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Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.
Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.
Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).
Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.
Low mass, main sequence stars like our Sun exhibit a wide variety of rotational and magnetic states. Observational and theoretical advances have led to a renewed emphasis on understanding the rotational and magnetic evolution of sun-like stars has become a pressing problem in stellar physics. We use global 3D convection and convective dynamo simulations in rotating spherical shells and with realistic stellar stratification to explore the behavior of “middle-aged” stars. We show that for stars with slightly less rotational influence than our Sun a transition occurs from solar-like (fast equator, slow poles) to anti-solar (slow equator, fast poles) differential rotation. We investigate this transition using two different treatments for the upper boundary of our simulations and we hypothesize that this transition from solar-like to anti-solar differential rotation may be responsible for observations of anomalously rapid rotation for stars older than our Sun.
Mongolia's Gobi Desert ecosystem, a stronghold for populations of the Asiatic wild ass (khulan) Equus hemionus and the goitered gazelle Gazella subgutturosa, faces conservation challenges as a result of rapid economic development, including mining-related infrastructure projects. There is a paucity of reliable data on population abundance for these ungulates in the region, which makes it difficult to assess how they are responding to increasing anthropogenic pressure. Our aim was to obtain abundance estimates for khulan and goitered gazelles to inform their management and form the basis of a long-term monitoring programme. Each year during 2012–2015 we surveyed a total of 64 line transects spaced 20 km apart, with a total of 3,464 km of survey effort across 78,717 km2. Distance sampling analysis provided annual estimates of density and abundance, which were cross-referenced with the results of an aerial survey conducted in 2013. Overall, we observed 784 groups (14,608 individuals) of khulan and 1,033 groups (3,955 individuals) of goitered gazelles during the four surveys. The abundance estimates for 2013 were 35,899 (95% CI 22,680–40,537) khulan and 28,462 (95% CI 21,326–37,987) goitered gazelles. These estimates were congruent with the results from the aerial survey, which overlapped spatially and temporally with our ground-based survey. Our findings confirm that Mongolia's Gobi Desert supports the largest population of khulan and goitered gazelles in the world, and we provide a critical update on the status of the two species.
Magnetic resonance imaging studies of maltreated children with posttraumatic stress disorder (PTSD) suggest that maltreatment-related PTSD is associated with adverse brain development. Maltreated youth resilient to chronic PTSD were not previously investigated and may elucidate neuromechanisms of the stress diathesis that leads to resilience to chronic PTSD. In this cross-sectional study, anatomical volumetric and corpus callosum diffusion tensor imaging measures were examined using magnetic resonance imaging in maltreated youth with chronic PTSD (N = 38), without PTSD (N = 35), and nonmaltreated participants (n = 59). Groups were sociodemographically similar. Participants underwent assessments for strict inclusion/exclusion criteria and psychopathology. Maltreated youth with PTSD were psychobiologically different from maltreated youth without PTSD and nonmaltreated controls. Maltreated youth with PTSD had smaller posterior cerebral and cerebellar gray matter volumes than did maltreated youth without PTSD and nonmaltreated participants. Cerebral and cerebellar gray matter volumes inversely correlated with PTSD symptoms. Posterior corpus callosum microstructure in pediatric maltreatment-related PTSD differed compared to maltreated youth without PTSD and controls. The group differences remained significant when controlling for psychopathology, numbers of Axis I disorders, and trauma load. Alterations of these posterior brain structures may result from a shared trauma-related mechanism or an inherent vulnerability that mediates the pathway from chronic PTSD to comorbidity.
In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children’s Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children’s Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary “think-tank”. The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute, to describe the “state of the art” of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.
Papillary microcarcinoma of the thyroid has been described as either a normal variant or a serious malignancy. We describe our experience with papillary microcarcinoma and lymph node metastases.
A total of 685 consecutive total thyroidectomies with central compartment neck dissection were reviewed for papillary microcarcinoma. Association of central compartment lymph node metastases with age, gender, tumour multifocality, bilaterality and extrathyroidal extension was analysed.
Out of 170 papillary microcarcinoma cases, multifocality was found in 72 (42.4 per cent), bilaterality in 49 (28.8 per cent) and extrathyroidal extension in 16 (9.4 per cent). In all, 23 patients (13.5 per cent) had lymph node metastases. There was a significant association (p < 0.05) between extrathyroidal extension (but no other tumour characteristics) and lymph node metastases.
In all, 13.5 per cent of papillary microcarcinomas in our series showed lymph node metastases. Lymph node metastases were associated with extrathyroidal invasion of the papillary microcarcinoma.
Physically based projections of the Greenland ice sheet contribution to future sea-level change are subject to uncertainties of the atmospheric and oceanic climatic forcing and to the formulations within the ice flow model itself. Here a higher-order, three-dimensional thermomechanical ice flow model is used, initialized to the present-day geometry. The forcing comes from a high-resolution regional climate model and from a flowline model applied to four individual marine-terminated glaciers, and results are subsequently extended to the entire ice sheet. The experiments span the next 200 years and consider climate scenario SRES A1B. The surface mass-balance (SMB) scheme is taken either from a regional climate model or from a positive-degree-day (PDD) model using temperature and precipitation anomalies from the underlying climate models. Our model results show that outlet glacier dynamics only account for 6–18% of the sea-level contribution after 200 years, confirming earlier findings that stress the dominant effect of SMB changes. Furthermore, interaction between SMB and ice discharge limits the importance of outlet glacier dynamics with increasing atmospheric forcing. Forcing from the regional climate model produces a 14–31 % higher sea-level contribution compared to a PDD model run with the same parameters as for IPCC AR4.
Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed (“idle”). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.
A retrospective observational study.
A 579-bed acute care, academic tertiary care facility.
A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.
We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P< .001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P< .001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P = .0013).
Significant proportions of ward CVC-days were unjustified. Reducing “idle CVC-days” and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.
Field surveys were conducted on 319 sites of the Western Australian grain belt in 2006 to determine the occurrence and distribution of summer fallow weed species. Sites were located across five growing season regions (north, north central, central, south central, and south) and three annual rainfall zones (high, medium, and low). A total of 51 species (or species groups) from 18 families were identified, with the large majority of species (35%) belonging to the Poaceae family. The most prevalent species found, being present at more than 10% of all sites, were wheat, “melons” (weedy watermelon and paddymelon), rigid ryegrass, capeweed, clover, mintweed, wild radish, fleabane, windmill grass, and rolypoly. Correspondence analysis revealed that the north, central, and southern regions of the grain belt could be predominately segregated according to dominant weed species occurrence; however, no segregation by rainfall zone was apparent. This study has given an overview of summer fallow weed occurrence in the Western Australian grain belt and highlights those weed species that are common and yet lack sufficient research into their ecology and management.
Previously we showed that 6-hydroxydopamine lesions of the substantia nigra eliminate corticostriatal LTP and that the neuroimmunolophilin ligand (NIL), GPI-1046, restores LTP.
We used cDNA microarrays to determine what mRNAs may be over- or under-expressed in response to lesioning and/or GPI-1046 treatment. Patch clamp recordings were performed to investigate changes in NMDA channel function before and after treatments.
We found that 51 gene products were differentially expressed. Among these we found that GPI-1046 treatment up-regulated presenilin-1 (PS-1) mRNA abundance. This finding was confirmed using QPCR. PS-1 protein was also shown to be over-expressed in the striatum of lesioned/GPI-1046-treated rats. As PS-1 has been implicated in controlling NMDA-receptor function and LTP is reduced by lesioning we assayed NMDA mediated synaptic activity in striatal brain slices. The lesion-induced reduction of dopaminergic innervation was accompanied by the near complete loss of NDMA receptor-mediated synaptic transmission between the cortex and striatum. GPI-1046 treatment of the lesioned rats restored NMDA-mediated synaptic transmission but not the dopaminergic innervation. Restoration of NDMA channel function was apparently specific as the sodium channel current density was also reduced due to lesioning but GPI-1046 did not reverse this effect. We also found that restoration of NMDA receptor function was also not associated with either an increase in NMDA receptor mRNA or protein expression.
As it has been previously shown that PS-1 is critical for normal NMDA receptor function, our data suggest that the improvement of excitatory neurotransmission occurs through the GPI-1046-induced up-regulation of PS-1.
Modifications to the p-type semiconductor TIPS-Pentacene can result in elimination of the solid-solid thermal transition at 124 °C. This new material has shown mobility higher than 1 cm2/Vs. Elimination of the solid-solid thermal transition leaves the melting point as the lowest temperature transition at 199 °C.
A differential inequality technique is used to determine a lower bound on the blow-up time for solutions to the heat equation subject to a nonlinear boundary condition when blow-up of the solution does occur. In addition, a sufficient condition which implies that blow-up does occur is determined.
The spread of coagulase-positive staphylococci has been studied in a modern hospital in which most of the patients were nursed in 4-bed rooms separated from a common corridor only by low dividing walls. Acquisition of new nasal strains from patients in other bedrooms was nearly as easy as from patients in the neighbouring beds. There was no indication that subdivision of this type hindered the spread of nasal strains as compared with open wards of the ‘Nightingale’ pattern.
Samples of yellow-fever vaccine prepared from homogenized chick embryos, and of an experimental measles vaccine prepared from chick embryo cells, have each been shown to contain a contaminant virus similar in properties to an avian leukosis virus. Young adult males injected with the yellow-fever vaccine did not develop neutralizing antibodies for Rous sarcoma virus.
Detectable allelic variation at the Gpi-1 loci on the short arms of the homoeologous group 1 chromsomes in wheat is not common. However, a variant null allele at the Gpi-D1 locus is present in some stocks of Chinese Spring. This has allowed the locus to be mapped between the ω-gliadin locus carried distally on the short arm of chromosome 1D, Gli-D1 (34·5%) and the high-molecular-weight glutenin subunit locus carried near the centromere on the long arm, Glu-D1 (36·2%). The origin of this isoenzyme polymorphism in Chinese Spring stocks is described and its potential significance is discussed in relation to quantitative analysis of aneuploids, alien chromosome addition and substitution lines and intervarietal chromosome substitution lines involving Chinese Spring.
The NASA Star and Exoplanet Database (NStED) is a general purpose stellar archive with the aim of providing support for NASA's planet finding and characterization goals, stellar astrophysics, and the planning of NASA and other space missions. There are two principal components of NStED: a database of (currently) 140,000 nearby stars and exoplanet-hosting stars, and an archive dedicated to high precision photometric surveys for transiting exoplanets. We present a summary of the NStED stellar database, functionality, tools, and user interface. NStED currently serves the following kinds of data for 140,000 stars (where available): coordinates, multiplicity, proper motion, parallax, spectral type, multiband photometry, radial velocity, metallicity, chromospheric and coronal activity index, and rotation velocity/period. Furthermore, the following derived quantities are given wherever possible: distance, effective temperature, mass, radius, luminosity, space motions, and physical/angular dimensions of habitable zone. Queries to NStED can be made using constraints on any combination of the above parameters. In addition, NStED provides tools to derive specific inferred quantities for the stars in the database, cross-referenced with available extra-solar planetary data for those host stars. NStED can be accessed at http://nsted.ipac.caltech.edu.