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Background The aim of this study is to assess the current status of non-communicable disease (NCD) risk factors amongst adolescents in Bangladesh. We also critically reviewed the existing policy responses to NCD risk among adolescents in Bangladesh. Methods This study used a mixed method approach. To quantify the NCD risk burden, we used data from the Global School-based Student Health Survey conducted in Bangladesh. To understand policy response, we reviewed NCD-related policy documents introduced by the Government of Bangladesh between 1971 and 2018 using the WHO recommended NCD Action Plan 2013–2020as study framework. Information from the policy documents was extracted using a matrix, mapping each document against the six objectives of the WHO 2013–2020 Action Plan. Results Almost all adolescents in Bangladesh had at least one NCD risk factor, and there was a high prevalence of concurrent multiple NCD risk factors; 14% had one NCD risk factor while 22% had two, 29% had three, 34% had four or more NCD risk factors. Out of 38 policy documents, eight (21.1%) were related to research and/or surveys, eight (21.1%) were on established policies, and eleven (29%) were on legislation acts. Three policy documents (7.9%) were related to NCD guidelines and eight (21.1%) were strategic planning which were introduced by the government and non-government agencies/institutes in Bangladesh. Conclusions The findings emphasize the needs for strengthening NCD risk factors surveillance and introducing appropriate intervention strategies targeted to adolescents. Despite the Government of Bangladesh introducing several NCD-related policies and programs, the government also needs more focus on clear planning, implementation and monitoring and evaluation approaches to preventing NCD risk factors among the adolescents in Bangladesh.

To understand how the brain processes sensory information to guide behavior, we must know how stimulus representations are transformed throughout the visual cortex. Here we report an open, large-scale physiological survey of activity in the awake mouse visual cortex: the Allen Brain Observatory Visual Coding dataset. This publicly available dataset includes the cortical activity of nearly 60,000 neurons from six visual areas, four layers, and 12 transgenic mouse lines in a total of 243 adult mice, in response to a systematic set of visual stimuli. We classify neurons on the basis of joint reliabilities to multiple stimuli and validate this functional classification with models of visual responses. While most classes are characterized by responses to specific subsets of the stimuli, the largest class is not reliably responsive to any of the stimuli and becomes progressively larger in higher visual areas. These classes reveal a functional organization wherein putative dorsal areas show specialization for visual motion signals.

Unhealthy diets pose a greater risk to morbidity and mortality than does unsafe sex, and alcohol, drug, and tobacco use combined. Because much of the world's population is inadequately nourished and many environmental systems and processes are pushed beyond safe boundaries by food production, a global transformation of the food system is urgently needed. More than 820 million people have insufficient food and many more consume an unhealthy diet that contributes to premature death and morbidity. [...]global food production is the largest pressure caused by humans on Earth, threatening local ecosystems and the stability of the Earth system. With food production causing major global environmental risks, sustainable food production needs to operate within the safe operating space for food systems at all scales on Earth. [...]sustainable food production for about 10 billion people should use no additional land, safeguard existing biodiversity, reduce consumptive water use and manage water responsibly, substantially reduce nitrogen and phosphorus pollution, produce zero carbon dioxide emissions, and cause no further increase in methane and nitrous oxide emissions. Because food systems are a major driver of poor health and environmental degradation, global efforts are urgently needed to collectively transform diets and food production.

Background Expiratory muscle weakness leads to difficult ventilator weaning. Maintaining their activity with functional electrical stimulation (FES) may improve outcome. We studied feasibility of breath-synchronized expiratory population muscle FES in a mixed ICU population (“Holland study”) and pooled data with our previous work (“Australian study”) to estimate potential clinical effects in a larger group. Methods Holland: Patients with a contractile response to FES received active or sham expiratory muscle FES (30 min, twice daily, 5 days/week until weaned). Main endpoints were feasibility (e.g., patient recruitment, treatment compliance, stimulation intensity) and safety. Pooled: Data on respiratory muscle thickness and ventilation duration from the Holland and Australian studies were combined ( N  = 40) in order to estimate potential effect size. Plasma cytokines (day 0, 3) were analyzed to study the effects of FES on systemic inflammation. Results Holland: A total of 272 sessions were performed (active/sham: 169/103) in 20 patients ( N  = active/sham: 10/10) with a total treatment compliance rate of 91.1%. No FES-related serious adverse events were reported. Pooled: On day 3, there was a between-group difference ( N  = active/sham: 7/12) in total abdominal expiratory muscle thickness favoring the active group [treatment difference (95% confidence interval); 2.25 (0.34, 4.16) mm, P  = 0.02] but not on day 5. Plasma cytokine levels indicated that early FES did not induce systemic inflammation. Using a survival analysis approach for the total study population, median ventilation duration and ICU length of stay were 10 versus 52 ( P  = 0.07), and 12 versus 54 ( P  = 0.03) days for the active versus sham group. Median ventilation duration of patients that were successfully extubated was 8.5 [5.6–12.2] versus 10.5 [5.3–25.6] days ( P  = 0.60) for the active ( N  = 16) versus sham ( N  = 10) group, and median ICU length of stay was 10.5 [8.0–14.5] versus 14.0 [9.0–19.5] days ( P  = 0.36) for those active ( N  = 16) versus sham ( N  = 8) patients that were extubated and discharged alive from the ICU. During ICU stay, 3/20 patients died in the active group versus 8/20 in the sham group ( P  = 0.16). Conclusion Expiratory muscle FES is feasible in selected ICU patients and might be a promising technique within a respiratory muscle-protective ventilation strategy. The next step is to study the effects on weaning and ventilator liberation outcome. Trial registration: ClinicalTrials.gov, ID NCT03453944. Registered 05 March 2018—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03453944 .

Despite advances in experimental techniques and accumulation of large datasets concerning the composition and properties of the cortex, quantitative modeling of cortical circuits under in-vivo-like conditions remains challenging. Here we report and publicly release a biophysically detailed circuit model of layer 4 in the mouse primary visual cortex, receiving thalamo-cortical visual inputs. The 45,000-neuron model was subjected to a battery of visual stimuli, and results were compared to published work and new in vivo experiments. Simulations reproduced a variety of observations, including effects of optogenetic perturbations. Critical to the agreement between responses in silico and in vivo were the rules of functional synaptic connectivity between neurons. Interestingly, after extreme simplification the model still performed satisfactorily on many measurements, although quantitative agreement with experiments suffered. These results emphasize the importance of functional rules of cortical wiring and enable a next generation of data-driven models of in vivo neural activity and computations.

Aim Poleward range shifts of species are among the most obvious effects of climate change on biodiversity. As a consequence of these range shifts, species communities are predicted to become increasingly composed of warm‐dwelling species, but this has only been studied for a limited number of taxa, mainly birds, butterflies and plants. As species groups may vary considerably in their adaptation to climate change, it is desirable to expand these studies to other groups, from different ecosystems. Freshwater macroinvertebrates, such as dragonflies (Odonata), have been ranked among the species groups with highest priority. In this paper, we investigate how the occurrence of dragonflies in Europe has changed in recent decades, and if these changes are in parallel with climate change. Location Europe. Methods We use data from 10 European geographical regions to calculate occupancy indices and trends for 99 (69%) of the European species. Next, we combine these regional indices to calculate European indices. To determine if changes in regional dragonfly communities in Europe reflect climatic warming, we calculate Species Temperature Indices (STI), Multi‐species Indicators (MSI) and Community Temperature Indices (CTI). Results 55 of 99 considered species increased in occupancy at European level, 32 species remained stable, and none declined. Trends for 12 species are uncertain. MSI of cold‐dwelling and warm‐dwelling species differ in some of the regions, but increased at a similar rate at European level. CTI increased in all regions, except Cyprus. The European CTI increased slightly. Main conclusions European dragonflies, in general, have expanded their distribution in response to climate change, even though their CTI lags behind the increase in temperature. Furthermore, dragonflies proved to be a suitable species group for monitoring changes in communities, both at regional and continental level.

PurposeLesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends.MethodsTwelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified).ResultsMale and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained.ConclusionThese results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.

Efficient lignin depolymerization is unique to the wood decay basidiomycetes, collectively referred to as white rot fungi. Phanerochaete chrysosporium simultaneously degrades lignin cellulose, whereas the closely related species, Ceriporiopsis subvermispora, also depolymerizes lignin but may do so with relatively little cellulose degradation. To investigate the basis for selective ligninolysis, we conducted comparative genome analysis of C. subvermispora and P. chrysosporium. Genes encoding man-ganese peroxidase numbered 13 and five in C. subvermispora and P. chrysosporium, respectively. In addition, the C subvermispora genome contains at least seven genes predicted to encode laccases, whereas the P. chrysosporium genome contains none. We also observed expansion of the number of C subvermispora desaturase-encoding genes putatively involved m lipid metabolism. Microarray-based transcriptome analysis showed substantial up-regulation of severdesaturase and MnP genes in wood-containing medium. MS identified MnP proteins in C subvermispora culture filtrates, but none in P. chrysosporium cultures. These results support the importance of MnP and a lignin degradation mechanism whereby Cleavage of the dominant nonphenolic Structures ¡s mediated by lipid peroxidation products. Two C. subvermispora genes were predicted to encode peroxidases structurally Similar to P. Chrysosporium lignin peroxidase and, following heterologous expression in Escherichia coli, the enzymes were Shown to oxidize high redox potential Substrates, but not Mn²⁺. Apart from oxidative lignin degradation, we also examined cellulolytic and hemicellulolytic systems in both fungi. In summary, the C. subvermispora genetic inventory and expression patterns exhibit increased oxidoreductase potential and diminished celluloand lytic capability relative to P. chrysosporium.

Background Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality. As the PDA might have closed spontaneously, treated children are potentially exposed to iatrogenic adverse effects. A conservative approach is gaining interest worldwide, although convincing evidence to support its use is lacking. Methods This multicentre, randomised, non-inferiority trial is conducted in neonatal intensive care units. The study population consists of preterm infants (GA < 28 weeks) with an echocardiographic-confirmed PDA with a transductal diameter > 1.5 mm. Early treatment (between 24 and 72 h postnatal age) with the cyclooxygenase inhibitor (COXi) ibuprofen (IBU) is compared with an expectative management (no intervention intended to close a PDA). The primary outcome is the composite of mortality, and/or necrotising enterocolitis (NEC) Bell stage ≥ IIa, and/or bronchopulmonary dysplasia (BPD) defined as the need for supplemental oxygen, all at a postmenstrual age (PMA) of 36 weeks. Secondary outcome parameters are short term sequelae of cardiovascular failure, comorbidity and adverse events assessed during hospitalization and long-term neurodevelopmental outcome assessed at a corrected age of 2 years. Consequences regarding health economics are evaluated by cost effectiveness analysis and budget impact analysis. Discussion As a conservative approach is gaining interest, we investigate whether in preterm infants, born at a GA less than 28 weeks, with a PDA an expectative management is non-inferior to early treatment with IBU regarding to the composite outcome of mortality and/or NEC and/or BPD at a PMA of 36 weeks. Trial registration This trial is registered with the Dutch Trial Register NTR5479 (registered on 19 October 2015), the registry sponsored by the United States National Library of Medicine Clinicaltrials.gov NCT02884219 (registered May 2016) and the European Clinical Trials Database EudraCT 2017–001376-28 .