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To evaluate prevalence and risk factors of posttraumatic stress disorder (PTSD) and depression among directly exposed (DE) and indirectly or nonexposed (INE) populations in Sri Lanka 8 y after the Indian Ocean Tsunami in 2004.
Methods:
Population-based structured survey study was conducted among Sri Lankan adults living in 5 coastal districts, Hamboantha, Matara, Galle, Kalutara, and Colombo in 2012-2013. A total of 430 individuals, 325 in DE, 105 in INE, participated in the survey. DE and INE groups were compared for demographics and outcomes. Bivariate and multiple logistic regressions with backward selection were used to identify risk factors for partial PTSD and depression.
Results:
The prevalence of PTSD, partial PTSD and depression were 2.8%, 10.5%, and 18.8% in DE group, respectively. In multivariable analyses tsunami exposure, female gender, subjective physical health before the tsunami, previous trauma, and depression were significantly associated with partial PTSD. Female gender, high frequency of religious activity, previous trauma, social support, and PTSD were significantly associated with depression.
Conclusions:
The psychological impacts of the tsunami did wane over time, but still present at lower rate even in 8 y. It is important to address these lingering sequelae and expand access to at risk individuals.
Zn deficiency arising from inadequate dietary intake of bioavailable Zn is common in children in developing countries. Because house crickets are a rich source of Zn, their consumption could be an effective public health measure to combat Zn deficiency. This study used Optifood, a tool based on linear programming analysis, to develop food-based dietary recommendations (FBR) and predict whether dietary house crickets can improve both Zn and overall nutrient adequacy of children’s diets. Two quantitative, multi-pass 24-h recalls from forty-seven children aged 2 and 3 years residing in rural Kenya were collected and used to derive model parameters, including a list of commonly consumed foods, median serving sizes and frequency of consumption. Two scenarios were modelled: (i) FBR based on local available foods and (ii) FBR based on local available foods with house crickets. Results revealed that Zn would cease to be a problem nutrient when including house crickets to children’s diets (population reference intake coverage for Zn increased from 89 % to 121 % in the best-case scenario). FBR based on both scenarios could ensure nutrient adequacy for all nutrients except for fat, but energy percentage (E%) for fat was higher when house crickets were included in the diet (23 E% v. 19 E%). This manoeuvre, combined with realistic changes in dietary practices, could therefore improve dietary Zn content and ensure adequacy for twelve nutrients for Kenyan children. Further research is needed to render these theoretical recommendations, practical.
OBJECTIVES/GOALS: Neonatal hypoxic-ischemic encephalopathy (HIE) is an acute neurologic syndrome where decreased blood flow and oxygen to the brain causes acute and chronic brain dysfunction. The only proven neuroprotective intervention for HIE is hypothermia treatment started within 6 hours of birth and 50% of survivors have long-term deficits. METHODS/STUDY POPULATION: Pre-clinical adult stroke studies demonstrated that vagus nerve stimulation (VNS) has anti-inflammatory effects and attenuates brain damage. Transcutaneous auricular VNS (taVNS) is safe and feasible in infants and may improve the motor skill of bottle feeding. We hypothesize that a combined hypothermia-taVNS treatment shortly after HIE birth will have neuroprotective effects, improve motor function, attenuate infarct volume inflammation compared to hypothermia alone. The HIE model includes ligation of the right common carotid artery in postnatal day 7 (P7) rats followed by 90min hypoxia (8% oxygen) and 2hr hypothermia. taVNS or sham taVNS was administered using a bipolar electrode placed on the auricular concha region for 30min, [30sec trains, 0.5msec duration, 20Hz frequency, followed by 4.5min breaks] RESULTS/ANTICIPATED RESULTS: Experimental groups include +HIE/+taVNS, +HIE/-taVNS, and -HIE/-taVNS. To assess motor function, grasping reflex and forelimb grip strength tasks were assessed prior to surgery through P10. Infarct volume was assessed at 72h after injury by staining coronal sections with cresyl-violet. Thirty-four rat pups underwent surgery with an 8.82% mortality rate. taVNS was well tolerated by the P7 rats when delivered below perceptual threshold (0.4-1.1mA). There was no difference in elementary motor function or infarct volume between any group. DISCUSSION/SIGNIFICANCE: Future studies will include 2.5hr hypoxia for a more severe brain injury and a -HIE/+taVNS control group. These initial pre-clinical studies in neonates are important in determining whether taVNS may translate as a treatment to improve outcomes after neonatal HIE.
The remarkable archaeological record of Neolithic Orkney has ensured that these islands play a prominent role in narratives of European late prehistory, yet knowledge of the subsequent Bronze Age is comparatively poor. The Bronze Age settlement and cemetery at the Links of Noltland, on the island of Westray, offers new evidence, including aDNA, that points to a substantial population replacement between the Late Neolithic and Bronze Age. Focusing on funerary practice, the authors argue for interconnecting identities centred on household and community, patrilocality and inheritance. The findings prompt a reconsideration of the Orcadian Bronze Age, with wider implications for population movement and the uptake of cultural innovations more widely across prehistoric north-western Europe.
Due to COVID-19, many households faced hardships in the spring of 2020 – unemployment, an uncertain economic future, forced separation, and more. At the same time, the number of people who participated in outdoor recreation in many areas increased, as it was one of the few activities still permitted. How these experiences affect the public’s willingness to pay (WTP) for environmental public goods is unknown. During the early months of the pandemic, we conducted a stated preference survey to value statewide water quality improvements in Delaware. While a majority of participants report experiencing hardship of some sort (economic, emotional, etc.), mean household WTP declined by only 7 % by May 2020.
Monoclonal antibody therapeutics to treat coronavirus disease (COVID-19) have been authorized by the US Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from 3 sites at medical centers in the United States supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.
COVID-19 has caused tremendous death and suffering since it first emerged in 2019. Soon after its emergence, models were developed to help predict the course of various disease metrics, and these models have been relied upon to help guide public health policy.
Methods:
Here we present a method called COVIDNearTerm to “forecast” hospitalizations in the short term, two to four weeks from the time of prediction. COVIDNearTerm is based on an autoregressive model and utilizes a parametric bootstrap approach to make predictions. It is easy to use as it requires only previous hospitalization data, and there is an open-source R package that implements the algorithm. We evaluated COVIDNearTerm on San Francisco Bay Area hospitalizations and compared it to models from the California COVID Assessment Tool (CalCAT).
Results:
We found that COVIDNearTerm predictions were more accurate than the CalCAT ensemble predictions for all comparisons and any CalCAT component for a majority of comparisons. For instance, at the county level our 14-day hospitalization median absolute percentage errors ranged from 16 to 36%. For those same comparisons, the CalCAT ensemble errors were between 30 and 59%.
Conclusion:
COVIDNearTerm is a simple and useful tool for predicting near-term COVID-19 hospitalizations.
Philip Selznick's The Moral Commonwealth was published in 1992. In 1993, the yearly meetings of the American Sociological Association (ASA) took place in Miami Beach, Florida, from August 13 to 17. Seymour Martin Lipset was ASA President and Committee Chair at the time. On August 16, an “Author Meets Critics” session was devoted to Selznick's new book. James S. Coleman (University of Chicago) had organized this session and was its chair. The critics were Douglas Heckathorn (University of Connecticut), Alan Silver (Columbia University), George Steinmetz (University of Chicago), and Alan Wolfe (New School of Social Research).
In 1994, The Newsletter of PEGS published a symposium on The Moral Commonwealth, to which Steinmetz and Heckathorn contributed the reviews they had prepared for the ASA “Author Meets Critics” session of the year before; Charles W. Anderson (University of Wisconsin, Madison) added a review; and Selznick responded to these three reviews. The PEGS Newsletter was published from 1991 to 1995 by Penn State University (PSU) Press, on behalf of the Committee on the Political Economy of the Good Society. In 1996, the name of the journal was changed to The Good Society. It appears biannually, still published by PSU Press.
In this chapter, we present the reviews by Anderson, Steinmetz, and Heckathorn, and the response by Selznick—all as published in the PEGS Newsletter in 1994. The original texts are only adjusted for style consistency (as in the references) and to correct typos and errors.
Philip Selznick's Classic Humanism
Charles W. Anderson
The remarkable thesis of Philip Selznick's The Moral Commonwealth is that we have the materials to resolve our moral uneasiness ready at hand. From the most familiar ideas of our century, the books we have all read, the conventional teachings of the social sciences, we can derive a public philosophy that is consistent with the strongest, most enduring ideals of our civilization. Thus we need not renounce the spirit of the age to return to ancient virtue, nor deconstruct our fabric of thought to achieve authenticity, nor try to prove rightfulness by clever new moves in game theory, a more sublime calculus of self-interest, nor pursue any of the other drastic and implausible strategies now fashionable in academic circles.
The Variables and Slow Transients Survey (VAST) on the Australian Square Kilometre Array Pathfinder (ASKAP) is designed to detect highly variable and transient radio sources on timescales from 5 s to
$\sim\!5$
yr. In this paper, we present the survey description, observation strategy and initial results from the VAST Phase I Pilot Survey. This pilot survey consists of
$\sim\!162$
h of observations conducted at a central frequency of 888 MHz between 2019 August and 2020 August, with a typical rms sensitivity of
$0.24\ \mathrm{mJy\ beam}^{-1}$
and angular resolution of
$12-20$
arcseconds. There are 113 fields, each of which was observed for 12 min integration time, with between 5 and 13 repeats, with cadences between 1 day and 8 months. The total area of the pilot survey footprint is 5 131 square degrees, covering six distinct regions of the sky. An initial search of two of these regions, totalling 1 646 square degrees, revealed 28 highly variable and/or transient sources. Seven of these are known pulsars, including the millisecond pulsar J2039–5617. Another seven are stars, four of which have no previously reported radio detection (SCR J0533–4257, LEHPM 2-783, UCAC3 89–412162 and 2MASS J22414436–6119311). Of the remaining 14 sources, two are active galactic nuclei, six are associated with galaxies and the other six have no multi-wavelength counterparts and are yet to be identified.
The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries.
Methods
Face-to-face interviews with community samples totaling n = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents.
Results
3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2–4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as very effective by 58.8% of users and somewhat effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness.
Conclusion
ADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.
Sickle cell disease is associated with lower selenium levels, and the serum selenium level is inversely associated with haemolysis in SCD. The SCD population is more vulnerable to adverse COVID-19 outcomes. SARS-CoV-2 infection lowers the serum selenium level and this is associated with severity of COVID-19. Selenium supplementation is proposed to improve COVID-19 outcomes in the sickle cell disease population.
Sports-related concussive (SRC) convulsions are defined as episodes of transient, abnormal movements, occurring immediately following a head injury and after which an individual returns to a normal or only mildly altered level of consciousness (GCS 13-15). These episodes do not recur in the absence of a repeat head injury. While SRC-convulsions were once assumed to be early manifestations of post-traumatic epilepsy (PTE), they are now recognized as a distinct clinical entity. The pathophysiology of this clinical entity is largely unknown, with hypotheses suggesting either hypoxia-related functional decerebration or functional decerebration from shear forces on the ascending reticular activating formation. Due to the relative dearth of studies on SRC-convulsions, robust epidemiologic data are lacking, and the exact incidence is unknown. The diagnosis of SRC-convulsions is largely clinical, relying on detailed history and observed convulsion semiology. Electroencephalography (EEG) and neuroimaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), are of limited utility in the work-up of SRC-convulsions. Management with anti-epileptic drugs (AEDs) appears to be unnecessary, and follow-up should occur similarly to any concussed patient. Ultimately, more research is needed to better understand SRC-convulsions.
Unhealthy diet is a modifiable risk factor leading to subclinical arterial damage (SAD), high BP and CVD. It was aimed to investigate the possible associations of dietary patterns (DPs) with SAD in adults having multiple CVD risk factors.
Design:
Dietary intake was evaluated through two 24-h dietary recalls and principal component analysis was used to identify DPs. Oscillometry, applanation tonometry with pulse wave analysis and carotid ultrasound were used to assess peripheral and aortic BP, arterial stiffness and pressure wave reflections.
Setting:
Laiko University Hospital, Athens, Greece.
Participants:
A total of 470 individuals (53·1 ± 14·2 years) with CVD risk factors were enrolled.
Results:
A pattern characterised by increased consumption of whole-grain cereals, white meat and reduced consumption of sugar was positively associated with common carotid compliance (β = 0·01, 95 % CI 0·00, 0·01), whereas a pattern high in refined cereals, red and processed meat was positively associated with brachial but not aortic systolic pressure (β = 1·76, 95 % CI 0·11, 3·42) and mean arterial pressure (MAP) (β = 1·18, 95 % CI 0·02, −2·38). Low consumption of low-fat dairy products, high consumption of full-fat cheese and butter was positively associated with MAP (β = 0·97, 95 % CI 0·01, 1·95). Increased consumption of vegetables, fruits, fresh juices, fish and seafood was inversely associated with augmentation index (AIx) (β = -1·01, 95 % CI -1·93, −0·09).
Conclusion:
Consumption of whole grains, white meat, fruits/vegetables, fish/seafood and avoidance of sugar was associated with improved SAD. Preference in refined grains, red/processed meat, high-fat cheese/butter and low intake of low-fat dairy products were associated with BP elevation. Future studies are needed to confirm the present findings.
Performance characteristics of SARS-CoV-2 nucleic acid detection assays are understudied within contexts of low pre-test probability, including screening asymptomatic persons without epidemiological links to confirmed cases, or asymptomatic surveillance testing. SARS-CoV-2 detection without symptoms may represent presymptomatic or asymptomatic infection, resolved infection with persistent RNA shedding, or a false-positive test. This study assessed the positive predictive value of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (rRT-PCR) assays by retesting positive specimens from 5 pre-test probability groups ranging from high to low with an alternate assay.
Methods:
In total, 122 rRT-PCR positive specimens collected from unique patients between March and July 2020 were retested using a laboratory-developed nested RT-PCR assay targeting the RNA-dependent RNA polymerase (RdRp) gene followed by Sanger sequencing.
Results:
Significantly fewer (15.6%) positive results in the lowest pre-test probability group (facilities with institution-wide screening having ≤3 positive asymptomatic cases) were reproduced with the nested RdRp gene RT-PCR assay than in each of the 4 groups with higher pre-test probability (individual group range, 50.0%–85.0%).
Conclusions:
Large-scale SARS-CoV-2 screening testing initiatives among low pre-test probability populations should be evaluated thoroughly prior to implementation given the risk of false-positive results and consequent potential for harm at the individual and population level.
Microscopic examination of blood smears remains the gold standard for laboratory inspection and diagnosis of malaria. Smear inspection is, however, time-consuming and dependent on trained microscopists with results varying in accuracy. We sought to develop an automated image analysis method to improve accuracy and standardization of smear inspection that retains capacity for expert confirmation and image archiving. Here, we present a machine learning method that achieves red blood cell (RBC) detection, differentiation between infected/uninfected cells, and parasite life stage categorization from unprocessed, heterogeneous smear images. Based on a pretrained Faster Region-Based Convolutional Neural Networks (R-CNN) model for RBC detection, our model performs accurately, with an average precision of 0.99 at an intersection-over-union threshold of 0.5. Application of a residual neural network-50 model to infected cells also performs accurately, with an area under the receiver operating characteristic curve of 0.98. Finally, combining our method with a regression model successfully recapitulates intraerythrocytic developmental cycle with accurate lifecycle stage categorization. Combined with a mobile-friendly web-based interface, called PlasmoCount, our method permits rapid navigation through and review of results for quality assurance. By standardizing assessment of Giemsa smears, our method markedly improves inspection reproducibility and presents a realistic route to both routine lab and future field-based automated malaria diagnosis.
For the last two decades, high-dimensional data and methods have proliferated throughout the literature. Yet, the classical technique of linear regression has not lost its usefulness in applications. In fact, many high-dimensional estimation techniques can be seen as variable selection that leads to a smaller set of variables (a “submodel”) where classical linear regression applies. We analyze linear regression estimators resulting from model selection by proving estimation error and linear representation bounds uniformly over sets of submodels. Based on deterministic inequalities, our results provide “good” rates when applied to both independent and dependent data. These results are useful in meaningfully interpreting the linear regression estimator obtained after exploring and reducing the variables and also in justifying post-model-selection inference. All results are derived under no model assumptions and are nonasymptotic in nature.
This study provided biological information on 146 specimens of the poorly known deepwater mastigoteuthid squid Idioteuthis cordiformis. Mantle length ranged from 200–500 mm for males and 270–702 mm for females. The largest female weighed just under 12 kg. The majority of males were mature and all females were immature. The fins were larger and thicker than the mantle. Mantle weight of males and females was 44.8% and 55.2% of fin weight, respectively, and were significantly different. There was a significant sex effect on mantle length, total weight, mantle weight and fin weight, with females having greater values in all categories. There was a small season effect for mantle weight and fin weight. There was little ingested prey material except fluid and oil in the caecum that was typically bright orange or red. Total fluid volume ranged from 23–230 ml and 20–550 ml for males and females, respectively. The per cent oil component of total fluids in the caecum ranged from 6.9–50% and 10.8–50% for males and females, respectively, with no significant difference in per cent oil between males and females. There was a significant positive relationship between total weight and oil volume for females, and for males and females combined. The function of the oil is uncertain. While this study provided information on sex differences in the body size, sexual dimorphism and caecum oil content, information is still incomplete regarding reproduction due to the lack of any mature females captured in this study.
Populations of the globally endangered Giant Nuthatch Sitta magna have declined significantly throughout their small world range in southern China and northern continental South-East Asia. Distance sampling and direct observations were used to estimate the density and habitat use of the Giant Nuthatch in a potential stronghold for the species, Chiang Dao Wildlife Sanctuary, Thailand. Thirteen line transects covering 6.2 km were established in open, pine-oak habitat favoured by the nuthatch, during November 2014 to December 2015. The mean density of Giant Nuthatch was 3.94±1.22 (95% CI = 2.15–7.22) individuals/km2. Hierarchical distance sampling models indicated that habitat use by Giant Nuthatch was strongly correlated with trees of large diameter. A pair of Giant Nuthatches was radio-tracked as they fed nestlings during the 2016 breeding season. The female’s home range, centred on the nest, was 7.79 ha (95% kernel home range), approximately one-fourth of that of the male, 32.01 ha. Giant Nuthatches showed a significant preference for foraging on pines Pinus spp. and used the fissured bark of mature pines in which to store acorns of deciduous tree species. Our research indicates the importance of large, mature trees in open pine-oak forest in supporting Giant Nuthatch populations.
Multicentre research databases can provide insights into healthcare processes to improve outcomes and make practice recommendations for novel approaches. Effective audits can establish a framework for reporting research efforts, ensuring accurate reporting, and spearheading quality improvement. Although a variety of data auditing models and standards exist, barriers to effective auditing including costs, regulatory requirements, travel, and design complexity must be considered.
Materials and methods:
The Congenital Cardiac Research Collaborative conducted a virtual data training initiative and remote source data verification audit on a retrospective multicentre dataset. CCRC investigators across nine institutions were trained to extract and enter data into a robust dataset on patients with tetralogy of Fallot who required neonatal intervention. Centres provided de-identified source files for a randomised 10% patient sample audit. Key auditing variables, discrepancy types, and severity levels were analysed across two study groups, primary repair and staged repair.
Results:
Of the total 572 study patients, data from 58 patients (31 staged repairs and 27 primary repairs) were source data verified. Amongst the 1790 variables audited, 45 discrepancies were discovered, resulting in an overall accuracy rate of 97.5%. High accuracy rates were consistent across all CCRC institutions ranging from 94.6% to 99.4% and were reported for both minor (1.5%) and major discrepancies type classifications (1.1%).
Conclusion:
Findings indicate that implementing a virtual multicentre training initiative and remote source data verification audit can identify data quality concerns and produce a reliable, high-quality dataset. Remote auditing capacity is especially important during the current COVID-19 pandemic.
Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.