Prevalence, socio-demographic and economic determinants of violence against ever-married women in Morocco

Background

Violence against women is a public health issue worldwide, affecting the physical and mental wellbeing of women, children and families.

Aim

To determine the socio-demographic and economic factors contributing to violence against women in Morocco and offer recommendations for the prevention and reduction of violence.

Methods

Data for this study was obtained from the 2018 National Population and Family Health Survey. We applied the Chi-square test and t-test to study the possible associations between some socio-demographic and economic variables and violence against women. We performed a logistic regression to indicate the simultaneous association of the variables.

Results

Among 9969 ever-married women aged 15-49, 15.0% [CI (95%): 14.3-15.7%] had suffered an act of violence in the last 12 months preceding the survey (17.0% in urban and 11.9% in rural areas). Violence against women depended significantly on age, age at first marriage, marital status, total children ever born, educational level, wealth index, being a household head, employment status, decision-maker regarding employment, number of marriages ever had, smoking, relationship with the husband, husband's age, husband's educational level, husband's polygamy, area of residence, and region of residence (P < 0.05).

Conclusion

Violence against women has reached endemic proportions in Morocco and this has serious consequences for population health and the country's economy. There is a need to reinforce and better structure public health programmes to sustainably prevent or reduce violence against women in the country. It is also important to take actions to mitigate the risk factors and provide adequate and quality care for victims.

Constructing a South Asian cardiovascular disease: a qualitative analysis on how researchers study cardiovascular disease in South Asians

BACKGROUND

Debates on the use of race in biomedical research have typically overlooked immigrant groups outside of the black-white racial dichotomy. Recent biomedical research on South Asians and cardiovascular disease provides an opportunity to understand how scientists define race and interpret racial health disparities from an underexamined perspective.

PURPOSE

To examine how researchers in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study defined a South Asian population, and then compared health differences between South Asians and other populations.

METHODS

Qualitative content analysis was performed on eleven articles from August 2013 to January 2021 that directly compared the South Asian cohort in MASALA to four other groups. The MASALA study design article was also included in this analysis. Articles were analysed for how South Asians were defined, and for how health differences between South Asians and other populations were studied and discussed.

RESULTS

Researchers in MASALA were neither clear nor precise in defining South Asians as either an ancestral group or ethnic group. Their studies also prioritised investigating genetic and molecular causes of the cardiovascular health disparity between South Asians and other populations and failed to examine possible social factors.

CONCLUSIONS

These findings reflect a broader trend in biomedical research in which race and racial health disparities are poorly defined and studied, limiting scientists' understanding of the relationship between race and health. I propose methodologies to help researchers define populations and design studies without relying on biologically reductive assumptions.

"Health Outcomes of Grandparents Caring for Double Orphans in South Africa": What Are the Determinants?

In the 21st century, grandparenthood is a significant phenomenon in the fields of demography, gerontology, and sociology. It is mainly explored in the context of ageing, as it is poised to become one of the most significant demographic phenomena and social issues in contemporary South Africa. Therefore, this study examined the determinants associated with grandparents who are parenting as caregivers and the health challenges they are exposed to as caregivers. The National Income Dynamics Study (NIDS) Wave 5 dataset was utilised, and a total of 302,476 grandparents aged 25 years and older, who were reported to be primary caregivers of double orphans, were included in the analysis. Both bivariate and multivariate binary logistic regressions were performed to determine the predictors of the determinants of grandparents parenting as caregivers and their health challenges in South Africa. Estimated odds ratios (ORs) with 95% confidence intervals (CIs) were used, and the threshold for statistical significance was established at ρ < 0.05. A majority of the male and female grandparent caregivers were aged 24-34 years, were Black Africans (69.8%), had secondary education (46.9%), reported health challenges (HC) (59.7%), with 26.4% reporting headaches in the last 30 days. Logistic regression revealed that grandparent caregivers aged 55-64 years were 8.9 times more likely to report health challenges compared to those aged 25-34 years. Non-Black African grandparent caregivers were found to be 0.61 times less likely to report health challenges, compared to Black African grandparent caregivers. Those with perceived poor health status were 3.3 times more likely to report health challenges, compared to those with excellent perceived health status. Therefore, there is an urgent need to redesign health interventions to address these health burdens among grandparent caregivers and to take cognisance of providing economic and social support for these vulnerable populations.

Variability in excess deaths across countries with different vulnerability during 2020-2023

Excess deaths provide total impact estimates of major crises, such as the COVID-19 pandemic. We evaluated excess death trajectories across countries with accurate death registration and population age structure data and assessed relationships with vulnerability indicators. Using the Human Mortality Database on 34 countries, excess deaths were calculated for 2020-2023 (to week 29, 2023) using 2017-2019 as reference, with adjustment for 5 age strata. Countries were divided into less and more vulnerable; the latter had per capita nominal GDP < $30,000, Gini > 0.35 for income inequality and/or at least ≥2.5% of their population living in poverty. Excess deaths (as proportion of expected deaths, p%) were inversely correlated with per capita GDP (r = -0.60), correlated with proportion living in poverty (r = 0.66), and modestly correlated with income inequality (r = 0.45). Incidence rate ratio for deaths was 1.062 (95% CI, 1.038-1.087) in more versus less vulnerable countries. Excess deaths started deviating in the two groups after the first wave. Between-country heterogeneity diminished gradually within each group. Less vulnerable countries had mean p% = -0.8% and 0.4% in 0-64 and >65-y-old strata. More vulnerable countries had mean p% = 7.0% and 7.2%, respectively. Lower death rates were seen in children of age 0-14 y during 2020-2023 versus prepandemic years. While the pandemic hit some countries earlier than others, country vulnerability dominated eventually the cumulative impact. Half the analyzed countries witnessed no substantial excess deaths versus prepandemic levels, while the others suffered major death tolls.

Demography of the understory herb Heliconia acuminata (Heliconiaceae) in an experimentally fragmented tropical landscape

Habitat fragmentation remains a major focus of research by ecologists decades after being put forward as a threat to the integrity of ecosystems. While studies have documented myriad biotic changes in fragmented landscapes, including the local extinction of species from fragments, the demographic mechanisms underlying these extinctions are rarely known. However, many of them-especially in lowland tropical forests-are thought to be driven by one of two mechanisms: (1) reduced recruitment in fragments resulting from changes in the diversity or abundance of pollinators and seed dispersers or (2) increased rates of individual mortality in fragments due to dramatically altered abiotic conditions, especially near fragment edges. Unfortunately, there have been few tests of these potential mechanisms due to the paucity of long-term and comprehensive demographic data collected in both forest fragments and continuous forest sites. Here we report 11 years (1998-2009) of demographic data from populations of the Amazonian understory herb Heliconia acuminata (LC Rich.) found at Brazil's Biological Dynamics of Forest Fragments Project (BDFFP). The data set comprises >66,000 plant × year records of 8586 plants, including 3464 seedlings established after the first census. Seven populations were in experimentally isolated fragments (one in each of four 1-ha fragments and one in each of three 10-ha fragments), with the remaining six populations in continuous forest. Each population was in a 50 × 100 m permanent plot, with the distance between plots ranging from 500 m to 60 km. The plants in each plot were censused annually, at which time we recorded, identified, marked, and measured new seedlings, identified any previously marked plants that died, and recorded the size of surviving individuals. Each plot was also surveyed four to five times during the flowering season to identify reproductive plants and record the number of inflorescences each produced. These data have been used to investigate topics ranging from the way fragmentation-related reductions in germination influence population dynamics to statistical methods for analyzing reproductive rates. This breadth of prior use reflects the value of these data to future researchers. In addition to analyses of plant responses to habitat fragmentation, these data can be used to address fundamental questions in plant demography and the evolutionary ecology of tropical plants and to develop and test demographic models and tools. Though we welcome opportunities to collaborate with interested users, there are no restrictions on the use of this data set. However, we do request that those using the data for teaching or research purposes inform us of how they are doing so and cite this paper and the data archive when appropriate. Any publication using the data must also include a BDFFP Technical Series Number in the Acknowledgments. Authors can request this series number upon the acceptance of their article by contacting the BDFFP's Scientific Coordinator or E. M. Bruna.

A comparison of endodontic registrar training experience with treatments provided by private practice endodontists

The primary aim was to compare cases seen by public endodontic clinicians (endodontists and endodontic registrars) to that of private endodontists. This was done by comparing item numbers charged over a 3-year period from 1 January 2016 to 1 January 2019 from both sectors. The secondary aim was to compare item numbers charged by endodontic registrars during their training as recorded by their submitted logbooks to that of private endodontists. In both comparisons, private endodontists recorded higher numbers of many item numbers including consultations, routine root canal treatment, removal of posts and broken instruments. Endodontic registrar logbooks also recorded fewer numbers compared to private endodontists, however, the frequency of more invasive procedures such as surgery and hemisection were similar.

"The future is unstable": Exploring changing fertility intentions in the United Kingdom during the COVID-19 pandemic

OBJECTIVE

To understand whether reproductive decision-making among United Kingdom (UK) respondents had changed in light of the COVID-19 pandemic and, if so, why COVID-19 had led them to change their intentions.

METHODS

We conducted a cross-sectional online survey in January 2021. We asked survey participants if their fertility intentions had changed and to rate how aspects of their life had changed during COVID-19. We also included an open-ended question and asked participants to explain in their own words how COVID-19 had influenced their reproductive decision-making. We used descriptive and regression analyses to explore the quantitative data and thematically analyzed written responses.

RESULTS

Nine percent (n = 70) of our 789 UK respondents reported a change in fertility intention after the start of the pandemic. Changes in both pro-natal and anti-natal directions made the overall change in intentions small: there was a 2% increase across the sample in not intending a child between the two time points. Only increased financial insecurity was predictive of changing intentions. Responses to the open-ended question (n = 103) listed health concerns, indirect costs of the pandemic, and changing work-life priorities as reasons for changing their intentions.

CONCLUSION

While studies conducted at the beginning of the pandemic found that fertility intentions became more anti-natal, we found little overall change in fertility intentions in January 2021. Our findings of small pro-natal and anti-natal changes in fertility intentions align with emerging UK birth rate data for 2021, which show minimal change in the total fertility rate in response to the pandemic.

Extinction risks and mitigation for a megaherbivore, the giraffe, in a human-influenced landscape under climate change

Megaherbivores play "outsized" roles in ecosystem functioning but are vulnerable to human impacts such as overhunting, land-use changes, and climate extremes. However, such impacts-and combinations of these impacts-on population dynamics are rarely examined using empirical data. To guide effective conservation actions under increasing global-change pressures, we developed a socially structured individual-based model (IBM) using long-term demographic data from female giraffes (Giraffa camelopardalis) in a human-influenced landscape in northern Tanzania, the Tarangire Ecosystem. This unfenced system includes savanna habitats with a wide gradient of anthropogenic pressures, from national parks, a wildlife ranch and community conservation areas, to unprotected village lands. We then simulated and projected over 50 years how realistic environmental and land-use management changes might affect this metapopulation of female giraffes. Scenarios included: (1) anthropogenic land-use changes including roads and agricultural/urban expansion; (2) reduction or improvement in wildlife law enforcement measures; (3) changes in populations of natural predators and migratory alternative prey; and (4) increases in rainfall as predicted for East Africa. The factor causing the greatest risk of rapid declines in female giraffe abundance in our simulations was a reduction in law enforcement leading to more poaching. Other threats decreased abundances of giraffes, but improving law enforcement in both of the study area's protected areas mitigated these impacts: a 0.01 increase in giraffe survival probability from improved law enforcement mitigated a 25% rise in heavy rainfall events by increasing abundance 19%, and mitigated the expansion of towns and blockage of dispersal movements by increasing abundance 22%. Our IBM enabled us to further quantify fine-scale abundance changes among female giraffe social communities, revealing potential source-sink interactions within the metapopulation. This flexible methodology can be adapted to test additional ecological questions in this landscape, or to model populations of giraffes or other species in different ecosystems.

Coral recruitment: patterns and processes determining the dynamics of coral populations

Coral recruitment describes the addition of new individuals to populations, and it is one of the most fundamental demographic processes contributing to population size. As many coral reefs around the world have experienced large declines in coral cover and abundance, there has been great interest in understanding the factors causing coral recruitment to vary and the conditions under which it can support community resilience. While progress in these areas is being facilitated by technological and scientific advances, one of the best tools to quantify recruitment remains the humble settlement tile, variants of which have been in use for over a century. Here I review the biology and ecology of coral recruits and the recruitment process, largely as resolved through the use of settlement tiles, by: (i) defining how the terms 'recruit' and 'recruitment' have been used, and explaining why loose terminology has impeded scientific advancement; (ii) describing how coral recruitment is measured and why settlement tiles have value for this purpose; (iii) summarizing previous efforts to review quantitative analyses of coral recruitment; (iv) describing advances from hypothesis-driven studies in determining how refuges, seawater flow, and grazers can modulate coral recruitment; (v) reviewing the biology of small corals (i.e. recruits) to understand better how they respond to environmental conditions; and (vi) updating a quantitative compilation of coral recruitment studies extending from 1974 to present, thus revealing long-term global declines in density of recruits, juxtaposed with apparent resilience to coral bleaching. Finally, I review future directions in the study of coral recruitment, and highlight the need to expand studies to deliver taxonomic resolution, and explain why time series of settlement tile deployments are likely to remain pivotal in quantifying coral recruitment.

[Anorexia nervosa: demographic, socio-economic and cultural data still too limited]

Although eating disorders are a public health issue, treating anorexia nervosa from a demographic and socio-economic perspective remains a challenge. Data are scarce, patchy and often of questionable quality. Such a lack of data on a somatopsychic illness with serious repercussions is a real problem, since reliable, longitudinal and detailed information could provide additional answers in understanding the illness, both in terms of age, sex and gender structure, and in terms of family, social and environmental factors.

[Epilepsy and inequality: demographic description and analysis of the difficulty in accessing advanced resources in a population in a small health area]

INTRODUCTION

Epilepsy is a very common neurological disease with high morbidity and mortality. Drug-resistant epilepsy (DRE) poses a major therapeutic challenge, even for experts in the field. Despite this, access to advanced resources for this type of patient remains difficult and unequal. The aim of this study is to analyse inequality in a population belonging to a first level hospital.

PATIENTS AND METHODS

An analytical observational cross-sectional study was conducted on epileptic patients attending neurology consultations in Area IX of the Murcian Health Service. Demographic, clinical, therapeutic, prognostic and equity variables are described, and significant differences between different subgroups are analysed.

RESULTS

The study included 68 patients with a mean age of 42.93 years. Focal epilepsy was the main type (64.7%), and the most commonly used drugs were levetiracetam (33.8%), valproic acid (27.9%) and lamotrigine (22.1%). DRE occurred in 18 patients (26.5% of the total) and only four were under active follow-up in an epilepsy unit, meaning that 71% did not have access to a necessary resource (advanced therapeutic gap).

CONCLUSIONS

This study demonstrates that epilepsy inequality continues to be a problem, especially in certain geographical areas, with a lack of access to advanced care for patients who need it most. The solution can be achieved by increasing human and material resources to improve overall patient care, thus strengthening both referral hospitals and epilepsy units.

Population age and household structures shape transmission dynamics of emerging infectious diseases: a longitudinal microsimulation approach

Host population demographics and patterns of host-to-host interactions are important drivers of heterogeneity in infectious disease transmission. To improve our understanding of how population structures and changes therein influence disease transmission dynamics at the individual and population level, we model a dynamic age- and household-structured population using longitudinal microdata drawn from Belgian census and population registers. At different points in time, we simulate the spread of a close-contact infectious disease and vary the age profiles of infectiousness and susceptibility to reflect specific infections (e.g. influenza and SARS-CoV-2) using a two-level mixing model, which distinguishes between exposure to infection in the household and exposure in the community. We find that the strong relationship between age and household structures, in combination with social mixing patterns and epidemiological parameters, shape the spread of an emerging infection. Disease transmission in the adult population in particular is to a large degree explained by differential household compositions and not just household size. Moreover, we highlight how demographic processes alter population structures in an ageing population and how these in turn affect disease transmission dynamics across population groups.

A multi-center cross-sectional study of 1495 Chinese oral lichen planus patients

OBJECTIVE

To explore the clinical epidemiological characteristics of oral lichen planus (OLP) and risk factors for erosive/ulcerative OLP.

MATERIALS AND METHODS

Patients diagnosed with OLP from 11 different hospitals were included in the study. Descriptive statistical methods were used to explore the clinical epidemiological characteristics and logistic regression, sensitivity analysis, and subgroup analysis were utilized to explore the risk factors for erosive/ulcerative OLP.

RESULTS

The average age of patients was 49.2 ± 13.3 years, and 61.4% of the patients were women. The ratios of patients with reticular, hyperemic/erythematous, and erosive/ulcerative lesions were 47.9%, 27.8%, and 24.2%, respectively. Analysis of risk factors for erosive/ulcerative OLP identified the following variables: age, course of disease of 12 months or more, II°-III° dental calculus, hypertension, diabetes, and heart disease, as well as regions of habitation. Subgroup analysis showed significant differences in risk factors for erosive/ulcerative OLP in patients with and without risk behaviors.

CONCLUSION

The clinical epidemiological characteristics of patients with OLP in the Chinese population in this study are basically consistent with existing reports in developed countries. And we identified clinical characteristics associated with erosive/ulcerative OLP through clinical epidemiological analysis.

Exploring Demographic and Clinical Characteristics of Racially and Ethnically Diverse Youth With Eating Disorders Using California Medicaid Claims Data

OBJECTIVE

To explore the scope of diagnosed eating disorders among Medicaid-insured youth in California, and to describe the demographic characteristics of this population in a repeated annual cross-sectional study design.

METHOD

California Medicaid claims data were extracted for youth aged 7 to 18 years between January 2014 and December 2016. Participants included all youth who received an eating disorder diagnosis at any point in the study period (N = 8,075). Additional analyses compared youth with eating disorders who were continuously enrolled across all 3 years (n = 4,500) to random subsamples of continuously enrolled youth diagnosed with a mood or anxiety disorder (n = 4,128), a disruptive behavior disorder (n = 4,599), or a psychotic disorder (n = 4,290).

RESULTS

About one-half of youth with eating disorders were Latinx (58.5%, n = 2,634) and indicated Spanish as their preferred language (48.9%, n = 2,199). About one-half (51%, n = 2,301) of eating disorder diagnoses were unspecified. Latinx ethnicity and Spanish language were significantly more frequent among youth with eating disorders than among those with other disorders (F11.97, F362.75, p values <.0005).

CONCLUSION

The first examination of publicly insured youth with eating disorders revealed a highly diverse group of individuals among whom Latinx youth were particularly prevalent. However, past-year national prevalence estimates suggest that most eating disorder cases were undiagnosed.

PLAIN LANGUAGE SUMMARY

Eating disorders affect approximately 10% of the US population and lead to serious mental health and medical problems. This study used California Medicaid claims data from 2014 to 2016 to characterize the population of youth aged 7 to 18 years with diagnosed with an eating disorder (N = 8,075). The authors found the prevalence of eating disorders among youth aged 13 to 18 years was about 0.20% across all 3 years of the study, which is far below the expected prevalence and suggests that most eating disorders in youth go undiagnosed. About half of eating disorder diagnoses provided to youth with Medicaid insurance are unspecified, which may hinder receipt of appropriate treatment. Of youth with an eating disorder, about half were Latinx and reported Spanish as their preferred language. The authors also found differences in the prevalences of eating disorder diagnoses when analyzing youth by age, sex, and ethnicity. These results suggest that more standardized screening and assessment is needed to improve eating disorders detection and diagnosis, particularly for minoritized youth.

The effects of mutation and recombination rate heterogeneity on the inference of demography and the distribution of fitness effects

Disentangling the effects of demography and selection has remained a focal point of population genetic analysis. Knowledge about mutation and recombination is essential in this endeavour; however, despite clear evidence that both mutation and recombination rates vary across genomes, it is common practice to model both rates as fixed. In this study, we quantify how this unaccounted for rate heterogeneity may impact inference using common approaches for inferring selection (DFE-alpha, Grapes, and polyDFE) and/or demography (fastsimcoal2 and δaδi). We demonstrate that, if not properly modelled, this heterogeneity can increase uncertainty in the estimation of demographic and selective parameters and in some scenarios may result in mis-leading inference. These results highlight the importance of quantifying the fundamental evolutionary parameters of mutation and recombination prior to utilizing population genomic data to quantify the effects of genetic drift (i.e., as modulated by demographic history) and selection; or, at the least, that the effects of uncertainty in these parameters can and should be directly modelled in downstream inference.

Insights into the evolutionary history of the most skilled tool-handling platyrrhini monkey: Sapajus libidinosus from the Serra da Capivara National Park

Sapajus libidinosus members of the Pedra Furada group, living in the Serra da Capivara National Park, use stone tools in a wider variety of behaviors than any other living animal, except humans. To rescue the evolutionary history of the Caatinga S. libidinosus and identify factors that may have contributed to the emergence and maintenance of their tool-use culture, we conducted fieldwork seasons to obtain biological samples of these capuchin monkeys. UsingCYTBsequences, we show a discrete but constant population growth from the beginning of the Holocene to the present, overlapping the emergence of the Caatinga biome. Our habitat suitability reconstruction reports the presence of plants whose hard fruits, seeds, or roots are processed by capuchins using tools. TheS. libidinosusindividuals in the Caatinga were capable of dynamically developing and maintaining their autochthonous culture thanks to: a) cognitive capacity to generate and execute innovation under selective pressure; b) tolerance favoring learning and cultural inheritance; c) an unknown genetic repertoire that underpins the adaptive traits; d) a high degree of terrestriality; e) presence and abundance of natural resources, which makes some places "hot spots" for innovation, and cultural diversification within a relatively short time.

Climate change is predicted to cause population collapse in a cooperative breeder

It has been suggested that animals may have evolved cooperative breeding strategies in response to extreme climatic conditions. Climate change, however, may push species beyond their ability to cope with extreme climates, and reduce the group sizes in cooperatively breeding species to a point where populations are no longer viable. Predicting the impact of future climates on these species is challenging as modelling the impact of climate change on their population dynamics requires information on both group- and individual-level responses to climatic conditions. Using a single-sex individual-based model incorporating demographic responses to ambient temperature in an endangered species, the African wild dog Lycaon pictus, we show that there is a threshold temperature above which populations of the species are predicted to collapse. For simulated populations with carrying capacities equivalent to the median size of real-world populations (nine packs), extinction risk increases once temperatures exceed those predicted in the best-case climate warming scenario (Representative Concentration Pathway [RCP] 2.6). The threshold is higher (between RCP 4.5 and RCP 6.0) for larger simulated populations (30 packs), but 84% of real-world populations number <30 packs. Simulated populations collapsed because, at high ambient temperatures, juvenile survival was so low that packs were no longer recruiting enough individuals to persist, leading them to die out. This work highlights the importance of social dynamics in determining impacts of climatic variables on social species, and the critical role that recruitment can play in driving population-level impacts of climate change. Population models parameterised on long-term data are essential for predicting future population viability under climate change.

Lack of intergenerational reproductive conflict, rather than lack of inclusive fitness benefits, explains absence of post-reproductive lifespan in long-finned pilot whales

Life-history theory suggests that individuals should reproduce until death, yet females of a small number of mammals live for a significant period after ceasing reproduction, a phenomenon known as post-reproductive lifespan. It is thought that the evolution of this trait is facilitated by increasing local relatedness throughout a female's lifetime. This allows older females to gain inclusive fitness through helping their offspring (known as a mother effect) and/or grandoffspring (known as a grandmother effect), rather than gaining direct fitness through reproducing. However, older females may only benefit from stopping reproducing when their direct offspring compete with those of their daughters. Here, we investigate whether a lack of post-reproductive lifespan in long-finned pilot whales (Globicephala melas) results from minimal benefits incurred from the presence of older females, or from a lack of costs resulting from mother-daughter co-reproduction. Using microsatellite data, we conducted parentage analysis on individuals from 25 pods and find that younger females were more likely to have offspring if their mother was present in their pod, indicating that mothers may assist inexperienced daughters to reproduce. However, we found no evidence of reproductive conflict between co-reproducing mothers and daughters, indicating that females may be able to reproduce into old age while simultaneously aiding their daughters in reproduction. This highlights the importance of reproductive conflict in the evolution of a post-reproductive lifespan and demonstrates that mother and grandmother effects alone do not result in the evolution of a post-reproductive lifespan.

Modeling the effects of ration on individual growth of Oncorhynchus tshawytscha under controlled conditions

Fed aquaculture is one of the fastest-growing and most valuable food production industries in the world. The efficiency with which farmed fish convert feed into biomass influences both environmental impact and economic revenue. Salmonid species, such as king salmon (Oncorhynchus tshawytscha), exhibit high levels of plasticity in vital rates such as feed intake and growth rates. Accurate estimations of individual variability in vital rates are important for production management. The use of mean trait values to evaluate feeding and growth performance can mask individual-level differences that potentially contribute to inefficiencies. Here, the authors apply a cohort integral projection model (IPM) framework to investigate individual variation in growth performance of 1625 individually tagged king salmon fed one of three distinct rations of 60%, 80%, and 100% satiation and tracked over a duration of 276 days. To capture the observed sigmoidal growth of individuals, they compared a nonlinear mixed-effects (logistic) model to a linear model used within the IPM framework. Ration significantly influenced several aspects of growth, both at the individual and at the cohort level. Mean final body mass and mean growth rate increased with ration; however, variance in body mass and feed intake also increased significantly over time. Trends in mean body mass and individual body mass variation were captured by both logistic and linear models, suggesting the linear model to be suitable for use in the IPM. The authors also observed that higher rations resulted in a decreasing proportion of individuals reaching the cohort's mean body mass or larger by the end of the experiment. This suggests that, in the present experiment, feeding to satiation did not produce the desired effects of efficient, fast, and uniform growth in juvenile king salmon. Although monitoring individuals through time is challenging in commercial aquaculture settings, recent technological advances combined with an IPM approach could provide new scope for tracking growth performance in experimental and farmed populations. Using the IPM framework might allow the exploration of other size-dependent processes affecting vital rate functions, such as competition and mortality.

Demographic patterns in Lyme borreliosis seasonality over 25 years

Lyme borreliosis, the most common vector-borne disease in Europe and North America, is attracting growing concern due to its expanding geographic range. The growth in incidence and geographic spread is largely attributed to climate and land-use changes that support the tick vector and thereby increase disease risk. Despite a wide range of symptoms displayed by Lyme borreliosis patients, the demographic patterns in clinical manifestations and seasonal case timing have not been thoroughly investigated and may result from differences in exposure, immunity and pathogenesis. We analysed 25 years of surveillance data from Norway, supplemented by population demography data, using a Bayesian modelling framework. The analyses aimed to detect differences in case seasonality and clinical manifestations of Lyme borreliosis across age and sex differentiated patient groups. The results showed a bimodal pattern of incidence over age, where children (0-9 years) had the highest incidence, young adults (20-29 years) had low incidence and older adults had a second incidence peak in the ages 70-79 years. Youth (0-19 years) presented with a higher proportion of neuroborreliosis cases and a lower proportion of arthritic manifestations compared to adults (20+ years). Adult males had a higher overall incidence than adult females and a higher proportion of arthritis cases. The seasonal timing of Lyme borreliosis consistently occurred around 4.4 weeks earlier in youth compared to adults, regardless of clinical manifestation. All demographic groups exhibited a shift towards an earlier seasonal timing over the 25-year study period, which appeared unrelated to changes in population demographics. However, the disproportionate incidence of Lyme borreliosis in seniors requires increased public awareness and knowledge about this high-risk group as the population continues to age concurrently with disease emergence. Our findings highlight the importance of considering patient demographics when analysing the emergence and seasonal patterns of vector-borne diseases using long-term surveillance data.

The role of seasonal migration in spatial population synchrony

Spatially synchronized population dynamics are common in nature, and understanding their causes is key for predicting species persistence. A main driver of synchrony between populations of the same species is shared environmental conditions, which cause populations closer together in space to be more synchronized than populations further from one another. Most theoretical and empirical understanding of this driver considers resident species. For migratory species, however, the degree of spatial autocorrelation in the environment may change across seasons and vary by their geographic location along the migratory route or on a nonbreeding ground, complicating the synchronizing effect of the environment. Migratory species show a variety of different strategies in how they disperse to and aggregate on nonbreeding grounds, ranging from completely shared nonbreeding grounds to multiple different ones. Depending on the sensitivity to environmental conditions off the breeding grounds, we can expect that migration and overwintering strategies will impact the extent and spatial pattern of population synchrony on the breeding grounds. Here, we use spatial population-dynamic modeling and simulations to investigate the relationship between seasonal environmental autocorrelation and migration characteristics. Our model shows that the effects of environmental autocorrelation experienced off the breeding ground on population synchrony depend on the number and size of nonbreeding grounds, and how populations migrate in relation to neighboring populations. When populations migrated to multiple nonbreeding grounds, spatial population synchrony increased with increasing environmental autocorrelation between nonbreeding grounds. Populations that migrated to the same place as near neighbors had higher synchrony at short distances than populations that migrated randomly. However, synchrony declined less across increasing distances for the random migration strategy. The differences in synchrony between migration strategies were most pronounced when the environmental autocorrelation between nonbreeding grounds was low. These results show the importance of considering migration when studying spatial population synchrony and predicting patterns of synchrony and population viability under global environmental change. Climate change and habitat loss and fragmentation may cause range shifts and changes in migratory strategies, as well as changes in the mean and spatial autocorrelation of the environment, which can alter the scale and patterns observed in spatial population synchrony.

German Ixodes inopinatus samples may not actually represent this tick species

Ticks are important vectors of human and animal pathogens, but many questions remain unanswered regarding their taxonomy. Molecular sequencing methods have allowed research to start understanding the evolutionary history of even closely related tick species. Ixodes inopinatus is considered a sister species and highly similar to Ixodes ricinus, an important vector of many tick-borne pathogens in Europe, but identification between these species remains ambiguous with disagreement on the geographic extent of I. inopinatus. In 2018-2019, 1583 ticks were collected from breeding great tits (Parus major) in southern Germany, of which 45 were later morphologically identified as I. inopinatus. We aimed to confirm morphological identification using molecular tools. Utilizing two genetic markers (16S rRNA, TROSPA) and whole genome sequencing of specific ticks (n = 8), we were able to determine that German samples, morphologically identified as I. inopinatus, genetically represent I. ricinus regardless of previous morphological identification, and most likely are not I. ricinus/I. inopinatus hybrids. Further, our results showed that the entire mitochondrial genome, let alone singular mitochondrial genes (i.e., 16S), is unable to distinguish between I. ricinus and I. inopinatus. Our results suggest that I. inopinatus is geographically isolated as a species (northern Africa and potentially southern Spain and Portugal) and brings into question whether I. inopinatus exists in central Europe. Our results highlight the probable existence of I. inopinatus and the power of utilizing genomic data in answering questions regarding tick taxonomy.

Attributable Costs of Stroke in Ontario, Canada and Their Variation by Stroke Type and Social Determinants of Health

BACKGROUND

Estimates of attributable costs of stroke are scarce, as most prior studies do not account for the baseline health care costs in people at risk of stroke. We estimated the attributable costs of stroke in a universal health care setting and their variation across stroke types and several social determinants of health.

METHODS

We undertook a population-based administrative database-derived matched retrospective cohort study in Ontario, Canada. Community-dwelling adults aged ≥40 years with a stroke between 2003 and 2018 were matched (1:1) on demographics and comorbidities with controls without stroke. Using a difference-in-differences approach, we estimated the mean 1-year direct health care costs attributable to stroke from a public health care payer perspective, accounting for censoring with a weighted available sample estimator. We described health sector-specific costs and reported variation across stroke type and social determinants of health.

RESULTS

The mean 1-year attributable costs of stroke were Canadian dollars 33 522 (95% CI, $33 231-$33 813), with higher costs for intracerebral hemorrhage ($40 244; $39 193-$41 294) than ischemic stroke ($32 547; $32 252-$32 843). Most of these costs were incurred in acute care hospitals ($15 693) and rehabilitation facilities ($7215). Compared with all patients with stroke, the mean attributable costs were higher among immigrants ($40 554; $39 316-$41 793), those aged <65 years ($35 175; $34 533-$35 818), and those residing in low-income neighborhoods ($34 687; $34 054-$35 320) and lower among rural residents ($29 047; $28 362-$29 731).

CONCLUSIONS

Our findings of high attributable costs of stroke, especially in immigrants, younger patients, and residents of low-income neighborhoods, can be used to evaluate potential health care cost savings associated with different primary stroke prevention strategies.

Demographic and microbiological profile of corneal ulcer patients presenting at a tertiary healthcare center of Eastern India during the COVID era: A hospital-based cross-sectional study

Purpose

To determine the demographic and microbiological profile involved in the causation of corneal ulcers in Eastern India during the COVID era.

Method

Patients presenting with corneal ulcers fulfilling the inclusion and exclusion criteria were taken as the case. The study duration was from January 2021 to December 2021. Socio-demographic details and information about risk factors were noted. A detailed corneal examination followed by corneal scraping was performed for microbiological evaluation.

Results

In 1 year, 99 infective corneal ulcer patients were evaluated. Farmers (24.2%) were found to be maximally affected by corneal ulcers. The peak in cases was recorded from October to December (38.4%). Ocular trauma was the commonest risk factor (42.4%). The majority (80.8%) of patients were already on some topical antimicrobials. 22.2% of samples showed fungal filaments on KOH mount; 54.5% of these cases turned out to be culture-positive. 17.56% of KOH-negative samples turned out to be culture-positive (fungal). Overall, the culture positivity rate was 28.28% out of which fungal isolates were 89.28% and bacterial isolates were 10.72%. Fusarium species were identified as the most common organism contributing 42.85%, followed by Aspergillus fumigatus (14.28%). 10.72% of cases were culture positive for Pseudomonas aeuroginosa.

Conclusion

Trauma with the organic matter was the predominant cause of fungal keratitis. In this study, fungal keratitis was found to be more common. Fusarium was the most common isolate.

Demographic reconstruction of the Western sheep expansion from whole-genome sequences

As one of the earliest livestock, sheep (Ovis aries) were domesticated in the Fertile Crescent about 12,000-10,000 years ago and have a nearly worldwide distribution today. Most of our knowledge about the timing of their expansions stems from archaeological data but it is unclear how the genetic diversity of modern sheep fits with these dates. We used whole-genome sequencing data of 63 domestic breeds and their wild relatives, the Asiatic mouflon (O. gmelini, previously known as O. orientalis), to explore the demographic history of sheep. On the global scale, our analysis revealed geographic structuring among breeds with unidirectional recent gene flow from domestics into Asiatic mouflons. We then selected 4 representative breeds from Spain, Morocco, the United Kingdom, and Iran to build a comprehensive demographic model of the Western sheep expansion. We inferred a single domestication event around 11,000 years ago. The subsequent westward expansion is dated to approximately 7,000 years ago, later than the original Neolithic expansion of sheep and slightly predating the Secondary Product Revolution associated with wooly sheep. We see some signals of recent gene flow from an ancestral population into Southern European breeds which could reflect admixture with feral European mouflon. Furthermore, our results indicate that many breeds experienced a reduction of their effective population size during the last centuries, probably associated with modern breed development. Our study provides insights into the complex demographic history of Western Eurasian sheep, highlighting interactions between breeds and their wild counterparts.

Maximum stem diameter predicts liana population demography

Determining population demographic rates is fundamental to understanding differences in species' life-history strategies and their capacity to coexist. Calculating demographic rates, however, is challenging and requires long-term, large-scale censuses. Body size may serve as a simple predictor of demographic rate; can it act as a proxy for demographic rate when those data are unavailable? We tested the hypothesis that maximum body size predicts species' demographic rate using repeated censuses of the 77 most common liana species on the Barro Colorado Island, Panama (BCI) 50-ha plot. We found that maximum stem diameter does predict species' population turnover and demography. We also found that lianas on BCI can grow to the enormous diameter of 635 mm, indicating that they can store large amounts of carbon and compete intensely with tropical canopy trees. This study is the first to show that maximum stem diameter can predict plant species' demographic rates and that lianas can attain extremely large diameters. Understanding liana demography is particularly timely because lianas are increasing rapidly in many tropical forests, yet their species-level population dynamics remain chronically understudied. Determining per-species maximum liana diameters in additional forests will enable systematic comparative analyses of liana demography and potential influence across forest types.

Adherence to oral antiretroviral therapy in Canada, 2010-2020

OBJECTIVE

To assess antiretroviral therapy (ART) adherence among people with HIV (PWH) in Canada and identify baseline characteristics associated with suboptimal adherence (<95%).

DESIGN

Retrospective observational study using data from the National Prescription Drug Utilization Information System and Régie de l'assurance maladie Quebec (RAMQ) Public Prescription Drug Insurance Plan.

METHODS

This analysis included PWH aged 18 years or older who initiated an ART regimen and were followed for at least 12 months (2010-2020). Patient characteristics were summarized using medical/pharmacy claims data from seven provinces (Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Ontario, Saskatchewan, and Quebec). ART regimen at index date (first dispensing of a regimen including a core agent) was defined as a single-tablet or multitablet regimen (MTR). Adherence was calculated using a Proportion of Days Covered approach, based on ART dispensing, recorded between April 2010 and the last available date. Multivariate linear regression analysis was used to determine correlations between suboptimal adherence and baseline characteristics.

RESULTS

We identified 19 322 eligible PWH, 44.7% of whom had suboptimal adherence (<95%). Among 12 594 PWH with evaluable baseline data, 10 673 (84.8%) were ART-naive, 74.2% were men, mean age was 42.9 years, and 54.1% received a MTR as their ART. Based on multivariate regression analysis, suboptimal adherence was significantly associated with multitablet ART ( P  < 0.001) and younger age ( P  < 0.001) but not sex.

CONCLUSION

Almost half of adult PWH in Canada had suboptimal adherence to ART. Better understanding of factors influencing adherence may help address gaps in current care practices that may impact adherence.

Breakdown of the growth-mortality trade-off along a soil phosphorus gradient in a diverse tropical forest

An ecological paradigm predicts that plant species adapted to low resource availability grow slower and live longer than those adapted to high resource availability when growing together. We tested this by using hierarchical Bayesian analysis to quantify variations in growth and mortality of ca 40 000 individual trees from greater than 400 species in response to limiting resources in the tropical forests of Panama. In contrast to theoretical expectations of the growth-mortality paradigm, we find that tropical tree species restricted to low-phosphorus soils simultaneously achieve faster growth rates and lower mortality rates than species restricted to high-phosphorus soils. This result demonstrates that adaptation to phosphorus limitation in diverse plant communities modifies the growth-mortality trade-off, with important implications for understanding long-term ecosystem dynamics.

Evaluating power to detect recurrent selective sweeps under increasingly realistic evolutionary null models

The detection of selective sweeps from population genomic data often relies on the premise that the beneficial mutations in question have fixed very near the sampling time. As it has been previously shown that the power to detect a selective sweep is strongly dependent on the time since fixation as well as the strength of selection, it is naturally the case that strong, recent sweeps leave the strongest signatures. However, the biological reality is that beneficial mutations enter populations at a rate, one that partially determines the mean wait time between sweep events and hence their age distribution. An important question thus remains about the power to detect recurrent selective sweeps when they are modeled by a realistic mutation rate and as part of a realistic distribution of fitness effects, as opposed to a single, recent, isolated event on a purely neutral background as is more commonly modeled. Here we use forward-in-time simulations to study the performance of commonly used sweep statistics, within the context of more realistic evolutionary baseline models incorporating purifying and background selection, population size change, and mutation and recombination rate heterogeneity. Results demonstrate the important interplay of these processes, necessitating caution when interpreting selection scans; specifically, false-positive rates are in excess of true-positive across much of the evaluated parameter space, and selective sweeps are often undetectable unless the strength of selection is exceptionally strong.

Population Regulation and Density-Dependent Demography in the Trinidadian Guppy

AbstractClassic theory for density-dependent selection for delayed maturation requires that a population be regulated through some combination of adult fecundity and/or juvenile survival. We tested whether those demographic conditions were met in four experimental populations of Trinidadian guppies in which delayed maturation of males evolved when the densities of those populations became high. We used monthly mark-recapture data to examine population dynamics and demography in these populations. Three of the four populations displayed clear evidence of regulation. In all four populations, monthly adult survival rates were independent of biomass density or actually increased with increased biomass density. Juvenile recruitment, which is a combination of adult fecundity and juvenile survival, decreased as biomass density increased in all four populations. Demography showed marked seasonality, with greater survival and higher recruitment in the dry season than the wet season. Population regulation via juvenile recruitment supports the hypothesis that density-dependent selection was responsible for the evolution of delayed maturity in males. This body of work represents one of the few complete tests of density-dependent selection theory.

Can demographic histories explain long-term isolation and recent pulses of asymmetric gene flow between highly divergent grey fox lineages?

Secondary contact zones between deeply divergent, yet interfertile, lineages provide windows into the speciation process. North American grey foxes (Urocyon cinereoargenteus) are divided into western and eastern lineages that diverged approximately 1 million years ago. These ancient lineages currently hybridize in a relatively narrow zone of contact in the southern Great Plains, a pattern more commonly observed in smaller-bodied taxa, which suggests relatively recent contact after a long period of allopatry. Based on local ancestry inference with whole-genome sequencing (n = 43), we identified two distinct Holocene pulses of admixture. The older pulse (500-3500 YBP) reflected unidirectional gene flow from east to west, whereas the more recent pulse (70-200 YBP) of admixture was bi-directional. Augmented with genotyping-by-sequencing data from 216 additional foxes, demographic analyses indicated that the eastern lineage declined precipitously after divergence, remaining small throughout most of the late Pleistocene, and expanding only during the Holocene. Genetic diversity in the eastern lineage was highest in the southeast and lowest near the contact zone, consistent with a westward expansion. Concordantly, distribution modelling indicated that during their isolation, the most suitable habitat occurred far east of today's contact zone or west of the Great Plains. Thus, long-term isolation was likely caused by the small, distant location of the eastern refugium, with recent contact reflecting a large increase in suitable habitat and corresponding demographic expansion from the eastern refugium. Ultimately, long-term isolation in grey foxes may reflect their specialized bio-climatic niche. This system presents an opportunity for future investigation of potential pre- and post-zygotic isolating mechanisms.

Whole genome analyses reveal weak signatures of population structure and environmentally associated local adaptation in an important North American pollinator, the bumble bee Bombus vosnesenskii

Studies of species that experience environmental heterogeneity across their distributions have become an important tool for understanding mechanisms of adaptation and predicting responses to climate change. We examine population structure, demographic history and environmentally associated genomic variation in Bombus vosnesenskii, a common bumble bee in the western USA, using whole genome resequencing of populations distributed across a broad range of latitudes and elevations. We find that B. vosnesenskii exhibits minimal population structure and weak isolation by distance, confirming results from previous studies using other molecular marker types. Similarly, demographic analyses with Sequentially Markovian Coalescent models suggest that minimal population structure may have persisted since the last interglacial period, with genomes from different parts of the species range showing similar historical effective population size trajectories and relatively small fluctuations through time. Redundancy analysis revealed a small amount of genomic variation explained by bioclimatic variables. Environmental association analysis with latent factor mixed modelling (LFMM2) identified few outlier loci that were sparsely distributed throughout the genome and although a few putative signatures of selective sweeps were identified, none encompassed particularly large numbers of loci. Some outlier loci were in genes with known regulatory relationships, suggesting the possibility of weak selection, although compared with other species examined with similar approaches, evidence for extensive local adaptation signatures in the genome was relatively weak. Overall, results indicate B. vosnesenskii is an example of a generalist with a high degree of flexibility in its environmental requirements that may ultimately benefit the species under periods of climate change.

Ghost introgression in ricefishes of the genus Adrianichthys in an ancient Wallacean lake

Because speciation might have been promoted by ancient introgression from an extinct lineage, it is important to detect the existence of 'ghost introgression' in focal taxa and examine its contribution to their diversification. In this study, we examined possible ghost introgression and its contributions to the diversification of ricefishes of the genus Adrianichthys in Lake Poso, an ancient lake on Sulawesi Island, in which some extinctions are known to have occurred. Population-genomic analysis revealed that two extant Adrianichthys species, A. oophorus and A. poptae are reproductively isolated from each other. Comparisons of demographic models demonstrated that introgression from a ghost population, which diverged from the common ancestor of A. oophorus and A. poptae, is essential for reconstructing the demographic history of Adrianichthys. The best model estimated that the divergence of the ghost population greatly predated the divergence between A. oophorus and A. poptae, and that the ghost population secondarily contacted the two extant species within Lake Poso more recently. Genome scans and simulations detected a greatly divergent locus, which cannot be explained without ghost introgression. This locus was also completely segregated between A. oophorus and A. poptae. These findings suggest that variants that came from a ghost population have contributed to the divergence between A. oophorus and A. poptae, but the large time-lag between their divergence and ghost introgression indicates that the contribution of introgression may be restricted.

Interpopulation differences and temporal synchrony in rates of adult survival between two seabird colonies that differ in population size and distance to foraging grounds

Understanding the processes that drive interpopulation differences in demography and population dynamics is central to metapopulation ecology. In colonial species, populations are limited by local resource availability. However, individuals from larger colonies will travel greater distances to overcome density-dependent competition. Consequently, these individuals may also experience greater carry-over effects and interpopulation differences in demography. To test this prediction, we use mark-recapture data collected over four decades from two breeding colonies of a seabird, the Manx shearwater (Puffinus puffinus), that exhibit strong spatial overlap throughout the annual cycle but differ in population size and maximum foraging distances. We quantify interpopulation differences and synchrony in rates of survival and assess whether local mean wind speeds act to strengthen or disrupt synchrony. In addition, we examine whether the imputed interpopulation differences in survival can generate population-level consequences. The colony where individuals travel further during the breeding season had slightly lower and more variable rates of survival, indicative of individuals experiencing greater carry-over effects. Fluctuations in survival were highly synchronous between the colonies, but neither synchronous, nor asynchronous, variation could be strongly attributed to fluctuations in local mean wind speeds. Finally, we demonstrate that the imputed interpopulation differences in rates of survival could lead to considerable differences in population growth. We hypothesise that the observed interpopulation differences in rates of adult survival reflect carry-over effects associated with foraging distances during the breeding season. More broadly, our results highlight that breeding season processes can be important for understanding interpopulation differences in the demographic rates and population dynamics of long-lived species, such as seabirds.

Darwin's dark matter: utter extinction

Species that died without leaving descendants Darwin called 'utterly extinct'. They far outnumber the ancestors of all living things, so they resemble the dark matter of modern cosmology, which far outweighs visible matter. He realized in 1837 that their absence is what creates the groups in a natural classification. In his Notebook B he combined the idea that species multiply with the idea that ancestors' relatives must mostly be extinct. The fossil Megatherium was utterly extinct. The iconic branching 'I think' diagram shows extinction causing the origin of genera by eliminating intermediate species. Darwin's concept of taxonomic ranks, starting with the genus, was informed by his interaction with taxonomists. Based on his familiarity with demography, Darwin reasoned that the survival of transitional forms was unlikely, which helped him decide to focus at the species level. When drafting his theory in the 1840s, he left out these speculative ideas, but they emerged again in the 1850s when he realized his theory needed a cause for branches to diverge. His ecological answer worked at the species level, but his Principle of Divergence was unconvincing at higher taxonomic levels. In the Origin, Darwin repeatedly insisted on the importance of utter extinction.

Pharmacoepidemiology and costs of medications dispensed during pregnancy: A retrospective population-based study

OBJECTIVE

To describe the pharmacoepidemiology and costs associated with medications dispensed during pregnancy.

DESIGN

Pharmacoepidemiological study and cost analysis.

SETTING

Queensland, Australia.

POPULATION

All women who gave birth in Queensland between January 2013 and June 2018.

METHODS

We used a whole-of-population linked administrative dataset, Maternity1000, to describe medications approved for public subsidy that were dispensed to 255 408 pregnant women. We describe the volume of medications dispensed and their associated costs from a Government and patient perspective.

MAIN OUTCOME MEASURES

Prevalence of medication use; proportion of total dispensings; total medication costs in AUD 2020/21 ($1AUD = $0.67USD/£0.55GBP in December 2022).

RESULTS

During pregnancy, 61% (95% CI 60.96-61.29%) of women were dispensed at least one medication approved for public subsidy. The mean number of items dispensed per pregnancy increased from 2.14 (95% CI 2.11-2.17) in 2013 to 2.47 (95% CI 2.44-2.51) in 2017; an increase of 15%. Furthermore, mean Government cost per dispensing increased by 41% from $21.60 (95% CI $20.99-$22.20) in 2013 to $30.44 (95% CI $29.38-$31.49) in 2017. These factors influenced the 53% increase in total Government expenditure observed for medication use during pregnancy between 2013 and 2017 ($2,834,227 versus $4,324,377); a disproportionate rise compared with the 17% rise in women's total out-of-pocket expenses observed over the same timeframe ($1,880,961 versus $2,204,415).

CONCLUSIONS

Prevalence of medication use in pregnancy is rising and is associated with disproportionate and rapidly escalating cost implications for the Government.

Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023

The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.

Decline of seagrass (Posidonia oceanica) production over two decades in the face of warming of the Eastern Mediterranean Sea

The response of Posidonia oceanica meadows to global warming of the Eastern Mediterranean Sea, where the increase in sea surface temperature (SST) is particularly severe, is poorly investigated. Here, we reconstructed the long-term P. oceanica production in 60 meadows along the Greek Seas over two decades (1997-2018), using lepidochronology. We determined the effect of warming on production by reconstructing the annual and maximum (i.e. August) SST, considering the role of other production drivers related to water quality (i.e. Chla, suspended particulate matter, Secchi depth). Grand mean (±SE) production across all sites and the study period was 48 ± 1.1 mg DW per shoot yr-1 . Production over the last two decades followed a trajectory of decrease, which was related to the concurrent increase in annual SST and SSTaug . Annual SST > 20°C and SSTaug  > 26.5°C was related to production decline (GAMM, P < 0.05), while the rest of the tested factors did not help explain the production pattern. Our results indicate a persistent and increasing threat for Eastern Mediterranean meadows, drawing attention to management authorities, highlighting the necessity of reducing local impacts to enhance the resilience of seagrass meadows to global change threats.

A comparison of endodontic referrals and treatment in the public and private sectors in Western Australia

The aim was to compare referral patterns and treatment provided by specialist Endodontists and Endodontic Registrars. A retrospective review was conducted of the clinical records of the first 25 patients seen by seven private endodontic clinicians and the equivalent number (175) of patients seen by five public sector endodontic clinicians from 1 January 2017. The average age and range of medical co-morbidities of patients in the public sector were statistically greater. Referred patients and referrers mainly worked in metropolitan Perth. The most frequent reasons for referral in both public and private sectors were to assess and manage non-painful endodontic pathosis, to manage pain, and to manage calcified canals. There was a wide range of cases referred to both sectors but with similar patterns suggesting that the training of specialists adequately prepares them for private practice. The results also indicate that Endodontists must be proficient in all aspects of the speciality.

Association Between Prenatal Diagnosis and Age at Surgery for Noncritical and Critical Congenital Heart Defects

BACKGROUND

The relationship between the prenatal diagnosis of congenital heart defects (CHDs) and age at CHD surgery is poorly understood, despite the known relationships between age at surgery and long-term outcomes. The objective of this study was to determine the associations between prenatal diagnosis of CHD and age at surgery, and whether these associations differ for critical and noncritical CHDs.

METHODS

This is a cohort analysis of patients aged 0 to 9 years who received their initial cardiac surgery at Ann & Robert H. Lurie Children's Hospital of Chicago between 2015 and 2021 with prenatal diagnosis as the exposure variable. All data were obtained from the locally maintained Society of Thoracic Surgeons Congenital Heart Surgery Database at Lurie Children's Hospital. We used multivariable fixed effects regression models to estimate the strength of the association of prenatal diagnosis with age at surgery among patients with critical (surgery ≤60 days) and noncritical (surgery >60 days) CHDs.

RESULTS

Of 1131 individuals who met inclusion criteria, 532 (47%) had a prenatal diagnosis, 428 (38%) had critical CHDs, 533 (47%) were female, and the median age at surgery was 119 days (interquartile range, 11-309 days). After controlling for demographics, comorbidities, and surgical complexity, the mean age at surgery was significantly younger in those with prenatally versus postnatally diagnosed critical CHD (7.1 days sooner, P<0.001) and noncritical CHDs (atrial septal defects [12.4 months sooner, P=0.037], ventricular septal defects [6.0 months sooner, P<0.003], and noncritical coarctation of the aorta [1.8 months sooner, P=0.010]).

CONCLUSIONS

Younger age at CHD surgery, which is associated with postsurgical neurodevelopmental and physical outcomes, is significantly associated with prenatal CHD diagnosis. This relationship was identified for both critical and noncritical CHDs.

MAIN PROBLEMS AFFECTING THE FORMATION OF THE WELL-BEING OF YOUNG RUSSIAN FAMILIES: ACCORDING TO THE RESULTS OF THE ALL-RUSSIAN SOCIOLOGICAL RESEARCH

The paper presents the findings of a study conducted using a mass questionnaire survey of members of young families (n = 893). The purpose of the study is to identify what problems affecting well-being are faced by members of young families. In the sample, young families are represented by two groups - families with children and families without children. It was revealed that the assessment of the significance of problems in family life is different in families with children and childless families, including the number of children in the family that affects the situation. Ratings of family problems were built according to the following criteria - self-assessment of men and women and parenting experience. It is concluded that, according to a number of criteria (both material and non-material), well-being is formed.

Generation time and seasonal migration explain variation in spatial population synchrony across European bird species

Spatial population synchrony is common among populations of the same species and is an important predictor of extinction risk. Despite the potential consequences for metapopulation persistence, we still largely lack understanding of what makes one species more likely to be synchronized than another given the same environmental conditions. Generally, environmental conditions in a shared environment or a species' sensitivity to the environment can explain the extent of synchrony. Populations that are closer together experience more similar fluctuations in their environments than those populations that are further apart and are therefore more synchronized. The relative importance of environmental and demographic stochasticity for population dynamics is strongly linked to species' life-history traits, such as pace of life, which may impact population synchrony. For populations that migrate, there may be multiple environmental conditions at different locations driving synchrony. However, the importance of life history and migration tactics in determining patterns of spatial population synchrony have rarely been explored empirically. We therefore hypothesize that increasing generation time, a proxy for pace of life, would decrease spatial population synchrony and that migrants would be less synchronized than resident species. We used population abundance data on breeding birds from four countries to investigate patterns of spatial population synchrony in growth rate and abundance. We calculated the mean spatial population synchrony between log-transformed population growth rates or log-transformed abundances for each species and country separately. We investigated differences in synchrony across generation times in resident (n = 67), short-distance migrant (n = 86) and long-distance migrant (n = 39) bird species. Species with shorter generation times were more synchronized than species with longer generation times. Short-distance migrants were more synchronized than long-distance migrants and resident birds. Our results provide novel empirical links between spatial population synchrony and species traits known to be of key importance for population dynamics, generation time and migration tactics. We show how these different mechanisms can be combined to understand species-specific causes of spatial population synchrony. Understanding these specific drivers of spatial population synchrony is important in the face of increasingly severe threats to biodiversity and could be key for successful future conservation outcomes.

Coral assemblages at higher latitudes favor short-term potential over long-term performance

The persistent exposure of coral assemblages to more variable abiotic regimes is assumed to augment their resilience to future climatic variability. Yet, while the determinants of coral population resilience across species remain unknown, we are unable to predict the winners and losers across reef ecosystems exposed to increasingly variable conditions. Using annual surveys of 3171 coral individuals across Australia and Japan (2016-2019), we explore spatial variation across the short- and long-term dynamics of competitive, stress-tolerant, and weedy assemblages to evaluate how abiotic variability mediates the structural composition of coral assemblages. We illustrate how, by promoting short-term potential over long-term performance, coral assemblages can reduce their vulnerability to stochastic environments. However, compared to stress-tolerant, and weedy assemblages, competitive coral taxa display a reduced capacity for elevating their short-term potential. Accordingly, future climatic shifts threaten the structural complexity of coral assemblages in variable environments, emulating the degradation expected across global tropical reefs.

Phenological mismatch affects individual fitness and population growth in the winter moth

Climate change can severely impact species that depend on temporary resources by inducing phenological mismatches between consumer and resource seasonal timing. In the winter moth, warmer winters caused eggs to hatch before their food source, young oak leaves, became available. This phenological mismatch changed the selection on the temperature sensitivity of egg development rate. However, we know little about the fine-scale fitness consequences of phenological mismatch at the individual level and how this mismatch affects population dynamics in the winter moth. To determine the fitness consequences of mistimed egg hatching relative to timing of oak budburst, we quantified survival and pupation weight in a feeding experiment. We found that mismatch greatly increased mortality rates of freshly hatched caterpillars, as well as affecting caterpillar growth and development time. We then investigated whether these individual fitness consequences have population-level impacts by estimating the effect of phenological mismatch on population dynamics, using our long-term data (1994-2021) on relative winter moth population densities at four locations in The Netherlands. We found a significant effect of mismatch on population density with higher population growth rates in years with a smaller phenological mismatch. Our results indicate that climate change-induced phenological mismatch can incur severe individual fitness consequences that can impact population density in the wild.

Self-esteem among nursing students at a public university in Saudi Arabia: A cross-sectional study

Background

Self-esteem is a subjective assessment of one's own value and worth as a person. Self-esteem is recognized as an indicator of a person's mental health, with lower levels associated with mental conditions such as stress and depression. In the context of nursing education, self-esteem has been linked to student's academic performance, clinical competence, and overall well-being. Existing literature suggests that self-esteem among student nurses varies across countries and cultures. Assessing the self-esteem level among student nurses is essential for identifying students at risk of experiencing academic difficulties or mental health problems.

Objective

The study aimed to assess the self-esteem level among student nurses at Al-Majmaah University, Saudi Arabia.

Methods

A cross-sectional design was employed and conducted with 346 nursing students conveniently selected at Majmaah University in Saudi Arabia in May 2023. A self-reported questionnaire utilizing the Rosenberg Self-Esteem Scale (RSES) was employed. Data were analyzed using SPSS Statistics software, including descriptive and inferential statistical techniques.

Results

The findings revealed that 265 students (76.6%) had moderate self-esteem levels, 53 students (15.3%) had low self-esteem, and 28 students (8.1%) had high levels of self-esteem. Examination of self-esteem in relation to socio-demographic variables resulted in statistically significant correlations with the year of study, physical health, psychological health, and father's education (p <0.05).

Conclusion

The study's results offer valuable insights for nurse educators, which can serve as a compass for designing educational and awareness programs to boost self-esteem among student nurses. These initiatives hold significance in equipping students with the necessary attributes for their upcoming roles as professional nurses. Nonetheless, further investigations are warranted to delve into self-esteem and associated factors.

Variability in excess deaths across countries with different vulnerability during 2020-2023

Excess deaths provide total impact estimates of major crises, such as the COVID-19 pandemic. We evaluated excess death's trajectories during 2020-2023 across countries with accurate death registration and population age structure data; and assessed relationships with economic indicators of vulnerability. Using the Human Mortality Database on 34 countries, excess deaths were calculated for 2020-2023 (to week 29, 2023) using 2017-2019 as reference, with weekly expected death calculations and adjustment for 5 age strata. Countries were divided into less and more vulnerable; the latter had per capita nominal GDP<$30,000, Gini>0.35 for income inequality and/or at least 2.5% of their population living in poverty. Excess deaths (as proportion of expected deaths, p%) were inversely correlated with per capita GDP (r=-0.60), correlated with proportion living in poverty (r=0.66) and modestly correlated with income inequality (r=0.45). Incidence rate ratio for deaths was 1.06 (95% confidence interval, 1.04-1.08) in the more versus less vulnerable countries. Excess deaths started deviating in the two groups after the first wave. Between-country heterogeneity diminished over time within each of the two groups. Less vulnerable countries had mean p%=-0.8% and 0.4% in 0-64 and >65 year-old strata while more vulnerable countries had mean p%=7.0% and 7.2%, respectively. Usually lower death rates were seen in children 0-14 years old during 2020-2023 versus pre-pandemic years. While the pandemic hit some countries earlier than others, country vulnerability dominated eventually the cumulative impact. Half of the analyzed countries witnessed no substantial excess deaths versus pre-pandemic levels, while the other half suffered major death tolls.

Demographic turnover can be a leading driver of hierarchy dynamics, and social inheritance modifies its effects

Individuals and societies are linked through a feedback loop of mutual influence. Demographic turnover shapes group composition and structure by adding and removing individuals, and social inheritance shapes social structure through the transmission of social traits from parents to offspring. Here I examine how these drivers of social structure feedback to influence individual outcomes. I explore these society-to-individual effects in systems with social inheritance of hierarchy position, as occur in many primates and spotted hyenas. Applying Markov chain models to empirical and simulated data reveals how demography and social inheritance interact to strongly shape individual hierarchy positions. In hyena societies, demographic processes-not status seeking-account for the majority of hierarchy dynamics and cause an on-average lifetime decline in social hierarchy position. Simulated societies clarify how social inheritance alters demographic effects-demographic processes cause hierarchy position to regress to the mean, but the addition of social inheritance modifies this pattern. Notably, the combination of social inheritance and rank-related reproductive success causes individuals to decline in rank over their lifespans, as seen in the hyena data. Further analyses explore how 'queens' escape this pattern of decline, and how variation in social inheritance generates variability in reproductive inequality. This article is part of the theme issue 'Evolutionary ecology of inequality'.

Wealth inequality in the prehispanic northern US Southwest: from Malthus to Tyche

Persistent differences in wealth and power among prehispanic Pueblo societies are visible from the late AD 800s through the late 1200s, after which large portions of the northern US Southwest were depopulated. In this paper we measure these differences in wealth using Gini coefficients based on house size, and show that high Ginis (large wealth differences) are positively related to persistence in settlements and inversely related to an annual measure of the size of the unoccupied dry-farming niche. We argue that wealth inequality in this record is due first to processes inherent in village life which have internally different distributions of the most productive maize fields, exacerbated by the dynamics of systems of balanced reciprocity; and second to decreasing ability to escape village life owing to shrinking availability of unoccupied places within the maize dry-farming niche as villages get enmeshed in regional systems of tribute or taxation. We embed this analytical reconstruction in the model of an 'Abrupt imposition of Malthusian equilibrium in a natural-fertility, agrarian society' proposed by Puleston et al. (Puleston C, Tuljapurkar S, Winterhalder B. 2014 PLoS ONE 9, e87541 (doi:10.1371/journal.pone.0087541)), but show that the transition to Malthusian dynamics in this area is not abrupt but extends over centuries This article is part of the theme issue 'Evolutionary ecology of inequality'.