Suicide is the leading cause of unnatural death among people with a diagnosis of schizophrenia. Alcohol use is a prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. We conducted a prospectively registered (PROSPERO, CRD42022358214) systematic review and meta-analysis to quantify the relationship between alcohol use and suicide-related outcomes in schizophrenia.

We searched Medline, Embase, and PsycINFO for cross-sectional, case–control and longitudinal studies using exhaustive terms from database inception to December 2022 inclusive. Computation of odds ratios (ORs) and hazard ratios (HRs) were performed using a random-effects model with DerSimonian–Laird estimation. We also evaluated publication bias, study quality, and performed subgroup analysis and meta-regression. Fifty studies, comprising 65 samples, met eligibility criteria. Overall, alcohol use was associated with suicide (OR 1.38, 95% CI 1.21–1.58; HR = 1.32, 95% CI 1.00–1.74), attempted suicide (OR 1.69, 95% CI 1.45–1.98), and suicidal ideation (OR 1.69, 95% CI 1.22–2.34). While there was no evidence of publication bias, between-sample heterogeneity was moderate in analyses of attempted suicide (I2 = 39.6%, p = 0.01) and suicidal ideation (I2 = 56.0%, p = 0.01). Summary effects were significant in all subgroups except for longitudinal studies of attempted suicide (OR 1.60, 95% CI 0.86–3.00) and studies of suicidal ideation using gender combined samples (OR 1.63, 95% CI 0.99–2.67). Alcohol use is significantly associated with suicide-related outcomes in schizophrenia. Clinicians should routinely inquire about alcohol use in mental health services to focus preventative treatment efforts.

We investigate the Lagrangian properties of fingering convection in a parameter regime that is far beyond marginality, but that does not lead to staircase formation. We find that most fluid particles perform very short vertical excursions before switching direction. Only a small fraction of them travels vertically in the same direction for lengths substantially larger than the typical spatial scales associated with fingering instabilities. These long travels are associated with vertical velocities, buoyancy anomalies and advective fluxes constrained within a relatively narrow range of values. Despite their limited occurrence, they contribute the overwhelming majority of the up-gradient buoyancy flux. A description of fingering convection emerges that partitions the fluid into an incoherent background, where fluxes may be down-gradient, and a set of relatively long-lived, coherent, buoyancy-carrying structures that travel vertically, interacting with each other.

Background: Tracheal aspirate bacterial cultures are routinely collected in mechanically ventilated children for the evaluation of ventilator-associated infections (VAIs). However, frequent bacterial colonization of endotracheal and tracheostomy tubes contribute to the marginal performance characteristics of the test for diagnosing VAI. Published literature characterizing drivers of culture collection and the predictive value of positive cultures are limited. Methods: This single-center, retrospective cohort study included children admitted to the pediatric intensive care unit who were receiving mechanical ventilation for at least 48 hours and had 1 or more semiquantitative tracheal aspirate cultures collected between September 1, 2019, and August 31, 2020. Indications for culture collection were determined through medical record review and included fever, hypothermia, tracheal secretion changes, radiographic pneumonia, increased oxygen requirement, and/or increased positive end-expiratory pressure (PEEP). A positive culture was defined as moderate or heavy growth of a noncommensal bacterial organism. A purulent Gram stain was defined as detection of moderate or many white blood cells. Diagnosis of VAI was based on treating-clinician documentation and was ascertained through medical record review. Logistic regression accounting for clustering by patient was performed to estimate the association between indications for culture collection and (1) culture positivity, (2) purulent Gram stain, and (3) diagnosis of VAI. Results: In total, 625 tracheal aspirate cultures were performed in 261 unique patients. Common indications for culture collection included isolated fever or hypothermia (n = 124, 20%), fever with an increase in oxygen requirement or PEEP (n = 71, 11%), isolated increase in oxygen requirement or PEEP (n = 67, 11%), or isolated secretion change (n = 54, 9%) (Figure 1). Overall, 230 cultures (37%) were positive and 218 (35%) Gram stains were purulent. There were no associations between culture indications and a positive culture. Presence of isolated fever was negatively associated with a purulent Gram stain (odds ratio [OR], 0.49; 95% CI, 0.30–0.81; P = .005); otherwise, there were no associations between indication and purulent Gram stain. Finally, in a multivariable model, odds of VAI diagnosis increased with both the number of indications for culture collection and purulent Gram stain, but not with positive culture (Figure 2). Conclusions: Number and type of clinical signs were not associated with tracheal aspirate culture positivity or purulence on Gram stain, but they were associated with a clinical diagnosis of VAI. These findings suggest that positive tracheal aspirate cultures may not aid clinicians in the diagnosis of VAI, and they highlight the opportunity for improved diagnostic stewardship.

Funding: No

Disclosures: None

Figure 1.

Figure 2.

The presence of body dissatisfaction (BD) in non-Western countries is an important area of empirical enquiry. The results reflect collectivistic and individualistic cultures of Malaysians and Australians, respectively, whereby social approval, social acceptance, and cultural values are of high importance to Malaysians compared with the more liberal attitudes of Australians with respect to health behaviours. This study sought to compare: (1) Australian and Malaysian women on BD, thin ideal internalisation, sociocultural influences, problematic weight-related behaviours, and health behaviours; and (2) the degree to which BD is associated with health behaviours (smoking, alcohol consumption, drug use, and sexual behaviours) across the two cultures. Participants were 428 Australian females and 402 Malaysian females aged 18–25 years old. Australians had higher BD, thin ideal internalisation, family and media influences, restrained eating, and poorer health behaviours, while Malaysians had higher peer influence. There was no difference for bulimic behaviours across the two countries. BD was found to have an association with use of drugs, smoking, and sexual behaviours among Malaysian women, but not for Australian participants. The permeation of Western standards of the thin ideal due to increased industrialisation, Westernisation, and modernisation has brought about bulimic behaviours in Malaysian women, similar to that of Australian women.

Adolescents who hold an entity theory of personality – the belief that people cannot change – are more likely to report internalizing symptoms during the socially stressful transition to high school. It has been puzzling, however, why a cognitive belief about the potential for change predicts symptoms of an affective disorder. The present research integrated three models – implicit theories, hopelessness theories of depression, and the biopsychosocial model of challenge and threat – to shed light on this issue. Study 1 replicated the link between an entity theory and internalizing symptoms by synthesizing multiple datasets (N = 6,910). Study 2 examined potential mechanisms underlying this link using 8-month longitudinal data and 10-day diary reports during the stressful first year of high school (N = 533, 3,199 daily reports). The results showed that an entity theory of personality predicted increases in internalizing symptoms through tendencies to make fixed trait causal attributions about the self and maladaptive (i.e., “threat”) stress appraisals. The findings support an integrative model whereby situation-general beliefs accumulate negative consequences for psychopathology via situation-specific attributions and appraisals.

Fossil charcoals from archaeological sites provide direct evidence for the relationship between environmental change and ancient peoples’ livelihoods in the past. Our identification of 5811 fossil charcoal fragments from 84 samples suggested temperate deciduous and mixed conifer-broadleaved forests as the dominant vegetation at the Erdaojingzi site in northeastern China ca. 3500 cal yr BP; the major representative taxa were Quercus, Pinus, and Ulmus. Four woody plants probably supplied humans with food resources at the Erdaojingzi site, including Quercus, Ulmus, Amygdalus/Armeniaca, and Ziziphus. The nuts of Quercus were utilized as staple foods because of their rich starch content. The leaves of Ulmus may have been used by humans because of their massive dietary fibre. Amygdalus/Armeniaca and Ziziphus probably provided fruits for humans. Based on the coexistence approach (CA) used on the fossil charcoals, we found that the MAT anomaly was 7.9 ± 5.9°C at ca. 3500 cal yr BP, which is almost the same as the modern one (7.8°C), while the MAP was halved from 772 ± 301 mm at ca. 3500 cal yr BP to 370 mm currently. The wet climate might have facilitated significant development of rain-fed agriculture, promoted the emergence of large settlements, and eventually facilitated the birth of civilization.

The present study aimed to investigate an interaction between energy intake, physical activity and UCP2 gene variation on weight gain and adiposity changes in Indonesian adults. This is a prospective cohort study conducted in 323 healthy adults living in the city of Yogyakarta, Indonesia. Energy intake, physical activity, body weight, BMI, percentage body fat and waist:hip ratio (WHR) were measured at baseline and after 2 years while UCP2 -866G/A gene variation was determined at baseline. We reported that after 2 years subjects had a significant increment in body weight, BMI, body fat and reduction in WHR (all P < 0·05). In all subjects, total energy intake was significantly correlated with changes in body weight (β = 0·128, P = 0·023) and body fat (β = 0·123, P = 0·030). Among subjects with the GG genotype, changes in energy intake were positively correlated with changes in body weight (β = 0·232, P = 0·016) and body fat (β = 0·201, P = 0·034). These correlations were insignificant among those with AA + GA genotypes (all P > 0·05). In summary, we show that UCP2 gene variation might influence the adiposity response towards changes in energy intake. Subjects with the GG genotype of UCP2 -866G/A gene were more responsive to energy intake, thus more prone to weight gain due to overeating.

In rapidly urbanising China, a high number of elderly people, the so-called ‘laopiao’, float to cities where their sons or daughters live to look after their children and grandchildren. Laopiao in urban China are thought to suffer poor mental health owing to their floating status. This study explores the inter-relationship among social capital, the built environment and mental health in urban China. Using a recent survey conducted in Nanjing (N = 591), structural equation modelling was performed to compare the local elderly people and the laopiao. Results showed that mental health determinants are dissimilar between the two groups of elderly people. Bonding social capital promotes mental health in both groups, while bridging and linking social capital only contributes to the mental health of the laopiao. Also, access to public transportation is positively correlated with mental health in both groups. Furthermore, lower street network density and better access to parks enhance the mental health of the local elderly people, while higher street network density and more open space within a community enhance the mental health of the laopiao. Our findings suggest that different policy measures should be implemented for different groups of elderly people in urban China to improve their mental health.

The Clinical and Translational Science Award (CTSA) Consortium and the National Center for Advancing Translational Science (NCATS) undertook a Common Metrics Initiative to improve research processes across the national CTSA Consortium. This was implemented by Tufts Clinical and Translational Science Institute at the 64 CTSA academic medical centers. Three metrics were collaboratively developed by NCATS staff, CTSA Consortium teams, and outside consultants for Institutional Review Board Review Duration, Careers in Clinical and Translational Research, and Pilot Award Publications and Subsequent Funding. The implementation program included training on the metric operational guidelines, data collection, data reporting system, and performance improvement framework. The implementation team provided small-group coaching and technical assistance. Collaborative learning sessions, driver diagrams, and change packages were used to disseminate best and promising practices. After 14 weeks, 84% of hubs had produced a value for one metric and about half had produced an initial improvement plan. Overall, hubs reported that the implementation activities facilitated their Common Metrics performance improvement process. Experiences implementing the first three metrics can inform future directions of the Common Metrics Initiative and other research groups implementing standardized metrics and performance improvement processes, potentially including other National Institutes of Health institutes and centers.

A viscous extension of Arnold’s inviscid theory for planar parallel non-inflectional shear flows is developed and a viscous Arnold’s identity is obtained. Special forms of the viscous Arnold’s identity have been revealed that are closely related to the perturbation’s enstrophy identity derived by Synge (Proceedings of the Fifth International Congress for Applied Mechanics, 1938, pp. 326–332, John Wiley) (see also Fraternale et al., Phys. Rev. E, vol. 97, 2018, 063102). Firstly, an alternative derivation of the perturbation’s enstrophy identity for strictly parallel shear flows is acquired based on the viscous Arnold’s identity. The alternative derivation induces a weight function. Thereby, a novel weighted perturbation’s enstrophy identity is established, which extends the previously known enstrophy identity to include general streamwise translation-invariant shear flows. Finally, the validity of the enstrophy identity for parallel shear flows is rigorously examined and established under global nonlinear dynamics imposed with two classes of wall boundary conditions. As an application of the enstrophy identity, we quantitatively investigate the mechanism of linear instability/stability within the normal modal framework. The investigation reveals a subtle interaction between a critical layer and its adjacent boundary layer, which determines the stability nature of the disturbance. As an implementation of the relaxed wall boundary conditions imposed for the enstrophy identity, a control scheme is proposed that transitions the wall settings from the no-slip condition to the free-slip condition, through which a flow is stabilized quickly in an early stage of the transition.

The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.