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We aimed to describe the evolution of gonorrhea infection and its antimicrobial resistance patterns in the Prairie provinces compared to Canada between 1980 and 2022. Data was collected from publicly available sexually transmitted infection reports in Canada, Alberta, Saskatchewan, and Manitoba. We extracted the number and rates of gonorrhea cases; percentage of cases by sex, age, ethnicity, sexual orientation; and data on cases diagnosed by culture and antimicrobial resistance. Descriptive statistics and age–period–cohort effect analysis were used. Gonorrhea cases in Canada rose from 32.4 per 100 000 in 1992 to 92.3 in 2022. In 2020, 36.9% of gonorrhea cases in Canada were females, compared to 42.8% in Alberta, 55.3% in Saskatchewan and 56% in Manitoba. People aged ≥30 years represented 22.5% of cases in 1980, and 54.1% in 2022. By 2022, the proportion of Canadian cases detected by culture declined to less than 10%, and azithromycin resistance of N. gonorrhoeae isolates was 8.1%. Alberta, Manitoba, and Saskatchewan reported higher rates of gonorrhea compared to Canada, with a higher proportion of female cases in Manitoba and Saskatchewan. Rising antimicrobial resistance rates and decreased culture testing present significant concerns for gonorrhea control and surveillance.
Many charities rely on donations to support their work addressing some of the world’s most pressing problems. We conducted a meta-review to determine what interventions work to increase charitable donations. We found 21 systematic reviews incorporating 1339 primary studies and over 2,139,938 participants. Our meta-meta-analysis estimated the average effect of an intervention on charitable donation size and incidence: r = 0.08 (95% CI [0.03, 0.12]). Due to limitations in the included systematic reviews, we are not certain this estimate reflects the true overall effect size. The most robust evidence found suggests charities could increase donations by (1) emphasising individual beneficiaries, (2) increasing the visibility of donations, (3) describing the impact of the donation, and (4) enacting or promoting tax-deductibility of the charity. We make recommendations for improving primary research and reviews about charitable donations, and how to apply the meta-review findings to increase charitable donations.
This study presents a comparative analysis of the radiocarbon dates obtained on paired samples of various organic materials extracted from a lake sediment core. AMS radiocarbon dating of bulk sediment, chironomid capsules, and Trapa seeds was conducted to assess whether systematic offsets exist in the dates obtained on material that are commonly used to develop chronological frameworks for lake-based paleoenvironmental research. The findings reveal significant discrepancies between 14C dates obtained on bulk sediment, chironomid capsules, and on the Trapa seeds used to develop a previously published age-depth model for a sediment core recovered from Deoria Tal, Garhwal Himalaya, India. The systematic offset between the bulk sediment, and to a lesser extent chironomid remains, and the Trapa seeds is attributed to the integration of allochthonous carbon in the bulk sediment, leading to older apparent ages. The 3.6‰ shift in the δ13C value of the bulk sediment at 252 cm is inferred to reflect an increase in the contribution of C4 plant matter to the lake. The increase in enriched δ13C organic matter, coincident with the increasing offset between the dates obtained on bulk sediment and chironomids, and those obtained on the Trapa seeds, between 800 and 400 cal BP, was likely driven by anthropogenic land use changes, as evidenced by the four-fold increase in Cerealia-type pollen during this interval. This study underscores the necessity of selecting appropriate materials for radiocarbon dating to ensure accurate chronological reconstruction and highlights the potential of using chironomids remains to develop robust radiocarbon chronologies for lake sediment records.
Motor functional neurological disorder (FND) is a common illness associated with significant functional impairment. There are no effective pharmacotherapies, and despite the early promise of physiotherapy studies, many suffer disabling symptoms in the long term. There is a theoretical rationale for combining psychedelics with physiotherapy; however, the potential benefit of this approach and optimal treatment model remains unexplored. Here, we present the protocol for the first study investigating the tolerability, feasibility, and potential efficacy of two distinct treatment regimens of psilocybin-assisted physiotherapy for refractory motor FND: a moderate dose that incorporates movement tasks during the acute drug effects versus a standard dose alone.
Methods:
Twenty-four participants with refractory motor FND will be randomised in a 1:1 ratio to either (1) psilocybin 15 mg, with movement tasks conducted during the acute drug effects, or (2) psilocybin 25 mg alone. All participants will receive two sessions of FND-specific physiotherapy pre-dosing, six sessions of physiotherapy post-dosing, and undergo follow-up visits one week and four weeks following their final physiotherapy session. A battery of outcome measures will be completed as scheduled, assessing tolerability, feasibility, motor FND symptom severity, psychiatric and physical symptoms, quality of life, treatment expectations, intensity of the acute drug effects, personality, motor function, force-matching performance, resting-state and task-based brain imaging, and subjective experiences of the study treatment.
Discussion:
These findings will assist the design of an adequately powered randomised controlled trial in this cohort. The findings may also inform the feasibility of psychedelic treatment in related functional and neuropsychiatric disorders.
Paleontology provides insights into the history of the planet, from the origins of life billions of years ago to the biotic changes of the Recent. The scope of paleontological research is as vast as it is varied, and the field is constantly evolving. In an effort to identify “Big Questions” in paleontology, experts from around the world came together to build a list of priority questions the field can address in the years ahead. The 89 questions presented herein (grouped within 11 themes) represent contributions from nearly 200 international scientists. These questions touch on common themes including biodiversity drivers and patterns, integrating data types across spatiotemporal scales, applying paleontological data to contemporary biodiversity and climate issues, and effectively utilizing innovative methods and technology for new paleontological insights. In addition to these theoretical questions, discussions touch upon structural concerns within the field, advocating for an increased valuation of specimen-based research, protection of natural heritage sites, and the importance of collections infrastructure, along with a stronger emphasis on human diversity, equity, and inclusion. These questions offer a starting point—an initial nucleus of consensus that paleontologists can expand on—for engaging in discussions, securing funding, advocating for museums, and fostering continued growth in shared research directions.
A stepped care approach to treating anxiety and depression is common in mental health services. Low-intensity interventions, typically based on cognitive behavioural principles, are offered first, followed by high-intensity therapy if required. In the English National Health Service Talking Therapies (NHS TT) programme, different types of therapists deliver low- and high-intensity interventions. ‘Stepping up’ therefore involves changing therapist, and often an additional wait, which could both disrupt treatment flow.
In NHS TT, many low-intensity therapists subsequently train at high intensity. Once dual-trained, they typically deliver only high-intensity treatment. With both skillsets, they could theoretically deliver a full stepped care pathway, avoiding potential disruption linked to stepping up.
Aims
To explore a blended treatment approach, where dual-trained therapists move between low- and high-intensity flexibly based on patient need.
Method
Ten dual-trained therapists across 4 services treated 43 patients. Patients with clinical complexities more likely to eventually require high-intensity support were selected. Propensity score matching was used to identify matched control groups from a pool of patients who received stepped care. Treatment characteristics and clinical outcomes were compared. Feedback was obtained from patients, therapists and supervisors.
Results
Compared with matched controls, who received low- then high-intensity treatment, blended treatment required four fewer sessions on average, saving a third of therapist time and was completed 121 days sooner. The reliable recovery rate (54.1%) was 9% higher than the stepped care group (44.7%), which is clinically, although not statistically, significant. Blended treatment showed a non-significantly higher reliable deterioration rate. Patient feedback was positive. Therapists and supervisors highlighted advantages alongside practical challenges.
Conclusions
The blended approach showed promise as an efficient and effective method to deliver therapy when clinicians are dual-trained. Larger-scale studies, and consideration of implementation challenges, are needed. However, results suggest that this approach could potentially offer more flexible and seamless care delivery.
Idioms are undoubtedly important for second language (L2) learners, who encounter them in instructed learning, textbooks/resources and in out-of-class language use. While research on first language (L1) and L2 idiom comprehension shows how well L1/L2 speakers understand various idioms and the role of different predictors, important questions remain about how knowledge varies with more difficult task types and stimuli, how well L1 ‘norms’ serve L2 learners, how subjective and objective predictors of idiom knowledge interact and how L2 learner inferencing works in learning idioms. To address these issues, university-age L1 and L2 English (L1 German) participants provided meaning descriptions and familiarity ratings for 100 challenging idioms from learner resources, and each idiom was assigned an OpenAI-generated transparency rating, corpus-based frequency and to one of six cross-language overlap (CLO) types. Descriptive statistics showed lower and more varied idiom meaning knowledge than might be expected, especially for the L1ers, who were some way off ceiling level. Mixed-effects regression revealed familiarity and transparency as positive L1 and L2 knowledge predictors, but groups differed in sensitivity to idiom frequency, which only mattered for the L1ers and CLO, which (as expected) only mattered for the L2ers, who mistook false friends as genuine allies.
Biological and physical retrospective dosimetry for ionizing radiation exposure is a rapidly growing field, and several methods for performing biological and physical retrospective dosimetry have been developed to provide absorbed dose estimates for individuals after occupational, accidental, intentional, and incidental exposures to ionizing radiation. In large-scale radiological/nuclear incidents, multiple retrospective dosimetry laboratories from several countries may be involved in providing timely dose estimates for effective medical management of several thousand exposed individuals. In such scenarios, the harmonization of methods among participating laboratories is crucial for consistency in data analysis, dose estimation, and medical decision-making. In this regard, ISO documents ensure that these practices are standardized globally across the laboratories by providing quality assurance and quality control documentation that guide laboratories in maintaining high-quality performance for consistency. With the intent of bringing standardization and harmonization of biological and physical retrospective dosimetry methodologies across national and international laboratories, the ISO working group 18 (WG18) was established under ISO/TC85/SC2 (Technical Committee 85, Subcommittee 2-Radiation Protection) in 1999. This manuscript summarizes some of the past, current, and future activities of WG18 on biological and physical retrospective dosimetry.
In Wisconsin, herbicide resistance in waterhemp [Amaranthus tuberculatus (Moq.) Sauer] has been confirmed to five herbicide sites of action, including protoporphyrinogen oxidase (PPO) inhibitors. Following a report of a suspected PPO inhibitor–resistant A. tuberculatus population (A92 accession), our objective was to characterize resistance to PPO inhibitors applied preemergence or postemergence to this accession, along with two PPO inhibitor–susceptible control accessions (A66 and A82). We hypothesized that PPO-inhibitor resistance in A92 was driven by target site–resistance mechanisms. According to our results, the A92 accession is resistant to sulfentrazone (3.1-fold; P-value = 0.0278) and fomesafen (3.1-fold; P-value = 0.0745) preemergence and to lactofen (18.6-fold; P-value = 0.0003) and fomesafen (5.9-fold; P-value <0.0001) postemergence. Resistance to PPO inhibitors was not explained by the presence of any known target-site mutations in PPX1 or PPX2 genes. Our study represents the first confirmed case of an A. tuberculatus accession resistant to PPO inhibitors applied preemergence in Wisconsin. Consistent with previous research, our results demonstrate that the A92 accession, compared with control accessions, is less sensitive to fomesafen regardless of the application timing. Further research is necessary to identify other potential PPO-inhibitor resistance mechanisms in the A92 accession, including potential non–target site resistance mechanisms associated with cytochrome P450 monooxygenases or glutathione S-transferases.
Genetic research on nicotine dependence has utilized multiple assessments that are in weak agreement.
Methods
We conducted a genome-wide association study (GWAS) of nicotine dependence defined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-NicDep) in 61,861 individuals (47,884 of European ancestry [EUR], 10,231 of African ancestry, and 3,746 of East Asian ancestry) and compared the results to other nicotine-related phenotypes.
Results
We replicated the well-known association at the CHRNA5 locus (lead single-nucleotide polymorphism [SNP]: rs147144681, p = 1.27E−11 in EUR; lead SNP = rs2036527, p = 6.49e−13 in cross-ancestry analysis). DSM-NicDep showed strong positive genetic correlations with cannabis use disorder, opioid use disorder, problematic alcohol use, lung cancer, material deprivation, and several psychiatric disorders, and negative correlations with respiratory function and educational attainment. A polygenic score of DSM-NicDep predicted DSM-5 tobacco use disorder criterion count and all 11 individual diagnostic criteria in the independent National Epidemiologic Survey on Alcohol and Related Conditions-III sample. In genomic structural equation models, DSM-NicDep loaded more strongly on a previously identified factor of general addiction liability than a “problematic tobacco use” factor (a combination of cigarettes per day and nicotine dependence defined by the Fagerström Test for Nicotine Dependence). Finally, DSM-NicDep showed a strong genetic correlation with a GWAS of tobacco use disorder as defined in electronic health records (EHRs).
Conclusions
Our results suggest that combining the wide availability of diagnostic EHR data with nuanced criterion-level analyses of DSM tobacco use disorder may produce new insights into the genetics of this disorder.
In April 2023, eighteen scholars from nine different subjects representing the humanities, natural and social sciences came together for a one-day workshop at St John’s College, Durham. Despite our differences, all had one aim: the study of past environmental change and its effects on human societies. Talking across disciplinary divides, we discussed what environmental history is, how it may or may not contribute to tackling the climate crisis, and the problems of sources, scale and temporality. This article collects select conversations into a roundtable format split into four areas: scale, time and space, interdisciplinarity, and the future of environmental history. We argue that environmental history is more usefully understood not as a distinct sub-field of history, but as an interdisciplinary meeting place for innovative collaboration. This also presents a model for future research aimed at tackling the climate crisis at higher education institutions.
Quality improvement programmes (QIPs) are designed to enhance patient outcomes by systematically introducing evidence-based clinical practices. The CONQUEST QIP focuses on improving the identification and management of patients with COPD in primary care. The process of developing CONQUEST, recruiting, preparing systems for participation, and implementing the QIP across three integrated healthcare systems (IHSs) is examined to identify and share lessons learned.
Approach and development:
This review is organized into three stages: 1) development, 2) preparing IHSs for implementation, and 3) implementation. In each stage, key steps are described with the lessons learned and how they can inform others interested in developing QIPs designed to improve the care of patients with chronic conditions in primary care.
Stage 1 was establishing and working with steering committees to develop the QIP Quality Standards, define the target patient population, assess current management practices, and create a global operational protocol. Additionally, potential IHSs were assessed for feasibility of QIP integration into primary care practices. Factors assessed included a review of technological infrastructure, QI experience, and capacity for effective implementation.
Stage 2 was preparation for implementation. Key was enlisting clinical champions to advocate for the QIP, secure participation in primary care, and establish effective communication channels. Preparation for implementation required obtaining IHS approvals, ensuring Health Insurance Portability and Accountability Act compliance, and devising operational strategies for patient outreach and clinical decision support delivery.
Stage 3 was developing three IHS implementation models. With insight into the local context from local clinicians, implementation models were adapted to work with the resources and capacity of the IHSs while ensuring the delivery of essential elements of the programme.
Conclusion:
Developing and launching a QIP programme across primary care practices requires extensive groundwork, preparation, and committed local champions to assist in building an adaptable environment that encourages open communication and is receptive to feedback.
The Australian SKA Pathfinder (ASKAP) offers powerful new capabilities for studying the polarised and magnetised Universe at radio wavelengths. In this paper, we introduce the Polarisation Sky Survey of the Universe’s Magnetism (POSSUM), a groundbreaking survey with three primary objectives: (1) to create a comprehensive Faraday rotation measure (RM) grid of up to one million compact extragalactic sources across the southern $\sim50$% of the sky (20,630 deg$^2$); (2) to map the intrinsic polarisation and RM properties of a wide range of discrete extragalactic and Galactic objects over the same area; and (3) to contribute interferometric data with excellent surface brightness sensitivity, which can be combined with single-dish data to study the diffuse Galactic interstellar medium. Observations for the full POSSUM survey commenced in May 2023 and are expected to conclude by mid-2028. POSSUM will achieve an RM grid density of around 30–50 RMs per square degree with a median measurement uncertainty of $\sim$1 rad m$^{-2}$. The survey operates primarily over a frequency range of 800–1088 MHz, with an angular resolution of 20” and a typical RMS sensitivity in Stokes Q or U of 18 $\mu$Jy beam$^{-1}$. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38% of the sky. POSSUM will enable the discovery and detailed investigation of magnetised phenomena in a wide range of cosmic environments, including the intergalactic medium and cosmic web, galaxy clusters and groups, active galactic nuclei and radio galaxies, the Magellanic System and other nearby galaxies, galaxy halos and the circumgalactic medium, and the magnetic structure of the Milky Way across a very wide range of scales, as well as the interplay between these components. This paper reviews the current science case developed by the POSSUM Collaboration and provides an overview of POSSUM’s observations, data processing, outputs, and its complementarity with other radio and multi-wavelength surveys, including future work with the SKA.
A key step toward understanding psychiatric disorders that disproportionately impact female mental health is delineating the emergence of sex-specific patterns of brain organisation at the critical transition from childhood to adolescence. Prior work suggests that individual differences in the spatial organisation of functional brain networks across the cortex are associated with psychopathology and differ systematically by sex.
Aims
We aimed to evaluate the impact of sex on the spatial organisation of person-specific functional brain networks.
Method
We leveraged person-specific atlases of functional brain networks, defined using non-negative matrix factorisation, in a sample of n = 6437 youths from the Adolescent Brain Cognitive Development Study. Across independent discovery and replication samples, we used generalised additive models to uncover associations between sex and the spatial layout (topography) of personalised functional networks (PFNs). We also trained support vector machines to classify participants’ sex from multivariate patterns of PFN topography.
Results
Sex differences in PFN topography were greatest in association networks including the frontoparietal, ventral attention and default mode networks. Machine learning models trained on participants’ PFNs were able to classify participant sex with high accuracy.
Conclusions
Sex differences in PFN topography are robust, and replicate across large-scale samples of youth. These results suggest a potential contributor to the female-biased risk in depressive and anxiety disorders that emerge at the transition from childhood to adolescence.
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.
Tropical peatlands are important global carbon sinks, and the ways they differ from adjacent forest ecosystems in environmental functions have not been well characterized. Our study investigated family-level floristic and soil differences between adjacent paired patches of intact waterlogged peat forests and kerangas (free-draining heath) forests in Brunei Darussalam. For each patch, we examined total and labile nutrient concentrations in soils, tree stand diversity and structural characteristics, functional traits of live leaves and leaf litter, and nutrient resorption during leaf senescence. We found that total nutrients were more abundant in peat and kerangas humus than in kerangas sand, while available nutrients were highest in kerangas humus, suggesting that anoxic conditions in peat soils impair mineralization of nutrients to available forms but do not lead to losses of nutrient capital. We also found significant compositional differences among those families that occur frequently in both peat and kerangas plots. Despite this, family-level measures of tree diversity and structural characteristics, including tree abundance and stand basal area, did not differ between forest types. Similarly, leaf and litter functional traits and nutrient resorption were invariant across forest types, indicating low plasticity of leaf characteristics associated with plant nutrition. This suggests that belowground carbon accumulation in peatlands is disconnected from aboveground plant community characteristics and is likely driven by belowground processes.
Objectives/Goals: The standard care for malignant gliomas includes maximal tumor resection, but challenges arise near functional (speech) areas. Direct cortical stimulation (DCS) identifies functional (nonresectable) cortex. We aim to identify electrophysiologic (via subdural electrode recordings [ECOG]) biomarkers of DCS-positive (functional) areas. Methods/Study Population: Our lab maintains one of the largest datasets of electrophysiology analysis of glioma infiltrated brain cortex in the USA. Recordings of intraoperative brain mapping were analyzed to identify cortical sites that were found to be positive (functional) during DCS. DCS positive and negative (nonfunctional) sites were aligned to corresponding subdural electrodes. Future analysis: We plan to compare the temporal and spectral electrophysiologic variations associated with cortical sites found to be DCS positive versus negative during brain mapping. We plan to train machine learning classifiers that utilize these electrophysiologic biomarkers to discriminate between DCS positive and negative sites. Results/Anticipated Results: In total, our database comprised of 110 resections with brain mapping (DCS) and ECOG, including 4 patients who underwent a second procedure for resection. Eight patients were excluded as their resections were for brain metastases, not glioma. Our final cohort was comprised of 98 glioma resections, including 4 patients who underwent surgery twice for recurrence. During these resections, a total of 1393 sites were mapped via DCS for language function (including picture naming, word reading, and sentence syntax tasks). Of these 1393 sites, 100 sites were found to be DCS positive (7.1% positivity rate). (Currently in the process of conducting analysis comparing electrophysiologic features and biomarkers of DCS positive versus negative sites.) Discussion/Significance of Impact: This research is ongoing. Identifying electrophysiologic biomarkers of critical DCS-positive regions may provide a durable alternative to stimulation mapping. Due to its resource intensity, DCS has access barriers. Future neurosurgeons may use biomarkers from subdural electrode recordings to plan safer cortical resections.