We describe the incidence of suicidality (2007–2017) in people with depression treated by secondary mental healthcare services at South London and Maudsley NHS Trust (n = 26 412). We estimated yearly incidence of ‘suicidal ideation’ and ‘high risk of suicide’ from structured and free-text fields of the Clinical Record Interactive Search system. The incidence of suicidal ideation increased from 0.6 (2007) to 1 cases (2017) per 1000 population. The incidence of high risk of suicide, based on risk forms, varied between 0.06 and 0.50 cases per 1000 adult population (2008–2017). Electronic health records provide the opportunity to examine suicidality on a large scale, but the impact of service-related changes in the use of structured risk assessment should be considered.

Suicide is the second most frequent cause of death among the youth and its rates among adolescents have recently risen. Up to 30% of adolescents who attempt suicide will try it again within a year. Our objective is to analyze how previous attempts and diagnosed psychiatric disorder behave as markers of risk of reattempts and their statistical interaction. We include every underage patient treated by an emergency room psychiatrist after a suicide attempt in a General Hospital between years 2010 and 2015. Patients free of relapse after 1000 days are censored. We obtain Kaplan–Meier estimates for the risk of a new attempt as a time-dependant variable, dividing them by the presence of previous suicide attempts, diagnosed psychiatric disorder or both at a time, checking the differences by using log-rank tests. Then, we perform Cox proportional risk models including both variables and a factor of their interaction and adjust them by sex and age in a non-automatically driven multivariate analysis, thus obtaining HR estimates. We present 150 cases (118 female; mean[SD] age in years: 15.8 [1.6]). Overall, 22.6% of them relapse during follow-up time. Multivariate models show interaction of previous attempts and diagnosed psychiatric disorder is associated with relapse with an HR of 1.27 × 108 (95% CI: 5.51 × 107 – 2.9 × 108). Interaction of both factors is an outstanding risk marker of relapse after an attempted suicide and should thus be given clinical importance in tertiary prevention.

OBJECTIVES/SPECIFIC AIMS: By combining clinical knowledge of hoarding disorder (HD) with qualitative methods from cultural anthropology, we hope to build a patient-centered approach that will allow us to better understand the clinician perspectives on patient motivations and explanatory models of individuals with HD, and improve treatment outcomes. We describe the ways that these methodologies are productively merged in this project as a result of TL1 collaboration, and present a preliminary picture of methodological and theoretical issues uncovered as part of this processes. We further describe the analytical methods used for this project, and explore issues raised through the combination of psychological and anthropological data and insights. METHODS/STUDY POPULATION: This study represents an attempt to combine the qualitative methodologies of cultural anthropology with the clinical knowledge of psychology and psychiatry in order to better understand gaps between provider and patient beliefs and knowledge about hoarding disorder. This study will present preliminary methodological issues arising from interviews with hoarding experts. RESULTS/ANTICIPATED RESULTS: This study will discuss preliminary issues including shared language, strengths and limitations of both disciplines, and factors for consideration when combining these disparate methodologies. It will close with recommendations for consideration when moving forward with similar collaborations. DISCUSSION/SIGNIFICANCE OF IMPACT: This project seeks to unite psychological and social factors that may contribute to the lived experience of individuals with HD in order to better understand the way that HD is manifested. It also unites disparate methodologies to provide us with a more holistic and complete picture of the experience of HD. While HD has been studied within psychiatry, it has never been assessed using the qualitative methods of anthropology. These methods provide the possibility of expanding knowledge about the ways that this disorder is experienced by individuals and their families, and potentially impacted by shared beliefs and cultures. Furthermore, qualitative data of this nature provides a patient perspective on the experience of HD as a psychiatric illness. This patient perspective can be used to better inform treatment, improve patient outcomes, and to allow providers and researchers to gain a fuller understanding of this complex population.

It is known that tungsten oxide may be reacted with selenium sources to form WSe2 but literature reports include processing steps that involve high temperatures, reducing atmospheres, and/or oxidative pre-treatments of tungsten oxide. In this work, we report a non-vacuum process for the fabrication of compositionally high quality WSe2 thin films via the selenization of tungsten oxide under milder conditions. Tungsten source materials were various hydrated WO3 and WO2.9 compounds that were prepared using chemical solution techniques. Resulting films were selenized using a two-stage heating profile (250 °C for 15 minutes and 550 °C for 30 minutes) under a static argon atmosphere. Effects of the starting tungsten oxide phase on WSe2 formation after single and double selenization cycles were investigated using Raman spectroscopy and X-ray diffraction (XRD). After two selenization cycles, hydrated WO3 was converted to (002)-oriented WSe2 that exhibits well-resolved peaks for E12g and A1g phonon modes. Only a single selenization cycle was required to convert amorphous WO2.9 to WSe2. All selenizations in this work were achieved in non-reducing atmospheres and at lower temperatures and shorter times than any non-laser-assisted processes reported for WO3-to-WSe2 conversions.

This study was aimed to investigate associations between birth weight and multiple adiposity indicators in youth, and to examine potential mediating effects by biological maturation. This was a school-based study involving 981 Brazilian adolescents aged between 10 and 17 years. Birth weight was reported retrospectively by mothers. Maturation was estimated by age of peak height velocity. Adiposity indicators included body mass index (BMI), waist circumference and percent body fat estimated from triceps and subscapular skinfolds. Multilevel mediation analyses were performed using the Sobel test, adjusted for chronological age, gestational age, cardiorespiratory fitness and socio-economic status. Except for body fat in girls, biological maturation partly or fully mediated (P<0.05) positive relationships between birth weight with all other obesity indicators in both sexes with their respective values of indirect effects with 95% confidence intervals: BMI [boys: 0.44 (0.06–0.82); girls: 0.38 (0.13–0.64)], waist circumference [boys: 1.14 (0.22–2.05); girls: 0.87 (0.26–1.48)] and body fat [boys: 0.60 (0.13–1.07)]. To conclude, birth weight is associated with elevated obesity risk in adolescence and biological maturation seems to at least partly mediate this relationship.

The study of the evolution of organic matter subjected to space conditions, and more specifically to Solar photons in the vacuum ultraviolet range (120–200 nm) has been undertaken in low-Earth orbit since the 1990s, and implemented on various space platforms. This paper describes a photochemistry experiment called AMINO, conducted during 22 months between 2009 and 2011 on the EXPOSE-R ESA facility, outside the International Space Station. Samples with relevance to astrobiology (connected to comets, carbonaceous meteorites and micrometeorites, the atmosphere of Titan and RNA world hypothesis) have been selected and exposed to space environment. They have been analysed after return to the Earth. This paper is not discussing the results of the experiment, but rather gives a general overview of the project, the details of the hardware used, its configuration and recent developments to enable long-duration exposure of gaseous samples in tight closed cells enabling for the first time to derive quantitative results from gaseous phase samples exposed in space.

During the past decade, parasites have been considered important components of their ecosystems since they can modify food-web structures and functioning. One constraint to the inclusion of parasites in food-web models is the scarcity of available information on their feeding habits and host–parasite relationships. The stable isotope approach is suggested as a useful methodology to determine the trophic position and feeding habits of parasites. However, the isotopic approach is limited by the lack of information on the isotopic discrimination (ID) values of parasites, which is pivotal to avoiding the biased interpretation of isotopic results. In the present study we aimed to provide the first ID values of δ15N and δ13C between the gyrocotylidean tapeworm Gyrocotyle urna and its definitive host, the holocephalan Chimaera monstrosa. We also test the effect of host body size (body length and body mass) and sex of the host on the ID values. Finally, we illustrate how the trophic relationships of the fish host C. monstrosa and the tapeworm G. urna could vary relative to ID values. Similar to other studies with parasites, the ID values of the parasite–host system were negative for both isotopic values of N (Δδ15N = − 3.33 ± 0.63‰) and C (Δδ13C = − 1.32 ± 0.65‰), independent of the sex and size of the host. By comparing the specific ID obtained here with ID from other studies, we illustrate the importance of using specific ID in parasite–host systems to avoid potential errors in the interpretation of the results when surrogate values from similar systems or organisms are used.

A statesman's responsibility to act morally while remaining politically fastidious is a primary difficulty in international relations. Theories that provide definitive guidance for political morality are often viewed with suspicion and considered unrealistic. Coll, in opposition to this dismissive approach, sees in the Christian worldview three core values that can be used to discern moral political actions: the importance of history, the ubiquity of tragedy, and practical wisdom. Coll explicates the Christian tradition that informs each of these values and considers their pertinence in international relations today. He goes on to extract some general prescriptions for foreign policy, showing that these core values speak to military action, immigration, foreign aid, and the environment.

Never before in its history has the United States enjoyed such a favorable strategic environment as it does today. There are few deadly enemies anywhere in sight. The U.S. military budget surpasses that of China, Russia, and the five Western European powers combined, and U.S. military capabilities are well ahead of those of any ally or potential adversary. America's booming economy and domestic social arrangements—with crime and unemployment down to the levels of thirty years ago—are a puzzle to those who, as recently as a decade ago, were predicting inexorable American decline. Such a surfeit of U.S. power and prestige, and the apparent absence of any significant obstacles to it, have prompted many to argue that this is a unique historic opportunity for the United States to fulfill the Wilsonian dream of remaking the world in America's image. Among conservatives, the argument has been made most forcefully by William Kristol and Robert Kagan of the Project for the New American Century; among liberals, by Secretary of State Madeleine Albright and Tony Smith, whose essay follows.