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QAnon started in late 2017 but gained traction and attention in 2020 amidst a chaotic social climate which is critical for understanding QAnon and its growth. This chapter presents evidence that QAnon-related traffic on social media increased during the pandemic, both domestically and globally, and offers anecdotal evidence of how QAnon’s messaging has changed as it has spread internationally, adopting nation-specific issues. Next, the chapter offers psychological explanations for these trends. Conspiracy theories flourish in times of uncertainty and group membership can provide meaningful connections that alleviate isolation. Conspiracies are more believed by people who also believe that society’s values are being threatened—an effect called system identity threat. Terror management theory suggests that reminders of death might affect the sentiment of individual people and society in general. Finally, mortality salience can promote following of religious beliefs. As a quasi-religious group, QAnon could have gained support due to mortality salience. The uncertainty and threats of 2020 might have contributed to QAnon’s popularity.
New technologies and disruptions related to Coronavirus disease-2019 have led to expansion of decentralized approaches to clinical trials. Remote tools and methods hold promise for increasing trial efficiency and reducing burdens and barriers by facilitating participation outside of traditional clinical settings and taking studies directly to participants. The Trial Innovation Network, established in 2016 by the National Center for Advancing Clinical and Translational Science to address critical roadblocks in clinical research and accelerate the translational research process, has consulted on over 400 research study proposals to date. Its recommendations for decentralized approaches have included eConsent, participant-informed study design, remote intervention, study task reminders, social media recruitment, and return of results for participants. Some clinical trial elements have worked well when decentralized, while others, including remote recruitment and patient monitoring, need further refinement and assessment to determine their value. Partially decentralized, or “hybrid” trials, offer a first step to optimizing remote methods. Decentralized processes demonstrate potential to improve urban-rural diversity, but their impact on inclusion of racially and ethnically marginalized populations requires further study. To optimize inclusive participation in decentralized clinical trials, efforts must be made to build trust among marginalized communities, and to ensure access to remote technology.
To assess the impact of overweight and obesity in the second and third trimesters of pregnancy on fetal cardiac function parameters.
We performed a prospective cohort study of 374 singleton pregnant women between 20w0d and 36w6d divided into three groups: 154 controls (body mass index - BMI < 25 kg/m2), 140 overweight (BMI 25–30 kg/m2) and 80 obese (BMI ≥ 30 kg/m2). Fetal left ventricular (LV) modified myocardial performance index (Mod-MPI) was calculated according to the following formula: (isovolumetric contraction time + isovolumetric relaxation time)/ejection time. Spectral tissue Doppler was used to determine LV and right ventricular (RV) myocardial performance index (MPI'), peak myocardial velocity during systole (S'), early diastole (E'), and late diastole (A').
We found significant differences between the groups in maternal age (p < 0.001), maternal weight (p < 0.001), BMI (p < 0.001), number of pregnancies (p < 0.001), parity (p < 0.001), gestational age (p = 0.013), and estimated fetal weight (p = 0.003). Overweight pregnant women had higher LV Mod-MPI (0.046 versus 0.044 seconds, p = 0.009) and LV MPI' (0.50 versus 0.47 seconds, p < 0.001) than the control group. Obese pregnant women had higher RV E' than control (6.82 versus 6.33 cm/sec, p = 0.008) and overweight (6.82 versus 6.46 cm/sec, p = 0.047) groups. There were no differences in 5-min APGAR score < 7, neonatal intensive care unit admission, hypoglycemia and hyperglobulinemia between the groups.
We observed fetal myocardial dysfunction in overweight and obese pregnant women with higher LV Mod-MPI, LV MPI' and RV E' compared to fetuses from normal weight pregnant women.
Schooling transforms child development yet fades into the background in research on prosocial behavior. Mass education, however, was central to the concerns of founding theorists such as Durkheim, Dewey, and Piaget. Putting on a sociological lens makes it easier to see how schools continue to play an active role in prosocial development, and how the concerns of these founding researchers resonate today. To situate the active role of school contexts in prosocial behavior, this chapter first examines schools as social systems, structuring children’s social networks, imposing roles and norms of behavior, and impacting the timing of development. The chapter then examines classroom, pedagogical, and peer prosocial behaviors, and their connection to classic theoretical work in the field. After reviewing these forms of prosocial behavior, the chapter closes by examining the links between prosocial behavior and student outcomes and implications and future directions for theory, research, and practice.
One challenge for multisite clinical trials is ensuring that the conditions of an informative trial are incorporated into all aspects of trial planning and execution. The multicenter model can provide the potential for a more informative environment, but it can also place a trial at risk of becoming uninformative due to lack of rigor, quality control, or effective recruitment, resulting in premature discontinuation and/or non-publication. Key factors that support informativeness are having the right team and resources during study planning and implementation and adequate funding to support performance activities. This communication draws on the experience of the National Center for Advancing Translational Science (NCATS) Trial Innovation Network (TIN) to develop approaches for enhancing the informativeness of clinical trials. We distilled this information into three principles: (1) assemble a diverse team, (2) leverage existing processes and systems, and (3) carefully consider budgets and contracts. The TIN, comprised of NCATS, three Trial Innovation Centers, a Recruitment Innovation Center, and 60+ CTSA Program hubs, provides resources to investigators who are proposing multicenter collaborations. In addition to sharing principles that support the informativeness of clinical trials, we highlight TIN-developed resources relevant for multicenter trial initiation and conduct.
Foramina of bones are beginning to yield more information about metabolic rates and activity levels of living and extinct species. This study investigates the relationship between estimated blood flow rate to the femur and body mass among cursorial birds extending back to the Late Cretaceous. Data from fossil foramina are compared with those of extant species, revealing similar scaling relationships for all cursorial birds and supporting crown bird–like terrestrial locomotor activity. Because the perfusion rate in long bones of birds is related to the metabolic cost of microfracture repair due to stresses applied during locomotion, as it is in mammals, this study estimates absolute blood flow rates from sizes of nutrient foramina located on the femur shafts. After differences in body mass and locomotor behaviors are accounted for, femoral bone blood flow rates in extinct species are similar to those of extant cursorial birds. Femoral robustness is generally greater in aquatic flightless birds than in terrestrial flightless and ground-dwelling flighted birds, suggesting that the morphology is shaped by life-history demands. Femoral robustness also increases in larger cursorial bird taxa, probably associated with their weight redistribution following evolutionary loss of the tail, which purportedly constrains femur length, aligns it more horizontally, and necessitates increased robustness in larger species.
The radio signal transmitted by the Mars Express (MEX) spacecraft was observed regularly between the years 2013–2020 at X-band (8.42 GHz) using the European Very Long Baseline Interferometry (EVN) network and University of Tasmania’s telescopes. We present a method to describe the solar wind parameters by quantifying the effects of plasma on our radio signal. In doing so, we identify all the uncompensated effects on the radio signal and see which coronal processes drive them. From a technical standpoint, quantifying the effect of the plasma on the radio signal helps phase referencing for precision spacecraft tracking. The phase fluctuation of the signal was determined for Mars’ orbit for solar elongation angles from 0 to 180 deg. The calculated phase residuals allow determination of the phase power spectrum. The total electron content of the solar plasma along the line of sight is calculated by removing effects from mechanical and ionospheric noises. The spectral index was determined as $-2.43 \pm 0.11$ which is in agreement with Kolmogorov’s turbulence. The theoretical models are consistent with observations at lower solar elongations however at higher solar elongation ($>$160 deg) we see the observed values to be higher. This can be caused when the uplink and downlink signals are positively correlated as a result of passing through identical plasma sheets.
Risk of suicide-related behaviors is elevated among military personnel transitioning to civilian life. An earlier report showed that high-risk U.S. Army soldiers could be identified shortly before this transition with a machine learning model that included predictors from administrative systems, self-report surveys, and geospatial data. Based on this result, a Veterans Affairs and Army initiative was launched to evaluate a suicide-prevention intervention for high-risk transitioning soldiers. To make targeting practical, though, a streamlined model and risk calculator were needed that used only a short series of self-report survey questions.
We revised the original model in a sample of n = 8335 observations from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) who participated in one of three Army STARRS 2011–2014 baseline surveys while in service and in one or more subsequent panel surveys (LS1: 2016–2018, LS2: 2018–2019) after leaving service. We trained ensemble machine learning models with constrained numbers of item-level survey predictors in a 70% training sample. The outcome was self-reported post-transition suicide attempts (SA). The models were validated in the 30% test sample.
Twelve-month post-transition SA prevalence was 1.0% (s.e. = 0.1). The best constrained model, with only 17 predictors, had a test sample ROC-AUC of 0.85 (s.e. = 0.03). The 10–30% of respondents with the highest predicted risk included 44.9–92.5% of 12-month SAs.
An accurate SA risk calculator based on a short self-report survey can target transitioning soldiers shortly before leaving service for intervention to prevent post-transition SA.
Quantifying and managing the cumulative effects of human activities on coastal and marine environments is among the foremost challenges in enabling sustainable development in the twenty-first century. As the speed with which these environments are changing increases, there is greater impetus to resolve the evident problems facing governance systems responsible for managing cumulative impacts. Policymakers and regulators recognise the need to assess and manage cumulative effects, as evidenced by widespread legislation requiring cumulative effects assessment (CEA). Yet there is ample evidence that we are not turning the tide in terms of balancing good environmental health with increasing demands of already degraded coastal and marine spaces that are increasingly impacted by climate change. This paper reviews the current state of knowledge regarding scientific and practical advances in CEA, assesses whether these advances are being applied in decision-making and identifies where challenges to implementation exist. Priority research questions are formulated to accelerate the inclusion of effective CEA in marine and coastal planning and management.
To conduct a systematic review of published real-world evidence describing the cost and healthcare resource use for Clostridiodes difficile infection (CDI) in the United States.
A systematic literature review was conducted searching for terms for CDI and healthcare costs. Titles of articles and abstracts were reviewed to identify those that met study criteria. Studies were evaluated to examine overall design and comparison groups in terms of healthcare resource use and cost for CDI.
In total, 28 articles met the inclusion criteria. Moreover, 20 studies evaluated primary CDI or did not specify, and 8 studies1–8 evaluated both primary CDI and recurrent (rCDI). Data from Medicare were used in 6 studies. Nearly all studies used a comparison group, either controls without CDI (N = 20) or comparison between primary CDI and rCDI (N = 7). Two studies examined costs of rCDI by the number of recurrences. Overall, the burden of CDI is significant, with higher aggregate costs for patients with rCDI. Compared with non-CDI controls, hospital length of stay increased in patients with both primary and rCDI compared to patients without CDI. Patients with primary CDI cost healthcare systems $24,000 more than patients without CDI. Additionally, 2 studies that evaluated the impact of recurrence among those patients with an index case of CDI demonstrated significantly higher direct all-cause medical costs among those with rCDI compared to those without.
CDI, and particularly rCDI, is a costly condition with hospitalizations being the main cost driver.
Commercial pigs kept outdoors are often given nose-rings, to inhibit rooting and minimize pasture damage. If rooting is a ‘behavioural need’ in the pig, and ringing is effective because it renders rooting painful, nose-ringing may be a threat to welfare. Thirty gestating sows were assigned to one of three conditions: unringed controls (UR); sows ringed with three, wire ‘clip’ rings through the snout rim (CR); or sows with one, rigid ‘bull’ ring (BR). They were observed on grass for 7h day−1 at intervals over 6 months. Ringing almost totally abolished penetration of the ground by rooting during the month after ringing (UR, CR and BR sows respectively spent 5.6%, 0.1% and 0.1 % of scan observations dig-rooting during this month; P < 0.001). These differences in recorded rooting were reflected in a much greater extent of pasture damage in paddocks containing UR sows. Rooting remained largely suppressed throughout the 6 months of observations in BR sows; but substantial recovery of this function occurred in CR sows by the sixth month, although much of this may be attributed to the fact that most sows lost at least some of their rings. Ringing also partially inhibited grazing (which accounted for 26.2%, 27.1% and 21.9 % of scans over the whole project in UR, CR and BR sows respectively; P < 0.05), nosing in straw, digging out wallows and stone-chewing (18.3%, 9.5% and 9.2% respectively of all scans in UR, CR and BR sows; P < 0.001). Ringed sows spent more time standing but otherwise inactive than did controls (0.8%, 1.7% and 4.0% of all scans in UR, CR and BR sows respectively; P < 0 .001), and displayed more straw-chewing, vacuum-chewing and digging at soil with the forepaw. We conclude that nose-ringing in pigs inhibited a range of functional activities, as well as rooting, and elicited more behaviours that suggest a degree of reduced welfare. BR sows displayed more of these effects than did CR ones, although these differences may be largely, but not entirely, due to a loss of clip rings over time.
A single solution to promote higher animal welfare across the whole EU is unlikely due to significant regional differences and because what is most appropriate for each region depends on many factors. Based on analyses of eight member and candidate EU countries, this paper provides a conceptual framework, an ‘animal welfare roadmap’, which can be used to assess the stage of maturity of a country in farm animal welfare policy development and identify appropriate policy instruments and indicators to monitor progress towards higher animal welfare. The ‘roadmap’ consists of five sequential stages: increasing compliance with legislation; raising awareness; product development; mainstreaming; and integration of animal welfare with other issues. For each stage, specific policy instruments are identified alongside the category of stakeholders most likely to be influential in the implementation of each instrument. The policy instruments used to achieve these stages are those used by government departments/agencies, private enterprises, academic bodies or non-governmental organisations who formulate standards for animal welfare. These are supported by indicators best suited to document their effectiveness. Although we have emphasised how different situations and contexts within the EU mean that there is no single optimal policy instrument for the EU as a whole, but rather appropriate policy instruments should be selected according to the stage of development of a country or sector, we do propose a harmonised choice of indicators to allow benchmarking of changes at the EU level with regard to progress towards animal welfare.
Two studies examined the relationship between individual differences in cognitive reflection (CRT) and the tendency to accord genuinely moral (non-conventional) status to a range of counter-normative acts — that is, to treat such acts as wrong regardless of existing social opinion or norms. We contrasted social violations that are intrinsically harmful to others (e.g., fraud, thievery) with those that are not (e.g., wearing pajamas to work and engaging in consensual acts of sexual intimacy with an adult sibling). Our key hypothesis was that more reflective (higher CRT) individuals would tend to moralize selectively — treating only intrinsically harmful acts as genuinely morally wrong — whereas less reflective (lower CRT) individuals would moralize more indiscriminately. We found clear support for this hypothesis in a large and ideologically diverse sample of American adults. The predicted associations were not fully accounted for by the subjects’ political orientation, sensitivity to gut feelings, gender, age, educational attainment, or their placement on a sexual morals-specific measure of social conservatism. Our studies are the first to demonstrate that, in addition to modulating the intensity of moral condemnation, reflection may also play a key role in setting the boundaries of the moral domain as such.
Increasing litter size has long been a goal of pig breeders and producers, and may have implications for pig (Sus scrofa domesticus) welfare. This paper reviews the scientific evidence on biological factors affecting sow and piglet welfare in relation to large litter size. It is concluded that, in a number of ways, large litter size is a risk factor for decreased animal welfare in pig production. Increased litter size is associated with increased piglet mortality, which is likely to be associated with significant negative animal welfare impacts. In surviving piglets, many of the causes of mortality can also occur in non-lethal forms that cause suffering. Intense teat competition may increase the likelihood that some piglets do not gain adequate access to milk, causing starvation in the short term and possibly long-term detriments to health. Also, increased litter size leads to more piglets with low birth weight which is associated with a variety of negative long-term effects. Finally, increased production pressure placed on sows bearing large litters may produce health and welfare concerns for the sow. However, possible biological approaches to mitigating health and welfare issues associated with large litters are being implemented. An important mitigation strategy is genetic selection encompassing traits that promote piglet survival, vitality and growth. Sow nutrition and the minimisation of stress during gestation could also contribute to improving outcomes in terms of piglet welfare. Awareness of the possible negative welfare consequences of large litter size in pigs should lead to further active measures being taken to mitigate the mentioned effects.
Increasing litter size has long been a goal of pig (Sus scrofa domesticus) breeders and producers in many countries. Whilst this has economic and environmental benefits for the pig industry, there are also implications for pig welfare. Certain management interventions are used when litter size routinely exceeds the ability of individual sows to successfully rear all the piglets (ie viable piglets outnumber functional teats). Such interventions include: tooth reduction; split suckling; cross-fostering; use of nurse sow systems and early weaning, including split weaning; and use of artificial rearing systems. These practices raise welfare questions for both the piglets and sow and are described and discussed in this review. In addition, possible management approaches which might mitigate health and welfare issues associated with large litters are identified. These include early intervention to provide increased care for vulnerable neonates and improvements to farrowing accommodation to mitigate negative effects, particularly for nurse sows. An important concept is that management at all stages of the reproductive cycle, not simply in the farrowing accommodation, can impact on piglet outcomes. For example, poor stockhandling at earlier stages of the reproductive cycle can create fearful animals with increased likelihood of showing poor maternal behaviour. Benefits of good sow and litter management, including positive human-animal relationships, are discussed. Such practices apply to all production situations, not just those involving large litters. However, given that interventions for large litters involve increased handling of piglets and increased interaction with sows, there are likely to be even greater benefits for management of hyper-prolific herds.
In recent years, evidence has started piling up that some high-energy cosmic neutrinos can be associated with blazars in flaring states. On 2022 February 26, a new blazar-neutrino coincidence was reported: the track-like neutrino event IC220225A detected by IceCube is spatially coincident with the flat-spectrum radio quasar PKS 0215+015. Like previous associations, this source was found to be in a high optical and γ-ray state. Moreover, the source showed a bright radio outburst, which substantially increases the probability of a true physical association. We have performed six observations with the VLBA shortly after the neutrino event with a monthly cadence and are monitoring the source with the Effelsberg 100m-Telescope, and with the Australia Compact Telescope Array. Here, we present first results on the contemporary parsec-scale jet structure of PKS 0215+015 in total intensity and polarization to constrain possible physical processes leading to neutrino emission in blazars.
We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.
We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.
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Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.
There is limited information on the volume of antibiotic prescribing that is influenza-associated, resulting from influenza infections and their complications (such as streptococcal pharyngitis). We estimated that for the Kaiser Permanente Northern California population during 2010–2018, 3.4% (2.8%–4%) of all macrolide prescriptions (fills), 2.7% (2.3%–3.2%) of all aminopenicillin prescriptions, 3.1% (2.4%–3.9%) of all 3rd generation cephalosporins prescriptions, 2.2% (1.8%–2.6%) of all protected aminopenicillin prescriptions and 1.3% (1%–1.6%) of all quinolone prescriptions were influenza-associated. The corresponding proportions were higher for select age groups, e.g. 4.3% of macrolide prescribing in ages over 50 years, 5.1% (3.3%–6.8%) of aminopenicillin prescribing in ages 5–17 years and 3.3% (1.9%–4.6%) in ages <5 years was influenza-associated. The relative contribution of influenza to antibiotic prescribing for respiratory diagnoses without a bacterial indication in ages over 5 years was higher than the corresponding relative contribution to prescribing for all diagnoses. Our results suggest a modest benefit of increasing influenza vaccination coverage for reducing prescribing for the five studied antibiotic classes, particularly for macrolides in ages over 50 years and aminopenicillins in ages <18 years, and the potential benefit of other measures to reduce unnecessary antibiotic prescribing for respiratory diagnoses with no bacterial indication, both of which may contribute to the mitigation of antimicrobial resistance.
To determine the proportion of hospitals that implemented 6 leading practices in their antimicrobial stewardship programs (ASPs). Design: Cross-sectional observational survey.
Advance letters and electronic questionnaires were initiated February 2020. Primary outcomes were percentage of hospitals that (1) implemented facility-specific treatment guidelines (FSTG); (2) performed interactive prospective audit and feedback (PAF) either face-to-face or by telephone; (3) optimized diagnostic testing; (4) measured antibiotic utilization; (5) measured C. difficile infection (CDI); and (6) measured adherence to FSTGs.
Of 948 hospitals invited, 288 (30.4%) completed the questionnaire. Among them, 82 (28.5%) had <99 beds, 162 (56.3%) had 100–399 beds, and 44 (15.2%) had ≥400+ beds. Also, 230 (79.9%) were healthcare system members. Moreover, 161 hospitals (54.8%) reported implementing FSTGs; 214 (72.4%) performed interactive PAF; 105 (34.9%) implemented procedures to optimize diagnostic testing; 235 (79.8%) measured antibiotic utilization; 258 (88.2%) measured CDI; and 110 (37.1%) measured FSTG adherence. Small hospitals performed less interactive PAF (61.0%; P = .0018). Small and nonsystem hospitals were less likely to optimize diagnostic testing: 25.2% (P = .030) and 21.0% (P = .0077), respectively. Small hospitals were less likely to measure antibiotic utilization (67.8%; P = .0010) and CDI (80.3%; P = .0038). Nonsystem hospitals were less likely to implement FSTGs (34.3%; P < .001).
Significant variation exists in the adoption of ASP leading practices. A minority of hospitals have taken action to optimize diagnostic testing and measure adherence to FSTGs. Additional efforts are needed to expand adoption of leading practices across all acute-care hospitals with the greatest need in smaller hospitals.