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The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.
We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking method.
The HAMD total scores of 10, 20 and 30 corresponded approximately with the BDI scores of 10, 27 and 42 or with the BDI-II scores of 13, 32 and 50. The HAMD change scores of −20 and −10 with the BDI of −29 and −15 and with the BDI-II of −35 and −16.
The results can help clinicians interpret the HAMD or BDI scores of their patients in a more versatile manner and also help clinicians and researchers evaluate such scores reported in the literature or the database, when scores on only one of these scales are provided. We present a conversion table for future research.
We present ALMA band 7 data of the extreme OH/IR star, OH 26.5+0.6. In addition to lines of CO and its isotopologues, the circumstellar envelope also exhibits a number of emission lines due to metal-containing molecules, e.g., NaCl and KCl. A lack of C18O is expected, but a non-detection of C17O is puzzling given the strengths of H217O in Herschel spectra of the star. However, a line associated with Si17O is detected. We also report a tentative detection of a gas-phase emission line of MgS. The ALMA spectrum of this object reveals intriguing features which may be used to investigate chemical processes and dust formation during a high mass-loss phase.
While lithium is well known for its neurotoxicity, there are very few publications about lithium-induced acute dystonic reaction. We are presenting a clinical case of lithium-induced acute intermittent dystonic reaction in a patient with schizoaffective disorder (SAD). The patient is a 69-year-old African-American male with a long history of SAD, who was treated for many years with ziprasidone and divalproex and was admitted with SAD exacerbation. Due to increased QTC interval, we switched patient to lurasidone. After 2 weeks, due to increased ammonia level, divalproex was switched to lithium (600 mg loading dose and then 450 mg twice/day). Three days later, patient developed a series of intermittent episodes of acute dystonia, manifested as mutism, dysarthria, upper and lower extremity muscle rigidity, dysphagia, and tremor (Table 1). Dystonic reactions responded to benztropine. Eventually, lithium was discontinued and patient did well on a combination of carbamazepine and olanzapine. In this case, we would like to emphasize not only the intermittent but also the atypical presentation of acute dystonic reactions with involvement of large muscle groups, the resemblance to NMS, and a “spectrum” of dystonic reactions rather than one clear-cut presentation. We can only speculate the role lurasidone played in this presentation but reoccurrence of dysarthria on day 54 after lithium was restarted points to its major role.
Table not available.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Gene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.
To synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.
Complete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).
The low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).
Early promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Deflection missions to near-Earth asteroids will encounter non-negligible uncertainties in the physical and orbital parameters of the target object. In order to reliably assess future impact threat mitigation operations such uncertainties have to be quantified and incorporated into the mission design. The implementation of deflection demonstration missions offers the great opportunity to test our current understanding of deflection relevant uncertainties and their consequences, e.g., regarding kinetic impacts on asteroid surfaces. In this contribution, we discuss the role of uncertainties in the NEOTωIST asteroid deflection demonstration concept, a low-cost kinetic impactor design elaborated in the framework of the NEOShield project. The aim of NEOTωIST is to change the spin state of a known and well characterized near-Earth object, in this case the asteroid (25143) Itokawa. Fast events such as the production of the impact crater and ejecta are studied via cube-sat chasers and a flyby vehicle. Long term changes, for instance, in the asteroid's spin and orbit, can be assessed using ground based observations. We find that such a mission can indeed provide valuable constraints on mitigation relevant parameters. Furthermore, the here proposed kinetic impact scenarios can be implemented within the next two decades without threatening Earth's safety.
We discuss the first applications of our newly developed Monte Carlo event generator SOPHIA to multiparticle photoproduction of relativistic protons with thermal and power-law radiation fields. The measured total cross section is reproduced in terms of excitation and decay of baryon resonances, direct pion production, diffractive scattering, and non-diffractive multiparticle production. Non-diffractive multiparticle production is described using a string fragmentation model. We demonstrate that the widely used ‘Δ-approximation’ for the photoproduction cross section is reasonable only for a restricted set of astrophysical applications. The relevance of this result for cosmic ray propagation through the microwave background and hadronic models of active galactic nuclei and gamma-ray bursts is briefly discussed.
Prodigies may be examples of extreme high intelligence, while savants may be examples of extreme low intelligence. There is relative consensus on how to define a savant but less agreement on the definition of a child prodigy. There have been a small number of more interpretive or theoretical efforts to comprehend and make sense of the prodigy phenomenon. With the availability of powerful imaging techniques like functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and others, prodigy cases shed light on some of the enduring issues in the study of intelligence. There have been advances in two areas that bear directly on savants and intelligence. One of these is of general interest and deals with all savants; this work shows that assumed constraints on IQ and other capabilities do not always hold for savants, that there is more diversity and greater plasticity in savant development than was previously believed.
Driving is a daily activity for most people in developed countries and is important in maintaining independence. Bipolar patients may have an impaired driving behavior because of the pathology itself, with psychomotor and cognitive disturbances. Additionally, adverse effects of pharmacologic treatment may be detrimental.
24 remitted bipolar outpatients diagnosed according to ICD-10 criteria were enrolled in the study, receiving either lithium (n = 12) or lamotrigine (n = 12). Participants were investigated under steady state plasma level conditions. According to the German Guidelines for road and traffic safety data were collected with the Wiener Testsystem (WTS) measuring visual perception, reactivity, stress tolerance, concentration and vigilance.
Psychopathologic symptoms were rated with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale - Clinician rated (YMRS-C).
About 40% of patients were without clinically relevant psychomotor disturbances. In 40% of cases mild to moderate impairments could be seen, and 20% of the patients were considered as severely impaired. Data show that patients under lamotrigine had an altogether better test performance than patients treated with lithium. Especially in visual perception and stress tolerance differences were most pronounced.
About 20% of remitted bipolar outpatients treated with lithium or lamotrigine must be considered unfit to drive. In 40% of the cases it seems justified to counsel patients individually, taking into account compensational factors. Analysis of our data point to an advantage for bipolar patients treated with lamotrigine when compared with lithium. However causal relationships can not be drawn from our data.
Psychotropic polypharmacy is widely used in routine clinical practice although there is still a substantial deficit in established knowledge about combination and augmentation treatments. Polypharmacy is related with a higher risk of adverse drug reactions and incompliance.
On two reference days per hospital and per year, the following data are recorded for all patients on the wards under AMSP surveillance: all drugs applied on that day with the daily dosage for psychotropic drugs, ICD diagnosis, age, and sex. Data is stored at the study center in Munich. We evaluated data from 2000 (N = 5669) and 2007 (N = 8346).
From 2000 to 2007 inpatient prescriptions including three or more drugs increased significantly from 59.4% to 69.3% (chi2: 144.913; df:1; p < 0.001). Furthermore the percentage of inpatients being prescribed three or more psychotropics increased significantly from 36.5% in 2000 to 47.97% in 2007 (chi2: 180.01; df:1; p < 0.001).
Investigating further, which inpatients, diagnosed according to ICD-10, tend to be treated with more than two psychotropics, we found that this was more common in inpatients, who had an F2., F3. or F9. ICD-10 diagnosis. Especially inpatients with a bipolar disorder (F31.) showed an extremely high rate for psychotropic polypharmacy with three or more psychotropic drugs, with rates of 63,8% in 2000 and 75,2% in 2007.
Polypharmacy is still gaining ground. Our results show that psychotropic agents are commonly used in combination; therefore further studies evaluating assumable positive results of psychotropic combinations are needed.
Progress in achieving improved performance in the generation and utilization of hydrogen depends on our ability to identify materials with optimized electrical and (photo)- electrochemical performance. Given their high volume fraction of interfaces, high chemical stability and versatility (ionic, electronic, optical property control), nanocrystalline electroceramic materials are of growing interest for advanced energy conversion and storage technologies. As grain size decreases towards the Debye length and grain boundaries come in closer proximity, space charge properties begin to dominate, resulting in modified charge transport. Through systematic variation of grain boundary properties by heterogeneous indiffusion of cations, the electronic and ionic carrier profiles in the space charge region may be altered. The relationships between space charge potential and defect profiles in the space charge regions are quantitatively analyzed, and implications for nano-ionic materials in thin film solid oxide fuel cells are discussed. From the standpoint of photoelectrochemical water splitting for hydrogen generation, optimizing the band gap, band alignments, and transport properties while retaining stability has remained a challenging objective. Novel nanocrystalline composite structures are discussed which exhibit features amenable to optimization of required properties and electrical measurements to determine key transport properties of titanium dioxide nanopowder, a photoanode material are introduced.
Among weevils of the subfamily Baridinae (548 extant genera and ca. 9,000 species), unique prosternal horns and associated sheaths have evolved independently multiple times. These structures are utilized in a unique form of male-male aggression in which males push, rather than overturn as in most other horned beetles, their competitor. Herein we report the first fossils of male Baridinae exhibiting such prosternal horns. Two males recovered from the middle Eocene Green River Formation in northwestern Colorado serve to provide a minimum age (at ca. 47 million years old) for both the origin of horns and its associated form of male-male combat in Baridinae.
Anorexia nervosa (AN) and bulimia nervosa (BN) are marked by longitudinal symptom fluctuations. DSM-IV-TR does not address how to classify eating disorder (ED) presentations in individuals who no longer meet full criteria for these disorders. To consider this issue, we examined subthreshold presentations in women with initial diagnoses of AN and BN.
A total of 246 women with AN or BN were followed for a median of 9 years; weekly symptom data were collected at frequent intervals using the Longitudinal Interval Follow-up Evaluation of Eating Disorders (LIFE-EAT-II). Outcomes were ED presentations that were subthreshold for ⩾3 months, including those narrowly missing full criteria for AN or BN, along with binge eating disorder (BED) and purging disorder.
During follow-up, most women (77.6%) experienced a subthreshold presentation. Subthreshold presentation was related to intake diagnosis (Wald χ2=8.065, df=2, p=0.018). Individuals with AN most often developed subthreshold presentations resembling AN; those with BN were more likely to develop subthreshold BN. Purging disorder was experienced by half of those with BN and one-quarter of those with AN binge/purge type (ANBP); BED occurred in 20% with BN. Transition from AN or BN to most subthreshold types was associated with improved psychosocial functioning (p<0.001).
Subthreshold presentations in women with lifetime AN and BN were common, resembled the initial diagnosis, and were associated with modest improvements in psychosocial functioning. For most with lifetime AN and BN, subthreshold presentations seem to represent part of the course of illness and to fit within the original AN or BN diagnosis.
Our adaptive optics observations of nearby AGN at spatial resolutions as small as 0.″085 show strong evidence for recent, but no longer active, nuclear star formation. We begin by describing observations that highlight two contrasting methods by which gas can flow into the central tens of parsecs. Gas accumulation in this region will inevitably lead to a starburst, and we discuss the evidence for such events. We then turn to the impact of stellar evolution on the further inflow of gas by combining a phenomenological approach with analytical modelling and hydrodynamic simulations. These complementary perspectives paint a picture in which all the processes are ultimately regulated by the mass accretion rate into the central hundred parsecs, and the ensuing starburst that occurs there. The resulting supernovae delay accretion by generating a starburst wind, which leaves behind a clumpy interstellar medium. This provides an ideal environment for slower stellar outflows to accrete inwards and form a dense turbulent disk on scales of a few parsecs. Such a scenario may resolve the discrepancy between the larger scale structure seen with adaptive optics and the small-scale structure seen with VLTI.
Male sterility, male recombination, and transmission ratio distortion – all examples of a syndrome known as hybrid dysgenesis in Drosophila melanogaster – were found to involve chromosome–cytoplasm interactions. The latter two have temperature optima near 25° and involve pre-meiotic events. In addition, sex ratio distortion, and induction of certain translocations of the X and Y chromosomes (but not the autosomes) were found to be part of hybrid dysgenesis. Both are caused by chromosome–cytoplasm interactions with pre-meiotic events playing a crucial role. The results agree with previous data on female sterility in hybrid dysgenesis, which also has cytoplasmic components and premeiotic origins.
Hybrid dysgenesis has been described as a syndrome of aberrant traits including sterility, male recombination, and mutation, which occurs in some inter-strain hybrids of Drosophila, but only from one of the two reciprocal crosses. In a series of experiments in which hybrids of various pedigrees were tested for sterility, it was found that a case of hybrid dysgenesis could be most easily interpreted as the interaction of two components. One component was found to be a polygenic Mendelian factor linked to each of the major chromosomes of π2, the paternally contributing strain (‘P strain’). These chromosomes were capable of causing sterility when inherited from either parent, provided the appropriate maternal component was also inherited. The ability to transmit this maternal component was designated ‘cytotype’ to indicate that it is a property of the entire cell. It was possible to classify nearly all hybrid females as either P or M cytotype on the basis of their ability to produce sterile daughters. All daughters of the M-cytotype mothers were susceptible to the sterilizing effects of the π2 chromosome, whereas all, or nearly all daughters of P-cytotype mothers were immune. When more than one of the π2 chromosomes were received by daughters of M-cytotype females, chromosomal interactions could be detected statistically, but the model of independent action remained a useful approximation. Cytotype was shown to be determined by chromosomal factors, but with limited cytoplasmic transmission. This unusual mode of inheritance can be compared with other cases of hybrid dysgenesis where the behaviour resembles that of self-replicating cytoplasmic particles which are dependent on certain chromosomes. The lack of sterility from intra-strain crosses can be explained by the fact that chromosomes capable of causing sterility also induce the P cytotype, and thus prevent sterility in the next generation.
Many crop genetic resources collections have been established without a clearly defined conservation goal or mandate, which has resulted in collections of considerable size, unbalanced composition and high levels of duplication. Attempts to improve the composition of collections are hampered by the fact that conceptual views to optimize collection composition are very rare. An optimization strategy is proposed herein, which largely builds on the concepts of core collection and core selection. The proposed strategy relies on hierarchically structuring the crop gene pool and assigning a relative importance to each of its different components. Comparison of the resulting optimized distribution of the number of accessions with the actual distribution allows identification of under- and over-representation within a collection. Application of this strategy is illustrated by an example using potato. The proposed optimization strategy is applicable not only to individual genebanks, but also to consortia of cooperating genebanks, which makes it relevant for ongoing activities within projects that aim at sharing responsibilities among institutions on the basis of rational conservation, such as a European genebank integrated system and the global cacao genetic resources network CacaoNet.