Demographic Responses Research Articles

Do Adult Philadelphia-Positive Acute Lymphoblastic Leukemia (Ph+ ALL) Patients Require Allogeneic Transplant in First Remission (CR1)?

Introduction: Ph+ ALL has long been considered a high risk leukemia with poor outcomes when multi-agent chemotherapy is used alone. Allogeneic transplantation is considered by many the only chance of cure in this population. After reviewing data at Princess Margaret Cancer Centre (PMCC) in 2016, we found no overall survival (OS) difference between transplanted and non-transplanted Ph+ ALL patients. Thereafter, only relapsed or refractory patients were transplanted. We sought to determine the outcomes of non-transplanted Ph+ ALL patients who received a modified pediatric regimen (without asparaginase) with imatinib. Methods: A retrospective chart review of Ph+ ALL treated at PMCC from 2001 to 2019 was undertaken. Patient demographic data, disease characteristics, response, and course, as well as treatment information, were collected and a descriptive summary was presented using counts/proportions and median/IQR or range as appropriate. OS/RFS rates were calculated using the Kaplan-Meier product-limit method, and the impact of covariates of interest were assessed using the Log-rank test. Results: 158 Ph+ ALL patients were identified since 2001. 56 patients (35.4%) received a transplant in CR1, while 102 (64.6%) did not. All patients received a modified pediatric-inspired regimen typically with imatinib (Table 1). Median follow up was 38 months (range 1 to 229 months). 144/158 patients achieved a CR with first induction (91%). N=6 patients died during induction (3.8%). Overall survival for all patients at 3 and 4 years, was 61.8% (95% CI 53.4-69.1%) and 54.1% (95% CI 45.5-61.9%) respectively. Overall RFS at 3 and 4 years, was 51.7% (95% CI 43.3-59.4%) and 46.3% (95% CI 37.9-54.2%) respectively. When stratified by transplant in CR1, 3-year OS was 49.8% (95% CI 36.1-62.0%) in transplanted patients vs 69.2% (95% CI 49.3-69.9%) in non-transplanted patients; p=0.145 (Figure 1). There was no significant difference in RFS at 3 years in transplanted (46.4% [95% CI 33.0-58.7%]) vs non-transplanted (55% [95% CI 44.2-64.6%]) patients; p=0.89. A 6-month PCR level indicating a molecular 3 log (or deeper) reduction (MR3) in BCR-ABL1 transcripts predicted a statistically significant improved 3-year RFS of 71.4% (95% CI 40.6-88.2%) vs those who had achieved only an MR2 (25% [95% CI 0.9%-66.5%] p=0.037). Overall, 48 patients relapsed. Of these, 13 received blinatumomab +/- a tyrosine kinase inhibitor (TKI) after relapse and 12/13 (92.3%) achieved a second CR, including one patient who had relapsed post-transplant. Of the 12 who achieved a CR2, 5 went on to an allogeneic transplant. Conclusion: Using a modified pediatric regimen and imatinib, there was no difference in overall survival between transplanted and non-transplanted Ph+ ALL patients, provided that they achieved an MR3 (or deeper) at 6 months. In those who were not transplanted in CR1 and subsequently relapsed, blinatumomab + TKI was a successful salvage regimen. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Selective effects of a short transient environmental fluctuation on a natural population.

Natural populations experience continuous and often transient changes of environmental conditions. These in turn may result in fluctuating selection pressures leading to variable demographic and evolutionary population responses. Rapid adaptation as short-term response to a sudden environmental change has in several cases been attributed to polygenic traits, but the underlying genomic dynamics and architecture are poorly understood. In this study, we took advantage of a natural experiment in an insect population of the non-biting midge Chironomus riparius by monitoring genome-wide allele frequencies before and after a cold snap event. Whole genome pooled sequencing of time series samples revealed 10 selected haplotypes carrying ancient polymorphisms, partially with signatures of balancing selection. By constantly cold exposing genetically variable individuals in the laboratory, we could demonstrate with whole genome resequencing (i) that among the survivors, the same alleles rose in frequency as in the wild, and (ii) that the identified variants additively predicted fitness (survival time) of its bearers. Finally, by simultaneously sequencing the genome and the transcriptome of cold exposed individuals we could tentatively link some of the selected SNPs to the cis- and trans-regulation of genes and pathways known to be involved in cold response of insects, such as cytochrome P450 and fatty acid metabolism. Altogether, our results shed light on the strength and speed of selection in natural populations and the genomic architecture of its underlying polygenic trait. Population genomic time series data thus appear as promising tool for measuring the selective tracking of fluctuating selection in natural populations.

Prevalence and predictors of naturopathic practitioners’ self-reported practice behaviours: results of an international survey

BackgroundThe naturopathic workforce spans over 108 countries and is estimated to provide care to over 5.5 million patients globally per month. Despite such demand, naturopathic practitioners are not well integrated into mainstream health systems, in part due to poor knowledge about naturopathy among policy makers and other health professionals. This study aims to describe naturopathic practitioners’ practice behaviours and examine the characteristics that predict the use of naturopathic treatments and practices around the world. MethodsAn international cross-sectional online survey was distributed through World Naturopathic Federation membership organisations and social media accounts. Multivariate reverse stepwise logistic regression was undertaken to examine potential predictors of practice behaviours, adjusting for the influence of demographic and practice characteristics ResultsA response rate of 78.4% was achieved (n=478). Lifestyle modifications, dietary changes, nutritional products and herbal medicines were most consistently prescribed Always or Most of the time. At least one-half of participants discussed nine of the ten health topics during clinical practice Always or Most of the time. More than one-half (55.1%) of participants practiced in a location with statutory regulation/occupational certification. Compared to participants located in countries with voluntary certification/no regulation, those in countries with statutory registration/occupational licensing had higher odds of prescribing nutritional products (adjusted odds ratio (aOR)=2.5) or IV/injection therapies (aOR=18.4). ConclusionThe findings of this study provide important insights into contemporary naturopathic practice behaviour, which may help to overcome misconceptions about such practice among other health professionals, policy makers and the community.

Electronic patient-reported outcome measures to enable systematic follow-up in treatment and care of women diagnosed with breast cancer: a feasibility study protocol

IntroductionThe use of patient-reported outcome measures (PROMs) in clinical practice has the potential to promote person-centred care and improve patients’ health-related quality of life. We aimed to develop an intervention...

Initial blood cultures in pediatric patients with central line infections and short bowel syndrome can direct a treatment plan that can reduce hospital length of stay

BackgroundChildren with short bowel syndrome requiring parenteral nutrition are at high risk of recurrent central line–associated bloodstream infections requiring inpatient admission. Predicting responses to treatment at admission could help revise our current treatment algorithm and reduce the length of stay. MethodsWe conducted a retrospective study of all intestinal rehabilitation clinic patients admitted for central line–associated bloodstream infections at our academic hospital between January 2018 and June 2021. Demographic, blood culture, and treatment response data were analyzed. ResultsThere were 180 separate admissions for central line–associated bloodstream infections, involving 24 patients who met the inclusion and exclusion criteria. The average length of stay was 9.4 days, and 77.1% of the admissions exceeded the predicted length of stay. All patients were treated according to the standard protocols. In the initial blood cultures, 64.4%, 10.6%, and 25% grew a single bacterium, a single fungus, and multiple organisms, respectively. After treatment initiation, 73.3% of single bacterial infections did not show additional positive cultures. However, 78.9% and 48.9% of fungal and multiple organism infections, respectively, had multiple positive cultures, even after initiating treatment. All positive repeat cultures were treated with an ethanol lock for 24 hours in addition to continued treatment. The treatment preserved 90.5% of the catheters. ConclusionPatients experiencing short bowel syndrome admitted for central line–associated bloodstream infections with initial cultures growing fungi or multiple organisms frequently had multiple positive cultures, whereas those with a single bacterial organism did not. Discharging patients who grew a single bacterial organism and placing an initial ethanol lock on those with multiple or fungal organisms could reduce the average length of stay, even if some of these patients would require readmission for line removal.

Prevalence of iron deficiency anemia in pregnancy and its therapeutic response to treatment: a retrospective audit in a tertiary hospital

Background: Iron deficiency anemia is the commonest type of nutritional anemia seen during pregnancy. Despite implementing oral iron prophylaxis in pregnancy, IDA in pregnant women constitute a major health problem. The present study aims to look at the prevalence of IDA in a pregnant population in Seremban, Malaysia and their response to treatment.Methods: This is a retrospective study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered between October 2019 to March 2020 in a state hospital in Seremban, Malaysia and their response to treatment. Main outcome measures were the prevalence of iron deficiency anaemia, associated demographic and clinical factors and response to iron therapy. Results: About 920 patients’ records were included for analysis. The prevalence of anaemia in this cohort was 42.8% (N=394). The prevalence of iron deficiency anemia (IDA) was 31.5% (N=124) among the anemic patients or 13.5% of the studied population. The mean hemoglobin level for this group was 10.0±0.74 g/dl (6.8-10.9 g/dl) and majority had mild anemia (91.9%, N=114). 68.5% IDA patients were successfully treated by 36 weeks pregnancy. Of the remaining 39 patients who were still anemic, 37 (94.9%) had mild anemia with mean hemoglobin level of 10.3g/dl (SD 0.48, range 9.0-10.9 g/dl). Conclusion: Current treatment strategy is inadequate to achieve the set national target. There is a role for an early recourse to parenteral iron therapy to improve treatment outcome.

Compensatory recruitment unlikely in high‐elevation amphibian populations challenged with disease

Abstract Understanding the causes of population variation in host response to disease, and the mechanisms of persistence, can serve as vital information for species conservation. One such mechanism of population persistence that has gained support is the demographic process of compensatory recruitment. Host populations may persist by increasing recruitment to compensate for reduced survival due to infection, thus limiting the negative effects of the disease on population trajectories. However, high‐elevation populations are inherently vulnerable to stochastic processes and may be limited in their ability to exhibit compensatory recruitment relative to lower elevation populations. We use long‐term mark–recapture data from five populations of boreal toads Anaxyrus boreas boreas, across an elevational gradient in Colorado, before and after pathogen arrival to assess whether populations can persist with Batrachochytrium dendrobatidis (Bd) via compensatory recruitment. Prior to pathogen arrival, we found a life‐history trade‐off between survival and recruitment across elevations, where high‐elevation toads have high survival but lower recruitment and vice versa at lower elevations. Pathogen arrival had a strong negative effect on apparent annual survival and recruitment leading to negative population growth rates and dramatically reduced host abundances. The data did not support the occurrence of compensatory recruitment. Synthesis and applications. Our unique dataset indicates that demographic responses to pathogens may be environmentally (i.e. elevationally) context dependent and highlights the value of long‐term monitoring. We recommend that practitioners verify that potential persistence mechanisms occur across multiple populations and relevant environmental gradients to counter any assumptions of the mechanism existing species‐wide. Quantifying variation in population responses to disease will aid in understanding the bounds of such persistence mechanisms and identify particularly vulnerable populations where mechanisms are nonexistent.

Overactive Bladder Patients With and Without Urgency Incontinence: A Spectrum of One Condition or Different Phenotypes?

The importance of this study is to explore potential differences in pathophysiologies of OAB-wet and OAB-dry. The aim of this study was to define fundamental and unique presenting features of patients exhibiting storage lower urinary tract symptoms (LUTS) with urgency incontinence (OAB-wet) and patients without urgency incontinence (OAB-dry). This was a secondary analysis of cross-sectional data from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases-sponsored Symptoms of Lower Urinary Tract Dysfunction Research Network. Demographic, physical examination, and questionnaire responses were analyzed for women seeking care for LUTS at 6 U.S. centers. Differences between OAB-wet and OAB-dry patients were compared using the Fisher exact test and Mann-Whitney U test. Differences in questionnaire data were assessed using a Benjamini-Hochberg false discovery rate correction. Fifty-six, 84, and 67 women were included in the OAB-dry, wet, and control cohorts, respectively. There was no difference in demographic and physical examination characteristics of the 2 groups. OAB-wet patients reported more urgency incontinence symptoms (LUTS 16a, P < 0.001). OAB-dry reported more bladder pain, feeling of incomplete bladder emptying (LUTS 4, P < 0.001), and a need to strain to urinate (AUA-SI 7, P = 0.003). Sensation of incomplete emptying and straining with urination did not correlate with elevated postvoid residual volumes. Although degrees of symptomatic bother were similar, bother in OAB-dry patients was most closely related to pelvic floor tenderness severity, whereas bother in OAB-wet patients was most related to urgency severity. Women with OAB-dry have distinct presenting features of straining with urination, bladder pain, and a feeling of incomplete emptying. These suggest a unique pathophysiology driving OAB-dry symptoms, which we hypothesize is pelvic floor myofascial dysfunction.

Use of Reference Management Software Among Allopathy, Ayurveda, and Homeopathy Practices

Background: Reference management software (RMS) enable researchers to organize and manage large number of references that are typically identified during the publication of research articles. Aims and Objectives: The purpose of our study was to determine the extent to which faculties from allopathy, homeopathy, and Ayurveda use RMS for their academic pursuits and to identify which methods are used most frequently. Methods: The survey was circulated among the faculties of three different disciplines of the health-care system to collect respondent demographic details and questionnaire responses. Data distribution and variable type were used to perform descriptive analysis. Results: The data from 114/150 respondents were analyzed. Of the 114 faculties who responded to our survey, 72 (63%) reported using RMS to publish their articles. Knowledge of how to use RMS software is common in allopathic faculties (40%), followed by homeopathy (14%) and Ayurveda (9%). Zotero (41%) is the most popular RMS software among users, followed by Mendeley (31%) and Endnote (12%). Conclusion: Despite being underreported, RMS software is frequently used for the needs of authors from various disciplines in the health-care system.

Durability and Safety of Deep Peroneal Nerve Neurectomy for Midfoot Arthritis at Midterm Follow Up

Category: Midfoot/Forefoot Introduction/Purpose: Midfoot osteoarthritis affects up to 12% of the adult population greater than 50 years old. Arthrodesis is the traditional surgical procedure performed when nonoperative management fails but is a technically demanding procedure that requires prolonged postoperative immobilization and is not uncommonly complicated by nonunion or deep infection. The deep peroneal nerve (DPN) plays a significant role in afferent nociceptive midfoot joint pain perception, most consistently in the second and third tarsometatarsal joints and the naviculocuneiform joint. Early outcomes following DPN neurectomy have demonstrated promising results as a safe and effective treatment that allows early mobilization and weight bearing. The purpose of our study was to evaluate the mid-term patient satisfaction and pain relief after DPN neurectomy for treatment of chronic midfoot pain due to osteoarthritis. Methods: In this retrospective IRB-approved questionnaire-based study, we evaluated 49 out of 95 patients identified (56 feet) with an average follow-up of 34.6 (range, 9 to 51) months, who underwent DPN neurectomy (Figure 1) at our institution between September 2017 and February 2021. There were 39 women and 10 men, 42 unilateral (23 right, 19 left) and 7 bilateral procedures, with an average age of 67.9 (range, 35 to 88) years at the time of surgery. A questionnaire which included questions regarding post-surgical dorsal midfoot pain relief, surgical result satisfaction, and current functional limitations was administered via telephone. Demographic information, patient responses, and complications were recorded. Results: There was an 81.2% patient satisfaction with the result of the surgery in relieving their dorsal midfoot pain. Of the 49 patients, 84.9% would repeat the surgery under the same circumstances, 84.1% would recommend the surgery to a friend, 10.2% reported they wish they had undergone arthrodesis, 8.2% reported no pain relief in the first 6 months, and 55.8% reported current activity limitations because of dorsal midfoot pain. Six feet (10.7%) underwent a second procedure with an average postoperative time of 20.5 (range, 1 to 36) months. Complications include one patient with deep wound infection, one DPN neurectomy revision and burial into bone, one DPN neuroma excision, one midfoot exostosis excision, and two conversions to arthrodesis. Theoretic complications of neuroarthropathy, midfoot collapse, and development of lesser toe deformities were not observed. Conclusion: DPN neurectomy is a safe and effective surgical option for the management of chronic dorsal midfoot pain due to midfoot osteoarthritis after failed nonoperative management. At midterm follow-up, patients who underwent dorsal midfoot denervation reported acceptable satisfaction rates, similar to those reported for arthrodesis, with associated improved functional outcomes and few complications.

Demographic declines over time and variable responses of breeding bird populations to human footprint in the Athabasca Oil Sands Region, Alberta, Canada

Abstract Habitat loss and disturbance from industrial resource development may be contributing to declines in boreal bird populations. We applied hierarchical multi-species models to data from 31 bird species at 38 Monitoring Avian Productivity and Survivorship (MAPS) stations to assess 10-year (2011–2020) demographic trends and responses to energy sector disturbance (human footprint proportion) in the Athabasca oil sands region of Alberta, Canada. Adult captures, productivity, and residency probability all declined over the study period, and adult apparent survival probability also tended to decline. Consistent with the hypothesis that habitat loss may be driving declines, trends in adult captures, productivity, and survival were all more negative at stations with larger increases in disturbance over the study period. Species associated with early seral stages were more commonly captured at more disturbed stations, while species typical of mature forests were more commonly captured at less disturbed stations. Productivity was positively correlated with disturbance within 5-km of stations after controlling for disturbance within 1-km of stations, suggesting the importance of earlier successional habitat for post-fledging birds in the larger landscape. Adult apparent survival showed relatively little response to disturbance; stresses experienced beyond the breeding grounds likely play a larger role in influencing survival. Residency probability was negatively related to disturbance within 1-km scale of stations and could reflect processes affecting the ability of birds to establish or maintain territories in disturbed landscapes. We conclude that successional habitats that result from natural regeneration or restoration in disturbed areas, as well as decreased future footprint through recovery of mature forests and limiting of new disturbances, will both be important components of efforts to reverse population declines and maintain bird populations in the region.

Demographic and functional responses of kit foxes to changes in prey abundance

Many carnivores exhibit demographic and functional responses to changes in prey abundance. Demographic responses often include changes in population size, litter size, and recruitment of young into the adult population. Functional feeding responses are commonly reported for many carnivore species. We investigated demographic and functional responses of kit foxes ( Vulpes macrotis Merriam, 1888) to changes in prey abundance during 2010–2013 in western Utah, USA. Between 2010 and 2013, litter size averaged 3.9 (±1.4) pups/litter. Survival rates of kit fox pups were 0.07, 0.01, 0.46, and 0.16, respectively, and there was a correlation between pup survival rates and rodent abundance; leporid (family Leporidae Fischer, 1817) abundance did not influence pup survival. There was a functional response as occurrence of kangaroo rat in the diet closely followed changes in kangaroo rat abundance. The occurrence of rodents in kit fox diet followed declines in rodent abundance (excluding Dipodomys spp. Gray, 1841). Leporid consumption by kit foxes was not correlated to leporid density. Kit fox survival was dependent on rodent abundance and more specifically, kangaroo rats. Understanding which population parameters of kit foxes are influenced by prey is critical for the conservation of this native mesocarnivore.

Faculty perceptions on one-best MCQ development.

The aim of this study was to determine the perception of faculty of undergraduate medical and dental programmes in various private and public sector institutes regarding their Readiness, Attitude and Institutional support for developing high-quality one-best MCQs. A validated questionnaire was designed for recording demographic data and responses related to Readiness, Attitude and Institutional support based on 5-point Likert scale and multiple options. Scores for items on Likert scale were categorised (Readiness: poor 0-12, good 13-24, Attitude: negative 0-12, positive 13-24, Institutional support: no support 0-12, highly supportive 13-24). The individual and overall scores related to Readiness, Attitude and Institutional support were compared to demographic characteristics using Independent samples and Paired samples t-test as appropriate. Data was analysed using SPSS version 25.0. P-value of <0.05 (two-sided) was considered significant. With a response rate of 87.5%, the mean scores for Institutional support were higher (14.45 ± 4.73) compared to those for Readiness (13.39 ± 4.51) and Attitude (12.54 ± 4.59). Responses to multiple choice items revealed that faculty considered MCQ writing workshops to be effective while facing most difficulty in formulating scenario and homogenous options. Most faculty reported no commitment issues but desired on-job protected time for item development. No significant association was found between the scores and age group, gender, qualification, institute type, department and designation of participants. Overall, the faculty were found to be motivated and committed to developing high-quality one-best MCQs. With continued institutional support, faculty can be expected to further engage in writing such items.

Psychological Assessment of Family Caregivers of Patients With COVID-19 in the United States of America and India.

Background and objectiveThe coronavirus disease 2019 (COVID-19) pandemic has highlighted the shortcomings worldwide in terms of preparedness protocols related to epidemics. A key area of research that is evidently overlooked across the globe is the mental health of family caregivers taking care of patients with COVID-19. In light of this, this study aimed to engage in a comparative analysis between the two worst affected countries, India and the United States of America (USA), which differ considerably in their demography, socio-epidemiological factors, and health system efficiency.MethodsA cross-sectional study was conducted among 1,250 family caregivers of patients with COVID-19 in India and the USA to assess their stress, anxiety, and sleep disturbance levels using the 10-item Perceived Stress Scale (PSS-10), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and the Pittsburgh Sleep Quality Index (PSQI), respectively. Psychological assessment questionnaires were administered through online mode, which gathered demographic information and responses on several self-reporting scales. The main outcome measures were self-reported ratings on PSS, GAD-7 scale, and PSQI.ResultsWe found that 75.4% of the family members of COVID-19 patients suffered from mental health issues. The scores of all three scales were higher in caregivers from the USA than in India, more evident and pronounced in caregivers of hospitalized patients. The test scores were statistically significant (p<0.05) indicating a negative impact of having a dependent member in the family, being married, being of younger age, and having a longer duration of COVID-19 infection. Vaccines were found to have a life-enhancing effect.ConclusionOur findings highlight that the mental health of family caregivers is an ignored aspect and must be addressed. We recommend the implementation of well-researched and appropriate legislation, treatment programs, and health policies that involve not only the patients but also their families.

An Investigation of the Knowledge, Attitudes, and Practices of Physicians Regarding Child Oral Health at Primary Health Centers in Qatar: A Cross-Sectional Study.

The aim of this study was to investigate physicians' knowledge, attitudes, and practices (KAP) in relation to oral health in children attending baby well clinics in primary health care centers (PHCC) in Qatar. A cross-sectional design was adopted in which a piloted self-administered questionnaire was sent electronically to 417 physicians (pediatricians/family physicians) practicing in all PHCCs in Qatar. The questionnaire gathered information concerning demographic characteristics and KAP in relation to oral health in children. A score for each domain was given based on the percentage of correct answers. Descriptive and analytical statistics were employed. For descriptive statistics, the frequency of distribution in relation to demographic data and responses to items of the questionnaire was presented. For analytical statistics, associations between independent variables (predictors) and KAP were assessed by employing univariate and multivariate logistic regressions. Predictors which were significantly associated in the unadjusted regression were entered into a final multivariate logistic regression to evaluate their effects after adjustment. The response rate was 24%. The overall mean scores of KAP were 61, 60, and 44.4%, respectively. Females were more likely to give positive answers than males (odds ratio [OR] = 12.3, 95% confidence interval [CI] 2.4-62.2, p = 0.02). Age groups 35 to 45 and >45 years had significantly more correct answers than <35 years age group (OR= 7.5, 95% CI = 1.1-56.6 and 9.2, 95% CI 1.2-44.6, respectively, p = 0.05). No significant associations were found between any of the independent variables with attitudes. With respect to practices, multivariate logistic regression revealed that specialty was significantly associated with practices. Pediatricians were more likely to adopt positive practices when compared with family medicine physicians (OR, 95% CI = 5.3 (1-25.6), p = 0.04). Although physicians demonstrated moderate levels of knowledge and attitudes, this did not reflect positively on their practices. The overall score of practices was considered poor (44.4%). Poor practices in our sample reflected an urgent need for actions and plans to improve this aspect and confirmed other findings which stated that acceptable levels of knowledge or attitudes do not necessarily translate into favorable practices.

Non-native grazers affect physiological and demographic responses of greater sage-grouse.

Non‐native ungulate grazing has negatively impacted native species across the globe, leading to massive loss of biodiversity and ecosystem services. Despite their pervasiveness, interactions between non‐native grazers and native species are not fully understood. We often observe declines in demography or survival of these native species, but lack understanding about the mechanisms underlying these declines. Physiological stress represents one mechanism of (mal)adaptation, but data are sparse. We investigated glucocorticoid levels in a native avian herbivore exposed to different intensities of non‐native grazing in the cold desert Great Basin ecosystem, USA. We measured corticosterone, a glucocorticoid in feathers for a large sample (n = 280) of female greater sage‐grouse (Centrocercus urophasianus) from three study areas in Northern Nevada and Southern Oregon with different grazing regimes of livestock and feral horses. We found that greater feral horse density was associated with higher corticosterone levels, and this effect was exacerbated by drought conditions. Livestock grazing produced similar results; however, there was more model uncertainty about the livestock effect. Subsequent nesting success was lower with increased feather corticosterone, but corticosterone levels were not predictive of other vital rates. Our results indicate a physiological response by sage‐grouse to grazing pressure from non‐native grazers. We found substantial among‐individual variation in the strength of the response. These adverse effects were intensified during unfavorable weather events, highlighting the need to reevaluate management strategies in the face of climate change.

Eating Disorder Examination-Questionnaire and Clinical Impairment Assessment norms for intersectional identities using an MTurk sample.

There are limited data to guide the interpretation of scores on measures of eating-disorder psychopathology among underrepresented individuals. We aimed to provide norms for the Eating Disorder Examination-Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA) across racial/ethnic, gender, and sexual identities, and sexual orientationsand their intersections by recruiting a diverse sample of Amazon MTurk workers (MTurkers; N =1782). We created a comprehensive, quantitative assessment of racial/ethnic identification, gender identification, sex assigned at birth, current sexual identification, and sexual orientation called the Demographic Assessment of Racial, Sexual, and Gender Identities (DARSGI). We calculated normative data for each demographic category response option. Our sample was comprised of 68% underrepresented racial/ethnic identities, 42% underrepresented gender identities, 13% underrepresented sexes, and 49% underrepresented sexual orientations. We reported means and standard deviations for each demographic category response option and, where possible, mean estimates by percentile across intersectional groups. EDE-Q Global Score for a subset of identities and intersections in the current study were higher than previously reported norms for those identities/intersections. This is the most thorough reporting of norms for the EDE-Q and CIA among racial/ethnic, sexual, and gender identities, and sexual orientations and the first reporting on multiple intersections, filling some of the gaps for commonly used measures of eating-disorder psychopathology. These norms may be used to contextualize eating-disorder psychopathology reported by underrepresented individuals. The data from the current study may help inform research on the prevention and treatment of eating-disorder psychopathology in underrepresented groups. We provide the most thorough reporting on racial/ethnic, sexual, and gender identities, and sexual orientations for the Eating Disorder Examination - Questionnaire and Clinical Impairment Assessment, and the first reporting on intersections, which fills some of the gaps for commonly used measures of eating-disorder psychopathology. These norms help inform research on the prevention and treatment of eating-disorder psychopathology in underrepresented groups.

Bat responses to climate change: a systematic review.

Understanding how species respond to climate change is key to informing vulnerability assessments and designing effective conservation strategies, yet research efforts on wildlife responses to climate change fail to deliver a representative overview due to inherent biases. Bats are a species-rich, globally distributed group of organisms that are thought to be particularly sensitive to the effects of climate change because of their high surface-to-volume ratios and low reproductive rates. We systematically reviewed the literature on bat responses to climate change to provide an overview of the current state of knowledge, identify research gaps and biases and highlight future research needs. We found that studies are geographically biased towards Europe, North America and Australia, and temperate and Mediterranean biomes, thus missing a substantial proportion of bat diversity and thermal responses. Less than half of the published studies provide concrete evidence for bat responses to climate change. For over a third of studied bat species, response evidence is only based on predictive species distribution models. Consequently, the most frequently reported responses involve range shifts (57% of species) and changes in patterns of species diversity (26%). Bats showed a variety of responses, including both positive (e.g. range expansion and population increase) and negative responses (range contraction and population decrease), although responses to extreme events were always negative or neutral. Spatial responses varied in their outcome and across families, with almost all taxonomic groups featuring both range expansions and contractions, while demographic responses were strongly biased towards negative outcomes, particularly among Pteropodidae and Molossidae. The commonly used correlative modelling approaches can be applied to many species, but do not provide mechanistic insight into behavioural, physiological, phenological or genetic responses. There was a paucity of experimental studies (26%), and only a small proportion of the 396 bat species covered in the examined studies were studied using long-term and/or experimental approaches (11%), even though they are more informative about the effects of climate change. We emphasise the need for more empirical studies to unravel the multifaceted nature of bats' responses to climate change and the need for standardised study designs that will enable synthesis and meta-analysis of the literature. Finally, we stress the importance of overcoming geographic and taxonomic disparities through strengthening research capacity in the Global South to provide a more comprehensive view of terrestrial biodiversity responses to climate change.

Horizontal Violence Toward Emergency Medicine Residents: Gender as a Risk Factor.

IntroductionHorizontal violence (HV) is defined as “persistent exposure to interpersonal aggression and mistreatment from colleagues.” Our objective in this pilot, single-site study was to identify sources of HV toward emergency medicine (EM) residents, using the Negative Acts Questionnaire-Revised (NAQ-R).MethodsIn this investigation we used a descriptive cross-sectional survey design to categorize HV. All voluntary participants were residents in an Accreditation Council for Graduate Medical Education-approved, three-year academic EM residency. Data were collected via electronic survey and occurred six months into an academic year. We collected demographic information and responses to the NAQ-R in 2020. Horizontal violence is subdivided into three categories: work-related; person-related; and physical intimidation. Emergency medicine residents answered questions as they related to their interactions with residents and support staff, which included nursing.ResultsA total of 23 of 26 residents responded (89%). Participants were 56% women, 78% white, 11% Hispanic, and 89% heterosexual. Participant clinical year was 39% first-, 39% second-, and 22% third-year residents. Women reported a higher frequency of HV compared to men (1.3 vs 1.1, P =.01). By category, women indicated higher incidence of work-related violence from other residents (P = .05) and staff (P =.02). There was no difference in reported frequency of violence for interns compared to senior residents.ConclusionOur pilot study demonstrated horizontal violence toward EM residents exists and is more prevalent in women.

Improving ecological insights from dendroecological studies of Arctic shrub dynamics: Research gaps and potential solutions

Rapid climate change has been driving changes in Arctic vegetation in recent decades, with increased shrub dominance in many tundra ecosystems. Dendroecological observations of tundra shrubs can provide insight into current and past growth and recruitment patterns, both key components for understanding and predicting ongoing and future Arctic shrub dynamics. However, generalizing these dynamics is challenging as they are highly scale-dependent and vary among sites, species, and individuals. Here, we provide a perspective on how some of these challenges can be overcome. Based on a targeted literature search of dendrochronological studies from 2005 to 2022, we highlight five research gaps that currently limit dendro-based studies from revealing cross-scale ecological insight into shrub dynamics across the Arctic biome. We further discuss the related research priorities, suggesting that future studies could consider: 1) increasing focus on intra- and interspecific variation, 2) including demographic responses other than radial growth, 3) incorporating drivers, in addition to warming, at different spatial and temporal scales, 4) implementing systematic and unbiased sampling approaches, and 5) investigating the cellular mechanisms behind the observed responses. Focusing on these aspects in dendroecological studies could improve the value of the field for addressing cross-scale and plant community-framed ecological questions. We outline how this could be facilitated through the integration of community-based dendroecology and dendroanatomy with remote sensing approaches. Integrating new technologies and a more multidisciplinary approach in dendroecological research could provide key opportunities to close important knowledge gaps in our understanding of scale-dependencies, as well as intra- and inter-specific variation, in vegetation community dynamics across the Arctic tundra.