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Impulsivity and aggression are known risk factors for suicide, with observed age and sex differences in their impact.
Aims
To explore variations in impulsivity and aggression based on sex and age and examine their roles in predicting suicide.
Method
We examined 582 participants (406 individuals who died by suicide, 176 non-suicidal sudden-death controls) using the psychological autopsy method. Measures of impulsivity and aggression included the Barratt Impulsiveness Scale (BIS) and the Brown–Goodwin History of Aggression (BGHA). Participants were categorised into four groups: suicide male, control male, suicide female and control female. For group comparisons, we used analyses of variance and Spearman’s rank correlation to assess the relationship between age and BIS and/or BGHA ratings. Stepwise logistic regression was used to identify predictors of suicide for each sex.
Results
Higher levels of BIS and BGHA ratings were found in the suicide group compared with controls (BIS: 51.3 v. 42.2, P = 0.002, η2 = 0.017; BGHA: 7.1 v. 4.1, P < 0.001, η2 = 0.028), with no significant sex differences. BIS and BGHA ratings decreased with age in the suicide groups (suicide male: impulsivity ρ = −0.327, P < 0.001; suicide female: aggression ρ = −0.175, P = 0.038) but not among controls. Logistic regression analysis revealed that for men, aggression (odds ratio 1.072, 95% CI: 1.032–1.112) was a key predictor. For women, younger age (odds ratio 0.970, 95% CI: 0.948–0.993), low BIS impulsivity ratings (odds ratio 1.018, 95% CI: 1.001–1.036) and living with children (odds ratio 0.448, 95% CI: 0.208–0.966) were protective factors.
Conclusions
Impulsive and aggressive behaviours are critical factors in suicide risk among younger individuals, indicating an age effect but no sex dimorphism, with aggressive behaviours being a better predictor for men and impulsive and aggressive behaviours for women.
Studies conducted during the COVID-19 pandemic found high occurrence of suicidal thoughts and behaviours (STBs) among healthcare workers (HCWs). The current study aimed to (1) develop a machine learning-based prediction model for future STBs using data from a large prospective cohort of Spanish HCWs and (2) identify the most important variables in terms of contribution to the model’s predictive accuracy.
Methods
This is a prospective, multicentre cohort study of Spanish HCWs active during the COVID-19 pandemic. A total of 8,996 HCWs participated in the web-based baseline survey (May–July 2020) and 4,809 in the 4-month follow-up survey. A total of 219 predictor variables were derived from the baseline survey. The outcome variable was any STB at the 4-month follow-up. Variable selection was done using an L1 regularized linear Support Vector Classifier (SVC). A random forest model with 5-fold cross-validation was developed, in which the Synthetic Minority Oversampling Technique (SMOTE) and undersampling of the majority class balancing techniques were tested. The model was evaluated by the area under the Receiver Operating Characteristic (AUROC) curve and the area under the precision–recall curve. Shapley’s additive explanatory values (SHAP values) were used to evaluate the overall contribution of each variable to the prediction of future STBs. Results were obtained separately by gender.
Results
The prevalence of STBs in HCWs at the 4-month follow-up was 7.9% (women = 7.8%, men = 8.2%). Thirty-four variables were selected by the L1 regularized linear SVC. The best results were obtained without data balancing techniques: AUROC = 0.87 (0.86 for women and 0.87 for men) and area under the precision–recall curve = 0.50 (0.55 for women and 0.45 for men). Based on SHAP values, the most important baseline predictors for any STB at the 4-month follow-up were the presence of passive suicidal ideation, the number of days in the past 30 days with passive or active suicidal ideation, the number of days in the past 30 days with binge eating episodes, the number of panic attacks (women only) and the frequency of intrusive thoughts (men only).
Conclusions
Machine learning-based prediction models for STBs in HCWs during the COVID-19 pandemic trained on web-based survey data present high discrimination and classification capacity. Future clinical implementations of this model could enable the early detection of HCWs at the highest risk for developing adverse mental health outcomes.
In Northeastern Brazil, successful release programmes have been implemented for the conservation of West Indian manatees (Trichechus manatus) since the 1990s. Recently, the non-government organization AQUASIS started releasing manatees in the state of Ceará, where oceanographic conditions and the absence of sheltered places pose new challenges for the release and monitoring of manatees. This research investigates the movement of a manatee named Tico, released in Icapuí, Ceará, Brazil, that travelled approximately 4017 km over 62 days through deep oceanic waters. Correlating Tico's trajectory and velocity with surface currents revealed the influence of the North Brazil Current (NBC) and its vortices on his movement. Tico crossed the diluted Amazon River plume with surface salinity as low as 26 g kg−1 in early August, potentially encountering areas of even lower salinity. Additionally, Tico experienced several storms, with significant rainfall during his journey, which may have provided freshwater. The erratic movement patterns and significant weight loss prompted the rescue of Tico on Isla la Blanquilla, Bolivarian Republic of Venezuela. Tico is currently being temporarily housed in Parque Zoológico y Botánico Bararida in Venezuela. Understanding the nature of Tico's long-distance movement could help inform decisions about his future. AQUASIS proposes to return Tico to Brazil, a region with an ecologically and genetically distinct population from Venezuela, for a second release attempt, incorporating lessons learned from the first release. Furthermore, AQUASIS has the necessary human and financial resources to ensure the continuous monitoring of Tico during his readaptation to the wild.
Annona crassiflora is a fruit-bearing tree species native to the Cerrado that has ecological and economic potential, mainly due to the production of attractive and useful fruits for a number of species, including humans. To provide a basis for its conservation and breeding, the objective was to assess the diversity and genetic structure of natural populations of the species using inter-simple sequence repeat (ISSR) molecular markers. Eight populations were analysed in the state of Minas Gerais, Brazil, with 24 individuals randomly sampled in each population, reaching a total of 192 trees. Ten ISSR primers were used, resulting in high genetic diversity for the combined data (H* = 0.35 and I* = 0.52). However, a wide range of representative values was observed in the individual assessment of populations, with JAN, GM and MC standing out for their low genetic diversity, resulting in H* of 0.19, 0.23 and 0.24 and I* of 0.28, 0.34 and 0.35, respectively. An analysis of molecular variance showed greater variation within populations, indicating gene flow (Nm), but genetic differentiation between populations was moderate. Bayesian analysis, although resulting in four genetic groups, revealed the presence of a majority group for the GM and JAN populations. We propose measures to maintain these populations, such as raising awareness of local extractivism and planting genetically divergent seedlings. Furthermore, we recommend including of all populations in conservation and breeding programmes, aiming to cover the maximum genetic variation for the species.
This position paper by the international IMMERSE consortium reviews the evidence of a digital mental health solution based on Experience Sampling Methodology (ESM) for advancing person-centered mental health care and outlines a research agenda for implementing innovative digital mental health tools into routine clinical practice. ESM is a structured diary technique recording real-time self-report data about the current mental state using a mobile application. We will review how ESM may contribute to (1) service user engagement and empowerment, (2) self-management and recovery, (3) goal direction in clinical assessment and management of care, and (4) shared decision-making. However, despite the evidence demonstrating the value of ESM-based approaches in enhancing person-centered mental health care, it is hardly integrated into clinical practice. Therefore, we propose a global research agenda for implementing ESM in routine mental health care addressing six key challenges: (1) the motivation and ability of service users to adhere to the ESM monitoring, reporting and feedback, (2) the motivation and competence of clinicians in routine healthcare delivery settings to integrate ESM in the workflow, (3) the technical requirements and (4) governance requirements for integrating these data in the clinical workflow, (5) the financial and competence related resources related to IT-infrastructure and clinician time, and (6) implementation studies that build the evidence-base. While focused on ESM, the research agenda holds broader implications for implementing digital innovations in mental health. This paper calls for a shift in focus from developing new digital interventions to overcoming implementation barriers, essential for achieving a true transformation toward person-centered care in mental health.
The actin filaments on the surface of echinoderm oocytes and eggs readily undergo massive reorganization during meiotic maturation and fertilization. In sea urchin eggs, the actin cytoskeletal response to the fertilizing sperm is fast enough to accompany Ca2+ signals and to guide sperm’s entry into the egg. Although recent work using live cell imaging technology confirmed changes in the actin polymerization status in fertilized eggs, as was previously shown using light and electron microscopy, it failed to provide experimental evidence of F-actin depolymerization a few seconds after insemination, which is concurrent with the sperm-induced Ca2+ release. In the present study, we applied Raman microspectroscopy to tackle this issue by examining the spectral profiles of the egg’s subplasmalemmal regions before and after treating the eggs with actin drugs or fertilizing sperm. At both early (15 s) and late (15 min) time points after fertilization, specific peak shifts in the Raman spectra revealed change in the actin structure, and Raman imaging detected the cytoskeletal changes corresponding to the F-actin reorganization visualized with LifeAct-GFP in confocal microscopy. Our observation suggests that the application of Raman spectroscopy, which does not require microinjection of fluorescent probes and exogenous gene expression, may serve as an alternative or even advantageous method in disclosing rapid subtle changes in the subplasmalemmal actin cytoskeleton that are difficult to resolve.
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
Methods
Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
Results
COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
Conclusions
COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
It is known that the disintegration of vertical liquid curtains (sheets) is affected crucially by the amplification of free edge holes forming inside the curtain. This paper aims to investigate the influence of the hole expansion dynamics, driven by the so-called rim retraction, on the breakup of a liquid curtain, in both supercritical (Weber number $We > 1$) and subcritical ($We < 1$) conditions. The analysis is based on three-dimensional direct numerical simulations. For a selected supercritical configuration, the steady flow topology is first analysed. The investigation reveals the classic triangular shape regime of the steady curtain, due to the surface-tension-induced borders retraction towards its centre plane. The unsteady dynamics is then investigated as the curtain response to a hole perturbation introduced artificially in the steady flow configuration. The hole evolution determines a rim retraction phenomenon inside the curtain, which is influenced by both capillary and gravity forces. In supercritical conditions, the hole does not influence the curtain flow dynamics in the long-time limit. By reducing the Weber number slightly under the critical threshold ($We=1$), the initial amplification rate of the hole area increases, due to the stronger retraction effect of surface tension acting on the hole rims. The free hole expansion in fully subcritical conditions ($We < 1$) is investigated finally by simulating an edge-free curtain flow. As $We$ decreases progressively, the hole expands while it is convected downstream by gravity acceleration. In the range $0.4< We<1$, the subcritical curtain returns to the intact unperturbed configuration after the hole expulsion at the downstream outflow. For $We<0.4$, the surface tension force becomes strong enough to reverse the gravitational motion of the hole top point, which retracts upstream towards the sheet inlet section while expanding along the lateral directions. This last phenomenon causes finally the breakup of the curtain, which results in a columnar regime strictly resembling similar experimental findings of the literature.
The sugarcane giant borer, Telchin licus licus, is an insect pest that causes significant losses in sugarcane crops and in the sugar-alcohol sector. Chemical and manual control methods are not effective. As an alternative, in the current study, we have screened Bacillus thuringiensis (Bt) Cry toxins with high toxicity against this insect. Bioassays were conducted to determine the activity of four Cry toxins (Cry1A (a, b, and c) and Cry2Aa) against neonate T. licus licus larvae. Notably, the Cry1A family toxins had the lowest LC50 values, in which Cry1Ac presented 2.1-fold higher activity than Cry1Aa, 1.7-fold larger than Cry1Ab, and 9.7-fold larger than Cry2Aa toxins. In silico analyses were performed as a perspective to understand putative interactions between T. licus licus receptors and Cry1A toxins. The molecular dynamics and docking analyses for three putative aminopeptidase N (APN) receptors (TlAPN1, TlAPN3, and TlAPN4) revealed evidence for the amino acids that may be involved in the toxin–receptor interactions. Notably, the properties of Cry1Ac point to an interaction site that increases the toxin's affinity for the receptor and likely potentiate toxicity. The interacting amino acid residues predicted for Cry1Ac in this work are probably those shared by the other Cry1A toxins for the same region of APNs. Thus, the presented data extend the existing knowledge of the effects of Cry toxins on T. licus licus and should be considered in further development of transgenic sugarcane plants resistant to this major occurring insect pest in sugarcane fields.
Chagas disease (CD) is a neglected tropical disease caused by the intracellular protozoan Trypanosoma cruzi that remains a serious public health issue affecting more than 6 million people worldwide. The available treatment includes 2 nitro derivatives, benznidazole (BZ) and nifurtimox, that lack in efficacy in the later chronic phase and when administered against the several naturally resistant parasite strains and present several side-effects, demanding new therapeutic options. One strategy is based on repurposing by testing drugs already used for other illness that may share similar targets. In this context, our previous data on imatinib (IMB) and derivatives motivated the screening of 8 new IMB analogues. Our findings showed that all except 1 were active against bloodstream trypomastigotes reaching drug concentration capable of inducing a 50% of parasite lysis (EC50) values < 12 μm after 2 h while BZ was inactive. After 24 h, all derivatives were more potent than BZ, exhibiting EC50 values 1.5–5.5 times lower. Against intracellular forms, 7 out of 8 derivatives presented high activity, with EC50 values ≤ BZ. LS2/89 stood out as one of the most promising, reaching EC90 values of 1.68 and 4.9 μm on intracellular and trypomastigote forms, respectively, with the best selectivity index (>60) towards the proliferative forms. Physicochemical parameters as well as the absorption, distribution, metabolism, excretion and toxicity properties were predicted to be acceptable and with good chance of a favourable oral bioavailability. The promising results motivate further studies such as in vivo and combinatory assays aiming to contribute for a novel safer and effective therapy for CD.
To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.
Design:
An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.
Setting:
Spanish older adults with metabolic syndrome (MetS).
Participants:
A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.
Results:
Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).
Conclusions:
According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
AI has had many summers and winters. Proponents have overpromised, and there has been hype and disappointment. In recent years, however, we have watched with awe, surprise, and hope at the successes: Better than human capabilities of image-recognition; winning at Go; useful chatbots that seem to understand your needs; recommendation algorithms harvesting the wisdom of crowds. And with this success comes the spectre of danger. Machine behaviours that embed the worst of human prejudice and biases; techniques trying to exploit human weaknesses to skew elections or prompt self-harming behaviours. Are we seeing a perfect storm of social media, sensor technologies, new algorithms and edge computing? With this backdrop: is AI coming of age?
The egg is one of the fundamental parts of the life cycle of Neoechinorhynchus buttnerae, and this stage involves the acanthor larva. It is also the infection phase for the intermediate host. Under normal conditions, the larva inside the egg can survive for months in the environment; however, information regarding this phase of life of the parasite is scarce. In addition, there is no quantitative information about the structural composition of the parasite's body from a histological point of view. Such information is essential in order to support decisions aimed at controlling infestations by these parasites in fish farming. This study aimed to present a detailed description of the stages of embryonic development of N. buttnerae eggs, as well as a stereological evaluation of the body of adult females of the parasite. Three phases of development characterized the eggs: cell division (with four stages), formation of the internal nuclear mass (with four stages) and formation of the acanthor larva (with five stages). The ovary comprised 26.61% of the volume of the animal and most of it contained eggs (21.28%), ovarian balls (3.88%) and empty spaces (1.45%). These results are of great importance and will support future studies that seek to interrupt the life cycle of this parasite.
Herein is reported the first occurrence of ostracodes from the Iapó Formation, an uppermost Ordovician unit of the Rio Ivaí Group in the Paraná basin, Brazil. Two ostracode species were identified in the Três Barras Farm section: Harpabollia harparum (Troedsson, 1918) and Satiellina paranaensis Adôrno and Salas in Adôrno et al., 2016 were recovered from dropstone-bearing shale overlying glaciogenic diamictites, a feature typical of Hirnantian (uppermost Ordovician) strata throughout Gondwana. The taxonomy of the Genus Harpabollia, as well as its type species Harpabollia harparum, was reviewed, and emended and new diagnoses were respectively proposed for each taxon. Occurrences of Harpabollia harparum and Satiellina species were common in areas influenced by cold waters. Additionally, the occurrence of Harpabollia harparum, an index species to the uppermost Ordovician of several stratigraphic units in Baltica and southern Gondwana, allowed us to infer a Hirnantian age for the deposits of the Iapó Formation. Other than being associated with Harpabollia harparum in Iapó Formation of the Paraná basin, Satiellina paranaensis is also found in lower levels of the Vila Maria Formation; therefore, these are also considered Hirnantian in age. Above these lower levels of the Vila Maria Formation, a well-dated Rhuddanian (lowermost Llandovery, Silurian) palynomorph assemblage is observed within the formation. These occurrences are evidence of a continuous process of sedimentary deposition during the Ordovician–Silurian transition in the Paraná basin.
Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key ‘bottlenecks’: inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.
This article addresses recent advances in liquid phase transmission electron microscopy (LPTEM) for studying nanoscale synthetic processes of carbon-based materials that are independent of the electron beam—those driven by nonradiolytic chemical or thermal reactions. In particular, we focus on chemical/physical formations and the assembly of nanostructures composed of organic monomers/polymers, peptides/DNA, and biominerals. The synthesis of carbon-based nanomaterials generally only occurs at specific conditions, which cannot be mimicked by aqueous solution radiolysis. Carbon-based structures themselves are also acutely sensitive to the damaging effects of the irradiating beam, which make studying their synthesis using LPTEM a unique challenge that is possible when beam effects can be quantified and mitigated. With new direct sensing, high frame-rate cameras, and advances in liquid cell holder designs, combined with a growing understanding of irradiation effects and proper experimental controls, microscopists have been able to make strides in observing traditionally problematic carbon-based materials under conditions where synthesis can be controlled, and imaged free from beam effects, or with beam effects quantified and accounted for. These materials systems and LPTEM experimental techniques are discussed, focusing on nonradiolytic chemical and physical transformations relevant to materials synthesis.
The recent renovation of a house in Chajul in western Guatemala has revealed an unparalleled set of wall paintings, most probably from the Colonial period (AD 1524–1821). The iconography of the murals combines pre-Columbian elements with imported European components in a domestic rather than a religious setting, making them a unique example of Colonial-period art. Here, the authors present the results of iconographic, chemical and radiocarbon analyses of the Chajul house paintings. Dating to the seventeenth to eighteenth centuries AD, the paintings may be connected to a revival of the local religious organisation (cofradías) in the context of waning Spanish colonial control.