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Plasma-terminating disruptions represent a critical outstanding issue for reactor-relevant tokamaks. ITER will use shattered pellet injection (SPI) as its disruption mitigation system to reduce heat loads, vessel forces and to suppress the formation of runaway electrons. In this paper we demonstrate that reduced kinetic modelling of SPI is capable of capturing the major experimental trends in ASDEX Upgrade SPI experiments, such as dependence of the radiated energy fraction on neon content, or the current quench dynamics. Simulations are also consistent with the experimental observation of no runaway electron generation with neon and mixed deuterium–neon pellet composition. We also show that statistical variations in the fragmentation process only have a notable impact on the disruption dynamics at intermediate neon doping, as was observed in experiments.
We are showing a significant enhancement in the temporal contrast by reducing the coherent noise of the 10 PW laser system at the Extreme Light Infrastructure - Nuclear Physics facility. The temporal contrast was improved by four orders of magnitude at 10 picoseconds and by more than one order of magnitude at 50 picoseconds before the main peak. This improvement of the picosecond contrast is critical for the experiments using thin solid targets.
Tape rolls are often used for multiple patients despite recommendations by manufacturers for single-patient use. We developed a survey to query Health Care Personnel about their tape use practices and beliefs and uncovered behaviors that put patients at risk for hospital-acquired infections due to tape use.
The hippocampal formation represents a key region in the pathophysiology of schizophrenia. Aerobic exercise poses a promising add-on treatment to potentially counteract structural impairments of the hippocampal formation and associated symptomatic burden. However, current evidence regarding exercise effects on the hippocampal formation in schizophrenia is largely heterogeneous. Therefore, we conducted a systematic review and meta-analysis to assess the impact of aerobic exercise on total hippocampal formation volume. Additionally, we used data from a recent multicenter randomized-controlled trial to examine the effects of aerobic exercise on hippocampal formation subfield volumes and their respective clinical implications.
Methods
The meta-analysis comprised six studies that investigated the influence of aerobic exercise on total hippocampal formation volume compared to a control condition with a total of 186 people with schizophrenia (100 male, 86 female), while original data from 29 patients (20 male, 9 female) was considered to explore effects of six months of aerobic exercise on hippocampal formation subfield volumes.
Results
Our meta-analysis did not demonstrate a significant effect of aerobic exercise on total hippocampal formation volume in people with schizophrenia (g = 0.33 [−0.12 to 0.77]), p = 0.15), but our original data suggested significant volume increases in certain hippocampal subfields, namely the cornu ammonis and dentate gyrus.
Conclusions
Driven by the necessity of better understanding the pathophysiology of schizophrenia, the present work underlines the importance to focus on hippocampal formation subfields and to characterize subgroups of patients that show neuroplastic responses to aerobic exercise accompanied by corresponding clinical improvements.
The U.S. Department of Veterans Affairs is actively transitioning away from a disease-centric model of healthcare to one that prioritizes disease prevention and the promotion of overall health and well-being. Described as Whole Health, this initiative aims to provide personalized, values-centered care that optimizes physical, behavioral, spiritual, and socioeconomic well-being. To inform this initiative, we analyzed cross-sectional data from a nationally representative sample of primarily older U.S. military veterans to estimate levels of well-being across these domains, and identify sociodemographic, military, and potentially modifiable health and psychosocial correlates of them. Results revealed that, overall, veterans reported high domain-specific well-being (average scores ranging from 6.7 to 8.3 out of 10), with the highest levels in the socioeconomic domain and lowest in the physical domain. Several modifiable factors, including purpose in life, resilience, and social support, were strongly associated with the examined well-being domains. Interventions targeting these constructs may help promote well-being among U.S. veterans.
The influence of Cu(II) on the hydrothermal and thermal transformations of a synthetic hectorite was investigated by a combined approach using mainly X-ray diffraction, thermal analyses, and electron paramagnetic resonance spectroscopy. The presence of Cu(II) during hydrothermal treatment increased the crystallite size. Copper (II) was both structure-bound and associated with the inner surfaces of the particles. Upon heating, structural destabilization of the hectorite began at ∼400°C as indicated by the formation of free radicals. Between 600 and 700°C, the hectorite converted to enstatite, and in the presence of Cu(II), to enstatite and richterite. The formation of richterite as an additional conversion product is explained by the creation of structural weakness due to structure-bound Cu(II) in F-containing hectorite. Our results suggest that traces of Cu(II), typical of natural environments, may influence the conversion products in high-temperature geochemical systems.
Inpatient equivalent home treatment (IEHT), implemented in Germany since 2018, is a specific form of home treatment. Between 2021 and 2022, IEHT was compared to inpatient psychiatric treatment in a 12-months follow-up quasi-experimental study with two propensity score matched cohorts in 10 psychiatric centers in Germany. This article reports results on the treatment during the acute episode and focuses on involvement in decision-making, patient satisfaction, and drop-out rates.
Methods
A total of 200 service users receiving IEHT were compared with 200 matched statistical “twins” in standard inpatient treatment. Premature termination of treatment as well as reasons for this was assessed using routine data and a questionnaire. In addition, we measured patient satisfaction with care with a specific scale. For the evaluation of patient involvement in treatment decisions, we used the 9-item Shared Decision Making Questionnaire (SDM-Q-9).
Results
Patients were comparable in both groups with regard to sociodemographic and clinical characteristics. Mean length-of-stay was 37 days for IEHT and 28 days for inpatient treatment. In both groups, a similar proportion of participants stopped treatment prematurely. At the end of the acute episode, patient involvement in decision-making (SDM-Q-9) as well as treatment satisfaction scores were significantly higher for IEHT patients compared to inpatients.
Conclusions
Compared to inpatient care, IEHT treatment for acute psychiatric episodes was associated with higher treatment satisfaction and more involvement in clinical decisions.
This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.
The last meal of Tollund Man, a bog body from Early Iron Age Denmark, has been re-examined using new analyses of plant macrofossils, pollen, non-pollen palynomorphs, steroid markers and proteins found in his gut. Some 12–24 hours before he was killed, he ate a porridge containing barley, pale persicaria and flax, and probably some fish. Proteins and eggs from intestinal worms indicate that he was infected with parasites. Although the meal may reflect ordinary Iron Age fare, the inclusion of threshing waste could possibly relate to ritual practices. This re-analysis illustrates that new techniques can throw fresh light on old questions and contribute to understanding life and death in the Danish Early Iron Age.
The ways in which cultural groups vary from one another has long been a matter of everyday observation. The construction of valid and reliable measures of these differences remains problematic. Comparisons of survey responses rest on assumptions about the functional equivalence of translated items and of the assumptions that respondents make about the meaning of such surveys. This chapter explores the different possible levels of measurement equivalence. Psychological variables are most frequently latent rather than directly observable. Philosophers of science have discussed how best to address the challenges one faces when working with latent variables. If we are to claim that latent variables such as individualism or collectivism can account for particular differences between groups, specific counterfactual theorising is required as to the limiting circumstances under which such effects will or will not occur. At a more practical level, we can note that differences are frequently found in the characteristic survey response styles of respondents from different cultural groups, but decisions as to whether or when to discount such variations rest on answers to the more basic philosophical questions raised in the earlier section of this chapter.
The 1717 Christmas flood is one of the most catastrophic storm surges the Frisian coast (Netherlands and Germany) has ever experienced. With more than 13,700 casualties it is the last severe storm surge with a death toll of this order. At the same time, little is known about the hydrodynamic conditions and the morphological effects associated with this storm surge.
In this study, 41 potential dyke failures in the Province of Groningen (Netherlands) associated with the 1717 Christmas flood were systematically reconstructed and mapped by using historical maps and literature and by analysing the recent topography in search of typical pothole structures and sediment fans. The dimensions of the sediment fans as derived from the topography show a good accordance with the dimensions documented by vibracore profiles, direct push tests and electrical resistivity tomography data taken at three fieldwork sites. Moreover, the fan dimensions closely agree with the dimensions as simulated using a process-based morphodynamic numerical model for one of the three sites, the village of Wierhuizen. Consequently, the recent topography is still indicative for the locations and dimensions of dyke failures and sediment fans associated with the 1717 Christmas flood. Considering the large number of detected dyke failures (41) and the large dimensions of the potholes and particularly of the sediment fans up to a few hundred metres wide and up to 0.7 m thick, this study proves significant morphological effects of the 1717 Christmas flood on the mainland of the Province of Groningen.
Based on the numerical simulation approach and the comparison with field data and field observations, a maximum seaward water level of 5 m NAP for the dyke failure at Wierhuizen during the Christmas flood can be derived. A similar maximum water level is indicated for the two other fieldwork sites Vierhuizen and Kohol, which is in good agreement with the maximum storm surge level of 4.62 m NAP historically documented for the city of Emden located almost 50 km to the east of Wierhuizen.
The results of the current study demonstrate that the reconstruction of historical dyke failures based on (i) historical sources, (ii) recent lidar/high-resolution topographical data, (iii) multi-proxy sedimentary field data and (iv) hydro- and morphodynamic numerical simulations is a highly promising approach to derive hydrodynamic conditions and the morphological onshore response of the 1717 Christmas flood in the Province of Groningen. This knowledge is essential to improve our understanding of extreme storm surge dynamics, their influence on the coastal landscape and the associated hazards for the coastal population.
Hala Sultan Tekke is a large Bronze Age city located on the southeastern littoral of Cyprus. The city flourished from approximately 1650 BC to 1150 BC according to the archaeological evidence. Since 2010, Swedish excavations have exposed four new city quarters (CQ1–4) with three occupational phases, the 14C dating of which is of highest importance also for other contemporaneous cultures. The finds demonstrate vast intercultural connections in the Mediterranean and even with southern Scandinavia. In 2014, roughly 500 m to the east of CQ1, one of the richest cemeteries on the island was discovered. According to the archaeological evidence, the finds from the city date mainly to the 13th and 12th centuries BC. However, many of the wealthy tombs and the offering pits from the cemetery are considerably older with the oldest finds dating to the 16th century BC. This raises the question where the city quarters belonging to the oldest finds from the cemetery are situated. The radiocarbon (14C) dates from Hala Sultan Tekke have much influence on the dating of related sites because of numerous imports from a vast area. We present here new 14C data obtained in the course of the current excavations, which add to sets of already existing data.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
Methods
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
Conclusions
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
After five positive randomized controlled trials showed benefit of mechanical thrombectomy in the management of acute ischemic stroke with emergent large-vessel occlusion, a multi-society meeting was organized during the 17th Congress of the World Federation of Interventional and Therapeutic Neuroradiology in October 2017 in Budapest, Hungary. This multi-society meeting was dedicated to establish standards of practice in acute ischemic stroke intervention aiming for a consensus on the minimum requirements for centers providing such treatment. In an ideal situation, all patients would be treated at a center offering a full spectrum of neuroendovascular care (a level 1 center). However, for geographical reasons, some patients are unable to reach such a center in a reasonable period of time. With this in mind, the group paid special attention to define recommendations on the prerequisites of organizing stroke centers providing medical thrombectomy for acute ischemic stroke, but not for other neurovascular diseases (level 2 centers). Finally, some centers will have a stroke unit and offer intravenous thrombolysis, but not any endovascular stroke therapy (level 3 centers). Together, these level 1, 2, and 3 centers form a complete stroke system of care. The multi-society group provides recommendations and a framework for the development of medical thrombectomy services worldwide.
Thin hole transport layers are important elements in organic semiconductor-based devices. Metal oxides are an encouraging material class for this purpose, as they may provide sufficient hole conduction in combination with excellent electron blocking properties. Both, long-term device stability, which may often be limited by the thermal stability of interfaces, and higher temperature processing steps, benefit strongly from the existence of thermally stable metal oxide interlayers. Provided that thermally stable electrodes can be fashioned, the stability of organic active layers—for example, in organic field effect transistors, light emitting diodes, or photovoltaic (OPV) devices can be investigated. Here, we apply this concept and report about the study of hole mobility (µh) in single-carrier-hole-only devices in dependence of thermal annealing up to the above the actual melting temperature of regio-regular poly(3-hexylthiophene-2,5-diyl) (P3HT).
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
Aims
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Method
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
Results
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
Conclusions
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
A new continuum approach to snowdrift modelling is introduced. In addition, numerical studies are carried out to identify the influence of time-varying wind conditions on snowdrift simulations. We compare the snowdrift patterns at Grimming mountain, Austria, derived using a time-averaged wind field and a time-varying wind field obtained from the numerical weather prediction model INCA. The results show significant differences in the deposition patterns and snow depth even after a 6 hour drift period. Using time-averaged boundary conditions leads to an underprediction of the resulting snow depth caused by averaging the wind speed, which lets gusts of wind disappear while snow transport is a non-linear function of the wind speed. Using numerical weather prediction models for snowdrift simulation therefore provides enhanced knowledge of the snow depth for local avalanche warning services.
Records of surface motion, englacial tilt and repeat inclinometry are used to determine patterns of surface, internal and basal motion across the tongue of Haut Glacier d’Arolla, Switzerland, over temporal scales ranging from days to months. Findings are interpreted with reference to contemporaneous measurements of subglacial water pressures, and prior knowledge of the glacier’s subglacial drainage-system structure. Long-term inclinometry results show pronounced extrusion flow over a subglacial drainage axis, with basal velocities up to twice those measured at the glacier surface. Deformation profiles are more conventional away from the drainage axis, with basal velocities ∼60–70% of surface velocities. Comparison of long-term tilt rates from repeat inclinometry and englacial tiltmeters shows close correspondence. Englacial tiltmeter data are used to reconstruct internal velocity profiles and to split surface velocities into internal deformation and basal motion contributions over spring, summer and autumn/winter periods. Although, spatial patterns of surface movement are similar between periods, patterns of internal and basal motion are not. Results are interpreted in terms of the location of sticky and slippery spots, with temporally changing patterns of basal drag reflecting changing distributions of water pressure.
Three early-melt-season high-velocity events (or “spring events”) occurred on Haut Glacier d’Arolla, Switzerland, during the melt seasons of 1998 and 1999. The events involve enhanced glacier velocity during periods of rapidly increasing bulk discharge in the proglacial stream and high subglacial water pressures. However, differences in spatial patterns of surface velocity, internal ice deformation rates, the spatial extent of high subglacial water pressures and in rates of subglacial sediment deformation suggest different hydrological and mechanical controls. The data from two of the events suggest widespread ice–bed decoupling, particularly along a subglacial drainage axis creating the highest rates of basal motion and “plug flow” in the overlying ice. The other event showed evidence of less extensive ice–bed decoupling and sliding along the drainage axis with more mechanical support for ice overburden transferred to areas adjacent to decoupled areas. We suggest that: (1) plug flow may be a common feature on glaciers experiencing locally induced reductions in basal drag; (2) under certain circumstances, enhanced surface motion may be due in part to non-locally forced enhanced bed deformation; and (3) subglacial sediment deformation is confined to a depth of the order of centimetres to decimetres.