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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.
Results from the Heinrich Event Intercomparison (HEINO) topic of the Ice-Sheet Model Intercomparison Project (ISMIP) are presented. ISMIP HEINO was designed to explore internal large-scale ice-sheet instabilities in different contemporary ice-sheet models. These instabilities are of interest because they are a possible cause of Heinrich events. A simplified geometry experiment reproduces the main characteristics of the Laurentide ice sheet, including the sedimented region over Hudson Bay and Hudson Strait. The model experiments include a standard run plus seven variations. Nine dynamic/thermodynamic ice-sheet models were investigated; one of these models contains a combination of the shallow-shelf (SSA) and shallow-ice approximation (SIA), while the remaining eight models are of SIA type only. Seven models, including the SIA–SSA model, exhibit oscillatory surges with a period of ∼1000 years for a broad range of parameters, while two models remain in a permanent state of streaming for most parameter settings. In a number of models, the oscillations disappear for high surface temperatures, strong snowfall and small sediment sliding parameters. In turn, low surface temperatures and low snowfall are favourable for the ice-surge cycles. We conclude that further improvement of ice-sheet models is crucial for adequate, robust simulations of cyclic large-scale instabilities.
Subjective cognitive decline (SCD) designates a self-reported cognitive decline despite preserved cognitive abilities. This study aims to explore, in older adults with SCD, the association between intensity of self-reported cognitive complaint and psychological factors including Young's early maladaptive schemas (EMSs) (i.e. enduring cognitive structures giving rise to beliefs about oneself and the world), as well as depression and anxiety.
Seventy-six subjects (69.22 years ± 6.1) with intact cognitive functioning were recruited through an advertisement offering free participation in an intervention on SCD. After undergoing a neuropsychological examination (including global cognition (MMSE) and episodic memory (FCSRT)) and a semi-structured interview to assess depressive symptoms (MADRS), they completed a set of online self-reported questionnaires on SCD (McNair questionnaire), Young's EMSs (YSQ-short form), depression (HADS-D), and anxiety (HADS-A and trait-STAI-Y).
The McNair score did not correlate with the neuropsychological scores. Instead, it was highly (r > 0.400; p < 0.005) correlated with trait anxiety and three EMSs belonging to the “Impaired autonomy and performance” domain: Dependence/incompetence, Failure to achieve and Vulnerability to harm or illness. Our final regression model comprising depression, anxiety, and these three EMSs as predictors (while controlling for age, gender, and objective cognition) accounted for 38.5% of the observed variance in SCD intensity.
The level of cognitive complaint is significantly associated with Young's EMSs in the category of “Impaired autonomy and performance”. We assume that SCD may primarily be driven by profound long-term inner beliefs about oneself that do not specifically refer to self-perceived memory abilities.
This paper reviews the scant economic literature on the transformations of farming households under the influence of land pressure, market development or technical change. Theoretical as well as empirical contributions are summarized with a special attention to the African context.
Ferroelectric epitaxial Pb(Zr,Ti)O3 (PZT) layers were grown by pulsed laser deposition on SrTiO3/GaAs templates fabricated by molecular beam epitaxy. The templates present an excellent structural quality and the SrTiO3/GaAs is abrupt at the atomic scale thanks to surface Ti pre-treatment. The PZT layers contain a- and c- domains, as shown by X-Ray diffraction analyses. Piezoforce microscopy experiments and macroscopic electrical characterizations indicate that PZT is ferroelectric. A relative dielectric permittivity of 164 is extracted from these measurements.
The present study investigated the impact of a Lactobacillus rhamnosus CGMCC1.3724 (LPR) supplementation on weight loss and maintenance in obese men and women over 24 weeks. In a double-blind, placebo-controlled, randomised trial, each subject consumed two capsules per d of either a placebo or a LPR formulation (1·6 × 108 colony-forming units of LPR/capsule with oligofructose and inulin). Each group was submitted to moderate energy restriction for the first 12 weeks followed by 12 weeks of weight maintenance. Body weight and composition were measured at baseline, at week 12 and at week 24. The intention-to-treat analysis showed that after the first 12 weeks and after 24 weeks, mean weight loss was not significantly different between the LPR and placebo groups when all the subjects were considered. However, a significant treatment × sex interaction was observed. The mean weight loss in women in the LPR group was significantly higher than that in women in the placebo group (P= 0·02) after the first 12 weeks, whereas it was similar in men in the two groups (P= 0·53). Women in the LPR group continued to lose body weight and fat mass during the weight-maintenance period, whereas opposite changes were observed in the placebo group. Changes in body weight and fat mass during the weight-maintenance period were similar in men in both the groups. LPR-induced weight loss in women was associated not only with significant reductions in fat mass and circulating leptin concentrations but also with the relative abundance of bacteria of the Lachnospiraceae family in faeces. The present study shows that the Lactobacillus rhamnosus CGMCC1.3724 formulation helps obese women to achieve sustainable weight loss.
Sessile animals that live on the foreshore undergo tidal cycles, and have to face
variations in physical and chemical parameters such as oxygen concentration. During
emersion, availability of dissolved oxygen can be lowered for bivalves, which have only a
small reserve of seawater inside their closed shell. Differences in oxygen concentration
are thus expected to lead to modifications of the metabolism, including changes in
mitochondrial activity. Previous studies investigated air exposure under extreme
conditions, which do not always reflect environmental conditions these invertebrates have
to cope with. In this study, oxidative capacities of gill mitochondria of the oyster
Crassostrea gigas were studied during a tidal cycle period, by
comparing oysters collected after emersion and immersion. Only minor differences were
found in state 3 (oxidative phosphorylation) or state 4 (non-phosphorylating oxygen
consumption) rates between the two conditions. Similarly, no difference was observed in
cytochrome c oxidase activity or in oxygen consumption related to maximal
electron flux through complexes I-IV, II-IV and IV. While capacities of substrate
oxidation were maintained in both emersion and immersion conditions, capacity of
mitochondria to produce adenosine triphosphate (ATP) was significantly lower in oysters
sampled during emersion. These results suggest that although C. gigas
could maintain aerobic metabolism during emersion period within a tidal cycle in
its environment, energy producing mechanisms are affected.
Catherine Esnouf, Institut National de la Recherche Agronomique (INRA), Paris,Marie Russel, Institut National de la Recherche Agronomique (INRA), Paris,Nicolas Bricas, Centre de Co-opération Internationale en Recherche Agronomique pour le Développement (CIRAD), Paris
Regional and global food systems are constantly evolving, thus the contextual elements presented in Chapter 1 are likely to evolve, and food systems will be transformed. Because it is impossible to predict the food systems of tomorrow, we have adopted a foresight approach in order to try and understand possible future changes. Our approach, which is presented in the first part of this chapter, has therefore mainly been based on identifying the main drivers of the transformation of food systems. This work was the fruit of collective discussions by a multidisciplinary group made up of some 15 experts. The plurality of their views and their areas of competence allowed them to analyse the potential impacts of the different evolutions identified relative to the sustainability of food systems in terms of their nutritional, economic, social, cultural, environmental and territorial dimensions. This step of the analysis also enabled us to highlight a certain number of points at issue, which are presented in the second part of the chapter; this does not end with a presentation of different scenarios (as might have been expected), but concludes with the three transversal messages arising from debate by this workshop: issues linked to inequalities of access to food, territorial dynamics and the governance of food systems.
Food systems evolving under the effects of various factors
Through the identification of factors underlying the transformation of food systems, it appears clearly that some trends have already been identified (see, in particular, Chapter 1 on the context and the challenges of food systems, and the retrospective analysis described in Chapter 2). Nevertheless, these trends involve a certain number of questions and uncertainties, notably regarding the nature and degree of their potential effects. These uncertainties thus open the way to contrasting scenarios for food systems throughout the world (see Figure 9.1).
FK506 binding protein 5 (FKBP5) has repeatedly been shown to be a critical determinant of post-traumatic stress disorder (PTSD) and depression following childhood trauma.
To examine the role of FKBP5-trauma interactions in the partly stress-related psychosis phenotype.
In 401 general population twins, four functional polymorphisms were examined in models of psychosis and Cortisol, and followed up in models of psychosis in three samples at different familial liability (175 controls, 200 unaffected siblings and 195 patients with a psychotic disorder).
The most consistent finding was an interaction between childhood trauma and rs9296158/rs4713916 on psychotic symptoms and Cortisol in the twin sample, combined with a directionally similar interaction in siblings (rs4713916) and patients (rs9296158), A-allele carriers at both polymorphisms being most vulnerable to trauma.
Trauma may increase the risk of psychosis through enduring changes in the Cortisol feedback loop, similar to that for PTSD, suggesting comparable biological mechanisms for psychosis across diagnostic boundaries.
Metallic nanoparticles under 10 nm are of particular interest for the microelectronics industry. However, there is a lack of convenient synthetic routes to control their size Oxophilic metals, such as Ta, are also of high interest, however, the high oxophilicity and melting point makes the synthesis of such nanoparticles challenging. Making use of imidazolium-based ionic liquids, monodisperse zero-valent tantalum nanoparticles (Ta(0)NPs) have been successfully synthesised at room temperature by reduction of tris(neopentyl)neopentylidenetantalum(V). Furthermore; well size-controlled bimetallic Ru-Ta NPs have also been synthesized.
Renewable energy sources – including biomass, geothermal, ocean, solar, and wind energy, as well as hydropower – have a huge potential to provide energy services for the world. The renewable energy resource base is sufficient to meet several times the present world energy demand and potentially even 10 to 100 times this demand. This chapter includes an in-depth examination of technologies to convert these renewable energy sources to energy carriers that can be used to fulfill our energy needs, including their installed capacity, the amount of energy carriers they produced in 2009, the current state of market and technology development, their economic and financial feasibility in 2009 and in the near future, as well as major issues they may face relative to their sustainability or implementation.
Present uses of renewable energy
Since 1990 the energy provided from renewable sources worldwide has risen at an average rate of nearly 2% a year, but in recent years this rate has increased to about 5% annually (see Figure 11.1.) As a result, the global contribution of renewables has increased from about 74 EJ in 2005 to about 89 EJ in 2009 and represents now 17% of global primary energy supply (528 EJ, see Figure 11.2). Most of this renewable energy comes from the traditional use of biomass (about 39 EJ) and larger-scale hydropower (about 30 EJ), while other renewable technologies provided about 20 EJ.
A high resolution analysis of benthic foraminifera as well as of aeolian terrigenous proxies extracted from a 37 m-long marine core located off the Mauritanian margin spanning the last ~ 1.2 Ma, documents the possible link between major continental environmental changes with a shift in the isotopic signature of deep waters around 1.0–0.9 Ma, within the so-called Mid-Pleistocene Transition (MPT) time period. The increase in the oxygen isotopic composition of deep waters, as seen through the benthic foraminifera δ18O values, is consistent with the growth of larger ice sheets known to have occurred during this transition. Deep-water mass δ13C changes, also estimated from benthic foraminifera, show a strong depletion for the same time interval. This drastic change in δ13C values is concomitant with a worldwide 0.3‰ decrease observed in the major deep oceanic waters for the MPT time period. The phase relationship between aeolian terrigeneous signal increase and this δ13C decrease in our record, as well as in other paleorecords, supports the hypothesis of a global aridification amongst others processes to explain the deep-water masses isotopic signature changes during the MPT. In any case, the isotopic shifts imply major changes in the end-member δ18O and δ13C values of deep waters.
The search for durable dyes led several past civilizations to develop artificial pigments. Maya Blue (MB), manufactured in pre-Columbian Mesoamerica, is one of the best known examples of an organic-inorganic hybrid material. Its durability is due to the unique association of indigo molecule and palygorskite, a particular fibrous clay occurring in Yucatan. Despite 50 years of sustained interest, the microscopic structure of MB and its relation to the durability remain open questions. Combining new thermogravimetric and synchrotron X-ray diffraction analyses, we show that indigo molecules can diffuse into the channel of the palygorskite during the heating process, replacing zeolitic water and stabilizing the room temperature phases of the clay.
We report on the effect of thermal annealing on the photoluminescence properties of a Ga0.65In0.35N0.02As0.98/GaAs single quantum well. Thermal annealing is shown to decrease the strong nitrogen-induced localization effects observed at low temperatures and to reduce the full width at half maximum of the emission peak. It also induces a strong blue shift of the emission peak energy, which is thought not to arise from an In-Ga interdiffusion alone, as it is much larger than in a nitrogen-free reference single quantum well.
We study the phase behavior of single walled carbon nanotubes in aqueous solutions of surfactant molecules or amphiphilic polymers. Homogeneous dispersions can be obtained by using sodium dodecyl sulfate (SDS) in a well-defined concentration range. In contrast, polyvinyl alcohol (PVA) is not efficient at stabilizing the tubes. Carbon nanotubes stick with each other when PVA is added to homogeneous dispersions initially stabilized by SDS. This behavior is the basis of a simple method that we developed to assemble single walled carbon nanotubes into indefinitely long ribbons and fibers. The processing consists of dispersing the nanotubes in SDS solutions, re-condensing the nanotubes in the flow of a PVA solution to form a nanotube mesh, and then collating this mesh to a nanotube fiber. Flow induced alignment may lead to a preferential orientation of the nanotubes in the mesh that has the form of a ribbon. Unlike classical carbon fibers, the nanotube fibers can be strongly bent without breaking. Their obtained elastic modulus is 10 times higher than the modulus of high-quality bucky paper.
Understanding the basics of cryobiology to develop improved cryopreservation procedures has been a major challenge to scientists all over the world. During a typical cryopreservation process ice tends to form at different rates. Intracellular ice formation is generally thought to be lethal as it causes injury to cellular membranes and intracellular structures. Conventional slow freezing protocols involve pretreatment of cells with cryoprotective agents (CPAs) in order to remove some water from the cells and to minimize some other harmful effects of freezing. The rate at which permeable CPA diffuses into the cells varies between the cryoprotectants and is also temperature and concentration dependant. Vitrification has become an increasingly accepted method for preserving embryos, oocytes and, recently, even sperm. An ideal vitrification method produces no ice formation and may therefore be an equilibrium method. The benefits of sperm cryopreservation are numerous in human reproductive medicine.