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Research in decentralized computing, specifically in consensus algorithms, has focused on providing resistance to an adversary with a minority stake. This has resulted in systems that are majoritarian in the extreme, ignoring valuable lessons learned in law and politics over centuries. In this article, we first detail this phenomenon of majoritarianism and point out how minority protections in the nondigital world have been implemented. We motivate adding minority protections to collaborative systems with examples. We also show how current software deployment models exacerbate majoritarianism, highlighting the problem of monoculture in client software in particular. We conclude by giving some suggestions on how to make decentralized computing less hostile to those in the minority.
Knowledge of weed seeds present in the soil seedbank is important for understanding population dynamics and forecasting future weed infestations. Quantification of the weed seedbank has historically been laborious, and few studies have attempted to quantify seedbanks on the scale required to make management decisions. An accurate, efficient, and ideally automated method to identify weed seeds in field samples is needed. To achieve sufficient precision, we leveraged YOLOv8, a machine learning object detection to accurately identify and count weed seeds obtained from the soil seedbank and weed seed collection. The YOLOv8 model, trained and evaluated using high-quality images captured with a digital microscope, achieved an overall accuracy and precision exceeding 80% confidence in distinguishing various weed seed species in both images and real-time videos. Despite the challenges associated with species having similar seed morphology, the application of YOLOv8 will facilitate rapid and accurate identification of weed seeds for the assessment of future weed management strategies.
To evaluate the effectiveness of a radio campaign involving serial 10-minute drama episodes, 10-minute on air discussion of each episode by trained community health workers and 30-minute phone-ins from listeners in improving mothers’ nutrition- and health-related attitudes (HNRAs) and children’s minimum acceptable diet (MAD).
Design:
A two-arm quasi-experimental trial with a pre-post design was used to quantify the effect of a radio campaign on nutrition before and immediately after the 6-month intervention. Difference-in-difference (DID) analysis was performed to assess the intervention’s effect.
Setting:
Saboba district (intervention) and Central Gonja (comparison district) of northern region of Ghana.
Participants:
At baseline, a total of 598 mothers with children aged 6–22 months were randomly selected from the intervention (n 298) and control (n 300) districts. At endline (6 months post-intervention), 252 mother–child dyads in the intervention district and 275 mother–child dyads in the control district were followed up.
Results:
The radio campaign was significantly and positively associated with a change in health- and nutrition-related attitudes (HNRA) over time, with DID in mean attitudes significantly improving more over time in the intervention district than the control (DID = 1·398, P < 0·001). Also, the prevalence of MAD over time in the intervention district was significantly higher than the control district (DID = 16·1 percentage points, P = 0·02) in the presence of food insecurity.
Conclusions:
The study indicates that a radio campaign on nutrition is associated with improved mothers’ HNRA and children’s MAD. Communication interventions on child nutrition targeting low-resource settings should consider this innovative approach.
The objective of the study was to compare the potential dietary impact of proposed and final front-of-pack labelling (FOPL) regulations (published in Canada Gazette I (CG1) and Canada Gazette II (CG2), respectively) by examining the difference in the prevalence of foods that would require a ‘High in’ front-of-pack nutrition symbol and nutrient intakes from those foods consumed by Canadian adults.
Design:
Foods in a generic food composition database (n 3676) were categorised according to the details of FOPL regulations in CGI and CGII, and the differences in the proportion of foods were compared. Using nationally representative dietary survey data, potential intakes of nutrients from foods that would display a ‘High in’ nutrition symbol according to CGI and CGII were compared.
Setting:
Canada
Participants:
Canadian adults (≥ 19 years; n 13 495)
Results:
Compared with CGI, less foods would display a ‘High in’ nutrition symbol (Δ = –6 %) according to CGII (saturated fat = –4 %, sugars = –1 %, sodium = –3 %). Similarly, potential intakes of nutrients-of-concern from foods that would display a ‘High in’ nutrition symbol were reduced according to CGII compared with CGI (saturated fat = –21 %, sugars = –2 %, sodium = –6 %). Potential intakes from foods that would display a ‘High in’ nutrition symbol were also reduced for energy and nutrients-to-encourage, including protein, fibre, calcium and vitamin D.
Conclusions:
Changes to FOPL regulations may have blunted their potential to limit intakes of nutrients-of-concern; however, they likely averted potential unintended consequences on intakes of nutrients-to-encourage for Canadians (e.g. calcium and vitamin D). To ensure policy objectives are met, FOPL regulations must be monitored regularly and evaluated over time.
Antimicrobial resistance (AMR) renders many bacterial infections untreatable and results in substantial morbidity and mortality worldwide. Understanding antibiotic use in clinical settings including hospitals is critical to optimize antibiotic use and prevent resistance.
Design:
Hospital antibiotic point prevalence survey (PPS).
Methods:
The study was conducted in two large, teaching hospitals in Addis Ababa, Ethiopia. We performed two survey rounds in December 2021 and January 2022 through real-time chart review using the World Health Organization PPS methodology. Data were collected using a web-based database, and descriptive statistics were performed to analyze antibiotic use by various characteristics.
Results:
Among 1020 hospitalized patients, 318 (32%) were ≤14 years and 370 (36%) had surgery during the current hospitalization. A total of 662 (65%) were receiving an antibiotic on the day of survey and 346 (39%) were receiving ≥2 antibiotics. A community-acquired infection (43%) was the most common indication for an antibiotic followed by surgical prophylaxis (27%) and hospital-acquired infection (23%). Antibiotic use was highest among those ≤24 months in age and among patients in trauma, surgical, and pediatric wards. Cephalosporin (42%) and penicillin (16%) antibiotics were the most frequently prescribed classes. Only 11% of patients on antibiotics had samples collected for microbiological testing; hence, almost all antibiotic therapy was empiric.
Conclusions:
Despite global and national efforts to improve antimicrobial stewardship, antibiotic use remains high in urban teaching hospitals in Ethiopia. Implementation of antimicrobial stewardship activities and microbiology utilization are needed to guide antimicrobial selection and curtail antibiotic overuse.
Depression is a widespread problem that affects individuals of all ages. This study looks at the use of omega-3 polyunsaturated fatty acids (PUFAs) as an additional therapy for depression in people of different ages. Depression has an impact on everyone, from youth to the elderly, causing therapeutic concerns such as treatment resistance and recurrence. Omega-3 PUFAs, which may be found in fish and flaxseed, are important because of their impact on neurochemistry, inflammation, and neuroprotection. While pharmacotherapy, including antidepressants, has proven beneficial for many, the likelihood of remission and recurrence remains substantial. In recent years, there has been a growing interest in the potential role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in mitigating depressive symptoms. The primary constituents of n-3 PUFAs are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Understanding the potential of omega-3 PUFAs across the lifespan can help address the multifaceted challenges posed by depression and improve mental health outcomes for diverse age groups.
Objectives
This review aims to assess the role of omega-3 fatty acids in depression treatment across different age groups: children and adolescents, adults (18–60), and the elderly (60+). It investigates the effectiveness and potential differences in omega-3 supplementation among these age cohorts.
Methods
A comprehensive literature search was conducted from 2003 to 2023 using PubMed, Google Scholar, and EMBASE, using specific keywords. Studies with inadequate age group information or Omega-3 intervention were excluded.
Results
In children and adolescents, several studies indicate a positive association between omega-3 supplementation and improved depressive symptoms. In adults, results are mixed, with some studies showing benefits while others do not. In the elderly, omega-3 PUFAs appear to have a more consistent positive effect on depression. In contrast, a consistent positive association was observed in the geriatric population, suggesting that Omega-3 PUFAs may hold particular promise in the treatment of depression among older adults. However, variations in methodology, dosage, and study populations contribute to these mixed findings.
Conclusions
Omega-3 PUFAs show promise as an adjunct therapy for depression across different age groups. Further research with standardized methodologies and larger sample sizes is needed to clarify their role and establish optimal dosage guidelines. Omega-3 PUFAs should be considered as a potential complement to conventional depression treatments, emphasizing the need for personalized approaches in depression management.
Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people.
Aims
To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness.
Method
A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach.
Results
A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions.
Conclusion
Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.
Artificial Intelligence (AI) is reshaping the world as we know it, impacting all aspects of modern society, basically due to the advances in computer power, data availability and AI algorithms. The dairy sector is also on the move, from the exponential growth in AI research, to ready to use AI-based products, this new evolution to Dairy 4.0 represents a potential ‘game-changer’ for the dairy sector, to confront challenges regarding sustainability, welfare, and profitability. This research reflection explores the possible impact of AI, discusses the main drivers in the field and describes its origins, challenges, and opportunities. Further, we present a multidimensional vision considering factors that are not commonly considered in dairy research, such as geopolitical aspects and legal regulations that can have an impact on the application of AI in the dairy sector. This is just the beginning of the third tide of AI, and a future is still ahead. For now, the current advances in AI at on-farm level seem limited and based on the revised data, we believe that AI can be a ‘game-changer’ only if it is integrated with other components of Dairy 4.0 (such as robotics) and is fully adopted by dairy farmers.
OBJECTIVES/GOALS: Our aim is to establish soluble salivary biomarkers indicative of increased risk of oral premalignancy to be used in a point-of-service technology. Our goal is to non-invasively assess risk level for premalignancy by characterizing a molecular signature pattern that can be applied to such a diagnostic tool at routine dental or medical visits. METHODS/STUDY POPULATION: Adult patients 18 years of age and older who are non-smokers and patients of the University of Maryland School of Dentistry Oral Medicine Clinic and have been diagnosed with oral premalignancy (proliferative verrucous leukoplakia) are eligible. Exclusion criteria include history of immunosuppression or immune compromise; use of antifungal, antibiotic, and/or antiviral medications within the past three months; and gross dental disease. Serial unstimulated saliva samples will be collected at baseline or diagnosis of oral premalignancy, 6 months and 12 months. Solubility testing will be completed to determine whether malignant markers such as EGFR/mTOR/PI3K/p53 are soluble in saliva, and patient samples will be analyzed by ELISA and compared to appropriate controls. RESULTS/ANTICIPATED RESULTS: We anticipate demonstrating increased activity of molecular pathways known to be involved in malignant transformation, such as EGFR/mTOR/PI3K/p53, or increased burden of select microbial pathogens to be associated with increased risk of oral premalignancy in the form of proliferative verrucous leukoplakia. Preliminary sensitivity and specificity testing of the identified markers will provide additional insight to the utility of a diagnostic tool with salivary specimen. Therefore, the microbiome and/or molecular profile proposed from these results will serve as a translational application to development of future point-of-service test devices to be used in the prevention and detection of oral premalignant lesions. DISCUSSION/SIGNIFICANCE: Oral cancer is the sixth most common cancer worldwide, and presents challenges in its diagnosis and clinical management. Later diagnosis is associated with poorer patient outcomes—therefore, a molecular and microbiome profile that may be used in a noninvasive diagnostic test technology would prove beneficial to providers and patients.
We propose a new method for identifying active galactic nuclei (AGN) in low mass ($\mathrm{M}_*\leq10^{10}\mathrm{M}_\odot$) galaxies. This method relies on spectral energy distribution (SED) fitting to identify galaxies whose radio flux density has an excess over that expected from star formation alone. Combining data in the Galaxy and Mass Assembly (GAMA) G23 region from GAMA, Evolutionary Map of the Universe (EMU) early science observations, and Wide-field Infrared Survey Explorer (WISE), we compare this technique with a selection of different AGN diagnostics to explore the similarities and differences in AGN classification. We find that diagnostics based on optical and near-infrared criteria (the standard BPT diagram, the WISE colour criterion, and the mass-excitation, or MEx diagram) tend to favour detection of AGN in high mass, high luminosity systems, while the “ProSpect” SED fitting tool can identify AGN efficiently in low mass systems. We investigate an explanation for this result in the context of proportionally lower mass black holes in lower mass galaxies compared to higher mass galaxies and differing proportions of emission from AGN and star formation dominating the light at optical and infrared wavelengths as a function of galaxy stellar mass. We conclude that SED-derived AGN classification is an efficient approach to identify low mass hosts with low radio luminosity AGN.
The Jurassic trigoniid bivalves of Gebel Maghara, northern Sinai, Egypt are described and figured. They belong to 14 species, nine genera, and two families. The identified taxa occur in rocks ranging in age from the Toarcian (Lower Jurassic) to the lower Kimmeridgian (Upper Jurassic). Five genera and one species are new: Magharitrigonia asymmetrica new genus new species; Cotswoldella aff. C. hemisphaerica (Lycett, 1853); Cornbrashella pullus (J. de C. Sowerby, 1826); Parorthotrigonia lepidomorpha (Abdallah and Fahmy, 1969); and Retetrigonia imbricata (J. de C. Sowerby, 1826). Five species, Trigonia reticulata Agassiz, 1840, T. cf. T. castor d'Orbigny, 1849, Promyophorella tuberculata (Agassiz, 1840), Orthotrigonia exortiva (Kitchin, 1903), and O. gracilis (Kitchin, 1903) are recorded from the Jurassic rocks of Gebel Maghara for the first time.
We demonstrate the importance of radio selection in probing heavily obscured galaxy populations. We combine Evolutionary Map of the Universe (EMU) Early Science data in the Galaxy and Mass Assembly (GAMA) G23 field with the GAMA data, providing optical photometry and spectral line measurements, together with Wide-field Infrared Survey Explorer (WISE) infrared (IR) photometry, providing IR luminosities and colours. We investigate the degree of obscuration in star-forming galaxies, based on the Balmer decrement (BD), and explore how this trend varies, over a redshift range of $0<z<0.345$. We demonstrate that the radio-detected population has on average higher levels of obscuration than the parent optical sample, arising through missing the lowest BD and lowest mass galaxies, which are also the lower star formation rate (SFR) and metallicity systems. We discuss possible explanations for this result, including speculation around whether it might arise from steeper stellar initial mass functions in low mass, low SFR galaxies.
People living with HIV experience psychosocial needs that often are not addressed. We designed an innovative low-resource model of phone-based psychosocial counseling (P-PSC). We describe cohort characteristics, acceptability, feasibility and utilization of P-PSC at health facilities supported by Baylor Foundation Malawi. Staff were virtually oriented at 120 sites concurrently. From facility-based phones, people with new HIV diagnosis, high viral load, treatment interruption or mental health concerns were referred without identifiable personal information to 13 psychosocial counselors via a WhatsApp group. Routine program data were retrospectively analyzed using univariate approaches and regressions with interrupted time series analyses. Clients utilizing P-PSC were 63% female, 25% youth (10–24 y) and 9% children (<10 y). They were referred from all 120 supported health facilities. Main referral reasons included new HIV diagnosis (32%), ART adherence support (32%) and treatment interruption (21%). Counseling was completed for 99% of referrals. Counseling sessions per month per psychosocial counselor increased from 77 before P-PSC to 216 in month 1 (95% CI = 82, 350, p = 0.003). Total encounters increased significantly to 31,642 in year 1 from ~6,000 during the 12 prior months, an over fivefold increase. P-PSC implementation at 120 remote facilities was acceptable and feasible with immediate, increased utilization despite few psychosocial counselors in Malawi.
The Arabian leopard Panthera pardus nimr is categorized as Critically Endangered, with < 200 individuals estimated to remain in the wild. Historically the species ranged over an extensive area of western Saudi Arabia but, with no confirmed sightings since 2014, investigating potential continued presence and distribution is of critical conservation importance. We present the results of a comprehensive survey designed to detect any remaining Arabian leopard populations in Saudi Arabia. We conducted 14 surveys, deploying 586 camera-trap stations at 13 sites, totalling 82,075 trap-nights. Questionnaire surveys were conducted with 843 members of local communities across the Arabian leopard's historical range to assess the presence of leopards, other predators and prey species. Predator scats were collected ad hoc by field teams and we used mitochondrial DNA analysis to identify the originating species. We obtained 62,948 independent photographs of animals and people, but none were of Arabian leopards. Other carnivores appeared widespread and domestic animals were numerous, but wild prey were comparatively scarce. Three questionnaire respondents reported sightings of leopards within the previous year, but targeted camera-trap surveys in these areas did not yield evidence of leopards. Of the 143 scats sent for analysis, no DNA was conclusively identified as that of the leopard. From this extensive study, we conclude there are probably no surviving, sustainable populations of Arabian leopards in Saudi Arabia. Individual leopards might be present but were not confirmed. Any future Arabian leopard conservation in Saudi Arabia will probably require reintroduction of captive-bred leopards.
Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65–3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.
Numerous studies have shown longer pre-hospital and in-hospital workflow times and poorer outcomes in women after acute ischemic stroke (AIS) in general and after endovascular treatment (EVT) in particular. We investigated sex differences in acute stroke care of EVT patients over 5 years in a comprehensive Canadian provincial registry.
Methods:
Clinical data of all AIS patients who underwent EVT between January 2017 and December 2022 in the province of Saskatchewan were captured in the Canadian OPTIMISE registry and supplemented with patient data from administrative data sources. Patient baseline characteristics, transport time metrics, and technical EVT outcomes between female and male EVT patients were compared.
Results:
Three-hundred-three patients underwent EVT between 2017 and 2022: 144 (47.5%) women and 159 (52.5%) men. Women were significantly older (median age 77.5 [interquartile range: 66–85] vs.71 [59–78], p < 0.001), while men had more intracranial internal carotid artery occlusions (48/159 [30.2%] vs. 26/142 [18.3%], p = 0.03). Last-known-well to comprehensive stroke center (CSC)-arrival time (median 232 min [interquartile range 90–432] in women vs. 230 min [90–352] in men), CSC-arrival-to-reperfusion time (median 108 min [88–149] in women vs. 102 min [77–141] in men), reperfusion status (successful reperfusion 106/142 [74.7%] in women vs. 117/158 [74.1%] in men) as well as modified Rankin score at 90 days did not differ significantly. This held true after adjusting for baseline variables in multivariable analyses.
Conclusion:
While women undergoing EVT in the province of Saskatchewan were on average older than men, they were treated just as fast and achieved similar technical and clinical outcomes compared to men.
To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents.
Design:
Cluster-randomised controlled trial.
Setting:
Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160).
Participants:
A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention.
Results:
Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002).
Conclusion:
Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.