Higher judgements of learning for emotional words: processing fluency or memory beliefs?

Previous research has shown that emotionally-valenced words are given higher judgements of learning (JOLs) than are neutral words. The current study examined potential explanations for this emotional salience effect on JOLs. Experiment 1 replicated the basic emotionality/JOL effect. In Experiments 2A and 2B, we used pre-study JOLs and assessed memory beliefs qualitatively, finding that, on average, participants believed that positive and negative words were more memorable than neutral words. Experiment 3 utilised a lexical decision task, resulting in lower reaction times (RTs) for positive words than for neutral words, but equivalent RTs for negative and neutral words, suggesting that processing fluency may partially account for higher JOLs for positive words, but not for negative words. Finally, we conducted a series of moderation analyses in Experiment 4 which assessed the relative contributions of fluency and beliefs to JOLs by measuring both factors in the same participants, showing that RTs made no significant contribution to JOLs for either positive or negative words. Our findings suggest that although positive words may be more fluently processed than neutral words, memory beliefs are the primary factor underlying higher JOLs for both positive and negative words.

Bringing Sectors Together in Da Nang, Vietnam: Participatory Systems Mapping.

The USAID-funded Building Healthy Cities (BHC) work in Da Nang, Vietnam, engaged 108 multi-sector stakeholders to gather qualitative data across two workshops and three citizen town halls from 2019 to 2021. These data were synthesized with the results from BHC's seven other activities in Da Nang to build systems maps. Contextual findings showed that multi-sector, multi-level participation and collaboration have been the key to moving the city toward their smart and livable city goals. Currently, citizen, nongovernmental organization, and private sector collaboration are low for many government sectors, which results in policy and programs that are mismatched to actual needs and therefore have less powerful impacts. When these policies and programs are implemented, they struggle to demonstrate strong benefits to these stakeholder groups, further decreasing participation. This is central to the systems map that BHC developed, and is expanded upon through additional patterns that fall within four main areas: management quality; vision and leadership; workforce capacity; and community engagement. Stakeholders found four key leverage points within this context that, if included in every action, could help overcome barriers. These leverage opportunities are: (1) investing at all levels; (2) improving function and innovation of information technology; (3) increasing participation and feedback; and (4) creating more responsive policy. As BHC concludes activities in Da Nang, local university students will be trained on systems mapping techniques to embed systems thinking skills into the next generation of workforce, and a set of recommendations will be developed to share with the government to act on these findings.

Participatory Systems Mapping for Municipal Prioritization and Planning.

Rapidly growing cities face new and compounding health challenges, leading governments and donors to seek innovative ways to support healthier, more resilient urban growth. One such approach is the systems mapping process developed by Engaging Inquiry (EI) for the USAID-funded Building Healthy Cities project (BHC) in four cities in Asia. This paper provides details on the theory and methods of the process. While systems mapping is not new, the approach detailed in this paper has been uniquely adapted to the purpose of municipal planning. Strategic stakeholder engagement, including participatory workshops with a diverse group of stakeholders, is at the core of this approach and led to deeper insights, greater buy-in, and shared understanding of the city's unique opportunities and challenges. This innovative mapping process is a powerful tool for defining municipal priorities within growing cities across the globe, where the situation is rapidly evolving. It can be used to provide evidence-based information on where to invest to gain the biggest impact on specific goals. This paper is part of a collection in this issue providing a detailed accounting of BHC's systems mapping approach across four project cities.

Designing for a Healthier Indore, India: Participatory Systems Mapping.

In Indore, India, BHC engaged 247 multi-sector stakeholders through a systems mapping approach to gather qualitative data across three workshops and four citizen town halls from 2018 to 2020. These data were synthesized with results from BHC's 18 other city activities to build a systems map and identify high-impact areas for engagement. Contextual findings showed a tension at the heart of Indore's growth-Indore's great success as a city has spurred rapid population growth. This growth creates pressure on municipal systems as population outpaces service delivery capacity. This is central to the systems map that BHC developed and is expanded upon through additional patterns that fall within four main domains: (1) leadership, governance, and financing; (2) essential service delivery and workforce; (3) information systems; and (4) community infrastructure and education. Stakeholders found three key leverage opportunities within this context that, if included in every action, could help overcome barriers. These opportunities are: (1) improving data quality, use, and integration; (2) supporting accountability to, and enforcement of, policies and regulations; and (3) increasing community engagement. Brought together through a better understanding of the key patterns driving system behavior from the context map and leverage opportunities, BHC was able to co-create, with stakeholders, seven "coherent actions" to move Indore to a healthier, more equitable state. When COVID-19 regulations ease, BHC and city officials will reconvene to finalize an implementation plan for these actions.

Designing for a Healthier Makassar, Indonesia: Participatory Systems Mapping.

In Makassar, Indonesia, the USAID-funded Building Healthy Cities (BHC) project engaged 240 multi-sector stakeholders to gather qualitative data across three workshops and two citizen town halls from 2019 to 2021. These data were synthesized with results from BHC's nine other Makassar activities to build maps of the current system and identify high-impact areas for engagement. Contextual findings showed that Makassar leadership has actively innovated and used new technology to improve the city, resulting in improved connectivity and responsiveness. However, this drive toward innovation has strained existing infrastructure and workforce capacity. When this strain fails to meet promised results, citizens are less likely to engage and support the innovations. This is central to the systems map that BHC developed, and is expanded upon through additional patterns that fall within four main areas: (1) leadership, governance, and financing; (2) infrastructure and workforce; (3) collaboration and data; and (4) community cohesion and awareness. Stakeholders found three key leverage points within this context that, if included in every action, could help overcome barriers. These leverage opportunities are: (1) increasing data-driven decision-making; (2) ensuring equitable policy and leadership; and (3) increasing community participation. By combining key patterns discovered in the Context Map with the leverage opportunities, BHC was able to co-create with stakeholders six "coherent actions" that can move Makassar to a healthier, "Sombere (kind-hearted and hospitable) and Smart City." BHC has been working with the city planning office to incorporate the map findings into its bottom-up planning processes and the 5-year mid-term plan for Makassar.

Engaging Citizens Via Journey Maps to Address Urban Health Issues.

Effectively addressing urban health challenges requires engagement of citizens. However, citizens often face barriers providing feedback, and city officials likewise face difficulties incorporating feedback in a meaningful and systematic way. This paper shares one innovative approach to capturing citizens' stories about urban health concerns, developed by the Building Healthy Cities (BHC) project in 2 Asian cities (Indore, India, and Makassar, Indonesia). Using ethnographic methods, BHC developed "journey maps" as a monitoring tool to follow key service issues over time. Several urban health-related issues were identified in each city. For this paper, we focus on wastewater management, which was a serious health issue in both cities. Qualitative data were collected from citizens in one neighborhood and city officials quarterly starting in early 2018; these data were supplemented by city spending data, usage statistics, photos and news articles. In both cities, the journey maps captured notable changes during the first 2 years of the project. At the start of the journeys (2018), informal settlement citizens in Indore reported poor drainage which was compounded by trash, narrow roads blocking vehicular removal of waste, and unsafe infrastructure leading to waterborne diseases and injuries (including several child deaths). Likewise in Makassar, dirty water overflowed from open drains due to frequent flooding and garbage. Citizens reported exposure to diarrhea, dengue and skin symptoms due to the drains, which was confirmed by the local health post. By the end of Year 2 (2019), these journeys captured increasing dialogue between citizens and the city, which resulted in several improvements. In Indore, changes included garbage vans built for narrow streets and construction of a safer bridge. In Makassar, while they still suffer from seasonal flooding, the city has increased garbage pickup, included drainage activities in the village-level budgeting process, and a slum improvement project has pledged funding to improve drainage and street issues in 41 neighborhoods. Journey maps work on the premise that capturing a community's experience and relaying it to government officials can bring about positive change. They also provide crucial grassroots level evidence to support more traditional research findings, which can lead to effective urban health solutions. As this work continues, BHC is training citizens to collect and share their own journeys.

Methyltransferase DnmA is responsible for genome-wide N6-methyladenosine modifications at non-palindromic recognition sites in Bacillus subtilis.

The genomes of organisms from all three domains of life harbor endogenous base modifications in the form of DNA methylation. In bacterial genomes, methylation occurs on adenosine and cytidine residues to include N6-methyladenine (m6A), 5-methylcytosine (m5C), and N4-methylcytosine (m4C). Bacterial DNA methylation has been well characterized in the context of restriction-modification (RM) systems, where methylation regulates DNA incision by the cognate restriction endonuclease. Relative to RM systems less is known about how m6A contributes to the epigenetic regulation of cellular functions in Gram-positive bacteria. Here, we characterize site-specific m6A modifications in the non-palindromic sequence GACGmAG within the genomes of Bacillus subtilis strains. We demonstrate that the yeeA gene is a methyltransferase responsible for the presence of m6A modifications. We show that methylation from YeeA does not function to limit DNA uptake during natural transformation. Instead, we identify a subset of promoters that contain the methylation consensus sequence and show that loss of methylation within promoter regions causes a decrease in reporter expression. Further, we identify a transcriptional repressor that preferentially binds an unmethylated promoter used in the reporter assays. With these results we suggest that m6A modifications in B. subtilis function to promote gene expression.

Crystal structure of N-allyl-4-methyl-benzene-sulfonamide.

The title compound, C10H13NO2S, was synthesized by a nucleophilic substitution reaction between allyl amine and p-toluene-sulfonyl chloride. The sulfonate S-O bond lengths are 1.4282 (17) and 1.4353 (17) Å, and the C-N-S-C torsion angle involving the sulfonamide moiety is -61.0 (2)°. In the crystal, centrosymmetric dimers of the title compound are present via inter-molecular N-H⋯O hydrogen bonds between sulfonamide groups. These dimers are linked into ribbons along the c-axis direction through offset π-π inter-actions.

Optimizing the Multisectoral Nutrition Policy Cycle: A Systems Perspective.

Based on the data collected in Uganda, Nepal, and Ethiopia, the papers included in this supplement fill a critical gap in evidence regarding multisectoral National Nutrition Action Plans. The studies offer new data and new thinking on how and why governance, effective financial decentralization, and improved accountability all matter for nutrition actions in low-income countries. This introductory paper offers an overview of the current state of evidence and thinking on the multisectoral nutrition policy cycle, including how governance and financing support that process. It also explores the benefits of applying a systems lens to understand the dynamic, enabling processes of the policy cycle-from research to knowledge and ultimately action-and to provide more dynamic and accurate information for nutrition advocacy and evidence-based decision-making. It concludes with key findings from the 5 country-level studies included. Several important themes emerge: the egregious gap in human resources needed for effective nutrition actions in most low-income settings, the value of research on bottlenecks and successes, and the need for routine monitoring of national policies and plans to measure their effectiveness in achieving both their own stated goals and global sustainable development goals. Reviewing these studies together provides a path forward in building stronger, evidence-based multisectoral nutrition policies and supporting implementation of the nutrition activities included within them.

Prioritizing and Funding the Uganda Nutrition Action Plan.

BACKGROUND: In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan. OBJECTIVE: We tracked the UNAP's influence on the process of priority setting and funding for nutrition from 2013 to 2015. METHODS: This study used a longitudinal mixed methods design to track qualitative and budgetary changes related to UNAP processes nationally as well as in 2 study districts. Qualitative changes were assessed through interviews, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews. RESULTS: Important enabling factors named by stakeholders included identity, human resources, sustainable structures, coordination, advocacy, and adaptation of the UNAP to local needs. Evidence suggests that the UNAP facilitated improvements in the last 3 factors. We found no systematic increases in planned nutrition activities, nor did we find increases in allocations or expenditures for nutrition between fiscal years 2013-2014 and 2014-2015. Expenditure data were not always available for all funding mechanisms. In the 2 study districts, there was little flexibility within financing structures to allow for additional nutrition activities. CONCLUSIONS: Results suggest the UNAP has played an important role in strengthening the enabling environment for nutrition action. The next UNAP will need to translate these improvements into a greater number of nutrition activities and higher levels of funding at the national and subnational levels.

Assessing Progress in Implementing Uganda's Nutrition Action Plan: District-Level Insights.

BACKGROUND: The 2011 Uganda Nutrition Action Plan (UNAP) established 2016 maternal and child nutrition targets. However, there is a lack of routine district-level data collection to assess UNAP implementation. OBJECTIVE: To use Nutrition Innovation Lab (NIL) data to inform policy makers on the progress of UNAP-related indicators. METHODS: The NIL collected serial household-level survey data (n = 3600) in 6 districts, including 2 UNAP implementation districts, in 2012 and 2014. Questionnaires focused on food security, nutrition, and health, among others, and included specific indicators relevant to UNAP's targets. RESULTS: In 2012, outcomes in Kisoro and Lira districts were below national average for some UNAP key indicators, including dietary diversity and anemia prevalence, but above average for others (exclusive breastfeeding and underweight among women and children). The prevalence of child stunting was higher than national averages in Kisoro but below national averages in Lira. In 2014, anemia among women and children decreased significantly. Kisoro also saw improvements in several other UNAP target indicators including underweight, breastfeeding, and stunting. CONCLUSION: Although the study showed improvements in key UNAP indicators, there is a need to invest in appropriate methods to gauge its progress because the NIL was not designed to assess UNAP. Since the quality of implementation of complex multisectoral programs can differ widely across different contexts, it is critical that effective monitoring of progress be part of such programs. National endorsement of nutrition plans doesn't in itself result in desired outcomes, hence, the allocation of scarce resources has to be based on rigorous evidence.

Prioritizing and Funding Nepal's Multisector Nutrition Plan.

BACKGROUND: Nepal has a long tradition of designing good multisectoral nutrition policy. However, success of policy implementation has varied. More evidence on how to successfully carry out multisector nutrition policy is needed. OBJECTIVE: We tracked the influence of Nepal's multisectoral nutrition plan (MSNP) on the process of priority setting and budgeting from 2014 to 2016. METHODS: This study used a mixed-method longitudinal design to track qualitative and budgetary changes related to MSNP processes nationally as well as in 3 districts. Qualitative changes in each study area were assessed through interviews, observation, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews. RESULTS: Improved understanding of the MSNP was documented nationally and in study districts but not in VDCs. Human resources, ownership, bottom-up planning, coordination, advocacy, and sustainable structures all emerged as important factors within the enabling environment. Evidence suggests the MSNP influenced improvements in the last 3 factors. We also found notable increases in activities and financing for nutrition-allocations increased steadily between FY 2013-2014 and FY 2015-2016, and 28% of total nutrition allocations in the final year came from new or expanded MSNP-affiliated activities. Data from 3 districts highlight challenges linking local planning and budgeting to central-level structures. CONCLUSIONS: The MSNP appears to have strengthened the nutrition system in Nepal and increased priority and funding for nutrition. Next steps include strengthening linkages to the districts and below. Other countries can learn from the MSNP's success in increasing investment for nutrition.

Robotic-assisted laparoscopy vs conventional laparoscopy for the treatment of advanced stage endometriosis.

STUDY OBJECTIVE: To compare robotic-assisted laparoscopy with conventional laparoscopy for treatment of advanced stage endometriosis insofar as operative time, estimated blood loss, complication rate, and length of hospital stay. STUDY DESIGN: Retrospective cohort study (Canadian Task Force classification II2). All procedures were performed by one surgeon between January 2004 and July 2012. Data was collected via chart review. SETTING: Tertiary referral center for treatment of endometriosis. PATIENTS: Four hundred twenty women with advanced endometriosis. INTERVENTIONS: Fertility-sparing surgery to treat advanced endometriosis, either via conventional or robotic-assisted laparoscopy. MEASUREMENTS AND MAIN RESULTS: Patient demographic data, operative time, estimated blood loss, complication rate, and length of hospital stay were compared between the 2 groups. Two hundred seventy-three patients underwent conventional laparoscopy and 147 patients underwent robotic-assisted laparoscopy for fertility-sparing treatment of advanced stage endometriosis. Patients in both groups had similar characteristics insofar as age, body mass index, and previous abdominal surgeries. There were no significant differences in blood loss or complication rate between the 2 groups. Mean operative time in the conventional laparoscopy group was 135 minutes (range, 115-156 minutes), and in the robotic-assisted laparoscopy group was 196 minutes (range, 185-209 minutes), with a mean difference in operative time of 61 minutes (p < .001). Length of hospital stay was also significantly increased in the robotic-assisted laparoscopy group. Most patients who underwent conventional laparoscopy were discharged to home on the day of surgery. Of 273 patients in the conventional laparoscopy group, only 63 remained in the hospital overnight, and all 147 patients in the robotic-assisted laparoscopy group were discharged on postoperative day 1. CONCLUSION: Conventional laparoscopy and robotic-assisted laparoscopy are excellent methods for treatment of advanced stages of endometriosis. However, use of the robotic platform may increase operative time and might also be associated with longer hospital stay.

Prolongation of the prothrombin time and activated partial thromboplastin time in children with sickle cell disease.

BACKGROUND: Patients with sickle cell disease (SCD) have high rates of perioperative complications, including bleeding 1,2. PROCEDURES: We conducted a retrospective review of pre-operative coagulation studies in pediatric patients with SCD followed by a prospective study of 100 well children with SCD to determine the prevalence of abnormal coagulation screening tests, and to evaluate potential etiologies. RESULTS: In the retrospective study, 32/84 (38.1%) had a prolonged prothrombin time (PT), compared to 8/100 in the prospective study. Prolongations of the activated partial thromboplastin time (aPTT) were less common. Children in the prospective study with prolonged PTs had significantly lower levels of Factor V and VII compared to those with normal PTs. Factor VII levels were <50% in 4/8 with long PTs, compared to 3/92 with normal PTs, P=0.001. Though retrospectively, several patients had normalization of their PT with vitamin K, there was no laboratory evidence of vitamin K deficiency in the prospective study. In the retrospective analysis, six of seven children who had pre-operative coagulation studies and significant intraoperative blood loss had prolonged PTs (P=0.04). CONCLUSIONS: Children with SCD admitted for surgical procedures were more likely to have prolonged PTs than those tested at a well visit. There was intra-patient variability in coagulation studies that may be related to clinical status, hepatocellular dysfunction, and/or increased clotting factor consumption. Future well-designed prospective studies to determine whether abnormal coagulation studies are associated with an increased risk of perioperative bleeding in children with SCD are necessary.