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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
The hemlock woolly adelgid, Adelges tsugae Annand (Hemiptera: Adelgidae), has distinct native and invasive populations in Canada. On the country’s west coast, the adelgid is a native insect that feeds on western hemlock, Tsuga heterophylla (Rafinesque-Schmaltz) Sargent, and mountain hemlock, Tsuga mertensiana (Bongard) Carrière (Pinaceae). In eastern Canada, the adelgid is an invasive species that attacks and kills eastern hemlock, Tsuga canadensis (Linnaeus) Carrière (Pinaceae). We obtained all Canadian records of A. tsugae in institutional and public databases, developed updated range maps and phenologies for the species in British Columbia and eastern Canada, and developed dispersal estimates for populations in Nova Scotia. In British Columbia, A. tsugae’s observed distribution is centred around the Lower Mainland and on Vancouver Island but with populations in the British Columbia Interior and along the Pacific coast that have been poorly explored. In eastern Canada, the adelgid has invaded southern Nova Scotia, portions of the Niagara region in Ontario as far west as Hamilton, and at least one site on the north shore of Lake Ontario. No populations have been found in New Brunswick, Quebec, or Prince Edward Island, Canada. Finally, we estimated the rate of spread in Nova Scotia at 12.6 ± 8.2 to 20.5 ± 27.21 km/year.
We examine the energy distribution of the fast radio burst (FRB) population using a well-defined sample of 63 FRBs from the Australian Square Kilometre Array Pathfinder (ASKAP) radio telescope, 28 of which are localised to a host galaxy. We apply the luminosity-volume ($V/V_{\mathrm{max}}$) test to examine the distribution of these transient sources, accounting for cosmological and instrumental effects, and determine the energy distribution for the sampled population over the redshift range $0.01 \lesssim z \lesssim 1.02$. We find the distribution between $10^{23}$ and $10^{26}$ J Hz$^{-1}$ to be consistent with both a pure power-law with differential slope $\gamma=-1.96 \pm 0.15$, and a Schechter function with $\gamma = -1.82 \pm 0.12$ and downturn energy $E_\mathrm{max} \sim 6.3 \, \times 10^{25}$ J Hz$^{-1}$. We identify systematic effects which currently limit our ability to probe the luminosity function outside this range and give a prescription for their treatment. Finally, we find that with the current dataset, we are unable to distinguish between the evolutionary and spectral models considered in this work.
Liquid flowing down a fibre readily destabilises into a train of beads, commonly called a bead-on-fibre pattern. Bead formation results from capillary-driven instability and gives rise to patterns with constant velocity and time-invariant bead frequency $f$ whenever the instability is absolute. In this study, we develop a scaling law for $f$ that relates the Strouhal number $St$ and capillary number $Ca$ for Ostwaldian power-law liquids with Newtonian liquids recovered as a limiting case. We validate our proposed scaling law by comparing it with prior experimental data and new experimental data using xanthan gum solutions to produce a low capillary number $Ca \leq 10^{-2}$ regime. The experimental data encompasses both Ostwaldian and Newtonian flow, as well as symmetric and asymmetric patterns, and we find the data collapses along the predicted trend across seven orders of magnitude in $Ca$. Our proposed scaling law is a powerful tool for studying and applying bead-on-fibre flows where $f$ is critical, such as heat and mass transfer systems.
Many important questions in political science require the use of human-coded data or information that has been systematically ordered and quantified by a human being from qualitative sources. This article discusses challenges and recent innovations in collecting and documenting human-coded data. We review five datasets produced within the past 10 years and also reflect on our experiences in collecting a quarterly dataset that tracked state responses to the COVID-19 pandemic. We argue that scholars can deliberately produce and publish theoretically grounded human-coded data in an accessible format that promotes transparency, traceability, and readability. We highlight several ways that scholars are already doing this, including narratives, source lists, and coding justifications that enhance the quality of their human-coded datasets. We also discuss common issues during coding and how technological innovation through interactive web-based platforms can improve the documentation of coding decisions.
The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis.
Methods
Genome-wide association study summary statistics from the Psychiatric Genomics Consortium and the Genomic Psychiatry Cohort were used to calculate schizophrenia and cannabis use disorder (CUD) PRS for 1098 participants from the EU-GEI study and 143600 from the UK Biobank. Both datasets had information on cannabis use.
Results
In both samples, schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with patterns of cannabis use in the EU-GEI cases or controls or UK Biobank cases. It was associated with lifetime and daily cannabis use among UK Biobank participants without psychosis, but the effect was substantially reduced when CUD PRS was included in the model. In the EU-GEI sample, regular users of high-potency cannabis had the highest odds of being a case independently of schizophrenia PRS (OR daily use high-potency cannabis adjusted for PRS = 5.09, 95% CI 3.08–8.43, p = 3.21 × 10−10). We found no evidence of interaction between schizophrenia PRS and patterns of cannabis use.
Conclusions
Regular use of high-potency cannabis remains a strong predictor of psychotic disorder independently of schizophrenia PRS, which does not seem to be associated with heavy cannabis use. These are important findings at a time of increasing use and potency of cannabis worldwide.
The Moment-SOS hierarchy, first introduced in optimization in 2000, is based on the theory of the S-moment problem and its dual counterpart: polynomials that are positive on S. It turns out that this methodology can also be used to solve problems with positivity constraints ‘f(x) ≥ 0 for all $\mathbf{x}\in S$’ or linear constraints on Borel measures. Such problems can be viewed as specific instances of the generalized moment problem (GMP), whose list of important applications in various domains of science and engineering is almost endless. We describe this methodology in optimization and also in two other applications for illustration. Finally we also introduce the Christoffel function and reveal its links with the Moment-SOS hierarchy and positive polynomials.
Diagnosis of acute ischemia typically relies on evidence of ischemic lesions on magnetic resonance imaging (MRI), a limited diagnostic resource. We aimed to determine associations of clinical variables and acute infarcts on MRI in patients with suspected low-risk transient ischemic attack (TIA) and minor stroke and to assess their predictive ability.
Methods:
We conducted a post-hoc analysis of the Diagnosis of Uncertain-Origin Benign Transient Neurological Symptoms (DOUBT) study, a prospective, multicenter cohort study investigating the frequency of acute infarcts in patients with low-risk neurological symptoms. Primary outcome parameter was defined as diffusion-weighted imaging (DWI)-positive lesions on MRI. Logistic regression analysis was performed to evaluate associations of clinical characteristics with MRI-DWI-positivity. Model performance was evaluated by Harrel’s c-statistic.
Results:
In 1028 patients, age (Odds Ratio (OR) 1.03, 95% Confidence Interval (CI) 1.01–1.05), motor (OR 2.18, 95%CI 1.27–3.65) or speech symptoms (OR 2.53, 95%CI 1.28–4.80), and no previous identical event (OR 1.75, 95%CI 1.07–2.99) were positively associated with MRI-DWI-positivity. Female sex (OR 0.47, 95%CI 0.32–0.68), dizziness and gait instability (OR 0.34, 95%CI 0.14–0.69), normal exam (OR 0.55, 95%CI 0.35–0.85) and resolved symptoms (OR 0.49, 95%CI 0.30–0.78) were negatively associated. Symptom duration and any additional symptoms/symptom combinations were not associated. Predictive ability of the model was moderate (c-statistic 0.72, 95%CI 0.69–0.77).
Conclusion:
Detailed clinical information is helpful in assessing the risk of ischemia in patients with low-risk neurological events, but a predictive model had only moderate discriminative ability. Patients with clinically suspected low-risk TIA or minor stroke require MRI to confirm the diagnosis of cerebral ischemia.
Using a unique dataset of legislators' electoral and biographical data in the Canadian provinces of Ontario, Quebec, New Brunswick, Nova Scotia and the federal parliament, this article analyses the extent to which family dynasties affected the career development of legislators since the mid-18th century. We find that the prevalence of dynasties was higher in provincial legislatures than it was in the federal parliament, that the number of dynasties in the Senate increased until the mid-20th century, and that the proportion of dynastic legislators at the subnational level was similar to the numbers seen in the United Kingdom during the early 19th century. Our results confirm the existence of a clear career benefit in terms of cabinet and senate appointments. In contrast to the American case and in line with the United Kingdom experience, we find no causal relationship between a legislator's tenure length and the presence of a dynasty.
This research note reports on a new dataset about legislators in four Canadian provinces since the establishment of their colonial assemblies in the eighteenth century. Over 7,000 legislators from Ontario, Quebec, New Brunswick, and Nova Scotia are included, with consolidated information drawn from multiple sources about parliamentarians’ years of birth and death, religion, electoral performance, kinship, and several other biographical indicators. We also illustrate the utility of such data with the help of a few descriptive examples drawn from the four provinces. We believe this consolidated dataset offers several opportunities for future research on representation, legislative activities and party politics.
Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP.
Methods
We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately.
Results
Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia.
Conclusions
Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.
Given the lack of comprehensive neuropsychological tools and neuropsychological services in Sub-Saharan Africa (SSA), cognitive screeners for dementia can be useful tools to screen for suspected dementia at the population level. However, most available screeners have not been developed or validated in SSA populations. The Community Screening Instrument for Dementia (CSID) was developed for cross-cultural use, and it has a cognitive testing component and informant interview. We have previously demonstrated that lower years of education and female sex are associated with lower scores on the CSID. Here, we examine the utility of demographically adjusted CSID scores in a community sample of Congolese older adults.
Participants and Methods:
354 participants (mean age=73.6±6.7, mean education (years) =7.3±4.7; 50% female) were randomly recruited in Kinshasa, Democratic Republic of the Congo, and completed the CSID and the Alzheimer's Questionnaire (AQ) to examine functional abilities. Raw scores were demographically adjusted for education and sex by adding 1 point for <12 years of education and 1 point for female. Cognitive impairment was classified as a total score below 25.5. Rates of impairment were compared between raw scores and demographically-adjusted scores. Demographic profiles were examined between both classifications
Results:
Average raw CSID scores were 25.23 (SD=4.19) and average demographically-adjusted scores were 26.59 (SD= 4.09). Approximately 43.1% of the sample was impaired based on the raw CSID scores compared to 30.4% with the demographically-adjusted scores (x2= 12.334, p<.001). There was a higher proportion of females (n=95; 26.8%) classified as impaired with the raw SCID scores compared to the demographically-adjusted scores (n=62; 17.5%; x2= 8.87, p=0.003). Approximately 27.4% (n=97) of the participants classified as impaired with the raw SCID scores had primary education or less (i.e., 1-6 years) compared to 18.9% with the demographically-adjusted scores (n=67; (x2= 107.77, p<.001). Forty-five participants were re-classified as not impaired with the demographically-adjusted scores with the majority of these participants being female (73.3%), having primary education (66.7%), and being functionally unimpaired on the AQ (91.1% unimpaired).
Conclusions:
We demonstrate that raw scores on the CSID can lead to misclassification of impairment in females and in individuals with lower years of education. Demographically-adjusted scores on the CSID can help properly capture those with suspected dementia while reducing false positives. Given the effects of education and sex on performance, future studies should examine if demographically adjusted scores improve the sensitivity and specificity of the CSID in Congolese populations and compare its performance to other screening tools to determine the most appropriate screener for this population.
This research communication paper addresses the hypothesis that the use of therapeutic alternatives for mastitis, such as intramammary ozone, can cure the disease with lower costs and without harmful residues for human consumption and without formation of microbial resistance like the ones caused by indiscriminate use of antibiotics in dairy farms. The study was performed in 36 mammary quarters from 12 dairy cows with subclinical mastitis grade three. The experimental units were randomly assigned into four groups and each group received a treatment. Treatments comprised (a) 20 μg/ml ozone gas; (b) 40 μg/ml ozone gas; (c) negative control treatment of 12.5 μg/ml ozonated saline and (d) positive control treatment of 100 mg of cephalexin + 100 mg of neomycin + 10 mg of prednisolone, all by intramammary injection. In all quarters, milk was collected before and after the application of treatments for California mastitis test and evaluation of milk composition, somatic cell count, and bacterial cultures. The results indicated that the use of intramammary ozone did have a therapeutic effect, and whilst this was less than that of antibiotics, ozone does confer some advantages. Treated milk had a good composition, the treatment cost was low, milk withdrawal may not be necessary and there is no risk of antibiotic resistance.
DEER WERE AMONG the most prized animals hunted in medieval Europe. Contemporary hunting treatises described the rituals of the deer hunt and the chase was celebrated in both literature and in art.1 Deer were protected and preserved, served at important feasts, and given as royal gifts. This chapter will concern itself with how deer were used by the thirteenth-century English kings for food and as gifts. The main sources for this subject are the English public records. Among the problems in analyzing them are missing records, changes in what was recorded, and undercounting. Many of the records for King John's reign were lost when part of his baggage train was caught in a tidal estuary. The Close Rolls for 23 Henry III (1238–1239) are missing and a number of Edward I's Wardrobe Books have not survived. In all three reigns there are years in which there were no records of deer ordered. In both John and Edward's reigns payments were made to huntsmen for their wages and the expenses of their dogs, but what was hunted and where were seldom recorded. In Henry's reign the numbers and types of dog were generally omitted. In all three reigns there were instances of hunters being sent to hunt deer without quantities or gender stipulated. Clearly the totals of recorded deer are a good deal less than the number actually taken or given as gifts. Nevertheless surviving material is sufficient to indicate general trends, identify huntsmen, note who received royal gifts, and the like.
William I established the framework within which deer hunting operated in medieval England. William, it is said, “loved the stags dearly as though he had been their father.” To enhance his sport William brought Norman forest law and forest courts to England. The Anglo-Saxon kings had had their own hunting preserves. William expanded these greatly and made them subject to severe restrictions to preserve game and to reserve it for his own pursuit. The Anglo-Saxon Chronicle recorded:
He set apart a vast deer preserve and imposed laws concerning it.
It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals.
Methods
To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects.
Results
Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects.
Conclusions
Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.
We present new data from the debris-rich basal ice layers of the NEEM ice core (NW Greenland). Using mineralogical observations, SEM imagery, geochemical data from silicates (meteoric 10Be, εNd, 87Sr/86Sr) and organic material (C/N, δ13C), we characterize the source material, succession of previous glaciations and deglaciations and the paleoecological conditions during ice-free episodes. Meteoric 10Be data and grain features indicate that the ice sheet interacted with paleosols and eroded fresh bedrock, leading to mixing in these debris-rich ice layers. Our analysis also identifies four successive stages in NW Greenland: (1) initial preglacial conditions, (2) glacial advance 1, (3) glacial retreat and interglacial conditions and (4) glacial advance 2 (current ice-sheet development). C/N and δ13C data suggest that deglacial environments favored the development of tundra and taiga ecosystems. These two successive glacial fluctuations observed at NEEM are consistent with those identified from the Camp Century core basal sediments over the last 3 Ma. Further inland, GRIP and GISP2 summit sites have remained glaciated more continuously than the western margin, with less intense ice-substratum interactions than those observed at NEEM.
Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis.
Methods
Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0–11 years), and late (12–17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use.
Results
The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord.
Conclusions
Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.
While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.
Methods
We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case–control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.
We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case–control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case–control status.
Results
Controls (86.1%) and FEPp (75.63%) were most likely to report ‘because of friends’ as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: ‘to feel better’ as their RFUC (χ2 = 50.97; p < 0.001). RFUC ‘to feel better’ was associated with being a FEPp (OR 1.74; 95% CI 1.03–2.95) while RFUC ‘with friends’ was associated with being a control (OR 0.56; 95% CI 0.37–0.83). The path model indicated an association between RFUC ‘to feel better’ with heavy cannabis use and with FEPp-control status.
Conclusions
Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use ‘to feel better’. People who reported their reason for first using cannabis to ‘feel better’ were more likely to progress to heavy use and develop a psychotic disorder than those reporting ‘because of friends’.
To review methodologies and outcomes reporting among these studies and to develop a conceptual framework of outcomes to assist in guiding studies and production of clinical metrics.
Data sources:
PubMed and Embase from January 1, 2012, thru December 1, 2021.
Study eligibility criteria:
Studies evaluating highly multiplex molecular respiratory diagnostics and their impact on either clinical or economic outcomes.
Methods:
A systematic literature review (SLR) of methodologies and outcomes reporting was performed. A qualitative synthesis of identified SLRs and associated primary studies was conducted to develop conceptual framework for outcomes.
Results:
Ultimately, 4 systemic literature reviews and their 12 associated primary studies were selected for review. Most primary studies included patient outcomes focusing on antimicrobial exposure changes such as antibiotic (80%) and antiviral use (50%) or occupancy changes such as hospital length of stay (60%). Economic outcomes were infrequently reported, and societal outcomes, such as antibiotic resistance impact, were absent from the reviewed literature. Qualitative evidence synthesis of reported outcomes yielded a conceptual framework of outcomes to include operational, patient, economic, and societal domains.
Conclusions:
Our review highlights the significant heterogeneity in outcomes reporting among clinical impact studies for highly multiplex molecular respiratory diagnostics. Furthermore, we developed a conceptual framework of outcomes domains that may act as a guide to improve considerations in outcomes selection and reporting when evaluating clinical impact of these tests. These improvements may be important in synthesizing the evidence for informing clinical decision making, guidelines, and financial reimbursement.
Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status.
Methods
We included FEP patients aged 18–64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status.
Results
We examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:χ2 = 11.3, p = 0.004) or by region of origin (likelihood test ratio:χ2 = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations.
Conclusions
The higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.