Dartmouth College

Maternity care is a core service provision of any healthcare system, delivering care for women and birthing people, and their wider family units. During the SARS-CoV-2 pandemic, much of maternity care service provision was reconfigured with the aim of continuing care provision which could not otherwise be re-scheduled or delayed, but in-line with infection control measures instituted through social and physical distancing. The RESILIENT Study was designed to investigate the impact of the COVID-19 pandemic and pandemic-related reconfigurations to maternity care service delivery. It is particularly concerned with the experiences of minority ethnic groups and those with social or medical complexity. One of our specific objectives was to investigate the experiences of maternity care during the pandemic from the perspective of women and birthing people; fathers, partners, and non-gestational parents; healthcare professionals; and policy makers through the use of in-depth interviews. We will analyse data on virtual care, self-monitoring, and vaccination (each using thematic framework analysis); care-seeking and care experience (using template analysis); and on building an ethical future of maternity care (using grounded theory analysis). This is the focus of this protocol. Our findings about the experiences of care receipt, provision, and planning during the pandemic will complement existing literature and our impact will be broad, on: individual patients, NHS maternity providers, NHS policies, and wider society.

A three‐dimensional particle‐in‐cell simulation is performed to study secondary reconnection between two interlinked flux tubes produced by neighboring guide field reconnection x‐lines. The reconnecting magnetic fields of this secondary reconnection is enhanced toward the diffusion region, agree well with that in observations. The magnetic field pileup is attributed to the upstream magnetic tension force, that smashes the flux tubes into each other. We propose that the primary reconnection x‐line length is a key parameter to determine the formation of interlinked flux tubes and secondary reconnection therein. Interlinked flux tubes will form only if the x‐line is short; when the x‐line is long enough, the regular flux ropes are formed instead. The critical x‐line length to form interlinked flux tubes is determined by the distance between two neighbor x‐lines and the magnetic shear angle of the primary reconnection. The results provide a novel scenario of secondary reconnection generation during three‐dimensional reconnection.

Innovations in interface design have made digital mediums increasingly appealing to children and adolescents. Today’s youth adapt quickly to new digital technologies, from smartphones to video game consoles. These factors have fueled interest in digital therapeutics to augment existing treatment modalities for various pediatric diseases. Digital therapeutics use gamification, momentary symptom assessment, and sensor-based data collection to provide immediate feedback to users in order to teach skills and manage maladaptive thoughts and behaviors. The first Food and Drug Administration (FDA)-approved digital therapeutic for child mental health, EndeavorRx, was approved in 2020 for the treatment of attention-deficit/hyperactivity disorder (ADHD)-associated symptoms. Other promising digital treatments include ecological momentary intervention (EMI) protocols for depression and anxiety and as mindfulness-based interventions for substance use disorders (SUDs). Despite the surging interest in digital therapeutics for mental health, their efficacy remains mostly unclear. Independent clinical trials are few in number, and it is challenging to compare studies that use different study populations, methodologies, and/or outcome measures. Outstanding issues of data security, digital literacy, and lack of clinician familiarity further limit incorporation of digital therapeutics into the clinical setting. Collaborative problem-solving between private industry, researchers, clinicians, and policymakers will be critical in order to ensure the creation of both efficacious technologies and equitable access.

Alcohol, tobacco, and firearm use are the root causes of disability and mortality in the United States. The use of these products in adolescence has considerable impacts on immediate and lifelong health. Adolescents have been the key targets of alcohol, tobacco, and firearm companies because of the potential to shape brand alliances and lifetime use. Marketing and product placements in media have often been used to reach the adolescent market for tobacco and alcohol products, continue to be used to reach the adolescent market for alcohol, and emerging data suggest that they may be used to reach the adolescent market for firearms as well. This chapter discusses how these products are marketed to adolescents using contemporary digital media, including social media, the metaverse, and video games. This chapter illustrates the marketing tactics used in these spaces and discusses the current research gaps that limit our understanding of a causal association between digital marketing exposures and adolescent product use. This chapter closes with recommendations for future efforts to protect adolescents from marketing by companies that produce harmful products.

Backward masking is a powerful phenomenon that can reduce, often to zero, the visibility of targets. Here, we show that when the masking is less than completely effective so that the target remains visible, the masking has other effects, specifically reducing the perceived size of the target.

In fighting infectious diseases posing a global health threat, ranging from influenza to Zika, nonpharmaceutical interventions (NPI), such as social distancing and face covering, remain mitigation measures public health can resort to. However, the success of NPI lies in sufficiently high levels of collective compliance, otherwise giving rise to recurrent infections that are not only driven by pathogen evolution but also changing vigilance in the population. Here, we show that compliance with each NPI measure can be highly dynamic and context-dependent during an ongoing epidemic, where individuals may prefer one to another or even do nothing, leading to intricate temporal switching behavior of NPI adoptions. By characterizing dynamic regimes through the perceived costs of NPI measures and their effectiveness in particular regarding face covering and social distancing, our work offers insights into overcoming barriers in NPI adoptions.

We present observations on 24 April 2023 by the Magnetospheric Multiscale spacecraft at the dayside, mid‐latitude magnetopause, when an interplanetary magnetic cloud (MC) with sub‐Alfvénic flows and northward and dawnward interplanetary magnetic field components impacted Earth's magnetosphere. The aim is to reveal the processes of solar wind‐magnetosphere interaction under sub‐Alfvénic solar wind with northward magnetic field. Our analysis of electron and ion data suggests that magnetopause reconnection occurred near both polar cusps, forming boundary layers on closed magnetic field lines on both the solar wind (i.e., MC) and magnetospheric sides of the magnetopause. Grad‐Shafranov, electron‐magnetohydrodynamics, and polynomial reconstructions of magnetopause current layers show that local (equator‐of‐the‐cusp) reconnection occurred in a sub‐ion‐scale magnetopause current sheet with a low magnetic shear angle (30°). Interestingly, the local reconnection was observed between the two (MC‐side and magnetosphere‐side) layers of closed field lines. It indicates that reconnected field lines from double cusp reconnection were interacting to induce another reconnection at the mid‐latitude magnetopause. Our results suggest that magnetopause reconnection was more efficient or frequent under sub‐Alfvénic solar wind with much lower beta plasma conditions than typical conditions. We discuss the role of such efficient reconnection in the formation of low‐latitude boundary layers.

Purpose Imaging phantoms with known anisotropic mechanical properties are needed to evaluate magnetic resonance elastography (MRE) methods to estimate anisotropic parameters. The aims of this study were to fabricate mechanically anisotropic MRE phantoms, characterize their mechanical behavior by direct testing, then assess the accuracy of MRE estimates of anisotropic properties using a transversely isotropic nonlinear inversion (TI‐NLI) algorithm. Methods Directionally scaled and unscaled lattices were designed to exhibit anisotropic or isotropic mechanical properties. Lattices were three‐dimensionally printed in poly(ethelyne glycol) diacrylate using a commercial digital light processing printer, then infilled with gelatin to form a composite material. Benchtop testing determined two shear stiffnesses, μ1${\mu}_1$ and μ2${\mu}_2$, governing loading parallel and perpendicular to the symmetry axis, and two analogous Young's moduli E1${E}_1$ and E2${E}_2$. From these measures, shear anisotropy ϕ$\phi$ = μ1/μ2−1${\mu}_1/{\mu}_2-1$ and tensile anisotropy ζ$\zeta$ = E1/E2−1${E}_1/{E}_2-1$ were calculated. Three phantoms were driven by a central actuator and imaged with MRE at frequencies from 300 to 500 Hz. From MRE data, the TI‐NLI algorithm estimated maps of μ2${\mu}_2$, ϕ$\phi$, and ζ$\zeta$. Results In benchtop tests, geometrically scaled lattice composites exhibited the following anisotropic properties: {μ2$\Big\{{\mu}_2$ = 6.1 ± 0.7 kPa, ϕ$\phi$ = 0.83 ± 0.13, ζ$\zeta$ = 0.78 ± 0.09} (mean ± standard deviation). MRE of scaled lattice composites revealed elliptical wavefields; TI‐NLI analysis identified the following median property ranges: {μ2$\Big\{{\mu}_2$ = 11–19 kPa, ϕ$\phi$ = 0.6–1.0, ζ$\zeta$ = 0.8–1.6}. Conclusion Anisotropic MRE phantoms are created by embedding anisotropic three‐dimensionally printed lattices into a softer matrix. The TI‐NLI algorithm accurately estimates spatial contrast in anisotropic properties.

This paper describes the use of a highly crystalline conductive 2D copper3(hexaiminobenzene)2 (Cu3(HIB)2) as an ultrasensitive (limit of detection of 1.8 part‐per‐billion), highly selective, reversible, and low power chemiresistive sensor for nitric oxide (NO) at room temperature. The Cu3(HIB)2‐based sensors retain their sensing performance in the presence of humidity, and exhibit strong signal enhancement towards NO over other highly toxic reactive gases, such as NO2, H2S, SO2, NH3, CO, as well as CO2. Mechanistic investigations of the Cu3(HIB)2‐NO interaction through spectroscopic analyses and density functional theory revealed that the Cu‐bis(iminobenzosemiquinoid) moieties serve as the binding sites for NO sensing, while the Ni‐bis(iminobenzosemiquinoid) MOF analog shows no noticeable response to NO. Overall, these findings provide a significant advance in the development of crystalline metal‐bis(iminobenzosemiquinoid)‐based conductive 2D MOFs as highly sensitive, selective, and reversible sensing materials for the low‐power detection of toxic gases.

People form impressions of one another in a split second from faces. However, people also infer others’ momentary mental states on the basis of context—for example, one might infer that somebody feels encouraged from the fact that they are receiving constructive feedback. How do trait judgements of faces influence these context-based mental state inferences? In this Registered Report, we asked participants to infer the mental states of unfamiliar people, identified by their neutral faces, under specific contexts. To increase generalizability, we representatively sampled all stimuli from inclusive sets using computational methods. We tested four hypotheses: that trait impressions of faces (1) are correlated with subsequent mental state inferences in a range of contexts, (2) alter the dimensional space that underlies mental state inferences, (3) are associated with specific mental state dimensions in this space and (4) causally influence mental state inferences. We found evidence in support of all hypotheses.

We consider a broad class of spatial models where there are many types of interactions across a large number of locations. We provide a new theorem that offers an iterative algorithm for calculating an equilibrium and sufficient and “globally necessary” conditions under which the equilibrium is unique. We show how this theorem enables the characterization of equilibrium properties for one important spatial system: an urban model with spillovers across a large number of different types of agents. An online appendix provides 12 additional examples of both spatial and nonspatial economic frameworks for which our theorem provides new equilibrium characterizations. (JEL C21, R15, R23)

What is the function of pain? A popular view in contemporary philosophy is that the pain system is a bodily disturbance detector: pain states track/detect and represent bodily disturbances and the phenomenal character of the (sensory dimension of) pain supervenes on this representational content. The view can accommodate paradigmatic pain cases, e.g., when pain follows from stepping on a nail. Once we consider more complex pain phenomena, however, it has seemingly little to offer. In this chapter, I discuss dissociation between pains and bodily disturbances, variation in pain thresholds, the effects of repeated stimulation on experienced pain intensity, and the modulation of pain experience by contextual factors. I argue that these phenomena suggest that the pain system is not a bodily disturbance detector, but a sophisticated security system.

Using micro-data on six surveys–the Gallup World Poll 2005–2023, the U.S. Behavioral Risk Factor Surveillance System, 1993–2022, Eurobarometer 1991–2022, the UK Covid Social Survey Panel, 2020–2022, the European Social Survey 2002–2020 and the IPSOS Happiness Survey 2018–2023 –we show individuals’ reports of subjective wellbeing in Europe declined in the Great Recession of 2008/9 and during the Covid pandemic of 2020–2021 on most measures. They also declined in four countries bordering Ukraine after the Russian invasion in 2022. However, the movements are not large and are not apparent everywhere. We also used data from the European Commission’s Business and Consumer Surveys on people’s expectations of life in general, their financial situation and the economic and employment situation in the country. All of these dropped markedly in the Great Recession and during Covid, but bounced back quickly, as did firms’ expectations of the economy and the labor market. Neither the annual data from the United Nation’s Human Development Index (HDI) nor data used in the World Happiness Report from the Gallup World Poll shifted much in response to negative shocks. The HDI has been rising in the last decade reflecting overall improvements in economic and social wellbeing, captured in part by real earnings growth, although it fell slightly after 2020 as life expectancy dipped. This secular improvement is mirrored in life satisfaction which has been rising in the last decade. However, so too have negative affect in Europe and despair in the United States.

Helicobacter pylori is one of the most common bacterial infections; over two-thirds of the world's population is infected by early childhood. Persistent H. pylori infection results in gastric ulcers and cancers. Due to drug resistance, there is a need to develop alternative treatments to clear H. pylori . The Seattle Structural Genomics Center for Infectious Disease (SSGCID) conducts structure–function analysis of potential therapeutic targets from H. pylori . Glutamyl-tRNA synthetase (GluRS) is essential for tRNA aminoacylation and is under investigation as a bacterial drug target. The SSGCID produced, crystallized and determined the apo structure of H. pylori GluRS ( Hp GluRS). Hp GluRS has the prototypical bacterial GluRS topology and has similar binding sites and tertiary structures to other bacterial GluRS that are promising drug targets. Residues involved in glutamate binding are well conserved in comparison with Pseudomonas aeruginosa GluRS ( Pa GluRS), which has been studied to develop promising new inhibitors for P. aeruginosa . These structural similarities can be exploited for drug discovery and repurposing to generate new antibacterials to clear persistent H. pylori infection and reduce gastric ulcers and cancer.