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Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are commonly reported co-occurring mental health consequences of psychological trauma exposure. The disorders have high genetic overlap. Trauma is a complex phenotype but research suggests that trauma sensitivity has a heritable basis. We investigated whether sensitivity to trauma in those with MDD reflects a similar genetic component in those with PTSD.
Genetic correlations between PTSD and MDD in individuals reporting trauma and MDD in individuals not reporting trauma were estimated, as well as with recurrent MDD and single-episode MDD, using genome-wide association study (GWAS) summary statistics. Genetic correlations were replicated using PTSD data from the Psychiatric Genomics Consortium and the Million Veteran Program. Polygenic risk scores were generated in UK Biobank participants who met the criteria for lifetime MDD (N = 29 471). We investigated whether genetic loading for PTSD was associated with reporting trauma in these individuals.
Genetic loading for PTSD was significantly associated with reporting trauma in individuals with MDD [OR 1.04 (95% CI 1.01–1.07), Empirical-p = 0.02]. PTSD was significantly more genetically correlated with recurrent MDD than with MDD in individuals not reporting trauma (rg differences = ~0.2, p < 0.008). Participants who had experienced recurrent MDD reported significantly higher rates of trauma than participants who had experienced single-episode MDD (χ2 > 166, p < 0.001)
Our findings point towards the existence of genetic variants associated with trauma sensitivity that might be shared between PTSD and MDD, although replication with better powered GWAS is needed. Our findings corroborate previous research highlighting trauma exposure as a key risk factor for recurrent MDD.
Definition of disorder subtypes may facilitate precision treatment for posttraumatic stress disorder (PTSD). We aimed to identify PTSD subtypes and evaluate their associations with genetic risk factors, types of stress exposures, comorbidity, and course of PTSD.
Data came from a prospective study of three U.S. Army Brigade Combat Teams that deployed to Afghanistan in 2012. Soldiers with probable PTSD (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition ≥31) at three months postdeployment comprised the sample (N = 423) for latent profile analysis using Gaussian mixture modeling and PTSD symptom ratings as indicators. PTSD profiles were compared on polygenic risk scores (derived from external genomewide association study summary statistics), experiences during deployment, comorbidity at three months postdeployment, and persistence of PTSD at nine months postdeployment.
Latent profile analysis revealed profiles characterized by prominent intrusions, avoidance, and hyperarousal (threat-reactivity profile; n = 129), anhedonia and negative affect (dysphoric profile; n = 195), and high levels of all PTSD symptoms (high-symptom profile; n = 99). The threat-reactivity profile had the most combat exposure and the least comorbidity. The dysphoric profile had the highest polygenic risk for major depression, and more personal life stress and co-occurring major depression than the threat-reactivity profile. The high-symptom profile had the highest rates of concurrent mental disorders and persistence of PTSD.
Genetic and trauma-related factors likely contribute to PTSD heterogeneity, which can be parsed into subtypes that differ in symptom expression, comorbidity, and course. Future studies should evaluate whether PTSD typology modifies treatment response and should clarify distinctions between the dysphoric profile and depressive disorders.
Playing into the master narrative of the US civil rights movement, John Lewis, Andrew Aydin, and Nate Powell's March trilogy negotiates not only the movement's tactics and achievements, but also its initial mediation through photography and television and its ongoing remediation. Taking the memoir's urge to teach as a starting point, this article assesses its didactic impulses and implications, combining a historiographic approach with an assessment of the narrative's visual construction. The article highlights the trilogy's potentials and shortcomings as an intervention into civil rights memory and outlines a metacritical pedagogy through which March can become potent classroom material.
Legendary jazz musician Louis Armstrong developed his autobiography in a variety of ways of far-reaching complexity and subtlety to expose and challenge the realities of Jim Crow–era racism. He ultimately sought, in these moves, to preserve the sound world of his upbringing, and in turn, a world otherwise hidden, even erased by the dominant society’s racist logic in that era. The movement of the sounds of the music across traditional racial boundaries and the movement of the musicians themselves around the city both functioned as precursors to broader possibilities of free movement that ultimately brought significant pressure to bear on the oppressive structures of the Jim Crow era.
At the northern edge of Sahara-Arabia, dust settles in water-bodies or forms widespread loess. Sr, Pb, and Nd isotopic ratios determine sources of atmospheric dust to the Levant in these vast deserts. Combining results of contemporary storms, Sr-Nd isotopes and Mg/Al of Negev loess, fine-grained deposits in the Red Sea and from the Dead Sea indicate shifts in delivery synoptic systems. The samples Nd-Sr results are in-between the fields of (mostly) Proterozoic Sahara Shields, late Proterozoic Arabian Nubian Shield (ANS) and Nile sediments containing Neogene-Quaternary basaltic derived material. The relative fraction of each of the source end members in the final sinks reflects configurations of atmospheric-synoptic patterns and their delivery efficiencies, which in turn, are related to regional changes in climate. Easttern Mediterranean cold frontal depressions and Sharav cyclones deliver most of the dust from the Sahara; Red Sea trough delivers fine-grain material from the Red Sea region and is responsible for bringing dust from ANS rock sources. During intervals of more frequent occurrences of Red Sea trough, the isotopic composition of the dust shifted accordingly.
The drilled Inter-Continental Drilling Project core at the deeps of the Dead Sea reveals thick sequences of halite deposits from the last interglacial period, reflecting prevailing arid conditions in the lake’s watershed. Here, we examine sequences of intercalating evaporates (halite or gypsum) and fine-detritus laminae and apply petrographic, micro-X-ray fluorescence, and statistical tools to establish in high-temporal resolution the hydroclimatic controls on the sedimentation in the last interglacial Dead Sea. The time series of the thickness of the best-recovered core sections of the layered halite, detritus, and gypsum reveals periodicities of ~11, 7–8, and 4–5 yr, pointing to a North Atlantic control and possibly solar influence on the hydrology of the Dead Sea watershed during the regionally arid period of the last interglacial period. Similar periodicities were detected in the last glacial and modern sedimentary sequences of the Dead Sea and other archives of the central Levant, indicating a persistent impact of the solar cycles on regional hydrology, possibly through the effects of the North Atlantic Oscillation.
Crop index microinsurance is a novel product that has been piloted and implemented in many developing countries. We attempt to give an overview of crop index microinsurance, covering the major issues needed to design, price and implement a crop index microinurance programme. In some ways, providing insurance to the poor is fundamentally different to providing insurance to the middle-income or rich; in other ways, including in the actuarial fields of product design, pricing and risk financing, there are strong similarities. We offer a stylised discussion of these differences and similarities, with particular reference to issues of potential interest to actuaries, and propose an actuarial framework for crop index microinsurance. Case studies from Malawi and the Philippines provide examples for what does and what does not seem to work in crop index microinsurance, and motivation for further work needed.
Egidio da Viterbo (1469–1532) wrote his Book on Hebrew Letters (Libellus de litteris hebraicis) in 1517 to persuade Pope Leo X to reform the Roman alphabet. Behind this concrete, if farfetched, proposal was a millenarian theology that Egidio revealed by introducing his Christian readers to Kabbalah, whose first Christian advocate, Giovanni Pico della Mirandola, had done his pioneering work only a few decades before. Inspired by Pico and by Johann Reuchlin, Egidio also absorbed the Platonism of Marsilio Ficino, applying it in the Libellus to a Kabbalist analysis of the Aeneid, which he reads as a prophecy of papal victory over the Jews at the end of time, while also seeing Pope Leo as a modern-day Etruscan. But the main source of Egidio’s apocalyptic theology is a medieval Hebrew book, the Sefer ha-Temunah, which in Italy was new to Jews at the time Egidio read it.
Fe-Al alloys with about 55 to 65 at.% Al undergo a eutectoid transformation at 1095 °C: Fe5Al8 (ε) ↔ FeAl + FeAl2. Hence, as-cast Fe-Al alloys in this composition range show a very fine-scaled lamellar microstructure (average lamellar spacing below 500 nm) consisting of the two phases FeAl and FeAl2. The microstructure looks similar to the α2 + γ lamellar microstructure of Ti-Al-based alloys, which is known for having well-balanced properties in terms of creep, ductility and strength. However, there is limited knowledge about the properties of Fe-Al-based alloys in this composition range. In this study, a series of as-cast as well as heat-treated Fe-Al alloys with compositions between 57 and 63 at.% Al were investigated. The microstructures and crystal structures were analysed by scanning electron microscopy (SEM) and X-ray diffraction (XRD), respectively. The composition dependence of all transition temperatures was obtained by differential thermal analysis (DTA).
Inappropriate distribution of casualties in mass-casualty incidents (MCIs) may overwhelm hospitals. This study aimed to review the consequences of evacuating casualties from a bus accident to a single peripheral hospital and lessons learned regarding policy of casualty evacuation.
Medical records of all casualties relating to evacuation times, injury severity, diagnoses, treatments, resources utilized and outcomes were independently reviewed by two senior trauma surgeons. In addition, four senior trauma surgeons reviewed impact of treatment provided on patient outcomes. They reviewed the times for the primary and secondary evacuation, injury severity, diagnoses, surgical treatments, resources utilized, and the final outcomes of the patients at the point of discharge from the tertiary care hospital.
Thirty-one survivors were transferred to the closest local hospital; four died en route to hospital or within 30 minutes of arrival. Twenty-seven casualties were evacuated by air from the local hospital within 2.5 to 6.15 hours to Level I and II hospitals. Undertriage of 15% and overtriage of seven percent were noted. Four casualties did not receive treatment that might have improved their condition at the local hospital.
In MCIs occurring in remote areas, policy makers should consider revising the current evacuation plan so that only immediate unstable casualties should be transferred to the closest primary hospital. On site Advanced Life Support (ALS) should be administered to non-severe casualties until they can be evacuated directly to tertiary care hospitals. First responders must be trained to provide ALS to non-severe casualties until evacuation resources are available.
AdiniB, CohenR, GlassbergE, AzariaB, SimonD, SteinM, KleinY, PelegK. Reconsidering Policy of Casualty Evacuation in a Remote Mass-Casualty Incident. Prehosp Disaster Med. 2013;28(6):1-5.
Writing back in 1888, Adolf Neubauer, the father of modern scholarship on the Lost Tribes, warned that “It would be lost time . . . to trouble ourselves about the identification of this stream.” Neubauer was referring, of course, to the Sambatyon River, the mythical waterway that, according to common understanding, rests each Sabbath and separates missing Jews—the ten lost tribes or others—from their brethren, and indeed from the known world. Six days each week, according to the legend, the river runs so powerfully that neither these tribes nor their seekers can cross it; on the Sabbath, either natural wonders or halakhic restrictions prevent them from doing so as well. Thus, whether showcasing the sheer power and solemnity of the seventh day or the piety of the isolated (or general) community, the Sambatyon legend certifies that only in the messianic age will this lost population be restored to the rest of the Jewish people.