given the option to answer open-ended questions through email. RESULTS/ANTICIPATED RESULTS: Out of the 481 who attended the play, 421 completed both the pre and post surveys, and 166 participants completed open-ended questions online ~1 week after the play. Across all participants, there were significant declines for Trust in Medical Researchers and for the survey item “is it ethical for genetic testing in children for adult onset conditions,” (p<0.001 for both) following the play. There was a significant increase in agreement to improve group identity protections (p<0.001) and no differences on willingness to donate biospecimens to research (p=0.777). When differences were analyzed by race of the participant, non-White participants (n=68) compared with White participants (n=344) were less willing to donate biospecimens in general (p<0.001). Further, non-White participants’ willingness to donate biospecimens decreased (p=0.049) after viewing the play while the white participants’ willingness to donate was unchanged. Qualitative data provided extensive contextual data supporting these perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This is one of the first studies to empirically examine the impact of a theatrical performance on both attitudes and behavioral intentions toward research and clinical research participation. Some attitudes changed following the play performance, but there were no significant differences on intention to donate biospecimens for research overall. Future research can further address the value and impact of theatrical performances and other creative arts as tools to engage the public and investigators in dialogue about the ethical issues and complexities in clinical research and further evaluation of the impact of performances on attitudes about research and ethics. Creative arts may be used to motivate investigators and study participants to confront fundamental questions about research participation and trust.

For this study, we adapted the Montgomery Borgatta Caregiver Burden Scale, used widely in the United States, to the Saudi Arabian context. To produce an Arabic, culturally sensitive version of the scale, we conducted semi-structured interviews with 20 Saudi family caregivers. The Arabic version of the scale was tested, and participants were asked to comment on the appropriateness of items for the construct of “caregiver burden” using the repertory grid technique and laddering procedure – two constructivist methods derived from personal construct theory. From interview findings, we examined the content of the items and the caregiver burden construct itself. Our findings suggest that the use of constructivist methods to refine constructs and quantitative instruments is highly informative. This strategy is feasible even when little is known about the investigated constructs in the target culture and further elucidates our understanding of cross-cultural variations or invariance of different versions of the scale.

Field studies were conducted at three locations in 1993 and 1994 to evaluate weed control and crop response to metolachlor plus combinations of 0.5 × and 1 × label rates of imazaquin applied preplant and imazethapyr applied early postemergence or postemergence in no-till narrow-row soybean production. Giant foxtail, common ragweed, common cocklebur, and large crabgrass population reductions were greater with sequential preplant metolachlor plus imazaquin followed by early postemergence or postemergence imazethapyr than with preplant metolachlor plus imazaquin or early postemergence/postemergence imazethapyr alone. Ivyleaf morningglory was not effectively controlled by any herbicide program. Pennsylvania smartweed populations were reduced with all herbicide treatments. Soybean yields with treatments utilizing 0.5 × rates were usually equal to 1 × rates if imazethapyr was applied early postemergence or postemergence. Net income with reduced herbicide rates was equal to full-label rates and provided no greater risk to net income.

Field studies were conducted at three locations in 1993 and 1994 to evaluate weed control and crop response to combinations of glyphosate, metolachlor, 0.5 X and 1 X label rates of chlorimuron plus metribuzin applied prior to planting (PP), and 0.5 X and 1 X label rates of imazethapyr applied early postemergence (EPOST) or postemergence (POST) in no-till narrow-row soybean production. Giant foxtail densities were reduced with sequential PP followed by (fb) EPOST or POST treatments. Large crabgrass was reduced equivalently with all herbicide combinations involving chlorimuron plus metribuzin PP fb imazethapyr. Common cocklebur control was variable but was usually greater with treatments that included imazethapyr. Ivyleaf morningglory densities were not reduced with any herbicide combinations. Sequential PP fb EPOST or POST treatments tended to provide slightly better weed suppression than PP-only treatments, but the difference was rarely significant. Soybean yields with treatments utilizing 0.5 X rates were usually equal to 1 X rates.

Weed management can be a significant challenge in cropping systems, partly because the effects of tillage systems on weed seedbank and seedling population dynamics are not well understood. Field research was conducted from 1994 to 1996 in established tillage plots consisting of moldboard plow (MP), chisel plow (CP), and no-tillage (NT). The objectives were to determine the effects of long-term tillage systems on the timing and duration of Setaria spp. emergence and percentage cumulative emergence from the soil seedbank and to investigate the effect of tillage on Setaria spp. density and seed production following glyphosate application at Setaria spp. heights of 5, 10, and 15 cm. NT contained a greater number of Setaria spp. seed in the 0- to 1-, 1- to 3-, and 3- to 6-cm depths than MP or CP systems. There was little difference between the three tillage systems at depths greater than 6 cm. Setaria spp. emergence was greater in NT than in MP or CP in 1994 and 1996 and greater than in MP in 1995. There was a substantial increase in Setaria spp. emergence in NT between 3 and 4 weeks after planting (WAP) in 1994 and between 5 and 6 WAP in 1995 and 1996. Significant emergence did not occur past 5 to 6 WAP in 1994 and 1995 but continued over a longer period of time in 1996. Setaria spp. plants consistently reached targeted herbicide application heights 4 to 9 d earlier in NT than in CP and MP. In 1994, final Setaria spp. density was greater in NT compared to CP and MP at the 5- and 10-cm herbicide application timings. When glyphosate was applied to 15-cm-tall Setaria, very few weeds were present following application across all tillage systems. In 1995, NT resulted in greater Setaria spp. density than MP or CP across all application timings. There was no difference in final Setaria spp. density between MP and CP across all glyphosate timings in 1994 and 1995. Seed production was negligible in MP and CP, regardless of glyphosate timing. In NT, however, significant seed production occurred, especially with early application. Results indicate that the effectiveness of nonresidual herbicides for Setaria faberi Herrm. control is influenced by tillage system and the timing of application.

Objectives: Huntington’s disease (HD) is a debilitating genetic disorder characterized by motor, cognitive and psychiatric abnormalities associated with neuropathological decline. HD pathology is the result of an extended chain of CAG (cytosine, adenine, guanine) trinucleotide repetitions in the HTT gene. Clinical diagnosis of HD requires the presence of an otherwise unexplained extrapyramidal movement disorder in a participant at risk for HD. Over the past 15 years, evidence has shown that cognitive, psychiatric, and subtle motor dysfunction is evident decades before traditional motor diagnosis. This study examines the relationships among subcortical brain volumes and measures of emerging disease phenotype in prodromal HD, before clinical diagnosis. Methods: The dataset includes 34 cognitive, motor, psychiatric, and functional variables and five subcortical brain volumes from 984 prodromal HD individuals enrolled in the PREDICT HD study. Using cluster analyses, seven distinct clusters encompassing cognitive, motor, psychiatric, and functional domains were identified. Individual cluster scores were then regressed against the subcortical brain volumetric measurements. Results: Accounting for site and genetic burden (the interaction of age and CAG repeat length) smaller caudate and putamen volumes were related to clusters reflecting motor symptom severity, cognitive control, and verbal learning. Conclusions: Variable reduction of the HD phenotype using cluster analysis revealed biologically related domains of HD and are suitable for future research with this population. Our cognitive control cluster scores show sensitivity to changes in basal ganglia both within and outside the striatum that may not be captured by examining only motor scores. (JINS, 2017, 23, 159–170)