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To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as fluvoxamine or fluoxetine, may be beneficial against COVID-19.
The main objective was two-fold: (i) to test the hypothesis that the prevalence of antidepressant use in patients hospitalized with COVID-19 would be lower than in patients with similar characteristics hospitalized without COVID-19, and (ii) to examine, among patients hospitalized with COVID-19, whether antidepressant use is associated with reduced 28-day mortality. Our secondary aim was to examine whether this potential association could only concern specific antidepressant classes or molecules, is dose-dependent, and/or only observed beyond a certain dose threshold.
We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP–HP (Assistance Publique–Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and without antidepressant use at admission (N = 1482) (Figure 1).
Antidepressant use was significantly less prevalent in inpatients with COVID-19 than in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR) = 0.38; 95%CI = 0.35–0.41, p < 0.001) (Figure 2). Antidepressant use was significantly associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR = 0.55; 95%CI = 0.41–0.72, p < 0.001), particularly at daily doses of at least 40 mg fluoxetine equivalents (Figure 3). Antidepressants with high FIASMA (Functional Inhibitors of Acid Sphingomyelinase) activity seem to drive both associations.
Antidepressant use is associated with a reduced likelihood of hospitalization in patients infected with SARS-CoV-2 and with a reduced risk of death in patients hospitalized with COVID-19. These associations were stronger for molecules with high FIASMA activity. These findings posit that prospective interventional studies of antidepressants with the highest FIASMA activity may be appropriate to help identify variant-agnostic, affordable, and scalable interventions for outpatient and inpatient therapy of COVID-19.
To understand healthcare worker (HCW) perceptions surrounding Staphylococcus aureus transmission and prevention in the neonatal intensive care unit (NICU).
Qualitative case study with focus groups.
A level IV, 150-bed NICU at a Midwestern academic medical center that conducts active surveillance and decolonization of S. aureus–positive patients.
NICU HCWs, including bedside nurses, nurse managers, therapy services personnel, pediatric nurse practitioners, clinical fellows, and attending neonatologists.
Semistructured focus group interviews, assembled by occupation, were conducted by 2 study team members. Interviews were video recorded and transcribed. Deductive coding and thematic analyses were performed using NVivo software.
In total, 38 HCWs participated in 10 focus groups (1–12 participants each), lasting 40–90 minutes. Four main themes emerged: (1) Methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) are inconsistently described as high risk. (2) Infection prevention interventions are burdensome. (3) Multiple sources of transmission are recognized. (4) opportunities exist to advance infection prevention. HCWs perceived MSSA to be less clinically relevant than MRSA. Participants expressed a desire to see published data supporting infection prevention interventions, including contact precautions, environmental cleaning, and patient decolonization. These practices were identified to be considerable burdens. HCWs perceived families to be the main source of S. aureus in the NICU, and they suggested opportunities for families to play a larger role in infection prevention.
These data highlight opportunities for HCW and parental education, research, and reevaluating interventions aimed at improving infection prevention efforts to reduce the burden of S. aureus in NICU settings.
Commercial activity and regulatory oversight of the digital economy are growing apace. This essay argues that regulatory heterogeneity can deter digital trade without discrimination. Domestic policies that are not discriminatory can still result in fragmentation of the global digital economy, if sufficiently heterogeneous. We find that rules at the World Trade Organization (WTO) and in digital trade agreements offer important directions but insufficiently mitigate heterogeneity. We suggest that heterogeneity should be addressed through the progressive expansion of international trade law. We emphasize the importance of encouraging regulatory coherence and pre-empting the formation of digital blocks.
Predictions of species-level extinction risk from climate change are mostly based on species distribution models (SDMs). Reviewing the literature, we summarise why the translation of SDM results to extinction risk is conceptually and methodologically challenged and why critical SDM assumptions are unlikely to be met under climate change. Published SDM-derived extinction estimates are based on a positive relationship between range size decline and extinction risk, which empirically is not well understood. Importantly, the classification criteria used by the IUCN Red List of Threatened Species were not meant for this purpose and are often misused. Future predictive studies would profit considerably from a better understanding of the extinction risk–range decline relationship, particularly regarding the persistence and non-random distribution of the few last individuals in dwindling populations. Nevertheless, in the face of the ongoing climate and biodiversity crises, there is a high demand for predictions of future extinction risks. Despite prevailing challenges, we agree that SDMs currently provide the most accessible method to assess climate-related extinction risk across multiple species. We summarise current good practice in how SDMs can serve to classify species into IUCN extinction risk categories and predict whether a species is likely to become threatened under future climate. However, the uncertainties associated with translating predicted range declines into quantitative extinction risk need to be adequately communicated and extinction predictions should only be attempted with carefully conducted SDMs that openly communicate the limitations and uncertainty.
Captive chimpanzees fed at regular, predictable intervals are known to exhibit higher rates of aggression immediately prior to, and during feeding. Presumably, anticipation of food creates tensions leading to increased agonistic interactions prior to feeding. This study was conducted to determine if seasonal variabilities might contribute to pre-feeding agonism. A quantitative examination was made looking at events affected by seasonal (summer versus autumn) changes. Seasonal fruit diversity and the amount of available space during feeding bouts in socially housed, captive chimpanzees were tested for an effect on pre-feeding agonism. Groups were observed for a five-week period during both seasons. Each social group was observed five times per season for 30 minutes, beginning 30 minutes prior to the morning feeding. All occurrences of agonistic behaviours were recorded. Average frequencies of agonistic behaviours were calculated for each group and compared across season using a Wilcoxon matched-pairs test to determine the effect of seasonal fluctuations in fruit diversity. There were no significant differences in the number of agonistic behaviours exhibited during summer versus autumn seasons. A strong negative correlation was found for agonistic behaviours in both seasons: as space decreased, agonism increased in both summer and autumn. In addition, males scored significantly higher in the summer versus the autumn for submissive behaviours when space decreased. The provision of a variety of seasonal fruits did not result in increased pre-feeding agonism in captive chimpanzees. In fact, cage size had a greater effect on levels of agonism than did the provision of seasonal fruits.
The northern bald ibis Geronticus eremita was once widespread throughout the Middle East, northern Africa, and southern and central Europe. Habitat destruction, persecution and the impacts of pesticides have led to its disappearance from most of its former range. It disappeared from central Europe > 400 years ago, but has persisted as a relict and slowly growing breeding population in Morocco, where c. 700 wild birds of all ages remain. In Algeria, the last confirmed breeding was in 1984; in Turkey the fully wild population disappeared in 1989, but a population remains in semi-wild conditions. In Syria a small population was rediscovered in 2002, only to subsequently decline to functional extinction. Restoration programmes have been initiated independently in several locations, with over 300 free-flying birds resulting from reintroduction projects in Austria, Germany, Spain and Turkey, to restore both sedentary and fully migratory populations. Maintaining current efforts in Morocco remains a high conservation priority.
In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.
We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.
The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006).
Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.
Different types of biogenic remains, ranging from siliceous algae to carbonate precipitates, accumulate in the sediments of lakes and other aquatic ecosystems. Unicellular algae called diatoms, which form a siliceous test or frustule, are an ecologically and biogeochemically important group of organisms in aquatic environments and are often preserved in lake or marine sediments. When diatoms accumulate in large numbers in sediments, the fossilized remains can form diatomite. In sedimentological literature, “diatomite” is defined as a friable, light-coloured, sedimentary rock with a diatom content of at least 50%, however, in the Quaternary science literature diatomite is commonly used as a description of a sediment type that contains a “large” quantity of diatom frustules without a precise description of diatom abundance. Here we pose the question: What is diatomite? What quantity of diatoms define a sediment as diatomite? Is it an uncompacted sediment or a compacted sediment? We provide a short overview of prior practices and suggest that sediment with more than 50% of sediment weight comprised of diatom SiO2 and having high (>70%) porosity is diatomaceous ooze if unconsolidated and diatomite if consolidated. Greater burial depth and higher temperatures result in porosity loss and recrystallization into porcelanite, chert, and pure quartz.
Response patterns derived from dichotomized (0/1) weekly CGI ratings conducted in antidepressant drug trials (Quitkin et al, 1984) were compared with those found in the pooled data from several randomized double-blind trials comparing the relative efficacy and tolerability low-dose flupenthixol im with that of three trieyclics (amitriptyline sr, imipramine, doxepine). Using the configurational frequency analysis (Krauth and Lienert, 1973), the postulated patterns could be rediscovered in our data apart from “early onset persistent patterns” which were less frequent in Quitkin et al's (1984) drug data. However, apart from this finding no “typical” patterns in terms of drug- or placebo-dependent response patterns could be detected in either the flupenthixol or Quitkin et al's (1984) data. It is concluded that there is little empirical evidence for the assumption of placebo- or drug related change- or response patterns. Moreover, theoretical aspects do not support the usefulness of such concepts.
Negative computer attitude has been shown to be a possible co-variable in computerized examinations of psychiatric patients, affecting patient-computer interaction as well as reliability and validity of assessment (Weber et al. 2002, Acta Psychiatr.Scand., 105, 126-130).
It remains still uncertain if the psychological construct of computer attitude can be dependably measured in acute psychiatric inpatients or whether it is impeded by the effects of mental illness. For that reason a German translation of the Groningen Computer Attitude Scale (GCAS) was evaluated in 160 acute psychiatric inpatients under naturalistic conditions.
General test criteria (internal structure, item analysis, internal consistency, split half reliability) to a large extent corresponded to those formerly found in healthy subjects and psychiatric outpatients. The mean GCAS score was calculated as 56.2 ± 10.8 points and a significantly better computer attitude was found in male, better educated and younger patients. Some diverging correlation patterns were found in diagnostic subgroups, indicating a possible minor impact of mental disorder on computer attitude.
Overall, the GCAS was found to be a suitable instrument for measuring computer attitude in acute psychiatric inpatients. It should be used in identifying patients with a negative attitude to computers in order to ensure reliability and validity of computerized assessment.
The introduction of 2,4-D–resistant soybean and cotton provided growers a new POST active ingredient to include in weed management programs. The technology raises concerns regarding potential 2,4-D off-target movement to sensitive vegetation, and spray droplet size is the primary management factor focused on to reduce spray particle drift. The objective of this study was to investigate the droplet size distribution, droplet velocity, and particle drift potential of glyphosate plus 2,4-D choline pre-mixture (Enlist Duo®) applications with two commonly used venturi nozzles in a low-speed wind tunnel. Applications with the TDXL11004 nozzle had larger DV0.1 (291 µm), DV0.5 (544 µm), and DV0.9 (825 µm) values compared with the AIXR11004 nozzle (250, 464, and 709 µm, respectively), and slower average droplet velocity (8.1 m s−1) compared with the AIXR11004 nozzle (9.1 m s−1). Nozzle type had no influence on drift deposition (P = 0.65), drift coverage (P = 0.84), and soybean biomass reduction (P = 0.76). Although the TDXL11004 nozzle had larger spray droplet size, the slower spray droplet velocity could have influenced the nozzle particle drift potential. As a result, both TDXL11004 and AIXR11004 nozzles had similar spray drift potential. Further studies are necessary to understand the impact of droplet velocity on drift potential at field scale and test how different tank solutions, sprayer configurations, and environmental conditions could influence the droplet size and velocity dynamics and consequent drift potential in pesticide applications.
Brightest cluster galaxies (BCGs) residing in cool-core clusters are known to be the stage of intricate baryon cycle phenomena (e.g. gas inflows, AGN outflows, star formation feedback). The scenarios describing the observed properties of these galaxies are still controversial, suffering from limitations due to the spatial resolving power of the instruments, specifically for galaxies beyond the Local Universe. However, the dramatic improvements introduced by the integral-field unit instruments (e.g. MUSE) could shed light on the physical processes driving the evolution of these galaxies. We present an extensive analysis of the stellar and gas properties (i.e. kinematics, stellar mass, star formation rate) of the radio-loud BCG sitting at the centre of the X-ray luminous cool-core cluster Abell 2667 (z = 0.23), based on MUSE data. Our results indicate that the BCG is a massive elliptical, hosting an AGN that is possibly undergoing accretion of cold star-forming clouds of ICM or galactic cannibalism.
Permafrost occupies 20 million square kilometres of Earth’s high-latitude and high-altitude landscapes. These regions are sensitive to climate change and human activities; hence, permafrost research is of considerable scientific and societal importance. However, the results of this research are generally not known by the general public. Communicating scientific concepts is an increasingly important task in the research world. Different ways to engage learners and incorporate narratives in teaching materials exist, yet they are generally underused. Here we report on an international scientific outreach project called “Frozen-Ground Cartoons”, which aims at making permafrost science accessible and fun for students, teachers, and parents through the creation of comic strips. We present the context in which the project was initiated, as well as recent education and outreach activities. The future phases of the project primarily involve a series of augmented reality materials, such as maps, photos, videos, and 3D drawings. With this project we aim to foster understanding of permafrost research among broader audiences, inspire future permafrost researchers, and raise public and science community awareness of polar science, education, outreach, and engagement.
A lasting legacy of the International Polar Year (IPY) 2007–2008 was the promotion of the Permafrost Young Researchers Network (PYRN), initially an IPY outreach and education activity by the International Permafrost Association (IPA). With the momentum of IPY, PYRN developed into a thriving network that still connects young permafrost scientists, engineers, and researchers from other disciplines. This research note summarises (1) PYRN’s development since 2005 and the IPY’s role, (2) the first 2015 PYRN census and survey results, and (3) PYRN’s future plans to improve international and interdisciplinary exchange between young researchers. The review concludes that PYRN is an established network within the polar research community that has continually developed since 2005. PYRN’s successful activities were largely fostered by IPY. With >200 of the 1200 registered members active and engaged, PYRN is capitalising on the availability of social media tools and rising to meet environmental challenges while maintaining its role as a successful network honouring the legacy of IPY.
Various paleoclimatic records have been used to reconstruct the hydrologic history of the Altiplano, relating this history to past variability of the South American summer monsoon. Prior studies of the southern Altiplano, the location of the world’s largest salt flat, the Salar de Uyuni, and its neighbor, the Salar de Coipasa, generally agree in their reconstructions of the climate history of the past ∼24 ka. Some studies, however, have highly divergent climatic records and interpretations of earlier periods. In this study, lake-level variation was reconstructed from a ∼14-m-long sediment core from the Salar de Coipasa. These sediments span the last ∼40 ka. Lacustrine sediment accumulation was apparently continuous in the basin from ∼40 to 6 ka, with dry or very shallow conditions afterward. The fossil diatom stratigraphy and geochemical data (δ13C, δ15N, %Ca, C/N) indicate fluctuations in lake level from shallow to moderately deep, with the deepest conditions correlative with the Heinrich-1 and Younger Dryas events. The stratigraphy shows a continuous lake of variable depth and salinity during the last glacial maximum and latter stages of Marine Oxygen Isotope Stage 3 and is consistent with environmental inferences and the original chronology of a drill core from Salar de Uyuni.
Cognitive decline is an important complication of joint replacement surgeries in senior people.
We determined incidence rates of dementia diagnosis following endoprosthetic joint replacement surgery (upper and lower extremities). The observation period covered up to 28 quarters using German claims data comprising 154,604 cases 65 years and older. Effects were controlled for cerebrovascular and vascular risk factors, age, sex, the presence of a diagnosis of delirium, and regular prescription of sedative or analgesic drugs (SAD).
The rate of incident dementia diagnoses in people without joint replacement surgery was 21.34 per 1,000 person years, compared with 80.76 incident cases when joint replacement surgery was conducted during the quarter of the incident dementia diagnosis; rates declined to 21.77 incident cases 7 and more quarters after joint replacement surgery had taken place. This pattern was maintained when controlling for delirium diagnosis and regular prescription of SAD. Among 10,563 patients with at least one joint replacement surgery, patients with a diagnosis of delirium in the quarter of the surgery were at increased risk of a dementia diagnosis compared to patients without such a diagnosis (HR=2.00, p < 0.001).
In people surviving the high-risk phase for dementia immediately after surgery, long-term risk of dementia may reach the level of those without surgery. These findings encourage consequent perioperative management to reduce the risk of dementia as well as prospective studies of potentially beneficial effects of joint replacement surgery on mid- to long-term recovery of mobility and cognition in geriatric patients.