The efficacy of bariatric surgery performed in the public sector for obese patients with comorbid conditions

Objective: To determine the effi cacy of bariatric surgery in the public sector for the treatment of complicated obesity. Design, setting and participants: A longitudinal observational study of obese participants with comorbid conditions, aged 21-73 years, who underwent publicly funded bariatric surgery. Data were extracted from clinical databases (1 October 2009 to 1 September 2013) and recorded at seven time points. Participants are from an ongoing public obesity program. Main outcome measures: Postoperative weight loss and partial or full resolution of: type 2 diabetes mellitus (T2DM), hypertension (HTN), dyslipidaemia and obstructive sleep apnoea (OSA). Results: The 65 participants in the cohort lost a mean weight of 22.6 kg (SD, 9.5 kg) by 3 months, 34.2.kg (SD, 20.1 kg) by 12 months and 39.9 kg (SD, 31.4 kg) by 24 months (P < 0.001). Body mass index (BMI) decreased from a preoperative mean of 48.2 kg/m<sup>2</sup> (SD, 9.5 kg/m<sup>2</sup>) to 35.7 kg/m<sup>2</sup> (SD, 7.7 kg/m<sup>2</sup>) by 24 months (P < 0.001). Full resolution of comorbid conditions by 18 months (P < 0.001) was achieved by almost half of those with baseline T2DM, nearly two-thirds with HTN and three-quarters of those with OSA, with continued improvements beyond 24 months. Conclusions: Bariatric surgery performed in the public sector is efficacious in the treatment of obese patients with comorbid conditions. Our findings parallel similar studies suggesting that there is equal benefit in publicly funded and privately performed procedures. This study highlights that obese patients reliant on public health care maintain sufficient intrinsic motivation in the absence of payment and supposed value-driven incentive. Improved access to bariatric surgery in the public sector can justifiably reduce the health inequities for those most in need

Factors Affecting Sensitivity to Frequency Change in School-Age Children and Adults

The factors affecting frequency discrimination in school-age children are poorly understood. The goal of the present study was to evaluate developmental effects related to memory for pitch and the utilization of temporal fine structure

Addressing Barriers to Universal Screening for Social, Emotional, and Behavioral Risk in Elementary Schools

Early identification of students in need of additional support in the classroom is an important structure for school districts to have in place. Universal screening for social-emotional and behavioral (SEB) risk is one method that schools can use to identify students in need of SEB support and to begin early intervention programing. Unfortunately, recommendations about universal screening and resources for universal screening for SEB risk are limited. As a result, barriers to screening are increased and interventions are delayed – sometimes indefinitely -- for those who need them most. This paper discusses the barriers and challenges experienced by elementary schools (grades K-5) in one school district in the South across a three-year consultative study. This district was supported by the researchers in identifying an appropriate SEB screener, in disseminating the screener, and in ensuring accuracy in its completion. Across the three years, data were evaluated from previous years, and recommendations to improve the district’s screening initiative were made by the lead consultant and school psychology graduate students. Over time, positive changes were noted in screening practices, but it is evident that more work needs to be done. Specific solutions and future implications for early childhood are discussed

Substantiating a political public sphere in the Scottish press : a comparative analysis

This article uses content analysis to characterize the performance of the media in a national public sphere, by setting apart those qualities that typify internal press coverage of a political event. The article looks at the coverage of the 1999 devolved Scottish election from the day before the election until the day after. It uses a word count to measure the election material in Scottish newspapers the Herald, the Press and Journal and the Scotsman, and United Kingdom newspapers the Guardian, the Independent and The Times, and categorizes that material according to discourse type, day and page selection. The article finds a number of qualities that typify the Scottish sample in particular, and might be broadly indicative of a political public sphere in action. Firstly, and not unexpectedly, it finds that the Scottish newspapers carry significantly more election coverage. Just as tellingly, though, the article finds that the Scottish papers offer a greater proportion of advice and background information, in the form of opinion columns and feature articles. It also finds that the Scottish papers place a greater concentration of both informative and evaluative material in the period before the vote, consistent with their making a contribution to informed political action. Lastly, the article finds that the Scottish sample situates coverage nearer the front of the paper and places a greater proportion on recto pages. The article therefore argues that the Scottish papers display features that distinguish them from the UK papers, and are broadly consistent with their forming part of a deliberative public sphere, and suggests that these qualities might be explored as a means of judging future media performance

Wolbachia in the flesh: symbiont intensities in germ-line and somatic tissues challenge the conventional view of Wolbachia transmission routes

Symbionts can substantially affect the evolution and ecology of their hosts. The investigation of the tissue-specific distribution of symbionts (tissue tropism) can provide important insight into host-symbiont interactions. Among other things, it can help to discern the importance of specific transmission routes and potential phenotypic effects. The intracellular bacterial symbiont Wolbachia has been described as the greatest ever panzootic, due to the wide array of arthropods that it infects. Being primarily vertically transmitted, it is expected that the transmission of Wolbachia would be enhanced by focusing infection in the reproductive tissues. In social insect hosts, this tropism would logically extend to reproductive rather than sterile castes, since the latter constitute a dead-end for vertically transmission. Here, we show that Wolbachia are not focused on reproductive tissues of eusocial insects, and that non-reproductive tissues of queens and workers of the ant Acromyrmex echinatior, harbour substantial infections. In particular, the comparatively high intensities of Wolbachia in the haemolymph, fat body, and faeces, suggest potential for horizontal transmission via parasitoids and the faecal-oral route, or a role for Wolbachia modulating the immune response of this host. It may be that somatic tissues and castes are not the evolutionary dead-end for Wolbachia that is commonly thought

Girls Are Good At STEM: Opening Minds And Providing Evidence Reduce Boys\u27 Stereotyping Of Girls\u27 STEM Ability

Girls and women face persistent negative stereotyping within STEM (science, technology, engineering, mathematics). This field intervention was designed to improve boys\u27 perceptions of girls\u27 STEM ability. Boys (N = 667; mostly White and East Asian) aged 9-15 years in Canadian STEM summer camps (2017-2019) had an intervention or control conversation with trained camp staff. The intervention was a multi-stage persuasive appeal: a values affirmation, an illustration of girls\u27 ability in STEM, a personalized anecdote, and reflection. Control participants discussed general camp experiences. Boys who received the intervention (vs. control) had more positive perceptions of girls\u27 STEM ability, d = 0.23, an effect stronger among younger boys. These findings highlight the importance of engaging elementary-school-aged boys to make STEM climates more inclusive

Discourses of antagonism and desire : marketing for international students in neighbourhood schools

This paper explores the consequences of these discourses for the ways that international students are identified and positioned within school communities. My argument is developed in four sections. The first describes my ongoing exploration into the impact of international student programmes in Australia. The second exemplifies my argument: exploring the day-to-day experiences of vice principals in two Victorian government state secondary schools as they market their schools, and examining the systemic and ontological discourses played out within those conversations. The third interrogates discourses of identity and difference, neo-liberalism and nave cosmopolitanism which I find shape teacher conversations about international student programmes. In the final section, I argue that the impact of the discourse formations implicit in teacher talk about international student programmes has been the objectification of international students and their ambivalent inclusion within the school community.<br /

O tratamento da polissemia e da homonímia nos learner's dictionaries: subsídios da semântica cognitiva para a disposição das acepções

No âmbito lexicográfico, diversas são as questões impostas pela consideração dos fenômenos da polissemia e da homonímia. Neste trabalho, abordamos dois problemas centrais: (i) a solução adotada para a estruturação dos verbetes (solução polissêmica ou solução homonímica) e (ii) os critérios empregados para a organização das acepções dentro dos verbetes. Para isso, apresentamos análises de itens lexicais presentes nos quatro principais learner’s dictionaries – CALD (2008), COBUILD (2006), LDCE (2009) e OALD (2005)1. Nelas constatamos que não há homogeneidade nas soluções empregadas, tanto entre as obras quanto dentro da mesma obra para o tratamento do mesmo fenômeno, e que o critério empregado pelos dicionários para a organização das acepções, a frequência, é problemático, tanto por questões anteriores a sua aplicação quanto por problemas exclusivos a esse critério. Dessa forma, buscamos na concepção de polissemia da Semântica Cognitiva um modelo de descrição que auxiliasse na disposição das acepções nos verbetes de learner’s dictionaries. Ao final, apresentamos nossa sugestão de verbete para o item lexical band. Concluímos com uma avaliação das questões que nosso modelo consegue tratar de forma mais efetiva e trazemos ainda problemas para os quais continuamos sem solução

Gut Microbiota-Derived Trimethylamine N-Oxide Contributes to Abdominal Aortic Aneurysm Through Inflammatory and Apoptotic Mechanisms

Background: Large-scale human and mechanistic mouse studies indicate a strong relationship between the microbiome-dependent metabolite trimethylamine N-oxide (TMAO) and several cardiometabolic diseases. This study aims to investigate the role of TMAO in the pathogenesis of abdominal aortic aneurysm (AAA) and target its parent microbes as a potential pharmacological intervention. Methods: TMAO and choline metabolites were examined in plasma samples, with associated clinical data, from 2 independent patient cohorts (N=2129 total). Mice were fed a high-choline diet and underwent 2 murine AAA models, angiotensin II infusion in low-density lipoprotein receptor-deficient (Ldlr-/-) mice or topical porcine pancreatic elastase in C57BL/6J mice. Gut microbial production of TMAO was inhibited through broad-spectrum antibiotics, targeted inhibition of the gut microbial choline TMA lyase (CutC/D) with fluoromethylcholine, or the use of mice genetically deficient in flavin monooxygenase 3 (Fmo3-/-). Finally, RNA sequencing of in vitro human vascular smooth muscle cells and in vivo mouse aortas was used to investigate how TMAO affects AAA. Results: Elevated TMAO was associated with increased AAA incidence and growth in both patient cohorts studied. Dietary choline supplementation augmented plasma TMAO and aortic diameter in both mouse models of AAA, which was suppressed with poorly absorbed oral broad-spectrum antibiotics. Treatment with fluoromethylcholine ablated TMAO production, attenuated choline-augmented aneurysm initiation, and halted progression of an established aneurysm model. In addition, Fmo3-/-mice had reduced plasma TMAO and aortic diameters and were protected from AAA rupture compared with wild-type mice. RNA sequencing and functional analyses revealed choline supplementation in mice or TMAO treatment of human vascular smooth muscle cells-augmented gene pathways associated with the endoplasmic reticulum stress response, specifically the endoplasmic reticulum stress kinase PERK. Conclusions: These results define a role for gut microbiota-generated TMAO in AAA formation through upregulation of endoplasmic reticulum stress-related pathways in the aortic wall. In addition, inhibition of microbiome-derived TMAO may serve as a novel therapeutic approach for AAA treatment where none currently exist

Correction to:The genetic architecture of Plakophilin 2 cardiomyopathy (Genetics in Medicine, (2021), 23, 10, (1961-1968), 10.1038/s41436-021-01233-7)

Due to a processing error Cynthia James, Brittney Murray, and Crystal Tichnell were assigned to the wrong affiliation. Cynthia James, Brittney Murray, and Crystal Tichnell have as their affiliation 5 Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. In addition Hana Zouk, Megan Hawley, and Birgit Funke were assigned only to affiliation 3; they also have affiliation 4 Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. The original article has been corrected