Clinical metagenomics.

Clinical metagenomic next-generation sequencing (mNGS), the comprehensive analysis of microbial and host genetic material (DNA and RNA) in samples from patients, is rapidly moving from research to clinical laboratories. This emerging approach is changing how physicians diagnose and treat infectious disease, with applications spanning a wide range of areas, including antimicrobial resistance, the microbiome, human host gene expression (transcriptomics) and oncology. Here, we focus on the challenges of implementing mNGS in the clinical laboratory and address potential solutions for maximizing its impact on patient care and public health.

Imaginal exposure processing during Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure (COPE) therapy: Examination of linguistic markers of cohesiveness.

Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is an integrated, evidence-based treatment that results in significant reductions in posttraumatic stress disorder (PTSD) and substance use disorder (SUD) severity. Emotional processing theory suggests that successful prolonged exposure-based treatments should result in more cohesive trauma narratives due to better integration and organization of trauma memory into cognitive conceptualizations of fear. Therefore, we hypothesized that language used by patients would become more cohesive over time and increased language cohesion would be related to larger reductions in PTSD and SUD outcomes. Broadly, language cohesion refers to several linguistic devices that help establish and cohere meaning throughout spoken and written discourse (e.g., increased use of transition words like "and," "then," and "but"). This was the first known study to examine changes in language related to both PTSD and SUD severity during COPE treatment. The sample included 28 military veterans with current comorbid PTSD/SUD enrolled in a larger COPE study. A text analysis program, Coh-Metrix, was used to analyze language cohesiveness. No language cohesion variables significantly changed over time. Narrativity levels significantly moderated change in PTSD outcomes, R ß 2 $R_\beta ^2\;$ = 0.11. Adversative connectives significantly moderated change in SUD outcomes, R ß 2 $R_\beta ^2\;$ = 0.26. The findings illuminate potential processes underlying successful COPE treatment. Less use of language conveying a narrative and more use of contrast-indicative words (e.g., but, whereas) was associated with larger reductions in PTSD and SUD outcomes during treatment. These results contribute to the extant literature on associations between trauma exposure, language, and emotional processing.

Numerical prediction of loudness metrics for N-waves and shaped sonic booms in kinematic turbulence.

The effects of a kinematic field of velocity fluctuations on the loudness metrics of two waveforms are examined with a three-dimensional one-way propagation solver. The waveforms consist of an N-wave and a simulated low-boom from NASA's X-59 QueSST aircraft. The kinematic turbulence is generated using a von Kármán composite spectrum, which is dependent on a root mean square (rms) velocity and outer scale of the turbulence. A length scale is proposed to account for the effect of the rms velocity and integral scale on the focusing and defocusing of the sonic boom waveform. The probability density function of the location of the first caustic attains a maximum value when the propagation distance is equal to the proposed length scale. Simulation results indicate that for small values of the nondimensional propagation distance, the standard deviation of the loudness metrics increases linearly. The loudness metrics follow a normal distribution within a given range of the nondimensional propagation distance. Results indicate the potential to parameterize the loudness metric distributions by the rms velocity and integral length scale.

2D beam steerer based on metalens on silicon photonics.

Beam steering with solid-state devices represents the cutting-edge technology for next-generation LiDARs and free-space communication transceivers. Here we demonstrate a platform based on a metalens on a 2D array of switchable silicon microring emitters. This platform enables scalable, efficient, and compact devices that steer in two dimensions using a single wavelength. We show a field of view of 12.4° × 26.8° using an electrical power of less than 83 mW, offering a solution for practical miniature beam steerers.

Communication About Medication by Providers-Adolescent and Young Adult Version: Confirmatory Factor Analyses.

OBJECTIVE: To replicate the factor structure of a patient-report measure of provider communication about key medication prescription information, the Communication about Medication by Providers-Adolescent and Young Adult (CAMP-AYA) Version. We evaluated whether the 15-item, two-factor structure identified previously could be replicated via confirmatory factor analysis, and we also examined fit of unidimensional and bifactor models. Associations of CAMP-AYA Total and Factor Scores with provider satisfaction and select patient and medication characteristics were also examined. METHODS: Participants were 739 AYA (ages 18-25) who completed the CAMP-AYA, a provider satisfaction rating, and provided demographic and medication information. RESULTS: The bifactor model was best fitting (χ2 [75] = 689.60, p < .0001; root mean squared error of approximation = 0.11, 90% CI [0.10, 0.11]; Comparative Fit Index = 0.98; Tucker-Lewis Index = 0.98; Standardized Root Mean Square Residual Index = 0.02). Internal consistency reliabilities for Total and Factor Scores were high (αs > .89) and Total and Factor Scores were associated with provider satisfaction (ps < .001). CAMP-AYA scores varied as a function of type of prescription (short vs. long term; new vs. refill), with higher scores reported in the context of long term (>30-day course) or refilled prescriptions (ps < .007) in most cases. CONCLUSIONS: This study provides additional support for the reliability of the CAMP-AYA as a tool to assess AYA perceptions of provider key information coverage about medication prescriptions.

Analysis of supersonic jet turbulence, fine-scale noise, and shock-associated noise from characteristic, bi-conic, faceted, and fluidic injection nozzles.

Fine-scale mixing noise (FSMN) and broadband shock-associated noise (BBSAN) are the dominant components of supersonic jet noise in the sideline and upstream directions. We use the previously developed statistical FSMN and BBSAN models to compare the noise radiated from three different nozzles, i.e., a method of characteristics nozzle, a bi-conic nozzle, and a faceted nozzle at different operating conditions. A numerical sensitivity analysis is performed using the models by perturbing various model parameters and conditions such as nozzle pressure ratio (NPR), total temperature ratio, area ratio, and boundary layer thickness. We observed that FSMN is most sensitive to NPR and BBSAN is most sensitive to area ratio. We also examine the changes in source statistics and corresponding correlations of the radiated noise using the fluidic injection noise reduction technique. Noise reduction predictions relative to the baseline cases are compared at different operating conditions and similar reduction as the experimental measurements were obtained at over-expanded conditions. Finally, we analyze the noise source locations for both components of jet noise in the sideline direction. The trends predicted in this study increase understanding of the changes in source statistics and radiated noise for different nozzles over a range of operating conditions.

Chip-scale blue light phased array.

Compact beam steering in the visible spectral range is required for a wide range of emerging applications, such as augmented and virtual reality displays, optical traps for quantum information processing, biological sensing, and stimulation. Optical phased arrays (OPAs) can shape and steer light to enable these applications with no moving parts on a compact chip. However, OPA demonstrations have been mainly limited to the near-infrared spectral range due to the fabrication and material challenges imposed by the shorter wavelengths. Here, we demonstrate the first chip-scale phased array operating at blue wavelengths (488 nm) using a high-confinement silicon nitride platform. We use a sparse aperiodic emitter layout to mitigate fabrication constraints at this short wavelength and achieve wide-angle beam steering over a 50° field of view with a full width at half-maximum beam size of 0.17°. Large-scale integration of this platform paves the way for fully reconfigurable chip-scale three-dimensional volumetric light projection across the entire visible range.

Broadband enhancement of thermal radiation.

Broadband thermal radiation sources are critical for various applications including spectroscopy and electricity generation. However, due to the difficulty in simultaneously achieving high absorptivity and low thermal mass these sources are inefficient. We show a platform that enables one to obtain enhanced emission by coupling a thermal emitter to an optical cavity. We experimentally demonstrate broadband enhancement of thermal emission between λ ~2 ̶ 4.2 µm using an inherently poor thermal emitter consisting of tens of nanometers thick SiC film with 10% emissivity (εSiC ~0.1). We measure over twofold enhancement of total emission power over the entire spectral band and threefold enhancement of thermal emission over 3 to 3.4 µm. Our platform has the potential to enable development of ideal blackbody sources operating at substantially lower heating powers.

Longitudinal Barriers to Thiopurine Adherence in Adolescents With Inflammatory Bowel Diseases.

Objectives: Cross-sectionally, more adherence barriers are associated with lower medication adherence. However, little is known about longitudinal associations between adherence barriers and adherence. Among adolescents with inflammatory bowel diseases (IBD), this study examined both (1) how time-varying self-reported adherence barriers affect daily thiopurine adherence and (2) how adherence barriers at baseline affect daily thiopurine adherence over a six-month period. Methods: Eighty-one adolescents 11-18 years old prescribed a once-daily oral IBD maintenance medication participated in a six-month observational study. Adherence barriers were self-reported monthly via the Medication Adherence Measure (MAM): Medication Subscale. Daily adherence estimates were collected via Medication Event Monitoring System (MEMS) Track Caps. Results: Generalized linear mixed modeling indicated that time alone did not significantly predict whether one was more likely to be adherent (p = .602). However, increasing adherence barriers lowered the likelihood that a participant would be adherent on a given day, and the interaction between time and barriers predicted likelihood of adherence on a given day (p < .01). Specifically, when participants reported no adherence barriers at baseline, adherence did not significantly change over time (p = .369). However, when barriers were endorsed, adherence decreased over time (p < .01). Conclusions: Fewer adherence barriers over time predicted greater likelihood of adherence on a given day, which is consistent with previous cross-sectional research. Routine assessment of barriers to adherence over the course of adolescence is critical in addressing suboptimal adherence behavior in youth with IBD.

Psychosocial factors associated with treatment outcomes in women with obesity and major depressive disorder who received behavioral activation for depression.

Behavioral activation is an empirically supported treatment for depression, but much is unknown about factors associated with treatment response. The present study aimed to determine whether baseline levels and subsequent changes in psychosocial factors were associated with improvement in depression in women with comorbid obesity who received behavioral activation treatment for depression and a lifestyle intervention. Multilevel modeling was used to estimate the associations between psychosocial factors and change in depression scores during the first 10 weeks of treatment and associations between changes in psychosocial factors from baseline to 6-month follow-up and change in depression over the same time period. No baseline psychosocial factors were associated with depression improvement during treatment (p = 0.110-0.613). However, greater improvement in hedonic capacity (p = 0.001), environmental reward (p = 0.004), and social impairment (p = 0.012) were associated with greater reductions in depression over 6 months. Findings highlight the differential relationship specific psychosocial factors have with depression treatment outcomes.

Statistical sources for broadband shock-associated noise using the Navier-Stokes equations.

A decomposition of the Navier-Stokes equations is used to identify the equivalent source term for broadband shock-associated noise (BBSAN). An analytical closed-form model to predict BBSAN is developed using an acoustic analogy based on the Navier-Stokes equations. The field-variables are decomposed into the base flow, aerodynamic fluctuations, and acoustic fluctuations. The spectral densities of fluctuating acoustic quantities are obtained by convolving the vector Green's function with the source terms involving the two-point cross-correlation of the aerodynamic quantities. The scaling of the source term with the off-design parameter ß=(|Mj 2-Md 2|)1/2 is compared with experimental results. The base flow is obtained using a Reynolds-averaged Navier-Stokes solution, while the fluctuating statistical quantities are obtained using theoretical and experimental results. This paper identifies the equivalent source of BBSAN based on the scaling analysis and the physical mechanism of shock-associated noise. The identified source term resides within the Navier-Stokes equations without further rearrangement and correlates very highly with BBSAN. Predictions for BBSAN are made at multiple observer angles and nozzle pressure ratios using the identified source term, and these predictions compare favorably with the experimental results. Finally, identification of the source locations in the jet exhaust responsible for BBSAN at different Strouhal numbers is performed.

On-chip thermo-optic tuning of suspended microresonators.

Suspended optical microresonators are promising devices for on-chip photonic applications such as radio-frequency oscillators, optical frequency combs, and sensors. Scaling up these devices demands the capability to tune the optical resonances in an integrated manner. Here, we design and experimentally demonstrate integrated on-chip thermo-optic tuning of suspended microresonators by utilizing suspended wire bridges and microheaters. We demonstrate the ability to tune the resonance of a suspended microresonator in silicon nitride platform by 9.7 GHz using 5.3 mW of heater power. The loaded optical quality factor (QL ~92,000) stays constant throughout the detuning. We demonstrate the efficacy of our approach by completely turning on and off the optical coupling between two evanescently coupled suspended microresonators.

Thermally controlled comb generation and soliton modelocking in microresonators.

We report, to the best of our knowledge, the first demonstration of thermally controlled soliton mode-locked frequency comb generation in microresonators. By controlling the electric current through heaters integrated with silicon nitride microresonators, we demonstrate a systematic and repeatable pathway to single- and multi-soliton mode-locked states without adjusting the pump laser wavelength. Such an approach could greatly simplify the generation of mode-locked frequency combs and facilitate applications such as chip-based dual-comb spectroscopy.

Tunable frequency combs based on dual microring resonators.

In order to achieve efficient parametric frequency comb generation in microresonators, external control of coupling between the cavity and the bus waveguide is necessary. However, for passive monolithically integrated structures, the coupling gap is fixed and cannot be externally controlled, making tuning the coupling inherently challenging. We design a dual-cavity coupled microresonator structure in which tuning one ring resonance frequency induces a change in the overall cavity coupling condition. We demonstrate wide extinction tunability with high efficiency by engineering the ring coupling conditions. Additionally, we note a distinct dispersion tunability resulting from coupling two cavities of slightly different path lengths, and present a new method of modal dispersion engineering. Our fabricated devices consist of two coupled high quality factor silicon nitride microresonators, where the extinction ratio of the resonances can be controlled using integrated microheaters. Using this extinction tunability, we optimize comb generation efficiency as well as provide tunability for avoiding higher-order mode-crossings, known for degrading comb generation. The device is able to provide a 110-fold improvement in the comb generation efficiency. Finally, we demonstrate open eye diagrams using low-noise phase-locked comb lines as a wavelength-division multiplexing channel.

Prediction of symptoms of emotional distress by mood regulation expectancies and affective traits.

Three studies examined negative mood regulation expectancies (NMRE) and affective traits as independent predictors of self-reported symptoms of emotional distress. NMRE represent individuals' beliefs that they can alleviate unpleasant emotional states. Stronger NMRE are associated with more adaptive coping, more positive cognition during negative moods, more effective responses under stress and less emotional distress. Affective traits represent long-term tendencies toward particular affective experiences; they confer risk for specific symptoms of emotional distress. In Study 1, NMRE, trait negative affect (TNA) and trait positive affect (TPA) were all independently associated with depression among students and staff of a German university. In Study 2, in prospective analyses among U.S. college students traits exhibited hypothesised relationships with anxiety and depressive symptoms, and NMRE uniquely predicted anhedonic depression. Study 3 revealed independent prediction of change in symptoms over time by NMRE among U.S. college students, whereas traits were not associated with change in distress, anxiety and depression symptoms. Results suggest independent roles for NMRE and traits in the development of depression and anxiety symptoms and highlight the importance of NMRE as a potential target of therapeutic intervention in the process of symptom change.

A 3-day 'stroke camp' addressed chronic disease self-management elements and perceived stress of survivors of stroke and their caregivers reduced: Survey results from the 14 US camps.

BACKGROUND: Stroke is a leading cause of disability for persons with stroke (PWS). Difficulty coping with long-term stress for PWS and their caregivers (CG) contributes to their poor health. Variations of chronic-disease self-management programs (CDSMPs) have reduced long-term stress in PWS and CGs. CDSMPs include training for decision-making, problem-solving, resource utilization, peer support, developing a patient-provider relationship, and environmental support. OBJECTIVE: This study examined whether a user-designed stroke camp addressed CDSMP domains, used consistent activities, and decreased stress in PWS and CG. METHODS: This open cohort survey study followed STROBE guidelines and assessed stress at four timepoints: 1 week before camp, immediately before camp, immediately after camp, and 1 month after camp. Mixed-model analysis examined changes in stress from the two baseline time points to the two post-camp time points. The research team reviewed documents and survey responses to assess activities described in camp documents and CDSMP domains across camps. POPULATION: PWS and CG who attended a camp in 2019. The PWS sample (n = 40) included50% males, aged 1-41-years post stroke, 60% with ischemic, one-third with aphasia, and 37.5% with moderate-severe impairment. CG sample (n = 24) was 60.8% female, aged 65.5 years, and had 7.4 years CG experience. RESULTS: Stress decreased significantly in PWS (Cohen's d = -0.61) and CGs (Cohen's d = -0.87) from pre- to post-camp. Activities addressing all but one CDSMP domains were evident across camps. CONCLUSIONS: Stroke camp is a novel model that addresses CDSMP domains, which may reduce stress in PWS and CG. Larger, controlled studies are warranted.

Person-environment interactions among residents of Oxford Houses.

The continued struggle of addiction recovery support systems suggest that the paradigm of this field needs to continue its evolution, which has increasingly emphasized environments. Field Theory suggests that the products of individual and environmental characteristics be considered rather than a summation of the two. This study examined such interactions in Oxford Houses, a network of democratic, and self-governed addiction recovery homes. This study examined sobriety in experienced houses (average length of residency > six months) compared to less experienced houses (average length of residency ≤ six months) in relation to individual resident characteristics (age, length of residence in an Oxford House, and referral from the criminal justice system). Using multilevel modeling, findings indicated that older residents living in an experienced Oxford Houses were more likely to remain abstinent over time than those in inexperienced homes. Additionally, for inexperienced houses, residents who had been in the Oxford House for a longer period had a higher the probability of abstinence than those that had been in the house for a shorter period of time. Finally, legal referral was related to a lower probability of one-year abstinence but only for those in experienced homes. These types of person-environment interactions point to the need for more research to better understand how person variables interact with environmental variables in the processes of recovery and adaptation to settings, as well as for treatment professionals' consideration of both person and environment when making recovery home referrals.

Latent structure of working memory and emotion regulation in pediatric ADHD.

Working memory is a key cognitive function that is often implicated in ADHD and may represent an underlying cognitive endophenotype of the disorder. Working memory is related to emotion regulation, which is a common area of impairment in children with ADHD. Given the high rate of comorbid diagnoses with ADHD, children with comorbid internalizing, externalizing, and developmental disorders may present with variable working memory profiles and subsequent emotion regulation deficits. This study aimed to adequately characterize the latent structure of working memory impairments and emotional regulation outcomes in a clinical sample of children ages 6-16 with ADHD. This study also examined the interplay between the identified working memory/emotion regulation patterns, demographic characteristics, and the role of comorbid diagnoses. Results highlighted two distinct, invariant, unrestricted classes of working memory/emotion regulation. Class 1 (Average; 62% of the sample) had significantly lower digit-span scores, and generally persevered emotion regulation functioning per parent/teacher report. Class 2 (Emotionally Dysregulated) had average working memory scores, and elevated emotion regulation problems. The working memory indicators had small correlations with parents (and not teacher) measures of emotion regulation. Finally, latent class membership did not differ by comorbid diagnosis, age, gender, or verbal IQ. Findings elucidate heterogeneity in common domains affected by ADHD and suggest that this heterogeneity may not be due to demographic/comorbidity factors. The role of varying information reports is discussed, and potential assessment and treatment implications are highlighted.

Examining the association between speed-accuracy trade-offs and psychopathy among male offenders in a facial affect recognition task.

Despite a large body of work examining the relationship between facial affect recognition and psychopathy, there is little consensus regarding the nature of emotion processing in such individuals. Although most previous studies have reported an association between psychopathy and some facial affect recognition deficits, results are mixed regarding which specific emotions are related to deficient recognition for these individuals. The current study aims to examine speed-accuracy trade-offs in psychopathy. Participants were 139 incarcerated adult male offenders assessed using the Psychopathy Checklist-Revised. Analyses demonstrated a 3-way interaction between psychopathy, response time, and level of stimulus expression for happiness in which psychopathy mitigated the relationship between response time and level of expression on accuracy. However, the overall pattern of findings does not suggest that speed-accuracy trade-offs are a central component of facial affect recognition in psychopathy. The theoretical implications of current findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Use of the Heterosexist Harassment, Rejection, and Discrimination Scale With Different Sexual Orientation, Gender, and Racial/Ethnic Groups: An Examination of Measurement Invariance.

The Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) is one of the most commonly used measures of sexual orientation-related discrimination, but little is known about its psychometric properties across different sexual orientations, gender, and racial/ethnic groups. A three-factor model was initially obtained, but most studies treat the HHRDS unidimensionally. Therefore, we tested whether the HHRDS exhibited measurement invariance across sexual orientation, gender, and racial/ethnic groups among 792 sexual minority young adults (aged 18-29) who participated in an online study. Across models, the three-factor solution fit better than the one-factor solution. All models achieved configural invariance and most achieved metric invariance; none of the considered models achieved scalar invariance (1-3 items were not equivalent across groups, depending on the comparison). Findings suggest that the HHRDS generally functions equivalently across sexual orientation, gender, and racial/ethnic groups, but some caution in interpreting scores is warranted.