28 results
A comprehensive hierarchical comparison of structural connectomes in Major Depressive Disorder cases v. controls in two large population samples
- Gladi Thng, Xueyi Shen, Aleks Stolicyn, Mark J. Adams, Hon Wah Yeung, Venia Batziou, Eleanor L. S. Conole, Colin R. Buchanan, Stephen M. Lawrie, Mark E. Bastin, Andrew M. McIntosh, Ian J. Deary, Elliot M. Tucker-Drob, Simon R. Cox, Keith M. Smith, Liana Romaniuk, Heather C. Whalley
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 18 March 2024, pp. 1-12
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Background
The brain can be represented as a network, with nodes as brain regions and edges as region-to-region connections. Nodes with the most connections (hubs) are central to efficient brain function. Current findings on structural differences in Major Depressive Disorder (MDD) identified using network approaches remain inconsistent, potentially due to small sample sizes. It is still uncertain at what level of the connectome hierarchy differences may exist, and whether they are concentrated in hubs, disrupting fundamental brain connectivity.
MethodsWe utilized two large cohorts, UK Biobank (UKB, N = 5104) and Generation Scotland (GS, N = 725), to investigate MDD case–control differences in brain network properties. Network analysis was done across four hierarchical levels: (1) global, (2) tier (nodes grouped into four tiers based on degree) and rich club (between-hub connections), (3) nodal, and (4) connection.
ResultsIn UKB, reductions in network efficiency were observed in MDD cases globally (d = −0.076, pFDR = 0.033), across all tiers (d = −0.069 to −0.079, pFDR = 0.020), and in hubs (d = −0.080 to −0.113, pFDR = 0.013–0.035). No differences in rich club organization and region-to-region connections were identified. The effect sizes and direction for these associations were generally consistent in GS, albeit not significant in our lower-N replication sample.
ConclusionOur results suggest that the brain's fundamental rich club structure is similar in MDD cases and controls, but subtle topological differences exist across the brain. Consistent with recent large-scale neuroimaging findings, our findings offer a connectomic perspective on a similar scale and support the idea that minimal differences exist between MDD cases and controls.
Granulocyte Colony-Stimulating Factor (Neupogen®; Filgrastim) Accelerates Neutrophil Recovery in a Rodent Model of Sulfur Mustard-Induced Hematologic Toxicity
- Phillip H Beske, Jill A Harvilchuck, Seth T Gibbs, Carol E Green, Lalitha Iyer, Kathleen O’Loughlin, Tom C-C Hu, Michael S Nealy, Gennady E Platoff, Jr, David T Yeung
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 04 December 2023, e550
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Objective:
Evidence of myelosuppression has been negatively correlated with patient outcomes following cases of high dose sulfur mustard (SM) exposure. These hematologic complications can negatively impact overall immune function and increase the risk of infection and life-threatening septicemia. Currently, there are no approved medical treatments for the myelosuppressive effects of SM exposure.
Methods:Leveraging a recently developed rodent model of SM-induced hematologic toxicity, post-exposure efficacy testing of the granulocyte colony-stimulating factor drug Neupogen® was performed in rats intravenously challenged with SM. Before efficacy testing, pharmacokinetic/pharmacodynamic analyses were performed in naïve rats to identify the apparent human equivalent dose of Neupogen® for efficacy evaluation.
Results:When administered 1 d after SM-exposure, daily subcutaneous Neupogen® treatment did not prevent the delayed onset of hematologic toxicity but significantly accelerated recovery from neutropenia. Compared with SM controls, Neupogen®-treated animals recovered body weight faster, resolved toxic clinical signs more rapidly, and did not display transient febrility at time points generally concurrent with marked pancytopenia.
Conclusions:Collectively, this work corroborates the results of a previous pilot large animal study, validates the utility of a rodent screening model, and provides further evidence for the potential clinical utility of Neupogen® as an adjunct treatment following SM exposure.
C.2 SUNFISH parts 1 and 2: 4-year efficacy and safety data of risdiplam in types 2 and 3 spinal muscular atrophy (SMA)
- JK Mah, M Oskoui, JW Day, N Deconinck, E Mazzone, A Nascimento, K Saito, C Vuillerot, G Baranello, O Boespflug-Tanguy, N Goemans, J Kirschner, A Kostera-Pruszczyk, L Servais, J Braid, M Gerber, K Gorni, C Martin, W Yeung, RS Scalco, E Mercuri
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 50 / Issue s2 / June 2023
- Published online by Cambridge University Press:
- 05 June 2023, pp. S51-S52
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Background: SMA affects individuals with a broad age range and spectrum of disease severity. Risdiplam (EVRYSDI®) is a centrally and peripherally distributed, oral SMN2 pre-mRNA splicing modifier. Methods: SUNFISH is a multicenter, two-part, randomized, placebo-controlled, double-blind study in patients with Types 2/3 SMA. Part 1 assessed the safety, tolerability and pharmacokinetics/pharmacodynamics of different risdiplam dose levels in patients with Types 2/3 SMA. Part 2 assessed the efficacy and safety of the selected dose of risdiplam versus placebo in Type 2 and non-ambulant Type 3 SMA. In Part 2, participants were treated with risdiplam or placebo for 12 months, then received risdiplam in a blinded manner until month 24. At month 24, patients were offered the opportunity to enter the open-label extension phase. Results: Change from baseline in MFM32 total score (Part 2- primary endpoint) in patients treated with risdiplam versus placebo was met at month 12. These increases in motor function were sustained in the second and third year after risdiplam treatment. Here we present 4-year efficacy and safety data from SUNFISH. Conclusions: SUNFISH is ongoing and will provide further long-term efficacy and safety data of risdiplam in a broad population of individuals with SMA.
Safety and Tolerability of Cariprazine for the Adjunctive Treatment of Major Depressive Disorder: A Pooled Analysis of Phase 2B and 3 Clinical Trials
- Michael E. Thase, Paul P. Yeung, Arlene Hankinson, Meng Liu, Ludmyla Rekeda, Willie R. Earley
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- Journal:
- CNS Spectrums / Volume 28 / Issue 2 / April 2023
- Published online by Cambridge University Press:
- 14 April 2023, pp. 255-256
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Background
Cariprazine has been shown to be efficacious in placebo-controlled clinical trials. In this pooled analysis, the safety of cariprazine in patients with major depressive disorder (MDD) with inadequate response to antidepressants was evaluated using data from placebo-controlled studies of up to 8 weeks’ duration and a long-term open-label safety study.
MethodsThe safety, tolerability, and efficacy of cariprazine as an adjunctive treatment for patients with MDD with inadequate response to antidepressant alone was assessed in five placebo-controlled studies (two 6-week fixed-dose studies [NCT03738215; NCT03739203] and three 8-week flexible-dose studies [NCT00854100; NCT01715805; NCT01469377]) and one 26-week open-label flexible-dose study (NCT01838876). Fixed doses of cariprazine 1.5 and 3 mg/d and flexible doses of 0.1-4.5 mg/d were evaluated. Safety assessments included adverse event (AE) reporting, clinical laboratory tests, weight and other vital signs, and suicide evaluation with Columbia-Suicide Severity Rating Scale (C-SSRS). Pooled analyses of the incidence of safety endpoints overall and within each treatment arm were performed using the most frequent (modal) daily dose taken by patients during the study.
ResultsA total of 2,222 MDD patients with an ongoing antidepressant received treatment with cariprazine, representing 370 patient-years of exposure in placebo-controlled and open-label studies. In the placebo-controlled studies, 1,969 patients were randomized to cariprazine (dose range, 0.1–4.5 mg/d) and 1,108 patients were randomized to placebo. Overall, treatment-emergent AEs occurred in 61% of cariprazine- and 48% of placebo-treated patients; discontinuation due to an AE occurred with 6% of cariprazine- and 2% of placebo-treated patients. The 2 AEs that occurred in at least 5% of cariprazine-treated patients and at a rate at least twice the rate in placebo-treated patients were akathisia (cariprazine=11%; placebo=2%) and restlessness (cariprazine=6%; placebo=2%). Changes in metabolic parameters, including shifts in fasting glucose and lipid parameters, were similar in cariprazine- and placebo-treated patients. In the long-term safety study, mean weight change was 1.6 kg over 6 months. In the placebo-controlled and long-term studies, other safety endpoints including laboratory and C-SSRS assessments of suicidality were generally consistent with the safety profile of cariprazine in approved indications of bipolar disorder and schizophrenia.
ConclusionCariprazine is generally safe and well-tolerated in MDD patients with inadequate response to antidepressant monotherapy. Safety analysis of 2,222 cariprazine-treated patients with MDD revealed no new safety signals, and the data is consistent with the currently approved prescribing information.
FundingAbbVie
Clearing the air: A study of cannabis-related presentations to urban Alberta emergency departments following legalization
- Matthew E. M. Yeung, Colin G. Weaver, Kevin Janz, Rebecca Haines-Saah, Eddy Lang
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 22 / Issue 6 / November 2020
- Published online by Cambridge University Press:
- 19 June 2020, pp. 776-783
- Print publication:
- November 2020
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Objectives
Non-medical cannabis recently became legal for adults in Canada. Legalization provides opportunity to investigate the public health effects of national cannabis legalization on presentations to emergency departments (EDs). Our study aimed to explore association between cannabis-related ED presentations, poison control and telemedicine calls, and cannabis legalization.
MethodsData were collected from the National Ambulatory Care Reporting System from October 1, 2013, to July 31, 2019, for 14 urban Alberta EDs, from Alberta poison control, and from HealthLink, a public telehealth service covering all of Alberta. Visitation data were obtained to compare pre- and post-legalization periods. An interrupted time-series analysis accounting for existing trends was completed, in addition to the incidence rate ratio (IRR) and relative risk calculation (to evaluate changes in co-diagnoses).
ResultsAlthough only 3 of every 1,000 ED visits within the time period were attributed to cannabis, the number of cannabis-related ED presentations increased post-legalization by 3.1 (range -11.5 to 12.6) visits per ED per month (IRR 1.45, 95% confidence interval [CI]; 1.39, 1.51; absolute level change: 43.5 visits per month, 95% CI; 26.5, 60.4). Cannabis-related calls to poison control also increased (IRR 1.87, 95% CI; 1.55, 2.37; absolute level change: 4.0 calls per month, 95% CI; 0.1, 7.9). Lastly, we observed increases in cannabis-related hyperemesis, unintentional ingestion, and individuals leaving the ED pre-treatment. We also observed a decrease in co-ingestant use.
ConclusionOverall, Canadian cannabis legalization was associated with small increases in urban Alberta cannabis-related ED visits and calls to a poison control centre.
MP03: Clearing the air: A retrospective cohort study of cannabis-related harms in urban Alberta emergency departments following legalization
- M. Yeung, C. Weaver, E. Lang, R. Saah-Haines, K. Janz
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 22 / Issue S1 / May 2020
- Published online by Cambridge University Press:
- 13 May 2020, p. S43
- Print publication:
- May 2020
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Introduction: Non-medical cannabis recently became legal on October 18th, 2018 to Canadian adults. The impact of legalization on Emergency Departments (EDs) has been identified as a major concern. The study objective was to identify changes in cannabis-related ED visits and changes in co-existing diagnoses associated with cannabis-related ED visits pre- and post-legalization for the entire urban population of Alberta. Urban Alberta was defined as Calgary and Edmonton, inclusive of Sherwood Park and St. Albert given the proximity of some Edmontonians to their EDs) encompassing 12 adult EDs and 2 pediatric EDs. Methods: Retrospective data was collected from the National Ambulatory Care Reporting System, and from the HealthLink and the Alberta Poison and Drug Information Service (PADIS) public telehealth call databases. An interrupted time-series analysis was completed via segmented regression calculation in addition to incident rate and relative risk ratio calculation for the pre- and post-legalization periods to identify both differences among the entire urban Alberta population and differences among individuals presenting to the ED. Data was collected from October 1st, 2013 up to July 31st, 2019 for ED visits and was adjusted for natural population increase using quarterly reports from the Government of Alberta. Results: The sample included 11 770 pre-legalization cannabis-related visits, and 2962 post-legalization visits. Volumes of ED visits for cannabis-related harms were found to increase post-legalization within urban EDs (IRR 1.45, 95% CI 1.39, 1.51; absolute level change: 43.48 visits per month in urban Alberta, 95% CI 26.52, 60.43), and for PADIS calls (IRR 1.87, 95% CI 1.55, 2.37; absolute level change: 4.02 calls per month in Alberta, 95% CI 0.11, 7.94). The increase in visits to EDs equates to an increase of 2.72 visits per month, per ED. Lastly, increases were observed for cannabinoid hyperemesis (RR 1.23, 95% CI 1.10, 1.36), unintentional ingestion (RR 1.48, 95% CI 1.34, 1.62), and in individuals leaving the ED pre-treatment (RR 1.28, 95% CI 1.08, 1.49). Decreases were observed for coingestant use (RR 0.77, 95% CI 0.73, 0.81) and hospital admissions (RR 0.88, 95% CI 0.80, 0.96). Conclusion: Overall, national legalization of cannabis appears to be correlated with a small increase in cannabis-related ED visits and poison control calls. Post-legalization, fewer patients are being admitted, though cannabinoid hyperemesis appears to be on the rise.
P.063 SUNFISH Part 1 results and Part 2 trial design in patients with type 2/3 spinal muscular atrophy (SMA) receiving risdiplam (RG7916)
- C Campbell, E Mercuri, G Baranello, J Kirschner, L Servais, N Goemans, M Pera, J Buchbjerg, W Yeung, H Kletzl, M Gerber, C Czech, Y Cleary, K Gorni, O Khwaja
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- Canadian Journal of Neurological Sciences / Volume 46 / Issue s1 / June 2019
- Published online by Cambridge University Press:
- 05 June 2019, p. S31
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Background: SMA is characterized by reduced levels of survival of motor neuron (SMN) protein from deletions and/or mutations of the SMN1 gene. While SMN1 produces full-length SMN protein, a second gene, SMN2, produces low levels of functional SMN protein. Risdiplam (RG7916/RO7034067) is an investigational, orally administered, centrally and peripherally distributed small molecule that modulates pre-mRNA splicing of SMN2 to increase SMN protein levels. Methods: SUNFISH (NCT02908685) is an ongoing multicenter, double-blind, placebo-controlled, operationally seamless study (randomized 2:1, risdiplam:placebo) in patients aged 2–25 years, with Type 2/3 SMA. Part 1 (n=51) assesses safety, tolerability, pharmacokinetics and pharmacodynamics of different risdiplam dose levels. Pivotal Part 2 (n=180) assesses safety and efficacy of the risdiplam dose level selected based on Part 1 results. Results: Part 1 results showed a sustained, >2-fold increase in median SMN protein versus baseline following 1 year of treatment. Adverse events were mostly mild, resolved despite ongoing treatment and reflected underlying disease. No drug-related safety findings have led to withdrawal (data-cut 06/17/18). SUNFISH Part 1 exploratory endpoint results and Part 2 study design will also be presented. Conclusions: To date, no drug-related safety findings have led to withdrawal. Risdiplam led to sustained increases in SMN protein levels.
P145: Orthomageddon: An epidemiological analysis of weather-dependent mass-casualty incidents in a Canadian city
- M. Yeung, C. Schweitzer, D. Wang, E. Lang
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 21 / Issue S1 / May 2019
- Published online by Cambridge University Press:
- 02 May 2019, pp. S116-S117
- Print publication:
- May 2019
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Introduction: Unique weather patterns on March 16th, 2017 led to 3 times the number of emergency department (ED) visits due to fall-injuries (FIs) on snow or ice compared to winter averages. The objective of the study was to identify weather-dependent differences in demographics, length-of-stay (LOS) predictors, and volume of ED presentations for winter FIs. We placed emphasis on Chinook phenomenon (rapid freeze-thaw cycles) common east of the Rocky Mountains. Methods: Patients with extremity injury due to fall on snow or ice were identified from the Alberta Health Services ED database from November 1st 2013 to March 31st 2018. We conducted regressions, chi-square analysis, bivariate correlations, and t-tests to identify differences in post-Chinook, high-volume, and regular winter patient cohorts. High-volume dates included any date with more than 25 FI presentations, representing a 400% increase from the daily average of 5. Results: We identified 3478 patients, with females more likely to present, X2 (1, N = 3480) = 443.266, p < 0.001, making up 67.8% of the total cohort. Mean age was 48.2 (SD ± 19.9) in all patients, and 48.4 (SD ± 20.0) among the post-Chinook cohort. Looking at ED LOS in the full patient cohort, age over 65 predicted longer ED LOS (mean = 4.23, SD ± 3.06) compared to younger age groups (mean = 3.42, SD ± 2.39), t(3478) = -7.37, p < 0.001]. Patients with fractures to the wrist or hand had shorter ED LOS (mean = 2.50, SD ± 5.83) than those without (mean = 10.95, SD ± 92.54), t(3478) = 2.64, p = 0.008. Among admitted patients, results were similar, with elevated inpatient LOS for patients over the age of 65 (mean = 171.71, SD ± 508.35) compared to younger patients (mean = 45.45, SD ± 39.53), t(3478) = −3.41, p = 0.001. Patients with radius fractures had shorter LOS (mean = 61.87, SD ± 210.37) compared to those without (mean = 288.83, SD ± 632.29), t(3478) = 3.87, p < 0.001. With respect to volume and weather, night-freezing events (below-freezing temperatures the preceding day, followed by freezing temperatures prior to 0600 hours the following day) were more likely to result in high FI volume (OR, 8.08; 95% CI, 5.14, 12.07; p < 0.001) as were recent Chinook events (OR, 1.39; 95% CI, 1.06, 1.81; p = 0.017). Conclusion: Chinook-induced meteorological mass-casualty events can be severe, but do not target populations distinct from winter averages. They can be predicted based on forecasted weather variations and should be considered for population-level alerts utilizing cellular technology.
P.029 Case report: pediatric enterovirus encephalitis - a rare complication of rituximab therapy
- L Sham, R Yeung, S Dell, A Bitnun, J Johnstone, E Yeh
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 45 / Issue s2 / June 2018
- Published online by Cambridge University Press:
- 27 June 2018, p. S23
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Background: Opportunistic infection should be considered when seeing neurological complications in the setting of immunosuppression. Accumulating evidence that enteroviral meningoencephalitis can occur after rituximab administration exists but differentiating it from non-infectious conditions can be challenging. Methods: Case report Results: We describe a 4 year-old-boy with a history of pulmonary capillaritis, treated with immunosuppressive therapy -including steroids, rituximab, and azathioprine. He developed mutism and ataxia after 18 months on rituximab. MRI Brain/Spine revealed extensive T2/FLAIR hyperintensities in the deep subcortical white matter, temporal lobes, globus pallidi, thalami, brainstem, and cerebellum; and swelling of the dorsal cervical cord, showing primarily grey matter involvement. IgG levels had a decreasing trend over the course of Rituximab. CSF, and subsequent brain biopsy, were both positive for enterovirus RNA by RT-PCR. He was thought to have enterovirus encephalitis secondary to rituximab therapy, and was treated with IVIG and fluoxetine. Conclusions: One should consider chronic opportunistic CNS infections in children treated with immunosuppressive therapy, and to consider chronic enterovirus infection when B-cell suppression has occurred. As rituximab is being increasingly used in the pediatric population, and is generally thought to be safe, attention should be paid to any child with chronic neurological signs, particularly younger children who may be at higher risk for chronic enterovirus infection.
High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients
- L. N. W. Tin, S. S. Y. Lui, K. K. Y. Ho, K. S. Y. Hung, Y. Wang, H. K. H. Yeung, T. Y. Wong, S. M. Lam, R. C. K. Chan, E. F. C. Cheung
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- Psychological Medicine / Volume 48 / Issue 8 / June 2018
- Published online by Cambridge University Press:
- 18 September 2017, pp. 1264-1273
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Background
Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance.
MethodsThirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM.
ResultsThe Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients.
ConclusionsThe findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism–schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.
The intertidal wetlands of southern Jiangsu Province, China – globally important for Spoon-billed Sandpipers and other threatened waterbirds, but facing multiple serious threats
- HE-BO PENG, GUY Q. A. ANDERSON, QING CHANG, CHI-YEUNG CHOI, SAYAM U. CHOWDHURY, NIGEL A. CLARK, XIAOJING GAN, RICHARD D. HEARN, JING LI, ELENA G. LAPPO, WENLIANG LIU, ZHIJUN MA, DAVID S. MELVILLE, JAMES F. PHILLIPS, EVGENY E. SYROECHKOVSKIY, MENXIU TONG, SONGLING WANG, LIN ZHANG, CHRISTOPH ZÖCKLER
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- Journal:
- Bird Conservation International / Volume 27 / Issue 3 / September 2017
- Published online by Cambridge University Press:
- 20 July 2017, pp. 305-322
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The Yellow Sea region is of high global importance for waterbird populations, but recent systematic bird count data enabling identification of the most important sites are relatively sparse for some areas. Surveys of waterbirds at three sites on the coast of southern Jiangsu Province, China, in 2014 and 2015 produced peak counts of international importance for 24 species, including seven globally threatened and six Near Threatened species. The area is of particular global importance for the ‘Critically Endangered’ Spoon-billed Sandpiper Calidris pygmaea (peak count across all three study sites: 62 in spring [2015] and 225 in autumn [2014] and ‘Endangered’ Spotted Greenshank Tringa guttifer (peak count across all three study sites: 210 in spring [2014] and 1,110 in autumn [2015]). The southern Jiangsu coast is therefore currently the most important migratory stopover area in the world, in both spring and autumn, for both species. Several serious and acute threats to waterbirds were recorded at these study sites. Paramount is the threat of large-scale land claim which would completely destroy intertidal mudflats of critical importance to waterbirds. Degradation of intertidal mudflat habitats through the spread of invasive Spartina, and mortality of waterbirds by entrapment in nets or deliberate poisoning are also real and present serious threats here. Collisions with, and displacement by, wind turbines and other structures, and industrial chemical pollution may represent additional potential threats. We recommend the rapid establishment of effective protected areas for waterbirds in the study area, maintaining large areas of open intertidal mudflat, and the urgent removal of all serious threats currently faced by waterbirds here.
Prenatal fish oil supplementation and early childhood development in the Upstate KIDS Study
- K. Vollet, A. Ghassabian, R. Sundaram, N. Chahal, E. H. Yeung
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 8 / Issue 4 / August 2017
- Published online by Cambridge University Press:
- 24 April 2017, pp. 465-473
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Fish oil contains omega-3 fatty acids, which play a vital role in fetal growth and development. In utero exposure to omega-3 fatty acids is exclusively dependent on maternal nutrition. Previous studies have suggested that prenatal fish oil supplementation has positive impacts on child neurodevelopment later in life. This study examines the associations between fish oil supplementation both before pregnancy and throughout pregnancy and subsequent child development. Mother–child pairs from the Upstate KIDS Study, a birth cohort consisting of children born between 2008 and 2010, were included. Self-reported prenatal fish oil supplementation data were available for 5845 children (3807 singletons and 2038 twins). At multiple time points, from 4 months to 3 years of age, child development was reported by the parents on the Ages and Stages Questionnaire (ASQ). Five developmental domains were assessed: fine motor, gross motor, communication, personal–social functioning and problem solving. Generalized linear mixed models were used to estimate odds ratios (OR) while adjusting for covariates. Primary analyses showed that the risk of failing the ASQ problem-solving domain was significantly lower among children of women who took fish oil before pregnancy (OR 0.40, 95% confidence intervals (CI) 0.18–0.89) and during pregnancy (OR 0.43, 95% CI 0.22–0.83). Gender interaction was not statistically significant, although stratified results indicated stronger associations among girls. Similarly, associations were primarily among singletons. Prenatal fish oil supplementation may be beneficial in regards to neurodevelopment. Specifically, it is associated with a lower risk of failing the problem-solving domain up to 3 years of age.
Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives
- N Mehta, R J Williams, M E Smith, A Hall, J C Hardman, L Cheung, M P Ellis, J M Fussey, R Lakhani, O McLaren, P C Nankivell, N Sharma, W Yeung, S Carrie, C Hopkins
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- Journal:
- The Journal of Laryngology & Otology / Volume 131 / Issue 6 / June 2017
- Published online by Cambridge University Press:
- 23 March 2017, pp. 518-522
- Print publication:
- June 2017
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Objective:
To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data.
Methods:Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires.
Results:Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5).
Conclusion:This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.
B.03 The Canadian neurology graduate survey
- BJ Murray, P Major, A Poppe, C Murphy, M Jenkins, M Nicolle, C Watling, HJ McMillan, M Yeung, D Callen, H Briemberg, DF Tang-Wai, C De Meulemeester, P Brna, M Savard, D Sahlas, A Yeh, G Gubitz, F Moore, K Khan, K Squarey, C Deacon, M Esser, R Vosoughi, S Taylor, S Weiss, E Hollenberg
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 43 / Issue S2 / June 2016
- Published online by Cambridge University Press:
- 17 June 2016, pp. S9-S10
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Background: Planning for neurology training necessitated a reflection on the experience of graduates. We explored practice characteristics, and training experience of recent graduates. Methods: Graduates from 2010-2014 completed a survey. Results: Response rate was 37% of 211. 56% were female. 91% were adult neurologists. 65% practiced in an outpatient setting. 63% worked in academics. 85% completed subspecialty training (median 1 year). 36% work 3 days a week or less. 82% took general call (median 1 night weekly). Role preparation was considered very good or excellent for most; however poor or fair ratings were 17% in advocacy and 8% in leadership. Training feedback was at least “good” for 87%. Burnout a few times a week or more was noted by 5% (6% during residency, particularly PGY1 and 5). 64% felt overly burdened by paperwork. Although most felt training was adequate, it was poor or fair at preparing for practice management (85%) and personal balance (55%). Most conditions were under-observed in training environment. Many noted a need for more independent practice development and community neurology. Conclusions: Although our training was found to be very good, some identified needs included advocacy training, and more training in general neurology in the longitudinal outpatient/community settings.
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- By Francesco Acerbi, Ayca Akgoz, Matthew R. Amans, Ramsey Ashour, Mohammed Ali Aziz-Sultan, H. Hunt Batjer, Donnie Bell, Bernard R. Bendok, Giovanni Broggi, Morgan Broggi, Charles A. Bruno, Steven D. Chang, In Sup Choi, Omar Choudhri, Douglas J. Cook, William P. Dillon, Peter Dirks, Rose Du, Travis M. Dumont, Tarek Y. El Ahmadieh, Najib E. El Tecle, Mohamed Samy Elhammady, Paolo Ferroli, Alana M. Flexman, John C. Flickinger, Kai U. Frerichs, Sasikhan Geibprasert, Adrian W. Gelb, Y. Pierre Gobin, Bradley A. Gross, Seunggu J. Han, Tomoki Hashimoto, Juha Hernesniemi, Roberto C. Heros, Steven W. Hetts, Randall T. Higashida, Joshua A. Hirsch, Nikolai J. Hopf, L. Nelson Hopkins, Maziyar A. Kalani, M. Yashar S. Kalani, Hideyuki Kano, Syed Aftab Karim, Robert M. Koffie, Douglas S. Kondziolka, Timo Krings, Aki Laakso, Giuseppe Lanzino, Michael T. Lawton, Elad I. Levy, L. Dade Lunsford, Adel M. Malek, Michael P. Marks, George A. C. Mendes, Philip M. Meyers, Jacques Morcos, Nitin Mukerji, Christian Musahl, Ludmila Pawlikowska, Matthew B. Potts, Ross Puffer, James D. Rabinov, Jonathan J. Russin, Mina G. Safain, Duke Samson, Marco Schiariti, R. Michael Scott, Jason P. Sheehan, Paul Singh, Edward R. Smith, Scott G. Soltys, Robert F. Spetzler, Gary K. Steinberg, Philip E. Stieg, Hua Su, Karel terBrugge, Kiron Thomas, Tarik Tihan, Babu Welch, Jonathan White, H. Richard Winn, Chun-Po Yen, Jacky T. Yeung, Byron Yip, Samer G. Zammar
- Edited by Robert F. Spetzler, Douglas S. Kondziolka, Randall T. Higashida, University of California, San Francisco, M. Yashar S. Kalani
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- Comprehensive Management of Arteriovenous Malformations of the Brain and Spine
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- 05 January 2015
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Collagen Ultrastructure and Skin Mechanics in DDR1 KO Mice
- D. Yeung, S. Chen, J. Tonniges, J. Lee, H. Powell, E. Calomeni, G. Agarwal
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- Microscopy and Microanalysis / Volume 19 / Issue S2 / August 2013
- Published online by Cambridge University Press:
- 09 October 2013, pp. 110-111
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- August 2013
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Extended abstract of a paper presented at Microscopy and Microanalysis 2013 in Indianapolis, Indiana, USA, August 4 – August 8, 2013.
THE ${L}^{2} $-SINGULAR DICHOTOMY FOR EXCEPTIONAL LIE GROUPS AND ALGEBRAS
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- K. E. HARE, D. L. JOHNSTONE, F. SHI, W.-K. YEUNG
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- Journal of the Australian Mathematical Society / Volume 95 / Issue 3 / December 2013
- Published online by Cambridge University Press:
- 24 July 2013, pp. 362-382
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- December 2013
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We show that every orbital measure, ${\mu }_{x} $, on a compact exceptional Lie group or algebra has the property that for every positive integer either ${ \mu }_{x}^{k} \in {L}^{2} $ and the support of ${ \mu }_{x}^{k} $ has non-empty interior, or ${ \mu }_{x}^{k} $ is singular to Haar measure and the support of ${ \mu }_{x}^{k} $ has Haar measure zero. We also determine the index $k$ where the change occurs; it depends on properties of the set of annihilating roots of $x$. This result was previously established for the classical Lie groups and algebras. To prove this dichotomy result we combinatorially characterize the subroot systems that are kernels of certain homomorphisms.
Prevalence of MTHFR C677T and MS A2756G polymorphisms in major depressive disorder, and their impact on response to fluoxetine treatment
- David Mischoulon, Stefania Lamon-Fava, Jacob Selhub, Judith Katz, George I. Papakostas, Dan V. Iosifescu, Albert S. Yeung, Christina M. Dording, Amy H. Farabaugh, Alisabet J. Clain, Lee Baer, Jonathan E. Alpert, Andrew A. Nierenberg, Maurizio Fava
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- CNS Spectrums / Volume 17 / Issue 2 / June 2012
- Published online by Cambridge University Press:
- 04 May 2012, pp. 76-86
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Objective
To examine the prevalence of the C677T polymorphism of the methylene tetrahydrofolate reductase (MTHFR) gene and the A2756G polymorphism of methionine synthase (MS), and their impact on antidepressant response.
MethodsWe screened 224 subjects (52% female, mean age 39 ± 11 years) with SCID-diagnosed major depressive disorder (MDD), and obtained 194 genetic samples. 49 subjects (49% female, mean age 36 ± 11 years) participated in a 12-week open clinical trial of fluoxetine 20–60 mg/day. Association between clinical response and C677T and A2756G polymorphisms, folate, B12, and homocysteine was examined.
ResultsPrevalence of the C677T and A2756G polymorphisms was consistent with previous reports (C/C = 41%, C/T = 47%, T/T = 11%, A/A = 66%, A/G = 29%, G/G = 4%). In the fluoxetine-treated subsample (n = 49), intent-to-treat (ITT) response rates were 47% for C/C subjects and 46% for pooled C/T and T/T subjects (nonsignificant). ITT response rates were 38% for A/A subjects and 60% for A/G subjects (nonsignificant), with no subjects exhibiting the G/G homozygote. Mean baseline plasma B12 was significantly lower in A/G subjects compared to A/A, but folate and homocysteine levels were not affected by genetic status. Plasma folate was negatively associated with treatment response.
ConclusionThe C677T and A2756G polymorphisms did not significantly affect antidepressant response. These preliminary findings require replication in larger samples.
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Prevalence of anaemia among pregnant women in south-east China, 1993–2005
- Lei Jin, Lorraine F Yeung, Mary E Cogswell, Rongwei Ye, Robert J Berry, Jianmeng Liu, Dale J Hu, Li Zhu
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- Public Health Nutrition / Volume 13 / Issue 10 / October 2010
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- 25 June 2010, pp. 1511-1518
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Objective
To report the prevalence of anaemia by demographic characteristics and its secular trend over 13 years for south-east Chinese pregnant women, and to determine the focus of anaemia prevention in Chinese pregnant women.
DesignProspective study of the data on Hb concentration and other demographic information from a large-scale population-based perinatal health surveillance system in south-east China.
SettingFourteen cities or counties in Jiangsu and Zhejiang provinces.
SubjectsA total of 467 057 prenatal women who had participated in the perinatal health-care surveillance system and delivered babies from 1 January 1993 to 31 December 2005 and had a record of Hb in all three pregnancy trimesters.
ResultsThe overall prevalence of anaemia among pregnant women was 39·6 % from 1993 to 2005. Anaemia prevalence increased from the first (29·6 %) to the second (33·0 %) and third (56·2 %) trimesters. The prevalence of anaemia was higher in villagers, in women with less education and in women with higher gravidity or parity. The prevalence of anaemia in all of the trimesters was higher in the spring, summer and autumn and lower in the winter. The prevalence decreased from 1993 to 2005, from 53·3 % to 11·4 % for the first trimester, 45·6 % to 22·8 % for the second trimester and 64·6 % to 44·6 % for the third trimester.
ConclusionsThe prevalence of anaemia among pregnant women in Jiangsu and Zhejiang provinces decreased substantially from 1993 to 2005. However, anaemia in the third trimester is still a severe public health problem among pregnant women in these areas.