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The worsening global environmental crisis highlights the urgency of integrating Environmental Education (EE) throughout the curriculum including in English as a Foreign Language (EFL) curricula. However, challenges exist, such as the development of appropriate curriculum documents and educators' understanding of approaches to EE. This study looked at Indonesian EFL textbooks for elementary schools, focusing mainly on the images and how they can portray environmental themes. These images and some brief texts that accompany the images were examined using tools from ecolinguistics literature, including Stibbe's (2021) nine stories and the United Nations' EE objectives (UNESCO-UNEP, 1975). This study intends to fill a gap in the EE literature by analyzing images in elementary school textbooks in the specific context of Indonesia, generalizing the idea of EE to other contexts. Findings revealed that while some EE efforts were evident, the majority of the material leaned towards an anthropocentric (human centered) perspective, indicating a need for greater incorporation of insights from ecolinguistics to enhance the content. Moreover, in terms of EE objectives, the textbooks provided ecological knowledge but lacked emphasis on developing skills and encouraging student participation in solving environmental problems. Examples demonstrating the ability to evaluate and address environmental issues were also absent. Suggestions are made for future EE content in EFL materials.

Abstract Background Indoor residual spraying (IRS) is a key tool for controlling and eliminating malaria by targeting vectors. To support the development of effective intervention strategies it is important to understand the impact of vector control tools on malaria incidence and on the spread of insecticide resistance. In 2006, the World Health Organization (WHO) stated that countries should report on coverage and impact of IRS, yet IRS coverage data are still sparse and unspecific. Here, the subnational coverage of IRS across sub-Saharan Africa for the four main insecticide classes from 1997 to 2017 were estimated. Methods Data on IRS deployment were collated from a variety of sources, including the President’s Malaria Initiative spray reports and National Malaria Control Programme reports, for all 46 malaria-endemic countries in sub-Saharan Africa from 1997 to 2017. The data were mapped to the applicable administrative divisions and the proportion of households sprayed for each of the four main insecticide classes; carbamates, organochlorines, organophosphates and pyrethroids was calculated. Results The number of countries implementing IRS increased considerably over time, although the focal nature of deployment means the number of people protected remains low. From 1997 to 2010, DDT and pyrethroids were commonly used, then partly replaced by carbamates from 2011 and by organophosphates from 2013. IRS deployment since the publication of resistance management guidelines has typically avoided overlap between pyrethroid IRS and ITN use. However, annual rotations of insecticide classes with differing modes of action are not routinely used. Conclusion This study highlights the gaps between policy and practice, emphasizing the continuing potential of IRS to drive resistance. The data presented here can improve studies on the impact of IRS on malaria incidence and help to guide future malaria control efforts.

BackgroundIn 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016.MethodsEight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS.ResultsComplete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019.ConclusionThrough effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets.

Antibiotics have revolutionized the treatment of bacterial infections. However, it is widely held that there is underinvestment in antibiotics research and development relative to the socially optimal level for a number of reasons. In this article, we discuss whether existing health technology assessment procedures recognize the full economic and societal value of new antibiotics to patients and society when making reimbursement decisions. We present three recommendations for modelling the unique attributes of value that are specific to novel antibiotics. We find, based on a review of the literature, that some of the value elements proposed by our framework have previously been discussed qualitatively by health technology assessment bodies when evaluating antibiotics, but are not yet formally captured via modelling. We present a worked example to show how it may be possible to capture these dimensions of value in a more quantitative manner. We conclude by answering the question of the title as follows: the unique attributes of novel antibiotics should be considered in reimbursement decision making, in a way that captures the full range of benefits these important technologies bring to patients, health care systems, and society.

This study examines terrestrial site contamination using metazoan meiofauna.

Background: In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016. Methods: Eight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS. Results: Complete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019. Conclusion: Through effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets. Author summary: Visceral Leishmaniasis (VL), also known as kala-azar, is a major parasitic disease in South Asia (Indian subcontinent), with 85% of the disease incidence in India. Historically VL had been controlled and almost eliminated with Indoor Residual Spraying (IRS) using dichlorodiphenyltrichloroethane (DDT). However, reinitiating this approach in 2015 failed due to high insecticide resistance in the sand fly vector and poor IRS quality, meaning that VL elimination targets were not met. To improve this the National Vector Borne Disease Control Programme changed to an effective insecticide, alpha-cypermethrin and altered the mode of application to compression pumps. Sentinel sites were established to monitor the entomological indicators, these showed the positive impact of these changes from 2016 to 2019. During this period the overall incidence of disease has decreased, and India is now on track to reach it's target incidence for VL of less than 1/1000 people at the sub-district (block) level. [ABSTRACT FROM AUTHOR]

Background Acinetobacter baumannii is a common cause of healthcare-associated infections. Carbapenem-resistant (CR) A baumannii is a significant threat globally. We used a large reference laboratory database to study the epidemiology of A baumannii in children in the United States. Methods Antimicrobial susceptibility data from The Surveillance Network were used to phenotypically identify antibiotic resistance in A baumannii isolates in children 1–17 years of age between January 1999 and July 2012. Logistic regression analysis was used to calculate trends in the prevalence of antibiotic resistance in A baumannii. Isolates from infants (<1 year old) were excluded. Results The crude proportion of cephalosporin-resistant (CephR) A baumannii increased from 13.2% in 1999 to 23.4% in 2012 with a peak of 32.5% in 2008, and the proportion of CR A baumannii increased from 0.6% in 1999 to 6.1% in 2012 with a peak of 12.7% in 2008. From 1999 to 2012, the proportion of CephR and CR A baumannii increased each year by 3% and 8%, respectively (CephR odds ratio [OR] = 1.03, 95% confidence interval [CI], 1.01–1.04; CR OR = 1.08, 95% CI, 1.05–1.12); however, after 2008, a significant decrease in trend was observed (CephR OR = 0.78, 95% CI, 0.71–0.87; CR OR = 0.73, 95% CI, 0.62–0.86), but resistance remained higher than baseline (1999). Conclusions Overall, between 1999 and 2012, CephR and CR A baumannii isolates increased in children; however, a decreasing trend was observed after 2008.There is a need for ongoing surveillance of A baumannii infections and continued assessment of effective prevention strategies in vulnerable populations. [ABSTRACT FROM AUTHOR]

Objectives: Borderline personality disorder (BPD) is associated with frequent self-harm and suicidal behaviours. This study compared physician-assessed self-harm risk and intervention choice according to a (i) standard risk assessment and (ii) BPD-specific risk assessment methods.Methods: Forty-five junior and senior mental health physicians were assigned to standard or BPD-specific risk training groups. The assessment utilized a BPD case vignette containing four scenarios describing high/low lethality self-harm and chronic/new patterns of self-harm behaviour. Participants chose from among four interventions, each corresponding to a risk category.Results: Standard and BPD-specific groups were alike in their assessment of self-harm risk. Divergence occurred on intervention choice for assessments of low lethality, chronic risk ( p<.01) and high lethality, chronic risk ( p<.005). Overall, psychiatrists were more likely than their junior colleagues to correctly assess risk and management options.Conclusions: Although standard and BPD-specific methods are well aligned for assessing self harm-associated risk, BPD-specific training raised awareness of BPD-appropriate interventions, particularly in the context of chronic patterns of self-harm behaviour. Wider dissemination of BPD-specific risk training may enhance the confidence of mental health clinicians in identifying the nature of self-harm risk as well as the most clinically appropriate interventions for clients with BPD. [ABSTRACT FROM AUTHOR]

The morphologies of microglial arbors in brain tissue are important indicators of their state of activation, and their spatial distribution indicates patterns of tissue perturbation. This paper presents a non-parametric Bayesian approach to unsupervised quantitative profiling of microglial activation states, and mapping their 3-D spatial distributions across extended brain tissue regions imaged by mosaiced confocal microscopy. Our approach is to perform large-scale automated reconstruction of all the microglia using a learned label-consistent dictionary model for the microglial processes, and extract 136 arbor features per cell. We then fit an infinite Gaussian mixture model with collapsed Gibbs sampling to the arbor features, to discover arbor-morphological classes, their morphological ‘signatures’, and the associated covariance matrices all in an unsupervised manner. This nonparametric approach can handle clusters with arbitrarily shaped covariance matrices, perform automatic model selection, handle unbalanced clusters, and detect overlapping classes, without the need to specify the number of clusters. The results can be used for diverse investigational purposes, including: population-scale modeling, automated discovery of arbor classes and their distinguishing quantitative signatures and features, quantifying the nature and extent of the cellular heterogeneity, and spatial mapping of cellular arbor morphologies, and mapping tissue alterations. [ABSTRACT FROM PUBLISHER]

Motivation: The arbor morphologies of brain microglia are important indicators of cell activation. This article fills the need for accurate, robust, adaptive and scalable methods for reconstructing 3-D microglial arbors and quantitatively mapping microglia activation states over extended brain tissue regions. Results: Thick rat brain sections (100-300 μm) were multiplex immunolabeled for IBA1 and Hoechst, and imaged by step-and-image confocal microscopy with automated 3-D image mosaicing, producing seamless images of extended brain regions (e.g. 5903×9874×229 voxels). An over-complete dictionary-based model was learned for the image-specific local structure of microglial processes. The microglial arbors were reconstructed seamlessly using an automated and scalable algorithm that exploits microglia-specific constraints. This method detected 80.1 and 92.8% more centered arbor points, and 53.5 and 55.5% fewer spurious points than existing vesselness and LoG-based methods, respectively, and the traces were 13.1 and 15.5% more accurate based on the DIADEM metric. The arbor morphologies were quantified using Scorcioni's L-measure. Coifman's harmonic co-clustering revealed four morphologically distinct classes that concord with known microglia activation patterns. This enabled us to map spatial distributions of microglial activation and cell abundances. [ABSTRACT FROM AUTHOR]

The article discusses a study aimed to determine the clinical benefit of a mentalization-based intervention (MBI) added to a recovery-based model of care for borderline personality disorder (BPD) consumers with a history of recurrent, deliberate self-harm. Topics covered include an assessment of the implementation of the MBI, its compatibility with a recovery-based case psychiatric management approach, and

In recent years, there has been an increase in resistance of malaria vectors to insecticides, particularly to pyrethroids which are widely used in insecticide-treated nets. The Global Plan for Insecticide Resistance Management in malaria vectors (GPIRM), released in May 2012, is a collective strategy for the malaria community to tackle this challenge. This review outlines progress made to date and the challenges experienced in the implementation of GPIRM, and outlines focus areas requiring urgent attention. Whilst there has been some advancement, uptake of GPIRM at the national level has generally been poor for various reasons, including limited availability of vector control tools with new mechanisms of action as well as critical financial, human and infrastructural resource deficiencies. There is an urgent need for a global response plan to address these deficits and ensure the correct and efficient use of available tools in order to maintain the effectiveness of current vector control efforts whilst novel vector control tools are under development. Emphasis must be placed on enhancing national capacities (such as human and infrastructural resources) to enable efficient monitoring and management of insecticide resistance, and to support availability and accessibility of appropriate new vector control products. Lack of action by the global community to address the threat of insecticide resistance is unacceptable and deprives affected communities of their basic right of universal access to effective malaria prevention. Aligning efforts and assigning the needed resources will ensure the optimal implementation of GPIRM with the ultimate goal of maintaining effective malaria vector control. [ABSTRACT FROM AUTHOR]

In this article, we describe the use of Python for large-scale automated server-based bio-image analysis in FARSIGHT, a free and open-source toolkit of image analysis methods for quantitative studies of complex and dynamic tissue microenvironments imaged by modern optical microscopes, including confocal, multi-spectral, multi-photon, and time-lapse systems. The core FARSIGHT modules for image segmentation, feature extraction, tracking, and machine learning are written in C++, leveraging widely used libraries including ITK, VTK, Boost, and Qt. For solving complex image analysis tasks, these modules must be combined into scripts using Python. As a concrete example, we consider the problem of analyzing 3-D multi-spectral images of brain tissue surrounding implanted neuroprosthetic devices, acquired using high-throughput multi-spectral spinning disk step-and-repeat confocal microscopy. The resulting images typically contain 5 fluorescent channels. Each channel consists of 6000 × 10,000 × 500 voxels with 16 bits/voxel, implying image sizes exceeding 250 GB. These images must be mosaicked, pre-processed to overcome imaging artifacts, and segmented to enable cellular-scale feature extraction. The features are used to identify cell types, and perform large-scale analysis for identifying spatial distributions of specific cell types relative to the device. Python was used to build a server-based script (Dell 910 PowerEdge servers with 4 sockets/server with 10 cores each, 2 threads per core and 1TB of RAM running on Red Hat Enterprise Linux linked to a RAID 5 SAN) capable of routinely handling image datasets at this scale and performing all these processing steps in a collaborative multi-user multi-platform environment. Our Python script enables efficient data storage and movement between computers and storage servers, logs all the processing steps, and performs full multi-threaded execution of all codes, including open and closed-source third party libraries. [ABSTRACT FROM AUTHOR]

Rescue excavation at Caldicot, C went (ST 4787) revealed at least six kilns of late third to early fourth century A. D. date, along with evidence for earlier (third century) production jars form the most important class of vessel produced and forms reminiscent of BB1 were particularly significant. The kiln products fit within the chronologically much broader reduced ware tradition of south-east Wales. [ABSTRACT FROM AUTHOR]

From 1989–1992, at quarterly intervals, the National Rivers Authority (NRA) (Thames Region) Thames Estuary Benthic Programme sampled 28 sites within the estuary for benthic macroinvertebrates; meiofauna samples were also taken for the first year. At one subtidal site, situated off Canvey Island, over 200 invertebrate species over the survey period from a sample area of 4·4 m2 were recorded. This species richness was far higher than surrounding sites, including those further out into the North Sea. The most important groups at this site were Nematoda (77 spp.), Crustacea (46 spp.) and Polychaeta (40 spp.) and a species capture curve for macroinvertebrates continued to rise after 44 day grabs. The mean biomass of the site (248 g wet weight /m2) was 20 times that of any other site in the outer estuary. The substratum at the site was highly heterogeneous, yet comparatively stable due to its situation at the base (>20 m depth) of a man-made shipping channel, the provision of a large number of niches perhaps explaining the high biodiversity. The anthropogenic influence on a naturally low biodiversity area emphasises the importance of these ecosystems when considering the conservation of global biodiversity. Methods to determine the relative importance of ecosystems are discussed. [ABSTRACT FROM PUBLISHER]

Background There is a need for effective computational methods for quantifying the three-dimensional (3-D) spatial distribution, cellular arbor morphologies, and the morphological diversity of brain astrocytes to support quantitative studies of astrocytes in health, injury, and disease. New method Confocal fluorescence microscopy of multiplex-labeled (GFAP, DAPI) brain tissue is used to perform imaging of astrocytes in their tissue context. The proposed computational method identifies the astrocyte cell nuclei, and reconstructs their arbors using a local priority based parallel (LPP) tracing algorithm. Quantitative arbor measurements are extracted using Scorcioni's L-measure, and profiled by unsupervised harmonic co-clustering to reveal the morphological diversity. Results The proposed method identifies astrocyte nuclei, generates 3-D reconstructions of their arbors, and extracts quantitative arbor measurements, enabling a morphological grouping of the cell population. Comparison with existing methods Our method enables comprehensive spatial and morphological profiling of astrocyte populations in brain tissue for the first time, and overcomes limitations of prior methods. Visual proofreading of the results indicate a >95% accuracy in identifying astrocyte nuclei. The arbor reconstructions exhibited 3.2% fewer erroneous jumps in tracing, and 17.7% fewer false segments compared to the widely used fast-marching method that resulted in 9% jumps and 20.8% false segments. Conclusions The proposed method can be used for large-scale quantitative studies of brain astrocyte distribution and morphology. [ABSTRACT FROM AUTHOR]

Introduction Mettre en place des programmes de bon usage des antibiotiques dans tous les hôpitaux est essentiel pour lutter contre l’antibiorésistance. Une liste des mesures devant impérativement faire partie de ces programmes n’a été établie qu’en Europe, aux États-Unis et en Australie. L’objectif de ce travail était d’identifier et valider avec une méthode Delphi les mesures essentielles aux programmes de bon usage des antibiotiques qui peuvent être applicables dans tous les hôpitaux au niveau mondial. Matériels et méthodes Une revue de la littérature a été effectuée à partir d’une recherche Medline et sur les sites internet des principales organisations nationales et internationales afin d’identifier toutes les mesures décrites ( core elements et checklist items ). Un groupe d’experts a évalué chaque mesure identifiée en répondant à deux reprises à un questionnaire en ligne. Les mesures sélectionnées par ≥ 80 % des experts étaient retenues dès le premier questionnaire, celles sélectionnées par 70–79 % des experts étaient réévaluées lors du deuxième questionnaire et les mesures sélectionnées par < 70 % des experts étaient rejetées. Résultats La revue de la littérature a identifié 48 références, à partir desquelles 7 core elements (type de stratégie, e.g. Formation) et 29 checklist items (mesure précise au sein de la stratégie, e.g. Formation des prescripteurs) ont été recueillis. Quinze experts (Amérique du Nord = 2, Amérique latine et du Sud = 2, Europe = 5, Afrique = 2, Asie = 3, Australie = 1) ont participé à la procédure de consensus formalisé. Au final, tous les 7 core elements ont été retenus et 29 checklist items ont été sélectionnés (28 des 29 identifiés initialement, + un item suggéré par les experts). Conclusion Nous avons validé des standards minimaux qui peuvent être applicables au niveau international pour les programmes de bon usage des antibiotiques hospitaliers. Ce travail peut aider chaque pays, y compris les pays aux ressources limitées, à développer des recommandations nationales. [ABSTRACT FROM AUTHOR]