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Mood disorders are among the leading causes of disease burden worldwide, with 20–70% of affected individuals experiencing comorbid premenstrual disorders. This systematic review and meta-analysis investigated the comorbidity of premenstrual dysphoric disorder (PMDD) or premenstrual syndrome (PMS) with non-reproductive mood disorders.
Aims
We aimed to determine the pooled prevalence of PMDD/PMS with adult mood disorders, assess the impact of comorbidity on clinical course and summarise the associated neurobiological findings.
Method
Eligible studies were identified through Embase, MEDLINE and APA PsycINFO from inception to 22 January 2024 (PROSPERO, no. CRD42021246796). Studies on women (‘females‘) with diagnoses of PMDD/PMS and mood disorders were included. Risk of bias was assessed using National Institutes of Health quality assessment tools. A random-effects, pooled-prevalence meta-analysis was conducted using the Comprehensive Meta-Analysis software, categorising diagnostic sampling strategies as follows: mood disorders diagnosed first, PMDD/PMS diagnosed first or concurrent diagnoses. A narrative synthesis explored secondary outcomes, including illness course and biomarkers.
Results
A total of 39 studies were included, with 36 of these (n = 3646) contributing to the meta-analysis. Seven studies focused on bipolar disorders, 18 on unipolar depressive disorders and 14 on mixed samples of bipolar and unipolar disorders. Random-effects pooled-prevalence meta-analyses showed consistently high comorbidity rates between PMDD/PMS and mood disorders, ranging from 42% (95% CI: 30%, 55%) to 49% (95% CI: 38%, 60%) across sampling strategies. Risk of bias varied, with methodological heterogeneity noted.
Conclusions
This review underscores high comorbidity rates between PMDD/PMS and mood disorders, regardless of sampling strategy, and highlights the need for research into clinical and neurobiological characteristics specific to this comorbidity. Limitations include study heterogeneity, reliance on cross-sectional designs and provisional PMDD/PMS diagnoses. Future research should address these gaps to inform diagnostic and therapeutic advancements tailored to this population.
In individuals with irritable bowel syndrome (IBS), eliminating dietary triggers can alleviate symptoms but may lead to nutrient deficiencies and overall health decline. Although various nutritional supplements show promising results in relieving IBS symptoms due to their potential to alter the microbiome, conclusive scientific evidence remains lacking. This exploratory study aims to assess the bifidogenic properties of four nutritional supplement interventions and their impact on IBS-symptoms, faecal microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, stool pattern, and quality of life (QoL), compared to a placebo control. Seventy subjects with IBS, meeting the ROME IV criteria, participated in this randomised, double-blind, placebo-controlled parallel intervention study. Subjects were assigned to one of the four treatment groups, receiving either resistant starch, pea fibre, chondroitin sulfate, protein hydrolysate, or placebo daily for four weeks. Daily reports on stool pattern and gastrointestinal complaints were collected. Stool samples and questionnaires on dietary intake, symptom severity, QoL, and anxiety and depression were collected at baseline and after the 4-week intervention. The results show no significant increase in Bifidobacterium abundance or faecal SCFA levels after the 4-week intervention with any of the four nutritional supplement interventions. While some improvements in symptom severity and QoL were observed within-groups, these were not significantly different from changes observed with placebo. In conclusion, the tested nutritional supplements did not increase Bifidobacterium abundance in subjects with IBS within four weeks. Furthermore, we conclude that future studies should consider a run-in period and a larger sample size to study improvements in IBS symptoms.
South Dakota, home to nine federally and state-recognized tribes, bears witness to a rich Native American history that predates colonialism. Yet, the representation of Native Americans in institutional archives remains sparse, often curated through the lens of non-Native creators. Addressing this gap involved a collaborative effort among Augustana University, Native American students from a federally funded tribal boarding school, and a regional cultural institution to facilitate the reclamation of archival narratives and the re-presentation of Native American histories through an innovative public humanities initiative. This project aimed to re-present archival material through creative interventions by young Native American artists, adhering to the First Nations principles of ownership, control, access, and possession. By transforming existing archival material into new artworks, the project fostered a deeper understanding of Native American history and its contemporary implications. Public exhibitions of these reinterpretations facilitated engagement with historical traumas and challenged normative perceptions of Native American experiences. The interdisciplinary approach highlighted the importance of Native American agency in curatorial processes, resulting in reflective public exhibitions. This project exemplifies how public humanities research can bridge historical gaps, support cultural recognition, and facilitate the reclamation of institutionalized narratives.
We explore an overlooked phenomenon in mortgage markets: repayment of underwater mortgages. Using a sample of mortgages terminated between 2007 and 2016, we show that such repayment indeed occurs, and that it is affected by the same factors commonly used in studies of default: the magnitude of home equity and the borrower’s credit score, which captures default cost as well as liquidity. A novel insight is that underwater repayers, unlike most defaulters, are not liquidity constrained, providing a much cleaner environment to study default costs. We estimate lower bounds on these costs. Our results indicate that default costs are substantial.
We present a financial justification for an outpatient infectious diseases pharmacist, based on cost savings from decreases in length of stay for patients with Staphylococcus aureus infections and additional revenue generated by physicians and pharmacists while following patients discharged on outpatient parenteral antimicrobial therapy.
One of the fundamental challenges for the UN plastics treaty is to shift the current linear plastic economy into a more circular plastic economy. Transitioning to a circular plastic economy requires a profound transformation of socio-technical systems, and research suggests that disruptive policies must simultaneously destabilize the entrenched linear system and cultivate a new regime that supports circular business models. A major barrier to this transformation lies in the artificially low cost of primary plastics, maintained by substantial subsidies for fossil fuels and plastic production. These subsidies, alongside the failure to internalize negative externalities – such as extensive health impacts and environmental damage – mask the true cost of plastic use, thereby undermining the economic case for innovation in sustainable alternatives. The upcoming UN plastics treaty presents a unique opportunity to realign market incentives and drive the necessary transition toward a circular, regenerative plastic economy.
Although many contemporary theologians and philosophers of religion distinguish between ‘idolatry’ in a general sense and ‘conceptual idolatry’ as a distinct error, close attention to theorists of idolatry shows that ‘conceptual idolatry’ should not be considered distinct from idolatry proper. After discussing the relation between concepts and idolatry in key thinkers from the phenomenological and grammatical traditions, this article discusses analytic attempts to understand idolatry, showing how each falls short.
Ultimately, attention to the category of ‘conceptual idolatry’ shows the deficiencies present in contemporary framings of idolatry simpliciter. This article concludes with a proposal for a new framework by which to understand the dispute about idolatry: turning away from the question of whether we are worshipping the right God, towards the question of how God might (and might not) become apt to human thought and speech.
We propose a novel micro-level Cox model for incurred but not reported (IBNR) claims count based on hidden Markov models. Initially formulated as a continuous-time model, it addresses the complexity of incorporating temporal dependencies and policyholder risk attributes. However, the continuous-time model faces significant challenges in maximizing the likelihood and fitting right-truncated reporting delays. To overcome these issues, we introduce two discrete-time versions: one incorporating unsystematic randomness in reporting delays through a Dirichlet distribution and one without. We provide the EM algorithm for parameter estimation for all three models and apply them to an auto-insurance dataset to estimate IBNR claim counts. Our results show that while all models perform well, the discrete-time versions demonstrate superior performance by jointly modeling delay and frequency, with the Dirichlet-based model capturing additional variability in reporting delays. This approach enhances the accuracy and reliability of IBNR reserving, offering a flexible framework adaptable to different levels of granularity within an insurance portfolio.
Prospective memory (PM) relies on switching processes to change from the ongoing activity to the future intention. Similarly, bilinguals in dual-language contexts are frequently required to switch between languages. In this study, we experimentally simulated the exposure to a dual-language context in a sample of single-language context bilinguals to explore the effect of language switching on PM. Thus, a group of bilinguals practiced language switching previous to the PM task (practice group) and were compared to a homologous group that did not receive this practice (control group). Event-related potential results indicated that the practice group showed greater wave amplitudes than the control group in the components associated to monitoring and switching processes. Whereas, this practice did not affect the retrospective components associated with the retrieval of the intention. This suggested that the interactional context in which bilinguals are immersed modulates their cognitive control strategies in charge of recalling future intentions.
This paper studies public opinion towards the introduction of a universal basic income in the case of Germany. Using novel data from a vignette survey experiment conducted in the summer of 2022, we analyse to what extent variations in the policy design characteristics of a hypothetical basic income scheme affect levels of support. We find that support for basic income strongly depends on these characteristics, with support being highest for schemes that are relatively generous, paid to citizens and long-term residents, paid to individuals rather than households, unconditional and financed with taxing the rich. In a further step, we explore interaction effects between vignette dimensions and respondent characteristics, finding significant heterogenous treatment effects in the cases of income, age and ideology.
Coarctation of the aorta is characterised by narrowing of the descending aorta and is a rare cause of secondary hypertension in children and young adults. The aortic stenosis lesion is in a special location with severe consequences, and long-term survival is very low, with high rates of disability and mortality, and can be challenging to detect due to its few clinical manifestations. We report a case of a young patient with atrial fibrillation, renal infarction, and acute cerebral infarction, which are consequences of untreated hypertension due to coarctation of the aorta. The purpose of this report is to emphasize the importance of early diagnosis and management of coarctation of the aorta as a cause of secondary hypertension in children and young adults.
Respiratory syncytial virus (RSV), although frequently reported in pediatric populations, is also associated with significant morbidity and mortality in vulnerable adults. From an Infection Control perspective, it is therefore of particular concern in hospital and long-term care settings.
Objective:
We report an RSV outbreak that occurred in the memory care unit of a Veterans Affairs-affiliated long-term care facility where the characteristics of the resident population posed unique challenges to halting transmission.
Setting:
The outbreak occurred in a 30-bed unit within a 230-bed Veterans Affairs-affiliated long-term care facility in Florida.
Methods:
An investigation was performed in coordination with the local Department of Health. All residents on the affected unit had dementia with resulting difficulty participating in infection prevention measures, including isolation, masking, and hand hygiene. Interventions implemented included twice weekly RSV testing, enhanced cleaning protocols, staggered mealtimes/outdoor dining, and cancellation of group activities, visitations, and new admissions. A retrospective case–control study was performed to assess for potential risk factors for acquiring RSV.
Results:
Over a 21-day period in 2022, 20 out of 29 residents tested positive for RSV within the affected unit. No other units were involved. Univariate analysis did not find any statistically significant risk factors for acquiring RSV infection, although small sample size may have impacted the results.
Conclusions:
A multifaceted approach was ultimately successful in preventing ongoing transmission of RSV within and beyond the unit. The infection control techniques utilized in this unique patient population could potentially be applicable to challenging outbreak situations at other facilities.
A museum should be a place where cultures, dialogue, and social relations are enhanced. Given the renewed public interest in the topic, the author poses the question: Is there a need and a possibility to decolonize ethnographic museums? Should we have common and shared practices? In an attempt to eliminate colonial vestiges in museums, an analysis of literature and practices leads the author to analyze five European ethnographic museums in order to understand their merits and shortcomings. The subjectivity of these institutions and the diversity with which colonization can be presented makes the proposal of a single generalized solution not preferable. An objective analysis, based on actions and variables, drives the author to determine, however, that in order to revitalize museum practices, there is a need to create a sharable framework. The design of minimum standards can help museums set clear and measurable goals to achieve a higher level of decolonization.
This letter investigates the electoral effects of symbolic class signalling through ‘cultural consumption’ in contemporary politics. We explore how politicians referring to an activity related to class-specific ‘cultural consumption’ – drinking beer in a pub or listening to classical music with a glass of wine – appeals to voters. We argue that symbolic class signalling has gained in importance due to the political realignment along the cultural dimension, and we expect radical right parties to benefit most from it. Our conjoint survey experiment with 1,550 respondents in Switzerland in January/February 2023 confirms our expectation. While many voters are biased against politicians claiming to enjoy classical music and wine, politicians drinking beer in a pub appeal particularly to radical right working-class voters without tertiary education. These findings contribute to our understanding of the role of symbolic politics and class identity in times of political transformation.
The physical fidelity of turbulence models can benefit from a partial resolution of fluctuations, but doing so often comes with an increase in computational cost. To explore this trade-off in the context of wall-bounded flows, this paper introduces a framework for turbulence-resolving integral simulations (TRIS) with the goal of efficiently resolving the largest motions using a two-dimensional, three-component representation of the flow defined by instantaneous wall-normal integrals of velocity and pressure. Self-sustaining turbulence with qualitatively realistic large-scale structures is demonstrated for TRIS on an open-channel (half-channel) flow configuration using moment-of-momentum integral equations derived from Navier–Stokes with relatively simple closure approximations. Evidence from direct numerical simulations (DNS) suggests that TRIS can theoretically resolve $35\,\%{-}40\,\%$ of the turbulent skin friction enhancement for friction Reynolds numbers between $180$ and $5200$, without a noticeable decrease or increase as a function of Reynolds number. The current implementation of TRIS can match this resolution while simulating one flow through time in ${\sim}1$ minute on a single processor, even for very large Reynolds numbers. The framework facilitates a detailed apples-to-apples comparison of predicted statistics against data from DNS. Comparisons at friction Reynolds numbers of $395$ and $590$ show that TRIS generates a relatively accurate representation of the flow, while highlighting discrepancies that demonstrate a need for improving the closure models. The present results for open-channel flow represent a proof of concept for TRIS as a new approach for wall-bounded turbulence modelling, motivating extension to more general flow configurations such as boundary layers on immersed objects.
Rapid molecular diagnostics, such as the BIOFIRE® Blood Culture Identification 2 (BCID2) panel, have improved the time to pathogen identification in bloodstream infections. However, accurate interpretation and antimicrobial optimization require Infectious Disease (ID) expertise, which may not always be readily available. GPT-powered chatbots could support antimicrobial stewardship programs (ASPs) by assisting non-specialist providers in BCID2 result interpretation and treatment recommendations. This study evaluates the performance of a GPT-4 chatbot compared to ASP prospective audit and feedback interventions.
Methods:
This prospective observational study assessed 43 consecutive real-world cases of bacteremia at a 399-bed VA Medical Center from January to May 2024. The GPT-chatbot utilized “chain-of-thought” prompting and external knowledge integration to generate recommendations. Two independent ID physicians evaluated chatbot and ASP recommendations across four domains: BCID2 interpretation, source control, antibiotic therapy, and additional diagnostic workup. The primary endpoint was the combined rate of harmful or inadequate recommendations. Secondary endpoints assessed the rate of harmful or inadequate responses for each domain.
Results:
The chatbot had a significantly higher rate of harmful or inadequate recommendations (13%) compared to ASP (4%, p = 0.047). The most significant discrepancy was observed in the domain of antibiotic therapy, where harmful recommendations occurred in up to 10% (p <0.05) of chatbot evaluations. The chatbot performed well in BCID2 interpretation (100% accuracy) but provided more inadequate responses in source control consideration (10% vs. 2% for ASP, p = 0.022).
Conclusions:
GPT-powered chatbots show potential for supporting antimicrobial stewardship but should only complement, not replace, human expertise in infectious disease management.
Many philosophers think that doing philosophy cultivates valuable intellectual abilities and dispositions. Indeed this is a premise in a venerable argument for philosophy’s value. Unfortunately, empirical support for this premise has heretofore been lacking. We provide evidence that philosophical study has such effects. Using a large dataset (including records from over half a million undergraduates at hundreds of institutions across the United States), we investigate philosophy students’ performance on verbal and logical reasoning tests, as well as measures of valuable intellectual dispositions. Results indicate that students with stronger verbal abilities, and who are more curious, open-minded, and intellectually rigorous, are more likely to study philosophy. Nonetheless, after accounting for such baseline differences, philosophy majors outperform all other majors on tests of verbal and logical reasoning and on a measure of valuable habits of mind. This offers the strongest evidence to date that studying philosophy does indeed make people better thinkers.
We explore the role that large fires played in the early development of the Japanese fire insurance industry. Using a prefecture-level data set spanning 30 years, our econometric analysis shows that large fires led to an increase in new policies and policy renewals, consistent with historical narratives that insurance companies used these events to advertise their business. We also show that this subsequent surge in policies led to more small fires due to arson. Anecdotal evidence suggests that it is more likely to have been due to moral hazard rather than adverse selection.
We assessed patient experience of care, comparing current and past smokers, and whether frequency of advice to quit smoking impacts patient rating of care.
Background:
Experience of care may be a concern for people who smoke and affect their partnership with healthcare providers.
Methods:
We surveyed adults aged over 35 years who had visited a general practitioner (GP) for health care in the past year (n = 611 current and n = 275 ex-smokers). Questions assessed smoking history, experience of care, anticipation of stigma, and perceptions of smoking cessation advice received in general practice.
Findings:
Fewer than half (48.8%) of current smokers reported ‘always’ or ‘usually’ being advised to quit smoking, or being advised in a way that motivated them to quit by a GP or other care provider at their GP practice. Current smokers tended to delay or avoid help seeking when needed and experienced more anticipation of stigma in healthcare settings. Conversely, respondents who reported being advised to quit more frequently rated overall quality of care more highly. These data show that asking about smoking and providing advice to quit smoking was acceptable to most respondents and associated with higher ratings of quality of care. However, advice should be provided in a way that motivates patients, without exacerbating the stigma associated with smoking, which may impact help seeking.