Early (before age 6) potentially traumatic events (PTEs) may interact with hypothalamic–pituitary–adrenal (HPA) axis functioning to shape outcomes involving externalizing problems and anxiety. However, directions of effects remain unclear. This study examined associations between aspects of HPA axis reactivity, anxiety, and externalizing problems over two years by early PTE exposure history, while statistically capturing the co-occurrence of symptom domains. Youth (N = 189; Mage = 10.96 years, SD = 2.51, Range = 8–15; 52.4% female, 47.1% male; 50.3% White, 35.4% Black/African American, 6.4% Other; 7.4% Hispanic/Latine) were included if they had early PTE exposure (n = 107) or had never experienced a PTE (n = 82). HPA axis reactivity to social stress was calculated using area under the curve with respect to ground (AUCg) and increase (AUCi). For youth with early PTE exposure, higher AUCg was concurrently associated with more externalizing symptoms and greater predominance of externalizing over anxiety. Blunted AUCi predicted increasing predominance of externalizing for the early PTE group, but elevated AUCi predicted increases in anxiety for the no PTE group. Findings highlight distinct roles of overall and reactive HPA axis functioning in shaping outcomes following early trauma.

Antibiotic overprescribing remains common in pediatric outpatient care. We evaluated Medicaid claims–based provider report cards as a scalable stewardship tool. Quarterly audit and feedback improved guideline concordance, diagnostic appropriateness, and reduced cefdinir use; highlighting claims-based electronic feedback as a sustainable outpatient antimicrobial stewardship strategy suitable for statewide implementation.

Objectives/Goals: To develop an information-theoretic alternative to ALE that integrates uneven datasets using log-likelihood ratios (LLRs) under noise versus signal world models. This approach aims to improve reproducibility, signal-to-noise ratio, and computational scalability in neuroimaging meta-analysis. Methods/Study Population: We used both real and simulated coordinate-based datasets to build an information-theoretic meta-analysis framework. The method models each study’s activations under noise versus signal expectations and computes voxelwise LLRs to combine information asymmetrically across uneven datasets. Implemented in Python with NumPy and custom modules, it integrates watershed segmentation for cluster detection and simulation-based calibration. Validation compares results to ALE, testing robustness to injected noise and recovery from highly imbalanced datasets. Results/Anticipated Results: Studies are ongoing. We anticipate improved SNR and recovery robustness compared to ALE, as our approach avoids pre-thresholding before combining information across datasets. Simulation evidence suggests far greater computational efficiency (e.g., reducing 45-min–20-hour ALE runs to under two minutes locally). Conceptually, the framework parallels modern AI training strategies – modeling signal and noise distributions to calibrate evidence rather than relying on fixed significance thresholds. These innovations leverage information theory, watershed algorithms, and simulation calibration to yield interpretable, high-resolution evidence maps. Discussion/Significance of Impact: This framework advances coordinate-based meta-analysis by modeling evidence directly rather than inferring it through p-values. It improves reproducibility, interpretability, and cross-disorder comparability, supporting more robust and scalable neurocircuit mapping for researchers and clinicians.

This article analyses how Flavius Josephus presents the conquests of Asinaeus and Anilaeus, two robber-bandits who established a fiefdom in first-century Babylonia. In dialogue with common Roman tropes about gender and his previous writings on the notable physical features of men in times of war, this article focusses on how Josephus progressively effeminizes Asinaeus and Anilaeus. Although their military feats abound, their increasingly risky behaviour and their growing neglect of Jewish ways of life jeopardize their own character and the safety of their Jewish kin. With this strategy of emasculation, Josephus undermines those who self-interestedly seek power and influence.

The American Society of Clinical Psychopharmacology convened a 45-member international expert task force to identify circumstances supporting the deprescribing of core psychotropic medications for major depressive disorder (MDD) and bipolar disorders. Three Delphi survey rounds plus a selective literature review identified points of consensus (predefined as ≥75% agreement) about when antidepressant, antipsychotic, mood stabiliser and sedative-hypnotic deprescribing is warranted. Twenty out of 32 statements (63%) achieved consensus across seven thematic areas. In MDD, panellists favoured discontinuing antidepressants when mechanisms of action are duplicative, adequate trials produce ≤25% improvement or loss of prior efficacy cannot be regained through dose increases or augmentations. Indefinite antidepressant maintenance in MDD was favoured after three or more lifetime episodes. In bipolar disorder, antidepressant deprescribing was favoured in the setting of rapid cycling, mixed features or emerging mania/hypomania symptoms; and discouraged if prior antidepressant cessation led to relapse. In nonpsychotic mood disorders, panellists favoured deprescribing antipsychotics that caused significant weight gain or tardive dyskinesia over adding pharmacological antidotes. Deprescribing to achieve an eventual medication-free status was considered inappropriate, in bipolar type 1, but not necessarily bipolar type 2 disorder. Although individualised circumstances necessarily inform psychopharmacology management, clinical presentations that misalign with existing pharmacotherapies may signal the desirability of cautious deprescribing.

The near-surface weathering crust is a thin (<0.5 m), low density ice layer that develops on glacier surfaces during the ablation season and is formed by internal melting driven by the penetration of shortwave radiation (SWR) into polycrystalline glacier ice. This ‘photic zone’ hosts microbial communities, mediates biogeochemical processes and routes meltwater to the channelised supraglacial drainage network. Despite these critical roles, direct field measurements of weathering crust formation and evolution are scarce—rather, current understanding is largely derived from modelling approaches. Here, we present in situ measurements of weathering crust evolution at five sites on the western Greenland ice sheet, each over a 19–25 hour period. Shallow ice cores revealed weathering crust ice densities of 420–910 kg m−3, demonstrating dynamic evolution of the weathering crust linked to diurnal SWR receipt. We compare our empirical data with two existing weathering crust models, neither of which fully reproduce the observed ice density or its temporal variability. Additionally, we reveal that the density of the uppermost 0.1 m of the weathering crust is a key control upon bare-ice albedo. Our findings highlight the need for improved process-level-understanding and parameterisations of weathering crust dynamics in surface energy balance models.

Powassan virus (POWV), a tick-borne flavivirus, is an emerging public health threat in the United States. In New York State (NYS), incidence of human POWV infection has increased in recent years. We describe the epidemiology of confirmed and probable POWV infection cases reported in NYS from 2013 to 2023. A total of 44 human cases were reported over the study period, with the highest incidence rates in Columbia and Putnam counties. Most cases occurred in White, non-Hispanic males over age 50. Hospitalization was reported in 91% of cases, and 11% were fatal. Human case data and tick surveillance results were analysed to assess spatiotemporal patterns of disease emergence. Spatial analysis revealed clustering of human cases in the Capital and Metropolitan regions of NYS. The prevalence of POWV in adult tick populations increased significantly statewide, and entomological risk was positively but modestly correlated to disease incidence at the ZIP code level. These findings suggest that POWV infection is emerging in geographically concentrated areas of NYS, highlighting the need for enhanced surveillance and targeted prevention efforts in high-risk regions.

In this note, we offer a cautionary tale on the dangers of drawing inferences from low-quality online survey datasets. We reanalyze and replicate a survey experiment studying the effect of acquiescence bias on estimates of conspiratorial beliefs and political misinformation. Correcting a minor data coding error yields a puzzling result: respondents with a postgraduate education appear to be the most prone to acquiescence bias. We conduct two preregistered replication studies to better understand this finding. In our first replication, conducted using the same survey platform as the original study, we find a nearly identical set of results. But in our second replication, conducted with a larger and higher-quality survey panel, this apparent effect disappears. We conclude that the observed relationship was an artifact of inattentive and fraudulent responses in the original survey panel, and that attention checks alone do not fully resolve the problem. This demonstrates how “survey trolls” and inattentive respondents on low-quality survey platforms can generate spurious and theoretically confusing results.

Liberia (West Africa) has an extensive (co)burden of urogenital and intestinal schistosomiasis; each largely restricted to more inland areas. Where urogenital schistosomiasis is endemic, as both disease surveillance and case management are nascent, many women may unknowingly be living with Female Genital Schistosomiasis (FGS). Using a recently developed FGS score card, we appraised FGS score card valuations with point-of-care gynaecological and molecular parasitological evaluations as undertaken within typical primary care settings of four Liberian counties. A total of 400 women, 100 participants from each of four endemic inland counties, underwent a cursory gynaecological examination using a speculum for visible FGS lesions, undertaken by a midwife, and provided a urine sample that was examined by centrifugation with microscopy for Schistosoma ova. Urine-sediments in ethanol were later analysed with a high-resolution melt (HRM) real-time (rt) PCR assay to screen for Schistosoma genetic markers. Using a combination of clinical and parasitological information, overall prevalence of UGS and FGS was <10% and a single case of putative FGS-associated co-infection with Schistosoma mansoni was observed. Participant interviews with the FGS score cards provided an insight into at-risk lifestyle and environmental factors, e.g. women who fished regularly were more likely to present with FGS whereas those who lived > 15 km from a local river were less likely to present with FGS. In this resource-poor setting of Liberia, active surveillance for FGS with either clinical or parasitological methods remains challenging such that sole future use of the FGS score card is most pragmatic for primary care.