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Borsboom and colleagues argue that reductionism in psychopathology research has not provided the expected insights. Instead, they suggest a systems approach of interacting syndromes, which, however, falls short of a perspective for empirical testing. Here, a combination of both approaches is suggested: a reductionistic empirical approach allowing testability, synergistic with a constructivistic systems appraisal of syndrome networks – a constructive reductionism.
The aim of this study was to assess the provision of information to, and seeking of information by, patients newly diagnosed with polymyalgia rheumatica (PMR) in primary care.
PMR is an inflammatory rheumatological condition of older people that can be treated with long-term oral glucocorticoids. Management usually requires the patient to understand the potential complications of treatment and the disease, as well as involvement in reducing treatment dose. This may be complex for patients to understand.
Data are taken from the baseline phase of the PMR Cohort study, which recruited newly diagnosed patients with PMR from UK primary care. Participants provided information on their PMR symptoms, general health and sociodemographics. They also completed items regarding information provision by their doctor at diagnosis, its usefulness and their own search for information.
A total of 652 people responded to the baseline survey. In all, 399 (62.7%) had received written information from their doctor; 237 (98%) found it useful; 265 (42.9%) would have liked more information; and 311 (48.4%) sought out more information. Those who were not given information and did not seek it out tended to be older and have poorer internet access.
Information provided at diagnosis to patients with PMR is useful, but more than a third did not receive any. This is concerning when PMR requires self-management and vigilance for red flags. Doctors should make use of the resources already available to them to support patients and should specifically ensure that these are available to more elderly patients and those without internet access.
Simultaneous PET/MR/EEG (Positron Emission Tomography – Magnetic Resonance – Electroencephalography), a new tool for the investigation of neuronal networks in the human brain, is presented here within the framework of the European Union Project TRIMAGE. The trimodal, cost-effective PET/MR/EEG imaging tool makes use of cutting edge technology both in PET and in MR fields. A novel type of magnet (1.5T, non-cryogenic) has been built together with a PET scanner that makes use of the most advanced photodetectors (i.e., SiPM matrices), scintillators matrices (LYSO) and digital electronics. The combined PET/MR/EEG system is dedicated to brain imaging and has an inner diameter of 260 mm and an axial Field-of-View of 160 mm.
It enables the acquisition and assessment of molecular metabolic information with high spatial and temporal resolution in a given brain simultaneously. The dopaminergic system and the glutamatergic system in schizophrenic patients are investigated via PET, the same physiological/pathophysiological conditions with regard to functional connectivity, via fMRI, and its electrophysiological signature via EEG. In addition to basic neuroscience questions addressing neurovascular-metabolic coupling, this new methodology lays the foundation for individual physiological and pathological fingerprints for a wide research field addressing healthy aging, gender effects, plasticity and different psychiatric and neurological diseases.
The preliminary performances of two components of the imaging tool (PET and MR) are discussed. Initial results of the search of possible candidates for suitable schizophrenia biomarkers are also presented as obtained with PET/MR systems available to the collaboration.
Fear responses are particularly intense and persistent in post-traumatic stress disorder (PTSD), and can be evoked by unspecific cues that resemble the original traumatic event. Overgeneralisation of fear might be one of the underlying mechanisms. We investigated the generalisation and discrimination of fear in individuals with and without PTSD related to prolonged childhood maltreatment.
Sixty trauma-exposed women with (N = 30) and without (N = 30) PTSD and 30 healthy control participants (HC) underwent a fear conditioning and generalisation paradigm. In a contingency learning procedure, one of two circles of different sizes was associated with an electrical shock (danger cue), while the other circle represented a safety cue. During generalisation testing, online risk ratings, reaction times and fear-potentiated startle were measured in response to safety and danger cues as well as to eight generalisation stimuli, i.e. circles of parametrically varying size creating a continuum of similarity between the danger and safety cue.
The increase in reaction times from the safety cue across the different generalisation classes to the danger cue was less pronounced in PTSD compared with HC. Moreover, PTSD participants expected higher risk of an aversive event independent of stimulus types and task.
Alterations in generalisation constitute one part of fear memory alterations in PTSD. Neither the accuracy of a risk judgement nor the strength of the induced fear was affected. Instead, processing times as an index of uncertainty during risk judgements suggested a reduced differentiation between safety and threat in PTSD.
Depression and obesity are highly prevalent, and major impacts on public health frequently co-occur. Recently, we reported that having depression moderates the effect of the FTO gene, suggesting its implication in the association between depression and obesity.
To confirm these findings by investigating the FTO polymorphism rs9939609 in new cohorts, and subsequently in a meta-analysis.
The sample consists of 6902 individuals with depression and 6799 controls from three replication cohorts and two original discovery cohorts. Linear regression models were performed to test for association between rs9939609 and body mass index (BMI), and for the interaction between rs9939609 and depression status for an effect on BMI. Fixed and random effects meta-analyses were performed using METASOFT.
In the replication cohorts, we observed a significant interaction between FTO, BMI and depression with fixed effects meta-analysis (β=0.12, P = 2.7 × 10−4) and with the Han/Eskin random effects method (P = 1.4 × 10−7) but not with traditional random effects (β = 0.1, P = 0.35). When combined with the discovery cohorts, random effects meta-analysis also supports the interaction (β = 0.12, P = 0.027) being highly significant based on the Han/Eskin model (P = 6.9 × 10−8). On average, carriers of the risk allele who have depression have a 2.2% higher BMI for each risk allele, over and above the main effect of FTO.
This meta-analysis provides additional support for a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. The findings provide a useful starting point in understanding the biological mechanism involved in the association between obesity and depression.
To evaluate the appropriateness of the screening strategy for healthcare personnel (HCP) during a hospital-associated Middle East Respiratory Syndrome (MERS) outbreak, we performed a serologic investigation in 189 rRT-PCR–negative HCP exposed and assigned to MERS patients. Although 20%–25% of HCP experienced MERS-like symptoms, none of them showed seroconversion by plaque reduction neutralization test (PRNT).
The FP-7 (Framework Programme 7 of the European Union) PERICLES project addresses the life-cycle of large and complex data sets to cater for the evolution of context of data sets and user communities, including groups unanticipated when the data was created. Semantics of data sets are thus also expected to evolve and the project includes elements which could address the reuse of data sets at periods where the data providers and even their institutions are not available any more. This paper presents the PERICLES science case with the example of the SOLAR (SOLAR monitoring observatory) payload on International Space Station-Columbus.
Between 2010 and 2012, 3 outbreaks of nosocomial infections in German neonatal intensive care units (NICUs) attracted considerable public interest. Headlines on national television channels and in newspapers had important consequences for the involved institutions and a negative impact on the relationship between families and staff in many German NICUs.
To determine whether NICU outbreaks reported in the media influenced provider behavior in the community of neonatal care and led to more third-line antibiotic prescribing.
Observational cohort study.
To investigate secular trends, we evaluated data for very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) enrolled in the German Neonatal Network (GNN) between 2009 and 2014 (N=10,253). For outbreak effects, we specifically analyzed data for VLBWIs discharged 6 months before (n=2,428) and 6 months after outbreaks (n=2,508).
The exposure of all VLBWIs to third-line antibiotics increased after outbreaks (19.4% before vs 22.5% after; P=.007). This trend particularly affected male infants (4.6% increase; P=.005) and infants with a birth weight between 1,000 and 1,499 g (3.5% increase; P=.001)
In a logistic regression analysis, month of discharge as linear variable of time was associated with increased exposure to third-line antibiotics (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.009–1.014; P<.001), and discharge within the 6-month period after outbreak reports independently contributed to this long-term trend (OR, 1.14; 95% CI, 1.017–1.270; P=.024).
Media reports directly affect medical practice, eg, overuse of third-line antibiotics. Future communication and management strategies must be based on objective dialogues between the scientific community and investigative journalists.
Models of ideal point estimation usually build on the assumption of spatial preferences. This ignores legislators' non-policy incentives and is thus likely to produce implausible results for many legislatures. We study this problem in parliamentary systems and develop a model of roll call voting that considers both the policy and the non-policy, tactical incentives of legislators. We go on to show how the relative weight of these policy and tactical incentives is influenced by the identity of the mover and characteristics of the motion. Analyses of two data sets of 2174 roll call votes in German state legislatures and 3295 roll call votes in the British House of Commons result in three main findings. First, we show that tactical incentives may be more important than policy incentives, and second, that the importance of tactical incentives varies with the importance of motions. Third, there are interesting twists: backbench private members' bills may reverse tactical incentives whereas proposals from anti-system parties are virtually always rejected by moderate parties, rendering these votes uninformative. Our findings have implications for ideal point estimation in parliamentary systems, as well as for research on separation of power systems.
Pb-lawsonite, PbAl2[(OH)2|Si2O7]·H2O, space group Pbnm, was synthesized as crystals up to 15 μm × 5 μm × 5 μm in size by a piston cylinder technique at a pressure of ∼4 GPa and a temperature of 873 ± 10 K. Temperature-dependent powder and single-crystal X-ray diffraction (XRD) analyses partly using synchrotron radiation as well as Raman spectroscopic investigations reveal a phase transition around 445 K resulting in the Cmcm high-temperature structure. The transformation temperature is considerably higher than that of lawsonite around 273 K, which is characterized predominantly by proton order/disorder. The transition is confirmed using principal component analysis and subsequent hierarchical cluster analysis on both the powder XRD patterns and the Raman spectra. Furthermore, a non-uniform change is observed around 355 K, which is not as pronounced as the 445 K transition and apparently comes from enhanced hydrogen bonding, which stops the atom shifts in Pb-lawsonite. These are the same bonds that mainly characterize the phase transition in lawsonite around 273 K. In contrast, the structural transition of Pblawsonite at 445 K seems to originate from the interaction of the SiO4 tetrahedra and AlO6 octahedra framework with the Pb2+ cation. The structural environment of Pb2+ can be described by a 12-fold coordination above 445 K, which changes towards irregular ten-fold coordination below this temperature. An assignment of the O–H stretching Raman bands confirms moderately strong H bonds in Pb-lawsonite, whereas both strong and weak H bonds exist in lawsonite. Therefore, a further phase transition of Pblawsonite, similar to that of lawsonite around 273 K, is not expected.
On the basis of data from Swedish, this paper examines the Small Clause Hypothesis (Kush & Lindahl 2011, Kush, Omaki & Hornstein 2013) proposed to account for relative clause (RC) extractions in Mainland Scandinavian. The hypothesis predicts that extraction possibilities differ for relative clauses in the complement of verbs which select and verbs which do not select a small clause (SC), and that the possibility of RC extraction hinges on the ability of the matrix verb to select SCs involving the predicational operator som. I report results from an acceptability judgment experiment on RC extraction in Swedish manipulating three conditions: (a) SC-selecting verbs compatible with som, (b) SC-selecting verbs incompatible with som, and (c) verbs that are incompatible with SCs. The results show no significant difference between these conditions, thus offer no support in favor of the Small Clause Hypothesis. Additional problems are posed by the possibility of extraction from object RCs and by extraction possibilities in the absence of som.
Kline proposes an evolutionary framework for teaching as a major base of human culture, in which she outlines how different types of teaching may solve adaptive problems with a focus on human behavior. Here it is argued that the ability to teach and the different types of teaching behavior may not only solve adaptive problems, but also create them.