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When dealing with stratigraphic successions in marginal basin settings, the geological record is often fragmented due to erosion and reworking processes. The North Sea Basin is an example: it has a fragmented Quaternary record; in particular, Middle Pleistocene intervals are poorly known. As a result, we have little insight into climate, marine environmental conditions and biodiversity in this period. Here we describe and discuss a succession of three interglacial marine mollusc-bearing intervals in a borehole from Ameland in the northern Netherlands (borehole B01H0189 near Hollum). These intervals are attributed to marine isotope stages MIS7, MIS5e and MIS1. The Holocene Celtic type of faunas (interval 0–26.24 m below surface (b.s.)) and Eemian Lusitanian type of faunas (26.24–30.40 m b.s.) are well-known from previous research. The newly reported MIS7 Oostermeer fauna (32.80–39.00 m b.s.) represents mostly full marine settings between storm wave base and fair-weather wave base. In composition and diversity, the MIS7 and MIS1 faunas strongly resemble and differ from the MIS5e fauna. This is the first well-documented record of three stacked marine interglacial assemblages from the southern North Sea Basin at one location. This new record enables us to make complete marine faunal characterisations of successive interglacial periods. Key implications for southern North Sea stratigraphy and palaeogeography are the resemblance of marine faunas and conditions in MIS7 and MIS1, the presence of a relatively warm latest MIS6 freshwater interval and confirmation and characterisation of the warm Eemian interval north of the classical type area.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
Quasicrystalline alloys and their composites have been extensively studied due to their complex atomic structures, mechanical properties, and their unique tribological and thermal behaviors. However, technological applications of these materials have not yet come of age and still require additional developments. In this review, we discuss the recent advances that have been made in the last years toward optimizing fabrication processes and properties of Al-matrix composites reinforced with quasicrystals. We discuss in detail the high-strength rapid-solidified nanoquasicrystalline composites, the challenges involved in their manufacturing processes and their properties. We also bring the latest findings on the fabrication of Al-matrix composites reinforced with quasicrystals by powder metallurgy and by conventional metallurgical processes. We show that substantial developments were made over the last decade and discuss possible future studies that may result from these recent findings.
We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.
While the overall prevalence of autism is 1.7% in the United States of America, research has demonstrated a two- to five-fold increase in CHD. The Cardiac Neurodevelopmental Outcome Collaborative recommends screening for autism from infancy through adolescence. This study investigated the frequency of autism concerns at a single Cardiac Neurodevelopmental Program and examined current clinical practice as a way to improve quality of care.
Materials and methods:
Patients (n = 134; mean age = 9.0 years) included children with high-risk CHD who completed a neurodevelopmental evaluation following a formalised referral to the Cardiac Neurodevelopmental Program between 2018 and 2019. Retrospective chart review included parent report on the Behaviour Assessment System for Children-3 and Adaptive Behaviour Assessment System-3. Descriptive and correlation analyses were completed.
In this sample, 11.2% presented with autism-related concerns at referral, 2 were diagnosed with autism, 9 were referred to an autism specialist (6 confirmed diagnosis; 3 not completed). Thus, at least 5.9% of the sample were diagnosed with autism following thorough clinical evaluation. Analyses showed atypicality, along with deficient adaptability, leisure, social, and communication skills. Frequency of early intervention, school supports, and relation with comorbidities are reported.
Prior to assessment recommendations by the Cardiac Neurodevelopmental Outcome Collaborative, autism screening may not be completed systematically in clinical care for CHD. The current sample demonstrates a high frequency of autism in the typically referred clinical sample. Commonly used parent-report measures may reveal concerns but will not help diagnosis. Systematic use of an autism screener is essential.
There are many screening instruments available for the detection of dementia. However, they were not tested in very old age and often not in the primary care setting for which they are developed.
We condensed a screening battery of all elements of common tests (MMSE, TFDD, DEMTECT, Clock Test…). Nine primary care practices took part in the study. The practice assistants were trained to approach all patients over 75y visiting the practice. Only patients with already diagnosed dementia, severe hearing or vision disability or communication deficits were excluded. After informed consent they applied the screening. Within the next days a second independent neuropsychological examination was arranged in the memory clinic of the University of Goettingen. This included established neuropsychological tests (CERAD-NP, WMS-R, TMT.) and further scales were applied (NPI, CDR..). All patients with CDR=0.5 were approached 1.5y later for a follow-up by phone.
N=90 patients (25M, 65F) took part in the initial evaluation. From N=54 with CDR=0.5 only N=14 could be reached for follow-up. None of them returned to CDR=0, most progressed up to CDR=4. There were some correlations to education and dementia severity. All available screenings showed a good effect size of >0.70 (MMSE, DEMTECT, TFDD, RDST).
Elements for an optimal screening of the oldest old are discussed.
Apolipoprotein E allele ɛ4 is a well established risk factor for Alzheimer dementia (AD). Its presence modifies also the influence of other risk factors as well as the conversion rate of mild cognitive impairment (MCI) to overt dementia. In how far it also influences the clinical presentation of AD, is not known yet.
Patients of the memory clinic Göttingen were approached if they fulfilled the inclusion criteria: very mild or mild AD according to NINCDS-ADRDA criteria, MMSE 20-30, and at least two of three typical instrumental findings (hippocampal atrophy in MRI, bilateral temporo-parietal hypoperfusion in Neurolite-SPET, low Aβ1-42and increased tau in CSF). They underwent an extensive neuropsychological investigation. A follow-up took place within one year.
N=74 patients (38M, 36F; mean age 68.1y; MMSE 25.9 ± 2.8) and N=28 age- and sex- and education-matched controls could be recruited. N=36 patients had one (N=20) or two (N=16) APOE -ɛ4-alleles. 53 of 57 CSF analyses revealed AD-typical findings, 64 of 74 cranial MRT revealed bilateral hippocampal or global atrophy and 42 of 64 Neurolite-SPETs showed typical findings. Results of non-memory tests - language, visuospatial ability, attention - did not reveal any difference with regard to APOE genotype. Two memory tests and a memory composite score were significantly worse in the APOE -ɛ4-positive group and even worse in the homozygote group.
APOE -ɛ4 influences in a dose dependent manner the neuropsychological functioning in mild AD.
Le lien, issu de l’ancien Français loien, du latin ligamen, avec influence de lier, a pour définition dans le dictionnaire Larousse comme « ce qui sert à maintenir ensemble ou à attacher, retenir, fermer ». La mission générale de l’équipe mobile de psychiatrie à Genève est de proposer un suivi intensif dans le milieu aux personnes présentant des troubles psychiques graves. Ils sont difficiles à atteindre ou à conserver dans un programme de traitement traditionnel. Dans un premier temps, un signalement effectué par l’entourage (famille, voisins, police, services sociaux…) de la personne nous parvient. La première rencontre avec la personne en difficulté est alors organisée avec le demandeur. Nous allons entendre les priorités du patient, écouter ses besoins. On s’en remet à ce qu’il nous dit pour, en douceur, le conduire plus loin.. Ceci sera notre levier pour débuter une collaboration susceptible de façonner une première attache. Au début du lien, nous nous mettons à côté de la personne, nous oublions notre fonction de soignant, jusqu’à adopter, parfois, leur fonctionnement particulier. De là, nous tissons une accroche, respectons le rythme du patient ainsi que sa capacité d’accepter notre présence. Petit à petit, nous devenons de plus en plus un interlocuteur montrant d’autres réalités, le patient devenant capable de partager là-dessus. Nous pouvons aborder les obstacles entravant la réussite de ses projets, besoins. Le patient accepte l’aide proposée pour les résoudre et ce, sans se sentir dévalorisé. Nous remettons le réseau en place, les liens entre les différents partenaires mais également nous permettons au patient d’être lui-même en lien avec ce réseau. Notre mission accomplie, nous prenons le temps de détisser ce lien en douceur vers une passation de prise en soins sécurisée. Cet accompagnement de fin de suivi permet une bonne intégration vers un suivi ambulatoire pérenne régulier.
Depression and obesity are highly prevalent major public health problems that frequently co-occur. Shared aetiological factors have been found between depression and obesity. The role of the fat mass and obesity associated (FTO) gene in body mass index (BMI) and obesity has been confirmed in many independent studies. Recently, we reported the first study implicating FTO in the association between depression and obesity.
We aimed to confirm these findings by investigating the FTO rs9939609 polymorphism in a meta-analysis of 13,701 individuals.
The sample consists of 6,902 depressed cases and 6,799 controls from five studies (Radiant, PsyCoLaus, GSK, MARS and NESDA/NTR). Common inclusion criteria were information available on a lifetime DSM-IV diagnosis of major depressive disorder (MDD), BMI and genotype data. Linear regression models for quantitative traits assuming an additive genetic model were performed to test for association and interaction between rs9939609, BMI and depression. Fixed and random-effects meta-analyses were performed.
Fixed-effects meta-analyses support a significant association between rs9939609 polymorphism and BMI (whole-sample: ß=0.07, p=1.29×10-12, depressive-cases: ß=0.12, p=6.92×10-12). No association was found in controls (ß=0.02, p=0.15). Meta-analyses further support a significant interaction between FTO, BMI and depression (fixed-effects: ß=0.13, p=3.087×10-7; random-effects: ß=0.12, p=0.027), wherein depressed carriers of the risk allele have an additional increase of 2.2% in BMI.
This meta-analysis demonstrates a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. Depression-related alterations in key biological processes may interact with the rs9939609 FTO risk allele to increase obesity risk.
Vietnamese migrants under the influence of migration-related stressors (MRS) represent a vulnerable group within the mental health care system in Germany.
First study examining the relationship between the quantity of experienced MRS and the severity of self-reported symptoms of depression in a Vietnamese outpatient-sample.
137 first-generation Vietnamese migrants diagnosed with depression were asked to complete the BDI-II and 24 questions about stressful experiences related to the migration process. Linear regression models was performed to examine the influence of the MRS-quantity on BDI-II total score and on BDI-II subscales (Buckley et al., 2001).
A higher number of experienced MRS was found to be related to a higher BDI-II total score, as well as to a higher score on the cognitive subscale in particular. Regarding the cognitive depression-dimension the BDI-II items pessimism, past failure, guilt feelings, punishment feelings and suicidal thoughts were positively related to the MRS-quantity.
Discussion and conclusion
A dose-response-relationship was found, with a higher number of MRS being related to a higher severity level of self-reported depressiveness as well as to a higher level of cognitive depression-symptoms in particular. The increase in suicidal ideations in the light of MRS-exposure is in line with findings from other migrant populations. Therapeutic interventions may focus (more) on depressive cognitions as a result of recurring MRS-experiences. Special attention should be placed on suicidal thoughts being boosted by MRS.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Current approaches to assess violence risk in secure hospitals are resource intensive, limited by accuracy and authorship bias and may have reached a performance ceiling. This study seeks to develop scalable predictive models for violent offending following discharge from secure psychiatric hospitals.
We identified all patients discharged from secure hospitals in Sweden between January 1, 1992 and December 31, 2013. Using multiple Cox regression, pre-specified criminal, sociodemographic, and clinical risk factors were included in a model that was tested for discrimination and calibration in the prediction of violent crime at 12 and 24 months post-discharge. Risk cut-offs were pre-specified at 5% (low vs. medium) and 20% (medium vs. high).
We identified 2248 patients with 2933 discharges into community settings. We developed a 12-item model with good measures of calibration and discrimination (area under the curve = 0.77 at 12 and 24 months). At 24 months post-discharge, using the 5% cut-off, sensitivity was 96% and specificity was 21%. Positive and negative predictive values were 19% and 97%, respectively. Using the 20% cut-off, sensitivity was 55%, specificity 83% and the positive and negative predictive values were 37% and 91%, respectively. The model was used to develop a free online tool (FoVOx).
We have developed a prediction score in a Swedish cohort of patients discharged from secure hospitals that can assist in clinical decision-making. Scalable predictive models for violence risk are possible in specific patient groups and can free up clinical time for treatment and management. Further evaluation in other countries is needed.
Wellcome Trust (202836/Z/16/Z) and the Swedish Research Council. The funding sources had no involvement in writing of the manuscript or decision to submit or in data collection, analysis or interpretation or any aspect pertinent to the study.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
The population dynamics of shrimp Pleoticus muelleri was used as a model to verify if the trend of continuous reproduction periodicity, shorter body size and longevity, and early sexual maturity found in tropical regions is corroborated in upwelling regions. Shrimps were sampled in a region under the influence of upwelling (northern coast of Rio de Janeiro State, Brazil). Characteristics of bottom water were registered, and shrimps were measured (carapace length – CL) and classified by sex and gonadal development stages. Reproduction was seasonal, from September to December, and favoured by water mass intrusions of low temperatures and high chlorophyll concentrations. The greatest number of reproductive females preceded periods with the highest chlorophyll concentrations in the water column (cross-correlation; P < 0.05, lag (month) = −3, r = 0.50), suggesting greater developmental success of larval stage due to increase of food availability. Von Bertalanffy growth models resulted in asymptotic carapace length estimates of CL∞ = 40.21 mm and CL∞ = 36.78 mm for females and males, respectively. The reproductive and growth characteristics of the P. muelleri population studied herein were similar to that of populations from higher latitudes, demonstrating that the latitudinal pattern rule cannot be applied in regions influenced by an upwelling phenomenon.
Compound-specific radiocarbon (14C) dating often requires working with small samples of < 100 µg carbon (µgC). This makes the radiocarbon dates of biomarker compounds very sensitive to biases caused by extraneous carbon of unknown composition, a procedural blank, which is introduced to the samples during the steps necessary to prepare a sample for radiocarbon analysis by accelerator mass spectrometry (i.e., isolating single compounds from a heterogeneous mixture, combustion, gas purification and graphitization). Reporting accurate radiocarbon dates thus requires a correction for the procedural blank. We present our approach to assess the fraction modern carbon (F14C) and the mass of the procedural blanks introduced during the preparation procedures of lipid biomarkers (i.e. n-alkanoic acids) and lignin phenols. We isolated differently sized aliquots (6–151 µgC) of n-alkanoic acids and lignin phenols obtained from standard materials with known F14C values. Each compound class was extracted from two standard materials (one fossil, one modern) and purified using the same procedures as for natural samples of unknown F14C. There is an inverse linear relationship between the measured F14C values of the processed aliquots and their mass, which suggests constant contamination during processing of individual samples. We use Bayesian methods to fit linear regression lines between F14C and 1/mass for the fossil and modern standards. The intersection points of these lines are used to infer F14Cblank and mblank and their associated uncertainties. We estimate 4.88 ± 0.69 μgC of procedural blank with F14C of 0.714 ± 0.077 for n-alkanoic acids, and 0.90 ± 0.23 μgC of procedural blank with F14C of 0.813 ± 0.155 for lignin phenols. These F14Cblank and mblank can be used to correct AMS results of lipid and lignin samples by isotopic mass balance. This method may serve as a standardized procedure for blank assessment in small-scale radiocarbon analysis.
Cognitive impairment is a core feature of major depressive disorder (MDD). Cognitive remediation may improve cognition in MDD, yet so far, the underlying neural mechanisms are unclear. This study investigated changes in intrinsic neural activity in MDD after a cognitive remediation trial.
In a longitudinal design, 20 patients with MDD and pronounced cognitive deficits and 18 healthy controls (HC) were examined using resting-state functional magnetic resonance imaging. MDD patients received structured cognitive remediation therapy (CRT) over 5 weeks. The whole-brain fractional amplitude of low-frequency fluctuations was computed before the first and after the last training session. Univariate methods were used to address regionally-specific effects, and a multivariate data analysis strategy was employed to investigate functional network strength (FNS).
MDD patients significantly improved in cognitive function after CRT. Baseline comparisons revealed increased right caudate activity and reduced activity in the left frontal cortex, parietal lobule, insula, and precuneus in MDD compared to HC. In patients, reduced FNS was found in a bilateral prefrontal system at baseline (p < 0.05, uncorrected). In MDD, intrinsic neural activity increased in right inferior frontal gyrus after CRT (p < 0.05, small volume corrected). Left inferior parietal lobule, left insula, left precuneus, and right caudate activity showed associations with cognitive improvement (p < 0.05, uncorrected). Prefrontal network strength increased in patients after CRT, but this increase was not associated with improved cognitive performance.
Our findings support the role of intrinsic neural activity of the prefrontal cortex as a possible mediator of cognitive improvement following CRT in MDD.
We present the second data release (DR2) of the SkyMapper Southern Survey, a hemispheric survey carried out with the SkyMapper Telescope at Siding Spring Observatory in Australia, using six optical filters: u, v, g, r, i, z. DR2 is the first release to go beyond the
) limit of the Shallow Survey released in the first data release (DR1), and includes portions of the sky at full survey depth that reach
mag in g and r filters. The DR2 photometry has a precision as measured by internal reproducibility of 1% in u and v, and 0.7% in griz. More than 21 000
have data in some filters (at either Shallow or Main Survey depth) and over 7 000
have deep Main Survey coverage in all six filters. Finally, about 18 000
have Main Survey data in i and z filters, albeit not yet at full depth. The release contains over 120 000 images, as well as catalogues with over 500 million unique astrophysical objects and nearly 5 billion individual detections. It also contains cross-matches with a range of external catalogues such as Gaia DR2, Pan-STARRS1 DR1, GALEX GUVcat, 2MASS, and AllWISE, as well as spectroscopic surveys such as 2MRS, GALAH, 6dFGS, and 2dFLenS.