Screening, Brief Intervention and Referral to Treatment (SBIRT): An examination of health disparities.

Risky substance use can lead to a variety of negative health outcomes, yet treatment is often underutilized by historically minoritized racial/ethnic groups. Screening, Brief Intervention and Referral to Treatment (SBIRT) is effective in changing substance use patterns across diverse settings and for diverse demographic groups. However, few studies have focused on whether individuals receive the appropriate level of care based on screening criteria. The purpose of this study was to investigate intervention match/mismatch and factors (e.g., service site, gender, race, ethnicity, age, socio-economic status) that predicted the likelihood of being matched/mismatched to an intervention. A sample of N = 3412 were available for analyses and logistic regressions were performed to examine the relationship between matching/mismatching to an intervention and other factors. Of participants, 2222 (65%) were matched to an intervention and 1190 (35%) were mismatched to an intervention. Being older, Hispanic, and receiving SBIRT by health-teams designed to reduce health disparities was related to increased odds of being mismatched. Exploratory results suggested that across predictors, individuals were more likely to receive a lesser intervention than their screening score indicated. Most clients were matched well to intervention as based on screening score. When mismatch occurred, a lower level of care was given. Staff may benefit from attending to more client engagement so that clients return for more intensive interventions; and agencies may need more resources to facilitate client access to services.

Induced Production of Atypical Naturally Nonpreferred Metal-Organic Frameworks and Their Detachment via Provoking Post-Mismatching.

The structures of metal-organic frameworks (MOFs) are typically determined by the building blocks that compose them and the conditions under which they are formed. MOFs tend to adopt a thermodynamically and/or kinetically stable structure (naturally preferred form). Thus, constructing MOFs with naturally nonpreferred structures is a challenging task, as it requires avoiding the easier pathway toward a naturally preferred MOF. Herein, an approach to construct naturally nonpreferred dicarboxylate-linked MOFs employing reaction templates is reported. This strategy relies on the registry between the surface of the template and the cell lattice of a target MOF, which reduces the effort required to form naturally nonpreferred MOFs. Reactions of p-block trivalent metal ions (Ga3+ and In3+ ) with dicarboxylic acids typically produce preferred MIL-53 or MIL-68. However, the surface of UiO-67 (and UiO-66) template exhibits the well-defined hexagonal lattice, which induce the selective formation of a naturally nonpreferred MIL-88 structure. Inductively grown MIL-88s are purely isolated from the template via provoking a post-mismatch in their lattices and weakening the interfacial interaction between product and template. It is also discovered that an appropriate template for effective induced production of naturally nonpreferred MOFs shall be properly selected based on the cell lattice of a target MOF.

Better soon than never: climate change induces strong phenological reassembly in the flowering of a Mediterranean shrub community.

● Flowering is a key process in the life cycle of a plant. Climate change is shifting flowering phenologies in the Northern Hemisphere, but studies with long data series at community level are scarce, and even more so those regarding the consequences of phenological changes for emerging ecological interactions. In the Mediterranean region, the effects of climate change are stronger than the global average and there is an urgent need to understand how biodiversity will be affected in this area. ● In this study we investigated how the entire flowering phenology of a community comprising 51 perennial species from the south of the Iberian Peninsula changed from the decade of the 1980s to the 2020s. Furthermore, we have analysed the consequences of these changes for flowering order and co-flowering patterns. ● We have found that the flowering phenology of the community has advanced by about 20 days, and was coherent with the increasing temperatures related to climate change. Individual species have generally advanced their entire flowering phenology (start and end) and increased their flowering duration. The early flowering has resulted in a re-organisation of the flowering order of the community and generated a new co-flowering assemblages of species, with a slight trend towards an increase of shared flowering time among species. ● The advanced flowering phenology and changes on flower duration reported here were of unprecedented magnitude, showcasing the extreme effects of climate change on Mediterranean ecosystems. Furthermore, the effects were not similar among species, which could be attributed to differences in sensitivities of environmental cues for flowering. One consequence of these changes in flowering times is the ecological mismatches indicated by the changes in flower order and co-flowering between decades. The novel scenario may lead to new competition or facilitation interactions and to the loss or gain of pollinators.

Pigeons learn two matching tasks, two nonmatching tasks, or one of each.

When pigeons learn matching-to-sample or nonmatching-to-sample there is good evidence that they can transfer that learning to novel stimuli. But early evidence suggests that in the rate of task acquisition, there is no benefit from a matching relation between the sample and the correct or incorrect comparison stimulus. In the present research we trained three groups of pigeons, each on two two-stimulus tasks simultaneously, matching-matching, nonmatching-nonmatching, or matching-nonmatching. If a common matching or nonmatching relationship benefits acquisition, the first two groups should acquire their tasks faster than the third group, for which the two tasks ought to be incompatible. The results indicated that all three groups acquired their tasks at about the same rate. A secondary goal of the experiment was to determine the basis of learning for the each of the three groups. During testing, for each task, there were test trials in which one of the stimuli from the other task replaced either the correct or the incorrect comparison stimulus. Surprisingly, neither comparison stimulus appeared to show complete control over comparison choice. Although replacing either comparison stimulus resulted in a decrement in task accuracy from about 90% to 70% correct, independent of which comparison stimulus was replaced, the pigeons chose correctly at well above chance accuracy. Suggestions to explain this unexpected outcome are discussed.

Near-Field Radiative Heat Transfer Modulation with an Ultrahigh Dynamic Range through Mode Mismatching.

Modulating near-field radiative heat transfer (NFRHT) with a high dynamic range is challenging in nanoscale thermal science and engineering. Modulation depths [(maximum value - minimum value)/(maximum value + minimum value) × 100%] of ≈2% to ≈15.7% have been reported with matched modes, but breaking the constraint of mode matching theoretically allows for higher modulation depth. We demonstrate a modulation depth of ≈32.2% by a pair of graphene-covered SU8 heterostructures at a gap distance of ≈80 nm. Dissimilar Fermi levels tuned by bias voltages enable mismatched surface plasmon polaritons which improves the modulation. The modulation depth when switching from a matched mode to a mismatched mode is ≈4.4-fold compared to that when switching between matched modes. This work shows the importance of symmetry in polariton-mediated NFRHT and represents the largest modulation depth to date in a two-body system with fixed gap distance and temperature.

Pollinator Community Predicts Trait Matching between Oil-Producing Flowers and a Guild of Oil-Collecting Bees.

AbstractThe impact of pollinator community diversity on trait matching in plant-pollinator interactions is poorly studied, even though many mutualisms involve multiple interaction partners. We studied 10 communities in which one to three species of oil-collecting Rediviva bees pollinate the long-spurred, oil-producing flowers of Diascia "floribunda" to examine how pollinator diversity affects covariation of functional traits across sites and trait matching within sites. Floral spur length was significantly correlated with weighted grand mean foreleg length of the local bee community but not with foreleg length of individual bee species. The closeness of trait matching varied among populations and was inversely related to pollinator community diversity. For all bee species, trait matching was closest at sites characterized by exclusive pairwise interactions. Reduced trait matching associated with increased community diversity for individual pollinator species but close matching at the community level supports the importance of community context for shaping interacting traits of flowers and pollinators.

Does HLA matching matter in the modern era of renal transplantation?

Children with end-stage kidney disease should be offered the best chance for future survival which ideally would be a well-matched pre-emptive kidney transplant. Paediatric and adult practice varies around the world depending on geography, transplant allocation schemes and different emphases on living (versus deceased) donor renal transplantation. Internationally, paediatric patients often have priority in allocation schemes and younger donors are preferentially allocated to paediatric recipients. HLA matching can be difficult and may result in longer waiting times. Additionally, with improved surgical techniques and modern immunosuppressive regimens, how important is the contribution of HLA matching to graft longevity? In this review, we discuss the relative importance of HLA matching compared with donor quality; and long-term patient outcomes including re-transplantation rates. We share empirical evidence that will be useful for clinicians and families to make decisions about best donor options. We discuss why living donation still provides the best allograft survival outcomes and what to do in the scenario of a highly mismatched living donor.

Prevalence and impact of HLA and MICA allele mismatching on donor-specific antibodies induction in kidney transplant rejection.

AIM: Donor-recipient antigen mismatching for anti-human leucocyte antigen (HLA) and MICA is one of the risk factors for antibody induction leading to graft rejection. Our aim was to analyze the incidence and specificity of the different DSAs developing and to investigate the impact of HLA and MICA allele mismatches on antibody production in kidney transplant patients experiencing antibody-mediated rejection (AMR). METHODS: We retrospectively reviewed 253 consecutive recipients of kidney transplant who were diagnosed as experiencing AMR. RESULTS: Our results showed that around 27% of our patients were positive for DSAs over a median follow-up period of 24 months. Antibody to HLA-DQ7 was the most prevalent DSA detected. The allele mismatch number was significantly lower for DQ loci than -A and -B loci (DQ vs. A, p < .001; DQ vs. B, p = .002). Considering each HLA antigen, the incidence rate of DQ-DSA [41.9 (32.92-51.46; 95%CI)] was much higher than the rate observed for DSA directed to -A, -DR and -B loci. Half of the recipients in the DQ-DSA-only group, and the DQ-DSA together with non-DQ group, had MFI > 5000. Only one case developed de novo MICA-DSA (MICA002). CONCLUSION: Our study indicates that mismatching for HLA and MICA alleles leads to the development of HLA and MICA antibodies in some kidney transplant recipients. We have also demonstrated that DSA to the DQ locus is the most prevalent in kidney transplant patients with AMR. Thus, matching the DQ locus in kidney allocation algorithms may reduce post-transplant development of DSA.

Community Assembly and Climate Mismatch in Late Quaternary Eastern North American Pollen Assemblages.

Plant community response to climate change ranges from synchronous tracking to strong mismatch. Explaining this variation in climate change response is critical for accurate global change modeling. Here we quantify how closely assemblages track changes in climate (match/mismatch) and how broadly climate niches are spread within assemblages (narrow/broad ecological tolerance, or "filtering") using data for the past 21,000 years for 531 eastern North American fossil pollen assemblages. Although climate matching has been strong over the last 21 millennia, mismatch increased in 30% of assemblages during the rapid climate shifts between 14.5 and 10 ka. Assemblage matching rebounded toward the present day in 10%-20% of assemblages. Climate-assemblage mismatch was greater in tree-dominated and high-latitude assemblages, consistent with persisting populations, slower dispersal rates, and glacial retreat. In contrast, climate matching was greater for assemblages comprising taxa with higher median seed mass. More than half of the assemblages were climatically filtered at any given time, with peak filtering occurring at 8.5 ka for nearly 80% of assemblages. Thus, vegetation assemblages have highly variable rates of climate mismatch and filtering over millennial scales. These climate responses can be partially predicted by species' traits and life histories. These findings help constrain predictions for plant community response to contemporary climate change.

Color Sensor Accuracy Index Utilizing Metamer Mismatch Radii.

A novel method is described for evaluating the colorimetric accuracy of digital color cameras based on a new measure of the metamer mismatch body (MMB) that is induced by the change from the camera as an 'observer' to the human standard observer. In comparison to the majority of existing methods for evaluating colorimetric accuracy, the advantage of using the MMB is that it is based on the theory of metamer mismatching and, therefore, shows how much color error can arise in principle. A new measure of colorimetric accuracy based on the shape of the camera-induced MMB is proposed and tested. MMB shape is measured in terms of the moments of inertia of the MMB treated as a mass of uniform density. Since colorimetric accuracy is independent of any linear transformation of the sensor space, the MMB measure needs to be as well. Normalization by the moments of inertia of the object color solid is introduced to provide this independence.

Epitope load identifies kidney transplant recipients at risk of allosensitization following minimization of immunosuppression.

Human leukocyte antigen (HLA) mismatching and minimization of immunosuppression are two major risk factors for the development of de novo donor-specific antibodies, which are associated with reduced kidney graft survival. Antibodies do not recognize whole HLA antigens but rather individual epitopes, which are short sequences of amino acids in accessible positions. However, compatibility is still assessed by the simple count of mismatched HLA antigens. We hypothesized that the number of mismatched epitopes, or ("epitope load") would identify patients at the highest risk of developing donor specific antibodies following minimization of immunosuppression. We determined epitope load in 89 clinical trial participants who converted from cyclosporine to everolimus 3 months after kidney transplantation. Twenty-nine participants (32.6%) developed de novo donor specific antibodies. Compared to the number of HLA mismatches, epitope load was more strongly associated with the development of donor specific antibodies. Participants with an epitope load greater than 27 had a 12-fold relative risk of developing donor-specific antibodies compared to those with an epitope load below that threshold. Using that threshold, epitope load would have missed only one participant who subsequently developed donor specific antibodies, compared to 8 missed cases based on a 6-antigen mismatch. DQ7 was the most frequent antigenic target of donor specific antibodies in our population, and some DQ7 epitopes appeared to be more frequently involved than others. Assessing epitope load before minimizing immunosuppression may be a more efficient tool to identify patients at the highest risk of allosensitization.

Fetal heart examination at the time of 13 weeks scan: a 5 years' prospective study.

Objective To evaluate our ability in classifying the fetal heart as normal or abnormal during the 1st trimester scan through fetal cardiac examination and determining the best time for this examination. Methods This was a prospective study performed on 3240 pregnant women to examine the fetal heart. Four chambers view and ventricular outflow tracts were mainly examined during the scan. We used grayscale and color mapping in the diagnosis. Color Doppler was used if additional information was needed, and all patients were rescanned during the 2nd trimester to confirm or negate our diagnosis. Results The cardiac findings were normal at both scans in 3108 pregnancies. The same cardiac abnormality was detected at both scans in 79 cases. In 36 cases there was false-positive diagnosis at the early scan; in 20 of these cases, there were mildly abnormal functional findings early in pregnancy with no abnormality found later. In 17 fetuses, there was discordance between the early and later diagnosis due to missed or incorrect diagnoses. The best time to do fetal heart examination during 1st trimester is between 13 and 13 + 6 weeks. Conclusion A high degree of accuracy in the identification of congenital heart disease (CHD) can be achieved by a 1st trimester fetal echocardiography.

Reproductive performance in generalist haematophagous ectoparasites: maternal environment, rearing conditions or both?

We tested whether and how the maternal environment (i.e. host species exploited by a mother), rearing conditions (i.e. host species exploited by her offspring) or both (i.e. matches and mismatches in host species exploited by a mother and her offspring) affect reproductive performance in the offspring. We experimentally manipulated maternal and rearing environments in two generalist fleas (Xenopsylla conformis and Xenopsylla ramesis) implementing a factorial cross-rearing design. Mothers exploited either the principal host (PH) or auxiliary hosts that were either closely (CAH) or distantly related (DAH) to the PH. After six generations of infesting a given host species, we cross-reared fleas within and between host species. These fleas reproduced and we measured their reproductive performance both quantitatively (i.e. egg number) and qualitatively (i.e. egg size, development time, body size of the next generation). We found that identity of the host a flea was reared on (=actual host) had the strongest effect on its performance. Individuals reared on the PH performed considerably better than those reared on either auxiliary host. Moreover, fleas reared on a CAH performed better than those reared on a DAH. Actual host identity also had a stronger effect on reproductive performance in X. ramesis than in X. conformis. Nevertheless, there was no difference in performance between match and mismatch maternal and actual host identities. We conclude that rearing environment has the strongest effect on fitness in generalist parasites. Moreover, phylogenetic distance between an auxiliary host and the PH determines the level of suitability of the former.

Early Fever after Haploidentical Bone Marrow Transplantation Correlates with Class II HLA-Mismatching and Myeloablation but Not Outcomes.

Noninfectious fevers are common early after T cell-replete HLA haploidentical (haplo) peripheral blood transplants and have been associated with cytokine release syndrome and overall mortality. However, less is known regarding the incidence and associations of early fever after bone marrow transplantation (BMT) with post-transplant cyclophosphamide (PTCy). We hypothesized that early fever would be associated with myeloablative conditioning (MAC), because of its relative increase in tissue damage augmenting antigen presentation and class II HLA-mismatching because of recognition of antigen-presenting cells by CD4+ T cells. In 672 recipients of MAC HLA-matched related donor (MRD) (n = 183), MAC HLA-matched unrelated donor (MUD) (n = 115), MAC haplo (n = 79), or nonmyeloablative (NMA) haplo (n = 295) T cell-replete BMT with PTCy, we retrospectively analyzed early noninfectious fever defined as temperature of ≥38.3°C once or ≥38.0°C twice or more on days 1 to 6. Fever occurred in 13% after MAC MRD, 23% after MAC MUD, 44% after NMA haplo, and 84% after MAC haplo BMT (P < .0001). Survival outcomes did not differ between patients with and without early fever. In NMA haplo BMT, mismatch in the graft-versus-host direction at HLA-DRB1 or -DPB1 (but not HLA-A, -B, -Cw, or -DQB1) was associated with early fever compared with no mismatches at these loci (P < .0001 and P = .02, respectively). In multivariable modeling, -DRB1 or -DPB1 mismatch and higher CD3+ graft cell dose were significantly associated with early fever. Early fever is more common after haplo compared with HLA-matched BMT. Fever is associated with myeloablation, -DRB1 or -DPB1 mismatching, and higher CD3+ graft cell dose but not survival.

Sameness May Be a Natural Concept That Does Not Require Learning.

It has been assumed that when pigeons learn how to match to sample, they learn simple stimulus-response chains but not the concept of sameness. However, transfer to novel stimuli has been influenced by pigeons' tendency to be neophobic. We trained pigeons on matching ( n = 7) and mismatching ( n = 8) with colors as samples and, with each sample, one color as the nonmatching comparison. We then replaced either the matching or the nonmatching stimulus with a familiar stimulus never presented with that sample. Results suggest that for both matching and mismatching, pigeons locate the stimulus that matches the sample: If the task involves matching, they chose it; if it involves mismatching, they avoid it. Thus, the concept of sameness is the basis for correct choice with both tasks. This finding suggests that sameness is a basic concept that does not have to be learned and may have evolved in many species, including humans.

Myocardial Mass Contributes to the Discrepancy Between Anatomic Stenosis Severity Assessed by Intravascular Ultrasound and Fractional Flow Reserve in Intermediate Lesions of the Coronary Artery.

OBJECTIVES: The present study investigated the major contributors to the discrepancy between the minimal lumen area (MLA) and fractional flow reserve (FFR). BACKGROUND: There was considerable discrepancy between MLA or diameter stenosis (DS) and FFR. METHODS: We enrolled 744 patients with intermediate stenoses of the left anterior descending artery (LAD). Summed epicardial coronary artery length distal to the target stenosis was obtained from each longest view of the vessels on the coronary angiograms. Mismatching was defined as a lesion with FFR of >0.80 and MLA smaller than the best cut-off value (BCV) for predicting FFR of ≤0.80. Reverse mismatching was defined as a lesion with FFR of ≤0.80 and MLA larger than the BCV. RESULTS: Summed epicardial coronary artery length was longer at the lesions of proximal LAD than that of middle LAD (380 mm ± 82 mm vs. 341 mm ± 80 mm, P < 0.001). Reverse mismatching was found more frequently in the proximal than middle LAD (28.3% vs. 5.5%, P < 0.001). Independent predictors of FFR ≤ 0.80 were age, male, multi-vessel disease, proximal LAD lesion, MLA, DS, plaque burden at distal reference, lesion length and summed epicardial coronary artery length. Proximal LAD lesion was an independent predictor of reverse mismatching (hazard ratio 3.162, 1.858-5.382, P < 0.001). CONCLUSIONS: Myocardial mass subtended by a lesion is an important factor predicting FFR ≤0.80 and discrepancy between FFR and MLA. Myocardial mass subtended by a lesion should be considered when determining the revascularization therapy by intravascular ultrasound parameters. © 2017 Wiley Periodicals, Inc.

Adaptive Feedforward Compensating Self-Sensing Method for Active Flutter Suppression.

A single piezoelectric patch can be used as both a sensor and an actuator by means of the self-sensing piezoelectric actuator, and the function of self-sensing shows several advantages in many application fields. However, some problems exist in practical application. First, a capacitance bridge circuit is set up to realize the function of self-sensing, but the precise matching of the capacitance of the bridge circuit is hard to obtain due to the standardization of electric components and variations of environmental conditions. Second, a local strain is induced by the self-sensing actuator that is not related to the global vibration of the structure, which would affect the performance of applications, especially in active vibration control. The above problems can be tackled by the feedforward compensation method that is proposed in this paper. A configured piezoelectric self-sensing circuit is improved by a feedforward compensation tunnel, and a gain of compensation voltage is adjusted by the time domain and frequency domain's steepest descent algorithms to alleviate the capacitance mismatching and local strain problems. The effectiveness of the method is verified in the experiment of the active vibration control in a wind tunnel, and the control performance of compensated self-sensing actuation is compared to the performance with capacitance mismatching and local strain. It is found that the above problems have negative effects on the stability and performance of the vibration control and can be significantly eliminated by the proposed method.

Donor selection in pediatric kidney transplantation using DR and DQ eplet mismatching: A new histocompatibility paradigm.

It is now appreciated that more HLA-DR mismatching at the time of the first renal transplant is associated with higher degrees of sensitization, lower rates and longer times to retransplantation, and worse graft outcomes in children who are subsequently retransplanted. As such, our pediatric renal transplant program preferentially uses 0 or 1 HLA-DR-mismatched kidneys and reserves 2 DR-mismatched kidneys for recipients with an eminent need for a kidney. Based on a new HLA class II epitope matching strategy that is designed to minimize dnDSA production to DR and DQ antigens, we evaluated the prevalence of DR and DQ eplet mismatching for dd offers made to our pediatric wait-listed candidates. Each candidate/dd pair were HLA-DR (ß1 and ß3 and/or ß5) and DQ (α1 and ß1) allele typed by rSSO and were then evaluated for eplet mismatches by the HLAMatchmaker program. We evaluated 78 offers made to 16 children on our UNOS waiting list from 27 consecutive dd from 4/14/14 to 3/23/15. The data show that 40% (8/20) of the 1 DR-mismatched dd offers and 64% (37/58) of the 2 DR-mismatched offers were in the high-risk category for both DR and DQ dnDSA development. Whereas only 15% (3/20) of the 1 DR-mismatched offers and 5% (3/58) of the 2 DR-mismatched offers were in the low-risk category for both DR and DQ dnDSA development, 55% and 33% of the 1 DR- and 2 DR-mismatched offers, respectively, had a favorable DQ eplet mismatch threshold. In summary, HLA class II eplet mismatching is common in potential pediatric transplant recipient/donor pairs. Additional study will be necessary to validate the DR and DQ eplet threshold levels in children and to determine whether eplet mismatching strategies in donor selection result in improved transplant outcome and decreased dnDSA production.

A Mutagenic Primer Assay for Genotyping of the CRHR1 Gene Rare Variant rs1876828 (A/G) in Asians: A Cost-Effective SNP Typing.

BACKGROUND: Today, the genetic and genomic research entered in a new era of high-throughput genotyping technology. However, mutagenic polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) is still a choice of genotyping method in molecular epidemiological research. It has been extensively used for the detection of risk alleles, if the target SNP has no natural discriminating restriction site. We undertook this study to develop a mutagenic primer assay for a CRHR1 rare gene variant: rs1876828 (A/G) and to determine their allele frequency in north Indian children. METHODS: The mutagenic primers were designed and assay conditions were optimized to perform mutagenic PCR-RFLP in 550 subjects. The efficiency of assay and results were validated by sequencing. RESULTS: This study demonstrated that the mutagenic primer assay is feasible and applicable to discriminate CRHR1 gene rare variant rs1876828 (A/G) and the "frequency of allele "G" was 100% in north Indian asthmatics as well as normal subjects. CONCLUSION: This method can be used for both large- and small-scale study of complex genetic, where CRHR1 gene plays the pivotal roles.

A novel robot visual homing method based on SIFT features.

Warping is an effective visual homing method for robot local navigation. However, the performance of the warping method can be greatly influenced by the changes of the environment in a real scene, thus resulting in lower accuracy. In order to solve the above problem and to get higher homing precision, a novel robot visual homing algorithm is proposed by combining SIFT (scale-invariant feature transform) features with the warping method. The algorithm is novel in using SIFT features as landmarks instead of the pixels in the horizon region of the panoramic image. In addition, to further improve the matching accuracy of landmarks in the homing algorithm, a novel mismatching elimination algorithm, based on the distribution characteristics of landmarks in the catadioptric panoramic image, is proposed. Experiments on image databases and on a real scene confirm the effectiveness of the proposed method.