Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence.

Due to unacceptably high mortality with pentavalent antimonials, Médecins Sans Frontières in 2006 began using liposomal amphotericin B (AmBisome) for visceral leishmaniasis (VL) patients in Ethiopia who were severely ill or positive for human immunodeficiency virus (HIV)

Strategies to Recruit and Retain College Smokers in Cessation Trials

Techniques to recruit and retain college fraternity and sorority members who reported past 30-day smoking into a cessation trial are described. Recruitment efforts included relationship-building, raffles, and screening survey administration during existing meetings. Surveys were administered to 76% (n = 3,276) of members in 30 chapters, 79% of eligible members agreed to participate, and 76% of those completed assessments and were enrolled in the trial (n = 452). The retention rate was 73%. Retention efforts included cash incentives, flexible scheduling, multiple reminders, chapter incentives, and use of chapter members as study personnel. Retention was not related to demographic, behavioral, or group characteristics. The strategies of partnership, convenience, and flexibility appear effective and may prove useful to investigators recruiting similar samples

Winter soil respiration in a humid temperate forest: The roles of moisture, temperature, and snowpack

Winter soil respiration at midlatitudes can comprise a substantial portion of annual ecosystem carbon loss. However, winter soil carbon dynamics in these areas, which are often characterized by shallow snow cover, are poorly understood due to infrequent sampling at the soil surface. Our objectives were to continuously measure winter CO2 flux from soils and the overlying snowpack while also monitoring drivers of winter soil respiration in a humid temperate forest. We show that the relative roles of soil temperature and moisture in driving winter CO2 flux differed within a single soil-to-snow profile. Surface soil temperatures had a strong, positive influence on CO2 flux from the snowpack, while soil moisture exerted a negative control on soil CO2 flux within the soil profile. Rapid fluctuations in snow depth throughout the winter likely created the dynamic soil temperature and moisture conditions that drove divergent patterns in soil respiration at different depths. Such dynamic conditions differ from many previous studies of winter soil microclimate and respiration, where soil temperature and moisture are relatively stable until snowmelt. The differential response of soil respiration to temperature and moisture across depths was also a unique finding as previous work has not simultaneously quantified CO2 flux from soils and the snowpack. The complex interplay we observed among snow depth, soil temperature, soil moisture, and CO2 flux suggests that winter soil respiration in areas with shallow seasonal snow cover is more variable than previously understood and may fluctuate considerably in the future given winter climate change

Loneliness, coping, suicidal thoughts and self-harm during the COVID-19 pandemic: a repeat cross-sectional UK population survey

Objectives: There has been speculation on the impact of the COVID-19 pandemic and the associated lockdown on suicidal thoughts and self-harm and the factors associated with any change. We aimed to assess the effects and change in effects of risk factors including loneliness and coping, as well as pre-existing mental health conditions on suicidal thoughts and self-harm during the COVID-19 pandemic. Design: This study was a repeated cross-sectional online population-based survey. Participants and measures: Non-probability quota sampling was adopted on the UK adult population and four waves of data were analysed during the pandemic (17 March 2020 to 29 May 2020). Outcomes were suicidal thoughts and self-harm associated with the pandemic while loneliness, coping, pre-existing mental health conditions, employment status and demographics were covariates. We ran binomial regressions to evaluate the adjusted risks of the studied covariates as well as the changes in effects over time. Results: The proportion of individuals who felt lonely increased sharply from 9.8% to 23.9% after the UK lockdown began. Young people (aged 18–24 years), females, students, those who were unemployed and individuals with pre-existing mental health conditions were more likely to report feeling lonely and not coping well. 7.7%–10.0% and 1.9%–2.2% of respondents reported having suicidal thoughts and self-harm associated with the pandemic respectively throughout the period studied. Results from cross-tabulation and adjusted regression analyses showed young adults, coping poorly and with pre-existing mental health conditions were significantly associated with suicidal thoughts and self-harm. Loneliness was significantly associated with suicidal thoughts but not self-harm. Conclusions: The association between suicidality, loneliness and coping was evident in young people during the early stages of the pandemic. Developing effective interventions designed and coproduced to address loneliness and promote coping strategies during prolonged social isolation may promote mental health and help mitigate suicidal thoughts and self-harm associated with the pandemic

Does gadolinium-based angiography protect against contrast-induced nephropathy?: A systematic review of the literature

We evaluated the incidence of contrast-induced nephropathy (CIN) in patients exposed to gadolinium for diagnostic or therapeutic procedures. Background: CIN with iodinated contrast agents is a leading cause of acute renal failure. Gadolinium is often used as an alternative to iodinated contrast in patients at increased risk of CIN. The safety of gadolinium in patients at increased risk of CIN has not been established. Methods and Results: The authors performed a systematic review by searching MEDLINE, ISI Web of Knowledge, Current Contents, Embase, and the Cochrane Central Register of Controlled Trials to identify relevant studies evaluating gadolinium and its associated incidence of CIN. They identified 17 studies that reported both favorable and negative results with regard to the association of gadolinium and CIN. The differences in the results appeared to be dose related. When gadolinium was used in doses of 0.4 mmol/kg or higher, there appeared to be an increased incidence of ARF particularly in patients with preexisting renal insufficiency. Conclusions: Although the evidence base is limited, gadolinium does not appear to be safer than iodinated contrast in patients at risk of CIN. Given the lack of randomized data to support its safety, gadolinium in lieu of iso-osmolar iodinated contrast cannot be advocated in patients at high risk of contrast nephropathy. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58087/1/21459_ftp.pd

Key Components of Musical Discourse Analysis

Musical discourse analysis is an interdisciplinary study which is incomplete without consideration of relevant social, linguistic, psychological, visual, gestural, ritual, technical, historical and musicological aspects. In the framework of Critical Discourse Analysis, musical discourse can be interpreted as social practice: it refers to specific means of representing specific aspects of the social (musical) sphere. The article introduces a general view of contemporary musical discourse, and analyses genres from the point of ‘semiosis’, ‘social agents’, ‘social relations’, ‘social context’, and ‘text’. These components of musical discourse analysis, in their various aspects and combinations, should help thoroughly examine the context of contemporary musical art, and determine linguistic features specific to different genres of musical discourse

Study of the proton arc spreading effect on primary ionization rates

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95168/1/jgra17792.pd

Lessons from Peer Support Among Individuals with Mental Health Difficulties: A Review of the Literature

We conducted a comprehensive narrative review and used a systematic search strategy to identify studies related to peer support among adults with mental health difficulties. The purposes of this review were to describe the principles, effects and benefits of peer support documented in the published literature, to discuss challenging aspects of peer support and to investigate lessons from peer support. Fifty-one studies, including 8 review articles and 19 qualitative studies, met the inclusion criteria for this review. Most of the challenges for peer support were related to “role” and “relationship” issues; that is, how peer support providers relate to people who receive peer support and how peer support providers are treated in the system. The knowledge gained from peer support relationships, such as mutual responsibility and interdependence, might be a clue toward redefining the helper-helper relationship as well as the concepts of help and support