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The schizophrenia polygenic risk score (SCZ-PRS) is an emerging tool in psychiatry.
We aimed to evaluate the utility of SCZ-PRS in a young, transdiagnostic, clinical cohort.
SCZ-PRSs were calculated for young people who presented to early-intervention youth mental health clinics, including 158 patients of European ancestry, 113 of whom had longitudinal outcome data. We examined associations between SCZ-PRS and diagnosis, clinical stage and functioning at initial assessment, and new-onset psychotic disorder, clinical stage transition and functional course over time in contact with services.
Compared with a control group, patients had elevated PRSs for schizophrenia, bipolar disorder and depression, but not for any non-psychiatric phenotype (for example cardiovascular disease). Higher SCZ-PRSs were elevated in participants with psychotic, bipolar, depressive, anxiety and other disorders. At initial assessment, overall SCZ-PRSs were associated with psychotic disorder (odds ratio (OR) per s.d. increase in SCZ-PRS was 1.68, 95% CI 1.08–2.59, P = 0.020), but not assignment as clinical stage 2+ (i.e. discrete, persistent or recurrent disorder) (OR = 0.90, 95% CI 0.64–1.26, P = 0.53) or functioning (R = 0.03, P = 0.76). Longitudinally, overall SCZ-PRSs were not significantly associated with new-onset psychotic disorder (OR = 0.84, 95% CI 0.34–2.03, P = 0.69), clinical stage transition (OR = 1.02, 95% CI 0.70–1.48, P = 0.92) or persistent functional impairment (OR = 0.84, 95% CI 0.52–1.38, P = 0.50).
In this preliminary study, SCZ-PRSs were associated with psychotic disorder at initial assessment in a young, transdiagnostic, clinical cohort accessing early-intervention services. Larger clinical studies are needed to further evaluate the clinical utility of SCZ-PRSs, especially among individuals with high SCZ-PRS burden.
Over 2.4 million children in the public school system are diagnosed with a learning disability, including dyslexia and developmental dyscalculia. Previous research has shown that some teachers are unaware of the importance of working memory in a student’s academic and social realm and what working memory deficits may look like in the classroom. The relationship between learning disabilities, working memory, and behaviour problems were examined with tailored recommendations for improvement to provide insight for classroom educators. Three children from the United Kingdom, all of whom were 8 years old and presented with symptoms of learning disorders and low working memory profiles, were selected for case studies. Measures of working memory, behaviour, and academic attainment were included. Results from their standardised assessments indicated that each child had below average working memory, as well as low scores in arithmetic, writing and spelling skills. Each child also exhibited some type of behavioural problem, such as inattention or hyperactivity. Implications of the impact of their working memory profile on their academic outcomes and behaviour are discussed. Recommendations, such as Response to Intervention (RTI), are included for classroom educators to bridge the gap between research and practice.
In Defense of Property: begins by cataloging various types of property and the ways in which Indigenous and European conceptions of property differ. It then proceeds to illustrate ways in which those conceptions have been stereotyped, thus leading to mistaken assumptions about the incompatibility of the two approaches. Carpenter, Katyal, and Riley conclude that using the concepts of fiduciary duty and stewardship found in both approaches can supply a foundation for bridging the different conceptions of property.
Diagnosis, treatment, and prevention of vector-borne disease (VBD) in pets is one cornerstone of companion animal practices. Veterinarians are facing new challenges associated with the emergence, reemergence, and rising incidence of VBD, including heartworm disease, Lyme disease, anaplasmosis, and ehrlichiosis. Increases in the observed prevalence of these diseases have been attributed to a multitude of factors, including diagnostic tests with improved sensitivity, expanded annual testing practices, climatologic and ecological changes enhancing vector survival and expansion, emergence or recognition of novel pathogens, and increased movement of pets as travel companions. Veterinarians have the additional responsibility of providing information about zoonotic pathogen transmission from pets, especially to vulnerable human populations: the immunocompromised, children, and the elderly. Hindering efforts to protect pets and people is the dynamic and ever-changing nature of VBD prevalence and distribution. To address this deficit in understanding, the Companion Animal Parasite Council (CAPC) began efforts to annually forecast VBD prevalence in 2011. These forecasts provide veterinarians and pet owners with expected disease prevalence in advance of potential changes. This review summarizes the fidelity of VBD forecasts and illustrates the practical use of CAPC pathogen prevalence maps and forecast data in the practice of veterinary medicine and client education.
The aim of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of a point-of-care ultrasound exam for undifferentiated shock in patients presenting to the emergency department.
Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and research meeting abstracts were searched from 1966 to June 2018 for relevant studies. QUADAS-2 was used to assess study quality, and meta-analysis was conducted to pool performance data of individual categories of shock.
A total of 5,097 non-duplicated studies were identified, of which 58 underwent full-text review; 4 were included for analysis. Study quality by QUADAS-2 was considered overall a low risk of bias. Pooled positive likelihood ratio values ranged from 8.25 (95% CI 3.29 to 20.69) for hypovolemic shock to 40.54 (95% CI 12.06 to 136.28) for obstructive shock. Pooled negative likelihood ratio values ranged from 0.13 (95% CI 0.04 to 0.48) for obstructive shock to 0.32 (95% CI 0.16 to 0.62) for mixed-etiology shock.
The rapid ultrasound for shock and hypotension (RUSH) exam performs better when used to rule in causes of shock, rather than to definitively exclude specific etiologies. The negative likelihood ratios of the exam by subtype suggest that it most accurately rules out obstructive shock.
The chemical enrichment of the Universe is considerably affected by the contribution of cool evolved stars. We studied the O-rich star R Peg and the C-rich star V Oph, using respectively the VLTI/GRAVITY and VLTI/MIDI instruments. We interpret the data using grids of 1-D and 3-D dynamic model atmospheres.
We present results from a multiwavelength study of the blazar PKS 1954–388 at radio, UV, X-ray, and gamma-ray energies. A RadioAstron observation at 1.66 GHz in June 2012 resulted in the detection of interferometric fringes on baselines of 6.2 Earth-diameters. This suggests a source frame brightness temperature of greater than 2 × 1012 K, well in excess of both equipartition and inverse Compton limits and implying the existence of Doppler boosting in the core. An 8.4-GHz TANAMI VLBI image, made less than a month after the RadioAstron observations, is consistent with a previously reported superluminal motion for a jet component. Flux density monitoring with the Australia Telescope Compact Array confirms previous evidence for long-term variability that increases with observing frequency. A search for more rapid variability revealed no evidence for significant day-scale flux density variation. The ATCA light-curve reveals a strong radio flare beginning in late 2013, which peaks higher, and earlier, at higher frequencies. Comparison with the Fermi gamma-ray light-curve indicates this followed ~ 9 months after the start of a prolonged gamma-ray high-state—a radio lag comparable to that seen in other blazars. The multiwavelength data are combined to derive a Spectral Energy Distribution, which is fitted by a one-zone synchrotron-self-Compton (SSC) model with the addition of external Compton (EC) emission.
Life has been described as information flowing in molecular streams (Dawkins, 1996).Our growing understanding of the impact of horizontal gene transfer on evolutionary dynamics reinforces this fluid-like flow of molecular information (Joyce, 2002). The diversity of nucleic acid sequences, those known and yet to be characterized across Earth's varied environments, along with the vast repertoire of catalytic and structural proteins, presents as more of a dynamic molecular river than a tree of life. These informational biopolymers function as a mutualistic union so universal as to have been termed the Central Dogma (Crick, 1958). It is the distinct folding dynamics-the digital-like base pairing dominating nucleic acids, and the environmentally responsive and diverse range of analog-like interactions dictating protein folding (Goodwin et al., 2012)-that provides the basis for the mutualism. The intertwined functioning of these analog and digital forms of information (Goodwin et al., 2012) unified within diverse chemical networks is heralded as the Darwinian threshold of cellular life (Woese, 2002).
The discovery of prion diseases (Chien et al., 2004; Jablonka and Raz, 2009; Paravastu et al., 2008) introduced the paradigm of protein templates that propagate conformational information, suggesting a new context for Darwinian evolution. When taking both protein and nucleic acid moelcular evolution into consideration (Cairns- Smith, 1966; Joyce, 2002), the conceptual framework for chemical evolution can be generalized into three orthogonal dimensions as shown in Figure 5.1 (Goodwin et al., 2014). The 1st dimension manifests structural order through covalent polymerization reactions and includes chain length, sequence, and linkage chemistry inherent to a dynamic chemical network. The 2nd dimension extends the order in dynamic conformational networks through noncovalent interactions of the polymers. This dimension includes intramolecular and intermolecular forces, from macromolecular folding to supramolecular assembly to multicomponent quaternary structure. Folding in this 2nd dimension certainly depends on the primary polymer sequence, and the folding/assembly diversity yields an additional set of environmentally constrained supramolecular folding codes. For example, double-stranded DNA assemblies are dominated by the rules of complementary base pairing, while the self-propagating conformations of prions are based on additional noncovalent, environmentally-dependent interactions.
Introduction: The Medical University of South Carolina (MUSC) hospital implemented an inpatient opt-out smoking-cessation service where smokers received a mandatory smoking-cessation consult and phone follow-up within 1-month post-discharge.
Aim: To examine predictors of patients who opted-out of bedside counselling or follow-up phone calls.
Methods: Eligible adult cigarette smokers admitted to the MUSC hospital were enrolled in the programme. Opting-out of bedside consult or follow-up calls were assessed separately using log-linear modelling where predictors included patient demographics, length of hospitalisation, insurance type, smoking history, and motivation/confidence to quit.
Results: Of the 38,758 admitted patients (February 2014–May 2015), 6,684 reported currently smoking and were automatically referred to bedside-consult. Approximately 26% of smokers made contact with the counselor, most of whom (83%) accepted the consult. Amongst patients eligible for post-discharge follow-up (n = 3485), 49% responded to the calls. Those who opted-out of the bedside-consult were mostly males (RR = 1.29). Those who did not respond to follow-up calls were younger age (RR = 1.33), with Medicaid/no insurance (RR = 1.17), and had not received a bedside consult (RR = 1.32).
Conclusions: An opt-out smoking-cessation programme was feasible and acceptable to most patients and was able to reach 65% of eligible smokers; 17% opted-out of bedside counselling; <1% asked to be removed from further phone calls.