Preliminary Analysis of Vermont\u27s EMS Naloxone Leave-Behind Program

Background: Naloxone is well known to effectively reverse the effects of unintentional opiate overdose and reduce mortality from opiate overdose (12, 18). Despite activation of emergency medical services (EMS) after an overdose, many patients choose against transport to a hospital for further treatment and initiation of support services. These patients were previously left on scene without any additional support or services, despite encountering emergency medical personnel. To supplement the state\u27s naloxone distribution efforts, Vermont initiated an EMS protocol allowing all levels of providers to provide naloxone leave-behind kits to patients and/or their family or friends when a patient is identified as high-risk for opiate overdose and is not transported to a hospital by the responding EMS agency. Objectives: To evaluate the preliminary outcomes of Vermont\u27s EMS naloxone leave-behind program. Methods: De-identified data was obtained from Vermont’s pre-hospital incident reporting tool, SIREN, containing incidents in which patients who were not transported to a hospital were identified by EMS as high-risk for future opiate overdose. The data was divided into two data sets. The first represented a retrospective time period of the 12 months leading up to the naloxone leave behind protocol initiation on 10/01/2020. The prospective data set includes all encounters in the 12-month period after the protocol was started. This analysis includes only the preliminary analysis of the first six months of the protocol. Results: In the retrospective time period between October 2019 and September 2020 (prior to starting the naloxone leave-behind program), Vermont EMS agencies responded to 195 incidents where a patient that was subsequently not transported to a hospital met criteria for being high-risk for future opioid overdose. In the preliminary prospective data period, from October 2020 through March 2021 (six months of naloxone leave-behind program), 119 patients were not transported to a hospital and were identified as high-risk for future opiate overdose. Of the 119 patients, 69 patients were offered a naloxone leave-behind kit by the responding EMS agency, representing 58% of the target population of high-risk individuals. Of these 69 patients, 59 patients accepted a kit, representing an overall naloxone leave-behind kit distribution rate of 50.0%, and a kit acceptance rate of 85.5%. The high-risk patients who were not transported to a hospital were most often ages 30-39 (48.7%), and 61.7% were male gender

Additional Thoughts on Rigor in Wildlife Science: Unappreciated Impediments

Traditionally, most scientists accepted reductionist and mechanistic approaches as the rigorous way to do science. Sells et al. (2018) recently raised the argument about reliability in wildlife science. Chamberlin (1890), Platt (1964), Romesburg (1981, 1991, 2009), and Williams (1997) were rightly referenced as very influential papers. My intention in this letter is not to refute the essence of the Sells et al. (2018) commentary but to add seldom addressed but important aspects that influence the attainment of rigor and certainty in wildlife studies. The elements of a rigorous approach (i.e., strong inference) as described by Platt (1964) included devising alternative hypotheses, devising ≥1 crucial experiments that will exclude ≥1 of the hypotheses, and carrying out the experiment to get a clean result. The process was then repeated using logical inductive trees (i.e., a continually bifurcated statement hypotheses approach) to obtain the essential cause for the effect. Platt (1964) agreed with Popper (1959) that science advanced only by disproof. He argued that this was a hard doctrine and leads to disputations between scientists, but that Chamberlin\u27s (1890) method of multiple working hypotheses helped to remove that difficulty. Platt (1964) emphasized inductive inference and crucial and critical experiments whereby alternate hypotheses are refuted. Romesburg (1981) explained that in wildlife biology, induction (reliable associations) and retroduction (developing hypotheses) were the basis for almost all wildlife research but were not sufficient. He proposed the hypothetical‐deductive (H‐D) method as a more reliable approach. Citing Harvey (1969), and Popper (1962), Romesburg (1981:294) explained that “Starting with the research hypothesis, usually obtained by retroduction, predictions are made about other classes of facts that should be true if the research hypothesis is actually true.” The hypothesis is then tested indirectly by using logic to deduce one or more test consequences (Romesburg 2014). Data are then collected in a statistical framework. Romesburg (1981) distinguished between a research hypothesis (i.e., a conjecture about some process) versus a statistical hypothesis (i.e., a conjecture about classes of facts encompassed by the process). Williams (1997) clearly explained the differences between necessary and sufficient causation and gave examples of the coherent logic both entailed. He summarized that the science endeavor included theory, hypotheses, predictions, observations, and comparison of predictions against data, and argued that inductive and deductive logic were required for testing hypotheses. Importantly, Williams (1997:1014) recognized that wildlife biology often involves simultaneous complementary explanatory factors, requiring “the framing of many scientifically interesting issues about cause and effect in terms of the relative contribution of multiple causal factors.” Over the years, many others have addressed the issue of rigor and reliability in the Journal of Wildlife Management (JWM) and the Wildlife Society Bulletin (WSB) either directly (McNab 1983, Eberhardt 1988, Anderson 2001) or indirectly (Steidl et al. 1997, Guthery et al. 2001). This is not a complete list and is limited primarily to JWM and WSB but gives an idea of the wide interest in achieving reliable results from wildlife studies

Musicians’ perceptions and experiences of using simulation training to develop performance skills

Simulation has been applied as a tool for learning and training in sports, psychology and medicine for some time, but its current use and potential for training musicians is less well understood. The aim of this study was to explore musicians’ perceptions and experiences of using simulated performance environments. Nine conservatory students performed in two simulations, each with interactive virtual elements and vivid environmental cues: a recital with a virtual audience and an audition with virtual judges. Qualitative data were collected through a focus group interview and written reflective commentaries. Thematic analysis highlighted the musicians’ experiences in terms of (1) their anticipation of using the simulations, (2) the process of performing in the simulations, (3) the usefulness of simulation as a tool for developing performance skills and (4) ways of improving simulation training. The results show that while simulation was new to the musicians and individual levels of immersion differed, the musicians saw benefits in the approach for developing, experimenting with and enhancing their performance skills. Specifically, the musicians emphasised the importance of framing the simulation experience with plausible procedures leading to and following on from the performance, and they recognised the potential for combining simulation with complementary training techniques

Human and computational models of atopic dermatitis:A review and perspectives by an expert panel of the International Eczema Council

Atopic dermatitis (AD) is a prevalent disease worldwide and is associated with systemic comorbidities representing a significant burden on patients, their families, and society. Therapeutic options for AD remain limited, in part because of a lack of well-characterized animal models. There has been increasing interest in developing experimental approaches to study the pathogenesis of human AD in vivo, in vitro, and in silico to better define pathophysiologic mechanisms and identify novel therapeutic targets and biomarkers that predict therapeutic response. This review critically appraises a range of models, including genetic mutations relevant to AD, experimental challenge of human skin in vivo, tissue culture models, integration of “omics” data sets, and development of predictive computational models. Although no one individual model recapitulates the complex AD pathophysiology, our review highlights insights gained into key elements of cutaneous biology, molecular pathways, and therapeutic target identification through each approach. Recent developments in computational analysis, including application of machine learning and a systems approach to data integration and predictive modeling, highlight the applicability of these methods to AD subclassification (endotyping), therapy development, and precision medicine. Such predictive modeling will highlight knowledge gaps, further inform refinement of biological models, and support new experimental and systems approaches to AD

Research Staff COVID-19 Pandemic Survey-Results from the Prevention and Early Treatment of Acute Lung Injury (PETAL) Network

Objectives: There is a lack of knowledge about the challenges of researchers who continued in-person research during the early phases of the COVID-19 pandemic. Design: Electronic survey assessing work-related exposure to COVID-19, logistical challenges, and procedural changes during the first year of the COVID-19 pandemic on clinical research. Setting: National Heart, Lung, and Blood Institute-sponsored Prevention and Early Treatment of Acute Lung Injury Clinical Trial Network Centers. Subjects: Research staff at research Network Sites. Measurements and Main Results: The 37-question survey was completed by 277 individuals from 24 states between 29 September 2020, and 12 December 2020, yielding a response rate of 37.7%. Most respondents (91.5%) indicated that non-COVID-19 research was affected by COVID-19 research studies. In response to the COVID-19 pandemic, 20% of respondents were reassigned to different roles at their institution. Many survey takers were exposed to COVID-19 (56%), with more than 50% of researchers requiring a COVID-19 test and 8% testing positive. The fear of infection was 2.7-times higher compared to pre-COVID-19 times. Shortages of personal protective equipment were encountered by 34% of respondents, primarily due to lack of access to N95 masks, followed by gowns and protective eyewear. Personal protective equipment reallocation from research to clinical use was reported by 31% of respondents. Most of the respondents (88.5%), despite these logistical challenges, indicated their willingness to enroll COVID-19 patients. Conclusions: During the first year of the COVID-19 pandemic, members of the research network were engaged in COVID-19 research despite logistical challenges, limited access to personal protective equipment, and fear of exposure. The research network’s survey experience can inform ongoing policy discussions to create research enterprises that can dexterously refocus research to address the knowledge gaps associated with novel public health emergencies while mitigating the effect of pandemics on existing research projects and research personnel

Organic Farming Improves Pollination Success in Strawberries

Pollination of insect pollinated crops has been found to be correlated to pollinator abundance and diversity. Since organic farming has the potential to mitigate negative effects of agricultural intensification on biodiversity, it may also benefit crop pollination, but direct evidence of this is scant. We evaluated the effect of organic farming on pollination of strawberry plants focusing on (1) if pollination success was higher on organic farms compared to conventional farms, and (2) if there was a time lag from conversion to organic farming until an effect was manifested. We found that pollination success and the proportion of fully pollinated berries were higher on organic compared to conventional farms and this difference was already evident 2–4 years after conversion to organic farming. Our results suggest that conversion to organic farming may rapidly increase pollination success and hence benefit the ecosystem service of crop pollination regarding both yield quantity and quality

Correlations of behavioral deficits with brain pathology assessed through longitudinal MRI and histopathology in the R6/1 mouse model of huntington's disease

Huntington's disease (HD) is caused by the expansion of a CAG repeat in the huntingtin (HTT) gene. The R6 mouse models of HD express a mutant version of exon 1 HTT and typically develop motor and cognitive impairments, a widespread huntingtin (HTT) aggregate pathology and brain atrophy. Unlike the more commonly used R6/2 mouse line, R6/1 mice have fewer CAG repeats and, subsequently, a less rapid pathological decline. Compared to the R6/2 line, fewer descriptions of the progressive pathologies exhibited by R6/1 mice exist. The association between the molecular and cellular neuropathology with brain atrophy, and with the development of behavioral phenotypes remains poorly understood in many models of HD. In attempt to link these factors in the R6/1 mouse line, we have performed detailed assessments of behavior and of regional brain abnormalities determined through longitudinal, in vivo magnetic resonance imaging (MRI), as well as an end-stage, ex vivo MRI study and histological assessment. We found progressive decline in both motor and non-motor related behavioral tasks in R6/1 mice, first evident at 11 weeks of age. Regional brain volumes were generally unaffected at 9 weeks, but by 17 weeks there was significant grey matter atrophy. This age-related brain volume loss was validated using a more precise, semi-automated Tensor Based morphometry assessment. As well as these clear progressive phenotypes, mutant HTT (mHTT) protein, the hallmark of HD molecular pathology, was widely distributed throughout the R6/1 brain and was accompanied by neuronal loss. Despite these seemingly concomitant, robust pathological phenotypes, there appeared to be little correlation between the three main outcome measures: behavioral performance, MRI-detected brain atrophy and histopathology. In conclusion, R6/1 mice exhibit many features of HD, but the underlying mechanisms driving these clear behavioral disturbances and the brain volume loss, still remain unclear. © 2013 Rattray et al

Validation of the Comprehensive Feeding Practices Questionnaire with parents of 10-to-12-year-olds

Abstract Background: There is a lack of validated instruments for quantifying feeding behavior among parents of older children and adolescents. The Comprehensive Feeding Practices Questionnaire (CFPQ) is a self-report measure to assess multiple parental feeding practices. The CFPQ is originally designed for use with parents of children ranging in age from about 2 to 8 years. It is previously validated with American and French parents of children within this age range. The aim of the present study was to adapt and test the validity of this measure with parents of older children (10-to-12-year-olds) in a Norwegian setting. Methods: A sample of 963 parents of 10-to-12-year-olds completed a Norwegian, slightly adapted version of the CFPQ. Scale analyses were performed to test the validity of the instrument in our sample. Results: Although a few problematic items and scales were revealed, scale analyses showed that the psychometric properties of the slightly adapted, Norwegian version of the CFPQ were surprisingly similar to those of the original CFPQ. Conclusions: Our results indicated that the CFPQ, with some small modifications, is a valid tool for measuring multiple parental feeding practices with parents of 10-to12-year-olds

The influence of wildlife water developments and vegetation on rodent abundance in the Great Basin Desert

Rodent communities have multiple functions including comprising a majority of the mammalian diversity within an ecosystem, providing a significant portion of the available biomass consumed by predators, and contributing to ecosystem services. Despite the importance of rodent communities, few investigations have explored the effects of increasing anthropogenic modifications to the landscape on rodents. Throughout the western United States, the construction of artificial water developments to benefit game species is commonplace. While benefits for certain species have been documented, several researchers recently hypothesized that these developments may cause unintentional negative effects to desert-adapted species and communities. To test this idea, we sampled rodents near to and distant from wildlife water developments over 4 consecutive summers. We employed an asymmetrical before-after-control-impact (BACI) design with sampling over 4 summers to determine if water developments influenced total rodent abundance. We performed an additional exploratory analysis to determine if factors other than free water influenced rodent abundance. We found no evidence that water developments impacted rodent abundance. Rodent abundance was primarily driven by vegetation type and year of sampling. Our findings suggested that water developments on our study area do not represent a significant disturbance to rodent abundance and that rodent abundance was influenced by the vegetative community and temporal factors linked to precipitation and primary plant production. Our findings represent one of the 1st efforts to determine the effects of an anthropogenic activity on the rodent community utilizing a manipulation design