Background A limited number of studies have shown that modulation of cortical excitability using transcranial direct current stimulation (tDCS) is safe and tolerable. Few have directly evaluated ...whether sham and active stimulation are indistinguishable. Objective We aimed to demonstrate tDCS safety and tolerability in a large cohort, and to compare the occurrence and severity of side effects between sham and active stimulation sessions. Methods One hundred thirty-one healthy subjects undergoing 277 tDCS sessions rated on a 1 to 5 scale the perception of side effects during and after stimulation. Proportions of active and sham sessions associated with side effects were compared using Fisher exact test, and distributions of severity ratings were compared using the Kruskal-Wallis test. Results No serious adverse effects occurred. Side effects most commonly reported were tingling (76%), itching (68%), burning (54%), and pain (25%). Side effect severity was mild, with fewer than 2% of responses indicating a severity > 3 on all questions except tingling (15%), itching (20%), burning (7%), pain (5%), and fatigue (3%) during stimulation. Rates of sensory side effects were statistically significantly higher in active stimulation sessions compared with sham sessions. No other stimulation parameters had a statistically significant impact on side effect occurrence. Conclusions TDCS is a safe well-tolerated technique with no evidence of risk for serious adverse effects. Sensory side effects are common, but the severity is typically low. Because sensory side effects are more frequent and more severe in active compared with sham tDCS, the current method of sham stimulation may not be an adequate control condition for some studies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
As crises escalate worldwide, there is an increasing demand for innovative solutions to enhance humanitarian outcomes. Within this landscape, digital health tools have emerged as promising solutions ...to tackle certain health challenges. The integration of digital health tools within the international humanitarian system provides an opportunity to reflect upon the system's paternalistic tendencies, driven largely by Global North organisations, that perpetuate existing inequities in the Global South, where the majority of crises occur. The Participation Revolution, a fundamental pillar of the Localisation Agenda, seeks to address these inequities by advocating for greater participation from crisis-affected people in response efforts. Despite being widely accepted as a best practice; a gap remains between the rhetoric and practice of participation in humanitarian response efforts. This study explores the extent and nature of participatory action within contemporary humanitarian digital health projects, highlighting participatory barriers and tensions and offering potential solutions to bridge the participation gap to enhance transformative change in humanitarian response efforts.
Sixteen qualitative interviews were conducted with humanitarian health practitioners and experts to retrospectively explored participatory practices within their digital health projects. The interviews were structured and analysed according to the Localisation Performance Measurement Framework's participation indicators and thematically, following the Framework Method. The study was guided by the COREQ checklist for quality reporting.
Varied participatory formats, including focus groups and interviews, demonstrated modest progress towards participation indicators. However, the extent of influence and power held by crisis-affected people during participation remained limited in terms of breadth and depth. Participatory barriers emerged under four key themes: project processes, health evidence, technology infrastructure and the crisis context. Lessons for leveraging participatory digital health humanitarian interventions were conducting thorough pre-project assessments and maintaining engagement with crisis-affected populations throughout and after humanitarian action.
The emerging barriers were instrumental in shaping the limited participatory reality and have implications: Failing to engage crisis-affected people risks perpetuating inequalities and causing harm. To advance the Participation Revolution for humanitarian digital health response efforts, the major participatory barriers should be addressed to improve humanitarian efficiency and digital health efficacy and uphold the rights of crisis-affected people.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Forced displacement is a crucial determinant of poor health. With 31 people displaced every minute worldwide, this is an important global issue. Addressing this, the Participation Revolution ...workstream from the World Humanitarian Summit's Localisation commitments has gained traction in attempting to improve the effectiveness of humanitarian aid. Simultaneously, digital health initiatives have become increasingly ubiquitous tools in crises to deliver humanitarian assistance and address health burdens.
This scoping review explores how the localisation agenda's commitment to participation has been adopted within digital health interventions used by displaced people in low-and-middle-income countries.
This review adopted the Arksey and O'Malley approach and searched five academic databases and three online literature repositories with a Population, Concept and Context inclusion criteria. Data were synthesised and analysed through a critical power lens from the perspective of displaced people in low-and-middle-income-countries.
27 papers demonstrated that a heterogeneous group of health issues were addressed through various digital health initiatives, principally through the use of mobile phones. The focus of the literature lay largely within technical connectivity and feasibility assessments, leaving a gap in understanding potential health implications. The varied conceptualisation of the localisation phenomenon has implications for the future of participatory humanitarian action: Authorship of reviewed literature primarily descended from high-income countries exposing global power dynamics leading the narrative. However, power was not a central theme in the literature: Whilst authors acknowledged the benefit of local involvement, participatory activities were largely limited to informing content adaptations and functional modifications within pre-determined projects and objectives.
With over 100 million people displaced globally, effective initiatives that meaningfully address health needs without perpetuating harmful inequalities are an essential contribution to the humanitarian arena. The gap in health outcomes evidence, the limited constructions of health, and the varying and nuanced digital divide factors are all indicators of unequal power in the digital health sphere. More needs to be done to address these gaps meaningfully, and more meaningful participation could be a crucial undertaking to achieve this. Registration The study protocol was registered before the study (10.17605/OSF.IO/9D25R) at https://osf.io/9d25r .
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We have used observations from the Mars Climate Sounder (MCS) to investigate the north polar hood (NPH) water ice clouds, including the first systematic examination of the vertical and nighttime ...structure. We show that the NPH clouds are present between LS = 150° (early autumn) and 30° (late spring) and that the clouds always extend to the pole. The daytime (1500 LMST) and nighttime (0300 LMST) clouds both have one layer that extends in altitude from 10 to 40 km above the surface, and the layer falls from its peak with a constant mixing ratio. We find that the cloud optical depth is controlled by the atmospheric thermal structure. The nighttime optical depth values are often higher than the daytime, sometimes due to tidally driven diurnal temperature differences and other times (i.e., LS = 240°–330°) a result of low temperatures associated with the polar vortex at night. We conclude that polar hood clouds are primarily controlled by the temperature structure and form at the water condensation level.
Abstract Few studies have investigated the impact of adolescent change language on substance use treatment outcomes and even fewer have examined how adolescents respond to normative feedback. The ...purpose of this study was to understand the influence normative feedback has on adolescent change language and subsequent alcohol and cannabis use 3 months later. We examined how percent change talk (PCT) was associated with subsequent alcohol and drug use outcomes. Adolescents (N = 48) were randomly assigned to receive brief motivational interviewing (MI) or MI plus normative feedback (NF). Audio recordings were coded with high interrater reliability. Adolescents with high PCT who received MI + NF had significantly fewer days of alcohol and binge drinking at follow up. There were no differences between groups on cannabis use or treatment engagement. Findings indicate that NF may be useful for adolescents with higher amount of change talk during sessions and may be detrimental for individuals with higher sustain talk.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Cyclodextrins are sugar compounds that are increasingly finding medicinal uses due to their ability to complex with hydrophobic molecules. One cyclodextrin in particular, ...2-hydroxypropyl-β-cyclodextrin (HPβCD), is used as a carrier to solubilize lipophilic drugs and is itself being considered as a therapeutic agent for treatment of Niemann-Pick Type C disease, due to its ability to mobilize cholesterol. Results from toxicological studies suggest that HPβCD is generally safe, but a recent study has found that it causes hearing loss in cats. Whether the hearing loss occurred via death of cochlear hair cells, rendering it permanent, was unexplored. In the present study, we examined peripheral auditory function and cochlear histology in mice after subcutaneous injection of HPβCD to test for hearing loss and correlate any observed auditory deficits with histological findings. On average, auditory brainstem response thresholds were elevated at 4, 16, and 32 kHz in mice one week after treatment with 8,000 mg/kg. In severely affected mice all outer hair cells were missing in the basal half of the cochlea. In many cases, surviving hair cells in the cochlear apex exhibited abnormal punctate distribution of the motor protein prestin, suggesting long term changes to membrane composition and integrity. Mice given a lower dose of 4,000 mg/kg exhibited hearing loss only after repeated doses, but these threshold shifts were temporary. Therefore, cyclodextrin-induced hearing loss was complex, involving cell death and other more subtle influences on cochlear physiology.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We have used observations from the Mars Climate Sounder to investigate south polar hood water ice clouds (at 12 μm), including the first systematic examination of the vertical (5 km resolution) and ...nighttime structure. We find that the structure and evolution of the polar hood is controlled more strongly by atmospheric temperature variations than by intrinsic fluctuations in water vapor abundance. The clouds form as a belt during LS = 10°–70° (phase 1) and LS = 100°–200° (phase 2). During phase 1, the cloud belt extends over a wide latitude range, between 30°S and 75°S with a visible column optical depth between 0.075 and 0.15. The cloud belt then evaporates as temperatures warm. During phase 2, the cloud belt reappears due to an increase in water vapor as a partial band of low‐opacity clouds south of the Tharsis region and eventually becomes continuous in longitude, with a visible column opacity between 0.125 and 0.25. As the southern spring equinox approaches, the cloud belt shifts southward, following the seasonal cap edge. From LS = 140° to LS = 200°, the daytime belt lies about 15° farther south than the nighttime belt, due to tidally driven diurnal temperature differences. The vertical structure of the cloud belt is consistent within and between the two seasonal phases and is characterized by a thick lower cloud deck and an upper layer whose altitude shifts between the nighttime and daytime because of thermal tidal control of the condensation altitudes. Overall, the southern polar hood is observed to rapidly form and dissipate as the temperature crosses the saturation point of water vapor.
The relationship of eelgrass survival and habitat quality to water column nitrogen level, phytoplankton biomass, particulate matter, bottom light intensity, and light attenuation was quantified at 70 ...sites within 19 Massachusetts estuaries through 4 growing seasons (2007–2009, 2011). Sites included a range of eelgrass habitat quality, from stable productive eelgrass beds, to degraded beds, to areas that have lost all eelgrass coverage. Survival of transplanted eelgrass culms was used as a bio-indicator of habitat quality. Habitat quality based upon both changes in stability of eelgrass coverage and transplant survival was positively related to light intensity and percent transmittance. Transplant survival was consistent with habitat designations based upon long-term changes in eelgrass coverage, with lowest light coinciding with areas that lost eelgrass in earlier decades. Bottom light declined in proportion to increases in total nitrogen levels, phytoplankton biomass, and water column particulates determined from long-term water quality data. Field surveys indicated that eelgrass survival required bottom light ≥100 μE/m2/s and healthy eelgrass existed where tidally-averaged total nitrogen was less than 0.34 mg/L, equivalent to a mid-ebb tide water-column total nitrogen of <0.37 mg/L. Traditional sampling of water column nitrogen at mid-ebb tide was found to slightly overestimate the average nitrogen level over a complete tidal cycle. However, since long-term, ebb-tide and tidally-averaged total nitrogen are correlated, it is possible to use the monitoring average to guide management until tidally-averaged TN becomes available. Nitrogen thresholds that support eelgrass communities provide a fundamental tool for managing this habitat and for selection of transplant sites aimed at accelerating restoration of this resource under increasing nitrogen loading of the coastal zone.
•We showed N-induced eutrophication lead to lower density and survival of eelgrass.•Bottom light for transplanted eelgrass restoration should be ≥100 μE/m2/s.•Natural eelgrass beds showed a light threshold of ∼70 μE/m2/s.•Eelgrass existed where tidally-averaged TN was <0.34 mg/L (mid-ebb tide <0.37 mg/L).•75th percentile yields a tidally-averaged TN of <0.36 mg/L (mid-ebb tide <0.38 mg/L).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Alström Syndrome is a life-threatening disease characterized primarily by numerous metabolic abnormalities, retinal degeneration, cardiomyopathy, kidney and liver disease, and sensorineural hearing ...loss. The cellular localization of the affected protein, ALMS1, has suggested roles in ciliary function and/or ciliogenesis. We have investigated the role of ALMS1 in the cochlea and the pathogenesis of hearing loss in Alström Syndrome. In neonatal rat organ of Corti, ALMS1 was localized to the basal bodies of hair cells and supporting cells. ALMS1 was also evident at the basal bodies of differentiating fibrocytes and marginal cells in the lateral wall. Centriolar ALMS1 expression was retained into maturity. In Alms1-disrupted mice, which recapitulate the neurosensory deficits of human Alström Syndrome, cochleae displayed several cyto-architectural defects including abnormalities in the shape and orientation of hair cell stereociliary bundles. Developing hair cells were ciliated, suggesting that ciliogenesis was largely normal. In adult mice, in addition to bundle abnormalities, there was an accelerated loss of outer hair cells and the progressive appearance of large lesions in stria vascularis. Although the mice progressively lost distortion product otoacoustic emissions, suggesting defects in outer hair cell amplification, their endocochlear potentials were normal, indicating the strial atrophy did not affect its function. These results identify previously unrecognized cochlear histopathologies associated with this ciliopathy that (i) implicate ALMS1 in planar cell polarity signaling and (ii) suggest that the loss of outer hair cells causes the majority of the hearing loss in Alström Syndrome.
There is considerable evidence for motivational interviewing (MI) in changing problematic behaviors. Research on the causal chain for MI suggests influence of facilitator speech on client speech. ...This association has been examined using macro (session-level) and micro (utterance-level) measures; however, effects across sessions have largely been unexplored, particularly with groups. We evaluated a sample of 129 adolescent Group MI sessions, using a behavioral coding system and timing information to generate information on facilitator and client speech (CT; change talk) within 5 successive segments (quintiles) of each group session. We hypothesized that facilitator speech (open-ended questions and reflections of CT) would be related to subsequent CT. Repeated measures analysis indicated significant quadratic and cubic trends for facilitator and client speech across quintiles. Across quintiles, cross-lagged panel analysis using a zero-inflated negative binomial model showed minimal evidence of facilitator speech on client CT, but did indicate several effects of client CT on facilitator speech, and of client CT on subsequent client CT. Results suggest that session-level effects of facilitator speech on client speech do not arise from long-duration effects of facilitator speech; instead, we detected effects of facilitator speech on client speech only at the beginning and end of sessions, when open questions, respectively, suppressed and enhanced client expressions of CT. Findings suggest that clinicians must remain vigilant to client CT throughout the group session, reinforcing it when it arises spontaneously and selectively employing open-ended questions to elicit it when it does not, particularly toward the end of the session.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
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