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Laser powder bed fusion (L-PBF) enables direct manufacturing of components with complex geometries and thin walls, but many authors report size-dependent mechanical properties that may complicate design. Size effects are commonly attributed to surface roughness, microstructure, and/or internal defects, but the relative importance of each is still not fully understood. To systematically study these effects, L-PBF specimens made of two microstructurally-distinct stainless steels (17-4PH and 316L) were manufactured and mechanically tested, in varied heat-treatment conditions and across a range of thicknesses and build angles. It was found that the size-dependent mechanical properties are efficiently predicted by the ratio of surface roughness to specimen thickness, Ra/t, in a way that is relatively microstructure-agnostic. This metric is particularly useful for predicting ultimate strength and elongation, while microstructure moderates its predictive power for yield strength, especially in the more processing-sensitive 17-4PH. When considered in isolation, thickness or surface roughness had weaker correlations with mechanical properties and, importantly, tended to correlate much more strongly with one steel's properties than the other's. Comparing this comprehensive dataset with summary data from other researchers highlights the utility of Ra/t, and provides semi-quantitative estimates of the relative impacts of porosity, microstructure, and Ra/t on size-dependent properties.

Policy perspectives on sustainability, particularly those dominating an era, can have long-lasting effects and shape the context in which decisions are made. Historical analyses of sustainability perspectives applied in policymaking can enrich our understanding of the sources contributing to decision-making processes. Through an in-depth analysis of policy documents published between 1986 and 2022 and interviews with former and current policymakers, we have studied the development of the Dutch regional government of Flevoland’s perspectives on sustainability in the agricultural sector. We developed a framework to guide our analysis of the concepts and rhetoric used and the assumptions made about social-ecological relationships, nature values, and structure and agency. Our findings show a gradual evolution of policy perspectives on sustainability, moving from an economic focus to recognising ecological value and the agricultural sector’s role in addressing environmental and social issues. However, aspects of social sustainability remain narrowly addressed, focusing on business aspects while overlooking farmers’ multifaceted roles and challenges. Moreover, despite encouraging farmer-led sustainability initiatives, the Province struggles to clarify its sustainability strategy and implement concrete measures. These insights can help challenge previously unquestioned or unknown assumptions and be instrumental in crafting better integrated and effective policy measures aimed at addressing sustainability challenges.

Abstract Background Peer support programs are promising approaches to diabetes prevention. However, there is still limited evidence on the health benefits of peer support programs for lay peer leaders. Purpose To examine whether a peer support program designed for diabetes prevention resulted in greater improvements in health behaviors and outcomes for peer leaders as compared to other participants. Methods 51 lay peer leaders and 437 participants from the Kerala Diabetes Prevention Program were included. Data were collected at baseline, 12 months, and 24 months. We compared behavioral, clinical, biochemical, and health-related quality of life parameters between peer leaders and their peers at the three time-points. Results After 12 months, peer leaders showed significant improvements in leisure time physical activity (+ 17.7% vs. + 3.4%, P = 0.001) and health-related quality of life (0.0 vs. + 0.1, P = 0.004); and a significant reduction in alcohol use (-13.6% vs. -6.6%, P = 0.012) and 2-hour plasma glucose (-4.1 vs. + 9.9, P = 0.006), as compared to participants. After 24 months, relative to baseline, peer leaders had significant improvements in fruit and vegetable intake (+ 34.5% vs. + 26.5%, P = 0.017) and leisure time physical activity (+ 7.9% vs. -0.9%, P = 0.009); and a greater reduction in alcohol use (-13.6% vs. -4.9%, P = 0.008), and waist-to-hip ratio (-0.04 vs. -0.02, P = 0.014), as compared to participants. However, only the changes in fruit and vegetable intake and waist-to-hip ratio were maintained between 12 and 24 months. Conclusion Being a peer leader in a diabetes prevention program was associated with greater health benefits during and after the intervention period. Further studies are needed to examine the long-term sustainability of these benefits.

Abstract Silanols are key players in the application performance of zeolites, yet, their localization and hydrogen bonding strength need more studies. The effects of post-synthetic ion exchange on nanosized chabazite (CHA), focusing on the formation of silanols, were studied. The significant alteration of the silanols of the chabazite nanozeolite upon ion exchange and their effect on the CO2 adsorption capacity was revealed by solid-state nuclear magnetic resonance (NMR), Fourier-transform infrared (FTIR) spectroscopy, and periodic density functional theory (DFT) calculations. Both theoretical and experimental results revealed changing the ratio of extra-framework cations in CHA zeolites changes the population of silanols; decreasing the Cs+/K+ ratio creates more silanols. Upon adsorption of CO2, the distribution and strength of the silanols also changed with increased hydrogen bonding, thus revealing an interaction of silanols with CO2 molecules. To the best of our knowledge, this is the first evidence of the interplay between alkali-metal cations and silanols in nanosized CHA.

Abstract Introduction India currently has more than 74.2 million people with Type 2 Diabetes Mellitus (T2DM). This is predicted to increase to 124.9 million by 2045. In combination with controlling blood glucose levels among those with T2DM, preventing the onset of diabetes among those at high risk of developing it is essential. Although many diabetes prevention interventions have been implemented in resource-limited settings in recent years, there is limited evidence about their long-term effectiveness, cost-effectiveness, and sustainability. Moreover, evidence on the impact of a diabetes prevention program on cardiovascular risk over time is limited. Objectives The overall aim of this study is to evaluate the long-term cardiometabolic effects of the Kerala Diabetes Prevention Program (K-DPP). Specific aims are 1) to measure the long-term effectiveness of K-DPP on diabetes incidence and cardiometabolic risk after nine years from participant recruitment; 2) to assess retinal microvasculature, microalbuminuria, and ECG abnormalities and their association with cardiometabolic risk factors over nine years of the intervention; 3) to evaluate the long-term cost-effectiveness and return on investment of the K-DPP; and 4) to assess the sustainability of community engagement, peer-support, and other related community activities after nine years. Methods The nine-year follow-up study aims to reach all 1007 study participants (500 intervention and 507 control) from 60 randomized polling areas recruited to the original trial. Data are being collected in two phases. In phase 1 (Survey), we are admintsering a structured questionnaire, undertake physical measurements, and collect blood and urine samples for biochemical analysis. In phase II, we are inviting participants to undergo retinal imaging, body composition measurements, and ECG. All data collection is being conducted by trained Nurses. The primary outcome is the incidence of T2DM. Secondary outcomes include behavioral, psychosocial, clinical, biochemical, and retinal vasculature measures. Data analysis strategies include a comparison of outcome indicators with baseline, and follow-up measurements conducted at 12 and 24 months. Analysis of the long-term cost-effectiveness of the intervention is planned. Discussion Findings from this follow-up study will contribute to improved policy and practice regarding the long-term effects of lifestyle interventions for diabetes prevention in India and other resource-limited settings. Trial registration Australia and New Zealand Clinical Trials Registry–(updated from the original trial)ACTRN12611000262909; India: CTRI/2021/10/037191.

BackgroundThe increasing prevalence of diabetes is placing important demands on the Chinese health care system. Providing self-management programs to the fast-growing number of people with diabetes presents an urgent need in rural primary care settings in China. Peer support has demonstrated effectiveness in improving self-management for individuals with diabetes in urban communities in China. A priority then becomes developing and evaluating a peer support program in primary care settings in rural communities of China and determining whether it is feasible and acceptable. ObjectiveThe aims of this study are (1) to evaluate the feasibility and acceptability of a peer support approach to type 2 diabetes self-management in rural primary care settings; (2) to identify enabler and facilitator factors likely to influence the peer support implementation; (3) to provide primary data and evidence for developing a version of the program suitable for a randomized controlled trial in rural primary care settings. MethodsThree townships will be sampled from 3 different counties of Anhui province as the study setting. Participants will be recruited based on these counties’ local primary care health record system. The peer supporters will be recruited from among the participants. The peer support program will be led by peer supporters who have completed 12 hours of training. It will be guided by primary care providers. The program will include biweekly meetings over 3 months with varied peer support contacts between meetings to encourage the implementation of diabetes self-management. Mixed methods will be used for evaluation. Qualitative methods will be used to collect information from health care system professionals, individuals with diabetes, and peer supporters. Quantitative methods will be used to collect baseline data and data at the end of the 3-month intervention regarding psychosocial factors and self-management practices. ResultsThe results will include (1) quantitative baseline data that will characterize type 2 diabetes self-management practices of individuals with diabetes; (2) qualitative data that will identify enablers of and barriers to self-management practices for individuals with type 2 diabetes in rural communities; (3) both qualitative and quantitative evaluation data, after the 3-month intervention, to demonstrate the feasibility and acceptability of the peer support approach for individuals with type 2 diabetes. ConclusionsOur findings will inform the design of a tailored intervention program to improve self-management among individuals with type 2 diabetes in rural primary care settings. If we find that the peer support approach is feasible and acceptable, we will develop a larger randomized controlled trial to evaluate effectiveness in multiple rural settings in the province. International Registered Report Identifier (IRRID)PRR1-10.2196/47822

BackgroundMobile health (mHealth) is a promising intervention mode for HIV prevention, but little is known about its feasibility and effects in promoting pre-exposure prophylaxis (PrEP) uptake among Chinese gay, bisexual and other men who have sex with men (GBMSM).MethodsWe evaluated an instant messaging application using a WeChat-based mini-app to promote PrEP uptake among GBMSM via a mixed-methods design that includes a 12-week, two-arm randomized controlled pilot trial and in-depth progress interviews in Guangzhou, China. Primary outcomes include the number of PrEP initiations, individual-level psychosocial variables related to PrEP initiation, and usability of the PrEP mini-app.ResultsBetween November 2020 and April 2021, 70 GBMSM were successfully enrolled and randomized into two arms at 2:1 ratio (46 to the intervention arm, 24 to the control arm). By the end of 12-week follow-up, 22 (31.4%) participants completed the initial consultation and lab tests for PrEP, and 13 (18.6%) filled their initial PrEP prescription. We observed modest but non-significant improvements in participants' intention to use PrEP, actual PrEP initiation, PrEP-related self-efficacy, stigma, and attitudes over 12 weeks when comparing the mini-app and the control arms. Qualitative interviews revealed the key barriers to PrEP uptake include anticipated stigma and discrimination in clinical settings, burden of PrEP care, and limited operating hours of the PrEP clinic. In-person clinic navigation support was highly valued.ConclusionsThis pilot trial of a mobile phone-based PrEP mini-app demonstrated feasibility and identified limitations in facilitating PrEP uptake among Chinese GBMSM. Future improvements may include diversifying the content presentation in engaging media formats, adding user engagement features, and providing off-line in-clinic navigation support during initial PrEP visit. More efforts are needed to understand optimal strategies to identify and implement alternative PrEP provision models especially in highly stigmatized settings with diverse needs.Trial registrationTrial registration: The study was prospectively registered on clinicaltrials.gov (NCT04426656) on 11 June, 2020.

This study examines the perception of Humanities and Social Science teachers among public Senior High Schools in the Department of Education’s Humanities and Social Sciences strand in the Philippines. It uses Erden’s element-based model of evaluation by considering the alignment to the goals of the Humanities and Social Sciences disciplines, the purpose, and core courses of the program, and the teaching-learning process. It also uses Tyler’s Rationale as frameworks in assessing the curriculum. Likewise, the study examines the problems and difficulties in curricular implementation. Upon administering a survey to 25 Humanities and Social Science teachers among four public senior high schools, data revealed that the respondents perceived the curriculum goals, and the purpose of the program as highly observed, while the core courses of the program and teaching-learning process were satisfactorily observed in the curriculum. Also, sex and age were not factors in their level of assessment of Humanities and Social Science goals. The problems and difficulties encountered by teachers included unbalanced time allocation of learning competencies, lack of available learning materials, and lack of specialized teachers. Based on the findings, it is suggested that the government provide stronger teacher support programs to address the gap in curriculum implementation. The K to 12 program also needs a full review, as the study only provides a presurvey to more significant institutional issues. While the Humanities and Social Science curriculum appears aligned with the goals of their disciplines, and to the country’s educational goals, its realization still depends upon the teachers’ implementation in the classroom level.

Introduction The large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up, suggesting an urgent need for innovative and accessible interventions. This study aims to develop and pilot test a theory-informed, tailored mobile phone intervention that was codeveloped by young gay men, HIV clinicians and public health researchers to increase engagement in PrEP education and initiation among Chinese gay, bisexual and other men who have sex with men (GBMSM), who bear a disproportionate burden of HIV infections and remain underserved in the healthcare system.Methods and analysis This two-phase study includes a formative assessment using in-depth interviews (N=30) and a 12-week experimental pilot study using a two-arm randomised controlled trial design (N=70). The primary intervention is delivered through a WeChat-based mini-app (a program built into a Chinese multipurpose social media application) developed by young GBMSM from a 2019 crowdsourcing hackathon. Using mixed methods, we will further investigate the specific needs and concerns among GBMSM in terms of using PrEP as an HIV prevention strategy, how their concerns and PrEP use behaviours may change with exposure to the mini-app intervention during the study period and how we can further refine this intervention tool to better meet GBMSM’s needs for broader implementation.Ethics and dissemination This study and its protocols have been reviewed and approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, USA (19-3481), the Guangdong Provincial Dermatology Hospital, China (2020031) and the Guangzhou Eighth People’s Hospital, China (202022155). Study staff will work with local GBMSM community-based organisations to disseminate the study results to participants and the community via social media, workshops and journal publications.Trial registration number The study was prospectively registered on clinicaltrials.gov (NCT04426656) on 11 June 2020.

BackgroundMobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD). ObjectiveThe aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants. MethodsWe developed an SMS text messaging program called Text4IBD. The program sent daily support messages and resources about disease self-management over the course of a 2-week, single-group, pretest-posttest intervention to participants (N=114) diagnosed with IBD. We examined intervention feasibility, acceptability, and engagement through Text4IBD message topic recall and use of resources (ie, visiting supplemental websites recommended by the Text4IBD program). We also assessed pretest-posttest measures of IBD-related distress, self-efficacy, perceived support, use of coping strategies, and medication adherence. Analyses examined participants’ evaluations of the intervention and compared pretest-posttest changes in secondary outcomes using paired-samples statistics. ResultsApproximately all participants who completed the intervention (n=105) were receptive to Text4IBD and viewed the program as feasible and acceptable. In addition, most participants (103/105, 98.1%) recalled at least one of the message topics sent by the program, and 79% (83/105) of them self-reported engaging with at least one of the external self-management resources recommended by the Text4IBD program. Pretest-posttest results showed reduced IBD-related distress (mean 3.33, SD 0.68 vs mean 2.86, SD 0.73; P

AbstractRNA-binding proteins support neurodevelopment by modulating numerous steps in post-transcriptional regulation, including splicing, export, translation, and turnover of mRNAs that can traffic into axons and dendrites. One such RNA-binding protein is ZC3H14, which is lost in an inherited intellectual disability. The Drosophila melanogasterDrosophila

BackgroundCollege students are at heightened risk for negative psychological outcomes due to COVID-19. We examined the prevalence of psychological distress and its association with social isolation among public university students in the southern United States.MethodsA cross-sectional survey was emailed to all University of North Carolina-Chapel Hill students in June 2020 and was open for two weeks. Students self-reported if they were self-isolating none, some, most, or all of the time. Validated screening instruments were used to assess clinically significant symptoms of depression, loneliness, and increased perceived stress. The data was weighted to the complete student population.Results7,012 completed surveys were included. Almost two-thirds (64%) of the students reported clinically significant depressive symptoms and 65% were categorized as lonely. An estimated 64% of students reported self-isolating most or all of the time. Compared to those self-isolating none of the time, students self-isolating some of the time were 1.78 (95% CI 1.37, 2.30) times as likely to report clinically significant depressive symptoms, and students self-isolating most or all of the time were 2.12 (95% CI 1.64, 2.74) and 2.27 (95% CI 1.75, 2.94) times as likely to report clinically significant depressive symptoms, respectively. Similar associations between self-isolation and loneliness and perceived stress were observed.ConclusionsThe prevalence of adverse mental health indicators among this sample of university students in June 2020 was exceptionally high. University responses to the COVID-19 pandemic should prioritize student mental health and prepare a range of support services to mitigate mental health consequences as the pandemic continues to evolve.

Background: Globally, diabetes has brought an enormous burden to public health resources, and the situation of disease burden caused by diabetes in China is especially severe. China is currently facing the dual threat of aging and diabetes, and wearable activity trackers could promote elderly diabetic patients' physical activity levels and help them to manage blood glucose control. Therefore, examining the influencing factors of elderly patients' adoption intention is critical as wearing adoption determines actual wearing behaviors.Objective: This study aims to explore the predicting factors of Chinese elderly type 2 diabetic patients' adoption intention to wearable activity trackers and their actual wearing behavior, using diffusion of innovation theory as the theoretical framework. We hope to provide insights into future interventions using wearable activity trackers as tools to improve the outcome of patients.Methods: Wearable activity trackers were freely distributed to type 2 diabetic patients in Beijing, China. A questionnaire survey was conducted to examine predicting factors of adoption intention after a week's try-on. Actual wearing behavior for 3-month was obtained from the exclusive cloud. Data were analyzed with structural equation modeling.Results: A total of 725 patients completed the questionnaire. Patients had a mean age of 60.3 ± 7.6 years old and the educational level was generally lower. The results indicated that observability was the primary influencing factor of patients' adoption intention (β = 0.775, P < 0.001). Relative advantage (β = 0.182, P = 0.014) and perceived social image (β = 0.080, P = 0.039) also had a positive influence while perceived risk (β = −0.148, P < 0.001) exerted a negative influence. In addition, results showed that the more intention led to the better actual wearing behavior (β = 0.127, P = 0.003). Observability (β = 0.103, P = 0.005), perceived ease (β = 0.085, P = 0.004), and relative advantage (β = 0.041, P = 0.009) also indirectly influenced the wearing behavior.Conclusion: The intentions of Chinese elderly type 2 diabetic patients to wearable activity trackers directly influenced the actual wearing behavior. In addition, their adoption intention to wearable activity trackers was mainly influenced by observability, perceived ease to use, relative advantage, perceived risk, and social image.

Background: There have been very limited prospective studies examining social-cognitive models within stages of behavior change in the exercise domain.Purpose: We examined the utility of the theory of planned behavior (TPB), incorporating self-identity and descriptive norm constructs, to predict exercise behavior across the stages of change, in individuals with type 2 diabetes.Methods: Data were obtained from a longitudinal study. Multi-group structural equation modeling was used to estimate the association between extended TPB constructs and exercise within different stages groups.Results: 647 individuals completed a self-report questionnaire at baseline and at 3 months follow-up. The extended TPB model explained 8–15% variance of exercise behavior and 42–81% variance of exercise intention within three stages groups in the cross-sectional design. The extended TPB model explained 4%-13% variance of exercise behavior and 42–66% variance of exercise intention in the longitudinal design. Intention was significantly related to exercise behavior in the pre-action and action stages. Self-identity, perceived behavioral control and descriptive norms were stronger predictors of intention in different stages.Conclusion: Discontinuity patterns in the extended theory of planned behavior for the different stages groups were found. Intention was a significant predictor of exercise in the pre-action and action stages at 3 months.

The Guayas estuary is an ecologically and economically vital, large estuarine system located on the western coast of South America. A suite of ∼400 water samples was collected and analyzed to enable investigation of the sources of water types within this estuary, as well as environmental processes active within various portions of it. These samples were obtained at sites distributed across the major areas of the inner and outer portions of the estuary at the ends of consecutive dry (December/January) and rainy (May) seasons. At each site, Van Dorn bottles were lowered into the water from a boat (or bridge) and then triggered when they reached specified depths. When the Van Dorn bottles were brought back aboard the boat, aliquots of water from them were promptly sealed in glass containers for later analysis. These were transported to onshore laboratories where their salinities, and their oxygen (δ18O) and hydrogen (δ2H) isotopic compositions were measured. Established analytical procedures and standards were employed to obtain a robust set of resultant data. The samples, analyses, and data presented here support the associated research article, “Stable isotope evidence for the origins of waters in the Guayas estuary and Gulf of Guayaquil” [1], to which readers are referred for interpretation.

Cost-effectiveness analysis (CEA) is a well-known, but resource intensive, method for comparing the costs and health outcomes of health interventions. To build on available evidence, researchers are developing methods to transfer CEA across settings; previous methods do not use all available results nor quantify differences across settings. We conducted a meta-regression analysis of published CEAs of human papillomavirus (HPV) vaccination to quantify the effects of factors at the country, intervention, and method-level, and predict incremental cost-effectiveness ratios (ICERs) for HPV vaccination in 195 countries. We used 613 ICERs reported in 75 studies from the Tufts University's Cost-Effectiveness Analysis (CEA) Registry and the Global Health CEA Registry, and extracted an additional 1,215 one-way sensitivity analyses. A five-stage, mixed-effects meta-regression framework was used to predict country-specific ICERs. The probability that HPV vaccination is cost-saving in each country was predicted using a logistic regression model. Covariates for both models included methods and intervention characteristics, and each country's cervical cancer burden and gross domestic product per capita. ICERs are positively related to vaccine cost, and negatively related to cervical cancer burden. The mean predicted ICER for HPV vaccination is 2017 US$4,217 per DALY averted (95% uncertainty interval (UI): US$773-13,448) globally, and below US$800 per DALY averted in 64 countries. Predicted ICERs are lowest in Sub-Saharan Africa and South Asia, with a population-weighted mean ICER across 46 countries of US$706 per DALY averted (95% UI: $130-2,245), and across five countries of US$489 per DALY averted (95% UI: $90-1,557), respectively. Meta-regression analyses can be conducted on CEA, where one-way sensitivity analyses are used to quantify the effects of factors at the intervention and method-level. Building on all published results, our predictions support introducing and expanding HPV vaccination, especially in countries that are eligible for subsidized vaccines from GAVI, the Vaccine Alliance, and Pan American Health Organization.

Since the turn of the twenty-first century, there has been a guiding imperative in anthropology to better understand people’s entanglements with nature. This article sets out to investigate the emergence of spiritual ecologies in the Chilean town of Constitución. Unlike most previous studies, we rethink the partial connections and entanglements of humans with nature through linking this to spirituality, environmental care and gender. By adopting a “kaleidoscopic perspective”, we aim to avoid a simplification or a singular representation of the (re-)entanglements with Mother Nature. Constitución provides an excellent setting for studying contemporary changes in human–nature entanglements as compounding crises of earthquakes, tsunami and forest fires, exacerbated by extensive timber production, that have struck the town during the past decade, have led to a resurgence by a large part of the population in interpreting and expressing their relationship with Mother Nature. Through intermittent ethnographic research between 2015 and 2019, we have concluded that the entanglements with Mother Nature in Constitución are the result of what we call Andean performative pragmatism, and the overrepresentation of women within the group of people who care for Mother Nature can be interpreted through an ecowomanist perspective that stands for the creation of social and environmental justice. As such, the findings offer a fresh and updated way to understand and interrogate the challenges confronting present-day human–nature relations in times of climate adaptation both in Chile and far beyond.

Abstract Background Diabetes management is influenced by a number of factors beyond the individual-level. This study examined how neighborhood social disorganization (i.e., neighborhoods characterized by high economic disadvantage, residential instability, and ethnic heterogeneity), is associated with diabetes-related outcomes. Methods We used a multilevel modeling approach to investigate the associations between census-tract neighborhood social disorganization, A1c, and self-reported use of acute or emergency health care services for a sample of 424 adults with type 2 diabetes. Results Individuals living in neighborhoods with high social disorganization had higher A1c values than individuals living in neighborhoods with medium social disorganization (B = 0.39, p = 0.01). Individuals living in neighborhoods with high economic disadvantage had higher self-reported use of acute or emergency health care services than individuals living in neighborhoods with medium economic disadvantage (B = 0.60, p = 0.02). Conclusions High neighborhood social disorganization was associated with higher A1c values and high neighborhood economic disadvantage was associated with greater self-reported use of acute or emergency health care services. Controlling for individual level variables diminished this effect for A1c, but not acute or emergency health care use. Comprehensive approaches to diabetes management should include attention to neighborhood context. Failure to do so may help explain the continuing disproportionate diabetes burden in many neighborhoods despite decades of attention to individual-level clinical care and education. Trial registration For this study, we used baseline data from a larger study investigating the impacts on patient-centered outcomes of three different approaches to self-monitoring of blood glucose among 450 adults with non-insulin dependent type 2 diabetes living in North Carolina. This study was registered as a clinical trial on 1/7/2014 (https://clinicaltrials.gov/ct2/show/NCT02033499).

Abstract Background Empirical research has revealed a positive relationship between type 2 diabetes mellitus and depression, but questions remain regarding timing of depression measurement, types of instruments used to measure depression, and whether “depression” is defined as clinical depression or depressive symptoms. The present study sought to establish the robustness of the depression-diabetes relationship across depression definition, severity of depressive symptoms, recent depression, and lifetime depression in a nationally representative dataset and a large rural dataset. Methods The present examination, conducted between 2014 and 2015, used two large secondary datasets: the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 (n = 3072) and the Arthritis, Coping, and Emotion Study (ACES) from 2002 to 2006 (n = 2300). Depressive symptoms in NHANES were measured using the Patient Health Questionnaire 9-item survey (PHQ-9). ACES used the Center for Epidemiologic Studies—Depression Scale (CES-D) to measure depressive symptoms and the Composite International Diagnostic Interview (CIDI) to measure diagnosable depression. Diabetes was modelled as the dichotomous outcome variable (presence vs. absence of diabetes). Logistic regression was used for all analyses, most of which were cross-sectional. Analyses controlled for age, ethnicity, sex, education, and body mass index, and NHANES analyses used sample weights to account for the complex survey design. Additional analyses using NHANES data focused on the addition of health behavior variables and inflammation to the model. Results NHANES. Every one-point increase in depressive symptoms was associated with a 5% increase in odds of having diabetes [OR: 1.05 (CI: 1.03, 1.07)]. These findings persisted after controlling for health behaviors and inflammation. ACES. For every one-point increase in depressive symptom score, odds of having diabetes increased by 2% [OR: 1.02 (CI: 1.01, 1.03)]. Recent (past 12 months) depression [OR: 1.49, (CI: 1.03, 2.13)] and lifetime depression [OR: 1.40 (CI: 1.09, 1.81)] were also significantly associated with having diabetes. Conclusions This study provides evidence for the robustness of the relationship between depression or depressive symptoms and diabetes and demonstrates that depression occurring over the lifetime can be associated with diabetes just as robustly as that which occurs more proximal to the time of study measurement.

Abstract Objectives Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. Data sources and eligibility PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000–7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000–12/31/2015. Results In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Conclusions Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

Abstract Background Telephone quitlines can help employees quit smoking. Quitlines typically use directive coaching, but nondirective, flexible coaching is an alternative. Call-2-Quit used a worksite-sponsored quitline to compare directive and nondirective coaching modes, and evaluated employee race and income as potential moderators. Methods An unblinded randomized controlled trial compared directive and nondirective telephone coaching by trained laypersons. Participants were smoking employees and spouses recruited through workplace smoking cessation campaigns in a hospital system and affiliated medical school. Coaches were four non-medical women trained to use both coaching modes. Participants were randomized by family to coaching mode. Participants received up to 7 calls from coaches who used computer assisted telephone interview software to track topics and time. Outcomes were reported smoking abstinence for 7 days at last contact, 6 or 12 months after coaching began. Both worksites implemented new tobacco control policies during the study. Results Most participants responded to an insurance incentive introduced at the hospital. Call-2-Quit coached 518 participants: 22 % were African-American; 45 % had incomes below $30,000. Income, race, and intervention did not affect coaching completion rates. Cessation rates were comparable with directive and nondirective coaching (26 % versus 30 % quit, NS). A full factorial logistic regression model identified above median income (odds ratio = 1.8, p = 0.02), especially among African Americans (p = 0.04), and recent quit attempts (OR = 1.6, p = 0.03) as predictors of cessation. Nondirective coaching was associated with high cessation rates among subgroups of smokers reporting income above the median, recent quit attempts, or use of alternative therapies. Waiting up to 4 weeks to start coaching did not affect cessation. Of 41 highly addicted or depressed smokers who had never quit more than 30 days, none quit. Conclusion Nondirective coaching improved cessation rates for selected smoking employees, but less expensive directive coaching helped most smokers equally well, regardless of enrollment incentives and delays in receiving coaching. Some subgroups had very low cessation rates with either mode of quitline support. Trial registration ClinicalTrials.gov NCT02730260 , Registered March 31, 2016

Introducción. Toxocara canis es un nematodo patógeno de cánidos que accidentalmente puede ser transmitido a los humanos. A pesar de la importancia de la serología para el diagnóstico de esta zoonosis, los kits diagnósticos usan antígenos crudos de excreción-secreción, en su mayoría glucoproteínas que no son específicas de especie, por lo cual pueden presentarse reacciones cruzadas con anticuerpos generados contra otros parásitos. Objetivos. Producir el antígeno recombinante TES-30 de T. canis y evaluarlo para el inmunodiagnóstico de la toxocariasis. Materiales y métodos. Se clonó el gen que codifica TES-30 en el vector de expresión pET28a (+), usando oligonucleótidos de cadena sencilla unidos mediante reacción en cadena de la polimerasa (PCR). La proteína rTES-30 se purificó por cromotografia de afinidad (Ni2+). La reacción serológica de rTES-30 se evaluó mediante immunoblot. Teniendo en cuenta que no existe una prueba de referencia, se observó el comportamiento del antigeno en comparación con la prueba de rutina para el inmunodiagnóstico de la toxocariasis, es decir, la técnica ELISA convencional con antígenos de excreción-secreción. Resultados. El rTES-30 se produjo a partir de un cultivo de Escherichia coli LB, con un rendimiento de 2,25 mg/l y 95 % de pureza. La concordancia de la reacción entre el immunoblot rTES-30 y la ELISA convencional, fue de 73 % (46/63) y de 100 % con los 21 sueros no reactivos. De los 21 sueros con diagnóstico de otras parasitosis, 19 fueron reactivos con ELISA, mientras que tan solo siete fueron positivos con el immunoblot rTES-30. La concordancia entre la ELISA y el immunoblot fue moderada (índice kappa de 0,575; IC95% 0,41-0,74). Conclusiones. Los datos presentados respaldan la utilidad del immunoblot rTES-30 para la confirmación de los posibles positivos por ELISA, no solo en los estudios epidemiológicos, sino también, como candidato para el desarrollo de pruebas diagnósticas de la toxocariasis ocular en Colombia.

BackgroundThe major efficacy trials on diabetes prevention have used resource-intensive approaches to identify high-risk individuals and deliver lifestyle interventions. Such strategies are not feasible for wider implementation in low- and middle-income countries (LMICs). We aimed to evaluate the effectiveness of a peer-support lifestyle intervention in preventing type 2 diabetes among high-risk individuals identified on the basis of a simple diabetes risk score.Methods and findingsThe Kerala Diabetes Prevention Program was a cluster-randomized controlled trial conducted in 60 polling areas (clusters) of Neyyattinkara taluk (subdistrict) in Trivandrum district, Kerala state, India. Participants (age 30-60 years) were those with an Indian Diabetes Risk Score (IDRS) ≥60 and were free of diabetes on an oral glucose tolerance test (OGTT). A total of 1,007 participants (47.2% female) were enrolled (507 in the control group and 500 in the intervention group). Participants from intervention clusters participated in a 12-month community-based peer-support program comprising 15 group sessions (12 of which were led by trained lay peer leaders) and a range of community activities to support lifestyle change. Participants from control clusters received an education booklet with lifestyle change advice. The primary outcome was the incidence of diabetes at 24 months, diagnosed by an annual OGTT. Secondary outcomes were behavioral, clinical, and biochemical characteristics and health-related quality of life (HRQoL). A total of 964 (95.7%) participants were followed up at 24 months. Baseline characteristics of clusters and participants were similar between the study groups. After a median follow-up of 24 months, diabetes developed in 17.1% (79/463) of control participants and 14.9% (68/456) of intervention participants (relative risk [RR] 0.88, 95% CI 0.66-1.16, p = 0.36). At 24 months, compared with the control group, intervention participants had a greater reduction in IDRS score (mean difference: -1.50 points, p = 0.022) and alcohol use (RR 0.77, p = 0.018) and a greater increase in fruit and vegetable intake (≥5 servings/day) (RR 1.83, p = 0.008) and physical functioning score of the HRQoL scale (mean difference: 3.9 score, p = 0.016). The cost of delivering the peer-support intervention was US$22.5 per participant. There were no adverse events related to the intervention. We did not adjust for multiple comparisons, which may have increased the overall type I error rate.ConclusionsA low-cost community-based peer-support lifestyle intervention resulted in a nonsignificant reduction in diabetes incidence in this high-risk population at 24 months. However, there were significant improvements in some cardiovascular risk factors and physical functioning score of the HRQoL scale.Trial registrationAustralia and New Zealand Clinical Trials Registry ACTRN12611000262909.

Traumatic brain injury (TBI) initiates a cascade of pathophysiological changes that are both complex and difficult to treat. Progesterone (P4) is a neuroprotective treatment option that has shown excellent preclinical benefits in the treatment of TBI, but these benefits have not translated well in the clinic. We have previously shown that P4 exacerbates the already hypoactive upper cortical responses in the short-term post-TBI and does not reduce upper cortical hyperactivity in the long term, and we concluded that there is no tangible benefit to sensory cortex firing strength. Here we examined the effects of P4 treatment on temporal coding resolution in the rodent sensory cortex in both the short term (4 d) and long term (8 wk) following impact-acceleration–induced TBI. We show that in the short-term postinjury, TBI has no effect on sensory cortex temporal resolution and that P4 also sharpens the response profile in all cortical layers in the uninjured brain and all layers other than layer 2 (L2) in the injured brain. In the long term, TBI broadens the response profile in all cortical layers despite firing rate hyperactivity being localized to upper cortical layers and P4 sharpens the response profile in TBI animals in all layers other than L2 and has no long-term effect in the sham brain. These results indicate that P4 has long-term effects on sensory coding that may translate to beneficial perceptual outcomes. The effects seen here, combined with previous beneficial preclinical data, emphasize that P4 is still a potential treatment option in ameliorating TBI-induced disorders.

Despite the great emphasis on sustainable forest management in the 1998 Indonesian reform movement, deforestation has only accelerated since then, with Kalimantan (Indonesian Borneo) exhibiting the highest rate of forest loss. Some forested areas have, however, been preserved by local communities. We investigate how and why two of these communities in Kapuas Hulu district, West Kalimantan, have managed to maintain their forests against the pressures of illegal logging and conversion to oil palm plantations. One village community had the capacity to act on its own, while the other needed additional capacity through intercommunity collaboration. Motivations behind these villages' decisions were both economic and eudaimonic; their desire for meaningful lives related to the community and environment and to past and future generations. The findings enrich the literature on land use change because description and analysis of successful resistance against logging and oil palm is still rare. As such, the findings offer a different way to understand and interrogate the challenges confronting present-day forest communities in Kalimantan and beyond, standing out against the mainstream impression that communities are still powerless or unwilling to resist the short-term economic lures. We also refer briefly to the environmental justice perspective.

Feature extraction is a central step of processing Light Detection and Ranging (LIDAR) data. Existing detectors tend to exploit characteristics of specific environments: corners and lines from indoor (rectilinear) environments, and trees from outdoor environments. While these detectors work well in their intended environments, their performance in different environments can be poor. We describe a general purpose feature detector for both 2D and 3D LIDAR data that is applicable to virtually any environment. Our method adapts classic feature detection methods from the image processing literature, specifically the multi-scale Kanade-Tomasi corner detector. The resulting method is capable of identifying highly stable and repeatable features at a variety of spatial scales without knowledge of environment, and produces principled uncertainty estimates and corner descriptors at same time. We present results on both software simulation and standard datasets, including the 2D Victoria Park and Intel Research Center datasets, and the 3D MIT DARPA Urban Challenge dataset.

Las ruinas de Oxpemul representan una corte real fortificada plasmada en la Cuenca de Calakmul adentro del Petén Campechano, ubicado unos 25 kms. al norte del centro regional de Calakmul. El Grupo Principal de Oxpemul está organizado sobre una meseta de 45.50 m de altura que forma su corte real con un patrón de asentamiento parecido a Calakmul y El Mirador. La Meseta Suroeste y otras más pequeñas están distribuidas alrededor del Bajo Central. Oxpemul incluye un total de 21 estelas con 18 altares, muchas de las estelas están de pie y muestran figuras humanas y textos jeroglíficos en buen estado de conservación. Varios de los altares también incluyen textos y uno muestra la figura de una deidad. Oxpemul está relacionado con 11 ejemplos de su glifo emblema en la forma de un "Trono de Piedra", uno fechado alrededor del Siglo Quinto. Se ha realizado un plano de 9 km² incluyendo su Grupo Principal y 1 400 estructuras que incluye varios grupos mayores y menores, además de aguadas, canales, albarradas, canteras y sascaberas.The Ruins of Oxpemul, Campeche represent a fortified royal court in the Peten Campechano and the Calakmul Basin some 25 kms north of the major regional center of Calakmul. Oxpemul's larger nucleus to the north is perched on a 45.50 m high mesa. Its settlement pattern closely resembles that of Calakmul and El Mirador. There is a smaller nucleus to the south. Oxpemul has 21 stelae with some 18 altars fronting them. Many of the stelae with human figures and hieroglyph texts are standing and well preserved. Several altars are also graced with texts with one appearing to be a deity figure. Oxpemul is associated with a stone throne emblem glyph that appears in texts five or more times. A 9 km² map has been made of the area surrounding Oxpemul's two nuclei that includes several major and minor groups as well as aguadas, canteras and sascaberas.

Traumatic brain injury (TBI) can result in persistent sensorimotor and cognitive deficits including long-term altered sensory processing. The few animal models of sensory cortical processing effects of TBI have been limited to examination of effects immediately after TBI and only in some layers of cortex. We have now used the rat whisker tactile system and the cortex processing whisker-derived input to provide a highly detailed description of TBI-induced long-term changes in neuronal responses across the entire columnar network in primary sensory cortex. Brain injury (n=19) was induced using an impact acceleration method and sham controls received surgery only (n=15). Animals were tested in a range of sensorimotor behaviour tasks prior to and up to 6 weeks post-injury when there were still significant sensorimotor behaviour deficits. At 8-10 weeks post-trauma, in terminal experiments, extracellular recordings were obtained from barrel cortex neurons in response to whisker motion, including motion that mimicked whisker motion observed in awake animals undertaking different tasks. In cortex, there were lamina-specific neuronal response alterations that appeared to reflect local circuit changes. Hyper-excitation was found only in supragranular layers involved in intra-areal processing and long-range integration, and only for stimulation with complex, naturalistic whisker motion patterns and not for stimulation with simple trapezoidal whisker motion. Thus TBI induces long-term directional changes in integrative sensory cortical layers that depend on the complexity of the incoming sensory information. The nature of these changes allow predictions as to what types of sensory processes may be affected in TBI and contribute to post-trauma sensorimotor deficits.

This study examines the perception of Humanities and Social Science teachers among public Senior High Schools in the Department of Education's Humanities and Social Sciences strand in the Philippines. It uses Erden's element-based model of evaluation by considering the alignment to the goals of the Humanities and Social Sciences disciplines, the purpose, and core courses of the program, and the teaching-learning process. It also uses Tyler's Rationale as frameworks in assessing the curriculum. Likewise, the study examines the problems and difficulties in curricular implementation. Upon administering a survey to 25 Humanities and Social Science teachers among four public senior high schools, data revealed that the respondents perceived the curriculum goals, and the purpose of the program as highly observed, while the core courses of the program and teaching-learning process were satisfactorily observed in the curriculum. Also, sex and age were not factors in their level of assessment of Humanities and Social Science goals. The problems and difficulties encountered by teachers included unbalanced time allocation of learning competencies, lack of available learning materials, and lack of specialized teachers. Based on the findings, it is suggested that the government provide stronger teacher support programs to address the gap in curriculum implementation. The K to 12 program also needs a full review, as the study only provides a presurvey to more significant institutional issues. While the Humanities and Social Science curriculum appears aligned with the goals of their disciplines, and to the country's educational goals, its realization still depends upon the teachers' implementation in the classroom level.

En este número no se incluyeron resúmenes ni palabras clave.

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