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This report highlights the design, implementation, and key lessons from the William Schnaper Visiting Scientist (WSVS) Program, developed to foster scientific exchange among predoctoral and postdoctoral Translational Science (TS) Trainees across Clinical and Translational Science Award (CTSA) hubs. Trainees were part of TL1 and T32 CTSA programs funded by the NIH National Center for Advancing Translational Sciences. The WSVS program includes three complementary training opportunities: Mini-Symposium, Debate Forum, and Grand Rounds (GR) which is the subject of this report. The GR program provides advanced trainees with opportunities to present their research at another CTSA institution through a virtual forum, offering national-level exposure and constructive feedback from experts. In addition to formal presentations, participants engage in personalized, one-on-one meetings with faculty members at the host institution, gaining insights into other academic cultures and expanding their professional networks. We surveyed trainees and host institutions who participated in the program using single-and multiple-response items, Likert scales, and short open-text response questions. Survey respondents were overwhelmingly positive; all trainees recommended the program to peers and affirmed the value of the program. This demonstrates a scalable approach to enhancing TS education, advancing professional development, and promoting a more interconnected biomedical research community.
To assess the association between hand hygiene adherence, as measured by an automated hand hygiene monitoring system (AHHMS), and multidrug-resistant organisms and other pathogens of epidemiologic significance (MDRO+).
Design:
Retrospective cohort study.
Setting:
Acute care hospitals within an academic healthcare system.
Participants:
Hand hygiene data was collected from all badged staff January 2021 through September 2022. Adult inpatients on non-maternity units during this period were eligible for inclusion.
Methods:
After implementing an AHHMS, we analyzed correlations between monthly unit-level hand hygiene adherence (proportion of room entry–exit opportunities during which hand hygiene solution was dispensed) and hospital-onset MDRO+ rates from all clinical cultures and Clostridioides difficile stool tests. Mixed-effect negative binomial regression models evaluated associations between monthly unit-level hand hygiene adherence and MDRO+ rates while adjusting for the number of clinical tests ordered, unit type, and average number of inpatient COVID-19 cases.
Results:
During the study period, there were 22,767,036 hand hygiene opportunities. Mean hand hygiene adherence improved from 41% (January 2021) to 57% (September 2022). 1,847 MDRO+ detections were observed in 752,341 patient days with a median composite MDRO+ rate of 1.7 per 1,000 patient days (IQR: 0–3.6). The mixed-effect negative binomial regression model found a null association between hand hygiene adherence and MDRO+ rates (rate ratio 1.01; 95% confidence interval: 1.00–1.01).
Conclusions:
Despite an improvement in hand hygiene adherence, we did not find a resultant impact on MDRO+ detection, likely owing to the complex interaction between the two variables and unmeasured confounders.
With the growing evolution of the theory of nonunique factorisation in integral domains and monoids, the study of several variations to the classical unique factorisation domain (or UFD) property has become popular in the literature. Using one of these variations, the length-factorial property, it can be shown that part of the standard classical axioms used in the definition of a UFD is essentially superfluous.
Use the electronic health record (EHR) to prospectively validate a risk prediction tool identifying patients at high-risk for carbapenem-resistant Enterobacterales (CRE).
Design:
Prospective, cross-sectional analysis.
Participants:
Adults admitted to two hospitals in Atlanta, Georgia.
Methods:
An EHR report calculated a CRE risk score on all admissions from 6/2024–3/2025. The risk score was determined from a prior model incorporating data from current and prior hospitalizations. Stool or perianal samples were cultured from a convenience sample of patients with the highest risk scores. A receiver operating curve analysis calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of various risk scores that could be used as a “threshold” for CRE admission testing. Using the threshold with the greatest Youden’s index, we estimated the cost of implementing a CRE screening program.
Results:
Of the 853 patients approached, 342 (40%) consented. Eleven (3.2%) tested positive for CRE. Patients with CRE had a higher median CRE risk score (0.19% vs 0.04%) than those who tested negative. The AUC of the model was 0.66. Using a testing threshold of 0.16% yielded a 55% sensitivity, 84% specificity, 10% PPV, and 98% NPV. The number needed to screen to diagnose 1 patient with CRE was 12 patients, and the screening program approximately costs $8,015/month.
Conclusions:
An EHR-based risk prediction tool can detect patients likely to be colonized with CRE. In facilities with a low CRE prevalence, identifying a high-risk subset of patients to test could be a cost-effective infection prevention initiative.
Systemic inflammation is hypothesized to contribute to post-traumatic stress disorder (PTSD) vulnerability. Few studies have examined inflammation shortly after trauma as a predictor of later PTSD symptoms. We examined whether inflammation from the emergency department (ED) post-trauma is associated with PTSD symptom severity over the following 6 months.
Methods
Our sample included 742 AURORA participants, a longitudinal cohort of patients in 29 EDs across the United States after a traumatic stressor, followed up to 6 months. Plasma cytokines were assessed from a study blood draw in the ED: an inflammatory index (standardized sum of generally pro-inflammatory markers interleukin [IL]-6, IL-8, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), and generally anti-inflammatory IL-10. PTSD symptoms were self-reported at 2 weeks, 8 weeks, 3 months, and 6 months post-ED. Covariate-adjusted repeated-measures regressions estimated associations between inflammation and PTSD symptoms, overall and sex-stratified.
Results
Among 742 participants (age m = 40.0 [13.7]; 479 [64.6%] female), PTSD symptoms were elevated then modestly decreased over follow-up. Higher ED inflammation was associated with higher PTSD symptoms across follow-up (standardized symptoms β = 0.05, 95% CI: 0.01–0.09), adjusted for potential confounders. Higher pro-inflammatory index levels and IL-6, IL-8, and TNF-α were associated with higher PTSD symptoms in males only, while higher IL-10 was associated with higher PTSD symptoms in females only.
Conclusions
Pro-inflammatory levels shortly after traumatic stress are associated with heightened PTSD symptoms, particularly among males. Inflammatory markers may prove useful additions to prediction models for PTSD following trauma, with attention to sex differences.
Maternal nutrition during gestation provides the nutrients for fetal growth and development. Herein, we investigated the transcriptomic responses of fetal brain and muscle tissues at day 83 of gestation (the end of the first trimester) in female fetuses from heifers assigned in a 2 × 2 factorial design to one of four treatments. The treatments consisted of the main effects of vitamin and mineral supplementation (VTM vs. NoVTM; 113 g·heifer−1·d−1 of mineral premix) and two maternal body weight gain rates (low [LG; 0.28 kg d−1] vs. moderate [MG; 0.79 kg d−1]). RNA sequencing of 31 fetuses revealed 399 unique differentially expressed genes (DEGs) in the brain and 1,273 unique DEGs in the muscle across the six contrasts (false discovery rate ≤ 0.1). Overall, brain DEGs were enriched in tissue morphogenesis and Wnt/phosphatidylinositol 3-kinase–protein kinase B signaling pathways, including WNT2B, WNT5A, and WNT7B (upregulated in VTM_LG vs. NoVTM_LG). In muscle, maternal gain and VTM supplementation modulated the expression of myogenic and epigenetic regulators, including PAX7, MSTN, FOXO3, and DNA demethylation enzymes TET1, TET2, and TET3, highlighting the potential epigenetic programming. These findings demonstrate that maternal diet during the first trimester of gestation alters fetal brain and muscle molecular profiles through genes involved in nutrient-sensing and epigenetic pathways. Together, these results highlight the potential for targeted maternal vitamin and mineral supplementation during early gestation to modulate brain and muscle development. Further research is needed to determine the long-term effects of supplementation on offspring behavior, growth, and efficiency in beef production systems.
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.
Biodiversity monitoring is essential to inform the state of wildlife populations, and the impacts of environmental change, conservation intervention, and sustainable development policies and actions. We review the current state of bird monitoring across Africa using public questionnaires and semi-structured interviews. We received 87 questionnaire responses from 46 (of 54) countries and, additionally, 24 in-depth interviews were carried out. Multiple data collection methods were reported with total counts of individuals being most frequent, but all-species surveys, essential for quantifying ecosystem health, were restricted to bird atlases and Common Bird Monitoring (CBM) projects in Kenya, Uganda, and Botswana. Data collection relied largely on volunteers, but their motivation, recruitment, training, and retention is a continuing challenge. The most sustainable programmes were driven by clear policy objectives (e.g. waterbird monitoring under the Ramsar Convention or the Convention on the Conservation of Migratory Species), monitoring of individual groups (e.g. raptors, vultures, bustards), specific threatened species, and where clear national priorities had been set within government agencies. Use of monitoring data by governments in country biodiversity reports or National Biodiversity Species Action Plans (NBSAPs) varied widely and, for many countries, simply did not exist. A lack of skilled analysts and a comprehensive approach to data curation and ownership were identified as major limitations. A more strategic approach to funding and monitoring is needed, whereby smaller funders collaborate to reduce costs associated with applying for small amounts of money, and bird (and biodiversity) monitoring is explicitly integrated with sustainable development goals to exploit broader funding streams.
Lung ultrasound findings in cardiac patients correlate with mortality, hospital length of stay, and rehospitalisation after surgery. We report a lung ultrasound protocol integrated with echocardiography and its ability to predict adverse events in children after discharge following congenital heart surgery.
Methods:
A prospective, single-blinded observational trial was performed. Subjects were consecutively identified after Fontan or septal defect repairs. Performed by cardiac sonographers at discharge, lung ultrasound scores were based on the number of B-lines. The primary outcome was subsequent development of new pericardial (≥small) or pleural (>small) effusion.
Results:
A total of 86 subjects were identified with adequate imaging for enrolment. Median age was 53 months. Procedures included Fontan (n = 23) and atrial (n = 30), ventricular (n = 28), and atrioventricular (n = 5) septal defect repairs. Lung ultrasound score was correlated with hospital length of stay (ρ = 0.29, p = 0.0066), discharge diuretic score (ρ = 0.38, p < 0.001), and chest tube duration (ρ = 0.25, p = 0.021); score was not correlated with age or weight. Primary outcome occurred in 12 subjects (atrial septal defect = 4, Fontan = 8). A lung ultrasound score ≥3 had a negative predictive value of 93% and an odds ratio of 24.5 (95%CI 5.3–113, p < 0.0001) for the primary outcome. Subjects following Fontan with the lung ultrasound score ≥3 had an odds ratio of 8.3 (95%CI 1.2–59.0, p < 0.036).
Conclusions:
Our results suggest that lung ultrasound during discharge echocardiography has encouraging prognostic value for post-operative complications in patients deemed suitable for discharge after congenital heart surgery. Further research is needed to discern how lung ultrasound can be used for goal-directed medical therapy.
This review highlights 10 recent advances in climate change research with high policy relevance, spanning diverse topics: (1) the global temperature jump of 2023–2024; (2) sea surface warming and marine heatwaves; (3) land carbon sinks; (4) interactions between climate change and biodiversity loss; (5) accelerated groundwater decline; (6) global dengue incidence; (7) income and labour productivity loss; (8) strategic considerations for scaling carbon dioxide removal (CDR); (9) integrity of carbon credit markets; and (10) policy mixes for climate change mitigation.
Technical Summary
Interdisciplinary understanding is vital for delivering sound climate policy advice. However, navigating the ever-growing and increasingly diverse scholarly literature on climate change is challenging for any individual researcher. This annual synthesis highlights and explains recent advances across a variety of fields of climate change research. This year, the 10 insights focus on: (1) the record-warmth of 2023/2024 and the elevated Earth energy imbalance; (2) acceleration of ocean warming and intensifying marine heatwaves; (3) northern land carbon sinks under strain; (4) reinforcing feedback between biodiversity loss and climate change; (5) accelerated depletion of groundwater; (6) global dengue incidence; (7) global income losses and labour productivity declines; (8) strategic scaling of CDR; (9) integrity challenges in carbon credit markets and emerging responses; and (10) effective policy mixes for emissions reductions. The insights have been written to be accessible to researchers from different fields, serving as entry-points to specific topics, as well as providing an overview of the evolving landscape of climate change research. In the final section, the insights are used to develop overarching policy-relevant messages. This paper provides the basis for a science-policy report that was shared with all Party delegations ahead of COP30 in Belém, Brazil.
Social Media Summary
Highlights of climate change research in 2024–2025: 10insightsclimate.science
Bars are ubiquitous morphological features in the observed distribution of galaxies. There are similarly many methods for classifying these features and, without a strict theoretical definition or common standard practice, this is often left to circumstance. So, we were concerned whether astronomers even agree on the bar which they perceive in a given galaxy and whether this could impact perceived scientific results. As an elementary test, we twenty-one astronomers with varied experience in studying resolved galaxies and circumstances, have each assessed 200 galaxy images, spanning the early phase of bar evolution in two different barred galaxy simulations. We find variations exist within the classification of all the standard bar parameters assessed: bar length, axis-ratio, pitch-angle and even whether a bar is present at all. If this is indicative of the wider community, it has implications for interpreting morphological trends, such as bar-end effects. Furthermore, we find that it is surprisingly not expertise but gender, followed by career stage, which gives rise to the largest discrepancies in the reported bar parameters. Currently, automation does not seem to be a viable solution, with bar classifications from two automated bar-finding algorithms tested and failing to find bars in snapshots where most astronomers agree a bar must exist. Increasing dependence on machine learning or crowdsourcing with a training dataset can only serve to obfuscate any existing biases if these originate from the specific astronomer producing the training material. On the strength of this small sample, we encourage an interim best practice to reduce the impact of any possible classification bias and set goals for the community to resolve the issue in the future.
We present microsecond-resolution, coherently dedispersed, polarimetric measurements of 35 fast radio bursts (FRBs) detected during the Commensal Real-time ASKAP Fast Transients (CRAFT) incoherent sum (ICS) survey with the Australian Square Kilometre Array Pathfinder (ASKAP). We find a wide diversity of time–frequency morphology and polarisation properties broadly consistent with those of currently known non-repeating FRBs. The high S/N and fine time-resolution of our data however reveals a wealth of new information. Key results include (i) the distribution of scattering timescales, ${{{\unicode{x03C4}}_\textrm{obs}}}$, is limited purely by instrumental effects, with no downturn at high ${{{\unicode{x03C4}}_\textrm{obs}}}$ as expected from a log-normal distribution; (ii) for the 29 FRBs with known redshift, there is no detectable correlation between ${{{\unicode{x03C4}}_\textrm{obs}}}$ and dispersion measure (DM) fluctuations about the Macquart relation, in contrast to expectations from pulsar scattering–DM relations; (iii) all FRBs probably have multiple components, and at least a large fraction have variable PA, the identification of which is limited by scattering; (iv) at least half of all FRBs exhibit PA microstructure at 200 $\mu{}$s–200 ns timescales, with behaviour most closely resembling a sub-category of Crab main pulses; (v) that there is a break in the FRB circular polarisation distribution at Stokes $V \gtrsim 20$%, which is suggestive of a discrete sub-population.
Introduction: Within our healthcare system, hospitalists receive feedback on antibiotic prescribing via an observed-to-expected ratio (OER) calculated by days of therapy (DOT) for CDC defined broad-spectrum, hospital-onset (BSHO) antibiotics and adjusted for patient characteristics and billing. In this sub-analysis, we quantify the impact of infectious disease (ID) consultations on OER. Methods: For each two-month period in five hospitals, encounters were assigned to each hospitalist if they billed for ≥1 day of care. The encounter was considered to involve an ID consult if an ID provider billed during the encounter. Percent of encounters with ID consultation (density) was calculated and stratum defined by gross ratios (e.g., 1 in 3 or 1 in 4 patients). We assessed whether consult density varied overtime, by facility, or by DOT. We assessed the effect of consult density on antibiotic DOT using established linear mixed effects model with random intercepts for both provider and facility (nested) and adjusted for patient characteristics and billing. Distribution of OERs were compared among strata to evaluate how ID consult changes OERs. Results: Between January and June 2023, 154 unique providers collectively received 458 bi-monthly OERs reflecting their care for 53,815 unique patients. Overall, 21% of hospital medicine patients were evaluated by an ID consultant during inpatient stay; median consultation density varied among providers by facility (19%-26%, Figure 1). Multivariate models (accounting for sepsis, UTI, renal disease) estimated significantly increased DOT for hospitalists having ~1:3 (+3.4 DOT, 95% CI 0.9 – 5.9) or 1:4 (+2.7 DOT, 95% CI 0.4-5.0) patients with ID consults compared to hospitalists with fewer than ~1:7 with an ID consult; however the effect was not significant in other strata and not linear (Table 1). Calculating the distribution of OERs both before and after adjusting for consult density resulted in small changes in OERs (Figure 1b). Discussion: The frequency of ID consults affected hospitalists’ BSHO-DOT in a non-linear fashion. Impact of ID consultation on prescribing metrics should be considered in building credibility of stewardship prescribing performance metrics.
Among 70 hospitalists across three facilities, 47% of high prescribers of broad-spectrum hospital-onset (BSHO) agents remained high in the subsequent period versus 24% for initially high prescribers of anti-MRSA agents. Findings of persistence of high prescribing add credibility to our metric for BSHO agents but not anti-MRSA agents.
Although life stressors are known risk factors for suicide, the specific stressor types that most strongly precipitate suicidal outcomes, and on what timescale, remain poorly understood. Based on existing theory, we investigated whether objectively rated interpersonal stressors, especially social and targeted rejection stressors, are proximally associated with increased likelihood of suicidal ideation and behavior.
Method
Using an objectively rated contextual threat interview to assess stressful life events, and a timeline followback procedure for assessing suicide-related outcomes, we examined how the severity of four types of acute life events (i.e. non-interpersonal, interpersonal without social rejection, social rejection without targeted rejection, and targeted rejection) were temporally associated with the likelihood of same-day and next-day suicidal ideation and behavior over 16 months in 143 young adults (Mage = 25.27, SD = 4.65) with recent suicidal ideation or behavior.
Results
After controlling for prior-day suicidal ideation and non-interpersonal stressors, daily within-person increases in interpersonal stressor severity were related to higher odds of same-day (but not next-day) suicidal ideation. Additionally, greater increases in targeted rejection severity were uniquely related to increased likelihood of both same-day and next-day suicidal behavior after controlling for prior-day suicidal behavior and other types of stressors.
Conclusions
Interpersonal stressors are strong, proximal risk factors for suicidal ideation and behavior, and these effects are particularly strong for targeted rejection life events. Clinicians should thus assess recent interpersonal and, especially, targeted rejection stressors when evaluating acute suicide risk, and may reduce such risk by helping patients stabilize and strengthen their social relationships.
UK Biobank (UKB) is a large-scale, prospective resource offering significant opportunities for mental health research. Data include genetic and biological data, healthcare linkage, and mental health enhancements. Challenges arise from incomplete linkage of some sources and the incomplete coverage for enhancements, which also occur at different times post-baseline. We searched for publications using UKB for mental health research from 2016 to 2023 to describe and inspire future use. Papers were classified by mental health topic, ‘additional’ aspects, and the data used to define the mental health topic. We identified 480 papers, with 338 focusing on mental health disorder topics (affective, anxiety, psychotic, multiple, and transdiagnostic). The most commonly studied disorder was depression (41%). The most common single method of ascertaining mental disorder status was the Mental Health Questionnaire (26%), with genetic risk, for example, using polygenic risk scores, also frequent (21%). Common additional aspects included brain imaging, gene–environment interaction, and the relationship with physical health. The review demonstrates the value of UKB to mental health research. We explore the strengths and weaknesses, producing resources informed by the review. A strength is the flexibility: conventional epidemiological studies are present, but also genomics, imaging, and other tools for understanding mental health. A major weakness is selection effects. UKB continues to hold potential, especially with additional data continuing to become available.
Strategists seek a competitive advantage by balancing legitimacy and novelty; however, each approach has distinct risks and trade-offs. Some firms take on too much risk and eventually fail, while other firms only seek risk-averse alternatives that appear to promote safety and optimal long-term performance. We question whether those decisions must be mutually exclusive. We generated and applied two generic strategy rationales to the results of a professional sports gambling pool. One rationale mirrored best practices, and the other included one minor adaptation, balancing risk and novelty. Our findings suggest profit potential for both approaches but deviating from the norm – occasionally and systematically – produced better outcomes. We demonstrate how industry-based best practices can serve as a foundation for rational decision-making and strategy development, thereby limiting potential adverse outcomes. However, savvy strategists should learn when and how to deviate from conventional wisdom to create more value for their firms.