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Introduction: Recently researchers started investigating brain aging and what factors can influence the way our brains age. As it is unclear at this point whether psychosocial stressor influence brain aging, the aim of the study was to investigate the association between psychosocial stress and brain aging.
Methods: Data from the German population-based cohort Study of Health in Pomerania (N = 991; age range 20– 78 years) were used to calculate a total psychosocial stress score by combining sub-scores from five domains: stress related to the living situation, the occupational situation, the social situation, danger experiences, and emotions. Associations with brain aging, indicated by an MRI-derived score quantifying age-related brain atrophy, were estimated by using regression models adjusted for age, gender, education, diabetes, problematic alcohol consumption, smoking, and hypertension.
Results: High emotional stress came with a relative risk of 1.21 (CI95% = 1.04 – 1.41) for advanced brain aging in fully adjusted models. Mental health symptoms additionally influenced brain aging, as statistically significant interactions between emotional stress and mental health symptoms on advanced brain aging indicate.
Discussion: Among the psychosocial stressors that we investigated; emotional stress seems to be relevant regarding brain aging. More research is needed to explore the potential pathways.
Digital technology brought informational saturation to our lives. In cyberspace, private and business users need help to make valuable pieces of information stand out from the noise of excessive information. With search algorithms, recommender systems, and online advertising, digital platforms specialised in providing relief for this problem. Their technologies arrange digitalised information to make it intelligible and relevant for individuals. But the separation of information from noise did not only become a necessity to comfortably navigate the depths of the web, it also became a commodity. There is a demand for it, a supply, a price, and an exchange on markets which is enabled by private law. The examples of general search, recommender systems, and online advertising illustrate that. At the same time, their commodification can become problematic. This paper argues that in the European Union (EU), the separation of information from noise has become a contested commodity according to M. J. Radin’s framework. The Digital Services Act and the Digital Markets Act purposefully limit the influence of the market price mechanism on the design and allocation of the separation technology to protect legal goods like the democratic process, innovation, and privacy.
Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic.
Methods:
Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care.
Results:
Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom’s follow-up was performed mainly by PHC.
Conclusion:
PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.
Autism spectrum disorders (ASD) are associated with high services use, but European data on costs are scarce.
Objectives
Utilisation and annual costs of 385 individuals with ASD (aged 4-67 years; 18.2% females; 37.4% IQ < 85) from German outpatient clinics were assessed.
Methods
Client Service Receipt Inventory
Results
Average annual costs per person were 3287 EUR, with psychiatric inpatient care (19.8%), pharmacotherapy (11.1%), and occupational therapy (11.1%) being the largest cost components. Females incurred higher costs than males (4864 EUR vs. 2936 EUR). In a regression model, female sex (Cost Ratio: 1.65), lower IQ (1.90), and Asperger syndrome (1.54) were associated with higher costs.
Conclusions
In conclusion, ASD-related health costs are comparable to those of schizophrenia, thus underlining its public health relevance. Higher costs in females demand further research.
Insufficient or faulty cooperation between the various child protection professions can have an extremly negative impact on the well-being of the concerned children. Communication problems that were revealed when dealing with cases of child abuse show the importance of adequate cooperation and common language of the involved professions in child protection.
Objectives
An online-course adressing medical-therapeutic professionals, youth welfare as well as judiciary and police was developed to impart skills and knowledge in child protection to create interdisciplinary understanding and improve cooperation between the involved professions.
Methods
The acquisition of competencies, the transfer of learning content into everyday work and the quality of the online-course are determined using an online-survey before starting (t1) and after completing (t2) the course. T1-assessment is currently being evaluated with 1034 datasets, t2-assessment will take place 03/2022.
Results
Intended target groups could be accessed and participated in the online-course, although the ratio of medical-therapeutic participants was greater than of judiciary professionals. Specific results of T1- and T2- assesssment and comparing analyses are expected in March 2022 and will be presented.
Conclusions
Based on existing online-courses developed by the Universityhospital Ulm, the suitability of online-education for training professionals in the field of child protection could be proven. If comparable effects can be shown for this online-course, there is an increase in evaluated offers of high quality. These enable comprehensive and low-threshold access to the subject of interdisciplinary communication and cooperation in child protection for involved professionals.
Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment.
Aims
To use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder.
Method
This study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework.
Results
The best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data.
Conclusions
Using PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.
Child maltreatment gives rise to atypical patterns of social functioning with peers which might be particularly pronounced in early adolescence when peer influence typically peaks. Yet, few neuroimaging studies in adolescents use peer interaction paradigms to parse neural correlates of distinct maltreatment exposures. This fMRI study examines effects of abuse, neglect, and emotional maltreatment (EM) among 98 youth (n = 58 maltreated; n = 40 matched controls) using an event-related Cyberball paradigm affording assessment of both social exclusion and inclusion across early and mid-adolescence (≤13.5 years, n = 50; >13.5 years, n = 48). Younger adolescents showed increased activation to social exclusion versus inclusion in regions implicated in mentalizing (e.g., superior temporal gyrus). Individual exposure-specific analyses suggested that neglect and EM coincided with less reduction of activation to social exclusion relative to inclusion in the dorsal anterior cingulate cortex/pre-supplementary motor area (dACC/pre-SMA) among younger versus older adolescents. Integrative follow-up analyses showed that EM accounted for this dACC/pre-SMA activation pattern over and above other exposures. Moreover, age-independent results within respective exposure groups revealed that greater magnitude of neglect predicted blunted exclusion-related activity in the parahippocampal gyrus, while EM predicted increased activation to social exclusion in the precuneus/posterior cingulate cortex.
The derivation and numerical implementation of a linearized version of the gyrokinetic (GK) Coulomb collision operator (Jorge et al., J. Plasma Phys., vol. 85, 2019, 905850604) and of the widely used linearized GK Sugama collision operator (Sugama et al., Phys. Plasmas, vol. 16, 2009, 112503) is reported. An approach based on a Hermite–Laguerre moment expansion of the perturbed gyrocentre distribution function is used, referred to as gyromoment expansion. This approach allows the considering of arbitrary perpendicular wavenumber and expressing the two linearized GK operators as a linear combination of gyromoments where the expansion coefficients are given by closed analytical expressions that depend on the perpendicular wavenumber and on the temperature and mass ratios of the colliding species. The drift-kinetic (DK) limits of the GK linearized Coulomb and Sugama operators are also obtained. Comparisons between the gyromoment approach and the DK Coulomb and GK Sugama operators in the continuum GK code GENE are reported, focusing on the ion-temperature-gradient instability and zonal flow damping, finding an excellent agreement. It is confirmed that stronger collisional damping of the zonal flow residual by the Sugama GK model compared with the GK linearized Coulomb (Pan et al., Phys. Plasmas, vol. 27, 2020, 042307) persists at higher collisionality. Finally, we show that the numerical efficiency of the gyromoment approach increases with collisionality, a desired property for boundary plasma applications.
Adolescent transitions to adulthood are a vulnerable phase for the development of mental illnesses. Additionally, there are often disruptions in psychiatric care delivery during the transition phase, potentially leading to a considerable treatment delay with a high risk of early chronification. Thus, the health care system and professionals in both child and adolescent psychiatry and adult psychiatry should be given greater consideration to the transition phase.
Objectives
The aim of the project ProTransition is the development of an online course for health care professionals to give in-depth knowledge of “transition psychiatry”, practical guidance and to sensitize them for the special challenges and needs of young adults with mental illness.
Methods
The online-course is being developed at the Department of Child and Adolescent Psychiatry/ Psychotherapy, Ulm and is expected to start in May 2021. It comprises e.g. special psychopathology of emerging adulthood, clinical interventions for adolescents with mental illness or legal aspects. An innovative and multi-didactical approach with specialized texts, case-studies, online-chats and interviews with experts and young people is applied. Additionally, user satisfaction with the online course will be evaluated.
Results
On the basis of the gained experiences, ideas for new transition-psychiatric treatment models will be derived. The accompanying research will point out the status quo and the course-related increasing knowledge of health care professionals regarding transition psychiatry. First results are expected in November 2021.
Conclusions
As transition psychiatry is facing great difficulties and challenges, professionals should be adequately educated. E-Learning offers a flexible and low-level approach to reach a broad target group.
German mental health care providers report to encounter many cases of NSSI in their professional context, but only around 50% know about the treatment guidelines for NSSI of children and adolescents. Many consider professional training about NSSI as necessary for themselves. In response to this need, within the project Star Train different strategies of dissemination of the content of the guidelines were developed.
Objectives
This study aims at comparing the effectiveness of different strategies of dissemination: printed material, e-learning and blended-learning.
Methods
Participants were randomly assigned to one of three different learning formats: printed material, e-learning, and blended-learning. Via online-survey participants provide pre- and post-training self-assessments of their knowledge of NSSI, practical skills, self-efficacy in handling cases of NSSI and attitudes towards NSSI and those affected. Additionally a multiple-choice-test of NSSI is assessed. For data-analyses between-group and within-group comparisons were conducted using a mixed design ANOVA. To ensure quality of learning formats, user-satisfaction was surveyed.
Results
Data of the pretest-posttest comparison group design show that knowledge, practical skills, and self-efficacy in handling cases of NSSI raise for all participants and that attitudes towards NSSI and those affected are improved. There is no difference between the learning formats, thus all participants profit equally from their education. User satisfaction is high.
Conclusions
Results of this study suggest that the developed different training strategies can contribute equally to a better understanding and enhance skills of professionals regarding NSSI. The choice of training method could be driven by considering which goals want to be achieved and cost-value ratio.
The main aim of the current study was to present the abilities of widely used crop models to simulate four different field crops (winter wheat, spring barley, silage maize and winter oilseed rape). The 13 models were tested under Central European conditions represented by three locations in the Czech Republic, selected using temperature and precipitation gradients for the target crops in this region. Based on observed crop phenology and yield from 1991 to 2010, performances of individual models and their ensemble were analyzed. Modelling of anthesis and maturity was generally best simulated by the ensemble median (EnsMED) compared to the ensemble mean and individual models. The yield was better simulated by the best models than estimated by an ensemble. Higher accuracy was achieved for spring crops, with the best results for silage maize, while the lowest accuracy was for winter oilseed rape according to the index of agreement (IA). Based on EnsMED, the root mean square errors (RMSEs) for yield was 1365 kg/ha for winter wheat, 1105 kg/ha for spring barley, 1861 kg/ha for silage maize and 969 kg/ha for winter oilseed rape. The AQUACROP and EPIC models performed best in terms of spread around the line of best fit (RMSE, IA). In some cases, the individual models failed. For crop rotation simulations, only models with reasonable accuracy (i.e. without failures) across all included crops within the target environment should be selected. Application crop models ensemble is one way to increase the accuracy of predictions, but lower variability of ensemble outputs was confirmed.
Childhood maltreatment is associated with altered neural reactivity during autobiographical memory (ABM) recall and a pattern of overgeneral memory (OGM). Altered ABM and OGM have been linked with psychopathology and poorer social functioning. The present study investigated the association between altered ABM and subsequent socio-emotional functioning (measured two years later) in a sample of adolescents with (N = 20; maltreatment group, MT) and without (N = 17; non-MT group) documented childhood maltreatment histories.
Method
At baseline, adolescents (aged 12.6 ± 1.45 years) were administered the Autobiographical Memory Test to measure OGM. Participants also recalled specific ABMs in response to emotionally valenced cue words during functional MRI. Adolescents in both groups underwent assessments measuring depressive symptoms and prosocial behavior at both timepoints. Regression analyses were carried out to predict outcome measures at follow-up controlling for baseline levels.
Results
In the MT group, greater OGM at baseline significantly predicted reduced prosocial behavior at follow-up and showed a trend level association with elevated depressive symptoms. Patterns of altered ABM-related brain activity did not significantly predict future psycho-social functioning.
Conclusions
The current findings highlight the potential value of OGM as a cognitive mechanism that could be targeted to reduce risk of depression in adolescents with prior histories of maltreatment.
Carnival in Rio de Janeiro is one of the biggest popular events in the world, gathering millions of people from different countries, social status, beliefs and cultures. As in other events of such magnitude, there are substance abuse problems and, consequently, medical and public order issues.
Objectives
Since 2005, the “No Hang Over Band” (“Banda Alegria sem Ressaca”) is part of the Carnival schedule and parades through Copacabana beach, enhanced by dancers, celebrities, health professionals, public authorities, politicians, patients and their families, besides many supporters who join the group.
Aims
This study aims to reach a massive population with a campaign to prevent substance abuse giving information and alerts about the risks of it and, also, show professional from all around the world a way to do it.
Methods
A few months before Carnival, health professionals from Jorge Jaber Clinic present lectures about prevention quoting the preparations to the parade, as they gather supporters and sponsors. The message reaches the population through flyers, clothes and media (newspapers, T.V., radio and internet) before, during and after Carnival.
Results
The parade itself has been growing year after year, when it comes to supporters, sponsors and media exposure. Schools and other institutions have asked more often for lectures. Brazilian people have shown response to the campaign when they seek for more information and treatment.
Conclusions
With efforts from different parts of society and very little financial investment, it is possible to have real influence over a risk population even in adverse situation.
The development and maintenance of an alcohol addiction is a complex interaction between genetic and environmental factors. Genetic effects seem to contribute substantially to the risk of developing an addiction, but also to its course and patients’ responses to different treatments. Recent studies identified associations between polymorphisms in the genes of glutamate and μ-opioid receptors and addiction risk. Those receptors are of special interest, because they are targets of therapeutic agents, such as acamprosate and topiramate.
Objectives and aims
Several studies were conducted, in order to further determine the effects of genetic polymorphisms in glutamate and opioid receptor genes on addictive behavior, neural response to alcohol cues and relapse risk.
Methods
Genetic effects were investigated in samples of alcohol-dependent patients using functional imaging techniques, neuropsychological tests and follow-up investigation after standard clinical treatment. Data on clinical parameters, neuronal response to alcohol cues, functional neuronal connectivity and relapse risk were collected and analyzed.
Results
Results demonstrate effects of genetic polymorphisms in glutamate and opioid receptors on neuronal response to alcohol cues in frontal and mesolimbic brain areas, subjective craving and time to first relapse. Current findings will be discussed in the light of existing evidence on the contribution of genetic effects to treatment outcome and patient stratification.
Conclusions
The investigation of genetic risk factors and mechanisms by which they affect addiction related phenotypes seems to be a promising tool to identify molecular treatment targets and predictors for successful treatment strategies.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The success of fecal microbiota transplantation (FMT) as a treatment for Clostrioides difficile infection (CDI) has stirred excitement about the potential for microbiota transplantation as a therapy for a wide range of diseases and conditions. In this article, we discuss vaginal microbiota transplantation (VMT) as “the next frontier” in microbiota transplantation and identify the medical, regulatory, and ethical challenges related to this nascent field. We further discuss what we anticipate will be the first context for testing VMT in clinical trials, prevention of the recurrence of a condition referred to as bacterial vaginosis (BV). We also compare clinical aspects of VMT with FMT and comment on how VMT may be similar to or different from FMT in ways that may affect research design and regulatory decisions.
Identifying options for the sustainable intensification of cropping systems in southern Africa under prevailing high climate risk is needed. With this in mind, we tested an intercropping system that combined the staple crop maize with lablab, a local but underutilised legume. Grain and biomass productivity was determined for four variants (i) sole maize (sole-maize), (ii) sole lablab (sole-lablab), (iii) maize/lablab with both crops sown simultaneously (intercropped-SP) and (iv) maize/lablab with lablab sown 28 days after the maize crop (intercropped-DP). Soil water and weather data were monitored and evaluated. The trial was conducted for two seasons (2015/2016 and 2016/2017) at two sites in the Limpopo Province, South Africa: Univen (847 mm rainfall, 29.2 °C maximum and 18.9 °C minimum temperature average for the cropping season over the years 2008–2017) and Syferkuil (491 mm rainfall, with 27.0 °C maximum and 14.8 °C minimum temperature). Analysis revealed three key results: The treatment with intercropped-SP had significantly lower maize yields (2320 kg ha−1) compared with maize in intercropped-DP (2865 kg ha−1) or sole-maize (2623 kg ha−1). As expected, maize yields in the El Niño affected in season 2015/2016 were on average 1688 kg ha−1 lower than in 2016/2017. Maize yields were significantly lower (957 kg ha−1) at Univen, the warmer site with higher rainfall, than at Syferkuil. In 2015/2016, maximum temperature at Univen exceeded 40 °C around anthesis. Furthermore, soil water was close to the estimated permanent wilting point (PWP) for most of the cropping season, which indicates possible water limitations. In Syferkuil, the soil water was maintained well above PWP. Lablab yields were low, around 500 ha−1, but stable as they were not affected by treatment across season and site. Overall, the study demonstrated that intercropped-DP appears to use available soil water more efficiently than sole maize. Intercropped-DP could therefore be considered as an option for sustainable intensification under high climate risk and resource-limited conditions for smallholders in southern Africa.
The mammal family Tenrecidae (Afrotheria: Afrosoricida) is endemic to Madagascar. Here we present the conservation priorities for the 31 species of tenrec that were assessed or reassessed in 2015–2016 for the IUCN Red List of Threatened Species. Six species (19.4%) were found to be threatened (4 Vulnerable, 2 Endangered) and one species was categorized as Data Deficient. The primary threat to tenrecs is habitat loss, mostly as a result of slash-and-burn agriculture, but some species are also threatened by hunting and incidental capture in fishing traps. In the longer term, climate change is expected to alter tenrec habitats and ranges. However, the lack of data for most tenrecs on population size, ecology and distribution, together with frequent changes in taxonomy (with many cryptic species being discovered based on genetic analyses) and the poorly understood impact of bushmeat hunting on spiny species (Tenrecinae), hinders conservation planning. Priority conservation actions are presented for Madagascar's tenrecs for the first time since 1990 and focus on conserving forest habitat (especially through improved management of protected areas) and filling essential knowledge gaps. Tenrec research, monitoring and conservation should be integrated into broader sustainable development objectives and programmes targeting higher profile species, such as lemurs, if we are to see an improvement in the conservation status of tenrecs in the near future.