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Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.
Although the impact of diarrhoeal disease on paediatric health in Nigeria has decreased in recent years, it remains an important cause of morbidity and mortality in children under 5 years. Rotavirus is recognised as an important aetiological agent, but information on the contribution of intestinal protozoa to watery diarrhoea in this age group in Nigeria is scarce. In this cross-sectional study, faecal samples from children admitted to healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea (N = 199) and faecal samples from age-matched controls (N = 37) were examined for Cryptosporidium and Giardia using immunofluorescent antibody testing and molecular methods. Cryptosporidium was identified in 13 case samples (6.5%) and no control samples. For three samples, molecular characterisation indicated C. hominis, GP60 subtypes IaA30R3, IaA14R3 and IdA11. Giardia was not detected in any samples. This contrast in prevalence between the two intestinal protozoa may reflect their variable epidemiologies and probably differing routes of infection. Given that these two parasitic infections are often bracketed together, it is key to realise that they not only have differing clinical spectra but also that the importance of each parasite is not the same in different age groups and/or settings.
Scientific fields benefit when their researchers engage in self-reflection. Accordingly, we welcome the evidence gathered by Gardner, Ryan, and Snoeyink (2018) on gender differences in our field, the field of industrial and organizational (I-O) psychology. In this commentary, we argue that such self-reflection processes can be further enhanced by taking advantage of the wealth and breadth of scientometrics, the quantitative study of science.
In this article, we generalize Courcelle's recognizable graph languages and results on monadic second-order logic to more general structures.
First, we give a category-theoretical characterization of recognizability. A recognizable subset of arrows in a category is defined via a functor into the category of relations on finite sets. This can be seen as a straightforward generalization of finite automata. We show that our notion corresponds to recognizable graph languages if we apply the theory to the category of cospans of graphs.
In the second part of the paper, we introduce a simple logic that allows to quantify over the subobjects of a categorical object. Again, we show that, for the category of graphs, this logic is equally expressive as monadic second-order graph logic (msogl). Furthermore, we show that in the more general setting of hereditary pushout categories, a class of categories closely related to adhesive categories, we can recover Courcelle's result that every msogl-expressible property is recognizable. This is done by giving an inductive translation of formulas of our logic into automaton functors.
Olfactory disorders increase with age and often affect elderly people who have pre-dementia or dementia. Despite the frequent occurrence of olfactory changes at the early stages of neurodegenerative disorders such as Alzheimer's disease, olfactory disorders are rarely assessed in daily clinical practice, mainly due to a lack of standardised assessment tools. The aims of this review were to (1) summarise the existing literature on olfactory disorders in ageing populations and patients with neurodegenerative disorders; (2) present the strengths and weaknesses of current olfactory disorder assessment tools; and (3) discuss the benefits of developing specific olfactory tests for neurodegenerative diseases.
A systematic review was performed of literature published between 2000 and 2015 addressing olfactory disorders in elderly people with or without Alzheimer's disease or other related disorders to identify the main tools currently used for olfactory disorder assessment.
Olfactory disorder assessment is a promising method for improving both the early and differential diagnosis of Alzheimer's disease. However, the current lack of consensus on which tests should be used does not permit the consistent integration of olfactory disorder assessment into clinical settings.
Otolaryngologists are encouraged to use olfactory tests in older adults to help predict the development of neurodegenerative diseases. Olfactory tests should be specifically adapted to assess olfactory disorders in Alzheimer's disease patients.
Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.
The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.
Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.
Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.
Feedback learning is essential for behavioral development. We investigated feedback learning in relation to behavior problems after pediatric traumatic brain injury (TBI).
Children aged 6–13 years diagnosed with TBI (n = 112; 1.7 years post-injury) were compared with children with traumatic control (TC) injury (n = 52). TBI severity was defined as mild TBI without risk factors for complicated TBI (mildRF− TBI, n = 24), mild TBI with ⩾1 risk factor for complicated TBI (mildRF+ TBI, n = 51) and moderate/severe TBI (n = 37). The Probabilistic Learning Test was used to measure feedback learning, assessing the effects of inconsistent feedback on learning and generalization of learning from the learning context to novel contexts. The relation between feedback learning and behavioral functioning rated by parents and teachers was explored.
No evidence was found for an effect of TBI on learning from inconsistent feedback, while the moderate/severe TBI group showed impaired generalization of learning from the learning context to novel contexts (p = 0.03, d = −0.51). Furthermore, the mildRF+ TBI and moderate/severe TBI groups had higher parent and teacher ratings of internalizing problems (p's ⩽ 0.04, d's ⩾ 0.47) than the TC group, while the moderate/severe TBI group also had higher parent ratings of externalizing problems (p = 0.006, d = 0.58). Importantly, poorer generalization of learning predicted higher parent ratings of externalizing problems in children with TBI (p = 0.03, β = −0.21) and had diagnostic utility for the identification of children with TBI and clinically significant externalizing behavior problems (area under the curve = 0.77, p = 0.001).
Moderate/severe pediatric TBI has a negative impact on generalization of learning, which may contribute to post-injury externalizing problems.
Theoretical models of high-mass star formation lie between two extreme scenarios. At one extreme, all the mass comes from an initially gravitationally bound core. At the other extreme, the majority of the mass comes from cluster scale gas, which lies far outside the initial core boundary. One way to unambiguously show high-mass stars can assemble their gas through the former route would be to find a high-mass star forming in isolation. Making use of recently available CORNISH and ATLASGAL Galactic plane survey data, we develop sample selection criteria to try and find such an object. From an initial list of approximately 200 sources, we identify the high-mass star-forming region G13.384 + 0.064 as the most promising candidate. The region contains a strong radio continuum source, that is powered by an early B-type star. The bolometric luminosity, derived from infrared measurements, is consistent with this. However, sub-millimetre continuum emission, measured in ATLASGAL, as well as dense gas tracers, such as HCO+(3–2) and N2H+(3–2) indicate that there is less than ~ 100 M⊙ of material surrounding this star. We conclude that this region is indeed a promising candidate for a high-mass star forming in isolation.
Low meeting quality is often attributed to poorly planned and poorly led meetings. In recent years, an increasing number of scientific studies have examined the effects of principal meeting design characteristics on employees' perceptions of meeting satisfaction and effectiveness. The aim of this chapter is to provide an overview of the literature and research on premeeting factors and design characteristics that have been identified as important: temporal characteristics related to how meeting time is used (e.g., starting and ending on time, pre-meeting talk), procedural characteristics that direct attendees' attention and efforts toward task-oriented activities (e.g., using a written agenda, setting clear goals), physical characteristics that relate to meeting settings and environments (e.g., appropriate venue quality, provision of refreshments), and characteristics of attendees. Our review shows how meeting leaders have the ability to design meetings more effectively and facilitate them in a manner that results in better outcomes. Based on the results of this review, we also discuss practical implications and directions for future research.
Given the number of scientific publications on meetings, it seems that the time is ripe for using scientifically based training to develop the skills of meeting leaders. The purpose of this chapter is to outline such a training course developed on the basis of empirical studies, with the target group consisting of participants with managerial responsibility for leading meetings. The suggested two-day training course comprises five modules: Module 1: “Sensitization to and analysis of prevalent meeting culture,” Module 2: “Preparing meetings,” Module 3: “Communication skills for meeting leaders,” Module 4: “Techniques during the meeting,” and Module 5: “Monitoring resolutions and following up on action items.” For each module, we describe the scientific background and outline how this training component can be implemented. We also recommend adding a follow-up event to refresh participants' memory of the training to support its transfer to meeting practice.
As physical activity may modify the effect of the apolipoprotein E (APOE) ε4 allele on the risk of dementia and Alzheimer's disease (AD) dementia, we tested for such a gene–environment interaction in a sample of general practice patients aged ⩾75 years.
Data were derived from follow-up waves I–IV of the longitudinal German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). The Kaplan–Meier survival method was used to estimate dementia- and AD-free survival times. Multivariable Cox regression was used to assess individual associations of APOE ε4 and physical activity with risk for dementia and AD, controlling for covariates. We tested for gene–environment interaction by calculating three indices of additive interaction.
Among the randomly selected sample of 6619 patients, 3327 (50.3%) individuals participated in the study at baseline and 2810 (42.5%) at follow-up I. Of the 2492 patients without dementia included at follow-up I, 278 developed dementia (184 AD) over the subsequent follow-up interval of 4.5 years. The presence of the APOE ε4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of APOE ε4 with low physical activity was associated with higher risk for dementia and AD and shorter dementia- and AD-free survival time than the presence of APOE ε4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the APOE ε4 allele for general dementia risk, but a possible additive interaction for AD risk.
Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. APOE ε4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.
Case management undertaken by healthcare assistants in small primary care practices is effective in improving depression symptoms and adherence in patients with major depression.
To evaluate the cost-effectiveness of depression case management by healthcare assistants in small primary care practices.
Cost-effectiveness analysis on the basis of a pragmatic randomised controlled trial (2005-2008): practice-based healthcare assistants in 74 practices provided case management to 562 patients with major depression over 1 year. Our primary outcome was the incremental costeffectiveness ratio (ICER) calculated as the ratio of differences in mean costs and mean number of qualityadjusted life-years (QALYs). Our secondary outcome was the mean depression-free days (DFDs) between the intervention and control group at 24-month follow-up. The study was registered at the International Standard Randomised Controlled Trial Number Registry: ISRCTN66386086.
Intervention v. control group: no significant difference in QALYs; significantly more DFDs (mean: 373 v. 311, P<0.01); no significant difference in mean direct healthcare costs (€4495 v. €3506, P = 0.16); considerably lower mean indirect costs (€5228 v. €7539, P = 0.06), resulting in lower total costs (€9723 v. €11 045, P = 0.41). The point estimate for the cost-utility ratio was €38 429 per QALY gained if only direct costs were considered, and ‘dominance’ of the intervention if total costs were considered. Yet, regardless of decision makers' willingness to pay per QALY, the probability of the intervention being cost-effective was never above 90%.
In small primary care practices, 1 year of case management did not increase the number of QALYs but it did increase the number of DFDs. The intervention was likely to be cost-effective.
Neuroimaging studies have demonstrated an association between lithium (Li) treatment and brain structure in human subjects. A crucial unresolved question is whether this association reflects direct neurochemical effects of Li or indirect effects secondary to treatment or prevention of episodes of bipolar disorder (BD).
To address this knowledge gap, we compared manually traced hippocampal volumes in 37 BD patients with at least 2 years of Li treatment (Li group), 19 BD patients with <3 months of lifetime Li exposure over 2 years ago (non-Li group) and 50 healthy controls. All BD participants were followed prospectively and had at least 10 years of illness and a minimum of five episodes. We established illness course and long-term treatment response to Li using National Institute of Mental Health (NIMH) life charts.
The non-Li group had smaller hippocampal volumes than the controls or the Li group (F2,102 = 4.97, p = 0.009). However, the time spent in a mood episode on the current mood stabilizer was more than three times longer in the Li than in the non-Li group (t51 = 2.00, p = 0.05). Even Li-treated patients with BD episodes while on Li had hippocampal volumes comparable to healthy controls and significantly larger than non-Li patients (t43 = 2.62, corrected p = 0.02).
Our findings support the neuroprotective effects of Li. The association between Li treatment and hippocampal volume seems to be independent of long-term treatment response and occurred even in subjects with episodes of BD while on Li. Consequently, these effects of Li on brain structure may generalize to patients with neuropsychiatric illnesses other than BD.
Roughly a decade ago an outstanding thermoelectric figure of merit ZT of 2.4 was reported for nanostructured Bi2Te3/Sb2Te3-based thin film superlattice (SL) structures. The published results strongly fueled and renewed the interest in the development of efficient novel nanostructured thermoelectric materials. This review article shall give an overview over the most recent theoretical and experimental advances on Bi2Te3/Sb2Te3 SLs and related superlattice systems. The presented theoretical models are subdivided into electronic and phononic aspects. The experimental results are summarized with regard to the method used. A more detailed elaboration on structural and transport properties is given in the subsequent sections.
It is well documented that global warming is unequivocal. Dairy production systems are considered as important sources of greenhouse gas emissions; however, little is known about the sensitivity and vulnerability of these production systems themselves to climate warming. This review brings different aspects of dairy cow production in Central Europe into focus, with a holistic approach to emphasize potential future consequences and challenges arising from climate change. With the current understanding of the effects of climate change, it is expected that yield of forage per hectare will be influenced positively, whereas quality will mainly depend on water availability and soil characteristics. Thus, the botanical composition of future grassland should include species that are able to withstand the changing conditions (e.g. lucerne and bird's foot trefoil). Changes in nutrient concentration of forage plants, elevated heat loads and altered feeding patterns of animals may influence rumen physiology. Several promising nutritional strategies are available to lower potential negative impacts of climate change on dairy cow nutrition and performance. Adjustment of feeding and drinking regimes, diet composition and additive supplementation can contribute to the maintenance of adequate dairy cow nutrition and performance. Provision of adequate shade and cooling will reduce the direct effects of heat stress. As estimated genetic parameters are promising, heat stress tolerance as a functional trait may be included into breeding programmes. Indirect effects of global warming on the health and welfare of animals seem to be more complicated and thus are less predictable. As the epidemiology of certain gastrointestinal nematodes and liver fluke is favourably influenced by increased temperature and humidity, relations between climate change and disease dynamics should be followed closely. Under current conditions, climate change associated economic impacts are estimated to be neutral if some form of adaptation is integrated. Therefore, it is essential to establish and adopt mitigation strategies covering available tools from management, nutrition, health and plant and animal breeding to cope with the future consequences of climate change on dairy farming.
Whether late-onset depression is a risk factor for or a prodrome of dementia remains unclear. We investigated the impact of depressive symptoms and early- v. late-onset depression on subsequent dementia in a cohort of elderly general-practitioner patients (n = 2663, mean age = 81.2 years).
Risk for subsequent dementia was estimated over three follow-ups (each 18 months apart) depending on history of depression, particularly age of depression onset, and current depressive symptoms using proportional hazard models. We also examined the additive prediction of incident dementia by depression beyond cognitive impairment.
An increase of dementia risk for higher age cut-offs of late-onset depression was found. In analyses controlling for age, sex, education, and apolipoprotein E4 genotype, we found that very late-onset depression (aged ⩾70 years) and current depressive symptoms separately predicted all-cause dementia. Combined very late-onset depression with current depressive symptoms was specifically predictive for later Alzheimer's disease (AD; adjusted hazard ratio 5.48, 95% confidence interval 2.41–12.46, p < 0.001). This association was still significant after controlling for cognitive measures, but further analyses suggested that it was mediated by subjective memory impairment with worries.
Depression might be a prodrome of AD but not of dementia of other aetiology as very late-onset depression in combination with current depressive symptoms, possibly emerging as a consequence of subjectively perceived worrisome cognitive deterioration, was most predictive. As depression parameters and subjective memory impairment predicted AD independently of objective cognition, clinicians should take this into account.
Energy-filtered transmission electron microscopy (EFTEM) yields new possibilities for the investigation of Bi2Te3 based nanomaterials. Combined low-loss electron energy-loss spectroscopy (EELS) and energy-dispersive x-ray microanalysis (EDS) and energy-filtered TEM were applied on a Zeiss 912Ω TEM to investigate nanowires, thin films, and bulk materials. Multilayered Bi-Sb-Te nanowires with a diameter of 65 nm and a period of 200 nm and stoichiometric Bi2Te3 nanowires were grown by potential-pulsed electrochemical deposition. Tellurium elemental maps of the multilayered nanowires were obtained by two-window edge-jump ratio images (EJI). EDS chemical analysis showed that small Te fluctuations of 3 at.% yielded significant contrast in EJI. Energy-filtered TEM applied on nano-alloyed Bi2Te3 thin films grown by molecular beam epitaxy (MBE) revealed 10-20 nm thick Bi-rich blocking layers at grain boundaries. Plasmon spectroscopy by EELS was applied on Bi2(Te0.91Se0.09)3 bulk and yielded a plasmon energy of 16.9 eV. Finally, plasmon dispersion was measured for Bi2(Te0.91Se0.09)3 bulk by angle-resolved EELS, which yields a fingerprint of the anisotropy and the dimensionality of the electronic structure of the materials.
Nano-alloyed p-type Sb2Te3 and n-type Bi2Te3 thin films were grown on SiO2/Si and BaF2 substrates by molecular beam epitaxy (MBE) in two steps: (i) Repeated deposition of five-layer stacks with sequence Te-X-Te-X-Te (X = Sb or Bi) with elemental layer thicknesses of 0.2 nm on substrates at room temperature, (ii) annealing at 250 °C for two hours at which phase formation of Sb2Te3 or Bi2Te3 occurred. The room temperature MBE deposition method reduces surface roughness, allows the use of non lattice-matched substrates, and yields a more accurate and easier control of the Te content compared to Bi2Te3 thin films, which were epitaxially grown on BaF2 substrates at 290 °C. X-ray diffraction revealed that the thin films were single phase, poly-crystalline, and textured. The films showed grain sizes of 500 nm for Sb2Te3 and 250 nm for Bi2Te3, analyzed by transmission electron microscopy (TEM). The in-plane transport properties (thermopower S, electrical conductivity σ, charge carrier density n, charge carrier mobility μ, power factor S2σ) were measured at room temperature. The nano-alloyed Sb2Te3 thin film revealed a remarkably high power factor of 29 μW cm-1 K-2 similar to epitaxially grown Bi2Te3 thin films and Sb2Te3 single crystalline bulk materials. This large power factor can be attributed to a high charge carrier mobility of 402 cm2 V−1 s-1 similar to high-ZT Bi2Te3/Sb2Te3 superlattices. However, for the nano-alloyed Bi2Te3 thin film a low power factor of 8 μW cm−1 K-2 and a low charge carrier mobility of 80 cm2 V−1 s−1 were found. Detailed microstructure and phase analyses were carried out by energy-filtered TEM in cross-sections. Quantitative chemical analysis by energy-dispersive x−ray spectroscopy (EDS) was also applied. In Bi2Te3 thin films, few nanometer thick Bi-rich blocking layers at grain boundaries and Te fluctuations by 1.3 at.% within the grains were observed. The small charge carrier densities are explained by a reduced antisite defect density due to the low temperatures to which the thin films were exposed during annealing.