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Medication Adherence Patterns Among Individuals With Bipolar Disorder With and Without Comorbid Substance Use Disorder
No full textBackground Comorbid substance use disorder (BD-SUD) is common among individuals with bipolar disorder (BD) and is associated with worse clinical outcomes. This study compares differences in medication adherence, adherence barriers, and symptom severity of individuals with BD-SUD based on diagnostic status (current, past, or none).Methods This interim analysis utilized screening and baseline data from a 12-month randomized controlled trial comparing adherence interventions among poorly adherent individuals with BD. Patients were recruited from public mental health settings and met strict diagnostic and symptom criteria.Results From the study sample (N = 129; Mage = 42.18; SDage = 13.04), no significant sociodemographic differences were found. Individuals with BD and current substance use disorder reported significantly higher rates of problematic substance use and motivation to reduce such use compared to the other groups. No other differences were found.Conclusions Comorbid substance use disorder is common among individuals with bipolar disorder and often associated with poor outcomes. In this baseline, cross-sectional analysis, minimal differences were observed across varying BD-SUD status. Longitudinal analyses will be important for clarifying whether adherence and related outcomes differ over time across BD-SUD groups
Phosphoester hydrolysis using a de novo designed protein: A combined experimental and computational study
No full textMetallohydrolases use metal cations in their active sites to catalyze the hydrolytic cleavage of biological substrates. We used a simple model protein Due Ferri single chain (DFsc) in combination with Mn-Mn and Zn-Zn to study the effect of the nature of metal ions on its reactivity. The ICP-OES analysis confirmed the metal ion binding with desired ratios. The Mn2-DFsc showed the highest hydrolytic activity with a catalytic efficiency (kcat/ Km) of 6.5 M-1 min-1. EPR analysis of the di-manganese DFsc indicates that two manganese centers are antiferromagnetically coupled in a S = 0 ground state. Based on both experimental and computational results, a mechanism of phosphoester hydrolysis is proposed, in which the substrate binds to Mn terminally, and follows an associative/dissociative mechanism with hydrolysis assisted by nucleophilic attack of the bridging OH nucleophile. The findings from this study can be used to further optimize the DFsc scaffold for designing artificial enzymes for bioremediation of multiple hazardous molecules.</p
Radial similarity measures for vectorial structured light
No full textProperties of a harmonic electromagnetic beam revealed by its polarization-orbitalization tensor (POT) at two radii are discussed. In particular, the polarization and orbitalization projections of the POT are extended to two radii, and various quantities distinguishing radial similarity and mixing among the components of the POT are examined. The results are demonstrated with a beam composed of Laguerre-Gaussian modes. (c) 2026 Optica Publishing Group. All rights, including for text and data mining (TDM), Artificial Intelligence (AI) training, and similar technologies, are reserved.</p
Education on Human Trafficking at an All-Speciality Residency Orientation at a Large Academic Hospital
No full textPhotocatalytic degradation of 2,4-dichlorophenol and parathion using gel-like carbon dots under simulated solar irradiation
No full textIn this work, gel-like carbon dots (gelCDs), synthesized via a hydrothermal reaction between citric acid and 1,2ethylenediamine, were investigated as a sustainable, metal-free advanced oxidation processes universal photocatalyst for the degradation of common persistent organic pollutants. In order to prove the universality of this photocatalyst, we have tested the photocatalytic oxidative degradation of 2,4-dichlorophenol (2,4-DCP) and parathion, two common persistent organic pollutants with unrelated structures, under simulated solar light. Photocatalytic advanced oxidation process degradation experiments demonstrated efficient removal of both pollutants, with the process following pseudo-first-order kinetics for 2,4-DCP and zero-order kinetics for parathion. Reactive oxygen species (ROS) scavenger studies identified superoxide radicals (O2-& sdot;) and photogenerated holes (h+) as the dominant oxidative species, supported by consistent inhibition trends across both pollutants. The catalyst retained photocatalytic activity over multiple reuse cycles, indicating moderate operational stability. These findings position gelCDs as a potential promising candidate for solar-driven wastewater treatment applications.</p
Anomaly changes in the functional connectome of post-operative neurosurgical patients: A case series
No full textThe use of neuronavigation with superimposed mapping tools has enabled visualization of key fiber tracts and improved peri-operative planning. However, a limitation of these approaches is their reliance on a static underlying brain atlas, particularly in neurosurgical patients with brain tumors. A tool that enables qualification and quantification of brain region connectivity could refine approaches to surgical resection.
We utilized a machine learning imaging platform, Quicktome™, to generate individualized functional parcels and tracts that dynamically adapt to perioperative change. The connectome was derived from a combination of diffusion tensor imaging and resting-state function magnetic resonance imaging. Matrices were generated from the functional MRI of four patients with intracranial neoplasms and the pre- and post-operative parcellation values were compared. The individual correlation and strength of regions were quantified. Hypo- and hyper-connected regions were marked as anomalous.
We present a case series of four patients to illustrate the correlation of the anomaly matrices with post-operative neurological changes. These include: post-operative delirium originating associated with salience network hypoconnectivity; visual hemineglect linked to hypoconnectivity in the dorsal attention network; and quantifiable improvements in the language network following the resolution of expressive aphasia. All differences between pre-and post-operative paired correlation values were statistically significant.
We demonstrate a novel approach to quantifying the extent to which anomalies in the functional connectome correlate with post-operative neurological changes. This has relevance in post-operative prognostication, provision of specialist therapy services, and could serve as a useful tool in surgical education and pre-operative planning.
•Peri-operative connectomic networks in four brain tumor patients were analyzed.•DTI and resting-state fMRI images were fed into Quicktome™ software.•Correlation matrices are generated to quantify perioperative network differences.•Anomaly matrices enable symptom-driven pre- and post-operative analysis
Drivers and barriers for the implementation of value-based healthcare in Latin America: a cross-country qualitative policy analysis
No full textValue-Based Healthcare (VBHC) represents a paradigm shift from the traditional fee-for-service model to a fee-for-value model, aiming to optimize patient outcomes relative to cost. This study assesses the transition to VBHC in three Latin American countries: Argentina, Brazil, and Mexico. By identifying barriers and opportunities to unlock value in these health systems, it provides recommendations for advancing VBHC across the region.
Multiple methods were used integrating targeted literature reviews, key informant interviews, and qualitative indicators scoring based on the Harvard High-Value Health System (HVHS) Model. Data were collected from academic and national health databases, government reports, and international health organizations. Thematic analysis was conducted to synthesize findings from the literature and interviews, while qualitative indicators were assessed using the HVHS Model.
Brazil and Mexico have made progress in adopting VBHC principles, particularly in digital health and integrated care models. Brazil's Health Value Score (HVS) pilot and the Adequate Childbirth Project are key initiatives demonstrating the potential for improving patient outcomes and resource allocation. Mexico's Telemedicine Program has improved access to specialized care in remote areas. However, both countries face challenges such as fragmented healthcare systems, procurement practices that undermine value, and limited data interoperability. For example, Brazil's health Ministry has yet to establish a national or regional policy on VBHC. Argentina has shown progress in digital data systems and analytics, driven by the National Strategy of Digital Health 2018–2024, but faces significant challenges in healthcare financing, outcome measurement, and performance benchmarking.
Advancing VBHC in Latin America requires comprehensive policy reforms, infrastructure investment, and collaboration among patients as well as the public, private, and non-profit sectors. Key recommendations include implementing standardized cost and outcome measurement frameworks, investing in health information technology, reforming procurement regulations to prioritize value, and providing training and support for healthcare providers. Addressing these challenges will enable the region to implement VBHC effectively, fostering more efficient, equitable, and sustainable, technologically flexible healthcare systems.
We acknowledge support from the U.S. Chamber of Commerce and the Global Innovation Hub
Provenance of pottery from the Florida Keys: A geochemical pilot study
No full text•First LA-ICP-MS for south Florida ceramics.•Ancestral ceramics made in the Florida Keys, not the mainland.•Ceramic technology shared throughout south Florida.•Hyperlocal traditions of craft production in Ancestral south Florida.
This study presents the first use of geochemical analysis to shed light on the provenance of Ancestral Florida pottery from the southeast coast, the Everglades, and the Keys to better understand production and exchange dynamics in a coastal wetland and island zone. The people who once occupied far south Florida during the Ancestral period can be characterized as living within a frontier zone, far from centers of technological innovation. Archaeologists have often conceived of coastal and wetland populations from the logistically more convenient mainland, although this perspective is changing. The use of compositional pottery analysis has proven effective at helping to further elucidate aspects of past lifeways, cultural differentiation, and community interactions not otherwise recognized through typological or technofunctional analyses. We report the results of a pilot study utilizing laser ablation – inductively coupled plasma – mass spectrometry (LA–ICP–MS) on materials from an expansive region with pottery assemblages dominated by plain ware dating to 100–1800 CE. Our results indicate at least two distinct compositional groups with hyperlocal areas of production. A larger and more robust baseline of compositional data on pottery and clay throughout far southern Florida could provide a proxy for the movement of ceramic technology knowledge and the people who held that knowledge
Is the seagrass greener on the other side? Faster growth in Biscayne Bay, Florida’s nurse sharks (Ginglymostoma cirratum) compared to neighboring conspecifics of Bimini, The Bahamas
No full textEffective management of vulnerable species requires a precise understanding of life history. In 2024, Fadool et al. published the first von Bertalanffy growth model for the nurse shark (
Ginglymostoma cirratum
), reporting an asymptotic maximum length
L
∞
of 303.28 cm and a growth coefficient
k
of 0.04 yr
−1
for the population in Bimini, The Bahamas. We investigated whether nurse shark growth varies in nearby Biscayne Bay, Florida, an adjacent site within the western Atlantic region. We used 37 recaptured nurse sharks from Biscayne Bay to generate a comparable growth model, which estimated a significantly smaller
L
∞
of 259.26 cm and a larger
k
of 0.11 yr
−1
than Bimini. Biscayne Bay’s empirical growth rates were significantly higher on average than Bimini and exhibited a significantly steep decrease with increasing shark size not observed in Bimini. Additionally, the minimum linear displacement of 48 recaptured sharks was positively correlated with shark size, suggesting potential site fidelity to a small home range (1.6 ± 2.2 km) that increases with age. Our results indicate that differences in growth can occur over relatively small spatial scales despite environmental and geographic similarities, potentially reflecting genetic differences driven by historic fishing pressure or differences in resource availability. Significant growth rate variation between adjacent shark subpopulations assumed to be ecologically indistinct highlights the importance of sampling across a region’s subpopulations to inform management with more accurate life history data
Potential and pitfalls: accuracy versus adequacy of ChatGPT’s performance on surgery shelf examination
No full textPurpose
The recent surge in artificial intelligence (AI)-related technologies presents an opportunity for revolutionary advances in traditional methods of medical education. ChatGPT is one such application of AI that can take free-form text as input and generate a human-like response. This study sought to evaluate ChatGPT’s performance on a simulated surgery shelf exam and assess its potential as a learning tool for medical students.
Methods
Two 50-question tests were randomly selected from the National Board of Medical Examiners (NBME) practice surgery shelf exams. ChatGPT (Generative Pretrained Transformer-4o, September 2024) evaluated each question sequentially. Questions with images were excluded. Responses were recorded, and a board-certified general surgeon evaluated each justification. Each justification was graded as either having no errors, minor errors that do not significantly impact understanding of the topic, or major errors that significantly impact understanding of the topic.
Results
ChatGPT answered 96.6% of questions correctly. 9.2% of all responses contained minor errors, and 9.2% contained major errors. Among correctly answered questions, 9.5% contained minor errors, while 6.0% contained major errors. All major errors were due to incorrect information that was presented as correct.
Conclusion
ChatGPT demonstrates high accuracy when assessed on its ability to correctly answer multiple-choice questions that medical students could encounter on a surgery shelf exam. However, caution must be used when using ChatGPT as an adjunct to traditional education methods. With 15.5% of ChatGPT’s correct responses containing errors, often confidently asserting false information, students risk learning incorrect information if unaware of this limitation