Nationally framed assessment and planning assists coordination of resource management activities across jurisdictional boundaries and provides context for assessing the cumulative effects of impacts ...that can be underestimated by local or regional studies. However, there have been significant shortcomings in the existing spatial frameworks supporting national assessment and planning for Australia's rivers and streams. We describe the development of a new national stream and nested catchment framework for Australia that includes a fully connected and directed stream network and a nested catchment hierarchy derived using a modified Pfafstetter scheme. The directed stream network with associated catchment boundaries and Pfafstetter coding respect all distributary junctions and topographically driven surface flow pathways, including those in the areas of low relief and internal drainage that make up over half of the Australian continent. The Pfafstetter coding facilitates multi-scale analyses and easy tracing and query of upstream/downstream attributes and tributary/main stem relationships. Accompanying the spatial layers are 13 lookup tables containing nearly 400 attributes describing the natural and anthropogenic environment of each of the 1.4 M stream segments at multiple spatial scales (segment, sub-catchment and catchment). The database supplies key spatial layers to support national water information and accounting needs and assists a wide range of research, planning and assessment tasks at regional and continental scales. These include the delineation of reporting units for the Australian Water Resources Assessment, the development of an ecohydrological environment classification for Australian streams and the identification of high conservation value aquatic ecosystems for northern Australia.
Malnutrition—in the form of insufficient energy intakes—affects millions of people worldwide and the negative impact of this kind of hunger is well acknowledged, not least by agronomists trying to ...increase yields to ensure a sufficient supply of food. This review focuses on another, more particular and “hidden” form of malnutrition, namely mineral malnutrition. It illustrates the burden of disease that is caused by mineral deficiencies and the social and economic consequences they bring about. Mineral malnutrition has a considerable negative impact on individual well-being, social welfare and economic productivity. Agricultural scientists should keep the nutritional qualities of food in mind and—next to optimizing the agricultural properties of crops that are paramount for their adoption by farmers—in particular try to increase the micronutrient content in major staple crops as one way to address vitamin and mineral malnutrition in humans; especially plant breeding approaches promise to be very cost-effective.
Social anxiety disorder Stein, Murray B, Prof; Stein, Dan J, Prof
Lancet,
2008-Mar-29, Letnik:
371, Številka:
9618
Journal Article
Recenzirano
Odprti dostop
Summary Our understanding of social anxiety disorder (also known as social phobia) has moved from rudimentary awareness that it is not merely shyness to a much more sophisticated appreciation of its ...prevalence, its chronic and pernicious nature, and its neurobiological underpinnings. Social anxiety disorder is the most common anxiety disorder; it has an early age of onset—by age 11 years in about 50% and by age 20 years in about 80% of individuals—and it is a risk factor for subsequent depressive illness and substance abuse. Functional neuroimaging studies point to increased activity in amygdala and insula in patients with social anxiety disorder, and genetic studies are increasingly focusing on this and other (eg, personality trait neuroticism) core phenotypes to identify risk loci. A range of effective cognitive behavioural and pharmacological treatments for children and adults now exists; the challenges lie in optimum integration and dissemination of these treatments, and learning how to help the 30–40% of patients for whom treatment does not work.
Although the burden of disease in sub-Saharan Africa continues to be dominated by infectious diseases, countries in this region are undergoing a demographic transition leading to increasing ...prevalence of non-communicable diseases (NCDs). To inform health system responses to these changing patterns of disease, we aimed to assess changes in the burden of NCDs in sub-Saharan Africa from 1990 to 2017.
We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to analyse the burden of NCDs in sub-Saharan Africa in terms of disability-adjusted life-years (DALYs)—with crude counts as well as all-age and age-standardised rates per 100 000 population—with 95% uncertainty intervals (UIs). We examined changes in burden between 1990 and 2017, and differences across age, sex, and regions. We also compared the observed NCD burden across countries with the expected values based on a country's Socio-demographic Index.
All-age total DALYs due to NCDs increased by 67·0% between 1990 (90·6 million 95% UI 81·0–101·9) and 2017 (151·3 million 133·4–171·8), reflecting an increase in the proportion of total DALYs attributable to NCDs (from 18·6% 95% UI 17·1–20·4 to 29·8% 27·6–32·0 of the total burden). Although most of this increase can be explained by population growth and ageing, the age-standardised DALY rate (per 100 000 population) due to NCDs in 2017 (21 757·7 DALYs 95% UI 19 377·1–24 380·7) was almost equivalent to that of communicable, maternal, neonatal, and nutritional diseases (26 491·6 DALYs 25 165·2–28 129·8). Cardiovascular diseases were the second leading cause of NCD burden in 2017, resulting in 22·9 million (21·5–24·3) DALYs (15·1% of the total NCD burden), after the group of disorders categorised as other NCDs (28·8 million 25·1–33·0 DALYs, 19·1%). These categories were followed by neoplasms, mental disorders, and digestive diseases. Although crude DALY rates for all NCDs have decreased slightly across sub-Saharan Africa, age-standardised rates are on the rise in some countries (particularly those in southern sub-Saharan Africa) and for some NCDs (such as diabetes and some cancers, including breast and prostate cancer).
NCDs in sub-Saharan Africa are posing an increasing challenge for health systems, which have to date largely focused on tackling infectious diseases and maternal, neonatal, and child deaths. To effectively address these changing needs, countries in sub-Saharan Africa require detailed epidemiological data on NCDs.
Bill & Melinda Gates Foundation, National Health and Medical Research Centre (Australia).
Approximately 250 million (43%) children under the age of 5 years in low- and middle-income countries (LMICs) are failing to meet their developmental potential. Risk factors are recognised to ...contribute to this loss of human potential. Expanding understanding of the risks that lead to poor outcomes and which protective factors contribute to resilience in children may be critical to improving disparities.
The Drakenstein Child Health Study is a population-based birth cohort in the Western Cape, South Africa. Pregnant women were enrolled between 20 and 28 weeks' gestation from two community clinics from 2012 to 2015; sociodemographic and psychosocial data were collected antenatally. Mothers and children were followed through birth until 2 years of age. Developmental assessments were conducted by trained assessors blinded to background, using the Bayley-III Scales of Infant and Toddler Development (BSID-III), validated for use in South Africa, at 24 months of age. The study assessed all available children at 24 months; however, some children were not able to attend, because of loss to follow-up or unavailability of a caregiver or child at the correct age. Of 1,143 live births, 1,002 were in follow-up at 24 months, and a total of 734 children (73%) had developmental assessments, of which 354 (48.2%) were girls. This sample was characterised by low household employment (n = 183; 24.9%) and household income (n = 287; 39.1% earning <R1,000 per month), and high prevalence of maternal psychosocial risk factors including alcohol use in pregnancy (n = 95; 14.5%), smoking (n = 241; 34.7%), depression (n = 156; 23.7%), lifetime intimate partner violence (n = 310; 47.3%), and history of maternal childhood trauma (n = 228; 34.7%). A high proportion of children were categorised as delayed (defined by scoring < -1 standard deviation below the mean scaled score calculated using the BSID-III norms from a United States population) in different domains (369 50.5% cognition, 402 55.6% receptive language, 389 55.4% expressive language, 169 23.2% fine motor, and 267 38.4% gross motor). Four hundred five (55.3%) children had >1 domain affected, and 75 (10.2%) had delay in all domains. Bivariate and multivariable analyses revealed several factors that were associated with developmental outcomes. These included protective factors (maternal education, higher birth weight, and socioeconomic status) and risk factors (maternal anaemia in pregnancy, depression or lifetime intimate partner violence, and maternal HIV infection). Boys consistently performed worse than girls (in cognition β = -0.74; 95% CI -1.46 to -0.03, p = 0.042, receptive language β = -1.10; 95% CI -1.70 to -0.49, p < 0.001, expressive language β = -1.65; 95% CI -2.46 to -0.84, p < 0.001, and fine motor β = -0.70; 95% CI -1.20 to -0.20, p = 0.006 scales). There was evidence that child sex interacted with risk and protective factors including birth weight, maternal anaemia in pregnancy, and socioeconomic factors. Important limitations of the study include attrition of sample from birth to assessment age and missing data in some exposure areas from those assessed.
This study provides reliable developmental data from a sub-Saharan African setting in a well-characterised sample of mother-child dyads. Our findings highlight not only the important protective effects of maternal education, birth weight, and socioeconomic status for developmental outcomes but also sex differences in developmental outcomes and key risk and protective factors for each group.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Runx2, a bone-specific transcriptional regulator, is abnormally expressed in highly metastatic prostate cancer cells. Here, we identified the functional activities of Runx2 in facilitating tumor ...growth and osteolysis. Our studies show that negligible Runx2 is found in normal prostate epithelial and non-metastatic LNCaP prostate cancer cells. In the intra-tibial metastasis model, high Runx2 levels are associated with development of large tumors, increased expression of metastasis-related genes (MMP9, MMP13, VEGF, Osteopontin) and secreted bone-resorbing factors (PTHrP, IL8) promoting osteolytic disease. Runx2 siRNA treatment of PC3 cells decreased cell migration and invasion through Matrigel in vitro, and in vivo shRunx2 expression in PC3 cells blocked their ability to survive in the bone microenvironment. Mechanisms of Runx2 function were identified in co-culture studies showing that PC3 cells promote osteoclastogenesis and inhibit osteoblast activity. The clinical significance of these findings is supported by human tissue microarray studies of prostate tumors at stages of cancer progression, in which Runx2 is expressed in both adenocarcinomas and metastatic tumors. Together these findings indicate that Runx2 is a key regulator of events associated with prostate cancer metastatic bone disease.
During metastasis, malignant cells escape the primary tumor, intravasate lymphatic vessels, and reach draining sentinel lymph nodes before they colonize distant organs via the blood circulation. ...Although lymph node metastasis in cancer patients correlates with poor prognosis, evidence is lacking as to whether and how tumor cells enter the bloodstream via lymph nodes. To investigate this question, we delivered carcinoma cells into the lymph nodes of mice by microinfusing the cells into afferent lymphatic vessels. We found that tumor cells rapidly infiltrated the lymph node parenchyma, invaded blood vessels, and seeded lung metastases without involvement of the thoracic duct. These results suggest that the lymph node blood vessels can serve as an exit route for systemic dissemination of cancer cells in experimental mouse models. Whether this form of tumor cell spreading occurs in cancer patients remains to be determined.
...mental health services should be scaled up as an essential component of universal health coverage and should be fully integrated into the global response to other health priorities, including ...non-communicable diseases, maternal and child health, and HIV/AIDS. ...barriers and threats to mental health need to be addressed; these include the lack of awareness of the value of mental health in social and economic development, the lack of attention to mental health promotion and protection across sectors, the severe demand-side constraints for mental health care caused by stigma and discrimination, and the increasing threats to mental health due to global challenges such as climate change and growing inequality. ...mental health needs to be protected by public policies and developmental efforts; these intersectoral actions should be undertaken by each country's leaders to engage a wide range of stakeholders within and beyond health, including sectors in education, workplaces, social welfare, gender empowerment, child and youth services, criminal justice and development, and humanitarian assistance. ...investments in research and innovation should grow and harness novel approaches from diverse disciplines such as genomics, neuroscience, health services research, clinical sciences, and social sciences, both for implementation research on scaling up mental health interventions and for discovery research to advance understanding of causes and mechanisms of mental disorders and develop effective interventions to prevent and treat them.
Multi-configurational approaches yield universal wave function parametrizations that can qualitatively well describe electronic structures along reaction pathways. For quantitative results, ...multi-reference perturbation theory is required to capture dynamic electron correlation from the otherwise neglected virtual orbitals. Still, the overall accuracy suffers from the finite size and choice of the active orbital space and peculiarities of the perturbation theory. Fortunately, the electronic wave functions at equilibrium structures of reactants and products can often be well described by single-reference methods and hence are accessible to accurate coupled cluster calculations. Here, we calculate the heterolytic double dissociation energy of four 3d-metallocenes with the complete active space self-consistent field method and compare to highly accurate coupled cluster data. Our coupled cluster data are well within the experimental error bars. This accuracy can also be approached by complete active space calculations with an orbital selection based on information entropy measures. The entropy based active space selection is discussed in detail. We find a very subtle balance between static and dynamic electron correlation effects that emphasizes the need for algorithmic active space selection and that differs significantly from restricted active space results for identical active spaces reported in the literature.
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