Search

These case studies explore the subjective visual experiences of individuals with cerebral visual impairment (CVI), specifically dorsal stream dysfunction (DSD) characterized by simultanagnosia. Through three in-depth case studies, this work documents the challenges these individuals face when navigating cluttered environments. The individuals were asked to describe their visual experiences while watching videos of varying complexity, with the future aim of creating a simulation of simultanagnosia. This process revealed a dynamic constriction of their attentional visual fields as scene complexity increased, and vice versa. Notably, the volunteers experienced a phenomenon where their vision could “get stuck” on specific items, with an apparent concurrent reduction in their ability to perceive and describe visual information as visual clutter increased. These consistent observations indicate that the symptoms of simultanagnosia are not simply limited to perceiving one or two objects at a time but can vary dynamically in response to environmental complexity. They enhance our understanding of how DSD impacts visual search and perceptual experiences, prompting us to propose the term “simultanagnostic vision” to describe this more nuanced and dynamic manifestation of CVI. The results are critical for developing effective interventions and optimizing support strategies for individuals affected by DSD, particularly children at sensitive developmental stages. Furthermore, we recommend deeper investigation into how different visual processing streams in the brain interconnect and influence each other, which may open new avenues for targeted therapeutic interventions.

Background: Post-traumatic stress disorder (PTSD) is characterised by pervasive and persistent symptoms that negatively impact quality-of-life. A relationship between brain-derived neurotrophic factor (BDNF) and PTSD symptom severity has been investigated with mixed results. This study aimed to systematically investigate BDNF and PTSD symptom severity in a PTSD cohort (n = 43). Methods: BDNF levels were determined from both serum and plasma using two BDNF assays (targeting general BDNF and mature BDNF specifically). BDNF levels were compared to PTSD symptom severity scores determined by clinical interview using the Clinician-Administered PTSD Scale (CAPS-5) for DSM-5 and the self-rated Posttraumatic Stress Disorder checklist (PCL-5) for DSM-5. Results: Only mature BDNF levels from serum revealed a significant negative correlation to both CAPS-5 and PCL-5 scores. Additionally, when the study cohort was defined by the CAPS-5 criteria for PTSD, the BDNF to symptom severity correlation was stronger than when the cohort was defined by the PCL-5 criteria. Limitations: This study acknowledges that limited numbers of PTSD participants with complex co-morbidities and multiple test comparisons requires caution in overinterpretation of results. Conclusions: Overall, this study found that decreasing levels of mature BDNF from serum was associated with increasing symptom severity and that the type of sample, the specificity of the BDNF assay and the PTSD evaluation method all impacted whether a relationship between BDNF and PTSD symptom severity could be detected.

BackgroundChronic lymphocytic leukaemia (CLL) typically presents with asymptomatic, early-stage disease that is monitored until disease progression (‘treatment-naïve’ CLL). The objective of this pilot study was to assess the feasibility and preliminary safety of an exercise program in treatment-naïve CLL. We also sought to preliminarily assess the impact of the exercise program on disease activity, as it has been proposed that exercise training may reduce disease outgrowth in treatment-naïve CLL.MethodsA total of 40 treatment-naïve CLL patients were recruited into this randomised-controlled pilot study, and after screening, n = 28 were randomised into a 16-week, home-based, partially supervised, personalised, progressive exercise intervention (n = 14: mean ± SD: age = 62 ± 12 years) or 16 weeks of usual care, control group (n = 14: mean ± SD: age = 61 ± 10 years). The primary outcome measures were safety (number and severity of adverse events) and feasibility (uptake, retention, and adherence to the trial). Disease activity (CD5+/CD19+ CLL cells clonally restricted to kappa or lambda) and other immune cell phenotypes, with a principal focus on T cells, were measured by flow cytometry. Other secondary outcomes included DEXA-derived body composition, cardiorespiratory and functional fitness, resting cardiovascular measures.ResultsTrial uptake was 40%, and the overall retention rate was 86%, with 79% of the exercise group and 93% of the control group completing the trial. Adherence to the exercise intervention was 92 ± 8%. One serious adverse event was reported unrelated to the trial, and one adverse event related to the trial was reported. The exercise intervention elicited a 2% increase in DEXA-derived lean mass in the exercise group compared with a 0.4% decrease in the control group (p = 0.01). No between-group differences were observed over time for whole-body mass, BMI, bone mineral density, body fat, blood pressure resting heart rate, or measures of cardiorespiratory or functional fitness (all p > 0.05). No between-group differences were observed over time for clonal CLL cells and CD4+ or CD8+ T-cell subsets (all p > 0.05).ConclusionThe exercise training program used in this study was feasible in people with treatment-naïve CLL who passed pre-trial screening, and we preliminarily conclude that the exercise training program was safe and also resulted in an increase in lean mass.Clinical trial registrationhttps://doi.org/10.1186/ISRCTN55166064, identifier ISRCTN 55166064.

AbstractThe INSITE (In-School Initial Teacher Education) executive mentoring and coaching program seeks to combine the key influencing factors (as identified within the research literature) for successful transition into, and retention in, the teaching profession. The program provides support that begins at the commencement of an Initial Teacher Education (ITE) degree and continues into the first five years of teaching. The program design is underpinned by the Jobs Demand-Resources model that identifies the provision of job resources as positively influencing worker’s assimilation into an organisation. The INSITE program provides a wide range of job resources to enable personal development, mitigate physiological and psychological costs, and ease stress inducing job demands. Our results report on Year 1 of a longitudinal study and are derived from case study data from social labs and interviews conducted with the first cohort of participant’s enrolled in a postgraduate ITE degree. We found a positive relationship between the provision of job resources and intention to complete ITE training. Whilst results cannot be generalised, they add to the growing body of literature investigating the significance of a mentoring framework to support the transition of mid-career professionals into teaching.

We critically examine how biological narratives of mental illness mediate relations between personal experiences and socio-structural conditions of distress in crisis contexts. Using three case studies of contemporary crises in Russia, the Republic of Cameroon, and Bangladesh, we showcase the ways in which biological meanings of mental illness carry political and structural significance as authorities employ “biologization” for political ends. In Russia, biologization is strategically useful to authorities seeking to control a populace, as chronic “conditions” can be “treated” indefinitely. In Cameroon, state psychiatrists in Yaoundé incentivize patient citizenship through biological frameworks of illness and intervention. In Bangladesh, the embodied presence of Rohingya refugees is a medium by which they can engage politically; therapeutic intervention becomes a site of political consensus in which Rohingya enact a “fictive biological citizenship.” Biologization of mental illness forms a basis for reinforcing or challenging the power of the state and the meaning of citizenship in distinct ways across these three contexts, highlighting the importance of attending to its political implications as it is invoked in frameworks of diagnosis, explanation, prognosis, and treatment in global contexts of ostensible crisis.

The importance of programs that develop the thinking skills of students has been emphasized by many educational researchers. However, the majority of these studies have focused on developing these skills of gifted students and of students in public schools. Few have focused on developing and strengthening such skills in students with learning disabilities. Thus, we aimed to a test a program that elevates thinking skills using a sample who have learning disabilities. A quasi-experimental design was employed with 20 female sixth-grade students with learning disabilities who were divided into an experimental group (n = 10) and a control group (n = 10). The instruments utilized were the Torrance Tests of Creative Thinking (TTCT)-Figural Test B and a training program based on active learning strategies (e.g. discussion, dialogue, brain-storming, mind-mapping) comprising 18 training sessions over 6 weeks. Differences (

ABSTRACT Introduction Subanesthetic doses of ketamine are a promising novel treatment for suicidality; however, the evidence for predictive biomarkers is sparse. Recently, measures of complexity, including Lempel–Ziv complexity (LZC) and multiscale entropy (MSE), have been implicated in ketamine's therapeutic action. We evaluated electroencephalogram (EEG)‐derived LZC and MSE differences between responders and nonresponders to oral ketamine treatment. Methods A total of 31 participants received six single, weekly (titrated) doses of oral racemic ketamine (0.5–3 mg/kg) and underwent EEG scans at baseline (Week 0), post‐treatment (Week 6), and follow‐up (Week 10). Resting‐state (eyes closed and open) recordings were processed in EEGLAB, and complexity metrics were extracted using the Neurokit2 package. Participants were designated responders or nonresponders by clinical response (Beck Suicide Scale [BSS] score reduction of ≥ 50% from baseline to the respective timepoint or score ≤ 6) and then compared in terms of complexity across resting‐state conditions and time. Results Employing a Bayesian mixed effects model, we found strong evidence that LZC was higher in the eyes‐open compared to eyes‐closed condition, as were MSE scales 1–3. At a global level, responders displayed elevated eyes‐open baseline complexity compared to nonresponders, with these values decreasing from baseline to post‐treatment (Week 6) in responders only. Exploratory analyses revealed that the elevated baseline eyes‐open LZC in responders was spatially localized to the left frontal lobe (F1, AF3, FC1, and F3). Conclusion EEG‐complexity metrics may be sensitive biomarkers for evaluating and predicting oral ketamine treatment response, with the left prefrontal cortex bein a possible treatment response region.

Cerebral visual impairment (CVI) is increasingly being recognized as a significant cause of visual difficulties in children, particularly those with typical visual acuity, who nonetheless struggle in educational settings. This narrative review aims to elucidate the nature and impact of visual perceptual difficulties (VPD) associated with CVI in school-aged children, who often remain undiagnosed due to the current erroneous focus on visual acuity as a required diagnostic criterion for CVI. The review synthesizes findings from recent studies, highlighting that up to 3.4% of children in mainstream schools and a higher percentage in special educational settings may experience VPD, which significantly impacts upon their learning and development. The manifestations of VPDs, such as difficulties in motion perception, recognition, and visuospatial processing, are often subtle and can thus be overlooked, leading to misconceptions about the origins of the affected child’s abilities and behaviors. The review also discusses the challenges in current diagnostic processes, emphasizing the need for comprehensive history taking and assessments that go beyond standard visual acuity tests. It proposes a multi-faceted approach to identification and support, incorporating both clinical assessments and teacher/parental observations, to better address the needs of affected children. Furthermore, this paper advocates for the inclusion of VPDs in the International Classification of Diseases (ICD 11) to ensure children with these visual issues receive appropriate educational support. By integrating lived experiences of individuals with CVI and the latest research findings, this review underscores the urgent need for awareness and tailored educational strategies designed to support children with VPDs. The findings suggest that without such recognition and intervention, many children with VPDs will continue to “hide in plain sight,” facing unnecessary challenges in their educational and social development. The review concludes with recommendations for policy changes and future research directions to improve the identification, classification, and support of children with VPDs within the educational system.

The organic carbon (Corg) stored in seagrass meadows is globally significant and could be relevant in strategies to mitigate increasing CO2 concentration in the atmosphere. Most of that stored Corg is in the soils that underlie the seagrasses. We explored how seagrass and soil characteristics vary among seagrass meadows across the geographic range of turtlegrass (Thalassia testudinum) with a goal of illuminating the processes controlling soil organic carbon (Corg) storage spanning 23° of latitude. Seagrass abundance (percent cover, biomass, and canopy height) varied by over an order of magnitude across sites, and we found high variability in soil characteristics, with Corg ranging from 0.08 to 12.59% dry weight. Seagrass abundance was a good predictor of the Corg stocks in surficial soils, and the relative importance of seagrass-derived soil Corg increased as abundance increased. These relationships suggest that first-order estimates of surficial soil Corg stocks can be made by measuring seagrass abundance and applying a linear transfer function. The relative availability of the nutrients N and P to support plant growth was also correlated with soil Corg stocks. Stocks were lower at N-limited sites than at P-limited ones, but the importance of seagrass-derived organic matter to soil Corg stocks was not a function of nutrient limitation status. This finding seemed at odds with our observation that labile standard substrates decomposed more slowly at N-limited than at P-limited sites, since even though decomposition rates were 55% lower at N-limited sites, less Corg was accumulating in the soils. The dependence of Corg stocks and decomposition rates on nutrient availability suggests that eutrophication is likely to exert a strong influence on carbon storage in seagrass meadows.

Bacterial-fungal interactions (BFIs) can shape the structure of microbial communities, but the small molecules mediating these BFIs are often understudied. We explored various optimization steps for our microbial culture and chemical extraction protocols for bacterial-fungal co-cultures, and liquid chromatography-tandem mass spectrometry (LC-MS/MS) revealed that metabolomic profiles are mainly comprised of fungi derived features, indicating that fungi are the key contributors to small molecules in BFIs. LC-inductively coupled plasma MS (LC-ICP-MS) and MS/MS based dereplication using database searching revealed the presence of several known fungal specialized metabolites and structurally related analogues in these extracts, including siderophores such as desferrichrome, desferricoprogen, and palmitoylcoprogen. Among these analogues, a novel putative coprogen analogue possessing a terminal carboxylic acid motif was identified from Scopulariopsis sp. JB370, a common cheese rind fungus, and its structure was elucidated via MS/MS fragmentation. Based on these findings, filamentous fungal species appear to be capable of producing multiple siderophores with potentially different biological roles (i.e. various affinities for different forms of iron). These findings highlight that fungal species are important contributors to microbiomes via their production of abundant specialized metabolites and that elucidating their role in complex communities should continue to be a priority.

We recently discovered that some bacteriophages establish a nucleus-like replication compartment (phage nucleus), but the core genes that define nucleus-based phage replication and their phylogenetic distribution were still to be determined. Here, we show that phages encoding the major phage nucleus protein chimallin share 72 conserved genes encoded within seven gene blocks. Of these, 21 core genes are unique to nucleus-forming phage, and all but one of these genes encode proteins of unknown function. We propose that these phages comprise a novel viral family we term Chimalliviridae. Fluorescence microscopy and cryoelectron tomography studies of Erwinia phage vB_EamM_RAY confirm that many of the key steps of nucleus-based replication are conserved among diverse chimalliviruses and reveal variations on this replication mechanism. This work expands our understanding of phage nucleus and PhuZ spindle diversity and function, providing a roadmap for identifying key mechanisms underlying nucleus-based phage replication.

The purpose of this work is to provide empirical evidence as to how state level Freedom of Information or Access to Information and data protection regulator bodies in Mexico carry out their training tasks. We use different theoretical assumptions, particularly those that refer to the idea of "training in the public sector" regarding two aspects that allow to account, at least in part, about the referred training practices: first, the pedagogical model they declared to use; and second, the evaluations regarding trained public officials. FOI/ATI and regulator bodies in Mexico have a legal obligation to train and carry out professional development for public officials. This responsibility associated, with performance management--along with other purposes--and to guarantee the human right to information and data privacy for individuals, is in the hands of public officials that must have not only knowledge and skills but also values and attitudes regarding this fundamental right. These public authorities have several challenges to comply with ATI and data privacy laws; some relate to responding public information requests--that is, in a timely and adequate manner--or publishing the information mandate by law. ATI regulator bodies mitigate these multi-casual issues through training or development courses. Currently, public officials are trained to comply with the law and its implementation in the best possible way. Our main finding is that the local regulator bodies overall comply with their legal training mandate. That is, they do have and carry out training programs, although in an unprofessional and potentially deficient manner.

Abstract Background Anaemia during pregnancy is common worldwide. In Australia, approximately 17% of non-pregnant women of reproductive age have anaemia, increasing to a rate of 25% in pregnant women. This study sought to determine the rate of screening for anaemia in pregnancy in regional New South Wales, and to determine whether screening and treatment protocols followed the recommended guidelines. Methods This retrospective study reviewed antenatal and postnatal (48 h) data of women (n = 150) who had a live birth at Bathurst Hospital between 01/01/2020 and 30/04/2020. Demographic data, risk factors for anaemia in pregnancy, antenatal bloods, treatments provided in trimesters one (T1), two (T2) and three (T3), and postpartum complications were recorded. These were compared to the Australian Red Cross Guidelines (ARCG) using descriptive statistics. Results Of the women with screening data available (n = 103), they were mostly aged 20-35yrs (79.6%), 23.3% were obese, 97.1% were iron deficient, 17% were anaemic and only a few (5.3%) completed the full pregnancy screening as recommended by the ARCG while a majority completed only partial screenings specifically Hb levels in T1 (56.7%), T2 (44.7%) and T3 (36.6%). Compliance to oral iron was largely undocumented, but constipation was a common side effect among the women. IV iron was administered in 14.0% of women, approximately 1.75x higher than the recommended rate. Conclusions This study provided useful information about compliance to screening and treatment guidelines for anaemia in pregnancy. We identified the need for improved documentation and communication between various health providers to ensure adequate antenatal care to prevent maternal complications during pregnancy. This will improve patient care and encourage further developments in maternal care, bridging the rural health gap.

Abstract Non-neovascular or dry age-related macular degeneration (AMD) is a multi-factorial disease with degeneration of the aging retinal-pigmented epithelium (RPE). Lysosomes play a crucial role in RPE health via phagocytosis and autophagy, which are regulated by transcription factor EB/E3 (TFEB/E3). Here, we find that increased AKT2 inhibits PGC-1α to downregulate SIRT5, which we identify as an AKT2 binding partner. Crosstalk between SIRT5 and AKT2 facilitates TFEB-dependent lysosomal function in the RPE. AKT2/SIRT5/TFEB pathway inhibition in the RPE induced lysosome/autophagy signaling abnormalities, disrupted mitochondrial function and induced release of debris contributing to drusen. Accordingly, AKT2 overexpression in the RPE caused a dry AMD-like phenotype in aging Akt2 KI mice, as evident from decline in retinal function. Importantly, we show that induced pluripotent stem cell-derived RPE encoding the major risk variant associated with AMD (complement factor H; CFH Y402H) express increased AKT2, impairing TFEB/TFE3-dependent lysosomal function. Collectively, these findings suggest that targeting the AKT2/SIRT5/TFEB pathway may be an effective therapy to delay the progression of dry AMD.

Nitrous oxide (N2O) is a long-lived potent greenhouse gas and stratospheric ozone-depleting substance that has been accumulating in the atmosphere since the preindustrial period. The mole fraction of atmospheric N2O has increased by nearly 25 % from 270 ppb (parts per billion) in 1750 to 336 ppb in 2022, with the fastest annual growth rate since 1980 of more than 1.3 ppb yr−1 in both 2020 and 2021. According to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC AR6), the relative contribution of N2O to the total enhanced effective radiative forcing of greenhouse gases was 6.4 % for 1750–2022. As a core component of our global greenhouse gas assessments coordinated by the Global Carbon Project (GCP), our global N2O budget incorporates both natural and anthropogenic sources and sinks and accounts for the interactions between nitrogen additions and the biogeochemical processes that control N2O emissions. We use bottom-up (BU: inventory, statistical extrapolation of flux measurements, and process-based land and ocean modeling) and top-down (TD: atmospheric measurement-based inversion) approaches. We provide a comprehensive quantification of global N2O sources and sinks in 21 natural and anthropogenic categories in 18 regions between 1980 and 2020. We estimate that total annual anthropogenic N2O emissions have increased 40 % (or 1.9 Tg N yr−1) in the past 4 decades (1980–2020). Direct agricultural emissions in 2020 (3.9 Tg N yr−1, best estimate) represent the large majority of anthropogenic emissions, followed by other direct anthropogenic sources, including fossil fuel and industry, waste and wastewater, and biomass burning (2.1 Tg N yr−1), and indirect anthropogenic sources (1.3 Tg N yr−1) . For the year 2020, our best estimate of total BU emissions for natural and anthropogenic sources was 18.5 (lower–upper bounds: 10.6–27.0) Tg N yr−1, close to our TD estimate of 17.0 (16.6–17.4) Tg N yr−1. For the 2010–2019 period, the annual BU decadal-average emissions for both natural and anthropogenic sources were 18.2 (10.6–25.9) Tg N yr−1 and TD emissions were 17.4 (15.8–19.20) Tg N yr−1. The once top emitter Europe has reduced its emissions by 31 % since the 1980s, while those of emerging economies have grown, making China the top emitter since the 2010s. The observed atmospheric N2O concentrations in recent years have exceeded projected levels under all scenarios in the Coupled Model Intercomparison Project Phase 6 (CMIP6), underscoring the importance of reducing anthropogenic N2O emissions. To evaluate mitigation efforts and contribute to the Global Stocktake of the United Nations Framework Convention on Climate Change, we propose the establishment of a global network for monitoring and modeling N2O from the surface through to the stratosphere. The data presented in this work can be downloaded from https://doi.org/10.18160/RQ8P-2Z4R (Tian et al., 2023).

Aims: Ankle fractures are common, mainly affecting adults aged 50 years and over. To aid recovery, some patients are referred to physiotherapy, but referral patterns vary, likely due to uncertainty about the effectiveness of this supervised rehabilitation approach. To inform clinical practice, this study will evaluate the effectiveness of supervised versus self-directed rehabilitation in improving ankle function for older adults with ankle fractures. Methods: This will be a multicentre, parallel-group, individually randomized controlled superiority trial. We aim to recruit 344 participants aged 50 years and older with an ankle fracture treated surgically or non-surgically from at least 20 NHS hospitals. Participants will be randomized 1:1 using a web-based service to supervised rehabilitation (four to six one-to-one physiotherapy sessions of tailored advice and prescribed home exercise over three months), or self-directed rehabilitation (provision of advice and exercise materials that participants will use to manage their recovery independently). The primary outcome is participant-reported ankle-related symptoms and function six months after randomization, measured by the Olerud and Molander Ankle Score. Secondary outcomes at two, four, and six months measure health-related quality of life, pain, physical function, self-efficacy, exercise adherence, complications, and resource use. Due to the nature of the interventions, participants and intervention providers will be unblinded to treatment allocation. Conclusion: This study will assess whether supervised rehabilitation is more effective than self-directed rehabilitation for adults aged 50 years and older after ankle fracture. The results will provide evidence to guide clinical practice. At the time of submission, the trial is currently completing recruitment, and follow-up will be completed in 2024. Cite this article: Bone Jt Open 2024;5(6):499–513.

Abstract A significant number of pregnancies are lost in the first trimester and 1–2% are ectopic pregnancies (EPs). Early pregnancy loss in general can cause significant morbidity with bleeding or infection, while EPs are the leading cause of maternal mortality in the first trimester. Symptoms of pregnancy loss and EP are very similar (including pain and bleeding); however, these symptoms are also common in live normally sited pregnancies (LNSP). To date, no biomarkers have been identified to differentiate LNSP from pregnancies that will not progress beyond early gestation (non-viable or EPs), defined together as combined adverse outcomes (CAO). In this study, we present a novel machine learning pipeline to create prediction models that identify a composite biomarker to differentiate LNSP from CAO in symptomatic women. This prospective cohort study included 370 participants. A single blood sample was prospectively collected from participants on first emergency presentation prior to final clinical diagnosis of pregnancy outcome: LNSP, miscarriage, pregnancy of unknown location (PUL) or tubal EP (tEP). Miscarriage, PUL and tEP were grouped together into a CAO group. Human chorionic gonadotrophin β (β-hCG) and progesterone concentrations were measured in plasma. Serum samples were subjected to untargeted metabolomic profiling. The cohort was randomly split into train and validation data sets, with the train data set subjected to variable selection. Nine metabolite signals were identified as key discriminators of LNSP versus CAO. Random forest models were constructed using stable metabolite signals alone, or in combination with plasma hormone concentrations and demographic data. When comparing LNSP with CAO, a model with stable metabolite signals only demonstrated a modest predictive accuracy (0.68), which was comparable to a model of β-hCG and progesterone (0.71). The best model for LNSP prediction comprised stable metabolite signals and hormone concentrations (accuracy = 0.79). In conclusion, serum metabolite levels and biochemical markers from a single blood sample possess modest predictive utility in differentiating LNSP from CAO pregnancies upon first presentation, which is improved by variable selection and combination using machine learning. A diagnostic test to confirm LNSP and thus exclude pregnancies affecting maternal morbidity and potentially life-threatening outcomes would be invaluable in emergency situations.

Objectives Deep Brain Stimulation (DBS) is an effective, yet underused therapy for people living with Parkinson’s disease (PD) in whom tremor, motor fluctuations and/or dyskinesia are not satisfactorily controlled by oral medical therapy. Fear of vascular complications related to the operative procedure remains a strong reason for both the referrer and patient reluctance. We review the incidence of vascular complications in the first 600 patients with Parkinson’s disease treated at our centre by a single neurologist/neurosurgical team.Methods Surgical data routinely collected for patients who underwent DBS implantation for the management of PD between the years 2001–2023 was retrospectively reviewed. Incidences of vascular complication were analysed in detail, examining causal factors.Results Including reimplantations, 600 consecutive DBS patients underwent implantation with 1222 DBS electrodes. Three patients (0.50%) experienced vascular complications.Conclusion This vascular complication rate is at the low end of that reported in the literature. Risk mitigation strategies discussed include a consistent neurosurgical team, dual methodology target and trajectory planning, control of cerebrospinal fluid egress during the procedure, use of a specialised microelectrode recording (MER)/macrostimulation electrode without an introducing brain cannula and low number of MER passes. A reduced vascular complication rate may improve the acceptability of DBS therapy for both patients and referrers.

IntroductionGreenness is considered to be a health-promoting feature of both natural and built environments and has the potential to influence mental health outcomes. However, most studies to date have neglected to address whether greenness differentially affects mental health outcomes for individuals across the socioeconomic spectrum. Our study explored if greenness is a moderating factor in the relationship between socioeconomic status (SES) and mental health using data from the Canadian Longitudinal Study on Aging (CLSA).MethodsA cross-sectional design was used to compare mental health outcomes between individuals with different levels of SES and residential greenness. We used self-rated social standing as a measure of SES and depression score measured using the Centre for Epidemiologic Studies 10-Item Depression Scale (CESD-10) as a measure of mental health. Greenness was measured using the annual maximum Normalized Difference Vegetation Index (NDVI) within a 1,000 m buffer area of participants' residential postal code locations.ResultsThere was a statistically significant moderating effect of greenness for the relationship between self-rated social standing and depression score. As greenness increased, individuals with lower self-rated social standing had the greatest decreases in depression score.DiscussionThe results of our study suggests that targeting greening interventions at individuals and communities with low SES may reduce depressive symptoms overall, as well as decrease socioeconomic inequalities in depression.

Objective and Approach Canada’s federated health data system along with access pathways geared toward academic research, pose challenges for knowledge Users (KUs) requiring timely, pan-Canadian evidence to inform decisions. To understand challenges and explore solutions, we conducted two use cases for a pan-Canadian health technology assessment organization and a federal agency, using health administrative data at one federal and six provincial data centres. The population-based cohort studies described socio-demographics, comorbidities, treatment patterns, service utilization and costs. One focused on spinal muscular atrophy, a rare disease and the other on dementia, a complex chronic disease. Results Administrative challenges included aligning varied ethical review and data access policies/procedures including requiring local and/or academic principal investigators and differing definitions of “research” vs. planning, evaluation, and monitoring. Data-related challenges included differences in structure, timeliness, and completeness across regions resulting in difficulty aligning constructs such as incident cases and episodes of care. Privacy requirements prohibited pooling jurisdictional estimates resulting in “small cells” that couldn’t be shared with KUs. Conclusions We provided analytic outputs from multiple regions, albeit with some differences and gaps, increasing knowledge around both diseases while developing capacity for combined analyses and gaining insight into national possibilities for data access. Implications As decision makers must rely on best available information, some data is better than none. However, to improve data-analytic services for Pan-Canadian KUs, next steps will include improving data harmonization, expanding data assets and filling data gaps, implementing common data models, and exploring options for federated and/or pooled analyses.

Abstract Aircraft observations of the four chloromethanes: carbon tetrachloride (CCl4), methyl chloride (CH3Cl), dichloromethane (CH2Cl2), and chloroform (CHCl3), collected over North America between 2000 and 2022, were used to evaluate their vertical distributions and temporal trends in the atmosphere. We examine the vertical profiles, from the surface to the lower stratosphere (LS), of these increasingly important contributors to ozone‐depleting chlorine in both altitude and potential temperature space. Airborne chloromethane trends were compared with those measured at long‐term, ground‐based monitoring stations. Below 20 km altitude, CCl4 trends were decreasing at all levels studied in the North American atmosphere (−1.1 ppt yr−1). CHCl3 and CH2Cl2 airborne observations were comparable to ground network measurements: CHCl3 increased between 2000 and 2018 and then decreased leading to a negligible trend over the 22 years studied and CH2Cl2 has been increasing at all levels in the troposphere (+2.41 ppt yr−1, 2000–2022,