STRIPE partners in precision medicine series: provider perspective
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Optimum corrosion performance using microstructure design and additive manufacturing process control
Compatibility of traditional metallic alloys, particularly 316 L stainless steel, with additive manufacturing (AM) processes, is essential for industrial applications. This involves manipulating process parameters to design microstructures at various length scales, achieving desired properties for high-performance components. In this study, a hierarchical design approach was used for LPBF 316 L parts, achieving cell sizes of 400 to 900 nm confined within grains of 40 to 60 μm. Findings showed that varying scan strategies with constant energy input produced high-density components, with the smallest grain and cell size achieved in the continuous scan strategy. In addition, equations were developed to connect energy density with grain size for LPBF-316L, highlighting optimal scanning strategies. Furthermore, the correlation between microstructural features and corrosion behavior, focusing on electrochemical properties, was explored by adjusting key LPBF process parameters. The results suggested a Hall-Petch relationship between grain size and corrosion rate, indicating that smaller grains and cells reduce corrosion rates by affecting electrochemical behavior.
Task-sharing and telemedicine delivery of psychotherapy to treat perinatal depression: a pragmatic, noninferiority randomized trial
Task-sharing and telemedicine can increase access to effective psychotherapies. Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) is pragmatic, multisite, noninferiority, four-arm trial that tested the non-inferiority of provider (non-specialist vs. specialist providers) and modality (telemedicine vs. in-person) in delivering psychotherapy for perinatal depressive symptoms. Across three university-affiliated networks in the United States and Canada, pregnant and postpartum adult participants were randomized 1:1:1:1 to each arm (472 nonspecialist telemedicine, 145 nonspecialist in-person, 469 specialist telemedicine and 144 specialist in-person) and offered weekly behavioral activation treatment sessions. The primary outcome was depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS)) and the secondary outcome was anxiety (Generalized Anxiety Disorder (GAD-7)) symptoms at 3 months post-randomization. Between 8 January 2020 and 4 October 2023, 1,230 participants were recruited. Noninferiority was met for the primary outcome comparing provider (EPDS: nonspecialist 9.27 (95% CI 8.85–9.70) versus specialist 8.91 (95% CI 8.49–9.33)) and modality (EPDS: telemedicine 9.15 (95% CI 8.79–9.50) versus in-person 8.92 (95% CI 8.39–9.45)) for both intention-to-treat and per protocol analyses. Noninferiority was also met for anxiety symptoms in both comparisons. There were no serious or adverse events related to the trial. This trial suggests compelling evidence for task-sharing and telemedicine to improve access to psychotherapies for perinatal depressive and anxiety symptoms. ClinicalTrials.gov NCT04153864
Aerospace medicine in China: advancements and perspectives
With the rapid growth of China’s space industry, long-term manned space missions face challenges from the complex space environment, posing risks to human health. Aerospace medicine, a key field, addresses these risks by researching the impacts of space on biochemical changes, cognitive abilities, and immune systems. This article reviews China’s aerospace medicine research, summarizing efforts from various institutions and offering insights for future developments in the field.
The effect of avatar identity on spontaneous perspective-taking in patients with schizophrenia
Controversy exists regarding whether the spontaneity of altercentric intrusion is impaired in patients with schizophrenia during implicit visual perspective-taking tasks. This study explored the characteristics of spontaneous visual perspective-taking in patients with schizophrenia and the effect of an avatar identity on their perspective-taking. We recruited 65 patients with schizophrenia and 65 healthy participants to complete 4 visual perspective-taking experiments for uncued other-avatar and self-avatar tasks and cued other-avatar and self-avatar tasks. In uncued other-avatar experiments, healthy controls showed a significant reduction in accuracy and an increase in response latency when the number of visible discs differed from that seen by the other-avatar (inconsistent condition), indicating altercentric intrusion. However, patients with schizophrenia did not exhibit this effect. In uncued self-avatar experiments, when the avatar was defined as the participant themselves, patients with schizophrenia did not show spontaneous perspective-taking. However, in cued other-avatar experiments, they showed altercentric intrusion in response latency, and in cued self-avatar experiments, they showed altercentric intrusion in accuracy and response latency. These results suggest that patients with schizophrenia have the tendency to spontaneously adopt the perspective of others, which is predicated on their awareness of the existence of perspectives. In addition, the avatar’s identity as a stranger hinders the spontaneous perspective-taking processes in patients with schizophrenia.
Contraception decision-making autonomy among adolescent girls and young women in Uganda
We assessed contraception decision-making autonomy among current contraceptive users and interest in self-care-oriented contraception among 2109 sexually-active adolescent girls and young women (AGYW) aged 10–24 years in Uganda. Current contraceptive users were asked about who made the decision to use contraception; those who made the decision on their own were considered to have contraception decision-making autonomy. More than half of AGYW (54.8%, n = 1155) were current contraceptive users; of these, 26.8% (n = 310) made the decision to use contraception on their own. Having contraception discussion with partner prior to contraceptive use (adj. PR = 0.39; 95%CI: 0.32, 0.48) and being currently married (adj. PR = 0.74; 95%CI: 0.56, 0.98) were negatively associated with contraception decision-making autonomy. Fifty-eight percent of AGYW (n = 1213) reported interest in obtaining information on how to access and/or use self-care-oriented contraceptive methods. These findings suggest a need to empower AGYW to not only make but also act on their contraceptive decisions.
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