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Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Focusing on orthography as a primary linguistic interface in every reading activity, the central research question we address here is how orthographic intelligibility can be measured and predicted between closely related languages. This paper presents methods and findings of modeling orthographic intelligibility in a reading intercomprehension scenario from the information-theoretic perspective. The focus of the study is on two Slavic language pairs: Czech–Polish (West Slavic, using the Latin script) and Bulgarian–Russian (South Slavic and East Slavic, respectively, using the Cyrillic script). In this article, we present computational methods for measuring orthographic distance and orthographic asymmetry by means of the Levenshtein algorithm, conditional entropy and adaptation surprisal method that are expected to predict the influence of orthography on mutual intelligibility in reading.
Surveys report that 25–57 % of cats are overweight or obese. The most evinced cause is neutering. Weight loss often fails; thus, new strategies are needed. Obesity has been associated with altered gut bacterial populations and increases in microbial dietary energy extraction, body weight and adiposity. This study aimed to determine whether alterations in intestinal bacteria were associated with obesity, energy restriction and neutering by characterising faecal microbiota using 16S rRNA gene sequencing in eight lean intact, eight lean neutered and eight obese neutered cats before and after 6 weeks of energy restriction. Lean neutered cats had a bacterial profile similar to obese rodents and humans, with a greater abundance (P<0·05) of Firmicutes and lower abundance (P<0·05) of Bacteroidetes compared with the other groups. The greater abundance of Firmicutes in lean neutered cats was due to a bloom in Peptostreptococcaceae. Obese cats had an 18 % reduction in fat mass after energy restriction (P<0·05). Energy reduction was concurrent with significant shifts in two low-abundance bacterial genera and trends in four additional genera. The greatest change was a reduction in the Firmicutes genus, Sarcina, from 4·54 to 0·65 % abundance after energy restriction. The short duration of energy restriction may explain why few bacterial changes were observed in the obese cats. Additional work is needed to understand how neutering, obesity and weight loss are related to changes in feline microbiota and how these microbial shifts affect host physiology.
Digital elevation models of the bed and surface of Unteraargletscher, Switzerland, are used to reconstruct the theoretical pattern of basal water drainage for the years 1927, 1947, 1961 and 1997, during which period the glacier was thinning and receding. The theoretical drainage pattern for 1997 compares well, in a broad sense, with the locations of active moulins and the hydraulic connection status of boreholes drilled to the glacier bed. Changes in the basal water-flow pattern over the period 1927–97 that are revealed by the theoretical reconstructions of the subglacial drainage system structure are likely to have resulted from changes in glacier geometry. Concurrent with the retreat and thinning of the glacier, the height of medial moraines increased, probably due to the insulating effect of the debris cover reducing the melt of the underlying ice. This increase of moraine heights has led to the formation of hydraulic barriers at the glacier bed such that water flow has become channelized beneath the ice along drainage axes that parallel the course of the medial moraines on the glacier surface.
This study illustrates the relevance of cryospheric changes for, and their impact on, ski tourism in Austria. The results of several case studies on snow reliability, snow production and mass balance in glacier ski resorts in the Ötz and Stubai valleys are summarized. Climate data from Obergurgl (1936ma.s.l.) in the Ötz valley are analyzed with respect to the amount and duration of natural snow cover and the possibility of snow production. A case study on Mittelbergferner focuses on the impacts of glacial recession on a ski resort and possible adaptation measures. From long-term glacier inventory and short-term mass-balance data, the effect of operating ski resorts on glaciers is investigated. At Obergurgl, the probability of both snow cover and snow production is >80% from December to March and decreases significantly in the months before and after this peak season. The interannual variability of snow cover and production is low during the main season and higher in other months. Year-to-year differences are larger than any long-term trend. Glacier ski resorts must adapt to shrinking glacial area and falling glacier surface. Covering the glacier with textiles reduces ablation by 60% and results in significantly less volume loss than on uncovered parts of the glacier. Neither the mass-balance comparison between groomed and ungroomed areas nor the comparison of long-term volume changes between 10 ski resort glaciers and 100 surrounding glaciers showed evidence for an impact of the operation of ski resorts on the glaciers.
Recent surges of two outlet glaciers of the Vatnajökull ice cap, Iceland, were observed using European Remote-sensing Satellite (ERS) synthetic aperture radar (SAR) tandem interferograms from12 different dates between December 1995 and January 2000. ERS SAR interferometry provided new information on the temporal and spatial variations in surface velocity during surges, after fieldwork became impossible. The area affected by the surge and therefore by increased basal sliding was delineated. Themigration of flow divides on the ice cap during a surge was described. At Sylgjujökull, a western outlet glacier covering an area of 175 km2, the fully developed surge and its abating phase were studied. Over a period of 4 2 years after December 1995, the ice motion decreased steadily, with initially the highest velocities and subsequently the most pronounced decrease in velocity at the glacier terminus. The surge of Dyngjujökull, a northern outlet glacier covering an area of 1040 km2, reached its maximum in 1999/2000. Slow acceleration over an area of about 200 km2 was first observed between March 1996 and January 1997. The interferogram from January 1999 shows a well-developed surge area, covering 210 km2. This area more than doubled by January 2000, with maximum velocities reaching >7 md–1. Between January 1997 and January 2000, the flow divide between Dyngju- and Skeiðararjökull shifted 16 km to the south. The investigations indicate that a surge cycle on these glaciers spans several years, with slowly increasing motion over an extended area in the beginning, and more pronounced velocity changes during the active surge phase lasting 1–2 years.
Over a two-year period, continuous measurements of temporal changes in tilt, conducted with a string of tilt meters in a borehole on Unteraargletscher, Bernese Alps, Switzerland, have been used to estimate the basal-motion component. This estimation is based on a comparison of the measurements with synthetic tilt curves, computed using a parameterization of a simplified flow field. The best agreement is found for a ratio of basal motion to forward motion due to ice deformation (slip ratio) equal to about 1.2. Measured tilt curves exhibit a number of different transient features. While an overall increase in tilt angle is observed at every tilt-meter location, two of the sensors recorded anomalous tilt behaviour. These anomalies are characterized by sudden and drastic variations in tilt. A particularly intriguing example of such short-term tilt variations was recorded with a tilt meter positioned 40 m above the bed during the 1997 summer melt season.
In order to develop and evaluate a method for the determination of glacier volume from ice-thickness data, the volume of Schaufelferner, Austria, is calculated (1) by manual interpolation of ground-penetrating radar (GPR) data based on measurements at 36 locations in 1995, (2) by manual interpolation of 144 GPR measurements acquired for a higher-resolution estimate in 2003 and 2006, (3) by multiplying the mean of the measured ice-thickness data by the glacier area, (4) by automatic kriging of the 1995 GPR data and (5) by application of area/volume scaling algorithms to the Austrian glacier inventory data of 1969, 1997 and 2006. The so determined glacier volumes are compared with the ice-volume changes calculated from digital elevation models (DEMs) of the Austrian glacier inventories. The manually interpolated volumes based on the 1995 and 2003/06 GPR data yielded a volume loss only slightly different from volume loss calculated from the glacier inventories of 1997 and 2007. Other methods were not able to reproduce the volume losses of the glacier inventory DEMs. To assess the accuracy of deriving ice-thickness changes with GPR, repeated ice-thickness measurements at the same locations were carried out between 2005 and 2008.
Glacier-surface displacements produced by geothermal and volcanic activity beneath Vatnajökull ice cap in Iceland are described by field surveys of the surface topography combined with interferograms acquired from repeat-pass synthetic aperture radar images. A simple ice-flow model serves well to confirm the basic interpretation of the observations. The observations cover the period October 1996–January 1999 and comprise: (a) the ice-flow field during the infilling of the depressions created by the subglacial Gjálp eruption of October 1996, (b) the extent and displacement of the floating ice cover of the subglacier lakes of Grímsvötn and the Skaftá cauldrons, (c) surface displacements above the subglacier pathways of the jökulhlaups from the Gjálp eruption site and the Grímsvötn lake, (d) detection of areas of increased basal sliding due to lubrication by water, and (e) detection of spots of temporal displacement that may be related to altering subglacial volcanic activity. At the depression created by the Gjálp eruption, the maximum surface displacement rate away from the radar decreased from 27 cm d−1 to 2 cm d−1 over the period January 1997–January 1999. The observed vertical displacement of the ice cover of Grímsvötn changed from an uplift rate of 50 cm d−1 to sinking of 48 cm d−1, and for Skaftá cauldrons from 2 cm d to 25 cm d−1.
The ongoing retreat of mountain glaciers necessitates the development of future scenarios of glacier runoff. These scenarios are not only governed by future climate scenarios influencing glacier mass balance but also by the glacier volumes, which are subject to melt. Ground-penetrating radar (GPR) is a valuable tool for measuring the thickness of mountain glaciers, although ground-based measurements are labour-intensive, so not all glaciers can be surveyed. This study presents the results of GPR surveys on 64 Alpine glaciers, carried out between 1995 and 2010. The glacier areas range from 0.001 to 18.4 km2, and their ice thickness was surveyed with an average density of 36 points km-2. The point measurements were extrapolated manually to derive volume maps. The mean ice thickness varies between 10 and 92 m; the maximum ice thickness is about three times the mean thickness. According to the glacier state recorded in the second glacier inventory, the 64 glaciers cover an area of 223.3 ± 3.6 km2, with a mean thickness of 50 ± 3 m and a glacier volume of 11.9 ± 1.1 km3. The mean maximum ice thickness is 119 ± 5m.
Snow avalanche simulation software is a commonly used tool for hazard estimation and mitigation planning. In this study a depth-averaged flow model, combining a simple entrainment and friction relation, is implemented in the software SamosAT. Computational results strongly depend on the simulation input, in particular on the employed model parameters. A long-standing problem is to quantify the influence of these parameters on the simulation results. We present a new multivariate optimization approach for avalanche simulation in three-dimensional terrain. The method takes into account the entire physically relevant range of the two friction parameters (Coulomb friction, turbulent drag) and one entrainment parameter. These three flow model parameters are scrutinized with respect to six optimization variables (runout, matched and exceeded affected area, maximum velocity, average deposition depth and mass growth). The approach is applied to a documented extreme avalanche event, recorded in St Anton, Austria. The final results provide adjusted parameter distributions optimizing the simulation–observation correspondence. At the same time, the degree of parameter–variable correspondence is determined. We show that the specification of optimal values for certain model parameters is near-impossible, if corresponding optimization variables are neglected or unavailable.
Observations show that glaciers around the world are in retreat and losing mass. Internationally coordinated for over a century, glacier monitoring activities provide an unprecedented dataset of glacier observations from ground, air and space. Glacier studies generally select specific parts of these datasets to obtain optimal assessments of the mass-balance data relating to the impact that glaciers exercise on global sea-level fluctuations or on regional runoff. In this study we provide an overview and analysis of the main observational datasets compiled by the World Glacier Monitoring Service (WGMS). The dataset on glacier front variations (∼42 000 since 1600) delivers clear evidence that centennial glacier retreat is a global phenomenon. Intermittent readvance periods at regional and decadal scale are normally restricted to a subsample of glaciers and have not come close to achieving the maximum positions of the Little Ice Age (or Holocene). Glaciological and geodetic observations (∼5200 since 1850) show that the rates of early 21st-century mass loss are without precedent on a global scale, at least for the time period observed and probably also for recorded history, as indicated also in reconstructions from written and illustrated documents. This strong imbalance implies that glaciers in many regions will very likely suffer further ice loss, even if climate remains stable.
An extensive high-resolution geophysical survey covering 2 km2 was undertaken to the north of Stonehenge in June and October 2011. The survey is important in providing, for the first time, abundant detail on the form and structure of the Stonehenge Cursus, including the recognition of entrances in both of the long sides. Much additional information about the internal form of round barrows in the Cursus Round Barrow Cemetery, the course of the Avenue, the course of the so-called Gate Ditch, and numerous tracks and early roads crossing the landscape was recorded. A series of previously unrecognized features were identified: a pit-arc or cove below a barrow on the west side of King Barrow Ridge, a square-shaped feature surrounded by pits on the east side of Stonehenge Bottom, and a linear ditch on the same solstical axis, and parallel to, the southern section of the Stonehenge Avenue. An extensive scatter of small metallic anomalies marking the position of camping grounds associated with the Stonehenge Free Festival in the late 1970s and early 1980s raise interesting conservation and management issues.
We report serendipitous detections of line emission with ALMA in band 3, 6, and 7 in the central parsec of the Galactic center at an up to now highest resolution (<0.7″). Among the highlights are the very first and highly resolved images of sub-mm molecular emission of CS, H13CO+, HC3N, SiO, SO, C2H, and CH3OH in the immediate vicinity (~1″ in projection) of Sgr A* and in the circumnuclear disk (CND). The central association (CA) of molecular clouds shows three times higher CS/X (X: any other observed molecule) luminosity ratios than the CND suggesting a combination of higher excitation - by a temperature gradient and/or IR-pumping - and abundance enhancement due to UV- and/or X-ray emission. We conclude that the CA is closer to the center than the CND is and could be an infalling clump consisting of denser cloud cores embedded in diffuse gas. Moreover, we identified further regions in and outside the CND that are ideally suited for future studies in the scope of hot/cold core and extreme PDR/XDR chemistry and consequent star formation in the central few parsecs.
In 2014, the UN Human Rights Committee published its Concluding Observations on the United States’ fourth periodic report on the progress of the implementation of the International Covenant on Civil and Political Rights (UN Doc CCPR/C/SR/3061), in which also the US surveillance practices are criticised. The Committee’s insistence on the right to privacy and its exterritorial effect is an important first step, but it is not comprehensive, as by remaining within the individual rights framework the UN Human Rights Committee fails to sufficiently take into account the systemic challenges in play. Developing a constitution of the Internet would necessitate not only protecting individual fundamental rights against state interference, but protecting communicative spheres by guaranteeing institutional autonomies and subjecting all social spheres to democratic control; this also requires opening up spaces for a critical public, including whistleblowers, and establishing a right to cryptography – a crucial refraction in the polycentric panoptic schema.
Migration crisis, food crisis, economic crisis - the most alarming tendencies in our contemporary world are related to the transnational social question. But what role does transnational law play in this context: Does it exacerbate the asymmetries by shielding the rich and exploiting the poor? Or is the emerging regime of international social human rights a promising candidate for countering the crisis of world society?This book scrutinises both the potentials and the boundaries of de-coupling the notion of "social rights" from the nation-state and of transferring it to the transnational sphere. By drawing on a critical theory of transnational law, it provides in-depth analyses of the different sites where the struggle for social rights is at stake, such as the emerging transnational food regime, the ILO, international environmental law and the accountability of private actors. It reveals enforcement structures, discusses judicial doctrine and relates these aspects to the social and political struggles which surround the transnationalisation of social rights.