Courtship is often a multimodal process involving several signals of different modalities occurring simultaneously. Male nursery web spiders (Pisaura mirabilis) perform substrate-borne vibrations while offering a nuptial gift (a nutritional donation which also serves as a visual and olfactory signal) as they court females. The nuptial gift, consisting of a prey item wrapped in silk, is a considerable investment for the male, and vibration is also likely an energetically costly signal. In this study, we investigate how these 2 expensive mate attraction tactics interact in order to explore how investment might be partitioned between them. We conducted behavioral experiments where male P. mirabilis were provided with nuptial gifts in 3 treatments-no gift, medium gift, large gift-and recorded their courtship vibrations in repeated trials (once with each nuptial gift treatment). We found that calling duration (the total amount of time spent signaling) is longer when males have a nuptial gift vs. when they do not, but the duration is not plastic in response to the mass of the gift. Pulse rate is not affected by the quality of the nuptial gift. In trials where a gift is present, only pulse interval consistency changes based on gift quality, with intervals becoming more consistent (putatively more attractive) as gifts increase in mass. Our results suggest that male spiders do adjust their investment in vibratory courtship signals at a general level, though the plasticity is slight.
Genome-wide association studies (GWAS) are commonly used to investigate the genetic basis of complex traits. However, to be adequately powered they typically require large sample sizes to provide precise inferences. To address this challenge, this paper introduces GIFT, a novel data analytic method that enhances the power of genetic analyses, enabling the use of smaller datasets without compromising precision. In a small cohort of 157 ponies, GIFT was applied to examine the complex trait of "height at withers", comparing its performance to traditional GWAS. GIFT enabled the identification genetic loci linked to insulin physiology validating, in turn, a long-standing hypothesis that "height at withers" is associated with insulin physiology in equids, potentially promoting equine metabolic syndrome (EMS). By redefining correlations between single nucleotide polymorphisms (SNPs), GIFT provides new insights into linkage disequilibrium and reveals underlying gene network structures. This, in turn, enables the distinction between core and peripheral genes within these networks. By reducing the time and cost associated with large-scale genotype-phenotype mapping studies without sacrificing statistical robustness, GIFT broadens access to quantitative genetic research, allowing smaller-scale studies to investigate the genetic architecture of complex traits with greater resolution.
Peer review is crucial for academic communities to ensure high-quality research, but yields relatively limited formal rewards for the individuals who perform it. Drawing on 39 semi-structured interviews, I study how reviewers for three publishing outlets in psychology experience the tension between community responsibility and various priorities of a more individual kind. Peer review functions as a gift economy, in which authors are expected to repay the work reviewers have invested in their submission by providing peer review for others. This gift economy is embedded in other economies, which are based on the accumulation of various types of capital (recognition, visibility, money etc.). If not kept in check, the competitive dynamics of accumulation tend to undermine the sense of reciprocity required for the continued functioning of peer review. One of the journals studied here is particularly prestigious and operates with a traditional format of pre-publication peer review. The model effectively exploits the tensions between gift giving and accumulation. It exposes reviewers to various undesirable submission practices characteristic of high impact publishing, but compensates them with a share of its reputation that reviewers can use to advance their own careers. The other two publishing outlets are based on not-for-profit business models and feature elements such as open peer review, portable reviews, and registered reports. Reviewers can thereby more easily see their work as something akin to co-authorship. This alleviates tensions between gift giving and the various encompassing economies, contributing to the sustainability of the respective peer review systems.
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This study describes the process of older adults creating a legacy of values (e.g., legacy letter), which promotes generativity by communicating emotional and supportive instruction (e.g., values and life lessons) to others. We conducted semi-structured interviews with community-dwelling older adults (n = 16, mean age 72.3 years) who had previously created a legacy of values. Following an interpretive descriptive framework, we integrated deductive and inductive coding, identified patterns through constant comparative analysis, and generated categories describing the essential (i.e., Motivation, Selecting Audience and Format, Selecting Content, and Sharing) and ancillary (i.e., procedural) elements of the process. Creation was a non-linear, iterative, and individualized process that helped participants communicate what matters most. Participants tailored the contents and format to the intended recipients, revised their document over time, and recommended the process to others. Our findings indicate that creating a legacy of values in a self-directed way is an accessible, appealing and individualized process.
Cheek teeth are filled to the cusp with information about mammalian evolution. Studying the evolution of mammalian cheek tooth crown complexity has benefited our understanding of mammalian evolution in developmental, morphological, and ecological contexts. Most work is focused on individual cheek tooth loci as opposed to considering the premolars and molars as serial homologues. This focus on individual tooth loci has left the exploration of inter-regional phenomena understudied. One such phenomenon is the molarization of premolars across hoofed mammals; some have simple unicuspid premolars while others have premolar crowns that are equal in complexity to their molars. Many developmental models have been proposed to understand cheek tooth evolution, but minimal work has been done to synthesize these models into a holistic understanding of cheek tooth crown complexity evolution. We investigated if applying a synergized theoretical framework of the inhibitory and patterning cascade model to artiodactyl and perissodactyl taxa could be used to study the evolution of molarization in hoofed mammals. We applied an existing 2D landmarking scheme for the upper and lower premolar molar boundaries of hoofed mammals to capture the morphology across this important identity boundary. Shape data were analyzed through phylogenetically informed modularity analyses to capture the covariation structure at the upper and lower premolar-molar boundaries. A-priori modularity hypotheses were proposed based on developmental models including the patterning cascade model and the inhibitory cascade model. Both artiodactyl and perissodactyl results showed support for modularity across the upper and lower premolar molar boundary but showed more variation in the upper premolar molar boundary. Artiodactyls show consistency in support for modularity hypotheses between upper and lower premolar molar boundaries where perissodactyls show significant differences in support for modularity hypotheses between upper and lower premolar molar boundaries. Our results illustrate that the covariation structure at the premolar molar boundary has convergent and divergent elements that both have consequences for our understanding of the evolution of molarization within and between artiodactyls and perissodactyls.
This reflection explores the experience of aphasia following a severe stroke and the subsequent loss of a professional identity as a practicing psychologist. Through the process of relearning language, reading, and writing fiction, the author reflects on questions of identity, recovery, and the unfinished nature of medicine, psychology, and human lives. Memories of the author's father, a rural country physician, provide a framework for understanding that healing is not about completing another person's story, but participating in it. Writing serves not as an endpoint but as a continuing process of meaning-making, listening, and beginning again.
Surgical repair of the Achilles tendon (AT) requires high failure load while limiting elongation. Midsubstance repairs are particularly reliant on suture techniques and typically use either a whip stitch or a locking stitch, such as the Krackow. Enhancements to the Krackow, such as the gift box, epitendinous, or alternative locking stitch techniques, aim to simplify surgical processes and improve biomechanics. The purpose of this study was to evaluate biomechanical properties of 3 enhanced techniques for midsubstance AT repair. We hypothesized that locking stitch constructs would demonstrate improved biomechanical performance compared with nonlocking constructs by minimizing elongation and increasing failure load. A total of 30 cadaveric lower leg specimens with simulated midsubstance AT ruptures were divided into 3 repair groups: whip stitch with gift box (WG), locking whip stitch with gift box (LG), Krackow stitch with epitendinous baseball (KB) stitch. Samples were preconditioned and then loaded from 20 to 100 N for 1000 cycles, followed by load to failure. Elongation, stiffness, failure load, survival, failure mode, and suture weight (burden) were compared. KB had the significantly lowest cyclic elongation, whereas LG had the significantly highest failure load. LG failure load increase was achieved while using less suture material than KB. All samples survived the cyclic loading protocol, and all whip stitch groups failed from tissue pull-through, whereas LG and KB failed only 40% from pull-through. This study presents 2 stitch techniques that can improve AT repair failure load (LG) and limit elongation (KB). Locking stitch techniques LG and KB demonstrated a significant improvement in biomechanical performance compared with nonlocking WG. Inferences should be limited to the 3 tested constructs rather than individual technical variables in isolation. The locking whip stitch gift box and Krackow epitendinous baseball stitch techniques are both viable methods for Achilles tendon repair. Nonlocking whip stitch gift box does not provide sufficient fixation.
In the US, low-income children have poorer dietary behaviors than high-income children and suffer disproportionately from nutrition-related chronic diseases. A growing literature examines whether food environments contribute to nutritional inequality, given evidence that low-income families differentially concentrate in neighborhoods characterized by limited access to healthy foods. Here we use a rigorous, randomized controlled trial (RCT) of poverty reduction among 901 low-income families to test whether improvements in the food environment mediate a demonstrated effect of cash transfers on children's diet. We first replicate prior work on the RCT showing a protective effect of treatment-i.e., assignment to a "high-cash" gift group (in which mothers received $333/month), relative to a "low-cash" gift group ($20/month)-on age-2 fruit and vegetable consumption. We then apply inverse odds ratio weighting (IORW) mediation methods to decompose the total effect of cash transfers into direct and indirect effects operating through changes in four food environment measures: 1) food deserts (census tract); 2) number of SNAP outlets (1-mile buffer); 3) Modified Retail Food Environment Index (mRFEI; census tract); and 4) supermarket proximity (straight-line distance). The proportion of the total effect explained by each food environment mediator ranged from 11% (mRFEI: β = 0.019, CI: -0.066, 0.104) to 14% (supermarket proximity: β = 0.025, CI: -0.057, 0.107) with all confidence intervals including zero, providing no evidence of mediation. Results suggest that changes in neighborhood food environments do not explain the effect of a poverty reduction trial on dietary improvements in early childhood.
Tobacco marketing shapes consumer perceptions, particularly among young people. Despite regulatory restrictions, subtle tactics may continue to mislead youth and young adults. This study examines how specific features in cigarette and e-cigarette ads affect perceived harm and addictiveness among 18-20-year-olds. We recruited 1,708 U.S. participants aged 18-20 across two survey waves (2022-2023). Participants viewed randomized cigarette and e-cigarette ads and rated perceived harm and addictiveness. Ads (n = 221) were coded for youth-relevant features. Mixed-effects logistic regression assessed associations between ad features and perceptions, adjusting for demographics, tobacco use, brand familiarity, and wave. For e-cigarette ads, flavors and gift promotions were associated with a lower likelihood of inaccurate harm perceptions, while sweepstakes, social media engagement, and socialization themes were linked to a higher likelihood of inaccurate harm perceptions. In cigarette ads, use cues and pleasure claims were linked to a lower likelihood of inaccurate harm perceptions, whereas gift promotions were linked to a higher likelihood of misperceptions. Regarding addiction, price promotions and use cues in e-cigarette ads were associated with a lower likelihood of inaccurate addiction perceptions, while sweepstakes, social media engagement, and socialization themes were linked to a higher likelihood of inaccurate addiction perceptions. For cigarette ads, only use cues predicted a lower likelihood of inaccurate addiction perceptions. Advertising features can influence young adults' misperceptions of nicotine and tobacco product risks. Specifically, sweepstakes, social media engagement, and youth-oriented socialization themes may obscure harm and addictiveness, especially for e-cigarettes. Findings support comprehensive regulation to address misleading marketing.
Interactions between physicians and pharmaceutical companies are common for mutual exchange of medical knowledge; pediatric field is no exception. However, vested commercial interests could encourage irrational prescribing behavior. The pharmaceutical industry can offer free drug samples, gifts, travel expenses and honoraria to physicians in addition to sponsorship for academic events, access to medical softwares or academic activities in return for promoting and endorsing their products. Given that pediatricians care for a particularly vulnerable population, they bear an added responsibility to uphold the highest standards of ethical professional conduct. Financial transparency, protection of data confidentiality, stricter framework by the journal editors in evaluating possible gift authorships and industry-facilitated research and careful vigil by professional bodies (Academies/Societies/Associations) are a few solutions that could ensure that their members adhere to ethical standards and regulatory guidelines.
The extended care for deceased organ donors can be challenging for resource-constrained hospitals that do not have the staff, equipment, or expertise to manage a donor. Donor care units provide a dedicated space and team for donor management, which allows for efficient and effective care. In 2020, the transplant institute at a New York City hospital established the first hospital-based donor care unit in the city with its local organ procurement organization to help alleviate the organ crisis in the United States. Hospital-based donor care units require a trusting relationship between the organ procurement organization and donor management team to maximize every donor's gift.
Despite effective antiretroviral therapy, HIV persists in the central nervous system (CNS) and may contribute to neuroinflammation and cognitive impairment. How viral persistence, immune responses, and regional CNS T-cell architecture relate to cognitive functioning remains unclear. We performed a cross-sectional, multi-compartmental immune-genomic study in 12 people with HIV on long-term viral suppression enrolled in the Last Gift rapid autopsy program. Quantitative HIV reservoir measures (total-episomal DNA, unspliced-multiply spliced RNA) and paired αβ T-cell receptor repertoire (TCRR) sequencing were performed in peripheral blood mononuclear cells and five CNS regions: hippocampus, frontal motor cortex, basal ganglia, occipital cortex, and spinal cord. Cognitive performance was assessed within one year of death. Tissue-resolved associations between cognition and HIV reservoir, TCRR architecture (richness, diversity, clonality), and pathogen-specific T-cell clonotypes (HIV, CMV, EBV, and riboflavin derivatives) were evaluated using participant-clustered multivariable models. False discovery rate was applied. HIV DNA and RNA were detectable across all tissues but were not associated with cognitive performance or TCRR metrics. Peripheral TCRR architecture was unrelated to cognition, whereas higher TCRR richness and diversity in the hippocampus and spinal cord were associated with worse verbal, motor, and attention/working memory scores. Higher TCRR richness in the spinal cord was also associated with better recall. T-cell receptor clonotype frequency distributions differed across CNS regions, consistent with regional immune compartmentalization. Epitope-inference analyses revealed pathogen-dependent associations: higher number of HIV-specific T-cell clonotypes in the basal ganglia was associated with better global and attention/working memory scores, whereas riboflavin derivative-specific clonotypes in frontal motor cortex were associated with better motor performance. CMV-specific clonotypes showed nominal associations with worse learning and memory. CNS-localized T-cell receptor architecture and antigenic imprinting related more closely to neurocognitive variability than quantitative measures of HIV persistence under viral suppression, highlighting regional specialization of T-cell responses as a potential correlate of brain health.
The cerebellum has been implicated in schizophrenia-related structural and functional deficits, with posterior Crus I and II most consistently affected. Source-based morphometry (SBM) involves applying independent component analysis to gray matter volume to identify spatially distinct structural networks that covary across individuals. We applied SBM and voxel-based morphometry (VBM) to cerebellar structural imaging data to identify patterns of gray matter differences across individuals with schizophrenia (SZ), bipolar disorder with psychotic features (BDwP), and healthy controls (HC). Data were drawn from the Psychosis Human Connectome Project (P-HCP) and included 168 participants: 85 with SZ, 36 with BDwP, and 47 HC. T1-weighted images were processed using the ENIGMA Cerebellum Volumetrics Pipeline, and ICA decompositions were performed using the SBM module of the GIFT Toolbox. One independent component (IC) showed a significant diagnostic group effect (p < 0.05, Bonferroni-corrected), differentiating SZ from HC and BDwP. This cerebellar network included vermis VIIIa, bilateral Crus I, and right lobule IX with positive loadings, and bilateral Crus I and lobule IX with negative loadings. Voxel-based morphometry showed reduced GM volume in negatively loaded regions in SZ. Composite cognitive performance correlated with GM volume (r = 0.27, p < 0.001) and network loadings (r = -0.29, p < 0.001). Mediation analyses showed a strong direct diagnostic effect on IC loadings (-0.42), with small, nonsignificant indirect effects via cognition. These findings identify a cerebellar structural network that differentiates schizophrenia from bipolar disorder and controls, underscoring the cerebellum's unique contribution to the neurobiology of schizophrenia.
Self-inflicted cutting, a common form of nonsuicidal self-injury (NSSI), has emerged as a significant clinical and pastoral concern in contemporary psychiatry. Clinically, cutting serves multiple psychological functions: regulation of intense affect, relief of overwhelming distress, externalization of emotional pain, self-punishment, indirect communication of suffering, induction of dissociative states, or generation of physiological arousal. These functions underscore the complexity of the behavior. From a Catholic theological perspective, these psychological mechanisms may be situated within a broader account of the human person. Catholic anthropology holds that the human being, created in the image of God (imago Dei), is ordered towards communion with God and others. Flowing from this orientation is a capacity for self-gift, by which suffering may be united to Christ's once-for-all redemptive sacrifice. Suffering is not salvific in itself; it becomes spiritually fruitful only insofar as it participates in Christ's redemptive act, sacramentally mediated through the Eucharist and the Sacrament of Reconciliation. Cutting can therefore be interpreted as a tragic misdirection of the human longing for communion and restoration. Pain, severed from relational participation in Christ's sacrifice, turns inward and becomes destructive rather than transformative. This essay examines cutting through an interdisciplinary lens integrating psychiatry, biblical theology, Catholic anthropology, and medical history to argue that authentic healing requires both rigorous psychiatric care and pastoral accompaniment that reorients suffering toward communion. Cutting is examined through psychiatry and Catholic theology as a misdirected attempt to relieve suffering.
The sural nerve is a superficial sensory nerve of the posterior leg that innervates the lateral foot. Anatomical variations in its course are clinically relevant, as they may affect surgical procedures, nerve blocks, and the risk of iatrogenic injury. This case report describes a rare variant in which the sural nerve pierces between the two heads of the gastrocnemius muscle, a course infrequently reported in the literature and important for surgical awareness. During routine lower-extremity dissection by first-year medical students at William Carey College of Osteopathic Medicine, Hattiesburg, USA, a rare sural nerve variant was identified in a 72-year-old Caucasian female cadaver obtained from the University of South Alabama Anatomical Gift Program, with dementia listed as the cause of death. The right sural nerve pierced both the medial and lateral heads of the gastrocnemius muscle approximately 11.43 cm inferior to the center of the popliteal fossa, deviating from its typical superficial course. After traversing the muscle, the nerve continued normally along the posterior leg. Adjacent structures, including the popliteal artery, popliteal vein, and tibial nerve, were unremarkable. Intact muscle fibers and the absence of fibrosis support this finding as a benign anatomical variation. While sural nerve variations are well-documented, instances of the nerve piercing the gastrocnemius muscle are exceedingly rare. Damage to the sural nerve can result in sensory deficits affecting the lateral foot and lower leg, which may impair recovery and quality of life. Awareness of such variations is vital for clinicians to prevent inadvertent nerve injury during surgeries or nerve blocks.
Virtual reality (VR) systems are increasingly used in rehabilitation to facilitate motor learning by providing visual feedback. However, few studies have validated the motion tracking accuracy of VR devices compared with gold-standard motion capture systems. In particular, validation evidence for upper-limb reaching with commercially available VR tracking setups remains limited. This study aimed to evaluate the validity of a custom VR-based rehabilitation system (VRactice) by comparing its motion tracking data with that of a Vicon motion capture system during a goal-directed reaching task in healthy adults. This laboratory-based validation study was conducted at Tokyo Kasei University, Sayama Campus, Japan (August-December 2023). Participants were recruited via posted announcements on campus (convenience sampling) and received a 1000 JPY gift card (US $7.00; JPY 142.79=US $1 as of August 1, 2023). A total of 16 healthy participants (n=6, 37.5% male and n=10, 62.5% female participants; mean age 25.3, SD 4.56 years; all right-handed) performed reaching tasks in a VR environment while being tracked simultaneously by both the VRactice system and a Vicon system. Trackers and reflective markers were attached to the hand and elbow to capture 3D coordinates. Each participant performed 10 reaching trials at a frequency of 1 Hz. Data were upsampled to 100 Hz, synchronized, and normalized to the initial position. Valid cycles were identified, and distance time series from the initial position were extracted for the 500-millisecond interval preceding the peak displacement. For each participant, all valid cycles were pooled, and the coefficient of determination (R2) between VRactice and Vicon trajectories was calculated. Of 160 planned trials (16 participants×10 trials), 4 (2.5%) trials were not recorded; the remaining 156 (97.5%) trials were analyzed without imputation. Statistical significance was evaluated at a 2-sided α level of .05. Strong agreement between VRactice and Vicon was observed at both the individual and group levels. The R2 ranged from 0.75 to 0.99 across participants, and all comparisons were statistically significant (P<.001). Deviations between the 2 systems remained minimal, confirming that VRactice reliably reproduced the temporal and spatial characteristics of reaching trajectories. At peak displacement, the participant-level mean absolute difference (mean of 10 trials per participant) was 36.5 (SD 29.3) mm (95% CI 20.9-52.1), suggesting spatial agreement that may be acceptable for upper-limb reaching measurements in this experimental context. The findings support the validity of VRactice in capturing reaching movements with high spatial accuracy compared with a motion capture system. By providing reliable motion data, VRactice may serve as a useful platform for delivering real-time visual feedback and supporting motor training applications in rehabilitation settings. This study is innovative in that it provides formative validity evidence for a VR-based system that integrates real-time trajectory monitoring with adaptive visual guidance, supporting subsequent clinical implementation and evaluation.
To assess physician acceptance of a Virtual Reality Brain Death Determination Tool (VRBDDT) as an educational modality and its impact on physician knowledge and confidence in brain death determination and communication with patient families. Prospective pilot study using surveys administered pretraining and post-training. One hundred twenty-six acute care hospitals within the Gift of Life Donor Program's Donor Service Area. Physicians responsible for performing brain death determination. Participants completed a novel, virtual reality-based training program consisting of eLearning modules integrated with virtual reality simulations of brain death determination procedures and family communication. Of 142 enrolled participants, 69 completed both pretraining and post-training assessments consisting of a 14-item questionnaire. Median scores significantly improved from 73.2% pretraining to 91.1% post-training (p < 0.001). Participants demonstrated the largest improvements in knowledge about clinical examination procedures and family communication skills. Self-reported confidence significantly increased post-training, with high satisfaction and acceptance ratings reported by participants. The VRBDDT was accepted by physicians and significantly enhanced knowledge and confidence related to brain death determination and family communication.
How did a philosopher who celebrated eccentricity, eroticism, and excess come to embrace the starkest of normative concepts, the imperative? This essay explores this productive tension in the work and life of Alphonso Lingis (1933-2025), drawing on a philosophical exchange and friendship spanning more than three decades. Lingis adapted Kant's concept of the imperative to argue that we are summoned, before and beyond reason, to accompany the dying, to respond to the elemental forces of nature, and to honour the singular gift of our lives by dedicating ourselves to the task that calls to us. Lingis's thinking resonates with Emmanuel Levinas's grounding of ethics in the vulnerability of the face of the Other, yet he anchored his imperative in deeply personal encounters with strangers who risked everything to save him. This personal and philosophical tribute traces how his extraordinary, unconventional life exemplified his insistence that we are all under an imperative to live fully.
Mad honey contains the neurotoxin grayanotoxin, which is produced by the flowers and nectar of the Rhododendron family. Bees incorporate this toxin into honey. Mad honey is consumed as a medicinal remedy in certain parts of the world, leading to persistent vagal activation and potentially serious complications, including hemodynamic instability. We report the case of a 75-year-old male patient with a medical history of hyperlipidemia and hypertension (managed with atorvastatin 20 mg and amlodipine 5 mg, respectively) who presented to the emergency department complaining of near-syncope, dizziness, lethargy, nausea, and one episode of diarrhea one hour after ingesting 20-30 mL of wild honey brought as a gift from abroad. On presentation, he was conscious and alert. Triage observations revealed a blood pressure of 65/41 mmHg, a heart rate of 45 beats/minute, a respiratory rate of 20 breaths/minute, an oxygen saturation of 98% on room air, and a temperature of 36.8°C. Physical examination was unremarkable. Electrocardiogram demonstrated sinus bradycardia. The patient was resuscitated with intravenous fluids and 0.6 mg of intravenous atropine, which normalized his heart rate and blood pressure within seconds. He was admitted for observation for 36 hours and was discharged without sequelae. Mad honey poisoning is rare in the United Kingdom and requires a high index of suspicion. Symptoms of hypotension and bradycardia following honey consumption should alert clinicians to this poisoning. Treatment with atropine is successful in alleviating symptoms, which typically resolve within 24 hours.