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Vitamin D deficiency is associated with an increased risk of acute respiratory infection. There is an excess of respiratory infections and deaths in schizophrenia, a condition where vitamin D deficiency is especially prevalent. This potentially offers a modifiable risk factor to reduce the risk for and the severity of respiratory infection in people with schizophrenia, although there is as yet no evidence regarding the risk of COVID-19. In this narrative review, we describe the prevalence of vitamin D deficiency in schizophrenia, report the research examining the relationship between vitamin D levels and COVID-19 and discuss the associations between vitamin D deficiency and respiratory infection, including its immunomodulatory mechanism of action.
Recent technological advances have led to a novel class of microfluidic devices which can be rapidly fabricated by printing a fluid onto a solid substrate with flows generated passively via surface tension. The nonlinear dependence between flow and the heights of the conduits, however, prevent straightforward calculation of the resulting dynamics. In this paper we use matched asymptotic expansions to predict how flow through these devices can be tuned by changing their geometry. We begin with the simple ‘dumbbell’ configuration in which two fluid drops with different sizes are connected by a long, thin and narrow conduit. We calculate the time scale required for one drop to drain into the other and how this depends both on the geometry of the pinned contact line and volume of fluid deposited into the drops. Our model therefore provides the mechanistic basis to design conduits with a particular fluid flux and/or shear stress, which are often key experimental constraints. Our asymptotic predictions are shown to be in excellent agreement with numerical simulations even for moderate aspect ratios (the ratio of conduit width to length). Next, we show how our results for the simple dumbbell configuration can be extended to predict the flow through networks of conduits with multiple drops and nodes, and hence may assist in their design and implementation. This new mathematical framework has the potential to increase the use of surface tension driven microfluidics across a wide range of disciplines as it allows alternate designs to be rapidly assessed.
Introduction: The opioid crisis has reached epidemic levels in Canada, driven in large part by prescription drug use. Emergency physicians are frequent prescribers of opioids; therefore, the emergency department (ED) represents an important setting for potential intervention to encourage rational and safe prescribing. The objective of this study was to systematically review the literature on interventions aimed to influence opioid prescribing in the ED. Methods: Electronic searches of Medline and Cochrane were conducted and reference lists were hand-searched. All quantitative studies published in English from 2009 to 2019 were eligible for inclusion. Two reviewers independently screened the search output to identify potentially eligible studies, the full texts of which were retrieved and assessed for inclusion. Outcomes of interest included opioid prescribing rate (proportion of ED visits resulting in an opioid prescription at discharge), morphine milligram equivalents per prescription and variability among prescribers. Results: The search strategy yielded 797 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 34 potentially relevant studies were retrieved in full text. Of these, 28 studies were included in the review. The majority (26, 92.9%) of studies were based in the United States and two (7.1%) were from Australia. Four (14.3%) were randomized controlled trials. The interventions were classified into six categories: prescribing guidelines (n = 10), regulation/rescheduling of opioids (n = 6), prescribing data transparency (n = 4), education (n = 4), care coordination (n = 3), and electronic medical record changes (n = 1). The majority of interventions reduced the opioid prescribing rate from the ED (21/28, 75.0%), although regulation/rescheduling of opioids had mixed effectiveness, with 3/6 (50%) studies reporting a small increase in the opioid prescribing rate post-intervention. Education had small yet consistent effects on reducing the opioid prescribing rate. Conclusion: A variety of interventions have attempted to improve opioid prescribing from the ED. These interventions include prescribing guidelines, regulation/rescheduling, data transparency, education, care coordination, and electronic medical record changes. The majority of interventions reduced the opioid prescribing rate; however, regulation/rescheduling of opioids demonstrated mixed effectiveness.
P300 wave anomalies correlate with genetic risk for schizophrenia and constitute a plausible endophenotype for the disease. The COMT gene is thought to influence cognitive performance and to be a susceptibility gene for schizophrenia. Unlike two previous studies, we found no significant influence of the COMT gene on P300 amplitude or latency in 189 individuals examined. The well-supported role of the COMT gene both in dopamine catabolism as well as in prefrontal cognition makes a strong theoretical case for the influence of COMT Val158Met polymorphism on P300 endophenotypes. However, the available neurophysiologic evidence suggests that any such association, if present, must be very subtle.
This study investigated the attitudes of medical students towards psychiatry, both as a subject on the medical curriculum and as a career choice. Three separate questionnaires previously validated on medical student populations were administered prior to and immediately following an 8-week clinical training programme. The results indicate that the perception of psychiatry was positive prior to clerkship and became even more so on completion of training. On completion of the clerkship, there was a rise in the proportion of students who indicated that they might choose a career in psychiatry. Attitudes toward psychiatry correlated positively with the psychiatry examination results. Those that intended to specialise in psychiatry achieved significantly higher examination scores in the psychiatry examination.
Australian conservation cropping systems are practiced on very large farms (approximately 3,000 ha) where herbicides are relied on for effective and timely weed control. In many fields, though, there are low weed densities (e.g., <1.0 plant 10 m−2) and whole-field herbicide treatments are wasteful. For fallow weed control, commercially available weed detection systems provide the opportunity for site-specific herbicide treatments, removing the need for whole-field treatment of fallow fields with low weed densities. Concern about the sustainability of herbicide-reliant weed management systems remain and there has not been interest in the use of weed detection systems for alternative weed control technologies, such as targeted tillage. In this paper, we discuss the use of a targeted tillage technique for site-specific weed control in large-scale crop production systems. Three small-scale prototypes were used for engineering and weed control efficacy testing across a range of species and growth stages. With confidence established in the design approach and a demonstrated 100% weed-control potential, a 6-m wide pre-commercial prototype, the “Weed Chipper,” was built incorporating commercially available weed-detection cameras for practical field-scale evaluation. This testing confirmed very high (90%) weed control efficacies and associated low levels (1.8%) of soil disturbance where the weed density was fewer than 1.0 plant 10 m−2 in a commercial fallow. These data established the suitability of this mechanical approach to weed control for conservation cropping systems. The development of targeted tillage for fallow weed control represents the introduction of site-specific, nonchemical weed control for conservation cropping systems.
In Australia, junglerice and feather fingergrass are problematic weeds in sorghum. The high seed production potential of these weeds increases their seedbank in the soil and makes weed control practices more difficult and expensive, particularly when weeds have evolved resistance to herbicides. A study was conducted to evaluate the seed production and seed retention behavior of junglerice and feather fingergrass at sorghum crop maturity following four transplanting times: 0, 2, 4, and 6 wk after sorghum emergence. Averaged across years, junglerice and feather fingergrass produced 4,060 and 5,740 seeds plant-1, respectively,when they were transplanted with the emergence of a sorghum crop. Seed retention ranged from 42% to 56% for junglerice and 67% to 75% for feather fingergrass when these weeds were transplanted from 0 to 4 wk after crop emergence. A positive correlation (r = 0.75 for junglerice; r = 0.44 for feather fingergrass) was found between seed production and weed biomass in both weeds, indicating that larger plants produced more seeds than smaller plants. However, no correlation was found between weed biomass and seed retention for junglerice. A weak positive correlation (r = 0.44) was found between feather fingergrass biomass and percent seed retention, indicating that seed retention was greater in larger plants compared with smaller plants. Our results suggest that feather fingergrass is a good candidate for harvest weed seed control (HWSC) tactics if crop harvest is timely. There is limited opportunity to use HWSC tactics for targeting junglerice seeds in sorghum crops, because most seeds dispersed before crop maturity. Additional research is required to evaluate seed retention levels of these weeds in other summer crops such as corn and soybean to determine the potential for HWSC for management of these species.
Junglerice [Echinochloa colona (L.) Link] is a problematic weed in the northern grain region of Australia. Two pot experiments (Experiment 1 and Experiment 2) were conducted in a screen house to evaluate the growth and reproductive behavior of two biotypes (A, collected from a cotton (Gossypium hirsutum L.)–fallow; B, collected from a fence near a water channel) of E. colona in response to water stress (100%, 75%, 50%, and 25% water holding capacity [WHC]). Averaged across both biotypes, the plant height, biomass, and seed production of E. colona were reduced at 25% WHC compared with 100% WHC. However, E. colona still produced a considerable amount of seeds at 25% WHC (at least 365 seeds plant−1). Biotype A produced more seeds in the second experiment, while biotype B produced more seeds in the first experiment. In Experiment 2, at 100% WHC, biotype A produced more seeds (17,618 seeds plant−1) than biotype B (4,378 seeds plant−1), and similar observations were noticed for root biomass. Growth and seed production of E. colona at all moisture levels and environmental conditions ensure survival in an unpredictable environment and contribute to the weedy nature of this species. Results indicate that biotype A is more invasive than biotype B under favorable environmental conditions (100% WHC). This study suggests an enhanced competitive ability of some biotypes of E. colona in response to a range of environmental and soil moisture conditions in Australia. Under favorable environmental conditions, biotype A could be more problematic, as it has higher seed production than biotype B. Therefore, it is important to implement sustainable weed control methods for such biotypes in the early stages of crop growth to prevent loss of stored moisture.
Introduction: Alcohol use disorder (AUD) is a chronic relapsing and highly comorbid disease. Patients suffering from AUD are frequently seen in the emergency department (ED) presenting intoxicated or in withdrawal. Brief interactions in the ED are often the only portal of entry to the healthcare system for many of these patients. Oral naltrexone and long acting injectable naltrexone are effective treatment options for AUD associated with decreased cravings, shorter length of hospital stay, and lower cost of healthcare utilization. This study's objective was to perform a systematic review of the literature evaluating initiation of naltrexone in the ED. Methods: Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) comparing initiation of naltrexone in patients (≥18 years) to standard care in the ED were included. Two reviewers independently screened titles and abstracts, reviewed full text articles for inclusion, assessed quality of the studies, and extracted data. Results: The search strategy yielded 183 potentially relevant citations. After eliminating duplicate citations and studies that did not meet eligibility criteria, 10 articles were retrieved for full text review. There were no published RCTs that examined naltrexone initiation in the ED. There is one ongoing study being conducted in New York, which aims to assess naltrexone initiation in the ED and measure health outcomes and quality of life of study participants, as well as potential healthcare cost savings. Conclusion: The lack of published research in this area demonstrates a significant gap in knowledge. It is clear that well-designed RCTs are needed to evaluate the effectiveness of initiating naltrexone for those with AUD at the ED visit.
Although polyphenols inhibit glucose absorption and transport in vitro, it is uncertain whether this activity is sufficient to attenuate glycaemic response in vivo. We examined this using orange juice, which contains high levels of hesperidin. We first used a combination of in vitro assays to evaluate the potential effect of hesperidin and other orange juice components on intestinal sugar absorption and then tested whether this translated to an effect in healthy volunteers. Hesperidin attenuated transfer of 14C-labelled glucose across differentiated Caco-2/TC7 cell monolayers. The involvement of the sugar transporter GLUT2 was demonstrated by experiments carried out in the absence of Na to exclude the contribution of sodium-glucose linked transporter 1 and further explored by the use of Xenopus laevis oocytes expressing human GLUT2 or GLUT5. Fructose transport was also affected by hesperidin partly by inhibition of GLUT5, while hesperidin, even at high concentration, did not inhibit rat intestinal sucrase activity. We conducted three separate crossover interventions, each on ten healthy volunteers using orange juice with different amounts of added hesperidin and water. The biggest difference in postprandial blood glucose between orange juice and control, containing equivalent amounts of glucose, fructose, sucrose, citric acid and ascorbate, was when the juice was diluted (ΔCmax=–0·5 mm, P=0·0146). The effect was less pronounced when the juice was given at regular strength. Our data indicate that hesperidin can modulate postprandial glycaemic response of orange juice by partial inhibition of intestinal GLUT, but this depends on sugar and hesperidin concentrations.
African turnipweed (Sisymbrium thellungii O. E.Schulz) is an emerging problematic broadleaf weed of the northern grain region of Australia. Laboratory experiments were conducted to evaluate the effects of temperature, light, salinity, pH, seed burial depth, and the amount of wheat crop residue on germination and emergence of two Australian S. thellungii weed populations (population C, cropped area; population F, fence line). Both populations behaved similarly across different environmental conditions, except in the residue study. Although the seeds of both populations of S. thellungii could germinate under complete darkness, germination was best (~95%) under light/dark conditions at the 20/10 C temperature regime. Both populations of S. thellungii germinated over a wide range of day/night temperatures (15/5, 20/10, 25/15, and 30/20 C). Osmotic stress had negative effects on germination, with 54% seeds (averaged over populations) able to germinate at −0.1MPa. Complete germination inhibition for both populations was observed at −0.8MPa osmotic potential. Both populations germinated at sodium chloride (NaCl) concentrations ranging from 50 to 100 mM, beyond which germination was completely inhibited. There were substantial reductions in seed germination, 32% (averaged over populations) under highly acidic conditions (pH 4.0) as compared with the control (water: pH 6.4). Seed germination of both populations on the soil surface was 77%, and no seedlings emerged from a burial depth of 1 cm. The addition of 6 Mg ha−1 of wheat (Triticum aestivum L.) residue reduced the emergence of the C and F populations of S. thellungii by 75% and 64%, respectively, as compared with the control (no residue). Information gathered from this study provides a better understanding of the factors favorable for germination and emergence of S. thellungii, which will aid in developing management strategies in winter crops, especially wheat, barley (Hordeum vulgare L.), and chick pea (Cicer arietinum L.).
It is thought that protoplanets formed in protoplanetary disks excite the orbital motion of the surrounding planetesimals, and the bow shocks caused by the highly excited planetesimals heat their icy component evaporating into gas. We have performed model calculations to study the evolution of molecular abundances of the evaporated icy component, which suggests sulfur-bearing molecules can be good tracers of icy planetesimal evaporation. Here we report the result of our ALMA observations of sulfur-bearing molecules towards protoplanetary disks. The lines were undetected but the obtained upper limits of the line fluxes and our model calculations give upper limits of the fractional abundances of x(H2S) < 10−11 and x(SO) < 10−10 in the outer disk. These results are consistent with the molecular abundances in comets in our Solar system.
Observationally locating the position of the H2O snowline in protoplanetary disks is crucial for understanding planetesimal and planet formation processes, and the origin of water on the Earth. In our studies, we conducted calculations of chemical reactions and water line profiles in protoplanetary disks, and identified that ortho/para-H216O, H218O lines with small Einstein A coefficients and relatively high upper state energies are dominated by emission from the hot midplane region inside the H2O snowline. Therefore, through analyzing their line profiles the position of the H2O snowline can be located. Moreover, because the number density of the H218O is much smaller than that of H216O, the H218O lines can trace deeper into the disk and thus they are potentially better probes of the exact position of the H2O snowline in disk midplane.
To identify ways that the built environment may support or disrupt safe doffing of personal protective equipment (PPE) in biocontainment units (BCU).
We observed interactions between healthcare workers (HCWs) and the built environment during 41 simulated PPE donning and doffing exercises.
The BCUs of 4 Ebola treatment facilities and 1 high-fidelity BCU mockup.
A total of 64 HCWs (41 doffing HCWs and 15 trained observers) participated in this study.
In each facility, we observed how the physical environment influences risky behaviors by the HCW. The environmental design impeded communication between trained observers (TOs) and HCWs because of limited window size or visual obstructions with louvers, which allowed unobserved errors. The size and configuration of the doffing area impacted HCW adherence to protocol, and lack of clear demarcation of zones resulted in HCWs inadvertently leaving the doffing area and stepping back into the contaminated areas. Lack of standard location for items resulted in equipment and supplies frequently shifting positions. Finally, different solutions for maintaining balance while removing shoe covers (ie, chair, hand grips, and step stool) had variable success. We identified the 5 key requirements that doffing areas must achieve to support safe doffing of PPE, and we developed a matrix of proposed design strategies that can be implemented to meet those requirements.
Simple, low-cost environmental design interventions can provide structure to support and improve HCW safety in BCUs. These interventions should be implemented in both current and future BCUs.
Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
Recent advances in early stage failure analysis approaches have introduced behavioral network analysis (BNA), which applies a network-based model of a complex engineered system to detect the system-level effect of ‘local’ failures of design variables and parameters. Previous work has shown that changes in microscale network metrics can signify system-level performance degradation. This article introduces a new insight into the influence of the community structure of the behavioral network on the failure tolerance of the system through the role of bridging nodes. Bridging nodes connect a community of nodes in a system to one or more nodes or communities outside of the community. In a study of forty systems, it is found that bridging nodes, under attack, are associated with significantly larger system-level behavioral degradation than non-bridging nodes. This finding indicates that the modularity of the behavioral network could be key to understanding the failure tolerance of the system and that parameters associated with bridging nodes between modules could play a vital role in system degradation.