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It is a high honor to be with the distinguished Africanists who form the African Studies Association.
Five years ago, you had the vision to recognize that what most people then thought was esoteric learning about a dark continent was, in fact, the essential understanding which would permit the people of America to live fruitfully with one of the most dynamic movements in world history.
This unique position in the intellectual world gives you not only an unusual opportunity to influence the events of your time, but a heavy responsibility to make certain that the fruit of your labors is of the very highest quality. Though I am but a neophyte in the field, I know many of you well enough to appreciate your recognition of and devotion to this awesome trust.
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.
Motivational Interviewing (MI) has demonstrated significant effects in diverse areas of practice, with over 2,000 controlled clinical trials published. Some criticisms of MI have emerged along the way.
Aims:
We examine theoretical and methodological critiques of MI.
Method:
We discuss three significant theoretical and methodological criticisms of MI: (1) that MI lacks conceptual stability; (2) that MI lacks a theoretical foundation; and (3) that MI is just common factors in psychotherapy.
Results:
It is true that definitions and descriptions of MI have evolved over the years. Mastery of MI clearly varies across providers, and when the quality of an intervention is unmeasured, it is unclear what has been trained or delivered. Reliable and valid tools to assess MI fidelity are available but often unused in outcome studies. It remains unclear what levels of proficiency are necessary to improve client outcomes. Some attempts to minimize variability in the delivery of MI appear to have reduced its effectiveness. In respect of the second critique is that MI lacks a theoretical foundation. It is unclear whether and how this is a disadvantage in research and practice. Various theories have been proposed and specific causal chain predictions have been tested. A third critique is that MI is merely common factors found among psychotherapists. The contribution of such relational skills is testable. There are specific aspects of MI related to client language that influence client outcomes above and beyond its relational components.
Conclusions:
The critiques reflect important factors to consider when delivering, training, and evaluating MI research.
Background: Functional movement disorder (FMD), a subtype of functional neurological disorder, is a complex neuropsychiatric syndrome characterized by inconsistent and incongruent motor symptoms, such as tremor and gait disorder. Despite its prevalence and associated disability, FMD remains understudied. The multidisciplinary FMD Clinic in Calgary, Alberta offers an opportunity to describe characteristics of FMD, focusing on sex and gender differences, neuropsychiatric risk factors, healthcare utilization and motor phenotypes. Methods: This ongoing registry study evaluates adult FMD patients seen in the Calgary FMD Clinic by a movement disorders neurologist and neuropsychiatrist. Patients undergo detailed movement disorders and neuropsychiatric assessments, including identifying motor phenotypes, psychiatric comorbidities, and relevant psychological traits. Standardized scales evaluate symptom severity and impact. Descriptive statistics and measure of variance will be calculated for variables of interest. Results: The Calgary FMD Registry was approved in March 2024, with 53 participants currently enrolled. Data collection for this study is projected to conclude in March 2025. Conclusions: The Calgary FMD Registry is the first of its kind to systematically characterize FMD based on both movement disorders and neuropsychiatric variables. This study aims to improve our understanding of neuropsychiatric factors related to FMD. Future studies from this registry will examine short- and long-term outcomes.
Background: Attitudes toward aging influence many health outcomes, yet their relationship with cognition and Alzheimer’s disease (AD) remains unknown. To better understand their impact on cognition and AD risk, we examined whether positive attitudes predict better cognition and diminished risk on AD biomarkers. Methods: A subsample of older adults with a family history of AD (n=54; women=39) from the McGill PREVENT-AD cohort participated in this study. Participants completed the Attitudes to Ageing Questionnaire (AAQ-24), providing three scores: psychosocial loss, psychological growth and physical change. Participants underwent cognitive testing (Rey Auditory Verbal Learning Test, RAVLT; Delis-Kaplan Executive Function System-Color Word Interference Test, D-KEFS-CWIT), and AD blood-based biomarker assessments (p-tau217, Aβ42/40). Regression models tested associations, adjusting for covariates (age, sex, education, depression, APOE4), and were Bonferroni corrected. Results: Positive attitudes were associated with better recall and recognition (RAVLT) and improved word reading, colour naming, switching, and inhibition (D-KEFS-CWIT) (p<0.00077), while negative attitudes showed the opposite pattern. Negative attitudes were correlated with lower Aβ42/40 ratios, while positive attitudes were linked to lower p-tau217 (p<0.0167). Conclusions: These findings demonstrate that positive attitudes predict better cognition and a lower risk profile for AD biomarkers, suggesting that life outlook may be an early disease feature or a risk factor.
Patients with schizophrenia have a significantly elevated risk of mortality. Clozapine is effective for treatment-resistant schizophrenia, but its use is limited by side-effects. Understanding its association with mortality risk is crucial.
Aims
To investigate the associations of clozapine with all-cause and cause-specific mortality risk in schizophrenia patients.
Method
In this 18-year population-based cohort study, we retrieved electronic health records of schizophrenia patients from all public hospitals in Hong Kong. Clozapine users (ClozUs) comprised schizophrenia patients who initiated clozapine treatment between 2003 and 2012, with the index date set at clozapine initiation. Comparators were non-clozapine antipsychotic users (Non-ClozUs) with the same diagnosis who had never received a clozapine prescription. They were 1:2 propensity score matched with demographic characteristics and physical and psychiatric comorbidities. ClozUs were further defined according to continuation of clozapine use and co-prescription of other antipsychotics (polypharmacy). Accelerated failure time (AFT) models were used to estimate the risk of all-cause and cause-specific mortality (i.e. suicide, cardiovascular disease, infection and cancer).
Results
This study included 9,456 individuals (mean (s.d.) age at the index date: 39.13 (12.92) years; 50.73% females; median (interquartile range) follow-up time: 12.37 (9.78–15.22) years), with 2020 continuous ClozUs, 1132 discontinuous ClozUs, 4326 continuous non-ClozUs and 1978 discontinuous Non-ClozUs. Results from adjusted AFT models showed that continuous ClozUs had a lower risk of suicide mortality (acceleration factor 3.01; 99% CI: 1.41–6.44) compared with continuous Non-ClozUs. Continuous ClozUs with co-prescription of other antipsychotics exhibited lower risks of suicide mortality (acceleration factor 3.67; 1.41–9.60) and all-cause mortality (acceleration factor 1.42; 1.07–1.88) compared with continuous Non-ClozUs. No associations were found between clozapine and other cause-specific mortalities.
Conclusions
These results add to the existing evidence on the effectiveness of clozapine, particularly its anti-suicide effects, and emphasise the need for continuous clozapine use for suitable patients and the possible benefit of clozapine polypharmacy.
During the past decade, mathematics education has changed rapidly, giving rise to a polarization of opinions among the community of research mathematicians. What is the appropriate balance between theory, technique, and applications? What is the role of technology? How do we fulfil the needs of students entering other fields? The purpose of this volume, the proceedings of a conference held at the Mathematical Sciences Research Institute in Berkeley in 1996, is to present a serious discussion of these educational issues, with a balanced representation of opposing ideas. Part I deals with general issues in university mathematics education; Part II presents case studies on particular projects; Part III presents a range of opinions on mathematics education in elementary and secondary schools; and Part IV presents the reports of the working groups.
The Paragaricocrinidae is an enigmatic late Paleozoic family of camerate crinoids that retained a robustly constructed calyx more typical of Devonian to Early Mississippian crinoids. The discovery of the oldest member of this family, Tuscumbiacrinus madisonensis n. gen. n. sp., initiated a phylogenetic investigation of the Paragaricocrinidae and consideration of its diversification and paleobiogeographic distribution. Phylogenetic analyses demonstrate the need to describe Tuscumbiacrinus n. gen and conduct revisions to preexisting taxa, resulting in the description of Palenciacrinus mudaensis n. gen. n. sp.; Pulcheracrinus n. gen.; Nipponicrinus hashimotoi n. gen. n. sp.; and Nipponicrinus akiyoshiensis n. gen. n. sp. Megaliocrinus exotericus Strimple is reassigned to Pulcheracrinus n. gen. In addition to having an anachronistic morphology, relatively few specimens are known through the ca. 76-million-year duration of this family. This pattern is unlikely to have resulted from low fossil sampling alone, and instead likely reflects low abundance and/or taxonomic richness of a long-lived waning clade. From its apparent origination in Laurussia during the Mississippian, the Paragaricocrinidae diversified into a cosmopolitan clade. Following a diversity drop during the Pennsylvanian, the Paragaricocrinidae persisted but exemplified characteristics of a dead clade walking until its eventual extinction during the middle Permian (Wordian).
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.
This study evaluates mental health treatment in a post-conflict setting with scant mental health resources. The study reports on a randomized crossover control group design with one intervention and two control groups implemented in the Central African Republic (CAR).
The intervention’s impact on symptoms of depression, anxiety and trauma was analyzed among a sample of 298 participants located in the capital city, Bangui. Participants were screened for elevated levels of anxiety and depression and randomly assigned to one of three groups: control, intervention and active control. Data included an initial interview, measurement following the two intervention workshops and a 3-month post-intervention follow-up.
The trauma reduction intervention significantly reduced symptoms of depression, anxiety and trauma compared to the waitlist control. The active control group focused on peace and value education and produced equivalent outcomes to the trauma-reduction intervention group. Further, at 3 months follow-up, the impact of both interventions remained significant, although lower. The two interventions did not differ from one another.
The study demonstrates two practical approaches for addressing anxiety, depression and trauma symptoms in post-conflict, low-resource settings. The similar outcome of the two interventions may suggest that they share common therapeutic elements.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Calyptosuchus wellesi is an aetosaur known from the upper Blue Mesa Member and lowermost Sonsela Member of the Chinle Formation in Arizona, and the Tecovas Formation of the Dockum Group of Texas. The taxon is considered biostratigraphically informative and aids in correlating Upper Triassic strata across the southwestern United States. Our anatomical understanding of Calyptosuchus was primarily based on the holotype specimen from Texas and referred specimens, including several disarticulated elements from the Placerias Quarry in northern Arizona. We provide a re-interpretation of the holotype specimen and describe two new specimens referrable to Calyptosuchus from northern Arizona. Together these specimens provide new information on the cranial anatomy, including dentition, and the positional and intraspecific variation within the carapace and vertebral column of the taxon. This new evidence suggests that the skull anatomy of Calyptosuchus is more similar to that of Neoaetosauroides and Stagonolepis than to other aetosaurs. The dentition of Calyptosuchus supports recent hypotheses suggesting that aetosaurs were more omnivorous/faunivorous. The associated carapace expands our anatomical understanding of characters that vary among trunk paramedian osteoderms. We identify variation in the vertebral column within the trunk region, including the prominence of the centrodiapophyseal lamina and anatomy of the neural spine. Additionally, we report the first documentation of co-ossified sacral vertebrae within Calyptosuchus, which is also the first observation of this state within the Aetosauria outside of the Desmatosuchini. This suggests that co-ossification of the sacral vertebrae may be more prevalent within the Aetosauria than previously recognized.
Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.
Aims
To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).
Method
The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.
Results
We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8–61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being ‘satisfied’ or ‘very satisfied’ compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.
Conclusions
It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.
Globally, glaciers are changing in response to climate warming, with those that terminate in water often undergoing the most rapid change. In Alaska and northwest Canada, proglacial lakes have grown in number and size but their influence on glacier mass loss is unclear. We characterized the rates of retreat and mass loss through frontal ablation of 55 lake-terminating glaciers (>14 000 km2) in the region using annual Landsat imagery from 1984 to 2021. We find a median retreat rate of 60 m a−1 (interquartile range = 35–89 m a−1) over 1984–2018 and a median loss of 0.04 Gt a−1 (0.01–0.15 Gt a−1) mass through frontal ablation over 2009–18. Summed over 2009–18, our study glaciers lost 6.1 Gt a−1 to frontal ablation. Analysis of bed profiles suggest that glaciers terminating in larger lakes and deeper water lose more mass to frontal ablation, and that the glaciers will remain lake-terminating for an average of 74 years (38–177 a). This work suggests that as more proglacial lakes form and as lakes become larger, enhanced frontal ablation could cause higher mass losses, which should be considered when projecting the future of lake-terminating glaciers.
Commercial targeted sprayer systems allow producers to reduce herbicide inputs but risks the possibility of not treating emerging weeds. Currently, targeted applications with the John Deere system have five spray sensitivity settings, and no published literature discusses the effects of these settings on detecting and spraying weeds of varying species, sizes, and positions in crops. Research was conducted in Arkansas, Illinois, Indiana, Mississippi, and North Carolina on plantings of corn, cotton, and soybean to determine how various factors might influence the ability of targeted applications to treat weeds. These data included 21 weed species aggregated to six classes with height, width, and densities ranging from 25 to 0.25 cm, 25 to 0.25 cm, and 14.3 to 0.04 plants m−2, respectively. Crop and weed density did not influence the likelihood of treating the weeds. As expected, the sensitivity setting alters the ability to treat weeds. Targeted applications (across sensitivity settings, median weed height and width, and density of 2.4 plants m−2) resulted in a treatment success of 99.6% to 84.4% for Convolvulaceae, 99.1% to 68.8% for decumbent broadleaf weeds, 98.9% to 62.9% for Malvaceae, 99.1% to 70.3% for Poaceae, 98.0% to 48.3% for Amaranthaceae, and 98.5% to 55.8% for yellow nutsedge. Reducing the sensitivity setting reduced the ability to treat weeds. The size of weeds aided targeted application success, with larger weeds being more readily treated through easier detection. Based on these findings, various conditions can affect the outcome of targeted multinozzle applications. Additionally, the analyses highlight some of the parameters to consider when using these technologies.
Objectives/Goals: Cervical cancer is preventable through HPV vaccination and the detection/removal of precancerous lesions. Incidence and mortality rates have only decreased by 3–4% in the past decade. Despite having the tools to prevent all cervical cancers, they are not being fully utilized. Our goal is to identify barriers and design strategies to overcome them. Methods/Study Population: Women in urban (750) and rural (750) settings will be screened for the presence of high-oncogenic risk HPV (hrHPV) by self-vaginal swab, complete the Monitoring Blunting Style Scale, a validation scale to determine attentional style, and a structural barrier to care survey. A subset (Results/Anticipated Results: The study, launched in September 2024 at the Medicine Primary Care Clinic at UMC in New Orleans, has enrolled 16 women. Sample adequacy was high (82%), with 5 women having hrHPV present. Participants expressed high satisfaction and acceptance of the self-administered vaginal swab, with most samples demonstrating high quality. Surveys have been collected, and hrHPV-positive women have been referred for gynecological follow-up. Shreveport site will recruit women across over 20 rural clinical sites using a Mobile Health Unit to increase access in rural and underserved communities. Discussion/Significance of Impact: The baseline study will take 12–18 months. We will identify and address key barriers to follow-up gynecological care, including logistical issues (improving access and navigation), educational needs (developing culturally sensitive materials), and emotional support. We will create a care delivery model to eliminate cervical cancer in Louisiana.
Objectives/Goals: Early childhood obesity is a major concern for Latin American children in the U.S., with gut barrier dysfunction as a key risk factor. Diet plays a role in gut development, but few studies have focused on Latin American infants. Our objective is to identify culturally relevant introductory foods that promote in vitro gut barrier development and function. Methods/Study Population: Pooled human milk (2.5 mL) from 6-month postpartum Hispanic mothers was combined with fruit and vegetable baby food products (2.5 g) and subjected to a 3-phase in vitro digestion system that simulates oral, gastric, and intestinal digestion. Digesta products were then anaerobically fermented for 24-hours using human stool inoculum, centrifuged, and filter sterilized. Intestinal epithelial cells (Caco-2, ATCC) were grown to confluence on 0.4 μm polystyrene transwell inserts using a DMEM + 10% FBS medium and allowed to differentiate for 21-days. Highly differentiated monolayers were treated with a 1:4 dilution of fermenta with medium in triplicate. The cell experiment was conducted twice. Cell layer integrity was measured using transepithelial electrical resistance (TEER) 24- and 48-hours after treatment. Results/Anticipated Results: Dietary intake data from the What We Eat in America database indicated that the top 3 fruit and vegetable exposures for infants with Mexican or Hispanic ethnicity were banana, apple, and carrot. Commercial baby food purees of these fruits and vegetables, in addition to baby foods with blueberry and spinach (Natural for Baby, Gerber Products Company) were acquired for digestion and fermentation experiments. Caco-2 cell experiments with these foods are ongoing. We expect Caco-2 monolayer incubated with fermenta from human milk and fruit or vegetables will have greater TEER values due to increased integrity of the cell layer as compared to those with breast milk alone. We also expect that exposure to fruit and vegetable fermenta will increase gene expression of tight junctions compared to exposure to media and human milk. Discussion/Significance of Impact: Using an in vitro digestion and fermentation system coupled with cell culture studies, we are identifying cellular mechanisms that link individual fruits and vegetables to gut barrier function. This will support translational work focused on mitigating obesity development in vulnerable populations.
Since cannabis was legalized in Canada in 2018, its use among older adults has increased. Although cannabis may exacerbate cognitive impairment, there are few studies on its use among older adults being evaluated for cognitive disorders.
Methods:
We analyzed data from 238 patients who attended a cognitive clinic between 2019 and 2023 and provided data on cannabis use. Health professionals collected information using a standardized case report form.
Results:
Cannabis use was reported by 23 out of 238 patients (9.7%): 12 took cannabis for recreation, 8 for medicinal purposes and 3 for both purposes. Compared to non-users, cannabis users were younger (mean ± SD 62.0 ± 7.5 vs 68.9 ± 9.5 years; p = 0.001), more likely to have a mood disorder (p < 0.05) and be current or former cigarette smokers (p < 0.05). There were no significant differences in sex, race or education. The proportion with dementia compared with pre-dementia cognitive states did not differ significantly in users compared with non-users. Cognitive test scores were similar in users compared with non-users (Montreal Cognitive Assessment: 20.4 ± 5.0 vs 20.7 ± 4.5, p = 0.81; Folstein Mini-Mental Status Exam: 24.5 ± 5.1 vs 26.0 ± 3.6, p = 0.25). The prevalence of insomnia, obstructive sleep apnea, anxiety disorders, alcohol use or psychotic disorders did not differ significantly.
Conclusion:
The prevalence of cannabis use among patients with cognitive concerns in this study was similar to the general Canadian population aged 65 and older. Further research is necessary to investigate patients’ motivations for use and explore the relationship between cannabis use and mood disorders and cognitive decline.
Residual herbicides are primarily degraded in the soil through microbial breakdown. Any practices that result in increased soil biological activity, such as cover cropping (between cash crop seasons), could lead to a reduced persistence of herbicides in the soil. Furthermore, cover crops can also interfere with herbicide fate by interception. Field trials were conducted between 2020 and 2023 in a corn (Zea mays L.)–soybean [Glycine max (L.) Merr.] rotation to investigate the influence of cover crop (cereal rye [Secale cereale L.] and crimson clover [Trifolium incarnatum L.]) use on soil enzyme activities (β-glucosidase [BG] and dehydrogenase [DHA]), its effect on the concentration of residual herbicides (sulfentrazone, S-metolachlor, cloransulam-methyl, atrazine, and mesotrione) in the soil, and the interception of herbicides by cover crop residue. The use of cover crops occasionally resulted in increased BG and DHA activities relative to the fallow treatment. However, even when there was an increase in the activity of these two enzymes, increased degradation of the residual herbicides was not observed. The initial concentrations of all residual herbicides in the soil were significantly reduced due to interception by cereal rye biomass. Nevertheless, significant reductions in early-season weed biomass were observed when residual herbicides were included in the tank mixture applied at cover crop termination relative to the application of glyphosate plus glufosinate. Results from this research suggest that the use of cereal rye or crimson clover as cover crops (between cash crop seasons) do not impact the persistence of residual herbicides in the soil or reduce their efficacy in controlling weeds early in the growing season.