From the cauldron of conflict: Endogenous gene regulation by piRNA and other modes of adaptation enabled by selfish transposable elements.

Transposable elements (TEs) provide a prime example of genetic conflict because they can proliferate in genomes and populations even if they harm the host. However, numerous studies have shown that TEs, though typically harmful, can also provide fuel for adaptation. This is because they code functional sequences that can be useful for the host in which they reside. In this review, I summarize the "how" and "why" of adaptation enabled by the genetic conflict between TEs and hosts. In addition, focusing on mechanisms of TE control by small piwi-interacting RNAs (piRNAs), I highlight an indirect form of adaptation enabled by conflict. In this case, mechanisms of host defense that regulate TEs have been redeployed for endogenous gene regulation. I propose that the genetic conflict released by meiosis in early eukaryotes may have been important because, among other reasons, it spurred evolutionary innovation on multiple interwoven trajectories - on the part of hosts and also embedded genetic parasites. This form of evolution may function as a complexity generating engine that was a critical player in eukaryotic evolution.

Impacts of management practices on habitat selection during juvenile mountain lion dispersal.

Dispersal is a complex series of movements before an individual establishes a home range. Animals must travel and forage in unfamiliar landscapes that include anthropogenic risks such as road crossings, harvest, and urban landscapes. We compare dispersal behavior of juvenile mountain lions (Puma concolor) from two geographically distinct populations in California and Nevada, USA. These two sites are ecologically similar but have different management practices; hunting is permitted in Nevada, whereas mountain lions are protected in California. We used GPS-collar data and net-squared displacement analysis to identify three dispersal states: exploratory, departure, and transient home range. We then compared each dispersal state of the two mountain lion populations using an integrated step selection analysis (iSSA). The model included explanatory variables hypothesized to influence one or more dispersal states, including distance to forest, shrub, water, hay and crop, developed lands, and four-wheel drive roads, as well as elevation and terrain ruggedness. Results revealed consistent habitat selection between sites across most landscape variables, with one notable exception: anthropogenic covariates, including distance to developed land, distance to hay and crop, and distance to four-wheeled drive roads, were only statistically significant on modeled habitat selection during dispersal in the population subject to hunting (i.e., Nevada). Results suggest that hunting (pursuit with hounds resulting in harvest) and non-lethal pursuit (pursuit with hounds but no harvest allowed) increase avoidance of anthropogenic landscapes during dispersal for juvenile mountain lions. By comparing populations, we provided valuable insights into the role of management in shaping dispersal behavior.

States of Resistance: nosocomial and environmental approaches to antimicrobial resistance in Lebanon.

Drawing on institutional historical records, interviews and student theses, this article charts the intersection of hospital acquired illness, the emergence of antimicrobial resistance (AMR), environments of armed conflict, and larger questions of social governance in the specific case of the American University of Beirut Medical Center (AUBMC) in Lebanon. Taking a methodological cue from approaches in contemporary scientific work that understand non-clinical settings as a fundamental aspect of the history and development of AMR, we treat the hospital as not just nested in a set of social and environmental contexts, but frequently housing within itself elements of social and environmental history. AMR in Lebanon differs in important ways from the settings in which global protocols for infection control or rubrics for risk factor identification for resistant nosocomial outbreaks were originally generated. While such differences are all too often depicted as failures of low and middle-income countries (LMIC) to maintain universal standards, the historical question before us is quite the reverse: how have the putatively universal rubrics of AMR and hospital infection control failed to take account of social and environmental conditions that clearly matter deeply in the evolution and spread of resistance? Focusing on conditions of war as an organized chaos in which social, environmental and clinical factors shift dramatically, on the social and political topography of patient transfer, and on a missing "meso" level of AMR surveillance between the local and global settings, we show how a multisectoral One Health approach to AMR could be enriched by an answering multisectoral methodology in history, particularly one that unsettles a canonical focus on the story of AMR in the Euro-American context.

Depression, Anxiety and Stress Symptoms among Afghan Healthcare Workers: A Cross-Sectional Analytical Study.

Background: Decades of conflict and cycles of disasters in Afghanistan have caused enormous impacts on health, the economy, and even national security. Objectives: We aimed to assess the levels of depression, anxiety, and stress symptoms and their determinants among Afghan healthcare workers. Methods: A cross-sectional study of 830 Afghan healthcare workers working in public and private hospitals was conducted between May and July 2021. We employed a non-probability sampling method to select our subjects. The questionnaire was composed of sections on sociodemographic information, working conditions, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Multivariable linear regression models were fitted using SPSS 21 to identify determinants of mental health symptoms among Afghan healthcare workers at a 5% significance level. Results: Of all participants, 52.3% (435) had symptoms of depression, 48.8% (405) anxiety, and 46.9% (389) stress. The likelihood of mental health symptoms was higher among those who worked in an urban setting (P = 0.001), were physically inactive (P = <0.001), had a decrease in income or an unpaid salary in the past six months (P = <0.001), thinking of leaving Afghanistan (P = <0.001), had medical comorbidity (P = <0.001), and being single (P = 0.048)]. Conclusion: This study highlights the important findings about the psychological health of healthcare workers in Afghanistan. These findings suggest rapid, actionable, and locally relevant interventions to assure potential improvements in working and living conditions for the health staff.

The association between maternal and child posttraumatic stress symptoms among families living in southern Israel: The buffering role of maternal executive functions.

Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high-level cognitive processes that enable self-regulation of thoughts and actions to achieve goal-directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress-buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent-child interactions.

An integrative framework of conflict and control.

People regularly encounter various types of conflict. Here, we ask if, and, if so, how, different types of conflict, from lab-based Stroop conflicts to everyday-life self-control or moral conflicts, are related to one other. We present a framework that assumes that action-goal representations are hierarchically organized, ranging from concrete actions to abstract goals. The framework's key assumption is that conflicts involving more abstract goals (e.g., self-control/moral conflict) are embedded in a more complex action space; thus, to resolve such conflicts, people need to consider more associated goals and actions. We discuss how differences in complexity impact conflict resolution mechanisms and the costs/benefits of resolving conflicts. Altogether, we offer a new way to conceptualize and analyze conflict regulation across different domains.

Exploring Pharmacy Students' Leadership Styles Using the 5 Voices Assessment.

OBJECTIVE: Leadership development assessments are a critical component of student pharmacists' understanding and development of effective team strategies. METHODS: The 5 Voices tool, developed by GiANT Worldwide, was incorporated into the leadership curriculum across 2 colleges of pharmacies for second-year Doctor of Pharmacy (PharmD) students. One public land-grant institution administers the assessment in the fall semester during a 2-h class session as part of a leadership elective leadership course and a private liberal arts institution distributes the 5 Voices assessment to all students during a 1-h spring semester required course. RESULTS: Responses from 456 PharmD students were included in the analysis, with 159 (34.9%) and 297 (65.1%) coming from the University of Minnesota and Drake University, respectively. Overall, 49.1% of PharmD students had nurturer as their foundational (first) voice. No differences were found in the distribution of first voices between institutions. The PharmD data are higher than the nurturer population-level average (43%). CONCLUSION: Introducing students to the 5 Voices assessment provides an opportunity for them to gain a better understanding of what they can contribute to a team. In addition, because nurturer is a dominant voice, this understanding can help provide appreciation for other voices necessary for team development.

Field report: ambulance service in Ukraine during weaponized conflict.

Crises require changes to established structures, and this also applies to ambulance services. This case report addresses the Ukrainian ambulance service and the changes resulting from the armed conflict in Ukraine. The purpose of this article is to provide insight into the activities of the ambulance service of the Kharkiv region, the second-largest city in Ukraine. Kharkiv is still under heavy fire.

Validation of a checklist to facilitate serious illness conversations in adult emergency in China: a single-centre pilot study.

BACKGROUND: Advances in emergency and critical care have improved outcomes, but gaps in communication and decision-making persist, especially in the emergency department (ED), prompting the development of a checklist to aid in serious illness conversations (SIC) in China. METHODS: This was a single-centre prospective interventional study on the quality improvement of SIC for life-sustaining treatment (LST). The study recruited patients consecutively for both its observational baseline and interventional stages until its conclusion. Eligible participants were adults over 18 years old admitted to the Emergency Intensive Care Unit (EICU) of a tertiary teaching hospital, possessing full decisional capacity or having a legal proxy. Exclusions were made for pregnant women, patients deceased upon arrival, those who refused participation, and individuals with incomplete data for analysis. First, a two-round Delphi process was organized to identify major elements and generate a standard process through a checklist. Subsequently, the efficacy of SIC in adult patients admitted to the EICU was compared using the Decisional Conflict Scale (DCS) score before (baseline group) and after (intervention group) implementing the checklist. RESULTS: The study participants presented with the most common comorbidities, such as diabetes, myocardial infarction, cerebrovascular disease, moderate-to-severe renal disease, congestive heart failure, and chronic pulmonary disease. The median Charlson Index did not differ between the baseline and intervention cohorts. The median length of hospital stay was 11.0 days, and 82.9% of patients survived until hospital discharge. The total DCS score was lower in the intervention group than in the baseline group. Three subscales, including the informed, values clarity, and support subscales, demonstrated significant differences between the intervention and baseline groups. Fewer intervention group patients agreed with and changed their minds about cardiopulmonary resuscitation (CPR) compared to the baseline group. CONCLUSION: The use of a SIC checklist in the EICU reduced the DCS score by increasing medical information disclosure, patient value awareness, and decision-making support.

Inhibitory dynamics in dual-route evidence accumulation account for response time distributions from conflict tasks.

Laboratory data from conflict tasks, e.g. Simon and Eriksen tasks, reveal differences in response time distributions under different experimental conditions. Only recently have evidence accumulation models successfully reproduced these results, in particular the challenging delta plots with negative slopes. They accomplish this with explicit temporal dependencies in their structure or activation functions. In this work, we introduce an alternative approach to the modeling of decision-making in conflict tasks exclusively based on inhibitory dynamics within a dual-route architecture. We consider simultaneous automatic and controlled drift diffusion processes, with the latter inhibiting the former. Our proposed Dual-Route Evidence Accumulation Model (DREAM) achieves equivalent performance to previous works in fitting experimental response time distributions despite having no time-dependent functions. The model can reproduce conditional accuracy functions and delta plots with positive and negative slopes. The implications of these results, including an interpretation of the parameters and potential links to perceptual representations, are discussed. We provide Python code to fit DREAM to experimental data. Supplementary Information: The online version contains supplementary material available at 10.1007/s11571-023-09990-8.

"TELL ME WHAT YOU THINK:" A REFLECTION ON JEREMY SAFRAN'S APPROACH TO PEDAGOGY.

The author reflects on how his relationship with Jeremy Safran during graduate school continues to inform his thinking around pedagogy and clinical training. Safran's emphasis on independent inquiry is highlighted, especially regarding the importance of seeking out perspectives and evidence that come into conflict with one's primary orientation. The author argues that Safran's pedagogical stance could be described as inhabiting a state of "pre-judgment," which is essential in both clinical and pedagogical contexts in the psychoanalytic field.

Exploring driving behavioral characteristics in pre-, in-, and post-conflict stages based on car-following trajectory data.

This study investigates driving behaviour in different stages of rear-end conflicts using vehicle trajectory data. Three conflict stages (pre-, in-, and post-conflict) are defined based on time-to-collision (TTC) indicator. Four indexes are selected to capture within-group and between-group characteristics of the stages. Besides, this study also examines the prediction performance of conflict stage identification using specific driving behaviour characteristics associated with each stage. Results reveal variations in dominant driving characteristics and predictive importance across stages. Heterogeneity exists within stages, with differences among clusters. Drivers slow down during in-conflict, with decreasing speed reduction as stages progress. Reaction time increases in post-conflict. Insufficient space gaps contribute to rear-end conflicts in the in-conflict stage. Furthermore, the prediction performance of conflict stage identification, based on the specific driving behaviour characteristics associated with each stage, is commendable. This study enhances understanding and prediction of conflict stage identification in rear-end conflicts.Practitioner summary: This study explores driving behaviour in rear-end conflict stages using trajectory data. It identifies pre-, in-, and post-conflict stages via time-to-collision indicator and assesses within-group and between-group characteristics. Besides, prediction performance for conflict stage identification based on these characteristics is commendable. This research enhances understanding and prediction of rear-end conflicts.

Adrenal and metabolic hormones demonstrate risk-reward trade-offs for African elephants foraging in human-dominated landscapes.

A key driver of the African savannah elephant population decline is the loss of habitat and associated human-elephant conflict. Elephant physiological responses to these pressures, however, are largely unknown. To address this knowledge gap, we evaluated faecal glucocorticoid metabolite (fGCM) concentrations as an indicator of adrenal activity and faecal thyroid metabolite (fT3) concentrations as an indicator of metabolic activity in relation to land use, livestock density, and human landscape modification, while controlling for the effects of seasonality and primary productivity (measured using the normalized difference vegetation index). Our best-fit model found that fGCM concentrations to be elevated during the dry season, in areas with higher human modification index values, and those with more agropastoral activities and livestock. There was also a negative relationship between primary productivity and fGCM concentrations. We found fT3 concentrations to be higher during the wet season, in agropastoral landscapes, in locations with higher human activity, and in areas with no livestock. This study highlights how elephants balance nutritional rewards and risks in foraging decisions when using human-dominated landscapes, results that can serve to better interpret elephant behaviour at the human-wildlife interface and contribute to more insightful conservation strategies.

Uptake of protective tetanus toxoid vaccine doses and maternal associated factors during pregnancy in armed conflict zone, hospital-based cross-sectional study.

Background: Vaccinating pregnant women with tetanus toxoid (TT) is crucial to prevent neonatal tetanus, reducing related deaths by 94%. In conflict zones with restricted access to deliveries, neonates face a fatality rate of 80%-100%. This study explores the uptake of protective TT vaccine doses and maternal associated factors during pregnancy in an armed conflict zone. Methods: A hospital-based, descriptive, cross-sectional study was conducted of 357 pregnant women at delivery using simple random sampling. Data were collected through interviews with a structured questionnaire, and entered using Epi-data version 3.1, and exported using SPSS version 22 for further analysis. Binary and multivariable logistic regression analyses were used to identify significant variables for receiving protective TT doses during pregnancy at P < 0.05. Result: In this study, 355 pregnant women were included, with response rate of 99.4%. The mean age of the participants was 27.65 ± 6.23 years. During the study period, 67.3% of pregnant women received a protective TT vaccine dose while 33.3% were missed due to escalated armed conflict. The dropout rates were significant from TT5 to TT2 (17.6%), TT5 to TT3 (11.9%), and TT5 to TT4 (6.1%). However, maternal associated factors for the uptake of the TT protective vaccine dose were identified, including being aged 36-49 years [adjusted odds ratio (AOR) = 3.7; 95% confidence interval (CI) 1.54-7.8; P = 0.001], completing high school (AOR = 3.05; 95% CI 1.5-8.9; P = 0.02), having an antenatal care follow-up (AOR = 9.4; 95% CI 2.9-24.3; P = 0.001), previous media exposure (AOR = 15.5; 95% CI 7.5-25.3; P = 0.001), and good maternal knowledge (AOR = 2.7; 95% CI 1.8-4.9; P = 0.02). Conclusion: The uptake of the protective TT vaccine dose among pregnant women in a continued armed conflict area was low compared with previous study findings. Efforts should be made to increase vaccine uptake and reduce dropout rates by addressing both community and individual-level factors.

CALMER Conflict: A Novel Curriculum for Graduating Medical Students to Manage and Defuse Patient-Provider Conflict.

BACKGROUND: Workplace violence disproportionately affects healthcare workers and verbal aggression from patients frequently occurs. While verbal de-escalation is the first-line approach to defusing anger, there is a lack of consistent curricula or robust evaluation in undergraduate medical education. AIM: To develop a medical school curriculum focused on de-escalation skills for adult patients and evaluate effectiveness with surveys and an objective structured clinical examination (OSCE). SETTING: We implemented this curriculum in the "Get Ready for Residency Bootcamp" of a single large academic institution in 2023. PARTICIPANTS: Forty-four fourth-year medical students PROGRAM DESCRIPTION: The curriculum consisted of an interactive didactic focused on our novel CALMER framework that prioritized six evidence-based de-escalation skills and a separate standardized patient practice session. PROGRAM EVALUATION: The post-curriculum survey (82% response rate) found a significant increase from 2.79 to 4.11 out of 5 (p ≤ 0.001) in confidence using verbal de-escalation. Preparedness improved with every skill and curriculum satisfaction averaged 4.79 out of 5. The OSCE found no differences in skill level between students who received the curriculum and those who did not. DISCUSSION: This evidence-based and replicable de-escalation skill curriculum improves medical student confidence and preparedness in managing agitated patients.

A surrogate model-based approach for adaptive selection of the optimal traffic conflict prediction model.

For identifying the optimal model for real-time conflict prediction, there is a necessity for proposing a quantitative analysis approach that adaptively selects the optimal prediction model from a large pool of task-suited models, while simultaneously considering the computational efficiency and prediction precision. Based on this line, this study developed an innovative approach termed surrogate model-based optimal prediction model selection (SM-OPMS). This approach aims to accelerate the optimal model selection while incorporating prediction precision considerations, under the precondition of comprehensively evaluating task-suited models. An analytical framework was proposed, further illustrated through a detailed case study. In the case study, real vehicle trajectory data from HighD were processed and applied, which can be aggregated to extract both traffic state variables and corresponding conflict data during a specific time interval. As for the conflict detection, Time-to-Collision (TTC) and Deceleration Rate to Avoid a Crash (DRAC) indicators were utilized to identify risky conditions. Based on the proposed approach, the selection for the optimal prediction model was conducted, and the variable importance in conflict prediction within the optimal models derived from the SM-OPMS was also investigated. Finally, a comparative analysis with the enumeration-based optimal prediction model selection (E-OPMS) approach was conducted to validate the superiority of the proposed approach. Results indicate that SM-OPMS outperforms E-OPMS in optimal model selection, notably enhancing computational efficiency by up to 94.03%, while maintaining prediction precision within a maximum reduction of only 7.91%. The significance of the SM-OPMS approach is revealed by its comprehensive selection of the optimal prediction models for specific traffic scenarios, taking into account both prediction efficiency and precision simultaneously. The proposed approach is expected to contribute to the development of real-time conflict prediction in the future.

Coming of age in war: Early life adversity, age at menarche, and mental health.

Armed conflict and forced migration (ACFM) represent a set of extreme environments that are increasingly common for children and adolescents to experience. Adolescence may constitute a sensitive period (puberty and psychoneurological maturation) through which ACFM adversity leaves a lasting mark. Adolescence has become a focal point for analysis and intervention as it relates to the effects of early life adversity on puberty, linear growth, and mental health. Research in public health and psychological science suggests early life adversity (ELA) may accelerate puberty, heightening risks for mental health disorders. However, it is not well substantiated whether ACFM-derived adversities accelerate or delay relative pubertal timing. Secondly, ACFM provides salient context through which to probe the relationships between nutritional, psychosocial, and demographic changes and their respective impact on puberty and mental health. We conducted a narrative review which 1) examined constructions of early life adversity and their proposed influence on puberty 2) reviewed empirical findings (n = 29 studies, n = 36 samples) concerning effects of ACFM ELA on age at menarche and 3) discussed proposed relationships between early life adversity, puberty, and mental ill-health. Contrary to prior research, we found war-derived early life adversity was more consistently associated with pubertal delay than acceleration and may exert counterintuitive effects on mental health. We show that ELA cannot be operationalized in the same way across contexts and populations, especially in the presence of extreme forms of human stress and resilience. We further discuss the ethics of puberty research among conflict-affected youth.

Fear of COVID-19, Health Anxiety and Work-Family Conflict in Nurses Working in the COVID-19 Ward.

Background: COVID-19 is an example of an epidemic and sudden crisis that has affected many aspects of life and work and identifying the factors that contribute to its impact can help prevent similar crises in the future. The purpose of this study was to investigate fear of COVID-19, health anxiety, and work-family conflict in nurses working in COVID-19 wards in hospitals affiliated with the Tehran University of Medical Sciences (TUMS). Materials and Methods: This descriptive-analytical study used a census method to survey 226 nurses working in eight hospitals affiliated with TUMS. Demographics information and three questionnaires including; the Fear of COVID-19 Scale, Short Health Anxiety Inventory, and Work-Family Conflict Scale were completed online. Data were analyzed using descriptive statistics and analytical statistics, and a significance level of p < 0.05 was considered. Results: Structural equation modeling test showed that work-family conflict had an effect on health anxiety, and health anxiety had an effect on fear of COVID-19 (p < 0.05). The severity of the effect of work-family conflict on health anxiety was 0.73, and the severity of the effect of health anxiety on fear of COVID-19 was 0.46. Work-family conflict had an indirect effect on fear of COVID-19 mediated only by health anxiety (p < 0.05) and the severity of the indirect effect was 0.33. Conclusions: Health anxiety plays a mediating role in the relationship between work-family conflict and fear of COVID-19. Workplaces should provide more support to their employees during a crisis such as the COVID-19 pandemic, and prevention programs should be implemented to decrease anxiety.

Khartoum War's echoes in oil and energy sectors: Economic and environmental implications for Sudan and South Sudan.

The energy sector is a main driver of African growth, particularly in regions with geopolitical conflicts like Sudan and South Sudan. The oil and gas industry notably influences these regions' economy, politics, humanitarian situation, and social stability. This study seeks to investigate how the Khartoum War affected the energy sector of both Sudan and South Sudan, particularly looking at the disruptions caused by recent conflicts and their impact on oil production, economic stability, and environmental conditions. The study employs a multi-disciplinary approach, utilising different sources such as regional legal agreements, government reports, academic articles, and press releases from international organisations. The key methodology includes qualitative analysis of several documents and quantitative assessment of production data and economic reports. The study's key findings show a significant decline in oil production and transportation due to the shutdown of key oilfields and pipelines, intensifying economic and humanitarian crises. Additionally, the damage to oil infrastructure has presented serious environmental risks, highlighting the delicate balance between resource management and regional stability. In conclusion, the study's findings underscore the intense impact of the Khartoum War on the energy sector of Sudan and South Sudan, and the urgent need for policy recommendations to mitigate these effects and foster sustainable development.