Search

Apoptosis is an essential defensive mechanism against tumorigenesis. Proteins of the B-cell lymphoma-2 (Bcl-2) family regulate programmed cell death by the mitochondrial apoptosis pathway. In response to intracellular stress, the apoptotic balance is governed by interactions of three distinct subgroups of proteins; the activator/sensitizer BH3 (Bcl-2 homology 3)-only proteins, the pro-survival, and the pro-apoptotic executioner proteins. Changes in expression levels, stability, and functional impairment of pro-survival proteins can lead to an imbalance in tissue homeostasis. Their overexpression or hyperactivation can result in oncogenic effects. Pro-survival Bcl-2 family members carry out their function by binding the BH3 short linear motif of pro-apoptotic proteins in a modular way, creating a complex network of protein-protein interactions. Their dysfunction enables cancer cells to evade cell death. The critical role of Bcl-2 proteins in homeostasis and tumorigenesis, coupled with mounting insight in their structural properties, make them therapeutic targets of interest. A better understanding of gene expression, mutational profile, and molecular mechanisms of pro-survival Bcl-2 proteins in different cancer types, could help to clarify their role in cancer development and may guide advancement in drug discovery. Here, we shed light on the pro-survival Bcl-2 proteins in breast cancer using different bioinformatic approaches, linking -omics with structural data. We analyzed the changes in the expression of the Bcl-2 proteins and their BH3-containing interactors in breast cancer samples. We then studied, at the structural level, a selection of interactions, accounting for effects induced by mutations found in the breast cancer samples. We find two complexes between the up-regulated Bcl2A1 and two down-regulated BH3-only candidates (i.e., Hrk and Nr4a1) as targets associated with reduced apoptosis in breast cancer samples for future experimental validation. Furthermore, we predict L99R, M75R as damaging mutations altering protein stability, and Y120C as a possible allosteric mutation from an exposed surface to the BH3-binding site.

Background:. We describe our 10-year experience performing total hip arthroplasty (THA) in patients enrolled in the National Joint Registry of the Malawi Orthopaedic Association. Methods:. Eighty-three THAs were performed in 70 patients (40 male and 30 female) with a mean age of 52 years (range, 18 to 77 years). The cohort included 24 patients (14 male and 10 female; mean age, 52 years [range, 35 to 78 years]) who were human immunodeficiency virus (HIV)-positive. Results:. The main indications for surgery were osteonecrosis (n = 41 hips) and osteoarthritis (n = 26 hips). There were no deaths perioperatively and no early complications at 6 weeks. Forty-six patients (59 THAs) were seen at 10 years postoperatively, with a mean Harris hip score (HHS) of 88 (range, 41 to 91) and a mean Oxford Hip Score (OHS) of 46 (range, 25 to 48). Five hips (8% of 59) were revised due to loosening (n = 4) and fracture (n = 1). There were no infections or dislocations. Fourteen patients died, including 4 HIV-positive patients, of unknown causes in the follow-up period, and 10 patients were lost to follow-up. In the group of 24 HIV-positive patients, there were no early complications, and the mean HHS was 88 (range, 76 to 91) at >10 years. Conclusions:. Our 10-year experience and long-term outcomes after primary THA in a low-income setting show that good results can be achieved within a controlled hospital environment, thereby establishing a benchmark against which other hospitals and registries in similar low-income countries can compare their results. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Background: Links between eating disorders (EDs) [e.g., anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED)] and the major neurodevelopmental disorders of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have been repeatedly highlighted. In both ASD and ADHD, these links range from an elevated risk for EDs to common symptomatic overlaps and etiological commonalities with EDs.Methods: We performed a systematic literature search (through July 2019) with Medline via Ovid for epidemiological data on EDs (AN, BN, and BED) in combination with both ASD and ADHD.Results: The reviewed studies showed that, on average, 4.7% of patients with certain ED diagnoses (AN, BN, or BED) received an ASD diagnosis. Reliable data on the prevalence of EDs in ASD samples are still scarce. Comorbid ASD is most commonly diagnosed in patients with AN. The prevalence of ADHD in EDs ranged between 1.6% and 18%. Comorbid ADHD was more often reported in the AN-binge eating/purging subtype and BN than in the AN restrictive subtype. The prevalence of EDs in ADHD ranged between no association and a lifetime prevalence of 21.8% of developing an ED in women with ADHD.Conclusions: Studies on the prevalence rates of EDs in ADHD and ASD and vice versa are heterogeneous, but they indicate frequent association. While there is growing evidence of clinical overlaps between the three disorders, it remains difficult to determine whether overlapping characteristics (e.g., social withdrawal) are due to common comorbidities (e.g., depression) or are instead primarily associated with EDs and neurodevelopmental disorders. Furthermore, prospective studies are required to better understand how these disorders are related and whether ADHD and ASD could be either specific or nonspecific predisposing factors for the development of EDs.

The ongoing economic crisis and the growing concerns about food quality and safety are leading to an increasing awareness of consumption habits among citizens. Critical consumption is defining an alternative geography of food. Alternative Food Networks (AFNs) are expanding market niches based on the commitment and involvement of local actors. By redefining consumption, distribution and production, they often bridge the gap between producers and consumers and promote endogenous development, production re-localization and food system re-territorialization. In this sense, AFNs could represent new forms of sustainable self-organized collective action. This article describes the evolution of alternative food practices in Bergamo, a medium-sized town in the North of Italy, and its province. It presents a reflection on the effect of the crisis on alternative economic practices, while taking into account the main constraints and opportunities that foster/limit their spread. Data for the analysis came from different sources of information such as interviews, participant observation, an extensive mapping of actors, practices and projects.

BACKGROUND:Weight loss interventions based solely on text messaging (short message service [SMS]) have been shown to be modestly effective for short periods of time and in some populations, but limited evidence is available for positive longer-term outcomes and for efficacy in Hispanic populations. Also, little is known about the comparative efficacy of weight loss interventions that use SMS coupled with brief, technology-mediated contact with health coaches, an important issue when considering the scalability and cost of interventions. We examined the efficacy of a 1-year intervention designed to reduce weight among overweight and obese English- and Spanish-speaking adults via SMS alone (ConTxt) or in combination with brief, monthly health-coaching calls. ConTxt offered 2-4 SMS/day that were personalized, tailored, and interactive. Content was theory- and evidence-based and focused on reducing energy intake and increasing energy expenditure. Monthly health-coaching calls (5-10 minutes' duration) focused on goal-setting, identifying barriers to achieving goals, and self-monitoring. METHODS AND FINDINGS:English- and Spanish-speaking adults were recruited from October 2011 to March 2013. A total of 298 overweight (body mass index [BMI] 27.0 to 39.9 kg/m2) adults (aged 21-60 years; 77% female; 41% Hispanic; 21% primarily Spanish speaking; 44% college graduates or higher; 22% unemployed) were randomly assigned (1:1) to receive either ConTxt only (n = 101), ConTxt plus health-coaching calls (n = 96), or standard print materials on weight reduction (control group, n = 101). We used computer-based permuted-block randomization with block sizes of three or six, stratified by sex and Spanish-speaking status. Participants, study staff, and investigators were masked until the intervention was assigned. The primary outcome was objectively measured percent of weight loss from baseline at 12 months. Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework. A total of 261 (87.2%) and 253 (84.9%) participants completed 6- and 12-month visits, respectively. Loss to follow-up did not differ by study group. Mean (95% confidence intervals [CIs]) percent weight loss at 12 months was -0.61 (-1.99 to 0.77) in the control group, -1.68 (-3.08 to -0.27) in ConTxt only, and -3.63 (-5.05 to -2.81) in ConTxt plus health-coaching calls. At 12 months, mean (95% CI) percent weight loss, adjusted for baseline BMI, was significantly different between ConTxt plus health-coaching calls and the control group (-3.0 [-4.99 to -1.04], p = 0.003) but not between the ConTxt-only and the control group (-1.07 [-3.05 to 0.92], p = 0.291). Differences between ConTxt plus health-coaching calls and ConTxt only were not significant (-1.95 [-3.96 to 0.06], p = 0.057). These findings were consistent across other weight-related secondary outcomes, including changes in absolute weight, BMI, and percent body fat at 12 months. Exploratory subgroup analyses suggested that Spanish speakers responded more favorably to ConTxt plus health-coaching calls than English speakers (Spanish contrast: -7.90 [-11.94 to -3.86], p < 0.001; English contrast: -1.82 [-4.03 to 0.39], p = 0.107). Limitations include the unblinded delivery of the intervention and recruitment of a predominantly female sample from a single site. CONCLUSIONS:A 1-year intervention that delivered theory- and evidence-based weight loss content via daily personalized, tailored, and interactive SMS was most effective when combined with brief, monthly phone calls. TRIAL REGISTRATION:ClinicalTrials.gov NCT01171586.

There are many challenges associated with increasing global legume production, and to overcome them will require stakeholders to modify certain perceptions and behaviors. Unfortunately, stakeholder motivation has been under-appreciated in global legumes research, despite its central role as a predictor of research uptake. Observational studies exist but often, motivation theory is wielded with a lack of conviction, and intervention studies have not yet emerged. Thus, participatory intervention research that embeds insight from contemporary understandings of motivated behavior, is a fruitful line of investigation. Participatory/transdisciplinary, reflective learning methodologies have demonstrated an ability to create new, and maximize existing, pathways to impact in legume productivity. Conversely, successes from the burgeoning field of implementation science have yet to be translated to agriculture research; frameworks exist that simplify the researcher's task of planning, applying, reporting, and replicating their transdisciplinary research. This review describes a novel methodological approach which promotes cross-fertilization of ideas between scientific, extension, farmer, and industry co-actors, engendering a dynamic learning culture; partners co-plan, co-execute, and co-disseminate their work together, in an equitable arrangement. This ensures that outputs are targeted to the needs of end-users and that both scientific and practical (local) knowledge is taken into account. Despite a recent proliferation of useful articles on knowledge co-creation in sustainable agriculture, this review is the first to rationalize to researchers the need to design participatory research which is informed by social psychology (Self-Determination Theory) and adheres to procedures championed in implementation science (e.g., feasibility and fidelity studies, systematic reporting). Theoretical rigor is added to the participatory research agenda, but this review also offers some practical suggestions for application in legumes research. While the focus is on legumes, this guidance is equally applicable to other crops and agricultural systems.

Abstract. Introduction:. There is a knowledge gap about the current experiences and needs of people with low back pain (LBP) seeking primary care in Australia. Objectives:. The aim of this study was to understand the experiences and needs of Australians who have received treatment for LBP in primary care. Methods:. This was a prospective, cross-sectional internet survey conducted between July 2017 and September 2017. Participants were adults who had experienced an episode of LBP in the past year, had sought primary care in Australia, and were proficient in English. Outcomes were patient-reported experiences about primary care treatment, including reasons for seeking care, health care practitioners consulted, components of care received, and patients' evaluations of the importance and helpfulness of treatment. Results:. A total of 426 Australians completed the survey. The response rate of survey completion was 50%. Participants reported seeking primary care for LBP not only for pain relief, but for difficulties with activities and participation with usual social roles as well as quality of life and mood. Participants consulted multiple health care practitioners and used numerous treatment modalities. Only half reported they received education and a very low proportion were aware of receiving guideline-based advice. The level of satisfaction with care was below moderate for 42% of respondents. Participants reported that they want LBP care to be more person-centred and better tailored to their needs; they also reported wanting more education, particularly about prevention of future episodes and self-management. Conclusions:. The needs of people currently seeking primary care for LBP in Australia do not seem to be adequately met. Improving patients' experiences and outcomes may require better integration of health care across providers and delivery of more person-centred care.

Background Diastolic pulmonary gradient (DPG) was proposed as a better marker of pulmonary vascular remodeling compared with pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG). The prognostic significance of DPG in patients requiring a left ventricular assist device (LVAD) remains unclear. We sought to investigate whether pre‐LVAD DPG is a predictor of survival or right ventricular (RV) failure post‐LVAD. Methods and Results We retrospectively reviewed 268 patients who underwent right heart catheterization before LVAD implantation from 2007 to 2017 and had pulmonary hypertension because of left heart disease. Patients were dichotomized using DPG ≥7 mm Hg, PVR ≥3 mm Hg, or TPG ≥12 mm Hg. The associations between these parameters and all‐cause mortality or RV failure post LVAD were assessed with Cox proportional hazards regression and Kaplan–Meier analyses. After a mean follow‐up time of 35 months, elevated DPG was associated with increased risk of RV failure (hazard ratio [HR]: 3.30; P=0.004, for DPG ≥7 versus DPG

Abstract Elevated cardiorespiratory fitness (CRF) is associated with reduced dynamic cerebral autoregulation (dCA), but the impact of exercise training per se on dCA remains equivocal. In addition, resting cerebral blood flow (CBF) and dCA after high‐intensity interval training (HIIT) in individuals with already high CRF remains unknown. We examined to what extent 6 weeks of HIIT affect resting CBF and dCA in cardiorespiratory fit men and explored if potential changes are intensity‐dependent. Endurance‐trained men were assigned to group HIIT85 (85% of maximal aerobic power, 1–7 min effort bouts, n = 8) and HIIT115 (115% of maximal aerobic power, 30 sec to 1 min effort bouts, n = 9). Training sessions were completed until exhaustion 3 times/week over 6 weeks. Mean arterial pressure (MAP) and middle cerebral artery mean blood velocity (MCAvmean) were measured continuously at rest and during repeated squat‐stands (0.05 and 0.10 Hz). Transfer function analysis (TFA) was used to characterize dCA on driven blood pressure oscillations during repeated squat‐stands. Neither training nor intensity had an effect on resting MAP and MCAvmean (both P > 0.05). TFA phase during 0.10 Hz squat‐stands decreased after HIIT irrespective of intensity (HIIT85: 0.77 ± 0.22 vs. 0.67 ± 0.18 radians; HIIT115: pre: 0.62 ± 0.19 vs. post: 0.59 ± 0.13 radians, time effect P = 0.048). These results suggest that HIIT over 6 weeks have no apparent benefits on resting CBF, but a subtle attenuation in dCA is seen posttraining irrespective of intensity training in endurance‐trained men.

INTRODUCTION: Hypertensive diseases in pregnancy are the leading medical problem during pregnancy. Some of the women affected remain hypertensive after pregnancy and the post-partum period. This study aimed to assess the factors associated to the persistence of hypertension after preeclampsia.

Objective: Severe malnutrition in patients with anorexia nervosa (AN) as well as possible trait-related aberrations lead to pronounced structural brain changes whose reversibility after recovery is currently unclear. Previous diffusion tensor imaging (DTI) studies investigating white matter (WM) microstructure alterations in AN are inconsistent.Methods: In this so far largest DTI study in adults, we investigated 33 AN patients, 20 recovered (REC), and 33 healthy women. DTI data were processed using the “DTI and Fiber tools,” and the Computational Anatomy Toolbox. WM integrity, both in terms of fractional anisotropy (FA) and mean diffusivity (MD), was assessed.Results: We found a significant FA decrease in the corpus callosum (body) and an MD decrease in the posterior thalamic radiation in the AN group. The REC group displayed FA decrease in the corpus callosum in comparison to HC, whereas there were no MD differences between the REC and HC groups.Conclusion: Despite prolonged restoration of weight in the REC group, no significant regeneration of WM integrity in terms of FA could be observed. Transient changes in MD likely represent a reversible consequence of the acute state of starvation or result from dehydration. Reduction of FA either may be due to WM damage resulting from malnutrition or may be considered a pre-morbid marker.

Background: Dengue Virus (DENV) associated disease is a major public health problem. Assessment of HLA class II restricted DENV-specific responses is relevant for immunopathology and definition of correlates of protection. While previous studies characterized responses restricted by the HLA-DRB1 locus, the responses associated with other class II loci have not been characterized to date. Accordingly, we mapped HLA-DP, DQ, and DRB3/4/5 restricted DENV-specific CD4 T cell epitopes in PBMCs derived from the DENV endemic region Sri Lanka.Methods: We studied 12 DP, DQ, and DRB3/4/5 alleles that are commonly expressed and provide worldwide coverage >82% for each of the loci analyzed and >99% when combined. CD4+ T cells purified by negative selection were stimulated with pools of HLA-predicted binders for 2 weeks with autologous APC. Epitope reactive T cells were enumerated using IFNγ ELISPOT assay. This strategy was previously applied to identify DRB1 restricted epitopes. In parallel, membrane expression levels of HLA-DR, DP, and DQ proteins was assessed using flow cytometry.Results: Epitopes were identified for all DP, DQ, and DRB3/4/5 allelic variants albeit with magnitudes significantly lower than the ones previously observed for the DRB1 locus. This was in line with lower membrane expression of HLA-DP and DQ molecules on the PBMCs tested, as compared to HLA-DR. Significant differences between loci were observed in antigen immunodominance. Capsid responses were dominant for DRB1/3/4/5 and DP alleles but negligible for the DQ alleles. NS3 responses were dominant in the case of DRB1/3/4/5 and DQ but absent in the case of DP. NS1 responses were prominent in the case of the DP alleles, but negligible in the case of DR and DQ. In terms of epitope specificity, repertoire was largely overlapping between DRB1 and DRB3/4/5, while DP and DQ loci recognized largely distinct epitope sets.Conclusion: The HLA-DP, DQ, and DRB3/4/5 loci mediate DENV-CD4 specific immune responses of lower magnitude as compared to HLA-DRB1, consistent with their lower levels of expression. The responses are associated with distinct and characteristic patterns of immunodominance, and variable epitope overlap across loci.

Natural variability and change of the Earth’s climate have significant global societal impacts. With its large heat and carbon capacity and relatively slow dynamics, the ocean plays an integral role in climate, and provides an important source of predictability at seasonal and longer timescales. In addition, the ocean provides the slowly evolving lower boundary to the atmosphere, driving, and modifying atmospheric weather. Understanding and monitoring ocean climate variability and change, to constrain and initialize models as well as identify model biases for improved climate hindcasting and prediction, requires a scale-sensitive, and long-term observing system. A climate observing system has requirements that significantly differ from, and sometimes are orthogonal to, those of other applications. In general terms, they can be summarized by the simultaneous need for both large spatial and long temporal coverage, and by the accuracy and stability required for detecting the local climate signals. This paper reviews the requirements of a climate observing system in terms of space and time scales, and revisits the question of which parameters such a system should encompass to meet future strategic goals of the World Climate Research Program (WCRP), with emphasis on ocean and sea-ice covered areas. It considers global as well as regional aspects that should be accounted for in designing observing systems in individual basins. Furthermore, the paper discusses which data-driven products are required to meet WCRP research and modeling needs, and ways to obtain them through data synthesis and assimilation approaches. Finally, it addresses the need for scientific capacity building and international collaboration in support of the collection of high-quality measurements over the large spatial scales and long time-scales required for climate research, bridging the scientific rational to the required resources for implementation.

This article explores the first training experience of teachers entering the career in professional and technological sectors. The author analyses what is involved in a pedagogical action by examining educational or teaching situations in what he calls collaborative investigation. According to him, using the concept of device makes it possible to understand the operation and principles of the action. The article also promotes the description and the analysis of both convergences and tensions between the actors’ initiatives in the system (designers, trainers, and teachers in training device).Narrative work appears prominent in this system by promoting dialogue around the profession of teacher in a professional and technological High School. In such case, the logic of inquiry supports the process of exchange between trainees and a kind of collective storytelling. This approach encourages confrontation with the professional gender of the teaching profession and also the positioning, but also emergence, of a style-action.

Abstract Background Family screening of a 48‐year‐old male with recently diagnosed IgG4‐related disease (IgG4‐RD) revealed unanticipated elevations in plasma IgG4 in his two healthy teenaged sons. Methods We performed gene sequencing, immune cell studies, HLA typing, and analyses of circulating cytotoxic CD4+ T lymphocytes and plasmablasts to seek clues to pathogenesis. DNA from a separate cohort of 99 patients with known IgG4‐RD was also sequenced for the presence of genetic variants in a specific gene, FGFBP2. Results The three share a previously unreported heterozygous single base deletion in fibroblast growth factor binding protein type 2 (FGFBP2), which causes a frameshift in the coding sequence. The FGFBP2 protein is secreted by cytotoxic T‐lymphocytes and binds fibroblast growth factor. The variant sequence in the FGFBP2 protein is predicted to form a disordered random coil rather than a helical‐turn‐helix structure, unable to adopt a stable conformation. The proband and the two sons had 5–10‐fold higher numbers of circulating cytotoxic CD4 + T cells and plasmablasts compared to matched controls. The three members also share a homozygous missense common variant in FGFBP2 found in heterozygous form in ~40% of the population. This common variant was found in 73% of an independent, well characterized IgG4‐RD cohort, showing enrichment in idiopathic IgG4‐RD. Conclusions The presence of a shared deleterious variant and homozygous common variant in FGFBP2 in the proband and sons strongly implicates this cytotoxic T cell product in the pathophysiology of IgG4‐RD. The high prevalence of a common FGFBP2 variant in sporadic IgG4‐RD supports the likelihood of participation in disease.

Background: The knowledge and ability to prescribe safely and effectively is a core competency for every graduating medical student. Our previous research suggested concerns about medical student prescribing abilities, and interest in a standardized assessment process. Methods: A multi-year cross-sectional study evaluating the feasibility, acceptability, and discriminative ability of an online prescribing competency assessment for final year Canadian medical students was conducted. Students at nine sites of four Ontario medical schools were invited to participate in an online one-hour exam of eight domains related to prescribing safely. Student feedback on perceived fairness, clarity, and ease of use formed the primary outcome. Exam performance and parity between schools were the secondary outcome. Results: A total of 714 students completed the assessment during spring final review courses between 2016 and 2018. Student feedback was more favourable than not for appropriateness of content (53.5% agreement vs 18.3% disagreement), clarity of questions (65.5% agreement vs 11.6% disagreement), question layout and presentation (70.8% agreement vs 12.2% disagreement), and ease of use of online interface (67.1% agreement vs 13.6% disagreement). Few (23.6% believed their course work had prepared them for the assessment. Mean total exam score was 70.0% overall (SD 10.4%), with 47.6% scoring at or above the pass threshold of 70%. Conclusion: Our prescribing competency assessment proved feasible, acceptable, and discriminative, and indicated a need for better medical school training to improve prescribing competency. Further evaluation in a larger sample of medical schools is warranted.

This essay considers relationships between nature, ecology and apocalypse in the poetry of Patrick Brontë (1777–1861) and Emily Brontë (1818–1848). It argues that though Patrick’s poetry emphasises the spiritual benefits of human connection with the natural world, his apocalypticism leads him to see no eschatological future for the natural world. Emily’s poetry is more attentive to destruction and violence in the natural world, but it also offers an eschatological vision of a future in which all of creation participates. Reading Emily’s poetry in theological conversation with that of her father, this essay argues that Emily reinterprets Patrick’s evangelical apocalypticism in the light of her understanding of God as the eternal source of all finite being. Drawing on a theological view of creation as God’s eternal relationship with the earth, Emily suggests that meaningful eschatological hope can be located only in a future in which the whole of creation participates with the human.

The analysis of historical disaster events is a critical step towards understanding current risk levels and changes in disaster risk over time. Disaster databases are potentially useful tools for exploring trends, however, criteria for inclusion of events and for associated descriptive characteristics is not standardized. For example, some databases include only primary disaster types, such as ‘flood’, while others include subtypes, such as ‘coastal flood’ and ‘flash flood’. Here we outline a method to identify candidate events for assignment of a specific disaster subtype—namely, ‘flash floods’—from the corresponding primary disaster type—namely, ‘flood’. Geophysical data, including variables derived from remote sensing, are integrated to develop an enhanced flash flood confidence index, consisting of both a flash flood confidence index based on text mining of disaster reports and a flash flood susceptibility index from remote sensing derived geophysical data. This method was applied to a historical flood event dataset covering Ecuador. Results indicate the potential value of disaggregating events labeled as a primary disaster type into events of a particular subtype. The outputs are potentially useful for disaster risk reduction and vulnerability assessment if appropriately evaluated for fitness of use.

Following the concept of the holobiont, insect-microbiota interactions play an important role in insect biology. Many examples of host-associated microorganisms have been reported to drastically influence insect biological processes such as development, physiology, nutrition, survival, immunity, or even vector competence. While a huge number of studies on insect-associated microbiota have focused on bacteria, other microbial partners including fungi have been comparatively neglected. Yeasts, which establish mostly commensal or symbiotic relationships with their host, can dominate the mycobiota of certain insects. This review presents key advances and progress in the research field highlighting the diversity of yeast communities associated with insects, as well as their impact on insect life-history traits, immunity, and behavior.

Immunological explanatory approaches are becoming increasingly important in schizophrenia research. In this context, the function of the blood-brain barrier (BBB) and the blood-cerebrospinal fluid (CSF) barrier (BCSFB) plays an essential role. Different adhesion molecules, such as intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), are key elements in sustaining the integrity of the BBB and BCSFB. The objectives of this study were to (1) compare the levels of different cell adhesion molecules in the CSF of patients with schizophrenia spectrum disorders to those of patients with unipolar depression and (2) analyze their association with the established markers of the BBB/BCSFB function (CSF total protein and albumin quotient (AQ)). Therefore, a total of 40 patients with schizophrenia spectrum disorder and 39 age- and sex-matched control patients with unipolar depression were analyzed. The levels of soluble ICAM-1 (s-ICAM-1), soluble VCAM-1 (s-VCAM-1), and plasminogen activator inhibitor 1 (PAI-1) in the CSF were measured using a magnetic bead multiplexing immunoassay. The levels of sICAM-1 (p < 0.001), sVCAM-1 (p < 0.001), and PAI-1 (p < 0.001) in the CSF were significantly higher in patients with schizophrenia spectrum disorder than in patients with unipolar depression. In addition, a significant correlation of sVCAM-1 levels with total protein concentrations (r = 0.454, p = 0.003) and AQ levels (r = 0.512, p = 0.001) in patients with schizophrenia spectrum disorders was observed. The results revealed that sICAM-1 and sVCAM-1 levels in the CSF were higher in patients with schizophrenia spectrum disorder than in those with depression. These circulating signaling molecules may indicate endothelial dysfunction causing impaired BBB/BCSFB function in patients with schizophrenia spectrum disorders. Consistent with this view, a highly significant correlation of sVCAM-1 with CSF protein and AQs was detected. Upregulation of these cell adhesion molecules might be indicative of a proinflammatory immune response underlying the BBB/BCSFB disturbance in a subgroup of patients with schizophrenia spectrum disorders. The significance of the study is limited by its retrospective research design and by the absence of a healthy control group. The assay used was not previously established for the measurement of CSF. Further translational and controlled studies of the role of different cell adhesion molecules in schizophrenia are needed.

An experimental study was performed to explore the influence of dwell time on the hydraulic interactions between injection events using pilot injection strategy, split injection strategy, post injection strategy and a solenoid diesel injector. To do so, a sweep of dwell time from 0.55 up to 2 ms using all multiple injection strategies and levels of rail pressure, of 80, 100 and 120 MPa, and single level of back pressure, of 5 MPa, was performed. The hydraulic interactions between injection events were characterized through the second injection hydraulic delay and second injection mass in an injection discharge curve indicator equipped with all the components required for its operation and control. In order to define the operating conditions of the multiple injection strategies, to ensure the same injected fuel mass in all cases, the characteristic curves of injection rate for the solenoid diesel injector studied were obtained. The second injection hydraulic delay increases with dwell time values in the range of 0.55–0.9 ms for all multiple injection strategies and levels of rail pressure tested. Conversely, the second injection hydraulic delay decreases with dwell time values higher than 0.9 ms. Moreover, the second hydraulic delay depends mainly on the dwell time and not on the injected fuel mass during the first injection event. The second injection mass increases with dwell values less than 0.6 ms. By contrast, the second injection mass is not significantly affected by that of the first injection at a dwell time higher than 0.6 ms.

Classics as a discipline has always taken advantage of digital methods in research, with projects dating back to the 1970s and earlier. This article examines the integration of classics and computing, and presents a case study of EpiDoc, a markup language used in epigraphy. Positive evidence can be found for EpiDoc’s influence on collaboration, with several current collaborative projects, and the nature of the technology encouraging open, reusable scholarship. The Inscriptions of Aphrodisias project illustrates much of the potential of electronic publishing. EpiDoc’s effect on research questions themselves remains inconclusive, although definite possibilities for the future are apparent. Opening up these conclusions to the wider digital classics community shows a trend towards collaboration in recent publications and projects, as well as a gradual uptake of electronic publication.

Introduction: Congenital heart diseases (CHD) have been reported to be responsible for 30 to 50% of infant mortality caused by congenital disabilities. In critical cases, survival of newborns with CHD depends on the patency of the ductus arteriosus (PDA), for maintaining the systemic or pulmonary circulation. The aim of the study was to assess the efficacy and side effects of PGE (prostaglandin E) administration in newborns with critical congenital heart disease requiring maintenance of the ductus arteriosus.

The 558 km range extension of the Amazonian aroid Dracontium nivosum (Lem.) G.H.Zhu into semi-arid Northeast Brazil is confirmed. This species occurs in Ceará in threatened fragments of brejo forest at ca. 580–870 m elevation. An illustrated taxonomic description is provided. The species’ Extent of Occurrence (EOO) is estimated as 356,392 km2 (meets Least Concern); the Area of Occupancy (AOO), 60 km2 using a 2×2 km cell (Endangered). Within Ceará the EOO is 41.4 km2 (Critically Endangered) and the AOO is 16 km2 (Endangered).

Introduction: Theoretically, caring relationship between faculty – student generates a caring moment. However, there is a scarcity of empirical evidence about how caring interactions with faculty can enhance students’ caring outcomes. Aim: The aim of this study was to identify the levels of students’ and instructors’ caring behavior and to explore the correlations between instructors’ and students’ caring behavior. Methods: A descriptive, non – experimental design has been used in this study. Data collection was based on interviews using two standardized questionnaires; the Nursing Students’ Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Respondents were consisting of nursing students from identified schools and colleges of nursing in different countries. Data were analyzed with SPSS version 21.0. Results: The sample was consisted of 368 nursing students (91% female, 9% male) from seven countries (26% Philippines, 31.5% Greece, 1% Kenya, 0.5 Oman, 35.5% India, 5% Nigeria, 0.5% Saudi Arabia). Forty two percent of students are in the second year of studies, 13% in the third year and 45% in the fourth year. The mean score of NSPIC was 4.02±0.30 and the mean of CBI was4.56±0.13. The mean for each factor of NSPIC was 4.39±0.13 for the factor “instills confidence through caring”, 3.92±0.212 for “supportive learning climate”, 4.06±0.06 for “appreciation of life’s meaning”, 3.66±0.11 for “control versus flexibility” and 4.01±0.48 for “respectful sharing”. The mean for each factor of CBI was 4.63±0.11 for the factor “assurance”, 4.58±0.06 for “knowledge and skills”, 4.55±0.18 for “respectful” and 4.47±0.14 for “connectedness”. Correlation analysis showed statistically significance between relevant variables. Conclusions: Instructors’ caring behavior affects nursing students’ caring behavior. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.

Monitoring fish species populations in very turbid environments is challenging. Acoustic cameras allow work in very poor visibility but are often deployed as a fixed observation point, limiting the scope of the survey. A BlueView P900-130 acoustic camera was deployed in rocky marine habitats off the coast of French Guiana in order to assess the total abundance, size structure and spatial distribution of a demersal fish population. The relevancy of using an acoustic camera to achieve these three objectives was evaluated by comparing acoustic data to those obtained from fishing surveys. The detection and identification of large demersal fish species were possible with the shape and size of the acoustic signal and acoustic shadow silhouette as well as swimming behavior. Mobile surveys combined with stationary surveys increased the probability of distinguishing individuals from inanimate objects. Estimated total length based on the acoustic signal underestimated the actual length of fish measured on deck, but the data showed the same trends in spatial and temporal variation. Acoustic cameras overcame the extreme lack of visibility by increasing knowledge of fish use of habitat, therefore providing much more efficiency in the effort, more accurate data on the abundance, size structure and spatial distribution than the fishing method. Thus, despite few limitations, acoustic camera surveys are far superior to fishing surveys in evaluating large demersal fish stock status.

Chronic wasting disease (CWD) is the most transmissible of the prion diseases. In 2016, an unexpected case was found in Norway, the first in Europe. Since then, there have been 32 confirmed cases in Norway, Sweden, and Finland. This paper aims to examine the situation from a social and political perspective: considering the management of CWD in the Swedish part of Sápmi—the Sami ancestral land; identifying the place of the Sami people in the risk management–because of the threats to Sami reindeer herding that CWD presents; and understanding how the disease can modify the modalities of Indigenous reindeer husbandry, whether or not CWD is epizootic. Based on interviews with various stakeholders and by examining the social sciences literature, this paper shows that the health risk management is structured by a politico-scientific controversy about the recognition, or not, of atypical and classical CWD. The Sami herders are currently cooperating with the state authorities in the surveillance program to sample their herds. This involvement takes place in a situation where the balance of power between the Sami people and the state, or the European Union, is framed by its colonial context. This has consequences with respect to the definition of a common interest and to implementing sanitary measures. The particular features of reindeer herding are seen as a challenge to managing CWD risk, compared with European health standards. We argue that CWD will greatly modify the modalities of Indigenous reindeer herding, whether there are positive cases or not in the Sami reindeer. By implementing new health guidelines, the authorities will create a cascading effect in Sami land and its use. The CWD situation in Fennoscandia is full of uncertainty but may cause a major shift in the organization and the governance of Sápmi. In September 2020, the identification of a new CWD case in a wild reindeer in Norway started a new episode in the disease management in Fennoscandia. Our paper raises various questions linked to understanding this new step in this crisis which is not only epidemiological, but also socio-cultural and political.

Zoo animal welfare is a high priority for many institutions worldwide, with modern zoos now ensuring that animals are housed and cared for to the highest standards. However, in countries where this knowledge is not as available or understood, standards may be lower. The aim of this research was to investigate if there were common zoo welfare concerns across developing country zoos. Wild Welfare is a charity working globally to improve welfare for zoo animals and has an independent welfare audit that is carried out before any intervention occurs. The Wild Welfare Audit, consisting of 110 questions, covering nine topics, was completed at 11 zoos in seven developing countries (Brazil, Egypt, Libya, Indonesia, Thailand, Malaysia and Vietnam) following a Likert scale score (1–3). A principal component analysis was also performed to evaluate the audit questions. The results suggest that common areas of concern were animal behaviour, positive animal mental states and human health and safety. These themes were likely due to the lack knowledge and understanding that may be linked to historical and cultural differences. This research has helped to revise the welfare audit as well as inform future intervention strategies for improving developing country zoo animal welfare.

Yellow fever virus (YFV) is a mosquito-borne member of the genus flavivirus, including other important human-pathogenic viruses, such as dengue, Japanese encephalitis, and Zika. Herein, we report identifying 129 YFV Class II epitopes in donors vaccinated with the live attenuated YFV vaccine (YFV-17D). A total of 1156 peptides predicted to bind 17 different common HLA-DRB1 allelic variants were tested using IFNγ ELISPOT assays in vitro re-stimulated peripheral blood mononuclear cells from twenty-six vaccinees. Overall, we detected responses against 215 YFV epitopes. We found that the capsid and envelope proteins, as well as the non-structural (NS) proteins NS3 and NS5, were the most targeted proteins by CD4+ T cells from YF-VAX vaccinated donors. In addition, we designed and validated by flow cytometry a CD4+ mega pool (MP) composed of structural and non-structural epitopes in an independent cohort of vaccinated donors. Overall, this study provides a comprehensive prediction and validation of YFV epitopes in a cohort of YF-17D vaccinated individuals. With the design of a CD4 epitope MP, we further provide a useful tool to detect ex vivo responses of YFV-specific CD4 T cells in small sample volumes.

Synchronization of different and independent oscillators that interact with each other via a common intermediate is ubiquitous in many fields. Here, we experimentally demonstrate the effect of crowd synchrony, analogous to that of the Millennium Bridge, by resorting to coupled lasers. When the number of lasers is below a critical number, there is no synchronization, but after reaching the critical number, the lasers instantaneously synchronize. We show that the synchronization of the lasers as a function of their number follows a first-order transition, and that our experimental results are in good agreement with those predicted by theoretical models.

Latent Heat Energy Storage (LHES) using Phase Change Materials (PCM) is considered a promising Thermal Energy Storage (TES) approach as it can allow for high levels of compactness, and execution of the charging and discharging processes at defined, constant temperature levels. These inherent characteristics make LHES particularly attractive for applications that profit from high energy density or precise temperature control. Many novel, promising heat exchanger designs and concepts have emerged as a way to circumvent heat transfer limitations of LHES. However, the extensive range of experimental conditions used to characterize these technologies in literature make it difficult to directly compare them as solutions for high thermal power applications. A methodology is presented that aims to enable the comparison of LHES designs with respect to their compactness and heat transfer performance even when largely disparate experimental data are available in literature. Thus, a pair of key performance indicators (KPI), ΦPCM representing the compactness degree and NHTPC, the normalized heat transfer performance coefficient, are defined, which are minimally influenced by the utilized experimental conditions. The evaluation procedure is presented and applied on various LHES designs. The most promising designs are identified and discussed. The proposed evaluation method is expected to open new paths in the community of LHES research by allowing the leveled-ground contrast of technologies among different studies, and facilitating the evaluation and selection of the most suitable design for a specific application.

The growing expansion of mosquito vectors leads to the emergence of vector-borne diseases in new geographic areas and causes major public health concerns. In the absence of effective preventive treatments against most pathogens transmitted, vector control remains one of the most suitable strategies to prevent mosquito-borne diseases. Insecticide overuse raises mosquito resistance and deleterious impacts on the environment and non-target species. Growing knowledge of mosquito biology has allowed the development of alternative control methods. Following the concept of holobiont, mosquito-microbiota interactions play an important role in mosquito biology. Associated microbiota is known to influence many aspects of mosquito biology such as development, survival, immunity or even vector competence. Mosquito-associated microbiota is composed of bacteria, fungi, protists, viruses and nematodes. While an increasing number of studies have focused on bacteria, other microbial partners like fungi have been largely neglected despite their huge diversity. A better knowledge of mosquito-mycobiota interactions offers new opportunities to develop innovative mosquito control strategies. Here, we review the recent advances concerning the impact of mosquito-associated fungi, and particularly nonpathogenic fungi, on life-history traits (development, survival, reproduction), vector competence and behavior of mosquitoes by focusing on Culex, Aedes and Anopheles species.

Coupled oscillators such as lasers, optical parametric oscillators, and Bose-Einstein-condensate polaritons can rapidly and efficiently dissipate into a stable phase-locked state that can be mapped onto the minimal energy (ground state) of classical spin Hamiltonians. However, for degenerate or near-degenerate ground-state manifolds, statistical fair sampling is required to obtain complete knowledge of the minimal-energy state, which needs many repetitions of simulations under identical conditions. We show that with dissipatively coupled lasers such fair sampling can be achieved rapidly and accurately by exploiting the many longitudinal modes of each laser to form an ensemble of identical but independent simulators, acting in parallel. We fairly sampled the ground-state manifold of square, triangular, and kagome lattices by measuring their coherence function and identifying manifolds composed of single, doubly degenerate, and highly degenerate ground states, respectively.

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by difficulties with social interaction, repetitive behavior, and additional features, such as special interests. Its precise etiology is unclear. Recently, immunological mechanisms, such as maternal autoantibodies/infections, have increasingly been the subject of discussion. Cerebrospinal fluid (CSF) investigations play a decisive role in the detection of immunological processes in the brain. This study therefore retrospectively analyzed the CSF findings of adult patients with ASD. CSF basic measures (white blood cell count, total protein, albumin quotient, immunoglobulin G (IgG) index, and oligoclonal bands) and various antineuronal antibody findings of 36 adult patients with ASD, who had received lumbar puncture, were compared with an earlier described mentally healthy control group of 39 patients with idiopathic intracranial hypertension. CSF protein concentrations and albumin quotients of patients with ASD were significantly higher as compared to controls (age corrected: p = 0.003 and p = 0.004, respectively); 17% of the patients with ASD showed increased albumin quotients. After correction for age and gender, the group effect for total protein remained significant (p = 0.041) and showed a tendency for albumin quotient (p = 0.079). In the CSF of two ASD patients, an intrathecal synthesis of anti-glutamate decarboxylase 65 (GAD65) antibodies was found. In total, more of the ASD patients (44%) presented abnormal findings in CSF basic diagnostics compared to controls (18%; p = 0.013). A subgroup of the patients with adult ASD showed indication of a blood–brain barrier dysfunction, and two patients displayed an intrathecal synthesis of anti-GAD65 antibodies; thus, the role of these antibodies in patients with ASD should be further investigated. The results of the study are limited by its retrospective and open design. The group differences in blood–brain barrier markers could be influenced by a different gender distribution between ASD patients and controls.

Learning skills from kinesthetic demonstrations is a promising way of minimizing the gap between human manipulation abilities and those of robots. We propose an approach to learn sequential force interaction skills from such demonstrations. The demonstrations are decomposed into a set of movement primitives by inferring the underlying sequential structure of the task. The decomposition is based on a novel probability distribution which we call Directional Normal Distribution. The distribution allows infering the movement primitive’s composition, i.e., its coordinate frames, control variables and target coordinates from the demonstrations. In addition, it permits determining an appropriate number of movement primitives for a task via model selection. After finding the task’s composition, the system learns to sequence the resulting movement primitives in order to be able to reproduce the task on a real robot. We evaluate the approach on three different tasks, unscrewing a light bulb, box stacking and box flipping. All tasks are kinesthetically demonstrated and then reproduced on a Barrett WAM robot.

Background: Circulating apoptotic signals (CASs) have been described in the pathologies associated with dysregulated apoptosis, such as cancer, heart diseases, and pulmonary hypertension (PH). However, nothing is known about the expression profiles of these markers in the circulation of humans exposed to acute and chronic effects of high altitude (HA).Methods: Gene expression levels of different apoptotic signals (ASs) were analyzed in human pulmonary artery smooth muscle cells (PASMCs) upon hypoxia incubation. In addition, we measured the plasma values of relevant CAS in Kyrgyz volunteers during acute and chronic exposure to HA. Finally, we analyzed the effects of pro-apoptotic mediator Fas ligand (FasL) on apoptosis and proliferation of human PASMCs.Results: Several cellular AS were increased in PASMCs exposed to hypoxia, in comparison to normoxia condition. Among analyzed CAS, there was a prominent reduction of FasL in lowlanders exposed to HA environment. Furthermore, decreased circulatory levels of FasL were found in highlanders with HA-induced PH (HAPH), as compared to the lowland controls. Furthermore, FasL concentration in plasma negatively correlated with tricuspid regurgitant gradient values. Finally, FasL exerted pro-apoptotic and anti-proliferative effects on PASMCs.Conclusion: Our data demonstrated that circulating levels of FasL are reduced during acute and chronic exposure to HA environment. In addition, dysregulated FasL may play a role in the context of HAPH due to its relevant functions on apoptosis and proliferation of PASMCs.

Background and Purpose: The immediate decrease of the apparent diffusion coefficient (ADC) is the main characteristic change of water diffusion in acute ischemic stroke. There is only limited information on the time course of diffusion parameters in different tissue compartments of cerebral ischemia.Materials and Methods: In a longitudinal study, we examined 21 patients with acute ischemic stroke by diffusion tensor imaging within 5 h after symptom onset, 3 h later, 2 days, and 1 month after symptom onset. Acute diffusion lesion and the fluid-attenuated inversion recovery (FLAIR) after 2 days were used as volumes of interest to define persistent core, lesion growth, and reversible acute diffusion lesion. For all diffusion parameters ratios between the stroke lesion VOIs and the mirror VOIs were calculated for each time point. ADC ratio, fractional anisotropy ratios, and eigenvalues ratios were measured in these volumes of interest and in contralateral mirror regions at each time points.Results: In the persistent core, ADC ratio (0.772) and all eigenvalues ratios were reduced on admission up to 1 day after stroke and increased after 1 month (ADC ratio 1.067). Within the region of infarct growth time course of diffusion parameter changes was similar, but delayed. In the brain area with reversible diffusion lesion, a partial normalization of diffusion parameters over the time was observed, while after 1 month diffusion parameters did not show the signature of healthy brain tissue. There were significantly different trends for all parameters over time between the three tissue compartments.Conclusion: Diffusion tensor imaging displays characteristic changes of water diffusion in different tissue compartments over time in acute ischemic stroke. Even regions with reversible diffusion lesion show diffusion signatures of persisting tissue alterations.

Background Left ventricular (LV) hemodynamic assessment has been sparsely performed in patients supported on continuous‐flow LV assist devices (cfLVADs). Insight into dynamic changes of left heart parameters during ramp studies may improve LV assist device optimization and evaluate pathology. Methods and Results To complement right heart catheterization, a novel technique for left heart catheterization in patients with a cfLVAD was developed. Patients implanted with cfLVADs underwent hemodynamic ramp left heart catheterization and right heart catheterization with transthoracic echocardiography. Continuous aortic and LV pressures were measured along with right atrial, pulmonary artery, and pulmonary capillary wedge pressures. A novel index, the transaortic gradient (TAG) was established. Thirty eight patients with cfLVADs were evaluated at a median of 446 days (interquartile range, 183–742) after device implant. During left heart catheterization performed for hemodynamic optimization, drop‐in LV end‐diastolic pressure and pulmonary capillary wedge pressure were associated with a rise in TAG. A range was identified for TAG (20–40 mm Hg) as providing the most optimal level of hemodynamic offloading. Pathologic states deviated from normal responses to ramp. LV assist device thrombosis was associated with an inability to increase in TAG during speed ramp. Significant aortic insufficiency was associated with a marked increase in LV end‐diastolic pressure despite a concomitant decrease in pulmonary capillary wedge pressure with increasing LV assist device speeds. Conclusions Inclusion of left heart catheterization to a typical right heart catheterization LV assist device ramp protocol imparted unique insights to optimize cfLVAD speeds in different clinical scenarios. A novel index, the TAG was defined and provided additional resolution to optimized offloading.

Objective: We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers. Methods: Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant. Results: Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001). Conclusion: Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.

BACKGROUND:Alcohol use disorder (AUD) is known to co-occur with other addictions, as well as with mental health problems. However, the effects of other addictions co-occurring with AUD on mental health problems were rarely studied and not considering them may bias estimates of the association between AUD and mental health problems. This study investigated which role co-occurring addictions play for the cross-sectional associations between self-reported AUD and mental health problems. METHOD:Participants were 5516 young Swiss men (73.0% of those that gave written informed consent) who completed a self-report questionnaire. Using short screening questionnaires, we assessed three substance use disorders (alcohol, cannabis and tobacco), seven behavioural addictions (internet, gaming, smartphone, internet sex, gambling, work, exercise) and four mental health problems (major depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) and social anxiety disorder). Differences in the proportions of mental health problems were tested using logistic regressions between (1) participants with no AUD and AUD, (2) participants with no AUD and AUD alone and (3) participants with no AUD and AUD plus at least one co-occurring addiction. RESULTS:Overall, (1) participants with AUD had higher proportions of major depression (Odds ratio (OR [95% confidence interval]) = 3.51 [2.73, 4.52]; ADHD (OR = 3.12 [2.41, 4.03]); bipolar disorder (OR = 4.94 [3.38, 7.21]) and social anxiety (OR = 2.21 [1.79, 2.73])) compared to participants with no AUD. Considering only participants with AUD alone compared to participants with no AUD (2), differences in proportions were no longer significant for major depression (OR = 0.83 [0.42, 1.64]), bipolar disorder (OR = 1.69 [0.67, 4.22]), social anxiety (OR = 1.15 [0.77, 1.73]) and ADHD (OR = 1.65 [1.00, 2.72]) compared to participants with no AUD. In contrast, (3) proportions of mental health problems were considerably higher for participants with AUD plus at least one other addiction when compared to participants with no AUD, with OR's ranging from 2.90 [2.27, 3.70] for social anxiety, 4.03 [3.02, 5.38] for ADHD, 5.29 [4.02, 6.97] for major depression to 6.64 [4.44, 9.94] for bipolar disorder. CONCLUSIONS:AUD was associated with all four measured mental health problems. However, these associations were mainly due to the high proportions of these mental health problems in participants with AUD plus at least one co-occurring addiction and only to a lesser degree due to participants with AUD alone (i.e. without any other co-occurring addictions). Hence, estimates of the association between AUD and mental health problems that do not consider other addictions may be biased (i.e. overestimated). These findings imply that considering addictions co-occurring with AUD, including behavioural addictions, is important when investigating associations between AUD and mental health problems, and for the treatment of AUD and co-morbid disorders.

Many smallholder farmers in Jaman North District, Brong‐Ahafo Region, Ghana are shifting from food crop production to increased cultivation of cashew, an export cash crop. This paper examines gendered and generational tensions in increased commercialisation of land, livelihood diversification, and household food security in the context of globalisation and environmental change. Using qualitative, participatory research with 60 middle‐generation men and women, young people and key stakeholders, the research found that community members valued the additional income stream. Young people and women, however, were apprehensive about the long‐term consequences for food security of allocating so much land to cashew plantations. Young, middle, and older generations were concerned about their weak bargaining position in negotiating fair prices with export companies and intermediaries. Greater integration into the global economy exposed rural actors to multiple risks and inequalities, such as the uneven effects of economic globalisation, rises in food prices, hunger and food insecurity, growing competition for land, youth outmigration and climate change. The shift towards cashew cultivation appears to be exacerbating gender and generational inequalities in access to land and food insecurity and leading to exploitation within the global agri‐food supply chain among already vulnerable rural communities in the global South. With stronger farmer associations and cooperatives, however, cashew farmers stand the chance of benefitting from greater integration into the global economy, through strengthened bargaining positions. Greater understanding is needed about the complex interactions between sustainable food systems, changing land use and gender and generational inequalities in rural spaces.

ObjectivesTo assess the occurrence of transient interruption of contrast (TIC) phenomenon in pulmonary computed tomography angiography (CTPA) exams performed in inspiratory breath-hold after patients were told to inspire gently.MethodsIn this retrospective single-centre study, CTPA exams of 225 consecutive patients scanned on a 16-slice CT scanner system were analysed. A-priori to measurements, exams were screened for inadequate pulmonary artery contrast due to incorrect bolus tracking or failure of i.v. contrast administration. Those exams were excluded. Attenuation values in the thoracic aorta and in the pulmonary trunk were assessed in duplicate measurements (M1 and M2) and the aorto-pulmonary density ratio was calculated. An aorto-pulmonary ratio > 1 with still contrast inflow being visible within the superior vena cava was defined as TIC.Results3 patients were excluded due to incorrect bolus tracking. Final analysis was performed in 222 patients (mean age 65 ± 19 years, range 18 to 99 years). Mean density in the pulmonary trunk was 275±17 HU, in the aorta 208 ± 15 HU. Mean aorto-pulmonary ratio was 0.81± 0.29. 48 patients (21.6%) had an aorto-pulmonary ratio >1. Correlation of mean aorto-pulmonary ratio and age was: -0.213 (p = 0.001). Age was not significantly different for an aorto-pulmonary ratio >1 vs. ≤1 (p = 0.122). Both in M1 and M2, 33/222 patients presented with absolute HU values of < 200 HU within the pulmonary artery. In M1 measurements, 24 of these 33 patients (72%) fulfilled TIC criteria (M2: 25/33 patients (75%)).ConclusionsTIC is a common phenomenon in CTPA studies with inspiratory breath-hold commands after patients were told to inspire gently with an incidence of 22% in our retrospective cohort. Occurrence of TIC shows a significant negative correlation with increasing age and disproportionately often occurs in patients with lower absolute contrast density values within their pulmonary arteries.

BACKGROUND:Clinical trials are most informative for evidence-based decision-making when they consistently measure and report outcomes of relevance to stakeholders, especially patients, clinicians, and policy makers. However, sometimes terminology used is interpreted differently by different stakeholders, which might lead to confusion during shared decision making. The construct dialysis adequacy is frequently used, suggesting it is an important outcome both for health care professionals as for patients. OBJECTIVE:To assess the scope and consistency of the construct dialysis adequacy as reported in randomised controlled trials in hemodialysis, and evaluate whether these align to the insights and understanding of this construct by patients. METHODS:To assess scope and consistency of dialysis adequacy by professionals, we performed a systematic review searching the Cochrane Central Register of Controlled Trials (CENTRAL) up to July 2017. We identified all randomised controlled trails (RCT) including patients on hemodialysis and reporting dialysis adequacy, adequacy or adequacy of dialysis and extracted and classified all reported outcomes. To explore interpretation and meaning of the construct of adequacy by patients, we conducted 11 semi-structured interviews with HD patients using thematic analysis. Belgian registration number B670201731001. FINDINGS:From the 31 included trials, we extracted and classified 98 outcome measures defined by the authors as adequacy of dialysis, of which 94 (95%) were biochemical, 3 (3%) non-biochemical surrogate and 2 (2%) patient-relevant. The three most commonly reported measures were all biochemical. None of the studies defined adequacy of dialysis as a patient relevant outcome such as survival or quality of life. Patients had a substantially different understanding of the construct dialysis adequacy than the biochemical interpretation reported in the literature. Being alive, time spent while being on dialysis, fatigue and friendliness of staff were the most prominent themes that patients linked to the construct of dialysis adequacy. CONCLUSION:Adequacy of dialysis as reported in the literature refers to biochemical outcome measures, most of which are not related with patient relevant outcomes. For patients, adequate dialysis is a dialysis that enables them to spend as much quality time in their life as possible.

Total above-ground biomass at harvest and ear density are two important traits that characterize wheat genotypes. Two experiments were carried out in two different sites where several genotypes were grown under contrasted irrigation and nitrogen treatments. A high spatial resolution RGB camera was used to capture the residual stems standing straight after the cutting by the combine machine during harvest. It provided a ground spatial resolution better than 0.2 mm. A Faster Regional Convolutional Neural Network (Faster-RCNN) deep-learning model was first trained to identify the stems cross section. Results showed that the identification provided precision and recall close to 95%. Further, the balance between precision and recall allowed getting accurate estimates of the stem density with a relative RMSE close to 7% and robustness across the two experimental sites. The estimated stem density was also compared with the ear density measured in the field with traditional methods. A very high correlation was found with almost no bias, indicating that the stem density could be a good proxy of the ear density. The heritability/repeatability evaluated over 16 genotypes in one of the two experiments was slightly higher (80%) than that of the ear density (78%). The diameter of each stem was computed from the profile of gray values in the extracts of the stem cross section. Results show that the stem diameters follow a gamma distribution over each microplot with an average diameter close to 2.0 mm. Finally, the biovolume computed as the product of the average stem diameter, the stem density, and plant height is closely related to the above-ground biomass at harvest with a relative RMSE of 6%. Possible limitations of the findings and future applications are finally discussed.

By assuming the endoscopic classification of automorphic representations on inner forms of unitary groups, which is currently work in progress by Kaletha, Minguez, Shin, and White, we bound the growth of cohomology in congruence towers of locally symmetric spaces associated to $U(n,1)$. In the case of lattices arising from Hermitian forms, we expect that the growth exponents we obtain are sharp in all degrees.

Three identical two-level atoms in free space prepared in particular entangled single-photon excited states display a “birth,” “death,” and a nonperiodic “revival” of spontaneous emission in selected directions. Instead of recording the spontaneously emitted photon with a maximum probability at t=0 as for a single atom, a “birth” manifests itself in an initially zero photon detection probability, increasing thereafter in particular directions. Alternatively, the photon detection probability decreases in particular directions from an initially maximal value to completely disappear (“death”) and to reappear again (“revival”). We show how these phenomena can be induced in the fully excited system, by projecting the atomic ensemble into the required entangled single-photon excited state via detection of the first two spontaneously emitted photons. To observe death and revival of spontaneous emission it is necessary to provide both spatial and temporal interference for which a minimum of three atoms is required. Hereby, the third atom, located at a large distance with respect to the other two atoms, can be used to tune the time and direction of the death of the photon. From this manipulation of spontaneous decay at a distance, we anticipate multiple applications, in fundamental science as well as in quantum technologies.

Background: Gaming disorder (GD) has been shown to co-occur with attention deficit hyperactivity disorder (ADHD), yet few studies to date have investigated their longitudinal associations.Method: The sample included 5,067 young Swiss men (mean age was 20 years at wave 1 and 25 years at wave 3). Measures were the Game Addiction Scale and the Adult ADHD Self-Report Scale (6-item screener). Longitudinal associations were tested using autoregressive cross-lagged models for binary measures of GD and ADHD, as well as continuous measures for GD score and ADHD subscales of inattention and hyperactivity.Results: ADHD at age 20 increased the risk for GD at age 25 (probit = 0.066 [0.023, 0.109]; p = 0.003). GD at age 20 also increased the risk for ADHD at wave 3 (probit = 0.058 [0.013, 0.102]; p = 0.011). Only the ADHD inattention subscale showed a bidirectional longitudinal relationship with the GD score (standardized Beta from inattention at age 20 to GD score at age 25: 0.090 [0.056, 0.124]; p < 0.001; from GD score at age 20 to inattention at age 25: 0.044 [0.016, 0.071]; p = 0.002), whereas associations between the hyperactivity subscale and GD were not significant.Discussion: GD had bidirectional longitudinal associations with ADHD, in that ADHD increased the risk for GD and GD increased the risk for ADHD, and they may reinforce each other. These associations may be linked more to the inattention ADHD component than to the hyperactivity ADHD component. Individuals with ADHD or GD should be screened for the other disorder, and preventive measures for GD should be evaluated in individuals with ADHD.