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Tuberculosis diagnosis might be delayed or missed in children with severe pneumonia because this diagnosis is usually only considered in cases of prolonged symptoms or antibiotic failure. Systematic tuberculosis detection at hospital admission could increase case detection and reduce mortality.We did a stepped-wedge cluster-randomised trial in 16 hospitals from six countries (Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Uganda, and Zambia) with high incidence of tuberculosis. Children younger than 5 years with WHO-defined severe pneumonia received either the standard of care (control group) or standard of care plus Xpert MTB/RIF Ultra (Xpert Ultra; Cepheid, Sunnyvale, CA, USA) on nasopharyngeal aspirate and stool samples (intervention group). Clusters (hospitals) were progressively switched from control to intervention at 5-week intervals, using a computer-generated random sequence, stratified on incidence rate of tuberculosis at country level, and masked to teams until 5 weeks before switch. We assessed the effect of the intervention on primary (12-week all-cause mortality) and secondary (including tuberculosis diagnosis) outcomes, using generalised linear mixed models. The primary analysis was by intention to treat. We described outcomes in children with severe acute malnutrition in a post hoc analysis. This study is registered with ClinicalTrials.gov (NCT03831906) and the Pan African Clinical Trial Registry (PACTR202101615120643).From March 21, 2019, to March 30, 2021, we enrolled 1401 children in the control group and 1169 children in the intervention group. In the intervention group, 1140 (97·5%) children had nasopharyngeal aspirates and 942 (80·6%) had their stool collected; 24 (2·1%) had positive Xpert Ultra. At 12 weeks, 110 (7·9%) children in the control group and 91 (7·8%) children in the intervention group had died (adjusted odds ratio [OR] 0·986, 95% CI 0·597-1·630, p=0·957), and 74 (5·3%) children in the control group and 88 (7·5%) children in the intervention group had tuberculosis diagnosed (adjusted OR 1·238, 95% CI 0·696-2·202, p=0·467). In children with severe acute malnutrition, 57 (23·8%) of 240 children in the control group and 53 (17·8%) of 297 children in the intervention group died, and 36 (15·0%) of 240 children in the control group and 56 (18·9%) of 297 children in the intervention group were diagnosed with tuberculosis. The main adverse events associated with nasopharyngeal aspirates were samples with blood in 312 (27·3%) of 1147 children with nasopharyngeal aspirates attempted, dyspnoea or SpOSystematic molecular tuberculosis detection at hospital admission did not reduce mortality in children with severe pneumonia. High treatment and microbiological confirmation rates support more systematic use of Xpert Ultra in this group, notably in children with severe acute malnutrition.Unitaid and L'Initiative.For the French translation of the abstract see Supplementary Materials section.

BACKGROUND: Severe depression is associated with accelerated brain aging. BrainAge gap, the difference between predicted and observed BrainAge was investigated in patients with late-life depression (LLD). We aimed to examine BrainAge gap in LLD and its associations with clinical characteristics indexing LLD chronicity, current severity, prior to electroconvulsive therapy (ECT) and ECT outcome. METHODS: Data was analyzed from the Mood Disorders in Elderly treated with Electroconvulsive Therapy (MODECT) study. A previously established BrainAge algorithm (BrainAge R by James Cole, (https://github.com/james-cole/brainageR)) was applied to pre-ECT T1-weighted structural MRI-scans of 42 patients who underwent ECT. RESULTS: A BrainAge gap of 1.8 years (SD = 5.5) was observed, Cohen's d = 0.3. No significant associations between BrainAge gap, number of previous episodes, current episode duration, age of onset, depression severity, psychotic symptoms or ECT outcome were observed. LIMITATIONS: Limited sample size. CONCLUSIONS: Our initial findings suggest an older BrainAge than chronological age in patients with severe LLD referred for ECT, however with high degree of variability and direction of the gap. No associations were found with clinical measures. Larger samples including are needed to better understand brain aging and to evaluate the usability of BrainAge gap as potential biomarker of prognosis an treatment-response in LLD. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02667353.

Examples are briefly described of organizations that offer a perspective to complement the experience of industrial democracy inNorway and Mondragon. The examples are organizations choosing a structure and culture that minimize hierarchy. They provide a less traditional approach to balancing political and socio-technical participation. To do so they devolve responsibility for coordination of effort and expertise to individuals and teams most directly providing the effort and expertise. This gives the individuals and teams high autonomy. Examples include a university class, action learning projects in community and organizational settings, and a voluntary self-organizing network of facilitators. In addition, a small sample of organizations from the larger sample documented by Corporate Rebels (https://corporate-rebels.com/) is also briefly described and compared. Finally, the examples are located within other, wider, changes taking place.

We supply a hypothesis that explains threshold voltage (Vth) drift under dynamic bipolar gate stress in SiC-MOSFETs, postulating that ionized donor-like interface traps in the lower half of the bandgap, give rise to an increased internal electric field at each rising edge of a gate voltage pulse. The enhancement of the internal electric field may be viewed as a Vth -reduction, and we devised different experiments to assess this Vth -reduction. Comparing Vth -drift rate using different pulse shapes in dynamic bipolar gate stress tests, we estimated a temporary Vth -reduction in the order of 15 V within 200 ns after the rising edge. Measuring the drain-source current peak 200 ns after the rising edge of a rectangular pulse, gives an estimate for the Vth -reduction of 5.5 V. To resolve this discrepancy, we postulate that in inversion, positive traps are effectively screened such that the impact on the channel is spatially restricted and smaller than the channel length. Channel current will only flow where positive charges induce a percolation path between drain and source, reducing the apparent Vth -reduction in the current based measurement.

Context: In Côte d’Ivoire, industrial banana plantations are faced with the problem of weediness. However, the use of herbicides as a means of control presents significant risks for human health and the environment. The abandonment of these products for more ecological alternatives such as cover crops is imminent. Aims: This study aimed to compare the relative abundance and the density of the main plant-parasitic nematodes in the roots of banana and cover crops according to three weed management treatments. Study Design and Methodology: The experimental design was a three-repeat Fisher block of three treatments consisting of implementation of A. repens and D. adscendens as cover crops and spraying of two synthetic herbicides (glufosinate and glyphosate) for weed management. The relative abundance and density of nematodes in the roots of banana and cover crops were assessed quarterly after extraction by the rapid double centrifugation-flotation method and enumeration under an optical microscope. Results: Both cover crops and banana plants had their roots infested by the major parasitic nematodes evaluated (Radopholus similis, Pratylenchus spp., Helicotylenchus spp., Meloidogyne spp., Rotylenchulus reniformis and Hoplolaimus pararobustus). These infestations were not a function of weed management treatments. Compared to the use of herbicides, A. repens and D. adscendens used as ground cover did not significantly increase or decrease nematode dynamics in the plots. Individuals extracted from the roots of the cover crops, and particularly from D. adscendens, were more numerous than from the roots of the banana plants. In terms of proportions, Pratylenchus spp., R. similis, Helicotylenchus spp. and Meloidogyne spp. were most abundant. R. reniformis and H. pararobustus as well as various nematodes (plant parasites: Hirschmanniella spp., Xiphinema spp., ..., and non-plant parasites: fungivorous, carnivorous, bacterivorous, ...) were in the minority. Conclusion: The results, particularly those of A. repens, could be useful in the biological, ecological and sustainable management of weed in banana plantations without important risks of pest pressure.

SamenvattingDe snelle technologische ontwikkelingen in de diabeteszorg zorgen voor betere uitkomsten, maar ook voor een toename van dataverkeer tussen patiënt en zorgverleners. De noodzaak voor die verbetering van uitkomsten wordt beschreven. De stappen die daartoe zijn gezet en die nog kunnen worden gezet, zijn aan de inzet van deze technologie verbonden. Daarbij moet en kan ook de diabeteszorg worden veranderd, waardoor er op nieuwe wijze continuïteit in contacten en coaching komt en traditionele zorg (3-4 x per jaar een consult) verandert naar nieuwe virtuele en automatische vormen. Daarvoor is een verandering nodig: in plaats van dat elk contact vanuit één patiënt of behandelaar wordt gestart, wordt op basis van de glucosedata populatiemanagement van diabetes verricht. Daarbij wordt op basis van zorggegevens een (continue) triage verricht en wordt direct persoonsgerichte zorg aangeboden aan mensen die problemen ervaren of risico hebben op problemen. De combinatie van diabetestechnologie en populatiemanagementmethoden wordt aan de hand van het ontwikkelde CloudCare-systeem toegelicht.

Background Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) is involved in the stress response and may play a key role in mood disorders, but no information is available on PACAP for the human brain in relation to mood disorders. Methods PACAP-peptide levels were determined in a major stress-response site, the hypothalamic paraventricular nucleus (PVN), of people with major depressive disorder (MDD), bipolar disorder (BD) and of a unique cohort of Alzheimer's disease (AD) patients with and without depression, all with matched controls. The expression of PACAP-(Adcyap1mRNA) and PACAP-receptors was determined in the MDD and BD patients by qPCR in presumed target sites of PACAP in stress-related disorders, the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC). Results PACAP cell bodies and/or fibres were localised throughout the hypothalamus with differences between immunocytochemistry and in situ hybridisation. In the controls, PACAP-immunoreactivity-(ir) in the PVN was higher in women than in men. PVN-PACAP-ir was higher in male BD compared to the matched male controls. In all AD patients, the PVN-PACAP-ir was lower compared to the controls, but higher in AD depressed patients compared to those without depression. There was a significant positive correlation between the Cornell depression score and PVN-PACAP-ir in all AD patients combined. In the ACC and DLPFC, alterations in mRNA expression of PACAP and its receptors were associated with mood disorders in a differential way depending on the type of mood disorder, suicide, and psychotic features. Conclusion The results support the possibility that PACAP plays a role in mood disorder pathophysiology.

This study evaluated the impact of the in-service training program offered by the Universal Basic Education Commission (UBEC) in Nigeria on the testing skill of Mathematics teachers in Akwa Ibom State, Nigeria. The study adopted the expo facto research design research. A two-stage sampling involving simple random and stratified techniques were employed to select 134 from the 530 Mathematics teachers in the public secondary schools in Akwa Ibom State, Nigeria. The instrument used for the data collection was, Teacher Testing Skills Assessment Scale (TTSAS) developed by the researchers based on the objective of the study. The instrument was validated by three measurement experts and trial tested. The reliability coefficient of .77 was obtained from the inter-rater method of reliability estimate. The data collected was analyzed using mean, standard deviation and independent sample t-test. The results of the analysis revealed that the UBEC in-service training program has significant positive impact on Mathematics teachers’ testing skills. It was concluded that the UBEC teachers’ capacity development program is a profitable venture with promising national gains. It was recommended that government should continue with her support for the UBEC in sustaining regular in-service training program for teachers in secondary schools across the nation.

Background: Oral morphine has been widely used to manage children’s pain during burn wound dressing. Rectal ketamine may also be safely administered to children. Objective: To evaluate and compare the efficacy of oral morphine vs. rectal racemic ketamine in management of pain during burn wound dressing in a pediatric population in a rural study population. Methods: This was a randomized open-label clinical trial done in a rural hospital in Uganda. Study participants were randomly assigned to one of the treatment groups, either oral morphine or rectal ketamine, with a ratio of 1:1. Overall, we enrolled 44 participants, with 22 in each treatment arm. Assessment of baseline vital signs, including pulse rate, blood pressure, respiratory rate, temperature, oxygen saturation (SPO2), pain assessment (using Face Legs Activity Cry Consolability [FLACC]), and sedation scores (using Richmond’s agitation and sedation scale [RASS]) among others was done. Study participants were followed up hourly for 8 hours for outcomes of interest: adequate pain management/adverse events. Results: The mean age of the study participants was 2.56 (±1.59) years. The overall mean intra-procedural pain difference score for children who received oral morphine was 2.7 (SD±2.2) compared to 0 (SD±0) among those who received rectal ketamine, and the mean difference of 2.7 was statistically significant (p < 0.0001). Sialorrhea (hyper-salivation) was the only significant adverse event, with more occurrence in the rectal Ketamine treatment arm (n= 8, 36.3%) compared to 1 (5%) in the oral Morphine treatment arm, p = 0.009. There were no significant adverse effects noted in either treatment arm. Conclusion: The study showed the non-inferiority of rectal ketamine over oral morphine and concluded that administration of rectal ketamine was better at pain management and safety compared to oral morphine. Rectal ketamine is associated with an increased incidence of sialorrhea compared to oral morphine.

The aim of this research was to replace petroleum-based polyols with polyols made from lignin and nano-lignin in the production of polyurethane coatings. Lignin and nano-lignin were first reacted with either diethylenetriamine (DETA) or ethylenediamine (EDA). Subsequently, they were modified with propylene carbonate. The lignin and nano-lignin derived polyols replaced the conventional polyol-acrylic in the production of polyurethane coatings. The results of FTIR analysis showed that urethane, isothiocyanate, and strong C-N bonds were formed in nano-lignin-based polyurethanes. Moreover, the surface-adhesion test of the lignin-based polyurethane coating showed that by increasing the lignin content, the adhesion strength of the coating decreased. Mixing lignin nanoparticles in the polyurethane substrate caused the adhesion strength to rise from 1.67 MPa to 4.52 MPa. An increase of amino nano-lignin content up to 7% of oil based polyol improved the curing of the coating and increased the scratch resistance to more than 5 Kg. The results showed that lignin from a mechanical pulping process has a direct effect on reducing the smoothness and the glossiness in polyurethane coatings.

This essay adapts presentations the authors shared at the Edge Hill NASSR/BARS conference in the Summer of 2022 into a collaboratively constructed discussion. It reflects on what a recent “coastal turn” in ecocriticism, critical geography, and related fields might contribute to Romantic studies, and considers how coastal geographies (real and imagined) have informed aesthetics, politics, and lived experience, especially in settler-colonial contexts. Ranging from seventeenth century poetry to contemporary fiction, from British waterways to the Mississippi Basin, it strives to bring Romantic accounts of coastal life into conversation with current modes of ecological thought and new forms of theoretical interrogation.

Chemically induced steatosis is characterized by lipid accumulation associated with mitochondrial dysfunction, oxidative stress and nucleus distortion. New approach methods integrating in vitro and in silico models are needed to identify chemicals that may induce these cellular events as potential risk factors for steatosis and associated hepatotoxicity. In this study we used high-content imaging for the simultaneous quantification of four cellular markers as sentinels for hepatotoxicity and steatosis in chemically exposed human liver cells in vitro. Furthermore, we evaluated the results with a computational model for the extrapolation of human oral equivalent doses (OED). First, we tested 16 reference chemicals with known capacities to induce cellular alterations in nuclear morphology, lipid accumulation, mitochondrial membrane potential and oxidative stress. Then, using physiologically based pharmacokinetic modeling and reverse dosimetry, OEDs were extrapolated from data of any stimulated individual sentinel response. The extrapolated OEDs were confirmed to be within biologically relevant exposure ranges for the reference chemicals. Next, we tested 14 chemicals found in food, selected from thousands of putative chemicals on the basis of structure-based prediction for nuclear receptor activation. Amongst these, orotic acid had an extrapolated OED overlapping with realistic exposure ranges. Thus, we were able to characterize known steatosis-inducing chemicals as well as data-scarce food-related chemicals, amongst which we confirmed orotic acid to induce hepatotoxicity. This strategy addresses needs of next generation risk assessment and can be used as a first chemical prioritization hazard screening step in a tiered approach to identify chemical risk factors for steatosis and hepatotoxicity-associated events., Archives of Toxicology, 97 (6), ISSN:0340-5761, ISSN:1432-0738

Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) is known to contain an active-site cysteine residue undergoing oxidation in response to hydrogen peroxide, leading to rapid inactivation of the enzyme. Here we show that human and mouse cells expressing a GAPDH mutant lacking this redox switch retain catalytic activity but are unable to stimulate the oxidative pentose phosphate pathway and enhance their reductive capacity. Specifically, we find that anchorage-independent growth of cells and spheroids is limited by an elevation of endogenous peroxide levels and is largely dependent on a functional GAPDH redox switch. Likewise, tumour growth in vivo is limited by peroxide stress and suppressed when the GAPDH redox switch is disabled in tumour cells. The induction of additional intratumoural oxidative stress by chemo- or radiotherapy synergized with the deactivation of the GAPDH redox switch. Mice lacking the GAPDH redox switch exhibit altered fatty acid metabolism in kidney and heart, apparently in compensation for the lack of the redox switch. Together, our findings demonstrate the physiological and pathophysiological relevance of oxidative GAPDH inactivation in mammals.

The coronavirus pandemic has generated renewed public debate about different forms of masking. In this article I analyze news frames that circulated in English- language Canadian news outlets throughout 2020, performing an informal discourse analysis of coverage of Quebec’s secularism law, Bill 21, alongside coverage of two anti-mask protests held in Aylmer, Ontario. In the case of Bill 21, I argue that the predominant frame that shaped coverage was one of hypocrisy, which foregrounded the discriminatory nature of the legislation but obscured the Christian cultural politics otherwise embedded in the law. In the case of the Aylmer marches, I argue that news coverage centered on the role of the religious outlier, particularly through attention to outspoken Church of God Restoration pastor Rev. Henry Hildebrandt. This frame amplified Hildebrandt’s political statements but downplayed the more quotidian role of conservative Christianity in shaping some anti-mask sentiment. In both cases I argue that attending to the Christian cultural politics which were obscured by dominant news frames can help us better understand the persistent role of religion in shaping public discourse.

Background: Widely used psychotropic medications for obsessive-compulsive disorder (OCD) may change the volumes of subcortical brain structures, and differently in children vs. adults. We measured subcortical volumes cross-sectionally in patients finely stratified for age taking various common classes of OCD drugs. Methods: The ENIGMA-OCD consortium sample (1081 medicated/1159 unmedicated OCD patients and 2057 healthy controls aged 6–65) was divided into six successive 6–10-year age-groups. Individual structural MRIs were parcellated automatically using FreeSurfer into 8 regions-of-interest (ROIs). ROI volumes were compared between unmedicated and medicated patients and controls, and between patients taking serotonin reuptake inhibitors (SRIs), tricyclics (TCs), antipsychotics (APs), or benzodiazepines (BZs) and unmedicated patients. Results: Compared to unmedicated patients, volumes of accumbens, caudate, and/or putamen were lower in children aged 6–13 and adults aged 50–65 with OCD taking SRIs (Cohen's d = −0.24 to −0.74). Volumes of putamen, pallidum (d = 0.18–0.40), and ventricles (d = 0.31–0.66) were greater in patients aged 20–29 receiving APs. Hippocampal volumes were smaller in patients aged 20 and older taking TCs and/or BZs (d = −0.27 to −1.31). Conclusions: Results suggest that TCs and BZs could potentially aggravate hippocampal atrophy of normal aging in older adults with OCD, whereas SRIs may reduce striatal volumes in young children and older adults. Similar to patients with psychotic disorders, OCD patients aged 20–29 may experience subcortical nuclear and ventricular hypertrophy in relation to APs. Although cross-sectional, present results suggest that commonly prescribed agents exert macroscopic effects on subcortical nuclei of unknown relation to therapeutic response.

Species that seasonally moult from brown to white to match snowy backgrounds become conspicuous and experience increased predation risk as snow cover duration declines. Long-term adaptation to camouflage mismatch in a changing climate might occur through phenotypic plasticity in colour moult phenology and or evolutionary shifts in moult rate or timing. Also, adaptation may include evolutionary shifts towards winter brown phenotypes that forgo the winter white moult. Most studies of these processes have occurred in winter white populations, with little attention to polymorphic populations with sympatric winter brown and winter white morphs. Here, we used remote camera traps to record moult phenology and mismatch in two polymorphic populations of Arctic foxes in Sweden over 2 years. We found that the colder, more northern population moulted earlier in the autumn and later in the spring. Next, foxes moulted earlier in the autumn and later in the spring during colder and snowier years. Finally, white foxes experienced relatively low camouflage mismatch while blue foxes were mismatched against snowy backgrounds most of the autumn through the spring. Because the brown-on-white mismatch imposes no evident costs, we predict that as snow duration decreases, increasing blue morph frequencies might help facilitate species persistence.

This study examined the feasibility of implementing the Screening Tool for Autism in Toddlers, an interactive Level-2 screen for autism spectrum disorder, within Part C Early Intervention settings. Participants included 69 Early Intervention providers ( M age = 43.3 years, 93.7% females, 92.4% Whites) from nine programs who attended a one-day Screening Tool for Autism in Toddlers training workshop. Half of the providers reported using the Screening Tool for Autism in Toddlers, and reported it to be feasible and effective. Regardless of Screening Tool for Autism in Toddlers use, providers reported increased knowledge about recognizing the early signs of autism spectrum disorder following the workshop. Provider-reported self-efficacy regarding skills related to autism spectrum disorder screening increased significantly from baseline to the 18-month follow-up. Providers also described the facilitators (e.g. promotes communication with families) and barriers (e.g. certification process), that influenced their adoption. Results highlight the potential use of the Screening Tool for Autism in Toddlers within Early Intervention settings to identify autism spectrum disorder, and suggest an implementation model in which specific providers serve as a screening “point-person,” rather than expecting it to be used by all providers. Future research should aim to identify characteristics of agencies or providers that might facilitate Screening Tool for Autism in Toddlers use, as well as specific implementation plans and strategies that might promote long-term sustainability of Level-2 screening practices. This study was registered on ClinicalTrials.gov before the time of the first study enrollee. Registration number: NCT02409303; URL: https://clinicaltrials.gov/ct2/show/NCT02409303 Lay abstract The early detection of autism spectrum disorder can lead to access to autism spectrum disorder-specific services that have been shown to have a large impact on a child’s overall development. Although a stable diagnosis of autism spectrum disorder can be made by age 2 years, most children are not diagnosed until much later. To address this issue, this study examined the effectiveness of training Part C Early Intervention providers to use an interactive autism spectrum disorder screening tool, the Screening Tool for Autism in Toddlers. Sixty-nine providers attended a 1-day training workshop on the use of the Screening Tool for Autism in Toddlers. After the workshop, providers reported increased knowledge about recognizing the early signs of autism spectrum disorder, and about 45% of the providers reported using the Screening Tool for Autism in Toddlers with families in their caseloads 18 months after the training. These results suggest that the Screening Tool for Autism in Toddlers is feasible for use within Early Intervention settings. In addition, they suggest that specific providers might serve as a screening “point-person,” rather than expecting the Screening Tool for Autism in Toddlers to be used by all providers. Future research should aim to identify specific characteristics of agencies or providers that might be best suited for using the Screening Tool for Autism in Toddlers.

To examine variation in prices paid by private medical insurers for fluoride varnish applications in medical settings, a newly reimbursed service that few children receive.Private-insurance medical claims from Connecticut, Maine, New Hampshire, and Rhode Island (2016-2018).We examined prices paid for fluoride varnish by private insurers and compared these to prices paid by Medicaid.Private claims for fluoride varnish during medical visits for children aged 1-5 years. State Medicaid rates for fluoride varnish were obtained from the American Academy of Pediatrics.Prices paid for fluoride varnish by private insurers varied within and across states, ranging from less than $5 to $50. Median prices closely followed Medicaid rates in three of the four states. In states covering a package of fluoride varnish plus additional preventive oral health services during medical visits, combined Medicaid rates were nearly double the median price paid by private insurers.Fluoride varnish is a recommended service, but few children receive it. Price variation may contribute to the low uptake of this service. Ensuring sufficient Medicaid and private insurance rates could increase fluoride varnish applications in medical settings and improve oral health.

Background: Patients presenting for emergency department (ED) evaluation may be appropriate for treatment with monoclonal antibodies for mild to moderate COVID-19. While many sites have implemented infusion centers for these agents, EDs will continue to evaluate these patients where appropriate identification and efficient infusion of eligible patients is critical. Objectives: Patients receiving bamlanivimab in the EDs of an academic medical center are described. The primary objective was to describe operational metrics and secondary objectives reported clinical outcomes. Methods: Patients receiving bamlanivimab and discharged from the ED were included from November 16, 2020 to January 16, 2021 in the retrospective, observational cohort. Primary outcome was adherence to institutional criteria. Secondary outcomes included ED visit metrics, clinical characteristics, and return visits within 30 days. Risk factors for return visits were assessed with regression. Results: One hundred nineteen patients were included. Most (71%) were diagnosed with COVID-19 during the ED visit and median symptom duration was 3(IQR 2-5) days. Median number of risk factors for progression to severe disease was 2 (IQR 1-2). Thirty percent had a documented abnormal chest x-ray. Institutional criteria adherence was 99.2%. Median time from ED room to bamlanivimab was 4 (IQR 3.1-5.2) hours. Thirty patients had return visit within 30 days; 19 were COVID-19 related. Two multivariable regression models were analyzed for COVID-19 related return visit. Characteristics on ED presentation were considered in Model I: male gender (OR 3.01[0.97-9.31]), age (per 10 years) (OR 1.49[1.05-2.12]), African-American race (OR 3.46[1.09-11.06]), and symptom duration (per day) (OR 1.34[1.05-1.73]). Model II included labs and imaging acquired in ED. In Model II, age (per 10 years) (OR 1.52[1.07-2.16]) and abnormal CXR (OR 5.74[1.95-16.9]) were associated with COVID-19 related return visits. Conclusions: Administration of bamlanivimab to ED patients can be done efficiently, with the potential to reduce COVID-19 related return visits. Age and abnormal imaging were independent predictors of COVID-19 return visits.

This paper discusses the victimisation of internally displaced persons (IDPs) in Nigeria by policy exclusion. It asserts that while in policy, Government bears the primary responsibility for the protection and assistance of all IDPs irrespective of the cause of displacement, in practice, humanitarian response plans for the protection and assistance of IDPs exclude victims of armed Fulani herdsmen conflicts from assistance. It also found that several proposed federal bills to address the armed Fulani herdsmen-farmer conflicts have focused on securing land from victimised farming communities to establish settlements for the Fulani herders. However, none of the bills has prohibited arbitrary displacement; return, resettlement or rehabilitation of persons displaced by the armed Fulani herdsmen. The paper concludes that the exclusion of victims of the armed Fulani herdsmen conflict from national humanitarian response plan is a strategy of Government that is unwilling to recognise and address the armed Fulani herdsmen as a national security challenge. It recommends that the Nigerian Government holistically addresses internal displacement and provide equal protection and assistance to all victims of displacement as stipulated by the Nigerian national policy on internal displacement.

This article tests two contrasting hypotheses about changes in the electoral relevance of moral traditionalism–progressiveness, which pertains to attitudes toward matters of procreation, sexuality, and family and gender roles. While the “cultural turn” literature expects the electoral relevance of moral traditionalism to increase over time alongside that of all other cultural issues, studies inspired by secularization theory rather predict a decrease in its relevance—due to religious decline. Analyzing the data from the European Values Study (1981–2017) for 20 West European countries, we find empirical evidence for a decrease and no indication of an increase in the electoral relevance of moral traditionalism. Religious decline weakened the effect of moral traditionalism on religious and conservative voting over time due to the most traditionalist voters shifting away from these parties. Our findings, therefore, highlight the need to differentiate between different types of cultural motives behind voting choice in Western Europe.

This paper investigated the bending moment of chair base joints. The ultimate bending moments (maximum moment), calculated on the base of the measured maximum applied loads (maximum force), were compared for the front leg and rear leg joints of a chair base. The joints had different angles between the stretcher and the leg (joint angle) as well different tenon lengths (30 mm and 32 mm). The results of the tests indicated that for different test specimen configurations but the same tenon-and-mortise geometry, the maximum force of joints with a smaller value of joint angle (front leg joints) was higher than the force values of joints with a larger angle (rear leg joints) for all tenon lengths. However, the results showed less difference among the calculated bending moments of the analysed sets of joints. A significant difference was not revealed between the bending moments of joints with a smaller value of joint angle and the bending moments of joints with a larger angle for all tenon lengths. A significant difference between the bending moments for the tenon length of 30 mm and tenon length of 32 mm was determined for rear leg joints but not for front leg joints. The presented approach of joint strength analysis through the testing of specimens with different shapes and dimensions are applicable to research and practice., U radu je proučavan moment savijanja spojeva na križnoj potkonstrukciji sjedala stolice. Krajnji momenti savijanja (najveći moment), izračunani na temelju izmjerenih najvećih opterećenja (najveća sila), uspoređeni su za spojeve prednjih i stražnjih nogu križne potkonstrukcije sjedala stolice. Spojevi su imali različite kutove između poveznika i noge (kut spoja), kao i različitu duljinu čepova (30 i 32 mm). Rezultati ispitivanja pokazali su da je za različitu konfiguraciju ispitnih uzoraka, ali za istu geometriju čepa i rupe, najveća sila bila veća za spojeve s manjim kutom (spojevi prednjih nogu) nego za spojeve s većim kutom (spojevi stražnjih nogu), i to za čepove obiju duljina. Rezultati su također pokazali manju razliku između izračunanih momenata savijanja analiziranih grupa spojeva. Nije utvrđena značajna razlika momenata savijanja spojeva s manjim i većim kutom za čepove obiju duljina. Značajna razlika između momenata savijanja za čepove dužine 30 i 32 mm utvrđena je za spojeve stražnjih nogu, ali ne i za spojeve prednjih nogu stolice. Prikazani pristup analize čvrstoće spojeva ispitivanjem uzoraka različitih oblika i dimenzija primjenjiv je u istraživanju i u praksi.

Aims: The hand-dug wells and river water in Oproama Community, Rivers State, Nigeria was assessed for its quality. Study Design: The study involved ten (10) sampling stations consisting of seven (7) hand-dug wells and three (3) points along the Oproama River. Place and Duration of Study: Oproama Community in Asari-toru Local Government Area of Rivers State, Nigeria between January and December, 2011 to cover both dry and wet seasons. Methodology: The parameters assessed were Vibrio (bacteria), salinity, calcium, magnesium concentrations as well as saltwater intrusion status employing standard laboratory procedures and estimation model. Results: The results reveal that Vibrio counts ranged from 2 x102 to 1.375 x104 cfu/100ml and the bacteria species identified from the water sources were Vibrio cholera and Vibrio parahaemolyticus. The study also reveals that salinity ranged from 11.97 to 13,772mg/l, calcium, 0.15 to 126.33mg/l and magnesium, 0.09 to 43.02mg/l. All parameters assessed exhibited seasonal variation during the study period; Calcium/magnesium (Ca/Mg) ratios for each well water sample ranged from 1.67 to 12.33 and indicate absence of saltwater intrusion which stands at a Ca/Mg limit of 1. Conclusion: Salinity (particularly well water samples), calcium and magnesium concentrations were within recommended limit; Vibrio counts were high and its presence in drinking water has public health risk; therefore, the use of sanitary buckets and point-of-use (households use) treatment and safe storage practices of water is strongly advocated.

The exterior application of fire-retardant (FR) timber necessitates it to have high durability because of the possibility to be exposed to rainfall. In this study, water-leaching resistance of FR wood has been imparted by grafting phosphate and carbamate groups of the water-soluble FR additives ammonium dihydrogen phosphate (ADP)/urea onto the hydroxyl groups of wood polymers via vacuum-pressure impregnation, followed by drying/heating in hot air. A darker and more reddish wood surface was observed after the modification. Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, solid-state 13C cross-polarization magic-angle-spinning nuclear magnetic resonance (13C CP-MAS NMR), and direct-excitation 31P MAS NMR suggested the formation of C–O–P covalent bonds and urethane chemical bridges. Scanning electron microscopy/energy-dispersive X-ray spectrometry suggested the diffusion of ADP/urea into the cell wall. The gas evolution analyzed by thermogravimetric analysis coupled with quadrupole mass spectrometry revealed a potential grafting reaction mechanism starting with the thermal decomposition of urea. Thermal behavior showed that the FR-modified wood lowered the main decomposition temperature and promoted the formation of char residues at elevated temperatures. The FR activity was preserved even after an extensive water-leaching test, confirmed by the limiting oxygen index (LOI) and cone calorimetry. The reduction of fire hazards was achieved through the increase of the LOI to above 80%, reduction of 30% of the peak heat release rate (pHRR2), reduction of smoke production, and a longer ignition time. The modulus of elasticity of FR-modified wood increased by 40% without significantly decreasing the modulus of rupture. Validerad;2023;Nivå 2;2023-04-21 (joosat);Funder: OP RDE (Grant no.CZ.02.1.01/0.0/0.0/16_019/0000803); CT WOOD, Luleå University of TechnologyLicens fulltext: CC BY License

Reproducibility is important for having confidence in evolutionary machine learning algorithms. Although the focus of reproducibility is usually to recreate an aggregate prediction error score using fixed random seeds, this is not sufficient. Firstly, multiple runs of an algorithm, without a fixed random seed, should ideally return statistically equivalent results. Secondly, it should be confirmed whether the expected behaviour of an algorithm matches its actual behaviour, in terms of how an algorithm targets a reduction in prediction error. Confirming the behaviour of an algorithm is not possible when using a total error aggregate score. Using an error decomposition framework as a methodology for improving the reproducibility of results in evolutionary computation addresses both of these factors. By estimating decomposed error using multiple runs of an algorithm and multiple training sets, the framework provides a greater degree of certainty about the prediction error. Also, decomposing error into bias, variance due to the algorithm (internal variance) and variance due to the training data (external variance) more fully characterises evolutionary algorithms. This allows the behaviour of an algorithm to be confirmed. Applying the framework to a number of evolutionary algorithms shows that their expected behaviour can be different to their actual behaviour. Identifying a behaviour mismatch is important in terms of understanding how to further refine an algorithm as well as how to effectively apply an algorithm to a problem.