Associations among psychological health problems, intimate-relationship problems, and suicidal ideation among United States Air Force active-duty personnel.

Linkages among psychological health problems, intimate relationship distress, and suicide risk have been widely studied, but less is known about how these factors interact, especially in military populations. With steady increases in suicide rates among active military and post-service members (SMs), it is critical to better understand the relation among known risk factors. The current study addresses this gap by testing a model hypothesizing that the association between intimate-relationship problems and suicidal ideation is mediated by individual mental health symptoms. We tested this model on a sample of 862 active-duty Air Force members in committed relationships. The sample consisted of 35.0% women and 64.8% men, with an average age of 21.9 years and a mean relationship length of 2.8 years. Findings supported the hypothesized statistical mediation model. Results indicated that relationship problems contribute to psychological health problems, which, in turn, are related to suicidal ideation. These findings may help direct suicide intervention and prevention protocols that consider intimate relationship distress as a significant risk factor. Limitations and further implications for policies regarding suicide prevention in the armed forces are discussed.

Zoon balanitis: not a distinct clinicopathological entity?

Zoon balanitis (ZB) was originally described in the 1950s in patients with clinical features resembling erythroplasia of Queyrat, but with histology that demonstrated a plasma cell infiltrate without evidence of dysplasia. Subsequently, ZB has been extensively reported in the literature, reflecting widespread acknowledgement as an established distinct clinicopathological entity. However, its existence as such has been questioned and there have been suggestions in the literature that ZB represents either a non-specific irritant reaction pattern, or a part of the heterogenous clinicopathological complex of male genital lichen sclerosus (MGLSc). In this study, the entire historical literature of published cases of ZB was subject to review, to determine respectively whether clinical or histological features of MGLSc had been present and been overlooked. One hundred and one papers were reviewed. Seventy-five contained images purporting to be of ZB. Images that were deemed to be of inadequate quality or to present uninformative anatomical views were excluded. The images in 66 manuscripts were amenable to scrutiny; 98.5% of these images demonstrated clinical signs of MGLSc, such as adhesions, effacement of the coronal sulcus and the frenulum, tightening of the prepuce, constrictive posthitis, etiolation of the glans, lichenoid inflammation and sclerosis. These findings strongly suggest that ZB occurs in the vast majority of cases as a manifestation of MGLSc and that its recognition as a distinct clinicopathological entity should be questioned, if not discontinued.

Optimal infused CD34+ cell dose in multiple myeloma patients undergoing upfront autologous hematopoietic stem cell transplantation.

Autologous transplantation remains the standard of care for eligible multiple myeloma (MM) patients, yet optimal CD34+ cell dose remains unclear. We conducted a retrospective study on MM patients undergoing upfront transplant between 2005 and 2021 and divided them into low (≤2.5 × 106 cells/kg) and high (>2.5 × 106 cells/kg) CD34+ dose groups. We included 2479 patients, 95 in the low CD34+ group and 2384 in the high CD34+ group. Patients in the low CD34+ group were older (63.2 vs 61.1 years, p = 0.013), more often had R-ISS III (19% vs 9%, p = 0.014), received plerixafor (60% vs 35%, p < 0.001) and transplanted after 2009 (88% vs 80%, p = 0.047). Time to neutrophil and platelet recovery was longer in the low CD34+ group. Median PFS and OS were lower in the low CD34+ group (31.6 vs. 43.6 months, p = 0.011 and 76.4 vs. 108.2 months, p < 0.001, respectively). Evaluation of incrementally higher CD34+ dose did not show significant improvement in survival at thresholds >2.5 × 106 cells/kg. Multivariable analysis affirmed that CD34+ >2.5 × 106 cells/kg was associated with better PFS (HR 0.71, p = 0.008) and OS (0.59, p < 0.001). After propensity score matching, a CD34+ dose >2.5 × 106 cells/kg remained a predictor of better OS (0.42, p < 0.001). In conclusion, CD34+ dose >2.5 × 106 cells/kg was associated with improved survival, without any additional benefit at incrementally higher doses.

Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability.

Importance: The US Department of Veterans Affairs (VA) partners with community organizations (grantees) across the US to provide temporary financial assistance (TFA) to vulnerable veterans through the Supportive Services for Veteran Families (SSVF) program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who have become homeless. Objective: To assess the cost-effectiveness of the SSVF program with TFA vs without TFA as an intervention for veterans who are experiencing housing insecurity. Design, Setting, and Participants: This study used a Markov simulation model to compare cost and housing outcomes in a hypothetical cohort of veterans enrolled in the SSVF program. Enrollees who are homeless receive rapid rehousing services, while those who are at risk of becoming homeless receive homelessness prevention services. Exposure: The SSVF program with TFA for veterans who are experiencing housing insecurity. Main Outcomes and Measures: The effectiveness measure was the incremental cost-effectiveness ratio (ICER) with quality-adjusted life-years (QALYs). The model was parameterized using a combination of inputs taken from published literature and internal VA data. The model had a 2-year time horizon and a 1-day cycle length. In addition, probabilistic sensitivity analyses were conducted using 10 000 Monte Carlo simulations. Results: The base case analyses found that the SSVF program with TFA was more costly ($35 814 vs $32 562) and yielded more QALYs (1.541 vs 1.398) than the SSVF program without TFA. The resulting ICER was $22 676 per QALY, indicating that TFA is the preferred strategy at a willingness-to-pay threshold of $150 000 per QALY. This ICER was $19 114 per QALY for veterans in the rapid rehousing component of the SSVF program and $29 751 per QALY for those in the homelessness prevention component of the SSVF program. At a willingness-to-pay threshold of $150 000 per QALY, probabilistic sensitivity analyses showed that TFA was cost-effective in 8972 of the 10 000 Monte Carlo simulations (89.7%) for rapid rehousing and in 8796 of the 10 000 Monte Carlo simulations (88.0%) for homelessness prevention only. Conclusions and Relevance: This economic evaluation suggests that TFA is a cost-effective approach (ie, yields improved health benefits at a reasonable cost) for addressing housing insecurity for veterans enrolling in the SSVF program. Future research could examine the cost effectiveness of large, nationwide housing interventions such as this one among subpopulations of veterans such as those with certain comorbidities including severe mental illness or substance use disorders, those with chronic diseases, or those experiencing long-term housing instability vs acute loss of housing.

Stoichiometric Lanthanide Compounds with Diglycolamides: A Synthetic Approach toward Understanding Rare-Earth Speciation in Solution.

A fundamental understanding of coordination chemistry across the lanthanide series is essential for explaining the chemical behavior of rare-earth metals in complex liquid-liquid extraction processes. Probing the exact bonding between the extractant and the metal is sometimes done through the synthesis of solid-state compounds that can serve as models for metal speciation in solution. In the case of diglycolamide (DGA), a commonly used neutral diamide extractant, extensive studies identify the stepwise formation of 1:1 [Ln(DGA)(H2O)6]3+, 1:2 [Ln(DGA)2(H2O)3]3+, and 1:3 [Ln(DGA)3]3+ complexes in solution. The crystallographic reports, however, exclusively show a 1:3 [Ln(DGA)3]3+ moiety in the solid state, while the structures of 1:1 and 1:2 complexes are yet to be isolated and comprehensively studied. In this work, we report the synthesis and characterization of three new families of stoichiometric N,N,N',N'-tetramethyldiglycolamide (TMDGA) compounds: [Ln(TMDGA)(H2O)5Cl]Cl2·2H2O, [Ln(TMDGA)2(H2O)3]Cl3·3H2O, and [Ln(TMDGA)3]Cl3·7H2O, where Ln = Nd, Eu, Gd, with Ln:TMDGA ratios of 1:1, 1:2, and 1:3, respectively. The compounds have been analyzed using vibrational spectroscopy (both Raman and FT-IR), as well as variable temperature fluorescence spectroscopy. A spectrophotometric titration of Eu(III) was performed to confirm the presence of the [Eu(TMDGA)n]3+ (n = 1, 2, and 3) species in solution and to compare the individual solid-state emission spectra to their respective analogues in solution.

Genetic and Environmental Patterns Underlying Phenotypic Plasticity in Flowering Time and Plant Height in Sorghum.

Phenotypic plasticity is the property of a genotype to produce different phenotypes under different environmental conditions. Understanding genetic and environmental factors behind phenotypic plasticity helps answer some longstanding biology questions and improve phenotype prediction. In this study, we investigated the phenotypic plasticity of flowering time and plant height with a set of diverse sorghum lines evaluated across 14 natural field environments. An environmental index was identified to quantitatively connect the environments. Reaction norms were then obtained with the identified indices for genetic dissection of phenotypic plasticity and performance prediction. Genome-wide association studies (GWAS) detected different sets of loci for reaction-norm parameters (intercept and slope), including 10 new genomic regions in addition to known maturity (Ma1) and dwarfing genes (Dw1, Dw2, Dw3, Dw4 and qHT7.1). Cross-validations under multiple scenarios showed promising results in predicting diverse germplasm in dynamic environments. Additional experiments conducted at four new environments, including one from a site outside of the geographical region of the initial environments, further validated the predictions. Our findings indicate that identifying the environmental index enriches our understanding of gene-environmental interplay underlying phenotypic plasticity, and that genomic prediction with the environmental dimension facilitates prediction-guided breeding for future environments.

Tibial Tubercle Osteotomies Performed in an Outpatient Setting Have a Low Rate of Early Complications.

Purpose: To characterize the early postoperative complications following outpatient tibial tubercle osteotomy (TTO) to determine its safety in this setting. Methods: Patients undergoing TTO by a single surgeon between July 2017 and August 2022 for patellar instability or patellofemoral chondromalacia and achieving a minimum of 3 months of clinical and radiographic follow-up were evaluated for inclusion. Although an inclusion criterion was a minimum follow-up of 3 months, if evidence of a healed osteotomy was observed sooner, final follow-up was accepted at 2 months. Patient demographics, perioperative risk factors, and incidence of complications were collected retrospectively. Categorical data were analyzed using χ2 and Fisher exact tests. Continuous data were analyzed using 2-tailed t tests and Mann-Whitney U data for parametric and nonparametric data, respectively. Results: A total of 195 knees in 167 patients met inclusion criteria, with a mean age of 24.7 ± 9.2 years and mean follow-up time of 10.9 months (range, 2-69 months). Fifty-one early postoperative complications occurred in 47 (24.1%) knees in 42 (25.1%) patients. Ten major and 41 minor complications occurred. Major complications were associated with older age (P = .015), smoking (P = .038), and smaller preoperative patellar tendon-lateral trochlear ridge distance (P = .012). Forty-four reoperations occurred in 42 (21.5%) knees in 37 (22.2%) patients. The most common reasons for reoperation included removal of symptomatic hardware (31 knees; 15.9%) and arthrofibrosis requiring lysis of adhesions and manipulation under anesthesia (8 knees; 4.1%). The mean time to reoperation was 13.0 months (range, 1-42 months). Smaller body mass index was associated with increased risk of reoperation (P = .002). Conclusions: Outpatient TTO is safe when performed with the described technique, but the later development of minor complications is not infrequent following surgery. Patients should be counseled regarding a relatively high incidence of hardware irritation, arthrofibrosis, and eventual reoperation. Level of Evidence: Level IV, case series.

The impact of single-port robotic surgery: a survey among urology residents and fellows in the United States.

Our aim was to investigate the perception and future expectations of Single-Port (SP) surgery among urology trainees in the United States. A 34-item online survey was distributed to urological residency and fellowship programs across the US, covering demographic profiles, SP training opportunities, perceived educational impact, and future perspectives. Descriptive analysis and multivariable linear regression were used to assess predictors of SP adoption. 201 surveys were completed (28.6% completion rate). Among institutions with an SP platform, about 50% have used it regularly for over 2 years, though often in less than 50% of procedures. While robotic simulators are commonly available, only 17% offer both multi-port and SP simulators, and structured pre-clinical SP training is limited. Approximately 30% of respondents expressed concerns over limited hands-on experience and a steeper learning curve with SP. Around 40% felt that their robotic surgery exposure was negatively impacted by SP's introduction. SP surgery's benefits are seen mostly in the immediate post-operative period and a significant number of respondents foresee a major role for SP in urology. However, proficiency in SP surgery is not seen as crucial for career advancement or job opportunities. Academic job aspirations, SP platform availability, and SP surgery workload are predictors of future SP implementation. Trainees increasingly recognize the clinical benefits of SP procedures but express concerns about the potential negative impact on hands-on experience. Training programs should more systematically integrate SP technology into curricula. There is a correlation between training in high-volume SP centers and future SP adoption.

The economic burden of type 2 diabetes on the public healthcare system in Kenya: a cost of illness study.

BACKGROUND: The burden of chronic non-communicable diseases (NCDs) is a growing public health concern. The availability of cost-of-illness data, particularly public healthcare costs for NCDs, is limited in Sub-Saharan Africa (SSA), yet such data evidence is needed for policy action. OBJECTIVE: The objective of this study was to estimate the economic burden of type 2 diabetes (T2D) on Kenya's public healthcare system in 2021 and project costs for 2045. METHODS: This was a cost-of-illness study using the prevalence-based bottom-up costing approach to estimate the economic burden of T2D in the year 2021. We further conducted projections on the estimated costs for the year 2045. The costs were estimated corresponding to the care, treatment, and management of diabetes and some diabetes complications based on the primary data collected from six healthcare facilities in Nairobi and secondary costing data from previous costing studies in low and middle-income countries (LMICs). The data capture and costing analysis were done in Microsoft Excel 16, and sensitivity analysis was conducted on all the parameters to estimate the cost changes. RESULTS: The total cost of managing T2D for the healthcare system in Kenya was estimated to be US$ 635 million (KES 74,521 million) in 2021. This was an increase of US$ 2 million (KES 197 million) considering the screening costs of undiagnosed T2D in the country. The major cost driver representing 59% of the overall costs was attributed to T2D complications, with nephropathy having the highest estimated costs of care and management (US$ 332 million (KES 36, 457 million). The total cost for T2D was projected to rise to US$ 1.6 billion (KES 177 billion) in 2045. CONCLUSION: This study shows that T2D imposes a huge burden on Kenya's healthcare system. There is a need for government and societal action to develop and implement policies that prevent T2D, and appropriately plan care for those diagnosed with T2D.

Impacts of testing and immunity acquired through vaccination and infection on covid-19 cases in Massachusetts elementary and secondary students.

BACKGROUND: During the 2021-22 academic year, Massachusetts supported several in-school testing programs to facilitate in-person learning. Additionally, COVID-19 vaccines became available to all school-aged children and many were infected with SARS-CoV-2. There are limited studies evaluating the impacts of these testing programs on SARS-CoV-2 cases in elementary and secondary school settings. The aim of this state-wide, retrospective cohort study was to assess the impact of testing programs and immunity on SARS-CoV-2 case rates in elementary and secondary students. METHODS: Community-level vaccination and cumulative incidence rates were combined with data about participation in and results of in-school testing programs (test-to-stay, pooled surveillance testing). School-level impacts of surveillance testing programs on SARS-CoV-2 cases in students were estimated using generalized estimating equations within a target trial emulation approach stratified by school type (elementary/middle/high). Impacts of immunity and vaccination were estimated using random effects linear regression. RESULTS: Here we show that among N = 652,353 students at 2141 schools participating in in-school testing programs, surveillance testing is associated with a small but measurable decrease in in-school positivity rates. During delta, pooled testing positivity rates are higher in communities with higher cumulative incidence of infection. During omicron, when immunity from prior infection became more prevalent, the effect reversed, such that communities with lower burden of infection during the earlier phases of the pandemic had higher infection rates. CONCLUSIONS: Testing programs are an effective strategy for supporting in-person learning. Fluctuating levels of immunity acquired via natural infection or vaccination are a major determinant of SARS-CoV-2 cases in schools.

During the height of the Covid-19 pandemic, multiple strategies were used to enable students to participate in in-person elementary and secondary schools. Little is known about the overall impact of prior immunity and in-person testing programs on the ability to maintain protection from Covid-19 in schools. This study, conducted in Massachusetts during the 2021-2022 academic year, found that community immunity gained through prior infection or vaccination, combined with testing strategies including testing programs to monitor infection and test to-stay modified quarantine programs, were safe and effective for allowing in-person learning. These data can be used to shape policy about in-school practices during future respiratory virus pandemics.

Determinants of under-five mortality in informal settlements in Nairobi, Kenya from 2002 to 2018.

BACKGROUND: Childhood mortality persists as a significant public health challenge in low and middle-income countries and is uneven within countries, with poor communities such as urban informal settlements bearing the highest burden. There is limited literature from urban informal settlements on the risk factors of mortality. We assessed under-five mortality and associated risk factors from the period 2002 to 2018 in Nairobi urban informal settlements. METHODS: We used secondary data from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), a longitudinal surveillance platform that routinely collects individual and household-level data in two informal settlements (Viwandani and Korogocho) in Nairobi, Kenya. We used Kaplan-Meier curves to estimate overall survival and the Cox proportional hazard model with a frailty term to evaluate the impact of risk factors on survival time. RESULTS: Overall under-five survival rate was 96.8% and this improved from 82.6% (2002-2006) to 95% (2007-2012) and 98.4% (2012-2018). There was a reduced risk of mortality among children who had BCG vaccination, those born to a married mother or a mother not engaging in any income-generating activity (both from 2007 to 2011), children from singleton pregnancy, children born in Viwandani slum and ethnicity of the child. CONCLUSION: Under-five mortality is still high in urban informal settlements. Targeted public health interventions such as vaccinations and interventions empowering women such as single mothers, those with multiple pregnancies, and more impoverished slums are needed to further reduce under-five mortality in urban informal settlements.

Neutrophil activation markers can predict rheumatoid arthritis treatment response to the Janus Kinase 1/2 inhibitor baricitinib.

OBJECTIVES: Neutrophils play an important role in regulating immune and inflammatory responses in rheumatoid arthritis (RA). We assessed whether baricitinib, a JAK1/JAK2 inhibitor, could reduce neutrophil activation, and whether a neutrophil activation score could predict treatment response. METHODS: Markers of neutrophil activation, calprotectin, and neutrophil extracellular traps (NETs) were analyzed using ELISA in RA plasma (n=271) and healthy controls (n=39). For RA patients, neutrophil activation markers were measured at baseline, 12 weeks, and 24 weeks after treatment with placebo, 2 mg, and 4 mg baricitinib. Whole blood RNA analyses from multiple randomized baricitinib RA trials were performed to study neutrophil-related transcripts (n=1651). RESULTS: Baseline levels of plasma neutrophil markers were elevated in RA patients compared to healthy controls (p<0.001). Baricitinib reduced levels of soluble calprotectin at 12 and 24 weeks, especially in RA patients responding to treatment, as determined by ACR20. Whole blood RNA analysis revealed similar changes in the predominant neutrophil markers calprotectin and FcαRI upon treatment with baricitinib in three randomized clinical trials involving RA patients at various stages of disease modifying therapy. Clustering analysis of plasma activation markers showed elevated levels of calprotectin and NETs, e.g., a neutrophil activation score, at baseline, could predict treatment response to baricitinib. In contrast, CRP levels could not distinguish between responders and non-responders. CONCLUSIONS: Neutrophil activation markers may add clinical value in predicting treatment response to baricitinib and other drugs targeting RA. This study supports personalized medicine, in treating RA patients, not only based on symptoms, but also based on immunophenotyping.

Pushing Scuba to New Heights: Approach, Decompression, and Logistical Considerations for High-Altitude Diving.

There is interest among technical, expedition, commercial, and military divers in expanding diving operations to high altitude. However, altitude diving presents unique challenges including acclimatization, increased decompression sickness (DCS) risk, and logistical and equipment considerations. Divers must plan altitude acclimatization strategies conservatively to reduce risk of acute mountain sickness and dehydration before diving. Several methods of augmenting sea level diving tables to be used at altitude have been theorized and tested both in simulated dives and high-altitude expeditions. With proper acclimatization, augmentation of standard diving tables, equipment, and safety planning, diving at high altitude may be performed in many contexts safely while minimizing risk of DCS or injury.

Psychosocial outcomes after adolescent metabolic and bariatric surgery: a narrative review of the literature.

The prevalence of severe obesity among adolescents continues to be a significant global concern. Metabolic and bariatric surgery (MBS) has increasingly shown to produce safe, efficacious, and durable effects on weight loss and related physical health complications, and evidence of psychosocial outcomes are beginning to mature. The revised American Society for Metabolic and Bariatric Surgery pediatric guidelines published in 2018 reported emergent data regarding key psychosocial outcomes, including mental health, disordered eating, and quality of life, although data were limited by small, short-term studies and often without comparison groups. The purpose of this narrative review was to expand the relevant findings regarding youth with severe obesity who receive MBS to further clarify the impact of surgery on psychosocial outcomes.

Neurointerventional payment for out-of-network mechanical thrombectomy in the era of the No Surprises Act.

BACKGROUND: Congress enacted the No Surprises Act (NSA) in 2021. The NSA relies on the ability for providers to appeal their out-of-network (OON) payment through an arbitration process known as Independent Dispute Resolution (IDR). This study was designed to evaluate the effective access to IDR for mechanical thrombectomy (MT). METHODS: This study uses a simulation to model the likelihood that neurointerventionalists have financially viable access to the NSA IDR process to seek adequate payment for MT OON claims. RESULTS: When evaluating professional claims, for only batches of four or more claims, would the expected payment recovery exceed the expected IDR costs. For global claims (both professional and technical components), a batch size of two claims would be required for the expected payment recovery to exceed expected IDR costs.For the 1000 simulations at large MT centers (300 MT annually), there were no instances where it would have been financially viable to submit professional-only OON claims to the IDR process. For global claims, it would have been financially viable to submit to IDR for only 13.2% of these claims. For smaller stroke centers, there were also no instances where it would have been financially viable to submit professional-only claims. For global claims, it would have been financially viable for only 3.3-6.1% of claims. CONCLUSIONS: The NSA process was designed to protect patients from unexpected bills following non-elective medical services. Given the emergent nature of many neuroendovascular cases and the lack of access to the IDR process as this model illustrates, the field is at risk for under-reimbursement due to NSA legislation.

Adolescents and Social Media: Longitudinal Links Between Motivations for Using Social Media and Subsequent Internalizing Symptoms.

Knowledge is lacking on whether adolescents' motivations for social media use predict internalizing symptoms, and few studies have considered the moderating role of extraversion. In 2017 (T1) and 2018 (T2), 197 adolescents (49.70% girls, Mage = 13.15, SD = 0.36) from a large metropolitan area participated in this study. Adolescents reported on their social media use motivations and extraversion (at T1) and depressive and anxiety symptoms (T1 and T2). Latent class analysis revealed four motivation profiles at T1: (1) entertainment and fun (30.97%); (2) avoidance and escapism (14.21%); (3) meeting new people, feel involved (16.75%); (4) boredom (38.07%). Social motivations (profile 3) predicted elevated internalizing symptoms at T2. Avoidance and boredom motivations (profile 2 and 4) predicted internalizing symptoms for adolescents with low extraversion. Social media use motivations and extraversion distinguish adolescents who benefit from social media from those who experience difficulties.

Optimization of testing protocols to screen for COVID-19: a multi-objective model.

In this paper we develop a new multi-objective simulated annealing (MOSA) algorithm to generate optimal testing protocols for infectious diseases, using the COVID-19 pandemic as our context. A SEIR (susceptible-exposed-infected-recovered) epidemiological model is embedded as the computational platform for our MOSA algorithm to optimize testing protocols for screening across three joint objectives: minimum cost of test materials, minimum total infections over the testing horizon, and minimum number of false negatives over the horizon. We demonstrate the application of this optimization tool to recommend screening protocols for K-12 school districts in the U.S. State of North Carolina. Our approach is scalable by population coverage and can be employed at the level of individual school districts or regional collections of districts, individual schools or collections of schools across a district, business sites, or nursing homes, among other congregate settings where individuals may be screened prior to gaining entry to the site. The algorithm can be solved two ways, generating either independent optimal protocols across individual testing locations, or a common protocol covering all locations in the collection of testing sites. Our findings can be used to inform policy decisions to guide the development of effective testing strategies for controlling the spread of COVID-19 or other pandemic diseases in a wide range of congregate settings across various geographic regions.

ToF-SIMS Investigation of Environmental Effects on Analyte Migration in Matrix Coatings for Mass Spectrometry Imaging Using a Newly Developed Vapor Deposition System.

High resolution mass spectrometry images are of increasing importance in biological applications, such as the study of tissues and single cells. Two promising techniques for this are matrix-enhanced secondary ion mass spectrometry (ME-SIMS) and matrix-assisted laser desorption/ionization (MALDI). For both techniques, the sample of interest must be coated with a matrix prior to analysis, and analytes must migrate into the matrix. The mechanisms involved in this migration and the factors that influence the migration are poorly understood, which lead to difficulties with reproducibility. In this work, a sublimation matrix coater with an effusion cell and sample cooling was developed and built in-house for controlled physical vapor deposition. In this system, sample transfer between the coater and mass spectrometer is possible without breaking vacuum, which facilitates the study of environmental influences on analyte migration. The influence of exposure to ambient air on the migration of two analytes (a lipid and a peptide), which were coated with the matrix α-cyano-4-hydroxycinnamic acid (CHCA), was studied using 3D-SIMS imaging. Although the distribution of analyte in the matrix changed very little after 21 h of storage in vacuum, significant redistribution of the analyte was observed after exposure to ambient air. The magnitude of the effect was greater for the lipid than for the peptide. Further work is needed to determine the role of humidity in the redistribution process and the impact of analyte redistribution on MALDI measurements.