(Post)Minimalism and Postmodern Spirituality: Vuk Kulenović’s Hilandar Bells

HLA haplotype frequency estimation for heterogeneous populations using a graph-based imputation algorithm

The International Study of Asthma and Allergies in Childhood (ISAAC) has developed an international version of the asthma video questionnaire (AVQ3.0) to measure asthma prevalence. This questionnaire has not been validated in adolescents from a mixed ethnic background. The aims of this study were to compare the video questionnaire with a written questionnaire in the detection of airway hyperresponsiveness to hypertonic saline in a population of adolescents from a mixed ethnic background, and to establish the repeatability and psychometric properties of the asthma video questionnaire. The study was conducted in four secondary schools in Sydney, an area with a high proportion of people from a non-English speaking background. Four hundred and seventy-five students from schools 1 and 2 completed the video questionnaire and a subgroup of these students (n = 170) completed the written questionnaire and a hypertonic saline inhalation challenge. Reproducibility of the questionnaire was evaluated by administering the questionnaire to a subsample of students 2 weeks later. The psychometric properties of the video questionnaire were examined in 852 students at two other schools (schools 3 and 4). One hundred and sixty-nine students aged 13.5 (sd 1.3) years completed both written and video questionnaires, and the hypertonic saline challenge. The students had widely different cultural backgrounds including Asian, South Pacific, Middle Eastern, European and African countries. There was good agreement between the questionnaires for wheeze (kappa 0.42). Questions on the video questionnaire concerning wheezing had good sensitivity (90%) and specificity (68%) for airway hyperresponsiveness to hypertonic saline. The video questionnaire was reproducible (kappa 0.82), had good internal consistency (Cronbach's alpha 0.81) and each question pertained to a single construct explaining 58% of the variance in total score. This study has validated the international version of the ISAAC video questionnaire against airway hyperresponsiveness to hypertonic saline in adolescents from a mixed ethnic background, and identified that the questionnaire has good psychometric properties. The ISAAC video has proved to be a valuable tool for the assessment of asthma prevalence in populations of ethnic diversity.

Y-chromosome AZFc structural architecture and relationship to male fertility

The law in England and Wales (as in Australia and other jurisdictions) enables a person to be convicted of an offence committed by another using complicity liability, sometimes termed ‘joint enterprise’. In England and Wales, 'joint enterprise' has been widely criticised for: failing to distinguish between the moral and legal culpability of the person who commits the substantive offence and those on the periphery of it; being disproportionality applied in cases involving young men from black and mixed ethnic backgrounds; and for lacking legal legitimacy. Thus, it was hoped that the decision of the Supreme Court in England and Wales in 2016 to abolish the extended form of complicity liability, known as Parasitic Accessorial Liability (PAL), would resolve these issues. Reporting on interviews with police detectives, and prosecution and defence lawyers in England involved in cases of serious youth violence, this paper argues that the problems associated with ‘joint enterprise’ in England and Wales remain, despite the change in the law. This is due to there being only ‘subtle shift’ in practice and a continued reliance on racialised inferences about young men from black and mixed ethnic backgrounds. To reduce problems with disproportionality and improve the fairness of the law related to complicity liability, changes to police and prosecutorial practice are required, alongside meaningful law reform.

BackgroundGlaucoma is the second leading cause of irreversible blindness. The iStent® Inject trabecular micro-bypass is a type of minimally invasive surgery that may effectively manage IOP and reduce dependence on...

Validation for Clinical Use of, and Initial Clinical Experience with, a Novel Approach to Population-Based Carrier Screening using High-Throughput, Next-Generation DNA Sequencing

Background The study explores how social network determinants relate to the prevalence and frequency of alcohol use of members of social networks. In a so-called dyadic design we study how similar alcohol habits co-exist among individuals (egos) and their peers (alters), when variables such as ethnic background, network composition, and other socio-cultural aspects are considered. Methods The data were derived from a Swedish survey entitled “Social Capital and Labor Market Integration: A Cohort Study.” The study participants (egos; n = 1989) were around age 23 at the time of the interview. A so-called dyadic design was applied, which means that all components of the analysis refer to ego-alter pairs (n = 7828). The outcome variable considered how alcohol prevalence and frequency of binge-drinking co-exist between egos and their alters. The independent variables also measured mutual attributes and behaviors - whether egos and alters were at the same age and sex, had same ethnic background, were relatives or friends, had similar religious affiliations, or intensely interacted with friends. Results The analysis revealed that ego-alter similarity in terms of age, sex and ethnic background predict ego-alter similarity in alcohol use and binge-drinking. For example, if egos and alters shared a similar ethnic background, their risk of alcohol use was at least 30 percent higher as compared to those with different ethnic backgrounds. Relative to ego-alter pairs with mixed ethnic backgrounds, the odds of binge-drinking were highest for ego-alters pairs with Yugoslavian background (OR 1.76; 95% CI 1.27-2.42), followed by those with Iranian (OR 1.57; 1.04-2.35) and Swedish background (OR 1.28; 0.84-1.95). Conclusions We conclude that network similarity (i.e., homophily) is an important explanation for the co-existence of alcohol use among members of peer networks. Alcohol use is more common in homogeneous peer dyads representing population groups with higher use. Key messages Peer similarity predicts alcohol use and binge drinking. Ethnic similarity of peers is associated with increased alcohol use and binge drinking.

The present study aimed to identify overall stress and salient stressors experienced by adolescents from different education tracks and self-perceived ethnic backgrounds. A total of 1489 adolescents ( M = 13.40 years; SD = 0.89 years) from nine Dutch secondary schools participated. Self-reported stressors were measured with the adapted version of the Adolescent Stress Questionnaire – Short. After controlling for age, gender, country of birth, and school classes, results showed that overall stress did not differ for educational track nor for ethnic background subgroups. Adolescents in academic education reported more stress from school-related stressors than adolescents attending vocational education. Adolescents with a mixed ethnic background (i.e., Dutch and another ethnicity) reported more stress regarding school-related stressors than adolescents with a Dutch ethnic background. These differences between adolescents of different educational tracks and ethnic backgrounds have implications for intervention programs targeting specific stressors.

The present study evaluated two non-invasive diagnostic methods for H. pylori infection in children, i.e. an in-house ELISA using sonicated Campylobacter jejuni antigen for absorption of cross-reacting antibodies and an immunoblot kit (Helico Blot 2.0, Genelabs, Singapore). 13C -Urea breath test (13C-UBT) was used as reference Sera and questionnaires were collected from 695/858 (81%) Swedish school children with mixed ethnic backgrounds within a cross-sectional, community-based study. Of 133 children with an ELISA OD value of > or = 0.1, all were screened with immunoblot and 107 made a 13C-UBT. The negative controls were 34/37 children from three school classes with an ELISA OD value of < 0.1 and volunteering for a 13C-UBT. An adjusted cut-off level for the ELISA of OD value 0.22 resulted in a sensitivity of 97.8%, a specificity of 95.8% and a concordance index of 97.2%. The Helico Blot 2.0 had a sensitivity of 97.8%, a specificity of 93.8% and a concordance index of 96.5%. The best concordance was seen for the 26.5 kDa (98.6%), 30 kDa (95.7%) and 19.5 kDa (91.5%) antigens. The corresponding concordance index for CagA was 78%, for VacA 73.8% and for the 35kDa antigen 68.8%. A significant difference in the distribution of the 19.5 and 26.5 kDa bands but not of CagA/VacA was noted by ethnic background. With an adjusted cut-off level for the enzyme-linked immunosorbent assay (ELISA), both non-invasive methods were found to have an adequate performance in a pediatric population. The differences in antibody response patterns by ethnic background represent a caveat in the interpretation of serological studies.

The aim of this study was to clarify the frequency of patients with type 1 diabetes that have serum that increases pancreatic beta-cell cytoplasmic free Ca(2+) concentration, [Ca(2+)](i), and if such an effect is also present in serum from first-degree relatives. We also studied a possible link between the serum effect and ethnic background as well as presence of autoantibodies. Sera obtained from three different countries were investigated as follows: 82 Swedish Caucasians with newly diagnosed type 1 diabetes, 56 Americans with different duration of type 1 diabetes, 117 American first-degree relatives of type 1 diabetic patients with a mixed ethnic background and 31 Caucasian Finnish children with newly diagnosed type 1 diabetes. Changes in [Ca(2+)](i) , upon depolarization, were measured in beta-cells incubated overnight with sera from type 1 diabetic patients, first-degree relatives or healthy controls. Our data show that there is a group constituting approximately 30% of type 1 diabetic patients of different gender, age, ethnic background and duration of the disease, as well as first-degree relatives of type 1 diabetic patients, that have sera that interfere with pancreatic beta-cell Ca(2+)-handling. This effect on beta-cell [Ca(2+)](i) could not be correlated to the presence of autoantibodies. In a defined subgroup of patients with type 1 diabetes and first-degree relatives a defect Ca(2+)-handling may aggravate development of beta-cell destruction.

Pseudoxanthoma elasticum (PXE), an autosomal recessive multisystem disorder, is caused by mutations in the ABCC6 gene, and approximately 300 distinct mutations representing >1000 mutant alleles have been disclosed thus far. Few population-based studies have reported mutational hotspots in some geographic areas. In this study, we attempted to correlate recurring mutations with the individuals' ethnic origin. Specifically, we plotted our international database of 70 families from distinct or mixed ethnic backgrounds against their mutations. The frequent p.R1141X mutation was distributed widely across Europe, while deletion of exons 23-29 (del23-29) was encountered in Northern Europe and in Northern Mediterranean countries. p.R1138W may be a marker for French descent, evidenced by its presence also in French Canadians. The splice site transition mutation 3736-1G→A was seen in the neighboring countries Greece and Turkey, whereas 2542 delG occurs only in the Japanese. Two mutations seem to be present worldwide without evidence of a founder effect, p.Q378X and p.R1339C, suggesting the presence of mutational hotspots. Knowledge of this distribution will allow us to streamline mutation screening through a targeted, stepwise approach when the ethnicity of a patient is known. This will facilitate the identification of individuals at risk, improving their care to prevent ophthalmological and vascular disease.

Objective: To reexamine literature and data on the effects of gene mutation on central precocious puberty (CPP) via a meta-analysis. Methods: Consultation of search engines Chinese Bio-medicine Database, China National Knowledge Infrastructure, Pubmed and Medline search resulted in a total of six studies containing more than 1600 individuals from various ethnic backgrounds. To evaluate the risk of CPP odds ratios (OR) for all case-control studies were calculated. Results: In this meta-analysis no significant association of the gene mutation with CPP in the combined case-control sample with mixed ethnic background (OR = 1.79, 95%CI: 0.65-4.93, P = 0.26) was found. Conclusion: This study found no evidence of gene mutation being an independent risk factor of CPP. Further studies are needed further understand the effects of the interactions between this gene and other genetic and/or environment factors on CPP.

Many patients are currently unable to access psychological treatments for post-traumatic stress disorder (PTSD), and it is unclear which types of therapist-assisted internet-based treatments work best. We aimed to investigate whether a novel internet-delivered cognitive therapy for PTSD (iCT-PTSD), which implements all procedures of a first-line, trauma-focused intervention recommended by the UK National Institute for Health and Care Excellence (NICE) for PTSD, is superior to internet-delivered stress management therapy for PTSD (iStress-PTSD), a comprehensive cognitive behavioural treatment programme focusing on a wide range of coping skills. We did a single-blind, randomised controlled trial in three locations in the UK. Participants (≥18 years) were recruited from UK National Health Service (NHS) Improving Access to Psychological Therapies (IAPT) services or by self-referral and met DSM-5 criteria for PTSD to single or multiple events. Participants were randomly allocated by a computer programme (3:3:1) to iCT-PTSD, iStress-PTSD, or a 3-month waiting list with usual NHS care, after which patients who still met PTSD criteria were randomly allocated (1:1) to iCT-PTSD or iStress-PTSD. Randomisation was stratified by location, duration of PTSD (<18 months or ≥18 months), and severity of PTSD symptoms (high vs low). iCT-PTSD and iStress-PTSD were delivered online with therapist support by messages and short weekly phone calls over the first 12 weeks (weekly treatment phase), and three phone calls over the next 3 months (booster phase). The primary outcome was the severity of PTSD symptoms at 13 weeks after random assignment, measured by self-report on the PTSD Checklist for DSM-5 (PCL-5), and analysed by intention-to-treat. Safety was assessed in all participants who started treatment. Process analyses investigated acceptability and compliance with treatment, and candidate moderators and mediators of outcome. The trial was prospectively registered with the ISRCTN registry, ISRCTN16806208. Of the 217 participants, 158 (73%) self-reported as female, 57 (26%) as male, and two (1%) as other; 170 (78%) were White British, 20 (9%) were other White, six (3%) were Asian, ten (5%) were Black, eight (4%) had a mixed ethnic background, and three (1%) had other ethnic backgrounds. Mean age was 36·36 years (SD 12·11; range 18-71 years). 52 (24%) participants met self-reported criteria for ICD-11 complex PTSD. Fewer than 10% of participants dropped out of each treatment group. iCT-PTSD was superior to iStress-PTSD in reducing PTSD symptoms, showing an adjusted difference on the PCL-5 of -4·92 (95% CI -8·92 to -0·92; p=0·016; standardised effect size d=0·38 [0·07 to 0·69]) for immediate allocations and -5·82 (-9·59 to -2·04; p=0·0027; d=0·44 [0·15 to 0·72]) for all treatment allocations. Both treatments were superior to the waiting list for PCL-5 at 13 weeks (d=1·67 [1·23 to 2·10] for iCT-PTSD and 1·29 [0·85 to 1·72] for iStress-PTSD). The advantages in outcome for iCT-PTSD were greater for participants with high dissociation or complex PTSD symptoms, and mediation analyses showed both treatments worked by changing negative meanings of the trauma, unhelpful coping, and flashback memories. No serious adverse events were reported. Trauma-focused iCT-PTSD is effective and acceptable to patients with PTSD, and superior to a non-trauma-focused cognitive behavioural stress management therapy, suggesting that iCT-PTSD is an effective way of delivering the contents of CT-PTSD, one of the NICE-recommended first-line treatments for PTSD, while reducing therapist time compared with face-to-face therapy. Wellcome Trust, UK National Institute for Health and Care Research Oxford Health Biomedical Research Centre.

To determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in pregnancy in an inner-city setting and assess associations with demographic factors and vaccination timing. Repeated cross-sectional surveillance study. London maternity centre. A total of 906 pregnant women attending nuchal scans, July 2020-January 2022. Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported vaccination status and coronavirus disease 2019 (COVID-19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres. Immunoglobulin G N- and S-protein antibody titres. Of the 960 women, 196 (20.4%) were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS-CoV-2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35-2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (versus white aRR 0.58, 95% CI 0.40-0.84, p = 0.004; aRR 0.56, 95% CI 0.34-0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold-change, 95% CI 2.65-6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S-antibody titres (mean difference -0.28 fold-change, 95% CI -2.61 to 2.04, p = 0.785). This cross-sectional study demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titres were highest among double-vaccinated, infected women.

Vinueza Veloz, Andrés Fernando, Aymaru Kailli Yaulema Riss, Chris I. De Zeeuw, Tannia Valeria Carpio Arias, and María Fernanda Vinueza Veloz. Blood pressure in Andean adults living permanently at different altitudes. High Alt Med Biol. 21:360-369, 2020. Aims: To estimate the association between blood pressure (BP) and chronic exposure to altitude in nonhypertensive Andean adults, while taking ethnicity into consideration. Materials and Methods: Sample included 10,041 nonhypertensive adults with indigenous or mixed ethnic background (the latter also referred to as mestizos), who permanently lived at different altitudes. BP was measured following international recommendations. Altitude was measured in meters above the sea level (masl) using a global positioning system. Data were analyzed through linear regression models with restricted cubic splines. Results: A significant nonlinear relation between altitude and systolic blood pressure (SBP) as well as diastolic blood pressure (DBP) was found (both p < 0.001). BP described a j-shaped curve, where the minimum was observed between 750 and 1250 masl, from where both SBP and DBP rose as altitude increased. These associations were independent from sex, age, index of economic wellbeing, body mass index, and years of education. Interestingly, at all altitudes indigenous people had lower SBP and DBP in comparison to mestizos (both p < 0.001). Conclusions: Living permanently at altitudes ≥750 masl is associated with higher SBP and DBP in Andean dwellers and this association is modulated by their ethnic background.