Displaying publications 1 - 20 of 21 in total

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  1. Muhammad SA, Frew RD, Hayman AR
    Front Chem, 2015;3:12.
    PMID: 25774366 DOI: 10.3389/fchem.2015.00012
    Compound-specific isotope analysis (CSIA) offers great potential as a tool to provide chemical evidence in a forensic investigation. Many attempts to trace environmental oil spills were successful where isotopic values were particularly distinct. However, difficulties arise when a large data set is analyzed and the isotopic differences between samples are subtle. In the present study, discrimination of diesel oils involved in a diesel theft case was carried out to infer the relatedness of the samples to potential source samples. This discriminatory analysis used a suite of hydrocarbon diagnostic indices, alkanes, to generate carbon and hydrogen isotopic data of the compositions of the compounds which were then processed using multivariate statistical analyses to infer the relatedness of the data set. The results from this analysis were put into context by comparing the data with the δ(13)C and δ(2)H of alkanes in commercial diesel samples obtained from various locations in the South Island of New Zealand. Based on the isotopic character of the alkanes, it is suggested that diesel fuels involved in the diesel theft case were distinguishable. This manuscript shows that CSIA when used in tandem with multivariate statistical analysis provide a defensible means to differentiate and source-apportion qualitatively similar oils at the molecular level. This approach was able to overcome confounding challenges posed by the near single-point source of origin, i.e., the very subtle differences in isotopic values between the samples.
  2. Muhammad SA, Hayman AR, Van Hale R, Frew RD
    J Forensic Sci, 2015 Jan;60 Suppl 1:S56-65.
    PMID: 25131396 DOI: 10.1111/1556-4029.12551
    Compound-specific isotope analysis offers potential for fingerprinting of diesel fuels, however, possible confounding effects of isotopic fractionation due to evaporation need to be assessed. This study measured the fractionation of the stable carbon and hydrogen isotopes in n-alkane compounds in neat diesel fuel during evaporation. Isotope ratios were measured using a continuous flow gas chromatograph/isotope ratio mass spectrometer. Diesel samples were progressively evaporated at 24 ± 2°C for 21 days. Increasing depletion of deuterium in nC12-nC17 alkanes in the remaining liquid with increasing carbon chain length was observed. Negligible carbon isotope fractionation was observed. Preferential vaporization was measured for the shorter chain n-alkanes and the trend decreased with increasing chain length. The decrease in δ(2) H values indicates the preferential vaporization of the isotopically heavier species consistent with available quantitative data for hydrocarbons. These results are most important in the application of stable isotope technology to forensic analysis of diesel.
  3. Malik AA, Williams CA, Weston KL, Barker AR
    J Sports Sci Med, 2019 03;18(1):1-12.
    PMID: 30787646
    High-intensity interval exercise (HIIE) may not elicit prominent unpleasant feelings even with elevated perceived exertion and physiological stress in adolescents. However, the influence of different HIIE work intensities on the affective experience and cardiorespiratory responses is unknown. This study examined the acute affective, enjoyment, perceived exertion and cardiorespiratory responses to HIIE with different work intensities in adolescents. Participants (n = 16; 8 boys; age 12.0 ± 0.3 years) performed, on separate days, HIIE conditions consisting of 8 x 1-minute work-intervals at 70%, 85%, or 100% peak power separated by 75 seconds recovery at 20 W. Affect, enjoyment and rating of perceived exertion (RPE) were recorded before, during, and after HIIE. Heart rate (HR) and oxygen uptake were collected during HIIE. Affect declined in all conditions (p < 0.01) but 100%HIIE elicited significantly lower affect than 70%HIIE and 85%HIIE at work-interval 8 (all p < 0.02, ES > 1.74; 70%HIIE = 2.5 ± 0.8; 85%HIIE = 1.1 ± 1.5; 100%HIIE = -1.5 ± 1.4 on feeling scale). Similar enjoyment was evident during and after all conditions (all p > 0.44). RPE was significantly higher during 100%HIIE than 70%HIIE and 85%HIIE across all work-intervals (all p < 0.01, ES > 1.56). The majority of the participants attained ≥90%HRmax during 85%HIIE (87%) and 100%HIIE (100%), but not during 70%HIIE (6%). Affect responses during HIIE are dependent on the intensity of the work-interval and are not entirely negative (unpleasant feelings). Despite similar enjoyment, positive affect experienced during 70%HIIE and 85%HIIE could serve as a strategy to encourage exercise adoption and adherence in adolescents, but only 85%HIIE elicits sufficient HR stimulus to facilitate potential health benefits.
  4. Malik AA, Williams CA, Weston KL, Barker AR
    Int J Psychophysiol, 2018 11;133:140-148.
    PMID: 30044953 DOI: 10.1016/j.ijpsycho.2018.07.473
    OBJECTIVES: Affect experienced during high-intensity interval exercise (HIIE) is dependent on work-intensity, but the influence of increasing (low-to-high (L-H)) or decreasing (high-to-low (H-L)) work-intensity during HIIE remains unclear in adolescents. The role of prefrontal cortex haemodynamics in mediating changes in affect during HIIE also remains unexplored in adolescents. We examined affect, enjoyment and cerebral haemodynamic responses to HIIE with increasing or decreasing work intensities in adolescents.

    METHODS: Participants (N = 16; 8 boys; age 12.5 ± 0.8 years) performed, on separate days, HIIE cycling consisting of 8 × 1-min work-intervals at 100%-to-70% (HIIEH-L), 70%-to-100% (HIIEL-H) or 85% (HIIECON) peak power separated by 75 s recovery. Affect, enjoyment and cerebral haemodynamics (oxygenation (∆O2Hb), deoxygenation (∆HHb) and tissue oxygenation index (TOI)) were recorded before, during, and after all conditions.

    RESULTS: Affect and enjoyment were lower during HIIEH-L compared to HIIEL-H and HIIECON at work-intervals 1 to 3 (all P  0.83) but were greater during HIIEH-L than HIIEL-H and HIIECON at work-interval 8 (all P  0.83). ∆O2Hb was similar across conditions (P = 0.87) but TOI and ∆HHb were significantly greater and lower, respectively during HIIEH-L compared to HIIEL-H and HIIECON at work-interval 8 (all P  0.40). Affect was correlated with TOI (all r > 0.92) and ∆HHb (all r > -0.73) across conditions.

    CONCLUSIONS: HIIEH-L offers advancement to the HIIECON and HIIEL-H which bring significant greater affect and enjoyment towards the end HIIE work-interval, implicating the feasibility and adoption of this protocol for health promotion in youth. Also, changes in prefrontal cortex haemodynamics are associated with the affect during HIIE.

  5. Watabe M, Kato TA, Teo AR, Horikawa H, Tateno M, Hayakawa K, et al.
    PLoS One, 2015;10(3):e0120183.
    PMID: 25836972 DOI: 10.1371/journal.pone.0120183
    Maladaptive social interaction and its related psychopathology have been highlighted in psychiatry especially among younger generations. In Japan, novel expressive forms of psychiatric phenomena such as "modern-type depression" and "hikikomori" (a syndrome of severe social withdrawal lasting for at least six months) have been reported especially among young people. Economic games such as the trust game have been utilized to evaluate real-world interpersonal relationships as a novel candidate for psychiatric evaluations. To investigate the relationship between trusting behaviors and various psychometric scales, we conducted a trust game experiment with eighty-one Japanese university students as a pilot study. Participants made a risky financial decision about whether to trust each of 40 photographed partners. Participants then answered a set of questionnaires with seven scales including the Lubben Social Network Scale (LSNS)-6 and the Patient Health Questionnaire (PHQ)-9. Consistent with previous research, male participants trusted partners more than female participants. Regression analysis revealed that LSNS-family (perceived support from family) for male participants, and item 8 of PHQ-9 (subjective agitation and/or retardation) for female participants were associated with participants' trusting behaviors. Consistent with claims by social scientists, our data suggest that, for males, support from family was negatively associated with cooperative behavior toward non-family members. Females with higher subjective agitation (and/or retardation) gave less money toward males and high attractive females, but not toward low attractive females in interpersonal relationships. We believe that our data indicate the possible impact of economic games in psychiatric research and clinical practice, and validation in clinical samples including modern-type depression and hikikomori should be investigated.
  6. Wilson CA, Berger JI, de Boer J, Sereda M, Palmer AR, Hall DA, et al.
    Hear Res, 2019 03 15;374:13-23.
    PMID: 30685571 DOI: 10.1016/j.heares.2019.01.009
    A common method for measuring changes in temporal processing sensitivity in both humans and animals makes use of GaP-induced Inhibition of the Acoustic Startle (GPIAS). It is also the basis of a common method for detecting tinnitus in rodents. However, the link to tinnitus has not been properly established because GPIAS has not yet been used to objectively demonstrate tinnitus in humans. In guinea pigs, the Preyer (ear flick) myogenic reflex is an established method for measuring the acoustic startle for the GPIAS test, while in humans, it is the eye-blink reflex. Yet, humans have a vestigial remnant of the Preyer reflex, which can be detected by measuring skin surface potentials associated with the Post-Auricular Muscle Response (PAMR). A similar electrical potential can be measured in guinea pigs and we aimed to show that the PAMR could be used to demonstrate GPIAS in both species. In guinea pigs, we compare the GPIAS measured using the pinna movement of the Preyer reflex and the electrical potential of the PAMR to demonstrate that the two are at least equivalent. In humans, we establish for the first time that the PAMR provides a reliable way of measuring GPIAS that is a pure acoustic alternative to the multimodal eye-blink reflex. Further exploratory tests showed that while eye gaze position influenced the size of the PAMR response, it did not change the degree of GPIAS. Our findings confirm that the PAMR is a sensitive method for measuring GPIAS and suggest that it may allow direct comparison of temporal processing between humans and animals and may provide a basis for an objective test of tinnitus.
  7. Tateno M, Teo AR, Shirasaka T, Tayama M, Watabe M, Kato TA
    Psychiatry Clin Neurosci, 2016 Dec;70(12):567-572.
    PMID: 27573254 DOI: 10.1111/pcn.12454
    AIM: Internet addiction (IA), also referred to as Internet use disorder, is a serious problem all over the world, especially in Asian countries. Severe IA in students may be linked to academic failure, attention-deficit hyperactivity disorder (ADHD), and forms of social withdrawal, such as hikikomori. In this study, we performed a survey to investigate the relation between IA and ADHD symptoms among college students.

    METHODS: Severity of IA and ADHD traits was assessed by self-report scales. Subjects were 403 college students (response rate 78%) who completed a questionnaire including Young's Internet Addiction Test (IAT) and the Adult ADHD Self-Report Scale-V1.1.

    RESULTS: Out of 403 subjects, 165 were male. The mean age was 18.4 ± 1.2 years, and mean total IAT score was 45.2 ± 12.6. One hundred forty-eight respondents (36.7%) were average Internet users (IAT < 40), 240 (59.6%) had possible addiction (IAT 40-69), and 15 (3.7%) had severe addiction (IAT ≥ 70). Mean length of Internet use was 4.1 ± 2.8 h/day on weekdays and 5.9 ± 3.7 h/day on the weekend. Females used the Internet mainly for social networking services while males preferred online games. Students with a positive ADHD screen scored significantly higher on the IAT than those negative for ADHD screen (50.2 ± 12.9 vs 43.3 ± 12.0).

    CONCLUSION: Our results suggest that Internet misuse may be related to ADHD traits among Japanese youth. Further investigation of the links between IA and ADHD is warranted.

  8. Kato TA, Teo AR, Tateno M, Watabe M, Kubo H, Kanba S
    Psychiatry Clin Neurosci, 2017 Jan;71(1):75-76.
    PMID: 27862668 DOI: 10.1111/pcn.12481
  9. Kato TA, Hashimoto R, Hayakawa K, Kubo H, Watabe M, Teo AR, et al.
    Psychiatry Clin Neurosci, 2016 Jan;70(1):7-23.
    PMID: 26350304 DOI: 10.1111/pcn.12360
    Japan's prototype of depression was traditionally a melancholic depression based on the premorbid personality known as shūchaku-kishitsu proposed by Mitsuzo Shimoda in the 1930s. However, since around 2000, a novel form of depression has emerged among Japanese youth. Called 'modern type depression (MTD)' by the mass media, the term has quickly gained popularity among the general public, though it has not been regarded as an official medical term. Likewise, lack of consensus guidelines for its diagnosis and treatment, and a dearth of scientific literature on MTD has led to confusion when dealing with it in clinical practice in Japan. In this review article, we summarize and discuss the present situation and issues regarding MTD by focusing on historical, diagnostic, psychosocial, and cultural perspectives. We also draw on international perspectives that begin to suggest that MTD is a phenomenon that may exist not only in Japan but also in many other countries with different sociocultural and historical backgrounds. It is therefore of interest to establish whether MTD is a culture-specific phenomenon in Japan or a syndrome that can be classified using international diagnostic criteria as contained in the ICD or the DSM. We propose a novel diagnostic approach for depression that addresses MTD in order to combat the current confusion about depression under the present diagnostic systems.
  10. Malik AA, Williams CA, Bond B, Weston KL, Barker AR
    Eur J Sport Sci, 2017 Nov;17(10):1335-1342.
    PMID: 28859545 DOI: 10.1080/17461391.2017.1364300
    This study aimed to examine adolescents' acute cardiorespiratory and perceptual responses during high-intensity interval exercise (HIIE) and enjoyment responses following HIIE and work-matched continuous moderate intensity exercise (CMIE). Fifty-four 12- to 15-year olds (27 boys) completed 8 × 1-min cycling at 90% peak power with 75-s recovery (HIIE) and at 90% of the gas exchange threshold (CMIE). Absolute oxygen uptake ([Formula: see text]), percentage of maximal [Formula: see text] (%[Formula: see text]), heart rate (HR), percentage of maximal HR (%HRmax) and ratings of perceived exertion (RPE) were collected during HIIE. Enjoyment was measured using the physical activity enjoyment scale (PACES) following HIIE and CMIE. Boys elicited higher absolute [Formula: see text] during HIIE work (p  1.22) and recovery (p  0.51) intervals but lower %[Formula: see text] during HIIE recovery intervals compared to girls (p  0.67). No sex differences in HR and %HRmaxwere evident during HIIE and 48 participants attained ≥90% HRmax. Boys produced higher RPE at intervals 6 (p = .004, ES = 1.00) and 8 (p = .003, ES = 1.00) during HIIE. PACES was higher after HIIE compared with CMIE (p = .003, ES = 0.58). Items from PACES "I got something out of it", "It's very exciting" and "It gives me a strong feeling of success" were higher after HIIE (all p  0.32). The items "I feel bored" and "It's not at all interesting" were higher after CMIE (all p  0.46). HIIE elicits a maximal cardiorespiratory response in most adolescents. Greater enjoyment after HIIE was due to elevated feelings of reward, excitement and success and may serve as a strategy to promote health in youth.
  11. Liu Y, Williams CA, Weston KL, Duncombe SL, Malik AA, Barker AR
    Pediatr Exerc Sci, 2024 Jan 08.
    PMID: 38194950 DOI: 10.1123/pes.2023-0084
    PURPOSE: Rating of perceived exertion (RPE) is a convenient and cost-effective tool that can be used to monitor high-intensity interval exercise (HIIE). However, no methodological study has demonstrated the validity of RPE in this context. Therefore, the aim of this study was to validate and calibrate RPE for monitoring HIIE in adolescents.

    METHODS: RPE, heart rate (HR), and oxygen uptake (V˙O2) data were retrospectively extracted from 3 lab-based crossover studies, with a pooled sample size of 45 adolescents, performing either cycling-based or running-based HIIE sessions. Within-participant correlations were calculated for RPE-HR and RPE-V˙O2, and receiver operator characteristic curve analysis was used to establish RPE cut points.

    RESULTS: The results showed that RPE-HR demonstrated acceptable criterion validity (r = .53-.74, P < .01), while RPE-V˙O2 had poor validity (r = .40-.48, P < .01), except for HIIE at 100% peak power (r = .59, P < .01). RPE cut points of 4 and 5 were established in corresponding to HR/V˙O2 based thresholds.

    CONCLUSION: RPE has some utility in evaluating intensity during lab-based running or cycling HIIE in adolescents. Future studies should expand the validation and calibration of RPE for prescribing and monitoring HIIE in children and adolescents in field-based contexts.

  12. Nomikou K, Dovas CI, Maan S, Anthony SJ, Samuel AR, Papanastassopoulou M, et al.
    PLoS One, 2009;4(7):e6437.
    PMID: 19649272 DOI: 10.1371/journal.pone.0006437
    Bluetongue virus (BTV) is the 'type' species of the genus Orbivirus within the family Reoviridae. The BTV genome is composed of ten linear segments of double-stranded RNA (dsRNA), each of which codes for one of ten distinct viral proteins. Previous phylogenetic comparisons have evaluated variations in genome segment 3 (Seg-3) nucleotide sequence as way to identify the geographical origin (different topotypes) of BTV isolates. The full-length nucleotide sequence of genome Seg-3 was determined for thirty BTV isolates recovered in the eastern Mediterranean region, the Balkans and other geographic areas (Spain, India, Malaysia and Africa). These data were compared, based on molecular variability, positive-selection-analysis and maximum-likelihood phylogenetic reconstructions (using appropriate substitution models) to 24 previously published sequences, revealing their evolutionary relationships. These analyses indicate that negative selection is a major force in the evolution of BTV, restricting nucleotide variability, reducing the evolutionary rate of Seg-3 and potentially of other regions of the BTV genome. Phylogenetic analysis of the BTV-4 strains isolated over a relatively long time interval (1979-2000), in a single geographic area (Greece), showed a low level of nucleotide diversity, indicating that the virus can circulate almost unchanged for many years. These analyses also show that the recent incursions into south-eastern Europe were caused by BTV strains belonging to two different major-lineages: representing an 'eastern' (BTV-9, -16 and -1) and a 'western' (BTV-4) group/topotype. Epidemiological and phylogenetic analyses indicate that these viruses originated from a geographic area to the east and southeast of Greece (including Cyprus and the Middle East), which appears to represent an important ecological niche for the virus that is likely to represent a continuing source of future BTV incursions into Europe.
  13. Kato TA, Katsuki R, Kubo H, Shimokawa N, Sato-Kasai M, Hayakawa K, et al.
    Psychiatry Clin Neurosci, 2019 Aug;73(8):448-457.
    PMID: 30900331 DOI: 10.1111/pcn.12842
    AIM: Understanding premorbid personality is important, especially when considering treatment selection. Historically, the premorbid personality of patients with major depression in Japan was described as Shuchaku-kishitsu [similar to Typus melancholicus], as proposed by Shimoda in the 1930s. Since around 2000, there have been increased reports in Japan of young adults with depression who have had premorbid personality differing from the traditional type. In 2005, Tarumi termed this novel condition 'dysthymic-type depression,' and more recently the condition has been called Shin-gata/Gendai-gata Utsu-byo [modern-type depression (MTD)]. We recently developed a semi-structured diagnostic interview to evaluate MTD. Development of a tool that enables understanding of premorbid personality in a short time, especially at the early stage of treatment, is desirable. The object of this study was to develop a self-report scale to evaluate the traits of MTD, and to assess the scale's psychometric properties, diagnostic accuracy, and biological validity.

    METHODS: A sample of 340 participants from clinical and community settings completed measures. Psychometric properties were assessed with factor analysis. Diagnostic accuracy of the MTD traits was compared against a semi-structured interview.

    RESULTS: The questionnaire contained 22 items across three subscales, thus we termed it the 22-item Tarumi's Modern-Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self-Esteem (TACS-22). Internal consistency, test-retest reliability, and convergent validity were all satisfactory. Among patients with major depression, the area under the curve was 0.757 (sensitivity of 63.1% and specificity of 82.9%) and the score was positively correlated with plasma tryptophan.

    CONCLUSION: The TACS-22 possessed adequate psychometric properties and diagnostic accuracy in an initial sample of Japanese adults. Additional research on its ability to support clinical assessment of MTD is warranted.

  14. Hayakawa K, Kato TA, Watabe M, Teo AR, Horikawa H, Kuwano N, et al.
    Sci Rep, 2018 02 13;8(1):2884.
    PMID: 29440704 DOI: 10.1038/s41598-018-21260-w
    Hikikomori, a severe form of social withdrawal syndrome, is a growing social issue in Japan and internationally. The pathophysiology of hikikomori has not yet been elucidated and an effective treatment remains to be established. Recently, we revealed that avoidant personality disorder is the most common comorbidity of hikikomori. Thus, we have postulated that avoidant personality is the personality underpinning hikikomori. First, we herein show relationships between avoidant personality traits, blood biomarkers, hikikomori-related psychological features, and behavioural characteristics assessed by a trust game in non-hikikomori volunteers. Avoidant personality traits were negatively associated with high-density lipoprotein cholesterol (HDL-C) and uric acid (UA) in men, and positively associated with fibrin degeneration products (FDP) and high sensitivity C-reactive protein (hsCRP) in women. Next, we recruited actual individuals with hikikomori, and compared avoidant personality traits, blood biomarkers, and psychological features between individuals with hikikomori and age-matched healthy controls. Individuals with hikikomori had higher avoidant personality scores in both sexes, and showed lower serum UA levels in men and lower HDL-C levels in women compared with healthy controls. This is the first report showing possible blood biomarkers for hikikomori, and opens the door to clarify the underlying biological pathophysiology of hikikomori.
  15. Byrne EM, Psychiatric Genetics Consortium Major Depressive Disorder Working Group, Raheja UK, Stephens SH, Heath AC, Madden PA, et al.
    J Clin Psychiatry, 2015 Feb;76(2):128-34.
    PMID: 25562672 DOI: 10.4088/JCP.14m08981
    OBJECTIVE: To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality.

    METHOD: Genome-wide association studies (GWASs) were conducted in Australian (between 1988 and 1990 and between 2010 and 2013) and Amish (between May 2010 and December 2011) samples in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered, and the results were meta-analyzed in a total sample of 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder, major depressive disorder (MDD), and schizophrenia were calculated to test for overlap in risk between psychiatric disorders and seasonality.

    RESULTS: The most significant association was with rs11825064 (P = 1.7 × 10⁻⁶, β = 0.64, standard error = 0.13), an intergenic single nucleotide polymorphism (SNP) found on chromosome 11. The evidence for overlap in risk factors was strongest for schizophrenia and seasonality, with the schizophrenia genetic profile scores explaining 3% of the variance in log-transformed global seasonality scores. Bipolar disorder genetic profile scores were also associated with seasonality, although at much weaker levels (minimum P value = 3.4 × 10⁻³), and no evidence for overlap in risk was detected between MDD and seasonality.

    CONCLUSIONS: Common SNPs of large effect most likely do not exist for seasonality in the populations examined. As expected, there were overlapping genetic risk factors for bipolar disorder (but not MDD) with seasonality. Unexpectedly, the risk for schizophrenia and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and schizophrenia.

  16. Sundara Rajoo K, Lepun P, Alan R, Singh Karam D, Abdu A, Rosli Z, et al.
    J Ethnopharmacol, 2023 Jan 30;301:115780.
    PMID: 36202163 DOI: 10.1016/j.jep.2022.115780
    ETHNOPHARMACOLOGICAL RELEVANCE: Sarawak is located in one of the world's most biodiverse regions and is home to more than 40 sub-ethnic groups that each have their own distinct culture, language and lifestyle. This has given rise to numerous, unique ethnobotanical systems. However, due to rapid urbanization, this traditional knowledge is at a risk of extinction. Yet, ethnobotanical studies in Sarawak are almost non-existent, especially among Orang Ulu communities like the Kenyah.

    AIM OF STUDY: Therefore, this study was conducted to document the ethnomedicinal knowledge of the Kenyah community. The main objectives of this study are: 1) To determine and document the diversity of medicinal plants used by the Kenyah community, 2) To determine whether the availability of modern medicine has affected Kenyah traditional medicine, and 3) To identify plants which have not been previously cited or used for previously unreported medical uses.

    MATERIALS AND METHODS: We conducted repeated interviews and field surveys at the Asap-Koyan Resettlement Area, Belaga Sarawak. A total of 24 respondents from four Kenyah longhouses were interviewed in this study. Individuals possessing extensive traditional medicinal knowledge were identified via preliminary interviews or by viva voce. Translators were employed to ensure that there was no miscommunication. The results were evaluated based on the plant's total use-reports and number of respondents citing the plant. The data was also evaluated based on use-reports by ailment category.

    RESULTS: Over 95% of the respondents were 40 years and older (58.21 years old ± 11.21). This was due to the younger members of the community (40 years old and below) admitting that they had almost no knowledge regarding traditional medicine, as they preferred relying on modern medicine. A total of 61 plant species were mentioned by the 24 respondents Seven plants had five or more respondents citing it, which was more than 20% of the respondents. These plants were Piper betle, Homalomena cordata, Senna alata, Annona muricata, Derris elliptica, Blumea balsamifera and Coscinium fenestratum.

    CONCLUSION: Almost all of the cited plants had been previously recorded to be used in either Ayurvedic, Chinese herbal medicine, Malay traditional medicine or other Asian ethnomedicinal systems. However, there were four highly cited species that were used for treatments that were scarcely reported in past literature. These were piper betle (used by Kenyah to treat fever), Sauropus andrognus (used by Kenyah to treat fever), Derris elliptica (used by Kenyah to treat fever and influenza) and Coscinuim fenestratum (used by Kenyah to treat toxic effects from non-medical substances).

  17. Janvier A, Lantos J, Aschner J, Barrington K, Batton B, Batton D, et al.
    Pediatrics, 2016 09;138(3).
    PMID: 27489297 DOI: 10.1542/peds.2016-0655
    For parents, the experience of having an infant in the NICU is often psychologically traumatic. No parent can be fully prepared for the extreme stress and range of emotions of caring for a critically ill newborn. As health care providers familiar with the NICU, we thought that we understood the impact of the NICU on parents. But we were not prepared to see the children in our own families as NICU patients. Here are some of the lessons our NICU experience has taught us. We offer these lessons in the hope of helping health professionals consider a balanced view of the NICU's impact on families.
  18. Bouvard V, Nethan ST, Singh D, Warnakulasuriya S, Mehrotra R, Chaturvedi AK, et al.
    N Engl J Med, 2022 Nov 24;387(21):1999-2005.
    PMID: 36378601 DOI: 10.1056/NEJMsr2210097
  19. Lundgren JD, Babiker AG, Sharma S, Grund B, Phillips AN, Matthews G, et al.
    NEJM Evid, 2023 Mar;2(3).
    PMID: 37213438 DOI: 10.1056/evidoa2200302
    BACKGROUND: For people with HIV and CD4+ counts >500 cells/mm3, early initiation of antiretroviral therapy (ART) reduces serious AIDS and serious non-AIDS (SNA) risk compared with deferral of treatment until CD4+ counts are <350 cells/mm3. Whether excess risk of AIDS and SNA persists once ART is initiated for those who defer treatment is uncertain.

    METHODS: The Strategic Timing of AntiRetroviral Treatment (START) trial, as previously reported, randomly assigned 4684 ART-naive HIV-positive adults with CD4+ counts .500 cells/mm3 to immediate treatment initiation after random assignment (n = 2325) or deferred treatment (n= 2359). In 2015, a 57% lower risk of the primary end point (AIDS, SNA, or death) for the immediate group was reported, and the deferred group was offered ART. This article reports the follow-up that continued to December 31, 2021. Cox proportional-hazards models were used to compare hazard ratios for the primary end point from randomization through December 31, 2015, versus January 1, 2016, through December 31, 2021.

    RESULTS: Through December 31, 2015, approximately 7 months after the cutoff date from the previous report, the median CD4+ count was 648 and 460 cells/mm3 in the immediate and deferred groups, respectively, at treatment initiation. The percentage of follow-up time spent taking ART was 95% and 36% for the immediate and deferred groups, respectively, and the time-averaged CD4+ difference was 199 cells/mm3. After January 1, 2016, the percentage of follow-up time on treatment was 97.2% and 94.1% for the immediate and deferred groups, respectively, and the CD4+ count difference was 155 cells/mm3. After January 1, 2016, a total of 89 immediate and 113 deferred group participants experienced a primary end point (hazard ratio of 0.79 [95% confidence interval, 0.60 to 1.04] versus hazard ratio of 0.47 [95% confidence interval, 0.34 to 0.65; P<0.001]) before 2016 (P=0.02 for hazard ratio difference).

    CONCLUSIONS: Among adults with CD4+ counts >500 cells/mm3, excess risk of AIDS and SNA associated with delaying treatment initiation was diminished after ART initiation, but persistent excess risk remained. (Funded by the National Institute of Allergy and Infectious Diseases and others.).

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