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Different agencies have emphasized the need to evaluate current serological methods for screening patients with suspected urogenital schistosomiasis. However, there is still a lack of evidence regarding the most appropriate methods for this purpose. Here we assessed the diagnostic efficacy of a newly developed serological technique that utilizes the recombinant protein Sh-TSP-2, applied to the urine and serum of migrants suspected of having urogenital schistosomiasis. The sensitivity, specificity, positive and negative predictive values of an in-house enzyme-linked immunosorbent assay (ELISA) using the recombinant protein Sh-TSP-2 were analysed and compared with other commercial serological methods. Due to the limitations of microscopy as a perfect reference method, a latent class analysis (LCA) and composite reference standard (CRS) approach was used to determine the sensitivity and specificity of each test. According to the LCA model, the commercial tests NovaLisa® and immunochromatography test (ICT) immunoglobulin G–immunoglobulin M (IgG–IgM) presented the highest sensitivity (100%), whereas the Sh-TSP-2 serum ELISA test had 79.2%. The Sh-TSP-2 urine and serum ELISA tests had the highest specificities among the serological methods (87.5 and 75%, respectively). CRS modelling showed that the ICT IgG–IgM, NovaLisa® and Sh-TSP-2 serum tests led in sensitivity at 97.1, 88.6 and 71.4%, respectively, with all tests except that the ICT IgG–IgM test having a specificity >90%. Sh-TSP-2 has been validated as a screening tool for patients suspected of having urogenital schistosomiasis. Although commercial serological tests have shown higher sensitivities, Sh-TSP-2 could be valuable for confirming results from tests with lower specificity. Nevertheless, further studies with larger patient cohorts are necessary to fully verify its potential.
In this paper, we construct interpretable zero-inflated neural network models for modeling hospital admission counts related to respiratory diseases among a health-insured population and their dependants in the United States. In particular, we exemplify our approach by considering the zero-inflated Poisson neural network (ZIPNN), and we follow the combined actuarial neural network (CANN) approach for developing zero-inflated combined actuarial neural network (ZIPCANN) models for modeling admission rates, which can accommodate the excess zero nature of admission counts data. Furthermore, we adopt the LocalGLMnet approach (Richman & Wüthrich (2023). Scandinavian Actuarial Journal, 2023(1), 71–95.) for interpreting the ZIPNN model results. This facilitates the analysis of the impact of a number of socio-demographic factors on the admission rates related to respiratory disease while benefiting from an improved predictive performance. The real-life utility of the methodologies developed as part of this work lies in the fact that they facilitate accurate rate setting, in addition to offering the potential to inform health interventions.
Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact.
Methods:
We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations.
Results:
BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI.
Conclusions:
We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.
Only a limited number of patients with major depressive disorder (MDD) respond to a first course of antidepressant medication (ADM). We investigated the feasibility of creating a baseline model to determine which of these would be among patients beginning ADM treatment in the US Veterans Health Administration (VHA).
Methods
A 2018–2020 national sample of n = 660 VHA patients receiving ADM treatment for MDD completed an extensive baseline self-report assessment near the beginning of treatment and a 3-month self-report follow-up assessment. Using baseline self-report data along with administrative and geospatial data, an ensemble machine learning method was used to develop a model for 3-month treatment response defined by the Quick Inventory of Depression Symptomatology Self-Report and a modified Sheehan Disability Scale. The model was developed in a 70% training sample and tested in the remaining 30% test sample.
Results
In total, 35.7% of patients responded to treatment. The prediction model had an area under the ROC curve (s.e.) of 0.66 (0.04) in the test sample. A strong gradient in probability (s.e.) of treatment response was found across three subsamples of the test sample using training sample thresholds for high [45.6% (5.5)], intermediate [34.5% (7.6)], and low [11.1% (4.9)] probabilities of response. Baseline symptom severity, comorbidity, treatment characteristics (expectations, history, and aspects of current treatment), and protective/resilience factors were the most important predictors.
Conclusions
Although these results are promising, parallel models to predict response to alternative treatments based on data collected before initiating treatment would be needed for such models to help guide treatment selection.
Fewer than half of patients with major depressive disorder (MDD) respond to psychotherapy. Pre-emptively informing patients of their likelihood of responding could be useful as part of a patient-centered treatment decision-support plan.
Methods
This prospective observational study examined a national sample of 807 patients beginning psychotherapy for MDD at the Veterans Health Administration. Patients completed a self-report survey at baseline and 3-months follow-up (data collected 2018–2020). We developed a machine learning (ML) model to predict psychotherapy response at 3 months using baseline survey, administrative, and geospatial variables in a 70% training sample. Model performance was then evaluated in the 30% test sample.
Results
32.0% of patients responded to treatment after 3 months. The best ML model had an AUC (SE) of 0.652 (0.038) in the test sample. Among the one-third of patients ranked by the model as most likely to respond, 50.0% in the test sample responded to psychotherapy. In comparison, among the remaining two-thirds of patients, <25% responded to psychotherapy. The model selected 43 predictors, of which nearly all were self-report variables.
Conclusions
Patients with MDD could pre-emptively be informed of their likelihood of responding to psychotherapy using a prediction tool based on self-report data. This tool could meaningfully help patients and providers in shared decision-making, although parallel information about the likelihood of responding to alternative treatments would be needed to inform decision-making across multiple treatments.
The history of agricultural terraces remains poorly understood due to problems in dating their construction and use. This has hampered broader research on their significance, limiting knowledge of past agricultural practices and the long-term investment choices of rural communities. The authors apply OSL profiling and dating to the sediments associated with agricultural terraces across the Mediterranean region to date their construction and use. Results from five widely dispersed case studies reveal that although many terraces were used in the first millennium AD, the most intensive episodes of terrace-building occurred during the later Middle Ages (c. AD 1100–1600). This innovative approach provides the first large-scale evidence for both the longevity and medieval intensification of Mediterranean terraces.
The ‘jumping to conclusions’ (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ.
Methods
A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia.
Results
The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI −0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25–0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = −1.7, 95% CI −2.8 to −0.5, p = 0.006), but did not relate to delusions in patients.
Conclusions
Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.
Micropaleontological and geochemical data were applied to sediments from southeastern Brazil to study the hydrodynamics associated with the Holocene sea level rise. Sediment cores were taken around Vitória Bay, examined for dinoflagellate cysts and subjected to isotopic analysis. The cyst assemblage mainly dominated by autotrophic species most notably O. centrocarpum, L. machaerophorum and T. vancampoae. The influence of the marine transgression and subsequent regression observed during the Holocene along the coast of Brazil could have initially favored the establishment of an oligotrophic and higher energy environment. The inflow of continental water from tributaries combined with a higher inflow of saline water into the estuarine system could have favored the establishment and subsequent deposition of the dinocysts.
Depressive symptoms show different trajectories throughout childhood and adolescence that may have different consequences for adult outcomes.
Aims
To examine trajectories of childhood depressive symptoms and their association with education and employment outcomes in early adulthood.
Method
We estimated latent trajectory classes from participants with repeated measures of self-reported depressive symptoms between 11 and 24 years of age and examined their association with two distal outcomes: university degree and those not in employment, education or training at age 24.
Results
Our main analyses (n = 9399) yielded five heterogenous trajectories of depressive symptoms. The largest group found (70.5% of participants) had a stable trajectory of low depressive symptoms (stable–low). The other four groups had symptom profiles that reached full-threshold levels at different developmental stages and for different durations. We identified the following groups: childhood–limited (5.1% of participants) with full-threshold symptoms at ages 11–13; childhood–persistent (3.5%) with full-threshold symptoms at ages 13–24; adolescent onset (9.4%) with full-threshold symptoms at ages 17–19; and early-adult onset (11.6%) with full-threshold symptoms at ages 22–24. Relative to the majority ‘stable–low’ group, the other four groups all exhibited higher risks of one or both adult outcomes.
Conclusions
Accurate identification of depressive symptom trajectories requires data spanning the period from early adolescence to early adulthood. Consideration of changes in, as well as levels of, depressive symptoms could improve the targeting of preventative interventions in early-to-mid adolescence.
As urbanization increases in low- and middle-income countries (LMICs), urban populations will be increasingly exposed to a range of environmental risk factors for non-communicable diseases. Inadequate living conditions in urban settings may influence mechanisms that regulate gene expression, leading to the development of non-communicable respiratory diseases. We conducted a systematic review of the literature to assess the relationship between respiratory health and epigenetic factors to urban environmental exposures observed in LMICs using MEDLINE, PubMed, EMBASE, and Google Scholar searching a combination of the terms: epigenetics, chronic respiratory diseases (CRDs), lung development, chronic obstructive airway disease, and asthma. A total of 2835 articles were obtained, and 48 articles were included in this review. We found that environmental factors during early development are related to epigenetic effects that may be associated with a higher risk of CRDs. Epigenetic dysregulation of gene expression of the histone deacetylase (HDAC) and histone acetyltransferase gene families was likely involved in lung health of slum dwellers. Respiratory-related environmental exposures influence HDAC function and deoxyribonucleic acid methylation and are important risk factors in the development of CRD. Additional epigenetic research is needed to improve our understanding of associations between environmental exposures and non-communicable respiratory diseases.
Triatomine bugs carry the parasitic protozoa Trypanosoma cruzi, the causal agent of Chagas disease. It is known that both the parasite and entomopathogenic fungi can decrease bug survival, but the combined effect of both pathogens is not known, which is relevant for biological control purposes. Herein, the survival of the triatomine Meccus pallidipennis (Stal, 1872) was compared when it was coinfected with the fungus Metarhizium anisopliae (Metschnikoff) and T. cruzi, and when both pathogens acted separately. The immune response of the insect was also studied, using phenoloxidase activity in the bug gut and hemolymph, to understand our survival results. Contrary to expectations, triatomine survival was higher in multiple than in single challenges, even though the immune response was lower in cases of multiple infection. We postulate that T. cruzi exerts a protective effect and/or that the insect reduced the resources allocated to defend itself against both pathogens. Based on the present results, the use of M. anisopliae as a control agent should be re-considered.
The Egyptian Vulture Neophron percnopterus was once an abundant species in the Cabo Verde Islands. Since the 1960s though, and especially during the 1980–1990s, it consistently declined to near extinction. Evidence collected indicates a remnant population of about a dozen pairs or less, scattered through the desert rangelands of only three islands. Extensive enquiry work revealed that this likely resulted from the concomitant effects of the rise in unnatural mortality due to the formerly widespread and long-lasting use of dangerous pesticides and the (still on-going) poisoning of stray dogs and other nuisance animals, and a decrease in food resources associated with factors linked with development, such as urbanisation, rural abandonment and better sanitation. Avoiding imminent extinction calls for emergency action against current threats to the remaining vultures, such as poisoning and electrocution, but also potential causes of impaired fecundity such as hazardous pesticides and shortage of food resources.
The aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile.
Design
Na excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka’s formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression.
Setting
Chileans aged ≥15 years.
Participants
Participants (n 2913) from the Chilean National Health Survey 2009–2010.
Results
Individuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors.
Conclusions
Age, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.
Marine insertion indicators in the Vitoria estuary (ES) revealed relative variations in sea level during the Holocene in three sediment cores. Sedimentological, geochemical (C/N ratio), and paleontological (shells and palynomorphs) analysis and 14C dating associated five sedimentary facies to different estuarine deposits. A C/N ratio <10 at the core base indicated organic matter of marine origin. Moving up the cores to 110–150 cm, an abrupt increase in C/N to 26–63 in every core suggests the sudden entry of higher plants into the estuary, potentially the moment sea level retreated. High continental (10,743 palynomorphs/g) and low marine palynomorph concentrations (323 palynomorphs/g) suggest a primarily continental source even during transgression and at high sea level. Around 8973 cal BP, an open bay already existed in the region of Vitoria. Sea level potentially exceeded the current level around 7110 cal BP. The transgressive maximum was at 5567 cal BP. Marine insertion indicators, such as marine shells, low C/N ratios and foraminiferal linings, did not always respond directly to sea level oscillations. These discrepancies probably result from lateral variations in sedimentary deposits from transport patterns and from variations in organic matter and palynomorph preservation due to differences in river and obstacle proximity.
Vitória Bay is located in the south-central part of the State of Espírito Santo (SES). Multiproxy analyses were performed on samples from a 490-cm-long sediment core collected at the coordinates 40°18′23′′W and 20°14′48′′S. The objective of this study was to identify and integrate the multiproxy data to determine the environmental dynamics during the Holocene. The material was subsampled every 10 m and submitted to standard methodological processing. The sediment core was dated to two depths: the oldest age was between 9396 and 9520 cal yr BP at a 480-cm depth, and the youngest age was from 7423 to 7511 cal yr BP at a 304-cm depth. The integrated analysis revealed evidence of three major environmental changes in Vitória Bay. The first phase had a fluvial influence (depth of 490–480 cm; 9396–9520 cal yr BP). This was followed by a transitional period (depth of 480–290 cm; 7423–7511 cal yr BP) with a salt influence due to the Last Marine Transgression (LMT). Later, the environmental stability was similar to that of today (290 cm to the core top). This was a reflection of the Last Marine Regression (LMR) in the Holocene.
This work investigates a diesel engine operating with different blends of diesel fuel, biodiesel and anhydrous ethanol. Anhydrous ethanol (99.8% purity) was added to diesel oil with 7% (B7) and 20% of biodiesel (B20), with the concentrations of 5% (E5), 10% (E10) and 15% (E15) and 20% (E20). The experiments were conducted on a naturally aspirated, four-stroke, four-cylinder, direct injection 44 kW diesel engine, operating at a constant speed of 1800 RPM and at the fixed load of 27.5 kW to attain the lowest specific fuel consumption (SFC). The results were compared with the standard B7 operation, and showed that ethanol addition (B7E5) reduced up to 7% carbon dioxide (CO2) emissions, associated with the decrease of the cylinder gas temperature, due to the ethanol high latent heat of evaporation, and to the ethanol lower carbon-to-hydrogen ratio and oxygen content. Total hydrocarbons (THC) emissions were reduced up to 14% with ethanol addition (B7E15), indicating higher fuel burn efficiency when ethanol is added to the fuel, as the oxygen available in ethanol molecule improves the burning during combustion. On the other hand, increasing biodiesel content in the fuel from 7% to 20% increased CO2 and THC emissions, both mitigated with the use of ethanol. Carbon monoxide (CO) and oxides of nitrogen (NOX) emissions showed different behavior, depending on ethanol and biodiesel concentration. Both biodiesel and ethanol increased SFC, due to the reduction of fuel lower heating value (LHV), although ethanol addition slightly increased fuel conversion efficiency.
In this study we present an experiment investigating the reconfiguration process elicited by the task switching paradigm in synaesthesia. We study the time course of the operations involved in the activation of photisms. In the experimental Group, four digit-color synaesthetes alternated between an odd-even task and a color task (to indicate the photism elicited by each digit). In both tasks, the target stimuli were numbers between 1 and 9 written in white. One of the control groups ran the same tasks but this time with colored numbers (Naïve Control Group). The results of these studies showed the expected pattern for the control group in the case of regular shift: a significant task switch cost with an abrupt offset and a cost reduction in long RSI. However for the experimental group, we found switch cost asymmetry in the short RSI and non-significant cost in the long RSI. A second control group performed exactly the same tasks as the experimental group (with white numbers as targets and a second imaginary color task) -Trained Control Group-. We found no cost for this second control group. This means that the cost of mental set reconfiguration between numbers (inducers) and their photisms (concurrent sensations) occurs, that there is a specific cost asymmetry (from photisms to inducers) and that this cost cannot be explained by associative learning. The results are discussed in terms of exogenous and endogenous components of mental set reconfiguration.
To understand the impact that the growth rate has on the residual stress of chemical vapor deposition-grown 3C–SiC heteroepitaxial films on Si substrates, growth experiments were performed. The film thickness was held constant at ∼2.5 μm independent of the growth rate so as to allow for direct film comparison as a function of the growth rate. Stress analysis performed by profilometer curvature measurement, μιχρο-Raman shift analysis and micro-machined freestanding structures, show an apparent disagreement about the stress nature. This incongruity between the experimental data can be explained assuming a strong stress field located in the substrate related to defects generated in the silicon during the growth process.