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Are you a picky eater? Do you worry that food will make you vomit or choke? Do you find eating to be a chore? If yes, this book is for you! Your struggles could be caused by Avoidant Restrictive Food Intake Disorder (ARFID); a disorder characterized by eating a limited variety or volume of food. You may have been told that you eat like a child, but ARFID affects people right across the lifespan, and this book is the first specifically written to support adults. Join Drs. Jennifer Thomas, Kendra Becker, and Kamryn Eddy - three ARFID experts at Harvard Medical School - to learn how to beat your ARFID at home and unlock a healthier relationship with food. Real-life examples show that you are not alone, while practical tips, quizzes, worksheets, and structured activities, take you step-by-step through the latest evidence-based treatment techniques to support your recovery.
Many restoration projects rely on invasive plant removal to restore ecosystems. However, success of restoration efforts relying on invasives removal can be jeopardized, because, in addition to displacing native plants, invasives can also dramatically impact soils. Many studies have documented invasives’ effects on soil chemistry and microbiota. While European beachgrass (Ammophila arenaria (L.) Link) is a worldwide invasives problem in coastal dunes outside northern Europe, little attention has been paid to effects of this species on soil chemistry following invasion, even though it establishes persistent, dense monocultures. In our study, we evaluated effects of A. arenaria invasion on soil chemistry of coastal dunes at Point Reyes National Seashore (PRNS); persistence of effects following removal by mechanical or herbicide treatment (legacy effects); and effects of treatment independent of invasion. Dune restoration efforts at PRNS have met with mixed success, especially in herbicide-treated backdunes, where decomposition of dead A. arenaria has been greatly delayed. Based on results, invasion impacted 74% of 19 variables assessed, although there was a significant interaction in many cases with successional status (earlier vs later). Almost 60% of invasion effects persisted after restoration, with legacy effects prevalent in herbicide-treated backdunes where sand deposition from adjacent beaches could not mitigate effects as it could in herbicide-treated foredunes. Mechanical removal — or inversion of invaded surface soils with less-contaminated subsoils — resulted in fewer legacy effects, but more treatment effects, primarily in backdunes. Soil chemistry may decelerate decomposition of A. arenaria due to the limited nitrogen (N) available to enable microbial breakdown of the high carbon(C):N (70.8:1) material, but microbial factors probably play a more important role. Success of restoration at PRNS may not be fully realized until legacy effects are resolved through additional actions such as inoculation with healthy microbiomes or necromass reduction through controlled burning.
In total numbers, Germany has faced the largest number of refugees and asylum seekers (RAS) in Europe in the past decade. Although a considerable proportion have experienced traumatic and stressful life events, there is no systematic review to date examining the prevalence of depressive symptoms and post-traumatic stress disorder (PTSD) symptoms in RAS in Germany.
To calculate the prevalence of depressive symptoms and PTSD symptoms in the general population of RAS living in Germany after the year 2000 and explore the impact of study- and participant-related characteristics on prevalence estimates.
We systematically searched PubMed, CINAHL, PsycINFO, PSYNDEX, Academic Search Complete, Science Direct and Web of Science from January 2000 to May 2020 to identify articles reporting prevalence of depressive symptoms and PTSD in RAS in Germany (PROSPERO registration number: CRD42020182796).
In total, 31 different surveys met inclusion criteria with 20 surveys reporting prevalence estimates of depressive symptoms and 25 surveys symptoms of PTSD. Based on screening tools, the pooled prevalence estimate of PTSD symptoms was 29.9% (95% CI 20.8–38.7%) and of depressive symptoms 39.8% (95% CI 29.8–50.1%). Heterogeneity was large within and between subgroups. In multivariate meta-regressions on depressive symptoms, heterogeneity was largely explained by survey period, length of field period and study quality.
Prevalence rates of depressive symptoms and PTSD symptoms in RAS are notably large. They exceed the prevalence in the general German population. As a result of high heterogeneity, however, pooled prevalence rates should be interpreted with caution.
Palmer amaranth–a fast-growing, challenging to control noxious weed that significantly reduces crop yields—was first found in Minnesota in September 2016 in conservation plantings sown with Palmer amaranth contaminated seed mixes. Minnesota Department of Agriculture (MDA) designated Palmer amaranth as a Prohibited Noxious Weed in 2015 and listed it as a Noxious Weed Seed in 2016 by emergency order. A genetic test to identify Palmer amaranth was simultaneously developed by multiple labs providing a tool to limit its spread as a contaminant in seed. Seed companies adopted genetic testing methods for labeling seed for sale reducing introductions via the seed pathway. Additionally, MDA determined that manure spread on crop fields from contaminated screenings fed to livestock resulted in new infestations. Limiting spread via these and other potential pathways was critical to successfully reducing the impact of Palmer amaranth. MDA, University of Minnesota (UMN) Extension, Conservation Corps Minnesota and Iowa (CCMI), farmers, and other partners are working to eradicate these infestations before they can spread. In 2016, 35 sites were sown with Palmer amaranth contaminated seed mixes. Palmer amaranth was found at eight (23%) of these sites. Management with intensive scouting, torching, prescribed burning, and herbicide application was implemented in 2016 and 2017. By 2018, no Palmer amaranth was found at any of these sites. Similar success to newer infestations in 2018, 2019, and 2020 was achieved using the same methods. MDA recorded management activities and documented a comprehensive timeline of Palmer amaranth in Minnesota. This timeline provides a story of success and challenges in combating and eradicating Palmer amaranth.
Nowadays many financial derivatives, such as American or Bermudan options, are of early exercise type. Often the pricing of early exercise options gives rise to high-dimensional optimal stopping problems, since the dimension corresponds to the number of underlying assets. High-dimensional optimal stopping problems are, however, notoriously difficult to solve due to the well-known curse of dimensionality. In this work, we propose an algorithm for solving such problems, which is based on deep learning and computes, in the context of early exercise option pricing, both approximations of an optimal exercise strategy and the price of the considered option. The proposed algorithm can also be applied to optimal stopping problems that arise in other areas where the underlying stochastic process can be efficiently simulated. We present numerical results for a large number of example problems, which include the pricing of many high-dimensional American and Bermudan options, such as Bermudan max-call options in up to 5000 dimensions. Most of the obtained results are compared to reference values computed by exploiting the specific problem design or, where available, to reference values from the literature. These numerical results suggest that the proposed algorithm is highly effective in the case of many underlyings, in terms of both accuracy and speed.
Scholars and practitioners continue to debate transatlantic burden sharing, which has implications for broader questions of collective action and international organizations. Little research, however, has analyzed domestic and institutional drivers of burden-sharing behavior; even less has disaggregated defense spending to measure burden sharing more precisely. This paper enhances understanding of the relationship between national political economies and burden shifting, operationalizing burden shifting as the extent to which a country limits or decreases defense expenditures, while at the same time favoring personnel over equipment modernization and readiness in the composition of defense budgets. Why do countries choose to allocate defense resources to personnel, rather than equipment modernization? I find that governments slightly decrease top-line defense spending in response to unemployment while shifting much more substantial amounts within defense budgets from equipment expenditures into personnel. This research highlights the intimate connection between Europe’s economic fortunes, transatlantic security, and burden sharing in North Atlantic Treaty Organization and the European Union – of particular interest as a pandemic buffets the transatlantic economy. It also points policy analysts toward factors more amenable to political decisions than the structural variables generally associated with burden sharing, bridging significant gaps between defense economics, security studies, and comparative political economy.
Previous case–control studies of autistic spectrum disorder (ASD) have identified altered brain structure such as altered frontal and temporal cortex volumes, or decreased fractional anisotropy (FA) within the inferior fronto-occipital fasciculus in patients. It remains unclear whether subclinical autistic-like traits might also be related to variation in these brain structures.
In this study, we analyzed magnetic resonance imaging (MRI) data of 250 psychiatrically healthy subjects phenotyped for subclinical autistic-like traits using the Autism Spectrum Quotient (AQ). For data analysis, we used voxel-based morphometry of T1-MRIs (Computational Anatomy Toolbox) and tract-based spatial statistics for diffusion tensor imaging data.
AQ attention switching subscale correlated negatively with FA values in the bilateral uncinate fasciculus as well as the bilateral inferior fronto-occipital fasciculus. Higher AQ attention switching subscale scores were associated with increased mean diffusivity and radial diffusivity values in the uncinate fasciculus, while axial diffusivity values within this tract show a negative correlation. AQ attention to detail subscale correlated positively with gray matter volume in the right pre- and postcentral gyrus.
We demonstrate that individuals with higher levels of autism-spectrum-like features show decreased white matter integrity in tracts associated with higher-level visual processing and increased cortical volume in areas linked to movement sequencing and working memory. Our results resemble regional brain structure alterations found in individuals with ASD. This offers opportunities to further understand the etiology and pathogenesis of the disorder and shows a subclinical continuum perspective.
ABSTRACT IMPACT: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. OBJECTIVES/GOALS: Opioid overdoses often occur in hotspots identified by geographic and temporal trends. This study uses principles of community engaged research to identify neighborhood and community-level factors associated with opioid overdose within overdose hotspots which can be targets for novel intervention design. METHODS/STUDY POPULATION: We conducted an environmental scan in three overdose hotspots’‘ two in an urban center and one in a small city’‘ identified by the Rhode Island Department of Health as having the highest opioid overdose burden in Rhode Island. We engaged hotspot community stakeholders to identify neighborhood factors to map within each hotspot. Locations of addiction treatment, public transportation, harm reduction programs, public facilities (i.e., libraries, parks), first responders, and social services agencies were converted to latitude and longitude and mapped in ArcGIS. Using Esri Service Areas, we will evaluate the service areas of stationary services. We will overlay overdose events and use logistic regression identify neighborhood factors associated with overdose by comparing hotspot and non-hotspot neighborhoods. RESULTS/ANTICIPATED RESULTS: We anticipate that there will be differing neighborhood characteristics associated with overdose events in the densely populated urban area and those in the smaller city. The urban area hotspots will have overlapping social services, addiction treatment, and transportation service areas, while the small city will have fewer community resources without overlapping service areas and reduced public transportation access. We anticipate that overdoses will occur during times of the day when services are not available. Overall, overdose hotspots will be associated with increased census block level unemployment, homelessness, vacant housing, and low food security. DISCUSSION/SIGNIFICANCE OF FINDINGS: Identifying factors associated with opioid overdoses will enable better resource allocation in communities most impacted by the overdose epidemic. Study results will be used for novel intervention design to prevent opioid overdose deaths in communities with high burden of opioid overdose.
The ‘Wadden Sea Archive of landscape evolution, climate change and settlement history’ project (WASA) focuses on the analysis of marine sediment archives from the East Frisian Wadden Sea region. It aims at understanding the formation of palaeolandscapes since the end of the last ice age. One part of the project studies the possible correlation and shift of archaeological settlement patterns, climate change and sea-level rise through time in order to derive archaeological expectancy maps. In this paper we present our findings for a quantifiable set of Stone Age sites in the area of the prehistorical Dornumer tidal basin, discussing them against the background of coastal environmental factors and the applied methodology of our modelling. To enable spatial analysis of these sites, we developed a palaeographic elevation model, which was subsequently flooded at 2000-year intervals between the Boreal and early Subboreal periods. Particular challenges are posed by the dynamics of marine transgression, the related changes in the natural environment and their spatial extent. As a result of our GIS-based approach, the model can be extended geographically and provides a basis for future research.
Palaeolandscape reconstructions at the German North Sea coast are essential for the understanding of coastal changes and dynamic landscape-forming processes. This study contributes to reconstructing Holocene coastal changes in the back-barrier area of the East Frisian island of Norderney and draws conclusions on the local palaeogeography. Five sediment cores were analysed in terms of sedimentology (grain-size distribution), geochemistry (TOC, TIC, N, C/N), microfauna (foraminifers and ostracods) and 13 radiocarbon dates. In order to identify driving environmental factors and support the facies interpretation, multivariate statistics (PCA) were carried out. Additional cores from the surrounding area (WASA Project and ‘Landesamt für Bergbau, Energie und Geologie’ (LBEG) Hannover) enabled correlation of the investigated cores over a transect of ~6 km, showing six depositional environments, which can be used for landscape reconstruction. Deposition starts with periglacial (aeolian and glaciofluvial) Pleistocene sediments, with subsequent pedogenesis followed by swamp conditions that develop into a salt marsh. The overlying tidal-flat sediments are partially cut by (fossil and recent) channel deposits. A hiatus at the base of the tidal-flat deposits that spans some 3000 years hints at their reworking caused by a combination of antrophogenic coastal protection measures and the impact of storms. Furthermore, based on the profile correlation and the age data, a widespread salt-marsh area with a minimum age of ~4000 cal BP is defined for the ‘Hohes Riff’ in the southwestern back-barrier of Norderney Island.
In times of digital pervasion of everyday life, the EU has strengthened a normative idea of European fundamental rights, especially by referring to a strong notion of privacy protection. A normative corridor is evolving with the “right to privacy” at its heart, a right that will be instrumental in shaping the European legal architecture’s future structure. In this Article we argue that the constitutional protection of privacy rights is not only of individual relevance but also of major democratic significance: it protects the integrity of the communication structures that underpin democratic self-determination. The debate on privacy protection, however, often lacks a democratic understanding of privacy and misses its public value. Following an interactionist understanding of privacy and a discourse-theoretical model of democracy, our argument puts forward a conceptual link between privacy and the idea of communicative freedom. From this perspective, the substantiation of a European fundamental right to privacy can be seen as a possible contribution to promoting European democracy in general.
Identifying the factors that structure host–parasite interactions is fundamental to understand the drivers of species distributions and to predict novel cross-species transmission events. More phylogenetically related host species tend to have more similar parasite associations, but parasite specificity may vary as a function of transmission mode, parasite taxonomy or life history. Accordingly, analyses that attempt to infer host−parasite associations using combined data on different parasite groups may perform quite differently relative to analyses on each parasite subset. In essence, are more data always better when predicting host−parasite associations, or does parasite taxonomic resolution matter? Here, we explore how taxonomic resolution affects predictive models of host−parasite associations using the London Natural History Museum's database of host–helminth interactions. Using boosted regression trees, we demonstrate that taxon-specific models (i.e. of Acanthocephalans, Nematodes and Platyhelminthes) consistently outperform full models in predicting mammal-helminth associations. At finer spatial resolutions, full and taxon-specific model performance does not vary, suggesting tradeoffs between phylogenetic and spatial scales of analysis. Although all models identify similar host and parasite covariates as important to such patterns, our results emphasize the importance of phylogenetic scale in the study of host–parasite interactions and suggest that using taxonomic subsets of data may improve predictions of parasite distributions and cross-species transmission. Predictive models of host–pathogen interactions should thus attempt to encompass the spatial resolution and phylogenetic scale desired for inference and prediction and potentially use model averaging or ensemble models to combine predictions from separately trained models.
New guidelines for peanut allergy prevention in high-risk infants recommend introducing peanut during infancy but do not address breastfeeding or maternal peanut consumption. We assessed the independent and combined association of these factors with peanut sensitization in the general population CHILD birth cohort (N = 2759 mother–child dyads). Mothers reported peanut consumption during pregnancy, timing of first infant peanut consumption, and length of breastfeeding duration. Child peanut sensitization was determined by skin prick testing at 1, 3, and 5 years. Overall, 69% of mothers regularly consumed peanuts and 36% of infants were fed peanut in the first year (20% while breastfeeding and 16% after breastfeeding cessation). Infants who were introduced to peanut early (before 1 year) after breastfeeding cessation had a 66% reduced risk of sensitization at 5 years compared to those who were not (1.9% vs. 5.8% sensitization; aOR 0.34, 95% CI 0.14–0.68). This risk was further reduced if mothers introduced peanut early while breastfeeding and regularly consumed peanut themselves (0.3% sensitization; aOR 0.07, 0.01–0.25). In longitudinal analyses, these associations were driven by a higher odds of outgrowing early sensitization and a lower odds of late-onset sensitization. There was no apparent benefit (or harm) from maternal peanut consumption without breastfeeding. Taken together, these results suggest the combination of maternal peanut consumption and breastfeeding at the time of peanut introduction during infancy may help to decrease the risk of peanut sensitization. Mechanistic and clinical intervention studies are needed to confirm and understand this “triple exposure” hypothesis.
The neuropeptide oxytocin is proposed as a promising therapy for social dysfunction by modulating amygdala-mediated social-emotional behavior. Although clinical trials report some benefits of chronic treatment, it is unclear whether efficacy may be influenced by dose frequency or genotype.
In a randomized, double-blind, placebo-controlled pharmaco-functional magnetic resonance imaging trial (150 male subjects), we investigated acute and different chronic (every day or on alternate days for 5 days) intranasal oxytocin (24 international units) effects and oxytocin receptor genotype-mediated treatment sensitivity on amygdala responses to face emotions. We also investigated similar effects on resting-state functional connectivity between the amygdala and prefrontal cortex.
A single dose of oxytocin-reduced amygdala responses to all face emotions but for threatening (fear and anger) and happy faces, this effect was abolished after daily doses for 5 days but maintained by doses given every other day. The latter dose regime also enhanced associated anxious-arousal attenuation for fear faces. Oxytocin effects on reducing amygdala responses to face emotions only occurred in AA homozygotes of rs53576 and A carriers of rs2254298. The effects of oxytocin on resting-state functional connectivity were not influenced by either dose-frequency or receptor genotype.
Infrequent chronic oxytocin administration may be therapeutically most efficient and its anxiolytic neural and behavioral actions are highly genotype-dependent in males.
Occipital nerve regional stimulation (ONS) is reported to improve pain in several studies. We examined long-term pain and functional outcomes of ONS in an open-label prospective study.
Patients with medically refractory and disabling craniofacial pain were prospectively selected for ONS. Primary outcome was a change in mean daily pain intensity on the numeric pain rating scale (NPRS) at 6 months. Secondary outcomes included changes in NPRS, Headache Impact Test-6 (HIT-6), Migraine Disability Assessment (MIDAS), Pain Disability Index (PDI), Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and Short Form-36 version 2 (SF36) at last follow-up.
Thirteen patients (mean age 49.7 ± 8.4) diagnosed with occipital neuralgia (6), hemicrania continua (2), persistent idiopathic facial pain (2), post-traumatic facial pain (1), cluster headache (1), and chronic migraine (1) were enrolled. Mean NPRS improved by 2.1 ± 2.1 at 6 months and 2.1 ± 1.9 at last follow-up (23.5 ± 18.1 months). HIT-6 decreased by 8.7 ± 8.8, MIDAS decreased by 61.3 ± 71.6, and PDI decreased by 17.9 ± 18. SF36 physical functioning, bodily pain, and social functioning improved by 16.4 ± 19.6, 18.0 ± 31.6, and 26.1 ± 37.3, respectively. Moderate to severe headache days (defined as ≥50% of baseline mean NPRS) were reduced by 8.9 ± 10.2 days per month with ONS.
ONS reduced the long-term NPRS and moderate–severe monthly headache days by 30% and improved functional outcomes and quality of life. A prospective registry for ONS would be helpful in accumulating a larger cohort with longer follow-up in order to improve the use of ONS.