Associations between the intraoperative fraction of inspired intraoperative oxygen administration and days alive and out of hospital after surgery.

Background: There is limited knowledge about the effect of liberal intraoperative oxygen on non-infectious complications and overall recovery from surgery. Methods: In this retrospective cohort study, we investigated associations between mean intraoperative fraction of inspired oxygen (FiO2), and outcome in adults undergoing elective surgery lasting more than 2 h at a large metropolitan New Zealand hospital from 2012 to 2020. Patients were divided into low, medium, and high oxygen groups (FiO2 ≤ 0.4, 0.41-0.59, ≥0.6). The primary outcome was days alive and out of hospital at 90 days (DAOH90). The secondary outcomes were post-operative complications and admission to the ICU. Results: We identified 15,449 patients who met the inclusion criteria. There was no association between FiO2 and DAOH90 when high FiO2 was analysed according to three groups. Using high FiO2 as the reference group there was an adjusted mean (95% confidence interval [CI]) difference of 0.09 (-0.06 to 0.25) days (P = 0.25) and 0.28 (-0.05 to 0.62) days (P = 0.2) in the intermediate and low oxygen groups, respectively. Low FiO2 was associated with increased surgical site infection: the adjusted odds ratio (OR) for low compared with high FiO2 was 1.53 (95% CI 1.12-2.10). Increasing FiO2 was associated with respiratory complications: the adjusted OR associated with each 10% point increase in FiO2 was 1.17 (95% CI 1.08-1.26) and the incidence of being admitted to an ICU had an adjusted OR of 1.1 (95% CI 1.03-1.18). Conclusions: We found potential benefits, and risks, associated with liberal intraoperative oxygen administration indicating that randomised controlled trials are warranted.

Telenomuscristatus Johnson (Hymenoptera, Scelionidae): new diagnostic data, distribution records and host associations.

Specimens of an egg parasitoid wasp, Telenomuscristatus Johnson (Platygastroidea, Scelionidae), were reared from stink bug egg masses collected in the wild, in Maryland, United States. The egg masses were identified morphologically as Halyomorphahalys (Stål), Banasa Stål and Euschistus Dallas (Hemiptera, Pentatomidae). Molecular tools were used to further identify the Euschistus egg masses as E.servus (Say) and E.tristigmus (Say). All of these are new host associations for Te.cristatus. We also provide data to contribute to future identification of Te.cristatus: images of the holotype specimen and COI sequences from two disparate localities.

Balclutha jafara (Hemiptera: Cicadellidae): integrative identification of a species introduced in the Western Hemisphere, and notes on other Balclutha.

Leafhopper specimens of the genus Balclutha Kirkaldy, found in southern Florida (Palm Beach and Collier Counties), United States, beginning in 2020, and in shipments of plant products originating from Colombia and entering the United States beginning in 2019, are identified as B. jafara Webb. This species was previously known only from the Seychelles and Aldabra Islands, which are parts of the Seychelles archipelago in the Indian Ocean east of mainland Africa. Identifications were made by comparison with type specimens, both morphologically and through molecular analysis. Specimens in Palm Beach Co. were swept from commercial rice (Oryza sativa L.) paddies. Mitochondrial cytochrome c oxidase I (COI) barcodes of specimens from Florida and Colombia were closely matched to each other and to partial barcodes obtained from paratype specimens of B. jafara. The COI barcodes also closely matched sequences from previously unidentified Balclutha specimens in the Barcode of Life Data Systems (BOLD) from Kenya and South Africa, several of which were confirmed later morphologically as B. jafara. Previously unidentified museum specimens from South Sudan, Zambia, and Zimbabwe were determined as B. jafara. Together, these specimens show that B. jafara has a more widespread African distribution than was known previously, and that it arrived in the Western Hemisphere by 2019. Balclutha jafara is redescribed and illustrated. Further studies on the Balclutha fauna of Florida were performed. COI barcode data were generated for Floridian specimens of B. caldwelli Blocker, B. curvata Caldwell, B. flavescens (Baker), B. frontalis (Ferrari), B. incisa (Matsumura), and B. lucida (Butler). A phylogenetic analysis of COI data was conducted using publicly available sequences and those generated here. A key to the Balclutha species known from Florida is provided. The names that have been applied and mis-applied to Western Hemisphere species are discussed. To clarify the identity of some species, illustrations are given for: the female holotype and a male paratype of Eugnathodus virescens Osborn (=B. flavescens); the holotype of Nesosteles robustus Caldwell (=B. robusta); and the holotype of Balclutha curvata Caldwell. Additional barcoded specimens of Balclutha from Kenya and Pakistan were provided for examination by the BOLD research group and determined as B. sujawalensis Ahmed, previously known only from India and Pakistan, and this species is also illustrated here.

Morphology, molecular phylogenetics, and DNA barcoding revealed a new unusual species of the aphid genus Pleotrichophorus from the USA (Insecta, Hemiptera: Aphididae).

Here, we present the descriptions of a new aphid species in the genus Pleotrichophorus Brner, 1930 (Hemiptera: Aphididae: Macrosiphini), found by Kenneth L. Hibbard, inspection supervisor for the Florida Department of Agriculture and Consumer Services, Division of Plant Industry. It is associated with Euthamia graminifolia (L.) Nutt. (Asteraceae) a native plant species in Florida, USA. Apterous and alate viviparous and oviparous females of Pleotrichophorus blackmani sp. n. are described and illustrated using light and scanning electron microscopy (SEM). SEM images of apterous viviparous female of Pleotrichophorus glandulosus (Kaltenbach, 1846), type species of the genus Pleotrichophorus, are given for the first time. Taxonomic notes are given, and an updated key to the apterae of the Euthamia-feeding aphids is provided. A multigene phylogenetic analyses of two New World Pleotrichophorus species places the genus in the tribe Macrosiphini sensu stricto. Pleotrichophorus glandulosus, the type species of the genus, was described from Germany. European specimens of P. glandulosus from France had similar molecular sequences to both Florida species, strongly suggesting that the new species belongs in Pleotrichophorus. COI and gnd sequence data indicate that P. blackmani sp. n. can be identified reliably by DNA barcodes.

Presence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies Among Vietnamese Healthcare Workers by Dosing Interval for ChAdOx1 nCoV-19 Vaccine.

BACKGROUND: Before the SARS-CoV-2 Delta variant arrived in Vietnam, case rates suggested seroprevalence of SARS-CoV-2 was low. Beginning in March 2021, we assessed different dosing schedules and adverse events following immunization (AEFIs) for ChAdOx1 nCoV-19 vaccine among healthcare workers (HCWs). METHODS: We performed a prospective cohort study to estimate the prevalence of IgG antibodies to SARS-CoV-2 before and after ChAdOx1 nCoV-19 vaccination. We conducted antibody testing among HCWs in February 2021 (baseline), before the second dose (June-July 2021), and 1 and 3 months after the second dose. We detected antibodies to SARS-CoV-2 using Tetracore® FlexImmArray™, and surrogate neutralizing antibodies using GenScript cPass™. Neither assay can distinguish natural from vaccine-induced antibodies. We assessed AEFIs through interview post-dose 1 and 1 month post-dose 2. RESULTS: Before vaccination, 1/617 participants (0.16%) had antibodies to SARS-CoV-2. Of these 617, 405 were vaccinated with ChAdOx1 nCoV-19 with 4-8- (60%), 9-12- (27%), or ≥13-week (13%) intervals between the 2 doses. Three months following series completion, 99% and 97% of vaccinated participants had ≥1 sample with detectable antibodies and surrogate neutralizing antibodies against SARS-CoV-2, respectively. We observed no significant differences among those with different dosing intervals at last follow-up. All participants reported PCR testing for SARS-CoV-2 during the study; 2 (0.5%) were laboratory-confirmed. AEFIs were more frequent post-dose 1 (81%) vs post-dose 2 (21%). CONCLUSIONS: In this population, regardless of dosing interval, ChAdOx1 nCoV-19 induced antibodies within 3 months of the second dose. These findings may offer flexibility to policymakers when balancing programmatic considerations with vaccine effectiveness.

Regional variability and genotypic and pharmacodynamic effects on PrP concentration in the CNS.

Prion protein (PrP) concentration controls the kinetics of prion replication and is a genetically and pharmacologically validated therapeutic target for prion disease. In order to evaluate PrP concentration as a pharmacodynamic biomarker and assess its contribution to known prion disease risk factors, we developed and validated a plate-based immunoassay reactive for PrP across 6 species of interest and applicable to brain and cerebrospinal fluid (CSF). PrP concentration varied dramatically across different brain regions in mice, cynomolgus macaques, and humans. PrP expression did not appear to contribute to the known risk factors of age, sex, or common PRNP genetic variants. CSF PrP was lowered in the presence of rare pathogenic PRNP variants, with heterozygous carriers of P102L displaying 55%, and D178N just 31%, of the CSF PrP concentration of mutation-negative controls. In rodents, pharmacologic reduction of brain Prnp RNA was reflected in brain parenchyma PrP and, in turn in CSF PrP, validating CSF as a sampling compartment for the effect of PrP-lowering therapy. Our findings support the use of CSF PrP as a pharmacodynamic biomarker for PrP-lowering drugs and suggest that relative reduction from individual baseline CSF PrP concentration may be an appropriate marker for target engagement.

Analysis of medication errors during anaesthesia in the first 4000 incidents reported to webAIRS.

Medication error is a well-recognised cause of harm to patients undergoing anaesthesia. From the first 4000 reports in the webAIRS anaesthetic incident reporting system, we identified 462 reports of medication errors. These reports were reviewed iteratively by several reviewers paying particular attention to their narratives. The commonest error category was incorrect dose (29.4%), followed by substitution (28.1%), incorrect route (7.6%), omission (6.5%), inappropriate choice (5.8%), repetition (5.4%), insertion (4.1%), wrong timing (3.5%), wrong patient (1.5%), wrong side (1.5%) and others (6.5%). Most (58.9%) of the errors resulted in at least some harm (20.8% mild, 31.0% moderate and 7.1% severe). Contributing factors to the medication errors included the presence of look-alike medications, storage of medications in the incorrect compartment, inadequate labelling of medications, pressure of time, anaesthetist fatigue, unfamiliarity with the medication, distraction, involvement of multiple people and poor communication. These data add to current evidence suggesting a persistent and concerning failure effectively to address medication safety in anaesthesia. The wide variation in the nature of the errors and contributing factors underline the need for increased systematic and multifaceted efforts underpinned by a strengthening of the current focus on safety culture to improve medication safety in anaesthesia. This will require the concerted and committed engagement of all concerned, from practitioners at the clinical workface, to those who fund and manage healthcare.

Exceptional larval morphology of nine species of the Anastrephamucronota species group (Diptera, Tephritidae).

Anastrepha is the most diverse and economically important genus of Tephritidae in the American tropics and subtropics. The striking morphology of the third instars of Anastrephacaballeroi Norrbom, Anastrephacrebra Stone, Anastrephahaplacantha Norrbom & Korytkowski, Anastrephakorytkowskii Norrbom, Anastrephanolazcoae Norrbom & Korytkowski, and three newly discovered and as yet formally unnamed species (Anastrepha sp. Peru-82, Anastrephasp.nr.protuberans, and Anastrepha sp. Sur-16), and the more typical morphology of Anastrephaaphelocentema Stone, are described using light and scanning electron microscopy. To contribute to a better understanding of the interspecific and intraspecific variation among species in the mucronota species group and facilitate phylogenetic studies, we integrate molecular and morphological techniques to confirm the identity and describe third instars. Larva-adult associations and the identification of described larvae were confirmed using DNA barcodes. We provide diagnostic characters to distinguish larvae among these nine species of the mucronota group and separate them from those of the 29 other Anastrepha species previously described. We introduce the vertical comb-like processes on the oral margin as a novel character, and the unusual character states, including position and shape of the preoral lobe, and dentate or fringed posterior margins of the oral ridges and accessory plates. Our comparative morphology concurs with most previously inferred phylogenetic relationships within the mucronota group.

New species and host plants of Anastrepha (Diptera: Tephritidae) primarily from Suriname and Par, Brazil.

Seventeen new species of Anastrepha, primarily from Suriname, French Guiana and Par, Brazil, are described and illustrated: A. aithogaster Norrbom from Brazil (Par), French Guiana, and Suriname; A. aliesae Norrbom from Suriname; A. brownsbergiensis Norrbom from Suriname; A. crassaculeus Norrbom Rodriguez Clavijo from Colombia (Magdalena, Norte de Santander) and Suriname; A. curvivenis Norrbom from Brazil (Amazonas), Ecuador (Zamora-Chinchipe), Peru (San Martn), and Suriname; A. fuscoalata Norrbom from Brazil (Par), French Guiana, and Suriname; A. gangadini Norrbom from Suriname; A. juxtalanceola Norrbom from Brazil (Par) and Suriname; A. microstrepha Norrbom from Brazil (Bahia) and Suriname; A. mitaraka Norrbom from French Guiana; A. neptis Norrbom from Brazil (Par), Ecuador (Orellana), Peru (Loreto) and Suriname; A. sobrina Norrbom from Brazil (Par), French Guiana, and Suriname; A. surinamensis Norrbom from Suriname; A. tenebrosa Norrbom from Brazil (Par) and Peru (Loreto); A. triangularis Norrbom from Suriname; A. wachiperi Norrbom from French Guiana and Peru (Cusco); and A. wittiensis Norrbom from Suriname. The following host plant records are reported: A. aithogaster from fruit of Parahancornia fasciculata (Poir.) Benoist (Apocynaceae); A. aliesae from fruit of Passiflora coccinea Aubl. and P. glandulosa Cav. (Passifloraceae); A. crassaculeus from fruit of an undetermined species of Pouteria (Sapotaceae); A. fuscoalata from fruit of Trymatococcus oligandrus (Benoist) Lanj. (Moraceae); A. sobrina from fruit of Eugenia lambertiana DC. (Myrtaceae); and A. wittiensis from fruit of Manilkara bidentata (A. DC.) A. Chev. (Sapotaceae).

Understanding the Factors Related to Trauma-Induced Stress in Cancer Patients: A National Study of 17 Cancer Centers.

OBJECTIVE: Posttraumatic stress symptoms (PTSS), defined as continued trauma, has been found to negatively impact mental and physical health. Many cancer centers routinely assess level of psychological distress but assessment of symptoms related to PTSS is less routine. Understanding the mechanisms by which psychological distress results in, or influences, PTSS will aid in developing protocols to more effectively identify PTSS in cancer patients. METHODS: Survey data were analyzed from intake data at 17 cancer centers across the U.S. Patients reported distress ratings on the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), responded to questions related to intrusive cognitive symptoms of PTSS and provided information about current symptoms and social support systems. Hypotheses were tested using a conditional process model, and paths were provided for direct and indirect effects, including moderation and mediated moderation. RESULTS: Findings indicated that, while distress scores were influential in the total model, the direct effect of distress on intrusive cognitive symptoms of PTSS was negated by the model's indirect effects. The effects of social support and older age were independent protective factors, and there was a moderation effect that varied across groups. Lastly, physical cancer symptoms as a mediating variable further explained the relationship between psychological distress and intrusive cognitive symptoms of PTSS. CONCLUSIONS: Study results provide evidence for a potential mechanism by which distress relates to intrusive cognitive symptoms of PTSS. Furthermore, findings suggest that older age and social support may be protective factors for certain groups and risk factors for others. This study provides formative data for potential next steps that could lead to improvements in routine psychosocial screenings in cancer treatment settings.

Taxonomic and identification review of adventive Fiorinia Targioni Tozzetti (Hemiptera, Coccomorpha, Diaspididae) of the United States.

This work provides general descriptions, illustrations, molecular diagnostic data, taxonomic keys, slide mounting recommendations, and Florida distribution records for Fiorinia Targioni Tozzetti species occurring in the USA. Species treated are F.externa Ferris, F.fioriniae (Targioni Tozzetti), F.japonica Kuwana, F.pinicola Maskell, F.phantasma Cockerell & Robinson, F.proboscidaria Green, and F.theae Green. New descriptions of second-instar males and females of all seven species in addition to first-instar nymphs and adult females of F.phantasma and F.proboscidaria are presented. Taxonomic keys to second-instar males and females are developed for the first time and previously available taxonomic keys to first-instar nymphs and adult females are improved. DNA sequences were used to further evaluate the monophyly of Fiorinia and provide additional diagnostic tools for Fiorinia species. Multigene phylogenetic analyses, COI barcoding methods, and examination of type material indicate that F.yongxingensis Liu, Cai & Feng, 2020, syn. nov. is a junior synonym of F.phantasma. A morphological survey of the genus demonstrates, for the first time, the utility of second-instar males for diagnostics. This study will help inform regulatory and pest management decisions by facilitating morphological and molecular identification of adventive Fiorinia species occurring in the USA.

Descripción de una nueva especie de Anastrepha grupo curvicauda (Diptera: Tephritidae) / Description of a new species of the Anastrepha curvicauda species group (Diptera: Tephritidae)

RESUMEN Las moscas del género Anastrepha, se consideran plagas de gran importancia económica, no solo por el daño directo que causan a la producción de fruta sino, también, por las restricciones de cuarentena impuestas a los países exportadores de fruta. Por lo tanto, preparar descripciones y generar herramientas de identificación taxonómica, que permitan un reconocimiento adecuado y oportuno de las especies de importancia agrícola, es una actividad básica para la sanidad de las plantas en los países productores y exportadores de frutas. En este trabajo, se describe e ilustra Anastrepha ligiae, una nueva especie del grupo Anastrepha curvicauda, capturada con trampas McPhail, en los municipios de Albán y Anolaima (Cundinamarca) y Vélez (Santander), Colombia y criados en la fruta de la papayuela Vasconcellea pubescens A. DC. (Caricaceae). V. pubescens, se registra por primera vez como una planta hospedante para el género Anastrepha.

ABSTRACT Fruit flies of the genus Anastrepha are considered pests of great economic importance because they do not only cause direct damage to the fruit production, but also due to the quarantine restrictions imposed to fruit exporting countries. Therefore, preparing descriptions and generating taxonomic identification tools that allow an appropriate and accurate recognition of the species of agricultural importance are basic plant health activities in the fruit producing and exporting countries. In this work, we describe and illustrate Anastrepha ligiae, a new species of the Anastrepha curvicauda group captured with McPhail traps in the municipalities of Albán and Anolaima (Cundinamarca) and Vélez (Santander), Colombia, and reared from papaya fruit Vasconcellea pubescens A. DC. (Caricaceae). V. pubescens is the first time recorded as a host plant of the genus Anastrepha.

Gryon ancinla Kozlov & Lê (Hymenoptera: Scelionidae): host association, expanded distribution, redescription and a new synonymy.

BACKGROUND: Gryon Haliday (Platygastroidea: Scelionidae) is a cosmopolitan genus of egg-parasitoid wasps primarily associated with Heteroptera. NEW INFORMATION: Gryon ancinla Kozlov & Lê is reported for the first time outside of Vietnam, in China and Cambodia, and as an egg parasitoid of the pestiferous leaf-footed bug, Acanthocoris scaber (L.). Gryon ancinla is redescribed based on recently collected specimens and compared to closely related species of Gryon in the region. Gryon clavaerus Kozlov & Lê is treated as a junior synonym and some characters found in the charon species group are discussed.

Mitochondrial sequence data clarify species concepts in the Cyclocephala mafaffa species complex (Coleoptera: Scarabaeidae: Dynastinae: Cyclocephalini).

The speciose genus Cyclocephala Dejean (Coleoptera: Scarabaeidae: Dynastinae: Cyclocephalini) has attracted research attention due to their diversity, agroeconomic importance, and floral visitation habits. Uniquely among Cyclocephala species, C. mafaffa Burmeister and C. deceptor (Casey), two nearly identical species, are diagnosed by a pronotal character: beaded or not beaded basal pronotal margin. We evaluated these morphological species hypotheses with a phylogenetic analysis of 12S and COI, neighbor-joining analysis, and several single-locus species delimitation procedures (automatic barcode gap analysis and three Poisson tree processes analyses). Together, these analyses supported the species concepts for C. deceptor and C. mafaffa. Delimitation procedures supported several distinct molecular operational taxonomic units among these taxa. We consider the separation of C. deceptor and C. mafaffa to be valid. We conservatively synonymize the West Indian subspecies C. mafaffa grandis Burmeister under C. mafaffa and offer a discussion on subspecific concepts in Cyclocephalini. We designate the lectotype of Stigmalia deficiens Casey. Implications of this study for other geographically widespread cyclocephalines or species with variable pronotal morphology are discussed.

CERE-120 Prevents Irradiation-Induced Hypofunction and Restores Immune Homeostasis in Porcine Salivary Glands.

Salivary gland hypofunction causes significant morbidity and loss of quality of life for head and neck cancer patients treated with radiotherapy. Preventing hypofunction is an unmet therapeutic need. We used an adeno-associated virus serotype 2 (AAV2) vector expressing the human neurotrophic factor neurturin (CERE-120) to treat murine submandibular glands either pre- or post-irradiation (IR). Treatment with CERE-120 pre-IR, not post-IR, prevented hypofunction. RNA sequencing (RNA-seq) analysis showed reduced gene expression associated with fibrosis and the innate and humoral immune responses. We then used a minipig model with CERE-120 treatment pre-IR and also compared outcomes of the contralateral non-IR gland. Analysis of gene expression, morphology, and immunostaining showed reduced IR-related immune responses and improved secretory mechanisms. CERE-120 prevented IR-induced hypofunction and restored immune homeostasis, and there was a coordinated contralateral gland response to either damage or treatment. CERE-120 gene therapy is a potential treatment for head and neck cancer patients to influence communication among neuronal, immune, and epithelial cells to prevent IR-induced salivary hypofunction and restore immune homeostasis.

A fortuitous find: a unique haplotype of Ooencyrtus nezarae Ishii (Encyrtidae: Encyrtinae) discovered in Florida.

The adventive arrival of biological control agents circumvents the regulatory process by introducing exotic species to control invasive pests and is generally followed by post hoc risk evaluation. The bean plataspid, Megacopta cribraria (Fabricius) (Hemiptera: Plataspidae), is an invasive pest of leguminous crops in the south-eastern United States that was eventually followed by two parasitoid wasps from its range in the eastern hemisphere, Paratelenomus saccharalis (Dodd) (Scelionidae) and Ooencyrtus nezarae Ishii (Encyrtidae). In North Central Florida, sentinel egg masses, intended to capture Paratelenomus saccharalis, instead yielded Ooencyrtus nezarae, which was previously known only from Alabama (Ademokoya et al. 2018). Two generations of O. nezarae were subsequently reared in the laboratory. COI sequences from the Florida population of O. nezarae differed by 1.3% from the Alabama population and the presence of a different haplotype suggests the possibility of a separate introduction. Laboratory parasitism rates, sex ratios, morphology, molecular diagnosis and implications for agriculture are discussed.

Measurement of patient-reported outcomes after laparoscopic cholecystectomy: a systematic review.

BACKGROUND: Patient-reported outcome (PRO) measures (PROMs) are increasingly used as endpoints in surgical trials. PROs need to be consistently measured and reported to accurately evaluate surgical care. Laparoscopic cholecystectomy (LC) is a commonly performed procedure which may be evaluated by PROs. We aimed to evaluate the frequency and consistency of PRO measurement and reporting after LC. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for prospective studies reporting PROs of LC, between 2013 and 2016. Data on the measurement and reporting of PROs were extracted. RESULTS: A total of 281 studies were evaluated. Forty-five unique multi-item questionnaires were identified, most of which were used in single studies (n = 35). One hundred and ten unique rating scales were used to assess 358 PROs. The visual analogue scale was used to assess 24 different PROs, 17 of which were only reported in single studies. Details about the type of rating scale used were not given for 72 scales. Three hundred and twenty-three PROs were reported in 162 studies without details given about the scale or questionnaire used to evaluate them. CONCLUSIONS: Considerable variation was identified in the choice of PROs reported after LC, and in how they were measured. PRO measurement for LC is focused on short-term outcomes, such as post-operative pain, rather than longer-term outcomes. Consideration should be given towards the development of a core outcome set for LC which incorporates PROs.

Mental Simulation of Facial Expressions: Mu Suppression to the Viewing of Dynamic Neutral Face Videos.

The mirror neuron network (MNN) has been proposed as a neural substrate of action understanding. Electroencephalography (EEG) mu suppression has commonly been studied as an index of MNN activity during execution and observation of hand and finger movements. However, in order to establish its role in higher order processes, such as recognizing and sharing emotions, more research using social emotional stimuli is needed. The current study aims to contribute to our understanding of the sensitivity of mu suppression to facial expressions. Modulation of the mu and occipital alpha (8-13 Hz) rhythms was calculated in 22 participants while they observed dynamic video stimuli, including emotional (happy and sad) and neutral (mouth opening) facial expressions, and non-biological stimulus (kaleidoscope pattern). Across the four types of stimuli, only the neutral face was associated with a significantly stronger mu suppression than the non-biological stimulus. Occipital alpha suppression was significantly greater in the non-biological stimulus than all the face conditions. Source estimation standardized low resolution electromagnetic tomography (sLORETA) analysis comparing the neural sources of mu/alpha modulation between neutral face and non-biological stimulus showed more suppression in the central regions, including the supplementary motor and somatosensory areas, than the more posterior regions. EEG and source estimation results may indicate that reduced availability of emotional information in the neutral face condition requires more sensorimotor engagement in deciphering emotion-related information than the full-blown happy or sad expressions that are more readily recognized.

Evaluation of an integrated multisector campaign to increase child helmet use in Vietnam.

OBJECTIVE: This study presents child helmet use before, during and after implementing the Vietnamese National Child Helmet Action Plan (NCHAP) and evaluates its effect on child helmet use. The NCHAP, an integrated multisector campaign, incorporated a wide-scale public awareness campaign, school-based interventions, increased police patrolling and enforcement, and capacity building and support to relevant government departments in target provinces. METHODS: In Vietnam's three largest cities, 100 schools in 20 districts were selected to monitor motorcycle helmet use behaviour. The effectiveness of the NCHAP was measured by unannounced, filmed observations of student motorcycle passengers and their adult drivers as they arrived or left their schools at four points. Baseline observations at each school were conducted in March 2014, with subsequent observations in April 2015, December 2015 and May 2016. RESULTS: Across the 84 218 observed students, student helmet prevalence increased from 36.1% in March 2014 to 69.3% immediately after the initiation in April 2015. Subsequent observations in December 2015 and May 2016 showed a reduction and stabilisation of helmet use, with 49.8% and 56.9% of students wearing helmets, respectively. Helmet use in students was higher when adult drivers were also wearing helmets. CONCLUSIONS: Integrated multisectoral interventions between governments, civil society and the corporate sector that incorporate communications, school-based education, incentives for change and police enforcement have the potential to increase helmet use among children. Future integrated campaigns may be more effective with an increased focus on parents and other adult drivers given their potential influence on child helmet use.