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Differing impact of the COVID-19 pandemic on youth mental health: combined population and clinical study
- Lu Qi, Zuo Zhang, Lauren Robinson, Marina Bobou, Chantal Gourlan, Jeanne Winterer, Rebecca Adams, Kofoworola Agunbiade, Yuning Zhang, Sinead King, Nilakshi Vaidya, Eric Artiges, Tobias Banaschewski, Arun L. W. Bokde, M. John Broulidakis, Rüdiger Brühl, Herta Flor, Juliane H. Fröhner, Hugh Garavan, Antoine Grigis, Andreas Heinz, Sarah Hohmann, Marie-Laure Paillère Martinot, Sabina Millenet, Frauke Nees, Betteke Maria van Noort, Dimitri Papadopoulos Orfanos, Luise Poustka, Julia Sinclair, Michael N. Smolka, Robert Whelan, Argyris Stringaris, Henrik Walter, Jean-Luc Martinot, Gunter Schumann, Ulrike Schmidt, Sylvane Desrivières, IMAGEN Consortium, ESTRA Consortium and STRATIFY Consortium
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- Journal:
- BJPsych Open / Volume 9 / Issue 6 / November 2023
- Published online by Cambridge University Press:
- 20 November 2023, e217
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Background
Identifying youths most at risk to COVID-19-related mental illness is essential for the development of effective targeted interventions.
AimsTo compare trajectories of mental health throughout the pandemic in youth with and without prior mental illness and identify those most at risk of COVID-19-related mental illness.
MethodData were collected from individuals aged 18–26 years (N = 669) from two existing cohorts: IMAGEN, a population-based cohort; and ESTRA/STRATIFY, clinical cohorts of individuals with pre-existing diagnoses of mental disorders. Repeated COVID-19 surveys and standardised mental health assessments were used to compare trajectories of mental health symptoms from before the pandemic through to the second lockdown.
ResultsMental health trajectories differed significantly between cohorts. In the population cohort, depression and eating disorder symptoms increased by 33.9% (95% CI 31.78–36.57) and 15.6% (95% CI 15.39–15.68) during the pandemic, respectively. By contrast, these remained high over time in the clinical cohort. Conversely, trajectories of alcohol misuse were similar in both cohorts, decreasing continuously (a 15.2% decrease) during the pandemic. Pre-pandemic symptom severity predicted the observed mental health trajectories in the population cohort. Surprisingly, being relatively healthy predicted increases in depression and eating disorder symptoms and in body mass index. By contrast, those initially at higher risk for depression or eating disorders reported a lasting decrease.
ConclusionsHealthier young people may be at greater risk of developing depressive or eating disorder symptoms during the COVID-19 pandemic. Targeted mental health interventions considering prior diagnostic risk may be warranted to help young people cope with the challenges of psychosocial stress and reduce the associated healthcare burden.
Independent contribution of polygenic risk for schizophrenia and cannabis use in predicting psychotic-like experiences in young adulthood: testing gene × environment moderation and mediation
- Laurent Elkrief, Bochao Lin, Mattia Marchi, Mohammad H Afzali, Tobias Banaschewski, Arun L. W. Bokde, Erin Burke Quinlan, Sylvane Desrivières, Herta Flor, Hugh Garavan, Penny Gowland, Andreas Heinz, Bernd Ittermann, Jean-Luc Martinot, Marie-Laure Paillère Martinot, Frauke Nees, Dimitri Papadopoulos Orfanos, Tomáš Paus, Luise Poustka, Sarah Hohmann, Juliane H. Fröhner, Michael N. Smolka, Henrik Walter, Robert Whelan, Gunter Schumann, Jurjen Luykx, Marco P. Boks, Patricia J. Conrod, the IMAGEN consortium
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- Journal:
- Psychological Medicine / Volume 53 / Issue 5 / April 2023
- Published online by Cambridge University Press:
- 23 September 2021, pp. 1759-1769
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Background
It has not yet been determined if the commonly reported cannabis–psychosis association is limited to individuals with pre-existing genetic risk for psychotic disorders.
MethodsWe examined whether the relationship between polygenic risk score for schizophrenia (PRS-Sz) and psychotic-like experiences (PLEs), as measured by the Community Assessment of Psychic Experiences-42 (CAPE-42) questionnaire, is mediated or moderated by lifetime cannabis use at 16 years of age in 1740 of the individuals of the European IMAGEN cohort. Secondary analysis examined the relationships between lifetime cannabis use, PRS-Sz and the various sub-scales of the CAPE-42. Sensitivity analyses including covariates, including a PRS for cannabis use, were conducted and results were replicated using data from 1223 individuals in the Dutch Utrecht cannabis cohort.
ResultsPRS-Sz significantly predicted cannabis use (p = 0.027) and PLE (p = 0.004) in the IMAGEN cohort. In the full model, considering PRS-Sz and covariates, cannabis use was also significantly associated with PLE in IMAGEN (p = 0.007). Results remained consistent in the Utrecht cohort and through sensitivity analyses. Nevertheless, there was no evidence of a mediation or moderation effects.
ConclusionsThese results suggest that cannabis use remains a risk factor for PLEs, over and above genetic vulnerability for schizophrenia. This research does not support the notion that the cannabis–psychosis link is limited to individuals who are genetically predisposed to psychosis and suggests a need for research focusing on cannabis-related processes in psychosis that cannot be explained by genetic vulnerability.
Sex differences in neural correlates of common psychopathological symptoms in early adolescence
- Francesca Biondo, Charlotte Nymberg Thunell, Bing Xu, Congying Chu, Tianye Jia, Alex Ing, Erin Burke Quinlan, Nicole Tay, Tobias Banaschewski, Arun L. W. Bokde, Christian Büchel, Sylvane Desrivières, Herta Flor, Vincent Frouin, Hugh Garavan, Penny Gowland, Andreas Heinz, Bernd Ittermann, Jean-Luc Martinot, Hervé Lemaitre, Frauke Nees, Dimitri Papadopoulos Orfanos, Luise Poustka, Sabina Millenet, Juliane H. Fröhner, Michael N. Smolka, Henrik Walter, Robert Whelan, Edward D. Barker, Gunter Schumann, IMAGEN Consortium
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- Journal:
- Psychological Medicine / Volume 52 / Issue 14 / October 2022
- Published online by Cambridge University Press:
- 26 March 2021, pp. 3086-3096
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Background
Sex-related differences in psychopathology are known phenomena, with externalizing and internalizing symptoms typically more common in boys and girls, respectively. However, the neural correlates of these sex-by-psychopathology interactions are underinvestigated, particularly in adolescence.
MethodsParticipants were 14 years of age and part of the IMAGEN study, a large (N = 1526) community-based sample. To test for sex-by-psychopathology interactions in structural grey matter volume (GMV), we used whole-brain, voxel-wise neuroimaging analyses based on robust non-parametric methods. Psychopathological symptom data were derived from the Strengths and Difficulties Questionnaire (SDQ).
ResultsWe found a sex-by-hyperactivity/inattention interaction in four brain clusters: right temporoparietal-opercular region (p < 0.01, Cohen's d = −0.24), bilateral anterior and mid-cingulum (p < 0.05, Cohen's d = −0.18), right cerebellum and fusiform (p < 0.05, Cohen's d = −0.20) and left frontal superior and middle gyri (p < 0.05, Cohen's d = −0.26). Higher symptoms of hyperactivity/inattention were associated with lower GMV in all four brain clusters in boys, and with higher GMV in the temporoparietal-opercular and cerebellar-fusiform clusters in girls.
ConclusionsUsing a large, sex-balanced and community-based sample, our study lends support to the idea that externalizing symptoms of hyperactivity/inattention may be associated with different neural structures in male and female adolescents. The brain regions we report have been associated with a myriad of important cognitive functions, in particular, attention, cognitive and motor control, and timing, that are potentially relevant to understand the behavioural manifestations of hyperactive and inattentive symptoms. This study highlights the importance of considering sex in our efforts to uncover mechanisms underlying psychopathology during adolescence.
Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries
- D. Wasserman, G. Apter, C. Baeken, S. Bailey, J. Balazs, C. Bec, P. Bienkowski, J. Bobes, M. F. Bravo Ortiz, H. Brunn, Ö. Bôke, N. Camilleri, B. Carpiniello, J. Chihai, E. Chkonia, P. Courtet, D. Cozman, M. David, G. Dom, A. Esanu, P. Falkai, W. Flannery, K. Gasparyan, G. Gerlinger, P. Gorwood, O. Gudmundsson, C. Hanon, A. Heinz, M. J. Heitor Dos Santos, A. Hedlund, F. Ismayilov, N. Ismayilov, E. T. Isometsä, L. Izakova, A. Kleinberg, T. Kurimay, S. Klæbo Reitan, D. Lecic-Tosevski, A. Lehmets, N. Lindberg, K. A. Lundblad, G. Lynch, C. Maddock, U.F. Malt, L. Martin, I. Martynikhin, N. O. Maruta, F. Matthys, R. Mazaliauskiene, G. Mihajlovic, A. Mihaljevic Peles, V. Miklavic, P. Mohr, M. Munarriz Ferrandis, M. Musalek, N. Neznanov, G. Ostorharics-Horvath, I. Pajević, A. Popova, P. Pregelj, E. Prinsen, C. Rados, A. Roig, M. Rojnic Kuzman, J. Samochowiec, N. Sartorius, Y. Savenko, O. Skugarevsky, E. Slodecki, A. Soghoyan, D. S. Stone, R. Taylor-East, E. Terauds, C. Tsopelas, C. Tudose, S. Tyano, P. Vallon, R. J. Van der Gaag, P. Varandas, L. Vavrusova, P. Voloshyn, J. Wancata, J. Wise, Z. Zemishlany, F. Öncü, S. Vahip
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- Journal:
- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 24 August 2020, e82
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Background.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
Methods.The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
Results.We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
Conclusions.We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study
- C. E. Lloyd, N. Sartorius, H. U. Ahmed, A. Alvarez, S. Bahendeka, A. E. Bobrov, L. Burti, S. K. Chaturvedi, W. Gaebel, G. de Girolamo, T. M. Gondek, M. Guinzbourg, M. G. Heinze, A. Khan, A. Kiejna, A. Kokoszka, T. Kamala, N. M. Lalic, D. Lecic-Tosevski, E. Mannucci, B. Mankovsky, K. Müssig, V. Mutiso, D. Ndetei, A. Nouwen, G. Rabbani, S. S. Srikanta, E. G. Starostina, M. Shevchuk, R. Taj, U. Valentini, K. van Dam, O. Vukovic, W. Wölwer
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 02 June 2020, e134
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Aims
To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.
MethodsPeople with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.
ResultsIn total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.
ConclusionThis study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.
Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives
- Britta Bernhard, Annette Schaub, Petra Kümmler, Sandra Dittmann, Emanuel Severus, Florian Seemüller, Christoph Born, Anna Forsthoff, Rasmus W. Licht, Heinz Grunze
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- Journal:
- European Psychiatry / Volume 21 / Issue 2 / March 2006
- Published online by Cambridge University Press:
- 16 April 2020, pp. 81-86
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Background.
In recent years, several controlled studies could show that psychoeducational interventions have been effective for relapse prevention in bipolar disorders. We therefore established a cognitive-psychoeducational group intervention with 14 sessions providing information about the illness, early warning signs, cognitive and behavioural strategies for stress management and social rhythm. Additionally we offered a group intervention for the patients' relatives. The objective of this study was to describe the outcome associated with our psychoeducational intervention in bipolar patients and their relatives.
Methods.Sixty-two bipolar patients attended 14 sessions (à 90 min) of cognitive-psychoeducational group therapy. Patients' knowledge of bipolar disorder and their satisfaction with the treatment were assessed using self-developed questionnaires before and after the group intervention. Additionally, 49 relatives of bipolar patients received two psychoeducational workshops of 4 hours each. We assessed demographic variables, burden, high expressed emotion and depressive symptoms of the relatives before and after the two workshops and at 1-year follow-up.
Results.Patients significantly improved their knowledge of bipolar disorder. They also have benefited from the discussions and the exchange of useful coping strategies. Burden and high expressed emotions showed no significant reductions at post-assessment, however they were significantly reduced at 1-year follow-up. Relatives also felt significantly better informed about the illness.
Conclusions.These findings show that psychoeducational interventions in bipolar patients and their relatives improve patients' and their relatives' knowledge of the illness and the burden of the disorder as well as high expressed emotions are reduced in relatives at 1-year follow-up.
FC18-04 - Cue-induced brain activation mediates subsequent relapse in abstinent alcohol-dependent patients
- A. Beck, T. Wüstenberg, J. Wrase-Post, F. Schlagenhauf, S. Vollstädt-Klein, D. Hermann, M.N. Smolka, M. Ruf, W. Weber-Fahr, H. Flor, K. Mann, D.F. Braus, A. Heinz
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- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 1913
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Introduction
In alcoholism, one relevant mechanism contributing to relapse is the exposure to stimuli that are associated with alcohol intake. Such conditioned cues can elicit conditioned responses like alcohol craving and consumption. In the last decade, considerable progress has been made in identifying basic neuronal mechanisms that underlie cue-induced alcohol craving.
Objectives/ aimsWe explored whether functional brain activation during exposure to alcohol-associated stimuli is related to the prospective relapse risk in detoxified alcohol-dependent patients.
Methods46 alcohol-dependent and 46 healthy volunteers participated in a fMRI study using a cue reactivity paradigm, in which visual alcohol-related and control stimuli were presented. Patients were followed for 3 months. Afterwards data was analysed regarding the subsequent relapse, resulting in 16 abstainers and 30 relapsers.
ResultsAlcohol-related versus neutral stimuli activated a frontocortical-limbic network including inferior, medial and middle frontal gyrus as well as putamen in the group of patients relative to healthy controls. Moreover, abstainers showed a stronger activation in orbitofrontal cortex as well as midbrain during the presentation of alcohol-related cues whereas relapsers revealed a stronger activation of cingulate gyrus.
ConclusionsThis study suggests that cue-induced activation of orbitofrontal cortex and dopaminergic innervated midbrain is negatively associated with the prospective relapse risk in alcohol-dependent patients. This could indicate a more pronounced and conscious processing of alcohol cues which might serve as a warning signal and a behavioural controlling function. In contrast, prospective relapsers showed a stronger activation of cingulate gyrus, a region involved in the attribution of motivational value.
Health services and the treatment of immigrants: data on service use, interpreting services and immigrant staff members in services across Europe
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U. Kluge, M. Bogic, W. Devillé, T. Greacen, M. Dauvrin, S. Dias, A. Gaddini, N. Koitzsch Jensen, E. Ioannidi-Kapolou, R. Mertaniemi, R. Puipcinós i Riera, S. Sandhu, A. Sarvary, J.J.F. Soares, M. Stankunas, C. Straßmayr, M. Welbel, A. Heinz, S. Priebe,
On behalf of the EUGATE- study group -
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- European Psychiatry / Volume 27 / Issue S2 / June 2012
- Published online by Cambridge University Press:
- 15 April 2020, pp. S56-S62
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Background
The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from immigrant groups.
MethodsStructured interviews were conducted with 15 health services (9 primary care, 3 emergency departments, 3 mental health) located in areas with high immigrant populations in each of 16 European countries (n = 240). Responses were collected on the availability of data on service use by immigrant patients, the provision of interpreting services and immigrant staff members.
ResultsData on service use by immigrants were recorded by only 15% of services. More than 40% of services did not provide any form of interpreting service and 54% of the services reported having no immigrant staff. Mental health services were more likely to use direct interpreting services, and both mental health and emergency services were more likely to have immigrant staff members.
DiscussionFor assessing and improving the quality of care provided for immigrants, there is a need to improve the availability of data on service use by immigrants in health services throughout Europe and to provide more consistent access to interpreting services.
Application of the radionuclide 210Pb in glaciology – an overview
- Heinz W. Gäggeler, Leonhard Tobler, Margit Schwikowski, Theo M. Jenk
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- Journal of Glaciology / Volume 66 / Issue 257 / June 2020
- Published online by Cambridge University Press:
- 13 April 2020, pp. 447-456
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210Pb is an environmental radionuclide with a half-life of 22.3 years, formed in the atmosphere via radioactive decay of radon (222Rn). 222Rn itself is a noble gas with a half-life of 3.8 days and is formed via radioactive decay of uranium (238U) contained in the Earth crust from where it constantly emanates into the atmosphere. 210Pb atoms attach to aerosol particles, which are then deposited on glaciers via scavenging with fresh snow. Due to its half-life, ice cores can be dated with this radionuclide over roughly one century, depending on the initial 210Pb activity concentration. Optimum 210Pb dating is achieved for cold glaciers with no – or little – influence by percolating meltwater. This paper presents an overview which not only includes dating of cold glaciers but also some special cases of 210Pb applications in glaciology addressing temperate glaciers, glaciers with negative mass balance, sublimation processes on glaciers in arid regions, determination of annual net snow accumulation as well as glacier flow rates.
Shall we really say goodbye to first rank symptoms?
- A. Heinz, M. Voss, S.M. Lawrie, A. Mishara, M. Bauer, J. Gallinat, G. Juckel, U. Lang, M. Rapp, P. Falkai, W. Strik, J. Krystal, A. Abi-Dargham, S. Galderisi
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- European Psychiatry / Volume 37 / September 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. 8-13
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Background
First rank symptoms (FRS) of schizophrenia have been used for decades for diagnostic purposes. In the new version of the DSM-5, the American Psychiatric Association (APA) has abolished any further reference to FRS of schizophrenia and treats them like any other “criterion A” symptom (e.g. any kind of hallucination or delusion) with regard to their diagnostic implication. The ICD-10 is currently under revision and may follow suit. In this review, we discuss central points of criticism that are directed against the continuous use of first rank symptoms (FRS) to diagnose schizophrenia.
MethodsWe describe the specific circumstances in which Schneider articulated his approach to schizophrenia diagnosis and discuss the relevance of his approach today. Further, we discuss anthropological and phenomenological aspects of FRS and highlight the importance of self-disorder (as part of FRS) for the diagnosis of schizophrenia. Finally, we will conclude by suggesting that the theory and rationale behind the definition of FRS is still important for psychopathological as well as neurobiological approaches today.
ResultsResults of a pivotal meta-analysis and other studies show relatively poor sensitivity, yet relatively high specificity for FRS as diagnostic marker for schizophrenia. Several methodological issues impede a systematic assessment of the usefulness of FRS in the diagnosis of schizophrenia. However, there is good evidence that FRS may still be useful to differentiate schizophrenia from somatic causes of psychotic states. This may be particularly important in countries or situations with little access to other diagnostic tests. FRS may thus still represent a useful aid for clinicians in the diagnostic process.
ConclusionIn conclusion, we suggest to continue a tradition of careful clinical observation and fine-grained psychopathological assessment, including a focus on symptoms regarding self-disorders, which reflects a key aspect of psychosis. We suggest that the importance of FRS may indeed be scaled down to a degree that the occurrence of a single FRS alone should not suffice to diagnose schizophrenia, but, on the other hand, absence of FRS should be regarded as a warning sign that the diagnosis of schizophrenia or schizoaffective disorder is not warranted and requires specific care to rule out other causes, particularly neurological and other somatic disorders. With respect to the current stage of the development of ICD-11, we appreciate the fact that self-disorders are explicitly mentioned (and distinguished from delusions) in the list of mandatory symptoms but still feel that delusional perceptions and complex hallucinations as defined by Schneider should be distinguished from delusions or hallucinations of “any kind”. Finally, we encourage future research to explore the psychopathological context and the neurobiological correlates of self-disorders as a potential phenotypic trait marker of schizophrenia.
Assessing failure in epitaxially encapsulated micro-scale sensors using micro and nano x-ray computed tomography
- Lizmarie Comenencia Ortiz, David B. Heinz, Ian B. Flader, Anne L. Alter, Dongsuk D. Shin, Yunhan Chen, Thomas W. Kenny
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- Journal:
- MRS Communications / Volume 8 / Issue 2 / June 2018
- Published online by Cambridge University Press:
- 12 April 2018, pp. 275-282
- Print publication:
- June 2018
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Millions of micro electro mechanical system sensors are fabricated each year using an ultra-clean process that allows for a vacuum-encapsulated cavity. These devices have a multi-layer structure that contains hidden layers with highly doped silicon, which makes common imaging techniques ineffective. Thus, examining device features post-fabrication, and testing, is a significant challenge. Here, we use a combination of micro- and nano-scale x-ray computed tomography to study device features and assess failure mechanisms in such devices without destroying the ultra-clean cavity. This provides a unique opportunity to examine surfaces and trace failure mechanisms to specific steps in the fabrication process.
Potential for climate variability reconstruction from Andean glaciochemical records
- Patrick Ginot, Margit Schwikowski, Ulrich Schotterer, Willibald Stichler, Heinz W. Gäggeler, Bernard Francou, Robert Gallaire, Bernard Pouyaud
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- Annals of Glaciology / Volume 35 / 2002
- Published online by Cambridge University Press:
- 14 September 2017, pp. 443-450
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In order to select glacier sites suitable for the reconstruction of short-term climate variability, chemical constituents of shallow cores from Chimborazo, Ecuador, Illimani, Bolivia, and Cerro Tapado, Chile, were analyzed to determine if they represent the climate and atmospheric conditions of the particular area. Pronounced variations were observed in the Chimborazo core, which were attributed to the seasonal occurrence of wet and dry periods. Using chemical tracers, the Pacific and the Amazon basin were identified as the two principal sources of atmospheric moisture. In the Illimani record, seasonality is obvious but is less regular than in the Chimborazo core. Chemical tracers point to the Amazon basin as a moisture source. Post-depositional sublimation masks a possible atmospheric signal in the glaciochemical records from Cerro Tapado. the arid conditions and a prevailing high condensation level also cause little variability in the stable-isotope content. Irregular, more negative δ18O values occur during the humid phases of El Niño events. Despite alterations due to sublimation, chemical tracers indicate the Pacific Ocean as a main moisture source for precipitation preserved on Glaciar CerroTapado.
A first shallow firn-core record from Glaciar La Ollada, Cerro Mercedario, central Argentine Andes
- David Bolius, Margit Schwikowski, Theo Jenk, Heinz W. Gäggeler, Gino Casassa, Andrés Rivera
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- Annals of Glaciology / Volume 43 / 2006
- Published online by Cambridge University Press:
- 14 September 2017, pp. 14-22
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In January 2003, shallow firn cores were recovered from Glaciar Esmeralda on Cerro del Plomo (33°14’S, 70°13’W; 5300 ma.s.l.), central Chile, and from Glaciar La Ollada on Cerro Mercedario (31°58’S, 70°07’W; 6070 ma.s.l.), Argentina, in order to find a suitable archive for paleoclimate reconstruction in a region strongly influenced by the El Nino-Southern Oscillation. In the area between 28°S and 35°S, the amount of winter precipitation is significantly correlated to the Southern Oscillation Index, with higher values during El Nino years. Glaciochemical analysis indicates that the paleo-record at Glaciar La Ollada is well preserved, whereas at Glaciar Esmeralda the record is strongly influenced by meltwater formation and percolation. A preliminary dating of the Mercedario core by annual-layer counting results in a time-span of 17 years (1986-2002), yielding an average annual net accumulation of 0.45 m w.e.
Glaciochemical dating of an ice core from upper Grenzgletscher (4200 m a.s.l.)
- Anja Eichler, Margit Schwikowski, Heinz W. Gäggeler, Verena Furrer, Hans-Arno Synal, Jürg Beer, Matthias Saurer, Martin Funk
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- Journal of Glaciology / Volume 46 / Issue 154 / 2000
- Published online by Cambridge University Press:
- 08 September 2017, pp. 507-515
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One crucial condition for the interpretation of ice-core records is the establishment of an accurate time-scale. This task is especially difficult for glacier sites in a complex topography such as the Alps, due to the often irregular deposition of fresh precipitation. In this work, dating techniques were applied to an Alpine ice core from upper Grenzgletscher, Monte Rosa massif (4200 m a.s.l.), representing about two-thirds of the total glacier thickness. They are based on (i) the radioactive decay of the isotope 210Pb, (ii) seasonally varying signals such as the concentrations of NH4+ and the isotopic ratio δ18O, and (iii) stratigraphic markers from Saharan dust falls, atmospheric nuclear weapon tests and the reactor accident in Chernobyl. From the combined application of these dating methods, a time period of 1937–94 covered by the ice core was derived. Dating uncertainty is <1 year for the period 1970–94 and ± 2 years for the period 1937–69. The observed thinning of the annual layers as a function of depth could be well described by a simple kinematic glacier flow model.
210 Pb dating of the Miaoergou ice core from the eastern Tien Shan, China
- Chaomin Wang, Shugui Hou, Hongxi Pang, Yaping Liu, Heinz W. Gäggeler, Leonhard Tobler, Sönke Szidat, Edith Vogel
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- Annals of Glaciology / Volume 55 / Issue 66 / 2014
- Published online by Cambridge University Press:
- 26 July 2017, pp. 105-110
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In 2005, two ice cores with lengths of 58.7 and 57.6 m respectively to bedrock were recovered from the Miaoergou flat-topped glacier (43°03′19″ N, 94°19′21″ E; 4512 m a.s.l.), eastern Tien Shan. 210Pb dating of one of the ice cores (57.6 m) was performed, and an age of AD 1851 ± 6 at a depth of 35.2 mw.e. was determined. For the period AD 1851-2005, a mean annual net accumulation of 229 ± 7 mm w.e. a–1 was calculated. At the nearby oasis city of Hami (~80 km from the Miaoergou flat-topped glacier) the annual precipitation rate is 38 mm w.e. a–1, hence glacial meltwater is a major water supply for local residents. The surface activity concentration of 210Pbex was found to be ~400 mBq kg–1, which is higher than observed at other continental sites such as Belukha, Russia, and Tsambagarav, Mongolia, which have surface activity concentrations of 280 mBq kg–1. The 210Pb dating agrees well with the chronological sequence deduced from the annual-layer counting resulting from the seasonalities of d18O and trace metals for the period AD 1953-2005, and ^-activity horizons resulting from atmospheric nuclear testing during the period AD 1962-63. We conclude that 210Pb analysis is a suitable method for obtaining a continuous dating of the Miaoergou ice core for ~160 years, which can also be applied to other ice cores recovered from the mountains of western China.
Reconstruction of a complex late Quaternary glacial landscape in the Cordillera de Cochabamba (Bolivia) based on a morphostratigraphic and multiple dating approach
- Jan-Hendrik May, Jana Zech, Roland Zech, Frank Preusser, Jaime Argollo, Peter W. Kubik, Heinz Veit
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- Journal:
- Quaternary Research / Volume 76 / Issue 1 / July 2011
- Published online by Cambridge University Press:
- 20 January 2017, pp. 106-118
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Although glacial landscapes have previously been used for the reconstruction of late Quaternary glaciations in the Central Andes, only few data exist for the Eastern Cordillera in Bolivia. Here, we present results from detailed morphostratigraphic mapping and new data of surface exposure dating (SED), optically stimulated luminescence (OSL), and radiocarbon dating (14C) from the Huara Loma Valley, Cordillera de Cochabamba (Bolivia). Discrepancies between individual dating methods could be addressed within the context of a solid geomorphic framework. We identified two major glaciations. The older is not well constrained by the available data, whereas the younger glaciation is subdivided into at least four major glacial stages. Regarding the latter, a first advance dated to ~ 29–25 ka occurred roughly contemporaneous with the onset of the global last glacial maximum (LGM) and was followed by a less extensive (re-)advance around 20–18 ka. The local last glacial maximum (LLGM) in the Huara Loma Valley took place during the humid lateglacial ~17–16 ka, followed by several smaller readvances until ~10–11 ka, and complete deglaciation at the end of the Early Holocene.
Three-Dimensional Determination of the Coordinates of Individual Atoms in Materials
- Jianwei Miao, Rui Xu, Chien-Chun Chen, Li Wu, M. C. Scott, W. Theis, Colin Ophus, Matthias Bartels, Yongsoo Yang, Hadi Ramezani-Dakhel, Michael R. Sawaya, Hendrik Heinz, Laurence D. Marks, Peter Ercius
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- Journal:
- Microscopy and Microanalysis / Volume 22 / Issue S3 / July 2016
- Published online by Cambridge University Press:
- 25 July 2016, pp. 916-917
- Print publication:
- July 2016
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Evaluation of the ‘Jumping to conclusions’ bias in different subgroups of the at-risk mental state: from cognitive basic symptoms to UHR criteria
- F. Rausch, S. Eisenacher, H. Elkin, S. Englisch, S. Kayser, N. Striepens, M. Lautenschlager, A. Heinz, Y. Gudlowski, B. Janssen, W. Gaebel, T. M. Michel, F. Schneider, M. Lambert, D. Naber, G. Juckel, S. Krueger-Oezguerdal, T. Wobrock, A. Hasan, M. Riedel, S. Moritz, H. Müller, J. Klosterkötter, A. Bechdolf, M. Zink, M. Wagner
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- Journal:
- Psychological Medicine / Volume 46 / Issue 10 / July 2016
- Published online by Cambridge University Press:
- 20 April 2016, pp. 2071-2081
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Background
Patients with psychosis display the so-called ‘Jumping to Conclusions’ bias (JTC) – a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in ‘at-risk mental state’ (ARMS) patients, specifically in ARMS samples fulfilling ‘ultra-high risk’ (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups.
MethodIn the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument – Adult Version (SPI-A).
ResultsThe mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement.
ConclusionsOur data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
Evolution of generic flight vehicle design synthesis
- B. Chudoba, W. Heinze
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- Journal:
- The Aeronautical Journal / Volume 114 / Issue 1159 / September 2010
- Published online by Cambridge University Press:
- 03 February 2016, pp. 549-567
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When defining a new product like an aircraft, space access vehicle or space mission, the Advanced Projects Group evaluates the available design space and compares it with the design space required to accomplish the specified mission. As with any product development process, the general life-cycle characteristics are established first during the conceptual design (CD) phase, clearly before a design proposal can be released to the follow-on design phases such as preliminary design (PD), detail design (DD), flight test (FT), and finally operation and disposal. As a rule of thumb, it can be assumed that around 80% of the flight vehicle configuration and mission tandem are determined during the CD phase alone, which is the key phase where the initial brainstorming has to take place. Clearly, it is the responsibility of the CD team to simulate the entire life-cycle of the project from ‘cradle to grave’ where the focus is on correctness rather accuracy in order to identify the design space and offer an overall proof of design convergence. Currently, the important primary aerospace vehicle and mission design decisions at CD level are still made using extremely simple analysis and heuristics. A reason for this scenario is the difficulty in synthesising the range of individual design disciplines for both, classical and novel aerospace vehicle conceptual designs, in more than an ad hoc fashion. Although the CD segment is seen as the most important step in the product development phase due to its pre-defining function, it is the least well understood part of the entire product evolution process due to its level of abstraction. This paper presents the roadmap towards the next generation of aerospace life-cycle synthesis systems, a software and management process capable to immediately calculate cost and time implications while simultaneously linking design, manufacturing, testing, and operation. A historical review of how design has been accomplished until today is presented. The design approaches are categorised and the characteristics of today’s state-of-the-art design synthesis systems are discussed. A specification for the new class of intelligent generic design synthesis systems is presented capable of satisfying the demands imposed by the new breed of high-performance aircraft, space access vehicles, space missions, and others. Finally, the development status of the next generation aerospace vehicle design synthesis (AVDS-PrADO) simulation-based acquisition environment is presented.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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