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Evaluating the reliability and validity of the 12-item WHODAS 2.0 among people with mental health conditions in seven low- and middle-income countries: analysis of secondary data
Get PDFTrauma-informed practice for children and young people with intellectual disabilities:A scoping review
Get PDFBackgroundThere is growing consensus that children and young people (CYP) with an intellectual disability are more likely to experience trauma than those in the general population, which can exacerbate their vulnerabilities and developmental challenges. Trauma-informed practices (TIPs) have been used to support those who have experienced trauma, but we need to know more about the implementation of TIPs with this population.AimThe study aimed to synthesize research investigating TIPs for CYP with intellectual disabilities. The review examined what TIPs, policies and models have been implemented, the effectiveness of these and barriers and facilitators of trauma-informed intervention implementation.MethodsA scoping review was conducted of quantitative and qualitative research. In total, 11 studies met the inclusion criteria. Study findings were analysed using a narrative synthesis approach.FindingsThe review identified several TIPs that have been used to support CYP with intellectual disability. However, limited intervention studies were found. Teacher training was discussed as a barrier and facilitator of TIP. Training is needed to enhance staff's ability, skills, and knowledge. It was also reported that adaptations to usual TIP can enhance efficacy.ConclusionsThe findings have implications for research, practice, and policy. More intervention studies are needed with this population. Policymakers must recognize the importance of teacher training and take action to provide such opportunities. We also urge practitioners to make adaptations to usual trauma therapy when working with CYP with intellectual disability. In doing so, such individuals may overcome trauma-related barriers and achieve positive developmental outcomes
Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma in acute care settings:a systematic review
Get PDFPURPOSE: Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia, are prevalent in older patients with physical trauma in acute care settings. Identifying NCDs in these patients can enhance care decisions to improve outcomes. This study aimed to identify the diagnostic accuracy of screening tools for NCDs in older patients with trauma in acute care settings.METHODS: Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) were searched from inception to 01 March 2024. Inclusion criteria were: older adults (≥ 60 years); admitted to acute care setting following physical trauma; diagnostic accuracy study of a screening tool for (1) delirium and/or (2) cognitive impairment or dementia against a reference standard of a clinical diagnosis (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A narrative synthesis was conducted. Methodological heterogeneity between the studies precluded meta-analysis.RESULTS: Five studies examining five different screening tools for delirium in older adults, all with hip fracture, were included. Studies reported wide variance in sensitivity (76.9-91.8) and specificity (54.5-99). Prevalence of detected delirium varied widely across studies (6.7-31.5%). All studies had a high or unclear risk of bias in at least one domain. No studies were found to examine the diagnostic accuracy of screening tools for cognitive impairment in older patients with trauma.CONCLUSION: This systematic review highlights the dearth of studies validating screening tools for NCDs in older patients following trauma in acute care settings.PROSPERO REGISTRATION NUMBER: CRD42024518730.</p
Estimating sectoral livestock biomass and stock value using data from national diseases eradication programs: a case study based on the Irish cattle herd from 2011 to 2021
Get PDFIntroduction: Livestock biomass is a denominator for a wide range of important production metrics, including productivity, environmental impact, greenhouse gas emissions, and antimicrobial usage. Accurate biomass estimates allow cross-sectoral and international comparisons for these important indices across a range of high-priority areas, which can then inform policy risk assessments and decision-making. Similarly, accurate estimates of the value of livestock are needed to monitor economic efficiency and productivity and understand the costs associated with animal health policy decisions. Previous methods to estimate biomass have relied on assigning an average liveweight for a given species and multiplying this by the number of individual animals of that species in a region. However, without taking into account the population’s demographics and structure, these approaches cannot be relied upon to accurately represent the cattle population.Methods: Using data from the Irish cattle herd as a case study, this study developed liveweight and value models and applied these models to a cattle registration and movement database to estimate the biomass (kg) and economic stock value (€) of each animal and herd, aggregated by herd type based on a herd classification tree model, and explored trends in biomass and stock value over time.Results: The Irish cattle sector biomass increased from 2,924,800 tonnes in 2011 to 3,317,100 tonnes in 2021, and the cattle sector stock value increased from €6,323.7 m in 2011 to €8,792.3 m in 2021. Furthermore, this study demonstrated the biomass and stock value within-year and between years.Discussion: We illustrate a novel approach using real-time movement data for dynamic estimates of biomass and stock value at animal-, herd- and national-level that can be applied in countries with existing animal registration and movement tracing systems
Unlocking hardware verification with oracle guided synthesis
Get PDFHardware verification is essential to ensure that hardware designs meet their design specifications and function as intended. However, use of formal verification requires extensive manual work in order to write formal specifications. Specification mining aims to alleviate this manual burden, with conventional techniques using statistical methods and pattern matching to generate likely specifications from sample execution traces from the hardware. A limitation of this is that the quality of the specifications is determined by the quality of the traces. In this paper, we present an approach that uses oracle-guided synthesis to generate specifications for hardware, using counterexamples and negative examples to refine specifications generated based on traces. We evaluate our approach on real-world Verilog benchmarks and demonstrate that specifications generated by our tool can detect high proportions of hardware mutations
Malliavin differentiability of McKean-Vlasov SDEs with common noise
Get PDFWe establish the Malliavin differentiability of McKean-Vlasov stochastic differential equations (MV-SDEs) with common noise under the global Lipschitz assumption in the space variable and the measure variable. Our result gives also meaning to the Malliavin derivative of the conditional law with respect to the common noise. As an application, we derive an integration by parts formula on the Wiener space for the class of common noise MV-SDEs under consideration
Connecting basal body and mitochondrial DNA: TAC53 and the tubular organization of the tripartite attachment complex
Get PDFAuthor summary Trypanosoma brucei is the causative agent of human African sleeping sickness and nagana in cattle. The eukaryotic parasite relies on the faithful inheritance of its singular mitochondrial genome, known as kinetoplast DNA (kDNA), to survive and proliferate. This genome is physically tethered to the flagellar basal body by the Tripartite Attachment Complex (TAC), a unique cytoskeleton-organelle connection. While previous studies described the TAC’s linear architecture, its full composition and spatial organization remained incomplete. Here, we use proteomics, RNAi, and ultrastructure expansion microscopy to identify TAC53 as a novel and essential TAC component. TAC53 localizes closest to the kDNA of all known TAC proteins and is required for correct mitochondrial genome segregation. High-resolution imaging reveals that the TAC is not a simple linear structure but instead forms a tubular architecture with two distinct TAC assemblies per individual genome, aligning with the cell’s basal body pairs. Our findings revise the current model of mitochondrial genome segregation in T. brucei and highlight TAC53 as the likely final component of the TAC, offering new insights into organelle genome inheritance mechanisms in early-branching eukaryotes
Epigenetic study of the long-term effects of gulf War illness
Get PDFINTRODUCTION: Gulf War Illness is a chronic multisymptomatic disorder that affects as many as 25-35% of the military personnel who were sent to the Persian Gulf war in 1991. The illness has many debilitating symptoms, including cognitive problems, gastrointestinal symptoms, and musculoskeletal pain. Those so afflicted have been sick for more than 30 years and, therefore, it has become imperative to understand the etiology of Gulf War Illness and then produce treatments to ease the symptoms. We hypothesized that the length of the disease was reflected in epigenetic modification of possibly several genes related to the symptoms.METHODS: We subjected male and female mice from 11 BXD strains to combined corticosterone and the sarin surrogate, diisopropylfluorophosphate, to emulate the physiological stress of war and the potential exposures to organophosphate pesticides and nerve agent in theater. Three hundred days after treatment, we used Methyl-CpG-binding domain sequencing (MBD-seq) to assay genome-wide methylation.RESULTS: The analysis revealed 20 methylated genes, notably Eif2b5, that regulates myelin production.DISCUSSION: Loss of myelin with accompanying musculoskeletal pain is a major symptom of Gulf War Illness. Our work demonstrates multiple genes were methylated by exposure to organophosphates and glucocorticoids. These genes point to biochemical mechanisms that may be targets for therapeutic intervention.</p
Medical expenditure risk and household portfolios:Evidence from an insurance reform in China
Get PDFWe examine how reductions in medical expenditure risk shape household portfolio choices. Exploiting the 2017 inclusion of cancer treatment drugs in China’s National Basic Medical Insurance Medicine List, we implement a difference-in-differences design comparing high-risk and low-risk insured individuals. The results show that households facing elevated cancer risk became significantly more likely to hold risky assets after the reform. These findings provide novel causal evidence that mitigating health-related background risk encourages financial risk-taking
Incidence and natural history of very early onset inflammatory bowel disease in Scotland: National and regional cohort studies
Get PDFABSTRACTBackground: Very-early-onset inflammatory bowel disease (VEOIBD; diagnosed under six years old) has attracted considerable attention in recent years, with monogenic forms providing insight into immune dysregulation. However, the majority of VEOIBD patients have a classical polygenic phenotype and a similar disease course to older children.Methods: To assess the incidence trends of VEOIBD in Scotland from 1981 to 2014, and to describe the natural history, phenotype, and treatment burden of VEOIBD in a regional cohort from South-East Scotland (1997 2021).Results: Nationally 128/1567 (8.1%) incident paediatric IBD patients (<16 years at diagnosis) were VEOIBD; 10/128 (8%) were diagnosed <2 years of age. The incidence of VEOIBD rose from 0.64 (1981-1985) to 2.73 per 100,000/year (2011-2014)(p=0.002), an incidence rate ratio of 4.3 (95% CI 2.4 8.3). The average annual percentage change was 3.9% (95% CI 2.1 5.7; p<0.05). Crohn's disease (CD) was the most common subtype (63%); median age at diagnosis was 4.4 years. The regional cohort (n=46) had a median follow-up of 11.9 years. CD casespresented with isolated colonic involvement in 47%, with pancolitis present in 64% of ulcerative colitis cases. Treatment exposures included immunosuppression (76%), 4 corticosteroids (67%) and anti-TNF therapies (50%). 11% were on no IBD-specific therapy at last follow-up, 11% required surgery and no patient had a diagnosis of monogenic IBD (mIBD), cancer or death.Conclusions:Scotland has a high incidence of VEOIBD with mIBD exceptionally rare. Although VEOIBD disease burden is high, treatment outcomes are broadly similar to those diagnosed later in childhood based on previous studies
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