Adverse Environment Research Articles

A mixed methods study of schema modes amongst people living with eating disorders

BackgroundSchema therapy is promising for people with eating disorders, especially those unresponsive to cognitive behavioural therapy. Complex underlying psychological constructs include dysfunctional schemas and maladaptive modes. This study aimed to explore people living with eating disorders’ schema modes and their identification with and understanding of their high scoring modes.MethodsSixteen women with enduring eating disorders without prior exposure to schema therapy completed the schema mode inventory for eating disorders short form (SMI-ED-SF), then participated in semi-structured interviews discussing their high scoring modes. Interviews were analysed by thematic analysis.ResultsAll participants scored above clinical concern on at least one maladaptive mode and many scored high on multiple modes, most commonly Demanding Mode, Vulnerable Child and Detached Self-Soother. Qualitatively, four themes emerged: 1) Adverse family environments related to (a) trauma and the vulnerable and angry child and (b) unrealistically high standards; 2) Mode effects on (a) everyday life and (b) disordered eating; 3) Modes are psychologically protective in (a) avoiding emotion by detachment and soothing, (b) people pleasing by compliance and surrender; 4) Help seeking including (a) barriers to recovery from an eating disorder, (b) dissatisfaction with interventions experienced to date, (c) schema therapy as a promising alternative.DiscussionParticipants recognised and identified with their high scoring schema modes. After negative experiences with previous interventions, they considered schema therapy to be a promising alternative that could understand and work on their deeper psychological issues. This suggests that schema modes are a promising way of understanding and working with enduring eating disorders.

Taking John Schulenberg's "long view" on successful transitions to adulthood: Associations with adult substance use.

Can positive transitions into young adulthood at age 25 prevent problematic substance use at age 31, even in the context of childhood adverse family environments, conduct problems, and adolescent substance use? We lean on John Schulenberg's developmental framework to examine this question, focusing on the potential young adult milestones of high school and college graduation, employment, residential independence, romantic partnership, and parenthood. Data came from a prospective-longitudinal multi-method study with N = 1199 participants who were first assessed at age 5 years old and followed to age 31. An accumulation of positive transitions in young adulthood (age 25) was associated with lower likelihood of age 31 problematic cannabis use. The protective effect for problematic cannabis use remained even when adjusting for childhood adverse family environments and was primarily driven by successful college graduation and/or home ownership. The accumulation of positive transitions protected individuals at modest to somewhat elevated risk due to childhood adverse family environments from experiencing age 31 cannabis use problems. However, for other individuals with very high numbers of conduct problems, or with high levels of adolescent substance use, the protective effects of accumulated positive transitions to young adulthood were less strong or nonexistent. Moreover, individuals who completed college or obtained full-time employment by 25 were more likely to report problematic age 31 alcohol use. These findings highlight the central tenets of John Schulenberg's developmental framework, including the examination of ontogenetic continuity and discontinuity, the interplay of developmentally distal and proximal effects, and the identification of developmental protective factors that may sway people toward or away from substance use.

Vices in Competitve Sports and Barriers That Hinder Inculcating Values among Learners in Primary and Secondary Schools Kenya

Education systems worldwide aim to not only impart knowledge but also instill values among learners. In Kenya, this objective faces several vices and barriers that hinder the effective inculcation of values in primary and secondary schools. Despite efforts to promote values in educational settings, vices such as cheating, fighting, and drug use remain prevalent in competitive sports within Kenyan schools. The objective of the study was to explore the prevalence of vices and the barriers hindering the inculcation of values among learners in primary and secondary schools in Kenya, particularly within the context of competitive sports. The study employed a mixed-method approach, incorporating both qualitative and quantitative methods. A cross-sectional survey design was used to collect data from schools across 24 counties, targeting school administrators, teachers, learners, and key informants. The sample included head teachers, teachers, learners, and stakeholders from various community sectors. Data collection instruments included questionnaires, interview schedules, and focus group discussions, with pre-testing to ensure reliability and validity. The findings highlight significant challenges in promoting values within the educational system. Vices such as cheating (39.3%), fighting (24.0%), and drug use (18.0%) are prevalent in competitive sports, undermining the ethos of sportsmanship and creating adverse environments for value promotion. Despite efforts to implement value-based education, barriers such as peer pressure (36.2%), lack of role models (45.1%), heavy academic workloads, and the influence of social media persist, impeding the effective inculcation of values among learners. In conclusion, the study indicates that vices such as cheating, fighting, and drug use are prevalent in competitive sports within Kenyan schools, posing significant challenges to the promotion of values among learners. To address these challenges, the study suggests several interventions. Strengthening value-based education through curriculum integration and ethical teachings that can foster critical thinking and ethical behavior among learners. Additionally, implementing stricter oversight and penalties for examination malpractices are necessary to maintain academic integrity.

Beyond Algorithmic Disclosure for Generative AI

One of the most commonly recommended policy interventions with respect to algorithms in general and artificial intelligence (“AI”) systems in particular is the need for greater transparency, often focusing on the disclosure of the variables employed by the algorithm and the weights given to those variables. This Essay argues that any meaningful transparency regime must provide information on other critical dimensions as well. For example, any transparency regime must also include key information about the data on which the algorithm was trained, including its source, scope, quality, and inner correlations, subject to constraints imposed by copyright, privacy, and cybersecurity law. Disclosures about pre-release testing also play a critical role in understanding an AI system’s robustness and its susceptibility to specification gaming. Finally, the fact that AI, like all complex systems, tends to exhibit emergent phenomena, such as proxy discrimination, interactions among multiple agents, the impact of adverse environments, and the well-known tendency of generative AI to hallucinate, makes ongoing post-release evaluation a critical component of any system of AI transparency.

Significant Differences in Intestinal Bacterial Communities of Sympatric Bean Goose, Hooded Crane, and Domestic Goose.

The host's physiological well-being is intricately associated with the gut microbiota. However, previous studies regarding the intestinal microbiota have focused on domesticated or captive birds. This study used high-throughput sequencing technology to identify the gut bacterial communities of sympatric bean geese, hooded cranes, and domestic geese. The results indicated that the gut bacterial diversity in domestic geese and hooded cranes showed considerably higher diversity than bean geese. The gut bacterial community compositions varied significantly among the three hosts (p < 0.05). Compared to the hooded crane, the bean goose and domestic goose were more similar in their genotype and evolutionary history, with less difference in the bacterial community composition and assembly processes between the two species. Thus, the results might support the crucial role of host genotypes on their gut microbiota. The gut bacteria of wild hooded cranes and bean geese had a greater capacity for energy metabolism compared to domestic geese, suggesting that wild birds may rely more on their gut microbiota to survive in cold conditions. Moreover, the intestines of the three hosts were identified as harboring potential pathogens. The relative abundance of pathogens was higher in the hooded crane compared to the other two species. The hooded crane gut bacterial community assemblage revealed the least deterministic process with the lowest filtering/selection on the gut microbiota, which might have been a reason for the highest number of pathogens result. Compared to the hooded crane, the sympatric bean goose showed the least diversity and relative abundance of pathogens. The intestinal bacterial co-occurrence network showed the highest stability in the bean goose, potentially enhancing host resistance to adverse environments and reducing the susceptibility to pathogen invasion. In this study, the pathogens were also discovered to overlap among the three hosts, reminding us to monitor the potential for pathogen transmission between poultry and wild birds. Overall, the current findings have the potential to enhance the understanding of gut bacterial and pathogenic community structures in poultry and wild birds.

Exploring the relationship between hemodynamics and the immune microenvironment in carotid atherosclerosis: Insights from CFD and CyTOF technologies

Carotid atherosclerosis is a major cause of stroke. Hemodynamic forces, such as shear stress and oscillatory shear, play an important role in the initiation and progression of atherosclerosis. The alteration of the immune microenvironment is the fundamental pathological mechanism by which diverse external environmental factors impact the formation and progression of plaques. However, Current research on the relationship between hemodynamics and immunity in atherosclerosis still lack of comprehensive understanding. In this study, we combined computational fluid dynamics (CFD) and Mass cytometry (CyTOF) technologies to explore the changes in the immune microenvironment within plaques under different hemodynamic conditions. Our results indicated that neutrophils were enriched in adverse flow environments. M2-like CD163+CD86+ macrophages were predominantly enriched in high WSS and low OSI environments, while CD163-CD14+ macrophages were enriched in low WSS and high OSI environments. Functional analysis further revealed T cell pro-inflammatory activation and dysregulation in modulation, along with an imbalance in M1-like/M2-like macrophages, suggesting their potential involvement in the progression of atherosclerotic lesions mediated by adverse flow patterns. Our study elucidated the potential mechanisms by which hemodynamics regulated the immune microenvironment within plaques, providing intervention targets for future precision therapies.

Intestinal Delivery of Probiotics: Materials, Strategies, and Applications.

Probiotics with diverse and crucial properties and functions have attracted broad interest from many researchers, who adopt intestinal delivery of probiotics to modulate the gut microbiota. However, the major problems faced for the therapeutic applications of probiotics are the viability and colonization of probiotics during their processing, oral intake, and subsequent delivery to the gut. The challenges of simple oral delivery (stability, controllability, targeting, etc.) have greatly limited the use of probiotics in clinical therapies. Nanotechnology can endow the probiotics to be delivered to the intestine with improved survival rate and increased resistance to the adverse environment. Additionally, the progress in synthetic biology has created new opportunities for efficiently and purposefully designing and manipulating the probiotics. In this article, a brief overview of the types of probiotics for intestinal delivery, the current progress of different probiotic encapsulation strategies, including the chemical, physical, and genetic strategies and their combinations, and the emerging single-cell encapsulation strategies using nanocoating methods, is presented. The action mechanisms of probiotics that are responsible for eliciting beneficial effects are also briefly discussed. Finally, the therapeutic applications of engineered probiotics are discussed, and the future trends toward developing engineered probiotics with advanced features and improved health benefits are proposed.

Methodological approaches in the study of hydric stress in plants

Drought significantly affects plant growth and development, having a negative impact on the productivity of crops and, respectively, on food security worldwide. To predict the response of agricultural crops to future global warming and water deficit and to develop effective risk management strategies, there is a need to understand, at various levels of organization, the processes that determine tolerance to adverse environments. In this context it is important to use appropriate models of hydric stress induction and response assessment. The paper presents a brief description of the methodological approaches used in plant drought stress studies (field, greenhouse, laboratory experiments; experimental models using different types of substrates; distinct methods to induce water deficit), reflects their particularities, advantages and limitations and highlights the importance of combining and adapting methods of analysis according to the studied species, the environment and the research objectives.

Genome-wide characterization of Remorin gene family and their responsive expression to abiotic stresses and plant hormone in Brassica napus.

Remorin proteins could be positively related to salt and osmotic stress resistance in rapeseed. Remorins (REMs) play a crucial role in adaptations to adverse environments. However, their roles in abiotic stress and phytohormone responses in oil crops are still largely unknown. In this study, we identified 47 BnaREM genes in the B.napus genome. Phylogenetic relationship and synteny analysis revealed that they were categorized into 5 distinct groups and have gone through 55 segmental duplication events under purifying selection. Gene structure and conserved domains analysis demonstrated that they were highly conserved and all BnaREMs contained a conserved Remorin_C domain, with a variable N-terminal region. Promoter sequence analysis showed that BnaREM gene promoters contained various hormones and stress-related cis-acting elements. Transcriptome data from BrassicaEDB database exhibited that all BnaREMs were ubiquitously expressed in buds, stamens, inflorescences, young leaves, mature leaves, roots, stems, seeds, silique pericarps, embryos and seed coats. The qRT-PCR analysis indicated that most of them were responsive to ABA, salt and osmotic treatments. Further mutant complementary experiments revealed that the expression of BnaREM1.3-4C-1 in the Arabidopsis rem1.3 mutant restored the retarded growth phenotype and the ability to resistance to salt and osmotic stresses. Our findings provide fundamental information on the structure and evolutionary relationship of the BnaREM family genes in rapeseed, and reveal the potential function of BnaREM1.3-4C-1 in stress and hormone response.

Antimicrobial mechanism of morusin against Bacillus cereus and its potential as an antimicrobial agent

Bacillus cereus, a food-borne pathogen, threatens human health and food safety. The quest for biologically active substances from natural sources acting as antimicrobial agents for the replacement of antibiotics and chemical additives has received increasing attention. In this study, the antimicrobial mechanism of morusin against B. cereus was outlined, as well as its function as a food supplement to extend the shelf-life of skimmed milk was assessed. Our findings demonstrated that the minimum inhibitory concentration (MIC) value of morusin against B. cereus was 2.25 μg/mL, inhibiting biofilm formation and reducing intracellular ATP and membrane depolarization by disturbing the permeability of the B. cereus cytoplasmic membrane. Damage or collapse of B. cereus cell membranes produced by morusin was identified using the field gun scanning electron microscope (FEG-SEM). Transcriptomic assessment indicated that the two-component system of B. cereus (narG, narH, narI, phoP, phoR, motA) responded positively to morusin within an adverse environment. Moreover, several genes associated with cell membrane and cell wall generation (murA, murB, ddlB) and amino acid metabolism (argF, argH, BCN_RS02850) were significantly downregulated, potentially accelerating the death of B. cereus. In addition, metabolomic investigation suggested that morusin restricted pyruvate metabolism, cysteine and methionine metabolic pathways, and disturbed the intracellular amino acid metabolism of B. cereus. Ultimately, 4.5 μg/mL of morusin was determined to significantly inhibit the growth of B. cereus within skimmed milk. Overall, morusin can be utilized as a natural antimicrobial agent for regulating B. cereus contamination in skimmed milk.

Proline priming: An efficient strategy to mitigate salinity impact at early developmental stages of the oilseed halophyte Cakile maritima

Seed germination is a vital process, yet extremely sensitive to salinity. This is particularly true for coastal halophytes like the annual oilseed species Cakile maritima, which faces the simultaneous impact of wind, salt-spray and seawater inundations in its natural biotopes. At the early developmental stages, this may jeopardize seed germination, plant establishment capacity and hence its development and persistence. Osmopriming is a pre-sowing approach aiming to improve seedling emergence and establishment in adverse environments. Here, we investigate the effect of proline (at 0, 1, 5, and 20 mM) pre-treatment on salt tolerance of C. maritima at the juvenile stage under salinity (0, 100, and 200 mM NaCl). Proline seed priming enhanced the germination rate (28% to 92%) and promoted seedling establishment of C. maritima by stimulating α-amylase activity even at the highest salinity (+55 %). Besides, after transfer of non-germinated seeds on distilled water, salt impact was fully reversible. At the seedling stage, chlorophyll fluorescence parameters showed that this osmoticum increased the maximal quantum yield of PSII photochemistry (Fv/Fm) and the quantum yield of photochemical energy conversion [Y(II)]. In contrast, the quantum yield of nonregulated nonphotochemical energy dissipation [Y(NO)] and the quantum yield of regulated nonphotochemical energy dissipation [Y(NPQ)], which might be correlated to the mitigation of the salt deleterious effects on PSII. Proline and carbohydrate concentrations also increased following priming. Overall, our data provide strong arguments for using proline at low doses (1 and 5 mM) as a successful priming agent to alleviate salinity-induced adverse effect on plants.

Ouabain, ATPase inhibitor, potentially enhances the effect of polyhexamethylene biguanide on Acanthamoeba castellanii

Acanthamoeba, a free-living amoeba, is commonly found in various natural environments, such as rivers and soil, as well as in public baths, swimming pools, and sewers. Acanthamoeba can cause severe illness such as granulomatous amoebic encephalitis and Acanthamoeba keratitis (AK) in humans. AK, the most recognized disease, can cause permanent visual impairment or blindness by affecting the cornea. AK commonly affects contact lens wearers who neglect proper cleaning habits. The symptoms of AK include epithelial and stromal destruction, corneal infiltrate, and intense ocular pain, occasionally necessitating surgical removal of the entire eyeball. Current AK treatment involves the hourly application of eye drops containing polyhexamethylene biocide (PHMB). However, studies have revealed their ineffectiveness against drug-resistant strains. Acanthamoeba can form cysts as a survival mechanism in adverse environments, though the exact mechanism remains unknown. Our experiments revealed that sodium P-type ATPase (ACA1_065450) is closely linked to encystation. In addition, various encystation buffers, such as MgCl2 or NaCl, induced the expression of P-type ATPase. Furthermore, we used ouabain, an ATPase inhibitor, to inhibit the Na+/K+ ion pump, consequently decreasing the encystation rate of Acanthamoeba. Our primary objective is to develop an advanced treatment for AK. We anticipate that the combination of ouabain and PHMB may serve as an effective therapeutic approach against AK in the future.

Queuosine biosynthetic enzyme, QueE moonlights as a cell division regulator.

In many organisms, stress responses to adverse environments can trigger secondary functions of certain proteins by altering protein levels, localization, activity, or interaction partners. Escherichia coli cells respond to the presence of specific cationic antimicrobial peptides by strongly activating the PhoQ/PhoP two-component signaling system, which regulates genes important for growth under this stress. As part of this pathway, a biosynthetic enzyme called QueE, which catalyzes a step in the formation of queuosine (Q) tRNA modification is upregulated. When cellular QueE levels are high, it co-localizes with the central cell division protein FtsZ at the septal site, blocking division and resulting in filamentous growth. Here we show that QueE affects cell size in a dose-dependent manner. Using alanine scanning mutagenesis of amino acids in the catalytic active site, we pinpoint residues in QueE that contribute distinctly to each of its functions-Q biosynthesis or regulation of cell division, establishing QueE as a moonlighting protein. We further show that QueE orthologs from enterobacteria like Salmonella typhimurium and Klebsiella pneumoniae also cause filamentation in these organisms, but the more distant counterparts from Pseudomonas aeruginosa and Bacillus subtilis lack this ability. By comparative analysis of E. coli QueE with distant orthologs, we elucidate a unique region in this protein that is responsible for QueE's secondary function as a cell division regulator. A dual-function protein like QueE is an exception to the conventional model of "one gene, one enzyme, one function", which has divergent roles across a range of fundamental cellular processes including RNA modification and translation to cell division and stress response.

Social Environment, Lifestyle, and Genetic Predisposition With Dementia Risk: A Long-Term Longitudinal Study Among Older Adults.

The role of social environment, that is, the aggregate effect of social determinants of health (SDOHs), in determining dementia is unclear. We developed a novel polysocial risk score for dementia based on 19 SDOH among 5199 participants in the Health and Retirement Study, United States, to measure the social environmental risk. We used a survival analysis approach to assess the association between social environment and dementia risk in 2006-2020. We further studied the interaction between social environment and lifestyles, and explored racial disparities. The study participants (mean age = 73.4 years, SD = 8.3; 58.0% female; 11.6% African American) were followed up for an average of 6.2 years, and 1089 participants developed dementia. Every 1-point increase in the polysocial risk score (ranging from 0 to 10) was associated with a 21.6% higher risk (adjusted hazard ratio [aHR] = 1.21, 95% confidence intervals [95% CI] = 1.15-1.26) of developing dementia, other things being equal. Among participants with high social environmental risk, regular exercise and moderate drinking were associated with a 43%-60% lower risk of developing dementia (p < .001). In addition, African Americans were 1.3 times (aHR = 2.28, 95% CI = 1.96-2.66) more likely to develop dementia than European Americans, other things being equal. An adverse social environment is linked to higher dementia risk, but healthy lifestyles can partially offset the increased social environmental risk. The polysocial risk score can complement the existing risk tools to identify high-risk older populations, and guide the design of targeted social environmental interventions, particularly focusing on improving the companionship of the older people, to prevent dementia.

Transcription factor shapes chromosomal conformation and regulates gene expression in bacterial adaptation.

Genomic mutations allow bacteria to adapt rapidly to adverse stress environments. The three-dimensional conformation of the genome may also play an important role in transcriptional regulation and environmental adaptation. Here, using chromosome conformation capture, we investigate the high-order architecture of the Zymomonas mobilis chromosome in response to genomic mutation and ambient stimuli (acetic acid and furfural, derived from lignocellulosic hydrolysate). We find that genomic mutation only influences the local chromosome contacts, whereas stress of acetic acid and furfural restrict the long-range contacts and significantly change the chromosome organization at domain scales. Further deciphering the domain feature unveils the important transcription factors, Ferric uptake regulator (Fur) proteins, which act as nucleoid-associated proteins to promote long-range (>200 kb) chromosomal communications and regulate the expression of genes involved in stress response. Our work suggests that ubiquitous transcription factors in prokaryotes mediate chromosome organization and regulate stress-resistance genes in bacterial adaptation.

All‐Optically Triggered In‐Sensor Collision Detection and Warning Based on 2D Complementary Material Devices

AbstractPrecise and timely collision detection and warning are essential to ensure the safety of autonomous driving. However, existing collision detection systems based on image sensors and radars are prone to misjudgment in adverse environments such as darkness or rain. The lobula giant movement detector (LGMD) neuron found in locusts achieves potential collision detection in unpredictable environments without the need for object recognition algorithms. Existing artificial collision detectors inspired by LGMD suffer from complex device structures and sophisticated operating modes. Here, an LGMD‐inspired all‐optically triggered in‐sensor collision detector is presented by 2D complementary material devices (2D‐CMDs) composed of n‐type molybdenum disulfide (MoS2) and p‐type platinum diselenide (PtSe2) connected in series. The proposed 2D‐CMDs couple the positive photoconductivity of MoS2 and negative photoconductivity of PtSe2 in response to looming light, successfully mimicking the antagonism of excitatory and inhibitory responses in LGMD neurons to generate a nonmonotonic escape response. The 2D‐CMDs exhibit a simple device structure and all‐optically controlled operation mode, consuming only 1 nJ of energy for each collision detection. Furthermore, in‐sensor real‐time collision warning is realized by employing a Recurrent Neural Network (RNN) to predict alarm time based on the escape response of the proposed 2D‐CMDs.

Early-life exposures and long-term health: adverse gestational environments and the programming of offspring renal and vascular disease.

According to the Developmental Origins of Health and Disease hypothesis, exposure to certain environmental influences during early life may be a key determinant of fetal development and short- and long-term offspring health. Indeed, adverse conditions encountered during the fetal, perinatal, and early childhood stages can alter normal development and growth, as well as put the offspring at elevated risk of developing long-term health conditions in adulthood, including chronic kidney disease and cardiovascular diseases. Of relevance in understanding the mechanistic basis of these long-term health conditions are previous findings showing low glomerular number in human intrauterine growth restriction and low birth weight-indicators of a suboptimal intrauterine environment. In different animal models, the main suboptimal intrauterine conditions studied relate to maternal dietary manipulations, poor micronutrient intake, prenatal ethanol exposure, maternal diabetes, glucocorticoid and chemical exposure, hypoxia, and placental insufficiency. These studies have demonstrated changes in kidney structure, glomerular endowment, and expression of key genes and signaling pathways controlling endocrine, excretion, and filtration function of the offspring. This review aims to summarize those studies to uncover the effects and mechanisms by which adverse gestational environments impact offspring renal and vascular health in adulthood. This is important for identifying agents and interventions that can prevent and mitigate the long-term consequences of an adverse intrauterine environment on the subsequent generation.NEW & NOTEWORTHY Human data and experimental animal data show that suboptimal environments during fetal development increase the risk of renal and vascular diseases in adult-life. This is related to permanent changes in kidney structure, function, and expression of genes and signaling pathways controlling filtration, excretion, and endocrine function. Uncovering the mechanisms by which offspring renal development and function is impacted is important for identifying ways to mitigate the development of diseases that strain health care services worldwide.

High mortality following early initiation of antiretroviral therapy in infants living with HIV from three African countries

Even with increasing access to rapid HIV diagnosis and early antiretroviral therapy (ART) initiation, infants living with HIV seem to have adverse outcomes. We assessed the probability of death, viral suppression, and other HIV-related events in the first three years of life among early-treated children with perinatally-acquired HIV in South Africa, Mozambique, and Mali. We enrolled a cohort of infants who initiated ART within the initial 6 months of life and within 3 months of diagnosis. These children were monitored 2, 6, 12 and 24 weeks after enrolment, followed by biannual check-ups up to 4 years after enrolment. We assessed the probability of death, viral load (VL) suppression, severe immunosuppression (according to WHO guidelines), and engagement in care using Kaplan-Meier plots, and hazard ratios for these outcomes using multivariable Cox regression models. Two hundred and fifteen infants were enrolled and monitored for a median of 34 months [IQR, 16.3; 44.1]. ART initiation occurred at a median of 34 days of age [IQR, 26.0; 73.0]. The probability of death at 1 year of ART was 10% (95% CI, 6-14), increased to 12% (95% CI, 8-17) at 2 and remained in 12% at 3 years. The main risk factor for HIV/AIDS-related mortality was baseline viral load [HR: 2.98 (95% CI, 1.25-7.12)]. Sixty-one of 146 (42%) children achieved sustained virological control below lower limit of detection for any ≥1 year period between enrolment and 4 years after enrolment. Viral suppression during follow-up was inversely associated with baseline viral load [Hazard Ratio (HR): 0.72 (95% CI, 0.58-0.89] and adverse maternal social events [HR: 0.26 (95% CI, 0.15-0.45)]. Adherence to ART was assessed as optimal in 81% of the visits. Female sex at birth, lower age at diagnosis and maternal adverse social life events were risk factors for low adherence [Odds ratio, OR 1.25 (95% CI, 1.00-1.56); 1.12 (95% CI, 1.01-1.27) and 2.52 (95% CI, 2.16-12.37), respectively]. Despite early ART, mortality remains high in infants. High baseline VL and adverse maternal social environment increased the risk of poor outcomes. Sustained supportive strategies are essential during and after pregnancy, to achieve better survival. Early Treated Perinatally HIV Infected Individuals: Improving Children's Actual Life (EPIICAL) is a research consortium funded by ViiV Healthcare and led by Penta Foundation. The funder was not involved in the analysis and interpretation of data, writing of the report, or the decision to submit the paper for publication. The corresponding authors had access to all data and take final responsibility for the decision to submit.

Cultural adaptation in the era of climate change: An ethnographic study on the resilience of indigenous people at Chittagong Hill Tracts area in Bangladesh

Climate change has gained global recognition as one of the most urgent challenges in recent decades. Many indigenous people attempt to overcome great challenges in their lives by adhering to their cultural customs and traditional knowledge. This is especially true for those who live in isolated, hilly places and are dependent on natural resources. The aim of the paper is to critically investigate the cultural facets of indigenous people's adaptation to and resilience to climate change in the Chittagong Hill Tracts (CHT), namely in the Rangamati Sadar sub-districts of the Rangamati districts, in Bangladesh. This paper also examines how cultural components in indigenous community are changing and influencing the adaptation process in adverse situations. This study used a critical ethnography technique in conjunction with participant observation, in-depth interviews (N ​= ​55), and focus group discussions (N ​= ​5, 45 participants) during a one-year period (October 2019 to October 2020). According to the study's findings, climate change-related risks have significant adverse effects on indigenous people. However, they develop their strategies to adjust to the adverse environment, like building different kinds of houses, changing cultural customs, relying less on natural resources, and adhering to their indigenous knowledge. They also strengthen their prayers and ceremonial practices, which reinforce their communal ties and allow them to become more resilient against challenges in their community. The popular belief that Indigenous people are stupid, poor, and helpless while they wait for outside help is challenged by this study. It also refutes the discourse that indigenous strategies and knowledge are not undervalued and can be an effective instrument for the adaptation process and combating hazards.

Identity Crises In The Novel of Anita Desai Voices In The City

Identity Crises In The Novel of Anita Desai Voices In The City