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The New Somatomorphic Matrix-Male (NSM-M; Talbot et al., 2019) is a pictorial bi-dimensional figure rating scale for men. The scale presents a matrix of 34 computer-rendered frontal-view male bodies, each with a unique graded combination of body fat and muscularity. It is used to assess how men perceive their body (actual body) and identify the body that they would like to have (ideal body). The difference (discrepancy) between a man’s selected actual and ideal bodies can be used as an index of body dissatisfaction. The NSM-M can be administered online or in-person to men and is free to use. This chapter first discusses the development of the NSM-M and then provides evidence of its psychometrics. Test-retest reliability, convergent validity, concurrent validity, and discriminant validity support the use of the NSM-M. The entire matrix is included within the chapter. Logistics of use, such as permissions, copyright, and contact information, are provided for readers.
Acute rhinosinusitis is one of the most common conditions seen in primary care. One in seven adults are diagnosed with ARS annually, resulting in one in five of all antibiotic prescriptions. Yet there has been limited research comparing the effectiveness of widely used treatments such as antibiotics and nasal steroids. Conducting such a trial in the context of decades of established practice poses unique challenges.
Methods:
A feasibility phase was conducted with continuing feedback to provide refinement and guidance regarding the design of a large-scale, pragmatic randomized controlled trial. The pilot trial assessed the ability to enroll, retain, and evaluate adherence to the intervention and assessment protocols.
Results:
The feasibility phase allowed us to seek input from patients and experts. This resulted in changes pre and post pilot that will impact the full study. A priori enrollment targets for the pilot were achieved, and with high adherence rates. In total, 373 patients were pre-screened and 140 patients were enrolled participants. Adherence to data collection via the daily diary was 93% throughout the study, with 95% completing their diary on the day of the primary outcome, 3 post-randomization.
Conclusion:
Expert panels and a patient advisory committee recommended critical changes to our study design. Stakeholder engagement is a key component of this funding source and was widely used throughout the 18-months. An achieved primary goal of the feasibility phase was to evaluate recruitment and study methods prior to implementing a large clinical trial that requires significant resources.
The first year of life is a critical period when nutrient intakes can affect long-term health outcomes. Although household food insecurity may result in inadequate nutrient intakes or a higher risk of obesity, no studies have comprehensively assessed nutrient intakes of infants from food insecure households. This study aimed to investigate how infant nutrient intakes and BMI differ by household food security.
Design:
Cross-sectional analysis of the First Foods New Zealand study of infants aged 7–10 months. Two 24-h diet recalls assessed nutrient intakes. ‘Usual’ intakes were calculated using the multiple source method. BMI z-scores were calculated using WHO Child Growth Standards.
Setting:
Dunedin and Auckland, New Zealand.
Participants:
Households with infants (n 604) classified as: severely food insecure, moderately food insecure or food secure.
Results:
Nutrient intakes of food insecure and food secure infants were similar, aside from slightly higher free and added sugars intakes in food insecure infants. Energy intakes were adequate, and intakes of most nutrients investigated were likely to be adequate. Severely food insecure infants had a higher mean BMI z-score than food secure infants, although no significant differences in weight categories (underweight, healthy weight and overweight) were observed between groups.
Conclusions:
Household food insecurity, in the short term, does not appear to adversely impact the nutrient intakes and weight status of infants. However, mothers may be protecting their infants from potential nutritional impacts of food insecurity. Future research should investigate how food insecurity affects nutrient intakes of the entire household.
A prominent literature on pre-modern warfare and institution-building holds that intense military competition in pre-modern Europe encouraged institutional innovations—for example, centralized bureaucracies and monopolies on coercion—that empowered rulers and enhanced state capacity, with salutary effects on long-run political development. States that adopted these innovations were more likely to survive, whereas those that did not succumbed to invading armies. Yet links between geopolitical competitiveness and capacity building are largely theorized and tested based on the European historical experience. A broader view of that period reveals a more complicated picture. The dominant mode of warfare throughout much of medieval and early modern Eurasia, Inner Asian cavalry warfare (IACW), favored succession institutions that selected for competent military leaders at the expense of long, secure reigns and cumulative capacity-building potential. I explore these links between IACW, succession practices, and rule duration with a novel dataset of over 300 Eurasian dynasties.
To describe trends in the prevalence of healthcare-associated infections (HAIs) and antibiotic-resistant organisms (AROs) in Canadian acute-care hospitals.
Design:
Repeated point prevalence surveys.
Setting:
Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals.
Methods:
Trained infection control professionals reviewed medical records of eligible adult patients and applied standardized definitions to collect demographic data and information on HAIs, AROs, and additional precautions from 39 to 62 hospitals in 2002, 2009, 2017, and 2024.
Results:
The prevalence of adult patients with at least one HAI increased from 10.4% (95% CI: 9.6%–11.2%) in 2002 to 12.4% (95% CI: 11.7%–13.2%) in 2009, declined to 8.4% (95% CI: 7.8%–9.0%) in 2017, and stabilized in 2024 (8.1%, 95% CI: 7.6%–8.6%) despite 3.1% of HAIs being due to SARS-CoV-2. Between 2017 and 2024, there were increases in bloodstream infections (1.0% to 1.5%, p = 0.002), viral respiratory infections (VRI) (0.3% to 0.6%, p < 0.001), and in the prevalence of patients on additional precautions for carbapenemase-producing organisms (0.1% to 1.7%, p < 0.001) and VRIs (2.1% to 3.6%, p < 0.001). In 2024, AROs were responsible for 6.6% of infections. One-third of HAIs were device-associated, and the prevalence of central line-associated bloodstream infections (CLABSIs) doubled from 0.4% in 2017 to 0.7% in 2024, p = 0.02.
Conclusions:
A point prevalence survey performed in Canada in 2024 following the COVID-19 pandemic identified a stable prevalence of HAIs and AROs despite the inclusion of SARS-CoV-2. Concerning trends were observed including the increased prevalence of certain HAIs such as CLABSIs and VRIs highlighting the need for ongoing efforts in hospital infection prevention.
The share of women in politics is higher, on average, under closed-list proportional representation (PR) electoral systems compared to majoritarian systems. Yet, even in PR systems, progress toward gender parity has been slow and uneven. We argue that women’s representation and career progression under PR might be impeded when single-occupant positions, such as local mayor and list leader, serve as important stepping stones in political career paths. Using a century of detailed candidate-level data from Norway, we investigate (1) whether gaps in women’s representation emerge at these “majoritarian stepping stones” and (2) how access to these positions affects women’s progression into higher offices. Our empirical analysis reveals that gender gaps indeed emerge at majoritarian stepping stones. However, we also document how Norwegian parties have employed workarounds—promoting women occupants of these positions at higher rates than men—to mitigate the adverse effects of this hidden majoritarianism on women’s representation in higher offices.
Functional impairment in daily activities, such as work and socializing, is part of the diagnostic criteria for major depressive disorder and most anxiety disorders. Despite evidence that symptom severity and functional impairment are partially distinct, functional impairment is often overlooked. To assess whether functional impairment captures diagnostically relevant genetic liability beyond that of symptoms, we aimed to estimate the heritability of, and genetic correlations between, key measures of current depression symptoms, anxiety symptoms, and functional impairment.
Methods
In 17,130 individuals with lifetime depression or anxiety from the Genetic Links to Anxiety and Depression (GLAD) Study, we analyzed total scores from the Patient Health Questionnaire-9 (depression symptoms), Generalized Anxiety Disorder-7 (anxiety symptoms), and Work and Social Adjustment Scale (functional impairment). Genome-wide association analyses were performed with REGENIE. Heritability was estimated using GCTA-GREML and genetic correlations with bivariate-GREML.
Results
The phenotypic correlations were moderate across the three measures (Pearson’s r = 0.50–0.69). All three scales were found to be under low but significant genetic influence (single-nucleotide polymorphism-based heritability [h2SNP] = 0.11–0.19) with high genetic correlations between them (rg = 0.79–0.87).
Conclusions
Among individuals with lifetime depression or anxiety from the GLAD Study, the genetic variants that underlie symptom severity largely overlap with those influencing functional impairment. This suggests that self-reported functional impairment, while clinically relevant for diagnosis and treatment outcomes, does not reflect substantial additional genetic liability beyond that captured by symptom-based measures of depression or anxiety.
Accessibility at the Sterkfontein Caves UNESCO World Heritage Site limits public and scientific engagement. The authors digitally visualised part of the cave using laser scans and photogrammetry, geospatially integrating the digital cave and fossil datasets. This enables broader access for learners, educators and scientists and enhances scientific outreach potential.
The digital twin approach has gained recognition as a promising solution to the challenges faced by the Architecture, Engineering, Construction, Operations, and Management (AECOM) industries. However, its broader application across some AECOM sectors remains limited. A significant obstacle is that traditional DTs rely on deterministic models, which require deterministic input parameters. This limits their accuracy, as they do not account for the substantial uncertainties that are inherent in AECOM projects. These uncertainties are particularly pronounced in geotechnical design and construction. To address this challenge, we propose a probabilistic digital twin (PDT) framework that extends traditional DT methodologies by incorporating uncertainties and is tailored to the requirements of geotechnical design and construction. The PDT framework provides a structured approach to integrating all sources of uncertainty, including aleatoric, data, model, and prediction uncertainties, and propagates them throughout the entire modeling process. To ensure that site-specific conditions are accurately reflected as additional information is obtained, the PDT leverages Bayesian methods for model updating. The effectiveness of the PDT framework is showcased through an application to a highway foundation construction project, demonstrating its potential to integrate existing probabilistic methods to improve decision-making and project outcomes in the face of significant uncertainties. By embedding these methods within the PDT framework, we lower the barriers to practical implementation, making probabilistic approaches more accessible and applicable in real-world engineering workflows.
Aims: To evaluate the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in treating treatment-resistant depression (TRD), with a focus on changes in depression severity measured by the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HAMD).
Methods: A prospective clinical trial was conducted with 15 patients diagnosed with TRD, defined as having failed at least two adequate antidepressant trials. rTMS was administered using a left dorsolateral prefrontal cortex (DLPFC) protocol, with sessions delivered five times per week over six weeks for the majority of participants. Depression severity was assessed using MADRS and HAMD scores both before and after treatment. Adverse events were monitored throughout the study. Paired t-tests were used to analyse changes in MADRS and HAMD scores, with statistical significance set at p<0.05. Effect sizes were calculated using Cohen’s d.
Results: The average MADRS score decreased from 35.33 pre-intervention to 24.67 post-intervention, reflecting a mean reduction of 10.67 points and a large effect size (Cohen’s d=1.23). Similarly, HAMD scores decreased from 22.83 to 13.67, with a mean reduction of 9.17 points and a large effect size (Cohen’s d=0.98). While most patients demonstrated significant improvement, one patient experienced worsening symptoms. Adverse events were generally mild, with 7 patients reporting no side effects and 4 reporting mild pain at the stimulation site.
Conclusion: rTMS appears to be an effective and well-tolerated treatment option for reducing depressive symptoms in patients with TRD. The significant reductions in MADRS and HAMD scores, along with large effect sizes, support the potential of rTMS as a therapeutic intervention for this population. Further research with larger sample sizes, including the use of a control group, is needed to confirm these findings and explore the long-term efficacy of rTMS in managing TRD.
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
People with severe mental illness (SMI) have a higher risk of premature mortality than the general population.
Aims
To investigate whether the life expectancy gap for people with SMI is widening, by determining time trends in excess life-years lost.
Method
This population-based study included people with SMI (schizophrenia, bipolar disorder and major depression) alive on 1 January 2000. We ascertained SMI from psychiatric hospital admission records (1981–2019), and deaths via linkage to the national death register (2000–2019). We used the Life Years Lost (LYL) method to estimate LYL by SMI and sex, compared LYL to the Scottish population and assessed trends over 18 3-year rolling periods.
Results
We included 28 797 people with schizophrenia, 16 657 with bipolar disorder and 72 504 with major depression. Between 2000 and 2019, life expectancy increased in the Scottish population but the gap widened for people with schizophrenia. For 2000–2002, men and women with schizophrenia lost an excess 9.4 (95% CI 8.5–10.3) and 8.2 (95% CI 7.4–9.0) life-years, respectively, compared with the general population. In 2017–2019, this increased to 11.8 (95% CI 10.9–12.7) and 11.1 (95% CI 10.0–12.1). The life expectancy gap was lower for bipolar disorder and depression and unchanged over time.
Conclusions
The life expectancy gap in people with SMI persisted or widened from 2000 to 2019. Addressing this entrenched disparity requires equitable social, economic and health policies, healthcare re-structure and improved resourcing, and investment in interventions for primary and secondary prevention of SMI and associated comorbidities.
Common neuroanatomical regions are associated with both states of anorexia nervosa (AN) and autistic characteristics, but restoration of body mass index (BMI) has been associated with decreased presentation of autistic characteristics in some individuals with AN. This study aims to examine neuroanatomical correlates associated with autistic characteristics in those with acute anorexia nervosa (ac-AN) and those previously diagnosed with AN but whose weight has been restored (WR). In total, 183 individuals (healthy controls [HCs] = 67; n[ac-AN] = 68; n[WR] = 48) from the Brain imaging of Emotion And Cognition of adolescents with Anorexia Nervosa (BEACON) study were included, with autistic characteristics determined in both ac-AN and WR individuals (n = 116). To further examine BMI, ac-AN and WR group associations were compared. Random forest regression (RFR) models examined whether autistic characteristics and morphology of the anterior cingulate cortex (ACC), middle frontal gyrus (MFG), and orbitofrontal cortex (OFC) were able to predict future levels of social anhedonia and alexithymia. Group-wise differences were identified within the volume and surface area of the MFG and OFC, which were unrelated to BMI. Autistic characteristics were inversely associated with MFG and ACC volume, with differences in associations between ac-AN and WR groups seen in the surface area of the MFG. RFR models identified moderate-to-weak performance and found that autistic characteristics were not important predictive features in a priori and exploratory models. Findings suggest that the presence of autistic characteristics in those with ac-AN are associated with the volume of the MFG and are unrelated to BMI restoration.
Patients with cancer benefit greatly from receiving palliative care (PC), improving their overall survival and quality of life. Despite its benefits, PC is underutilized among patients with hematologic malignancies (HMs), particularly among Black patients, who face higher symptom burdens and lower survival rates compared to White patients. The purpose of this review was to identify and describe what is known about PC use among Black HM patients in the United States.
Methods
This review was conducted using the Joanna Briggs Institute approach for scoping reviews and included a search of the databases MEDLINE (PubMed), Embase (Elsevier), Scopus and Web of Science (Clarivate). The search was developed and conducted by a professional medical librarian in consultation with the author team and focused on keywords such as Black/African American patients, HM, and PC. Articles were screened and selected based on predefined inclusion criteria and carried out using Covidence software for systematic review management.
Results
Seven publications were included in the final sample and most used quantitative methods and data from large national databases such as the National Cancer Database. Four of the studies reported that Black patients with HM were less likely to receive or use PC compared to White patients. Access to PC was associated with better outcomes, such as lower hospital charges and a reduced likelihood of dying within 30 days of initiating palliative radiotherapy.
Significance of the results
This scoping review highlights ongoing inequities in the use of PC among Black patients with HM which mirrors trends in patients with solid cancers. Future studies should be conducted to understand the determinants of these disparities and to also build testable interventions to improve PC use within this underserved population.
Glufosinate serves as both a primary herbicide option and a complement to glyphosate and other postemergence herbicides for managing herbicide-resistant weed species. Enhancing broadleaf weed control with glufosinate through effective mixtures may mitigate further herbicide resistance evolution in soybean and other glufosinate-resistant cropping systems. Two field experiments were conducted in 2020 and 2021 at four locations in Wisconsin (Arlington, Brooklyn, Janesville, and Lancaster) and one in Illinois (Macomb) to evaluate the effects of postemergence-applied glufosinate mixed with inhibitors of protoporphyrinogen oxidase (PPO) (flumiclorac-pentyl, fluthiacet-methyl, fomesafen, and lactofen; Group 14 herbicides), bentazon (a Group 6 herbicide), and 2,4-D (a Group 4 herbicide) on waterhemp control, soybean phytotoxicity, and yield. The experiments were established in a randomized, complete block design with four replications. The first experiment focused on soybean phytotoxicity 14 d after treatment (DAT) and yield in the absence of weed competition. All treatments received a preemergence herbicide, with postemergence herbicide applications occurring between the V3 and V6 soybean growth stages, depending on the site-year. The second experiment evaluated the effect of herbicide treatments on waterhemp control 14 DAT and on soybean yield. Lactofen, applied alone or with glufosinate, produced the greatest phytotoxicity to soybean at 14 DAT, but this injury did not translate into yield loss. Mixing glufosinate with 2,4-D, bentazon, and PPO-inhibitor herbicides did not increase waterhemp control, nor did it affect soybean yield compared to when glufosinate was applied alone, but it may be an effective practice to reduce selection pressure for glufosinate-resistant waterhemp.
Surfactant transport is central to a diverse range of natural phenomena with numerous practical applications in physics and engineering. Surprisingly, this process remains relatively poorly understood at the molecular scale. Here, we use non-equilibrium molecular dynamics (NEMD) simulations to study the spreading of sodium dodecyl sulphate on a thin film of liquid water. The molecular form of the control volume is extended to a coordinate system moving with the liquid–vapour interface to track surfactant spreading. We use this to compare the NEMD results to the continuum description of surfactant transport on an interface. By including the molecular details in the continuum model, we establish that the transport equation preserves substantial accuracy in capturing the underlying physics. Moreover, the relative importance of the different mechanisms involved in the transport process is identified. Consequently, we derive a novel exact molecular equation for surfactant transport along a deforming surface. Close agreement between the two conceptually different approaches, i.e. NEMD simulations and the numerical solution of the continuum equation, is found as measured by the surfactant concentration profiles, and the time dependence of the so-called spreading length. The current study focuses on a relatively simple specific solvent–surfactant system, and the observed agreement with the continuum model may not arise for more complicated industrially relevant surfactants and anti-foaming agents. In such cases, the continuum approach may fail to predict accompanying phase transitions, which can still be captured through the NEMD framework.
Objectives/Goals: We hypothesized that the bulk transcriptomic profiling of blood collected from within the ischemic vasculature during an acute ischemic stroke with large vessel occlusion (LVO) will contain unique biomarkers that are different from the peripheral circulation and may provide much-needed insight into the underlying pathogenesis of LVO in humans. Methods/Study Population: The transcriptomic biomarkers of Inflammation in Large Vessel Ischemic Stroke pilot study prospectively enrolled patients ≥ 18 years of age with an anterior circulation LVO, treated with endovascular thrombectomy (EVT). Two periprocedural arterial blood samples were obtained (DNA/RNA Shield™ tubes, Zymo Research); 1) proximal to the thrombus, from the internal carotid artery and 2) immediately downstream from the thrombus, by puncturing through the thrombus with the microcatheter. Bulk RNA sequencing was performed and differential gene expression was identified using the Wilcoxon signed rank test for paired data, adjusting for age, sex, use of thrombolytics, last known well to EVT, and thrombolysis in cerebral infarction score. Bioinformatic pathway analyses were computed using MCODE and reactome. Results/Anticipated Results: From May to October 2022, 20 patients were screened and 13 were enrolled (median age 68 [SD 10.1], 47% male, 100% white). A total of 608 differentially expressed genes were found to be significant (p-value) Discussion/Significance of Impact: These results provide evidence of significant gene expression changes occurring within the ischemic vasculature of the brain during LVO, which may correlate with larger ischemic infarct volumes and worse functional outcomes at 90 days. Future studies with larger sample sizes are supported by this work.
Objectives/Goals: The World Trade Center (WTC) Health Program (Program) Data Group was formed to address the increasing volume and complexity of analytics requests and to improve the Program’s data management capacity. Over time, the Group’s role expanded to include comprehensive data leadership and providing data-based support for decision-making. Methods/Study Population: The Program provides medical monitoring and treatment for WTC-related conditions to those directly affected by the 9/11 attacks. These activities generate an abundance of administrative and surveillance data. The Data Group was formed to establish structures and processes that would be adaptable and efficient in leveraging these data. We created a unified workflow including a shared inbox, a standardized request form, and a request-managing tracker. We established communication channels to distribute requests efficiently. We designed a request form to balance the administrative burden on requestors with the need to gather useful information for analyses. We also developed a documentation system to extract key details from forms and incorporate other relevant data to support evaluation and record-keeping. Results/Anticipated Results: From November 2021 through the end of 2023, the Data Group processed and fulfilled 93 data requests. These requests covered a multitude of functional areas essential to the administration of a limited health benefits program. The following top five functional areas made up two-thirds of all requests: Contract Management (n = 30), Research and Quality (n = 15), Operations (n = 11), Medical Policy (n = 10), and Communications (n = 7). Leveraging data collected through our request tracker, the Group conducted annual evaluations and developed visualizations to analyze trends in these requests. The evaluations helped us identify knowledge gaps, highlight areas for improvement – across the Program and within our own processes, and continue to guide and support future Program priorities. Discussion/Significance of Impact: The creation of the Data Group and unified workflow fulfilled the Program’s increasing analytic needs, enhanced oversight of data quality and usage, and facilitated data-driven Program decision-making. Continual optimization of the group’s processes enables opportunities to identify gaps in and support a range of health care delivery initiatives.
For decades, in most states with a party registration option, the percentage of voters registering as unaffiliated with a major political party has steadily increased. But who are these registered voters in these polarized partisan times, and why might they register without a major party? We address these questions by drawing on parallel large-N original surveys of registered voters in two southeastern states experiencing a notable rise in registered independents but with different electoral rules for unaffiliated registrants. The closed primary rule in Florida reflects a much greater share of major party registrants versus North Carolina, which has a semi-closed primary rule. Nevertheless, even with these different primary laws, in both states we find that the decision not to register with a major party strongly covaries with identity as a political independent. Hence, registration rules may alter registration patterns, but individuals claiming to be less attached to a major party are markedly more likely to manifest this position by registering unaffiliated.
Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.
Aims
To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.
Method
Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.
Results
Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).
Conclusions
These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.