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Ethnic minority groups often have more complex and aversive pathways to mental health care. However, large population-based studies are lacking, particularly regarding involuntary hospitalisation. We sought to examine the risk of involuntary admission among first-generation ethnic minority groups with early psychosis in Ontario, Canada.
Using health administrative data, we constructed a retrospective cohort (2009–2013) of people with first-onset non-affective psychotic disorder aged 16–35 years. This cohort was linked to immigration data to ascertain migrant status and country of birth. We identified the first involuntary admission within 2 years and compared the risk of involuntary admission for first-generation migrant groups to the general population. To control for the role of migrant status, we restricted the sample to first-generation migrants and examined differences by country of birth, comparing risk of involuntary admission among ethnic minority groups to a European reference. We further explored the role of migrant class by adjusting for immigrant vs refugee status within the migrant cohort. We also explored effect modification of migrant class by ethnic minority group.
We identified 15 844 incident cases of psychotic disorder, of whom 19% (n = 3049) were first-generation migrants. Risk of involuntary admission was higher than the general population in five of seven ethnic minority groups. African and Caribbean migrants had the highest risk of involuntary admission (African: risk ratio (RR) = 1.52, 95% CI = 1.34–1.73; Caribbean: RR = 1.58, 95% CI = 1.37–1.82), and were the only groups where the elevated risk persisted when compared to the European reference group within the migrant cohort (African: RR = 1.24, 95% CI = 1.04–1.48; Caribbean: RR = 1.29, 95% CI = 1.07–1.56). Refugee status was independently associated with involuntary admission (RR = 1.16, 95% CI = 1.02–1.32); however, this risk varied by ethnic minority group, with Caribbean refugees having an elevated risk of involuntary admission compared with Caribbean immigrants (RR = 1.72, 95% CI = 1.15–2.58).
Our findings are consistent with the international literature showing increased rates of involuntary admission among some ethnic minority groups with early psychosis. Interventions aimed at improving pathways to care could be targeted at these groups to reduce disparities.
The Rio Branco is a river with unique biogeographic and ecological features, threatened by the Brazilian Government’s plan to build a major hydroelectric dam and associated hydroway along its course. The river crosses one of Amazonia’s largest rainfall gradients and a major geomorphological boundary along a savanna/forest ecotone, marked by the Bem Querer rapids. Above the rapids, the upper Rio Branco runs through the Boa Vista sedimentary formation and crosses the crystalline rocks of the Guiana Shield, and its margins are flanked by gallery forests. Downriver, it runs through a low-lying sedimentary basin, with Amazonian floodplain forests along its margins. Here, we present the results of ∼ 15 years of ornithological research on the Branco and its major tributaries, providing baseline data and evaluating potential threats to the riverine avifauna. Our surveys included opportunistic observations and standardized surveys along the entire length of the river in 16 systematically distributed localities. We catalogued 439 bird species, 87% of which are documented by physical evidence (specimens, recordings, photographs). Forty-six percent are restricted to single habitats, suggesting a high degree of habitat specialisation. A third of the species are widely distributed along the river, whereas 45% are restricted to either the upper or the lower Rio Branco, including 40 and 30 Indicator Species, respectively. Twenty-five species are threatened at global or national levels, including two ‘Critically Endangered’, nine ‘Vulnerable’, and 14 ‘Near Threatened’. We present a list of 50 bird species that are candidates for monitoring studies. Threats to the avifauna from dam construction include permanent flooding above the dam, eliminating gallery forests, river islands, and sandy beaches, and the disruption of the flood pulse along the river, affecting river island and floodplain forest specialists, many of which are globally threatened with extinction. If built, the Bem Querer dam will wipe out the ecotone region and affect dramatically the river’s avifauna.
Survival and infectivity of trypanosomatids rely on cell-surface and secreted glycoconjugates, many of which contain a variable number of galactose residues. Incorporation of galactose to proteins and lipids occurs along the secretory pathway from UDP-galactose (UDP-Gal). Before being used in glycosylation reactions, however, this activated sugar donor must first be transported across the endoplasmic reticulum and Golgi membranes by a specific nucleotide sugar transporter (NST). In this study, we identified an UDP-Gal transporter (named TcNST2 and encoded by the TcCLB.504085.60 gene) from Trypanosoma cruzi, the etiological agent of Chagas disease. TcNST2 was identified by heterologous expression of selected putative nucleotide sugar transporters in a mutant Chinese Hamster Ovary cell line. TcNST2 mRNA levels were detected in all T. cruzi life-cycle forms, with an increase in expression in axenic amastigotes. Confocal microscope analysis indicated that the transporter is specifically localized to the Golgi apparatus. A three-dimensional model of TcNST2 suggested an overall structural conservation as compared with members of the metabolite transporter superfamily and also suggested specific features that could be related to its activity. The identification of this transporter is an important step toward a better understanding of glycoconjugate biosynthesis and the role NSTs play in this process in trypanosomatids.
Expression of estrus near timed artificial insemination (TAI) is associated with greater fertility, and estrus detection could improve TAI fertility or direct TAI management, although accurate estrus detection can be difficult and time-consuming using traditional methods. The aim of this study is to evaluate influence of estrus on pregnancy (artificial insemination pregnancy rates (P/AI)) and to validate an alternative method to classify estrus/heat expression using tail chalking (HEATSC) in postpartum Bos indicus cows subjected to TAI in progesterone–estrogen-based protocols. In experiment 1 (Exp. 1), cows (5491) were subjected to visual observation of estrus after progesterone device removal, before TAI, and P/AI was evaluated according to estrus and body condition score (BCS). Cows received a progesterone device and 2 mg estradiol benzoate (EB). After 8 days, the device was removed and 150 μg of d-cloprostenol and 300 IU equine chorionic gonadotrophin was given. Later, animals in Exp. 1 received 1 mg EB and TAI 44 to 48 h. In the Exp. 2 – 3830 cows using similar protocol, received different ovulation inducers: 1 mg EB (n=1624) or 1 mg estradiol cypionate (EC; n=2206) on day 8 (D8). Cows were then marked with chalk, and HEATSC evaluated at TAI on D10 (HEATSC1 – no chalk removal=no estrus expression; HEATSC2 – partial chalk removal=low estrus expression; HEATSC3 – near complete/complete chalk removal=high estrus expression). In Exp. 1, cows showing estrus presented greater P/AI (48.4% v. 40.2%, P<0.05). In Exp. 2, P/AI (HEATSC1 – 40.0%; HEATSC2 – 49.7%; HEATSC3 – 60.9%; P<0.001), and larger follicle timed artificial insemination (LFTAI) (<0.001) varied according to HEATSC. There was no difference in P/AI (P=0.41) or LFTAI (P=0.33) according to ovulation inducer. Cows with greater BCS showed greater P/AI in both experiments (P<0.05). Estrus presence and greater HEATSC improved P/AI, and EC v. EB used promoted differential estrus manifestation (cows showing HEATSC2 and HEATSC3: 79.5% with EB v. 69.98% with EC use, P<0.001), however, with similar P/AI. The use of HEATSC in B. indicus cows subjected to TAI is useful to identify cows with greater estrus expression and consequently improved pregnancy rates in TAI, allowing the cows with low HEATSC to be targeted for additional treatments aimed at improving P/AI.
We present some recent advances on the question of enumeration and classification of self-dual codes invariant under finite non-solvable permutation groups. In particular, we examine the question for almost simple groups of sporadic or rank 3 types. As a by-product we determine all doubly even and extremal codes of length n ≤ 4095 which admit an almost simple group of sporadic or rank 3 type as a permutation group of automorphisms acting transitively on the code’s coordinate positions.
The mechanisms involved in kidney disturbances during development, induced by vitamin D3 deficiency in female rats, that persist into adulthood were evaluated in this study. Female offspring from mothers fed normal (control group, n=8) or vitamin D-deficient (Vit.D-, n=10) diets were used. Three-month-old rats had their systolic blood pressure (SBP) measured and their blood and urine sampled to quantify vitamin D3 (Vit.D3), creatinine, Na+, Ca+2 and angiotensin II (ANGII) levels. The kidneys were then removed for nitric oxide (NO) quantification and immunohistochemical studies. Vit.D- pups showed higher SBP and plasma ANGII levels in adulthood (P<0.05) as well as decreased urine osmolality associated with increases in urinary volume (P<0.05). Decreased expression of JG12 (renal cortex and glomeruli) and synaptopodin (glomeruli) as well as reduced renal NO was also observed (P<0.05). These findings showed that renal disturbances in development in pups from Vit.D- mothers observed in adulthood may be related to the development of angiogenesis, NO and ANGII alterations.
Cognitive impairment is a core feature of psychotic disorders, but the profile of impairment across adulthood, particularly in African-American populations, remains unclear.
Using cross-sectional data from a case–control study of African-American adults with affective (n = 59) and nonaffective (n = 68) psychotic disorders, we examined cognitive functioning between early and middle adulthood (ages 20–60) on measures of general cognitive ability, language, abstract reasoning, processing speed, executive function, verbal memory, and working memory.
Both affective and nonaffective psychosis patients showed substantial and widespread cognitive impairments. However, comparison of cognitive functioning between controls and psychosis groups throughout early (ages 20–40) and middle (ages 40–60) adulthood also revealed age-associated group differences. During early adulthood, the nonaffective psychosis group showed increasing impairments with age on measures of general cognitive ability and executive function, while the affective psychosis group showed increasing impairment on a measure of language ability. Impairments on other cognitive measures remained mostly stable, although decreasing impairments on measures of processing speed, memory and working memory were also observed.
These findings suggest similarities, but also differences in the profile of cognitive dysfunction in adults with affective and nonaffective psychotic disorders. Both affective and nonaffective patients showed substantial and relatively stable impairments across adulthood. The nonaffective group also showed increasing impairments with age in general and executive functions, and the affective group showed an increasing impairment in verbal functions, possibly suggesting different underlying etiopathogenic mechanisms.
Hepatocytes constitute the majority of hepatic cells, and play a key role in controlling systemic innate immunity, via pattern-recognition receptors (PRRs) and by synthesizing complement and acute phase proteins. Leishmania infantum, a protozoan parasite that causes human and canine leishmaniasis, infects liver by establishing inside the Kupffer cells. The current study proposes the elucidation of the immune response generated by dog hepatocytes when exposed to L. infantum. Additionally, the impact of adding leishmanicidal compound, meglumine antimoniate (MgA), to parasite-exposed hepatocytes was also addressed. L. infantum presents a high tropism to hepatocytes, establishing strong membrane interactions. The possibility of L. infantum internalization by hepatocytes was raised, but not confirmed. Hepatocytes were able to recognize parasite presence, inducing PRRs [nucleotide oligomerization domain (NOD)1, NOD2 and Toll-like receptor (TLR)2] gene expression and generating a mix pro- and anti-inflammatory cytokine response. Reduction of cytochrome P 450s enzyme activity was also observed concomitant with the inflammatory response. Addition of MgA increased NOD2, TLR4 and interleukin 10 gene expression, indicating an immunomodulatory role for MgA. Hepatocytes seem to have a major role in coordinating liver's innate immune response against L. infantum infection, activating inflammatory mechanisms, but always balancing the inflammatory response in order to avoid cell damage.
To compare the accuracy of Mini-Mental State Examination (MMSE) and of the Montreal Cognitive Assessment (MoCA) in tracking mild cognitive impairment (MCI) and Alzheimer’s Disease (AD).
A Systematic review of the PubMed, Bireme, Science Direct, Cochrane Library, and PsycInfo databases was conducted. Using inclusion and exclusion criteria and staring with 1,629 articles, 34 articles were selected. The quality of the selected research was evaluated through the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2).
More than 80% of the articles showed MoCA to be superior to MMSE in discriminating between individuals with mild cognitive impairment and no cognitive impairment. The area under the curve varied from 0.71 to 0.99 for MoCA, and 0.43 to 0.94 for MMSE, when evaluating the ability to discriminate MCI in the cognitively healthy elderly individuals, and 0.87 to 0.99 and 0.67 to 0.99, respectively, when evaluating the detection of AD. The AUC mean value for MoCA was significantly larger compared to the MMSE in discriminating MCI from control [0.883 (CI 95% 0.855-0.912) vs MMSE 0.780 (CI 95% 0.740-0.820) p < 0.001].
The screening tool MoCA is superior to MMSE in the identification of MCI, and both tests were found to be accurate in the detection of AD.
Sugarcane is an important forage source for dairy cows in tropical countries. However, it provides limited digestible fiber and energy intake, and fat supplementation can be a way to increase energy density and decrease dietary, non-fiber carbohydrates concentrations. We aimed to evaluate the performance, digestion and metabolism of dairy cows in early lactation fed different concentrations of soybean oil (SBO) in sugarcane-based diets. Fourteen primiparous (545±17.2 kg of BW) and eight multiparous (629±26.7 kg BW) Holstein dairy cows were used according to a randomized block design. After calving, diets were randomly assigned to cows within the two parity groups. Diets were formulated with increasing concentrations of SBO (g/kg dry matter (DM)): control (0), low (LSBO; 15.7), medium (MSBO; 44.3) and high (HSBO; 73.4). The study was performed from calving until 84 days in milk, divided into three periods of 28 days each. Dry matter intake (DMI) was affected quadratically in response to SBO addition with the greatest and lowest values of 19.0 and 16.0 kg/day for LSBO and HSBO diets, respectively. The digestibility of potentially digestible NDF was quadratically affected by SBO with the greatest value of 623 g/kg for LSBO diet. Both milk and energy-corrected milk (ECM) production were quadratically affected by SBO inclusion, with greatest ECM values of 27.9 and 27.3 for LSBO and MSBO, respectively. Soybean oil inclusion linearly decreased milk fat concentration by 13.2% from control to HSBO. The CLA t10,c12-18:2 was observed in milk fat only for MSBO and HSBO diets. Soybean oil inclusion did not affect plasma glucose or serum concentrations of total proteins, globulins, albumin, urea nitrogen, beta-hydroxybutyrate, non-esterified fatty acids or insulin. Serum concentrations of total cholesterol, triglycerides and low-density lipoprotein increased with SBO supplementation. Soybean oil inclusion in sugarcane-based diets for early lactation dairy cows from 15.7 to 44.3 g/kg DM can improve energy intake and performance; however, at 44.3 g/kg DM milk fat concentration and ECM decreased. Soybean oil inclusion at 73.4 g/kg DM adversely affected energy intake, fiber digestion and performance of early lactation dairy cows and is not recommended.
The family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.
Our objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.
We will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.
These findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.
Mullets inhabit a wide range of habitats from tropical to temperate regions and play a critical role in their ecosystems. This commercially important fish group constitutes a significant source of food in several geographic regions, and the production of some species for consumption is an increasing trend. About 64 myxosporean species have been reported in mullets, some of which are cryptic, as is the case of Myxobolus exiguus, and M. muelleri. This paper provides, for the first time, a detailed and critical revision of the data available for myxobolids reported in mullets, determining the species that have bona fide mugiliform fish hosts, in accordance with the original species descriptions, the available molecular data and the currently accepted taxonomic and phylogenetic criteria. Phylogenetic analyses using Bayesian inference and maximum-likelihood methodologies suggest that the evolutionary history of myxobolids with bona fide mugiliform fish hosts reflects that of its vertebrate hosts, while reinforcing known evolutionary factors and old systematic issues of the clade of myxobolids. A comprehensive morphological, ultrastructural and molecular redescription is also provided for the cryptic species M. exiguus, from infections in the visceral peritoneum of the thinlip-grey mullet Chelon ramada in the River Minho, Portugal.
Globally, the prevalence of tuberculosis (TB) disease is higher in males. This study examined the effect of sex and age on Mycobacterium tuberculosis (Mtb) infection. Demographic and exposure data were collected on household contacts of sputum smear-positive pulmonary TB patients in Brazil. Contacts with tuberculin skin test induration ⩾10 mm at baseline or 12 weeks were considered Mtb infected. The study enrolled 917 household contacts from 160 households; 508 (55.4%) were female, median age was 21.0 years (range 0.30–87.0) and 609 (66.4%) had Mtb infection. The proportion infected increased with age from 63.3% in girls <5 years to 75.4% in women ⩾40 years and from 44.9% in boys <5 years to 73.6% in men ⩾40 years. Multivariable modelling showed the odds of infection increased between age 5 and 14 years among female contacts (OR 1.5 per 5-year age increase; 95% CI 1.1–2.2; P = 0.02) and between ages 0–4 and 15–39 years among male contacts (OR 2.7, 95% CI 0.83–8.9 and 1.1, 95% CI 0.99–1.3 per 5-year age increase; P = 0.10, 0.07, respectively). The study suggests that the age at which Mtb infection increases most is different in females compared with males. Studies are needed to explore whether these findings are due to differences in host susceptibility, exposure outside the household or other factors.
Sugar cane and maize silage samples were evaluated by the semi automated in vitro gas production technique. The associations between gas production and dry matter degradation (DMD) were analysed and high coefficients of determination were obtained for all the substrates. The results showed that particles losses could be influencing the DMD, including errors mostly when obtained before 6 hours of incubation. The gas alone could better predict the lag phase than the DMD before 6 hours of incubation.
Acinetobacter spp. are important healthcare pathogens, being closely linked to antibiotic resistance and outbreaks worldwide. Although such species are rarely observed in patients with cystic fibrosis (CF), we describe the characteristics of 53 strains of Acinetobacter spp. isolated from the sputum of 39 Brazilian patients with CF. The species distribution was A. baumannii (n = 29), A. pittii (n = 13), A. nosocomialis (n = 8), A. seifertii (n = 1), A. soli (n = 1) and A. variabilis (n = 1) determined by partial rpoB gene sequencing. Sixteen strains (10 A. baumannii, 3 A. pittii and 3 A. nosocomialis) were multidrug-resistant (MDR) by disk diffusion test (30%) and eight MDR carbapenem-resistant A. baumannii strains harboured the blaOXA-23-like oxacillinase gene. Thirty-three sequence types (STs) were identified by multilocus sequence typing of which eight were novel (A. baumannii: 843, 844, 845, 847, 848; A. pitti: 643; A. nosocomialis: 862 and A. seifertii: 846); six STs (2 A. baumannii, 3 A. pittii and 1 A. nosocomialis) were found in more than one patient. Four strains of A. baumannii were assigned to two common clonal complexes (CCs), namely, CC1 (ST1, ST20 and ST160), and CC79 (ST79). This study underlines the extensive species diversity of Acinetobacter spp. strains in CF lung infections which may present difficulties for therapy due to significant antimicrobial resistance.
Urban slums provide suitable conditions for infestation by rats, which harbour and shed a wide diversity of zoonotic pathogens including helminths. We aimed to identify risk factors associated with the probability and intensity of infection of helminths of the digestive tract in an urban slum population of Rattus norvegicus. Among 299 rats, eleven species/groups of helminths were identified, of which Strongyloides sp., Nippostrongylus brasiliensis and, the human pathogen, Angiostrongylus cantonensis were the most frequent (97, 41 and 39%, respectively). Sex interactions highlighted behavioural differences between males and females, as eg males were more likely to be infected with N. brasiliensis where rat signs were present, and males presented more intense infections of Strongyloides sp. Moreover, rats in poor body condition had higher intensities of N. brasiliensis. We describe a high global richness of parasites in R. norvegicus, including five species known to cause disease in humans. Among these, A. cantonensis was found in high prevalence and it was ubiquitous in the study area – knowledge which is of public health importance. A variety of environmental, demographic and body condition variables were associated with helminth species infection of rats, suggesting a comparable variety of risk factors for humans.
We present preliminary analysis of new HST observations of the transiting extrasolar planet HD 209458b. Photometric observations were obtained with the Fine Guidance Sensor (FGS) on the Hubble Space Telescope (HST), providing milli-mag precision and high time resolution (40 Hz). The FGS photometry allows us to derive precise stellar/orbital parameters (ephemeris, inclination, limb darkening) and planetary radius, and also allows a search for the presence of planetary rings and satellites. We discuss preliminary results and two approaches to modelling the observations.
Data of our on-going program on the interstellar polarization in the Small Magellanic Cloud (SMC) seem to show a correlation between the UV extinction and the parameters of the Serkowski law which describe the polarization. Fits of popular interstellar dust models to the polarization data are not always satisfactory, being better for stars with small wavelength of maximum polarization, λmax.
Seed longevity is dependent on seed traits and storage conditions. This study evaluated the seed longevity and physical dormancy (PY)-break of two species of Dimorphandra endemic to Brazilian biodiversity hotspots. Longevity was tested in situ, by burying seeds in their natural habitats (12 months), and ex situ, by storage in a cold chamber (5°C; 24 months). Seeds were taken at regular intervals to assess germinability at 30°C (12 h photoperiod) using intact and scarified seeds. Intact seeds (freshly collected, and after 12 months storage) were analysed using scanning electron microscopy. The germinability of freshly collected seeds of both species reached approximately 10% for intact seeds and >85% for scarified seeds. Cold storage maintained seed viability in both species, and broke dormancy for 35% of D. wilsonii seeds. After 12 months, only 55% (for D. exaltata) and 41% (for D. wilsonii) of the buried seeds were recovered; more than 90% of which remained viable in both species. Seeds gradually overcame PY during burial, with a higher germination increase for D. wilsonii (71%) than D. exaltata (32%). Dimorphandra exaltata seeds did not show clear structural changes after cold storage although D. wilsonii seeds evidently experience an increase in the depth of fracture lines. Burial promoted deep seed coat changes in both species, more intense in D. wilsonii, indicating that temperature and humidity variations throughout the year are among the main factors releasing Dimorphandra seeds from PY. The seeds of both studied species overcame PY during burial and are able to form small persistent soil seed banks.