A short trajectory is all you need: A transformer-based model for long-time dissipative quantum dynamics.

In this Communication, we demonstrate that a deep artificial neural network based on a transformer architecture with self-attention layers can predict the long-time population dynamics of a quantum system coupled to a dissipative environment provided that the short-time population dynamics of the system is known. The transformer neural network model developed in this work predicts the long-time dynamics of spin-boson model efficiently and very accurately across different regimes, from weak system-bath coupling to strong coupling non-Markovian regimes. Our model is more accurate than classical forecasting models, such as recurrent neural networks, and is comparable to the state-of-the-art models for simulating the dynamics of quantum dissipative systems based on kernel ridge regression.

SPINE20 Recommendations 2024 -Spinal Disability: Social Inclusion as a Key to Prevention and Management.

Spine disorders are the leading cause of disability worldwide. To promote social inclusion, it is essential to ensure that people can participate in their societies by improving their ability, opportunities, and dignity, through access to high-quality, evidence-based, and affordable spine services for all.To achieve this goal, SPINE20 recommends six actions.- SPINE20 recommends that G20 countries deliver evidence-based education to the community health workers and primary care clinicians to promote best practice for spine health, especially in underserved communities.- SPINE20 recommends that G20 countries deliver evidence-based, high-quality, cost-effective spine care interventions that are accessible, affordable and beneficial to patients.- SPINE20 recommends that G20 countries invest in Health Policy and System Research (HPSR) to generate evidence to develop and implement policies aimed at integrating rehabilitation in primary care to improve spine health.- SPINE20 recommends that G20 countries support ongoing research initiatives on digital technologies including artificial intelligence, regulate digital technologies, and promote evidence-based, ethical digital solutions in all aspects of spine care, to enrich patient care with high value and quality.- SPINE20 recommends that G20 countries prioritize social inclusion by promoting equitable access to comprehensive spine care through collaborations with healthcare providers, policymakers, and community organizations.- SPINE20 recommends that G20 countries prioritize spine health to improve the well-being and productivity of their populations. Government health systems are expected to create a healthier, more productive, and equitable society for all through collaborative efforts and sustained investment in evidence-based care and promotion of spine health.

Design of a low-cost force insoles to estimate ground reaction forces during human gait.

This paper proposes a low-cost electronic system for estimating ground reaction forces (GRF) during human gait. The device consists of one master node and two slave nodes. The master node sends instructions to slave nodes that sample and store data from two force insoles located at the participant's feet. These insoles are equipped with 14 piezo-resistive FlexiForce A301 sensors (FSR). The slave nodes are attached to the ankles and feet of each participant. Subsequently, the start command is transmitted through the master node, which is connected to the USB port of a personal computer (PC). Once the walking session is completed, the information obtained by the slave nodes can be downloaded by accessing the access point generated by these devices through Wi-Fi communication. The GRF estimation system was validated with force platforms (BTS Bioengineering P6000, Italy), giving on average a fit measure equal to 68 . 71 % ± 4 . 80 % in dynamic situations. Future versions of this device are expected to increase this fit by using machine learning models.

Prevalence and Trends in Cardiovascular Risk Factors Among Middle Aged Persons from Five Race and Ethnic Groups in the United States: A Longitudinal Analysis of Two Cohort Studies.

Importance: It is well established that people of South Asian background have a high burden of atherosclerotic cardiovascular disease (ASCVD). However, few studies have comprehensively examined if South Asian adults in the United States (US) develop cardiovascular risk factors at younger ages than adults from other race and ethnic groups. Objective: To compare the prevalence and change in ASCVD risk factors across age strata by race and ethnic group. Design: We combined data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohort studies. Longitudinal data from all eligible participants at all available exam visits were used to estimate the prevalence of risk factors at ages 45 and 55 years for each race and ethnic group. Setting: Multicenter longitudinal cohort study in 7 field centers across the U.S. Participants: The baseline study sample included individuals free of clinical ASCVD; 554 South Asians, 796 White, 588 Black, 517 Hispanic/Latino, and 245 Chinese adults aged 45-55 years were included. Exposures: Self-identified race (Black, Chinese, South Asian, or White) or ethnic group (Hispanic/Latino). Main Outcomes and Measures: Prevalence of clinical (prediabetes & diabetes, hypertension, dyslipidemia, BMI) and behavioral (diet quality, alcohol use, exercise) ASCVD risk factors at age 45 and age 55. Results: At age 45, South Asian men and women had the highest prevalence of pre-diabetes and diabetes and higher prevalence of hypertension compared to White, Chinese, and Hispanic/Latino men and women. South Asian men had a higher prevalence of dyslipidemia than White, Chinese, and Black men, and South Asian women had a higher prevalence than Chinese and Black women. All groups had worse diet quality than South Asian men and women at age 45, and most also had higher rates of alcohol use. Conclusions and Relevance: We observed significant differences in the prevalence of risk factors for South Asian adults compared to adults from other U.S. race and ethnic groups at age 45 years. Understanding trends and disparities in cardiovascular risk and protective factors across the life course can help equitably improve prevention and treatment strategies for US populations. Key Points: Question: Do South Asian adults have a higher burden of cardiovascular risk factors at age 45 years compared adults from other race and ethnic groups?Findings: In this study of 2754 adults from two cohort studies, the prevalence of prediabetes and diabetes at age 45 years was higher among South Asians than in Black, Chinese, Hispanic and White adults; hypertension prevalence was higher among South Asians than all groups except Black adults.Meaning: South Asian adults have a higher prevalence of several clinical cardiovascular risk factors at a younger age.

Toxicological Evaluation of Kaempferol and Linearolactone as Treatments for Amoebic Liver Abscess Development in Mesocricetus auratus.

Several studies with kaempferol (KP) and linearolactone (LL) have demonstrated their antiparasitic activity. However, the toxicity of these treatments is unknown. Therefore, this study aimed to evaluate the possible toxicological effects of intraperitoneal (i.p.) administration of KP or LL on the amoebic liver abscess model (ALA) in Mesocricetus auratus. An ALA was induced in male hamsters with 1.5 × 105Entamoeba histolytica (E. histolytica) trophozoites inoculated in the left hepatic lobe. The lesion evolved for 4 days, and then KP (5 mg/kg body weight/day) or LL (10 mg/kg body weight/day) was administered for 4 consecutive days. Then, magnetic resonance imaging (MRI), paraclinical analyses, and necropsy for histopathological evaluation were performed. There was similar ALA inhibition by KP (19.42%), LL (28.16%), and metronidazole, the antiamoebic control (20.87%) (p ≤ 0.05, analysis of variance [ANOVA]). There were hepatic and renal biochemical alterations in all treatment groups, mainly for KP (aspartate aminotransferase: 347.5 ± 37.5 U/L; blood urea nitrogen: 19.4 ± 1.9 g/dL; p ≤ 0.05, ANOVA). Lesions found in the organs were directly linked to the pathology. In conclusion, KP and LL decreased ALA development and exerted fewer toxicological effects compared with metronidazole. Therefore, both compounds exhibit therapeutic potential as an alternative treatment of amoebiasis caused by E. histolytica. However, additional clinical studies in different contexts are required to reaffirm this assertion.

Comprehensive Evaluation and Selection of Cardamom (Elettaria cardamomum (L.) Maton) Germplasm Using Morphological Traits.

Cardamom (Elettaria cardamomum (L.) Maton) plays a crucial role in Guatemala's agriculture, supporting local families and covering 169,429.29 ha (making it the world's leading producer). Since its introduction to Guatemala in 1910, limited research has focused on unraveling the diversity and defining morphological traits critical for selecting excellent accessions. In this study, we examined 17 morphological traits across 288 accessions to identify key features associated with the germplasm. The comprehensive analysis employed principal component analysis, a morphological composite value (F-value), linear regression, and hierarchical clustering. The Shannon-Wiener diversity index ranged from 0.10 to 2.02, indicating the variation in diversity among traits. Principal component analysis and hierarchical clustering revealed six distinct germplasm groups. The comprehensive analysis facilitated the selection of 14 excellent accessions, and the regression equation incorporating criteria such as plant height, capsule color, panicle number per plant, panicle length, rhizome color, cluster number per panicle, cluster node length, and capsule number per cluster to identify cardamom germplasm. To develop a conservation strategy for the two putative foreign varieties ('Malabar' and 'Mysore'/'Vazhukka') introduced in Guatemala based on plant height, another 12 accessions were selected with a second comprehensive evaluation. This information offers insights into cardamom diversity for informed selection enhancing national utilization, productivity, and conservation.

A genome-wide association study of adults with community-acquired pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) is associated with high morbidity and hospitalization rate. In infectious diseases, host genetics plays a critical role in susceptibility and immune response, and the immune pathways involved are highly dependent on the microorganism and its route of infection. Here we aimed to identify genetic risk loci for CAP using a case-control genome-wide association study (GWAS). METHODS: We performed a GWAS on 3,765 Spanish individuals, including 257 adult patients hospitalized with CAP and 3,508 population controls. Pneumococcal CAP was documented in 30% of patients; the remaining 70% were selected among patients with unidentified microbiological etiology. We tested 7,6 million imputed genotypes using logistic regressions. UK Biobank GWAS of bacterial pneumonia were used for results validation. Subsequently, we prioritized genes and likely causal variants based on Bayesian fine mapping and functional evidence. Imputation and association of classical HLA alleles and amino acids were also conducted. RESULTS: Six independent sentinel variants reached the genome-wide significance (p < 5 × 10-8), three on chromosome 6p21.32, and one for each of the chromosomes 4q28.2, 11p12, and 20q11.22. Only one variant at 6p21.32 was validated in independent GWAS of bacterial and pneumococcal pneumonia. Our analyses prioritized C4orf33 on 4q28.2, TAPBP on 6p21.32, and ZNF341 on 20q11.22. Interestingly, genetic defects of TAPBP and ZNF341 are previously known inborn errors of immunity predisposing to bacterial pneumonia, including pneumococcus and Haemophilus influenzae. Associations were all non-significant for the classical HLA alleles. CONCLUSIONS: We completed a GWAS of CAP and identified four novel risk loci involved in CAP susceptibility.

18F-FDG-PET/CT Scan for Detection of Large Vessel Involvement in Giant Cell Arteritis: Arteser Spanish Registry.

Background/Objectives: Imaging studies have transformed the diagnosis of large vessel vasculitis (LVV) involvement in giant cell arteritis (GCA). A positron emission tomography/computed tomography (PET/CT) scan with 18-fluorodeoxyglucose (18F-FDG) has emerged as a valuable tool for assessing LVV. We aimed to determine the utility of an 18F-FDG-PET/CT scan in detecting LVV in GCA in the ARTESER registry. Methods: The ARTESER study is a large multicenter, retrospective, longitudinal, and observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed with GCA across 26 tertiary hospitals from 1 June 2013 to 29 March 2019. Patients with a diagnosis of incidental GCA were included if they fulfilled specific criteria, including the ACR 1990 criteria, positive imaging examinations, or the expert clinical opinion of investigators. Differences between patients with positive and negative 18F-FDG-PET/CT scan results were analyzed using a bivariate model. A regression model assessed associations in patients with a positive scan, and the predictive capacity of the cumulative dose of glucocorticoids (GC) on PET scan outcomes was evaluated using ROC curve analysis. Results: Out of 1675 GCA patients included in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. The thoracic aorta was the most frequently affected. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as the number of days increased. Depending on the cumulative dosage of the GC, the 18F-FDG-PET/CT scan showed an AUC of 0.74, with a Youden index > 60 mg/day. Conclusions: Younger patients showed a higher probability of presenting LVV as detected by the 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of the GC influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation.

Torsion-Induced Traumatic Optic Neuropathy (TITON): A Physiologically Relevant Animal Model of Traumatic Optic Neuropathy.

Traumatic optic neuropathy (TON) is a common cause of irreversible blindness following head injury. TON is characterized by axon damage in the optic nerve followed by retinal ganglion cell death in the days and weeks following injury. At present, no therapeutic or surgical approach has been found to offer any benefit beyond observation alone. This is due in part to the lack of translational animal models suitable for understanding mechanisms and evaluating candidate treatments. In this study, we developed a rat model of TON in which the eye is rapidly rotated, inflicting mechanical stress on the optic nerve and leading to significant visual deficits. These functional deficits were thoroughly characterized up to one week after injury using electrophysiology and immunohistochemistry. The photopic negative response (PhNR) of the light adapted full field electroretinogram (LA ffERG) was significantly altered following injury. This correlated with increased biomarkers of retinal stress, axon disruption, and ganglion cell death. Together, this evidence suggests the utility of our model for mimicking clinically relevant TON and that the PhNR may be an early diagnostic for TON. We also found indirect evidence that ketamine, which was used for anesthesia, may ameliorate TON. Future studies will utilize this animal model for evaluation of candidate treatments.

Two Outbreaks of Legionnaires Disease Associated with Outdoor Hot Tubs for Private Use - Two Cruise Ships, November 2022-July 2024.

Legionnaires disease is a serious pneumonia caused by Legionella bacteria. During November 2022-June 2024, CDC was notified of 12 cases of Legionnaires disease among travelers on two cruise ships; eight on cruise ship A and four on cruise ship B. CDC, in collaboration with the cruise lines, initiated investigations to ascertain the potential sources of on-board exposure after notification of the second potentially associated case for each ship. Epidemiologic data collected from patient interviews and environmental assessment and sampling results identified private hot tubs on selected cabin balconies as the most likely exposure source. To minimize Legionella growth, both cruise lines modified the operation and maintenance of these devices by removing the heating elements, draining water between uses, and increasing the frequency of hyperchlorination and cleaning. Hot tubs offer favorable conditions for Legionella growth and transmission when maintained and operated inadequately, regardless of location. Private hot tubs on cruise ships are not subject to the same maintenance requirements as are public hot tubs in common areas. Given the range of hot tub-type devices offered as amenities across the cruise industry, to reduce risk for Legionella growth and transmission, it is important for cruise ship water management program staff members to inventory and assess private balcony hot tubs and adapt public hot tub maintenance and operations protocols for use on private outdoor hot tubs.

Molecular, Pathophysiological, and Clinical Aspects of Corticosteroid-Induced Neuropsychiatric Effects: From Bench to Bedside.

Corticosteroids are frequently prescribed across medical disciplines, yet they are associated with various adverse effects, including neuropsychiatric symptoms, documented since their introduction over 60 years ago. The cellular mechanisms underlying neuropsychiatric symptoms are complex and somewhat obscure, involving multiple pathways. Notably, they include changes in excitability, cellular death of hippocampal and striatal neurons, and increased inflammation and oxidative stress. Clinical presentation varies, encompassing affective disorders (anxiety, euphoria, depression), psychotic episodes, and cognitive deficits. It is crucial to note that these manifestations often go unnoticed by treating physicians, leading to delayed detection of severe symptoms, complications, and underreporting. Discontinuation of corticosteroids constitutes the cornerstone of treatment, resolving symptoms in up to 80% of cases. Although the literature on this topic is scant, isolated cases and limited studies have explored the efficacy of psychotropic medications for symptomatic control and prophylaxis. Pharmacological intervention may be warranted in situations where corticosteroid reduction or withdrawal is not feasible or beneficial for the patient.

The Fabrication of Gold Nanostructures as SERS Substrates for the Detection of Contaminants in Water.

Gold nanostructures (AuNSs) were used to fabricate surface-enhanced Raman spectroscopy (SERS) substrates. These AuNSs were produced using the solid-state dewetting method from thin films. The fragmentation process was studied at 300 °C, with durations of thermal treatment of 1, 3, 6, and 12 h. These SERS substrates were then employed to detect Rhodamine B (RhB) as the model analyte, simulating a contaminant in the water at a concentration of 5 ppm. The morphology of the AuNSs was examined using SEM, which revealed a spheroidal shape that began to coalesce at 12 h. The size of the AuNSs was estimated to range from 22 ± 7 to 24 ± 6 nm, depending on the annealing time. The localized surface plasmon resonance of the AuNSs was determined using absorption spectroscopy, showing a shift as the annealing time increased. The SERS signals of RhB adsorbed on the AuNS substrates were validated by performing a 10 × 10 point map scan over each sample surface (1, 3, 6, and 12 h), and a comparative analysis showed no significant differences in the positions of the bands; however, variations in intensity enhancement ranged from 5 to 123 times at 6 and 1 h, respectively.

In Vitro Evaluation of Anti-Hemolytic and Cytotoxic Effects of Traditional Mexican Medicinal Plant Extracts on Human Erythrocytes and Cell Cultures.

Plant extracts of fifteen plants of ethnomedicinal use in Mexico were analyzed to provide scientific knowledge of their medicinal properties through the evaluation of different biological activities such as anti-hemolytic, antioxidant, and cytotoxic effects in normal cells. Therefore, methanolic extracts were obtained from each of the plants by the Soxhlet extraction. The hemolytic activity in human erythrocytes was evaluated, as was their potential to protect the erythrocyte membrane against the 2,2'-azobis (2-methylpropionamidine) dihydrochloride (AAPH) and 1,1-diphenyl-2-picryl hydrazyl (DPPH) radicals. Finally, the toxicity of the extracts in normal cell cultures of African green monkey kidney cells (Vero) and peripheral blood mononuclear cells (PBMC) was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction method. Most of the extracts showed low hemolytic activity and high anti-hemolytic activity as well as high selectivity indices (SI) and antioxidant effects. Extracts of H. inuloides, J. dioica, and J. spicigera induced cell proliferation of the Vero cells. K. daigremontiana, A. adstringens, S. mexicanum, J. spicigera, L. tridentata, and M. tenuiflora extracts showed PBMC cell proliferation. In the present study, it was observed that the evaluated extracts did not present hemolytic activity, and some presented low toxicity when Vero and PBMC cell cultures were exposed. In conclusion, traditionally used plants possess beneficial health properties, and it is hoped that this study will serve as a basis for understanding the biological effects of traditionally used plants and may complement future studies.

Antiretroviral Therapy and Cardiovascular Risk in People With HIV in the United States-An Updated Analysis.

Background: Several antiretroviral therapy (ART) medications have been associated with increased cardiovascular risk, but less is known about the safety of modern ART. We sought to compare the risk of major adverse cardiac events (MACEs) among different ART regimens. Methods: Using insurance claims databases from 2008 to 2020, we identified adults aged <65 years who newly initiated ART. We compared non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens to protease inhibitors (PI)- and integrase inhibitors (INSTI)-based regimens. We used propensity score-weighted Kaplan-Meier functions to estimate the 6, 12, 18, 24, 36, and 48 months' risk and risk differences (RD) of MACE. Results: Among 37 935 ART initiators (median age, 40 years; 23% female; 26% Medicaid-insured), 45% started INSTI-, 16% PI-, and 39% NNRTI-based regimens. MACE occurred in 418 individuals (1.1%) within 48 months after ART initiation. Compared to NNRTI initiators, the risk of MACE was higher at 12 months (RD, 0.50; 95% CI, 0.14-0.99), 18 months (RD, 0.53; 95% CI, 0.11-1.06), and 24 months (RD, 0.62; 95% CI, 0.04-1.29) for PI initiators, and at 12 (RD, 0.20; 95% CI, 0.03-0.37) and 18 months (RD, 0.31; 95% CI, 0.06-0.54) for INSTI initiators; the precision of estimates was limited for longer duration of follow-up. Conclusions: Among ART initiators, PI-based and INSTI-based regimens were associated with higher short-term risk of MACE compared to NNRTI-based regimens. The pattern of association between INSTIs and PIs with excess risk of MACE was similar.

Standardized intrapulmonary lymph node dissection in lung cancer specimens: A national Colombian analysis.

Objective: In patients with non-small cell lung cancer, lymph node assessment is essential for appropriate staging. The intrapulmonary lymph nodes (IPLNs) should be considered when assigning the N stage but are infrequently evaluated in Colombian centers, resulting in understaging that may hinder optimal treatment. Methods: We conducted a prospective study of IPLN dissection in patients with clinical stage I or II non-small cell lung cancer who underwent surgical resection at 9 institutions in Colombia between 2021 and 2023. IPLN dissection was performed by trained surgeons who collected lymph nodes from fresh specimens after resection and before formalin fixation. Results: One hundred patients were eligible for the analysis. Their mean age was 67 ± 10.9 years, and 76% were women. Most (74%) had adenocarcinoma, 20% had neuroendocrine tumors, and 6% had squamous cell carcinoma. Successful sampling and histopathologic analysis of at least one IPLN station was obtained in 85% of patients, 9% had upstaging due to positive N2 lymph nodes, and 5% had upstaging due to positive N1 lymph nodes. Among the patients with pN0 or pN1 disease, 3.2% (3 out of 91) were upstaged exclusively due to positive IPLNs. Conclusions: Fresh-specimen dissection to collect IPLNs is appropriate and feasible to achieve more accurate pathological staging in Colombian lung cancer patients. In clinical N0 patients, IPLN dissection maximizes selection for adjuvant therapy.

Diffuse pulmonary lymphangiomatosis as a differential diagnosis of anterior mediastinal mass.

Diffuse pulmonary lymphangiomatosis (DLP) is an extremely rare silent disease, characterized by proliferation and thickening of abnormal pulmonary, pleural, and mediastinal soft tissue lymphatic channels. Its clinical presentation is nonspecific symptoms such as cough, dyspnea, and hemoptysis. Tomographic findings for DLP include thickening of the interlobular septa and peribronchovascular interstitium and ground glass opacities. Nevertheless, the anterior mediastinal mass, associated with thickening of interlobular septa and peribronchovascular interstitial, ground glass opacities, pleural effusion, diffuse infiltration of the mediastinum and pleural thickening in a patient with lymphangiomas, DLP should be suspected as a differential diagnosis.

Mass vaccination with reassortment-impaired live H9N2 avian influenza vaccine.

Avian influenza poses a severe threat to poultry production and global food security, prompting the development of vaccination programs in numerous countries. Modified live virus (MLV) vaccines, with their potential for mass application, offer a distinct advantage over existing options. However, concerns surrounding reversion, recombination, and unintended transmission have hindered the progress of MLV development for avian influenza in poultry. To address these concerns, we engineered reassortment-impaired, non-transmissible, safe, immunogenic, and protective MLVs through the rearrangement of internal gene segments and additional modifications to the surface gene segments HA and NA. The unique peptide marker aspartic acid-arginine-proline-alanine-valine-isoleucine-alanine-asparragine (DRPAVIAN) was incorporated into HA, while NA was modified to encode the chicken interleukin-18 (ckIL18) gene (MLV-H9N2-IL). In vitro, the MLV-H9N2 and MLV-H9N2-IL candidates demonstrated stability and virus titers comparable to the wild-type H9N2 strain. In chickens, the MLV-H9N2 and MLV-H9N2-IL candidates did not transmit via direct contact. Co-infection studies with wild-type virus confirmed that the altered HA and NA segments exhibited fitness disadvantages and did not reassort. Vaccinated chickens showed no clinical signs upon vaccination, all seroconverted, and the inclusion of ckIL18 in the MLV-H9N2-IL vaccine enhanced neutralizing antibody production. A significant decrease in viral loads post-challenge underscored the protective effect of the MLVs. The MLV-H9N2-IL vaccine, administered via drinking water, proved immunogenic in chickens in a dose-dependent manner, generating protective levels of neutralizing antibodies upon aggressive homologous virus challenge. In summary, this study lays the groundwork for safe MLVs against avian influenza suitable for mass vaccination efforts.

Modeling the 2014-2015 Vesicular Stomatitis Outbreak in the United States Using an SEIR-SEI Approach.

Vesicular stomatitis (VS) is a vector-borne livestock disease caused by the vesicular stomatitis New Jersey virus (VSNJV). This study presents the first application of an SEIR-SEI compartmental model to analyze VSNJV transmission dynamics. Focusing on the 2014-2015 outbreak in the United States, the model integrates vertebrate hosts and insect vector demographics while accounting for heterogeneous competency within the populations and observation bias in documented disease cases. Key epidemiological parameters were estimated using Bayesian inference and Markov chain Monte Carlo (MCMC) methods, including the force of infection, effective reproduction number (Rt), and incubation periods. The model revealed significant underreporting, with only 10-24% of infections documented, 23% of which presented with clinical symptoms. These findings underscore the importance of including competence and imperfect detection in disease models to depict outbreak dynamics and inform effective control strategies accurately. As a baseline model, this SEIR-SEI implementation is intended to serve as a foundation for future refinements and expansions to improve our understanding of VS dynamics. Enhanced surveillance and targeted interventions are recommended to manage future VS outbreaks.

Cavity-Mediated Enhancement of the Energy Transfer in the Reduced Fenna-Matthews-Olson Complex.

Strong light-matter interaction leads to the formation of hybrid polariton states and can alter the light-harvesting properties of natural photosynthetic systems without modifying their chemical structure. In the present study, we computationally investigate the effect of the resonant cavity on the efficiency and the rate of the population transfer in a quantum system coupled to the cavity and the dissipative environment. The parameters of the model system were chosen to represent the Fenna-Matthews-Olson natural light-harvesting complex reduced to the three essential sites. The dynamics of the total system was propagated using the hierarchical equations of motion. Our results show that the strong light-matter interaction can accelerate the population transfer process compared to the cavity-free case but at the cost of lowering the transfer efficiency. The transition to the strong coupling regime was found to coincide with the degeneracy of polariton eigenvalues. Our findings indicate the potential and the limit of tuning the energy transfer in already efficient natural light-harvesting systems.

A mixed-methods assessment of engagement in wellness programs for patients with prediabetes: Factors associated with referral and participation in lifestyle wellness programs.

Objective: We assessed factors associated with engagement in lifestyle wellness programs for patients with prediabetes. Methods: This mixed-methods study, conducted between March 2018 and April of 2021, combined a retrospective cohort study and semi-structured interviews in a Northern California cohort of patients from a randomized controlled pragmatic clinical trial aged 18-75 with body mass index ≥ 25 and at least one HbA1c between 5.7-6.4 % in the previous 3 months. Patients were assigned to a peer support, enhanced usual care, or control arm. We used generalized linear mixed models to analyze the association between clinical, demographic, and study-related factors and referral to and participation in wellness programs within 12 months. We conducted semi-structured interviews with intervention participants and analyzed them using thematic analysis. We integrated qualitative and quantitative findings using the "following a thread" method. Results: We identified 2,164 eligible patients; 12.8% were referred to a wellness program and 7% attended a wellness program. Patients not exposed to peer support, males, and Asian-American participants had the lowest odds of participation in wellness programs. Qualitative interviews with 30 intervention participants provided contextual information on quantitative findings including the importance of physician referrals and formal recruitment, a need for social support and accountability, and matching patient needs to wellness program descriptions as facilitators of engaging in wellness programs. Conclusion: Given the low percentage of patients with prediabetes referred to and participating in wellness programs, there is a need to develop health system strategies to improve wellness program engagement for patients at-risk for diabetes.