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Background: Information on COVID-19 vaccination effects on mortality among patients hospitalized with COVID-19 could inform vaccination outreach efforts and increase understanding of patient risk. Objective: Determine the associations of vaccination status with mortality in adult patients hospitalized with COVID-19. Design: This retrospective cohort study assessed the characteristics and mortality rates of adult patients hospitalized with COVID-19 across 21 healthcare systems in the USA from January 1, 2021, to January 31, 2022. Participants: Adult patients admitted to participating hospitals who had COVID-19 diagnoses and/or positive PCR tests and completed their hospital stay via discharge or death. Main Measure: In-hospital mortality vs. discharge (outcome) and patient age, sex, race, ethnicity, BMI, insurance status, comorbidities, and vaccination status extracted from the electronic health record (EHR). Key Results: Of 86,732 adult patients hospitalized with COVID-19, 45,082 (52%) were female, mean age was 60 years, 20,800 (24%) were Black, and 22,792 (26.3%) had one or more COVID-19 vaccinations. Statistically adjusted mortality rates for unvaccinated and vaccinated patients were 8.3% (95% CI, 8.1–8.5) and 5.1% (95% CI, 4.8–5.4) respectively (7.9% vs. 4.5% with no immune compromise). Vaccination was associated with especially large reductions in mortality for obese (OR = 0.67; 95% CI 0.56–0.80) and severely obese (OR = 0.52; 95% CI, 0.41–0.67) patients and for older patients (OR = 0.99; 95% CI, 0.98–0.99). Mortality likelihood was higher later in the study period (August 2021–January 31, 2022) than earlier (January 1, 2021–July 30, 2021) (OR = 1.10; 95% CI = 1.04–1.17) and increased significantly for vaccinated patients from 4.6% (95% CI, 3.9–5.2%) to 6.5% (95% CI, 6.2–6.9%). Conclusions: Patients vaccinated for COVID-19 had reduced mortality, especially for obese/severely obese and older individuals. Vaccination's protective effect against mortality declined over time and hospitalized obese and older individuals may derive especially great benefit from prior vaccination against SARS-CoV-2. [ABSTRACT FROM AUTHOR]

It is vital to determine how patient characteristics that precede COVID-19 illness relate to COVID-19 mortality. This is a retrospective cohort study of patients hospitalized with COVID-19 across 21 healthcare systems in the US. All patients (N = 145,944) had COVID-19 diagnoses and/or positive PCR tests and completed their hospital stays from February 1, 2020 through January 31, 2022. Machine learning analyses revealed that age, hypertension, insurance status, and healthcare system (hospital site) were especially predictive of mortality across the full sample. However, multiple variables were especially predictive in subgroups of patients. The nested effects of risk factors such as age, hypertension, vaccination, site, and race accounted for large differences in mortality likelihood with rates ranging from about 2–30%. Subgroups of patients are at heightened risk of COVID-19 mortality due to combinations of preadmission risk factors; a finding of potential relevance to outreach and preventive actions. [ABSTRACT FROM AUTHOR]

There are evidence-based treatments for tobacco dependence, but inequities exist in the access to and reach of these treatments. Traditional models of tobacco treatment delivery are "reactive" and typically provide treatment only to patients who are highly motivated to quit and seek out tobacco treatment. Newer models involve "proactive" outreach, with benefits that include increasing access to tobacco treatment, prompting quit attempts among patients with low motivation, addressing health disparities, and improving population-level quit rates. However, the definition of "proactive" is not clear, and adoption has been slow. This commentary introduces a comprehensive yet flexible model of proactive outreach and describes how proactive outreach can optimize clinical research and care delivery in these domains: (1) identifying the population, (2) offering treatment, and (3) delivering treatment. Dimensions relevant to each domain are the intensity of proactive outreach (low to high) and the extent to which proactive outreach activities rely on human interaction or are facilitated by information technology (IT). Adoption of the proposed proactive outreach model could improve the precision and rigor with which tobacco cessation research and tobacco treatment programs report data, which could have a positive effect on care delivery and patient outcomes. [ABSTRACT FROM AUTHOR]

The feasibility of implicitly assessing medical student burnout was explored, using the Implicit Relational Assessment Procedure (IRAP), to measure longitudinal student burnout over the first two years of medical school and directly comparing it with an existing explicit measure of burnout (Maslach Burnout Inventory; MBI). Three successive cohorts of medical students completed both implicit and explicit measures of burnout at several time points during their first two years of medical school. Both assessments were conducted via the internet within a one-week period during the first week of medical school, the end of the first year of medical school, and the end of the second year, though not all cohorts were able to complete the assessments at all time points. Mixed linear models were used to compare the two measures directly, as well as to evaluate changes over time in each measure separately. Minimal correspondence was observed between the implicit and explicit measures of burnout on a within-subject basis. However, when analyzed separately, all subscales of both measures detected significant change over time in the direction of greater levels of burnout, particularly during the first year of medical school. These results provide preliminary evidence the IRAP is able to assess implicit attitudes related to burnout among medical students, though additional research is needed. The IRAP detected consistent improvements in positive implicit attitudes toward medical training during students' second year of medical school, which was not detected by the MBI. Possible implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The development in the past decade of both unmanned aerial systems, or drones, and near infrared camera technology has significantly augmented the use of remote sensing in agriculture. The increased consumer availability, rapid deployment, and simple operation of drones when partnered with the smaller size and high resolution of imagery obtained by newer near infrared cameras makes them an ideal tool for obtaining very current assessments of crop health and pest status in crops. We discuss some of the potential uses and successful applications of these technologies in scouting for insects in potato. [ABSTRACT FROM AUTHOR]

Tropical ecosystems adapted to high water availability may be highly impacted by climatic changes that increase soil and atmospheric moisture deficits. Many tropical regions are experiencing significant changes in climatic conditions, which may induce strong shifts in taxonomic, functional and phylogenetic diversity of forest communities. However, it remains unclear if and to what extent tropical forests are shifting in these facets of diversity along climatic gradients in response to climate change. Here, we show that changes in climate affected all three facets of diversity in West Africa in recent decades. Taxonomic and functional diversity increased in wetter forests but tended to decrease in forests with drier climate. Phylogenetic diversity showed a large decrease along a wet-dry climatic gradient. Notably, we find that all three facets of diversity tended to be higher in wetter forests. Drier forests showed functional, taxonomic and phylogenetic homogenization. Understanding how different facets of diversity respond to a changing environment across climatic gradients is essential for effective long-term conservation of tropical forest ecosystems. Different aspects of biodiversity may not necessarily converge in their response to climate change. Here, the authors investigate 25-year shifts in taxonomic, functional and phylogenetic diversity of tropical forests along a spatial climate gradient in West Africa, showing that drier forests are less stable than wetter forests. [ABSTRACT FROM AUTHOR]

Many proteins exist naturally as symmetrical homooligomers or homopolymers1. The emergent structural and functional properties of such protein assemblies have inspired extensive efforts in biomolecular design2–5. As synthesized by ribosomes, proteins are inherently asymmetric. Thus, they must acquire multiple surface patches that selectively associate to generate the different symmetry elements needed to form higher-order architectures1,6—a daunting task for protein design. Here we address this problem using an inorganic chemical approach, whereby multiple modes of protein–protein interactions and symmetry are simultaneously achieved by selective, 'one-pot' coordination of soft and hard metal ions. We show that a monomeric protein (protomer) appropriately modified with biologically inspired hydroxamate groups and zinc-binding motifs assembles through concurrent Fe3+ and Zn2+ coordination into discrete dodecameric and hexameric cages. Our cages closely resemble natural polyhedral protein architectures7,8 and are, to our knowledge, unique among designed systems9–13 in that they possess tightly packed shells devoid of large apertures. At the same time, they can assemble and disassemble in response to diverse stimuli, owing to their heterobimetallic construction on minimal interprotein-bonding footprints. With stoichiometries ranging from [2 Fe:9 Zn:6 protomers] to [8 Fe:21 Zn:12 protomers], these protein cages represent some of the compositionally most complex protein assemblies—or inorganic coordination complexes—obtained by design. An inorganic chemical approach to biomolecular design is used to generate 'cages' that can simultaneously promote symmetry and multiple modes of protein interactions. [ABSTRACT FROM AUTHOR]

Global patterns of species and evolutionary diversity in plants are primarily determined by a temperature gradient, but precipitation gradients may be more important within the tropics, where plant species richness is positively associated with the amount of rainfall. The impact of precipitation on the distribution of evolutionary diversity, however, is largely unexplored. Here we detail how evolutionary diversity varies along precipitation gradients by bringing together a comprehensive database on the composition of angiosperm tree communities across lowland tropical South America (2,025 inventories from wet to arid biomes), and a new, large-scale phylogenetic hypothesis for the genera that occur in these ecosystems. We find a marked reduction in the evolutionary diversity of communities at low precipitation. However, unlike species richness, evolutionary diversity does not continually increase with rainfall. Rather, our results show that the greatest evolutionary diversity is found in intermediate precipitation regimes, and that there is a decline in evolutionary diversity above 1,490 mm of mean annual rainfall. If conservation is to prioritise evolutionary diversity, areas of intermediate precipitation that are found in the South American 'arc of deforestation', but which have been neglected in the design of protected area networks in the tropics, merit increased conservation attention. [ABSTRACT FROM AUTHOR]

The Implicit Relational Assessment Procedure (IRAP, Barnes-Holmes et al. in Psychol Rec 60:527-542, 2010) was utilized as a relatively new tool to measure implicit weight bias in first- and third-year medical students. To date, only two studies (Miller et al. in Acad Med 88:978-982, 2013; Phelan et al. in Med Educ 49:983-992, 2015) have investigated implicit weight bias with medical students and both have found pro-thin/anti-fat implicit attitudes, on average, using the Implicit Association Test (IAT, Greenwald and Banaji in Psychol Rev 102:4-27, 1995) as the assessment tool. The IRAP, however, allows for a deeper analysis of implicit attitudes with respect to both thin and fat in isolation, and it was found that medical students are, on average, actually both pro-thin and pro-fat, and on average are more pro-thin than pro-fat, as opposed to anti-fat. Additionally, it was found that medical students' implicit weight bias against fat/obese individuals improved over the first 2 years of medical training, and this improvement was specifically driven by improved implicit attitudes toward overweight and obese, while implicit attitudes toward thin remained constant over that time. The implications of more sensitive implicit bias assessment and specific changes in bias over time are discussed within the context of medical education curriculum development. [ABSTRACT FROM AUTHOR]

An approach has been developed to characterize the individual chemical constituents of botanicals. The challenge was to identify and quantitate the significant analytes in these complex mixtures, largely in the absence of authentic standards. The data-rich information content generated by this three-detector configuration was specifically intended to be used to conduct safety and/or quality evaluations for complex botanical mixtures, on a chemical constituent basis. The approach utilized a broad gradient UHPLC chromatographic separation. Following the chromatographic separation and UV detection, the eluent was split and sent into a charged aerosol detector (CAD), for quantitation, and a quadrupole/time-of-flight high-resolution mass spectrometer for component identification. The known bias of the otherwise universal CAD response, for organic solvent composition of the mobile phase, was compensated by the addition of an inverse gradient make-up stream. This approach and the orthogonal information content from the chromatography and three different detectors was specifically designed to enable in-silico safety assessments. These guide, minimize, or even eliminate the need for in vivo and in vitro safety assessments. The methodology was developed and demonstrated using standardized extracts of Ginkgo biloba. Results from the development of this novel approach and the characterization example reported here demonstrate the suitability of this instrumental configuration for enabling in-silico safety assessments and proving general quality assessments of botanicals. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of five intervention components on smokers’ adherence to combined nicotine patch and nicotine gum during a quit attempt and assess whether adherence is related to cessation.Method: Smokers interested in quitting (N = 513; 59% female; 87% White) received nicotine patch plus nicotine gum and participated in a 2x2x2x2x2 randomized factorial experiment (i.e., 32 treatment conditions) evaluating five intervention components: (1) medication adherence counseling versus none; (2) automated medication adherence calls versus none; (3) electronic medication monitoring with feedback and counseling versus e-monitoring alone; (4) 26 versus 8 weeks of nicotine patch plus nicotine gum; and (5) maintenance counseling versus none. Adherence was assessed over the first 6 weeks post-target quit day via timeline follow-back (nicotine patch) and electronic medication dispenser (gum).Results: In the first 6 weeks post-quit day, 12% of participants used no patches or gum, and 40% used the patch every day. Only 1.4% used both patch and gum adherently every day in the 6 weeks post-target quit day. E-monitoring counseling increased gum use (from 1.9 to 2.6 pieces/day; p < .001) but did not increase abstinence. More adherent patch and gum use in the first 6 weeks were each associated with higher point-prevalence abstinence rates through 1 year.Conclusions: This large experiment with electronic monitoring of nicotine gum adherence showed that e-monitoring counseling increased gum use but not abstinence. Adherence to nicotine patch and to gum were each strongly related to abstinence, but it is unclear whether adherence increases abstinence, or relapse causes medication discontinuation.Clinical Trial Registration: ClinicalTrials.gov NCT01120704. [ABSTRACT FROM AUTHOR]

Coxsackievirus A6 (CVA6) has recently emerged as a major cause of hand, foot and mouth disease in children worldwide but no vaccine is available against CVA6 infections. Here, we demonstrate the isolation of two forms of stable CVA6 particles-procapsid and A-particlewith excellent biochemical stability and natural antigenicity to serve as vaccine candidates. Despite the presence (in A-particle) or absence (in procapsid) of capsid-RNA interactions, the two CVA6 particles have essentially identical atomic capsid structures resembling the uncoating intermediates of other enteroviruses. Our near-atomic resolution structure of CVA6 A-particle complexed with a neutralizing antibody maps an immune-dominant neutralizing epitope to the surface loops of VP1. The structure-guided cell-based inhibition studies further demonstrate that these loops could serve as excellent targets for designing anti-CVA6 vaccines. [ABSTRACT FROM AUTHOR]

Little is known about patients' electronic cigarette use, interest in and use of smoking cessation treatments, and providers' attitude towards such treatment. We assessed patients (N = 231) and providers (45 psychiatrists, 97 case workers) in four Community Mental Health Centers. Interestingly, 50% of smokers reported interest in using electronic cigarettes to quit smoking, and 22% reported current use. While 82% of smokers reported wanting to quit or reduce smoking, 91% of psychiatrists and 84% of case workers reported that patients were not interested in quitting as the lead barrier, limiting the provision of cessation interventions. Providers' assumption of low patient interest in treatment may account for the low rate of smoking cessation treatment. In contrast, patients report interest and active use of electronic cigarettes to quit smoking. This study highlights the need for interventions targeting different phases of smoking cessation in these patients suffering disproportionately from tobacco dependence. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the cost-utility of nivolumab plus ipilimumab (NIVO + IPI) versus other first-line therapies for advanced melanoma in the United States (US) from the third-party payer perspective.This analysis estimated total expected life-years (LYs), quality-adjusted LYs (QALYs), and costs for first-line treatments of advanced melanoma during a 30-year time horizon using indirect treatment comparisons based on time-varying hazard ratios (HRs) and a three-state partitioned survival model. Overall survival (OS) and progression-free survival reference curves were extrapolated based on 5-year follow-up from the phase III Checkmate 067 trial (NCT01844505). Comparators of NIVO + IPI were NIVO, IPI, pembrolizumab, dabrafenib plus trametinib, encorafenib plus binimetinib (ENCO + BINI), and vemurafenib plus cobimetinib. Drug acquisition costs, treatment administration costs, follow-up time, subsequent therapy data, and adverse event frequencies were obtained from published sources. Utility weights were estimated from Checkmate 067, which compared NIVO + IPI or NIVO monotherapy with IPI monotherapy as first-line therapy in advanced melanoma. A 3% annual discount rate was applied to costs and outcomes. Sensitivity scenarios for BRAF-mutant subgroups were conducted.NIVO + IPI was estimated to generate the longest OS and the highest total costs versus all comparators, accruing 6.99 LYs, 5.70 QALYs, and $469,469 over the 30-year time horizon. The incremental cost utility of NIVO + IPI versus comparators ranged from $2130 per QALY (versus ENCO + BINI) to $76,169 per QALY (versus NIVO). In all base-case and most sensitivity analyses, the incremental cost-utility ratios for NIVO + IPI were below $100,000 per QALY.NIVO + IPI is estimated to be a life-extending and cost-effective treatment versus other therapies in the US, with base-case incremental cost-utility ratios below $100,000 per QALY.Methods: The aim of this study was to evaluate the cost-utility of nivolumab plus ipilimumab (NIVO + IPI) versus other first-line therapies for advanced melanoma in the United States (US) from the third-party payer perspective.This analysis estimated total expected life-years (LYs), quality-adjusted LYs (QALYs), and costs for first-line treatments of advanced melanoma during a 30-year time horizon using indirect treatment comparisons based on time-varying hazard ratios (HRs) and a three-state partitioned survival model. Overall survival (OS) and progression-free survival reference curves were extrapolated based on 5-year follow-up from the phase III Checkmate 067 trial (NCT01844505). Comparators of NIVO + IPI were NIVO, IPI, pembrolizumab, dabrafenib plus trametinib, encorafenib plus binimetinib (ENCO + BINI), and vemurafenib plus cobimetinib. Drug acquisition costs, treatment administration costs, follow-up time, subsequent therapy data, and adverse event frequencies were obtained from published sources. Utility weights were estimated from Checkmate 067, which compared NIVO + IPI or NIVO monotherapy with IPI monotherapy as first-line therapy in advanced melanoma. A 3% annual discount rate was applied to costs and outcomes. Sensitivity scenarios for BRAF-mutant subgroups were conducted.NIVO + IPI was estimated to generate the longest OS and the highest total costs versus all comparators, accruing 6.99 LYs, 5.70 QALYs, and $469,469 over the 30-year time horizon. The incremental cost utility of NIVO + IPI versus comparators ranged from $2130 per QALY (versus ENCO + BINI) to $76,169 per QALY (versus NIVO). In all base-case and most sensitivity analyses, the incremental cost-utility ratios for NIVO + IPI were below $100,000 per QALY.NIVO + IPI is estimated to be a life-extending and cost-effective treatment versus other therapies in the US, with base-case incremental cost-utility ratios below $100,000 per QALY.Results: The aim of this study was to evaluate the cost-utility of nivolumab plus ipilimumab (NIVO + IPI) versus other first-line therapies for advanced melanoma in the United States (US) from the third-party payer perspective.This analysis estimated total expected life-years (LYs), quality-adjusted LYs (QALYs), and costs for first-line treatments of advanced melanoma during a 30-year time horizon using indirect treatment comparisons based on time-varying hazard ratios (HRs) and a three-state partitioned survival model. Overall survival (OS) and progression-free survival reference curves were extrapolated based on 5-year follow-up from the phase III Checkmate 067 trial (NCT01844505). Comparators of NIVO + IPI were NIVO, IPI, pembrolizumab, dabrafenib plus trametinib, encorafenib plus binimetinib (ENCO + BINI), and vemurafenib plus cobimetinib. Drug acquisition costs, treatment administration costs, follow-up time, subsequent therapy data, and adverse event frequencies were obtained from published sources. Utility weights were estimated from Checkmate 067, which compared NIVO + IPI or NIVO monotherapy with IPI monotherapy as first-line therapy in advanced melanoma. A 3% annual discount rate was applied to costs and outcomes. Sensitivity scenarios for BRAF-mutant subgroups were conducted.NIVO + IPI was estimated to generate the longest OS and the highest total costs versus all comparators, accruing 6.99 LYs, 5.70 QALYs, and $469,469 over the 30-year time horizon. The incremental cost utility of NIVO + IPI versus comparators ranged from $2130 per QALY (versus ENCO + BINI) to $76,169 per QALY (versus NIVO). In all base-case and most sensitivity analyses, the incremental cost-utility ratios for NIVO + IPI were below $100,000 per QALY.NIVO + IPI is estimated to be a life-extending and cost-effective treatment versus other therapies in the US, with base-case incremental cost-utility ratios below $100,000 per QALY.Conclusions: The aim of this study was to evaluate the cost-utility of nivolumab plus ipilimumab (NIVO + IPI) versus other first-line therapies for advanced melanoma in the United States (US) from the third-party payer perspective.This analysis estimated total expected life-years (LYs), quality-adjusted LYs (QALYs), and costs for first-line treatments of advanced melanoma during a 30-year time horizon using indirect treatment comparisons based on time-varying hazard ratios (HRs) and a three-state partitioned survival model. Overall survival (OS) and progression-free survival reference curves were extrapolated based on 5-year follow-up from the phase III Checkmate 067 trial (NCT01844505). Comparators of NIVO + IPI were NIVO, IPI, pembrolizumab, dabrafenib plus trametinib, encorafenib plus binimetinib (ENCO + BINI), and vemurafenib plus cobimetinib. Drug acquisition costs, treatment administration costs, follow-up time, subsequent therapy data, and adverse event frequencies were obtained from published sources. Utility weights were estimated from Checkmate 067, which compared NIVO + IPI or NIVO monotherapy with IPI monotherapy as first-line therapy in advanced melanoma. A 3% annual discount rate was applied to costs and outcomes. Sensitivity scenarios for BRAF-mutant subgroups were conducted.NIVO + IPI was estimated to generate the longest OS and the highest total costs versus all comparators, accruing 6.99 LYs, 5.70 QALYs, and $469,469 over the 30-year time horizon. The incremental cost utility of NIVO + IPI versus comparators ranged from $2130 per QALY (versus ENCO + BINI) to $76,169 per QALY (versus NIVO). In all base-case and most sensitivity analyses, the incremental cost-utility ratios for NIVO + IPI were below $100,000 per QALY.NIVO + IPI is estimated to be a life-extending and cost-effective treatment versus other therapies in the US, with base-case incremental cost-utility ratios below $100,000 per QALY. [ABSTRACT FROM AUTHOR]

A Correction to this paper has been published: https://doi.org/10.1038/s41467-020-20537-x [ABSTRACT FROM AUTHOR]

Numerical simulations of flow over hills that are partially covered with a forest canopy are performed. This represents a much more realistic situation than previous studies that have generally concentrated on hills that are fully-forested. The results show that the flow over the hill is sensitive to where on the hill the forest is positioned. In particular, for low slopes flow separation is predominantly located within the forest on the lee slope. This has implications for the transport of scalars in the forest canopy. For large hills the results show more variability in scalar concentrations within the canopy compared to either a fully-forested hill or a patch of forest over flat terrain. These results are likely to have implications for a range of applications including the siting and interpretation of flux measurements over forests in complex terrain, predicting wind damage to trees and wind-farm developments. Calculation of the hill-induced pressure drag and canopy-plus-surface stress shows a strong sensitivity to the position of the forest relative to the hill. Depending on the position of the forest the individual drag terms may be strongly enhanced or reduced and may even change sign. The net impact is generally to reduce the total drag compared to an equivalent fully-forested hill, but the amount of the reduction depends strongly on the position of the forest canopy on the hill. In many cases with large, wide hills there is a clear separation of scales between the adjustment of the canopy to a forest edge (of order 6 − 8 L, where L is the canopy adjustment length scale) and the width of the hill. This separation means that the hill-induced pressure and flow fields and the forest-edge induced pressure and flow fields can in some sense be considered as acting separately. This provides a means of explaining the combined effects of partial forestation and terrain. It also offers a simple method for modelling the changes in drag over a hill due to partial forest cover by considering the impact of the hill and the partial canopy separately. Scaling arguments based on this idea successfully collapse the modelled drag over a range of different hill widths and heights and for different canopy parameters. This offers scope for a relatively simple parametrization of the effects of partial forest cover on the drag over a hill. [ABSTRACT FROM AUTHOR]

Proteins represent the most sophisticated building blocks available to an organism and to the laboratory chemist. Yet, in contrast to nearly all other types of molecular building blocks, the designed self-assembly of proteins has largely been inaccessible because of the chemical and structural heterogeneity of protein surfaces. To circumvent the challenge of programming extensive non-covalent interactions to control protein self-assembly, we have previously exploited the directionality and strength of metal coordination interactions to guide the formation of closed, homoligomeric protein assemblies. Here, we extend this strategy to the generation of periodic protein arrays. We show that a monomeric protein with properly oriented coordination motifs on its surface can arrange, on metal binding, into one-dimensional nanotubes and two- or three-dimensional crystalline arrays with dimensions that collectively span nearly the entire nano- and micrometre scale. The assembly of these arrays is tuned predictably by external stimuli, such as metal concentration and pH. [ABSTRACT FROM AUTHOR]

Rationale: Tobacco withdrawal is a key factor in smoking relapse, but important questions about the withdrawal phenomenon remain. Objectives: This research was intended to provide information about two core components of withdrawal (negative affect and craving): (1) how various withdrawal symptom profile dimensions (e.g., mean level, volatility, extreme values) differ between negative affect and craving; and (2) how these dimensions relate to cessation outcome. Methods: Adult smokers ( N = 1,504) in a double-blind randomized placebo-controlled smoking cessation trial provided real-time withdrawal symptom data four times per day for 4 weeks (2 weeks pre-quit and 2 weeks post-quit) via palmtop computers. Cessation outcome was biochemically confirmed 8-week point-prevalence abstinence. Results: Examination of craving and negative affect dimensions following a cessation attempt revealed that craving symptoms differed from negative affect symptoms, with higher means, greater variability, and a greater incidence of extreme peaks. Regression analyses revealed that abstinence was associated with lower mean levels of both craving and negative affect and fewer incidences of extreme craving peaks. In a multivariate model, the increase in mean craving and negative affect scores each uniquely predicted relapse. Conclusions: Real-time reports revealed different patterns of abstinence-related negative affect and craving and that dimensions of both predict cessation outcome, suggesting that negative affect and craving dimensions each has motivational significance. This underscores the complexity of withdrawal as a determinant of relapse and the need to measure its distinct components and dimensions. [ABSTRACT FROM AUTHOR]

Rationale: Attentional biases and executive control deficits may play a role in smoking cessation failure. Objectives: The object of this study was to determine whether smokers' pre-quit reaction times on a computerized modified Simon task (which assesses attentional biases and executive control deficits) predict abstinence following a quit attempt. Methods: Participants ( N = 365) in a larger smoking cessation clinical trial completed the modified Simon task twice (while 10-h nicotine-deprived vs. not deprived). In the task, two photographs (i.e., two digital slides) were displayed-one always neutral, the other positive, negative, smoking-relevant, or neutral. A probe (<<< or >>>) then appeared to the left or right of center, and participants indicated the arrow's direction (left or right) which was either congruent or incongruent with the arrow's location on the screen. The incongruency effect, a measure of executive control, was calculated by subtracting the reaction time to congruent probes from the reaction time to incongruent probes. Results: Greater impairment in executive control (i.e., greater probe incongruency effects) after viewing positive and smoking slides relative to negative slides predicted an inability to establish initial cessation and to maintain abstinence up to 8 weeks post-quit. Conclusions: These effects may be because smokers who avoid/escape from processing negative affect are more likely to fail in a cessation attempt. Differences in relatively automatic responses to affective cues distinguish smokers who are successful and unsuccessful in their smoking cessation attempts, but effects were modest in size. [ABSTRACT FROM AUTHOR]

Background: Resident physicians' preparedness to provide dietary counseling for the rising number of diabetic patients is unclear.Objective: To assess the comfort with, frequency of, and perceived effectiveness of diabetic dietary counseling by internal medicine (IM) residents.Design: Cross-sectional survey.Participants: One hundred eleven IM residents at a single academic institution.Results: Survey response rate was 94%. Fewer residents (56%) were comfortable with diabetic dietary counseling compared with counseling on symptoms of hypo/hyperglycemia (90%, p < 0.001). Residents less frequently provided diabetic dietary counseling (63%), compared with counseling for medication adherence (87%, p < 0.001). The 28% of residents reporting prior education with chronic disease self-management were more comfortable with diabetic dietary counseling (OR 3.2, 95% CI 1.4-7.3, p = 0.006), and reported counseling more frequently, although this difference was not statistically significant (OR 1.8, 95% CI 0.86-3.8, p = 0.12). More frequent counseling was reported by those residents who were more comfortable (OR 1.5, 95% CI 1.0-2.2, p = 0.03) or felt more effective (OR 3.6, 95% CI 2.1-6.1, p < 0.001) with their diabetic dietary counseling.Conclusion: Overall, IM residents reported low levels of comfort with and frequency of diabetic dietary counseling. However, residents who were more comfortable or who felt more effective with their dietary counseling counseled more frequently. [ABSTRACT FROM AUTHOR]

The response of terrestrial vegetation to a globally changing environment is central to predictions of future levels of atmospheric carbon dioxide. The role of tropical forests is critical because they are carbon-dense and highly productive. Inventory plots across Amazonia show that old-growth forests have increased in carbon storage over recent decades, but the response of one-third of the world’s tropical forests in Africa is largely unknown owing to an absence of spatially extensive observation networks. Here we report data from a ten-country network of long-term monitoring plots in African tropical forests. We find that across 79 plots (163 ha) above-ground carbon storage in live trees increased by 0.63 Mg C ha-1 yr-1 between 1968 and 2007 (95% confidence interval (CI), 0.22–0.94; mean interval, 1987–96). Extrapolation to unmeasured forest components (live roots, small trees, necromass) and scaling to the continent implies a total increase in carbon storage in African tropical forest trees of 0.34 Pg C yr-1 (CI, 0.15–0.43). These reported changes in carbon storage are similar to those reported for Amazonian forests per unit area, providing evidence that increasing carbon storage in old-growth forests is a pan-tropical phenomenon. Indeed, combining all standardized inventory data from this study and from tropical America and Asia together yields a comparable figure of 0.49 Mg C ha-1 yr-1 (n = 156; 562 ha; CI, 0.29–0.66; mean interval, 1987–97). This indicates a carbon sink of 1.3 Pg C yr-1 (CI, 0.8–1.6) across all tropical forests during recent decades. Taxon-specific analyses of African inventory and other data suggest that widespread changes in resource availability, such as increasing atmospheric carbon dioxide concentrations, may be the cause of the increase in carbon stocks, as some theory and models predict. [ABSTRACT FROM AUTHOR]

Species’ functional traits may help determine rates of carbon gain, with physiological and morphological trade-offs relating to shade tolerance affecting photosynthetic capacity and carbon allocation strategies. However, few studies have examined these trade-offs from the perspective of whole-plant biomass gain of adult trees. We compared tree-level annual diameter increments and annual above-ground biomass (AGB) increments in eight long-term plots in hyper-diverse northwest Amazonia to wood density (ρ; a proxy for shade tolerance), whilst also controlling for resource supply (light and soil fertility). ρ and annual diameter increment were negatively related, confirming expected differences in allocation associated with shade tolerance, such that light-demanding species allocate a greater proportion of carbon to diameter gain at the expense of woody tissue density. However, contrary to expectations, we found a positive relationship between ρ and annual AGB increment in more fertile sites, although AGB gain did not differ significantly with ρ class on low-fertility sites. Whole-plant carbon gain may be greater in shade-tolerant species due to higher total leaf area, despite lower leaf-level carbon assimilation rates. Alternatively, rates of carbon loss may be higher in more light-demanding species: higher rates of litterfall, respiration or allocation to roots, are all plausible mechanisms. However, the relationships between ρ and AGB and diameter increments were weak; resource availability always exerted a stronger influence on tree growth rates. [ABSTRACT FROM AUTHOR]

At best, computational models that study organizations incorporate only one perspective of how organizations are known to act within their environments. Such single-perspective models are limited in their generalizability and applicability to the real world and allow for researcher bias. This work develops a multi-agent simulation using eight different well-known organizational perspectives: Strategic choice, contingency theory, behavioral decision theory, enactment, resource dependence, institutional theory, population ecology, and transaction cost economics. A literature review of each field is applied to the construction of algorithms which, when combined with techniques derived from a literature review of computational modeling of organizations, was applied to the construction of a series of algorithms describing a multi-perspective computational model. Computer code was written based on the algorithms and run across different types of environments. Results were statistically analyzed to both validate the model and to generate contingency-oriented hypotheses. Conclusions were made with regard to the expected behavior of organizations and the model’s applicability toward further research. [ABSTRACT FROM AUTHOR]

The stocks and dynamics of coarse woody debris (CWD) are significant components of the carbon cycle within tropical forests. However, to date, there have been no reports of CWD stocks and fluxes from the approximately 1.3 million km2 of lowland western Amazonian forests. Here, we present estimates of CWD stocks and annual CWD inputs from forests in southern Peru. Total stocks were low compared to other tropical forest sites, whether estimated by line-intercept sampling (24.4 ± 5.3 Mg ha−1) or by complete inventories within 11 permanent plots (17.7 ± 2.4 Mg ha−1). However, annual inputs, estimated from long-term data on tree mortality rates in the same plots, were similar to other studies (3.8 ± 0.2 or 2.9 ± 0.2 Mg ha−1 year−1, depending on the equation used to estimate biomass). Assuming the CWD pool is at steady state, the turnover time of coarse woody debris is low (4.7 ± 2.6 or 6.1 ± 2.6 years). These results indicate that these sites have not experienced a recent, large-scale disturbance event and emphasise the distinctive, rapid nature of carbon cycling in these western Amazonian forests. [ABSTRACT FROM AUTHOR]

It is difficult to determine the relative efficacy of atypical antipsychotics for the treatment of schizophrenia, based on the available literature. The purpose of this article is to review and compare the efficacy of two atypical antipsychotics: olanzapine and ziprasidone. This review focused on randomised trials in which these two antipsychotics were compared with placebo, conventional antipsychotics and each other. Common efficacy measures were the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Schedule for Assessment of Negative Symptoms. When sufficient data were available, the mean treatment effect (with 95% confidence intervals) was computed and presented. Olanzapine was consistently found to be significantly superior to placebo and comparable with, or superior to, haloperidol for the treatment of overall, positive and negative schizophrenic symptoms. Ziprasidone appears to have significantly greater efficacy than placebo for overall and negative symptoms, but it remains uncertain whether ziprasidone is comparable in efficacy with conventional antipsychotics such as haloperidol. Two unpublished clinical trials have directly compared olanzapine and ziprasidone. One of these trials found no significant efficacy differences between the two drugs, whereas the results of the other study favoured olanzapine. Compared with ziprasidone, olanzapine has a larger body of evidence supporting its efficacy, and a greater proportion of findings for olanzapine have been published, allowing for greater scrutiny of results. Both drugs appear to be superior to placebo for the treatment of overall and negative symptoms of schizophrenia, but olanzapine generally compares more favourably with conventional antipsychotics. Firm conclusions regarding the comparison between olanzapine and ziprasidone require additional published trials on ziprasidone, particularly in direct comparison with olanzapine. [ABSTRACT FROM AUTHOR]

Reovirus is an icosahedral, double-stranded (ds) RNA virus that uses viral polymerases packaged within the viral core to transcribe its ten distinct plus-strand RNAs. To localize these polymerases, the structure of the reovirion was refined to a resolution of 7.6 Å by cryo-electron microscopy (cryo-EM) and three-dimensional (3D) image reconstruction. X-ray crystal models of reovirus proteins, including polymerase ?3, were then fitted into the density map. Each copy of ?3 was found anchored to the inner surface of the icosahedral core shell, making major contacts with three molecules of shell protein ?1 and overlapping, but not centering on, a five-fold axis. The overlap explains why only one copy of ?3 is bound per vertex. ?3 is furthermore oriented with its transcript exit channel facing a small channel through the ?1 shell, suggesting how the nascent RNA is passed into the large external cavity of the pentameric capping enzyme complex formed by protein ?2. [ABSTRACT FROM AUTHOR]

Improved technology for reconstructing cryo-electron microscopy (cryo-EM) images has now made it possible to determine secondary structural features of membrane proteins in enveloped viruses. The structure of mature dengue virus particles was determined to a resolution of 9.5 Å by cryo-EM and image reconstruction techniques, establishing the secondary structural disposition of the 180 envelope (E) and 180 membrane (M) proteins in the lipid envelope. The a-helical 'stem' regions of the E molecules, as well as part of the N-terminal section of the M proteins, are buried in the outer leaflet of the viral membrane. The 'anchor' regions of E and the M proteins each form antiparallel E-E and M-M transmembrane a-helices, leaving their C termini on the exterior of the viral membrane, consistent with the predicted topology of the unprocessed polyprotein. This is one of only a few determinations of the disposition of transmembrane proteins in situ and shows that the nucleocapsid core and envelope proteins do not have a direct interaction in the mature virus. [ABSTRACT FROM AUTHOR]

Shows that non-fragmented Amazon forests are experiencing a concerted increase in the density, basal area and mean size of woody climbing plants lianas. Structural importance of lianas in each neotropical site; Changes in measures of liana dominance; Increase in liana density and dominance.

Group B coxsackieviruses (CVB) utilize the coxsackievirus-adenovirus receptor (CAR) to recognize host cells. CAR is a membrane protein with two Ig-like extracellular domains (D1 and D2), a transmembrane domain and a cytoplasmic domain. The three-dimensional structure of coxsackievirus B3 (CVB3) in complex with full length human CAR and also with the D1D2 fragment of CAR were determined to ∼22 Å resolution using cryo-electron microscopy (cryo-EM). Pairs of transmembrane domains of CAR associate with each other in a detergent cloud that mimics a cellular plasma membrane. This is the first view of a virus?receptor interaction at this resolution that includes the transmembrane and cytoplasmic portion of the receptor. CAR binds with the distal end of domain D1 in the canyon of CVB3, similar to how other receptor molecules bind to entero- and rhinoviruses. The previously described interface of CAR with the adenovirus knob protein utilizes a side surface of D1. [ABSTRACT FROM AUTHOR]

This clinically based study asked 165 batterers attending a court-mandated assessment program to quantify a series of behaviors that occurred since being convicted of battering. The behaviors clustered into 2 factors: (1) an Ambivalent Contact Pattern whereby behaviors of batterers were associated with contacting their ex-partner, sending gifts and letters, and watching her without her knowing while harboring conflicting feelings of love, hate, and anger; and (2) a Predatory Contact Pattern whereby the behaviors of batterers were associated with hang up calls, entering her home without permission, threatening or physically causing harm to her while harboring a propensity for abusiveness. Clinicians should assess batterers for predatory thoughts about the estranged partner, and reason for the contact since separation. Presence of stalking behaviors and predatory fantasy is a window to determine repetitive and escalating domestic violence. [ABSTRACT FROM AUTHOR]

Describes the motor that packages the double-stranded DNA of the Bacillus subtilis bacteriophage...29 into a precursor capsid. Determination of the structure of the head-tail connector by means of X-ray crystallography; Use of cryo-electron microscopy and image reconstruction analysis; Suggestion that the prohead plus dodecameric connector, prohead RNA , viral ATPase and DNA comprise a rotary motor with the head-prohead RNA-ATPase complex acting as a stator, the DNA acting as a spindle, and the connector as a ball-race.

An examination of data from 120 male and female batterers of varied age and marital, educational, and economic status, who attended group treatment for batterers or who were charged with domestic violence from January to February 1996 in a district court setting, produced the following findings: Stalkers tended to live alone, were less likely to be married, not living with children, and used more alcohol than nonstalkers. They also tended to have had a history of prior stalking offenses and of being abused themselves. Factor analysis found three stalking groupings: one in which discrediting was the key, a second revolving around love turning to hate, and a third with violent confrontation with the ex-partner. [ABSTRACT FROM AUTHOR]

The accurate assessment of both tobacco withdrawal and the impact of the nicotine patch on withdrawal may be compromised by attrition of subjects, or by subjects smoking during withdrawal. To reduce these occurrences, 211 participants were provided with intensive cessation counseling while trying to quit smoking with either nicotine (21 mg) or placebo transdermal patches. Subject attrition was low, with 80.5% of participants continuing through the 5-week study period. Abstinence rates were also high over this period (75% and 61% in active and placebo groups, respectively). In this multisite, double-blind trial, withdrawal severity was assessed using a nine-item daily self-report questionnaire, and abstinence was confirmed via CO monitoring. Abrupt smoking cessation increased multiple tobacco withdrawal symptoms/signs including craving for cigarettes, irritability, anxiety, appetite, sleep disruption, difficulty concentrating, restlessness, depression, and impatience. Treatment with transdermal nicotine reduced craving for cigarettes, anxiety, irritability, and appetite, as well as weight gain (1.85 versus 2.88 kg mean gain over 4 weeks in active and placebo groups, respectively). [ABSTRACT FROM AUTHOR]

Copyright of American Potato Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of American Potato Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although nicotine is a drug of abuse for millions of smokers, it has been difficult to demonstrate clearly the motivational properties of nicotine with rats using the conditioned place preference (CPP) paradigm. The first experiment attempted to replicate CPPs reported by other researchers using nicotine doses of 0.4, 0.8, and 1.2 mg/kg. There was a trend for all three doses to produce aversions, but it was significant only for the 0.8 mg/kg dose. Exposures to the CS alone extinguished aversions, but a 'priming' dose (0.2 mg/kg) of nicotine given after extinction produced aversions only in animals exposed to 1.2 mg/kg. Experiment 2 tested whether preexposure to morphine or nicotine would sensitize animals to nicotine's reinforcing effects. In this experiment, rats were exposed to either six nicotine (0.6 mg/kg) or morphine (1.0 mg/kg) dosings prior to preference conditioning. Neither preferences nor aversions were observed in any group following subsequent conditioning with 0.6 mg/kg nicotine. The results suggest that previous observations of preference effects may have been due to specific procedural factors or may have depended on negative reinforcement due to stress reduction. [ABSTRACT FROM AUTHOR]

The effect of a variety of morphine doses on thermoregulatory effector systems was examined in ambient temperatures of 27.0° C and 4.0° C. Rats were given saline or morphine sulfate (5, 15, or 25 mg/kg); their core temperature, oxygen consumption, and activity were monitored for 4 or 6 h post-injection. The results suggest two distinct actions of morphine, possibly mediated by two opiate receptors. Low doses of morphine produce hyperthermia that is the result of a direct activation of activity and whole body heat production. High doses produce effects dependent on ambient temperature: hypermetabolism and hyperthermia in the 27.0° C environment; hypometabolism, vasodilation, and hypothermia in the 4.0° C environment. The findings suggest limitations in current set-point theories of morphine's thermic actions. [ABSTRACT FROM AUTHOR]

Thirty rats were randomly assigned to three groups. Group 1 was given a 21-day exposure to an ethanol (EtOH) liquid diet, while Groups 2 and 3 were given equivalent amounts of an isocaloric non-EtOH liquid diet. Group 1 rats had withdrawal syndromes following EtOH removal. After a two-week recovery period, Groups 1 and 2 were both exposed to an EtOH diet, while Group 3 again received an isocaloric non-EtOH liquid diet. Groups 1 and 2 were withdrawn after 12 days of EtOH exposure and were rated with a behavioral withdrawal rating scale, for which interobserver reliability estimates were determined. Previously dependent (Group 1) rats showed more severe withdrawal syndromes, including a higher incidence of seizures, than rats undergoing their initial withdrawal (Group 2). Studies that do not agree with this finding are discussed. [ABSTRACT FROM AUTHOR]