Predicting response to and relapse after treatment of trichotillomania with the Comprehensive Behavioral model (ComB).

Prior studies of behavior therapy for trichotillomania (TTM) have shown that response is variable, and relapse after treatment discontinuation is common. Little information is available concerning prognostic factors capable of predicting individual differences in response or maintenance of improvement. The present study is a secondary analysis of a randomized controlled trial (N = 36) of the Comprehensive Behavioral (ComB) model of treatment for TTM (Carlson et al., 2021). We investigated age, disorder history, pre-treatment symptom severity, longest prior period of abstinence from pulling, and Emotion and Intention hair pulling styles as predictors of initial response. We studied age, disorder history, pre-treatment symptom severity, longest prior period of abstinence from pulling, and post-treatment symptom severity or hair-pulling abstinence as predictors of relapse following treatment. Older age significantly predicted lower TTM severity following treatment. Lower pre-treatment severity significantly predicted lower severity of TTM at the 3-month follow-up.

Electronic Health Record-Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review.

BACKGROUND: Managing hypertension in racial and ethnic minoritized groups (eg, African American/Black patients) in primary care is highly relevant. However, evidence on whether or how electronic health record (EHR)-driven approaches in primary care can help improve hypertension management for patients of racial and ethnic minoritized groups in the United States remains scarce. OBJECTIVE: This review aims to examine the role of the EHR in supporting interventions in primary care to strengthen the hypertension management of racial and ethnic minoritized groups in the United States. METHODS: A search strategy based on the PICO (Population, Intervention, Comparison, and Outcome) guidelines was utilized to query and identify peer-reviewed articles on the Web of Science and PubMed databases. The search strategy was based on terms related to racial and ethnic minoritized groups, hypertension, primary care, and EHR-driven interventions. Articles were excluded if the focus was not hypertension management in racial and ethnic minoritized groups or if there was no mention of health record data utilization. RESULTS: A total of 29 articles were included in this review. Regarding populations, Black/African American patients represented the largest population (26/29, 90%) followed by Hispanic/Latino (18/29, 62%), Asian American (7/29, 24%), and American Indian/Alaskan Native (2/29, 7%) patients. No study included patients who identified as Native Hawaiian/Pacific Islander. The EHR was used to identify patients (25/29, 86%), drive the intervention (21/29, 72%), and monitor results and outcomes (7/29, 59%). Most often, EHR-driven approaches were used for health coaching interventions, disease management programs, clinical decision support (CDS) systems, and best practice alerts (BPAs). Regarding outcomes, out of 8 EHR-driven health coaching interventions, only 3 (38%) reported significant results. In contrast, all the included studies related to CDS and BPA applications reported some significant results with respect to improving hypertension management. CONCLUSIONS: This review identified several use cases for the integration of the EHR in supporting primary care interventions to strengthen hypertension management in racial and ethnic minoritized patients in the United States. Some clinical-based interventions implementing CDS and BPA applications showed promising results. However, more research is needed on community-based interventions, particularly those focusing on patients who are Asian American, American Indian/Alaskan Native, and Native Hawaiian/Pacific Islander. The developed taxonomy comprising "identifying patients," "driving intervention," and "monitoring results" to classify EHR-driven approaches can be a helpful tool to facilitate this.

Longitudinal neurocognitive effects of nonmyeloablative hematopoietic stem cell transplant among older adolescents and adults with sickle cell disease: A description and comparison with sibling donors.

Sickle cell disease (SCD) is associated with increased risk of neurocognitive deficits. However, whether functioning changes following nonmyeloablative hematopoietic stem cell transplant (HSCT) remains unclear. This study aimed to examine changes in neuropsychological functioning pre- to post-transplant among patients with SCD and compare patients and siblings. Adults with SCD (n = 47; Mage = 31.8 ± 8.9) and their sibling stem cell donors (n = 22; Mage = 30.5± 9.2) enrolled on a nonmyeloablative HCST protocol completed cognitive and patient-reported outcome assessments at baseline and 12 months post-transplant. Path analyses were used to assess associations between pre-transplant variables and sibling/patient group status and post-transplant function. Mean patient cognitive scores were average at both timepoints. Patient processing speed and somatic complaints improved from baseline to follow-up. Baseline performance predicted follow-up performance across cognitive variables; patient/sibling status predicted follow-up performance on some processing speed measures. Results suggest that patients with SCD demonstrate slower processing speed than siblings. Processing speed increased pre- to post-HSCT among patients and siblings, and on some measures patients demonstrated greater improvement. Thus, HSCT may improve processing speed in patients, although further confirmation is needed. Findings provide promising evidence that neurocognitive functioning remains stable without detrimental effects from pre- to 12-months post nonmyeloablative HSCT in individuals with SCD.

Salinity and pH effects on survival, growth, and reproduction of quagga mussels.

Background: In recent decades, invasive quagga mussels have expanded to the Western United States from the Great Lakes region of North America. Most studies that evaluate the invasion potential of quagga mussels in western water bodies have utilized physiological and life history information from zebra mussels, a related taxon. Few studies have assessed the potential for invasion using specific information from quagga mussel life history or experiments that test for their survival in the fresh and saline waters of the western United States. Methods: We investigated quagga mussel survival, growth, and reproduction using semi-natural experiments under temperature and light controlled conditions across a gradient of water salinity (fresh to brackish) and pH (8.4-11). Water from Lake Mead was used as a positive control in our experiment, and water from Pyramid Lake and the Truckee River was used as brackish and freshwater treatments, respectively. The mussels used in the experiments were collected from Lake Mead. Results: After 12 h in brackish water (4 ppt, pH 9.3), we observed 100% mortality of adult mussels. The swelling and disintegration of body tissues and high mortality rates indicated that high potassium, sodium, and chloride concentrations were the likely causes of death in brackish water treatments. In contrast, mussels were able to survive, grow, and reach sexual maturity in freshwater (0.1 ppt) with a low calcium concentration (17 mg L-1) after 57 days. Mussels died after 2 days at pH 11 and after 12 days at pH 10; during the 14-day monitoring period, no mortality was detected at pH 9.0, 9.3, or 9.5 and mussels did not exhibit any visual indications of stress. Understanding quagga mussel physiological and environmental tolerances appears to be essential for assessing their invasion potential in aquatic habitats.

Postural and Gestural Synchronization, Sequential Imitation, and Mirroring Predict Perceived Coupling of Dancing Dyads.

Body movement is a primary nonverbal communication channel in humans. Coordinated social behaviors, such as dancing together, encourage multifarious rhythmic and interpersonally coupled movements from which observers can extract socially and contextually relevant information. The investigation of relations between visual social perception and kinematic motor coupling is important for social cognition. Perceived coupling of dyads spontaneously dancing to pop music has been shown to be highly driven by the degree of frontal orientation between dancers. The perceptual salience of other aspects, including postural congruence, movement frequencies, time-delayed relations, and horizontal mirroring remains, however, uncertain. In a motion capture study, 90 participant dyads moved freely to 16 musical excerpts from eight musical genres, while their movements were recorded using optical motion capture. A total from 128 recordings from 8 dyads maximally facing each other were selected to generate silent 8-s animations. Three kinematic features describing simultaneous and sequential full body coupling were extracted from the dyads. In an online experiment, the animations were presented to 432 observers, who were asked to rate perceived similarity and interaction between dancers. We found dyadic kinematic coupling estimates to be higher than those obtained from surrogate estimates, providing evidence for a social dimension of entrainment in dance. Further, we observed links between perceived similarity and coupling of both slower simultaneous horizontal gestures and posture bounding volumes. Perceived interaction, on the other hand, was more related to coupling of faster simultaneous gestures and to sequential coupling. Also, dyads who were perceived as more coupled tended to mirror their pair's movements.

Risk for Infection in Humans after Exposure to Birds Infected with Highly Pathogenic Avian Influenza A(H5N1) Virus, United States, 2022.

During February 7─September 3, 2022, a total of 39 US states experienced outbreaks of highly pathogenic avian influenza A(H5N1) virus in birds from commercial poultry farms and backyard flocks. Among persons exposed to infected birds, highly pathogenic avian influenza A(H5) viral RNA was detected in 1 respiratory specimen from 1 person.

"Setting Them Up for Success": Including Youth on the Autism Spectrum in 4-H.

Youth on the autism spectrum often face challenges accessing services in rural communities compared to those who live in higher resource areas. There is a particular need for services that support skills that will help youth transition to adulthood and future employment. 4-H is a national youth development program that is well-positioned to address the needs of youth on the autism spectrum; however, minimal empirical evidence exists about the implementation and effectiveness of inclusive practices in 4-H programs. The goal of this study was to better understand barriers to enrollment and to identify gaps in support for youth on the autism spectrum participating in 4-H. Twenty Extension Educators in Indiana participated in two focus groups. Thematic analysis of focus group transcripts identified barriers to enrollment including awareness of 4-H as an inclusive program and difficulties navigating 4-H culture. Our analysis identified themes related to new training content and delivery including a resource portfolio, communication, individualized accommodations, and working within the existing leadership training structure. Findings support the benefits of 4-H as a program that can promote life skills and personal development for youth on the autism spectrum but also highlight a significant need for additional training opportunities and resources to increase uptake and improve the implementation of inclusive practices.

Decoding Individual differences and musical preference via music-induced movement.

Movement is a universal response to music, with dance often taking place in social settings. Although previous work has suggested that socially relevant information, such as personality and gender, are encoded in dance movement, the generalizability of previous work is limited. The current study aims to decode dancers' gender, personality traits, and music preference from music-induced movements. We propose a method that predicts such individual difference from free dance movements, and demonstrate the robustness of the proposed method by using two data sets collected using different musical stimuli. In addition, we introduce a novel measure to explore the relative importance of different joints in predicting individual differences. Results demonstrated near perfect classification of gender, and notably high prediction of personality and music preferences. Furthermore, learned models demonstrated generalizability across datasets highlighting the importance of certain joints in intrinsic movement patterns specific to individual differences. Results further support theories of embodied music cognition and the role of bodily movement in musical experiences by demonstrating the influence of gender, personality, and music preferences on embodied responses to heard music.

Extended follow-up of a comprehensive behavioral (ComB) treatment sample during the COVID-19 pandemic.

This study provides the longest follow-up yet for comprehensive behavioral (ComB) treatment of trichotillomania (TTM) (M = 24.59 months after pre-treatment and 15.92 months after the last follow-up point in a recent clinical trial (Carlson et al., 2021), which had shown ComB to be significantly more efficacious than minimal attention at post-treatment). This study also examined changes in TTM severity from before to during the COVID-19 pandemic. Participants (N = 23) completed a survey assessing current TTM symptoms, the impact of the pandemic on their coping with TTM, and their experience with ComB treatment. Self-reported symptom severity at this follow-up evaluation fell between the scores obtained at the clinical trial's pre-treatment assessment and at its last follow-up before the pandemic and did not significantly differ from either time point. Most participants (73%) reported some change in their TTM management since onset of the pandemic, with changes to their environment/routine (61%) and in anxiety (32%) being the most common. Pandemic-related changes were associated with variable outcomes, improving symptoms and management for some while worsening them for others. Use of strategies from ComB had declined since the most recent follow-up, but more than half (55%) of participants reported that strategies from ComB remained useful.

Comprehensive Behavioral (ComB) Treatment of Trichotillomania: A Randomized Clinical Trial.

OBJECTIVE: This study is the first controlled trial of comprehensive behavioral (ComB) treatment of trichotillomania (TTM). ComB provides individualized treatment based on factors triggering and maintaining hair pulling. METHOD: Participants (N = 36) were adults (M = 34.08 years old, SD = 12.26) meeting DSM5 criteria for TTM. A majority were female (80%) and Caucasian (75%), whereas 17% were African American and 19% Hispanic/Latinx. In a parallel-group design, participants were randomly assigned to (a) Immediate ComB (12 sessions) or (b) Minimal Attention Control (MAC), followed by delayed ComB after week 12. Follow-up continued through week 38. Primary outcomes were self-report (Massachusetts General Hospital Hair pulling Scale; MGH-HPS) and interviewer-rated (NIMH-Trichotillomania Impact Scale and Trichotillomania Severity Scale; TIS/TSS) TTM symptom severity, as well as diagnosis (Trichotillomania Diagnostic Interview). RESULTS: Immediate efficacy of ComB (vs. MAC) was statistically significant (p = .03) for self-reported symptoms, with an effect size d = -.78, but not significant for interviewer-rated symptoms or diagnostic status. Immediate ComB was significantly more likely than MAC (27% vs. 0%) to lead to complete abstinence from hair pulling at week 12. Follow-ups showed good maintenance of effects. CONCLUSIONS: Efficacy of ComB was established for self-reported symptoms. Future research is needed to establish whether the lack of more widespread effects stems from limitations of the model or to a need for more extensive therapist training, as secondary analyses suggested stronger results among therapists with more TTM experience.

The Role of Music in Everyday Life During the First Wave of the Coronavirus Pandemic: A Mixed-Methods Exploratory Study.

Although music is known to be a part of everyday life and a resource for mood and emotion management, everyday life has changed significantly for many due to the global coronavirus pandemic, making the role of music in everyday life less certain. An online survey in which participants responded to Likert scale questions as well as providing free text responses was used to explore how participants were engaging with music during the first wave of the pandemic, whether and how they were using music for mood regulation, and how their engagement with music related to their experiences of worry and anxiety resulting from the pandemic. Results indicated that, for the majority of participants, while many felt their use of music had changed since the beginning of the pandemic, the amount of their music listening behaviors were either unaffected by the pandemic or increased. This was especially true of listening to self-selected music and watching live streamed concerts. Analysis revealed correlations between participants' use of mood for music regulation, their musical engagement, and their levels of anxiety and worry. A small number of participants described having negative emotional responses to music, the majority of whom also reported severe levels of anxiety.

Adoption of Telemedicine for Type 1 Diabetes Care During the COVID-19 Pandemic.

Background: We describe the utilization of telemedicine visits (video or telephone) across the type 1 diabetes (T1D) Exchange Quality Improvement Collaborative (T1DX-QI) during the COVID-19 pandemic. Metrics, site-level survey results, and examples of interventions conducted to support telemedicine in T1D are shown. Materials and Methods: Thirteen clinics (11 pediatric, 2 adult) provided monthly telemedicine metrics between December 2019 and August 2020 and 21 clinics completed a survey about their telemedicine practices. Results: The proportion of telemedicine visits in T1DX-QI before the pandemic was <1%, rising to an average of 95.2% in April 2020 (range 52.3%-99.5%). Three sites initially used mostly telephone visits before converting to video visits. By August 2020, the proportion of telemedicine visits decreased to an average of 45% across T1DX-QI (range 10%-86.6%). The majority of clinics (62%) performed both video and telephone visits; Zoom was the most popular video platform used. Over 95% of clinics reported using CareLink™, Clarity®, Glooko™, and/or t:connect® to view device data, with only one center reporting automated data upload into the electronic medical record. The majority of centers had multidisciplinary teams participating in the video visits. All sites reported reimbursement for video visits, and 95% of sites reported coverage for telephone visits early on in the pandemic. Conclusions: There was rapid adoption of telemedicine in T1DX-QI during the COVID-19 pandemic. Future insurance reimbursement for telemedicine visits and the ideal ratio of telemedicine to in-person visits in T1D care remain to be determined.

Collection and Identification of Pollen from Honey Bee Colonies.

Researchers often collect and analyze corbicular pollen from honey bees to identify the plant sources on which they forage for pollen or to estimate pesticide exposure of bees via pollen. Described herein is an effective pollen-trapping method for collecting corbicular pollen from honey bees returning to their hives. This collection method results in large quantities of corbicular pollen that can be used for research purposes. Honey bees collect pollen from many plant species, but typically visit one species during each collection trip. Therefore, each corbicular pollen pellet predominantly represents one plant species, and each pollen pellet can be described by color. This allows the sorting of samples of corbicular pollen by color to segregate plant sources. Researchers can further classify corbicular pollen by analyzing the morphology of acetolyzed pollen grains for taxonomic identification. These methods are commonly used in studies related to pollinators such as pollination efficiency, pollinator foraging dynamics, diet quality, and diversity. Detailed methodologies are presented for collecting corbicular pollen using pollen traps, sorting pollen by color, and acetolyzing pollen grains. Also presented are results pertaining to the frequency of pellet colors and taxa of corbicular pollen collected from honey bees in five different cropping systems.

Field rates of Sivanto™ (flupyradifurone) and Transform® (sulfoxaflor) increase oxidative stress and induce apoptosis in honey bees (Apis mellifera L.).

Pesticide exposures can have detrimental impacts on bee pollinators, ranging from immediate mortality to sub-lethal impacts. Flupyradifurone is the active ingredient in Sivanto™ and sulfoxaflor is the active ingredient in Transform®. They are both relatively new insecticides developed with an intent to reduce negative effects on bees, when applied to bee-attractive crops. With the growing concern regarding pollinator health and pollinator declines, it is important to have a better understanding of any potential negative impacts, especially sub-lethal, of these pesticides on bees. This study reports novel findings regarding physiological stress experienced by bees exposed to field application rates of these two insecticides via a Potter Tower sprayer. Two contact exposure experiments were conducted-a shorter 6-hour study and a longer 10-day study. Honey bee mortality, sugar syrup and water consumption, and physiological responses (oxidative stress and apoptotic protein assays) were assessed in bees exposed to Sivanto™ and Transform®, and compared to bees in control group. For the longer, 10-day contact exposure experiment, only the Sivanto™ group was compared to the control group, as high mortality recorded in the sulfoxaflor treatment group during the shorter contact exposure experiment, made the latter group unfeasible to test in the longer 10-days experiment. In both the studies, sugar syrup and water consumptions were significantly different between treatment groups and controls. The highest mortality was observed in Transform® exposed bees, followed by the Sivanto™ exposed bees. Estimates of reactive oxygen/nitrogen species indicated significantly elevated oxidative stress in both pesticide treatment groups, when compared to controls. Caspase-3 protein assays, an indicator of onset of apoptosis, was also significantly higher in the pesticide treatment groups. These differences were largely driven by post exposure duration, indicating sub-lethal impacts. Further, our findings also emphasize the need to revisit contact exposure impacts of Sivanto™, given the sub-lethal impacts and mortality observed in our long-term (10-day) contact exposure experiment.

Kinematics of perceived dyadic coordination in dance.

We investigated the relationships between perceptions of similarity and interaction in spontaneously dancing dyads, and movement features extracted using novel computational methods. We hypothesized that dancers' movements would be perceived as more similar when they exhibited spatially and temporally comparable movement patterns, and as more interactive when they spatially oriented more towards each other. Pairs of dancers were asked to move freely to two musical excerpts while their movements were recorded using optical motion capture. Subsequently, in two separate perceptual experiments we presented stick figure animations of the dyads to observers, who rated degree of interaction and similarity between dancers. Mean perceptual ratings were compared with three different approaches for quantifying coordination: torso orientation, temporal coupling, and spatial coupling. Correlations and partial correlations across dyads were computed between each estimate and the perceptual measures. A systematic exploration showed that torso orientation (dancers facing more towards each other) is a strong predictor of perceived interaction even after controlling for other features, whereas temporal and spatial coupling (dancers moving similarly in space and in time) are better predictors for perceived similarity. Further, our results suggest that similarity is a necessary but not sufficient condition for interaction.

Effect of Native Type I Collagen with Polyhexamethylene Biguanide Antimicrobial on Wounds: Interim Registry Results.

BACKGROUND: Biofilm can impair wound healing by maintaining an elevated, but ineffective, inflammatory state. This article describes interim results from the prospective RESPOND postmarketing registry evaluating the use of a native type 1, porcine collagen matrix with the embedded antimicrobial polyhexamethylene biguanide (PCMP) in the management of chronic wounds. METHODS: Adults ≥18 years of age with ≥1 appropriate wound were eligible for inclusion. Data that were final on January 26, 2018 were included in this analysis. At week 0, wounds were cleaned, debrided, and prepared as necessary and PCMP was applied, with a dressing to fix it in place. Patients received standard wound care plus PCMP weekly, up to 24 weeks, at the investigator's discretion. At each visit, wounds were assessed for area and quality of granulation tissue. RESULTS: Most common wound types (N = 63) were venous ulcers (28.6%), trauma and lacerations (22.2%), postsurgical open wounds (15.9%), pressure injuries (12.7%), and diabetic ulcers (9.5%). Median baseline wound area was 6.5 cm2; mean wound duration at baseline was 4 months. Of the 63 wounds, 43 (68.3%) achieved complete wound closure, 41 of 43 (95.3%) closed after PCMP treatment, and 2 of 43 (4.7%) after bridging to other modalities and surgical closure. Twelve out of 63 wounds were bridged to other modalities after PCMP treatment. Mean time to closure for PCMP wounds was 5.0 weeks. CONCLUSIONS: PCMP appears to be a useful adjunct for treating various wound types. PCMP use should be considered when managing chronic or acute wounds.

The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

BACKGROUND: A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. METHODS: In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. RESULTS: Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, p<0.001), more drinks per drinking day (b=0.267, p<0.001), and fewer days of alcohol abstinence (b=-0.285, p<0.001) spent more time homeless. CONCLUSIONS: Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness.

Conscientiousness and Extraversion relate to responsiveness to tempo in dance.

Previous research has shown broad relationships between personality and dance, but the relationship between personality and specific structural features of music has not been explored. The current study explores the influence of personality and trait empathy on dancers' responsiveness to small tempo differences between otherwise musically identical stimuli, measured by difference in the amount in acceleration of key joints. Thirty participants were recorded using motion capture while dancing to excerpts from six popular songs that were time-stretched to be slightly faster or slower than their original tempi. Analysis revealed that higher conscientiousness and lower extraversion both correlated with greater responsiveness to tempo change. Partial correlation analysis revealed that conscientiousness remained significantly correlated with responsiveness when extraversion was controlled, but not vice versa. No effect of empathy was found. Implications are discussed.

Type 1 Ring-Opening Reactions of Cyclopropanated 7-Azabenzonorbornadienes with Organocuprates.

The first nucleophilic ring-opening reactions of cyclopropanated 7-azabenzonorbornadienes have been achieved using organocuprates. Tricyclic or tetracyclic γ-lactams were obtained as the sole product in good yields of up to 98% when alkoxycarbonyl groups occupied the N-substituent position. Successful conversions to lactams were observed for primary, secondary, tertiary, and aromatic nucleophiles, as well as for a variety of substrates functionalized on the benzene ring. A possible mechanism for these transformations is discussed.

Functional mechanics of beetle mandibles: Honest signaling in a sexually selected system.

Male stag beetles possess colossal mandibles, which they wield in combat to obtain access to females. As with many other sexually selected weapons, males with longer mandibles win more fights. However, variation in the functional morphology of these structures, used in male-male combat, is less well understood. In this study, mandible bite force, gape, structural strength, and potential tradeoffs are examined across a wide size range for one species of stag beetle, Cyclommatus metallifer. We found that not only does male mandible size demonstrate steep positive allometry, but the shape, relative bite force, relative gape, and safety factor of the mandibles also change with male size. Allometry in these functionally important mandibular traits suggests that larger males with larger mandibles should be better fighters, and that the mandibles can be considered an honest signal of male fighting ability. However, negative allometry in mandible structural safety factor, wing size, and flight muscle mass suggest significant costs and a possible limit on the size of the mandibles. J. Exp. Zool. 325A:3-12, 2016. © 2015 Wiley Periodicals, Inc.