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Daily use of high-potency cannabis has been reported to carry a high risk for developing a psychotic disorder. However, the evidence is mixed on whether any pattern of cannabis use is associated with a particular symptomatology in first-episode psychosis (FEP) patients.
We analysed data from 901 FEP patients and 1235 controls recruited across six countries, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We used item response modelling to estimate two bifactor models, which included general and specific dimensions of psychotic symptoms in patients and psychotic experiences in controls. The associations between these dimensions and cannabis use were evaluated using linear mixed-effects models analyses.
In patients, there was a linear relationship between the positive symptom dimension and the extent of lifetime exposure to cannabis, with daily users of high-potency cannabis having the highest score (B = 0.35; 95% CI 0.14–0.56). Moreover, negative symptoms were more common among patients who never used cannabis compared with those with any pattern of use (B = −0.22; 95% CI −0.37 to −0.07). In controls, psychotic experiences were associated with current use of cannabis but not with the extent of lifetime use. Neither patients nor controls presented differences in depressive dimension related to cannabis use.
Our findings provide the first large-scale evidence that FEP patients with a history of daily use of high-potency cannabis present with more positive and less negative symptoms, compared with those who never used cannabis or used low-potency types.
Radar sounding is a powerful geophysical approach for characterizing the subsurface conditions of terrestrial and planetary ice masses at local to global scales. As a result, a wide array of orbital, airborne, ground-based, and in situ instruments, platforms and data analysis approaches for radioglaciology have been developed, applied or proposed. Terrestrially, airborne radar sounding has been used in glaciology to observe ice thickness, basal topography and englacial layers for five decades. More recently, radar sounding data have also been exploited to estimate the extent and configuration of subglacial water, the geometry of subglacial bedforms and the subglacial and englacial thermal states of ice sheets. Planetary radar sounders have observed, or are planned to observe, the subsurfaces and near-surfaces of Mars, Earth's Moon, comets and the icy moons of Jupiter. In this review paper, and the thematic issue of the Annals of Glaciology on ‘Five decades of radioglaciology’ to which it belongs, we present recent advances in the fields of radar systems, missions, signal processing, data analysis, modeling and scientific interpretation. Our review presents progress in these fields since the last radio-glaciological Annals of Glaciology issue of 2014, the context of their history and future prospects.
The directions of strong winds are important for the distribution of marine salt spray, rock weathering, lake chemistry and the distribution of vegetation in Bunger Hills, a coastal ice-free oasis in East Antarctica. Present-day strong winds (> 10 m s−1) dominantly blow from 118 ± 21 degrees true (°T; ± 1 SD). Orientated tafoni (weathering pits) might form in bedrock surfaces by salt and ice crystallization, thermal stress and saltating sand particles, recording the orientation of a strongly directional wind field since the last deglaciation, which commenced > 30 000 years ago. The orientations of these tafoni, at 101 ± 18°T for 686 measurements at 28 sites, are indistinguishable from the direction of modern-day strong winds (> 10 m s−1), indicating that the orientation of the slope of the ice sheet has been stable throughout the last 10 000 years during the Holocene.
Terrestrial environments at Bunger Hills, East Antarctica, vary from vegetation-rich, little-weathered rock surfaces retaining glacial polish and striations near the glacier and ice-sheet margins to salty, vegetation-poor, extensively weathered regions near to and downwind of marine bays and inlets. Weathering forms include tafoni and orientated pits, which record former wind directions. Although salts are found all over Bunger Hills, the strongly weathered area is coincident with the distribution of halite (NaCl) and thenardite (Na2SO4), both of which are derived from seawater and marine salt spray. Salts elsewhere in Bunger Hills are either subglacial calcium carbonates or rock weathering products including gypsum (CaSO4⋅2H2O) and a range of rarer minerals. These other salt minerals do not weather rocks and sediment. The distribution of halite and thenardite acts as a major control on the geomorphology, sediment geochemistry and biogeography of Bunger Hills.
The types and distributions of anthropogenic rubbish have been documented at Bunger Hills, East Antarctica. The area has been the site of scientific research stations from 1958 to the present. Rubbish types include deliberately or negligently discarded items (gas cylinders, broken glass), abandoned unserviceable equipment (boats, vehicles, scientific equipment), spills (chemicals, fuel, oil) and the slow collapse of old buildings. Some rubbish remained where it was left, while other material was redistributed by strong winds. Modern expeditioner training should limit the production of new rubbish, while inadvertent wind dispersal of rubbish from old station buildings could be minimized by better management of these structures and their surrounds. Buildings and other constructed items need ongoing maintenance if they are not to break down and be distributed by wind, or they should be removed within a reasonable period.
In this paper, we synthesize recorded observations of moss, lichen and bird species in Bunger Hills, East Antarctica, and assess the role of environmental controls, including sediment, salinity, moisture and geology, on species' distributions. The distribution of snow petrels (Pagodroma nivea) appears to be associated with geology; they nest by preference in crevices in bedrock outcrops around the margins of the hills or wherever jointed cliffs are found. South polar skuas (Catharacta maccormicki) are seen throughout Bunger Hills, where they nest and prey on snow petrels. Mosses and lichens were most abundant around the ice margins where fresh snow and ice meltwater are abundant. In the central area of Bunger Hills, where the highest salt concentration in sediments is found and exposure to abrasion by wind-driven mineral sand grains and ice particles is greatest, mosses and lichens are reduced in abundance and diversity. Exposure of parts of Bunger Hills from the ice sheet throughout the Last Glacial Maximum, c. 20 ka bp, means that some land and lakes could have acted as regional refugia and as a locus of recolonization of other ice-free areas.
− Agency is one of five core analytical problems in the Earth System Governance (ESG) Project’s research framework, which offers a unique approach to the study of environmental governance. − Agency in Earth System Governance draws lessons from ESG–Agency research through a systematic review of 322 peer-reviewed journal articles published between 2008 and 2016 and contained in the ESG–Agency Harvesting Database.− ESG–Agency research draws on diverse disciplinary perspectives with distinct clusters of scholars rooted in the fields of global environmental politics, policy studies, and socio-ecological systems. − Collectively, the chapters in Agency in Earth System Governance provide an accessible synthesis of some of the field’s major questions and debates and a state-of-the-art understanding of how diverse actors engage with and exercise authority in environmental governance.
Given the high prevalence (30–35%) of psychosocial and psychiatric morbidity amongst cancer patients in any phase of the disease trajectory, screening for emotional problems and disorders has become mandatory in oncology. As a process, screening begins at the entry to the cancer care system and continues at clinically meaningful times, periodically during active cancer care, or when clinically indicated. The goal is to facilitate proper referral to psychosocial oncology specialists for more specific assessment and care, as well as treatment and evaluation of the response, according to the implementation of distress management guidelines. In this editorial, we will provide a non-exhaustive overview of relevant protocols, with particular reference to the National Comprehensive Cancer Network (NCCN) Distress Management in Oncology Guidelines, and review the challenges and the problems in implementing screening, and the assessment and management of psychosocial and psychiatric problems in cancer centres and community care.
The objective of this systematic review was to evaluate the efficacy of antibiotics to prevent or control colibacillosis in broilers. Studies found eligible were conducted controlled trials in broilers that evaluated an antibiotic intervention, with at least one of the following outcomes: mortality, feed conversion ratio (FCR), condemnations at slaughter, or total antibiotic use. Four electronic databases plus the gray literature were searched. Abstracts were screened for eligibility and data were extracted from eligible trials. Risk of bias was evaluated.
Seven trials reported eligible outcomes in a format that allowed data extraction; all reported results for FCR and one also reported mortality. Due to the heterogeneity in the interventions and outcomes evaluated, it was not feasible to conduct meta-analysis.
Qualitatively, for FCR, comparisons between an antibiotic and an alternative product did not show a significant benefit for either. Some of the comparisons between an antibiotic and a no-treatment placebo showed a numerical benefit to antibiotics, but with wide confidence intervals. The risk-of-bias assessment revealed concerns with reporting of key trial features.
The results of this review do not provide compelling evidence for or against the efficacy of antibiotics for the control of colibacillosis.
A systematic review and network meta-analysis (NMA) were conducted to address the question, ‘What is the efficacy of litter management strategies to reduce morbidity, mortality, condemnation at slaughter, or total antibiotic use in broilers?’ Eligible studies were clinical trials published in English evaluating the efficacy of litter management in broilers on morbidity, condemnations at slaughter, mortality, or total antibiotic use. Multiple databases and two conference proceedings were searched for relevant literature. After relevance screening and data extraction, there were 50 trials evaluating litter type, 22 trials evaluating litter additives, 10 trials comparing fresh to re-used litter, and six trials evaluating floor type. NMAs were conducted for mortality (61 trials) and for the presence or absence of footpad lesions (15 trials). There were no differences in mortality among the litter types, floor types, or additives. For footpad lesions, peat moss appeared beneficial compared to straw, based on a small number of comparisons. In a pairwise meta-analysis, there was no association between fresh versus used litter on the risk of mortality, although there was considerable heterogeneity among studies (I2 = 66%). There was poor reporting of key design features in many studies, and analyses rarely accounted for non-independence of observations within flocks.
Glacier thinning and retreat drives initial acceleration of glacier sliding and erosion, de-buttressing of steep valley walls, and destabilization of ice-marginal deposits and bedrock, which can lead to massive rock avalanching and accelerated incision of tributary watersheds. A compelling example of these changes occurred in Taan Fjord in SE Alaska due to the rapid thinning and retreat of Tyndall Glacier over the past half century. Increased glacier sliding speeds led to both increased rates of subglacial erosion and the evacuation of subglacially stored sediments into the proglacial basins. The shrinking glacier also exposed proglacial tributary watersheds to rapid incision and denudation driven by >350 m of baselevel fall in a few decades. Moreover, in October 2015 a large tsunamigenic landslide occurred at the terminus of Tyndall Glacier, largely due to thinning exposing oversteepened, unstable slopes. Sediment yields from the glacier, the landslide and the tributary watersheds, measured from surveys of the sediments in the fjord collected in 1999 and 2016, are compared to ongoing changes in glacier and fjord geometry to investigate the magnitude of glacial and paraglacial denudation in Taan Fjord during retreat. In the last 50 years, sediment yields from the glacier and non-glacial tributaries kept pace with the rapid rate of retreat, and were on par with each other. Notably, basin-averaged erosion rates from the paraglacial landscape were twice that from the glacier, averaging 58 ± 9 and 26 ± 5 mm a−1, respectively. The sharp increases in sediment yields during retreat observed from both the glacier and the adjacent watersheds, including the landslide, highlight the rapid evolution of landscapes undergoing glacier shrinkage.
Prevention and control of respiratory disease is a major contributor to antibiotic use in swine. A systematic review was conducted to address the question, ‘What is the comparative efficacy of antimicrobials for the prevention of swine respiratory disease?’ Eligible studies were controlled trials published in English evaluating prophylactic antibiotics in swine, where clinical morbidity, mortality, or total antibiotic use was assessed. Four databases and the gray literature were searched for relevant articles. Two reviewers working independently screened titles and abstracts for eligibility followed by full-text articles, and then extracted data and evaluated risk of bias for eligible trials. There were 44 eligible trials from 36 publications. Clinical morbidity was evaluated in eight trials where antibiotics were used in nursery pigs and 10 trials where antibiotics were used in grower pigs. Mortality was measured in 22 trials in nursery pigs and 12 trials in grower pigs. There was heterogeneity in the antibiotic interventions and comparisons published in the literature; thus, there was insufficient evidence to allow quantification of the efficacy, or relative efficacy, of antibiotic interventions. Concerns related to statistical non-independence and quality of reporting were noted in the included trials.
A systematic review and network meta-analysis (MA) was conducted to address the question, ‘What is the efficacy of bacterial vaccines to prevent respiratory disease in swine?’ Four electronic databases and the grey literature were searched to identify clinical trials in healthy swine where at least one intervention arm was a commercially available vaccine for one or more bacterial pathogens associated with respiratory disease in swine, including Mycoplasma hyopneumoniae, Actinobacillus pleuropneumonia, Actinobacillus suis, Bordetella bronchiseptica, Pasteurella multocida, Stretococcus suis, Haemophils parasuis, and Mycoplasma hyorhinis. To be eligible, trials had to measure at least one of the following outcomes: incidence of clinical morbidity, mortality, lung lesions, or total antibiotic use. There were 179 eligible trials identified in 146 publications. Network MA was undertaken for morbidity, mortality, and the presence or absence of non-specific lung lesions. However, there was not a sufficient body of research evaluating the same interventions and outcomes to allow a meaningful synthesis of the comparative efficacy of the vaccines. To build this body of research, additional rigor in trial design and analysis, and detailed reporting of trial methods and results are warranted.
Translocation and rehabilitation programmes are critical tools for wildlife conservation. These methods achieve greater impact when integrated in a combined strategy for enhancing population or ecosystem restoration. During 2002–2016 we reared 37 orphaned southern sea otter Enhydra lutris nereis pups, using captive sea otters as surrogate mothers, then released them into a degraded coastal estuary. As a keystone species, observed increases in the local sea otter population unsurprisingly brought many ecosystem benefits. The role that surrogate-reared otters played in this success story, however, remained uncertain. To resolve this, we developed an individual-based model of the local population using surveyed individual fates (survival and reproduction) of surrogate-reared and wild-captured otters, and modelled estimates of immigration. Estimates derived from a decade of population monitoring indicated that surrogate-reared and wild sea otters had similar reproductive and survival rates. This was true for males and females, across all ages (1–13 years) and locations evaluated. The model simulations indicated that reconstructed counts of the wild population are best explained by surrogate-reared otters combined with low levels of unassisted immigration. In addition, the model shows that 55% of observed population growth over this period is attributable to surrogate-reared otters and their wild progeny. Together, our results indicate that the integration of surrogacy methods and reintroduction of juvenile sea otters helped establish a biologically successful population and restore a once-impaired ecosystem.
While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.
Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.
Median age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.
In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.
No standardized surveillance criteria exist for surgical site infection after breast tissue expander (BTE) access. This report provides a framework for defining postaccess BTE infections and identifies contributing factors to infection during the expansion period. Implementing infection prevention guidelines for BTE access may reduce postaccess BTE infections.
Organic cropping systems are characterized by soil-disturbance events that can be diversified over years through crop rotations and within seasons by varying planting dates. The Farming Systems Project at Beltsville, MD, USA, is a long-term experiment that includes three organic rotations, corn (Zea mays L.)–soybean [Glycine max (L.) Merr.], corn–soybean–wheat (Triticum aestivum L.), and corn–soybean–wheat–alfalfa (Medicago sativa L.). Analysis of weed presence and cover over the first 18 yr of this experiment revealed that the tall, erect annual broadleaf weeds smooth pigweed (Amaranthus hybridus L.), common lambsquarters (Chenopodium album L.), horseweed (Erigeron canadensis L.), jimsonweed (Datura stramonium L.), and/or velvetleaf (Abutilon theophrasti Medik.) were most prominent in corn and soybean. Generally, these species exhibited traits adapted to the disturbance regimes, nutrient availability, crop environment and duration, and local meteorological conditions associated with the summer annual corn and soybean crops. Abundance of A. hybridus, D. stramonium, and A. theophrasti were controlled primarily by rotation diversity, whereby presence and cover of these species were highest in the short corn–soybean rotation and lowest in the longer rotations that had more diverse seasonal soil-disturbance regimes. Early-season temperature was the primary factor controlling C. album presence and cover, which were higher at lower temperatures associated with earlier planting dates. Higher early-season precipitation was the primary factor associated with higher presence of annual grass species. The relative abundance of species in organic corn and soybean was determined primarily by the diversity of crops and disturbance operations in rotation, the timing of spring tillage and planting, and annual meteorological conditions driving emergence periodicity.
Many school-based interventions for obesity prevention have been proposed with positive changes in behaviour, but with unsatisfactory results on weight change. The objective was to verify the effectiveness of a combined school- and home-based obesity prevention programme on excessive weight gain in adolescents. Teachers delivered the school-based primary prevention programme to fifth- and sixth-graders (nine schools, forty-eight control classes, forty-nine intervention classes), which included encouraging healthy eating habits and physical activity. A subgroup of overweight or obese adolescents also received a home-based secondary prevention programme delivered by community health professionals. Schools were randomised to intervention or control group. Intent-to-treat analysis used mixed models for repeated continuous measures and considered the cluster effect. The main outcomes were changes in BMI and percentage body fat (%body fat) after one school-year of intervention and follow-up. Against our hypothesis, BMI increased more in the intervention group than in the control group (Δ = 0·3 kg/m2; P = 0·05) with a greater decrease in %body fat among boys (Δ = –0·6 %; P = 0·03) in the control group. The intervention group increased physical activity by 12·5 min per week compared with the control group. Female adolescents in the intervention group ate healthier items more frequently than in the control group. The subgroup that received both the school and home interventions had an increase in %body fat than in the control group (Δ = 0·89 %; P = 0·01). In the present study, a behavioural change led to a small increase in physical activity and healthy eating habits but also to an overall increase in food intake.
It is becoming clear that post-traumatic stress disorder (PTSD) is not simply a psychiatric disorder, but one that involves pervasive physiological impairments as well. These physiological disturbances deserve attention in any attempt at integrative treatment of PTSD that requires a focus beyond the PTSD symptoms themselves. The physiological disturbances in PTSD range over many systems, but a common thread thought to underlie them is that the chronic effects of PTSD involve problems with allostatic control mechanisms that result in an excess in what has been termed “allostatic load” (AL). A pharmacological approach to reducing AL would be valuable, but, because of the large range of physiological issues involved – including metabolic, inflammatory, and cardiovascular systems – it is unclear whether there exists a simple comprehensive way to address the AL landscape. In this paper, we propose that the cannabinoid system may offer just such an approach, and we outline evidence for the potential utility of cannabinoids in reducing many of the chronic physiological abnormalities seen in PTSD which are thought to be related to excess AL.
Antipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.