Defining a recovery-oriented cascade of care for opioid use disorder: A community-driven, statewide cross-sectional assessment

Background In light of the accelerating and rapidly evolving overdose crisis in the United States (US), new strategies are needed to address the epidemic and to efficiently engage and retain individuals in care for opioid use disorder (OUD). Moreover, there is an increasing need for novel approaches to using health data to identify gaps in the cascade of care for persons with OUD. Methods and findings Between June 2018 and May 2019, we engaged a diverse stakeholder group (including directors of statewide health and social service agencies) to develop a statewide, patient-centered cascade of care for OUD for Rhode Island, a small state in New England, a region highly impacted by the opioid crisis. Through an iterative process, we modified the cascade of care defined by Williams et al. for use in Rhode Island using key national survey data and statewide health claims datasets to create a cross-sectional summary of 5 stages in the cascade. Approximately 47,000 Rhode Islanders (5.2%) were estimated to be at risk for OUD (stage 0) in 2016. At the same time, 26,000 Rhode Islanders had a medical claim related to an OUD diagnosis, accounting for 55% of the population at risk (stage 1); 27% of the stage 0 population, 12,700 people, showed evidence of initiation of medication for OUD (MOUD, stage 2), and 18%, or 8,300 people, had evidence of retention on MOUD (stage 3). Imputation from a national survey estimated that 4,200 Rhode Islanders were in recovery from OUD as of 2016, representing 9% of the total population at risk. Limitations included use of self-report data to arrive at estimates of the number of individuals at risk for OUD and using a national estimate to identify the number of individuals in recovery due to a lack of available state data sources. Conclusions Our findings indicate that cross-sectional summaries of the cascade of care for OUD can be used as a health policy tool to identify gaps in care, inform data-driven policy decisions, set benchmarks for quality, and improve health outcomes for persons with OUD. There exists a significant opportunity to increase engagement prior to the initiation of OUD treatment (i.e., identification of OUD symptoms via routine screening or acute presentation) and improve retention and remission from OUD symptoms through improved community-supported processes of recovery. To do this more precisely, states should work to systematically collect data to populate their own cascade of care as a health policy tool to enhance system-level interventions and maximize engagement in care

Study on the Self-Repairing Effect of Nanoclay in Powder Coatings for Corrosion Protection

Powder coatings are a promising, solvent-free alternative to traditional liquid coatings due to the superior corrosion protection they provide. This study investigates the effects of incorporating montmorillonite-based nanoclay additives with different particle sizes into polyester/triglycidyl isocyanurate (polyester/TGIC) powder coatings. The objective is to enhance the corrosion-protective function of the coatings while addressing the limitations of commonly employed epoxy-based coating systems that exhibit inferior UV resistance. The anti-corrosive and surface qualities of the coatings were evaluated via neutral salt spray tests, electrochemical measurements, and surface analytical techniques. Results show that the nanoclay with a larger particle size of 18.38 µm (D50, V) exhibits a better barrier effect at a lower dosage of 4%, while a high dosage leads to severe defects in the coating film. Interestingly, the coating capacitance is found, via electrochemical impedance spectroscopy, to decrease during the immersion test, indicating a self-repairing capability of the nanoclay, arising from its swelling and expansion. Neutral salt spray tests suggest an optimal nanoclay dosage of 2%, with the smaller particle size (8.64 µm, D50, V) nanoclay providing protection for 1.5 times as many salt spray hours as the nanoclay with a larger particle size. Overall, incorporating montmorillonite-based nanoclay additives is suggested to be a cost-effective approach for significantly enhancing the anti-corrosive function of powder coatings, expanding their application to outdoor environments

An Earthworm Riddle: Systematics and Phylogeography of the Spanish Lumbricid Postandrilus

As currently defined, the genus Postandrilus Qui and Bouché, 1998, (Lumbricidae) includes six earthworm species, five occurring in Majorca (Baleares Islands, western Mediterranean) and another in Galicia (NW Spain). This disjunct and restricted distribution raises some interesting phylogeographic questions: (1) Is Postandrilus distribution the result of the separation of the Baleares-Kabylies (BK) microplate from the proto-Iberian Peninsula in the Late Oligocene (30-28 Mya)--vicariant hypothesis? (2) Did Postandrilus diversify in Spain and then colonize the Baleares during the Messinian salinity crisis (MSC) 5.96-5.33 Mya--dispersal hypothesis? (3) Is the distribution the result of a two-step process--vicariance with subsequent dispersal?To answer these questions and assess Postandrilus evolutionary relationships and systematics, we collected all of the six Postandrilus species (46 specimens - 16 locations) and used Aporrectodea morenoe and three Prosellodrilus and two Cataladrilus species as the outgroup. Regions of the nuclear 28S rDNA and mitochondrial 16S rDNA, 12S rDNA, ND1, COII and tRNA genes (4,666 bp) were sequenced and analyzed using maximum likelihood and Bayesian methods of phylogenetic and divergence time estimation. The resulting trees revealed six new Postandrilus species in Majorca that clustered with the other five species already described. This Majorcan clade was sister to an Iberian clade including A. morenoe (outgroup) and Postandrilus bertae. Our phylogeny and divergence time estimates indicated that the split between the Iberian and Majorcan Postandrilus clades took place 30.1 Mya, in concordance with the break of the BK microplate from the proto-Iberian Peninsula, and that the present Majorcan clade diversified 5.7 Mya, during the MSC.Postandrilus is highly diverse including multiple cryptic species in Majorca. The genus is not monophyletic and invalid as currently defined. Postandrilus is of vicariant origin and its radiation began in the Late Oligocene

The Observed Evolution of the Stellar Mass-Halo Mass Relation for Brightest Central Galaxies

We quantify evolution in the cluster-scale stellar mass–halo mass (SMHM) relation's parameters using 2323 clusters and brightest central galaxies (BCGs) over the redshift range 0.03 ≤ z ≤ 0.60. The precision on the inferred SMHM parameters is improved by including the magnitude gap (mgap) between the BCG and fourth-brightest cluster member (M14) as a third parameter in the SMHM relation. At fixed halo mass, accounting for mgap, through a stretch parameter, reduces the SMHM relation's intrinsic scatter. To explore this redshift range, we use clusters, BCGs, and cluster members identified using the Sloan Digital Sky Survey C4 and redMaPPer cluster catalogs and the Dark Energy Survey redMaPPer catalog. Through this joint analysis, we detect no systematic differences in BCG stellar mass, mgap, and cluster mass (inferred from richness) between the data sets. We utilize the Pareto function to quantify each parameter's evolution. We confirm prior findings of negative evolution in the SMHM relation's slope (3.5σ), and detect negative evolution in the stretch parameter (4.0σ) and positive evolution in the offset parameter (5.8σ). This observed evolution, combined with the absence of BCG growth, when stellar mass is measured within 50 kpc, suggests that this evolution results from changes in the cluster's mgap. For this to occur, late-term growth must be in the intracluster light surrounding the BCG. We also compare the observed results to IllustrisTNG 300-1 cosmological hydrodynamic simulations and find modest qualitative agreement. However, the simulations lack the evolutionary features detected in the real data

Characterizing the intracluster light over the redshift range 0.2 < z < 0.8 in the DES-ACT overlap

We characterize the properties and evolution of bright central galaxies (BCGs) and the surrounding intracluster light (ICL) in galaxy clusters identified in the Dark Energy Survey and Atacama Cosmology Telescope Survey (DES-ACT) overlapping regions, covering the redshift range 0.20 14.4. We also measure the stellar mass–halo mass (SMHM) relation for the BCG+ICL system and find that the slope, β, which characterizes the dependence of M200m,SZ on the BCG+ICL stellar mass, increases with radius. The outskirts are more strongly correlated with the halo than the core, which supports that the BCG+ICL system follows a two-phase growth, where recent growth (z < 2) occurs beyond the BCG’s core. Additionally, we compare our observed SMHM relation results to the IllustrisTNG300-1 cosmological hydrodynamic simulations and find moderate qualitative agreement in the amount of diffuse light. However, the SMHM relation’s slope is steeper in TNG300-1 and the intrinsic scatter is lower, likely from the absence of projection effects in TNG300-1. Additionally, we find that the ICL exhibits a colour gradient such that the outskirts are bluer than the core. Moreover, for the lower halo mass clusters (log10(M200m,SZ/M⊙) < 14.59), we detect a modest change in the colour gradient’s slope with lookback time, which combined with the absence of stellar mass growth may suggest that lower mass clusters have been involved in growth via tidal stripping more recently than their higher mass counterparts

Local-Scale Patterns of Genetic Variability, Outcrossing, and Spatial Structure in Natural Stands of Arabidopsis thaliana

As Arabidopsis thaliana is increasingly employed in evolutionary and ecological studies, it is essential to understand patterns of natural genetic variation and the forces that shape them. Previous work focusing mostly on global and regional scales has demonstrated the importance of historical events such as long-distance migration and colonization. Far less is known about the role of contemporary factors or environmental heterogeneity in generating diversity patterns at local scales. We sampled 1,005 individuals from 77 closely spaced stands in diverse settings around Tübingen, Germany. A set of 436 SNP markers was used to characterize genome-wide patterns of relatedness and recombination. Neighboring genotypes often shared mosaic blocks of alternating marker identity and divergence. We detected recent outcrossing as well as stretches of residual heterozygosity in largely homozygous recombinants. As has been observed for several other selfing species, there was considerable heterogeneity among sites in diversity and outcrossing, with rural stands exhibiting greater diversity and heterozygosity than urban stands. Fine-scale spatial structure was evident as well. Within stands, spatial structure correlated negatively with observed heterozygosity, suggesting that the high homozygosity of natural A. thaliana may be partially attributable to nearest-neighbor mating of related individuals. The large number of markers and extensive local sampling employed here afforded unusual power to characterize local genetic patterns. Contemporary processes such as ongoing outcrossing play an important role in determining distribution of genetic diversity at this scale. Local “outcrossing hotspots” appear to reshuffle genetic information at surprising rates, while other stands contribute comparatively little. Our findings have important implications for sampling and interpreting diversity among A. thaliana accessions

The James Webb Space Telescope Mission: Optical Telescope Element Design, Development, and Performance

The James Webb Space Telescope (JWST) is a large, infrared space telescope that has recently started its science program which will enable breakthroughs in astrophysics and planetary science. Notably, JWST will provide the very first observations of the earliest luminous objects in the Universe and start a new era of exoplanet atmospheric characterization. This transformative science is enabled by a 6.6 m telescope that is passively cooled with a 5-layer sunshield. The primary mirror is comprised of 18 controllable, low areal density hexagonal segments, that were aligned and phased relative to each other in orbit using innovative image-based wavefront sensing and control algorithms. This revolutionary telescope took more than two decades to develop with a widely distributed team across engineering disciplines. We present an overview of the telescope requirements, architecture, development, superb on-orbit performance, and lessons learned. JWST successfully demonstrates a segmented aperture space telescope and establishes a path to building even larger space telescopes.Comment: accepted by PASP for JWST Overview Special Issue; 34 pages, 25 figure

Global Spatial Risk Assessment of Sharks Under the Footprint of Fisheries

Effective ocean management and conservation of highly migratory species depends on resolving overlap between animal movements and distributions and fishing effort. Yet, this information is lacking at a global scale. Here we show, using a big-data approach combining satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively) and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of high-seas fishing effort. Results demonstrate an urgent need for conservation and management measures at high-seas shark hotspots and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real time, dynamic management

The Present and Future Role of Insect-Resistant Genetically Modified Maize in IPM

Commercial, genetically-modified (GM) maize was first planted in the United States (USA, 1996) and Canada (1997) but now is grown in 13 countries on a total of over 35 million hectares (\u3e24% of area worldwide). The first GM maize plants produced a Cry protein derived from the soil bacteriumBacillus thuringiensis (Bt), which made them resistant to European corn borer and other lepidopteran maize pests. New GM maize hybrids not only have resistance to lepidopteran pests but some have resistance to coleopteran pests and tolerance to specific herbicides. Growers are attracted to the Btmaize hybrids for their convenience and because of yield protection, reduced need for chemical insecticides, and improved grain quality. Yet, most growers worldwide still rely on traditional integrated pest management (IPM) methods to control maize pests. They must weigh the appeal of buying insect protection “in the bag” against questions regarding economics, environmental safety, and insect resistance management (IRM). Traditional management of maize insects and the opportunities and challenges presented by GM maize are considered as they relate to current and future insect-resistant products. Four countries, two that currently have commercialize Bt maize (USA and Spain) and two that do not (China and Kenya), are highlighted. As with other insect management tactics (e.g., insecticide use or tillage), GM maize should not be considered inherently compatible or incompatible with IPM. Rather, the effect of GM insect-resistance on maize IPM likely depends on how the technology is developed and used