Corrigendum: Endothelial ß-catenin deficiency causes blood-brain barrier breakdown via enhancing the paracellular and transcellular permeability.

[This corrects the article DOI: 10.3389/fnmol.2022.895429.].

Cross-cultural ethnobotany of the Baltis and Shinas in the Kharmang district, Trans-Himalaya India-Pakistan border.

Human communities that inhabit the political borders live a transitional life, which is due to several socio-political and geo-climatic factors. The current cross-cultural ethnomedicinal study was conducted at the highly elevated Pakistan-India borders of the Western Himalayas in order to address the medicinal flora and folk knowledge of Balti and Shina communities. Ethnobotanical field surveys were conducted from May 2021 to September 2022. We used semi-structured interviews in order to collect the ethnomedicinal data. The collected data was analyzed using the relative frequency of the citations, use value, and Venn diagrams. A total of 140 interviews were conducted, which comprised of 90 (64.28%) Baltis and 50 (35.71%) Shinas. The interviews recorded 60 medicinal plant species that belong to 56 genera and 35 families. Asteraceae (5 spp.), Lamiaceae (5 spp.), and Apiaceae (4 spp.) were the families that were the most represented. These medicinally valued plants were being used for 55 health issues that are related to different body systems. Delphinium brunonianum, Thymus linearis, Hymenolaena candollei, Corydalis adiantifolia, and Seriphidium brevifolium were medicinal taxa with maximum RFCs and UV. The Baltis have comparatively more ethnomedicinal knowledge than the Shinas. The Baltis commonly used 22 (36.66%) species, which 34 (56.66%) were exclusive to the Baltis and 4 (6.66%) to the Shinas. Both ethnic groups collectively hold significant ethnobotanical knowledge that demands the preservation of risked folk knowledge, which is due to uncertain border situations, outmigration, and permeating allopathic drugs.

Assessment of the impact of integrated disease surveillance and response system on surveillance management at healthcare facilities in Pakistan.

Background: Disease surveillance is very crucial especially in high vulnerability settings like Pakistan. However, surveillance and outbreak response management are still evolving in the country and research studies are needed to assess the existing system. Aim: To assess the impact of integrated disease surveillance and response system (IDSRS) implemented by the provincial government to strengthen infectious disease surveillance and reporting in 6 districts of Pakistan in 2016. Methods: A baseline cross-sectional assessment of health facilities and the healthcare workforce was conducted in 2016 to identify needs and gaps in public sector health facilities and the health system of 6 selected districts of Khyber Pakhtunkhwa Province, Pakistan. This was followed by a 2018 endline survey of the same facilities using the same variables. Results: Overall, there was improvement in district management and facility level performance (χ2 (1, 314) = 21.19, P < 0.001, V = 0.26). District level management improved significantly in areas with relatively lower Gross Domestic Product (GDP)? χ2(1, 154) = 30.41, P <0.001, V = 0.44). Facilitation domain variables improved in the lower GDP districts (χ2 (1, 74) = 5.76, P = 0.016, V = 0.28) and showed counterintuitive deterioration (χ2 (1, 74) = 4.80, P = 0.028, V = 0.25) in relatively higher GDP areas. Conclusion: IDSRS is effective in improving surveillance and response systems, however, its effectiveness appears to depend on locale-specific economies and can be enhanced by modifying the implementation approach. Better empowerment of the local workforce can contribute to such improvement.

Psychological intervention for a person living with amblyopia: a case study from home-based integrated care.

Amblyopia is a common developmental disability resulting in reduced visual acuity and gaze stability; it occurs in approximately 5% of the general population. Here, we present the case of an 18-year-old girl diagnosed with amblyopia. Subsequent to her diagnosis of amblyopia, she developed a depressive episode with co-morbid anxiety symptoms. She was treated with low intensity psychological intervention, Problem Management Plus, as home-based intervention. This intervention was associated both subjectively and objectively utilising psychometric measures (i.e. psychiatric interview, depression, anxiety and stress scale, general health questionnaire) with a significant amelioration of her mental state. This case provides preliminary evidence for the effectiveness of Problem Management Plus intervention and suggests that this intervention should be considered for other individuals with similar clinical presentations.

Longitudinal realist evaluation of the Dementia PersonAlised Care Team (D-PACT) intervention: protocol.

BACKGROUND: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial. AIM: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact. DESIGN & SETTING: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings. METHOD: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and 'near misses'. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis. CONCLUSION: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.

Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review.

Introduction: Loneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored. Objective: To synthesize the literature related to loneliness and social networks of older adults in rural settings. Methods: A mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically. Results: A total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based. Conclusion: The prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.

A multicomponent equimolar proton-conducting quadruple hexagonal perovskite-related oxide system.

Since the high configurational entropy-driven structural stability of multicomponent oxide system was proposed Rost et al. in 2015, many experiments and simulations have been done to develop new multicomponent oxides. Although many notable findings have shown unique physical and chemical properties, high configurational entropy oxide systems that have more than 3 distinct cation sites are yet to be developed. By utilizing atomic-scale direct imaging with scanning transmission electron microscopy and AC-impedance spectroscopy analysis, we demonstrated for the first time that a multicomponent equimolar proton-conducting quadruple hexagonal perovskite-related Ba5RE2Al2ZrO13 (RE = rare earth elements) oxide system can be synthesized even when adding eight different rare earth elements. In particular, as the number of added elements was increased, i.e., as the configurational entropy was increased, we confirmed that the chemical stability toward CO2 was improved without a significant decrement of the proton conductivity. The findings in this work broaden the use of the crystal structure to which the multicomponent model can be applied, and a systematic study on the correlation between the configurational entropy and proton conductivity and/or chemical stability is noteworthy.

Health Help-Seeking Behavior: The Scavengers' Perspective.

Scavengers are prone to various health problems, hence seeking healthcare is inevitable. Despite the importance of the help-seeking behavior of scavengers, it has not been addressed explicitly in the existing literature. Addressing this gap, this study intends to explore the help-seeking behavior of scavengers and to identify the factors that influence healthcare utilization among them. This qualitative study conducted thirty-one in-depth interviews through a semi-structured interview guide and analyzed them using thematic analysis. Andersen's Behavioral Model of Health Service Use was employed to explore the findings. The findings showed that the scavengers utilized multiple healthcare options depending on the severity and reoccurrence of the illness. The process of help-seeking and health services utilization was largely influenced by the cost of the health service, long distance to the health facility, traveling cost and waiting time. The study highlights the need for scavengers' enrolment in micro health insurance schemes. The initiative would facilitate scavengers' access to medical care. Health awareness campaigns and the provision of free mobile medical services, especially at the landfill sites, would also improve curative treatment among scavengers.

Suicidal tendencies and psychiatric symptoms as consequence of anabolic androgenic steroid usage among athletes in District Rawalpindi.

OBJECTIVE: To elucidate the possible association between suicidal tendencies and psychiatric symptoms associated with anabolic androgenic steroid usage among athletes. Methods: The cross-sectional study was conducted from December 2016 to July 2017 in Rawalpindi and Wah Canttonment, Pakistan, after approval from the International Islamic University, Islamabad, and comprised male athletes aged >18 years. Those using androgenic anabolic steroid formed group A, while the non-users were in group B. In addition to demographics, data was collected using Beck Scale for Suicidal Ideation and the Symptoms Checklist-90. Data was analysed using SPSS 22. RESULTS: Of the 60 subjects, there were 30 (50%) in each of the two groups. The majority were aged 24-26 years 41 (68.30%). Group A scored significantly higher compared to group B on suicidal ideation, had more interpersonal problems, depression, hostility, paranoia and psychoticism (p<0.05). Unemployment and low household income increased steroid usage (p<0.05). CONCLUSIONS: There was found to be a significant association of anabolic androgenic steroid use with suicidal tendencies and mental health issues.

Endothelial ß-Catenin Deficiency Causes Blood-Brain Barrier Breakdown via Enhancing the Paracellular and Transcellular Permeability.

Disruption of the blood-brain barrier (BBB) causes or contributes to neuronal dysfunction and several central nervous system (CNS) disorders. Wnt/ß-catenin signaling is essential for maintaining the integrity of the adult BBB in physiological and pathological conditions, including stroke. However, how the impairment of the endothelial Wnt/ß-catenin signaling results in BBB breakdown remains unclear. Furthermore, the individual contributions of different BBB permeability-inducing mechanisms, including intercellular junction damage, endothelial transcytosis, and fenestration, remains unexplored. Here, we induced ß-catenin endothelial-specific conditional knockout (ECKO) in adult mice and determined its impact on BBB permeability and the underlying mechanism. ß-catenin ECKO reduced the levels of active ß-catenin and the mRNA levels of Wnt target genes in mice, indicating downregulation of endothelial Wnt/ß-catenin signaling. ß-catenin ECKO mice displayed severe and widespread leakage of plasma IgG and albumin into the cerebral cortex, which was absent in wild-type controls. Mechanistically, both the paracellular and transcellular transport routes were disrupted in ß-catenin ECKO mice. First, ß-catenin ECKO reduced the tight junction protein levels and disrupted the intercellular junction ultrastructure in the brain endothelium. Second, ß-catenin ECKO substantially increased the number of endothelial vesicles and caveolae-mediated transcytosis through downregulating Mfsd2a and upregulating caveolin-1 expression. Interestingly, fenestration and upregulated expression of the fenestration marker Plvap were not observed in ß-catenin ECKO mice. Overall, our study reveals that endothelial Wnt/ß-catenin signaling maintains adult BBB integrity via regulating the paracellular as well as transcellular permeability. These findings may have broad applications in understanding and treatment of CNS disorders involving BBB disruption.

Overcoming COVID-19 vaccine hesitancy among ethnic minorities: A systematic review of UK studies.

Ethnic minority communities in the UK have been disproportionately affected by the pandemic, with increased risks of infection, severe disease, and death. Hesitancy around the COVID-19 vaccine may be contributing to disparities in vaccine delivery to ethnic minority communities. This systematic review aims to strengthen understanding of COVID-19 vaccine concerns among ethnic minorities in the UK. Five databases were searched in February 2022, yielding 24 peer-reviewed studies reporting on vaccine hesitancy or acceptance in ethnic minority groups. Data were extracted using a standardised form, and quality assessment was carried out using the Standard Quality Criteria. There were three key themes: (1). Prevalence of vaccine hesitancy; (2). Reasons for vaccine hesitancy and acceptance; and (3). Recommendations to address vaccine concerns. Vaccine hesitancy, which was more common among some ethnic minority groups, is a complex phenomenon, driven by misinformation, mistrust, concerns about safety and efficacy, and structural and systemic inequities. Community engagement and tailored communication may help to address vaccine concerns. Robust data disaggregated by ethnicities are needed to better understand barriers and facilitators for COVID-19 vaccine delivery in ethnic minority communities. Strategies to address structural disadvantage need to be inclusive, comprehensive, and behaviorally informed and foster confidence in healthcare systems and governments. Community leaders and health care practitioners may prove to be the most important agents in creating an environment of trust within ethnic minority groups.

Performance measurement and management in the British higher education sector.

Theoretical enquiry and empirical studies demonstrate the significance of performance management (PM) in the higher education sector and it is a fulcrum for developing a strategic role for people management within universities. In spite of the perceived weaknesses of people management in the higher education sector, in general, the current period of rapid and substantial contextual change may necessitate greater formalisation of HR practices across the British higher education sector. In addition to the changing role of the HR function and line managers, these developments may result in an increasingly stringent performance regime across the sector, especially in more hard-pressed institutions. Through a literature review and a pilot study, this paper attempts to address two main research questions: (i) what are the current performance management practices in the British Higher Education sector? and (ii) what needs to be done to strategically align these practices within HEIs in the UK? This paper discusses the wider literature related to performance management in general and to academic institutions in particular. We also undertook a small-scale qualitative study to explore the views of HR professionals on the need for, and the current performance measurement systems in their universities in the UK. The preliminary findings confirmed that PM is a key issue in the respondents' institutions, with substantial and recent changes in policy. This underscores the need for a large-scale research agenda to capture the current dynamics of change the sector is undergoing. The paper concludes by stimulating a policy debate and placing a number of research calls, along with suggestions on how these research questions may be investigated.

Health-care professionals coping responses to the COVID-19 pandemic in Pakistan.

BACKGROUND: In the initial stage of infectious diseases such as COVID-19 creates a prodigious uncertainty not only in general population but also in health care professionals. This often leads to emotional distress in general public and particularly in health care professionals. OBJECTIVES: During COVID-19 pandemic in Pakistan, the health care professionals experienced unusual stressors. This study aimed to examine the coping responses, optimism, pessimism and psychiatric morbidity of health professionals serving the COVID-19 patients. PARTICIPANTS: Total 87, health care professionals take part in study, whom 36 were physicians and 51 nursing staff. Among these 44 were male, and 43 were female. METHOD: Researchers used cross sectional research design in this study. Physicians and nurses completed self-reported questionnaires. Participants provided demographics data and recorded their responses to self-administered questionnaires. Researchers administered Brief coping orientation to problems experiences (COPE) for assessing the coping strategies, while they assessed psychiatric morbidity through general health questionnaires. Similarly, future expectancy of health care professional was assessed by using life orientation scale. Participants were recruited from quarantine words in two federal government hospitals providing health care services to COVID-19 patients in Pakistan. RESULT: The result showed a significant relationship in optimism and problem focus coping style and avoidance coping style. Moreover, male health professionals score high on optimism as compared to female health professionals. While, avoidance coping style were seen higher in female health professional as compare to male. The result revealed that optimism and psychiatric morbidity were significantly positive in health professionals having problem focus and avoidance coping style.

Blood-Brain Barrier Breakdown: An Emerging Biomarker of Cognitive Impairment in Normal Aging and Dementia.

The blood-brain barrier (BBB) plays a vital role in maintaining the specialized microenvironment of the neural tissue. It separates the peripheral circulatory system from the brain parenchyma while facilitating communication. Alterations in the distinct physiological properties of the BBB lead to BBB breakdown associated with normal aging and various neurodegenerative diseases. In this review, we first briefly discuss the aging process, then review the phenotypes and mechanisms of BBB breakdown associated with normal aging that further cause neurodegeneration and cognitive impairments. We also summarize dementia such as Alzheimer's disease (AD) and vascular dementia (VaD) and subsequently discuss the phenotypes and mechanisms of BBB disruption in dementia correlated with cognition decline. Overlaps between AD and VaD are also discussed. Techniques that could identify biomarkers associated with BBB breakdown are briefly summarized. Finally, we concluded that BBB breakdown could be used as an emerging biomarker to assist to diagnose cognitive impairment associated with normal aging and dementia.

Psychosocial functioning of the patient with spinal cord and whiplash injury: A case report.

Whiplash is a soft tissue injury of the cervical spine that is generally caused by trauma from a motor vehicle accident or gunshot. It is associated with a wide range of clinical symptoms, including neck pain and stiffness, pain and restricted movement in the upper arms. We report the manifestations of this trauma within the beliefs and psychological functioning based on a comprehensive psychological assessment that include a review of hospital records, clinical examinations, a structured clinical interview, an inventory of psychosocial function, and a post-traumatic maladaptive belief scale. The results show that the patient's traumatic cervical syndrome manifested as moderate impairment in friendships and romantic relationships which reveal severe daily impairment in work, parenting, and self-care activities. The study further suggests that the injury is associated with maladaptive beliefs and significant impairment in psychosocial functioning.

Updates on Clinical and Genetic Heterogeneity of ASPM in 12 Autosomal Recessive Primary Microcephaly Families in Pakistani Population.

Microcephaly (MCPH) is a genetically heterogeneous disorder characterized by non-progressive intellectual disability, small head circumference, and small brain size compared with the age- and sex-matched population. MCPH manifests as an isolated condition or part of another clinical syndrome; so far, 25 genes have been linked with MCPH. Many of these genes are reported in Pakistani population, but due to a high rate of consanguinity, a significant proportion of MCPH cohort is yet to be explored. MCPH5 is the most frequently reported type, accounting for up to 68.75% alone in a genetically constrained population like Pakistan. In the current study, whole exome sequencing (WES) was performed on probands from 10 families sampled from South Waziristan and two families from rural areas of the Pakistani Punjab. Candidate variants were validated through Sanger sequencing in all available family members. Variant filtering and in silico analysis identified three known mutations in ASPM, a MCPH5-associated gene. The founder mutation p.Trp1326* was segregating in 10 families, which further confirmed the evidence that it is the most prominent mutation in Pashtun ethnicity living in Pakistan and Afghanistan. Furthermore, the previously known mutations p.Arg3244* and p.Arg1019* were inherited in two families with Punjab ethnic profile. Collectively, this study added 12 more families to the mutational paradigm of ASPM and expanded the Pakistani MCPH cohort.

Indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU): A randomized controlled trial.

This study aims to assess whether 12 sessions of indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared with brief educational data alone (n = 62). Symptoms of depression, anxiety, stress, and peer relations were also compared between the two groups. The IACBT-ESU group demonstrated significant reductions in excessive smartphone use, with reduced symptoms of depression, anxiety, stress, hyperactivity, and emotional difficulties at both trial end and at 3-month follow-up (p < .01) compared with control participants. IACBT-ESU was associated with reduced excessive smartphone use and improved psychological well-being, with beneficial findings maintained 3 months after the trial's end. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Peripheral inflammation and blood-brain barrier disruption: effects and mechanisms.

The blood-brain barrier (BBB) is an important physiological barrier that separates the central nervous system (CNS) from the peripheral circulation, which contains inflammatory mediators and immune cells. The BBB regulates cellular and molecular exchange between the blood vessels and brain parenchyma. Normal functioning of the BBB is crucial for the homeostasis and proper function of the brain. It has been demonstrated that peripheral inflammation can disrupt the BBB by various pathways, resulting in different CNS diseases. Recently, clinical research also showed CNS complications following SARS-CoV-2 infection and chimeric antigen receptor (CAR)-T cell therapy, which both lead to a cytokine storm in the circulation. Therefore, elucidation of the mechanisms underlying the BBB disruption induced by peripheral inflammation will provide an important basis for protecting the CNS in the context of exacerbated peripheral inflammatory diseases. In the present review, we first summarize the physiological properties of the BBB that makes the CNS an immune-privileged organ. We then discuss the relevance of peripheral inflammation-induced BBB disruption to various CNS diseases. Finally, we elaborate various factors and mechanisms of peripheral inflammation that disrupt the BBB.

An Urdu adaptation of smartphone addiction scale-short version (SAS-SV).

OBJECTIVE: To adapt the English version of Smartphone Addiction Scale-Short Version into Urdu language. METHODS: The cross-sectional study was conducted from October 2017 to January 2018 at the International Islamic University, Islamabad, Pakistan. In the first stage, Smartphone Addiction Scale-Short Version was translated by 8 experts. In stage 2, the translated version was pilot-tested on 30 university students aged 18-19. Finally, the version was tested on the actual subjects who were students aged 11-30 years at schools, colleges and universities within Rawalpindi and Islamabad. SPSS 22 was used for data analysis. RESULTS: Of the 348 subjects, 216(62%) were males. Overall, 194(55.7%) students were above the addiction cutoff value. Inter-item reliability of the translated version was good (α = 0.81); the construct validity was adequate (P<0.001); Comparative Fit Index = 0.95; Tucker Lewis Index= 0.93; Normative Fit Index= 0.92; and Root Mean Squared Error Approximation = 0.05. CONCLUSIONS: Smartphone Addiction Scale-Short Version can be used as a screening tool for assessment and identification of smartphone addiction in Pakistan..