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Background Discrimination may contribute to sleep health disparities among women, yet limited research has investigated the association between discrimination and insomnia with short sleep. Methods and Results Among a racially and ethnically diverse sample of women (N=25 920; mean age, 72.2±6.1 years), we investigated the relationship of discrimination with insomnia symptoms and sleep duration. Poisson models with robust variance were fit to examine discrimination with insomnia, sleep duration (short 9 hours versus recommended 7–9 hours), and insomnia short sleep phenotype adjusted for covariates. Insomnia symptoms, short and long sleep, and high discrimination were reported by 53%, 11%, 15%, and 40% of women, respectively. Women reporting high versus low discrimination were more likely to report insomnia, short sleep, and insomnia short sleep phenotype (insomnia: adjusted prevalence ratio, 1.15 [95% CI, 1.13–1.18]; short sleep: adjusted prevalence ratio, 1.24 [95% CI, 1.16–1.34]; insomnia short sleep phenotype: adjusted prevalence ratio, 1.45 [95% CI, 1.31–1.61]). In exploratory analyses, the association between discrimination and insomnia symptoms was present among Asian and White women, whereas the association between discrimination and sleep duration was among Hispanic (long sleep) and White (short sleep) women. Further, the association between discrimination and insomnia symptoms was more pronounced among those with less than a bachelor's degree, whereas women with a bachelor's degree or higher were less vulnerable to the association between discrimination and long sleep. Conclusions Discrimination was associated with insomnia and short sleep, a more severe phenotype for adverse cardiovascular health. Discrimination may be a target for reducing sleep problems among older women.

Abstract Objective To quantify the association between attributional ambiguity–the uncertainty of whether an experience is discrimination–and mental health. Methods Using a nationally representative sample of U.S. adults recruited through an online survey by Ipsos (April 23 and May 3, 2021), attributional ambiguity was quantified by asking participants if they experienced anything in the past 6 months that they were unsure was discrimination. The survey also assessed the degree to which these experiences caused participants to feel bothered and to ruminate on them. Multiple linear regression models were used to analyze associations between attributional ambiguity and depressive symptoms and mental health status. Results Black and Hispanic participants reported higher rates of attributional ambiguity than White participants. Experiencing attributional ambiguity was associated with higher levels of depressive symptoms and poorer self-reported mental health status. Among those who reported attributional ambiguity, increases in bother and rumination scores were positively associated with depressive symptoms. Conclusion Attributional ambiguity is an important yet overlooked social determinant of mental health. More research is needed to fully understand the impact of this stressor on population health, particularly among minoritized populations.

The present study focused on the roles of self-forgiveness and feeling divine forgiveness in mitigating the adverse effects of stress on substance use cravings in Trinidad and Tobago. We assessed 869 individuals (62 percent of whom were women) through self-report online questionnaires. A moderation analysis using the PROCESS macro and a bootstrapping strategy (N = 5000) revealed that greater levels of self-forgiveness weakened the positive relationship between stress and substance use cravings, though the relationship remained significant. This moderating effect was evident only when individuals reported high levels of feeling divine forgiveness. The findings suggest that both forms of forgiveness lessen the impact of stress on substance use cravings, highlighting their potential as protective factors and underscoring the importance of incorporating religious and spiritual dimensions into psychological education and intervention. However, the study’s cross-sectional nature makes it difficult to make causal inferences, indicating a need for longitudinal research.

Recent studies have suggested that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this study we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica's south-east health region. Socio-demographic data and information on cigarette smoking, physical activity, dietary practices, blood pressure, body size, cholesterol, and glucose, were collected by trained personnel. The outcome variable, ideal cardiovascular health, was defined as having optimal levels of ≥5 of these characteristics (ICH-5) according to the American Heart Association definitions. Social support exposure variables included number of friends (network size), number of friends willing to provide loans (instrumental support) and number of friends providing advice (informational support). Principal component analysis was used to create a social support score using these three variables. Survey-weighted logistic regression models were used to evaluate the association between ICH-5 and social support score. Analyses included 841 participants (279 males, 562 females) with mean age of 47.6 ± 18.42 years. ICH-5 prevalence was 26.6% (95%CI 22.3, 31.0) with no significant sex difference (male 27.5%, female 25.7%). In sex-specific, multivariable logistic regression models, social support score, was inversely associated with ICH-5 among males (OR 0.67 [95%CI 0.51, 0.89], p = 0.006) but directly associated among females (OR 1.26 [95%CI 1.04, 1.53], p = 0.020) after adjusting for age and community SES. Living in poorer communities was also significantly associated with higher odds of ICH-5 among males, while living communities with high property value was associated with higher odds of ICH among females. In this study, higher level of social support was associated with better cardiovascular health among women, but poorer cardiovascular health among men in urban Jamaica. Further research should explore these associations and identify appropriate interventions to promote cardiovascular health.

The production and consumption of food is one of the main drivers of environmental change globally. Meanwhile, many populations remain malnourished due to insufficient or unhealthy diets. Increasingly, dietary shifts are proposed as a means to address both environmental and health concerns. We have a limited understanding of how dietary shifts could alter where food is produced and consumed and how these changes would affect the distribution of environmental pressures both globally and across different groups of people. Here we combine new food flow data linking producing to consuming country with environmental pressures to estimate how a global shift to each of four diets (Indian, EAT-Lancet, Mediterranean, and mean Food Based Dietary Guidelines (FBDGs)) could affect environmental pressures at the global, country income group, and country level. Globally, cumulative pressures decrease under the Indian, EAT-Lancet, and Mediterranean scenarios and increase under FBDGs. On average, low income countries increase their cumulative consumption and production pressures while high income countries decrease their consumption pressures, and typically decrease their production pressures. Increases in low income countries are likely due to the nutritional inadequacy of current diets and the corresponding increases in consumption quantities with a shift to our diet scenarios. Despite these increases, we believe that three out four of our simulated dietary shifts can be seen as a net benefit by decreasing global pressures while low income countries increase pressures to adequately feed their populations. Additionally, considering principles of fairness applied, some nations are more responsible for causing historical environmental pressures and should shoulder more of the change. To facilitate more equitable shifts in global diets, resources, capacity, and knowledge sharing of sustainable agricultural practices are critical to minimize the increases in pressures that low income countries would incur to adequately feed their populations.

The ideal magnetohydrodynamic torus instability can drive the eruption of coronal mass ejections. The critical threshold of magnetic field strength decay for the onset of the torus instability occurs at different heights in different solar active regions, and understanding this variation could therefore improve space weather prediction. In this work, we aim to find out how the critical torus instability height evolves throughout the solar activity cycle. We study a significant subset of Helioseismic and Magnetic Imager (HMI) and Michelson Doppler Imager Space-Weather HMI Active Region Patches (SHARPs and SMARPs) from 1996 to 2023, totaling 21,584 magnetograms from 4436 unique active-region patches. For each magnetogram, we compute the critical height averaged across the main polarity inversion line, the total unsigned magnetic flux, and the separation between the positive and negative magnetic polarities. We find the critical height in active regions varies with the solar cycle, with higher (lower) average critical heights observed around solar maximum (minimum). We conclude that this is because the critical height is proportional to the separation between opposite magnetic polarities, which in turn is proportional to the total magnetic flux in a region, and more magnetic regions with larger fluxes and larger sizes are observed at solar maximum. This result is noteworthy because, despite the higher critical heights, more coronal mass ejections are observed around solar maximum than at solar minimum.

Abstract In the face of an accelerating extinction crisis, scientists must draw insights from successful conservation interventions to uncover promising strategies for reversing broader declines. Here, we synthesize cases of recovery from a list of 362 species of large carnivores, ecologically important species that function as terminal consumers in many ecological contexts. Large carnivores represent critical conservation targets that have experienced historical declines as a result of direct exploitation and habitat loss. We examine taxonomic and geographic variation in current extinction risk and recovery indices, identify conservation actions associated with positive outcomes, and reveal anthropogenic threats linked to ongoing declines. We find that fewer than 10% of global large carnivore populations are increasing, and only 12 species (3.3%) have experienced genuine improvement in extinction risk, mostly limited to recoveries among marine mammals. Recovery is associated with species legislation enacted at national and international levels, and with management of direct exploitation. Conversely, ongoing declines are robustly linked to threats that include habitat modification and human conflict. Applying lessons from cases of large carnivore recovery will be crucial for restoring intact ecosystems and maintaining the services they provide to humans.

Background: Despite the high cost of low birth weight and the persistent challenge of racial inequities affecting the Arab American community, there has been limited research to identify and examine risk factors for these inequities with validated data on Arab American ethnicity and recent population stressors. Objectives: This study examined whether the 2016 presidential election is associated with low birth weight among non-Hispanic White, Arab American, Hispanic, and non-Hispanic Black women. Design: This population-based study of singleton births in Michigan (2008–2017) used an algorithm to identify mothers who were of Arab descent. Methods: We used logistic regression to estimate odds ratios and 95% confidence intervals for the association between race/ethnicity and the odds of low birth weight. We examined whether these associations differed before and after the 2016 presidential election and according to maternal education. Results: There were 1,019,738 births, including 66,272 (6.5%) classified as low birth weight. The odds of having a low-birth-weight infant were higher among all minority women compared to non-Hispanic White women. The association was similar before and after the 2016 presidential election and stronger among women with higher levels of education. Conclusion: This is the first study to estimate low birth weight among Arab American women in the context of political events. There are opportunities for future studies to discuss this issue in depth.

BackgroundDespite limited data on neighborhood factors and health risk in Caribbean populations, previous analyses from Jamaica have shown that neighborhood and home disorder were associated with lower physical activity and higher cumulative biological risk among women, while poorer neighborhood infrastructure was associated with higher overweight/obesity among men.DesignCross-sectional survey design.ObjectivesIn this study, we explored whether community stressors, as measured by community violence, victimization and neighborhood disorder scores, were associated with cardiometabolic outcomes (obesity, diabetes, hypertension and high cholesterol) in urban Jamaican communities. Sex-specific Poisson regression models were used to estimate prevalence ratios (PR) for these associations, adjusting for age, education, diet, physical activity and smoking.ParticipantsOf the 849 participants (M = 282; F = 567), mean age was 48 ± 18.5 years and most had at least a high school education. Men were more likely to be current smokers (29.4 vs. 10.6%) and adequately physically active (53.2 vs. 42.0%); more women were obese (46.0 vs. 19.0%), more likely to have hypertension (52.9 vs. 45.4%) and had high cholesterol (34.2 vs. 21.6%) (all p

Abstract Synthesis research in ecology and environmental science improves understanding, advances theory, identifies research priorities, and supports management strategies by linking data, ideas, and tools. Accelerating environmental challenges increases the need to focus synthesis science on the most pressing questions. To leverage input from the broader research community, we convened a virtual workshop with participants from many countries and disciplines to examine how and where synthesis can address key questions and themes in ecology and environmental science in the coming decade. Seven priority research topics emerged: (1) diversity, equity, inclusion, and justice (DEIJ), (2) human and natural systems, (3) actionable and use‐inspired science, (4) scale, (5) generality, (6) complexity and resilience, and (7) predictability. Additionally, two issues regarding the general practice of synthesis emerged: the need for increased participant diversity and inclusive research practices; and increased and improved data flow, access, and skill‐building. These topics and practices provide a strategic vision for future synthesis in ecology and environmental science.

Although race/ethnicity is associated with substantial differences in risk for depression and other diseases of aging in the United States, the processes underlying these health disparities remain poorly understood. We addressed this issue by examining how levels of a robust marker of inflammatory activity, C-reactive protein (CRP), and depression symptoms varied across racial/ethnic groups. Additionally, we tested whether the inflammation-depression association differed across groups. Data were drawn from the Chicago Community Adult Health Survey, an epidemiological survey examining biopsychosocial factors affecting health and well-being. Participants were 3105 Chicago community adults, of which 610 provided blood samples and were included in analyses. C-reactive protein was assayed from blood samples, and depression symptoms were assessed using the 11-item Center for Epidemiologic Studies-Depression scale. Race/ethnicity was self-reported and consisted of Black, Hispanic, White, and other racial/ethnic groups. Results revealed that these racial/ethnic groups differed in terms of both their CRP and depression levels. Specifically, Black Americans exhibited higher levels of CRP as compared to White and other race/ethnicity Americans. Moreover, Black Americans exhibited more depression symptoms than Hispanic Americans. Finally, we found that inflammatory levels were strongly related to depression symptoms but only for Black Americans, with CRP alone accounting for 8% of the variance in depression symptoms in this subgroup. These data thus point to a biological process that may help to explain disparities in mental health outcomes across race/ethnicity in the United States. At the same time, additional research is needed to understand the social and structural factors driving these effects.

Abstract Background It is well established that racism is a fundamental contributor to poor health and inequities. There is consistent evidence of high exposure to discrimination among Aboriginal and Torres Strait Islander (Indigenous Australian) peoples, but impacts have not been fully quantified, in part due to limited measurement tools. We aim to validate instruments developed to measure interpersonal discrimination. Methods Instruments were discussed at five focus groups and with experts, and field tested in developing Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing. Data from 7501 baseline survey participants were analysed. Acceptability was assessed according to extent of missingness, construct validity using exploratory and confirmatory factor analysis, and reliability using Cronbach’s alpha. Associations between each instrument and outcomes conceptually understood to be closely (community-level racism) or less closely (family wellbeing) related were quantified to test convergent and discriminant validity. Results An 8-item instrument captures experiences of discrimination in everyday life and a 4-item instrument experiences in healthcare, each followed by a global attribution item. Item missingness was 2.2–3.7%. Half (55.4%) of participants reported experiencing any everyday discrimination, with 65.7% attributing the discrimination to Indigeneity; healthcare discrimination figures were 34.1% and 51.1%. Items were consistent with two distinct instruments, differentiating respondents with varying experiences of discrimination. Scales demonstrated very good reliability and convergent and divergent validity. Conclusion These brief instruments demonstrate face validity and robust psychometric properties in measuring Aboriginal and Torres Strait Islander adults’ experiences of interpersonal discrimination in everyday life and in healthcare. They can be used to quantify population-level experiences of discrimination, and associated wellbeing consequences, and monitor change.

It has been argued that intensive livestock farming increases the risk of pandemics of zoonotic origin because of long-distance livestock movements, high livestock densities, poor animal health and welfare, low disease resistance and low genetic diversity. However, data on many of these factors are limited, and analyses to date typically ignore how land use affects emerging infectious disease (EID) risks, and how these risks might vary across systems with different yields (production per unit area). Extensive, lower yielding practices typically involve larger livestock populations, poorer biosecurity, more workers and more area under farming, resulting in different, but not necessarily lower, EID risks than higher yielding systems producing the same amount of food. To move this discussion forward, we review the evidence for each of the factors that potentially link livestock production practices to EID risk. We explore how each factor might vary with yield and consider how overall risks might differ across a mix of production systems chosen to reflect in broad terms the current livestock sector at a global level and in hypothetical low- and high-yield systems matched by overall level of production. We identify significant knowledge gaps for all potential risk factors and argue these shortfalls in understanding mean we cannot currently determine whether lower or higher yielding systems would better limit the risk of future pandemics.

Non-human primate models are important for the development of high quality vision restoration therapies for blindness. Here, the authors demonstrate restoration of light responses in foveal retinal ganglion cells of the living macaque following optogenetic gene therapy.

The primate fovea is specialized for high acuity chromatic vision, with the highest density of cone photoreceptors and a disproportionately large representation in visual cortex. The unique visual properties conferred by the fovea are conveyed to the brain by retinal ganglion cells, the somas of which lie at the margin of the foveal pit. Microelectrode recordings of these centermost retinal ganglion cells have been challenging due to the fragility of the fovea in the excised retina. Here we overcome this challenge by combining high resolution fluorescence adaptive optics ophthalmoscopy with calcium imaging to optically record functional responses of foveal retinal ganglion cells in the living eye. We use this approach to study the chromatic responses and spatial transfer functions of retinal ganglion cells using spatially uniform fields modulated in different directions in color space and monochromatic drifting gratings. We recorded from over 350 cells across three Macaca fascicularis primates over a time period of weeks to months. We find that the majority of the L vs. M cone opponent cells serving the most central foveolar cones have spatial transfer functions that peak at high spatial frequencies (20-40 c/deg), reflecting strong surround inhibition that sacrifices sensitivity at low spatial frequencies but preserves the transmission of fine detail in the retinal image. In addition, we fit to the drifting grating data a detailed model of how ganglion cell responses draw on the cone mosaic to derive receptive field properties of L vs. M cone opponent cells at the very center of the foveola. The fits are consistent with the hypothesis that foveal midget ganglion cells are specialized to preserve information at the resolution of the cone mosaic. By characterizing the functional properties of retinal ganglion cells in vivo through adaptive optics, we characterize the response characteristics of these cells in situ.

The Slow Solar Wind Connection Solar Orbiter Observing Plan (Slow Wind SOOP) was developed to utilize the extensive suite of remote-sensing and in situ instruments on board the ESA/NASA Solar Orbiter mission to answer significant outstanding questions regarding the origin and formation of the slow solar wind. The Slow Wind SOOP was designed to link remote-sensing and in situ measurements of slow wind originating at open–closed magnetic field boundaries. The SOOP ran just prior to Solar Orbiter’s first close perihelion passage during two remote-sensing windows (RSW1 and RSW2) between 2022 March 3–6 and 2022 March 17–22, while Solar Orbiter was at respective heliocentric distances of 0.55–0.51 and 0.38–0.34 au from the Sun. Coordinated observation campaigns were also conducted by Hinode and IRIS. The magnetic connectivity tool was used, along with low-latency in situ data and full-disk remote-sensing observations, to guide the target pointing of Solar Orbiter. Solar Orbiter targeted an active region complex during RSW1, the boundary of a coronal hole, and the periphery of a decayed active region during RSW2. Postobservation analysis using the magnetic connectivity tool, along with in situ measurements from MAG and SWA/PAS, showed that slow solar wind originating from two out of three of the target regions arrived at the spacecraft with velocities between ∼210 and 600 km s ^−1 . The Slow Wind SOOP, despite presenting many challenges, was very successful, providing a blueprint for planning future observation campaigns that rely on the magnetic connectivity of Solar Orbiter.

Achieving sustainable development requires understanding how human behavior and the environment interact across spatial scales. In particular, knowing how to manage tradeoffs between the environment and the economy, or between one spatial scale and another, necessitates a modeling approach that allows these different components to interact. Existing integrated local and global analyses provide key insights, but often fail to capture ‘meso-scale’ phenomena that operate at scales between the local and the global, leading to erroneous predictions and a constrained scope of analysis. Meso-scale phenomena are difficult to model because of their complexity and computational challenges, where adding additional scales can increase model run-time exponentially. These additions, however, are necessary to make models that include sufficient detail for policy-makers to assess tradeoffs. Here, we synthesize research that explicitly includes meso-scale phenomena and assess where further efforts might be fruitful in improving our predictions and expanding the scope of questions that sustainability science can answer. We emphasize five categories of models relevant to sustainability science, including biophysical models, integrated assessment models, land-use change models, earth-economy models and spatial downscaling models. We outline the technical and methodological challenges present in these areas of research and discuss seven directions for future research that will improve coverage of meso-scale effects. Additionally, we provide a specific worked example that shows the challenges present, and possible solutions, for modeling meso-scale phenomena in integrated earth-economy models.

Background: Hypertension is the leading cardiovascular disease in Africa. It is increasing in prevalence due partly to the epidemiological transition that African countries, including South Africa, are undergoing. This epidemiological transition is characterised by a nutrition transition andurbanisation; resulting in behavioural, environmental and stress changes that are subject to racial and geographic divides. The South African National Health and Nutrition Examination Survey (SANHANES) examined the association of traditional risk factors; and less traditional risk factors such as race, geographical location, social stressors and psychological distress with hypertension in a national population-based sample of South Africans. Methods: Data were analysed on individuals ≥15 years who underwent a physical examination in the SANHANES (n = 7443). Hypertension was defined by blood pressure ≥140/90 mmHg or self-reported hypertension medication usage. Stepwise regression examined the association of demographic, socioeconomic, life stressors, and health risk factors with systolic blood pressure, diastolic blood pressure, and hypertension. Secondly, the risk factor associations and geographical location effects were investigated separately for the African race group. Results: Increasing age (AOR = 1.069, p

Objective Idiopathic macular telangiectasia (MacTel) is considered primarily a vascular disease affecting juxtafoveal retinal capillaries. However, recent evidence suggests that neuronal changes may occur early in disease development. We used high-resolution adaptive optics retinal imaging to elucidate the foveal cone photoreceptor changes at a cellular level in patients with MacTel.Methods and analysis We used adaptive optics scanning light ophthalmoscopy (AOSLO) to evaluate the foveal cone photoreceptors in the less-affected eye of patients with asymmetric MacTel. AOSLO images of cone photoreceptors were obtained in a 4°×4° area centred on the foveola. Individual cone positions were identified within a 2°×2° area centred on the fovea, using semiautomatic cone marking software with manual correction, permitting calculation of a map of cone density.Results In all participants, one eye was affected with MacTel, the fellow eye was clinically normal or near normal, with visual acuity of 20/25 or better and subtle angiographic leakage. The foveal cone mosaics were continuous with tight packing and cones exhibited normal reflectivity. However, cone density was significantly lower for all participants (mean=80 733 cones/mm2) within 0.5° than the cone density previously reported for normal eyes.Conclusions Foveal cone density is lower than normal in the clinically less-affected eyes of patients with asymmetric MacTel. This suggests that cone photoreceptor loss may precede classic obvious vascular changes in idiopathic MacTel.

The purpose of this study was to examine multiple direct and indirect pathways of the association between older age and mental health through COVID-19-related stress perceptions, meaning in life, and forgiveness of situations. Participants were 1,382 U.S. adults who were part of the Harvard Digital Lab for the Social Sciences panel who volunteered to complete a 12 min survey in the spring of 2020. The sample had an average age of 56 years, was slightly more male (55%) than female (44%) or other (2%), mostly White (88%), well-educated (70% bachelors degree or more), and middle-income ($60,000–$75,000 annually). Measures included: COVID-19-related stress perceptions (e.g., concerns about infection, job, lack of necessities), presence of and search for meaning in life, forgiveness of situations, psychological distress, hopelessness, and optimism. A latent mental health variable was created that was comprised of psychological distress, hopelessness, and optimism. All hypothesized direct effects were in evidence, and all but one indirect effect were observed. Specifically, older age was related to better mental health through higher presence of meaning and lower search for meaning. Older age was also related to better mental health through a serial indirect pathway from lower COVID-19-related stress perceptions to higher presence of and lower search for meaning and higher forgiveness of situations to mental health. The proposed model was largely supported and confirms existing theory and research on aging, positive psychological processes, and mental health. Findings also offer new insights on the unique potential role of forgiveness of situations and its theoretical relevance to offending situations such as the COVID-19 pandemic. The present study offers a beginning for theorists, researchers, and practitioners to consider the connections between aging and mental health and the intricate interconnections between stress appraisal and positive coping resources that may serve to support it.

Background: Despite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders. Method: Data were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence. Results: Non-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p

Objectives: To evaluate the proportion of Parkinson's disease (PD) patients identified as having advanced Parkinson's disease (APD) according to physician's judgement in Australia. Methods: This cross-sectional, non-interventional observational study was performed in movement disorder clinics from 18 countries. Results from Australia are presented. Participants included consecutive adults with PD attending routine clinical visits, or inpatients, who could speak English. The primary outcome was the proportion of patients diagnosed with APD via physician judgement. Results: 100 patients were recruited in Australia: 61.0% (95% CI 51.4–70.6%) diagnosed with APD by physician judgement. Patients were 66.6 ± 8.5 years, 65% were male, were living at home (97%), and diagnosed with PD for median 10.7 years (0–30.5 years). Motor fluctuations were present in 68%. For those with APD, referral was predominantly to enable access to device assisted therapies (DAT) (49%), while for non-APD, referral was largely for diagnostic purposes (41%). Patients had a median follow-up at the movement disorder clinic of 4.8 years for those with APD, or 3.6 years for non-APD. While 62% were eligible for DAT, only two-thirds of these received them. The most commonly used DAT was deep brain stimulation (64.3%). There was fair agreement between physician's judgement and the APD criteria by Delphi method (Cohen's kappa) 0.325 (95% CI 0.150–0.500) in the Australian subset. Conclusions: The definition of APD requires refinement in order to facilitate greater agreement among movement disorder specialists. A third of APD patients eligible for DAT remain untreated. Better referral and education of patients with APD is needed.

Excessive home cage aggression often results in severe injury and subsequent premature euthanasia of male laboratory mice. Aggression can be reduced by transferring used nesting material during cage cleaning, which is thought to contain aggression appeasing odors from the plantar sweat glands. However, neither the composition of plantar sweat nor the deposits on used nesting material have been evaluated. The aims of this study were to (1) identify and quantify volatile compounds deposited in the nest site and (2) determine if nest and sweat compounds correlate with social behavior. Home cage aggression and affiliative behavior were evaluated in 3 strains: SJL, C57BL/6N, and A/J. Individual social rank was assessed via the tube test, because ranking may influence compound levels. Sweat and urine from the dominant and subordinate mouse in each cage, plus cage level nest samples were analyzed for volatile compound content using gas chromatography-mass spectrometry. Behavior data and odors from the nest, sweat, and urine were statistically analyzed with separate principal component analyses (PCA). Significant components, from each sample analysis, and strain were run in mixed models to test if odors were associated with behavior. Aggressive and affiliative behaviors were primarily impacted by strain. However, compound PCs were also impacted by strain, showing that strain accounts for any relationship between odors and behavior. C57BL/6N cages displayed the most allo-grooming behavior and had high scores on sweat PC1. SJL cages displayed the most aggression, with high scores on urine PC2 and low scores on nest PC1. These data show that certain compounds in nesting material, urine, and sweat display strain specific patterns which match strain specific behavior patterns. These results provide preliminary information about the connection between home cage compounds and behavior. Salient compounds will be candidates for future controlled studies to determine their direct effect on mouse social behavior.

Objective Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES).Design Cross-sectional study.Setting Urban communities in Jamaica.Participants 360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016–2017.Exposures Community SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level.Primary outcome The main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations.Results The prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women.Conclusion Living in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.

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Background: The ability to resist adverse outcomes, or demonstrate resilience after exposure to trauma is a thriving field of study. Yet ongoing debate persists regarding definitions of resilience, generalizability of the extant literature, neurobiological correlates, and a consensus research agenda. Objectives: To address these pressing questions, Drs. Christy Denckla and Karestan Koenen (co-chairs) convened a multidisciplinary panel including Drs. Dante Cicchetti, Laura Kubzansky, Soraya Seedat, Martin Teicher, and David Williams at the 2019 annual meeting of the International Society for Traumatic Stress Studies (ISTSS). Questions included (1) how have definitions of resilience evolved, (2) what are the best approaches to capture the complexity of resilience processes, and (3) what are the most important areas for future research? Methods: The proceedings of this panel are summarized in this report, and prominent themes are synthesized and integrated. Results: While different definitions emerged, all shared a focus on conceptualizing resilience at multiple levels, from the biological to the social structural level, a focus on the dynamic nature of resilience, and a move away from conceptualizing resilience as only an individual trait. Critical areas for future research included 1) focused efforts to improve assessment that has international and cross-cultural validity, 2) developing within-study designs that employ more intensive phenotyping strategies, 3) examining outcomes across multiple levels and domains, and 4) integrating conceptualizations of resilience from the individual-level to the larger social context at the population health level. Conclusion: Increasingly sophisticated and nuanced conceptual frameworks, coupled with research leveraging advances in genetics, molecular biology, increased computational capacity, and larger, more diverse datasets suggest that the next decade of research could bring significant breakthroughs.

Purpose: The purpose was to use Twitter to conduct online surveillance of negative sentiment towards Mexicans and Hispanics during the 2016 United States presidential election, and to examine its relationship with mental well-being in this targeted group at the population level. Methods: Tweets containing the terms Mexican(s) and Hispanic(s) were collected within a 20-week period of the 2016 United States presidential election (November 9th 2016). Sentiment analysis was used to capture percent negative tweets. A time series lag regression model was used to examine the association between percent count of negative tweets mentioning Mexicans and Hispanics and percent count of worry among Hispanic Gallup poll respondents. Results: Of 2,809,641 tweets containing terms Mexican(s) and Hispanic(s), 687,291 tweets were negative. Among 8,314 Hispanic Gallup respondents, a mean of 33.5% responded to be worried on a daily basis. A significant lead time of 1 week was observed, showing that negative tweets mentioning Mexicans and Hispanics appeared to forecast daily worry among Hispanics by 1 week. Conclusion: Surveillance of online negative sentiment towards racially vulnerable population groups can be captured using social media. This has potential to identify early warning signals for symptoms of mental well-being among targeted groups at the population level.

Preparation for the fftieth anniversary of human spacefight in the spring of 2011 provides the space faring nations with an opportunity to refect on past achievements as well as consider the next fifty years of human spacefight. The International Space Station is a unique platform for long duration life science research that will play a critical role in preparing for future human space exploration beyond low earth orbit. Some feel the future path back to the Moon and on to Mars may be delayed with the current commitment of the united States to support the development of human-rated commercial spacecraft. others see this as a unique opportunity to leverage the capability of the private sector in expanding access to space exploration. This article provides an overview of the past achievements in hu- man spacefight and discusses future missions over the next ffty years and the role space medicine will play in extending the time-distance constant of human space exploration.

Abstract Global biodiversity losses continue despite tremendous growth in the volume of conservation science and many local successes. Research that can achieve conservation science's aims—arresting declines in biodiversity and preventing extinctions—is therefore of ever greater importance. Here, we ask whether conservation science, as currently performed, is progressing in such a way as to maximize its impact. We present a simple framework for how effective conservation research could progress, from identifying problems to diagnosing their proximate and ultimate causes, and from proposing, to designing, implementing, and testing responses. We then demonstrate that for three well‐known examples—South Asian vultures, whooping cranes, and bycatch of procellariform seabirds—published studies appear to follow this sequence, with considerable benefits. However, for a representative sample of the wider conservation literature, we find no evidence of such a progression. Instead, the vast majority of papers remain focused on describing the state of nature or on mechanisms directly causing changes, with very little research on designing or implementing conservation responses. This lack of research on the sorts of questions that might most help conservation science deliver its stated mission strongly suggests we will struggle to translate the huge increase in research activity into real‐world benefits.

Raloxifene (RAL) is an FDA-approved drug used to treat osteoporosis in postmenopausal women. RAL suppresses bone loss primarily through its role as a selective estrogen receptor modulator (SERM). This hormonal estrogen therapy promotes unintended side effects, such as hot flashes and increased thrombosis risk, and prevents the drug from being used in some patient populations at-risk for fracture, including children with bone disorders. It has recently been demonstrated that RAL can have significant positive effects on overall bone mechanical properties by binding to collagen and increasing bone tissue hydration in a cell-independent manner. A Raloxifene-Analog (RAL-A) was synthesized by replacing the 6-hydroxyl substituent with 6-methoxy in effort to reduce the compound's binding affinity for estrogen receptors (ER) while maintaining its collagen-binding ability. It was hypothesized that RAL-A would improve the mechanical integrity of bone in a manner similar to RAL, but with reduced estrogen receptor binding. Molecular assessment showed that while RAL-A did reduce ER binding, downstream ER signaling was not completely abolished. In-vitro, RAL-A performed similarly to RAL and had an identical concentration threshold on osteocyte cell proliferation, differentiation, and function. To assess treatment effect in-vivo, wildtype (WT) and heterozygous (OIM+/−) female mice from the Osteogenesis Imperfecta (OI) murine model were treated with either RAL or RAL-A from 8 weeks to 16 weeks of age. There was an untreated control group for each genotype as well. Bone microarchitecture was assessed using microCT, and mechanical behavior was assessed using 3-point bending. Results indicate that both compounds produced analogous gains in tibial trabecular and cortical microarchitecture. While WT mechanical properties were not drastically altered with either treatment, OIM+/− mechanical properties were significantly enhanced, most notably, in post-yield properties including bone toughness. This proof-of-concept study shows promising results and warrants the exploration of additional analog iterations to further reduce ER binding and improve fracture resistance.

Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young children (birth to 5 years) from a community health clinic and administered survey questions to assess stressors and resources. We constructed inventories of stressors and resources and examined the relationships between these inventories and caregivers’ depressive symptoms, anxiety symptoms, and sleep problems, and young children’s medical diagnoses derived from electronic health records. Cumulative stressors and resources displayed bivariate and adjusted associations with caregivers’ depressive symptoms, anxiety symptoms, and sleep problems. For depressive and anxiety symptoms, these associations were evident in models that included stressors and resources together. Caregivers with high stressors and low resources displayed the highest levels of depressive and anxiety symptoms and sleep problems. In terms of children’s health outcomes, only modest trends were evident for developmental/mental health outcomes, but not other diagnostic categories. Future studies are needed to examine stressors and resources together in larger samples and in relation to prospectively assessed measures of child well-being.

Objective Clinicopathological studies over the last decade have broadened the clinical spectrum of progressive supranuclear palsy (PSP) to include several distinct clinical syndromes. We examined the cognitive profiles of patients with PSP-Richardson’s syndrome (PSP-RS) and two atypical ‘brainstem predominant’ PSP phenotypes (PSP-parkinsonism, PSP-P; and PSP-pure akinesia with gait freezing, PSP-PAGF) using a comprehensive neuropsychological battery. Methods Fourteen patients diagnosed as PSP-RS, three patients with PSP-P and four patients with PSP-PAGF were assessed using a comprehensive battery of neuropsychological tests. Results The typical PSP-RS subgroup demonstrated greater impairments in processing speed [t(19) = -4.10, p = 0.001 (d =1.66)] and executive function [t(19) = -2.63, p = 0.02 (d = 1.20)] compared to the ‘brainstem predominant’ PSP phenotype. Conclusion This is the first prospective study to demonstrate that PSP-RS and ‘brainstem predominant’ PSP phenotypes can be differentiated on cognitive grounds. These differences correspond with variations in pathological profiles reported in the literature.

Abstract Background Although the quality of life (QoL) experienced by patients with schizophrenia has been recognized, few studies have assessed the relationship between the caregivers’ QoL and patients’ QoL. Methods The study included 253 stabilized outpatients with schizophrenia and their caregivers from 3 Mental Health Services in Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Caregivers’ and patients’ QoL were respectively assessed using two specific QoL questionnaires (S-CGQoL and S-QoL 18). We collected socio-demographic information and clinical data. Multiple linear regressions were performed to determine which variables were associated with patient’s QoL. We tested the following hypothesis using structural equation modeling (SEM): caregivers’ QoL may have an indirect effect on patients’ QoL mediated by their influence of the severity of psychotic symptoms. Results In the multivariate analysis, the caregivers’ QoL was not significantly associated with the patients’ QoL, except for one QoL dimension about relationship with family (Beta = 0.23). Among patients’ characteristics, being a woman and Aymara, having lower educational level, unemployment and severity of symptoms was significantly associated to a lower QoL. The SEM revealed a moderate significant association between caregivers’ QoL and psychotic symptoms severity (path coefficient = −0.32) and a significant association between psychotic symptoms severity and patients QoL (path coefficient = −0.40). The indirect effect of caregivers’ QoL on patients’ QoL was significant (mediated effect coefficient = 0.13). Conclusion Improvement of caregiver’s QoL may have a direct impact on the psychotic symptoms of patients and indirectly on patient’s QoL, confirming the need for ongoing family interventions in these regions.

The association between pulmonary hypertension (PH) and hypoxia is well-established, with two key mechanistic processes, hypoxic pulmonary vasoconstriction and hypoxia-induced vascular remodeling, driving changes in pulmonary arterial pressure. In contrast to other forms of pulmonary hypertension, the vascular changes induced by hypoxia are reversible, both in humans returning to sea-level from high altitude and in animal models. This raises the intriguing possibility that the molecular drivers of these hypoxic processes could be targeted to modify pulmonary vascular remodeling in other contexts. In this review, we outline the history of research into PH and hypoxia, before discussing recent advances in our understanding of this relationship at the molecular level, focussing on the role of the oxygen-sensing transcription factors, hypoxia inducible factors (HIFs). Emerging links between HIF and vascular remodeling highlight the potential utility in inhibiting this pathway in pulmonary hypertension and raise possible risks of activating this pathway using HIF-stabilizing medications.

Background: Cross-national variance in smoking prevalence is relatively well documented. The aim of this study is to estimate levels of smoking persistence across 21 countries with a hypothesized inverse relationship between country income level and smoking persistence. Methods: Data from the World Health Organization World Mental Health Survey Initiative were used to estimate cross-national differences in smoking persistence—the proportion of adults who started to smoke and persisted in smoking by the date of the survey. Results: There is large variation in smoking persistence from 25% (Nigeria) to 85% (China), with a random-effects meta-analytic summary estimate of 55% with considerable cross-national variation. (Cochran’s heterogeneity Q statistic = 6845; p < 0.001). Meta-regressions indicated that observed differences are not attributable to differences in country’s income level, age distribution of smokers, or how recent the onset of smoking began within each country. Conclusion: While smoking should remain an important public health issue in any country where smokers are present, this report identifies several countries with higher levels of smoking persistence (namely, China and India).

Background. While numerous validated questionnaires measuring psychiatric symptoms in Parkinson’s disease (PD) are available, a quick multifaceted screening tool is lacking. Objective. To generate the Brief Psychiatric Questionnaire (BPQ) that quickly screens for depression, anxiety, and apathy and to evaluate its content validity against three reference scales. Methods. Forty-seven questions were drafted and measured against the Geriatric Depression Scale (GDS), State Trait Anxiety Inventory (Form Y2) (STAI-Y2), and Apathy Evaluation Scale (AES). Data were reduced by principal component analysis and linear regression. Content validity and repeatability were assessed in a second cohort. Results. Data from ninety-five patients were used for BPQ development. Variation explained by the final linear regression models was 52% for GDS (R2 = 0.521, F(2,94) = 49.97, p

The current research focuses on modeling the lift response due to dynamic (time-varying) “burst-type” actuation on a stalled airfoil. Here, the “burst-type” actuation refers to the synthetic jet (generated from the actuator) that is used for flow separation mitigation. Dynamic “burst-type” actuation exhibits two different characteristic dynamic behaviors within the system; namely, the high-frequency and low-frequency components. These characteristics introduce modeling challenges. In this paper, we propose a hybrid model composed of two individual sub-models, one for each of the two frequencies. The lift response due to high-frequency burst actuation is captured using a convolution model. The low-frequency component due to nonlinear burst-burst interactions is captured using a Wiener model, consisting of linear time-invariant dynamics and a static output nonlinearity. The hybrid model is validated using data from wind tunnel experiments.