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Patients with Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) have mental health sequelae that impact their quality of life. The burden of mental health disorders in these patients is poorly established.
Aim:
To review the literature on the frequency and risk of mental disorders in GBS and CIDP.
Methods:
A systematic review was conducted to identify primary studies that reported mental health outcomes in patients with GBS and CIDP. Screening, full-text review, data extraction and quality assessment were performed in duplicate, with discrepancies resolved by a third party.
Results:
This systematic review included 19 studies. Three studies reported mental health diagnoses using the International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders criteria: up to 82%, 67%, 25% and 22% of patients following GBS were diagnosed with anxiety, depression, brief reactive psychosis and post-traumatic stress disorders, respectively. The risk of anxiety disorders following GBS normalized after 3 months, but the risk of depressive disorders remained elevated for 2 years. Although 30%–50% of patients with CIDP described mental health symptoms, no studies reported mental health diagnoses. Active disease and neuropathic pain were associated with more depressive symptoms in patients with CIDP.
Conclusion:
Many patients following GBS or with active CIDP experience symptoms that may fulfill the criteria for mental health diagnoses, but the paucity of literature suggests that mental health disorders are underdiagnosed and undertreated in this population. These patients are at higher risk of developing mental health disorders, thereby emphasizing the need for timely mental health care and assessment of their disease-specific risk factors.
We study the dynamics of a generic automorphism f of a Stein manifold with the density property. Such manifolds include almost all linear algebraic groups. Even in the special case of ${\mathbb {C}}^n$, $n\geq 2$, most of our results are new. We study the Julia set, non-wandering set and chain-recurrent set of f. We show that the closure of the set of saddle periodic points of f is the largest forward invariant set on which f is chaotic. This subset of the Julia set of f is also characterized as the closure of the set of transverse homoclinic points of f, and equals the Julia set if and only if a certain closing lemma holds. Among the other results in the paper is a generalization of Buzzard’s holomorphic Kupka–Smale theorem to our setting.
Understanding of predators functional responses is critical in assessing their efficiency as biological control agents. This study investigates the functional responses of three coccinellid predators Scymnus posticalis Sicard (Coleoptera: Coccinellidae), Platynaspis saundersi Crotch (Coleoptera: Coccinellidae), and Pharoscymnus horni Weise (Coleoptera: Coccinellidae) against varying densities of the prey aphid, Myzus persicae (Hemiptera: Aphididae) under controlled conditions (25 ± 1°C temperature, 70 ± 5% relative humidity and 14 L:10D photoperiod). Predation trials across different prey densities were performed with these adult coccinellid predators. Logistic regression analysis confirmed a Type II functional response for all the three species used in the experiments. Among the three, S. posticalis showed a superior predatory efficiency, with the highest attack rate (a) (0.0994 h−1), shortest handling time (Th) (0.5016 h) and a maximum theoretical predation rate (K) of 48.76 aphids. P. saundersi and P. horni showed lower predatory parameters, positioning S. posticalis as the most efficient predator. These findings underscore S. posticalis as a promising candidate for biological control of M. persicae, with a clear advantage in predation metrics over P. saundersi (a = 0.0876 h−1; Th = 0.5193 h; K = 48.27 aphids) and P. horni (a = 0.0695 h−1; Th = 0.5316 h; K = 47.97 aphids). However, further field validation is essential to assess its real-world efficacy, considering environmental variability and complex ecological interactions.
Sustainable diets should promote good health for both the planet and the individual. While there is a clear association between lower environmental impact diets and better health outcomes, intervention studies are needed to determine the range of dietary changes and to understand inter-individual differences in response. Individuals having different responses to dietary interventions are underpinned by a variety of genetic, phenotypic and behavioural factors. The aim of this review is to apply the findings from previous literature examining inter-individual variation and phenotypic response to the future of sustainable healthy diets. Despite changing diets or improving diet quality, physiological responses are varied in randomised controlled trials. To better understand response, individuals can be grouped based on shared baseline characteristics or by their shared response to an intervention. Studies grouping individuals by shared characteristics use a metabolic phenotyping or metabotyping approach which demonstrates that some phenotypes are more predisposed to respond to a particular intervention. Tailoring dietary advice to metabolic phenotype shows promise for improving health and diet quality. However, more evidence is needed to understand the complexity that will come with whole dietary change in the context of sustainable healthy diets. We envisage a future where metabolic phenotyping is an integral element for prescribing personalised nutrition advice for sustainable healthy diets.
This study uses panel data to examine the relationships among citizen attitudes related to Quebec independence. It has long been established that support for sovereignty is correlated to expectations about the economic and linguistic consequences of independence. Proponents of Quebec sovereignty tend to believe it will enhance the economy and preserve the French language, while opponents anticipate adverse effects on both fronts. We investigate whether economic and linguistic expectations drive preferences about independence, or whether preferences shape expectations. The analyses rely on Canadian Election Study panel surveys from 2004 to 2011 and employ cross-lagged models. Findings show that economic and linguistic expectations do affect support for sovereignty to some degree. However, the influence of sovereignty support on expectations is much more pronounced.
Both multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are chronic progressive immune-mediated peripheral neuropathies without sensory loss. We aimed to explore the different features of ultrasonographic and electrophysiological changes among MMN, motor CIDP and typical CIDP patients.
Methods:
Nerve ultrasonographic studies were performed in 19 patients with MMN, 15 patients with motor CIDP and 117 patients with typical CIDP. Cross-sectional areas (CSAs) were measured on the bilateral median and ulnar nerves and brachial plexus. Nerve conduction studies (NCSs) were performed on the median and ulnar nerves.
Results:
In patients with MMN and typical CIDP, the percentage enlargement in the brachial plexus (MMN 45.7%, typical CIDP 78%) was similar to that in the arm (MMN 42.9%, typical CIDP 76.8%) and forearm (MMN 42.9%, typical CIDP 79.4%). However, in patients with motor CIDP, the percentage enlargement in the brachial plexus (74.1%) was more pronounced than in the arm (65.5%) and forearm (58.6%). The CMAPerb/CMAPaxilla in MMN was significantly higher than in motor CIDP (median nerve, 0.82 ± 0.28 for MMN and 0.60 ± 0.37 for motor CIDP, P = 0.017). The CSA decreased in the order of typical CIDP, motor predominant CIDP (MPred-CIDP), pure motor CIDP (PM-CIDP) and MMN. The motor nerve conduction velocity increased in the order of typical CIDP, MPred-CIDP, PM-CIDP and MMN. A total of 3/6 PM-CIDP and 3/3 MPred-CIDP patients responded to steroid treatment.
Conclusion:
Treatment response, nerve ultrasonography and NCS in MMN, PM-CIDP, MPred-CIDP and typical CIDP constitute a spectrum.
A textbook objection to consequentialism is that it is too demanding—on the assumption that a moral theory which is excessively demanding thereby loses plausibility. In this paper, I assess whether the mechanisms employed by two versions of rule consequentialism, those of Brad Hooker and Tim Mulgan, adequately meet the requirement of not being too demanding. I also examine whether the concept of human nature might help determine what should count as demanding for a moral theory. While this suggestion also faces significant challenges, I contend that prescribing less partiality towards the present generation may not be a drawback for the consequentialist frameworks under consideration.
We study the homogeneous isotropic turbulence of a shear-thinning fluid modelled by the Carreau model, and show how the variable viscosity affects the multiscale behaviour of the turbulent flow. We show that Kolmogorov theory can be extended to such non-Newtonian fluids, provided that the correct choice of average is taken when defining the mean Kolmogorov scale and dissipation rate, to properly capture the effect of the variable viscosity. Thus the classical phenomenology à la Kolmogorov can be observed in the inertial range of scale, with the energy spectra decaying as $k^{-5/3}$, with $k$ being the wavenumber, and the third-order structure function obeying the $4/5$ law. The changing viscosity instead strongly alters the small scale of turbulence, leading to an enhanced intermittent behaviour of the velocity field.
We construct an explicit algebraic example of a subshift of finite type over a group $\Gamma $ with an invariant Markov measure which has completely positive sofic entropy (with respect to ‘most’ sofic approximations) and yet does not have a direct Bernoulli factor because its model spaces shatter into exponentially many clusters of sub-exponential size. The example and its analysis are related to random low-density parity-check (LDPC) codes.
This article examines the two families of denominative verbs from the semantic field of atimia: atimaô/atimoô and atimazô. By analysing their use in the Attic orators and other major prose texts from the Classical period (Herodotus, Thucydides, Xenophon, Plato and Aristotle), the article shows that these verbs were consistently employed in differentiated, well-defined ways: atimaô/atimoô for ‘effecting an actual loss of status’, and most normally for ‘imposing the legal penalty of atimia’ (especially in the orators), and atimazô for extra-legal examples of ‘dishonour’. This distinction is in part reflected also in the ratios of verbal aspect for the two families, with atimaô/atimoô being used mostly in aorist and perfective forms and atimazô mostly in imperfective forms.
A nonlinear Schrödinger equation for pure capillary waves propagating at the free surface of a vertically sheared current has been used to study the stability and bifurcation of capillary Stokes waves on arbitrary depth. A linear stability analysis of weakly nonlinear capillary Stokes waves on arbitrary depth has shown that (i) the growth rate of modulational instability increases as the vorticity decreases whatever the dispersive parameter $kh$, where $k$ is the carrier wavenumber and $h$ the depth; (ii) the growth rate is significantly amplified for shallow water depths; and (iii) the instability bandwidth widens as the vorticity decreases. Particular attention has been paid to damping due to viscosity and forcing effects on modulational instability. In addition, a linear stability analysis to transverse perturbations in deep water has been carried out, demonstrating that the dominant modulational instability is two-dimensional whatever the vorticity. Near the minimum of linear phase velocity in deep water, we have shown that generalised capillary solitary waves bifurcate from linear capillary Stokes waves when the vorticity is positive. Moreover, we have shown that the envelope of pure capillary waves in deep water is unstable to transverse perturbations. Consequently, deep-water generalised capillary solitary waves are expected to be unstable to transverse perturbations.
In Modern Standard German both bare infinitives and those formed with the particle zu are used as independent main clause predicates, where they each have illocutionary force. While the former can be associated with a range of functions, the latter specifically encodes indignation towards a state of affairs on the part of the speaker. Taking a constructionist approach, I argue that the exclamative zu-infinitive has emerged as a schematic construction, which is best described as a conventionalized form–function relation between the structure [X + zu + Inf] and an attitudinal semantic feature that represents speaker indignation. I provide diachronic data as well as a cross-linguistic comparison to support this constructionalization process.
Görtler vortices induced by concave curvature in supersonic turbulent flows are investigated using resolvent analysis and large-eddy simulations at Mach 2.95 and Reynolds number $ Re_{\delta }=63\,500$ based on the boundary-layer thickness $ \delta$. Resolvent analysis reveals that the most amplified coherent structures manifest as streamwise counter-rotating vortices with optimal spanwise wavelength $ 2.4\delta$ at cut-off frequency $f\delta /{u}_{\infty } =0.036$, where $ {u}_{\infty }$ is the freestream velocity. The leading spectral proper orthogonal decomposition modes with spanwise wavelength approximately $ 2\delta$ align well with the predicted coherent structures from resolvent analysis at $f\delta /{u}_{\infty } =0.036$. These predicted and extracted coherent structures are identified as Görtler vortices, driven by the Görtler instability. The preferential spanwise scale of the Görtler vortices is further examined under varying geometric and freestream parameters. The optimal spanwise wavelength is insensitive to the total turning angle beyond a critical value, but sensitive to the concave curvature $ K$ at the same turning angle. A limit spanwise wavelength $ 1.96\delta$, corresponding to an infinite concave curvature as $ K\rightarrow \infty$, is identified and validated. Increasing the freestream Mach number or decreasing the ratio of wall temperature to freestream temperature reduces the optimal wavelength normalised by $ \delta$, while variations in freestream Reynolds number have negligible impact. Additionally, a modified definition of the turbulent Görtler number $ G_{T}$ based on the peak eddy viscosity in boundary layers is proposed and employed to assess the occurrence of Görtler instability.
We investigate a bracketing property that purports to yield upper- and lower bounds on the treatment effects obtained from a fixed effects (FE) and lagged dependent variable (LDV) model. Referencing both analytical results and a Monte Carlo simulation, we explore the conditions under which the bracketing property holds, confirming this to be the case when the data generating process (DGP) is characterized by either unobserved heterogeneity or feedback effects from a lagged dependent variable. However, when the DGP is characterized by both features simultaneously, we find that bracketing of the treatment effect only holds under certain conditions—but not in general. Practitioners can nevertheless obtain the lower bound estimate by referencing a model that includes both FE and an LDV. While the Nickell bias in the coefficient of the LDV is known to be of order $1/T$, we show that the Nickell-type bias in the estimator of the treatment effect is of order $1/T^2$.
The supersonic wake of a circular cylinder in Mach 3 flow was studied through spectral proper orthogonal decomposition (SPOD) of high-speed focussing schlieren datasets. A wavenumber decomposition of the SPOD eigenvectors was found to be an effective tool for isolating imaging artefacts from the flow features, resulting in a clearer interpretation of the SPOD modes. The cylinder wake consists of both symmetric and antisymmetric instabilities, with the former being the dominant type. The free shear layers that form after the flow separates from the cylinder surface radiate strong Mach waves that interact with the recompression shocks to release significant disturbances into the wake. The wake shows a bimodal vortex shedding behaviour with a purely hydrodynamic instability mode around a Strouhal number of 0.2 and an aeroacoustic instability mode around Strouhal number of 0.42. The hydrodynamic mode, which is presumably the same as the incompressible case, is weaker and decays rapidly as the wake accelerates due to increasing compressibility. The aeroacoustic mode is the dominant shedding mode and persists farther into the wake because of an indirect energy input received through free-stream acoustic waves. A simple aeroacoustic feedback model based on an interaction between downstream propagating shear-layer instabilities and upstream propagating acoustic waves within the recirculation region is shown to accurately predict the shedding frequency. Based on this model, the vortex shedding in supersonic flows over a circular cylinder occurs at a universal Strouhal number (based on approach free-stream velocity and feedback path length) of approximately 0.3.