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Background & Aims: The coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide, making the uptake of effective vaccines critical to saving lives. In Sierra Leone and Zimbabwe, two countries selected for focus in a privately funded project to boost COVID-19 vaccination coverage through interventions carried out by faith-based networks in Africa, both supply-and demand-side challenges have made high rates of vaccination difficult to achieve. The current study seeks to describe vaccination rates and reasons for vaccine hesitancy in both Sierra Leone and Zimbabwe. Methods: A cross-sectional survey was conducted face-to-face in Sierra Leone and Zimbabwe. This study uses frequency statistics and multivariate regression analysis to identify key demographic predictors of COVID-19 vaccination acceptance and to examine perceived COVID-19 infection vulnerability in both countries. The Health Belief Model was used as a framework for sorting and understanding findings. Results and Conclusions: Individuals who were older, from Zimbabwe, and were healthcare workers or community leaders were more likely to be vaccinated. Those who were from Zimbabwe, had secondary or tertiary education, and were community leaders were more likely to be concerned about catching COVID-19 than community members. Faith leaders were less likely to be concerned about catching COVID-19 in public. These findings add to our understanding of attitudes that lead to vaccine hesitancy and uptake.

Abstract Background Infection Prevention and Control (IPC) is critical in controlling the COVID-19 pandemic and is one of the pillars of the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to the COVID-19 pandemic in Cox's Bazar, Bangladesh, to identify best practices, challenges, and recommendations for improvement of the current and future responses. Methods We conducted two meetings with 54 participants purposively selected from different organizations and agencies involved in the frontline implementation of IPC in Cox's Bazar district, Bangladesh. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meeting notes and transcripts were then analyzed manually using content analysis, and results were presented in text and quotes. Results Best practices included: assessments, a response plan, a working group, trainings, early case identification and isolation, hand hygiene in Health Facilities (HFs), monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centers (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of availability of uniforms for health workers, in particular cultural and gender appropriate uniforms and Personal Protective Equipment (PPE). Recommendations from the IAR were: (1) to promote the institutionalization of IPC, programs in HFs (2) establishment of IPC monitoring mechanisms in all HCFs, (3) strengthening IPC education and training in health care facilities, and (4) strengthen public health and social measures in communities. Conclusion Establishing IPC programmes that include monitoring and continuous training are critical in promoting consistent and adaptive IPC practices. Response to a pandemic crisis combined with concurrent emergencies, such as protracted displacement of populations with many diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization, and close supervision.

INTRODUCTION: lack of knowledge of where to obtain correct family planning (FP) information and methods can be a critical barrier to eventual uptake of FP services. We assessed knowledge, sources and use of FP methods among women of reproductive age in rural Uganda. METHODS: this secondary analysis uses data from a larger cross-sectional study conducted to measure changes in perceptions towards long-term and reversible contraceptive use among 2,033 women of reproductive age (15-49years) resident in 34 districts of Uganda. Both users and non-users of FP methods were interviewed. Data were analyzed using STATA statistical software, version 12. RESULTS: majority of the women were less than 30 years of age (64.3%). Nearly three-quarters were married (73.1%), 51.1% had primary education and more than half (57%) were engaged in employment. Knowledge of FP methods was universal (98.1%). Clinic providers (60.4%), friends (56.9%) and the media (51.3%) were the most trusted sources of contraceptive information. Government (27.6%) and private (21.1%) health facilities were the main sources of modern FP methods. Sixty two per cent of women reported current use of any FP method. Among non-users of FP, injectables (50.4%), implants (22.8%) and pills (20.2%) were the most preferred FP methods. CONCLUSION: our findings show that knowledge of FP methods is almost universal and that six in ten women use any FP method. Clinic providers, friends and the media are the most trusted sources of FP information. Government and private health facilities are the main sources of FP services.

While multiple factors impact disease, artificial intelligence (AI) studies in medicine often use small, non-diverse patient cohorts due to data sharing and privacy issues. Federated learning (FL) has emerged as a solution, enabling training across hospitals without direct data sharing. Here, we present FL-PedBrain, an FL platform for pediatric posterior fossa brain tumors, and evaluate its performance on a diverse, realistic, multi-center cohort. Pediatric brain tumors were targeted due to the scarcity of such datasets, even in tertiary care hospitals. Our platform orchestrates federated training for joint tumor classification and segmentation across 19 international sites. FL-PedBrain exhibits less than a 1.5% decrease in classification and a 3% reduction in segmentation performance compared to centralized data training. FL boosts segmentation performance by 20 to 30% on three external, out-of-network sites. Finally, we explore the sources of data heterogeneity and examine FL robustness in real-world scenarios with data imbalances., (© 2024. The Author(s).)

Introduction: Cholera remains a substantial public health challenge in Somalia. Ongoing droughts in the country have caused significant outbreaks which have negatively affected the lives of many individuals and overwhelmed health facilities. We aimed to estimate the costs associated with cholera cases for households and health facilities in Somalia., Methods: This cost-of-illness study was conducted in five cholera treatment centres in Somalia and 400 patients treated in these facilities. Data collection took place during October and November 2023. Given that a significant portion of the patients were children, we interviewed their caregivers to gather cost data. We interviewed staff at the centres and the patients. The data obtained from the household questionnaire covered direct (medical and non-medical) and indirect (lost wages) costs, while direct costs were estimated for the health facility (personnel salaries, drugs and consumables used to treat a patient, and utility expenses). All costs were calculated in US dollars (USD), using 2023 as the base year for the estimation., Results: The average total cost of a cholera episode for a household was US$ 33.94 (2023 USD), with 50.4% (US$ 17.12) being direct costs and 49.6% (US$ 16.82) indirect costs. The average total cost for a health facility to treat an episode of cholera was US$ 82.65. The overall average cost to households and health facilities was US$ 116.59. The average length of stay for a patient was 3.08 days. In the households, patients aged 41 years and older incurred the highest mean total cost (US$ 73.90) while patients younger than 5 years had the lowest cost (US$ 21.02). Additionally, 61.8% of households had to use family savings to cover the cost of the cholera episode, while 14.5% had to borrow money. Most patients (71.8%) were younger than 16 years- 45.3% were 5 years or younger- and 94.0% had never received a cholera vaccine., Conclusion: Our study suggests that preventing one cholera episode in Somalia could avert substantial losses for both the households and cholera treatment centres. The findings shed light on the expenses associated with cholera that extend beyond healthcare, including substantial direct and indirect costs borne by households. Preventing cholera cases could lead to a decrease in this economic burden, consequently our study supports the need for preventive measures., (© 2024. The Author(s).)

Background: Several factors shape the neurodevelopmental trajectory. A key area of focus in neurodevelopmental research is to estimate the factors that have maximal influence on the brain and can tip the balance from typical to atypical development., Methods: Utilizing a dissimilarity maximization algorithm on the dynamic mode decomposition (DMD) of the resting state functional MRI data, we classified subjects from the cVEDA neurodevelopmental cohort ( n = 987, aged 6-23 years) into homogeneously patterned DMD (representing typical development in 809 subjects) and heterogeneously patterned DMD (indicative of atypical development in 178 subjects)., Results: Significant DMD differences were primarily identified in the default mode network (DMN) regions across these groups ( p < 0.05, Bonferroni corrected). While the groups were comparable in cognitive performance, the atypical group had more frequent exposure to adversities and faced higher abuses ( p < 0.05, Bonferroni corrected). Upon evaluating brain-behavior correlations, we found that correlation patterns between adversity and DMN dynamic modes exhibited age-dependent variations for atypical subjects, hinting at differential utilization of the DMN due to chronic adversities., Conclusion: Adversities (particularly abuse) maximally influence the DMN during neurodevelopment and lead to the failure in the development of a coherent DMN system. While DMN's integrity is preserved in typical development, the age-dependent variability in atypically developing individuals is contrasting. The flexibility of DMN might be a compensatory mechanism to protect an individual in an abusive environment. However, such adaptability might deprive the neural system of the faculties of normal functioning and may incur long-term effects on the psyche.

The relationship between the pharmaceutical companies and the healthcare profession, especially doctors, has always been fraught with conflicts of interest (COI). The publication of the influential The Diagnostic and Statistical Manual for Mental Disorders, Fifth edition, Text Revision (DSM-5-TR), by the American Psychiatric Society (APA) raised concerns that the financial relationships between pharma and members responsible for DSM could result in bias. This resulted in calls for stricter enforcement of controls on financial conflict of interest (FCOI) [1, 2], which could influence the formulation of diagnostic criteria (resulting in more people being "diagnosable as mentally ill"), creating a larger pool of "patients" who "need" pharmaceutical drugs. Knowingly or unknowingly, they would end up serving the pharmaceutical companies' agenda to sell more drugs and drive up profits [2] .

Background: Overweight/obesity is increasing leading to high rates of non-communicable diseases. The study aimed to assess the prevalence, knowledge and practices on prevention and management of overweight/obesity among adults in Dodoma region., Methodology: A cross- sectional research was conducted among 313 randomly selected adults aged 25-65 years. Face to face interviews were conducted to obtain demographic information, knowledge on preventing and managing overweight/obesity using a pre-tested questionnaire. Weight and height were measured following standard procedures and nutrition status was categorized using WHO criteria. Dietary intake was assessed using qualitative 24 hours recall to obtain dietary diversity score. Data was analyzed using the SPSS™ Version 20 to obtain descriptive and inferential statistics., Results: About 62.6% (n = 196) of the participants were females. The overall prevalence of overweight/obesity was 59.7% (n = 186) of which 28% (n = 88) were overweight and 31.3% (n = 98) obese. Obesity was three times higher among females (41.8% vs 13.7%) than males. Overweight/obesity was positively associated with female sex (Adjusted OR 2.34; 95%CI: 1.235-4.68; p = 0.001), low knowledge (Adjusted OR 2.15; 95%CI: 1.22-3.81; p = 0.008) and negatively associated with dietary diversity score (Adjusted OR 0. 452; 95%CI: 0.199-1.87; p = 0.03). About 76% of respondents reported that overweight/obesity is a result of consuming high energy (38.8%; n = 92) and high fat foods (27%; n = 63). More than half of the respondents reported to be insensitive with kind of foods they consume and for those who were sensitive, 64% do so to avoid diseases. Furthermore, 60% control their weight by doing physical exercises while 18% by both physical exercises and diet management. However, about 43% did not know foods exposing individuals to health problems., Conclusion and Recommendations: High prevalence of overweight/obesity was observed and significantly associated with female sex, low dietary diversity and knowledge on overweight/obesity prevention. This creates a need to improve knowledge on prevention of overweight/obesity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Msollo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims and Background: To describe the prevalence of IgA deposits (IgAD) in renal allografts in a cohort of renal transplant recipients and to analyze their management strategies and histopathology. To assess graft function and proteinuria after 1 year of follow-up., Materials and Methods: A prospective longitudinal follow-up study was carried out in VPS Lakeshore Hospital and Research Centre, Kochi, Kerala, over a period of 5 years (July 2015 to June 2020). Kidney transplant recipients with allograft biopsies that reported IgAD on immunofluorescence were included in the study. Light microscopy and immunofluorescence studies were performed. Mesangial hypercellularity (M); segmental glomerulosclerosis (S); endocapillary hypercellularity (E); tubular atrophy/interstitial fibrosis (T); crescents (C) (MEST-C) Scoring was done in patients with pathogenic IgAD. Treatment strategies included increased baseline steroid dosage, rituximab administration, and plasma exchange. Clinical details and management strategies were analyzed, and patients were followed up for 1 year after diagnosis. Changes in graft function (S. Creatinine) and proteinuria (Urine Protein/Creatinine ratio) were analyzed. Clinico-pathologic correlation with the MEST-C scores was also done., Results: Out of 1036 kidney transplants done in the study period, 760 graft biopsies were performed. Sixty-four cases had post-transplant deposition of IgA (8%). The mean age was 45 ± 11.25SD years. The study had 51 men and 13 women. Induction immunosuppression comprised rabbit antithymocyte globulin in 29 (45%) patients and basiliximab in 35 (54%). Maintenance immunosuppression in all comprised tacrolimus, mycophenolate mofetil, and steroids. There were 2 groups: group A (pathogenic IgAD) and group B (incidental IgAD). Group A had 46 cases (71.9%), out of which 8 had "active" IgA nephropathy (endocapillary proliferation, crescents, and IgA vasculitis), and 38 had "inactive" IgAD. In patients with active deposits, 3 had cellular crescents (18%, 30%, and 23%), all 8 had endocapillary proliferation, and 2 had vasculitis. Group B had 18 cases (28.1%), comprising T cell-mediated rejections (5), antibody-mediated rejection (8), BK virus nephropathy (1), and interstitial fibrosis and tubular atrophy (4). In group A, 22 (47.8%) presented with graft dysfunction, 8 (17.3%) with isolated proteinuria, and 14 (30.4%) patients presented with a combination. Two (4.3%) patients had neither. Fourteen (30.4%) patients presented within 1 month of renal transplant. In patients of group A, at the end of 1 year of treatment, the mean S. Creatinine reduced to 1.68 mg/dL from 1.84 mg/dL, and the mean protein/creatinine ratio reduced from 1.2 to 0.5 (±1.17). In patients with "active IgA" lesions, at the end of 1 year of treatment, the mean S. Creatinine increased slightly to 1.68 mg/dL (±0.47SD) from 1.48 mg/dL (±0.52SD), and the mean protein/creatinine ratio reduced from 2.32 (±1.56SD) to 1.05 (±1.70SD). In the 16 patients with IgAD and proteinuria, at the end of 1 year of treatment, the mean S. Creatinine decreased to 1.41 ± 0.32 SD mg/dL from 1.47±0.37SD mg/dL and the mean protein/creatinine ratio reduced from 1.12 ± 1.31 SD to 0.39±0.75 SD. In the remaining 22 patients with acute tubular injury, at the end of 1 year, the mean S. Creatinine decreased to 1.920.32 SD mg/dL from 2.10.8SD mg/dL, and the mean protein/creatinine ratio reduced from 1.1 ± 1.31 SD to 0.66 ± 1.45 SD. In the MEST-C scoring analysis, all scores were 0 in 20 (43.4%) biopsies, only M1 score in 11 (23.9%) biopsies, only E1 score in 10 biopsies (21.7%), S1 in 13 (28.2%) cases., Conclusion: Immunoglobulin A deposits occur commonly after transplant; these may represent recurrence, de novo IgA, or donor-derived IgAD. Although commonly benign, some may cause significant graft dysfunction and graft loss. IgAD can present as varying combinations of graft dysfunction and proteinuria. Active IgA pathologies may occur early in the post-transplant course, may have significant graft dysfunction, and need proactive management. There is a correlation between segmental sclerosis and proteinuria. Evidence for the efficacy of Rituximab, plasma exchange, and prolonged courses of steroids is wanting; however, some benefits are possible. Long-term follow-up is essential., Competing Interests: Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The relationship between tau deposition and cognitive decline in cognitively healthy older adults is still unclear. The tau PET tracer 18 F-MK-6240 has shown favorable imaging characteristics to identify early tau deposition in aging. We evaluated the relationship between in vivo tau levels ( 18 F-MK-6240) and retrospective cognitive change over 5 years in episodic memory, processing speed, and reasoning. For tau quantification, a set of regions of interest (ROIs) was selected a priori based on previous literature: (1) total-ROI comprising selected areas, (2) medial temporal lobe-ROI, and (3) lateral temporal lobe-ROI and cingulate/parietal lobe-ROI. Higher tau burden in most ROIs was associated with a steeper decline in memory and speed. There were no associations between tau and reasoning change. The novelty of this finding is that tau burden may affect not only episodic memory, a well-established finding but also processing speed. Our finding reinforces the notion that early tau deposition in areas related to Alzheimer's disease is associated with cognitive decline in cognitively unimpaired individuals, even in a sample with low amyloid-β pathology., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: To characterize the presentation, clinical course, and treatment of a series of children with leukemic optic neuropathy., Methods: Patients with leukemia who were treated at a tertiary children's hospital for optic nerve infiltration were included (n = 11). Demographic information, cancer history, ophthalmologic examination findings, treatment, and outcomes were retrospectively collected., Results: Mean age was 10.0 ± 4.8 years, and 63.6% were male and 36.4% were female. The most common underlying oncologic diagnosis was B-precursor acute lymphoblastic leukemia (n = 7, 63.6%). Notably, the majority presented with optic nerve infiltration during presumed remission (n = 9, 81.8%), but 2 patients (18.2%) presented with optic nerve infiltration at their initial leukemia diagnosis. Cerebrospinal fluid was positive for leukemic cells in 36.4% of patients. Magnetic resonance imaging demonstrated optic nerve enhancement and/or enlargement in only 8 patients (72.7%). In addition to other leukemia-directed treatment, 8 patients (72.7%) received emergent local radiation within 1.5 ± 1.2 days of initial ophthalmology examination., Conclusions: The largely negative cerebrospinal fluid results and variable magnetic resonance imaging findings in this study emphasize the importance of clinical context for this diagnosis. Clinicians should consider optic nerve infiltration in patients with leukemia and visual or ocular complaints, because urgent treatment is required to preserve vision and manage systemic disease. [ J Pediatr Ophthalmol Strabismus . 2024;61(1):67-72.] .

Competing Interests: The authors report no conflicts of interest.

Summer monsoon frontal rainfall in East Asia (EA) is crucial for water resources and flood hazards in densely populated areas. Recent studies have documented the increasing intensity of summer frontal rainfall over recent decades. However, the extent of ongoing climate change on the intensification of the EA frontal precipitation system remains uncertain. Using an objective method for detecting frontal systems, we found a 17 ± 3% increase in observed frontal rainfall intensity during 1958 to 2015. Climate model simulations with and without greenhouse gases suggest that anthropogenic warming plays a key role in the intensification of EA summer frontal precipitation by 5.8% from 1991 to 2015. The analysis highlights that enhanced water vapor convergence and reinforced western North Pacific subtropical High collectively increased moisture transport to the region, resulting in intensified EA frontal precipitation. The results lend support to the anthropogenic warming-induced enhancement of the EA frontal precipitation and its persistence in the future.

Human infants acquire language with notable ease compared to adults, but the neural basis of their remarkable brain plasticity for language remains little understood. Applying a scaling analysis of neural oscillations to address this question, we show that newborns' electrophysiological activity exhibits increased long-range temporal correlations after stimulation with speech, particularly in the prenatally heard language, indicating the early emergence of brain specialization for the native language.

The study of an Ischemic stroke infarction allows verifying how the lesion produces alterations in the neuronal networks resulting in cognitive deficits. It also allows the verification of adaptive and maladaptive cerebral reorganization related to the injury. In our previous fMRI study, we found that patients without ischemic vascular lesions in left inferior frontal gyrus showed an efficient compensation mechanism during the associative encoding of face name pairs, by the increased activation of ventrolateral and dorsolateral areas of contralesional hemisphere associated with better memory performance. While patients with ischemic vascular lesions on left inferior frontal gyrus (IFG) demonstrated worse memory performance and no signs of compensation mechanism. The present study explores more of these findings by analyzing perilesional and contralesional activations related to unfamiliar face name associative encoding in adults with chronic ischemic stroke, with or without left IFG lesion, compared to healthy controls. The main results showed that stroke survivors without lesions in IFG demonstrated increased activation in perilesional and contralesional prefrontal regions associated with better associative memory recognition, which are indicative of adaptive compensatory mechanisms. However, they also showed a negative correlation between the activation of right anterior prefrontal and inferior parietal regions and the associative memory performance, which may indicate the presence of maladaptive interhemispheric disinhibition. On the other hand, stroke survivors with IFG lesions demonstrated negative correlations in activations of the ipsilesional inferior parietal cortex and positive correlations in activations of the left middle frontal gyrus and left precentral cortex, which demonstrate the simultaneous occurrence of adaptive and maladaptive brain reorganization mechanisms in this group. However, the increase in perilesional prefrontal regions, associated with bilateral activation of the hippocampus and amygdala, was not enough to compensate for the inefficiency of associative memory performance. Finally, the differences in activation observed in stroke survivors reflect their clinical heterogeneity and demonstrate that adaptive or maladaptive compensatory mechanisms can coexist in the same group of patients. Furthermore, they reinforce the importance of the left IFG in the associative encoding of unfamiliar face name pairs and may suggest a deficit in associative memory related to injury in this region., (Copyright © 2023. Published by Elsevier Ltd.)

In this article, we analyze "digital massification" in smart cities, that is, an ever-growing number of market participants, consumers, and Internet of Things devices with simultaneous accommodation of users to increasing disturbances and inconveniences due to data congestion-as a driver for systemic risk. We argue that digital massification phenomena largely escape societal awareness due to their protracted evolution and are therefore still in the blind spot of long-term governance. Our analysis makes methodological use of historical and relational analogy, and we introduce and elaborate concepts and terms that allow us to discuss the evolutionary nature of massification, that is, the foreseeable increasing probability of the occurrence of trigger events. Using the analogy to the history of road traffic congestion, we deduce that digital massification will most likely lead to a future "risk transition" where tolerated disturbances and inconveniences of the present will turn into systemic impacts. This insight calls for heightened sensitivity in governance to massification phenomena to ensure the long-term resilience of smart cities., (© 2023 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

With the improvement of consumers' environmental awareness and the popularity of the Internet of Things, green smart home products (GSHPs) are becoming the dominant trend of future home life. This shift not only makes tedious home life easier and more convenient but also helps families save energy and reduce carbon emissions. However, given the impact of the current technological level, the proportion of users who actually purchase GSHPs remains small. Thus, seeking ways to promote the consumption of GSHPs has become an urgent issue. Hence, this study seeks to fill the gap in the existing research on green consumption behavior and obtain a full understanding of the factors influencing the purchase intention of GSHPs. To do so, this work uses task-technology fit theory and considers the actual situation of green smart home consumption to add social-technology fit into the original theoretical basis. In particular, this research focuses on middle- and high-end Chinese consumers who have experience in purchasing GSHPs. Moreover, it aims for an in-depth exploration of the formation mechanism of Chinese consumers' purchase intention for GSHPs through structural equation modeling. Using survey data collected from 331 green smart home product users in China, the study empirically examines the relationships among autonomy, environmental agility, sense of belonging, and self-actualization, and both task-technology fit and social-technology fit, which are expected to shape the purchase intention of GSHP users. The empirical results provide broad support for our hypotheses. The results of this study offer important contributions to the increasing research on GSHPs consumption and shed light on the importance of both technology characteristics and the needs of users in achieving both task-technology fit and social-technology fit and, ultimately enhancing the users' intention to purchase GSHPs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Guo and Xiao.)

Introduction: The Brazilian population in the United States (U.S.), a Latinx subgroup, is rapidly growing and aging but remains underrepresented in U.S. health research. In addition to group-specific genetic and environmental risks, Brazilian immigrants and their offspring in the U.S. likely have cumulative risks for health inequities.It is estimated that 71% of Brazilian immigrants in the U.S. are undocumented, which may limit healthcare access/utilization. Furthermore, mental health is reported as a health priority by Brazilian immigrants in the U.S., and there is a lack of research on Alzheimer's disease and related dementia (AD/ADRD) in this population., Methods: We reviewed the scientific literature using traditional (e.g., PubMed) sources and databases generated by U.S. and Brazilian governments, as well as international organizations, and press articles., Results: This perspective review lists recommendations for researchers, health providers, and policymakers to promote greater inclusion of U.S. Brazilian populations in health research and care. The review identifies research areas in need of attention to address health inequities and promote mental/brain health in Brazilian immigrants and their offspring living in the U.S. These research areas are: 1) epidemiological studies to map the prevalence and incidence of mental/brain health conditions; 2) research on aging and AD/ADRD risk factors among Brazilian populations in the U.S.; and 3) the need for greater representation of U.S-residing Brazilian population in other relevant research areas involving genetics, neuropathology, and clinical trials., Conclusions: The recommendation and research efforts proposed should help to pave the way for the development of community-engagement research and to promote mental/brain health education, improvement of mental/brain health and AD/ADRD services, and the development of culturally-informed intervention to the U.S.-residing Brazilian communities., Highlights: The Brazilian population in the United States is growing but is underrepresented in U.S. health research.Approximately 71% of Brazilian immigrants in the United States are undocumented, with an increased risk for health inequities.Mental health is reported as a central health priority by Brazilian immigrants in the United States.There is a lack of research on Alzheimer's disease and other dementias (ADRD) in Brazilian immigrants in the United States.Epidemiological research is needed to map the prevalence/incidence of mental health conditions and ADRD risk factors among Brazilian immigrants in the United States., Competing Interests: The authors have no competing interests to declare., (© 2023 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Importance: Arsenic, a contaminant of groundwater and irrigated crops, is a global public health hazard. Exposure to low levels of arsenic through food extends well beyond the areas with high arsenic content in water., Objective: To identify cognitive impairments following commonly prevalent low-level arsenic exposure and characterize their underlying brain mechanisms., Design, Setting, and Participants: This multicenter population-based cohort study analyzed cross-sectional data of the Indian Consortium on Vulnerability to Externalizing Disorders and Addictions (cVEDA) cohort, recruited between November 4, 2016, and May 4, 2019. Participants aged 6 to 23 years were characterized using deep phenotyping measures of behavior, neuropsychology, psychopathology, brain neuroimaging, and exposure to developmental adversities and environmental neurotoxins. All analyses were performed between June 1, 2020, and December 31, 2021., Exposure: Arsenic levels were measured in urine as an index of exposure., Main Outcomes and Measures: Executive function measured using the cVEDA neuropsychological battery, gray matter volume (GMV) from T1-weighted magnetic resonance imaging, and functional network connectivity measures from resting state functional magnetic resonance imaging., Results: A total of 1014 participants aged 6 to 23 years (589 male [58.1%]; mean [SD] age, 14.86 [4.79] years) were included from 5 geographic locations. Sparse-partial least squares analysis was used to describe a negative association of arsenic exposure with executive function (r = -0.12 [P = 5.4 × 10-4]), brain structure (r = -0.20 [P = 1.8 × 10-8]), and functional connectivity (within network, r = -0.12 [P = 7.5 × 10-4]; between network, r = -0.23 [P = 1.8 × 10-10]). Alterations in executive function were partially mediated by GMV (b = -0.004 [95% CI, -0.007 to -0.002]) and within-network functional connectivity (b = -0.004 [95% CI, -0.008 to -0.002]). Socioeconomic status and body mass index moderated the association between arsenic and GMV, such that the association was strongest in participants with lower socioeconomic status and body mass index., Conclusions and Relevance: The findings of this cross-sectional study suggest that low-level arsenic exposure was associated with alterations in executive functioning and underlying brain correlates. These results indicate potential detrimental consequences of arsenic exposure that are below the currently recommended guidelines and may extend beyond endemic risk areas. Precision medicine approaches to study global mental health vulnerabilities highlight widespread but potentially modifiable risk factors and a mechanistic understanding of the impact of low-level arsenic exposure on brain development.

Developmental adversities early in life are associated with later psychopathology. Clustering may be a useful approach to group multiple diverse risks together and study their relation with psychopathology. To generate risk clusters of children, adolescents, and young adults, based on adverse environmental exposure and developmental characteristics, and to examine the association of risk clusters with manifest psychopathology. Participants (n = 8300) between 6 and 23 years were recruited from seven sites in India. We administered questionnaires to elicit history of previous exposure to adverse childhood environments, family history of psychiatric disorders in first-degree relatives, and a range of antenatal and postnatal adversities. We used these variables to generate risk clusters. Mini-International Neuropsychiatric Interview-5 was administered to evaluate manifest psychopathology. Two-step cluster analysis revealed two clusters designated as high-risk cluster (HRC) and low-risk cluster (LRC), comprising 4197 (50.5%) and 4103 (49.5%) participants, respectively. HRC had higher frequencies of family history of mental illness, antenatal and neonatal risk factors, developmental delays, history of migration, and exposure to adverse childhood experiences than LRC. There were significantly higher risks of any psychiatric disorder [Relative Risk (RR) = 2.0, 95% CI 1.8-2.3], externalizing (RR = 4.8, 95% CI 3.6-6.4) and internalizing disorders (RR = 2.6, 95% CI 2.2-2.9), and suicidality (2.3, 95% CI 1.8-2.8) in HRC. Social-environmental and developmental factors could classify Indian children, adolescents and young adults into homogeneous clusters at high or low risk of psychopathology. These biopsychosocial determinants of mental health may have practice, policy and research implications for people in low- and middle-income countries.

With the growth of decentralized/federated analysis approaches in neuroimaging, the opportunities to study brain disorders using data from multiple sites has grown multi-fold. One such initiative is the Neuromark, a fully automated spatially constrained independent component analysis (ICA) that is used to link brain network abnormalities among different datasets, studies, and disorders while leveraging subject-specific networks. In this study, we implement the neuromark pipeline in COINSTAC, an open-source neuroimaging framework for collaborative/decentralized analysis. Decentralized exploratory analysis of nearly 2000 resting-state functional magnetic resonance imaging datasets collected at different sites across two cohorts and co-located in different countries was performed to study the resting brain functional network connectivity changes in adolescents who smoke and consume alcohol. Results showed hypoconnectivity across the majority of networks including sensory, default mode, and subcortical domains, more for alcohol than smoking, and decreased low frequency power. These findings suggest that global reduced synchronization is associated with both tobacco and alcohol use. This proof-of-concept work demonstrates the utility and incentives associated with large-scale decentralized collaborations spanning multiple sites., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Feedback is central to a quality medical and dental education in promoting self-directed learning and enhance progressive sharpening of trainees' skills, which are applicable in orthodontics. Hence, orthodontic educators must be conversant with the subject of feedback. There is insufficient information concerning this at the moment., Aim and Objectives: To determine the prevalence, quality, and barriers to feedback culture among Nigerian orthodontic educators., Design of the Study: Cross sectional., Setting: Nigerian orthodontists in training institutions., Materials and Methods: A descriptive study involving orthodontic educators in Nigeria, was done using a 26-item structured questionnaire distributed face-to-face or through google forms. Simple descriptive data analysis was done to address the study objectives., Results: Twenty-five orthodontic educators participated. Sixteen (60%) alluded to existence of a formal feedback culture in their centers, and 10, that is, 40% of the educators were comfortable giving feedback by themselves. Over half, 13, that is, 52% of the educators gave feedback as the need arises, and a few educators (18, 72%) rated the quality of feedback given as "good." In contrast, 11, that is, 44% of the educators always sought feedback from trainees, and 8, that is, 32% among them never sought feedback from colleagues. Feedback execution was preferred at different times including after teaching (10, 40%), after assessment (3, 12%), during practical (7, 28%), and on observations relating to attitude and professionalism (7, 28%). Feedback was mainly verbal and based on reports/observations. Time constraint was the barrier identified by the majority (13, 52%) of the participants., Conclusion: The scope and quality of feedback practice among orthodontic educators in Nigeria were inadequate. Time constraint was the most common barrier to feedback alluded to by the participants. There is a need to improve on feedback culture in orthodontics training in Nigeria., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of the West African College of Surgeons.)

Cognitive abilities are markers of brain development and psychopathology. Abilities, across executive, and social domains need better characterization over development, including factors that influence developmental change. This study is based on the cVEDA [Consortium on Vulnerability to Externalizing Disorders and Addictions] study, an Indian population based developmental cohort. Verbal working memory, visuo-spatial working memory, response inhibition, set-shifting, and social cognition (faux pas recognition and emotion recognition) were cross-sectionally assessed in > 8000 individuals over the ages 6-23 years. There was adequate representation across sex, urban-rural background, psychosocial risk (psychopathology, childhood adversity and wealth index, i.e. socio-economic status). Quantile regression was used to model developmental change. Age-based trajectories were generated, along with examination of the impact of determinants (sex, childhood adversity, and wealth index). Development in both executive and social cognitive abilities continued into adulthood. Maturation and stabilization occurred in increasing order of complexity, from working memory to inhibitory control to cognitive flexibility. Age related change was more pronounced for low quantiles in response inhibition (β∼4 versus  -1 versus -0.25 for lower quantiles). Wealth index had the largest influence on developmental change across cognitive abilities. Sex differences were prominent in response inhibition, set-shifting and emotion recognition. Childhood adversity had a negative influence on cognitive development. These findings add to the limited literature on patterns and determinants of cognitive development. They have implications for understanding developmental vulnerabilities in young persons, and the need for providing conducive socio-economic environments., Competing Interests: Conflict of interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To compare the incidence, aetiology, and patterns of maxillofacial fracture presentations during the various stages of the 2020 Melbourne COVID-19 lockdown restrictions to periods outside lockdown in 2019 and 2020., Methods: This is a retrospective study of 344 subjects. The patterns of facial trauma presentations to a tertiary hospital in metropolitan Melbourne during the 2020 COVID-19 restrictions were compared to periods with no restrictions over 22 months from March 2019 to December 2020., Results: The incidence of maxillofacial fractures decreased by 28% during lockdown (0.41 vs. 0.57 injuries/day, P = 0.0003). Falls overtook interpersonal violence as the leading cause of fractures (44% of lockdown presentations vs. 25.7% of presentations outside lockdown, P = 0.002), while sporting injuries dropped drastically (4% vs. 17.1%, P = 0.005). Lockdowns saw an increase in the proportion of female patients (40% vs. 26.8%, P = 0.03) and a fivefold increase in proportion of domestic violence-related fractures (6.7% vs. 1.1%, P = 0.006). Alcohol-related injuries decreased significantly (11% vs. 21%, P = 0.03)., Conclusions: While restrictions reduced rates of interpersonal violence and alcohol-related maxillofacial trauma, there was a higher proportion of injuries to females, increased falls, and domestic violence-related injuries., (© 2022. Crown.)

Objective: to analyze trends in mortality rates due to Alzheimer's disease in Brazil and its macro-regions by age and sex, from 2000 to 2019., Methods: this was a time-series study on mortality from Alzheimer's disease in Brazil and its macro-regions by age and sex; data were obtained from the Mortality Information System; a Prais-Winsten model was used to analyze trends., Results: there were 211,658 deaths in the period analyzed, with an increasing trend in Alzheimer's disease mortality in Brazil in elderly people aged 60-69 years (APC = 4.3; 95%CI 2.9;5.9), 70-79 years (APC = 8.1; 95%CI 4.8;11.5) and ≥ 80 years (APC = 11.3; 95%CI 8.1;14.6) and in all macro-regions, age groups and sexes., Conclusion: Brazil and all its macro-regions showed a rising trend in Alzheimer's disease mortality rates, following the global trend.

Mines are mostly located in the mountains and national forestlands in Taiwan. The development and use of mines have severely damaged the environment. Despite the long history of mining, the value of forest ecological services lost during mining operations have not yet been incorporated into the expenses borne by miners, and miners are not liable for compensation for ecological damage. This study evaluated the forest ecosystem service benefits lost since mining began, with the aim of providing future reference for calculating ecological damage related to mining. We investigated Mount Taibai mines in Yilan (northeast Taiwan) and Mount Yongshi mines in Hualian (east Taiwan), which are richly forested areas. According to Article 13 of the Mining Act in Taiwan, mining rights have a limitation of 20 years, and the two mines in this study have been in operation for 20 years. By using four ecological services-forest production, carbon sequestration, water resource replenishment, and forest recreation-we estimated the loss of ecological values in both mining regions. The result indicated that the loss of total forest production benefits over 20 years was 7,498.6 k New Taiwanese dollars (NTD) in Mount Taibai mines and 6,543.1 k NTD for Mount Yongshi mines, while the loss for the total carbon sequestration benefits over 20 years was 19,950 k NTD in Mount Taibai mines and 17,400 k NTD in Mount Yongshi mines. The loss of value for the total water conservation benefits over 20 years was 11,160 k NTD in Mount Taibai mines and 5,070 k NTD in Mount Yongshi mines. The loss value of forest recreation over 20 years was 1,443,855 k NTD for the two mines., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Effective teaching methods are important in psychiatry. Previous studies have focused on the assessment of students about the effective teaching methods but not on a self-assessment by teachers., Aims: Primary objective is to evaluate the teachers' and students' perspectives of effective teaching methods in psychiatry for medical undergraduates. Secondary objectives include assessment of the concordance of each item and exploring innovative teaching methods., Settings and Design: A cross-sectional study design used in teachers and medical students from St. John's Medical College, Bangalore (India)., Methods and Material: A modified teachers and medical students perspectives of effective psychiatry teaching methods were used., Statistical Analysis: Differences in continuous variable assessed with independent sample-test and categorical variables with Chi-square test. The Domain scores were divided into tertiles and the highest and lowest tertiles were analyzed., Results: Both students and teachers had high perspectives on most of the teaching methods. Differences were found in items such as " using multimedia slide effectively ," " good sense of humor while teaching ," " presentation summarizes the key points ," and " presentation links ideas effectively ." Role play-based and live/simulated patient-based teachings were reported most frequently by both. Significantly, a higher proportion of the 6 th term students and a lesser proportion of teachers were associated with the lowest tertiles for Domain 1, 2, and 3. Significantly, increased number of 8 th term students were found in the higher tertiles in Domain 3., Conclusions: These findings have practical implications in identifying the gaps in effective teaching methods by the teachers. Teachers can improve their teaching methods by upgrading their presentation skills, employing new and innovative teaching skills., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Psychiatry.)

Introduction: The often-cited mechanism linking brain-derived neurotrophic factor (BDNF) to cognitive health has received limited experimental study. There is evidence that cognitive training, physical exercise, and mindfulness meditation may improve cognition. Here, we investigated whether improvements in cognition after these three types of structured interventions are facilitated by increases in BDNF., Methods: A total of 144 heathy older adults completed a 5-week intervention involving working memory/cognitive training, physical exercise, mindfulness meditation, or an active control condition. Serum BDNF levels and Digit Symbol Test (DST) performance were measured pre- and post-intervention., Results: Linear mixed models suggested that only the cognitive training group demonstrated augmentation of BDNF and DST performance relative to the control condition. Path analysis revealed that changes in BDNF mediate intervention-related improvement in task performance. Regression analyses showed that, across all intervention conditions, increased BDNF levels were associated with increased DST scores., Discussion: This study appears to be the first to suggest that BDNF helps mediate improvements in cognition after working memory training in healthy older adults., Highlights: Older adults were randomized to physical activity, mindfulness, cognitive training (computerized cognitive training (CCT), or control.CCT, but no other condition, led to increased serum brain-derived neurotrophic factor (BDNF) levels.CCT led to improvement on the untrained Digit Symbol Test (DST) of speed/working memory.Path analysis: increases in BDNF mediate intervention-related improvement on DST.Increases in BDNF associated with improved DST across all experimental groups., Competing Interests: The authors of this manuscript have no activities or interests to disclose related to the content of this submission. Author disclosures are available in the supporting information., (© 2022 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania., Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus™ and diagnosed in accordance with the World Health Organization's criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured questions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model's performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science™., Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumference ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with gestational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96-0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46., Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population., (© 2022. The Author(s).)

Background and Objective: Neuro-ophthalmic manifestations of cancer are vast and early recognition of a serious ocular condition due to either cancer or its therapy is important for both vision preservation as well as providing valuable treatment and prognostic information regarding the underlying malignancy. This review focuses on direct and indirect effects of cancer on the eye and its adnexa, hematologic malignancy, complications of traditional and novel oncologic therapies, and paraneoplastic syndromes as they relate to the eye as these disorders can lead to potentially devastating or irreversible vision loss., Methods: PubMed was searched primarily for the following topics: optic nerve infiltration, primary vitreoretinal lymphoma (PVRL), ocular paraneoplastic disorders, and ophthalmic complications of cancer therapeutics. Literature was selected based on historical significance and landmark studies (e.g., Cross et al. series of paraneoplastic optic neuritis patients; Chan's textbook on primary intraocular lymphoma) as well as publications published after 2000. References from select studies were additionally included. Given the sparsity of literature on many subjects, most publications were included during this time frame in our review., Key Content and Findings: There are several ophthalmic entities that the oncologist should be aware of including leukemic optic nerve infiltration, PVRL, paraneoplastic syndromes as they related to the eye, and adverse effects of therapeutics. Unfortunately, given the rarity of some of these entities [e.g., paraneoplastic optic neuropathy (PON), cancer-associated retinopathy (CAR)], diagnosis can be difficult and treatment options are often limited., Conclusions: Oncologists can develop a set of basic ophthalmology examination skills that will help to triage and manage patient eye complaints. In certain instances, oncologists have the potential to avert devastating vision loss with early recognition of neuro-ophthalmic complications.

Competing Interests: The authors report no conflicts of interest.

Introduction: Severe internal carotid stenosis, if left untreated, can pose serious risks for ischemic stroke and cognitive impairments. The effects of revascularization on any aspects of cognition, however, are not well understood, as conflicting results are reported, which have mainly been centered on paper-based cognitive analyses. Here, we summarized and evaluated the publications to date of functional MRI (fMRI) studies that examined the mechanisms of functional brain activation and connectivity as a way to reflect cognitive effects of revascularization on patients with carotid stenosis., Methods: A PubMed and Google Scholar (covering the relevant literature until November 1, 2021) search yielded eight original studies of the research line, including seven resting-state and one task-based fMRI reports., Results: Findings demonstrated treatment-related alterations in fMRI signal intensity and symmetry level, regional fMRI activation pattern, and functional brain network connectivity. The functional brain changes were associated largely with improvement in cognitive function assessed using standard cognitive test scores., Conclusions: These findings support the contribution of fMRI to the understanding of brain functional activation and connectivity changes revealing cognitive effects of revascularization in the management of severe carotid stenosis. The review also highlighted the importance of reproducibility through enhancing experimental designs and cognitive task applications with future research for potential clinical translation., (© 2022 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Consensus on the cause of recent midlatitude circulation changes toward a wavier manner in the Northern Hemisphere has not been reached, albeit a number of studies collectively suggest that this phenomenon is driven by global warming and associated Arctic amplification. Here, through a fingerprint analysis of various global simulations and a tropical heating-imposed experiment, we suggest that the suppression of tropical convection along the Inter Tropical Convergence Zone induced by sea surface temperature (SST) cooling trends over the tropical Eastern Pacific contributed to the increased summertime midlatitude waviness in the past 40 years through the generation of a Rossby-wave-train propagating within the jet waveguide and the reduced north-south temperature gradient. This perspective indicates less of an influence from the Arctic amplification on the observed mid-latitude wave amplification than what was previously estimated. This study also emphasizes the need to better predict the tropical Pacific SST variability in order to project the summer jet waviness and consequent weather extremes., (© 2022. The Author(s).)

Climate warming in recent decades has negatively impacted forest health in the western United States. Here, we report on potential early warning signals (EWS) for drought-related mortality derived from measurements of tree-ring growth (ring width index; RWI) and carbon isotope discrimination (∆ 13 C), primarily focused on ponderosa pine (Pinus ponderosa). Sampling was conducted in the southern Sierra Nevada Mountains, near the epicenter of drought severity and mortality associated with the 2012-2015 California drought and concurrent outbreak of western pine beetle (Dendroctonus brevicomis). At this site, we found that widespread mortality was presaged by five decades of increasing sensitivity (i.e., increased explained variation) of both tree growth and ∆ 13 C to Palmer Drought Severity Index (PDSI). We hypothesized that increasing sensitivity of tree growth and ∆ 13 C to hydroclimate constitute EWS that indicate an increased likelihood of widespread forest mortality caused by direct and indirect effects of drought. We then tested these EWS in additional ponderosa pine-dominated forests that experienced varying mortality rates associated with the same California drought event. In general, drier sites showed increasing sensitivity of RWI to PDSI over the last century, as well as higher mortality following the California drought event compared to wetter sites. Two sites displayed evidence that thinning or fire events that reduced stand basal area effectively reversed the trend of increasing hydroclimate sensitivity. These comparisons indicate that reducing competition for soil water and/or decreasing bark beetle host tree density via forest management-particularly in drier regions-may buffer these forests against drought stress and associated mortality risk. EWS such as these could provide land managers more time to mitigate the extent or severity of forest mortality in advance of droughts. Substantial efforts at deploying additional dendrochronological research in concert with remote sensing and forest modeling will aid in forecasting of forest responses to continued climate warming., (© 2021 John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Objectives: The objective of this study was to determine the incidence of redrainage in odontogenic orofacial infections and evaluate possible risk factors. The investigators hypothesized that wait times to first surgery >48 hours and clinical risk factors may predispose patients to higher rates of redrainage., Study Design: Two hundred nineteen patients who underwent surgical drainage for odontogenic orofacial infections over an 8-year period were identified through Western Health electronic medical records. The primary outcome measure was the rate of redrainage. Secondary outcomes included total length of hospital stay and intensive care unit admission and length of stay. Stratified risk factors were analyzed using the Cochran-Mantel-Haenszel test to produce a total overall estimate risk ratio (forest plot)., Results: Of 219 patients, 16 (7.3%) required at least 1 return to theater for redrainage. First surgery wait times >48 hours, multispace infection, C-reactive protein ≥150, trismus, and immunosuppression were associated with a significantly increased risk of redrainage (88%; combined risk ratio = 1.88; 95% confidence interval, 1.31-2.69; P = .001)., Conclusions: To minimize the risk of redrainage, patients with orofacial infections requiring surgery should undergo surgery within 48 hours of presentation to hospital, particularly when presenting with an elevated C-reactive protein ≥150, trismus, immunosuppression, or multispace involvement., (Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.)

Wind energy producers need deployable devices for wind turbines that prevent bat fatalities. Based on the speculation that bats approach turbines after visually mistaking them for trees, we tested a potential light-based deterrence method. It is likely that the affected bats see ultraviolet (UV) light at low intensities. Here, we present the results of a multi-month experiment to cast dim, flickering UV light across wind turbine surfaces at night. Our objectives were to refine and test a practical system for dimly UV-illuminating turbines while testing whether the experimental UV treatment influenced the activity of bats, birds, and insects. We mounted upward-facing UV light arrays on turbines and used thermal-imaging cameras to quantify the presence and activity of night-flying animals. The results demonstrated that the turbines can be lit to the highest reaches of the blades with "invisible" UV light, and the animal responses to such experimental treatment can be concurrently monitored. The UV treatment did not significantly change nighttime bat, insect, or bird activity at the wind turbine. Our findings show how observing flying animals with thermal cameras at night can help test emerging technologies intended to variably affect their behaviors around wind turbines.

Background: Breast cancer (BC) is the most commonly diagnosed cancer and the second leading cause of cancer-related deaths among women in Africa after cervical cancer. Even if the epidemiological data are now aligned with those relating to industrialized countries, the knowledge concerning breast cancer in Africa, particularly in Western Africa, still lack clinical data, medical treatments, and the evaluation of genetic and non-genetic factors implicated in the etiology of the disease. The early onset and the aggressiveness of diagnosed breast cancers in patients of African ancestry strongly suggest that the genetic risk factor may be a key component, but so far, very few studies on the impact of germ line mutations in breast cancer in Africa have been conducted, with negative consequences on prevention, awareness and patient management. Through Next Generation sequencing (NGS), we analyzed all of the coding regions and the exon-intron junctions of BRCA1 and BRCA2 genes-the two most important genes in hereditary breast cancer-in fifty-one women from Burkina Faso with early onset of breast cancer with or without a family history., Results: We identified six different pathogenic mutations (three in BRCA1, three in BRCA2), two of which were recurrent in eight unrelated women. Furthermore, we identified, in four other patients, two variants of uncertain clinical significance (VUS) and two variants never previously described in literature, although one of them is present in the dbSNP database., Conclusions: This is the first study in which the entire coding sequence of BRCA genes has been analyzed through Next Generation Sequencing in Burkinabe young women with breast cancer. Our data support the importance of genetic risk factors in the etiology of breast cancer in this population and suggest the necessity to improve the genetic cancer risk assessment. Furthermore, the identification of the most frequent mutations of BRCA1 and BRCA2 in the population of Burkina Faso will allow the development of an inexpensive genetic test for the identification of subjects at high genetic cancer risk, which could be used to design personalized therapeutic protocols., (© 2021. The Author(s).)

Objective  This study assesses a new departmental role-a professionalism mentor-who receives sexual harassment reporting, liaisons with campus resources, and organizes educational sessions. Study Design  Multicenter randomized controlled survey study. Methods  Academic ophthalmology departments in the United States were randomized to a professionalism mentor group ( n  = 9) and a control group ( n  = 7). Among both pre- and postsurveys, 605 faculty and trainee responses were received and 546 were complete. The intervention group was assigned a professionalism mentor with educational session for a 6- to 10-month period. Sexual harassment and reporting rate change over time were compared between the two groups. Results  Among 546 anonymous responses, 16% experienced workplace sexual harassment during the prior 10 months. Location in the South or Midwest was a risk factor ( p  < 0.001). Victims were mostly women (76%), including residents/fellows (46%) and academic attendings (49%); perpetrators included patients (35%) and academic attendings (35%). Departments with and without a professionalism mentor had stable harassment from pre- to postsurvey ( p  = 0.95 comparing change). The professionalism mentor group had an increase in reporting to an authority from pre- to postsurvey (7-23%), whereas the control group had a decrease (27-12%; p  = 0.07 comparing change). Most faculty and trainees in the interventional arm of this study recommended instituting a professionalism mentor with educational session (66% presurvey and 68% postsurvey), compared with educational session alone (25% presurvey and 23% postsurvey), or neither (9% presurvey and 9% postsurvey). Residency program directors in the professionalism mentor group even more strongly supported instituting both a professionalism mentor and educational program (100% presurvey and 100% postsurvey) as opposed to educational program alone (0% presurvey and 0% postsurvey) or neither (0% presurvey and 0% postsurvey). Conclusion  This study identified a high sexual harassment rate in academic ophthalmology departments over a brief period. The presence of a professionalism mentor was viewed favorably and may lead to increased reporting., Competing Interests: Conflict of Interest None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Purpose of Review: Retinal disease can manifest with visual symptoms similar to those which result from central nervous system disorders. We provide a framework for considering retinal causes of common visual complaints presenting to a neurology clinic., Recent Findings: Technological advances have afforded quicker detection and a more thorough understanding of these retinal entities and are crucial to consider when evaluating visual complaints in the neurology clinic., Summary: It is essential to maintain a working knowledge of common retinal conditions that symptomatically overlap with common neurologic conditions. Furthermore, the ophthalmoscopic exam and retinal imaging modalities can both aid in the diagnosis and workup of visual complaints and neurologic disease., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID-) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis.

Temperate fruit trees require chilling for rest completion, followed by sufficient heat accumulation for onset of growth and bloom. The application of phenological models to predict bloom dates has been widely used in orchard management. Examples of such application include selecting adapted cultivars less prone to early bloom, predicting needs for frost protection, and preventing damage from late spring freezes. This study merged the Utah (chill) and ASYMCUR (forcing) phenological models by combining chill units and heat units (measured in growing degree hours) to predict bloom dates of tart cherries (Prunus cerasus L.) in Utah and Michigan, the top producing states of the USA. It was found that the modified Utah model improves the estimation of chill units compared with the original one, while the original Utah model may still be suitable for use in the colder winter of Michigan (with its later bloom dates than Utah). The combined models were applied with the temperature predicted by the Climate Forecast System v2 (CFSv2) model. The prediction was applied twice a month, starting from 1 February to 1 May. The Utah-ASYMCUR model using the forecasted temperature from CFSv2 exhibits subseasonal performance in predicting the bloom dates for 6 weeks in advance. The prediction can offer growers a way to mitigate extreme climate anomalies.

Unprecedented heatwave-drought concurrences in the past two decades have been reported over inner East Asia. Tree-ring-based reconstructions of heatwaves and soil moisture for the past 260 years reveal an abrupt shift to hotter and drier climate over this region. Enhanced land-atmosphere coupling, associated with persistent soil moisture deficit, appears to intensify surface warming and anticyclonic circulation anomalies, fueling heatwaves that exacerbate soil drying. Our analysis demonstrates that the magnitude of the warm and dry anomalies compounding in the recent two decades is unprecedented over the quarter of a millennium, and this trend clearly exceeds the natural variability range. The "hockey stick"-like change warns that the warming and drying concurrence is potentially irreversible beyond a tipping point in the East Asian climate system., (Copyright © 2020, American Association for the Advancement of Science.)

Introduction: Mnemonic strategy training (MST) has been shown to improve cognitive performance and increase brain activation in those with mild cognitive impairment (MCI). However, little is known regarding the effects of MST on functional connectivity (FC) at rest. The aim of the present study was to investigate the MST focused on face-name associations effect on resting-state FC in those with MCI., Methods: Twenty-six amnestic MCI participants were randomized in MST (N = 14) and Education Program (active control; N = 12). Interventions occurred twice a week over two consecutive weeks (ie, four sessions). Resting-state functional magnetic resonance imaging was collected at pre- and post-intervention. Regions of interest (ROIs) were selected based on areas that previously showed task-related activation changes after MST. Changes were examined through ROI-to-ROI analysis and significant results were corrected for multiple comparisons., Results: At post-intervention, only the MST group showed increased FC, whereas the control group showed decreased or no change in FC. After MST, there was an increased FC between the left middle temporal gyrus and right orbitofrontal cortex. In addition, a time-by-group interaction indicated that the MST group showed greater increased FC between the right inferior frontal gyrus and left brain regions, such as fusiform gyrus, temporal pole, and orbitofrontal cortex relative to controls., Discussion: MST enhanced FC in regions that are functionally relevant for the training; however, not in all ROIs investigated. Our findings suggest that MST-induced changes are reflected in task-specific conditions, as previously reported, but also in general innate connectivity. Our results both enhance knowledge about the mechanisms underlying MST effects and may provide neurophysiological evidence of training transfer., Competing Interests: No author has any conflict of interest., (© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.)

Forests in the western United States are being subject to more frequent and severe drought events as the climate warms. The 2012-2015 California drought is a recent example, whereby drought stress was exacerbated by a landscape-scale outbreak of western pine beetle (Dendroctonus brevicomis) and resulted in widespread mortality of dominant canopy species including ponderosa pine (Pinus ponderosa). In this study, we compared pairs of large surviving and beetle-killed ponderosa pines following the California drought in the southern Sierra Nevadas to evaluate physiological characteristics related to survival. Inter-annual growth rates and tree-ring stable isotopes (∆ 13 C and δ 18 O) were utilized to compare severity of drought stress and climate sensitivity in ponderosa pines that survived and those that were killed by western pine beetle. Compared to beetle-killed trees, surviving trees had higher growth rates and grew in plots with lower ponderosa pine basal area. However, there were no detectable differences in tree-ring ∆ 13 C, δ 18 O, or stable isotope sensitivity to drought-related meteorological variables. These results indicate that differences in severity of drought stress had little influence on local, inter-tree differences in growth rate and survival of large ponderosa pines during this drought event. Many previous studies have shown that large trees are more likely to be attacked and killed by bark beetles compared to small trees. Our results further suggest that among large ponderosa pines, those that were more resistant to drought stress and bark beetle attacks were in the upper echelon of growth rates among trees within a stand and across the landscape.

Objective: Personality and cognitive abilities have been previously linked. However, there are inconsistencies regarding whether this relationship varies as a function of age, and a lack of evidence on whether gender contributes to this relation, particularly across the adulthood. Therefore, this study investigated the association between personality and cognition across the adult life span, accounting for age and gender., Methods: We examined the association between personality and cognition in two large samples (Sample 1: N = 422; Sample 2: N = 549) including young, middle-aged and older adults. Participants completed personality scales and several cognitive measures related to reasoning, language, memory and speed of processing. Structural equation modeling was applied in order to investigate associations between personality and cognition, and moderation of age and gender within this relationship. We also conducted a mini-meta-analysis procedure in order to examine personality-cognition associations, combining results from the two samples., Results: Openness was the main trait associated with cognitive performance; however, Extraversion, Conscientiousness, and Neuroticism were also independently associated with cognition. Age and gender did not consistently moderate personality-cognition in each sample, but the mini-metanalysis showed that gender moderated Conscientiousness-cognition associations., Conclusions: We provided robust evidence of personality-cognition associations across the adult life span, which was not consistently moderated by age, but in part by gender., (© 2020 Wiley Periodicals, Inc.)

Prior work has revealed that mnemonic strategy training (MST) can enhance memory for specific content and engages regions in the frontoparietal cognitive control network. Evidence of transfer to novel content is less clear. Here, we provide secondary analysis of functional magnetic resonance imaging (fMRI) data acquired during a randomized controlled trial that compared MST to an active education control condition in patients with amnestic mild cognitive impairment (a-MCI). In the trial, thirty participants with a-MCI were randomized to the education program (EP) or MST, where they learned to apply the technique to face-name associations during four intervening hour long training sessions. Participants underwent pre- and post-training fMRI scans, during which they encoded both the trained (i.e., those used during the four training sessions) and untrained ('novel') face-name associations. The primary cognitive outcome measures revealed significantly improved memory for both trained and novel stimuli - effects supporting near transfer of MST. Relative to pre-training, there were significant and highly similar increases in activation for both trained and novel stimuli, especially in regions associated with the frontoparietal cognitive control network bilaterally, but also in temporal areas related to social cognition and emotional processing. Critically, this pattern of activation was notably different from the EP group. Thus, the changes in activation were consistent with the strategies trained and, combined with the cognitively-based near transfer effects, suggest that MST focused on face-name association enhances performance by engaging cognitive control and social/emotional processing. Finally, our data indicated that our MST is a relevant and efficient intervention to a-MCI., (Copyright © 2019 Elsevier B.V. All rights reserved.)