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Major depressive disorder (MDD) is a common mood disorder, with a heritability of around 34%. Molecular genetic studies made significant progress and identified genetic markers associated with the risk of MDD; however, progress is slowed down by substantial heterogeneity as MDD is assessed differently across international cohorts. Here, we used a standardized online approach to measure MDD in multiple cohorts in the Netherlands and evaluated whether this approach can be used in epidemiological and genetic association studies of depression.
Within the Biobank Netherlands Internet Collaboration (BIONIC) project, we collected MDD data in eight cohorts involving 31 936 participants, using the online Lifetime Depression Assessment Self-report (LIDAS), and estimated the prevalence of current and lifetime MDD in 22 623 unrelated individuals. In a large Netherlands Twin Register (NTR) twin-family dataset (n ≈ 18 000), we estimated the heritability of MDD, and the prediction of MDD in a subset (n = 4782) through Polygenic Risk Score (PRS).
Estimates of current and lifetime MDD prevalence were 6.7% and 18.1%, respectively, in line with population estimates based on validated psychiatric interviews. In the NTR heritability estimates were 0.34/0.30 (s.e. = 0.02/0.02) for current/lifetime MDD, respectively, showing that the LIDAS gives similar heritability rates for MDD as reported in the literature. The PRS predicted risk of MDD (OR 1.23, 95% CI 1.15–1.32, R2 = 1.47%).
By assessing MDD status in the Netherlands using the LIDAS instrument, we were able to confirm previously reported MDD prevalence and heritability estimates, which suggests that this instrument can be used in epidemiological and genetic association studies of depression.
We describe morphological features not previously reported for this old acanthocephalan Nephridiacanthus major (Bremser, 1811 in Westrumb, 1821) Golvan, 1962 first described over 200 years ago. Our specimens were collected from long-eared hedgehog Hemiechinus auritus (Gmelin, 1770) (Erinaceidae) in Iran. We compare the morphometrics of our material with others previously reported from the same host in Iran, Russia, central Asia and Europe. Our specimens had markedly smaller proboscides, proboscis hooks and lemnisci than those reported from Russia and central Asia, but comparable measurements of other structures with specimens previously described from other collections. We document our new observations with scanning electron microscopy features not previously demonstrable by other observers and provide a chemical analysis of proboscis hooks using energy-dispersive X-ray analysis for the first time. The molecular profile of this acanthocephalan, based on 18S rDNA and cox1 genes, was generated for the first time. The phylogenetic analysis showed that N. major is placed in a clade of the family Oligacanthorhynchidae, well separated from the families Moniliformidae and Gigantorhynchidae.
Ladybeetles are known beneficial insects, with a long history in augmentative and classical biological control. The ladybeetle Oenopia conglobata (L.) is a natural enemy of many herbivores, particularly aphids. The temperature-dependent development of O. conglobata was studied at six constant temperatures (22.5, 25, 27.5, 30, 32.5 and 35 °C) to understand its development rate and environmental constraints better. Linear and nonlinear (Lactin) models were fitted to the data. In the thermal range from 22.5 to 32.5 °C, the rate of development increased for all stages; 35 °C was lethal for all stages and no eggs hatched. The Tb and K values for the biological cycle (egg–adult) were 8.84 °C and 263.15 DD, respectively. Depending on the model, tmin values for the total development time of the coccinellid ranged from 8.45 to 8.82 °C. The nonlinear model of Lactin estimated the optimum and upper temperature thresholds for the total development time of the ladybeetle to be 33.2 and 35.0 °C, respectively. High R2 values and low residual sum of squares values revealed a good fit to the experimental data for total development and different developmental stages of O. conglobata. The results may contribute to the improvement of practical methods for mass rearing of O. conglobata.
Background: Continuous video-EEG (cvEEG) monitoring is the standard of care for diagnosis and management of neonatal seizures. However, it is labour-intensive. We aimed to establish consistency in monitoring of newborns utilising NICU nurses. Methods: Neonatal nurses were trained to apply scalp electrodes, troubleshoot technical issues. Guidelines, checklists and visual training modules were developed. A central network system allowed remote access to the cvEEGs by the epileptologist for timely interpretation and feedback. We compared 100 infants with moderate to severe HIE before and after the training program. Results: 192 cvEEGs were performed. Of the 100 infants compared; time to initiate brain monitoring decreased by average of 31.5 hours, in electrographic seizure detection increased(20% compared to 34% a), seizure clinical misdiagnosis decreased (65% compared to 36% ), and Anti-Seizure burden decreased. Conclusions: Training experienced NICU nurses to set-up, start and monitor cvEEG can decrease the time to initiate cvEEG which may lead to better seizure diagnosis and management.
Introduction: Delays in transfer to an in-patient bed of admitted patients boarded in the ED has been identified as one of the chief drivers of ED overcrowding. Our study aims to replicate findings from a previous study in identifying patient characteristics associated with increased boarding time, and the impact of increased boarding time on in-patient length of stay (IPLOS). Methods: We conducted a retrospective single-centre observational study during the period between January 1, 2015 December 31, 2015 at a very high volume community hospital (~ 75,000 ED visits/year). All patients admitted from the ED to Medicine, Pediatrics, Surgery, and Critical Care were identified. The mean time to in-patient bed (TTB), as well as patient-specific and institutional factors that were associated with prolonged boarding times ( 12 hours) were identified. Mean IP LOS was calculated for those with prolonged boarding times and compared to those without prolonged boarding times. Results: There were 8,096 unique admissions during the study period. Patients admitted to the Medicine service exhibited significantly higher boarding times than those admitted to other services, with a mean boarding time of 17.4 hrs, as compared to 4.2 hrs, 5.7 hrs, and 4.0 hrs for those admitted to Surgery, Critical Care and Pediatrics respectively. Within Medicine patients, there was a statistically significant greater odds of prolonged boarding time for patients who were older, had a greater comorbidity burden, and required more specialized in-patient care (i.e. an isolation bed or telemetry bed). Medicine patients with prolonged boarding times also experienced 0.7 days longer IP LOS, even after correcting for age and comorbidity (mean adjusted IP LOS 10.6 days versus 11.3 days). Conclusion: Within our study period, older, sicker patients and those patients requiring more resource-intensive in-patient care have the longest ED boarding times. These prolonged ‘boarding’ times are associated with significantly increased IP LOS.
To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2–11 years.
A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry.
The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months.
Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.
The effect of the transverse magnetic field on laser-induced breakdown spectroscopy and surface modifications of germanium (Ge) has been investigated at various fluences. Ge targets were exposed to Nd: YAG laser pulses (1064 nm, 10 ns, 1 Hz) at different fluences ranging from 3 to 25.6 J/cm2 to generate Ge plasma under argon environment at a pressure of 50 Torr. The magnetic field of strength 0.45 Tesla perpendicular to the direction of plasma expansion was employed by using two permanent magnets. The emission spectra of laser-induced Ge plasma was detected by the laser-induced breakdown spectroscopy system. The electron temperature and number density of Ge plasma are evaluated by using the Boltzmann plot and stark broadening methods, respectively. The variations in emission intensity, electron temperature (Te), and number density (ne) of Germanium plasma are explored at various fluences, with and without employment of the magnetic field. It is observed that the magnetic field is responsible for significant enhancement of both excitation temperature and number density at all fluences. It is revealed that an excitation temperature increases from Te,max,without B = 16,190 to Te,max,with B = 20,123 K. Similarly, the two times enhancement in the electron density is observed from ne,max,without B = 2 × 1018 to ne,max,with B = 4 × 1018 cm−3. The overall enhancement in Ge plasma parameters in the presence of the magnetic field is attributed to the Joule heating effect and adiabatic compression. With increasing fluence both plasma parameters increase and achieve their maxima at a fluence of 12.8 J/cm2 and then decrease. In order to correlate the plasma parameters with surface modification, scanning electron microscope analysis of irradiated Ge was performed. Droplets and cones are formed for both cases. However, the growth of ridges and distinctness of features is more pronounced in case of the absence of the magnetic field; whereas surface structures become more diffusive in the presence of the magnetic field.
Introduction: The term cor triatriatum is used to describe a fibromuscular partition that divides an atrium into two compartments. It was first used by Borst in 1905, although the lesion had been described before by Church in 1868. Both described divided left atrial chamber (also referred to as cor triatriatum sinister). The incidence of the divided left atrial chamber among patients with congenital heart disease is reported at 0.1% and 0.4% in an autopsy study. Divided right atrial chamber – also referred to as cor triatriatum dexter – is even rarer to an extent that there is no reported incidence and only few hundred cases have been reported so far. A search through pubMed library revealed only 90 publications on humans, either under the term “dexter” or “dextrum”. We would like to report a new association of bilateral divided atrial chambers and pulmonary vein stenosis, with a review of the literature.
Imprinting is a well-established technique to induce recognition features in both organic and inorganic materials for a variety of target analytes. In this study, ion imprinted polysiloxanes with varying percentage of coupling agent i.e. 3-chloro propyl trimethoxy silane (CPTM) were synthesized by sol-gel method for imprinting of Cr3+. The imprinting of Cr3+ in cross-linked siloxane network was investigated by FT-IR which indicates the metal ion is coordinated with oxygen atoms of polysiloxanes. SEM images revealed that imprinted polysiloxanes possess uniform particles of submicron size. It was experienced that by increasing the concentration of CPTM up to 10% (v/v) substantially improves the binding capacity of polysiloxanes which allows us to recognized Cr3+ down to 50µg/L. Furthermore, the selectivity of Cr3+-imprinted polysiloxanes was evaluated by treating them with other competing metal ions of same concentration i.e. Cr6+, Pb2+ and Ni2+. In this regard, polysiloxanes showed much higher binding for imprint ion i.e. Cr3+ in comparison to above mentioned metal ions. Finally, the regenerated polysiloxanes were studied in order to reuse them thus, developing cost effective biomimetic sensor coatings.
The department of Psychiatry at Hamad Medical Corporation (HMC) in Qatar, and guided by the national mental health plan, initiated a plan for suicide registry for the country.
Collect information on the patients presenting with self-harm and suicidal behaviors to the Emergency Department (ED), the primary emergency facility in Qatar.
Collection of data on the characteristics of the patients presenting to ED with intentional or accidental self-harm.
Retrospective chart review of all the cases presented to ED with self-harm, suicide attempts or committed suicide during the period between July 2011 and July 2012. Questionnaires were developed to collect the socio-demographic and clinical data available.
A total of 470 cases were identified (48 completed suicide, 165 admitted/suicide attempts, 105 intentional self-harm/not admitted and 152 accidental self harm). The majority of completed suicide were males, expatriates, in their mid 30s and died by hanging. In the admitted suicide attempters, the method was overdose; the male/female ratio was equal, mostly single, employed expatriates, and no past psychiatric diagnosis, substance abuse or previous suicide attempts. The majority of accidental self-harm were secondary to intake of high doses of non-opiate painkillers. Data on many variables were missing. More comparisons will be presented in relation to the demographics in Qatar.
The data suggest that the single male immigrants in Qatar should receive more support and more screening. More prospective data are needed with adequate collection of data to improve the quality of the registry and thus design better prevention programs.
Discrimination between radiation necrosis and tumor progression after radiation therapy represents a radiologic challenge. The aim of our investigation is to identify patterns of radiation necrosis on brain magnetic resonance imaging (MRI) and positron emission tomography (PET) with Fluoroethyltyrosin (FET) after proton beam therapy (PBT) for skull base tumors.
Material and Methods:
Five consecutive patients with extra-axial neoplasms were included, presenting a total of eight radiation necrosis lesions (three clival chordomas; two petroclival chondrosarcomas; two women; mean age: 49 ± 18.2 years). Radiation necrosis was defined as the appearance of abnormal enhancement on MRI after PBT decreasing over time, and additional histopathologic confirmation in one patient. MRI and PET imaging were retrospectively analyzed by two experienced radiologists in consensus.
All lesions were localized close to the primary tumor in the field of irradiation. Three patients showed bilateral symmetrical lesions. All lesions showed T2 hyperintensity and T1 hypointensity. Cerebral blood volume (CBV) was reduced in all available studies. None of the lesions showed a restricted diffusion. FET-PET (three patients) showed a higher uptake in four out of five lesions; three of which had a mean tumor-to-background (TBRmean) uptake lower than 1.95 and FET uptake increasing over time and were correctly classified into radiation necrosis.
Most radiation necroses were in direct continuity with the primary tumor mimicking tumor progression. The most consistent imaging findings for PBT radiation necrosis are low CBV without restricted diffusion and FET-PET TBRmean lower than 1.95 or increasing uptake over time. Bilateral symmetric involvement may be another indicator of radiation necrosis.
Diagnostic ability is essential in laryngology. The UK Higher Surgical Training syllabus includes competencies specific to laryngology. This study aimed to identify the factors in training that lead to a consultant level of laryngology-related diagnostic ability.
An online test of training experience was constructed using laryngoscopy videos obtained from a specialist UK voice clinic. Participation was aimed at both trainees and trainers via invitation through national ENT forums.
There were 51 complete responses. Trainees with six months of laryngology experience scored significantly higher than those without this experience (p < 0.001). There was no improvement in score demonstrated for those with head and neck specialty experience without laryngology experience. Trainees who had completed 12 months of laryngology, or 6 months of laryngology coupled with 12 months of head and neck training, scored similarly to their consultant trainers.
It is recommended that all trainees have at least six months of experience in a specialist voice or laryngology placement prior to gaining the Certificate of Completion of Training.
Little is known about the qualitative and quantitative differences in the use of antipsychotics in Arab countries. This study is aimed to examine and compare the prescribing pattern of antipsychotics in two different Arab settings and specifically determine the factors influencing polypharmacy.
Materials and methods:
This cross-sectional study was conducted in Jordan (National Center for Mental Health Hospital, Amman) and Egypt (Mansoura University Hospital, Mansoura) and included 162 inpatients [g1] with schizophrenia. Patients were surveyed using a standardized protocol.[g2]
There were no significant differences between Egyptians and Jordanians with respect to; demographic, anthropometric, polypharmacy or mean maximum dose of antipsychotics. Jordanians had significantly lower number of hospitalizations and relapses than Egyptian patients. Atypical than typical first antipsychotics were prescribed more to Jordanians compared to Egyptian patients. Irrespective of the patients’ nationalities, the mean hospitalizations, and relapse were predictors of polypharmacy.
Antipsychotic prescribing pattern differs between the Egyptians and Jordanian patients with schizophrenia[g3]. The risks with polytherbay calls for improving the prescribing patterns of antipsychotic drugs in Arab region to establish guidelines on the proper indications and uses for antipsychotic drugs.
We use nonparametric production function methods to decompose farm-level labor productivity growth into components attributable to efficiency change, technical change, and factor intensity. The estimation is accomplished using balanced panel data drawn from the Kansas Farm Management Association for the period 1993 to 2007. We find that labor productivity growth is primarily driven by factor intensity and technical change. Efficiency change is declining with increasing productivity growth, and technical change is not Hicks-neutral and occurs at high levels of factor intensity, suggesting that innovation is embodied in factor intensity.
Normal balance relies on three sensory inputs: vision, proprioception and the peripheral vestibular system. This study assessed hearing change and postural control in normal subjects.
Materials and methods:
Postural control in 20 normal volunteers was assessed using a Nintendo Wii gaming console and balance board. Each subject was tested standing upright for 30 seconds in a clinic room and a soundproof room with their eyes open, eyes closed, whilst standing on and off foam, and with and without ear defenders.
There was significantly more postural sway in the following subjects: those standing with their eyes closed vs those with eyes open (normal room, p = 0.0002; soundproof room, p = 0.0164); those standing on foam with eyes open vs those standing normally with eyes open (in both rooms; p < 0.05); those standing with eyes open in a soundproof room vs a normal room (p = 0.0164); and those standing on foam in a soundproof room with eyes open and wearing ear defenders vs those in the same circumstances but without ear defenders.
Our results suggest that this method provides a simple, inexpensive tool for assessing static postural control. Whilst it is recognised that visual input and proprioception play a central role in maintaining posture, our findings suggest that ambient sound and hearing may also have a significant influence.