Where is Batho Pele? The perspective of child and adolescent mental health service users in the Western Cape Province of South Africa.

Background: Mental health disorders of children and adolescents represent a key area of concern, yet child and adolescent mental health services (CAMHS) are neglected, especially in low- and middle-income countries. There is a clear need to provide services that are relevant to the needs of service users, but little research to date has explored their needs and experiences of services, or to identify their recommendations for service strengthening. In 1997 the South African Government introduced the "Batho Pele" ('People First') initiative in all public sector services, with the aim of putting the voices of service users at the centre of decision-making of policy development and implementation.

Intravesical Instillation of Chemotherapy Before Radical Surgery for Upper Urinary Tract Urothelial Carcinoma: The REBACARE Trial.

Background And Objective: Intravesical instillation of chemotherapy (IIC) after radical surgery for upper urinary tract urothelial carcinoma (UTUC) reduces the risk of intravesical recurrence (IVR). However, compliance is low because of possible extravesical leakage after bladder cuff excision. The aim of this study was to evaluate the efficacy of preoperative IIC in reducing the risk of IVR.

Genomic and phenotypic correlates of mosaic loss of chromosome Y in blood.

Mosaic loss of Y (mLOY) is the most common somatic chromosomal alteration detected in human blood. The presence of mLOY is associated with altered blood cell counts and increased risk of Alzheimer disease, solid tumors, and other age-related diseases. We sought to gain a better understanding of genetic drivers and associated phenotypes of mLOY through analyses of whole-genome sequencing (WGS) of a large set of genetically diverse males from the Trans-Omics for Precision Medicine (TOPMed) program.

The expected polygenic risk score (ePRS) framework: an equitable metric for quantifying polygenetic risk via modeling of ancestral makeup.

Polygenic risk scores (PRSs) depend on genetic ancestry due to differences in allele frequencies between ancestral populations. This leads to implementation challenges in diverse populations. We propose a framework to calibrate PRS based on ancestral makeup.

Migratory movements of bats are shaped by barrier effects, sex-biased timing and the adaptive use of winds.

Background: Migratory bats perform seasonal movements between their summer and winter areas. When crossing ecological barriers, like the open sea, they are exposed to an increased mortality risk due to energetically demanding long-distance flights and unexpected inclement weather events. How such barriers affect bat migratory movements is still poorly known.

Adapting an early autism caregiver coaching intervention for telehealth delivery in low-resource settings: A South African study of the 'what' and the 'why'.

We were busy with an early autism caregiver-coaching programme in South Africa, when COVID-19 stopped all in-person work. We changed the programme so it could be done using computers and/or phones. Here, we describe programme changes (which we call the 'what') and the reasons for those changes (which we call the 'why').

Binary Nature of Collisions Facilitates Runaway Electron Generation in Weakly Ionized Plasmas.

Dreicer generation is one of the main mechanisms of runaway electron generation in weakly ionized plasmas. It is often described as a diffusive flow from the Maxwellian core into high energies under the effect of the electric field. In this Letter we demonstrate a critical role of the binary nature of inelastic collisions in weakly ionized plasma during tokamak startup, where some electrons experience virtually no collisions during acceleration to the critical energy.

[Trial of labor and gynecological uterine scars : a narrative review].

The increasing number of women of childbearing age with gynecological uterine scars presents a significant clinical challenge. -Planning the route of birth for a subsequent pregnancy necessitates -careful consideration and should be the subject of an informed -discussion. Unfortunately, the heterogeneity of data in the literature with regards to gynecological uterine scars makes this choice -debatable.

Prostate Cancer-related Events in Patients with Synchronous Metastatic Hormone-sensitive Prostate Cancer Treated with Androgen Deprivation Therapy with and Without Concurrent Radiation Therapy to the Prostate; Data from the HORRAD Trial.

Background And Objective: A survival benefit was demonstrated for patients with low-volume synchronous metastatic hormone-sensitive prostate cancer (mHSPCa) when local radiotherapy to the prostate was added to androgen deprivation therapy. This study aims to determine the incidence of prostate cancer-related events and treatments in those who received and those who did not receive external beam radiotherapy for mHSPCa.

Methods: The HORRAD trial is a multicentre randomised controlled trial recruiting originally 432 patients with mHSPCa diagnosed between 2004 and 2014.

Regulation of fibrinogen synthesis.

The plasma protein fibrinogen is encoded by 3 structural genes (FGA, FGB, and FGG) that are transcribed to mRNA, spliced, and translated to 3 polypeptide chains (Aα, Bβ, and γ, respectively). These chains are targeted for secretion, decorated with post-translational modifications, and assembled into a hexameric "dimer of trimers" (AαBβγ). Fully assembled fibrinogen is secreted into the blood as a 340 kDa glycoprotein.

ECOTOXr: An R package for reproducible and transparent retrieval of data from EPA's ECOTOX database.

The US EPA ECOTOX database provides key ecotoxicological data that are crucial in environmental risk assessment. It can be used for computational predictions of toxicity or indications of hazard in a wide range of situations. There is no standardised or formalised method for extracting and subsetting data from the database for these purposes.

A Large-Scale Genome-Wide Study of Gene-Sleep Duration Interactions for Blood Pressure in 811,405 Individuals from Diverse Populations.

Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes.

Accessibility and satisfaction's analysis of simulation-based training in surgery for residents and surgical fellows in France.

Background: In surgery, simulated-based training improves the knowledge and interpersonal skills needed for surgeons to improve their performance and meet the "never the first time on a patient" imperative. The objective is to evaluate the effects of a 2017 reform on surgeon's accessibility to simulation-based training, five years after the implementation of the program, and to gauge surgeon satisfaction.

Methods: A 27-item national online survey was sent to all surgical residents and fellows in the 13 surgical specialties.

Time to redefine prolonged third stage of labor? A systematic review and meta-analysis of the length of the third stage of labor and adverse maternal outcome after vaginal birth.

Objective: This study aimed (1) to assess the association between the length of the third stage of labor and adverse maternal outcome after vaginal birth and (2) to evaluate whether earlier manual placenta removal reduces the risk of adverse outcome.

Data Sources: PubMed, MEDLINE, Embase, ClinicalTrials.gov, the Cochrane Library, Journals@Ovid, and the World Health Organization International Clinical Trials Registry were searched from January 1, 2000, to June 13, 2023.

A cumulative impact assessment on the marine capacity to supply ecosystem services.

Ecosystem services link the status of biodiversity and its functioning to societal goods and benefits contributing to human wellbeing. As such, they can play a key role in preserving the environment and managing natural resources and ecosystems to conserve nature's contributions to people. Identification of the main threats acting on the natural environment, and how these may impact its capacity to supply ecosystem services, is fundamental to the maintenance of these services.

Demographic and mental health profile of youth in a gender service: An African case series.

Background: Despite a massive global increase in research on gender-diverse youth, there have been no studies in Africa on gender-diverse children and adolescents presenting to health services.

Aim: This study aimed to present the first African findings of the demographic and mental health profile of youth who have presented at a gender service in South Africa.

Setting: A specialist mental health outpatient service, consisting of psychiatry, psychology and nursing input, for gender-diverse child and adolescent patients in the Western Cape.