Biodiversity conservation, human-animal interactions, and zootherapy in ecological knowledge of Indonesian Healers.

We examined the entanglement of biodiversity conservation, human-animal interactions, zootherapy, and local beliefs among Sumatran Healers and their local community by completing an ethnography of 43 Indigenous Healers across 8 tribes in Bengkulu Province, Sumatra, Indonesia. Data collection tools were interviews, observations, videos, photographs, and a researcher journal. Of the 43 Healers, 30 used animals and mentioned 62 species. Of the animals identified, the International Union for Conservation of Nature Red List lists 34% (n = 21) as endangered, decreasing, or vulnerable, including Sumatran tiger (Panthera tigris sumatrae), Sumatran elephant (Elephas maximus sumatranus), and Sumatran rhinoceros (Dicerorhinus sumatrensis). Of the 30 Healers using animals, 50% (n = 15) practiced healing with at least one endangered, decreasing, or vulnerable animal. We defined 3 personas: Healer self-persona, Healer-imposed persona, and community-imposed persona. A persona represented a group's opinions and sentiments related to Healers killing animals for medicinal purposes. Using an iterative data analysis process, we grouped the data across the 3 personas into 5 themes: ease of killing and preparing animals, emotions related to killing animals, animal value, relationship to religion, and Healers are tricksters. The complexity of merging the identities of Healers and the community within an actor-network embodies the relationality of actions, interactions, and feelings among Healers, between Healers and animals, and between Healers and the community. Conservationists should be cognizant of Healers' medicinal use of animals, views of human-animal interactions, and zootherapy from all social and emotional perspectives. The data led to defining Indigenous Healer ecological knowledge components of zootherapy, human-animal interactions, and biodiversity conservation.

Conservación de la biodiversidad, interacciones humano­fauna y zooterapia dentro del conocimiento ecológico de los curanderos indonesios Resumen Analizamos la complejidad de la conservación de la biodiversidad, las interacciones humano­fauna, la zooterapia y las creencias locales de los curanderos y su comunidad local mediante una etnografía de 43 curanderos indígenas de ocho tribus en la provincia de Bengkulu en Sumatra, Indonesia. Usamos entrevistas, observaciones, videos, fotografías y una bitácora de investigador como herramientas de recolección de datos. De los 43 curanderos, 30 usaban animales y mencionaron 62 especies. El 34% (n = 21) de los animales identificados están catalogados como en peligro, en disminución o vulnerables en la Lista Roja de la Unión Internacional para la Conservación de la Naturaleza, incluidos el tigre de Sumatra (Panthera tigris sumatrae), el elefante de Sumatra (Elephas maximus sumatranus) y el rinoceronte de Sumatra (Dicerorhinus sumatrensis). De los 30 curanderos que usan animales, el 50% (n = 15) practica la sanación con al menos una especie en peligro, en disminución o vulnerable. Definimos tres percepciones: autopercepción de curandero, percepción impuesta de curandero y percepción impuesta de comunidad. Cada percepción representó las opiniones y sentimientos de un grupo con respecto a la matanza de animales por cuestiones medicinales. Usamos un proceso de análisis de datos repetitivos para agrupar la información de las tres percepciones en tres temas: facilidad para matar y preparar animales, emociones relacionadas con matar animales, valor del animal, relación con la religión y los curanderos son estafadores. La complejidad de combinar las identidades de los curanderos dentro de una red de actores representa cómo se relacionan las acciones, interacciones y sentimientos dentro de la comunidad de curanderos, entre los curanderos y los animales y entre los curanderos y la comunidad. Los conservacionistas deben ser conscientes desde todas las perspectivas sociales y emocionales del uso medicinal que los curanderos dan a los animales, las percepciones sobre las interacciones humano­fauna y la zooterapia. Esta información nos llevó a definir los componentes del conocimiento ecológico de los curanderos indígenas en materia de zooterapia, interacciones humano­fauna y conservación de la biodiversidad.

Tetrahydrobenzothiophene derivatives ameliorate Mia PaCa-2 cell progression and induces apoptosis via inhibiting EGFR2 tyrosine kinase signal.

A series of new thiophene analogues with acarbonitrile-basedmoiety were designed and synthesized via structural optimization. The conjugates were assessed for their in-vitro cytotoxic activity against a human pancreatic cancer cell line (Mia PaCa-2) and among them compound 5b showed IC50 value of 13.37 ± 2.37 µM. The compounds 5b (20 µM & 25 µM) and 7c (30 & 35 µM) also showed reduced clonogenicity, enhanced ROS and decreased mitochondrial membrane potential in Mia PaCa-2 cells. Treatment with these compounds also increased apoptotic population as evident with the double staining assay. Among the evaluated series, compounds 5b, 5g, 7c, and 9a attained a greater inhibitory potency than first generation's reversible EGFR inhibitor, Gefitinib. EGFR2 enzyme inhibitory studies revealed that 5b efficiently and arbitrarily suppressed the development of EGFR2 dependent cells and inhibited the enzymatic activity with an IC50 value of 0.68 µM; interestingly, the most effective molecule 5b with N-methyl piperazine substitution, has 1.29-fold greater potency than well-known EGFR inhibitor Gefitinib and increased Gefitinib's anti-growth impact with 2.04 folds greater against Mia PaCa-2. The in-vitro studies were validated with in-silico docking studies wherein compounds 5b and 7c exhibited binding energies of -8.2 and -7.4 Kcal/mol respectively. The present study reveals that tetrahydrobenzothiophene based analogues could be a promising lead for the evolution of potent chemo preventives over pancreatic cancer.

Z-scan model for Laguerre-Gaussian excitation in mode-mismatched thermal lens spectrometry.

In this work, we have introduced a Z-scan thermal lens (TL) model based on Laguerre-Gaussian (LG) L G10 laser induced excitation in a mode-mismatched dual-beam configuration. The analytical expression of the TL signal and its dependence on sample to detector distance as well as the Z-scan have been derived. The theoretical analysis shows that the phase shift and TL signal are higher than the values obtained using an excitation with the T E M 00 Gaussian profile. The experimental demonstration of the theoretical approach has been performed using the L G10 and T E M 00 Gaussian beams, respectively. Experimental proofs of the model are presented and found to be in agreement, demonstrating that Laguerre-Gaussian induced excitation is more sensitive than the Gaussian one.

Synthesis of Palladium-Catalysed C-C Bond Forming 5-Chloro Quinolines via Suzuki-Miyaura Coupling; Anti-Pancreatic Cancer Screening on PANC-1 Cell Lines.

Pancreatic cancer is the most severe among other cancers due to its late detection and less chance of survivability. Heterocycles are proven ring systems in the treatment of various cancers and this is due to the presence of two biodynamic molecules combined, which have a greater synergistic efficacy in many anticancer drugs. Quinoline and pyridine ring systems are brought together to obtain greater potency and this is achieved by coupling both using Pd-catalyst, and in the present investigation, Suzuki-Miyaura coupling (SMC) reactions are adopted to generate potent molecular entities. Pancreatic cancer is difficult to treat due to overexpression of the VEGFR2 protein. VEGFR2 is targeted to design the molecules of quinoline-coupled pyridine moieties and is docked to evaluate the protein-ligand interaction at the binding site. The binding affinity of conjugates revealed the potency and capability of ligands to inhibit the VEGFR2 pathway. The in-silico ADMET properties determined their inherent pharmacokinetic feasibility. The synthesized conjugates have been evaluated by MTT assay against the human pancreatic cancer cell lines (PANC-1). Among the series, compounds 5d, 5e, and 5h exhibited a greater inhibitory activity against the cell lines with an IC50 value of 82.32±1.38, 54.74±1.18 and 80.35±1.68 µM. In the present exploration, 5e exhibited greater inhibitory activity and it could be a promising lead for the development of new chemotherapeutics against pancreatic cancer.

Matrix-Metalloproteinase Inhibitory Study of Novel Tetrahydroisoquinoline-4-carboxylates: Design, Synthesis, and Molecular Docking Studies.

The design, molecular docking, synthesis and structure-activity relationship (SAR) of a series of novel methyl 1-oxo-2-(propan-2-yl)-3-(pyridin-3-yl)-1,2,3,4-tetrahydroisoquinoline-4-carboxylates, were investigated for antiproliferative and cytotoxic studies by screening against cancer cell lines of different origin by MTT, LDH and Trypan Blue Assay. Irrespective of cell lines, among the synthesized nonpeptido-mimetic analogs 5a-e, 5c has executed potent bio-potency with IC50 value of 7.00 to 7.21 µM, which further expressed in-vivo anti-tumor activity against murine T-cell lymphoma cell lines (Daltons Lymphoma-DLA) by regressing tumor growth. The formation of neovessels from the vasculogenesis was diminished reflecting the antitumor activity. The neovessel formation is directly relied on expression of matrix meteloproteases (MMP's) level which was drastically reduced by 5c treatment as evaluated by immonoblot assays. This is further supported by in-silico ADMET studies performed by ACD I-Lab 2.0 were in agreement with Lipinski rule of five. Reporting results were assessed as a positive parameter for further validation of the compound for therapeutic potential of cancer by 5c for preclinical studies in near future.

3D-DIoU: 3D Distance Intersection over Union for Multi-Object Tracking in Point Cloud.

Multi-object tracking (MOT) is a prominent and important study in point cloud processing and computer vision. The main objective of MOT is to predict full tracklets of several objects in point cloud. Occlusion and similar objects are two common problems that reduce the algorithm's performance throughout the tracking phase. The tracking performance of current MOT techniques, which adopt the 'tracking-by-detection' paradigm, is degrading, as evidenced by increasing numbers of identification (ID) switch and tracking drifts because it is difficult to perfectly predict the location of objects in complex scenes that are unable to track. Since the occluded object may have been visible in former frames, we manipulated the speed and location position of the object in the previous frames in order to guess where the occluded object might have been. In this paper, we employed a unique intersection over union (IoU) method in three-dimension (3D) planes, namely a distance IoU non-maximum suppression (DIoU-NMS) to accurately detect objects, and consequently we use 3D-DIoU for an object association process in order to increase tracking robustness and speed. By using a hybrid 3D DIoU-NMS and 3D-DIoU method, the tracking speed improved significantly. Experimental findings on the Waymo Open Dataset and nuScenes dataset, demonstrate that our multistage data association and tracking technique has clear benefits over previously developed algorithms in terms of tracking accuracy. In comparison with other 3D MOT tracking methods, our proposed approach demonstrates significant enhancement in tracking performances.

Real-Time Robotic Presentation Skill Scoring Using Multi-Model Analysis and Fuzzy Delphi-Analytic Hierarchy Process.

Existing methods for scoring student presentations predominantly rely on computer-based implementations and do not incorporate a robotic multi-classification model. This limitation can result in potential misclassification issues as these approaches lack active feature learning capabilities due to fixed camera positions. Moreover, these scoring methods often solely focus on facial expressions and neglect other crucial factors, such as eye contact, hand gestures and body movements, thereby leading to potential biases or inaccuracies in scoring. To address these limitations, this study introduces Robotics-based Presentation Skill Scoring (RPSS), which employs a multi-model analysis. RPSS captures and analyses four key presentation parameters in real time, namely facial expressions, eye contact, hand gestures and body movements, and applies the fuzzy Delphi method for criteria selection and the analytic hierarchy process for weighting, thereby enabling decision makers or managers to assign varying weights to each criterion based on its relative importance. RPSS identifies five academic facial expressions and evaluates eye contact to achieve a comprehensive assessment and enhance its scoring accuracy. Specific sub-models are employed for each presentation parameter, namely EfficientNet for facial emotions, DeepEC for eye contact and an integrated Kalman and heuristic approach for hand and body movements. The scores are determined based on predefined rules. RPSS is implemented on a robot, and the results highlight its practical applicability. Each sub-model is rigorously evaluated offline and compared against benchmarks for selection. Real-world evaluations are also conducted by incorporating a novel active learning approach to improve performance by leveraging the robot's mobility. In a comparative evaluation with human tutors, RPSS achieves a remarkable average agreement of 99%, showcasing its effectiveness in assessing students' presentation skills.

Seroprevalence and haemato-biochemical effects of bovine leucosis in buffalo, Punjab, Pakistan.

Enzootic bovine leucosis is caused by bovine leukaemia virus (BLV), a Deltaretrovirus belonging to the family Retroviridae. BLV causes huge economic losses to the dairy industry in the form of decreased milk production, premature culling, and poor reproductive performance of the animals. The aim of the present study was to determine the seroprevalence of BLV infection in buffalo in two districts of Punjab, Pakistan. A total of 384 samples were collected and analysed using a commercial indirect enzyme-linked immunosorbent assay (ELISA) to investigate the seroprevalence of BLV through the detection of the anti-BLV gp51 antibody. A predesigned data questionnaire proforma was employed to find out the association of risk factors with disease. Overall, 18.2% of buffaloes were seropositive for BLV in the study population. The results revealed a significant association (P < 0.05) of age with BLV infection. Furthermore, milk yield and pregnancy had a significant association with the seroprevalence of BLV infection in buffalo whereas no significant association was found with sex, breeding, and health status. Biochemical and oxidative stress markers revealed a significant decrease in liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST), glutathione peroxidase (GPX), and superoxide dismutase (SOD) in seropositive animals as compared to healthy animals. It is concluded that BLV has a considerable prevalence in buffalo in Punjab, Pakistan and there is a dire need to investigate the disease epidemiology at both national and international levels and strategies should be developed to implement an effective control program.

Role of sustainable development goals in advancing the circular economy: A state-of-the-art review on past, present and future directions.

The purpose of this study is to review the relationship between the highly anticipated concept of circular economy (CE) and sustainable development goals (SDGs). These two sustainability principles have transformed organizations and countries in their quest to achieve sustainable development. Despite their importance to the business and corporate realm, the discussion of these two concepts has been developed in silos, arbitrarily connected. Through a bibliometric approach, this study reviewed 226 journal publications and 16,008 cited references from the Web of Science (WoS) to understand the past, present and future trends of the two concepts and their impact on the sustainability development. The bibliometric approach of citation, co-citation and co-word analysis uncovers the relevant and significant themes and research streams. Theoretical and practical implications were discussed within the broader business and governance perspective to develop a substantial triple bottom line in creating a sustainable future for civil society.

Current Insights on Dyslipidaemia Management for Prevention of Atherosclerotic Cardiovascular Disease: A Malaysian Perspective.

Dyslipidaemia is highly prevalent in the Malaysian population and is one of the main risk factors for atherosclerotic cardiovascular disease (ASCVD). Low-density lipoprotein cholesterol (LDL-C) is recognised as the primary target of lipid-lowering therapy to reduce the disease burden of ASCVD. Framingham General CV Risk Score has been validated in the Malaysian population for CV risk assessment. The Clinical Practice Guidelines (CPG) on the management of dyslipidaemia were last updated in 2017. Since its publication, several newer randomised clinical trials have been conducted with their results published in research articles and compared in meta-analysis. This underscores a need to update the previous guidelines to ensure good quality care and treatment for the patients. This review summarises the benefits of achieving LDL-C levels lower than the currently recommended target of < 1.8mmol/L without any safety concerns. In most high and very high-risk individuals, statins are the first line of therapy for dyslipidaemia management. However, certain high-risk individuals are not able to achieve the LDL-C goal as recommended in the guideline even with high-intensity statin therapy. In such individuals, lower LDL-C levels can be achieved by combining the statins with non-statin agents such as ezetimibe and PCSK9 inhibitors. Emerging non-statin lipid-lowering therapies and challenges in dyslipidaemia management are discussed in this article. The review also summarises the recent updates on local and international guidelines for dyslipidaemia management.

Frequency tunable superflash based on an electromagnetically induced transparency (EIT).

We present a new controllable superflash, a maximum transient peak at the falling edge of a square pulse, using a three-level electromagnetically induced transparency (EIT). The superflash in a two-level system occurs at a certain value of the detuning of the probe laser (Δpeak) when the optical depth (OD) of the medium is sufficiently large and constant. Here, we show the external tunability of the Δpeak for obtaining the maximum transient peak by introducing a three-level EIT. Owing to the EIT dispersion properties, we effectively tune the phase of the forward-scattered light (Es) by externally controlling the EIT coupling light intensities associated with the Rabi frequency (Ωc). When the incident light is turned off, the total transmitted field (Et) experiences an out-of-phase shift, producing a peak intensity that is three times higher than the input. We observe that this new class of superflash (Type II) occurs near the EIT window and exhibits inverse-linearity of the OD, which is in contrast with the characteristics of the previously reported two-level superflash (Type I). Furthermore, we find the quadratic nature of tunability in Δpeak(Ωc).The new tunability of the superflash by the Rabi frequency may facilitate more rapid and effective control of the superflash compared to a passive optical medium.

Serum pepsinogen level as a biomarker for atrophy, reflux esophagitis, and gastric cancer screening in Indonesia.

Background: Chronic dyspepsia's symptoms are frequently seen in primary to tertiary healthcare in Indonesia. This study aimed to describe the potential usability of pepsinogen (PG) values in determining gastric mucosal conditions, including superficial gastritis and atrophic gastritis. Materials and Methods: We recruited 646 adult dyspeptic patients and then analyzed PG values (including PGI, PGII, and PGI/II ratio) with endoscopic findings, gastric mucosal damages, and Helicobacter pylori infection. The gastric mucosal damage and H. pylori infection were evaluated using histological examination based on the updated Sydney system. Results: Among 646 enrolled patients, 308 (47.2%), 212 (32.8%), 91 (14.1%), 34 (5.2%), and 1 (0.2%) patient were diagnosed with normal mucosa, gastritis, reflux esophagitis, peptic ulcer disease, and gastric cancer, respectively. Significant differences in PGI, PGII, and PGI/II ratio values were observed among ethnic groups (all P < 0.01). The PGI and PGII levels were significantly higher and PGI/II was significantly lower in H. pylori-infected patients than in uninfected ones (all P < 0.001). The optimal cutoff value for PGII and PGI/II was 12.45 ng/mL with an area under the curve (AUC) value of 0.755 (0.702-0.811), sensitivity 59.3%, and specificity 77.1%; and 4.75 with AUC value of 0.821 (0.763-0.855), sensitivity 81.5%, and specificity 78.7%, respectively, to determine moderate-severe atrophy. Conclusion: Serum PG levels, a useful biomarker, represent the endoscopic findings, especially for reflux esophagitis. In addition, the benefits of PG values detecting atrophic gastritis were limited to moderate-severe atrophic gastritis. This usefulness requires careful attention for several ethnic groups in Indonesia.

Synthesis of novel nicotinamide susbstituted phthalocyanine and photodynamic antomicrobial chemotherapy evaluation potentiated by potassium iodide against the gram positive S. aureus and gram negative E. coli.

In the present work, we propose the synthesis of novel nicotinamide subsituted phthlocyanine photosensitizer (PS) and characterized by FTIR, UV-visible, H-NMR and MALDI Toff spectroscopy. Nicotinamide plays a vital rule in the central nervous system and its potential as a therapeutic for neurodegenerative disease. Nicotinamide substituted PS (3) efficiently produced ROS via type-1 process as measured by DCF assay. We observed that our PS after red light illumination (22 J/cm2) killed gram positive S. aureus upto 3 log reduction. Furher the addition of Potassium Iodide (100 mM) significantly potentiated PS at lower concentrations and enhanced the bacterial killing upto 6 log reduction against the S. aureus. We further found that the synergistic effect of PS and KI also eradicated the gram negative E. coli strain at lower concentraion of PS and found to killed E. coli upto 5 log reduction under the red light illumination at 22 J/cm2 of light dose. The conjugation of such biologically important form of vitamin B3 with PS would be a great addition and could pav the way for the novel photodynamic agent in the treatement of cancer and infectious diseases. A new symmetrical Nicotinamide tetrasubstituted zinc phthalocyanine (3) was synthesized. Upon addition of potassium Iodide with PS, the PS exhibited significant photodynamic activity with 5-6 logs reduction in bacterial load was achieved.

Fast Enantio- and Chemoselective Arylation of Ketones with Organoboronic Esters Enabled by Nickel/N-Heterocyclic Carbene Catalysis.

A general, efficient, highly enantio- and chemoselective N-heterocyclic carbene (NHC)/Ni-catalyzed addition of readily available and stable arylboronic esters to ketones is reported. This protocol provides unexpectedly fast access (usually 10 min) to various chiral tertiary alcohols with exceptionally broad substrate scope and excellent functional group tolerance (76 examples, up to 98 % ee). This process is orthogonal to other known Ni-mediated Suzuki-Miyaura couplings, as it tolerates aryl chlorides, fluorides, ethers, esters, amides, nitriles, and alkyl chlorides. The reaction is applied to late-stage modifications of various densely functionalized medicinally relevant molecules. Preliminary mechanistic studies suggest that a rare enantioselective η2 -coordinating activation of ketone carbonyls is involved. This cross-coupling-like mechanism is expected to enable other challenging transformations of ketones.

Development and application of chiral spirocyclic phosphoric acids in asymmetric catalysis.

The development of suitable chiral catalysts, which represent powerful, economically feasible tools for the preparation of optically active organic molecules, is a fundamental endeavour in synthetic chemistry. Chiral phosphoric acids derived from axially chiral 1,1'-bi-2-naphthol (BINOL) are a widely used class of strong Brønsted acid catalysts and have been applied successfully in many asymmetric catalyzed reactions. Accordingly, the development and application of chiral spirocyclic phosphoric acids derived from axially chiral 1,1'-spirobiindane-7,7'-diol (SPINOL) have received increasing attention in the last eight years. This review covers the synthetic methods and the application of chiral spirocyclic phosphoric acids in asymmetric catalysis.

Asymmetric organocatalytic synthesis of chiral 3,3-disubstituted oxindoles via a 1,6-conjugate addition reaction.

A highly efficient synthesis of chiral 3,3-disubstituted oxindoles was developed using a chiral spirocyclic phosphoric acid catalyzed 1,6-conjugate addition reaction of para-quinone methides derived from N-unprotected isatins with indoles. The reaction proceeds under mild reaction conditions to provide indole-containing N-unprotected oxindoles bearing quaternary stereocenters in good yields and with moderate to excellent enantioselectivities (up to 97% ee).

Organocatalytic asymmetric synthesis of benzazepinoindole derivatives with trifluoromethylated quaternary stereocenters by chiral phosphoric acid catalysts.

An enantioselective aza-Friedel-Crafts reaction of trifluoromethyl dihydrobenzoazepinoindoles with pyrroles catalyzed by a chiral spirocyclic phosphoric acid was developed. This methodology provides a facile route to CF3- and pyrrole-containing benzazepinoindoles bearing quaternary stereocenters in good yields and with moderate to excellent enantioselectivities (up to 93% ee). Indoles were also investigated as electron-rich aromatic substrates to afford the corresponding chiral heterocycles with good yields and considerable enantioselectivities. The introduction of CF3 shows a remarkable fluorine effect and increases the activation and stereoinduction.

All-cause and cause-specific mortality rates of patients treated for alcohol use disorders: A meta-analysis.

BACKGROUND: Although alcohol use disorders (AUDs) are known to increase the relative risk of all-cause and some cause-specific mortality, the absolute mortality rates of the AUD population are unknown. Such knowledge would benefit planners of the provision of services for this population, including in prioritizing the identification and/or treatment of diseases likely to cause their death. METHODS: We conducted a systematic review of studies in English, reporting the cause-specific mortality rates among people treated for AUDs. Number of deaths by cause and total person-years of follow-up were extracted. All-cause and cause-specific mortality rates per 1000 person-years were meta-analyzed assuming random effects. RESULTS: Thirty-one studies were included. Participants were mainly middle-aged males. The quality of studies was generally good. A total of 6768 all-cause deaths in 276,990.7 person-years of follow-up (36,375 patients) were recorded, and the pooled all-cause mortality rate was 27.67/1000 person-years (py) (95% confidence interval [CI]: 23.9, 32.04). The most common cause of death in the AUD population was cardiovascular disease (CVD) (6.9/1000 py; 95% CI: 5.61, 8.49), followed by gastrointestinal deaths (5.63/1000 py; 95% CI: 4.1, 7.74), unnatural deaths (4.95/1000 py; 95% CI: 4.01, 6.09)), neoplasms, respiratory diseases, and substance use disorders. CONCLUSIONS: Patients with AUDs have increased rates of all-cause and cause-specific mortality compared with the general population. Like the general population, they are most likely to die of CVD. In contrast to the general population, gastrointestinal and unnatural deaths are the next most common causes of death. We believe these facts should be considered when planning health care services for patients with AUDs.

Enantioselective synthesis of cyclic quaternary α-amino acid derivatives by chiral phosphoric acid catalysis.

A highly enantioselective aza-Friedel-Crafts reaction of N-sulfonyl cyclic ketimines with indoles catalyzed by chiral phosphoric acids has been developed. This methodology provides an efficient and facile route to indole-containing chiral cyclic α-amino acid derivatives bearing a quaternary stereocenter in high yields and up to 98% enantioselectivity.

Mental health literacy in primary care: Canadian Research and Education for the Advancement of Child Health (CanREACH).

The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period. Referrals were analysed for evidence of change based on frequencies and measures of clinical urgency. Participants of the training programme also completed standardised baseline and outcome self-evaluations. Congruent with participants self-reported evaluative reports of improved knowledge and practice, analysis of referral frequency and the clinical urgency of referrals to paediatric psychiatric services over the study period indicated that trained physicians made more appropriate referrals (clinically more severe) and reduced referrals to emergency services. Quantitative clinical differences as completed by intake clinicians blind to referrals from the study group designations were observed within the trained physician group pretraining and post-training, and between the trained physician group and the unexposed physician group. The results illustrate a novel model for objectively measuring change among physicians based on training in paediatric mental health management.