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This article argues for a more diverse approach to the appearance of enslaved persons in Greek historiography through an analysis of the Persian navy's battlefield tour of Thermopylae in Book 8 of Herodotus’ Histories. Previous approaches to slavery in Greek historiography have rightly commented on the cultural awkwardness to Greek authors of slaves’ extensive involvement in ancient warfare. However, this is only one aspect of how slaves featured in historiographical narrative. Herodotus continually problematizes the methods of enquiry and many characters within his work engage in enquiry-like activities. Book 8 itself is no different, with much of the action involving errors in human perception. The appearance of helots amongst the heroic dead at Thermopylae is intended both as a narrative reveal, since their presence has not previously been known to the reader, and as a comment on the contestation of Greek identity, which is framed at the start of Book 8 with a series of direct addresses to different groups of Greeks, all of whom take a different approach to their participation in the Persian Wars. Hence what appears to be an incidental detail can in fact be understood in the wider, thematic context of the Histories and especially that of the books concerning the Persian Wars.
The Brazil Nut tree (Bertholletia excelsa, Lecythidaceae) is a species of considerable historical, economic and ecological importance in South America. Radiocarbon dating indicates some individuals can live from hundreds to more than 1000 years, which means they have the potential to reconstruct deep time growth patterns and their relationship to anthropogenic management or climate change from pre-colonial to present times. However, age estimates vary considerably amongst trees dated with different methods (i.e. tree-ring analysis, radiocarbon-dating, and repeated diameter measurements). Here we analyze living Brazil Nut trees growing in four distinct regions across the Brazilian Amazon using two dating methods: tree-ring counting and radiocarbon dating. Our results show that the congruence between the two methods varies amongst regions, and the highest congruence is found at the site of Tefé, Amazonas. This region features archaeological sites with anthropogenic Terra Preta soils, and is known for its long-term human forest management. This management likely enhanced light and nutrient availability, which possibly enabled the trees to grow at higher rates and form annual rings. Our findings highlight the need for better understanding of the growth of Brazil Nut trees for ecological research, but also the potential of dendrochronology for exploring climate change and human-forest interactions in the Amazon Basin.
In situ elemental imaging of planetary surface regolith at a spatial resolution of 100s to 1000s of microns can provide evidence of the provenance of rocks or sediments and their habitability, and can identify post-depositional diagenetic alteration affecting preservation. We use high-resolution elemental maps and XRF spectra from MapX, a flight prototype in situ X-ray imaging instrument, to demonstrate this technology in rock types relevant to astrobiology. Examples are given for various petrologies and depositional/diagenetic environments, including ultramafic/mafic rocks, serpentinites, hydrothermal carbonates, evaporites, stromatolitic cherts and diagenetic concretions.
Data compilations expand the scope of research; however, data citation practice lags behind advances in data use. It remains uncommon for data users to credit data producers in professionally meaningful ways. In paleontology, databases like the Paleobiology Database (PBDB) enable assessment of patterns and processes spanning millions of years, up to global scale. The status quo for data citation creates an imbalance wherein publications drawing data from the PBDB receive significantly more citations (median: 4.3 ± 3.5 citations/year) than the publications producing the data (1.4 ± 1.3 citations/year). By accounting for data reuse where citations were neglected, the projected citation rate for data-provisioning publications approached parity (4.2 ± 2.2 citations/year) and the impact factor of paleontological journals (n = 55) increased by an average of 13.4% (maximum increase = 57.8%) in 2019. Without rebalancing the distribution of scientific credit, emerging “big data” research in paleontology—and science in general—is at risk of undercutting itself through a systematic devaluation of the work that is foundational to the discipline.
International commercial courts seem quite likely to become a successful product on the dispute resolution market. But they are not merely that. They are not mechanisms resolving an array of disputes which are isolated from and have no effect on their socio-economic environment. They rather are likely to trigger social externalities, to contribute to the development or reinforcement of a wider social order. It is too early to say with certitude what that social order will be, given both the state of the research and the current level of use and impact of these courts. But plausible hypotheses suggest that a general societal pushback is possible, and at the very least that this is a question that deserves our attention, as much if not more than procedural technicalities.
Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression (TRD). However, due to response delay and cognitive impairment, ECT remains an imperfect treatment. Compared to ECT, repetitive transcranial magnetic stimulation (rTMS) is less effective at treating severe depression, but has the advantage of being quick, easy to use, and producing almost no side effects. In this study, our objective was to assess the priming effect of rTMS sessions before ECT on clinical response in patients with TRD.
Methods
In this multicenter, randomized, double-blind, sham-controlled trial, 56 patients with TRD were assigned to active or sham rTMS before ECT treatment. Five sessions of active/sham neuronavigated rTMS were administered over the left dorsolateral prefrontal cortex (20 Hz, 90% resting motor threshold, 20 2 s trains with 60-s intervals, 800 pulses/session) before ECT (which was active for all patients) started. Any relative improvements were then compared between both groups after five ECT sessions, in order to assess the early response to treatment.
Results
After ECT, the active rTMS group exhibited a significantly greater relative improvement than the sham group [43.4% (28.6%) v. 25.4% (17.2%)]. The responder rate in the active group was at least three times higher. Cognitive complaints, which were assessed using the Cognitive Failures Questionnaire, were higher in the sham rTMS group compared to the active rTMS group, but this difference was not corroborated by cognitive tests.
Conclusions
rTMS could be used to enhance the efficacy of ECT in patients with TRD. ClinicalTrials.gov: NCT02830399.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19.
Methods
This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis.
Results
In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9–59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1–11.4), an affective disorder (OR 4.1; CI 1.6–10.9), and severe respiratory symptoms (OR 4.6; CI 2.2–9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1–0.9) predicted a lower risk of a confusional state.
Conclusion
COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.
During the Randomized Assessment of Rapid Endovascular Treatment (EVT) of Ischemic Stroke (ESCAPE) trial, patient-level micro-costing data were collected. We report a cost-effectiveness analysis of EVT, using ESCAPE trial data and Markov simulation, from a universal, single-payer system using a societal perspective over a patient’s lifetime.
Methods:
Primary data collection alongside the ESCAPE trial provided a 3-month trial-specific, non-model, based cost per quality-adjusted life year (QALY). A Markov model utilizing ongoing lifetime costs and life expectancy from the literature was built to simulate the cost per QALY adopting a lifetime horizon. Health states were defined using the modified Rankin Scale (mRS) scores. Uncertainty was explored using scenario analysis and probabilistic sensitivity analysis.
Results:
The 3-month trial-based analysis resulted in a cost per QALY of $201,243 of EVT compared to the best standard of care. In the model-based analysis, using a societal perspective and a lifetime horizon, EVT dominated the standard of care; EVT was both more effective and less costly than the standard of care (−$91). When the time horizon was shortened to 1 year, EVT remains cost savings compared to standard of care (∼$15,376 per QALY gained with EVT). However, if the estimate of clinical effectiveness is 4% less than that demonstrated in ESCAPE, EVT is no longer cost savings compared to standard of care.
Conclusions:
Results support the adoption of EVT as a treatment option for acute ischemic stroke, as the increase in costs associated with caring for EVT patients was recouped within the first year of stroke, and continued to provide cost savings over a patient’s lifetime.
The 2019 coronavirus disease (COVID-19) infection had newly emerged with predominant respiratory complications. Other extrapulmonary features had been recently described. Here, we describe a COVID-19 patient presenting with multiorgan involvement mimicking systemic lupus erythematosus. He was successfully treated with glucocorticoids and tocilizumab.
Oases are subject to decreasing resources and changing human activities. Fully aware of their rich heritage, the United Arab Emirates (UAE) have undertaken work to preserve and revitalize these oases. However, there is a clear lack of understanding of the dynamic links between climate change, hydraulic and agricultural management, and socioeconomic activities. To clarify these links, our team conducted a systematic geoarchaeological, geophysical, spatial, and chronological study of the Masafi oasis, UAE. Results indicate the existence of a natural humid area as early as the late Pleistocene (~18 cal ka BP). These conditions persist during the early-mid Holocene with drainage activation and soil development (~12–6.3 ka). During the late Holocene, after the emergence of the “artificial” oasis around ~3250 cal yr BP, cycles of intense management suggesting water availability (~3250–2380 cal yr BP; 550 cal yr BP) alternate with episodes of fluvial detritism (~2380–1870 cal yr BP; >550 cal yr BP) and scattered evidence of farming activities with complex hydroclimatic signatures (~2300–550 cal yr BP). These results, together with regional environmental data, indicate that water and soil resources were available and exploited strategically throughout the Holocene despite adverse climatic conditions, and the oasis of Masafi could have acted as a desert refugium.
The Wasserstein gradient flow structure of the partial differential equation system governing multiphase flows in porous media was recently highlighted in Cancès et al. [Anal. PDE10(8), 1845–1876]. The model can thus be approximated by means of the minimising movement (or JKO after Jordan, Kinderlehrer and Otto [SIAM J. Math. Anal.29(1), 1–17]) scheme that we solve thanks to the ALG2-JKO scheme proposed in Benamou et al. [ESAIM Proc. Surv.57, 1–17]. The numerical results are compared to a classical upstream mobility finite volume scheme, for which strong stability properties can be established.
We present Phantom, a fast, parallel, modular, and low-memory smoothed particle hydrodynamics and magnetohydrodynamics code developed over the last decade for astrophysical applications in three dimensions. The code has been developed with a focus on stellar, galactic, planetary, and high energy astrophysics, and has already been used widely for studies of accretion discs and turbulence, from the birth of planets to how black holes accrete. Here we describe and test the core algorithms as well as modules for magnetohydrodynamics, self-gravity, sink particles, dust–gas mixtures, H2 chemistry, physical viscosity, external forces including numerous galactic potentials, Lense–Thirring precession, Poynting–Robertson drag, and stochastic turbulent driving. Phantom is hereby made publicly available.
Little is known about the accuracy of expert outlooks, so heavily relied upon by industry participants and policy makers, regarding the future path of oil prices. Using the regular publications by the Energy Information Administration (EIA), we examine the accuracy of annual recursive oil price forecasts generated by the National Energy Modeling System model of the Agency for forecast horizons of up to 15 years. Our results reveal that the EIA model outperforms the benchmark random walk model around the two ends of the forecast horizon spectrum. Additionally, at the longer horizons, simple econometric forecasting models often produce similar, if not better accuracy than the EIA model. Time varying such specifications generally also exhibit stability in their forecast performance. Finally, although combining forecasts does not change the overall patterns, some additional accuracy gains are obtained at intermediate horizons, and in some cases, forecast performance stability is also achieved.
The enterohormone glucagon-like peptide-1 (GLP-1) is required to amplify glucose-induced insulin secretion that facilitates peripheral glucose utilisation. Alteration in GLP-1 secretion during obesity has been reported but is still controversial. Due to the high adaptability of intestinal cells to environmental changes, we hypothesised that the density of GLP-1-producing cells could be modified by nutritional factors to prevent the deterioration of metabolic condition in obesity. We quantified L-cell density in jejunum samples collected during Roux-en-Y gastric bypass in forty-nine severely obese subjects analysed according to their fat consumption. In mice, we deciphered the mechanisms by which a high-fat diet (HFD) makes an impact on enteroendocrine cell density and function. L-cell density in the jejunum was higher in obese subjects consuming >30 % fat compared with low fat eaters. Mice fed a HFD for 8 weeks displayed an increase in GLP-1-positive cells in the jejunum and colon accordingly to GLP-1 secretion. The regulation by the HFD appears specific to GLP-1-producing cells, as the number of PYY (peptide YY)-positive cells remained unchanged. Moreover, genetically obese ob/ob mice did not show alteration of GLP-1-positive cell density in the jejunum or colon, suggesting that obesity per se is not sufficient to trigger the mechanism. The higher L-cell density in HFD-fed mice involved a rise in L-cell terminal differentiation as witnessed by the increased expression of transcription factors downstream of neurogenin3 (Ngn3). We suggest that the observed increase in GLP-1-positive cell density triggered by high fat consumption in humans and mice might favour insulin secretion and therefore constitute an adaptive response of the intestine to balance diet-induced insulin resistance.
Clostridium difficile infection (CDI) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (CA) CDI remain uncertain. This study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with CA-CDI.
Methods
A systematic search was conducted in 5 electronic databases for epidemiologic studies that examined the association between the presence of comorbidities and exposure to medications with the risk of CA-CDI. Pooled odds ratios were estimated using 3 meta-analytic methods. Subgroup analyses by location of studies and by life stages were conducted.
Results
Twelve publications (n=56,776 patients) met inclusion criteria. Antimicrobial (odds ratio, 6.18; 95% CI, 3.80–10.04) and corticosteroid (1.81; 1.15–2.84) exposure were associated with increased risk of CA-CDI. Among the comorbidities, inflammatory bowel disease (odds ratio, 3.72; 95% CI, 1.52–9.12), renal failure (2.64; 1.23–5.68), hematologic cancer (1.75; 1.02–5.68), and diabetes mellitus (1.15; 1.05–1.27) were associated with CA-CDI. By location, antimicrobial exposure was associated with a higher risk of CA-CDI in the United States, whereas proton-pump inhibitor exposure was associated with a higher risk in Europe. By life stages, the risk of CA-CDI associated with antimicrobial exposure greatly increased in adults older than 65 years.
Conclusions
Antimicrobial exposure was the strongest risk factor associated with CA-CDI. Further studies are required to investigate the risk of CA-CDI associated with medications commonly prescribed in the community. Patients with diarrhea who have inflammatory bowel disease, renal failure, hematologic cancer, or diabetes are appropriate populations for interventional studies of screening.
In a recent paper, Girard (2012) proposed to use his recent construction of a geometry of interaction in the hyperfinite factor (Girard 2011) in an innovative way to characterize complexity classes. We begin by giving a detailed explanation of both the choices and the motivations of Girard's definitions. We then provide a complete proof that the complexity class co-NL can be characterized using this new approach. We introduce the non-deterministic pointer machine as a technical tool, a concrete model to compute algorithms.
To identify and explore concepts important to patients with cognitive symptoms of major depressive disorder (MDD) and adapt an existing patient-reported outcome (PRO) measure to assess these symptoms.
Methods
Four focus groups were conducted with MDD patients (n = 33) to elicit relevant concepts and determine whether one of several PRO scales could be used to assess cognitive symptoms of depression. Following selection and minor modification of the Perceived Deficits Questionnaire (PDQ), cognitive debriefing interviews were conducted with additional patients (n = 17) to further refine and adapt this measure for use in MDD. Minor revisions based on patient input yielded the PDQ for Depression (PDQ-D).
Results
Focus group participants reported a variety of cognitive symptoms that were classified into 7 general categories: lack of focus and clear thought, memory problems, difficulty with lexical access, difficulty with divided attention, difficulty with decision making, difficulty thinking quickly, and difficulty learning new things. Limitations in work productivity were the most commonly reported impacts of cognitive symptoms. While suggesting a few modifications, focus group participants reacted positively to the PDQ based on the breadth, specificity, and relevance of the items. Cognitive debriefing participants indicated that the modified PDQ items were generally easy to understand and relevant to their experiences with MDD.
Conclusion
Because cognitive symptoms are burdensome to patients with MDD, their assessment is important to optimize treatment outcomes. The PDQ-D has the potential to supplement existing assessment methods, providing unique information important for both comprehensive evaluation of individuals with MDD and evaluation of new treatments.
Discrete-velocity approximations represent a popular way for computing the Boltzmanncollision operator. The direct numerical evaluation of such methods involve a prohibitivecost, typically O(N2d + 1)where d is the dimension of the velocity space. In this paper, followingthe ideas introduced in [C. Mouhot and L. Pareschi, C. R. Acad. Sci. Paris Sér. IMath. 339 (2004) 71–76, C. Mouhot and L. Pareschi, Math.Comput. 75 (2006) 1833–1852], we derive fast summation techniquesfor the evaluation of discrete-velocity schemes which permits to reduce the computationalcost from O(N2d + 1) to O(N̅dNd log2N), N̅ ≪ N, with almost no loss of accuracy.