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Twenty-four new optically stimulated luminescence (OSL) and radiocarbon ages from sediment cores in nine lakes associated with the Shipshewana and Sturgis moraines in northern Indiana and southern Michigan estimate when recession of the Saginaw Lobe of the Laurentide Ice Sheet was underway in the southern Great Lakes region, USA. Average OSL ages of 23.4 ± 2.2 ka for the Shipshewana Moraine and 19.7 ± 2.2 ka for the Sturgis Moraine are considered minimum limiting deglacial ages for these recessional moraines. The much younger radiocarbon ages are consistent with other regional radiocarbon ages from lakes, and record climate amelioration around ~16.5 cal ka BP. Early recession of the interlobate Saginaw Lobe was well underway by 23.4 ± 2.2 ka, when the adjacent Lake Michigan and Huron-Erie lobes were a few hundred kilometers farther south and near their maximum southerly limits. The results provide the first time constraints when sediment from the Lake Michigan and Huron-Erie lobes began filling the accommodation space left by the Saginaw Lobe. The difference between the oldest radiocarbon and OSL age is 7400 yr for the Shipshewana Moraine and 3400 yr for the Sturgis Moraine.
Environment early in life may have a long-lasting impact on mental health through epigenetic mechanisms. We studied the effect of early life adversity (ELA) on high risk subjects for Depression (MDD). 20 unaffected first degree relatives (FHP) and 20 controls (FHN) underwent high resolution MRI. We used CTQ questionnaire to assess ELA. Manual tracing of hippocampal subregions and voxel-based morphometry (VBM) analysis were used. We concluded that FHP individuals had reduced volume of those brain areas of emotional processing, in particular if they had a history of ELA. This suggests that ELA might influence brain structure via epigenetic mechanisms and structural changes may precede MDD.
We determined how the brain-derived neurotrphic factor (BDNF) Val66Met polymorphism and ELA affect volumetric measures of hippocampus. 62 MDD patients and 71 healthy controls underwent high-resolution MRI. We manually teaced hippocampi, assessed childhood adversity with CTQ and genotyped Val66Met BDNF. Met-allele carriers showed significantly smaller hippocampal volumes when they had a history of ELA, both in patients and controls. Our results highlight how relevant stress-gene interactions are for hippocampal volume reductions.
Another 37 patients with MDD and 42 healthy participants underwent Diffussion Tensor Imaging (DTI). Deterministic tractography was applied and Val66Met BDNF polymorphism genotyped. Patients carrying the BDNF met-allele had smaller FA in Uncinate Fasciculus (UF) compared to homozygous for val-allele and controls. The met allele of the BDNF polymorphism seems to render subjects more vulnerable for dysfunctions associated with the UF, a brain region which is very closely related to emotional and cognitive function.
Despite the increase of research and awareness in delirium it remains underdiagnosed, protean, difficult to manager and more difficult to comprehend.
To find the clinical diagnosed rates of delirium, the possible aetiologies to describe treatment (psychotropics) and to investigate the reasons of referrals to Old age psychiatric team in relation to delirium in a general medical hospital.
Retrospective study of medical records of inpatients admitted to Sligo Regional Hospital during a 6 month time
156 files had a documentation of delirium (time prevalence 2%).
Mean age of the sample was 82 years old (SD=7.2), 66 (42%) were male.
69 (44.2%) of the total sample had a previous history of dementia, 57 (36.5%) had a previous history of delirium. In 62 (40%) the cause was infection while in 4 no specific cause was indentified.
90 (58%) referred to liaison service but only in the 26 (28.9%) the reason for referral was’acute confusion’ or’delirium’ while in a majority of referrals the reason was one of the affective disorders and more often depression. There were not any significant differences between delirium subtypes and referrals (χ2=3.868, df:3, p=0.28). Examination of the amount of antipsychotics prescribed pre during and after delirium shows that there was a significant increase of antipsychotics during the delirium (χ2=17.512, df:8, p=0.025) decrease of z-medication, (χ2=20.114, df:4, p<0.001) while benzodiazepines and antidepressants remained same.
Delirium is often misdiagnosed and unrecognized in hospital settings, however when is indentified the pharmacological management is rather optimal
Forensic Mental Health provision in secure healthcare is complex. the availability of a short and quantifiable, yet comprehensive instrument for summarising patient progress encompassing multi-professional clinical input would facilitate clinical decision-making.
To develop and validate a Progress Rating Scale (PRS) for use in secure healthcare to assess patient course in treatment.
PRS items will reflect multi-professional clinical input. Measurement will be valid and reliable.
Development was undertaken at the Personality Disorder Service, Arnold Lodge Regional Secure Unit. Thematic analysis of 5 randomly selected archived treatment reviews resulted in a preliminary list of items. This scale was then piloted and refined via independent rating of further anonymised reports.
Validation and further development
To assess content validity, 3 independent raters applied the scale on archived treatment reviews of 12 randomly selected patients. Following examination of single-rating intra-class correlations (ICCs), items were revised to achieve greater content validity.
The domains of the scale were: Engagement, Behaviour, Mental State, Interactions with Peers and Staff, Insight, Supportive relationship, Employment, Leave, Violence/risk, Psychometric score and Final outcome (upon discharge). Initial inter-rater agreement ranged from fair to substantial (ICCs: 0.37–0.82). Following revisions, agreement improved ranging from moderate to substantial (ICCs: 0.63–0.92), the latter applying to most items.
A scale for evaluating patient progress was developed based on multi-professional clinical input. the scale was refined to improve content validity. Internal consistency and factorial structure are under scrutiny and results will be available at the conference.
The thickness of glaciers in High-Mountain Asia (HMA) is critical in determining when the ice reserve will be lost as these glaciers thin but is remarkably poorly known because very few measurements have been made. Through a series of ground-based and airborne field tests, we have adapted a low-frequency ice-penetrating radar developed originally for Antarctic over-snow surveys, for deployment as a helicopter-borne system to increase the number of measurements. The manoeuvrability provided by helicopters and the ability of our system to detect glacier beds through thick, dirty, temperate ice makes it well suited to increase greatly the sample of measurements available for calibrating ice thickness models on the regional and global scale. The Bedmap Himalayas radar-survey system can reduce the uncertainty in present-day ice volumes and therefore in projections of when HMA's river catchments will lose this hydrological buffer against drought.
The existence of a frontotemporal dementia phenocopy (phFTD) syndrome remains controversial. Opinions differ on whether the phenocopy presentation represents the neuropsychological manifestation of a mid-life decompensation in vulnerable pre-morbid personalities or an indolent prodrome of behavioral-variant FTD (bvFTD). Literature on this topic is sparse and clinicians and patients have little guidance around prognosis and management.
To describe the demographic, neuropsychological and biomarker profiles of a case series of phFTD patients, attending the memory clinic and review relevant literature.
Retrospective review of all cases diagnosed with phFTD.
Eleven cases were identified (male = 9, female = 2). Mean age 55.8 years. Subjective complaints comprised memory and language difficulties. Collateral reports described apathy, aggression, impulsivity, disinhibition, hyperorality. Function was relatively preserved though motivation or supervision for higher-level tasks was sometimes required. All had non-neurodegenerative MRI and PET scans. Neuropsychological test (NPT) findings predominantly showed executive dysfunction and fluency impairment. A total of 3/11 had non-amnestic memory impairment. Follow-up imaging and NPT were invariably unchanged; 1/11 had a pre-morbid psychiatric diagnosis; 5/11 had unusual personality traits pre-morbidly. Major psychosocial stressors were documented in 7/11. Management consisted of psychosocial interventions to support function and interpersonal relationships.
The literature describes the phFTD syndrome as predominantly affecting males though we include 2 females who meet the criteria. In keeping with our findings, personality traits and psychosocial stressors may be more common in phFTD than bvFTD. More severe symptoms, memory impairment at presentation and C9ORF72 gene mutation may predict eventual progression. Those who do not progress have minimal long-term functional impairment though behavioral symptoms persist.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Ergothioneine (ERG) is an unusual thio-histidine betaine amino acid that has potent antioxidant activities. It is synthesised by a variety of microbes, especially fungi (including in mushroom fruiting bodies) and actinobacteria, but is not synthesised by plants and animals who acquire it via the soil and their diet, respectively. Animals have evolved a highly selective transporter for it, known as solute carrier family 22, member 4 (SLC22A4) in humans, signifying its importance, and ERG may even have the status of a vitamin. ERG accumulates differentially in various tissues, according to their expression of SLC22A4, favouring those such as erythrocytes that may be subject to oxidative stress. Mushroom or ERG consumption seems to provide significant prevention against oxidative stress in a large variety of systems. ERG seems to have strong cytoprotective status, and its concentration is lowered in a number of chronic inflammatory diseases. It has been passed as safe by regulatory agencies, and may have value as a nutraceutical and antioxidant more generally.
As the Boko Haram insurgency heads into its second decade, it seems no quick end is in sight. What are the possible scenarios for the future trajectory of Boko Haram, and in particular what is its endgame? While predicting the future is a very hazardous business, plausible endgame scenarios can be envisioned based on reflection on the metamorphoses of Boko Haram, careful analysis of the dynamics of its current situation, and prognosis of its emergent trends. The formal declaration of the Boko Haram Caliphate and its territorial control over much of Borno State are no more. Yet the ‘technical military defeat’ proclaimed by President Muhammad Buhari in 2015 has not prevented Boko Haram from carrying out attacks not only in rural areas, but in big towns and even military bases, often killing Nigerian soldiers – as many as 100 soldiers in one attack. Negotiations leading to the release of Boko Haram captives in exchange for freeing incarcerated leaders of the insurgency came about more than a year after the proclamation of the technical defeat. It seems that decisive defeat leading to complete surrender and total cessation of hostilities is not on the immediate horizon. Yet what scenario is likely to unfold?
This chapter explores this question by drawing insights from the literature on the growth, decline, and end of past insurgent insurgencies and civil wars. Theoretically, one may argue that there are only a few possible outcomes to an insurgency: the government may defeat the insurgents; the insurgents may defeat the government; both parties may reach a negotiated settlement; there may be a stalemate; or the insurgency may transform into something else, such as organized crime. We suggest that rather than one distinct ending, Boko Haram is likely to continue its previous patterns of transformations and factionalization, precluding decisive outcomes. Unless distinctively different approaches are taken by the state, likely endgames include a negotiated settlement with some factions, the further entrenchment of the war economy with its continuous menacing of rural areas by others, and some elements potentially becoming absorbed into the global terrorist networks of the Islamic State.
The world's population is getting older. By 2050 it is projected that 22% of the global population will be over 60 years of age. Aging is characterized by a decline in physiological functions and an increase in malnutrition and associated disease. Oxidative stress is associated with several age-related conditions, including cardiovascular disease, obesity, neurodegenerative disease and cancer. The negative effects of reactive oxygen species (ROS) are neutralized by antioxidants, which can be endogenously synthesised or consumed through the diet. Cheese is a nutritious dairy food and previous research has highlighted the antioxidant potential of some cheese types. Physiological changes associated with age can impact digestion processes, thus the ability to efficiently release bioactive compounds, including antioxidants, may be impaired with age. Cheese products varying by milk source, texture and fat content were subjected to simulated gastrointestinal in vitro digestion (SGID) using a modified model to account for physiological changes associated with aging. The antioxidant potential of undigested and digested cheese (n = 11) was determined in vitro using DPPH radical scavenging, ferric reducing antioxidant power (FRAP) and total phenolic content (TPC) assays. Cellular antioxidant potential was also investigated using the reduced glutathione assay (GSH) in the human macrophage cell line (U937). Experiments were carried out in triplicate. Statistical analysis by T-test demonstrated that digestion significantly increased (P < 0.05) FRAP and TPC of all cheese products analysed. Of the eleven cheese products investigated, goats’ cheese displayed a significant increase (P < 0.05) in radical scavenging properties (89.8% inhibition). Low fat white cheddar had significantly higher (P < 0.05) GSH levels compared to full fat white cheddar (0.16 ± 0.01, 0.11 ± 0.01 μmol GSH/mg protein, respectively). Findings from this study suggest that despite physiological changes associated with age, cheese digestates retain, and in some cases, possess higher antioxidant potential than undigested samples. Cheese demonstrates potential as a functional food for the elderly by neutralizing the negative effects associated with age-related oxidative stress.
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
Silicon carbide together with amorphous carbon are the main components of dust grains in the atmospheres of C-rich AGB stars. Small gaseous Si-C bearing molecules (such as SiC, SiCSi, and SiC2) are efficiently formed close to the stellar photosphere. They likely condense onto dust seeds owing to their highly refractory nature at the lower temperatures (i.e., below about 2500 K) in the dust growth zone which extends a few stellar radii from the photosphere. Beyond this region, the abundances of Si-C bearing molecules are expected to decrease until they are eventually reformed in the outer shells of the circumstellar envelope, owing to the interaction between the gas and the interstellar UV radiation field. Our goal is to understand the time-dependent chemical evolution of Si-C bond carriers probed by molecular spectral line emission in the circumstellar envelope of IRC+10216 at millimeter wavelengths.