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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.
To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.
Design:
Cross-sectional study.
Setting:
US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011–2012 through 2018–2019 seasons.
Methods:
Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza.
Results:
Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons.
Conclusions:
Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.
We present the data and initial results from the first pilot survey of the Evolutionary Map of the Universe (EMU), observed at 944 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The survey covers $270 \,\mathrm{deg}^2$ of an area covered by the Dark Energy Survey, reaching a depth of 25–30 $\mu\mathrm{Jy\ beam}^{-1}$ rms at a spatial resolution of $\sim$11–18 arcsec, resulting in a catalogue of $\sim$220 000 sources, of which $\sim$180 000 are single-component sources. Here we present the catalogue of single-component sources, together with (where available) optical and infrared cross-identifications, classifications, and redshifts. This survey explores a new region of parameter space compared to previous surveys. Specifically, the EMU Pilot Survey has a high density of sources, and also a high sensitivity to low surface brightness emission. These properties result in the detection of types of sources that were rarely seen in or absent from previous surveys. We present some of these new results here.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
Important Bird and Biodiversity Areas (IBAs) are sites identified as being globally important for the conservation of bird populations on the basis of an internationally agreed set of criteria. We present the first review of the development and spread of the IBA concept since it was launched by BirdLife International (then ICBP) in 1979 and examine some of the characteristics of the resulting inventory. Over 13,000 global and regional IBAs have so far been identified and documented in terrestrial, freshwater and marine ecosystems in almost all of the world’s countries and territories, making this the largest global network of sites of significance for biodiversity. IBAs have been identified using standardised, data-driven criteria that have been developed and applied at global and regional levels. These criteria capture multiple dimensions of a site’s significance for avian biodiversity and relate to populations of globally threatened species (68.6% of the 10,746 IBAs that meet global criteria), restricted-range species (25.4%), biome-restricted species (27.5%) and congregatory species (50.3%); many global IBAs (52.7%) trigger two or more of these criteria. IBAs range in size from < 1 km2 to over 300,000 km2 and have an approximately log-normal size distribution (median = 125.0 km2, mean = 1,202.6 km2). They cover approximately 6.7% of the terrestrial, 1.6% of the marine and 3.1% of the total surface area of the Earth. The launch in 2016 of the KBA Global Standard, which aims to identify, document and conserve sites that contribute to the global persistence of wider biodiversity, and whose criteria for site identification build on those developed for IBAs, is a logical evolution of the IBA concept. The role of IBAs in conservation planning, policy and practice is reviewed elsewhere. Future technical priorities for the IBA initiative include completion of the global inventory, particularly in the marine environment, keeping the dataset up to date, and improving the systematic monitoring of these sites.
There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the ‘Emerging mental health systems in low- and middle-income countries’ (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.
Efforts to support the scale-up of integrated mental health care in low- and middle-income countries (LMICs) need to focus on building human resource capacity in health system strengthening, as well as in the direct provision of mental health care. In a companion editorial, we describe a range of capacity-building activities that are being implemented by a multi-country research consortium (Emerald: Emerging mental health systems in low- and middle-income countries) for (1) service users and caregivers, (2) service planners and policy-makers and (3) researchers in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). In this paper, we focus on the methodology being used to evaluate the impact of capacity-building in these three target groups. We first review the evidence base for approaches to evaluation of capacity-building, highlighting the gaps in this area. We then describe the adaptation of best practice for the Emerald capacity-building evaluation. The resulting mixed method evaluation framework was tailored to each target group and to each country context. We identified a need to expand the evidence base on indicators of successful capacity-building across the different target groups. To address this, we developed an evaluation plan to measure the adequacy and usefulness of quantitative capacity-building indicators when compared with qualitative evaluation. We argue that evaluation needs to be an integral part of capacity-building activities and that expertise needs to be built in methods of evaluation. The Emerald evaluation provides a potential model for capacity-building evaluation across key stakeholder groups and promises to extend understanding of useful indicators of success.
Important Bird Areas (IBAs) form a network of priority sites that are critical for the conservation of birds and biodiversity. A standard framework for monitoring IBAs is being implemented by the BirdLife Partnership globally. Scores are assigned on a simple ranked scale for state (condition), pressure (threats) and response (conservation action) at each site, from which IBA indices can be calculated. In Kenya, this scoring system was applied retrospectively using information in the national IBA directory (1999) and subsequent status reports (2004 and 2005). IBA indices for 36 IBAs show that their average condition deteriorated between 1999 and 2005, with the mean state score being between ‘unfavourable’ and ‘near favourable’. Pressures on IBAs showed a slight decline in intensity, especially from 2004 to 2005, coincident with an improvement in management that was reflected in increasing response scores. Compared to unprotected IBAs, officially protected sites had substantially greater conservation responses underway, were subject to marginally lower pressures and tended to be in slightly better condition. Other disaggregations of the data allow comparisons to be made for sites in different habitats, of different size, and managed by different agencies. This national example for Kenya suggests that the BirdLife IBA monitoring framework provides a simple but effective way of tracking trends in the state of IBAs, the pressures upon them, and the responses in place. The system is sensitive enough to detect differences between sites and over time, but simple enough to be implemented with little training and without sophisticated technology. The results provide vital information for managers of individual protected areas, management agencies responsible for suites of sites, and national governments, and can be used to track progress in tackling the global biodiversity crisis.
The UK was one of few European countries to document a substantial wave of pandemic (H1N1) 2009 influenza in summer 2009. The First Few Hundred (FF100) project ran from April–June 2009 gathering information on early laboratory-confirmed cases across the UK. In total, 392 confirmed cases were followed up. Children were predominantly affected (median age 15 years, IQR 10–27). Symptoms were mild and similar to seasonal influenza, with the exception of diarrhoea, which was reported by 27%. Eleven per cent of all cases had an underlying medical condition, similar to the general population. The majority (92%) were treated with antiviral drugs with 12% reporting adverse effects, mainly nausea and other gastrointestinal complaints. Duration of illness was significantly shorter when antivirals were given within 48 h of onset (median 5 vs. 9 days, P=0·01). No patients died, although 14 were hospitalized, of whom three required mechanical ventilation. The FF100 identified key clinical and epidemiological characteristics of infection with this novel virus in near real-time.
There were four 1.5-hour sessions of Division I business meetings during the XXVIIth IAU General Assembly. The first three were devoted to the reports of Commissions, Working Groups and services associated with the Division, discussion about plans for the next triennium and future structure of the Division. Scientific presentations on the future space astrometric mission Gaia were made at the fourth session.
The Tarantula Survey is an ambitious ESO Large Programme that has obtained multi-epoch spectroscopy of over 1000 massive stars in the 30 Doradus region in the Large Magellanic Cloud. Here, we introduce the scientific motivations of the survey and give an overview of the observational sample. Ultimately, quantitative analysis of every star, paying particular attention to the effects of rotational mixing and binarity, will be used to address fundamental questions in both stellar and cluster evolution.
Cytoplasmic petite mutants, spontaneous and induced, show various patterns of ability υ. inability to utilize the sugars galactose, α-methylglucoside and maltose, depending on the strain from which they were isolated. Petites recombine and segregate their different sugar deficiencies among vegetative diploid progeny when crossed, indicating mitochondrial control. Crosses between petites and wild-type further indicate that mitochondrial factors may be interacting with nuclear factors in a complex regulatory system.
A haploid strain of Saccharomyces cerevisiae has been described which, on glucose medium, segregates vegetatively a high frequency of mutants with different degrees of respiratory impairment. The range of mutants seemingly encompasses both non-revertible ρ- petites and revertible point mutations resembling leaky mit- mutations. The segregants have aberrant cytochrome contents and reduced growth capabilities on fermentable sugars other than glucose; these defects apparently correlate with the degree of respiratory impairment. Genetic analysis of this mutator phenomenon has implicated a nuclear gene which appears to show specificity of interaction with the mitochondrial genome as well as a requirement for glucose repression. The mutator effect seems to extend also to the loci in mitochondrial DNA for resistance to the antibiotics erythromycin and oligomycin.
Incubation of adult Schistosoma mansoni at 37 °C in chemically defined media caused the shedding of variable amounts of the parasite's tegument. In phosphate-buffered saline, pH 7·4, 37% of 125I-labelled wheat germ agglutinin which was attached to the schistosome surface was released within 5 min. When the released material was collected by centrifugation at 55000 g for 1 h, the pellet was seen to consist of components of the parasite tegument and contained 1% of the parasite protein and 6·2% of the 5′-AMPase activity. By monitoring the release of the gut enzyme, haemoglobinase, it was shown that predominantly tegumental material was released under these conditions. The material released from the parasite was separated by discontinuous sucrose gradient centrifugation into 4 major fractions and it was shown that a material banding at low density was highly enriched in vesicles of parasite outer membrane. Major polypeptides of apparent molecular weights 135000, 110000, 90000, 65000, 47000 and 40000 and glycoproteins of apparent molecular weights 135000, 120000, 65000, 63000 and 30–40000 were identified in this fraction. Comparison of the distribution of 5′-AMPase activity and the contents of each fraction as revealed by ultrastructural examination showed that this enzyme is a good marker for the tegumental outer membrane.