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Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.
Methods
In total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance.
Results
Three trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12.
Conclusions
Our findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Psychiatric intensive care units (or PICU’s) emerged to manage high acuity patients outside the justice system. Studies have sought to better understand characteristics of those admitted to forensic or civilian PICU’s. Few, in contrast, have explored the frequency and contributors to readmission. The following study was conducted on Apsley unit, a Forensic PICU based in Melbourne, Australia, and seeks to understand the differences which would allow early identification of patients likely to require readmission and the provision of targeted interventions.
Objectives
Examine rates of and contributors to forensic PICU readmission over a 6-month period.
Methods
A retrospective audit was conducted to collect clinical, problem behaviour (and strategies to manage), forensic history and demographic information for consecutively admitted patients to an 8-bed forensic PICU between March-September 2019.
Results
Data analysis is ongoing. Interim analysis found that 96 patients were admitted during the 6-month study period: 74 (77.1%) had a single admission; 22 (22.9%) required readmission. Almost all were admitted from prison (96.9%), most had a psychosis diagnosis (80.2%) and substance abuse history (96.9%), and many had a personality disorder (24.0%) and history of adolescent antisocial behaviour (46.5%). Patients requiring readmission were significantly more likely to have been previously under compulsory mental health treatment (95.5% vs 75.3%, p=.039) and have a Positive Behaviour Support Plan developed during admission (85.7% vs 54.8%, p=.010).
Conclusions
Interim analysis highlighted the multicomplexity for forensic PICU patients alongside the occurrence of problem behaviour during admission and history of compulsory treatment as indicators of increased risk for re-admission.
Wildlife reintroduction projects often face resistance from local residents who see potential conflicts with the species or lack trust or confidence in the agencies and professionals involved in reintroduction. Yet the linkages between trust, confidence, risk perceptions, attitudes towards the species and local support for its reintroduction are not well known. The Dual-Mode Model of Cooperation and Cognitive Hierarchy Model were theoretical frameworks used to shed light on these linkages by exploring the potential roles trust and confidence play as mediators between risk perceptions and attitudes towards, and support for, reintroduced elk in Tennessee (USA). A mail survey of 1005 residents living in the five-county area surrounding the North Cumberland Elk Restoration Zone assessed resident attitudes and risk perceptions towards the reintroduced elk, trust towards the managing wildlife agency and support for continued conservation efforts. A structural equation model revealed that trust and confidence play positive roles in mitigating risk perceptions and improving support for the reintroduction of elk. The findings confirm the roles public trust and confidence play in wildlife reintroductions and should help agencies work towards building local trust and confidence, minimizing risks, improving attitudes and increasing the chances for successful outcomes for the species and people.
This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
Methods
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Results
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
Conclusions
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
One major challenge in the study of late-Quaternary extinctions (LQEs) is providing better estimates of past megafauna abundance. To show how megaherbivore population size varied before and after the last extinctions in interior Alaska, we use both a database of radiocarbon-dated bone remains (spanning 25–0 ka) and spores of the obligate dung fungus, Sporormiella, recovered from radiocarbon-dated lake-sediment cores (spanning 17–0 ka). Bone fossils show that the last stage of LQEs in the region occurred at about 13 ka ago, but the number of megaherbivore bones remains high into the Holocene. Sporormiella abundance also remains high into the Holocene and does not decrease with major vegetation changes recorded by arboreal pollen percentages. At two sites, the interpretation of Sporormiella was enhanced by additional dung fungal spore types (e.g., Sordaria). In contrast to many sites where the last stage of LQEs is marked by a sharp decline in Sporormiella abundance, in interior Alaska our results indicate the continuance of megaherbivore abundance, albeit with a major taxonomic turnover (including Mammuthus and Equus extinction) from predominantly grazing to browsing dietary guilds. This new and robust evidence implies that regional LQEs were not systematically associated with crashes of overall megaherbivore abundance.
Sexually transmitted infections (STIs) can be found in a range of hosts. Their epidemiology is predicted to vary with mean and variance in number of mating partners and, in more refined models, contact and social structure. Weak dependence of mating rate on host density leads to a prediction of density-independent dynamics, including the possibility that sterilising infections could drive their hosts extinct. Infection’s impact on the host is predicted to select for mate choice against infected partners and reduced mating rates. We examine these predictions against STIs in nature, with a particular focus on studies of beetle–ectoparasitic mite interactions. The Adalia bipunctata–Coccipolipus interaction has given rich insights, with ease of scoring infection and mating activity in natural populations enabling detailed documentation of dynamics. Laboratory study has allowed precise estimation of transmission parameters to inform models and focused analysis of behaviour. These studies have confirmed the core impact of mating rate on STI dynamics, but revealed unexpected drivers such as food supply (positively driving mating rate) and sex ratio (enhancing spread and producing male-biased prevalence), alongside constraints on spread from host phenology.
The sternocleidomastoid can be used as a pedicled flap in head and neck reconstruction. It has previously been associated with high complication rates, likely due in part to the variable nature of its blood supply.
Objective
To provide clinicians with an up-to-date review of clinical outcomes of sternocleidomastoid flap surgery in head and neck reconstruction, integrated with a review of vascular anatomical studies of the sternocleidomastoid.
Methods
A literature search of the Medline and Web of Science databases was conducted. Complications were analysed for each study. The trend in success rates was analysed by date of the study.
Results
Reported complication rates have improved over time. The preservation of two vascular pedicles rather than one may have contributed to improved outcomes.
Conclusion
The sternocleidomastoid flap is a versatile option for patients where prolonged free flap surgery is inappropriate. Modern vascular imaging techniques could optimise pre-operative planning.
Several grass and broadleaf weed species around the world have evolved multiple-herbicide resistance at alarmingly increasing rates. Research on the biochemical and molecular resistance mechanisms of multiple-resistant weed populations indicate a prevalence of herbicide metabolism catalyzed by enzyme systems such as cytochrome P450 monooxygenases and glutathione S-transferases and, to a lesser extent, by glucosyl transferases. A symposium was conducted to gain an understanding of the current state of research on metabolic resistance mechanisms in weed species that pose major management problems around the world. These topics, as well as future directions of investigations that were identified in the symposium, are summarized herein. In addition, the latest information on selected topics such as the role of safeners in inducing crop tolerance to herbicides, selectivity to clomazone, glyphosate metabolism in crops and weeds, and bioactivation of natural molecules is reviewed.
Building on the recent advances in next-generation sequencing, the integration of genomics, proteomics, metabolomics, and other approaches hold tremendous promise for precision medicine. The approval and adoption of these rapidly advancing technologies and methods presents several regulatory science considerations that need to be addressed. To better understand and address these regulatory science issues, a Clinical and Translational Science Award Working Group convened the Regulatory Science to Advance Precision Medicine Forum. The Forum identified an initial set of regulatory science gaps. The final set of key findings and recommendations provided here address issues related to the lack of standardization of complex tests, preclinical issues, establishing clinical validity and utility, pharmacogenomics considerations, and knowledge gaps.
OBJECTIVES/SPECIFIC AIMS: Objectives/goals: Describe the process used to develop leveled competencies and associated examples. Discuss the final leveled competencies and their potential use in clinical research professional workforce initiatives. METHODS/STUDY POPULATION: The revised JTFCTC Framework 2.0 has 51 competency statements, representing 8 domains. Each competency statement has now been refined to delineate fundamental, skilled or advanced levels of knowledge and capability. Typically, the fundamental level describes the competency for a professional that requires some coaching and oversight, but is able to understand and identify basic concepts. The skilled level of the competency reflects the professional’s solid understanding of the competency and use of the information to take action independently in most situations. The advanced level embodies high level thinking, problem solving, and the ability to guide others in the competency. The process for developing both the three levels and examples involved 5 workgroups, each chaired by a content expert and comprising of national/international clinical research experts, including representatives from research sites, professional associations, government, and industry and academic sponsors. RESULTS/ANTICIPATED RESULTS: The committee developed 51 specific competencies arrayed across 3 levels and examples of each to demonstrate an appropriate application of the competency. The competencies and examples, and potential utilization, will be described. DISCUSSION/SIGNIFICANCE OF IMPACT: The use of competencies in the context of workforce development and training initiatives is helping to create standards for the clinical research profession. These leveled competencies allow for an important refinement to the standards that can be used to enhance the quality and safety of the clinical research enterprise and guide workforce development.
Chemical constituents trapped within glacial ice provide a unique record of climate, as well as repositories for biological material such as pollen grains, fungal spores, viruses, bacteria and dissolved organic carbon. Past research suggests that the veins of polycrystalline ice may provide a liquid microenvironment for active microbial metabolism fueled by concentrated impurities in the veins. Despite these claims, no direct measurements of impurity concentration in ice veins have been made. Using micro-Raman spectroscopy, we show that sulfate and nitrate concentrations in the veins of glacial ice from Greenland (Greenland Ice Sheet Project 2) and Antarctic (Newall Glacier and a Dominion Range glacier) core samples were 104 and 105 times greater than the concentrations measured in melted (bulk) core water. Methanesulfonate was not found in the veins, consistent with its presence as particulate matter within the ice. The measured vein concentration of molecular anions implies a highly acidic (pH < 3) vein environment with high ionic strength (mM-M). We estimate that the vein volume provides 16.7 and 576 km3 of habitable space within the Greenland and Antarctic ice sheets, respectively, which could support the metabolism of organisms that are capable of growing in cold, high ionic strength solutions with low pH.
Two field experiments were conducted to examine the competitive effect of common cocklebur and sicklepod in soybean. Factors examined included sap flow of both the weed and the crop, as well as the traditional parameters of weed and crop growth and crop yield. The intent was to determine to what extent competitive effects could be attributed to differential water utilization. In the first study, soybean planted at 20 plants m−1 row was infested with either sicklepod at 10 plants m−1 row or common cocklebur at two plants m−1 row. Sicklepod reduced soybean sap flow and yield 53 and 49%, respectively. Common cocklebur reduced soybean sap flow and yield 31 and 38%, respectively. Within a weed species, weed-induced yield and sap flow reductions were comparable, indicating that water deprivation was the primary detriment that these weeds inflicted on soybean. Individual common cocklebur plants were 3.9 times more competitive than sicklepod with respect to reducing soybean yield. However, sap flow of individual common cocklebur plants was only 1.4 times more than that of sicklepod, indicating that water deprivation was not the only causal factor in weed-crop competition. In the second experiment, sicklepod was planted in soybean (fixed density) and clipped to either half the height, same height as soybean, or left unclipped, in an attempt to simulate herbicide-induced stunting. Clipping sicklepod had a positive effect on soybean sap flow and yield. Thus, the benefits of reduced weed competition were achieved without killing sicklepod.
Field experiments evaluated pitted morningglory, velvetleaf, and barnyardgrass control in soybean with imazethapyr applied alone and with either crop oil concentrate at 1.0% v/v, a blend of methylated seed oil and organosilicone surfactant, or a blend of methylated seed oil, phosphate esters, and organosilicone surfactant at 0.5% v/v, each with and without a 28% N mixture of urea and ammonium nitrate (URAN) applied at 2.3 L/ha. Treatments were applied at spray volumes of 94 and 9.4 L/ha. Control of each species was often increased with the addition of both oil adjuvants and URAN. The blend of methylated seed oil, phosphate esters, and organosilicone surfactant and the blend of methylated seed oil and organosilicone surfactant were each more effective than crop oil concentrate on pitted morningglory and barnyardgrass, while each oil adjuvant was similar on velvetleaf. The URAN effectively increased imazethapyr control of all species. Control of all species was similar at the spray volume of 9.4 L/ha and at 94 L/ha.
Greenhouse and growth chamber experiments with potted plants were conducted to determine the effects of interspecific root and canopy interference, light intensity, and soil moisture on water uptake and biomass of soybean, common cocklebur, and sicklepod. Canopy interference and canopy plus root interference of soybean with common cocklebur increased soybean water uptake per plant and per unit leaf area. Root interference with soybean decreased common cocklebur water uptake per plant. Canopy interference of soybean with sicklepod increased soybean water uptake per unit leaf area, while root interference decreased uptake per plant. Combined root and canopy interference with soybean decreased water uptake per plant for sicklepod. Soybean leaf area and shoot weight were reduced by root interference with both weeds. Common cocklebur and sicklepod leaf area and shoot weight were reduced by root and canopy interference with soybeans. Only common cocklebur root weight decreased when canopies interfered and roots did not. The relationship between light intensity and water uptake per unit leaf area was linear in both years with water uptake proportional to light intensity. In 1991 water uptake response to tight was greater for common cocklebur than for sicklepod. The relationship between soil moisture level and water uptake was logarithmic. Common cocklebur water uptake was two times that of soybean or sicklepod at −2 kPa of pressure potential. In 1991 common cocklebur water uptake decreased at a greater rate than soybean or sicklepod in response to pressure potential changes from −2 to −100 kPa.
Laboratory and field studies were conducted to determine the effect of the drift control adjuvants HM 2005B and HM 9752 on the droplet spectra and efficacy of spray mixtures of a potassium salt formulation of glyphosate. Droplet spectra were examined using a laser spray droplet analyzer. The addition of each adjuvant decreased the percentage of the spray volume in small diam spray droplets (<141μm) and either had no effect or increased glyphosate efficacy. These adjuvants could prove useful for providing management in potential drift situations.
Survey-based contingent valuation (CV) techniques are commonly used to value the potential effects of a policy change when market-based valuation of those effects is not possible. The results of these analyses are often intended to inform policy decisions, which are made within the context of formal policymaking institutions. These institutions are typically designed to reduce the large number of potential options for addressing any given policy problem to a binary choice between the continuation of current policy and a single, specified alternative. In this research we develop an approach for conducting CV exercises in a manner consistent with the decision structure typically faced by policymakers. The data generated from this approach allow for an estimate of willingness to pay (WTP) for a defined policy alternative, relative to leaving policy unchanged, which we argue is of direct interest to policymakers. We illustrate our approach within the context of policy governing the storage of used nuclear fuel in the United States. We value the policy option of constructing an interim storage facility relative to continuation of current policy, wherein used nuclear fuel is stored on-site at or near commercial nuclear generating plants. We close the paper with a discussion of the implications for future research and the role of CV in the policymaking process.
We have attempted to verify the presence of increased aluminum (Al) levels in Alzheimer's disease (AD) brains by energy dispersive X-ray microanalysis (EDX) and flameless atomic absorption spectrophotometry (AAS). Tissue from seven AD brains, mounted on carbon polymerized coverslips, were stained with Congored or treated immunohistochemically to allow optical localization of AD-associated lesions during EDX. Despite a demonstrated sensitivity of 20-25 ppm, we were unable to detect Al in either plaque cores or neurons containing neurofibrillary tangles. For AAS, wet weight samples (ranging from 48-144 mg) from six of the seven AD brains and four controls were selected from regions similar to those studied under EDX, i.e., Brodmann areas 9, 11, 28, 46, 47, and the hippocampus. The tissue surrounding each sample site was sectioned and stained for thioflavin S. Both controls and AD samples revealed similar levels of Al ranging from undetectable to 1.80 ng/mg wet wt. (mean AD: 0.28 ± 0.39 (SD), control: 0.54 ± 0.58 (SD)), independent of degree of histopathology or age of the case. We conclude that the combined strengths of these two techniques on similar tissue specimens demonstrate that abnormal Al levels are not required to produce the histologic findings of AD and that this element may not accumulate in the aging brain. It is unlikely, therefore, that Al is essential in the etiology of pathogenesis of plaques and tangles in AD. Al's role as a primary or secondarily associated event, when present, needs further delineation.