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The Mental Health Bill, 2025, proposes to remove autism and learning disability from the scope of Section 3 of the Mental Health Act, 1983 (MHA). The present article represents a professional and carer consensus statement that raises concerns and identifies probable unintended consequences if this proposal becomes law. Our concerns relate to the lack of clear mandate for such proposals, conceptual inconsistency when considering other conditions that might give rise to a need for detention and the inconsistency in applying such changes to Part II of the MHA but not Part III. If the proposed changes become law, we anticipate that detentions would instead occur under the less safeguarded Deprivation of Liberty Safeguards framework, and that unmanaged risks will eventuate in behavioural consequences that will lead to more autistic people or those with a learning disability being sent to prison. Additionally, there is a concern that the proposed definitional breadth of autism and learning disability gives rise to a risk that people with other conditions may unintentionally be unable to be detained. We strongly urge the UK Parliament to amend this portion of the Bill prior to it becoming law.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
The kinetic stability of collisionless, sloshing beam-ion ($45^\circ$ pitch angle) plasma is studied in a three-dimensional (3-D) simple magnetic mirror, mimicking the Wisconsin high-temperature superconductor axisymmetric mirror experiment. The collisional Fokker–Planck code CQL3D-m provides a slowing-down beam-ion distribution to initialize the kinetic-ion/fluid-electron code Hybrid-VPIC, which then simulates free plasma decay without external heating or fuelling. Over $1$–$10\;\mathrm{\unicode{x03BC} s}$, drift-cyclotron loss-cone (DCLC) modes grow and saturate in amplitude. The DCLC scatters ions to a marginally stable distribution with gas-dynamic rather than classical-mirror confinement. Sloshing ions can trap cool (low-energy) ions in an electrostatic potential well to stabilize DCLC, but DCLC itself does not scatter sloshing beam-ions into the said well. Instead, cool ions must come from external sources such as charge-exchange collisions with a low-density neutral population. Manually adding cool $\mathord {\sim } 1\;\mathrm{keV}$ ions improves beam-ion confinement several-fold in Hybrid-VPIC simulations, which qualitatively corroborates prior measurements from real mirror devices with sloshing ions.
The dispersion behaviour of solutes in flow is crucial to the design of chemical separation systems and microfluidics devices. These systems often rely on coupled electroosmotic and pressure-driven flows to transport and separate chemical species, making the transient dispersive behaviour of solutes highly relevant. However, previous studies of Taylor dispersion in coupled electroosmotic and pressure-driven flows focused on the long-term dispersive behaviour and the associated analyses cannot capture the transient behaviour of solute. Further, the radial distribution of solute has not been analysed. In the current study, we analyse the Taylor dispersion for coupled electroosmotic and pressure-driven flows across all time regimes, assuming a low zeta potential (electric potential at the shear plane), the Debye–Hückel approximation and a finite electric double layer thickness. We first derive analytical expressions for the effective dispersion coefficient in the long-time regime. We also derive an unsteady, two-dimensional (radial and axial) solute concentration field applicable in the latter regime. We next apply Aris’ method of moments to characterise the unsteady propagation of the mean axial position and the unsteady growth of the variance of the solute zone in all time regimes. We benchmark our predictions with Brownian dynamics simulations across a wide and relevant dynamical regime, including various time scales. Lastly, we derive expressions for the optimal relative magnitudes of electroosmotic versus pressure-driven flow and the optimum Péclet number to minimise dispersion across all time scales. These findings offer valuable insights for the design of chemical separation systems, including the optimisation of capillary electrophoresis devices and electrokinetic microchannels and nanochannels.
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.
It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
Microbial mineral weathering has been predominantly investigated at shallow depths in humid and tropical environments. Much less is understood about its role in the deeper subsurface of arid and semi-arid environments where microbial weathering is limited by the availability of water and energy sources for microbial metabolism. However, the deep subsurface in these climate zones may host a microbial community that thrives on weathering of iron (Fe)-bearing minerals that serve as electron donors or acceptors.
To investigate the role of microorganisms in weathering of Fe-bearing minerals in a dry climate, we recovered a >80 m deep weathering profile in a semi-arid region of the Chilean Coastal Cordillera. The bedrock is rich in Fe-bearing minerals (hornblende, biotite, chlorite, magnetite and hematite) but lacks detectable organic carbon. We evaluated the bioavailability of Fe(III)-bearing minerals that may serve as an electron acceptor for Fe(III)-reducing microorganisms. Using geochemical, mineralogical and cultivation-based methods, we found enhanced Fe bioavailability and more in vitro microbial Fe(III) reduction at increased depth. We obtained an Fe(III)-reducing enrichment culture from the deepest weathered rock found at 77 m depth. This enrichment culture is capable of reducing ferrihydrite (up to 0.6 mM d–1) using lactate or dihydrogen as an electron donor and grows at circumneutral pH. The main organism in the enrichment culture is the spore-forming Desulfotomaculum ruminis (abundance of 98.5%) as revealed by 16S rRNA gene amplicon sequencing.
Our findings provide evidence for a microbial contribution to the weathering of Fe-bearing minerals in semi-arid environments. While microorganisms are probably not contributing to the weathering of Fe(II)-bearing silicate minerals, they are most likely of importance regarding reductive dissolution of secondary weathering products. The Fe(III) reduction quantified in this weathering profile by the in situ microbial community suggests that microorganisms are active weathering agents in semi-arid climates.
Like all catastrophes, 3.11 generated pain and imagination, heroes and villains. Political entrepreneurs with motivation and resources were quick to do battle for control of the event. They spun narrative explanations for the tragedy across a broad horizon of meanings and values, all conforming to their own preexisting preferences and to what they believed would be effective with the Japanese public. Existing enemies were enemies still, but newly villainous. The stakeholders, thus rearmed, used these narratives aggressively in an effort to shift the still unformed preferences of a general public struggling to make sense of otherwise unfathomable events. But 3.11 is not alone in this respect. This chapter locates the dueling narratives of 3.11 in their historical and comparative contexts to derive guidance for understanding how disasters can be used by politicians and their allies as well as by citizens.
Community-engaged partnerships (community/academia/government) can play a role in developing effective protocols that address public health crises. Systemic racism, prioritization of money over humanity, and the repression of the local democratic processes through the State of Michigan Emergency Manager Law (Order of Act 439) all played a role in the Flint Water Crisis. Despite decades of collaboration between Flint-based community organizations and academic institutions, ways to navigate such crises and conduct relevant research were ineffective.
Methods:
The Michigan Institute for Clinical and Health Research Community Engagement program at the University of Michigan and Flint’s Community Based Organization Partners co-developed the Research Readiness and Partnership Protocol (R2P2) to provide community-engaged recommendations that inform a rapid research response to public health emergencies. The R2P2 Workgroup conducted an extensive literature review and key interviews to inform protocol development.
Results:
This manuscript provides an overview of the Workgroup’s methods, key interview findings, and the main principles identified. Detailed recommendations and key elements to address prior to and during a crisis will be presented including methods for: establishing and maintaining trust, ensuring transparency, supporting clear communication, establishing a “front door” to academic institutions including a means to “sound the alarm,” addressing academic incentives, achieving equitable resource sharing, and addressing systemic racism.
Conclusion:
This manuscript of community perspectives provides essential elements to develop meaningful community-academic research partnerships to address public health crises impacting communities, particularly communities of color. Furthermore, this work highlights an opportunity for greater acknowledgment and utilization of community-based participatory research (CBPR) by academic institutions.
Objectives/Goals: Despite the acknowledgment of post-Ebola syndrome (PES), young EVD survivors have received little attention. The mechanistic drivers and long-term consequences of PES and EVD early in life are unknown. We aim to define PES presentations in pediatric EVD survivors and propose potential mechanistic factors contributing to PES in young people. Methods/Study Population: Here we focus on physical health outcomes in an ongoing cohort study assessing mental and physical health in pediatric EVD survivors (age Results/Anticipated Results: 671 participants were enrolled between 2021 and 2022 (Infected: n = 226, Affected: n = 207, and Control: n = 238). Groups were similar in sex distribution (52.7%, 54.0%, and 53.8% female, respectively) and mean age, although the Infected group was slightly older (14.6 y) than the Affected (13.5 y) and Control groups (14.1 y), a difference unlikely to be clinically significant. Notably, the EVD Infected group exhibited a higher burden of symptoms, with significant findings in cardiac, MSK, ophthalmologic, and “ear, nose, and throat” systems. Principal component analysis showed differential patterns of sequelae across the groups, primarily defined by MSK. Discussion/Significance of Impact: PES is heterogeneous in pediatric EVD survivors. EVD Affected children exhibit a similar yet distinct pattern of clinical sequelae indicating ecological factors impact sequelae and raising questions about the mechanistic drivers of PES in children. Potential mechanisms include inflammation or accelerated aging and immune dysfunction.
A fundamental pillar of science is the estimation of the effect size of associations. However, this task is sometimes difficult and error-prone. To facilitate this process, the R package metaConvert automatically calculates and flexibly converts multiple effect size measures. It applies more than 120 formulas to convert any relevant input data into Cohen’s d, Hedges’ g, mean difference, odds ratio, risk ratio, incidence rate ratio, correlation coefficient, Fisher’s r-to-z transformed correlation coefficient, variability ratio, coefficient of variation ratio, or number needed to treat. Researchers unfamiliar with R can use this software through a browser-based graphical interface (https://metaconvert.org/). We hope this suite will help researchers in the life sciences and other disciplines estimate and convert effect sizes more easily and accurately.
After 1973, employers in Japan who had been promising to adopt a weekend system began to withdraw those plans. Thus began a yet-unfinished debate in Japan about how to balance need for employee rest with the demands of employers to increase economic output. The Liberal Democratic Party's current approach to the overwork problem, including its recent labor reforms—which emphasize granting legal flexibility to employees without creating firm regulations to prevent employers from demanding excessive labor—reflects the continued refusal of employers and political leaders to accept the need for employee work-life balance.
Increased ultra-processed food (UPF) is associated with adverse health outcomes. However, with limitations in UPF evidence, and partial overlap between UK front-of-package labelling (FOPL) and degree of food processing, the value of food processing within dietary guidance is unclear. This study compared food and drink from the UK National Diet and Nutrition Survey (NDNS) database based on micronutrient content, Nova classification and FOPL. The aim was to examine the micronutrient contributions of UK food and drink to UK government dietary micronutrient recommendations for adult females and males, aged 19–64 years, based on the degree of food processing and FOPL. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients, processed food (PF) and UPF, and FOPL traffic lights. MPF, PF and UPF provided similar average contributions per 100 g to micronutrient recommendations. Per 100 kcal, MPF provided the greatest average contribution (14·4 % (interquartile range (IQR): 8·2–28·1)), followed by PF (7·7 % (IQR: 4·6–10·9) and then UPF (5·8 % (IQR: 3·1–9·7)). After adjusting for healthy/unhealthy items (presence of 1+ red FOPL), MPF had higher odds of an above-average micronutrient contribution per 100 kcal than UPF (OR: 5·9 (95 % CI 4·9–7·2)) and PF (OR: 3·2 (95 % CI 2·4–4·2)). MPF were more likely to provide greater contributions to micronutrient recommendations than PF or UPF per 100 kcal. These findings suggest that UPF or PF diets are less likely to meet micronutrient recommendations than an energy-matched MPF diet. The results are important for understanding how consumers perceive the healthiness of products based on FOPL.
This Element aims to deepen our understanding of how the fields of multilingualism, second language acquisition and minority language revitalisation have largely overlooked the question of queer sexual identities among speakers of the languages under study. Based on case studies of four languages experiencing differing degrees of minoritisation – Irish, Breton, Catalan and Welsh – it investigates how queer people navigate belonging within the binary of speakers/non-speakers of minoritised languages while also maintaining their queer identities. Furthermore, it analyses how minoritised languages are dealing linguistically with the growing need for 'gender-fair' or 'gender-neutral' language. The marginalisation of queer subjects in these strands of linguistics can be traced to the historical dominance of the Fishmanian model of 'Reversing Language Shift' (RLS), which assumed the importance of the deeply heteronormative model of 'intergenerational transmission' of language as fundamental to language revitalisation contexts.
The incidence of facial palsy has been rising worldwide, with recent evidence emerging of links to COVID-19 infection. To date, guidance on cost-effective treatments is limited to medication (prednisolone). In terms of physical therapy, neuromuscular retraining (NMR) to restore balanced facial function has been most widely evaluated, but not in terms of cost effectiveness. The added value of telerehabilitation is unknown.
Methods
A multistage technology assessment was conducted, which included the following:
• a national survey of current therapy pathways in the UK and patients’ and clinicians’ views on the benefits and challenges of telerehabilitation;
• a systematic review of clinical effectiveness trials evaluating facial NMR therapy;
• calculation of long-term morbidity costs (national economic burden) based on incidence, patient recovery profiles, health-related quality of life, and national facial palsy treatment costs (valuation of clinical improvements in monetary terms was provided by a national Delphi panel); and
• evaluation of the cost effectiveness of telerehabilitation (remote monitoring wearables) added to current face-to-face NMR delivery.
Results
Nationally, approximately five percent of patients with facial palsy (17% of unresolved cases) are referred for facial NMR. The long-term economic burden associated with unresolved cases is estimated to range from GBP351 (EUR417) to GBP584 (EUR692) million, indicating substantial savings if long-term recovery can be improved. Medical treatment costs are GBP86.34 (EUR102) million per annual cohort, and physical and psychological therapy costs are GBP643,292 (EUR762,561). Economic modeling showed that telerehabilitation was cost effective, producing a health gain and a cost-saving of GBP468 (EUR555) per patient. If scaled to the national level for all patients who do not recover fully, an annual saving of GBP3.075 (EUR3.65) million is possible.
Conclusions
Economic modeling indicates that NMR could improve patient outcomes and reduce costs. The national survey demonstrated that access to NMR therapy services is limited, so introduction of telerehabilitation could improve access for currently underserved populations. Future clinical trials need to incorporate economic evaluations to help inform decision-making.