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Sub-Saharan Africa has the highest natural twinning rate in the world. Unfortunately, due to lack of adequate care during pregnancy, labor and postnatally, twin mortality in Sub-Saharan Africa also remains very high. Thus, it has been estimated that one in five twins dies during the childhood years. In spite of this, surprisingly few twin studies have been conducted in the region, making additional epidemiological data much needed. In 2009, we established one of the first twin registries in Sub-Saharan Africa at the Bandim Health Project in Guinea-Bissau. The registry had two main objectives. First, we wanted to describe the twinning rate and mortality patterns among newborn twins, including mortality risk factors and hospitalization patterns. Such studies can help the local clinicians improve twin health by identifying the most vulnerable children. Second, and in light of the rapidly increasing diabetes rates in Africa, we wanted to use the registry to particularly focus on metabolic disorders. Twins are often born with low birth weight, which according to the ‘thrifty phenotype hypothesis’ could predispose them to metabolic disorders later in life. Yet, no such ‘fetal programming’ data have previously been available from African twins despite the fact that nutritional patterns and influences from other factors (e.g., infections) could be markedly different here compared to high-income settings. In this article, we summarize the findings and current status of the Guinea-Bissau twin registry.
Physical activity (PA) may be therapeutic for people with severe mental illness (SMI) who generally have low PA and experience numerous life style-related medical complications. We conducted a meta-review of PA interventions and their impact on health outcomes for people with SMI, including schizophrenia-spectrum disorders, major depressive disorder (MDD) and bipolar disorder. We searched major electronic databases until January 2018 for systematic reviews with/without meta-analysis that investigated PA for any SMI. We rated the quality of studies with the AMSTAR tool, grading the quality of evidence, and identifying gaps, future research needs and clinical practice recommendations. For MDD, consistent evidence indicated that PA can improve depressive symptoms versus control conditions, with effects comparable to those of antidepressants and psychotherapy. PA can also improve cardiorespiratory fitness and quality of life in people with MDD, although the impact on physical health outcomes was limited. There were no differences in adverse events versus control conditions. For MDD, larger effect sizes were seen when PA was delivered at moderate-vigorous intensity and supervised by an exercise specialist. For schizophrenia-spectrum disorders, evidence indicates that aerobic PA can reduce psychiatric symptoms, improves cognition and various subdomains, cardiorespiratory fitness, whilst evidence for the impact on anthropometric measures was inconsistent. There was a paucity of studies investigating PA in bipolar disorder, precluding any definitive recommendations. No cost effectiveness analyses in any SMI condition were identified. We make multiple recommendations to fill existing research gaps and increase the use of PA in routine clinical care aimed at improving psychiatric and medical outcomes.
It has been established that ingestion of a high-fat diet increases the blood levels of lipopolysaccharides (LPS) from Gram-negative bacteria in the gut. Obesity is characterised by low-grade systemic and adipose tissue inflammation. This is suggested to be implicated in the metabolic syndrome and obesity. In the present review, we hypothesise that LPS directly and indirectly participates in the inflammatory reaction in adipose tissue during obesity. The experimental evidence shows that LPS is involved in the transition of macrophages from the M2 to the M1 phenotype. In addition, LPS inside adipocytes may activate caspase-4/5/11. This may induce a highly inflammatory type of programmed cell death (i.e. pyroptosis), which also occurs after infection with intracellular pathogens. Lipoproteins with or without LPS are taken up by adipocytes. Large adipocytes are more metabolically active and potentially more exposed to LPS than small adipocytes are. Thus, LPS might be involved in defining the adipocyte death size and the formation of crown-like structures. The adipocyte death size is reached when the intracellular concentration of LPS initiates pyroptosis. The mechanistic details remain to be elucidated, but the observations indicate that adipocytes are stimulated to cell death by processes that involve LPS from the gut microbiota. There is a complex interplay between the composition of the diet and microbiota. This influences the amount of LPS that is translocated from the gut. In particular, the lipid content of a meal may correlate with the amount of LPS built in to chylomicrons.
Supraglacial deposits are known for their influence on glacier ablation. The magnitude of this influence depends on the thickness and the type of the deposited material. The effects of thin layers of atmospheric black carbon and of thick moraine debris have been intensively studied. Studies related to regional-scale deposits of volcanic tephra with thicknesses varying between millimetres and metres and thus over several orders of magnitude are scarce. We present results of a field experiment in which we investigated the influence of supraglacial deposits of tephra from Grímsvötn volcano on bare-ice ablation at Svínafelsjökull, Iceland. We observed that the effective thickness at which ablation is maximized ranges from 1.0 to 2.0 mm. At ~10 mm a critical thickness is reached where sub-tephra ablation equals bare-ice ablation. We calibrated two empirical ablation models and a semi-physics-based ablation model that all account for varying tephra-layer thicknesses. A comparison of the three models indicates that for tephra deposits in the lower-millimetre scale the temperature/radiation-index model performs best, but that a semi-physics-based approach could be expected to yield superior results for tephra deposits of the order of decimetres.
Phytochemicals may protect cellular DNA by direct antioxidant effect or modulation of the DNA repair activity. We investigated the repair activity towards oxidised DNA in human mononuclear blood cells (MNBC) in two placebo-controlled antioxidant intervention studies as follows: (1) well-nourished subjects who ingested 600 g fruits and vegetables, or tablets containing the equivalent amount of vitamins and minerals, for 24 d; (2) poorly nourished male smokers who ingested 500 mg vitamin C/d as slow- or plain-release formulations together with 182 mg vitamin E/d for 4 weeks. The mean baseline levels of DNA repair incisions were 65·2 (95 % CI 60·4, 70·0) and 86·1 (95 % CI 76·2, 99·9) among the male smokers and well-nourished subjects, respectively. The male smokers also had high baseline levels of oxidised guanines in MNBC. After supplementation, only the male smokers supplemented with slow-release vitamin C tablets had increased DNA repair activity (27 (95 % CI 12, 41) % higher incision activity). These subjects also benefited from the supplementation by reduced levels of oxidised guanines in MNBC. In conclusion, nutritional status, DNA repair activity and DNA damage are linked, and beneficial effects of antioxidants might only be observed among poorly nourished subjects with high levels of oxidised DNA damage and low repair activity.
We extend the boson process first to a large class of Cox processes and second to an even larger class of infinitely divisible point processes. Density and moment results are studied in detail. These results are obtained in closed form as weighted permanents, so the extension is called a permanental process. Temporal extensions and a particularly tractable case of the permanental process are also studied. Extensions of the fermion process along similar lines, leading to so-called determinantal processes, are discussed.
This pearl gives a discount proof of the folklore theorem that every strongly $\beta$-normalizing $\lambda$-term is typable with an intersection type. (We consider typings that do not use the empty intersection $\omega$ which can type any term.) The proof uses the perpetual reduction strategy which finds a longest path. This is a simplification over existing proofs that consider any longest reduction path. The choice of reduction strategy avoids the need for weakening or strengthening of type derivations. The proof becomes a bargain because it works for more intersection type systems, while being simpler than existing proofs.
The psychopharmacotherapy of somatoform disorders (SD; ICD-10: F45) has been less frequently investigated and is not as well established as in other (neurotic) disorders of ICD-10 section F4, i.e. generalized anxiety disorder (GAD; ICD-10: F41.1). The atypical compound opipramol is very often used to treat SD and GAD in clinical practice in Germany. However, state-of-the-art controlled clinical trials have not yet been performed.
Two clinical trials were performed with the aim of confirming the efficacy and tolerability of opipramol in SD and GAD.
Both trials were performed as randomized, double-blind, placebo-controlled, multicenter studies. While the GAD trial was a three-arm study with opipramol (200 mg/day) vs. placebo and alprazolam (2 mg/day) for 28 days, the SD trial was a placebo-controlled two-arm study with a treatment duration of 42 days. Each group consisted of about 100 patients.
Significant differences (alpha = 0.05) were found for the primary efficacy criteria (HAMA total score in GAD, HAMA somatic subscore in SD) and most of the secondary criteria in favor of the active drug therapies. Considerable differences between the psychopathology of SD and GAD were detected.
The well-tolerated anxiolytic opipramol is the first psychotropic drug with proven efficacy in somatoform disorders with effects on symptoms of somatization, anxiety, and depression. The compound is also effective and safe in GAD.
Despite direction by the Conservation Act (1987) to give effect to the principles of the Treaty of Waitangi, New Zealand's Department of Conservation has few formal collaborative management arrangements with Maori. Obstacles to establishing agreements that involve Maori in equitable conservation decision-making roles include divergent philosophies (preservation versus conservation for future use), institutional inertia, a lack of concrete models of co-management to evaluate success or otherwise to promote conservation, a lack of resources and opportunities for capacity building and scientific research amongst Maori, opposition and a lack of trust from conservation non-governmental organizations that are predominantly euro-centric in approach and membership, and a fundamental reluctance of some to share power with Maori. Recent examples of work towards co-management emphasize the need for innovative methods to build trust and explore common ground and differences. Meetings on marae (traditional Maori gathering places) have established guiding principles, lengthy dialogue, and a collective symbol as a metaphor for co-management. These were valuable steps towards building trust and understanding required for the restoration of coastal lakes and a river, and the potential joint management of two national parks on the west coast of the North Island. Establishment of a research project to assess the sustainability of a traditional harvest of a sea-bird (Puffinus griseus) by Rakiura Maori was facilitated by drawing up a 'cultural safety' contract. This contract underscored the role of Maori as directors of the research, protected their intellectual property rights to their traditional environmental knowledge, guaranteed continuity of the collaborative research project and regulated how results were to be communicated. The scientific ethics of a university ecological research team were safeguarded by the contract, which ensured that they could publish their inferences without erasure or interference. The New Zealand experience shows that even when legislation signals from the top down that the doorway is open for co-management with indigenous people, this by itself is unlikely to make it happen. Active facilitation by innovative middle-level agreements and the creation of new administrative structures are needed to govern co-management of a broad spectrum of resource issues. Bottom-up initiatives involving single, or very localized, resource uses may also trigger co-management. Models for successful co-management involving indigenous peoples must focus more strongly on issues of equity or power sharing, and therefore may be very different from models directed at a single conservation outcome.
A model for quality assessment of heart transplantation that combines a scientific method for studying the recipients' quality of life and a basis for a method of clinical work by nurses and other health care professionals is discussed. Besides its use as a research method, this model also may serve as an instrument for documenting patients' biopsychosocial status, including coping capacity, and for evaluating nursing interventions.
We report on a family with co-occurrence of affective disorder and Hailey-Hailey disease in two brothers and the mother. The putative chromosomal locus of Hailey-Hailey disease, which is a rare dominantly inherited dermatosis, may be a promising candidate region for genetic studies in affective disorder.
British Journal of Psychiatry (1993), 163, 109–110
Certain shallow-water embayments (< 1 m) along the Swedish west coast have recently been documented as highly productive areas for both infauna (Moller & Rosenberg, 1982, 1983) and mobile epifauna (Pihl & Rosenberg, 1982) as well as important nursery and feeding grounds for fish (Pihl, 1982; Evans, 1983). The present report, dealing with Nereis diversicolor O. F. Miiller, complements the earlier descriptions of recruitment, abundance and production of the dominant infauna species Mya arenaria L., Cardium (Cerastoderma) edule L. and Corophium volutator (Pallas) in these rather sheltered shallow areas in the archipelago of western Sweden.
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