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The aim of this study was to describe how the detection of protozoan and helminth parasites has been affected by the introduction of polymerase chain reaction (PCR) and changes in test algorithms. We extracted data about faecal samples tested for parasites (n = 114839) at five Norwegian clinical microbiology laboratories. Samples were classified into prePCR or postPCR depending on whether they were submitted before or after the introduction of PCR, and into diagnostic episodes (n = 99320). The number of diagnostic episodes increased 3.7-fold from prePCR to postPCR. Giardia positive episodes doubled, the positivity rate decreased from 2.0% to 1.3%. Cryptosporidium was hardly detected prePCR and increased to a positivity rate of 1.2%. Entamoeba histolytica was rarely found. Episodes examined for helminths decreased 51%, the number of positive episodes decreased 34%. Samples from immigrants were more likely to be positive for Giardia, E. histolytica, or helminths and less likely to be Cryptosporidium positive. During the COVID-19 pandemic, the number of Giardia and helminth-positive episodes decreased. Cryptosporidium-positive episodes remained unchanged. The implementation of multiplex PCR for protozoa led to a doubling of Giardia cases and a better test for Cryptosporidium. Fewer microscopy examinations raise concerns that helminth infections may be overlooked.
The measurement of lift on symmetrically shaped obstacles immersed in low Reynolds number flow is the quintessential way to signal odd viscosity. For flow past cylinders, such a lift force does not arise if incompressibility and no-slip boundary conditions are fulfilled, whereas for spheres, a lift force has been found in Stokes flow, which is valid for cases where the Reynolds numbers are negligible and convection can be ignored. When considering the role of convection at low but non-zero Reynolds numbers, two hurdles arise, the Whitehead paradox and the breaking of axial symmetry, which are overcome by the method of matched asymptotic expansions and the Lorentz reciprocal theorem, respectively. We also consider the case where axial symmetry is preserved because the translation of the sphere is aligned with the axis of chirality of odd viscosity. We find that while lift vanishes, the interplay between odd viscosity and convection gives rise to a stream-induced torque.
The sheer number of research outputs published every year makes systematic reviewing increasingly time- and resource-intensive. This paper explores the use of machine learning techniques to help navigate the systematic review process. Machine learning has previously been used to reliably “screen” articles for review – that is, identify relevant articles based on reviewers’ inclusion criteria. The application of machine learning techniques to subsequent stages of a review, however, such as data extraction and evidence mapping, is in its infancy. We, therefore, set out to develop a series of tools that would assist in the profiling and analysis of 1952 publications on the theme of “outcomes-based contracting.” Tools were developed for the following tasks: assigning publications into “policy area” categories; identifying and extracting key information for evidence mapping, such as organizations, laws, and geographical information; connecting the evidence base to an existing dataset on the same topic; and identifying subgroups of articles that may share thematic content. An interactive tool using these techniques and a public dataset with their outputs have been released. Our results demonstrate the utility of machine learning techniques to enhance evidence accessibility and analysis within the systematic review processes. These efforts show promise in potentially yielding substantial efficiencies for future systematic reviewing and for broadening their analytical scope. Beyond this, our work suggests that there may be implications for the ease with which policymakers and practitioners can access evidence. While machine learning techniques seem poised to play a significant role in bridging the gap between research and policy by offering innovative ways of gathering, accessing, and analyzing data from systematic reviews, we also highlight their current limitations and the need to exercise caution in their application, particularly given the potential for errors and biases.
It has become a commonplace to say that Western civilization—all the civilizations of the globe, in fact—is in a state of crisis. Spengler and Toynbee, after studying the laws governing the development of great cultures of the past, expressed the opinion that our experience is repeating what marked the decline of each of them: development of universal empires, atony of languages, cultural as well as religious agnosticism. For those who may distrust such sweeping views, it is sufficient to observe that today's questioning attitudes represent neither mere matters of detail nor even the major renewals experienced by a civilization in a state of becoming. Humanism is shaken to its very foundations, and, the object of criticism and schism, has lost its inspirational force. Renaissance and revolutions broke with their immediate past only to breathe new life into an endangered civilization. This new breath was either drawn from an old tradition or anticipated in political and social readjustment. The French Revolution professed to be carrying out the aims of reason and nature, which had inspired the West for eight centuries, just as the Renaissance had professed to rediscover the spirit of antiquity. Our questions, on the other hand, arise not from a disorder in the old but from a conviction that the old has exhausted its principles and its possibilities and that it can henceforth only give way to something entirely new.
Bertus van Lier was born in Utrecht on 10 September 1906 and was interested in music from an early age. At the age of eight he took cello lessons at the local music school in his home town and he sang in the boys’ choir, performing Bach's St Matthew Passion. During his early years as a pupil at the Utrecht City Gymnasium, he was fascinated by the problems of composing music. In 1923, at sixteen years old, he completed his first composition, Prologue for cello and piano. On the occasion of the 450th anniversary of his gymnasium, Euripides’ tragedy Bacchae was performed, with incidental music by Willem Pijper; Van Lier was given the demanding role of Messenger for which he was commended in the press. He was much inspired by this experience and decided he would be a composer, beginning as a student of Pijper. In an interview dated 3 June 1964 Van Lier tells the interviewer:
I met Pijper for the first time at the Utrecht Gymnasium around 1925. We celebrated the lustrum with the performance of Euripides’ Bacchae. I was part of the cast. The music was Pijper’s. I had been composing from my 12th year on and I was very much impressed by Pijper's music. I cornered him and he looked at my music and he said: ‘Alright, I’ll give you lessons’. But after I passed my final examination of the gymnasium, he told me: ‘First of all get yourself registered at the Conservatorium!’ And that is how things went.
Deciding on his programme at the Amsterdam Conservatoire proved a little complicated: Pijper was teaching harmony, not composition, and van Lier decided to study with Pijper privately. He wanted to study singing as his main subject, but Pijper refused to accept a singer as his composition student. Van Lier therefore studied cello at the Conservatoire, as a student of Max Orobio de Castro. Meanwhile, van Lier's father nourished hopes that his only son would study law, to follow in his father's footsteps as director of the Utrechtsche Hypotheekbank (Utrecht Mortgage Bank), but when his son presented his First Symphony in 1927–28, there were no longer any doubts about his chosen career.
Current categorical classification systems of psychiatric diagnoses lead to heterogeneity of symptoms within disorders and common co-occurrence of disorders. We investigated the heterogeneous and overlapping nature of symptom endorsement in a population-based sample across three of the most common categories of psychiatric disorders: depressive disorders, anxiety disorders, and sleep–wake disorders using unsupervised machine learning approaches.
Methods
We assessed a total of 43 symptoms in a discovery sample of 6,602 participants of the population-based Rotterdam Study between 2009 and 2013, and in a replication sample of 3,005 participants between 2016 and 2020. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index. Hierarchical clustering analysis was applied on test items and participants to investigate common patterns of symptoms co-occurrence, and further quantitatively investigated with clustering methods to find groups that may represent similar psychiatric phenotypes.
Results
First, clustering analyses of the questionnaire items suggested a three-cluster solution representing clusters of “mixed” symptoms, “depressed affect and nervousness”, and “troubled sleep and interpersonal problems”. A highly similar clustering solution was independently established in the replication sample. Second, four groups of participants could be separated, and these groups scored differently on the item clusters.
Conclusions
We identified three clusters of psychiatric symptoms that most commonly co-occur in a population-based sample. These symptoms clustered stable over samples, but across the topics of depression, anxiety, and poor sleep. We identified four groups of participants that share (sub)clinical symptoms and might benefit from similar prevention or treatment strategies, despite potentially diverging, or lack of, diagnoses.
Dustbathing in fowls (eg chickens, Gallus gallus) consists of tossing the litter onto and between the fluffed feathers and subsequently enclosing it by flattening the feathers. The proximal contact between litters like sand and peat, and the integument is intensified by rubbing the body. This is not the case in wood-shavings which adhere to the distal plumage after tossing; rubbings in wood-shavings are frequently interrupted by reinitiated tossings. Lipids accumulate on the feathers and become stale during dust deprivation. Only baths in sand and peat are effective in removing excessive lipids from the proximal downy feather parts. Fluffiness of the down is highest in hens on peat, intermediate on sand and lowest on wood-shavings, while the reverse is true for the plumage surface temperature of the back Hens monitor the integumental lipid condition which becomes causally connected with bathing in the course of experiencing litter bathing effects. It is shown from the author's experimental study that hens naive of bathing in litter, and hens experienced with wood-shavings initially shifted bathing litters but finally preferred peat or sand (in that order) when peat, sand and wood-shavings were simultaneously presented Most of the hens experienced with bathing in sand did not shift to another substrate when presented with one. Recommendations are given concerning adequate dustbathing litter. A chronic deprivation of adequate litter leads to an uncontrollable condition of the lipids on the integument and an abnormal development of dustbathing. Such a deprivation therefore reduces animal welfare. Moreover, it is suggested to be costly.
Aging populations and specialized medicine are leading to increasing healthcare costs which are expected to rise in the next decades. The Netherlands Organization for Health Research and Development (ZonMw) funds trials that address the efficiency of healthcare interventions in order to evaluate new and existing interventions. These studies have led to considerable cost savings and increased health outcomes. However, efficiency studies often face setbacks during the start-up and inclusion which limit the available research capacity and postpone the availability of novel findings. Here, we investigate the scope of these problems and identify common causes.
Methods
Records from efficiency research trials funded by ZonMw from 2014-2020 were combined with information provided by project leaders through a survey. The combined dataset was explored through statistical analysis. Next, a subset of 30 selected projects was evaluated qualitatively to gain a better understanding of the possible underlying reasons for the experienced problems.
Results
The response rate among project leaders was 73 percent (146/201). Data indicate that 61 percent of projects started as planned and 35 percent included the first patient as scheduled. The complexity of setting up a multicenter study and legal procedures like local ethical approval were associated with delays in starting inclusions. In addition, 56 percent of studies had to extend the inclusion period by more than 6 months. Possible reasons that were identified include the limited numbers of patients available, and treatment preferences of the doctor, the patient, or the participating center.
Conclusions
Our results indicate that the majority of trials face setbacks and the main reasons include time to procure legal and ethical approval, limited patient numbers, as well as unforeseen treatment preferences. More streamlined procedures regarding approvals could speed up trial initiation, and better knowledge of eligible patients and treatment preferences could lead to more realistic planning. The results and conclusions from this study can be applied by ZonMw and other relevant stakeholders to resolve the identified problems in order to accelerate healthcare efficiency research.
Today’s conflicts are becoming increasingly complex, fluid, and fragmented, often involving a host of national and international actors with multiple and often divergent interests. This development poses significant challenges for conflict mediation, as mediators struggle to make sense of conflict dynamics, such as the range of conflict parties and the evolution of their political positions, the distinction between relevant and less relevant actors in peace-making, or the identification of key conflict issues and their interdependence. International peace efforts appear ill-equipped to successfully address these challenges. While technology is already being experimented with and used in a range of conflict related fields, such as conflict predicting or information gathering, less attention has been given to how technology can contribute to conflict mediation. This case study contributes to emerging research on the use of state-of-the-art machine learning technologies and techniques in conflict mediation processes. Using dialogue transcripts from peace negotiations in Yemen, this study shows how machine-learning can effectively support mediating teams by providing them with tools for knowledge management, extraction and conflict analysis. Apart from illustrating the potential of machine learning tools in conflict mediation, the article also emphasizes the importance of interdisciplinary and participatory, cocreation methodology for the development of context-sensitive and targeted tools and to ensure meaningful and responsible implementation.
Heightened sensation-seeking is related to the development of delinquency. Moreover, sensation-seeking, or biological correlates of sensation-seeking, are suggested as factors linking victimization to delinquency. Here, we focused on epigenetic correlates of sensation-seeking. First, we identified DNA methylation (DNAm) patterns related to sensation-seeking. Second, we investigated the association between sensation-seeking related DNAm and the development of delinquency. Third, we examined whether victimization was related to sensation-seeking related DNAm and the development of delinquency. Participants (N = 905; 49% boys) came from the Avon Longitudinal Study of Parents and Children. DNAm was assessed at birth, age 7 and age 15–17. Sensation-seeking (self-reports) was assessed at age 11 and 14. Delinquency (self-reports) was assessed at age 17–19. Sensation-seeking epigenome-wide association study revealed that no probes reached the critical significance level. However, 20 differential methylated probes reached marginal significance. With these 20 suggestive sites, a sensation-seeking cumulative DNAm risk score was created. Results showed that this DNAm risk score at age 15–17 was related to delinquency at age 17–19. Moreover, an indirect effect of victimization to delinquency via DNAm was found. Sensation-seeking related DNAm is a potential biological correlate that can help to understand the development of delinquency, including how victimization might be associated with adolescent delinquency.
In our earlier work, we demonstrated that the oxidases tyrosinase (TYR), laccase (LAC), and a heme peroxidase (POX) occur widely in lichens. Here we report on the occurrence of another oxidoreductase enzyme, quinone reductase (QR) (EC 1.6.5.5). While QR has been reported to occur widely in other organisms, there is currently no information on QR activities in lichens. Here we present a survey of QR activity in 14 species of lichens. Results demonstrate that QR activity is readily detectable in all lichen species tested. However, activities vary greatly, with ‘jelly’ lichens in the genera Collema and Leptogium having the highest activities. QR, LAC and POX are all believed to have a role in extracellular hydroxyl radical production. However, in this study no correlation was found between the activities of these enzymes and the rates at which hydroxyl radicals were produced. Possible roles for QR in lichen biology are discussed.
Provision of high-quality care and ensuring retention of children on antiretroviral therapy (ART) are essential to reduce human immunodeficiency virus (HIV)-associated morbidity and mortality. Virological non-suppression (≥1000 viral copies/ml) is an indication of suboptimal HIV care and support. This retrospective cohort study included ART-naïve children who initiated first-line ART between July 2015 and August 2017 in Johannesburg and rural Mopani district. Of 2739 children started on ART, 29.5% (807/2739) were lost to care at the point of analysis in August 2018. Among retained children, overall virological non-suppression was 30.2% (469/1554). Virological non-suppression was associated with higher loss to care 30.3% (229/755) compared with suppressed children (9.7%, 136/1399, P < 0.001). Receiving treatment in Mopani was associated with virological non-suppression in children under 5 years (adjusted odds ratio (aOR) 1.7 (95% confidence interval (CI) 1.1–2.4), 5–9 years (aOR 1.8 (1.1–3.0)) and 10–14 years (aOR 1.9 (1.2–2.8)). Virological non-suppression was associated with lower CD4 count in children 5–9 years (aOR 2.1 (1.1–4.1)) and 10–14 years (aOR 2.1 (1.2–3.8)). Additional factors included a shorter time on ART (<5 years aOR 1.8–3.7 (1.3–8.2)), and male gender (5–9 years, aOR1.5 (1.01–2.3)), and receiving cotrimoxazole prophylaxis (10–14 years aOR 2.0 (1.2–3.6)). In conclusion, virological non-suppression is a factor of subsequent programme loss in both regions, and factors affecting the quality of care need to be addressed to achieve the third UNAIDS 90 in paediatric HIV.
Massive material injection has been proposed as a way to mitigate the formation of a beam of relativistic runaway electrons that may result from a disruption in tokamak plasmas. In this paper we analyse runaway generation observed in eleven ASDEX Upgrade discharges where disruption was triggered using massive gas injection. We present numerical simulations in scenarios characteristic of on-axis plasma conditions, constrained by experimental observations, using a description of the runaway dynamics with a self-consistent electric field and temperature evolution in two-dimensional momentum space and zero-dimensional real space. We describe the evolution of the electron distribution function during the disruption, and show that the runaway seed generation is dominated by hot-tail in all of the simulated discharges. We reproduce the observed dependence of the current dissipation rate on the amount of injected argon during the runaway plateau phase. Our simulations also indicate that above a threshold amount of injected argon, the current density after the current quench depends strongly on the argon densities. This trend is not observed in the experiments, which suggests that effects not captured by zero-dimensional kinetic modelling – such as runaway seed transport – are also important.
The aim of the present study was to examine if patients’ expectancy after bariatric surgery was related to improvement of body appearance, health, physical fitness, or ability to work. Further, the relationship between psychiatric comorbid disorders and outcome expectancies after surgery was investigated.
Method
The study population consisted of 94 patients (F/M:74/20) age 22 to 62 years (mean 41.1, SD=10.2), with BMI from 33.4 to 64.7 kg/m2 (mean 44.9 kg/m2, SD=5.5). Psychiatric assessment was done prior to bariatric surgery, and included structured psychiatric interviews (M.I.N.I. International Neuropsychiatric Interview and Structured Clinical Interview for DSM IV Axis II disorders). The patients were asked to identify their most important expectancies after surgery.
Results
The overall prevalence of current psychiatric disorders was 47%, with Social Phobia (18%, n=17), Dysthymic Disorder (14%, n=13), and Avoidant Personality Disorder (17%, n=16) as the most common ones. Thirty-six percent (n=34) rated improvement of health, 34% (n=32) physical fitness, 22% (n=21) improvement of body appearance, and 7% (n=7) ability to work as their most important expectancy after surgery. Patients with psychiatric comorbidity rated significantly more frequent improvement in body appearance as their most preferred outcome than patients without psychiatric comorbidity (34%/ 12%, p= .01, chi-square test).
Conclusion
Patients with psychiatric disorders rated improvement in body appearance as their most preferred outcome after surgery more often than patients without psychiatric comorbidity. Future studies should examine whether patient expectations predict outcomes and satisfaction after surgery.
Obesity is associated with psychological, social and physical problems. The aim of this study was to examine the prevalence of subjective health complaints and their impact on work ability in a sample with morbid obesity.
Method:
Fortysix patients, 31 women and 15 men, aged 23 to 65 years (mean 43.7, s.d. 10.7), with BMI from 37 to 60 kg/m2 (mean 45 kg/m2, s.d. 5.02), on a waiting list for bariatric surgery participated. Subjective health complaints were measured by the 29-items Subjective Health Complaint Inventory. Five subscales were computed; Allergy, Flu, Musculoskeletal pain, Gastrointestinal problems and Pseudoneurology.
Results:
All participants reported subjective health complaints the last month, in particular they suffered from musculoskeletal (mean 8.2, s.d. 5.46), pseudoneurological (mean 4.7, s.d. 4.31) and gastrointestinal (mean 3.2, s.d. 5.46) complaints. Mean sickness absence the last year was 185 days (s.d. 163.32). Days of sickness absence were significant correlated with the Musculoskeletal (r = .35, p= .023) and Pseudoneurological (r= .40, p= .009) subscales.
Conclusion:
All patients reported subjective health complaints, with mean levels of symptoms considerably higher than in the general population. In particular, levels of musculoskeletal and pseudoneurological complaints were high, and these complaints were significantly related to work absence. It thus seems like subjective health complaints influence work ability to a significant degree in patients with morbid obesity.
The high-Alpine ice-core drilling site Colle Gnifetti (CG), Monte Rosa, Swiss/Italian Alps, provides climate records over the last millennium and beyond. However, the full exploitation of the oldest part of the existing ice cores requires complementary knowledge of the intricate glacio-meteorological settings, including glacier dynamics. Here, we present new ice-flow modeling studies of CG, focused on characterizing the flow at two neighboring drill sites in the eastern part of the glacier. The3-D full Stokes ice-flow model is thermo-mechanically coupled and includes firn rheology, firn densification and enthalpy transport, and is implemented using the finite element software Elmer/Ice. Measurements of surface velocities, accumulation, borehole inclination, density and englacial temperatures are used to validate the model output. We calculate backward trajectories and map the catchment areas. This constrains, for the first time at this site, the so-called upstream effects for the stable water isotope time series of the two ice cores drilled in 2005 and 2013. The model also provides a 3-D age field of the glacier and independent ice-core chronologies for five ice-core sites. Model results are a valuable addition to the existing glaciological and ice-core datasets. This especially concerns the quantitative estimate of upstream conditions affecting the interpretation of the deep ice-core layers.