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Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains.
Aims
We investigated employment and relationship status changes among patients across the affective and psychotic spectrum – in comparison with healthy controls, examining whether diagnostic groups or functional levels influence these transitions.
Method
The sample from the longitudinal multicentric PsyCourse Study comprised 1260 patients with affective and psychotic spectrum disorders and 441 controls (mean age ± s.d., 39.91 ± 12.65 years; 48.9% female). Multistate models (Markov) were used to analyse transitions in employment and relationship status, focusing on transition intensities. Analyses contained multiple multistate models adjusted for age, gender, job or partner, diagnostic group and Global Assessment of Functioning (GAF) in different combinations to analyse the impact of the covariates on the hazard ratio of changing employment or relationship status.
Results
The clinical group had a higher hazard ratio of losing partner (hazard ratio 1.46, P < 0.001) and job (hazard ratio 4.18, P < 0.001) than the control group (corrected for age/gender). Compared with controls, clinical groups had a higher hazard of losing partner (affective group, hazard ratio 2.69, P = 0.003; psychotic group, hazard ratio 3.06, P = 0.001) and job (affective group, hazard ratio 3.43, P < 0.001; psychotic group, hazard ratio 4.11, P < 0.001). Adjusting for GAF, the hazard ratio of losing partner and job decreased in both clinical groups compared with controls.
Conclusion
Patients face an increased hazard of job loss and relationship dissolution compared with healthy controls, and this is partially conditioned by the diagnosis and functional level. These findings underscore a high demand for destigmatisation and support for individuals in managing their functional limitations.
Shales have undergone a complex burial diagenesis that involved a severe modification of the pore structure. Reconstituted shales can provide new insights into the nature of the pore structure in natural materials. The effects of diagenesis on the microfabric, pore size distribution, and porosity of Opalinus shale were measured by comparing the behavior of natural and reconstituted specimens. The parent material (Opalinus shale) was reconstituted through multiple grinding operations, sedimentation from a dispersed slurry, and one-dimensional isothermal consolidation. This process produced uniform specimens that were not cemented and had replicable microfabric and engineering properties. The microfabric and mineralogy of the materials were examined using high-resolution scanning/backscattered electron microscopy (SEM/BSEM) and energy-dispersive X-ray spectroscopy (EDS) for specimens with broken and milled surfaces. Mercury intrusion porosimetry (MIP) and N2 adsorption were used to assess the pore size distributions and specific surface areas of the materials. The microstructure of natural shale was characterized to be highly heterogeneous with significant concentrations of calcareous microfossils, calcite, and quartz particles embedded within the clay matrix. The microfossils were observed to be locally infilled and rimmed by a calcite cement that showed evidence of dissolution. The reconstituted specimens showed a double-structure microfabric that evolved with the level of consolidation stress and converged into a single-structure material (comparable to the natural shale) at a consolidation stress of more than twice the estimated maximum in situ effective stress. The natural shale had a lower specific surface area in comparison to the reconstituted material, which was consolidated at large effective stresses. These differences can be attributed to cementation at a submicron pore scale and highlight chemical diagenesis effects that were not replicated in the reconstituted specimens.
This paper presents 66 radiocarbon (14C) dates obtained at 33 key sites from the Polish part of the European Sand Belt. These calibrated dating results were compared to 34 high-resolution 14C dates obtained from a fluvial-aeolian sediments to identify pedogenic phases from the late Pleniglacial interval to the early Holocene. These identified pedogenic phases were correlated with Greenland ice-core records, revealing high sensitivity of the fluvio-aeolian paleoenvironment to climate changes. Two pedogenic phases were identified from the late Pleniglacial interval (Greenland Stadial GS-2.1b and GS-2.1a), three from the Bølling-Allerød interstadial (Greenland Stadial GI-1), one from the late Allerød–Younger Dryas boundary, and at least one from the Younger Dryas. The ages of these pedogenic phases reveal a distinct delay of 50–100 calendar years after the onset of cool climate conditions during GI-1, reflecting gradual withdrawal of vegetation. Soil horizons from the early Holocene do not show any clear relation with climate change, where breaks in soil formation were caused by local factors such as human activity.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behaviour and, therefore, the risk of contracting the virus.
Aims
We examined overlapping genetic underpinnings between major psychiatric disorders, personality traits and susceptibility to SARS-CoV-2 infection.
Method
Linkage disequilibrium score regression was used to explore the genetic correlations of coronavirus disease 2019 (COVID-19) susceptibility with psychiatric disorders and personality traits based on data from the largest available respective genome-wide association studies (GWAS). In two cohorts (the PsyCourse (n = 1346) and the HeiDE (n = 3266) study), polygenic risk scores were used to analyse if a genetic association between, psychiatric disorders, personality traits and COVID-19 susceptibility exists in individual-level data.
Results
We observed no significant genetic correlations of COVID-19 susceptibility with psychiatric disorders. For personality traits, there was a significant genetic correlation for COVID-19 susceptibility with extraversion (P = 1.47 × 10−5; genetic correlation 0.284). Yet, this was not reflected in individual-level data from the PsyCourse and HeiDE studies.
Conclusions
We identified no significant correlation between genetic risk factors for severe psychiatric disorders and genetic risk for COVID-19 susceptibility. Among the personality traits, extraversion showed evidence for a positive genetic association with COVID-19 susceptibility, in one but not in another setting. Overall, these findings highlight a complex contribution of genetic and non-genetic components in the interaction between COVID-19 susceptibility and personality traits or mental disorders.
We present new updates to the calendar and radiocarbon (14C) chronologies for the Cariaco Basin, Venezuela. Calendar ages were generated by tuning abrupt climate shifts in Cariaco Basin sediments to those in speleothems from Hulu Cave. After the original Cariaco-Hulu calendar age model was published, Hulu Cave δ18O records have been augmented with increased temporal resolution and a greater number of U/Th dates. These updated Hulu Cave records provide increased accuracy as well as precision in the final Cariaco calendar age model. The depth scale for the Ocean Drilling Program Site 1002D sediment core, the primary source of samples for 14C dating, has been corrected to account for missing sediment from a core break, eliminating age-depth anomalies that afflicted the earlier calendar age models. Individual 14C dates for the Cariaco Basin remain unchanged from previous papers, although detailed comparisons of the Cariaco calibration dataset to those from Hulu Cave and Lake Suigetsu suggest that the Cariaco marine reservoir age may have shifted systematically during the past. We describe these recent changes to the Cariaco datasets and provide the data in a comprehensive format that will facilitate use by the community.
The concentration of radiocarbon (14C) differs between ocean and atmosphere. Radiocarbon determinations from samples which obtained their 14C in the marine environment therefore need a marine-specific calibration curve and cannot be calibrated directly against the atmospheric-based IntCal20 curve. This paper presents Marine20, an update to the internationally agreed marine radiocarbon age calibration curve that provides a non-polar global-average marine record of radiocarbon from 0–55 cal kBP and serves as a baseline for regional oceanic variation. Marine20 is intended for calibration of marine radiocarbon samples from non-polar regions; it is not suitable for calibration in polar regions where variability in sea ice extent, ocean upwelling and air-sea gas exchange may have caused larger changes to concentrations of marine radiocarbon. The Marine20 curve is based upon 500 simulations with an ocean/atmosphere/biosphere box-model of the global carbon cycle that has been forced by posterior realizations of our Northern Hemispheric atmospheric IntCal20 14C curve and reconstructed changes in CO2 obtained from ice core data. These forcings enable us to incorporate carbon cycle dynamics and temporal changes in the atmospheric 14C level. The box-model simulations of the global-average marine radiocarbon reservoir age are similar to those of a more complex three-dimensional ocean general circulation model. However, simplicity and speed of the box model allow us to use a Monte Carlo approach to rigorously propagate the uncertainty in both the historic concentration of atmospheric 14C and other key parameters of the carbon cycle through to our final Marine20 calibration curve. This robust propagation of uncertainty is fundamental to providing reliable precision for the radiocarbon age calibration of marine based samples. We make a first step towards deconvolving the contributions of different processes to the total uncertainty; discuss the main differences of Marine20 from the previous age calibration curve Marine13; and identify the limitations of our approach together with key areas for further work. The updated values for ΔR, the regional marine radiocarbon reservoir age corrections required to calibrate against Marine20, can be found at the data base http://calib.org/marine/.
Radiocarbon (14C) ages cannot provide absolutely dated chronologies for archaeological or paleoenvironmental studies directly but must be converted to calendar age equivalents using a calibration curve compensating for fluctuations in atmospheric 14C concentration. Although calibration curves are constructed from independently dated archives, they invariably require revision as new data become available and our understanding of the Earth system improves. In this volume the international 14C calibration curves for both the Northern and Southern Hemispheres, as well as for the ocean surface layer, have been updated to include a wealth of new data and extended to 55,000 cal BP. Based on tree rings, IntCal20 now extends as a fully atmospheric record to ca. 13,900 cal BP. For the older part of the timescale, IntCal20 comprises statistically integrated evidence from floating tree-ring chronologies, lacustrine and marine sediments, speleothems, and corals. We utilized improved evaluation of the timescales and location variable 14C offsets from the atmosphere (reservoir age, dead carbon fraction) for each dataset. New statistical methods have refined the structure of the calibration curves while maintaining a robust treatment of uncertainties in the 14C ages, the calendar ages and other corrections. The inclusion of modeled marine reservoir ages derived from a three-dimensional ocean circulation model has allowed us to apply more appropriate reservoir corrections to the marine 14C data rather than the previous use of constant regional offsets from the atmosphere. Here we provide an overview of the new and revised datasets and the associated methods used for the construction of the IntCal20 curve and explore potential regional offsets for tree-ring data. We discuss the main differences with respect to the previous calibration curve, IntCal13, and some of the implications for archaeology and geosciences ranging from the recent past to the time of the extinction of the Neanderthals.
Supplier of system components face the challenge of customer requirements influencing the property level functional integral product architectures. For this, solution approaches focusing on the re-use of pre-engineered part variants are not applicable. However, to generate a valid product structure, customer-specific properties have to fit modelled product knowledge. Therefore, the approach models a reference class structure and analysis compatibilities on the property level for customer specific inputs concerning explicit product knowledge and constraints.
Facing a rising competitive pressure, manufactures create advantages when they are able to offer customer-specific products to the conditions of a mass production article. Traditional configurators support the creation of personalized products from the elements of a modular product system, but are based on a pre-defined set of rules. The model based approach changes the environment of configuration from static configuration rules to the dependencies defined within the product's system model. So, by regarding target quantities of the user, the configurator identifies the optimal variant.
Behavioral and psychological symptoms of dementia (BPSD) are common during the course of dementia and are associated with poor outcome for patients. There are some clinical data indicating that SSRI antidepressants have a positive influence on BPSD. Escitalopram has an excellent side-effect profile and might be a suitable treatment for BPSD in older demented patients.
Methods
An open-label observation of inpatients aged 65 to 90 years with a clinical diagnosis of probable AD and an MMSE score of 6 to 20 points and NPI total score ≥20 points treated with escitalopram for 8 weeks. The evaluation of improvement/worsening counted as ±10% change from baseline score in NPI and CMAI short. The results expressed in numbers of improved, unchanged and worsened patients.
Results
13 patients, 12 women and 2 men. The average age was 79.3 years, the average MMSE was 12.8 points. Three patients discontinued due to AEs (bronchopneumonia, progressive worsening of dementia, transfer to another institution). The other AEs were mild and not related to study medication.
NPI patient scale
CMAI short scale
Baseline Day 1 (N=13)
31.2
29.9
Day 14 (N=13)
27.1
26.9
Day 28 (N=11)
220
23 7
Day 56 (N=10)
16.9
21 5
2 unchanged
3 unchanged
8 improved
7 improved
(5 of them much improved) defined as ≥62% reduction of score
(5 of them much improved) defined as ≥38% reduction of score
Conclusions
Most patients exhibited a reduction of BPSD, half of them with a very substantial reduction. Patients exhibited very good tolerance of the medication.
The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries.
Methods
The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations.
Results
We found large cross-national differences in patients’ desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P < 0.001). Averaged over time and independent of patient characteristics, London (mean = 2.27), Ulm (mean = 2.13) and Zurich (mean = 2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean = 1.97), where scores were in turn significantly higher than in Debrecen (mean = 1.56). The lowest scores were reported in Naples (mean = 1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b = 0.23) and decreased in Naples (b = −0.14). In all other centers, values remained stable.
Conclusions
This study demonstrates that patients’ desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe.
Coronary artery complications are the main reason for early mortality after an arterial switch operation. Late complications are relatively rare, and there is no consensus regarding the need or indications for routine follow-up coronary artery evaluations or the best first-line assessment modality. The aim of this study was to present the long-term post-operative frequency of coronary abnormalities in asymptomatic patients with transposition of the great arteries discovered by coronary CT angiography and potential “red flags” revealed by other examinations.
Patients and methods:
A group of 50 consecutive asymptomatic patients who underwent routine long-term coronary artery evaluation after an arterial switch operation according to our institutional protocol were qualified for this study. This routine in-hospital visit included a detailed medical interview, electrocardiography, echocardiography, Holter electrocardiography examinations, and laboratory and cardiopulmonary exercise tests. Patients who showed significant abnormalities were qualified for perfusion scintigraphy.
Results:
Unfavourable coronary abnormalities were detected in 30 patients (60%) and included ostial stenosis, muscular bridge, coronary fistula, interarterial course, proximal kinking, high ellipticity index, proximal acute angulation (<30 degree) of the left coronary artery, and proximal acute angulation of the right coronary artery. These features could not be predicted based on the medical interviews, surgical reports, or non-invasive screening test results.
Conclusion:
Complex coronary configurations with potentially dangerous coronary features are common in patients with transposition after an arterial switch operation. Such high-risk patients cannot be identified indirectly, and coronary CT angiography provides accurate information that is useful for post-operative management.
Surface mass balance (SMB) is the net input of mass on a glacier's upper surface, composed of snow deposition, melt and erosion processes, and is a major contributor to the overall mass balance. Pine Island Glacier (PIG) in West Antarctica has been dynamically imbalanced since the early 1990s, indicating that discharge of solid ice into the oceans exceeds snow deposition. However, observations of the SMB pattern on the fast flowing regions are scarce, and are potentially affected by the firn's strain history. Here, we present new observations from radar-derived stratigraphy and a relatively dense network of firn cores, collected along a ~900 km traverse of PIG. Between 1986 and 2014, the SMB along the traverse was 0.505 m w.e. a−1 on average with a gradient of higher snow deposition in the South-West compared with the North-East of the catchment. We show that along ~80% of the traverse the strain history amounts to a misestimation of SMB below the nominal uncertainty, but can exceed it by a factor 5 in places, making it a significant correction to the SMB estimate locally. We find that the strain correction changes the basin-wide SMB by ~0.7 Gt a−1 and thus forms a negligible (1%) correction to the glacier's total SMB.
With the emergence of modern techniques of environmental analysis and widespread availability of accessible tools and quantitative data, the question of environmental determinism is once again on the agenda. This paper is theoretical in character, attempting, for the benefit of drawing up research designs, to understand and evaluate the character of environmental determinism. We reach three main conclusions: (1) in a typical pattern of research design, studies seek to detect simultaneous shifts in the environmental and archaeological records, variously positing the former to have influenced, triggered or caused the latter; (2) the question of determinism involves uncertainty about the justification for the above research design in particular in what comes to biologism and the concept of environmental thresholds on the one hand and the externality of the drivers of transformation in human groups and societies on the other; (3) adapting the concepts of the social production of vulnerability and the social basis of hazards from anthropology may help to clarify the available research design choices at hand.
Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.
Methods
Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.
Results
CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.
Conclusions
Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.
A set of points in d-dimensional Euclidean space is almost equidistant if, among any three points of the set, some two are at distance 1. We show that an almost-equidistant set in ℝd has cardinality O(d4/3).
West Antarctic climate and surface mass balance (SMB) records are sparse. To fill this gap, regional atmospheric climate modelling is useful, providing that such models are employed at sufficiently high horizontal resolution and coupled with a snow model. Here we present the results of a high-resolution (5.5 km) regional atmospheric climate model (RACMO2) simulation of coastal West Antarctica for the period 1979–2015. We evaluate the results with available in situ weather observations, remote-sensing estimates of surface melt, and SMB estimates derived from radar and firn cores. Moreover, results are compared with those from a lower-resolution version, to assess the added value of the resolution. The high-resolution model resolves small-scale climate variability invoked by topography, such as the relatively warm conditions over ice-shelf grounding zones, and local wind speed accelerations. Surface melt and SMB are well reproduced by RACMO2. This dataset will prove useful for picking ice core locations, converting elevation changes to mass changes, for driving ocean, ice-sheet and coupled models, and for attributing changes in the West Antarctic Ice Sheet and shelves to changes in atmospheric forcing.
Eddy covariance data collected over a horizontal surface on the largest ice body on Kilimanjaro, Tanzania, over 26–29 July 2005 were used to assess the uncertainty of calculating sublimation with a surface energy balance (SEB) model. Data required for input to the SEB model were obtained from an existing automatic weather station. Surface temperatures that were solved iteratively by the SEB model were used to compute emitted longwave radiation, turbulent heat fluxes using the aerodynamic bulk method and the subsurface heat flux. Roughness lengths for momentum and temperature, which were found to be the most important input parameters controlling the magnitude of modelled (bulk method) turbulent heat fluxes, were obtained using eddy covariance data. The roughness length for momentum was estimated to be 1.7×10–3 m, while the length for temperature was one order of magnitude smaller. Modelled sensible and latent heat fluxes (bulk method) compared well to eddy covariance data, with root-mean-square differences between 3.1 and 4.8 Wm–2 for both turbulent heat fluxes. Modelled sublimation accounted for about 90% of observed ablation, confirming that mass loss by melting is much less important than sublimation on the horizontal surfaces of the remaining plateau glaciers on Kilimanjaro.