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Arctic mining has a bad reputation because the extractive industry is often responsible for a suite of environmental problems. Yet, few studies explore the gap between untouched tundra and messy megaproject from a historical perspective. Our paper focuses on Advent City as a case study of the emergence of coal mining in Svalbard (Norway) coupled with the onset of mining-related environmental change. After short but intensive human activity (1904–1908), the ecosystem had a century to respond, and we observe a lasting impact on the flora in particular. With interdisciplinary contributions from historical archaeology, archaeozoology, archaeobotany and botany, supplemented by stable isotope analysis, we examine 1) which human activities initially asserted pressure on the Arctic environment, 2) whether the miners at Advent City were “eco-conscious,” for example whether they showed concern for the environment and 3) how the local ecosystem reacted after mine closure and site abandonment. Among the remains of typical mining infrastructure, we prioritised localities that revealed the subtleties of long-term anthropogenic impact. Significant pressure resulted from landscape modifications, the import of non-native animals and plants, hunting and fowling, and the indiscriminate disposal of waste material. Where it was possible to identify individual inhabitants, these shared an economic attitude of waste not, want not, but they did not hold the environment in high regard. Ground clearances, animal dung and waste dumps continue to have an effect after a hundred years. The anthropogenic interference with the fell field led to habitat creation, especially for vascular plants. The vegetation cover and biodiversity were high, but we recorded no exotic or threatened plant species. Impacted localities generally showed a reduction of the natural patchiness of plant communities, and highly eutrophic conditions were unsuitable for liverworts and lichens. Supplementary isotopic analysis of animal bones added data to the marine reservoir offset in Svalbard underlining the far-reaching potential of our multi-proxy approach. We conclude that although damaging human–environment interactions formerly took place at Advent City, these were limited and primarily left the visual impact of the ruins. The fell field is such a dynamic area that the subtle anthropogenic effects on the local tundra may soon be lost. The fauna and flora may not recover to what they were before the miners arrived, but they will continue to respond to new post-industrial circumstances.
Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity.
We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year.
The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854).
The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.
Families facing end-stage nonmalignant chronic diseases (NMCDs) are presented with similar symptom burdens and need for psycho-social–spiritual support as their counterparts with advanced cancers. However, NMCD patients tend to face more variable disease trajectories, and thus may require different anticipatory supports, delivered in familiar environments. The Life Rainbow Programme (LRP) provides holistic, transdisciplinary, community-based end-of-life care for patients with NMCDs and their caregivers. This paper reports on the 3-month outcomes using a single-group, pre–post comparison.
Patients with end-stage NMCDs were screened for eligibility by a medical team before being referred to the LRP. Patients were assessed at baseline (T0), 1 month (T1), and 3 months (T2) using the Integrated Palliative Outcome Scale (IPOS). Their hospital use in the previous month was also measured by presentations at accident and emergency services, admissions to intensive care units, and number of hospital bed-days. Caregivers were assessed at T0 and T2 using the Chinese version of the Modified Caregiver Strain Index, and self-reported health, psychological, spiritual, and overall well-being. Over-time changes in outcomes for patients, and caregivers, were tested using paired-sample t-tests, Wilcoxon-signed rank tests, and chi-square tests.
Seventy-four patients and 36 caregivers participated in this research study. Patients reported significant improvements in all IPOS domains at both 1 and 3 months [ranging from Cohen's d = 0.495 (nausea) to 1.793 (depression and information needs fulfilled)]. Average hospital bed-days in the previous month fell from 3.50 to 1.68, comparing baseline and 1 month (p < 0.05). At 3 months, caregiver strain was significantly reduced (r = 0.332), while spiritual well-being was enhanced (r = 0.333).
After receiving 3 month's LRP services, patients with end-stage NMCDs and their caregivers experienced significant improvements in the quality of life and well-being, and their hospital bed-days were reduced.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
This study examined subjective and objective cognitive functioning in 26 female breast cancer survivors (BCS) who received chemotherapy treatment that finished .5 to 5 years prior to testing and compared their results to 25 demographically matched women with no history of cancer. Participants were assessed on prospective memory (PM) tasks; neuropsychological tests of processing speed, attentional flexibility with greater cognitive load, executive function, and verbal memory; self-report measures of cognitive dysfunction and PM failures; and distress. The BCS group showed significantly slower speed of processing and reduced attentional flexibility, and reported significantly more cognitive complaints and PM failures than the control group on five of six self-report measures. The groups did not differ on other PM or neuropsychological measures or on a measure of distress. Subjective cognition correlated with some neuropsychological tests and with a virtual reality PM task. Objective cognitive impairments were associated with reduced quality of life in the BCS group. The results provide some evidence of both self-reported impairment and objective cognitive dysfunction following chemotherapy treatment.
Extreme rainfall events may cause pluvial flooding, increasing the transmission of several waterborne pathogens. However, the risk of experiencing clinically overt infections following exposure to pluvial floodwater is poorly estimated. A retrospective cross-sectional survey was performed to quantify the occurrence of self-reported gastrointestinal, influenza-like illness (ILI) and dermatological complaints, and the frequency of visits to the general practitioner (GP), during a 4-week observation period following pluvial flooding at seven locations in The Netherlands. Questionnaires were sent to 817 flooded households, 149 (17%) of which returned the questionnaire reporting information for 199 participants. Contact with floodwater was significantly associated with increased occurrence of gastrointestinal [odds ratio (OR 4·44)], ILI (OR 2·75) and dermatological (OR 6·67) complaints, and GP visits (OR 2·72). Having hand contact with floodwater was associated with gastrointestinal and dermatological complaints, whereas ILI complaints were associated with being engaged in post-flooding cleaning operations and having walked/cycled through floodwater. This study shows that floodwater-associated diseases occur in urban settings following extreme rainfall events in a high-income country. As pluvial floods are expected to escalate in the future due to global climate change, further research is warranted to determine the disease burden of pluvial flooding and to assess the effect of different interventions, including raising awareness among stakeholders.
In-situ wafer curvature measurements were used to study the effect of Si doping on intrinsic growth stress during the metalorganic chemical vapor deposition (MOCVD) growth of AlxGa1-xN (x=0-0.62) layers on SiC substrates. Post-growth transmission electron microscopy (TEM) characterization was used to correlate measured changes in stress with changes in film microstructure. Si doping was found to result in the inclination of edge-type threading dislocations (TDs) in AlxGa1-xN which resulted in a relaxation of compressive stress and generation of tensile stress. The experimentally measured stress gradient was similar to that predicted by an effective climb model. Dislocation inclination resulted in a reduction in the TD density for Si-doped layers compared to undoped AlxGa1-xN likely due to increased opportunities for dislocation interaction and annihilation. The TD density, which increased with increasing Al-fraction, was found to significantly alter the stress gradients in the films. Film stress was also observed to play a role in TD inclination. In undoped AlxGa1-xN, TD inclination was observed only when the film grew under a compressive stress while in Si-doped AlxGa1-xN, TD inclination was observed independent of the sign or magnitude of the film stress. Si dopants are believed to alter the concentration of surface vacancies which gives rise to dislocation jog via a surface-mediated climb mechanism.
The cemetery in the Riparo Valtenesi rockshelter at Manerba del Garda in northern Italy is well known for its wooden burial chambers. These chambers are some of the best sources of evidence for 3rd millennium BC collective burial in Europe. To further refine the absolute dating of burial activity at the site (beyond the approximate data provided by a previous series of routine radiocarbon measurements), a charred construction oak timber was sampled from Chamber 133 for 14C dendro wiggle-matching (DWM). We present the results from the DWM analysis, the first of its kind for the Italian Copper Age as a whole, establishing a terminus post quem for construction of Chamber 133 ∼2955–2872 cal BC.
Analyses of shallow cores obtained at the European Project for Ice Coring in Antarctica (EPICA) drilling site Kohnen station (75°00′ S, 00°04′ E; 2892 m a.s.l.) on the plateau of Dronning Maud Land reveal the presence of conserved snow dunes in the firn. In situ observations during three dune formation events in the 2005/06 austral summer at Kohnen station show that these periods were characterized by a phase of 2 or 3 days with snowdrift prior to dune formation which only occurred during high wind speeds of >10 m s-1 at 2 m height caused by the influence of a low-pressure system. The dune surface coverage after a formation event varied between 5% and 15%, with a typical dune size of (4 ± 2) m × (8 ± 3) m, a maximum height of 0.2 ± 0.1 m and a periodicity length of about 30 m. The mean density within a snow dune varied between 380 and 500 kg m-3, whereas the mean density at the surrounding surface was 330 ± 5 kgm-3. The firn cores covering a time-span of 22 ± 2 years reveal that approximately three to eight events per year occurred, during which snow dunes had been formed and were preserved in the firn.
Nano- and hetero-structures of carbon nanotube (CNT) and indium tin oxide (ITO) can control significantly piezoelectric and optoelectronic properties in Microelectromechanical Systems (MEMS) as sensing and actuators under cyclic loading. Optimized preparation conditions were obtained for multi-functional purpose of the specimens by obtaining the best dispersion and turbidity in the solution. Optical transmittance and electrical properties were investigated for CNT and ITO dipping and spraying coating on boro-silicate glass and polyethylene terephthalate (PET) substrates by electrical resistance measurement under cyclic loading and wettability test. Uniform dipping coating was performed using Wilhelmy plate method due to it simple and convenience. Specimen was applied with spraying coating additionally. The change in the electrical and optical properties of coated layer is mainly dependent upon the number of dip-coating, the concentration of CNT and ITO solutions, and the surface treatment condition. Electric properties of coating layers were measured using four-point probe method, and surface resistance was calculated using a dual configuration method. Optical transmittance of CNT and ITO coated PET film was also evaluated using UV spectrum. Surface energy and their hydrophilic and hydrophobic properties of CNT and ITO coated substrates were investigated by wettability test via static and dynamic contact angle measurements. As the elapsing time of cyclic loading passed, the stability of surface resistance and thus comparative interfacial adhesion between coated layer and substrates was evaluated to compare the thermodynamic work of adhesion, Wa. As dip-coating number increased, surface resistance of CNT coating decreased, whereas the transmittance decreased step-by-step due to the thicker CNT and ITO networking layer. Nano- and hetero-structural effects of CNT and ITO solution on the optical and electrical effects have been studied continuously.
During the eight years I spent in the Arctic, I have experimented with a variety of clothing, but in neither winter nor summer have I found any more suitable than that worn by the present-day Eskimos in districts where caribou are still plentiful. From 1938 to 1941 we prepared all our own skins, and my wife made all the skin clothing excepting the seal-skin boots. The descriptions are primarily intended to give practical information on clothing to travellers in Arctic regions. For this reason we have made no attempt to discuss women's clothing. My wife adopted men's clothing because of its superior convenience, and because it requires less material. Women's clothing is made with a view both of being different from the men's and of accommodating the baby, always carried on the back. Except as otherwise indicated, both the clothing and the methods of preparation here described are those of the Eskimos of Baffin Island, Melville Peninsula, Southampton Island, and the coastal region from Repulse Bay to Chesterfield Inlet; and where mention is made of “the Eskimos”, the reference is to those of these regions only.
B. J. Mans, Old Main Building, Rm 35 Parasites, Vectors and Vector-Borne Diseases Onderstepoort Veterinary Institute Agricultural Research Council Onderstepoort 0110 South Africa,
R. Gothe, Department of Biochemistry University of Pretoria Pretoria 0002 South Africa,
A. W. H. Neitz, Department of Biochemistry University of Pretoria Pretoria 0002 South Africa
Tick toxicosis has been a research focus for almost 80 years and during this time, several excellent reviews on this subject have been written that cover the history of toxicosis research as well as its aetiology and pathology (Gregson, 1943, 1973; Stampa, 1959; Neitz, 1962; Murnaghan & O'Rouke, 1978; Gothe, Kunze & Hoogstraal, 1979; Gothe, 1984, 1999; Wikel, 1984; Gothe & Neitz, 1991; Sonenshine, 1993; Masina & Broady, 1999). A comprehensive monograph on tick toxicoses of all forms has also been published (Gothe, 1999).
FUNCTIONAL SIGNIFICANCE OF TICK TOXINS
While arthropods such as spiders and scorpions are notoriously venomous organisms that utilize their toxins for protection as well as predation, the advantages for ticks being toxic is unclear. It has been suggested that tick paralysis may be a vestigial function conserved in ticks, when ticks evolved a parasitic lifestyle (Stone et al., 1989). Paralysis toxins have been attributed to functional significance during feeding of the tick, in that host mobility and grooming is impaired. This might be relevant, as tick paralysis sets in at the later stages of tick engorgement, when the tick is most liable to be killed by grooming practices. Paralysis would also affect the respiratory system leading to elevated breathing rates and an increase in carbon dioxide expiration. This together with pheromone secretion could attract ticks to the paralysed animal, which accelerates the finding and feeding of ticks.
The present study examined word learning difficulties in Chinese dyslexic children, readers of a nonalphabetic script. A total of 105 Hong Kong Chinese children were recruited and divided into three groups: Dyslexic (mean age 8;8), CA control (mean age 8;9), and RL control (mean age 6;11). They were given a word learning task and a familiar word writing task. It was found that the Dyslexic group performed less well than the RL group in learning irregular words over trials but not the regular ones. Error analyses showed that the Dyslexic group made more orthographic and word association errors but less intra-wordlist interference errors than the RL control group. The Dyslexic group also performed significantly less well than both control groups in writing familiar words (e.g. their own name). These findings suggest that Chinese dyslexic children have difficulty learning new words, especially irregular ones, and retaining overlearned words in long-term memory. We conclude that Chinese dyslexic children have a specific impairment in word learning like their alphabetic counterparts.
Tick toxicoses, of which paralysis is the most widespread and dominant form, are important elements of pathogenesis induced by ticks. Tick paralysis is the most widespread and dominant form of tick toxicoses. Non-paralytic forms of tick toxicoses do occur and evidence suggests that these forms of toxicoses are not evolutionary related. While functional significance has been suggested for tick toxins, the advantages for tick survival in general are not clear. This review considers the molecular nature of tick toxins, the possibility that tick toxins have originated more than once independently and whether these toxins could have unrecognized benign functions.