116 results
Esketamine nasal spray shows higher remission and response rates over 32 weeks of treatment compared with quetiapine extended-release in patients with treatment resistant depression: Results from ESCAPE-TRD, a randomised, phase IIIb clinical trial
- A. Reif, A. E. Anıl Yağcıoğlu, A. Luts, T. Messer, R. Nielsen, J. Buyze, T. Ito, Y. Kambarov, S. Mulhern Haughey, B. Rive, I. Usankova, C. von Holt, Y. Godinov
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S90-S91
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Treatment resistant depression (TRD) is estimated to affect 10–30% of patients with major depressive disorder (Al‑Harbi et al. Patient Prefer Adherence 2012; 6 369–88). Esketamine nasal spray (NS), in combination with a selective serotonin reuptake inhibitor (SSRI) or serotonin norepinephrine reuptake inhibitor (SNRI), increases remission and response rates in patients with TRD compared with placebo plus SSRI/SNRI (Popova et al. Am J Psychiatry 2019; 176 428–38). ESCAPE-TRD (NCT04338321) is the first randomised clinical trial to compare esketamine NS to quetiapine extended-release (XR), an antipsychotic augmentation therapy for patients with TRD.
ObjectivesTo explore the efficacy and safety of esketamine NS compared with quetiapine XR in TRD over 32 weeks (wks).
MethodsIn the ESCAPE-TRD phase IIIb open-label, rater-blinded trial, patients were randomised 1:1 to esketamine NS (56/84 mg; twice per wk, weekly or every 2 wks) or quetiapine XR (150–300 mg daily) both in combination with an ongoing SSRI/SNRI. Remission (Montgomery-Åsberg Depression Rating Scale [MADRS] total score of ≤10) and response (≥50% improvement in MADRS total score from baseline or MADRS≤10) rates were analysed over time using last observation carried forward. MADRS change from baseline was analysed using Mixed Models for Repeated Measures (MMRM). The most common adverse events (AEs) leading to discontinuation are reported for patients who received ≥1 dose of study medication.
ResultsAt baseline, 336 patients were randomised to esketamine NS and 340 to quetiapine XR. A significantly higher percentage of patients in the esketamine NS group achieved remission (at each visit from Wk6 [p=0.008] onward) and response (at each visit from Day 15 [p<0.001] onward) versus patients treated with quetiapine XR. Esketamine NS significantly improved MADRS score compared to quetiapine XR at each visit from Day 8 onwards, with an average difference over time in the least squares means total MADRS score change from baseline of -2.4 (Figure). The most common AEs leading to treatment discontinuation for esketamine NS were dizziness (n=2, 0.6%), dissociation (n=2, 0.6%) and vomiting (n=2, 0.6%), and for quetiapine XR were sedation (n=7, 2.1%), weight increased (n=6, 1.8%) and somnolence (n=5, 1.5%).
Image:
ConclusionsEsketamine NS increased the percentage of patients achieving response and remission and improved MADRS total score over time compared with quetiapine XR. Rates of discontinuation arising from the most common AEs were generally lower with esketamine NS than quetiapine XR.
AcknowledgementsWe thank participating patients and all who assisted with the study. This study was funded by Janssen; medical writing support was provided by Carolyn Walsh, PhD, Costello Medical, UK.
Disclosure of InterestA. Reif Grant / Research support from: Medice, Consultant of: National Care Guidelines (NVL, S3) on major depression, bipolar disorder, ADHD and suicidal behaviour (aided in developing guidelines); board member of DGBS, DGPPN, ECNP and German Depression Foundation, Speakers bureau of: (and participated in advisory boards over the last 3 years) for Cyclerion, Janssen, Medice, SAGE/Biogen and Shire/Takeda; received speaker’s honoraria from Das Fortbildungskolleg; , A. E. Anıl Yağcıoğlu Grant / Research support from: Participated as an investigator for Janssen, Speakers bureau of: (and participated in advisory boards over the last 3 years) for Janssen and Abdi İbrahim Otsuka, A. Luts Speakers bureau of: (or participated in advisory boards for or participated as an investigator) for Janssen-Cilag, Asarina Pharma, Bristol Meyer Squibb, Dr August Wolff GmbH & Co, Eli Lilly, Lundbeck, Pfizer, Allergan, Sunovion and Regeneron., T. Messer Consultant of: National Care Guidelines (NVL, S3) on major depression (aided in developing guidelines), Speakers bureau of: (and participated in advisory boards) for Janssen-Cilag and Otsuka/Lundbeck, R. Nielsen Consultant of: Board member of DSAL and IGSLi, Speakers bureau of: (or participated in advisory boards, received research funds or participated as investigator over the last 3 years) for Boehringer Ingelheim, Compass Pharmaceuticals, Janssen-Cilag, Lundbeck, Otsuka, Sage and Teva Pharmaceuticals, J. Buyze Employee of: Janssen, T. Ito Employee of: Janssen, Y. Kambarov Employee of: Janssen, S. Mulhern Haughey Employee of: Janssen, B. Rive Employee of: Janssen, I. Usankova Employee of: Janssen, C. von Holt Employee of: Janssen, Y. Godinov Employee of: Janssen
Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood
- H. N. Ziobrowski, B. Holt-Gosselin, M. V. Petukhova, A. J. King, S. Lee, S. L. House, F. L. Beaudoin, X. An, J. S. Stevens, D. Zeng, T. C. Neylan, G. D. Clifford, S. D. Linnstaedt, L. T. Germine, K. A. Bollen, S. L. Rauch, J. P. Haran, A. B. Storrow, C. Lewandowski, P. I. Musey, P. L. Hendry, S. Sheikh, C. W. Jones, B. E. Punches, M. C. Kurz, R. A. Swor, L. A. Hudak, J. L. Pascual, M. J. Seamon, E. Harris, C. Pearson, R. C. Merchant, R. M. Domeier, N. K. Rathlev, B. J. O'Neil, P. Sergot, L. D. Sanchez, S. E. Bruce, M. W. Miller, R. H. Pietrzak, J. Joormann, D. M. Barch, D. A. Pizzagalli, S. E. Harte, J. M. Elliott, K. J. Ressler, S. A. McLean, K. C. Koenen, R. C. Kessler
-
- Journal:
- Epidemiology and Psychiatric Sciences / Volume 32 / 2023
- Published online by Cambridge University Press:
- 10 January 2023, e1
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Aims
Childhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse posttraumatic neuropsychiatric sequelae (APNS) is important for targeting prevention interventions.
MethodsData came from n = 999 patients ages 18–75 presenting to 29 U.S. emergency departments after a motor vehicle collision (MVC) and followed for 3 months, the amount of time traditionally used to define chronic PTSD, in the Advancing Understanding of Recovery After Trauma (AURORA) study. Six CA types were self-reported at baseline: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and bullying. Both dichotomous measures of ever experiencing each CA type and numeric measures of exposure frequency were included in the analysis. Risk ratios (RRs) of these CA measures as well as complex interactions among these measures were examined as predictors of APNS 3 months post-MVC. APNS was defined as meeting self-reported criteria for either PTSD based on the PTSD Checklist for DSM-5 and/or MDE based on the PROMIS Depression Short-Form 8b. We controlled for pre-MVC lifetime histories of PTSD and MDE. We also examined mediating effects through peritraumatic symptoms assessed in the emergency department and PTSD and MDE assessed in 2-week and 8-week follow-up surveys. Analyses were carried out with robust Poisson regression models.
ResultsMost participants (90.9%) reported at least rarely having experienced some CA. Ever experiencing each CA other than emotional neglect was univariably associated with 3-month APNS (RRs = 1.31–1.60). Each CA frequency was also univariably associated with 3-month APNS (RRs = 1.65–2.45). In multivariable models, joint associations of CAs with 3-month APNS were additive, with frequency of emotional abuse (RR = 2.03; 95% CI = 1.43–2.87) and bullying (RR = 1.44; 95% CI = 0.99–2.10) being the strongest predictors. Control variable analyses found that these associations were largely explained by pre-MVC histories of PTSD and MDE.
ConclusionsAlthough individuals who experience frequent emotional abuse and bullying in childhood have a heightened risk of experiencing APNS after an adult MVC, these associations are largely mediated by prior histories of PTSD and MDE.
Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK
- K. S. Young, K. L. Purves, C. Hübel, M. R. Davies, K. N. Thompson, S. Bristow, G. Krebs, A. Danese, C. Hirsch, C. E. Parsons, E. Vassos, B. N. Adey, S. Bright, L. Hegemann, Y. T. Lee, G. Kalsi, D. Monssen, J. Mundy, A. J. Peel, C. Rayner, H. C. Rogers, A. ter Kuile, C. Ward, K. York, Y. Lin, A. B. Palmos, U. Schmidt, D. Veale, T. R. Nicholson, T. A. Pollak, S. A. M. Stevelink, T. Moukhtarian, A. R. Martineau, H. Holt, B. Maughan, A. Al-Chalabi, K. Ray Chaudhuri, M. P. Richardson, J. R. Bradley, P. F. Chinnery, N. Kingston, S. Papadia, K. E. Stirrups, R. Linger, M. Hotopf, T. C. Eley, G. Breen
-
- Journal:
- Psychological Medicine / Volume 53 / Issue 12 / September 2023
- Published online by Cambridge University Press:
- 26 July 2022, pp. 5428-5441
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors.
MethodOnline questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change.
ResultsProspective symptom analyses showed small decreases in depression (PHQ-9: −0.43 points) and anxiety [generalised anxiety disorder scale – 7 items (GAD)-7: −0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status.
ConclusionsWe highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.
Value of Nontargeted Screening for Highly Resistant Microorganisms: The MOVE Study
- Adriënne S. van der Schoor, Anne F. Voor in ‘t holt, Juliëtte A. Severin, Diederik Gommers, Marco J. Bruno, Joke M. Hendriks, Margreet C. Vos
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s429-s430
- Print publication:
- October 2020
-
- Article
-
- You have access Access
- Export citation
-
Background: In the Erasmus MC University Medical Center, Rotterdam, the Netherlands, patients considered at risk for carrying highly resistant microorganisms (HRMO) are placed in isolation on admission, until tested negative for HRMO (ie, targeted screening). Patients without risk factors are not routinely screened (ie, nontargeted screening). However, nontargeted screening could identify patients colonized with HRMO missed by targeted screening. To determine the additional value of nontargeted screening, we compared the outcomes of the nontargeted screening approach with all available clinical cultures. Objective: We aim to identify patients colonized with HRMO, but missed by targeted screening, and to determine whether non-targeted screening has additional value. Methods: For the MOVE study, nontargeted admission and discharge cultures (nose and perianal) were obtained from randomly selected patients admitted to specific wards, regardless of HRMO risk factors. This study was part of a research initiative to identify the relation of a contaminated environment with the risk of becoming infected or colonized on a patient level. All bacteriological clinical samples positive for at least 1 HRMO from January 1, 2018, until August 31, 2019, were compared with the nontargeted screening samples. Samples were screened for methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) as well as highly resistant Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus faecium, and Enterobacteriales. Broth enrichment was used for all cultures. Results: During the study period, 50,653 patients were admitted. 706 patients (1%) had a clinical sample positive for at least 1 HRMO during their hospital stay. 936 (1.8%) patients were included in the nontargeted screening for the MOVE study, and 40 patients were found to have at least 1 culture positive for HRMO (4.3%). Among these 40 patients, 28 were positive at admission and 12 were positive at discharge. Extended-spectrum β-lactamase (ESBL)–producing Enterobacteriales were most prevalent (n = 36, 90.0%) both at admission and discharge (n = 26 and n = 10, respectively). At admission, 1 patient was identified with MRSA and 1 patient was positive for vancomycin-resistant E. faecium (VRE). At discharge, 1 patient was identified with VRE and 1 had Verona Integron-encoded Metallo-β-lactamase (VIM)–positive P. aeruginosa. Conclusions: Our results show that the current targeted screening does not identify all HRMO carriers. Furthermore, patients who acquire an HRMO during admission are missed. The nontargeted screening identified 40 unknown carriers (4.3%). The limitations of the study are the restricted number of sample sites and the fact that we were unable to culture all patients. Therefore, it is likely that our study shows an underestimation of the true number of patients with HRMO.
Funding: None
Disclosures: None
100% Single-Patient Rooms and Environmental Contamination With Highly Resistant Microorganisms: The MOVE Study
- Adriënne S. van der Schoor, Anne F. Voor in ‘t holt, Juliëtte A. Severin, Diederik Gommers, Marco J. Bruno, Joke M. Hendriks, Margreet C. Vos
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s91-s92
- Print publication:
- October 2020
-
- Article
-
- You have access Access
- Export citation
-
Background: Studies have shown that patients colonized with highly resistant microorganisms (HRMO) contaminate the hospital environment, and that transmission from contaminated environments to patients occurs. In May 2018, the Erasmus MC University Medical Center, Rotterdam, moved from a hospital with mostly multiple-occupancy rooms to a new hospital with 100% single-patient rooms with private bathrooms. This move provided the unique opportunity to determine environmental contamination before the new hospital was open for admissions and thereafter and to compare the environmental contamination to the number of patients colonized with HRMO. Method: Environmental sampling took place twice in the old building and 12 times in the new building, from 2 weeks before to 15 months after relocating patients. At each moment, ~306 samples were taken from 13 locations (eg, nightstands, sinks) in 40 patient rooms. Samples were screened for Staphylococcus aureus (methicillin-susceptible [MSSA] and methicillin resistant [MRSA]) and highly resistant Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus faecium, and Enterobacteriales. During the study period, January 1, 2018, until August 31, 2019, all clinical samples positive for HRMO were included. Results: Environmental sampling revealed that 29 of 724 (4.0%) locations were positive for HRMO in the old building, whereas 4 of 3,358 (0.1%) samples in the new building were positive for HRMO (P < .001). In the old building, 14 of 29 locations were positive for extended-spectrum β-lactamase (ESBL)–producing bacteria and 15 were positive for carbapenemase-producing bacteria. In the new building, 3 of 4 positive samples were positive for vancomycin-resistant E. faecium (VRE), 1 was positive for ESBL-producing K. pneumoniae. For both HRMO, no carriers were detected. In the old building, 145 of 12,256 adult patients (1.2%) had clinical samples positive for HRMO, compared to 561 of 38,397 (1.5%) in the new building, a small but significant increase (P = .02). Conclusions: The transition from mainly 2- and 4-person rooms to 100% single-patient rooms resulted in a significant decrease in environmental contamination, even though the number of patients colonized with HRMO slightly increased. No molecular typing to determine transfer from environment to patients and vice versa has yet been performed. Future sampling is needed to determine whether the low environmental contamination is a long-term effect of the transition to single rooms.
Funding: None
Disclosures: None
Surviving psychiatry on-calls
- C. Holt, R. Mirvis, S. Butler, A. Howe, P. Lowe, J. Mullin, D. Mirzadeh, R. Sedgwick, T. Zacharia
-
- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. s896
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Out of hours, there is only one on-site junior doctor. First year psychiatry trainees (CT1s) and GP trainees may have no prior experience in psychiatry. On-call shifts are therefore potentially daunting for new trainees.
ObjectivesExpand the resources available for trainees when on-call.
MethodsWe issued questionnaires to CT1s asking if they would have appreciated more information about on-call scenarios and in what format.
Based on the questionnaire results we implemented some changes. These were:
– a printed “pocket-guide” summarising common on-call scenarios;
– a training video on common on-call scenarios.
The handout was given to new trainees in February 2016 and in August 2016. The video was shown to new trainees in August 2016. Trainees provided feedback on the resources.
ResultsOf 24 CT1s, 15 (63%) were “neutral” or “disagreed” that they had felt prepared for on-calls.
CT1s wanted additional resources, especially a paper handout or phone download.
Feedback on the “pocket-guide” from trainees in February 2016 (n = 8) was positive (62.5% reported increased confidence in on-call situations). Feedback is also being collected from trainees who received the guide in August 2016.
Trainees in August 2016 (n = 36) liked the video – no trainees “disagreed” with statements asking if the video had been useful.
The video improved the confidence of trainees about on-call situations by an average of 2.8 points.
ConclusionsWe have expanded available resources relating to on-calls and improved confidence. Further improvements would include making resources more easily available in downloadable formats.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
An outbreak of ST307 extended-spectrum beta-lactamase (ESBL)–producing Klebsiella pneumoniae in a rehabilitation center: An unusual source and route of transmission
- Marrit B. Boonstra, Dorien C. M. Spijkerman, Anne F. Voor in ‘t holt, Rob J. van der Laan, Lonneke G. M. Bode, Wim van Vianen, Corné H. W. Klaassen, Margreet C. Vos, Juliëtte A. Severin
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue 1 / January 2020
- Published online by Cambridge University Press:
- 05 November 2019, pp. 31-36
- Print publication:
- January 2020
-
- Article
- Export citation
-
Objective:
Nosocomial outbreaks due to multidrug-resistant microorganisms in rehabilitation centers have rarely been reported. We report an outbreak of extended-spectrum beta-lactamase (ESBL)–producing Klebsiella pneumoniae (ESBL-K. pneumoniae) on a single ward in a rehabilitation center in Rotterdam, The Netherlands.
Design:Outbreak description.
Setting:A 40-bed ward of a rehabilitation center in the Netherlands.
Methods:In October 2016, 2 patients were found to be colonized by genetically indistinguishable ESBL-K. pneumoniae isolates. Therefore, an outbreak management team was installed, by whom a contact tracing plan was made. In addition to general outbreak measures, specific measures were formulated to allow continuation of the rehabilitation process. Also, environmental cultures were taken. Multiple-locus variable-number tandem-repeat analysis and amplification fragment-length polymorphism were used to determine strain relatedness. Selected isolates were subjected to whole-genome multilocus sequence typing.
Results:The outbreak lasted 8 weeks. In total, 14 patients were colonized with an ESBL-K. pneumoniae, of whom 11 patients had an isolate belonging to sequence type 307. Overall, 163 environmental cultures were taken. Several sites of a household washing machine were repeatedly found to be contaminated with the outbreak strain. This machine was used to wash lifting slings and patient clothing contaminated with feces. The outbreak was contained after taking the machine temporarily out of service and implementing a reinforced and adapted protocol on the use of this machine.
Conclusion:We conclude that in this outbreak, the route of transmission of the outbreak strain via the household washing machine played a major role.
Maternal antenatal mood and child development: an exploratory study of treatment effects on child outcomes up to 5 years
- J. Milgrom, C. J. Holt, L. S. Bleker, C. Holt, J. Ross, J. Ericksen, V. Glover, K. J. O’Donnell, S. R. de Rooij, A. W. Gemmill
-
- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 10 / Issue 2 / April 2019
- Published online by Cambridge University Press:
- 10 October 2018, pp. 221-231
-
- Article
- Export citation
-
Effective treatment of maternal antenatal depression may ameliorate adverse neurodevelopmental outcomes in offspring. We performed two follow-up rounds of children at age 2 and age 5 whose mothers had received either specialized cognitive-behavioural therapy or routine care for depression while pregnant. Of the original cohort of 54 women, renewed consent was given by 28 women for 2-year follow-up and by 24 women for 5-year follow-up. Child assessments at the 2-year follow-up included the Parenting Stress Index (PSI), Bayley Scales of Infant Development (BSID-III) and the Child Behaviour Checklist (CBCL). The 5-year follow-up included the Wechsler Preschool and Primary Scales of Intelligence (WPPSI-III) and again the CBCL. Treatment during pregnancy showed significant benefits for children’s development at age 2, but not at age 5. At 2 years, intervention effects were found with lower scores on the PSI Total score, Parent Domain and Child domain (d=1.44, 1.47, 0.96 respectively). A non-significant trend favoured the intervention group on most subscales of the CBCL and the BSID-III (most notably motor development: d =0.52). In contrast, at 5-year follow-up, no intervention effects were found. Also, irrespective of treatment allocation, higher depression or anxiety during pregnancy was associated with higher CBCL and lower WPPSI-III scores at 5 years. This is one of the first controlled studies to evaluate the long-term effect of antenatal depression treatment on infant neurodevelopmental outcomes, showing some benefit. Nevertheless, caution should be taken interpreting the results because of a small sample size, and larger studies are warranted.
Challenges and Opportunities with Highly Brilliant X-ray Sources for multi-Modal in-Situ and Operando Characterization of Solar Cells
- M. E. Stuckelberger, T. Nietzold, B. M. West, T. Walker, C. Ossig, M. Kahnt, F. Wittwer, J. Deng, J. M. Maser, B. Lai, Z. Cai, V. Rose, A. Ulvestad, M. V. Holt, S. Hruszkewycz, J. J. Dynes, J. Wang, D. Salomon, R. Tucoulou, X. Huang, H. Yan, E. Nazaretski, Y. S. Chu, C. G. Schroer, M. I. Bertoni
-
- Journal:
- Microscopy and Microanalysis / Volume 24 / Issue S2 / August 2018
- Published online by Cambridge University Press:
- 10 August 2018, pp. 434-435
- Print publication:
- August 2018
-
- Article
-
- You have access Access
- Export citation
Stable isotope (δD–δ18O) relationships of ice facies and glaciological structures within the mid-latitude maritime Fox Glacier, New Zealand
- John R. Appleby, Martin S. Brook, Travis W. Horton, Ian C. Fuller, Katherine A. Holt, Duncan J. Quincey
-
- Journal:
- Annals of Glaciology / Volume 58 / Issue 75pt2 / July 2017
- Published online by Cambridge University Press:
- 04 July 2017, pp. 155-165
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Relationships between stable isotopes (δD–δ18O), ice facies and glacier structures have hitherto gone untested in the mid-latitude maritime glaciers of the Southern Hemisphere. Here, we present δD–δ18O values as part of a broader study of the structural glaciology of Fox Glacier, New Zealand. We analyzed 94 samples of δD–δ18O from a range of ice facies to investigate whether isotopes have potential for structural glaciological studies of a rapidly deforming glacier. The δD–δ18O measurements were aided by structural mapping and imagery from terminus time-lapse cameras. The current retreat phase was preceded by an advance of 1 km between 1984 and 2009, with the isotopic sampling and analysis undertaken at the end of that advance (2010/11). Stable isotopes from debris-bearing shear planes near the terminus, interpreted as thrust faults, are isotopically enriched compared with the surrounding ice. When plotted on co-isotopic diagrams (δD–δ18O), ice sampled from the shear planes appears to show a subtle, but distinctive isotopic signal compared with the surrounding clean ice on the lower glacier. Hence, stable isotopes (δD–δ18O) have potential within the structural glaciology field, but larger sample numbers than reported here may be required to establish isotopic contrasts between a broad range of ice facies and glacier structures.
Genetic Variation in Yellow Nutsedge (Cyperus esculentus)
- Michael J. Horak, Jodie S. Holt, Norman C. Ellstrand
-
- Journal:
- Weed Science / Volume 35 / Issue 4 / July 1987
- Published online by Cambridge University Press:
- 12 June 2017, pp. 506-512
-
- Article
- Export citation
-
Genetic diversity within and among populations of yellow nutsedge (Cyperus esculentus L. # CYPES) was analyzed to evaluate and quantify the genetic consequences of the reported predominance of asexually-produced tubers as colonizing agents. Ten populations were examined using starch gel electrophoresis for allozyme analysis. Four populations of purple nutsedge (Cyperus rotundus L. # CYPRO) were surveyed for comparison. Twelve loci were identified in yellow nutsedge among the eight enzyme systems examined; ten of these loci were found in purple nutsedge. Yellow nutsedge showed relatively low genetic diversity. Most of the genetic diversity occurred as differences among individuals within populations (Hs), compared to differences among populations (Dst) for the four variable loci identified in this species. Thus, most genetic distances between its populations were small. Generally, only a few genotypes occurred within each population. Purple nutsedge was found to possess even lower within- and among-population gene and genotypic diversity. This study supports the view that tubers account for most of the establishment of new populations of both species.
Planetary science and exploration in the deep subsurface: results from the MINAR Program, Boulby Mine, UK
- Samuel J. Payler, Jennifer F. Biddle, Andrew J. Coates, Claire R. Cousins, Rachel E. Cross, David C. Cullen, Michael T. Downs, Susana O. L. Direito, Thomas Edwards, Amber L. Gray, Jac Genis, Matthew Gunn, Graeme M. Hansford, Patrick Harkness, John Holt, Jean-Luc Josset, Xuan Li, David S. Lees, Darlene S. S. Lim, Melissa Mchugh, David Mcluckie, Emma Meehan, Sean M. Paling, Audrey Souchon, Louise Yeoman, Charles S. Cockell
-
- Journal:
- International Journal of Astrobiology / Volume 16 / Issue 2 / April 2017
- Published online by Cambridge University Press:
- 20 April 2016, pp. 114-129
-
- Article
- Export citation
-
The subsurface exploration of other planetary bodies can be used to unravel their geological history and assess their habitability. On Mars in particular, present-day habitable conditions may be restricted to the subsurface. Using a deep subsurface mine, we carried out a program of extraterrestrial analog research – MINe Analog Research (MINAR). MINAR aims to carry out the scientific study of the deep subsurface and test instrumentation designed for planetary surface exploration by investigating deep subsurface geology, whilst establishing the potential this technology has to be transferred into the mining industry. An integrated multi-instrument suite was used to investigate samples of representative evaporite minerals from a subsurface Permian evaporite sequence, in particular to assess mineral and elemental variations which provide small-scale regions of enhanced habitability. The instruments used were the Panoramic Camera emulator, Close-Up Imager, Raman spectrometer, Small Planetary Linear Impulse Tool, Ultrasonic drill and handheld X-ray diffraction (XRD). We present science results from the analog research and show that these instruments can be used to investigate in situ the geological context and mineralogical variations of a deep subsurface environment, and thus habitability, from millimetre to metre scales. We also show that these instruments are complementary. For example, the identification of primary evaporite minerals such as NaCl and KCl, which are difficult to detect by portable Raman spectrometers, can be accomplished with XRD. By contrast, Raman is highly effective at locating and detecting mineral inclusions in primary evaporite minerals. MINAR demonstrates the effective use of a deep subsurface environment for planetary instrument development, understanding the habitability of extreme deep subsurface environments on Earth and other planetary bodies, and advancing the use of space technology in economic mining.
Whole genome sequencing reveals extensive community-level transmission of group A Streptococcus in remote communities
- A. C. BOWEN, T. HARRIS, D. C. HOLT, P. M. GIFFARD, J. R. CARAPETIS, P. T. CAMPBELL, J. McVERNON, S. Y. C. TONG
-
- Journal:
- Epidemiology & Infection / Volume 144 / Issue 9 / July 2016
- Published online by Cambridge University Press:
- 01 February 2016, pp. 1991-1998
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Impetigo is common in remote Indigenous children of northern Australia, with the primary driver in this context being Streptococcus pyogenes [or group A Streptococcus (GAS)]. To reduce the high burden of impetigo, the transmission dynamics of GAS must be more clearly elucidated. We performed whole genome sequencing on 31 GAS isolates collected in a single community from children in 11 households with ⩾2 GAS-infected children. We aimed to determine whether transmission was occurring principally within households or across the community. The 31 isolates were represented by nine multilocus sequence types and isolates within each sequence type differed from one another by only 0–3 single nucleotide polymorphisms. There was evidence of extensive transmission both within households and across the community. Our findings suggest that strategies to reduce the burden of impetigo in this setting will need to extend beyond individual households, and incorporate multi-faceted, community-wide approaches.
High burden of invasive group A streptococcal disease in the Northern Territory of Australia
- R. BOYD, M. PATEL, B. J. CURRIE, D. C. HOLT, T. HARRIS, V. KRAUSE
-
- Journal:
- Epidemiology & Infection / Volume 144 / Issue 5 / April 2016
- Published online by Cambridge University Press:
- 14 September 2015, pp. 1018-1027
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Although the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 with Streptococcus pyogenes isolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response.
6 - Crisis and civil war
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 174-209
-
- Chapter
- Export citation
-
Summary
Magna Carta reflects two distinct conditioning circumstances. On the one hand it emerged from the increasing maturity of European political thought and practice, from the concept of rule according to law, from the demand for the preservation of the rights of subjects within a feudal and ecclesiastical hierarchy and from routine patterns of government which went with more disciplined and sophisticated forms of administration. On the other hand it was a product of a political crisis. It sprang directly from the flexibility and severity of Angevin methods of government under the ruthless and capable direction of King John, from the urgent requirements imposed by foreign wars for the defence and, after 1204, the recovery of Normandy, and from the final collapse of John's military and diplomatic schemes on the field of Bouvines in July 1214.
Thus the Charter was not simply a statement of administrative practices, or desired regulations or principles of law. These were no more than the terms of reference establishing broad limits within which the opposing parties made their demands, or compromised and hedged, or sought hidden advantages, or skilfully provided escape routes from the letter of the documents. The Charter and its associated documents are complex records which bear the imprint of nearly three years of political crisis and protracted, discontinuous negotiation. They cannot be properly understood apart from this crisis, for to separate them from the detail of politics is to risk anachronism and to hinder our understanding of the relative importance which men then attached to particular issues and demands. By 1215 negotiation had acquired a momentum of its own, and particular details had achieved a crucial significance out of all proportion to their ultimate effects, if any, on the course of English history. Thus the restoration of a castle, the claim to an inheritance, the dismissal of a royal official, and issues such as these, became nodal points, important both in themselves and as tests of the king's good faith, from which there grew suspicion, mistrust and civil war.
4 - Custom and law
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 88-123
-
- Chapter
- Export citation
-
Summary
Resistance to the abuse of monarchical power in the twelfth and thirteenth centuries was based on assumptions which permeated the society of western Europe. Magna Carta was more than a simple reaction against Angevin government, and more than a statement of the privileges which the Angevins had made available; it was also a statement of principles about the organization of a feudal state. As such it drew on a common body of experience and custom which, with local variants, was shared throughout western Europe and the Latin states in the east. Hence the Norman and Angevin kings had to contend with men who shared strong views on the constitution of society, on title to feudal property, on the right to judgement and on the proper conduct of lords and kings. The Angevins gave their men the grievances and the education in government which were woven into the tapestry of Magna Carta. But the warp and weft were derived from the structure of society itself.
This common experience was embodied in custumals and law-books, it was formulated in statutes, it was sharpened by the conflict between Church and State, it was laid down as assizes when new states were founded, and it was stated in charters of liberties when the interaction of royal policy and aristocratic interests exploded into political crises. Together these scattered and widely different sources reveal legal and political principles of remarkable permanence and pervasiveness. For example, the insistence on judgement by peers in cap. 39 of Magna Carta was simply an assertion of a generally recognized axiom. It received its first clear statement in the edict of the Emperor Conrad II of 1037 which laid down that military tenants were not to be deprived of their fiefs ‘except by the laws of our ancestors and the judgement of their peers’.
6 - Magna Carta, 1215
- from Appendices
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 373-398
-
- Chapter
- Export citation
-
Summary
There are four surviving originals of the Great Charter, two at the British Library, one at Lincoln Cathedral and one at Salisbury Cathedral. These are conventionally designated Ci, Cii, L and S. Ci was badly damaged in the fire of the Cottonian library in 1731; an engraved copy of it was published by John Pine in 1733. The others are in good condition, although none now carry the king's seal. Yet another possible original, inspected and noted by Matthew Hale, was ‘sent to the abbey of Tewkesbury’. As far as is known, this no longer survives.
L, certainly, and S, probably, reside in the counties which obtained them in 1215; Ci possibly went to the Cinque Ports. Ci and Cii share a small number of amendments which are noted below in the text. These have been used to argue that they were drafted either (a) earlier or (b) later than L and S, but they may well have been nothing more serious than copyists' omissions. The debate is not of great moment. It derived essentially from the assumption that there was a single authoritative original which figured in the ceremonies at Runnymede and from which all other versions were copied. This assumption was first questioned among later authorities by Professor V. H. Galbraith, and has now been rejected. There is no sound reason for giving any one of the surviving texts priority over the others, nor is there any need to do so. With the possible exception of S, they are all exemplifications of equal weight and value.
S presents its own special problems. The other three are plainly in a Chancery hand; S not so – not, at least, until the scribe of S is discovered at work in other Chancery documents. His hand is too ‘bookish’. Yet this may not render S any the less authentic.
14 - Liberties and perpetuity
- from Appendices
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 434-437
-
- Chapter
- Export citation
-
Summary
‘We have also granted to all the free men of our realm for ourselves and our heirs for ever (in perpetuum) all the liberties written below.’ Thus cap. 1 of Magna Carta. The words are repeated in cap. 63 in corroboration –‘the men in our realm shall have and hold all the aforesaid liberties … … for ever (in perpetuum), as is aforesaid’. The immediate precedent is contained in the Charter itself. Cap. 1 opens – ‘In the first place [we have] granted to God and by this our present charter have confirmed, for us and our heirs in perpetuity, that the English church shall be free … ’, and also – ‘we conceded and confirmed by our charter, freedom of elections … which we shall observe and wish our heirs to observe in good faith in perpetuity’. Here the Charter repeated John's grant of freedom of election to the church of 21 November 1214 – ‘libere sint in perpetuum elections’. So cap. 1 of the Charter elides very easily from the liberties of the church to the liberties of the realm. It is as if ecclesiastical liberties infected all the rest, the whole placed within the broader notion of free and perpetual alms, the community of freemen viewed as if it were as permanent and undying as the church itself with all its component institutions. If so, the infection was a strong one; all subsequent reissues of the Charter and the Charter of the Forest are grants made in perpetuity.
Similar language was used for individuals – in ordinary grants occasionally, in quitclaims more frequently, in warranty clauses commonly. That apart, the norm was a simple concession from the grantor and his heirs to the recipient and his heirs. Earlier in the Anglo-Norman world hereditary tenure by laymen and perpetual tenure by the church had grown up side by side, the one reinforcing the other in the act of benefaction; indeed the earliest grants to the reformed Norman church were expressed in the language of perpetual inheritance.
9 - The achievement of 1215
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 254-290
-
- Chapter
- Export citation
-
Summary
Magna Carta was not a simple statement of law. That part of it which was confirmed in 1217 and 1225 did in fact become law. But it was not an accurate statement of law as it had been before 1215. Its supporters claimed that it was. Indeed, their arguments had been concentrated on reviving the ‘good old laws7’ and confirming existing privileges and liberties. But theirs was only one side of the case. The other side was equally convinced. The papal agents who excommunicated the king's opponents in the autumn denounced them for introducing new laws and depriving the king of his customary rights. Maitland asserted that ‘the charter contains little that is absolutely new. It is restorative. John in these last years has been breaking the law; therefore the law must be defined and set in writing.’ McKechnie likewise frequently assumed that John had been breaking principles which Magna Carta largely confirmed. But this is to accept the opposition's case and to by-pass important problems. How far, for example, did Magna Carta state existing law? Where it did, had John been breaking it? Whether it was law or not, was John the only king to contravene its principles?
None of these questions permit simple answers applicable to every clause. For example, it was existing law to levy aids by consent as cap. 12 of the Charter confirmed, but there is no certain evidence that John or any other king had habitually levied aids in any other manner. In contrast, it seems to have been generally accepted that knightly tenants of escheats in the king's hands should pay reliefs at the rate of £5 per fee. John had sometimes broken this rule, and so occasionally had Henry II.
2 - Notification of Thomas count of Perche, February 1215
- from Appendices
- J. C. Holt, University of Cambridge
- Preface by George Garnett, University of Oxford, John Hudson, University of St Andrews, Scotland
-
- Book:
- Magna Carta
- Published online:
- 05 July 2015
- Print publication:
- 28 May 2015, pp 340-340
-
- Chapter
- Export citation
-
Summary
The letter printed below was issued by Thomas count of Perche on behalf of his knights of the castlery of Bellême. It specifies four occasions for the feudal aid: the count's first knighting, his first ransom, the knighting of his eldest son and the marriage of his eldest daughter. It is also of great interest in its language. The aids are described as tallia (tailles or tallages) levied both on knights and their men; and it provides a rare instance of the adverb feodaliter, here used synonymously with ‘lawfully’.
Thomas accompanied Prince Louis to England and was killed at the battle of Lincoln in 1217, the subject of a famous drawing by Matthew Paris.
Thomas comes Pertici omnibus ad quos presentes littere pervenerint salutem in domino. Ad universorum noticiam volumus pervenire quod milites nostri de castellario Beilim' talliam de feodis suis et hominibus suis nobis debent tantummodo feodaliter pro hiis quatuor rebus que sequuntur: pro prima milicia nostra; pro prima captione nostra de guerra; pro milicia filii nostri primogeniti viventis; et pro prima filia nostra maritanda. Preter has tallias nec a militum feodis nec ab eorum hominibus tallias possumus feodaliter extorquere, et ne hujusmodi libertas ab aliquo heredum nostrorum in posterum infringatur, eam sigilli nostril caractere fecimus conmuniri. Actum anno gracie M cc quartodecimo mense februario.