We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
The First Large Absorption Survey in H i (FLASH) is a large-area radio survey for neutral hydrogen in and around galaxies in the intermediate redshift range $0.4\lt z\lt1.0$, using the 21-cm H i absorption line as a probe of cold neutral gas. The survey uses the ASKAP radio telescope and will cover 24,000 deg$^2$ of sky over the next five years. FLASH breaks new ground in two ways – it is the first large H i absorption survey to be carried out without any optical preselection of targets, and we use an automated Bayesian line-finding tool to search through large datasets and assign a statistical significance to potential line detections. Two Pilot Surveys, covering around 3000 deg$^2$ of sky, were carried out in 2019-22 to test and verify the strategy for the full FLASH survey. The processed data products from these Pilot Surveys (spectral-line cubes, continuum images, and catalogues) are public and available online. In this paper, we describe the FLASH spectral-line and continuum data products and discuss the quality of the H i spectra and the completeness of our automated line search. Finally, we present a set of 30 new H i absorption lines that were robustly detected in the Pilot Surveys, almost doubling the number of known H i absorption systems at $0.4\lt z\lt1$. The detected lines span a wide range in H i optical depth, including three lines with a peak optical depth $\tau\gt1$, and appear to be a mixture of intervening and associated systems. Interestingly, around two-thirds of the lines found in this untargeted sample are detected against sources with a peaked-spectrum radio continuum, which are only a minor (5–20%) fraction of the overall radio-source population. The detection rate for H i absorption lines in the Pilot Surveys (0.3 to 0.5 lines per 40 deg$^2$ ASKAP field) is a factor of two below the expected value. One possible reason for this is the presence of a range of spectral-line artefacts in the Pilot Survey data that have now been mitigated and are not expected to recur in the full FLASH survey. A future paper in this series will discuss the host galaxies of the H i absorption systems identified here.
To improve early intervention and personalise treatment for individuals early on the psychosis continuum, a greater understanding of symptom dynamics is required. We address this by identifying and evaluating the movement between empirically derived attenuated psychotic symptomatic substates—clusters of symptoms that occur within individuals over time.
Methods
Data came from a 90-day daily diary study evaluating attenuated psychotic and affective symptoms. The sample included 96 individuals aged 18–35 on the psychosis continuum, divided into four subgroups of increasing severity based on their psychometric risk of psychosis, with the fourth meeting ultra-high risk (UHR) criteria. A multilevel hidden Markov modelling (HMM) approach was used to characterise and determine the probability of switching between symptomatic substates. Individual substate trajectories and time spent in each substate were subsequently assessed.
Results
Four substates of increasing psychopathological severity were identified: (1) low-grade affective symptoms with negligible psychotic symptoms; (2) low levels of nonbizarre ideas with moderate affective symptoms; (3) low levels of nonbizarre ideas and unusual thought content, with moderate affective symptoms; and (4) moderate levels of nonbizarre ideas, unusual thought content, and affective symptoms. Perceptual disturbances predominantly occurred within the third and fourth substates. UHR individuals had a reduced probability of switching out of the two most severe substates.
Conclusions
Findings suggest that individuals reporting unusual thought content, rather than nonbizarre ideas in isolation, may exhibit symptom dynamics with greater psychopathological severity. Individuals at a higher risk of psychosis exhibited persistently severe symptom dynamics, indicating a potential reduction in psychological flexibility.
Diagnosis in psychiatry faces familiar challenges. Validity and utility remain elusive, and confusion regarding the fluid and arbitrary border between mental health and illness is increasing. The mainstream strategy has been conservative and iterative, retaining current nosology until something better emerges. However, this has led to stagnation. New conceptual frameworks are urgently required to catalyze a genuine paradigm shift.
Methods
We outline candidate strategies that could pave the way for such a paradigm shift. These include the Research Domain Criteria (RDoC), the Hierarchical Taxonomy of Psychopathology (HiTOP), and Clinical Staging, which all promote a blend of dimensional and categorical approaches.
Results
These alternative still heuristic transdiagnostic models provide varying levels of clinical and research utility. RDoC was intended to provide a framework to reorient research beyond the constraints of DSM. HiTOP began as a nosology derived from statistical methods and is now pursuing clinical utility. Clinical Staging aims to both expand the scope and refine the utility of diagnosis by the inclusion of the dimension of timing. None is yet fit for purpose. Yet they are relatively complementary, and it may be possible for them to operate as an ecosystem. Time will tell whether they have the capacity singly or jointly to deliver a paradigm shift.
Conclusions
Several heuristic models have been developed that separately or synergistically build infrastructure to enable new transdiagnostic research to define the structure, development, and mechanisms of mental disorders, to guide treatment and better meet the needs of patients, policymakers, and society.
Hypereutrophic Grand Lake St Marys (GLSM) is a large (52 km2), shallow (mean depth ~ 1.5 m) reservoir in an agricultural watershed of western Ohio (USA). GLSM suffers from extensive cyanobacterial harmful algal blooms (cHABs) that persist much of the year, resulting in total microcystin concentrations that are often above safe contact levels. Over two summers (2020 and 2021), two phosphorus (P) binding agents (alum and lanthanum/bentonite clay Phoslock, respectively), in conjunction with a P-binding algaecide (SeClear) in 2021, were applied to a 3.24-ha enclosure to mitigate cHAB activity and create a ‘safe’ recreational space for the public. We evaluated these applications by comparing total phosphorus (TP), total microcystin, total chlorophyll, and phycocyanin concentrations within the enclosure and the adjacent lake. Some evidence for short-term reductions in TP, microcystin, chlorophyll, and phycocyanin concentrations were observed following each P binding treatment, but all parameters rapidly returned to or exceeded pre-application levels within 2–3 weeks after treatment. These results suggest that in-lake chemical treatments to mitigate cHABs are unlikely to provide long-lasting benefits in these semi-enclosed areas of large, shallow, hypereutrophic systems, and resources may be better applied toward reducing external nutrient loads (P and nitrogen) from the watershed.
The aim of this paper is to characterise the internal structures and ice-flow history of representative valley glaciers in Svalbard and infer from them dynamic changes over centennial timescales. Three polythermal and one cold valley glacier are investigated using field- and laboratory-based techniques and remote sensing. Structures along flow-unit boundaries indicate that ice-flow configuration in three of the glaciers has remained stable spanning the residence time of the ice. Deformation of a flow-unit boundary in the fourth reveals an ice-flow instability, albeit one that has been maintained since its most recent advance. Macro-crystallographic, sedimentological and isotopic analyses indicate that basal ice is elevated to the glacier surface, as shown by entrained sediments and enrichment in heavy isotopes. In narrow zones of enhanced cumulative strain, new ice facies are generated through dynamic recrystallisation. The surface density of longitudinal foliation is shown to represent the relative magnitude of cumulative strain. Geometric similarities between flow-unit boundaries in Svalbard valley glaciers and larger scale longitudinal surface structures in ice sheets suggest that deformation mechanisms are common to both.
The performance and confidence in fault detection and diagnostic systems can be undermined by data pipelines that feature multiple compounding sources of uncertainty. These issues further inhibit the deployment of data-based analytics in industry, where variable data quality and lack of confidence in model outputs are already barriers to their adoption. The methodology proposed in this paper supports trustworthy data pipeline design and leverages knowledge gained from one fully-observed data pipeline to a similar, under-observed case. The transfer of uncertainties provides insight into uncertainty drivers without repeating the computational or cost overhead of fully redesigning the pipeline. A SHAP-based human-readable explainable AI (XAI) framework was used to rank and explain the impact of each choice in a data pipeline, allowing the decoupling of positive and negative performance drivers to facilitate the successful selection of highly-performing pipelines. This empirical approach is demonstrated in bearing fault classification case studies using well-understood open-source data.
Given increased survival for adults with CHD, we aim to determine outcome differences of infective endocarditis compared to patients with structurally normal hearts in the general population.
Methods:
We conducted a retrospective cross-sectional study identifying infective endocarditis hospitalisations in patients 18 years and older from the National Inpatient Sample database between 2001 and 2016 using International Classification of Disease diagnosis and procedure codes. Weighting was used to create national annual estimates indexed to the United States population, and multivariable logistic regression analysis determined variable associations. Outcome variables were mortality and surgery. The primary predictor variable was the presence or absence of CHD.
Results:
We identified 1,096,858 estimated infective endocarditis hospitalisations, of which 17,729 (1.6%) were adults with CHD. A 125% increase in infective endocarditis hospitalisations occurred for adult CHD patients during the studied time period (p < 0.001). Adults with CHD were significantly less likely to experience mortality (5.4% vs. 9.5%, OR 0.54, CI 0.47–0.63, p < 0.001) and more likely to undergo in-hospital surgery (31.6% vs. 6.7%, OR 6.49, CI 6.03–6.98, p < 0.001) compared to the general population. CHD severity was not associated with increased mortality (p = 0.53). Microbiologic aetiology of infective endocarditis varied between groups (p < 0.001) with Streptococcus identified more commonly in adults with CHD compared to patients with structurally normal hearts (36.2% vs. 14.4%).
Conclusions:
Adults with CHD hospitalised for infective endocarditis are less likely to experience mortality and more likely to undergo surgery than the general population.
Flumioxazin and S-metolachlor are widely used in conventional sweetpotato production in North Carolina and other states; however, some growers have recently expressed concerns about potential effects of these herbicides on sweetpotato yield and quality. Previous research indicates that activated charcoal has the potential to reduce herbicide injury. Field studies were conducted in 2021 and 2022 to determine whether flumioxazin applied preplant and S-metolachlor applied before and after transplanting negatively affect sweetpotato yield and quality when activated charcoal is applied with transplant water. The studies evaluated five herbicide treatments and two activated charcoal treatments. Herbicide treatments included two flumioxazin rates, one S-metolachlor rate applied immediately before and immediately after transplanting, and no herbicide. Charcoal treatments consisted of activated charcoal applied at 9 kg ha−1, and no charcoal. No visual injury from herbicides or charcoal was observed. Likewise, no effect of herbicide or charcoal treatment on no. 1, marketable (sum of no. 1 and jumbo grades), or total yield (sum of canner, no. 1, and jumbo grades) was observed. Additionally, shape analysis conducted on calculated length-to-width ratio (LWR) for no. 1 sweetpotato roots found no effect from flumioxazin at either rate on sweetpotato root shape. However, both S-metolachlor treatments resulted in lower LWR of no. 1 sweetpotato roots in 2021. Results are consistent with prior research and indicate that flumioxazin and S-metolachlor are safe for continued use on sweetpotato at registered rates.
The psychometric rigor of unsupervised, smartphone-based assessments and factors that impact remote protocol engagement is critical to evaluate prior to the use of such methods in clinical contexts. We evaluated the validity of a high-frequency, smartphone-based cognitive assessment protocol, including examining convergence and divergence with standard cognitive tests, and investigating factors that may impact adherence and performance (i.e., time of day and anticipated receipt of feedback vs. no feedback).
Methods:
Cognitively unimpaired participants (N = 120, Mage = 68.8, 68.3% female, 87% White, Meducation = 16.5 years) completed 8 consecutive days of the Mobile Monitoring of Cognitive Change (M2C2), a mobile app-based testing platform, with brief morning, afternoon, and evening sessions. Tasks included measures of working memory, processing speed, and episodic memory. Traditional neuropsychological assessments included measures from the Preclinical Alzheimer’s Cognitive Composite battery.
Results:
Findings showed overall high compliance (89.3%) across M2C2 sessions. Average compliance by time of day ranged from 90.2% for morning sessions, to 77.9% for afternoon sessions, and 84.4% for evening sessions. There was evidence of faster reaction time and among participants who expected to receive performance feedback. We observed excellent convergent and divergent validity in our comparison of M2C2 tasks and traditional neuropsychological assessments.
Conclusions:
This study supports the validity and reliability of self-administered, high-frequency cognitive assessment via smartphones in older adults. Insights into factors affecting adherence, performance, and protocol implementation are discussed.
While clozapine has risks, relative risk of fatality is overestimated. The UK pharmacovigilance programme is efficient, but comparisons with other drugs can mislead because of reporting variations. Clozapine actually lowers mortality, partly by reducing schizophrenia-related suicides, but preventable deaths still occur. Clozapine should be used earlier and more widely, but there should be better monitoring and better management of toxicity.
We report the presence of three Palaearctic species, Suillia variegata (Loew), Tephrochlamys flavipes (Zetterstedt), and Tephrochlamys tarsalis (Zetterstedt) (Diptera: Heleomyzidae), recently introduced to North America. We use community science (also known as citizen science) data to show that S. variegata, which was first reported in Portland, Oregon, United States of America, in 2016, has persisted in that area and has subsequently also been observed in Washington and California. Tephrochlamys flavipes, first reported in Seattle, Washington, United States of America, in 2010, has been observed comparatively more rarely, in a more restricted geographic area. The presence of T. tarsalis in the Nearctic, previously reported in Canada based on genetic barcodes, is verified from photographs taken in British Columbia, Canada and Washington. We provide updates to the keys to Suillia Robineau-Desvoidy and Tephrochlamys Loew of the United States of America and Canada. Finally, we discuss potential means of introduction and patterns of dispersal for each species.
Greenhouse trials were conducted to determine the response of stevia to reduced-risk synthetic and nonsynthetic herbicides applied over-the-top post-transplant. In addition, field trials were conducted with stevia grown in a polyethylene mulch production system to determine crop response and weed control in planting holes to reduced-risk synthetic and nonsynthetic herbicides applied post-transplant directed. Treatments included caprylic acid plus capric acid, clove oil plus cinnamon oil, d-limonene, acetic acid (200 grain), citric acid, pelargonic acid, eugenol, ammonium nonanoate, and ammoniated soap of fatty acids. Stevia yield (dry aboveground biomass) in the greenhouse was reduced by all herbicide treatments. Citric acid and clove oil plus cinnamon oil were the least injurious, reducing yield by 16% to 20%, respectively. In field studies, d-limonene, pelargonic acid, ammonium nonanoate, and ammoniated soap of fatty acids controlled Palmer amaranth (>90% 1 wk after treatment (WAT). In field studies caprylic acid plus capric acid, pelargonic acid, and ammonium nonanoate caused >30% injury to stevia plants at 2 WAT, and d-limonene, citric acid, acetic acid, and ammoniated soap of fatty acids caused 18% to 25% injury 2 WAT. Clove oil plus cinnamon oil and eugenol caused <10% injury. Despite being injurious, herbicides applied in the field did not reduce yield compared to the nontreated check. Based upon yield data, these herbicides have potential for use in stevia; however, these products could delay harvest if applied to established stevia. In particular, clove oil plus cinnamon oil has potential for use for early-season weed management for organic production systems. The application of clove oil plus cinnamon oil over-the-top resulted in <10% injury 28 d after treatment (DAT) in the greenhouse and 3% injury 6 WAT postemergence-directed in the field. In addition, this treatment provided 95% control of Palmer amaranth 4 WAT.
Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT).
Methods
Individuals with BED (N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type.
Results
Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up.
Conclusions
Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.
Soil amelioration via strategic deep tillage is occasionally utilized within conservation tillage systems to alleviate soil constraints, but its impact on weed seed burial and subsequent growth within the agronomic system is poorly understood. This study assessed the effects of different strategic deep-tillage practices, including soil loosening (deep ripping), soil mixing (rotary spading), or soil inversion (moldboard plow), on weed seed burial and subsequent weed growth, compared with a no-till control. The tillage practices were applied in 2019 at Yerecoin and Darkan, WA, and data on weed seed burial and growth were collected during the following 3-yr winter crop rotation (2019 to 2021). Soil inversion buried 89% of rigid ryegrass (Lolium rigidum Gaudin) and ripgut brome (Bromus diandrus Roth) seeds to a depth of 10 to 20 cm at both sites, while soil loosening and mixing left between 31% and 91% of the seeds in the top 0 to 10 cm of soil, with broad variation between sites. Few seeds were buried beyond 20 cm despite tillage working depths exceeding 30 cm at both sites. Soil inversion reduced the density of L. rigidum to <1 plant m−2 for 3 yr after strategic tillage. Bromus diandrus density was initially reduced to 0 to 1 plant m−2 by soil inversion, but increased to 4 plants m−2 at Yerecoin in 2020 and 147 plants at Darkan in 2021. Soil loosening or mixing did not consistently decrease weed density. The field data were used to parameterize a model that predicted weed density following strategic tillage with greater accuracy for soil inversion than for loosening or mixing. The findings provide important insights into the effects of strategic deep tillage on weed management in conservational agricultural systems and demonstrate the potential of models for optimizing weed management strategies.
We examined 3,046,538 acute respiratory infection (ARI) encounters with 6,103 national telehealth physicians from January 2019 to October 2021. The antibiotic prescribing rates were 44% for all ARIs; 46% were antibiotic appropriate; 65% were potentially appropriate; 19% resulted from inappropriate diagnoses; and 10% were related to coronavirus disease 2019 (COVID-19) diagnosis.
Peer victimization predicts the development of mental health symptoms in the transition to adolescence, but it is unclear whether and how parents and school environments can buffer this link.
Methods
We analyzed two-year longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study, involving a diverse sample of 11 844 children across the United States (average at baseline = 9.91 years; standard deviation = 0.63; range = 8.92–11.08; complete case sample = 8385). Longitudinal associations between peer victimization and two-year changes in mental health symptoms of major depression disorder (MDD), separation anxiety (SA), prodromal psychosis (PP), and attention-deficit/hyperactivity disorder (ADHD) were examined including a wide range of covariates. Mixed linear models were used to test for the moderating effects of parental warmth and prosocial school environment.
Results
20% of children experienced peer victimization. Higher exposure to peer victimization was associated with increases in MDD, SA, and ADHD symptoms. Parental warmth was associated with decreases in MDD symptoms but did not robustly buffer the link between peer victimization and mental health symptoms. Prosocial school environment predicted decreases in PP symptoms and buffered the link between peer victimization and MDD symptoms but amplified the link between peer victimization and SA and ADHD symptoms.
Conclusions
Peer victimization is associated with increases in mental health symptoms during the transition to adolescence. Parental warmth and prosocial school environments might not be enough to counter the negative consequences of peer victimization on all mental health outcomes.
Evaluation of adult antibiotic order sets (AOSs) on antibiotic stewardship metrics has been limited. The primary outcome was to evaluate the standardized antimicrobial administration ratio (SAAR). Secondary outcomes included antibiotic days of therapy (DOT) per 1,000 patient days (PD); selected antibiotic use; AOS utilization; Clostridioides difficile infection (CDI) cases; and clinicians’ perceptions of the AOS via a survey following the final study phase.
Design:
This 5-year, single-center, quasi-experimental study comprised 5 phases from 2017 to 2022 over 10-month periods between August 1 and May 31.
Setting:
The study was conducted in a 752-bed tertiary care, academic medical center.
Intervention:
Our institution implemented AOSs in the electronic medical record (EMR) for common infections among hospitalized adults.
Results:
For the primary outcome, a statistically significant decreases in SAAR were detected from phase 1 to phase 5 (1.0 vs 0.90; P < .001). A statistically significant decreases were detected in DOT per 1,000 PD (4,884 vs 3,939; P = .001), fluoroquinolone orders (407 vs 175; P < .001), carbapenem orders (147 vs 106; P = .024), and clindamycin orders (113 vs 73; P = .01). No statistically significant change in mean vancomycin orders was detected (991 vs 902; P = .221). A statistically significant decrease in CDI cases was also detected (7.8, vs 2.4; P = .002) but may have been attributable to changes in CDI case diagnosis. Clinicians indicated that the AOSs were easy to use overall and that they helped them select the appropriate antibiotics.
Conclusions:
Implementing AOS into the EMR was associated with a statistically significant reduction in SAAR, antibiotic DOT per 1,000 PD, selected antibiotic orders, and CDI cases.