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The Columbia Suicide Severity Rating Scale (C-SSRS) is a predominant tool for screening and scoring suicidal ideation and behaviour to identify individuals at risk. No meta-analysis has examined its predictive significance.
Aims
To evaluate the C-SSRS assessment of suicidal ideation and suicidal behaviour as predictors of future fatal and non-fatal suicide attempts.
Method
A systematic search of Medline, PsycInfo, Embase, and Health and Psychosocial Instruments databases was conducted from January 2008 to February 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study was registered in PROSPERO (CRD42022361944). Two independent reviewers screened and extracted data, and assessed the risk of bias. Pooled odds ratios were calculated using random-effects models, and heterogeneity was assessed with the I2 statistic. Publication bias was evaluated with Egger’s test and funnel plots.
Results
The search identified 1071 unique records, of which 28 studies met inclusion criteria. The meta-analysis included 27 studies with independent samples. Suicidal behaviour (pooled odds ratio 3.14, 95% CI 1.86–5.31) and suicide attempts (pooled odds ratio 2.78, 95% CI 1.82–4.24) were predictors of future non-fatal suicide attempts. Suicidal ideation severity (odds ratio 1.46/point, 95% CI 1.28–1.77) was a stronger predictor of future non-fatal suicide attempts than suicideal ideation intensity (odds ratio 1.11/point, 95% CI 1.04–1.18). Two studies linked higher suicidal ideation severity and a history of suicidal behaviour with an increased risk of fatal suicide attempts, though meta-analysis was not feasible for only two studies.
Conclusions
Suicidal behaviour, suicide attempts and to a lesser extent suicidal ideation, identified using the C-SSRS, predicted future non-fatal suicide attempts. These findings support the use of the C-SSRS to detect individuals at higher-risk requiring enhanced preventive interventions.
Psychiatric disorders are highly heterogeneous. It is clinically valuable to distinguish psychiatric disorders by the presence or absence of a specific comorbid condition.
Methods
We employed a novel algorithm (CombGWAS) to decipher the genetic basis of psychiatric disorder combinations using genome-wide association studies summary statistics. We focused on comorbidities and combinations of diseases, such as schizophrenia (SCZ) with and without depression, which can be considered as two ‘subtypes’ of SCZ. We also studied psychiatric disorders comorbid with obesity as disease subtypes.
Results
We compared the genetic architectures of psychiatric disorders with and without specific comorbidities, identifying both shared and unique susceptibility genes/variants across 8 subtype pairs (16 entities). Despite high genetic correlations between subtypes, most subtype pairs exhibited distinct genetic correlations with the same cardiovascular disease (CVD). Some pairs even displayed opposite genetic correlations, especially those involving obesity. For instance, the genetic correlation (rg) between SCZ with obesity and type 2 diabetes (T2DM) was 0.248 (p = 4.42E−28), while the rg between SCZ without obesity and T2DM was −0.154 (p = 6.79E−12). Mendelian randomization analyses revealed that comorbid psychiatric disorders often have stronger causal effects on cardiovascular risks compared to single disorders, but the effects vary across psychiatric subtypes. Notably, obese and nonobese major depressive disorder/SCZ showed opposite causal effects on the risks of T2DM.
Conclusions
Our study provides novel insights into the genetic basis of psychiatric disorder heterogeneity, revealing unique genetic signatures across various disorder combinations. Notably, comorbid psychiatric disorders often showed different causal relationships with CVD compared to single disorders.
Cancer heterogeneity presents a major obstacle to effective drug treatment, emphasizing the need for personalized approaches that can accurately predict drug responses. Advances in high-throughput technologies have driven precision medicine initiatives toward integrating multi-omics data, enabling a more comprehensive understanding of tumor biology. However, integration of diverse omics layers poses challenges for computational modeling, as many traditional machine learning (ML) and statistical methods are not designed to capture complex, high-dimensional and multimodal data. This review examines the studies that integrate multi-omics datasets, aiming to enhance drug response prediction (DRP). Specifically, it outlines the most used omics types and computational approaches – classical ML models, as well as advanced deep learning and multimodal integration frameworks for improving DRP, detailing key methodologies and evaluation metrics, such as area under the dose–response curve, F1 score and mean square error, which assess model performance. By summarizing the integrated omics data, computational methods and challenges encountered, this review provides an in-depth overview of the existing landscape of precision medicine and future directions for advancing drug-response prediction.
What is the optimal level of questionnaire detail required to measure bilingual language experience? This empirical evaluation compares alternative measures of language exposure of varying cost (i.e., questionnaire detail) in terms of their performance as predictors of oral language outcomes. The alternative measures were derived from Q-BEx questionnaire data collected from a diverse sample of 121 heritage bilinguals (5–9 years of age) growing up in France, the Netherlands and the UK. Outcome data consisted of morphosyntax and vocabulary measures (in the societal language) and parental estimates of oral proficiency (in the heritage language). Statistical modelling exploited information-theoretic and cross-validation approaches to identify the optimal language exposure measure. Optimal cost–benefit was achieved with cumulative exposure (for the societal language) and current exposure in the home (for the heritage language). The greatest level of questionnaire detail did not yield more reliable predictors of language outcomes.
Pygoscelis penguins are valuable indicators of the effects of rapid warming in the Antarctic Peninsula. In the western Antarctic Peninsula, Adélie penguins show a declining population trend, whereas gentoo penguins are expanding. The notably low reproductive success of Adélie but not gentoo penguins at Ardley Island during the 2023/2024 breeding season provided an opportunity to explore the potential effects of weather conditions and food availability as possible determinants of reproductive output. We explore associations between reproductive output, air temperature, wind speed, wind chill temperature and accumulated rain and snow. As a proxy for food availability, we used data of penguins’ foraging trips, which reflect krill abundance. A late-winter storm at the end of October 2023 led to a record-low wind chill temperature and sustained snow cover, negatively affecting the number of eggs that hatched successfully and/or the number of chicks that survived the first days after hatching. The effects were similar for both species, yet for gentoo penguins chick survival in the late stage of the chick-rearing phase was remarkably higher, possibly due to high food availability and a longer nestling period. As previously suggested, the greater plasticity of gentoo penguins may allow them to mitigate the negative effects of environmental variability, potentially explaining this divergent breeding success despite unusually harsh meteorological conditions.
This article analyses the activities conducted by the Banca Nazionale del Lavoro (BNL) in Spain between 1936 to 1943 to understand Italian policy towards the Francoist regime during that period. In doing so, this piece argues that it is important to adopt a political economy approach that looks at production, trade and industrial investments, always in relation to politics, diplomacy, law, culture and government. In fact, this article establishes that, for the main actors in Rome at the time, all these considerations were inseparable when it came to the Italian policy towards Franco’s Spain. Furthermore, I argue that the BNL initiatives are better understood when situated within the larger history of the Fascist regime in Italy and its imperialistic policies in the Mediterranean area.
The EU has been represented as a singular ‘Digital Empire’ speaking with one voice on matters of EU digital regulation. Closer examination of discrete areas of EU digital regulation reveals a more nuanced picture suggesting clear institutional divergence between the EU institutions regarding the substantive protection afforded by EU law. A detailed analysis of EU data protection adequacy decisions brings to the surface intra-EU tensions concerning the substance of core EU fundamental rights. This analysis reveals that the EU Commission has taken on a more prominent role in adequacy decision-making since the entry into force of the EU’s General Data Protection Regulation at the expense of other relevant stakeholders. Furthermore, the Commission’s decisional practice does not align fully with the stance of the Court of Justice on the right to data protection. New sites of intra-EU human rights tensions are therefore uncovered with consequences for the legitimacy of the EU as a digital regulator and the role of the Commission as a guardian of the treaties.
The Stable Roommates problems are characterized by the preferences of agents over other agents as roommates. A solution is a partition of the agents into pairs that are acceptable to each other (i.e., they are in the preference lists of each other), and the matching is stable (i.e., there do not exist any two agents who prefer each other to their roommates and thus block the matching). Motivated by real-world applications, and considering that stable roommates problems do not always have solutions, we continue our studies to compute “good-enough” matchings. In addition to the agents’ habits and habitual preferences, we consider their networks of preferred friends and introduce a method to generate personalized solutions to stable roommates problems. We illustrate the usefulness of our method with examples and empirical evaluations.
Building on previous scholarship on “genetic capital” and the politicization of animal economies, this paper examines how animal breeds and their transnational movement became geopolitical issues in late seventeenth- and eighteenth-century Europe. In particular, it examines how the French government’s efforts to emulate English and Spanish wool pro-duction, and to overcome the economic advantage stemming from its rivals’ superior sheep breeds, intensified in the wake of the Seven Years’ War (1756–1763). Despite bans on the exportation of live sheep from Britain and Spain, the French strove to improve their flocks through illicit imports and diplomatic agreements. These efforts culminated in the 1760s, as the Bureau of Commerce began to collaborate with agriculturalists, naturalists, diplomats, and smugglers to bring superior breeds of sheep across the Anglo-French maritime border and the Pyrenean frontier with Spain. These projects developed in tandem with new conceptions of the permanence of race and breed, according to which animals would retain their characteristics in new climates and environments. Combining perspectives from economic, agricultural, political, and cultural history, this article uses the concept of animal mercantilism to open up the geopolitical stakes inherent in understandings of animals, race, and climate.
Two months after its premiere in Leipzig, Ernst Krenek’s Leben des Orest (1930) came to the Berlin Kroll Opera, a notorious centre for experimental, modernist productions. Inevitably, critics compared the two productions, much to the Berlin production’s detriment. In particular, critics faulted the Berlin stage designs by Greek-Italian painter Giorgio de Chirico. I argue that this reception reflected a fundamental divergence in Krenek and de Chirico’s neoclassicism, which was only exacerbated by how neither Krenek nor de Chirico’s neoclassicism aligned with pre-existing expectations about the Kroll Opera’s production aesthetic, as exemplified in Igor Stravinsky’s Oedipus Rex (staged at the Kroll in 1928). Attending to these differences not only explains the troubled reception of Leben des Orest at the Kroll, but also provides fertile ground to examine the complicated and sometimes contradictory meanings ascribed to neoclassicism in the interwar period, especially as it moved between media and across national borders.
Novel utility computing paradigms rely upon the deployment of multi-service applications to pervasive and highly distributed cloud-edge infrastructure resources. Deciding onto which computational nodes to place services in cloud-edge networks, as per their functional and non-functional constraints, can be formulated as a combinatorial optimisation problem. Most existing solutions in this space are not able to deal with unsatisfiable problem instances, nor preferences, i.e., requirements that DevOps may agree to relax to obtain a solution. In this article, we exploit Answer Set Programming optimisation capabilities to tackle this problem. Experimental results in simulated settings show that our approach is effective on lifelike networks and applications.
We present the first results from the COS-EDGES survey, targeting the kinematic connection between the interstellar medium and multi-phase circumgalactic medium (CGM) in nine isolated, near-edge-on galaxies at $z\sim0.2$, each probed along its major axis by a background quasar at impact parameters of $D=13-38$ kpc. Using VLT/UVES and HST/COS quasar spectra, we analyse Mgi, Mgii, Hi, Cii, Ciii, and Ovi absorption relative to galaxy rotation curves from Keck/LRIS and Magellan/MagE spectra. We find that low ionisation absorption for 8/9 galaxies lies below the halo escape velocity, indicating bound inflow or recycling gas, while 6/9 galaxies have high ionisation gas reaching above the halo escape velocity, suggesting some unbound material. We find that at lower $D/R_{\textrm{vir}}$ ($0.12\leq D/R_{\textrm{vir}} \leq0.20$), over 80% of absorption in all ions lies on the side of systemic velocity matching disk rotation, and the optical-depth–weighted median velocity ($v_{abs}$) is consistent with the peak rotation speed. At higher $D/R_{\textrm{vir}}$ ($0.21\leq D/R_{\textrm{vir}} \leq0.31$), the kinematics diverge by ionisation state: For the low ionisation gas, the amount of co-rotating absorption remains above 80%, yet $v_{abs}$ drops to roughly 60% of the galaxy rotation speed. For the high ionisation gas (Ovi), only 60% of the absorption is consistent with co-rotation and $v_{abs}$ drops to 20% of the galaxy rotation speed. Furthermore, the velocity widths, corresponding to 50% of the total optical depth ($\Delta v_{50}$) for low ionisation gas is up to 1.8 times larger in the inner halo than at larger radii, while for Ciii and Ovi$\Delta v_{50}$ remains unchanged with distance. The 90% optical-depth width ($\Delta v_{90}$) shows a modest decline with radius for low ionisation gas but remains constant Ciii and Ovi. At high $D/{R}_{\textrm{vir}}$, both $\Delta v_{50}$ and $\Delta v_{90}$ increase with ionisation potential. These results suggest a radially dependent CGM kinematic structure: the inner halo hosts cool, dynamically broad gas tightly coupled to disk rotation, whereas beyond $\gtrsim 0.2 R_{\textrm{vir}}$, particularly traced by Ovi and Hi, the CGM shows weaker rotational alignment and lower relative velocity dispersion. Therefore, low-ionisation gas likely traces extended co-rotating gas, inflows and/or recycled accretion, while high-ionisation gas reflects a mixture of co-rotating, lagging, discrete collisionally ionised structures and volume-filling warm halo, indicating a complex kinematic stratification of the multi-phase CGM.
Individuals with a family history of bipolar disorder are at increased risk of developing affective psychopathology. Longitudinal imaging studies in young people with familial risk have been limited, and cortical developmental trajectories in the progression towards illness remain obscure.
Aims
To establish high-resolution longitudinal differences in cortical structure that are associated with risk of bipolar disorder.
Method
Using structural magnetic resonance imaging data from 217 unrelated ‘Bipolar Kids and Sibs study’ participants (baseline n = 217, follow-up n = 152), we examined changes over a 2-year period in cortical area, thickness and volume, measured at each vertex across the cortical surface. Groups comprised 105 ‘high-risk’ participants with a first-degree relative with bipolar disorder (female n = 64; age in years: M (mean) = 20.9, s.d. = 5.5) and 112 controls with no familial psychiatric history (females n = 60; age in years: M = 22.4, s.d. = 3.7).
Results
Accelerated thickness and volume reductions over time were observed in ‘high-risk’ individuals across multiple cortical regions, relative to controls, including right lateral orbitofrontal thickness (β = 0.033, P < 0.001) and inferior frontal volume (β = 0.021, P < 0.001). These differences were observed after controlling for age, sex, ancestry, current medication status, lifetime psychiatric diagnoses and measures of gross brain morphology.
Conclusions
Longitudinal group differences suggest the presence of thicker cortex in familial ‘high-risk’ individuals at earlier developmental stages, followed by accelerated thinning towards the typical age of bipolar disorder onset. Future examination of genetic and environmental components of familial risk and the mechanistic nature (pathological or protective) of cortical-trajectory differences over time may facilitate the identification of prodromal biomarkers and opportunities for early clinical intervention.
Loneliness is a common public health concern, particularly among mid- to later-life adults. However, its impact on early mortality (deaths occurring before reaching the oldest old age of 85 years) remains underexplored. This study examined the predictive role of loneliness on early mortality across different age groups using data from the Health and Retirement Study (HRS).
Methods
A retrospective cohort study was conducted using data from the 2010–2020 waves of the HRS, restricted to participants aged 50–84 years at baseline. Loneliness was measured using the 11-item UCLA Loneliness Scale, categorized into four levels: low/no loneliness (scores 11–13), mild loneliness (14–16), moderate loneliness (17–20) and severe loneliness (21–33). Cox proportional hazards models and time-varying Cox regression models with age as the time scale were created to evaluate the relationship between loneliness and early mortality, adjusting for sociodemographic, lifestyle, and physical and mental health factors.
Results
Among 6,392 participants, the overall mortality rate before the age of 85 years was 19.1 per 1,000 person-years. A dose–response relationship was observed, with moderate and severe loneliness associated with 23% (adjusted hazard ratio [aHR]: 1.23, 95% confidence interval [CI] = 1.02–1.48) and 36% (aHR: 1.36, 95% CI = 1.13–1.65) higher mortality risk, respectively. Significant associations existed for the 65–74-year-old (aHR = 1.37, 95% CI = 1.03–1.83) and 75–84-year-old (aHR = 1.77, 95% CI = 1.23–2.56) age groups in the fully-adjusted models, but not for the 50–64-year-old age group. Time-varying Cox models showed a stronger association for severe loneliness (aHR = 1.65, 95% CI = 1.37–1.99).
Conclusions
Loneliness is a significant predictor of mortality among older adults. Preventive and interventional programs targeting loneliness may promote healthy ageing.
A growing literature explores the representational detail of infants’ early lexical representations, but no study has investigated how exposure to real-life acoustic-phonetic variation impacts these representations. Indeed, previous experimental work with young infants has largely ignored the impact of accent exposure on lexical development. We ask how routine exposure to accent variation affects 6-month-olds’ ability to detect mispronunciations. Forty-eight monolingual English-learning 6-month-olds participated. Mono-accented infants, exposed to minimal accent variation, detected vowel mispronunciations in their own name. Multi-accented infants, exposed to high levels of accent variation, did not. Accent exposure impacts speech processing at the earliest stages of lexical acquisition.
While associations of ultra-processed food (UPF) consumption with adverse health outcomes are accruing, its environmental and food biodiversity impacts remain underexplored. This study examines associations between UPF consumption and dietary greenhouse gas emissions (GHGe), land use and food biodiversity.
Design:
Prospective cohort study. Linear mixed models estimated associations between UPF intake (g/d and kcal/d) and GHGe (kg CO2-equivalents/day), land use (m2/d) and dietary species richness (DSR). Substitution analyses assessed the impact of replacing UPF with unprocessed or minimally processed foods.
Participants:
368 733 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.
Setting:
Europe.
Results:
Stronger associations were found for UPF consumption in relation with GHGe and land use compared with unprocessed or minimally processed food consumption. Substituting UPF with unprocessed or minimally processed foods was associated with lower GHGe (8·9 %; 95 % CI: –9·0, –8·9) and land use (9·3 %; –9·5; –9·2) when considering consumption by gram per day and higher GHGe (2·6 %; 95 % CI: 2·5, 2·6) and land use (1·2 %; 1·0; 1·3) when considering consumption in kilocalories per day. Substituting UPF by unprocessed or minimally processed foods led to negligible differences in DSR, both for consumption in grams (–0·1 %; –0·2; –0·1) and kilocalories (1·0 %; 1·0; 1·1).
Conclusion:
UPF consumption was strongly associated with GHGe and land use as compared with unprocessed or minimally processed food consumption, while associations with food biodiversity were marginal. Substituting UPF with unprocessed or minimally processed foods resulted in differing directions of associations with environmental impacts, depending on whether substitutions were weight or energy based.
Situated at the junction of Cognitive Semantics and Experimental Phenomenology, this study investigates how participants perceive the structure of 18 perceptual dimensions of opposites across the visual, auditory, tactile, gustatory and olfactory sensory modalities. The structures include three components: two poles (high; low) and an intermediate (neither high nor low). Participants were asked to provide examples of contexts for each dimension for which they could experience the five sensory modalities and then describe their experiences of the structures with respect to whether the poles were experienced as a single property (Point), or a range of properties with or without a precise limit (Bounded Range or Unbounded Range respectively). For the intermediate region, they described if they experienced a single property (Point) or many (Range) or none (No Intermediates). The study centres on two main questions. Is the perceptual structure invariant across the sensory modalities? If not, how do the structures differ? The study shows that the overall structure of all dimensions was stable in at least two of the modalities, and many structures were stable across more than two modalities. Stability was particularly pertinent across the visual and tactile modalities, and the gustatory and olfactory modalities.
Despite its geographic correspondence with a key fourteenth-century BC port, the tell of Yavneh-Yam has yielded only meagre evidence for Late Bronze Age occupation. The recent discovery of a sealed monumental rock-cut burial cave with hundreds of grave goods provides the first clear evidence for a significant polity.