Disengagement from care in a decentralised primary health care antiretroviral treatment programme: cohort study in rural South Africa.

OBJECTIVE: To determine rates of, and factors associated with, disengagement from care in a decentralised antiretroviral programme. METHODS: Adults (≥16 years) who initiated antiretroviral therapy (ART) in the Hlabisa HIV Treatment and Care Programme August 2004-March 2011 were included. Disengagement from care was defined as no clinic visit for 180 days, after adjustment for mortality. Cumulative incidence functions for disengagement from care, stratified by year of ART initiation, were obtained; competing-risks regression was used to explore factors associated with disengagement from care. RESULTS: A total of 4,674 individuals (median age 34 years, 29% male) contributed 13 610 person-years of follow-up. After adjustment for mortality, incidence of disengagement from care was 3.4 per 100 person-years (95% confidence interval (CI) 3.1-3.8). Estimated retention at 5 years was 61%. The risk of disengagement from care increased with each calendar year of ART initiation (P for trend 200 cells/μl respectively, compared with CD4 count <50 cells/μl). Of those disengaged from care with known outcomes, the majority (206/303, 68.0%) remained resident within the local community. CONCLUSIONS: Increasing disengagement from care threatens to limit the population impact of expanded antiretroviral coverage. The influence of both individual and programmatic factors suggests that alternative service delivery strategies will be required to achieve high rates of long-term retention

Internet Facilitated Rape: A Multivariate Model of Offense Behavior

In recent years there has been a significant increase in individuals reporting they have been raped by someone they have met through the internet (IFR). Previous literature has primarily focused on child victims, hence, the overriding aim of this study is to further our understanding of IFR in terms of overt crime scene behaviour. The sample consisted of 144 single IFR cases and two comparative samples of age-matched non-IFR offenders (confidence approach and surprise approach). Thirty-eight crime scene actions were coded as either present or absent for each offence. Findings suggest that the platforms IFR offenders use to meet their victims were not suggestive of the behaviour they were likely to display. In terms of specific offence behaviours, the IFR and confidence approach samples were considerably similar and both samples were comparatively different from the surprise approach cases. A smallest space analysis of the IFR sample revealed three distinct themes of behaviour with 71% of cases being assigned to a dominant behavioural theme. The practical and theoretical implications of the findings will be discussed

Author Correction: Greenhouse gas emissions resulting from conversion of peat swamp forest to oil palm plantation (Nature Communications, (2020), 11, 1, (407), 10.1038/s41467-020-14298-w)

The original version of this article contained an error in Fig. 2a, in which additional tick marks were added to the y-axis. This has been corrected in both the PDF and HTML versions of the article

The Inverse Amplitude Method in ππ\pi\pi Scattering in Chiral Perturbation Theory to Two Loops

The inverse amplitude method is used to unitarize the two loop $\pi\pi$ scattering amplitudes of SU(2) Chiral Perturbation Theory in the $I=0,J=0$, $I=1,J=1$ and $I=2,J=0$ channels. An error analysis in terms of the low energy one-loop parameters $\bar l_{1,2,3,4,}$ and existing experimental data is undertaken. A comparison to standard resonance saturation values for the two loop coefficients $\bar b_{1,2,3,4,5,6}$ is also carried out. Crossing violations are quantified and the convergence of the expansion is discussed.Comment: (Latex, epsfig) 30 pages, 13 figures, 8 table

A Comparison of the Differences in Soil Structure under Long-Term Conservation Agriculture Relative to a Secondary Forest

Conservation agriculture is increasingly preferred to conventional methods due to its benefits in promoting more sustainable soil management. Our study aims to compare physical and morphological properties, at the microscale, of soils under long-term no tillage (NT) and minimum-tillage (MT) to adjacent ‘natural’ soils under long-term secondary forest (SF). Soil aggregates of c. 2 cm length were imaged by X-ray Computed Tomography (XCT). The three-dimensional (3D) images were segmented and analyzed in order to assess properties such as porosity, number of pores, degree of anisotropy, pore shape, volume classifications, Euler number for pore connectivity, and pore tortuosity. The pore architecture of soils under NT and MT, for c. 40 years, was similar to that from the SF in terms of imaged porosity, pore size, and shape distributions, as hypothesized in our study. However, we observed some important differences; for instance, SF had larger, more connected, and more complex pores, likely due to the greater biological activity. In addition, SF had more isotropic pores than NT and MT, i.e., without preferential flow paths for water redistribution. Therefore, we concluded that long-term conservation agriculture was efficient at reversing structural damage typically associated with conventional, intensive agriculture, but some large differences remain, particularly concerning the pore network complexity and connectivity

Proteomic changes in serum of first onset, antidepressant drug-naïve major depression patients

Major depressive disorder (MDD) is a complex and multi-factorial disorder. Although genetic factors and other molecular aspects of MDD have been widely studied, the underlying pathological mechanisms are still mostly unknown. We sought to investigate the pathophysiology of MDD by identifying and characterising serum molecular differences and their correlation to symptom severity in first onset, antidepressant drug-naïve MDD patients. We performed an exploratory molecular profiling study on serum samples of MDD patients and controls using multiplex immunoassay and label-free liquid chromatography mass spectrometry in data independent mode (LC-MSE). We included two independent cohorts of first onset, antidepressant drug-naïve MDD patients (n = 23 and 15) and matched controls (n = 42 and 21) in our study in order to validate the results. The main outcome included the following list of circulatory molecules changing and/or correlating to symptom severity: angiotensin-converting enzyme, acute phase proteins (e.g. ferritin and serotransferrin), brain-derived neurotrophic factor, complement component C4-B, cortisol, cytokines (e.g. macrophage migration inhibitory factor and interleukin-16), extracellular newly identified receptor for advanced glycosylation end products-binding protein, growth hormone and superoxide dismutase-1. This study provides evidence of an increased pro-inflammatory and oxidative stress response, followed by a hyperactivation of the HPA-axis in the acute stages of first onset MDD, as well as a dysregulation in growth factor pathways. These findings help to elucidate MDD related pathways in more detail and further studies may lead to identification of novel drug targets, inc

The three-peat challenge : business as usual, responsible agriculture, and conservation and restoration as management trajectories in global peatlands

FundingThis work was supported by the Natural Environment Research Council [grant numbers NE/X015238/1; NE/ V006444/1; NE/V018760/1], the Royal Geographical Society (RBEA 02.21), the Royal Society (RGS\R2\202229), and Growing Health (BB/X010953/1) BBSRC Institute Strategic Programme.Peer reviewedPublisher PD

Soil structure has a greater effect on the rooting of wheat (Triticum aestivum L.) than nitrogen fertilisation rate or genotype

Despite extensive research over the last century concerning the application of nitrogen fertilizer to support the production of wheat (Triticum aestivum L.), our understanding on how this impacts on root growth in subsoils is limited. In this study, we investigated how different rates of nitrogen fertilization (100, 200 and 350 kg/ha N) affected the root and shoot growth of three different wheat genotypes. We collected field soil cores to a depth of 100 cm and scanned them using X-ray Computed Tomography (CT) to quantify the volume of macropores and stony material. The collected soil cores were then destructively segmented to determine root number density. Our results showed nitrogen fertilization rate had a limited effect on root growth and proliferation in both the topsoil and subsoil. Furthermore, wheat genotype did not play a significant role in determining root growth at any depth, with no significant differences between the different genotypes. However, soil macroporosity was positively correlated to root number density, accounting for 48% of the variation. Our results provide evidence that soil management (e.g. cultivation techniques) may be the key to improving subsoil rooting regardless of crop genotype and nitrogen rates applied

The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM)

BACKGROUND: Physical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD. METHODS: This was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM. RESULTS: 340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively. CONCLUSION: Results from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD. TRIAL REGISTRATION: NCT04872933. Registered 5th May 2021

Genome sequence of an Australian kangaroo, Macropus eugenii, provides insight into the evolution of mammalian reproduction and development.

BACKGROUND: We present the genome sequence of the tammar wallaby, Macropus eugenii, which is a member of the kangaroo family and the first representative of the iconic hopping mammals that symbolize Australia to be sequenced. The tammar has many unusual biological characteristics, including the longest period of embryonic diapause of any mammal, extremely synchronized seasonal breeding and prolonged and sophisticated lactation within a well-defined pouch. Like other marsupials, it gives birth to highly altricial young, and has a small number of very large chromosomes, making it a valuable model for genomics, reproduction and development. RESULTS: The genome has been sequenced to 2 × coverage using Sanger sequencing, enhanced with additional next generation sequencing and the integration of extensive physical and linkage maps to build the genome assembly. We also sequenced the tammar transcriptome across many tissues and developmental time points. Our analyses of these data shed light on mammalian reproduction, development and genome evolution: there is innovation in reproductive and lactational genes, rapid evolution of germ cell genes, and incomplete, locus-specific X inactivation. We also observe novel retrotransposons and a highly rearranged major histocompatibility complex, with many class I genes located outside the complex. Novel microRNAs in the tammar HOX clusters uncover new potential mammalian HOX regulatory elements. CONCLUSIONS: Analyses of these resources enhance our understanding of marsupial gene evolution, identify marsupial-specific conserved non-coding elements and critical genes across a range of biological systems, including reproduction, development and immunity, and provide new insight into marsupial and mammalian biology and genome evolution