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Residents in a community in the South Peninsula of the Western Cape, South Africa live with the reality of unresolved challenges. The women and children of this community face a burden from the prevailing inequality and structural violence that plays out in their daily lives as high levels of unemployment, substance abuse, violence in many forms, food insecurity, high school dropout rates and teenage pregnancy. The complexities of living in this community were exacerbated by the arrival of the Covid-19 pandemic and the resultant lockdown regulations that destabilised all previous notions of normality. The pre-existing social challenges can be viewed as the residents’ experiences of hazards and stressors that have been in place for years in the unequal social structures of South Africa (The World Bank 2022). In this environment, of what can be interpreted as a community in chronic crisis (Dekker et al., 2021), the addition of the acute crisis of the pandemic, posed further cumulative effects on households that impacted more seriously on those who are already the most vulnerable. This paper presents reflections on the stories of women talking about their experiences of the global pandemic to this coastal community. We aim to show the impact on their lives as members of families within their community. The analysis will utilise the phases of a crisis (Emergency Management, 2022) where the pre-crisis or prodromal phase was recognised as life in the chronic crisis of structural violence. The acute or crisis phase of the pandemic became a lens for the effects of an existing long-term crisis compounded by athe. The response or chronic phase of the acute crisis was again found to be exacerbated by the existence of a long drawn out response phase to the chronic crisis. This paper is a window into the innovative attempts by this community to cope with the immense challenges of Covid-19, followed now by the post-crisis (resolution) phase that reflects the ongoing efforts to rebuild the community in the face of the cumulative effects of the pandemic, as but a temporary diversion from the challenges of a continuous chronic crisis. The post-crisis phase remains incomplete, however, a deeper understanding of crisis upon crisis provides knowledge that can assist those implementing social interventions in this community to tackle challenges as a state of chronic crisis for residents.

Funder: Alzheimer Society of Canada; Id: http://dx.doi.org/10.13039/501100000143, Funder: Weston Brain Institute; Id: http://dx.doi.org/10.13039/100012479, Funder: Fonds de Recherche du Québec ‐ Santé, Funder: Canadian Institutes of Health Research; Id: http://dx.doi.org/10.13039/501100000024, Funder: NIHR Rare Diseases Translational Research Collaboration, Funder: Deutsche Forschungsgemeinschaft; Id: http://dx.doi.org/10.13039/501100001659, Recent studies have reported early cerebellar and subcortical impact in the disease progression of genetic frontotemporal dementia (FTD) due to microtubule-associated protein tau (MAPT), progranulin (GRN) and chromosome 9 open reading frame 72 (C9orf72). However, the cerebello-subcortical circuitry in FTD has been understudied despite its essential role in cognition and behaviors related to FTD symptomatology. The present study aims to investigate the association between cerebellar and subcortical atrophy, and neuropsychiatric symptoms across genetic mutations. Our study included 983 participants from the Genetic Frontotemporal dementia Initiative including mutation carriers and noncarrier first-degree relatives of known symptomatic carriers. Voxel-wise analysis of the thalamus, striatum, globus pallidus, amygdala, and the cerebellum was performed, and partial least squares analyses (PLS) were used to link morphometry and behavior. In presymptomatic C9orf72 expansion carriers, thalamic atrophy was found compared to noncarriers, suggesting the importance of this structure in FTD prodromes. PLS analyses demonstrated that the cerebello-subcortical circuitry is related to neuropsychiatric symptoms, with significant overlap in brain/behavior patterns, but also specificity for each genetic mutation group. The largest differences were in the cerebellar atrophy (larger extent in C9orf72 expansion group) and more prominent amygdalar volume reduction in the MAPT group. Brain scores in the C9orf72 expansion carriers and MAPT carriers demonstrated covariation patterns concordant with atrophy patterns detectable up to 20 years before expected symptom onset. Overall, these results demonstrated the important role of the subcortical structures in genetic FTD symptom expression, particularly the cerebellum in C9orf72 and the amygdala in MAPT carriers.

We use the surface detector of the Pierre Auger Observatory to search for air showers initiated by photons with an energy above 1019 eV. Photons in the zenith angle range from 30∘ to 60∘ can be identified in the overwhelming background of showers initiated by charged cosmic rays through the broader time structure of the signals induced in the water-Cherenkov detectors of the array and the steeper lateral distribution of shower particles reaching ground. Applying the search method to data collected between January 2004 and June 2020, upper limits at 95% CL are set to an E-2 diffuse flux of ultra-high energy photons above 1019 eV, 2 × 1019 eV and 4 × 1019 eV amounting to 2.11 × 10-3, 3.12 × 10-4 and 1.72 × 10-4 km-2 sr-1 yr-1, respectively. While the sensitivity of the present search around 2 × 1019 eV approaches expectations of cosmogenic photon fluxes in the case of a pure-proton composition, it is one order of magnitude above those from more realistic mixed-composition models. The inferred limits have also implications for the search of super-heavy dark matter that are discussed and illustrated.

Acknowledgements: This project was funded by NCCR Marvel Inspire Fellowship (MP), NCCR Marvel (RKC & MC), Trinity College (EAE), and ERC Grant 677013-HBMAP (RKC & MC). The authors would like to acknowledge Federico Giberti, Andrea Anelli, and Guillaume Fraux for fruitful conversations at the study's start and culmination., Funder: National Center of Competence in Research Materials’ Revolution: Computational Design and Discovery of Novel Materials; doi: 10.13039/501100009150; Grant(s): 182892, Due to the subtle balance of intermolecular interactions that govern structure-property relations, predicting the stability of crystal structures formed from molecular building blocks is a highly non-trivial scientific problem. A particularly active and fruitful approach involves classifying the different combinations of interacting chemical moieties, as understanding the relative energetics of different interactions enables the design of molecular crystals and fine-tuning of their stabilities. While this is usually performed based on the empirical observation of the most commonly encountered motifs in known crystal structures, we propose to apply a combination of supervised and unsupervised machine-learning techniques to automate the construction of an extensive library of molecular building blocks. We introduce a structural descriptor tailored to the prediction of the binding (lattice) energy and apply it to a curated dataset of organic crystals, exploiting its atom-centered nature to obtain a data-driven assessment of the contribution of different chemical groups to the lattice energy of the crystal. We then interpret this library using a low-dimensional representation of the structure-energy landscape and discuss selected examples of the insights into crystal engineering that can be extracted from this analysis, providing a complete database to guide the design of molecular materials.

The REAl2 series was characterized by solid-state NMR and Raman experiments. The spectroscopic data was correlated to the XRD measurements and the DFT calculations, gaining an insight into bonding, charge distribution and the strain.

Tor is a popular privacy-enhancing technology that allows anonymous communication using onion routing. However, such technologies are only helpful if used; therefore, performance is an important aspect. One of the main performance bottlenecks of Tor is the cross-circuit interference (CCI) problem. Tor multiplexes multiple circuits over a single Transport Layer Security (TLS) 1.2 connection if they share a path segment (link). Therefore, they have the same congestion window, which can yield unfair bandwidth allocation. However, there has been little work in understanding this problem in more depth. This paper investigates the number of simultaneously shared links in the current Tor network, which are the root cause of CCI. We developed a novel shared links simulator called SALSA to investigate this problem. Our results show that 3.7 % of active links are shared, and the involving Onion Routers (ORs) have the most common bandwidth capabilities. Additionally, we show that the internal circuits and exit policy influence the CCI problem. Furthermore, we model the number of shared links when the demand grows further and show that the number of shared links can go up to 16 %. Finally, we run Shadow simulations with a 25 % down-scaled Tor network and show that a network without shared links is faster.

Objectives. To compare the effectiveness of 3 approaches for communicating opioid risk during an emergency department visit for a common painful condition. Methods. This parallel, multicenter randomized controlled trial was conducted at 6 geographically disparate emergency department sites in the United States. Participants included adult patients between 18 and 70 years of age presenting with kidney stone or musculoskeletal back pain. Participants were randomly assigned to 1 of 3 risk communication strategies: (1) a personalized probabilistic risk visual aid, (2) a visual aid and a video narrative, or 3) general risk information. The primary outcomes were accuracy of risk recall, reported opioid use, and treatment preference at time of discharge. Results. A total of 1301 participants were enrolled between June 2017 and August 2019. There was no difference in risk recall at 14 days between the narrative and probabilistic groups (43.7% vs 38.8%; absolute risk reduction = 4.9%; 95% confidence interval [CI] = −2.98, 12.75). The narrative group had lower rates of preference for opioids at discharge than the general risk information group (25.9% vs 33.0%; difference = 7.1%; 95% CI = 0.64, 0.97). There were no differences in reported opioid use at 14 days between the narrative, probabilistic, and general risk groups (10.5%, 10.3%, and 13.3%, respectively; P = .44). Conclusions. An emergency medicine communication tool incorporating probabilistic risk and patient narratives was more effective than general information in mitigating preferences for opioids in the treatment of pain but was not more effective with respect to opioid use or risk recall. Trial Registration. Clinical Trials.gov identifier: NCT03134092. (Am J Public Health. 2022;112(S1):S45–S55. https://doi.org/10.2105/AJPH.2021.306511 )

Background and objectives The C9orf72 expansion is the most common genetic cause of frontotemporal dementia (FTD) and/or motor neuron disease (MND). Corticospinal degeneration has been described in post-mortem neuropathological studies in these patients, especially in those with MND. We used MRI to analyze white matter (WM) volumes in presymptomatic and symptomatic C9orf72 expansion carriers and investigated whether its measure may be helpful in predicting the onset of symptoms. Methods We studied 102 presymptomatic C9orf72 mutation carriers, 52 symptomatic carriers: 42 suffering from FTD and 11 from MND, and 75 non-carriers from the Genetic Frontotemporal dementia Initiative (GENFI). All subjects underwent T1-MRI acquisition. We used FreeSurfer to estimate the volume proportion of WM in the brainstem regions (midbrain, pons, and medulla oblongata). We calculated group differences with ANOVA tests and performed linear and non-linear regressions to assess group-by-age interactions. Results A reduced WM ratio was found in all brainstem subregions in symptomatic carriers compared to both noncarriers and pre-symptomatic carriers. Within symptomatic carriers, MND patients presented a lower ratio in pons and medulla oblongata compared with FTD patients. No differences were found between presymptomatic carriers and non-carriers. Clinical severity was negatively associated with the WM ratio. C9orf72 carriers presented greater age-related WM loss than non-carriers, with MND patients showing significantly more atrophy in pons and medulla oblongata. Discussion We find consistent brainstem WM loss in C9orf72 symptomatic carriers with differences related to the clinical phenotype supporting the use of brainstem measures as neuroimaging biomarkers for disease tracking.

Introduction: Individuals with developmental coordination disorder frequently report emotional and functional difficulties. A stressful era as COVID-19 pandemic may enhance emotional load. The present study aimed to (1) examine the emotional distress and quality of life among adults with developmental coordination disorder during COVID-19 as compared to typical controls, and (2) examine the relationships between these factors in adults with developmental coordination disorder. Method: Participants were 317 adults, aged 18–66, recruited during the first year of COVID-19: 227 were included in the developmental coordination disorder group, and 90 in the control group (normal motor performance) based on the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist cutoff score. Participants completed a sociodemographic health status/daily life under COVID-19 questionnaire and self-reports about their emotional status (depression, anxiety, stress) and a quality of life. Results: The developmental coordination disorder group had significantly greater depression, anxiety, stress, and lower quality of life. Participants with developmental coordination disorder who were infected by COVID-19 or reported reduction of working hours due to COVID-19 had the lowest social and environmental quality of life. Depression significantly predicted reduced quality of life and mediated between developmental coordination disorder severity and quality of life. Conclusions: Prevention and intervention programs for adults with developmental coordination disorder should be elaborated, with reference to emotional load and to implications on daily life, especially in times of crisis, like COVID-19.

BackgroundAlthough multiple sclerosis (MS) is an immune-related disorder, pharmaceutical interventions targeting the immune system do not stop or reverse disability progression; the major challenge for this condition. Studies show that disability progression in MS is associated with vascular comorbidity and brain volume loss, indicating that a multi-targeted approach is required to prevent debilitation. The aim of the present study was to examine the associations between vascular ultrasound, disability, biochemistry and lifestyle data in people with MS (pwMS).MethodsExtracranial vascular ultrasound was performed on 51 pwMS and 25 age-matched controls. Sonographic interrogation determined carotid intima-media thickness (cIMT) and abnormal blood flow patterns. Disability was assessed using the Expanded Disability Status Scale (EDSS). Biochemical and lifestyle data were obtained for all participants.ResultsThe EDSS had a highly significant positive association with the cIMT of the right (r = 0.63; p = 0.001) and left (r = 0.49; p = 0.001) common carotid arteries and negative associations with the peak systolic blood flow velocity of the right vertebral artery (r = -0.42; p = 0.01) as well as end-diastolic velocity of the left internal carotid artery (r = -0.47; p = 0.01). These associations were significantly influenced by biochemical and lifestyle factors. Both cIMT and age showed significant associations with the EDSS. When cIMT was adjusted for age in a regression analysis, the association between the EDSS and the cIMT remained significant (p < 0.01), while the age association was reduced to being significant only at 10% (p = 0.06). There was no association between the use of MS medication and the EDSS (p = 0.56).ConclusionPwMS who had increased cIMT, a surrogate marker for atherosclerosis, and reduced carotid artery blood flow velocities were at risk for greater disability over and above the effect of aging. These findings provide important information for disease management and disability prevention in pwMS. Modification of diet and lifestyle may promote the unhindered flow of essential nutritional factors into the brain in pwMS.

This study explored the ability of Tenebrio molitor, one of the most widely bred and traded insect species in Europe, to bioaccumulate polychlorobiphenyls (PCBs) from their feeding substrate. T. molitor larvae were reared for 20 days in a temperature- and humidity-controlled incubator and fed with wheat bran artificially contaminated with PCBs at a concentration of 0.67, 4.0 or 24.4 μg/kg. The larvae PCB content was then measured based on an analysis by GC-MS and GC-μECD. Whatever the level, a bran contamination by PCBs did not affect the body weight of larvae indicating a high tolerance to PCBs. The bioaccumulation factors (BAF; concentration of PCBs in larvae / concentration of PCBs in wheat bran) obtained with fresh larvae ranged between 0.4 and 1.0 and were significantly higher with the highest contamination level for PCBs 153 and 180. Although there is no bioaccumulation of PCBs in T. molitor larvae during rearing, PCBs can be transferred from the diet to the larvae. This study highlights the significant impact of the drying process which induces an increase of the PCB concentration in larvae by a factor of almost 3. This demonstrates the importance of considering the quality of the substrates used for farming insects as food and feed in terms of content in chemical contaminants including persistent organic pollutants like PCBs.

OBJECTIVE The aim of this study was to evaluate the utility and safety of "hybrid" stereo-electroencephalography (SEEG) in guiding epilepsy surgery and in providing information at single-neuron levels (i.e., single-unit recording) to further the understanding of the mechanisms of epilepsy and the neurocognitive processes unique to humans. METHODS The authors evaluated 218 consecutive patients undergoing SEEG procedures from 1993 through 2018 at a single academic medical center to assess the utility and safety of this technique in both guiding epilepsy surgery and providing single-unit recordings. The hybrid electrodes used in this study contained macrocontacts and microwires to simultaneously record intracranial EEG and single-unit activity (hybrid SEEG). The outcomes of SEEG-guided surgical interventions were examined, as well as the yield and scientific utility of single-unit recordings in 213 patients who participated in the research involving single-unit recordings. RESULTS All patients underwent SEEG implantation by a single surgeon and subsequent video-EEG monitoring (mean of 10.2 electrodes per patient and 12.0 monitored days). Epilepsy networks were localized in 191 (87.6%) patients. Two clinically significant procedural complications (one hemorrhage and one infection) were noted. Of 130 patients who underwent subsequent focal epilepsy surgery with a minimum 12-month follow-up, 102 (78.5%) underwent resective surgery and 28 (21.5%) underwent closed-loop responsive neurostimulation (RNS) with or without resection. Seizure freedom was achieved in 65 (63.7%) patients in the resective group. In the RNS group, 21 (75.0%) patients achieved 50% or greater seizure reduction. When the initial period of 1993 through 2013 before responsive neurostimulator implantation in 2014 was compared with the subsequent period of 2014 through 2018, the proportion of SEEG patients undergoing focal epilepsy surgery grew from 57.9% to 79.7% due to the advent of RNS, despite a decline in focal resective surgery from 55.3% to 35.6%. A total of 18,680 microwires were implanted in 213 patients, resulting in numerous significant scientific findings. Recent recordings from 35 patients showed a yield of 1813 neurons, with a mean yield of 51.8 neurons per patient. CONCLUSIONS Hybrid SEEG enables safe and effective localization of epileptogenic zones to guide epilepsy surgery and provides unique scientific opportunities to investigate neurons from various brain regions in conscious patients. This technique will be increasingly utilized due to the advent of RNS and may prove a useful approach to probe neuronal networks in other brain disorders.

Intellectual curiosity - the tendency to seek out and engage in opportunities for effortful cognitive activity - is a crucial construct in educational research and beyond. Measures of intellectual curiosity vary widely in psychometric quality, and few measures have demonstrated validity and comparability of scores across multiple languages. We analyzed a novel, six-item intellectual curiosity scale (ICS) originally developed for cross-national comparisons in the context of the OECD's Programme for the International Assessment of Adult Competencies (PIAAC). Samples from six countries representing six national languages (U.S. Germany, France, Spain, Poland, and Japan; total N = 5,557) confirmed that the ICS possesses very good psychometric properties. The scale is essentially unidimensional and showed excellent reliability estimates. On top of factorial validity, the scale demonstrated strict measurement invariance across demographic segments (gender, age groups, and educational strata) and at least partial scalar invariance across countries. As per its convergent and divergent associations with a broad range of constructs (e.g., Open-Mindedness and other Big Five traits, Perseverance, Sensation Seeking, Job Orientations, and Vocational Interests), it also showed convincing construct validity. Given its internal and external relationships, we recommend the ICS for assessing intellectual curiosity, especially in cross-cultural research applications, yet we also point out future research areas.

O que acontece quando levamos a sério a multidão articulada para se realizar o cuidado e a ambivalência das consequências materiais de suas práticas? Essa questão-problema mobiliza a organização do presente dossiê. Este material entra no boom da atenção dada ao cuidado nos últimos anos, mas destaca algo ainda pouco discutido: seu caráter mais que humano, atravessado por agencialidades múltiplas. Os quatro artigos originais que o compōem oferecem engajamentos específicos que destacam contribuiçōes dos estudos da ciência e tecnologia para os estudos sobre o cuidado, e vice-versa. O dossiê conta ainda com a tradução da introdução do livro Matters of care: Speculative ethics more than human worlds, de Maria Puig de la Bellacasa (2017), o qual se alinha com as etnografias e cria junto com elas., O que acontece quando levamos a sério a multidão articulada para se realizar o cuidado e a ambivalência das consequências materiais de suas práticas? Essa questão-problema mobiliza a organização do presente dossiê. Este material entra noboomda atenção dada ao cuidado nos últimos anos, mas destaca algo ainda pouco discutido: seu caráter mais que humano, atravessado por agencialidades múltiplas. Os quatro artigos originais que o compōem oferecem engajamentos específicos que destacam contribuiçōes dos estudos da ciência e tecnologia para os estudos sobre o cuidado, e vice-versa. O dossiê conta ainda com a tradução da introdução do livroMatters of care: Speculative ethics more than human worlds, de Maria Puig de la Bellacasa (2017), o qual se alinha com as etnografias e cria junto com elas.

Initial radioactive disequilibrium amongst intermediate nuclides of the U decay chains can have a significant impact on the accuracy of U–Pb ages, especially in young samples. For samples that can reasonably be assumed to have attained radioactive equilibrium at the time of analysis, a relatively straightforward correction may be applied. However, in younger materials where this assumption is unreasonable, it is necessary to replace the familiar U–Pb age equations with more complete expressions that account for growth and decay of intermediate nuclides through time. DQPB is software for calculating U–Pb ages while accounting for the effects of radioactive disequilibrium among intermediate nuclides of the U decay chains. The software is written in Python and distributed as both a pure Python package and a stand-alone graphical user interface (GUI) application that integrates with standard Microsoft Excel spreadsheets. The software implements disequilibrium U–Pb equations to compute ages using various approaches, including concordia intercept ages on a Tera–Wasserburg diagram, U–Pb isochron ages, Pb*/U ages based on single aliquots, and 207Pb-corrected ages. While these age-calculation approaches are tailored toward young samples that cannot reasonably be assumed to have attained radioactive equilibrium at the time of analysis, they may also be applied to older materials where disequilibrium is no longer analytically resolvable. The software allows users to implement a variety of regression algorithms based on both classical and robust statistical approaches, compute weighted average ages and construct customisable, publication-ready plots of U–Pb age data. The regression and weighted average algorithms implemented in DQPB may also be applicable to other (i.e. non-U–Pb) geochronological datasets.

Quality of life (QoL) is an important outcome in aged care, but self-report is not always possible due to the high prevalence of cognitive impairment in older aged care residents. This study aims to assess the impact of family member proxy perspective (proxy-proxy or proxy-person) on interrater agreement with resident self-report by different cognition levels. The influence of proxy perspective and cognition level is a significant gap in the extant literature which this study seeks to address. A cross-sectional study was undertaken with residents classified into cognition subgroups according to the Mini Mental State Examination. Residents completed the self-report EQ-5D-5L, a well-established generic measure of health-related quality of life (HRQoL). Family member proxies completed EQ-5D-5L proxy version 1 (proxy-proxy perspective, where the proxy responds based on their own opinions) and proxy version 2 (proxy-person perspective, where the proxy responds as they believe the person would). Interrater agreement was assessed using the concordance correlation coefficient (CCC) for utility scores and the weighted kappa for dimension-level responses. Sixty-three residents (n = 22 no cognitive impairment, n = 27 mild impairment, and n = 14 moderate impairment) and proxies participated. EQ-5D-5L utility scores were lower for proxies compared with residents (self-report = 0.522, proxy-proxy = 0.299, and proxy-person = 0.408). Interrater agreement with self-report was higher for proxy-person (CCC = 0.691) than for proxy-proxy (CCC = 0.609). Agreement at the dimension level was higher for more easily observable dimensions, such as mobility, compared to less observable dimensions, such as anxiety/depression. Resident self-reported and proxy family member-reported HRQoL assessments, using the EQ-5D-5L, are different but may be more closely aligned when the proxy is specifically guided to respond from the person’s perspective. Further research is needed to address the impact of divergences in self-report and proxy-report ratings of HRQoL for quality assessment and economic evaluation in aged care.

Doğu Akdeniz’de bir tedarik merkezi olması mahiyetine ışık tutmayı amaçlamaktadır. Makalede arşiv kaynaklarına dayanarak merkezden Mısır valiliğine merkezden Mısır valiliğine, kadılığına ve diğer yerel yöneticilere gönderilen kayıtlar incelenmekte ve bunların değerlendirmesi yapılmaktadır. Buna göre devletin ticareti zaman zaman kontrol altında tutmaya çalıştığı, öncelikli olarak pirinç ve kahve gibi gıda mallarının ihracına yasak koyduğu ve ülke içinde kalmasını sağlamaya çalıştığı görülmekte ve özellikle İstanbul piyasası olmak üzere imparatorluk içindeki fiyat artışını engellemeye yönelik tedbirler aldığı anlaşılmaktadır. Devletin bu politikaları Osmanlı toplumunda tüketim malları ticaretinin yönünü de kontrol altında tutmaya çalıştığının açık göstergesi olmalıdır. Osmanlı piyasasında kalan bu malların alıcısı olan tüketiciler de mercek altına alınmıştır. Yazışmalarda göze çarpan diğer bir nokta ise söz konusu malların lojistiğinde başvurulan Avrupalı gemiler ve bunların mal taşımalarıyla alakalı düzenlemelerdir. Buna göre Osmanlı yönetimi Mısır mallarının İstanbul’a nakliyesi için İskenderiye limanında bulunan Avrupa bandıralı gemilerin kullanımının azaltılarak mîrî kalyonların kullanımını teşvik etmiş; ancak yerli gemi sayısının yetersiz kalması sebebiyle bu prensibini sık sık esnetmek zorunda kalmıştır.

With concepts like the consumer revolution or the industrious revolution, the changing behaviour of private households in the 18th and early 19th centuries has become of great interest. The article suggests a new way to observe intentions and decisions, by utilizing a database of 850,000 classified ads from the Basel Avisblatt over a span of 116 years. Changes in food prices constantly altered the discretionary income of households, which forced budget-related decisions. By cross-correlating indicators of discretionary income with the changing number of different types of ads, patterns of utilizing the Avisblatt can be identified, and strategies to stabilize discretionary income deduced.

Background. Asymptomatic children can be a major reservoir of pharyngeal group A streptococcus (GAS). The role of GAS carriage causing subsequent infections resulting in the manifestation of clinical symptoms, or being associated with transmission to uninfected individuals, is not entirely clear. Furthermore, data on GAS carriage from countries in Africa remain scant with only a few studies reporting carriage. Objectives. We performed a cross-sectional study to determine the prevalence of asymptomatic pharyngeal carriage of group A streptococci in school children in Cape Town. We considered our results in the context of a meta-analysis of data of GAS carriage in Africa. Methods. We conducted a school-based cross-sectional study from 2009 to 2011 in two Cape Town peri-urban communities, enrolling 950 healthy learners. Pharyngeal swabs were obtained from learners and processed at the National Health Laboratory Service (NHLS) microbiology laboratory at Groote Schuur Hospital, Cape Town. Thereafter, we conducted a systematic review through a comprehensive literature search among several sources. Prevalence estimates with 95% confidence intervals (CIs) were determined using a random-effects meta-analysis model. Results. GAS was isolated from 31 participants corresponding to a carrier rate of 3% (95% CI 2% - 4%). Combining our results with 18 other studies revealed a pooled prevalence of 9% (95% CI 6% - 11%). Regional pooled rates were similar across southern, eastern and northern Africa, of between 9% (95% CI 6% - 11%) and 11% (95% CI 4% - 21%) while countries within Central Africa had a pooled estimate of 7% (95% CI 5% - 9%). Western Africa had the lowest pooled estimate of 2% (95% CI 1% - 2%). Conclusion. There was a relatively low rate of carriage of GAS in asymptomatic school children residing in South Africa. Pooled prevalence rates revealed regional differences across the African continent as regards the rate of GAS carriage, with the western and northern African regions having rates of GAS carriage that were lower and higher respectively than those of East, Central and southern African countries, which demonstrated similar rates of carriage.

Objective: Previous studies have shown that socioeconomically deprived groups exhibit higher lesion load of the white matter (WM) in aging. The aim of this study was to (i) investigate to what extent education and income may contribute to differences in white matter hyperintensities (WMHs) and (ii) identify risk profiles related to a higher prevalence of age-associated WMH. Design and Setting: Population-based adult study of the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany. Participants: Dementia-free sample aged 40–80 years (n = 1,185) derived from the population registry. Measurements: Information was obtained in standardized interviews. WMH (including the derived Fazekas scores) were assessed using automated segmentation of high-resolution T1-weighted anatomical and fluid-attenuated inversion recovery (FLAIR) MRI acquired at 3T. Results: Despite a significant association between income and WMH in univariate analyses, results from adjusted models (age, gender, arterial hypertension, heart disease, and APOE e4 allele) indicated no association between income and WMH. Education was associated with Fazekas scores, but not with WMH and not after Bonferroni correction. Prevalence of some health-related risk factors was significantly higher among low-income/education groups. After combining risk factors in a factor analysis, results from adjusted models indicated significant associations between higher distress and more WMH as well as between obesity and more deep WMH. Conclusions: Previously observed differences in WMH between socioeconomically deprived groups might stem from differences in health-related risk factors. These risk factors should be targeted in prevention programs tailored to socioeconomically deprived individuals.

While bariatric surgery results in substantial weight loss, one negative side effect of surgery is that patients often experience more rapid and intense intoxication effects after consuming alcohol.Given that alcohol use has been associated with impaired cognitive functioning in the general population, this study examined whether acute alcohol consumption after bariatric surgery immediately led to impaired cognitive control, and whether this effect was impacted by baseline levels of cognitive control.Nonprofit teaching hospital, United States.Participants were 34 adults who attended a laboratory visit before and 1 year after Roux-en-Y gastric bypass surgery, wherein they consumed a weight-based dose of alcohol and completed cognitive testing over the course of 3 hours.A series of generalized mixed-effect models demonstrated that performance on the cognitive task generally improved over time, likely due to practice effects. However, following bariatric surgery, individuals with impaired cognitive control before consuming alcohol experienced greater commission errors immediately afterward.These findings suggest that alcohol use after bariatric surgery may produce immediate deficits in inhibitory control among individuals who are already vulnerable to impaired cognitive control. Clinicians should seek to educate bariatric surgery candidates on this possible effect, as deficits in inhibitory control may ultimately lead to risky behaviors and poor adherence with postsurgical medical recommendations.

ZusammenfassungRückenschmerzen sind weit verbreitet und weltweit eine der führenden Ursachen für eine eingeschränkte körperliche Funktion und Belastbarkeit. Training und Bewegung zählen neben kognitiver Verhaltenstherapie und Edukation zu den First-Line-Treatments, vor allem bei chronischen nicht-spezifischen Rückenschmerzen. Die Wirksamkeit von Training kann anhand von Einzelstudien sowie RCTs und Metaanalysen belegt werden. Dabei zeigt sich, dass Training anderen konservativen Behandlungsformen überlegen ist. Evidenz-basiert lässt sich derzeit keine spezifische Trainingsform als am wirksamsten identifizieren. Es zeigt sich jedoch wiederholt, dass vor allem Trainingsprogramme, die sowohl die (senso)motorische Kontrolle und Stabilisationsfähigkeit als auch die Kräftigung des Rumpfes in den Fokus legen, sich als besonders geeignet zur Reduktion der Schmerzen und der damit verbundenen Einschränkungen erweisen. Messbare neuromuskuläre Defizite im Zusammenhang mit Rückenschmerzen untermauern dabei die Bedeutung des Trainings der reaktiven motorischen Kontrolle, vor allem in Situationen mit plötzlichen Lasteinwirkungen. Allerdings lassen sich derzeit evidenz-basierte Empfehlungen zur Dosis-Wirkung nur begrenzt ableiten. Schließlich ist die Notwendigkeit einer möglichen Individualisierung des Trainings zu klären.

Background: Tertiary drug information resources are utilized frequently by health care providers. While pharmacists are uniquely trained and prepared to interpret the information available on these resources, including the results of drug-drug interaction evaluations, discrepancies between such resources pose a major concern for clinicians with regard to patient safety and medication regimen efficacy. It was postulated that drug-drug interaction evaluations between prescription medications and over-the-counter herbal supplements would be particularly problematic. Objective: The objective of this project was to distinguish the discrepancies between tertiary drug information resources in the setting of drug-drug interactions between tricyclic antidepressants (TCAs) and herbal supplements. Methods: The following medications and herbal supplements were evaluated on Lexicomp, Micromedex, and Medscape: amitriptyline, nortriptyline, doxepin, imipramine, desipramine, amoxapine, St. John’s Wort, valerian root, ginkgo biloba, and ginseng. Results: While all of the tertiary drug information resources identified a significant reaction between each TCA and St. John’s Wort due to the risk of serotonin syndrome, several other discrepancies were noted, with regard to both the severity of the interaction indicated and whether or not an interaction was identified. Conclusion: It is imperative that clinicians be aware of potential discrepancies between tertiary drug information resources, including the potential for variation in both the clinical interpretation of its severity and the recognition of an interaction.

Oral medications for chronic conditions often involve a variety of instructions, including time of day/dosing, drug interactions, and food intake restrictions. However, the extent to which patients follow these instructions is unclear. We surveyed patients from the US and Europe (UK, France, Germany, Italy, Spain) who were prescribed sulfonylureas (SU: glimepiride, glipizide, or gliclazide) for diabetes or levothyroxine for hypothyroidism. Patients kept a daily diary for 3–5 days documenting their adherence to three criteria: dosing regimen including time of day, warning labels including drug interactions, and food restrictions. A total of 421 US and 493 European patients took the study medications; 546 patients took SU and 368 took levothyroxine. Overall, 48% of patients were males; 46% were age 65 years or older. Despite most patients having received instructions on medication requirements (US 71%, EU 75%), most patients reported being only somewhat knowledgeable (US 69%; EU 71%). Adherence, measured by the proportion of the days a participant was adherent to each category out of the observational period (ranging from 3–5 days), varied by type of instruction, with the poorest adherence observed for food restriction requirements (US 34% of the observation days, EU 26%) compared to warning labels (US 77%, EU 67%) and dosing regimen (US 85%, EU 87%). Patients adhered to dosing and cautionary instructions across the majority of the study period but were largely non-adherent to food intake restrictions. Improved communication and increased emphasis on food intake restrictions is needed when advising patients on their medications.

A new species of large Callomegachile Michener, subgenus Eumegachilana Michener (Megachilini), is described and figured from Larat Island, Indonesia. The new species is superficially most similar to Callomegachile (Eumegachilana) godeffroyi (Friese) from New Britain, Papua New Guinea owing to the orange to orangish setae of the propodeum and first metasomal tergum, but can be distinguished by the absence of such setae on the head and pleura, the form and sculpturing of the clypeus, the form of the labrum, and the smaller size. A key is provided to the subgenera of Callomegachile, with Oxymegachile subgen. n. established for C. duponti (Vachal).

Abundance estimates are presented for the humpback whales wintering off Brazil which ‘visit’ a surveyed area off Abrolhos Bank and display fluke-exposing behaviour. The study is based on photo-identification data collected between 1996 and 2000. Chapman-corrected Petersen estimates for all pairs of data result in estimates from 1,948 individuals up to 3,001 with coefficients of variation around 0.25. A more elaborate closed population multiple-recapture maximum-likelihood estimate is 2,393 with 95% profile-likelihood confidence interval (CI=1,924, 3,060). Replacing the closed-population assumption with a population allowed to grow (or decrease) according to some constant rate over the study period, the maximum-likelihood estimate of population size for the year 2000 becomes 3,871 (CI=2,795, 5,542) associated to an estimated annual growth rate of 31% over the study period and in the surveyed area. Although the inclusion of the growth rate results in a less restrictive assumption about population size, it is unclear at this time how to interpret it since the population around the Abrolhos Bank is some (unknown) fraction of whales wintering off Brazil. Alternatively, a fit of Whitehead’s model allowing for emigration and re-immigration gives an estimate of about 3,000 whales (CI=2,500, 3,650).

Dieser Beitrag hebt die Bedeutung von Daten für politische Entscheidungen hervor und leitet daraus eine Verantwortung des Bildungssystems ab, Bürger:innen zu befähigen, Daten und Statistiken nicht nur fundiert lesen und interpretieren zu können, sondern auch selbst Datenerhebungen zu vollziehen. Der Beitrag zeigt auf, wie dies mittels digitaler Werkzeuge gelingen kann.

Most models of population structure for Southern Hemisphere humpback whales (Megaptera novaeangliae) assume that individuals feeding in the Scotia Sea migrate primarily to breeding and calving areas off Brazil. However data to support this are few and mostly indirect. Abrolhos Bank, Brazil, is the largest breeding and calving ground for humpback whales in the western South Atlantic Ocean. Historically, the waters near South Georgia held the largest concentrations of humpback whales in Antarctic Area II and were among the largest in the Southern Ocean. Photographs of individually distinctive natural markings on humpback whale flukes collected from the Scotia Sea (n=9) were compared with two collections of photographs from Brazilian waters (n=829 and n=735) to identify re-sightings. A humpback whale photographed in August 2000 at Abrolhos Bank was subsequently photographed in December 2004 near Shag Rocks off South Georgia. The migratory distance between these sightings is 3,945km. This finding constitutes the first long-distance individual resighting to be documented from either of these areas.

In the Southern Hemisphere, humpback whales (Megaptera novaeangliae) were heavily exploited from both coastal stations and in pelagic waters in all major ocean basins. About 200,000 whales were taken after 1900, causing declines of populations to small percentages of their pre-exploitation levels. The study presented here aimed to investigate humpback whale abundance in the Brazilian coastal breeding ground, in order to provide information to support further analysis of the population recovery. Between 25 August and 2 September 2001, a fixed wing, flat window, aircraft was used to survey transect lines along the northern limit of Bahia State (12°10’S), to the southern limit of Espírito Santo State (20°42’S). All on-effort sightings were recorded and abundance was estimated according to standard distance sampling methodology (Burnham et al., 1980; Buckland et al., 1993). Group sizes of humpback whales ranged between 1-5 and the mean group size was 1.52 (±0.06). The model that best fitted the perpendicular distance data, based on the minimum Akaike Information Criterion, was the hazard rate model. The population size estimated using uncorrected data was 1,493 (CV=0.21) whales. Surface time was used to correct the estimates for gˆ(0), resulting in a correction factor of 0.67 (±0.15). The corrected analysis for each block and combined result, increased the population size estimate to 2,229 (CV=0.31) individuals. The data from this study could be used to identify new areas appropriate for whalewatching, to monitor the status and dynamics of the humpback whale population off the Brazilian coast and to provide information for the establishment of new protected areas.