The Role of Race in Admission to a Dual Diagnosis Unit Versus General Inpatient Psychiatric Unit in those with Active Substance Use

Psychiatric disorders are highly comorbid with substance use disorders, and the presence of co-occurring conditions increases severity of illness and complicates recovery. Those with comorbid mental illness and substance use disorders may benefit from specialized services, specifically integrated dual diagnosis treatment. Admission to a dual diagnosis unit requires health care providers to consider a number of factors, including severity of illness, psychiatric history, bed availability, and providers’ perceived likelihood of benefit of specialized services. Ideally, decisions regarding the necessity of substance use treatment are made independent of race, and yet, racial disparities exist among those who are offered substance use treatment. The aim of this study was to evaluate the demographic differences of patients who are identified as having active substance use admitted from the comprehensive psychiatric emergency program (CPEP) to a dual diagnosis unit versus those admitted to a general inpatient psychiatric unit. Our study consists of a retrospective analysis of patients, aged 18–90 (n = 100), admitted to either a dual diagnosis unit (8B) or general psychiatric unit (6K) at Mount Sinai Beth Israel (MSBI), a private metropolitan hospital in New York City, between November 1st to November 30th, 2020. We hypothesized that there are racial disparities in unit assignments while accounting for a variety of potentially relevant demographic and clinical variables. The primary outcome was a comparison of demographic factors, particularly racial composition, of those admitted to the dual diagnosis unit versus those admitted to the general psychiatric unit. After accounting for 6 clinical and 3 other demographic variables, patients of Black race were over 5 times more likely (adjusted odds ratio 5.31; P = 0.011) to be assigned to 8B than patients of White, Asian, or Other race. Additional contributors to 8B assignment were male gender, IM or IV PRNs, and documented substance use ('Table 1'). There were no significant differences between Black and Non-Black patients in rates of substance use detected on toxicology ('Table 2'). These findings suggest that race may be a driving factor in unit assignment, and unconscious racial bias may potentially confound admission decision-making, limiting access to available resources and services for some populations. More research is needed to understand factors contributing to racial disparities in substance use treatment

Long-term qualitative changes in fish populations and aquatic habitat in San Mateo Creek Lagoon, northern San Diego County, southern California, USA.

Observations beginning in 1974 and later surveys of increasing intensity with small seines, traps, and dipnets (1991 to mid-2008) documented patterns of abundance, colonization, and extirpation of 15 species of native and non-native fishes as well as crayfishes, and amphibians in the lagoon at the mouth of San Mateo Creek, northern San Diego County, California. Fish populations varied with Mediterranean climate patterns of stream flow and breaching of the lagoon to the ocean through the barrier sand berm. Two near-record rainfall seasons occurred during this period; the 1997-1998 El Niño due to southern storms and the 2004-2005 winter wet season of more usual storms from the north and northwest. The lagoon stabilized as fresh to brackish in the dry season and for multiple years during successive dry winters. Closed conditions benefitted the native, federally endangered Southern Tidewater Goby, Eucyclogobius n. sp., but were unsuitable for other native estuarine species more common in wetter years. Wet year flows also brought down non-native freshwater species to the lagoon; some thrived and increased predation pressure on the tidewater goby. Historically these exotics were absent and two additional native species were present in the lagoon, Partially Armored Threespine Stickleback, Gasterosteus aculeatus, and the now federally endangered Southern Steelhead, Oncorhynchus mykiss. Restoring and maintaining a full suite of native species will require a combination of 1) habitat maintenance, 2) control or management of non-native species, and 3) reintroduction of some native fishes and amphibians to restore the faunal communities of remaining small coastal estuarine systems

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Comparing imaging, acoustics, and radar to monitor Leach’s storm-petrel colonies

Seabirds are integral components of marine ecosystems and, with many populations globally threatened, there is a critical need for effective and scalable seabird monitoring strategies. Many seabird species nest in burrows, which can make traditional monitoring methods costly, infeasible, or damaging to nesting habitats. Traditional burrow occupancy surveys, where possible, can occur infrequently and therefore lead to an incomplete understanding of population trends. For example, in Oregon, during the last three decades there have been large changes in the abundance of Leach’s storm-petrels (Hydrobates leucorhoa), which included drastic declines at some colonies. Unfortunately, traditional monitoring failed to capture the timing and magnitude of change, limiting managers’ ability to determine causes of the decline and curtailing management options. New, easily repeatable methods of quantifying relative abundance are needed. For this study, we tested three methods of remote monitoring: passive acoustic monitoring, time-lapse cameras, and radar. Abundance indices derived from acoustics and imagery: call rates, acoustic energy, and counts were significantly related to traditional estimates of burrow occupancy of Leach’s storm-petrels. Due to sampling limitations, we were unable to compare radar to burrow occupancy. Image counts were significantly correlated with all other indices, including radar, while indices derived from acoustics and radar were not correlated. Acoustic data likely reflect different aspects of the population and hold the potential for the further development of indices to disentangle phenology, attendance of breeding birds, and reproductive success. We found that image counts are comparable with standard methods (e.g., radar) in producing annual abundance indices. We recommend that managers consider a sampling scheme that incorporates both acoustics and imaging, but for sites inaccessible to humans, radar remains the sole option. Implementation of acoustic and camera based monitoring programs will provide much needed information for a vulnerable group of seabirds

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries.

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways

Changes in preterm birth and stillbirth during COVID-19 lockdowns in 26 countries.

Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from -90% to +30%, were reported in many countries following early COVID-19 pandemic response measures ('lockdowns'). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95-0.98, P value <0.0001), second (0.96, 0.92-0.99, 0.03) and third (0.97, 0.94-1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96-1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88-1.14, 0.98), third (0.99, 0.88-1.12, 0.89) and fourth (1.01, 0.87-1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02-1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03-1.15, 0.002), third (1.10, 1.03-1.17, 0.003) and fourth (1.12, 1.05-1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways