National University of Natural Medicine

The Revised Universal Soil Loss Equation, Version 2 (RUSLE2), is the primary water erosion prediction tool used by the USDA Natural Resources Conservation Service (NRCS) for land management planning across the United States. Despite its widespread adoption, RUSLE2’s reliance on a personal computer-based model limits its capacity for large-scale, dynamic applications. This research addresses these constraints by developing a novel cloud-based platform to host and enhance RUSLE2, enabling server-based computation, geospatial data integration, and scalable modeling capabilities. Built on Amazon Web Services (AWS), the platform integrates web-based user interfaces, spatial databases, and geoprocessing tools to streamline soil erosion modeling. It incorporates historical data on soil properties, weather patterns, and land use practices to support precise assessments of rill and interrill erosion. A redesigned database architecture ensures computational efficiency, data security, and collaborative development. Scientific advancements in RUSLE2 include quantifying the effects of precipitation variability and land use on the spatiotemporal dynamics of key soil properties. Leveraging advanced field and laboratory methods, remote sensing, and machine learning, the platform improves the measurement and mapping of soil erodibility and soil loss across diverse U.S. agricultural landscapes. These enhancements enable more accurate forecasts of erosion risk under evolving environmental scenarios and support flexible land management strategies. This transformative, cloud-based platform delivers innovative tools to guide land use practices and improve long-term agricultural productivity. By integrating cutting-edge technologies and data-driven modeling, this work addresses longstanding challenges in erosion science and enhances regional and national resilience in soil resource management.

Abstract BACKGROUND Lumbosacral radicular pain (LRP) is a highly disabling condition frequently accompanied by pain-related fear, reduced physical activity, and difficulty engaging in daily activities. Although mindfulness-based and movement-based interventions are recommended for chronic low back pain, few programs have been specifically designed for individuals with LRP or developed using patient-centered, theory-informed methods. Before large-scale evaluation, early-phase work is needed to establish the feasibility and acceptability of such interventions and their associated study procedures. This protocol describes the development and pilot testing of Move-MORE, a multicomponent, digitally delivered mindfulness and movement intervention for adults with LRP and elevated kinesiophobia. METHODS This study uses an iterative convergent mixed methods design comprising two sub-studies. Study 1 is a qualitative-dominant intervention development study involving patient focus groups ( n = 10) and clinician interviews ( n = 10) conducted using the Person-Based Approach to refine intervention content and delivery. Study 2 is a single-arm pilot feasibility trial ( n = 32) enrolling adults aged 18–75 with LRP and elevated kinesiophobia. Move-MORE will be delivered virtually in a group format with primary outcomes of feasibility and acceptability, including recruitment, retention, adherence, engagement, safety, and data completeness. Acceptability will be assessed using validated satisfaction and expectancy measures and qualitative exit interviews. A comprehensive set of patient-reported outcomes, ecological momentary assessment, actigraphy, quantitative sensory testing, and biomechanical assessments will be collected to characterize participants, evaluate data collection procedures, and inform outcome selection and design considerations for a future randomized controlled trial. Quantitative analyses of patient reported outcomes and objective assessments will be descriptive. Finally, patient partners were involved throughout the study using a patient-engaged research approach, including participation in focus groups to inform intervention development, review of participant-facing materials, and input on interpretation and dissemination of study findings. DISCUSSION This protocol outlines a systematic, patient-engaged approach to developing and testing the feasibility of a novel multicomponent intervention tailored to individuals with LRP. Findings will inform refinement of the Move-MORE intervention, feasibility benchmarks, and methodological decisions needed to support subsequent efficacy testing in a randomized trial. TRIAL REGISTRATION : Clinicaltrials.gov #: NCT07125027

Abstract The survival of many species has been impacted dramatically by human activities over the last few centuries. More specifically, forest fragmentation, due to human settlement and development of agriculture, has highly affected arboreal species. Understanding patterns of genetic structure of endangered species occupying fragmented forest habitats is a requirement for appropriate conservation management, especially for species with low dispersal abilities like the hazel dormouse (Muscardinus avellanarius). The hazel dormouse is an arboreal rodent that is strictly protected in Europe. The aim of this study conducted from 2004 to 2011 was to investigate population fragmentation of the hazel dormouse in part of the Meuse-Rhine Euregion using microsatellite markers. The results revealed a significant genetic differentiation and low gene flow between subpopulations. Fragmentation of the hazel dormouse population in this region seems to have occurred during the 20th century, suggesting that active management to improve habitat quality, amount of habitat and connectivity is essential to impede future genetic erosion. Furthermore, our results show that railway verges, like other linear habitat elements, cannot only be permanently inhabited, but also act as a valuable corridor, connecting subpopulations and allowing the colonisation of new sites. Finally, in response to our study, both Flemish and Dutch hazel dormouse species protection plans included the objective of providing a functional ecological corridor between several of the subpopulations, which has already been partially implemented.

In the urgent care (UC) setting, patients commonly present with nominal requests for herpes simplex virus (HSV) testing. HSV infections are common, pleomorphic, and associated with significant stigma. This combination creates a situation where decisions regarding which, if any, test(s) to obtain can be highly impactful for the mental health of patients and their romantic partners. It is imperative that UC clinicians understand the utility and test characteristics of HSV testing and the implications of findings before ordering testing. Given that both HSV-1 and HSV-2 are chronic infections, serologic testing results have the potential for lifelong consequences and should only be obtained in settings where clinically indicated and with appropriate patient counseling.

To facilitate high spatial-temporal resolution fMRI (≦1mm3) at more broadly available field strengths (3T) and to better understand the neural underpinnings of joy, we used SE-based generalized Slice Dithered Enhanced Resolution (gSLIDER). This sequence increases SNR efficiency utilizing sub-voxel shifts along the slice direction. To improve the effective temporal resolution of gSLIDER, we utilized the temporal information within individual gSLIDER RF encodings to develop gSLIDER with Sliding Window Accelerated Temporal resolution (gSLIDER-SWAT). We first validated gSLIDER-SWAT using a classic hemifield checkerboard paradigm, demonstrating robust activation in primary visual cortex even with stimulus frequency increased to the Nyquist frequency of gSLIDER (i.e., TR = block duration). gSLIDER provided ~2× gain in tSNR over traditional SE-EPI. GLM and ICA results suggest improved signal detection with gSLIDER-SWAT's nominal 5-fold higher temporal resolution that was not seen with simple temporal interpolation. Next, we applied gSLIDER-SWAT to investigate the neural networks underlying joy using naturalistic video stimuli. Regions significantly activated during joy included the left amygdala, specifically the basolateral subnuclei, and rostral anterior cingulate, both part of the salience network; the hippocampus, involved in memory; the striatum, part of the reward circuit; prefrontal cortex, part of the executive network and involved in emotion processing and regulation [bilateral mPFC/BA10/11, left MFG (BA46)]; and throughout visual cortex. This proof of concept study demonstrates the feasibility of measuring the networks underlying joy at high resolutions at 3T with gSLIDER-SWAT, and highlights the importance of continued innovation of imaging techniques beyond the limits of standard GE fMRI.

The modest effect sizes of most pain treatments make it essential that randomized controlled trials (RCTs) use methods that clearly define treatment effects of interest and consider the role of concurrent treatments. This study aims to determine how frequently concurrent analgesic use is reported in interventional pain RCTs and how accounting for analgesic use can affect estimates of pain intensity outcomes. Meta-epidemiologic study. We conducted a study of concurrent analgesic use among RCTs from a recent systematic review of non-surgical interventional pain treatments (n = 37). We calculated the prevalence of methods used to report concurrent analgesic use. We performed meta-analyses to compare treatment effects on pain intensity with vs without accounting for concurrent analgesic use via a novel quantitative composite outcome, the "QPAC1.5." About half of interventional pain RCTs reported concurrent analgesic use, but only one directly accounted for concurrent analgesic use in their pain intensity outcome. Analyses accounting for concurrent analgesics using the QPAC1.5 substantially increased the estimated treatment effect of interventions on pain intensity by an average of -0.45 numeric rating scale points (95% CI -0.76 to -0.14; P < 0.001), as compared to analyses that did not adjust for analgesic use. Concurrent analgesic use is sometimes reported in interventional pain RCTs, but rarely accounted for when examining treatment effects on pain intensity. Accounting for concurrent analgesic use may mitigate the effects of that use and substantially impact estimated treatment effect sizes.

Interoception is the perception of one's internal physiological state. Altered interoception may play a role in the pathogenesis of attention-deficit/hyperactivity disorder (ADHD). We reviewed the literature on interoception and ADHD symptoms (inattention, hyperactivity/impulsivity, executive function, emotional dysregulation) in individuals with and without the disorder. Studies included assessments of interoception and ADHD symptoms in (1) individuals with/without diagnoses of ADHD or (2) the general population. Interoception assessments included objective measures (heartbeat-tracking test) and self-report questionnaires. The literature search included the PubMed/MEDLINE, PsychINFO, CINAHL and Scopus databases. A protocol was prospectively registered in the PROSPERO database (CRD #42022351726); the PRISMA guidelines directed reporting. The Newcastle-Ottawa scale was adapted to evaluate study quality. Of 636 articles identified, 17 articles (based on 18 studies) met inclusion criteria. Five studies compared interoception in participants with/without ADHD, and three found that interoception was reduced in participants with ADHD. One study compared interoception between presentations of ADHD, finding no differences. Twelve studies assessed the association of ADHD symptoms and interoception in the general population. Overall, results suggested that interoception is reduced in individuals who reported higher symptoms of inattention, hyperactivity, impulsivity, emotional dysregulation, and executive dysfunction. Studies were of moderate quality; issues included small sample sizes and inadequate reporting. Individuals with ADHD may have decreased interoception compared to individuals without. Interoception is negatively associated with ADHD symptoms in the general population. Interventions focused on improving interoceptive abilities may provide an avenue for ADHD treatment. Future work should consider the role of culture in interoception.

ABSTRACT There are currently no evidence-based treatment guidelines for antisocial personality disorder (ASPD). Instead, treatment typically focuses on comorbid conditions. There is currently no literature documenting cases or research, theoretical or otherwise of using ketamine-assisted therapy or any other psychedelic therapy in cases of ASPD. In this case report, a 43-year-old man seeking ketamine-assisted psychotherapy (KAP) for alcoholism and depression was diagnosed with comorbid antisocial personality disorder. A series of psycholytic (low dose) ketamine therapy sessions and other integrative approaches over the course of 3 years results in resolution of severe alcoholism, reduction in violent thoughts about people and the world, and a reduction in depression symptoms. With additional precautions, utilizing a ketamine-assisted psychotherapy approach led to clinical improvements in depression, alcohol abuse, and ASPD traits.

Lumbosacral radicular pain (LRP) is a common sequelae of low back pain, the world’s leading cause of years lived with disability. LRP typically causes numbness, weakness, and tingling into the lower extremity and is associated with high rates of pain and impaired function. Despite its prevalence, there is significant heterogeneity among clinical practice guidelines for the treatment of LRP, which may contribute to poor patient outcomes. The aim of the present study was to identify treatments that participants had previously attempted before enrolling in a randomized controlled trial of a mindfulness-based intervention. This analysis evaluated prior pharmaceutical use, procedures, and non-pharmacologic treatments, with a special focus on complementary and integrative health (CIH) utilization. The data for the present analysis were taken from the health history form of the baseline visit for the randomized controlled trial by Wexler et al 2024. Treatment utilization was evaluated and reported using descriptive characteristics. In this sample of chronic LRP patients (n = 71), we found a high proportion of CIH utilization, including acupuncture (58%), chiropractic care (58%), and herbs/supplements (42%). Most patients (52%) were utilizing two or more CIH modalities to manage their pain. A high percentage of participants had also previously used non-steroidal anti-inflammatories (61%) to manage their pain, and over a third of participants had previously undergone an epidural steroid injection (34%). In our trial, CIH utilization was much higher for treatments like chiropractic care, acupuncture, natural products, and physical activity than has been reported in previous large datasets of patients with chronic pain such as the National Health Interview Survey. Collecting data on CIH utilization in clinical trials can enable researchers to compare their samples to large national datasets and identify differences in use among specific populations. In addition, healthcare utilization data collected in clinical trials can further inform the development of clinical practice guidelines.

ABSTRACTObjectiveThe modest effect sizes of most pain treatments make it essential that randomized controlled trials (RCTs) use methods that clearly define treatment effects of interest and consider the role of concurrent treatments. This study aims to determine how frequently concurrent analgesic use is reported in interventional pain RCTs and how accounting for analgesic use can affect pain intensity outcomes.DesignMeta-epidemiologic study.MethodsWe conducted a study of concurrent analgesic use among RCTs from a recent systematic review of non-surgical interventional pain treatments (n= 37). We calculated the prevalence of different methods used to report concurrent analgesic use. We performed meta-analyses to compare treatment effects on pain intensity with vs. without accounting for concurrent analgesic use via a novel quantitative composite outcome, the “QPAC1.5.”ResultsAbout half of interventional pain RCTs reported concurrent analgesic use, but only one RCT directly accounted for concurrent analgesic use in their pain intensity outcome. Analyses accounting for concurrent analgesic use using the QPAC1.5substantially increased the estimated treatment effect of interventions on pain intensity by an average of −0.45 numeric rating scale points (95% CI −0.76 to −0.14; p&lt;0.001), as compared to analyses that did not adjust for analgesic use.ConclusionConcurrent analgesic use is sometimes reported in interventional pain RCTs, but rarely accounted for when examining treatment effects on pain intensity. Accounting for concurrent analgesic use changes the treatment effect of interest to remove differential analgesic rates and has the potential to significantly affect estimates of effect sizes on pain treatments.