Using Resting-State Functional Connectivity of the Basal Ganglia as a Biomarker for Symptoms of Parkinson\u27s Disease

Parkinson\u27s disease (PD) is characterized by the degeneration of nigrostriatal dopaminergic neurons, resulting in dysfunctional cortico­-striato-­thalamic­cortical loops. Parkinson\u27s disease patients suffer from chronic movement disabilities as well as cognitive impairments and other nonmotor symptoms, which implies a system­wide effect on overall brain function. Because the disease currently has no cure, the discovery of a biomarker for specific PD symptoms is crucial for monitoring treatment potency. This study aimed to evaluate the validity of using functional connectivity between regions of the basal ganglia as a biomarker for specific symptoms of PD

Reflections on Ecological Social Theory marking fifty years of E.F. Schumacher’s Small is Beautiful

While not primarily a social theorist in the classical sense, E.F. Schumacher’s interdisciplinary thought helped galvanise ecological social theory and the ecological movement more broadly. In this article we introduce a special issue of the European Journal of Social Theory dedicated to engaging with E.F. Schumacher’s Small is Beautiful on its 50th anniversary. We provide both an overview of his life and work before locating Small is Beautiful within both its contemporary context and within today’s social theoretical literature. As we show, Schumacher was a fierce critic of capitalist modernity and its ‘gigantist’ tendencies. As we discuss below, he advocated a metaphysical turn in economics, the implementation of intermediate technology, and a reorientation of social practices in line with a more ecologically-attuned political economy.

André Gorz and contemporary Frankfurt School Critical Theory : alienation, eco-socialism and post-productivism

We argue that Gorz’s work offers a nuanced engagement with alienation that is instructive for contemporary social theory. In keeping with Gorz’s broader politics, we contend that the utility of his framing of alienation derives from his insistence that progressive critique must challenge the ideal of productivism. We start the paper by presenting a sympathetic reconstruction of Gorz’s understanding of alienation. Next, we explicitly detail the strengths his approach carries for furthering sociological research today. We then reinforce this point by arguing that Gorz’s work offers particularly valuable theoretical resources for contemporary Frankfurt School Critical Theory, in which the study of alienation has been somehow hampered by the ascent of ‘recognition theory’. While not sharing all the methodological commitments of first-generation Critical Theorists, Gorz was well versed in Frankfurt School scholarship and is therefore an apposite interlocutor to engage ‘third-generation’ Critical Theory. Gorz’s insights are thus shown to be important for furthering contemporary social theory, and in particular, for helping to combat the unsustainable productivism of neoliberal capitalism

Health facility utilisation changes during the introduction of community case management of malaria in South Western Uganda: An interrupted time series approach.

This dataset contains all visits made to health facilities in Bwambara Sub-county, South Western Uganda as part of a cluster randomised trial. The anonymised dataset includes basic demographic details of the visit and the diagnosis made

Gaps in Protoplanetary Disks as Signatures of Planets: I. Methodology and Validation

We examine the observational consequences of partial gaps being opened by planets in protoplanetary disks. We model the disk using a static alpha-disk model with detailed radiative transfer, parametrizing the shape and size of the partially cleared gaps based on the results of hydrodynamic simulations. Shadowing and illumination by stellar irradiation at the surface of the gap leads to increased contrast as the gap trough is deepened by shadowing and cooling and the far gap wall is puffed up by illumination and heating. In calculating observables, we find that multiple scattering is important and derive an approximation to include these effects. A gap produced by a 200 M_Earth (70 M_Earth) planet at 10 AU can lower/raise the midplane temperature of the disk by up to ~-25/+29% (~-11/+19%) by shadowing in the gap trough and illumination on the far shoulder of the gap. At the distance of Taurus, this gap would be resolvable with ~0.01" angular resolution. The gap contrast is most significant in scattered light and at thermal continuum wavelengths characteristic of the surface temperature, reducing or raising the surface brightness by up to order of magnitude. Since gaps sizes are correlated to planet mass, this is a promising way of finding and determining the masses of planets embedded in protoplanetary disks.Comment: 11 pages, 9 figures. Accepted to Ap

How have surface NO2 concentrations changed as a result of the UK's COVID-19 travel restrictions?

Restrictions as a result of the COVID-19 pandemic have led to fewer vehicles on UK roads. Since fuel combustion is responsible for a large fraction of UK emissions it is expected that surface NO2 concentrations would reduce as a result. However, over parts of the UK, surface NO2 concentrations have increased following the implementation of travel restrictions. NO2 measurements from 142 Automatic Urban and Rural Network sites are combined with meteorological data from the Met Office high-resolution weather prediction model to build site specific models. These models predict NO2 concentrations given no change in emissions. It is found that both meteorological and emission changes contribute to the observed changes in NO2 concentrations. Given no change in emissions, changes in meteorology between pre- and post-lockdown periods would have led to a mean increase in NO2 concentrations of +6%. Conversely, changes in emissions would have led to a mean reduction in NO2 concentrations of -18%, resulting in the observed total change in NO2 concentrations of -12%. However at some sites the reduction in emissions is smaller than the increase in NO2 concentrations due to meteorology. The largest increases associated with changes in the meteorology are seen at rural sites (+20%) where NO2 measurements are representative of large areas and thus dominated by the regional advection of secondary NO2 from Europe. Conversely, the largest decreases associated with reduced emissions are found at urban traffic and urban background sites (-27% and -14% respectively) where NO2 concentrations are representative of local areas and thus dominated by local reduction in emissions from vehicles. As lockdown measures are relaxed, NO2 concentrations are likely to return to pre-COVID levels, but these results demonstrate that changes in our behaviour can result in positive impacts on air quality and illustrate the effectiveness of travel-reducing strategies in urban area

A mixed methods study to assess the impact of COVID-19 on maternal, newborn, child health and nutrition in fragile and conflict-affected settings.

BACKGROUND: The impacts of COVID-19 are unprecedented globally. The pandemic is reversing decades of progress in maternal, newborn, child health and nutrition (MNCHN), especially fragile and conflict-affected settings (FCAS) whose populations were already facing challenges in accessing basic health and nutrition services. This study aimed to investigate the collateral impact of COVID-19 on funding, services and MNCHN outcomes in FCAS, as well as adaptations used in the field to continue activities. METHODS: A scoping review of peer-reviewed and grey literature published between 1st March 2020-31st January 2021 was conducted. We analysed 103 publications using a narrative synthesis approach. 39 remote semi-structured key informant interviews with humanitarian actors and donor staff within 12 FCAS were conducted between October 2020 and February 2021. Thematic analysis was undertaken independently by two researchers on interview transcripts and supporting documents provided by key informants, and triangulated with literature review findings. RESULTS: Funding for MNCHN has been reduced or suspended with increase in cost of continuing the same activities, and diversion of MNCHN funding to COVID-19 activities. Disruption in supply and demand of interventions was reported across different settings which, despite data evidence still being missing, points towards likely increased maternal and child morbidity and mortality. Some positive adaptations including use of technology and decentralisation of services have been reported, however overall adaptation strategies have been insufficient to equitably meet additional challenges posed by the pandemic, and have not been evaluated for their effectiveness. CONCLUSIONS: COVID-19 is further exacerbating negative women's and children's health outcomes in FCAS. Increased funding is urgently required to re-establish MNCHN activities which have been deprioritised or halted. Improved planning to sustain routine health services and enable surge planning for emergencies with focus on the community/service users throughout adaptations is vital for improved MNCHN outcomes in FCAS

Community health workers adherence to referral guidelines: evidence from studies introducing RDTs in two malaria transmission settings in Uganda.

BACKGROUND: Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs' ability to adhere to malaria rapid diagnostic tests (RDTs) and treatment guidelines, there is limited evidence whether CHWs adhere to the referral guidelines and refer severely ill children for further management. In southwest Uganda, this study examined whether CHWs referred children according to training guidelines and described factors associated with adherence to the referral guideline. METHODS: A secondary analysis was undertaken of data collected during two cluster-randomized trials conducted between January 2010 and July 2011, one in a moderate-to-high malaria transmission setting and the other in a low malaria transmission setting. All CHWs were trained to prescribe artemisinin-based combination therapy (ACT) and recognize symptoms in children that required immediate referral to the nearest health centre. Intervention arm CHWs had additional training on how to conduct an RDT; CHWs in the control arm used a presumptive diagnosis for malaria using clinical signs and symptoms. CHW treatment registers were reviewed to identify children eligible for referral according to training guidelines (temperature of ≥38.5 °C), to assess whether CHWs adhered to the guidelines and referred them. Factors associated with adherence were examined with logistic regression models. RESULTS: CHWs failed to refer 58.8% of children eligible in the moderate-to-high transmission and 31.2% of children in the low transmission setting. CHWs using RDTs adhered to the referral guidelines more frequently than CHWs not using RDTs (moderate-to-high transmission: 50.1 vs 18.0%, p = 0.003; low transmission: 88.5 vs 44.1%, p < 0.001). In both settings, fewer than 20% of eligible children received pre-referral treatment with rectal artesunate. Children who were prescribed ACT were very unlikely to be referred in both settings (97.7 and 73.3% were not referred in the moderate-to-high and low transmission settings, respectively). In the moderate-to-high transmission setting, day and season of visit were also associated with the likelihood of adherence to the referral guidelines, but not in the low transmission setting. CONCLUSIONS: CHW adherence to referral guidelines was poor in both transmission settings. However, training CHWs to use RDT improved correct referral of children with a high fever compared to a presumptive diagnosis using sign and symptoms. As many countries scale up CHW programmes, routine monitoring of reported data should be examined carefully to assess whether CHWs adhere to referral guidelines and take remedial actions where required

Meteorological drivers and mortality associated with O3 and PM2.5 air pollution episodes in the UK in 2006

In this study we examine the meteorological drivers resulting in concurrent high levels of ozone (O3) and particulate matter smaller than 2.5 andmu;m in diameter (PM2.5) during two five-day air pollution episodes in 2006 (1st - 5th July and 18th andndash; 22nd July) using an air quality model (AQUM) at 12 km horizontal resolution to simulate air pollutant concentrations. The resultant UK health burden associated with short-term exposure to simulated maximum daily 8-h O3andnbsp;(MDA8 O3) and daily mean PM2.5andnbsp;is estimated at the national and regional level. Both episodes were found to be driven by anticyclonic conditions with light easterly and south easterly winds and high temperatures that aided pollution build up in the UK. The estimated total mortality burden associated with short-term exposure to MDA8 O3andnbsp;is similar during the chosen episodes with about 70 daily deaths brought forward (summed across the UK) during the first and second episode, respectively. The estimated health burden associated with short-term exposure to daily mean PM2.5andnbsp;concentrations differs between the first and second episode resulting in about 43 and 36 daily deaths brought forward, respectively. The corresponding percentage of all-cause mortality due to short-term exposure to MDA8 O3andnbsp;and daily mean PM2.5during these two episodes and across the UK regions, ranges from 3.4% to 5.2% and from 1.6% to 3.9%, respectively. The attributable percentage of all-cause mortality differs between the regions depending on the pollution levels in each episode, but the overall estimated health burdens are highest in regions with higher population totals. We estimate that during these episodes the short-term exposure to MDA8 O3and daily mean PM2.5andnbsp;is between 36-38% and 39andndash;56% higher, respectively, than if the pollution levels represented typical seasonal-mean concentrations. This highlights the potential of air pollution episodes to have substantial short-term impacts on public health.</p

Caregivers' compliance with referral advice: evidence from two studies introducing mRDTs into community case management of malaria in Uganda.

BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance to referral advice and the outcomes of children under-5 referred by CHWs. This analysis examined whether caregivers complied with CHWs referral advice. METHODS: Data from two cluster (village) randomised trials, one in a moderate-to-high malaria transmission setting, another in a low-transmission setting conducted between January 2010-July 2011 were analysed. CHW were trained to recognise signs and symptoms that required referral to a health centre. CHW in the intervention arm also had training on; malaria rapid diagnostic tests (mRDT) and administering artemisinin based combination therapy (ACT); CHW in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings < 10% of caregivers complied with referral advice. In the moderate-to-high transmission setting compliance was higher if children were tested with mRDT compared to children who were not tested with mRDT. In both settings, nearly all children treated with pre-referral rectal artesunate failed to comply with referral and compliance was independently associated with factors such as health centre distance and day of referral by a CHW. In the moderate-to-high transmission setting, time of presentation, severity of referral were also associated with compliance, whilst in the low-transmission setting, compliance was low if an ACT was prescribed. CONCLUSIONS: This analysis suggests there are several barriers to comply with CHWs referral advice by caregivers. This is concerning for children who received rectal artesunate. As CHW programmes continue scale-up, barriers to referral compliance need to be addressed to ensure a continuum of care from the community to the health centre. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov. Identifier NCT01048801 , 13th January 2010