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Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes.
204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up.
Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present.
Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.
This work presents the results of physical and biological investigations at 27 biogeochemical stations of early winter sea ice in the Ross Sea during the 2017 PIPERS cruise. Only two similar cruises occurred in the past, in 1995 and 1998. The year 2017 was a specific year, in that ice growth in the Central Ross Sea was considerably delayed, compared to previous years. These conditions resulted in lower ice thicknesses and Chl-a burdens, as compared to those observed during the previous cruises. It also resulted in a different structure of the sympagic algal community, unusually dominated by Phaeocystis rather than diatoms. Compared to autumn-winter sea ice in the Weddell Sea (AWECS cruise), the 2017 Ross Sea pack ice displayed similar thickness distribution, but much lower snow cover and therefore nearly no flooding conditions. It is shown that contrasted dynamics of autumnal-winter sea-ice growth between the Weddell Sea and the Ross Sea impacted the development of the sympagic community. Mean/median ice Chl-a concentrations were 3–5 times lower at PIPERS, and the community status there appeared to be more mature (decaying?), based on Phaeopigments/Chl-a ratios. These contrasts are discussed in the light of temporal and spatial differences between the two cruises.
Here we provide an update of the 2013 report on the Nigerian Twin and Sibling Registry (NTSR). The major aim of the NTSR is to understand genetic and environmental influences and their interplay in psychological and mental health development in Nigerian children and adolescents. Africans have the highest twin birth rates among all human populations, and Nigeria is the most populous country in Africa. Due to its combination of large population and high twin birth rates, Nigeria has one of the largest twin populations in the world. In this article, we provide current updates on the NTSR samples recruited, recruitment procedures, zygosity assessment and findings emerging from the NTSR.
In this chapter, we investigate the tension between
bureaucratic expertise and situated knowledge in the
context of social innovation. We address the
frictions that emerge internally in public
organisations when they attempt to respond to local
demands of social innovation, citizen's engagement
and democratic participation. Our contribution to a
critique of contemporary technocratic urban
management and planning lies in identifying the key
axes of internal conflict between public
professional expertise and the situated knowledge in
urban neighbourhoods. We particularly look at the
actions of ‘boundary spanners’, and their
narratives, to examine the role of a new
professional profile within public organisations.
Boundary spanners work across organisational
boundaries developing a specific expertise which is
instituted to connect the internal working of
bureaucracies with the external demands and needs of
actors in particular urban areas.
Throughout Europe, organisations with a public task aim
to facilitate community initiatives, as these are
believed to strengthen citizens’ capabilities and
community cohesion, as well as contributing to more
tailored responses to the local context and needs
(Boonstra and Boelens, 2011; De Wilde et al, 2014;
Edelenbos and Van Meerkerk, 2016). Community
initiatives are collaborative activities by citizens
through which they provide community goods or
services based on their own motives and under their
own conditions (Bakker et al, 2012; Denters, 2016).
Examples include citizens starting community
gardens, setting up local sustainable energy
companies or organising community activities to
increase interaction between neighbours.
Facilitating such initiatives will entail public
professionals serving the ambitions of citizens and
generating conditions which support community
initiatives in realising and managing their
initiative, such as providing means, networks and
intellectual support (Oude Vrielink and Van de
Wijdeven, 2011). However, a facilitating role comes
with complicating tensions as the informal and
action-oriented logic of community initiatives (CIs)
are often at odds with the formal and
procedurally-oriented logic of organisations with a
public task (POs) (Van Dam et al, 2014). For
instance, there is a tension between acting fast to
retain the enthusiasm of initiators and
simultaneously carefully aligning the initiative
with the policies and interests of the PO, to
support the initiative more sustainably. In this
chapter we analyse such tensions and explore how
boundary spanners, who provide POs with specific
expertise in facilitating CIs, can make tensions
Elemental, chemical, and structural analysis of polycrystalline materials at the micron scale is frequently carried out using microfocused synchrotron X-ray beams, sometimes on multiple instruments. The Maia pixelated energy-dispersive X-ray area detector enables the simultaneous collection of X-ray fluorescence (XRF) and diffraction because of the relatively large solid angle and number of pixels when compared with other systems. The large solid angle also permits extraction of surface topography because of changes in self-absorption. This work demonstrates the capability of the Maia detector for simultaneous measurement of XRF and diffraction for mapping the short- and long-range order across the grain structure in a Ni polycrystalline foil.
Asbestos bodies are the histological hallmarks of asbestos exposure. Both conventional and advanced techniques are used to evaluate abundance and composition in histological samples. We previously reported the possibility of using synchrotron X-ray fluorescence microscopy (XFM) for analyzing the chemical composition of asbestos bodies directly in lung tissue samples. Here we applied a high-performance synchrotron X-ray fluorescence (XRF) set-up that could allow new protocols for fast monitoring of the occurrence of asbestos bodies in large histological sections, improving investigation of the related chemical changes. A combination of synchrotron X-ray transmission and fluorescence microscopy techniques at different energies at three distinct synchrotrons was used to characterize asbestos in paraffinated lung tissues. The fast chemical imaging of the XFM beamline (Australian Synchrotron) demonstrates that asbestos bodies can be rapidly and efficiently identified as co-localization of high calcium and iron, the most abundant elements of these formations inside tissues (Fe up to 10% w/w; Ca up to 1%). By following iron presence, we were also able to hint at small asbestos fibers in pleural spaces. XRF at lower energy and at higher spatial resolution was afterwards performed to better define small fibers. These analyses may predispose for future protocols to be set with laboratory instruments.
Dutch-Ghanaians had a significantly higher prevalence of overweight and obesity (men 69·1 %, women 79·5 %) than urban Ghanaians (men 22·0 %, women 50·0 %) and rural Ghanaians (men 10·3 %, women 19·0 %). Urban Ghanaian men and women also had a significantly higher prevalence of overweight and obesity than their rural Ghanaian counterparts. In a logistic regression analysis adjusting for age and education, the odds ratios for being overweight or obese were 3·10 (95 % CI 1·75, 5·48) for urban Ghanaian men and 19·06 (95 % CI 8·98, 40·43) for Dutch-Ghanaian men compared with rural Ghanaian men. Among women, the odds ratios for being overweight and obese were 3·84 (95 % CI 2·66, 5·53) for urban Ghanaians and 11·4 (95 % CI 5·97, 22·07) for Dutch-Ghanaians compared with their rural Ghanaian counterparts.
Our current findings give credence to earlier reports of an increase in the prevalence of overweight/obesity with urbanization within Africa and migration to industrialized countries. These findings indicate an urgent need to further assess migration-related factors that lead to these increases in overweight and obesity among migrants with non-Western background, and their impact on overweight- and obesity-related illnesses such as diabetes among these populations.
Like other network industries, construction and maintenance of transport infrastructure have also seen a recent trend towards liberalization, deregulation, re-regulation, and sometimes privatization. With respect to institutional arrangements, this change implies that previously vertically integrated state-owned enterprises have been replaced by ‘more market’, meaning private ownership and contracts together with regulation by an independent government agency. When economists discuss institutions, this is preferably done in terms of efficiency and equilibrium. We discuss Williamson's Transaction Cost Economics (TCE) and Aoki's Comparative Institutional Analysis (CIA) as being two representative approaches of New Institutional Economics in which efficiency and equilibrium are central. What is the applicability of these two approaches to explain institutional change? The case of road management in Nordic countries provides the empirical evidence. We will draw conclusions as to the strengths and weaknesses of the two approaches and add suggestions to complement the efficiency approach, which allow for a more detailed level of analysis, in which also issues of political power are included.
To create a general framework for the simulation of intakes from mandatory or voluntary fortification, which will make outcomes of simulation studies more comparable and give insight on uncertainties.
A general framework was developed based on methods used in already published case studies of mandatory fortification. The framework was extended to be suitable for the simulation of voluntary fortification. Case studies of folic acid fortification were used to illustrate the general framework.
The developed framework consists of six steps. First, the definition of the fortification strategy (step 1), followed by the identification of potential carrier products (step 2), and the definition of fortification levels or ranges (step 3). Thereafter, virtual food/supplement composition data are created (step 4) and food/supplement consumption data are required (step 5). Finally, the intake of the functional ingredient from functional foods, other foods and dietary supplements is calculated during the simulation resulting in total habitual intake distributions (step 6).
Simulation of both mandatory and voluntary folic acid fortification in The Netherlands showed that the general framework is applicable. Also with incomplete data or data from different sources, the (habitual) intake distributions can be estimated using assumptions, statistical procedures or probabilistic modelling approaches. It is important that the simulation procedure is described well, so that an insight on uncertainties and knowledge gaps to be filled is given.
We have developed a model to calculate the evolution of AGB stars in a synthetic way. The evolution is started at the first thermal pulse (TP) and ends when the envelope mass has been lost due to mass loss or when the core mass reaches the Chandrasekhar mass.
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