Additional Contacts Research Articles

LTBI-negative close contacts of tuberculosis are more likely to develop the disease: enlightenment and lessons from a cluster outbreak.

Tuberculosis (TB) prevention and control among groups living together, such as students, workers, older adults in nursing homes, and prisoners, present many challenges due to their particular age and environmental factors, which can make them more susceptible to TB clusters with significant societal impact. This study aimed to evaluate a TB cluster outbreak epidemic in a university and provide suggestions for improving TB control strategies for groups living together. Pulmonary TB screening and close-contact investigation were conducted using acid-fast staining, sputum culture, GeneXpert testing, tuberculin skin testing (TST), interferon-gamma release assay (IGRA), and chest computed tomography (CT). GraphPad Prism 9.5.1 was utilized for data analysis. Collected epidemic data were comprehensively analyzed by rate comparison. The TB cluster outbreak epidemic was identified with an index case confirmed positive. The initial screening was conducted on potential close contacts of the index case, and the TST's positive rate (diameter ≥ 5 mm) and strong positive rate (diameter ≥ 15 mm) among these close contacts were 65.60% (21/32) and 34.40% (11/32), respectively. Moreover, the latent TB infection (LTBI) rate (diameter ≥ 10 mm) was 43.75% (14/32), and the IGRA's positive rate was 9.30% (3/32). Chest CT scans did not reveal any abnormalities. Surprisingly, 5 of the close contacts developed active TB in the second screening, accompanied by changes from negative to positive TST and/or IGRA results, after 3 months of follow-up. Accordingly, we expanded the screening scope to include another 28 general contacts. We found that the positive rate (78.00%, 25/32), strong positive rate (50.00%, 16/32), and LTBI rate (62.50%, 20/32) of the 32 close contacts were significantly higher than those of the additional general contacts (28.00%, 8/28; 14.3%, 4/28; 25.00%, 7/28), as indicated by p < 0.05. In the event of an epidemic TB outbreak, it is essential to rapidly identify the source of infection and initiate timely screening of close contacts. The initial screening should be focused on individuals without LTBI, who are at higher risk of developing TB. In purified protein derivative-negative individuals living in groups, additional vaccination or revaccination with Bacille Calmette-Guérin may help prevent cluster outbreaks of TB.

Lessons Learned from Telemonitoring in an Outpatient Bariatric Surgery Pathway—Secondary Outcomes of a Patient Preference Clinical Trial

BackgroundRemote monitoring is increasingly used to support postoperative care. This study aimed to describe the lessons learned from the use of telemonitoring in an outpatient bariatric surgery pathway.Materials and MethodsPatients were assigned based on their preference to an intervention cohort of same-day discharge after bariatric surgery. In total, 102 patients were monitored continuously for 7 days using a wearable monitoring device with a Continuous and Remote Early Warning Score–based notification protocol (CREWS). Outcome measures included missing data, course of postoperative heart and respiration rate, false positive notification and specificity analysis, and vital sign assessment during teleconsultation.ResultsIn 14.7% of the patients, data for heart rate was missing for > 8 h. A day-night-rhythm of heart rate and respiration rate reappeared on average on postoperative day 2 with heart rate amplitude increasing after day 3. CREWS notification had a specificity of 98%. Of the 17 notifications, 70% was false positive. Half of them occurred between day 4 and 7 and were accompanied with surrounding reassuring values. Comparable postoperative complaints were encountered between patients with normal and deviated data.ConclusionTelemonitoring after outpatient bariatric surgery is feasible. It supports clinical decisions, however does not replace nurse or physician care. Although infrequent, the false notification rate was high. We suggested additional contact may not be necessary when notifications occur after restoration of circadian rhythm or when surrounding reassuring vital signs are present. CREWS supports ruling out serious complications, what may reduce in-hospital re-evaluations. Following these lessons learned, increased patients’ comfort and decreased clinical workload could be expected.Trial RegistrationClinicalTrials.gov. Identifier: NCT04754893.Graphical

A multicomponent complex intervention for supportive follow-up of persons with chronic heart failure: a randomized controlled pilot study (the UTILE project)

BackgroundHeart failure (HF) is a progressive disease associated with a high burden of symptoms, high morbidity and mortality, and low quality of life (QoL). This study aimed to evaluate the feasibility and potential outcomes of a novel multicomponent complex intervention, to inform a future full-scale randomized controlled trial (RCT) in Switzerland.MethodsWe conducted a pilot RCT at a secondary care hospital for people with HF hospitalized due to decompensated HF or with a history of HF decompensation over the past 6 months. We randomized 1:1; usual care for the control (CG) and intervention group (IG) who received the intervention as well as usual care. Feasibility measures included patient recruitment rate, study nurse time, study attrition, the number and duration of consultations, intervention acceptability and intervention fidelity. Patient-reported outcomes included HF-specific self-care and HF-related health status (KCCQ-12) at 3 months follow-up. Clinical outcomes were all-cause mortality, hospitalization and days spent in hospital.ResultsWe recruited 60 persons with HF (age mean = 75.7 years, ± 8.9) over a 62-week period, requiring 1011 h of study nurse time. Recruitment rate was 46.15%; study attrition rate was 31.7%. Follow-up included 2.14 (mean, ± 0.97) visits per patient lasting a total of 166.96 min (mean, ± 72.55), and 3.1 (mean, ± 1.7) additional telephone contacts. Intervention acceptability was high. Mean intervention fidelity was 0.71. We found a 20-point difference in mean self-care management change from baseline to 3 months in favour of the IG (Cohens’ d = 0.59). Small effect sizes for KCCQ-12 variables; less IG participants worsened in health status compared to CG participants. Five deaths occurred (IG = 3, CG = 2). There were 13 (IG) and 18 (CG) all-cause hospital admissions; participants spent 8.90 (median, IQR = 9.70, IG) and 15.38 (median, IQR = 18.41, CG) days in hospital. A subsequent full-scale effectiveness trial would require 304 (for a mono-centric trial) and 751 participants (for a ten-centre trial) for HF-related QoL (effect size = 0.3; power = 0.80, alpha = 0.05).ConclusionWe found the intervention, research methods and outcomes were feasible and acceptable. We propose increasing intervention fidelity strategies for a full-scale trial.Trial registrationISRCTN10151805, retrospectively registered 04/10/2019.

Free drug provision for tuberculosis increases patient follow-ups and successful treatment outcomes in the Indian private sector: a quasi experimental study using propensity score matching

BackgroundThe private sector is an important yet underregulated component of the TB treatment infrastructure in India. The Joint Effort for Elimination of Tuberculosis (Project JEET) aims to link private sector TB care with the constellation of social support mechanisms available through the Indian National TB Elimination Programme (NTEP), including the provision of free fixed-dose combination (FDCs) drugs to patients. This quasi-experimental study analysed routinely collected data to determine the impact of free drugs on patient follow-ups and treatment outcomes.MethodsWe used data for private sector patients enrolled with Project JEET who were diagnosed with pulmonary and extrapulmonary TB between 1 January 2019 and 31 March 2020, and completed treatment by 31 December 2021. Propensity score matching was used to create a dataset to compare the number of follow-ups and proportion of successful treatment outcomes for patients on free drugs to a control group who paid out-of-pocket. 11,621 matched pairs were included in the analysis. Logistic regression and ordinary least squares regression models were used to estimate the impact of free drugs on number of follow-ups and treatment success, where latter is defined as treatment completion or cure.ResultsAfter controlling for potential confounders, patients on free drugs received on average 2.522 (95% C.I.: 2.325 to 2.719) additional follow-ups compared to patients who paid out of pocket. This equates to a 25% mean and 32% median increase in follow-ups for patients availing free drugs. For treatment success, patients receiving free drugs had 45% higher odds of a successful treatment (Odds Ratio: 1.452, 95% C.I.: 1.288 to 1.637).ConclusionsPatients receiving free drugs were found to follow up with their treatment coordinator more frequently, in part likely to enable drug refilling, compared to patients who were paying out of pocket. These additional contacts would have offered opportunities to address concerns regarding side effects, provide additional treatment information, and connect with social support services, all of which subsequently contributed to patients’ continual engagement with their treatment. This potentially represents the unmeasured effect of free drugs on continual social support, which translates into a higher odds of treatment success for patients.

The Rise of Fake and Clone Journals in Medical Sciences: A Threat to Research Integrity

Open-access publishing has made research sharing and access easier, but it has also led to the proliferation of deceitful journals that exploit the author-pay model, endangering research integrity. These journals appear trustworthy, claim high impact factors, but lack review information and editorial board details. Identifying fake journals is challenging, but researchers can use indicators like thorough website examination, searching for additional contact information, and verifying indexing in reputable databases. Clone journals are fraudulent replicas of authentic ones that deceive authors and readers with identical names, logos, and designs. They lack peer reviews and publish flawed or deceitful research. Medical research is particularly vulnerable, with even prominent journals falling victim. Fake and cloned journals misguide researchers, clinicians, and policymakers, harming public health and undermining genuine research credibility. To protect valuable findings, researchers must stay vigilant, evaluate journals carefully, and choose reputable ones with rigorous peer-review processes and high impact factors. By doing so, researchers ensure comprehensive evaluation and contribute to medical science advancement. Addressing the issue requires collective attention from researchers, publishers, and policymakers, preserving research integrity and public well-being.

Multi-Axial Elastic Averaging for Sub-Micron Passive Alignment of Photonic Components

In recent years, heterogeneous integration (HI) has become a game-changing technology for the construction of complex photonic integrated circuits. Comparing to monolithic integration (MI) technique, chips are stacked or add-on during HI. These components are attached to the substrate using an active or passive alignment scheme. As the passive alignment system does not actively search for the optical axis, it allows more die to be bonded per unit time as compared to active alignment. The main challenge is then to obtain consistent sub-micron alignment accuracy during chip manufacturing process to ensure good device performance. To achieve sub-micron alignment accuracy, slide-stop structures with multi-axial elastic averaging coupling designs are implemented. In this work, optical dies are bonded to silicon interposers with two geometrically different slide-stop designs: triangle and rectangle in designs, respectively. Due to an additional surface contact and smaller internal angle for the former, the triangle slide-stop design improves the translational-axes and rotational-axis post-bond alignment accuracy, from (Reference) −0.27 μm ± 2.54 μm @ 3sigma to (slide-stop) −0.09 μm ± 1.37 μm @ 3sigma, (Reference) 1.00 μm ± 3.19 μm @ 3sigma to (slide-stop) 0.39 μm ± 1.29 μm @ 3sigma, and (Reference) 0.06° ± 0.34° @ 3sigma to (slide-stop) 0.0002° ± 0.15° @ 3sigma respectively. Finally, narrower optical power output distribution of P-down bonded lasers with triangle slide-stop over lasers with rectangle slide-stop is demonstrated.

Three-Dimensional-Printed Polymeric Cores for Methane Hydrate Enhanced Growth.

Polymeric models of the core prepared with a Raise3D Pro2 3D printer were employed for methane hydrate formation. Polylactic acid (PLA), acrylonitrile butadiene styrene (ABS), carbon fiber reinforced polyamide-6 (UltraX), thermoplastic polyurethane (PolyFlex), and polycarbonate (ePC) were used for printing. Each plastic core was rescanned using X-ray tomography to identify the effective porosity volumes. It was revealed that the polymer type matters in enhancing methane hydrate formation. All polymer cores except PolyFlex promoted the hydrate growth (up to complete water-to-hydrate conversion with PLA core). At the same time, changing the filling degree of the porous volume with water from partial to complete decreased the efficiency of hydrate growth by two times. Nevertheless, the polymer type variation allowed three main features: (1) managing the hydrate growth direction via water or gas preferential transfer through the effective porosity; (2) the blowing of hydrate crystals into the volume of water; and (3) the growth of hydrate arrays from the steel walls of the cell towards the polymer core due to defects in the hydrate crust, providing an additional contact between water and gas. These features are probably controlled by the hydrophobicity of the pore surface. The proper filament selection allows the hydrate formation mode to be set for specific process requirements.

Fluorescence polarization reveals a possible displacement model of competition in PRC2:RNA:DNA interactions

PRC2 is a histone methyltransferase that acts on histone subunit H3 at lysine 27 to repress chromatin state and inhibit gene expression. The interactions between PRC2 and RNA have been heavily studied in vivo and in vitro with conflicting results reported on the relationship, but there is less data on interactions between PRC2 and DNA. Fluorescence polarization-based methodology was used with various RNA and DNA species to study the binding kinetics of PRC2 with RNA and DNA. Previous data indicate that PRC2 has a relatively high affinity for DNA species that are rich in consecutive G and C nucleotides. Double-stranded DNA species with lengths of 50-60 bp were designed for this project. Fluorescence polarization binding experiments were used to identify the general binding affinity of the DNA and RNA species to PRC2 by calculating the Kd apparent for the binding curve. After the apparent binding affinities were determined, various FP-competition experiments were performed to determine if each DNA species could be competed off by an RNA species or itself, and vice versa. These results showed that the DNA species were more effective competitors although the RNA species were stronger binders. These results suggest a mechanism for RNA-mediated PRC2 regulation that could reconcile the conflicting experimental results and interpretations of past experiments. Further FP-based Kd experiments under varying salt concentrations revealed PRC2 has ionic interactions with DNA that are not seen with RNA. This suggests PRC2 has extra unique interactions with DNA, which could explain the differing effectiveness of DNA versus RNA as competitors. Altogether, the results imply that DNA has additional contacts with PRC2 that limit its displacement by RNA, allowing for RNA to guide PRC2 to its target genetic loci and then for PRC2 to deposit its methyl marks without being sequestered by RNA. Lay Summary PRC2 is a protein involved in gene expression. Its role is to repress chromatin state, inhibiting gene expression during development. This protein is vital to developmentand has been linked to multiple diseases of the body including skin cancer and other forms. When the protein is doing its job correctly, it interacts with DNA in order to repress chromatin. RNA has been shown to be vital in anchoring PRC2 in the correct spot on chromatin, but studies have shown conflicting results in how it interacts with PRC2. In order to study how PRC2 interacts with DNA and RNA, fluorescence polarization-based methodology was used with various RNA and DNA species to study their binding kinetics to PRC2 individually. After the apparent binding affinities were determined, various FP-competition experiments were performed to determine if each DNA species could be competed off by an RNA species or itself, and vice versa. The DNA species were more effective competitors although the RNA species were stronger binders. These results along with other experiments revealed PRC2 has ionic interactions with DNA that are unique to DNA, which explains how the DNA species could compete off RNA. Altogether, the results imply that DNA has additional contacts with PRC2 that limit its displacement by RNA, allowing for RNA to guide PRC2 to its target genetic loci and then for PRC2 to deposit its methyl marks without being sequestered by RNA. To see the complete thesis, please visit https://scholar.colorado.edu/concern/undergraduate_honors_theses/5x21tg835.

Structural inventory of cotranslational protein folding by the eukaryotic RAC complex

The challenge of nascent chain folding at the ribosome is met by the conserved ribosome-associated complex (RAC), which forms a chaperone triad with the Hsp70 protein Ssb in fungi, and consists of the non-canonical Hsp70 Ssz1 and the J domain protein Zuotin (Zuo1). Here we determine cryo-EM structures of Chaetomium thermophilum RAC bound to 80S ribosomes. RAC adopts two distinct conformations accommodating continuous ribosomal rotation by a flexible lever arm. It is held together by a tight interaction between the Ssz1 substrate-binding domain and the Zuo1 N terminus, and additional contacts between the Ssz1 nucleotide-binding domain and Zuo1 J- and Zuo1 homology domains, which form a rigid unit. The Zuo1 HPD motif conserved in J-proteins is masked in a non-canonical interaction by the Ssz1 nucleotide-binding domain, and allows the positioning of Ssb for activation by Zuo1. Overall, we provide the basis for understanding how RAC cooperates with Ssb in a dynamic nascent chain interaction and protein folding.

The use of pigs vocalisation structure to assess the quality of human-pig relationship

Studying human-animal interactions in domestic species and how they affect the establishment of a positive Human-Animal Relationship (HAR) may help us improve animal welfare and better understand the evolution of interspecific interactions associated with the domestication process. Understanding and describing the quality of an HAR requires information on several aspects of the animal biology and emotional states (social, spatial and postural behaviours, physiological and cognitive states). Growing evidence shows that acoustic features of animal vocalisations may be indicators of emotional states. Here, we tested the hypothesis that vocal structure may indicate the quality of HAR. At weaning, 30 piglets were positively handled by an experimenter who talked to and physically interacted with them three times a day, while 30 other piglets only received the contact necessary for proper husbandry. After two weeks, we recorded the behaviours and vocalisations produced in the presence of the static experimenter for 5 min. We repeated this test two weeks later, after a conditioning period during which human presence with additional positive contacts was used as a reward for all piglets. We hypothesized this conditioning period would lead to a positive human-piglet relationship for all piglets. As expected, piglets that were positively handled at weaning expressed a higher attraction toward the experimenter, and, after the conditioning, piglets that were not positively handled at weaning expressed a similar level of attraction than the positively handled ones. Piglets positively handled at weaning produced shorter grunts than the other ones, regardless of the context of recording, which may indicate a more positive affect. During reunions with the static experimenter, a more positive HAR was associated with a decrease in vocal reactivity to human proximity. However, during reunions with the experimenter providing additional positive contacts and over the conditioning, spatial proximity to the human systematically triggered shorter and higher pitched grunts, which may indicate a more positive emotional state. Results first show that changes in vocal structure are consistent with indicators of positive states in the presence of a human. Second, these changes are stronger when the human positively interact with the piglets, supposedly emphasizing a higher positive arousal state during these interactions. We show that vocalisation structure may be a promising indicator of the quality of human-pig relationship.

Yeast PIC-mediator structure with RNA polymerase II C-terminal domain

For transcription initiation, RNA polymerase II (Pol II) forms a preinitiation complex (PIC) that associates with the general coactivator Mediator. Whereas atomic models of the human PIC-Mediator structure have been reported, structures for its yeast counterpart remain incomplete. Here, we present an atomic model for the yeast PIC with core Mediator, including the Mediator middle module that was previously poorly resolved and including subunit Med1 that was previously lacking. We observe three peptide regions containing eleven of the 26 heptapeptide repeats of the flexible C-terminal repeat domain (CTD) of Pol II. Two of these CTD regions bind between the Mediator head and middle modules and form defined CTD-Mediator interactions. CTD peptide 1 binds between the Med6 shoulder and Med31 knob domains, whereas CTD peptide 2 forms additional contacts with Med4. The third CTD region (peptide 3) binds in the Mediator cradle and associates with the Mediator hook. Comparisons with the human PIC-Mediator structure show that the central region in peptide 1 is similar and forms conserved contacts with Mediator, whereas peptides 2 and 3 exhibit distinct structures and Mediator interactions.

404 If You Build It, Will They Come? Navigating Research Resources at CTSA Hubs

OBJECTIVES/GOALS: CTSA Program hubs provide a wide range of research support services (funding, training, consultations, etc.) to individuals and teams. The CTSA Program hub at Columbia University seeks to identify best practices across CTSA hubs in how they facilitate researchers to identify, navigate, and access services at complex academic medical centers. METHODS/STUDY POPULATION: o A landscape analysis across CTSA Program hub websites was conducted during December 2021-February 2022, with the goal of assessing the availability of research navigation services and the ease of accessing and requesting research support services at each hub. Websites of 66 CTSA hubs were accessed and browsed for the following: 1) if a research navigation or concierge service was available; 2) how to request and apply to use common services such as pilot funding, biostatistics, clinical research services; 3) if there was a contact form and/or email address for general inquiries. Binary coding (1=Yes, 2=No) was used to track and summarize if these features were available, and then further classification and observations were noted into the full data set. RESULTS/ANTICIPATED RESULTS: The landscape analysis determined that 68% of CTSA hubs offer a form of research navigation including consultative models (personalized guidance, studios) and web-based models (self-service web portals, graphics, toolkits). Consultative models could be classified into three levels of support ranging from general information sharing to providing scientific expertise to convening more intensive studio sessions. 92% of CTSA hubs have at least 1 system in place for researchers to request services with a majority of hubs using a mix of tools and systems. In addition, 36% of hubs have additional general contact forms and 75% have general email addresses to assist researchers in obtaining more information. DISCUSSION/SIGNIFICANCE: There is a relative lack of data and information on the effectiveness of different research navigation models across the CTSA network, and barriers for researchers to identify services remain (Elworth et al). Our team is planning additional evaluations including interviews with leaders at other CTSA hubs and researchers and trainees at Columbia.

A new method for the joint estimation of instantaneous reproductive number and serial interval during epidemics.

Although some methods for estimating the instantaneous reproductive number during epidemics have been developed, the existing frameworks usually require information on the distribution of the serial interval and/or additional contact tracing data. However, in the case of outbreaks of emerging infectious diseases with an unknown natural history or undetermined characteristics, the serial interval and/or contact tracing data are often not available, resulting in inaccurate estimates for this quantity. In the present study, a new framework was specifically designed for joint estimates of the instantaneous reproductive number and serial interval. Concretely, a likelihood function for the two quantities was first introduced. Then, the instantaneous reproductive number and the serial interval were modeled parametrically as a function of time using the interpolation method and a known traditional distribution, respectively. Using the Bayesian information criterion and the Markov Chain Monte Carlo method, we ultimately obtained their estimates and distribution. The simulation study revealed that our estimates of the two quantities were consistent with the ground truth. Seven data sets of historical epidemics were considered and further verified the robust performance of our method. Therefore, to some extent, even if we know only the daily incidence, our method can accurately estimate the instantaneous reproductive number and serial interval to provide crucial information for policymakers to design appropriate prevention and control interventions during epidemics.

Blended learning programs in hearing health care in developing countries during a pandemic: Opportunity or disaster?

Introduction: With COVID-19, tertiary education was mostly transferred to online instead of face-to-face learning, as this was the only way to go forward during the pandemic. Blended learning refers to teaching that combine face-to-face instruction with online learning. It has the advantages that students can learn at their own pace through the convenience of online learning and can interact with peers and tutors in face-to-face sessions. For blended learning, the challenges during COVID-19 were even more. The Eduplex Training Institute (ETI) in South Africa, presents blended learning programs in hearing health care for students. Completion of these programs during COVID-19 were specifically challenged since students completed an online theoretical component and had to travel to South Africa to attend face-to-face practical workshops. In Africa, travel restrictions were set in many countries and specific travel to South Africa was prohibited by many governments. This prohibited students from attending face-to-face practical sessions and additional plans had to be made for students to successfully complete programs. Methodology: The purpose of this study was to determine whether students and tutors from developing countries, found blended learning during COVID-19 as a possible way to continue studies. A survey research design was implemented to determine students’ and tutors’ perceptions regarding blended learning during the COVID-19 pandemic, challenges faced and adaptations that had to be made to complete programs successfully. Results: Results indicated that students and tutors felt that it was possible to complete blended learning programs successful during the COVID-19 pandemic but there were several challenges that required adaptations to current programs. Students considered the lack of availability and affordability of internet connectivity as the biggest challenge, followed by the lack of access to personal equipment, unsuitable learning environments and insufficient time for learning as many of the students were working while studying. For tutors the main challenges were that they had to be adaptable – programs could not continue as initially planned. This had specific influence on the timeline of the program as it took students longer to complete programs than the initial time that was allocated. Other challenges included lack of appropriate learning material for the original planned face-to-face sessions that had to be presented in a different manner, lack of appropriate training to design and manage learning management programs, lack of personal equipment and software programs at their home environment and keeping students motivated. Changes that were required to the programs included: use of programs that required little data, ensuring Word documents, PowerPoint presentations and PDF files were downloadable, restricted use of images and graphics, use of pre-recorded lectures and allowing additional contact sessions. Conclusion: Although blended learning in general composes many challenges to students in developing countries, these challenges were even more during the COVID-19 pandemic. Blended learning is however often the only way in which these students can acquire new knowledge and therefore strategies should be implemented to ensure the success thereof. With the combination of dedicated tutors and motivated students many challenges can be overcome, and new plans can be made to result in the successful completion of training programs.

Qualitative aspects of grunts vary with pigs' mental states

Studying human-animal interactions in domestic species and how they affect the establishment of a positive Human-Animal Relationship (HAR) may help us improve animal welfare and better understand the evolution of interspecific interactions associated with the domestication process. Understanding and describing the quality of an HAR requires information on several aspects of the animal biology and emotional states (social, spatial and postural behaviours, physiological and cognitive states). Growing evidence shows that acoustic features of animal vocalisations may be indicators of emotional states. Here, we tested the hypothesis that the quality of vocal expression may indicate the quality of HAR. At weaning, 30 piglets were positively handled by an experimenter who talked to and physically interacted with them three times a day, while 30 other piglets only received the contact necessary for proper husbandry. After two weeks, we recorded the behaviours and vocalisations produced in the presence of the static experimenter for five minutes. We repeated this test two weeks later, after a conditioning period during which human presence with additional positive contact was used as a reward for all piglets. We hypothesized this conditioning period would lead to a positive human-piglet relationship for all piglets. As expected, piglets that were positively handled at weaning expressed a higher attraction toward the experimenter, and, after the conditioning, piglets that were not positively handled at weaning expressed a similar level of attraction than the positively handled ones. Piglets positively handled at weaning generally produced shorter grunts than the other ones. However the latter expressed more flexibility in call structure when vocalising close to a human, with a decrease of grunt duration and an increase in pitch, frequency range and noisiness in their grunt. This differential effect of proximity between groups of piglets was attenuated after the conditioning during a standard reunion with a static human but remained over time when the human was providing additional positive contacts. Results suggest that first, changes in vocal structure are consistent with indicators of positive states in the presence of a human. Second, increasing familiarity and proximity between a human and a pig may induce changes in the acoustic structure of its grunts. Third, a human providing additional positive contacts triggers more changes in vocalisation structure than by their presence only. We show that vocalisation structure may allow us to assess the quality of human-pig relationship.

Adherence to Hepatitis C Treatment Among Underserved Patients With Substance Use Disorder in a Pharmacist-led Treatment Model

Background Treatment with medications for opioid use disorder (MOUD) may improve hepatitis C virus (HCV) treatment outcomes by providing additional contact with health care professionals to support patient engagement. Objective: We describe a pharmacist-led HCV treatment model and assessed the effect of MOUD on adherence to direct-acting antivirals (DAAs) in an underserved patient population. Methods: This was a retrospective cohort study of adults (age≥18 years) treated for HCV infection with DAAs at a Federally Qualified Health Center in Portland, Oregon, between March 1, 2019, and March 16, 2020. Patients were followed to 12 weeks to assess adherence to DAAs by MOUD status. Results: Among 59 eligible patients, 16 (27%) were prescribed MOUD. Baseline characteristics were similar between patients who did and did not receive MOUD. Adherence to DAAs was overall high and not significantly different between the groups (median: 98.5% vs median: 100%; P = .06). Five patients missed at least one dose due to an adverse drug effect and two of these patients discontinued HCV therapy due to these effects. Conclusion: Adherence to HCV therapy was nearly 100% among underserved patients in a pharmacist-led HCV treatment model and did not differ by MOUD engagement.

Individual differences in social homeostasis.

The concept of "social homeostasis", introduced by Matthews and Tye in 2019, has provided a framework with which to consider our changing individual needs for social interaction, and the neurobiology underlying this system. This model was conceived as including detector systems, a control center with a setpoint, and effectors which allow us to seek out or avoid additional social contact. In this article, we review and theorize about the many different factors that might contribute to the setpoint of a person or animal, including individual, social, cultural, and other environmental factors. We conclude with a consideration of the empirical challenges of this exciting new model.

Evaluation of a smartphone application for self-help for patients with social anxiety disorder: a randomized controlled study—SMASH

BackgroundThere is growing evidence that Internet-based cognitive behavioral therapy (ICBT) is as effective as a stand-alone treatment and helps facilitating access to treatment. Given the complexity of the treatment, we argue that the effect of ICBT could be even greater if guided by a therapist, as this could increase treatment adherence. We modified an established and well-evaluated treatment approach and developed a mobile application for treating social anxiety disorder (SAD). In the present study, we compare the efficacy of app use alone (APP) with video-based, therapist-guided app use (TG-APP) and with a wait-list control group (WLC) in terms of symptom reduction, and various secondary outcomes such as increase in quality of life or decrease of general psychological distress.Methods/designA within-between interaction design with randomization to one of three conditions will be used. In the APP condition, patients receive only the app without any additional contact with therapists, while in the TG-APP condition, therapists provide 8 sessions of video-based treatment in addition to using the app. The study will be conducted in two university outpatient treatment centers with reliably diagnosed SAD patients. The primary outcome will be defined as change in SAD symptoms, as measured by the Liebowitz Social Anxiety Scale (expert rating). Furthermore, a wide range of self-reports and clinician ratings for other symptoms (depression, general psychopathology) or quality of life will be used. A simulation-based power analysis for a 3 × 2 interaction effect (group × time) on the primary outcome in a linear mixed model resulted in a total sample size of N = 165.DiscussionThe present study will be one of the first to examine the additional benefit of therapist-guided video sessions regarding the use of an app treating SAD. Study results are pivotal to future treatment application in SAD.

Measuring the professional social capital of psychiatrists: adaptation and validation of the Resource Generator for Psychiatrists (RG-Psy)

Introduction Psychiatrists need access to professional resources to care for their patients. In mental health settings, clinical innovations such as a new therapeutic approach, clinical guidelines or new drugs can diffuse more or less, depending on the social capital of these clinicians. The Resource Generator developed by Snijders &amp; Van Der Gaag (2004) measures access to resources within a social network for the general population. It may therefore not capture access to social capital in the professional field of psychiatry.ObjectivesWe aimed to develop and validate the Resource Generator for Psychiatrists and to detect factors influencing the social capital of clinicians.Methods The development of the final 11-item questionnaire followed multiple steps. First, the items were selected and adapted by an expert in the sociology of mental health to match the sector of psychiatry. Content validity and detection of important issues or misunderstandings were ensured by cognitive interviews with a panel of 6 clinicians. Each item has a 6-point response scale, rated from 0 to 6. Answers were coded “0” when the respondent did not need a certain resource or it was not applicable to their situation, while answering the closest resource was coded “6”. The online self-completion questionnaire was administered through a link sent by email to all adult psychiatrists and psychiatric residents licensed to work in Belgium. Additional warm contacts were performed for psychiatrists working in ambulatory care. An exploratory factor analysis was conducted. Internal consistency was ensured with Pearson’s correlation, item-total correlation and Cronbach’s alpha. Test-retest reliability was also measured. Multivariable linear regression analysis assessed the association between psychiatrist demographics and the RG-Psy total score.Results The Resource Generator for Psychiatrists questionnaire completed by 152 psychiatrists showed a normal distribution with a mean of 32.5 (SD=12), good test-retest reliability (ICC=0.81), and good total Cronbach’s alpha (0.74). Exploratory factor analysis revealed two main subtypes in psychiatrists’ social capital: “attention and access to advice” and “practical assistance, knowledge and expertise”, with Cronbach’s alpha of 0.62 and 0.7 respectively. Clinicians attending institutional seminars (β=5.5221, p=0.013) and working in multidisciplinary settings such as hospitals (β=4.7448, p=0.023) or a mobile team (β=8.7475, p=0.014) were more likely to have higher social capital.ConclusionsPsychiatrists’ access to professional resources can be reliably measured by a 11-item questionnaire and can be used to test the influence of their professional social capital on different outcomes.Disclosure of InterestNone Declared

Deep Brain Stimulation: When to Test Directional?

Directional deep brain stimulation (DBS) allows for steering of the stimulation field, but extensive and time-consuming testing of all segmented contacts is necessary to identify the possible benefit of steering. It is therefore important to determine under which circumstances directional current steering is advantageous. Fifty two Parkinson's disease patients implanted in the STN with a directional DBS system underwent a standardized monopolar programming session 5 to 9 months after implantation. Individual contacts were tested for a potential advantage of directional stimulation. Results were used to build a prediction model for the selection of ring levels that would benefit from directional stimulation. On average, there was no significant difference in therapeutic window between ring-level contact and best directional contact. However, according to our standardized protocol, 35% of the contacts and 66% of patients had a larger therapeutic window under directional stimulation compared to ring-mode. The segmented contacts warranting directional current steering could be predicted with a sensitivity of 79% and a specificity of 57%. To reduce time required for DBS programming, we recommend additional directional contact testing initially only on ring-level contacts with a therapeutic window of less than 2.0 mA.