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Intake of the plant-derived n-3 fatty acid α-linolenic acid (ALA) has been associated with anti-atherosclerotic properties. However, information on the association between ALA intake and development of peripheral artery disease (PAD) is lacking. In this follow-up study, we investigated the association between dietary intake of ALA and the rate of PAD among middle-aged Danish men and women enrolled into the Danish Diet, Cancer and Health cohort between 1993 and 1997. Incident PAD cases were identified through the Danish National Patient Register. Intake of ALA was assessed using a validated FFQ. Statistical analyses were performed using Cox proportional hazard regression allowing for separate baseline hazards among sexes and adjusted for established risk factors for PAD. During a median of 13·6 years of follow-up, we identified 950 valid cases of PAD with complete information on covariates. The median energy-adjusted ALA intake within the cohort was 1·76 g/d (95 % central range: 0·94–3·28). In multivariable analyses, we found no statistically significant association between intake of ALA and the rate of PAD (P = 0·339). Also, no statistically significant associations were observed in analyses including additional adjustment for co-morbidities and in sex-specific analyses. In supplemental analyses with additional adjustment for potential dietary risk factors, we found a weak inverse association of PAD with ALA intake above the median, but the association was not statistically significant (P = 0·314). In conclusion, dietary intake of ALA was not consistently associated with decreased risk of PAD.
Emerging adulthood (age 18–25 years) is a distinct developmental phase, characterized by multiple life changes, transitions and uncertainties, associated with significant risk of mental ill health in vulnerable individuals. Identity exploration and development is key during this phase, and the development of an eating disorder during this time can significantly impact on this process. This single-case study details the treatment of an 18-year-old female outpatient with first episode, recent onset anorexia nervosa. Using the Maudsley Model of Anorexia Nervosa Treatment in Adults (MANTRA), focus was placed on identity exploration and development as a tool to reduce the dominance of anorexia nervosa and increase recovery focus. Outcome measures at end of treatment and 6-month follow-up showed significant sustained improvement in BMI and EDE-Q scores. The patient gave detailed positive feedback suggesting that this was a highly acceptable and effective intervention. The case study is discussed with reference to limitations and some reflections on the utility of incorporating identity work in the treatment of anorexia nervosa in emerging adulthood.
Key learning aims
(1)This case study is thought to have important clinical implications for tailoring the treatment of early stage AN to the emerging adult population.
(2)Identity exploration is a key feature of this developmental stage, and incorporating this work into therapy allows for experimentation and formation of an alternative, healthy set of values, beliefs and behaviours.
(3)This case also highlights the value of using role models in the construction of a non-illness driven identity, to support with behavioural change.
Recent evidence shows that the serotonin 2A receptor (5-hydroxytryptamine2A receptor, 5-HT2AR) is critically involved in the formation of visual hallucinations and cognitive impairments in lysergic acid diethylamide (LSD)-induced states and neuropsychiatric diseases. However, the interaction between 5-HT2AR activation, cognitive impairments and visual hallucinations is still poorly understood. This study explored the effect of 5-HT2AR activation on response inhibition neural networks in healthy subjects by using LSD and further tested whether brain activation during response inhibition under LSD exposure was related to LSD-induced visual hallucinations.
In a double-blind, randomized, placebo-controlled, cross-over study, LSD (100 µg) and placebo were administered to 18 healthy subjects. Response inhibition was assessed using a functional magnetic resonance imaging Go/No-Go task. LSD-induced visual hallucinations were measured using the 5 Dimensions of Altered States of Consciousness (5D-ASC) questionnaire.
Relative to placebo, LSD administration impaired inhibitory performance and reduced brain activation in the right middle temporal gyrus, superior/middle/inferior frontal gyrus and anterior cingulate cortex and in the left superior frontal and postcentral gyrus and cerebellum. Parahippocampal activation during response inhibition was differently related to inhibitory performance after placebo and LSD administration. Finally, activation in the left superior frontal gyrus under LSD exposure was negatively related to LSD-induced cognitive impairments and visual imagery.
Our findings show that 5-HT2AR activation by LSD leads to a hippocampal–prefrontal cortex-mediated breakdown of inhibitory processing, which might subsequently promote the formation of LSD-induced visual imageries. These findings help to better understand the neuropsychopharmacological mechanisms of visual hallucinations in LSD-induced states and neuropsychiatric disorders.
Anorexia nervosa (AN) is a disabling, deadly and costly mental disorder. Until recently, treatment recommendations were based on expert opinion and limited evidence. The aim of this systematic review is to synthesise recent evidence on established and emerging AN treatments and to forecast trends for future developments.
We systematically review trials of established treatments and associated process outcome studies from the last 5 years, published since a previous review in this journal. ‘Established’ treatments were those that are widely used in AN, recommended by guidelines and/or have been tested in at least one large randomised controlled trial. Secondly, we summarise emerging treatments for AN, i.e. those that have only been (or are currently being) tested in proof-of concept, feasibility or pilot trials.
We identified 19 published trials of established treatments (15 of high or moderate quality), mostly assessing psychological therapies (n = 17). We also found 11 published trials of emerging treatments, and a total of 34 registered, as yet unpublished trials. Promising emerging treatments include cognitive remediation therapy, exposure therapy and non-invasive neuromodulation.
Evidence generation on the treatment of AN has dramatically accelerated, with our understanding of the role of family-based approaches for adolescents more nuanced and a range of psychological approaches available for the treatment of adults. Evidence on emerging treatments and from forthcoming trials suggests that there is a shift towards more targeted brain-based interventions. Future studies need to focus on elucidating mechanisms of action of treatments and what works best for whom.
Sublimation (vaporization) of the icy component of a cometary nucleus determines the initial composition of the coma gas as it streams outward and escapes. Photolytic reactions in the inner coma, escape of fast, light species such as atomic and molecular hydrogen, and solar wind interaction in the outer coma alter the chemical composition and the physical nature of the coma gas. Models that describe these interactions must include (1) chemical kinetics, (2) coma energy balance, (3) multifluid flow for the rapidly escaping light components, the heavier bulk fluid, and the plasma with separate temperatures for electrons and the remainder of the gas, (4) transition from a collision dominated inner region to free molecular flow of neutrals in the outer region, (5) pickup of cometary ions by the solar wind, (6) counter and cross streaming of neutrals with respect to the plasma which outside of the contact surface also contains solar wind ions, and (7) magnetic fields carried by the solar wind. Progress on such models is described and results including velocity, temperature, and number density profiles for important chemical species are presented and compared with observations.
The magnetic structure of a simple, relatively symmetric sunspot is determined using the extremely Zeeman sensitive Landé g = 3 line of Fe I at 1.5648 μm. From the measured strength and inclination of the magnetic field we estimate the fraction of the total magnetic flux of the sunspot passing through the solar surface in the penumbra. It is found that on average approximately 1/2–2/3 of the total magnetic flux of the spot emerges in the penumbra. Sunspot penumbrae are therefore deep, i.e., the τ = 1 level does not correspond to the lower magnetic boundary of the spot in its penumbra.
Compound-specific radiocarbon analysis (CSRA) of benzene polycarboxylic acids (BPCAs) yields molecular-level, source-specific information necessary to constrain isotopic signatures of pyrogenic carbon. However, the purification of individual BPCAs requires a multistep procedure that typically results in only microgram quantities of the target analyte(s). Such small samples are highly susceptible to contamination by extraneous carbon, which needs to be minimized and carefully accounted for in order to yield accurate results. Here, we undertook comprehensive characterization and quantification of contamination associated with molecular radiocarbon (14C) BPCA analyses through systematic processing of multiple authentic standards with both fossil and modern 14C signatures at various concentrations. Using this approach, we precisely apportion the contribution of extraneous carbon with respect to the four implemented subprocedures. Assuming a constant source and quantity of extraneous carbon we correct and statistically evaluate uncertainties in resulting 14C data. Subsequently, we examine the results of triplicate analyses of reference materials representing four different environmental matrices (sediment, soil, aerosol, riverine natural organic matter) and apportion their BPCA sources in terms of carbon residues derived from biomass or fossil fuel combustion. This comprehensive approach to CSRA facilitates retrieval of robust 14C data, with application in environmental studies of the continuum of pyrogenic carbon.
There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.
A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.
Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.
The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.
We present first results of a new heterodyne spectrometer dedicated to high-resolution spectroscopy of molecules of astrophysical importance. The spectrometer, based on a room-temperature heterodyne receiver, is sensitive to frequencies between 75 and 110 GHz with an instantaneous bandwidth of currently 2.5 GHz in a single sideband. The system performance, in particular the sensitivity and stability, is evaluated. Proof of concept of this spectrometer is demonstrated by recording the emission spectrum of methyl cyanide, CH3CN. Compared to state-of-the-art radio telescope receivers the instrument is less sensitive by about one order of magnitude. Nevertheless, the capability for absolute intensity measurements can be exploited in various experiments, in particular for the interpretation of the ever richer spectra in the ALMA era. The ease of operation at room-temperature allows for long time integration, the fast response time for integration in chirped pulse instruments or for recording time dependent signals. Future prospects as well as limitations of the receiver for the spectroscopy of complex organic molecules (COMs) are discussed.
Composite magnetoelectrics implemented as thin film heterostructures are discussed in view of their applicability as highly sensitive magnetic field sensors. Here, either PZT or AlN served as piezoelectric component. The magnetostrictive phase consisted of layer systems based on FeCo or (Fe90Co10)78Si12B10. All functional layers were deposited with thicknesses of a few micrometers on Si cantilever structures with typical lateral dimensions of 25 mm by 2.2 mm. Magnetoelectric coefficients as large as 6900 V/cm Oe and a limit of detection as low as 1 pT/(Hz)1/2 were measured. Currently, the best result demonstrates a detection limit of 500 fT/(Hz)1/2 at 958 Hz frequency using a set of two sensors for external noise suppression. A frequency conversion technique is proposed to broaden the applicability of resonant magnetoelectric sensors to a wider frequency range. Finally, the achieved sensor performance is evaluated with regard to typical magnetic field amplitudes in medical applications.
Red meat has been suggested to be adversely associated with risk of myocardial infarction (MI), whereas vegetable consumption has been found to be protective. The aim of this study was to investigate substitutions of red meat, poultry and fish with vegetables or potatoes for MI prevention. We followed up 29 142 women and 26 029 men in the Danish Diet, Cancer and Health study aged 50–64 years with no known history of MI at baseline. Diet was assessed by a validated 192-item FFQ at baseline. Adjusted Cox proportional hazard models were used to calculate hazard ratios (HR) and 95 % CI for MI associated with specified food substitutions of 150 g/week. During a median follow-up of 13·6 years, we identified 656 female and 1694 male cases. Among women, the HR for MI when replacing red meat with vegetables was 0·94 (95 % CI 0·90, 0·98). Replacing fatty fish with vegetables was associated with a higher risk of MI (HR 1·23; 95 % CI 1·05, 1·45), whereas an inverse, statistically non-significant association was found for lean fish (HR 0·93; 95 % CI 0·83, 1·05). Substituting poultry with vegetables was not associated with risk of MI (HR 1·00; 95 % CI 0·90, 1·11). Findings for substitution with potatoes were similar to findings for vegetables. Among men, a similar pattern was observed, but the associations were weak and mostly statistically non-significant. This study suggests that replacing red meat with vegetables or potatoes is associated with a lower risk of MI, whereas replacing fatty fish with vegetables or potatoes is associated with a higher risk of MI.
Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.
The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.
Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.
Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.
The last three years have witnessed a growing interest in the physical properties of the small bodies in the solar system. Perhaps the most significant impetus to research on small bodies has been the imminent arrival of Comet Halley in the inner solar system. This famous comet, which was recovered in autumn 1982, has been the object of intense study during the past year as it has approached the sun and developed a tail. Much of the international, ground-based astronomical research on Halley has been coordinated through the International Halley Watch program. Spacecraft from several nations have been successfully launched (or soon will be, we hope) and are on their way to intercept the comet and make close-up observations and in situ measurements. The commencement of spacecraft study of small bodies marks a new era in comet/asteroid science and, in coordination with ground-based and Earth-orbital observations, will result in unprecedented new knowledge about the origin of the solar system and about solar system processes. Although Halley is receiving the most attention, interest is also high in Comet Giacobini-Zinner, the vicinity of which will be probed by a diverted American spacecraft in September 1985. Upcoming spacecraft studies of comets through 1986 are described at the end of the comet section of this report. Asteroid exploration by spacecraft is also anticipated to begin in the near future. The trajectory of the NASA Gailieo Mission to Jupiter has been changed to permit close-encounter observations of the large main-belt asteroid 29 Amphitrite in December 1986; these observations will be conducted on a “best effort” basis only a few months after launch of Galileo. Interest is also high in Europe, the Soviet Union, and the United States in possible spacecraft missions to additional comets and asteroids during the 1990’s. If these efforts are pursued, there will be a concomitant ground-based effort. The last three years have also witnessed extremely productive efforts to observe small bodies from Earth orbit. For example, the Infrared Astronomical Satellite discovered a comet in 1983, which made the closest approach to the Earth of any comet in centuries. IRAS made important discoveries and measurements of other comets and also assembled an immense database on infrared brightnesses of thousands of numbered and unnumbered asteroids. The planned launch of the Hubble Space Telescope next year highlights the continuing potential for applying extremely powerful instrumental techniques to the study of comets and asteroids from above the Earth’s atmosphere.
Much has been learned about the physics and chemistry of comets from the successful spacecraft encounters and intensive remote observing programs of Comets Halley and Giacobini-Zinner. Instead of being the panacea for our comet curiosity, these tantalizing “snapshots” have raised new questions, and many fundamental problems remain unsolved. To reap fuller benefits, extensive modeling is necessary to characterize the physical structure and chemical properties of the coma and to infer the composition and structure of the nucleus.
Recent interest in the subject of this discussion gained momentum by an observation which did not concern magnetic fields directly. The filigree which Dr. Richard Dunn on Sacramento Peak found 2 Angstrom off the center of Hαis a bright and crisp structure in the photosphere with a width o: 1/5 arcsec. It was described in proper detail by Dunn and Zirker (1973). Even in the printed pictures in their paper one clearly sees one step beyond the solar granulation. The filigree is certainly related to the small scale structure of the photospheric magnetic field, but it is not yet clear whether the flux elements are exactly cospatial and have the same small dimensions. Simon and Zirker (1974) concluded froi spectra that the field structure is wider than the filigree. On the other hand Harvey (1976) in his excellent review of the observations has also presented the arguments of several authors who conclude that the sizes of the flux elements are as small as those of the filigree. This discrepancy certainly needs further study before such even more delicate questions as the spatial extent of the downdraft inside and around the flux elements can be reliably answered from observations. The theoretical interpretation of the downdraft depends on this answer as different sources of the mass flow are involved: the overlying atmosphere and the convergent mass flow of the surrounding convection. The latter stays partly outside the flux element, partly diffuses into it with an efficiency that might be enhanced by convection of still smaller scale.
Red meat has been suggested to be adversely associated with risk of myocardial infarction (MI), but previous studies have rarely taken replacement foods into consideration. We aimed to investigate optimal substitutions between and within the food groups of red meat, poultry and fish for MI prevention. We followed up 55 171 women and men aged 50–64 years with no known history of MI at recruitment. Diet was assessed by a validated 192-item FFQ at baseline. Adjusted Cox proportional hazard models were used to calculate hazard ratios (HR) and 95 % CI for specified food substitutions of 150 g/week. During a median follow-up time of 13·6 years, we identified 656 female and 1694 male cases. Among women, the HR for replacing red meat with fatty fish was 0·76 (95 % CI 0·64, 0·89), whereas the HR for replacing red meat with lean fish was 1·00 (95 % CI 0·89, 1·14). Similarly, replacing poultry with fatty but not lean fish was inversely associated with MI: the HR was 0·81 (95 % CI 0·67, 0·98) for fatty fish and was 1·08 (95 % CI 0·92, 1·27) for lean fish. The HR for replacing lean with fatty fish was 0·75 (95 % CI 0·60, 0·94). Replacing processed with unprocessed red meat was not associated with MI. Among men, a similar pattern was found, although the associations were not statistically significant. This study suggests that replacing red meat, poultry or lean fish with fatty fish is associated with a lower risk of MI.
The fine structure in the chromosphere is probably controlled by magnetic flux concentrations which cellular convection produces in the photosphere. We will first deal with this flux concentration by the convection and its constraints. Then we will discuss the chromospheric network and its main constituent, the spicules. Following that we will look at the inside of the network, i.e. the fibrils.
The dynamics of the magnetic fields which are imbedded into the non-stationary outer layers of the Sun show many facets of interest to observers and theoreticians alike. In a short review I can only deal with a small number of them and occasionally glance at some others. I hate to call these magnetic fields frozen into a matter which is rather in a boiling state, but the electrical conductivity in these layers is high enough to keep matter and magnetic flux together for rather long times, so that we can discuss the most important questions within the framework of magnetohydrodynamics with infinite conductivity. I will first talk mainly about the layers below the photosphere, where the matter controls the motion of the field, secondly about the intermediate state near the photosphere, where matter and field have comparable energy, and finally about the upper layers where the field controls the material motion.