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Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown.
Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses.
Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo.
These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.
If the head is religion, the gut is magic. Taking up this provocation, this Element delves into the digestive system within transnational Afro-Diasporic religions such as Haitian Vodou, Brazilian Candomblé, and Cuban Lucumí (also called Santería). It draws from the ethnographic and archival record to probe the abdomen as a vital zone of sensory perception, amplified in countless divination verses, myths, rituals, and recipes for ethnomedical remedies. Provincializing the brain as only one locus of reason, it seeks to expand the notion of 'mind' and expose the anti-Blackness that still prevents Black Atlantic knowledges from being accepted as such. The Element examines gut feelings, knowledge, and beings in the belly; African precedents for the Afro-Diasporic gut-brain axis; post-sacrificial offerings in racist fantasy and everyday reality; and the strong stomachs and intestinal fortitude of religious ancestors. It concludes with a reflection on kinship and the spilling of guts in kitchenspaces.
This article aims to determine what important new developments have emerged in reparation for victims of serious violations of international humanitarian law (IHL). Our hypothesis is that there have been significant new developments in this area of particular relevance to IHL and that reparation for victims of serious violations of IHL is increasingly being incorporated into this body of law as one of its key components. It is submitted that the following developments are evidence of this gradual transformation of IHL: (i) broad recognition of the right of victims of serious violations of IHL to reparation; (ii) extension of the scope of the obligation to provide reparation under IHL to include non-State armed groups and individuals as well as States; (iii) the existence of innovative domestic reparation mechanisms complemented or supervised by regional courts, as evidenced by experiences in Latin America; and (iv) the reparation system of the International Criminal Court as a global mechanism.
The early clinical predictors of respiratory failure in Latin Americans with Guillain–Barré syndrome (GBS) have scarcely been studied. This is of particular importance since Latin America has a high frequency of axonal GBS variants that may imply a worse prognosis.
We studied 86 Mexican patients with GBS admitted to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, a referral center of Mexico City, to describe predictors of invasive mechanical ventilation (IMV).
The median age was 40 years (interquartile range: 26–53.5), with 60.5% men (male-to-female ratio: 1.53). Most patients (65%) had an infectious antecedent (40.6% gastrointestinal). At admission, 38% of patients had a Medical Research Council (MRC) sum score <30. Axonal subtypes predominated (60.5%), with acute motor axonal neuropathy being the most prevalent (34.9%), followed by acute inflammatory demyelinating polyneuropathy (32.6%), acute motor sensory axonal neuropathy (AMSAN) (25.6%), and Fisher syndrome (7%). Notably, 15.1% had onset in upper limbs, 75.6% dysautonomia, and 73.3% pain. In all, 86% received either IVIg (9.3%) or plasma exchange (74.4%). IMV was required in 39.5% patients (72.7% in AMSAN). A multivariate model without including published prognostic scores yielded the time since onset to admission <15 days, axonal variants, MRC sum score <30, and bulbar weakness as independent predictors of IMV. The model including grading scales yielded lower limbs onset, Erasmus GBS respiratory insufficiency score (EGRIS) >4, and dysautonomia as predictors.
These results suggest that EGRIS is a good prognosticator of IMV in GBS patients with a predominance of axonal electrophysiological subtypes, but other early clinical data should also be considered.
Controversial Harlem-born rapper/singer, songwriter, and provocateuse Azealia Banks is the most (in)famous, vocal, and visible proponent of Black Atlantic traditions in recent times—making a critical reckoning well overdue. I begin here by tracing Banks's engagement with Afro-Diasporic religions (including Caribbean Espiritismo, Afro-Cuban Lucumí, and Dominican “21 Divisions”) as a trajectory from vamp to bruja [witch]/santera to mayombera. A review of Banks's public statements reveals her growing commitment to championing “so-called voodoo” and urging other African Americans to do so as well. I argue that the release of Beyoncé's Lemonade in 2016 catalyzed Banks's advocacy for Kongo-inspired Palo Mayombe, long overshadowed by Yorùbá-based orisha worship. I further demonstrate that Banks's espousal of Palo Mayombe has been bound up with her identity as a Womanist and dark-skinned, cisgender femme fatale. More than a political program, however, Banks's discursive constructions amount to a Black Atlantic metaphysics. Drawing on Irene Lara's formulation of “bruja positionalities,” I propose that the theoretical scaffolding for her metaphysics should be designated Brujx Womanism. Missteps notwithstanding, Banks emerges as a metaphysician, aspiring to repair Black bodies by re-membering Kongo traditions. In closing, I suggest that Banks's Brujx Womanism may contribute to the conceptualization of Conjure Feminism in four crucial respects.
While American political development scholars tend to focus on national or state-level politics, late nineteenth-century cities provided the lion's share of services: clean water, paved and lighted streets, and sanitation. How did cities innovate and build municipal capacity to do these things? We answer this question by looking at municipal responses to the garbage problem. As cities grew and trash piled up in the 1890s, cities explored ways to effectively collect the garbage. A government requires not just resources, but also the ability to marshal those resources. Corruption could provide such abilities. Looking at four corrupt cities—Pittsburgh, Charleston, New Orleans, and St. Louis—we consider whether corruption, and what type of corruption, fostered innovation and capacity. We compare these corrupt cities with a shadow study of the reformist government of Columbus. We found the following: (1) The logic of corruption is the most important factor to explain why municipal governments chose particular garbage strategies. Corrupt regimes chose garbage collection and disposal strategies that would benefit themselves—but these varied depending on what type of corruption dominated a city. (2) Corruption sometimes promoted innovation and capacity, but at other times, corruption hindered them. For better or worse, cities ruled by corruption gained the capacity that these informal regimes held.
When Hurricane Harvey landed along the Texas coast on August 25, 2017, it caused massive flooding and damage and displaced tens of thousands of residents of Harris County, Texas. Between August 29 and September 23, Harris County, along with community partners, operated a megashelter at NRG Center, which housed 3365 residents at its peak. Harris County Public Health conducted comprehensive public health surveillance and response at NRG, which comprised disease identification through daily medical record reviews, nightly “cot-to-cot” resident health surveys, and epidemiological consultations; messaging and communications; and implementation of control measures including stringent isolation and hygiene practices, vaccinations, and treatment. Despite the lengthy operation at the densely populated shelter, an early seasonal influenza A (H3) outbreak of 20 cases was quickly identified and confined. Influenza outbreaks in large evacuation shelters after a disaster pose a significant threat to populations already experiencing severe stressors. A holistic surveillance and response model, which consists of coordinated partnerships with onsite agencies, in-time epidemiological consultations, predesigned survey tools, trained staff, enhanced isolation and hygiene practices, and sufficient vaccines, is essential for effective disease identification and control. The lessons learned and successes achieved from this outbreak may serve for future disaster response settings. (Disaster Med Public Health Preparedness. 2019;13:97-101)
Rapid diagnostic technologies can assist Antimicrobial Stewardship Programs (ASPs) in achieving the goals of reducing unnecessary antimicrobial exposure and optimizing patient care. The Society of Infectious Diseases Pharmacists supports all members of the ASP team as essential components of optimal use of these technologies for management of antibiotic prescribing and cost-reduction strategies.
A controversy at the 2016 IUCN World Conservation Congress on the topic of closing domestic ivory markets (the 007, or so-called James Bond, motion) has given rise to a debate on IUCN's value proposition. A cross-section of authors who are engaged in IUCN but not employed by the organization, and with diverse perspectives and opinions, here argue for the importance of safeguarding and strengthening the unique technical and convening roles of IUCN, providing examples of what has and has not worked. Recommendations for protecting and enhancing IUCN's contribution to global conservation debates and policy formulation are given.
Overall, autologous bone grafting continues to be the gold standard for the restoration of bone defects while other practices include metallic meshes and plates. These practices are not always suitable particularly when performing reconstructive surgery in the maxillofacial region as the defects tend to be complex in terms of size and shape. These bone defect usually occur due to trauma, infection or a result of oncologic surgeries and therefore the patient requires large amount of bone grafting material .
There is a need for alternative methods such as is artificial bone scaffolds with regenerative medicine approaches in order to enable original tissue regeneration. In order to stimulate tissue regeneration scaffolding materials are required to have certain properties such as biocompatibility, adequate mechanical properties and internal and surface topographical features in order to provide specific biological signals to promote cell attachment and proliferation. Ideally, it would also need to be biodegradable and provide sufficient support for both the particular defect area and cellular ingrowth to degrade over time as new bone tissue is formed . This work analyses the mechanical and chemical properties of Hydroxyapatite (HA) - poly(ethylene glycol) dimethacrylate (PEGDMA) and Hydroxyapatite (HA) - poly(ethylene glycol) diacrylate (PEGDA) based composites used as artificial bone scaffold material with internal structures optimized using finite element analysis (FEA) using Hyperworks OptiStruct (Altair, USA) Topological Optimization and manufactured using commercially available additive manufacturing techniques in order to develop a product that can be introduced directly into the patient. The technique allows implants to be custom made, having the right dimensions and the right mechanical properties.
Testing of the ceramic-hydrogel composite include mechanical testing in compression, tension, bending, impact and hardness while chemical analysis include Fourier Transform Infrared spectroscopy (ATR-FTIR) and Differential Scanning Calorimetry (DSC). Morphology was analyzed using Scanning Electron Microscopy (SEM) and Laser Scanning Confocal Microscopy.
The degree of development and operability of the indicators for the Marine Strategy Framework Directive (MSFD) using Descriptor 1 (D1) Biological Diversity was assessed. To this end, an overview of the relevance and degree of operability of the underlying parameters across 20 European countries was compiled by analysing national directives, legislation, regulations, and publicly available reports. Marked differences were found between countries in the degree of ecological relevance as well as in the degree of implementation and operability of the parameters chosen to indicate biological diversity. The best scoring EU countries were France, Germany, Greece and Spain, while the worst scoring countries were Italy and Slovenia. No country achieved maximum scores for the implementation of MSFD D1. The non-EU countries Norway and Turkey score as highly as the top-scoring EU countries. On the positive side, the chosen parameters for D1 indicators were generally identified as being an ecologically relevant reflection of Biological Diversity. On the negative side however, less than half of the chosen parameters are currently operational. It appears that at a pan-European level, no consistent and harmonized approach currently exists for the description and assessment of marine biological diversity. The implementation of the MSFD Descriptor 1 for Europe as a whole can therefore at best be marked as moderately successful.
Understanding genetic and environmental effects on white matter development in the first years of life is of great interest, as it provides insights into the etiology of neurodevelopmental disorders. In this study, the genetic and environmental effects on white matter were estimated using data from 173 neonatal twin subjects. Diffusion tensor imaging scans were acquired around 40 days after birth and were non-rigidly registered to a group-specific atlas and parcellated into 98 ROIs. A model of additive genetic, and common and specific environmental variance components was used to estimate overall and regional genetic and environmental contributions to diffusion parameters of fractional anisotropy, radial diffusivity, and axial diffusivity. Correlations between the regional heritability values and diffusion parameters were also examined. Results indicate that individual differences in overall white matter microstructure, represented by the average diffusion parameters over the whole brain, are heritable, and estimates are higher than found in studies in adults. Estimates of genetic and environmental variance components vary considerably across different white matter regions. Significant positive correlations between radial diffusivity heritability and radial diffusivity values are consistent with regional genetic variation being modulated by maturation status in the neonatal brain: the more mature the region is, the less genetic variation it shows. Common environmental effects are present in a few regions that tend to be characterized by low radial diffusivity. Results from the joint diffusion parameter analysis suggest that multivariate modeling approaches might be promising to better estimate maturation status and its relationship with genetic and environmental effects.
We describe subject recruitment from the University of Chile School-Age Children Twin Registry (REMEUCHI). The research aim of REMEUCHI is to quantify the impact of genetic and environmental factors on scholastic achievement in a multicausal approach. The Ministry of Education of Chile, in collaboration with the Registry Office, provided the list of possible twin pairs graduated from high school in 2004 in Chile's metropolitan region. From a population of 70,065 school-age children who had graduated from high school, 434 possible twin pairs were analyzed. Of these, 327 were twins reared together (75.3% of the 434 possible twins pairs) and born between 1986 and 1987 in Chile (mean age 18 years), and approximately 8% were not twins despite matches on full name and birth data. The rest of the possible twin pairs were probably twins reared apart, since one member of the pair had moved to study in another region of Chile. Zygosity was determined through questionnaires, maternal reports of twin similarities, and by the hospital records of the twins at the time of birth. Three hundred and twenty-seven pairs were identified, where monozygotic (MZ) and dizygotic (DZ) twins represented 46.8% and 53.2% of pairs, respectively, with a DZ/MZ ratio of 1.14. Considering same-sex MZ pairs, the percentage of female pairs was greater (55.6%) than male pairs (44.4%). When DZ pairs were analyzed, 47.7% were of opposite sex, 20.1% were male pairs and 32.2% female pairs. In Chile, these findings represent a baseline study to contribute to the establishment of a national twin registry in the future.
The risk of latent tuberculosis (LTBI) in healthcare workers (HCWs) is high. Until recently, the tuberculin skin test (TST) was the only diagnostic test available for Mycobacterium tuberculosis infection. A new enzyme-linked immunosorbent assay test, the QuantiFERON-TB Gold (QFT-G) test, was recommended by the US Centers for Disease Control and Prevention as an alternative test for the diagnosis of LTBI in HCWs. The purpose of our study was to compare the TST and the QFT-G test in Spanish HCWs in order to improve procedures for the detection of LTBI.
A cross-sectional study with blinded comparison of TST and QFT-G test results was carried out among 134 HCWs at an 800-bed Spanish university hospital. The level of interferon-7 production stimulated by the QFT-G test was measured. A concentration of at least 0.35 IU/mL was considered a positive result. An induration of at least 5 mm in non-BCG-vaccinated or at least 15 mm in BCG-vaccinated HCWs for the TST was considered positive.
Of the 134 HCWs included (mean age, 33.4 years; 101 [75.4%] women; 47 [35.1%] BCG vaccinated), the LTBI prevalence diagnosed with any test was 11.2% (95% confidence interval, 6.6%-18.1%), with the TST was 8.96%, and with the QFT-G test was 5.97% (nonsignificant differences). The QFT-G test value was higher in subjects with TST induration of at least 15 mm than in subjects with TST induration of less than 15 mm (P < .001). Overall agreement between the results of the two tests was found in 94% of HCWs (K = 0.56), but agreement was only 59% in HCWs who had a positive result for both tests. Disagreement was present in the results found for 5% of HCWs.
Few studies have compared both tests in populations with high M. tuberculosis exposure but low BCG vaccination prevalence. Agreement between both tests is high, especially among negative Results. Studies are needed to clarify the reasons for disagreement and to establish the best TST and QFT-G test cutoff point.
Spatial and seasonal patterns of seed removal by rodents, ants and birds were evaluated using seed-dish experiments in a Trachypogon savanna in Venezuela. Four-day experiments were conducted on three dates and at four different sites. Seeds from 10 native plant species representing a broad mass range were offered at densities equivalent to 3145 seeds m−2. We found that total seed removal and relative importance of granivorous groups varied widely among sites and dates. Rodents were the major seed predators in all the habitats, except for the savanna/forest border where birds dominated. Ants removed more seeds than birds, but since they preferred the smallest seeds, ants ranked last in mass removed. We found a temporally variable relationship between seed removal rates and seed rain or seed bank. We inferred monthly seed predation from seed-dish experiments as well as through the decline of the seed bank in the environment during the dry season, and compared both estimations to evaluate the suitability of the seed-dish technique for estimating granivory. We initially hypothesized that seed-dish experiments that emulate seed availability more closely may yield a better estimate of seed predation, but in fact, they may still overestimate granivory intensity.
Elizabeth A. Sinclair, Department of Integrative Biology, School of Natural Sciences, Edith Cowan University, Perth, WA 6027, Australia,
Marcos Pérez-Losada, Department of Integrative Biology, School of Natural Sciences, Edith Cowan University, Perth, WA 6027, Australia,
Keith A. Crandall, Department of Integrative Biology, Monte L. Bean Life Science Museum, Brigham Young University, Provo, UT 84602-5255, USA
Phylogeny reconstruction has been historically used as a tool in systematics and taxonomy, examining relationships among species and at higher level taxonomic classifications. However, with recent advances in our ability to collect nucleotide sequence data from a wide variety of organisms, coupled with advances in phylogenetic methodology and their comparative testing, there has been a broader application of phylogeny reconstruction into areas such as describing biodiversity to assign regional conservation priorities (Crozier 1992; Faith 1992), defining critical habitat areas (see, for example, Crandall 1998), and for understanding genetic patterns and processes at or below the species level (see, for example, Fetzner & Crandall 2003; Morando et al. 2003). There is also an increasing awareness among those involved in the development of conservation programmes that molecular data can be usefully combined for integrated conservation planning from the broader landscape or community level, to biogeographic subregions, and to individual species (Moritz 2002).
In cases where morphology is unable to resolve relationships among closely related taxa or particularly at the population level (intraspecific relationships), molecular approaches provide the much-needed resolution to interpret evolutionary histories. Defining species still remains an extremely contentious issue among scientists; however, criteria may be defined to test (morphologically cryptic) species boundaries, phylogenies may be statistically tested according to these criteria (see below), and outcomes compared between different phylogenetic reconstruction methods or different data sets (e.g. morphology versus molecular, different gene regions).
Wildlife (bushmeat or game) is the primary source of protein for most poor households in tropical forests, and its consumption is resulting in unsustainable hunting of large animals, even in isolated regions. As a result, loss of fauna is often a more immediate and significant threat to the conservation of biological diversity in tropical forests than is deforestation. Although the potential effects of the extirpation from tropical forests of large, seed predating and seed dispersing wild animals is poorly understood, it is likely that there will be irrevocable changes in the structure and function of these ecosystems. We carried out a survey of 510 households of Tsimane' Amerindians in the rainforest of Bolivia to investigate how the prices of game and meat from domesticated animals affect the consumption of game. The results indicated that the price of fish and meat from livestock is positively correlated with consumption of wildlife, suggesting that policy makers may be able to reduce the unsustainable hunting of wildlife for food by reducing the price of fish and the price of meat from domesticated animals relative to that of wildlife. Increasing the production of livestock without causing environmental degradation will require long-term public investment in agricultural research and extension, and substitution of fish for game meat in the absence of sustainable management regimes will result in over-exploitation of riverine and lacustrine fish stocks.
A total of 537 crops from four coexisting granivorous doves (Columbina minuta, C. passerina, C. talpacoti and Scardafella squammata),
collected on seven sampling dates in a Venezuelan savanna, were examined to assess food partitioning. These closely related doves are resident birds, and overlap broadly both in daily activity patterns and habitat use; in circumstances like this, segregation in the use of food resources often occurs. It was found that: (a) differences in body dimensions did not account for variations in seed
size taken by doves; they all ate seeds in the same size range and they showed high similarity in seed size preferred; (b) the importance of different seed sizes in the diets changed seasonally with similar tendencies for all four species, (c) there were differences up to 4-fold in mean seed size consumed by individuals of the same species on the same date; (d) seeds of 63 plant species were
consumed by the four dove species and constituted from 98 to 99.5% of the diets; (e) high dietary overlap both in prey size and prey type was found throughout the year. The dietary relationships found in this study support the idea that these birds forage opportunistically, and that some differences found among their diets may be the result of random seed sampling from the heterogeneous seed
To assess the prevalence of tuberculosis (TB) or a positive skin test in healthcare workers (HCWs) providing services to human immunodeficiency virus (HIV)-infected individuals and to determine prospectively the incidence of new infections in this population.
This prospective cohort study enrolled 1,014 HCWs working with HIV-infected populations from 10 metropolitan areas. Purified protein derivative (PPD) tuberculin skin tests were placed at baseline and every 6 months afterwards on those without a history of TB or a positive PPD. Demographic, occupational, and TB exposure data also were collected.
Outpatient clinics, hospitals, private practice offices, and drug treatment programs providing HIV-related healthcare and research programs.
A voluntary sample of staff and volunteers from 16 Community Programs for Clinical Research on AIDS units.
Factors related to prior TB or a positive skin test at baseline included being foreign-born, increased length of time in health care, living in New York City, or previous bacille Calmette-Guerín vaccination. The rate of PPD conversion was 1.8 per 100 person years of follow-up. No independent relation was found between the amount or type of contact with HIV-infected populations and the risk of TB infection.
These data provide some reassurance that caring for HIV-infected patients is not related to an increased rate of TB infection among HCWs in these settings.
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