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It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
We argue that negative references to amicus curiae briefs in high court judgments – instances where a court explicitly signals disagreement with the legal arguments in such briefs – are a significant and understudied feature of judicial reasoning. We theorize that such references may provide courts with a tool for increasing the precision of its case law, fostering its legitimacy, and increasing compliance pressure. Our empirical analysis of the Court of Justice of the European Union indicates that negative references are used both to boost its legitimacy and to specify not only what the law is, but what it is not.
How should a democratic assembly be designed to attract large and diverse groups of citizens? We addressed this question by conducting a population survey in three communities with institutionalized participatory deliberative democracy in Switzerland. To examine participatory disposition in light of both individual characteristics and design features of the assembly that citizens contemplate joining, the survey comprised a conjoint experiment in which each respondent was asked to indicate his or her likelihood of participating in democratic assemblies with varying design features. The main result is that design features emphasizing the communitarian character of the assembly increase citizens’ willingness to participate, especially among disengaged citizens. Moreover, citizens were found to be less attracted by both very consensual and very adversarial meeting styles. Rather, we found meeting styles combining both controversy and consensus to be most favorable to assembly turnout. The implication is that practitioners of participatory or deliberative democracy must engage in community-building to foster turnout and inclusiveness in democratic assemblies.
The Magellanic Stream (MS), a tail of diffuse gas formed from tidal and ram pressure interactions between the Small and Large Magellanic Clouds (SMC and LMC) and the Halo of the Milky Way, is primarily composed of neutral atomic hydrogen (HI). The deficiency of dust and the diffuse nature of the present gas make molecular formation rare and difficult, but if present, could lead to regions potentially suitable for star formation, thereby allowing us to probe conditions of star formation similar to those at high redshifts. We search for $\text{HCO}^{+}$, HCN, HNC, and C$_2$H using the highest sensitivity observations of molecular absorption data from the Atacama Large Millimeter Array (ALMA) to trace these regions, comparing with HI archival data from the Galactic Arecibo L-Band Feed Array (GALFA) HI Survey and the Galactic All Sky Survey (GASS) to compare these environments in the MS to the HI column density threshold for molecular formation in the Milky Way. We also compare the line of sight locations with confirmed locations of stars, molecular hydrogen, and OI detections, though at higher sensitivities than the observations presented here.
We find no detections to a 3$\sigma$ significance, despite four sightlines having column densities surpassing the threshold for molecular formation in the diffuse regions of the Milky Way. Here we present our calculations for the upper limits of the column densities of each of these molecular absorption lines, ranging from $3 \times 10^{10}$ to $1 \times 10^{13}$ cm$^{-2}$. The non-detection of $\text{HCO}^{+}$ suggests that at least one of the following is true: (i) $X_{\text{HCO}^{+}{}, \mathrm{MS}}$ is significantly lower than the Milky Way value; (ii) that the widespread diffuse molecular gas observed by Rybarczyk (2022b, ApJ, 928, 79) in the Milky Way’s diffuse interstellar medium (ISM) does not have a direct analogue in the MS; (iii) the HI-to-$\text{H}_{2}$ transition occurs in the MS at a higher surface density in the MS than in the LMC or SMC; or (iv) molecular gas exists in the MS, but only in small, dense clumps.
Circadian dysfunction is a core feature of bipolar disorder and may be due, at least in part, to abnormalities of non-visual photoreception. We critically review the evidence for light hypersensitivity in bipolar disorder and discuss how this may shape future research and clinical innovation, with a focus on a possible novel mechanism of action for lithium.
Unconformity-related uranium deposits, which represent a significant high-grade uranium resource, are systematically surrounded by a host-rock alteration halo enriched in clay minerals. Illite is often the major clay mineral component of the halo and it displays a variable crystal structure. New data are provided on the crystal structure and the chemistry of illite encountered within and outside of the alteration halo surrounding the Shea Creek deposit. Two illite populations were distinguished using textural and structural criteria: samples rich in the tv-1M polytype display thin (sub-micrometer) and ‘hairy’ shapes, while samples richer in the cv-1M polytype contain illites with rigid lath-like shapes several micrometers wide. In barren ‘regional’ sandstone, the trends with depth of the textural and microstructural properties of illite particles are: (1) an increase of particle size, (2) an evolution to a more isometric form, and (3) a dominance of the cv-1M polytype over the tv-1M polytype. These trends record diagenetic processes under conditions of deep burial and differ from those observed in altered sandstone around the uranium mineralization. The altered sandstone is characterized by enrichment in the tv-1M polytype near the unconformity and/or brittle structural features. This tv-1M illitization took place in response to structurally-controlled infiltration of basement rocks by diagenetic brines which were further recycled after interaction into the overlying basin. Variations of the illite structural and textural properties may result from nucleation/growth kinetics and may be indicative of a change in the flow regime, and/or a change of saturation state of the fluid vs. illite. The tv-1M illite may be favored in environments characterized by a high fluid/rock ratio and a high supersaturation state of the fluids in proximity to mineralization.
The spatial distribution of the dominant matrix minerals present in the middle-Proterozoic Athabasca Group sandstone (kaolin, illite, sudoite, dravite, hematite) was studied at a regional scale in the Shea Creek region (Saskatchewan, Canada), in which two epigenetic unconformity-type uranium deposits have been discovered. 3D models of matrix mineral distribution were derived from normative mineral calculations and 3D interpolation using whole-rock geochemical analyses of sandstone samples collected from both mineralized and barren areas. The calculations were constrained by information obtained from petrographic and crystal-chemical clay mineralogical studies on representative samples. The 3D mineral distribution models were compared to the lithostratigraphy and structural features of the Athabasca Group sandstone to ascertain the source and mobility of the main elements involved in the sandstone host-rock alteration processes related to the U mineralization. The distribution of Al is conformable with the lithostratigraphy throughout the studied area, regardless of proximity to basement-rooted structures and U ore bodies. The distribution of illite displays similar features, but the intensity of the illitization of kaolin decreases with increasing distance from the structures and U ore bodies. Hematite bleaching and neoformation of sudoite and dravite were restricted to the vicinity of the fault zones above the U ore bodies. The spatial configurations of the mineral anomalies show that syn-ore fluids flowed from the basement towards the sandstone cover via the fault zones, as described in current metallogenic models. Although Al remained immobile (mass transfer), the anomalous K, B and Mg present in the host-rock alteration haloes were probably imported from the basement rocks (mass transport). Unlike B and Mg, K migrated laterally at least several kilometers from the basement-rooted faults. The mineral distribution models were used to quantify the volume of altered sandstone (10−2−10−1 km3) and the amounts of K, Mg and B which were imported to the alteration haloes above the Shea Creek U ore bodies: 186,000 t of K, 66,000 t of Mg, and 11,000 t of B above the Anne ore body, and 24,000 t of K, 185,000 t of Mg, and a similar 11,000 t of B above the Colette ore body.
Low-temperature chlorites formed in diagenetic to low-grade metamorphic environments generally have greater Si contents and larger numbers of octahedral vacancies, and smaller Fe+Mg contents than higher-grade metamorphic chlorites. The compositional variations are characterized approximately by four end-member components: Al-free trioctahedral chlorite, chamosite, corundophilite, and sudoite. The solid solution is considered to be a random mix of cations and vacancies in the octahedral sites. Using the compositions of chlorites from Niger, Rouez, and Saint Martin diagenetic-hydrothermal series, a new, more convenient geothermometer, applicable to low-T chlorites is proposed and comparison made with geothermometers proposed previously. The chlorites studied contain appreciable amounts of Fe(III) (>14% of the total Fe), determined by Mössbauer spectroscopy. The calculations under which all Fe was regarded as ferrous gave considerable overestimates for the formation temperature, irrespective of the geothermometer used. This problem was reduced by taking into account the presence of Fe(III) in the octahedral sites. The geothermometer from this study gave more reasonable estimates than the geothermometers proposed by Walshe (1986) and Vidal et al. (2001), particularly in the case of the Niger chlorites which crystallized in the lowest-temperature conditions. The ordered-site substitution model of solid solution developed by Vidal et al. (2001) predicted satisfactorily the formation temperature of the Rouez chlorites and of some of the Saint Martin chlorites, suggesting that the chlorite compositions are controlled by the exchange at low-T conditions while they are controlled by Tschermak exchange at higher temperatures. The decreasing number of vacancies with temperature are poorer in Fe-rich than in Fe-poor chlorites. Furthermore, the ordered-site occupation of cations and vacancies in trioctahedral chlorite occurs concomitantly with the compositional changes ruled by increasing temperature conditions.
Up to 10% of patients report penicillin allergy (PA), although only 1% are truly affected by Ig-E-mediated allergies. PA has been associated with worse postoperative outcomes, but studies on the impact of reported PA in cancer patients are lacking, and especially in these multimorbid patients, a non-complicated course is of utmost importance.
Methods:
Retrospective analysis of patients undergoing elective oncological surgery at a tertiary reference center. Data on surgical site infections (SSI), postoperative complications (measured by Clavien-Dindo classification and Comprehensive Complication Index (CCI)), hospitalization duration, and treatment costs were collected.
Results:
Between 09/2019 and 03/2020, 152 patients were identified. 16/152 patients (11%) reported PA, while 136/152 (89%) did not. There were no differences in age, BMI, Charlson Comorbidity Index, and smoking status between groups (p > 0.4). Perioperative beta-lactam antibiotics were used in 122 (89.7%) and 15 (93.8%) patients without and with reported PA, respectively. SSI and mean numbers of infections occurred non-significantly more often in patients with PA (p = 0.2 and p = 0.47). The median CCI was significantly higher in PA group (26 vs. 51; p = 0.035). The median hospitalization duration and treatment costs were similar between non-PA and PA groups (4 vs 3 days, p = 0.8; 16’818 vs 17’444 CHF, p = 0.4).
Conclusions:
In patients undergoing cancer surgery, reported PA is common. Failure to question the unproven PA may impair perioperative outcomes. For this reason, patient and provider education on which reactions constitute a true allergy would also assist in allergy de-labeling. In addition, skin testing and oral antibiotic challenges can be performed to identify the safe antibiotics and to de-label appropriate patients.
Coercive measures such as involuntary psychiatric admission are considered a last resort in the treatment of people with psychiatric disorders. So far, numerous factors have been identified that influence their use. However, the link between a pandemic – in particular, restrictions such as lockdowns – and the use of involuntary psychiatric admission is unclear.
Aim
To examine the association between COVID-19 lockdowns and involuntary psychiatric admissions in Austria.
Method
This retrospective exploratory study assessed all involuntary psychiatric admissions and use of mechanical restraint in Austria, except for the federal state of Vorarlberg, between 1 January 2018 and 31 December 2020. Descriptive statistics and regression models were used.
Results
During the 3-year study period, 40 012 individuals (45.9% females, mean age 51.3 years) had 66 124 involuntary psychiatric admissions for an average of 10.9 days. Mechanical restraint was used during 33.9% of these admissions. In weeks of nationwide COVID-19 lockdowns (2020 v. 2018/2019), involuntary psychiatric admissions were significantly fewer (odds ratio = 0.93, P = 0.0001) but longer (11.6 (s.d.: 16) v. 10.9 (s.d.: 15.8) days). The likelihood of involuntary admission during lockdowns was associated with year (2020 v. 2018–2019; adjusted odds ratio = 0.92; P = 0.0002) but not with sex (P = 0.814), age (P = 0.310), use of mechanical restraint (P = 0.653) or type of ward (P = 0.843).
Conclusions
Restrictions such as lockdowns affect coercive measures and resulted in fewer but longer involuntary psychiatric admissions during weeks of lockdown in Austria. These results strengthen previous findings that showed the dependence of coercive measures on external factors, highlighting the need to further clarify causality and desired prevention effects when using coercive measures.
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
Edited by
Alexandre Caron, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), France,Daniel Cornélis, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) and Foundation François Sommer, France,Philippe Chardonnet, International Union for Conservation of Nature (IUCN) SSC Antelope Specialist Group,Herbert H. T. Prins, Wageningen Universiteit, The Netherlands
One of iconic Africa's Big Five, the African buffalo is the largest African bovine or antelope that occurs throughout most of sub-Sahara and in a wide range of ecosystems from savanna to rainforest. The African buffalo is also one of the most successful large African mammals in terms of abundance and biomass. This species thus represents a powerful model to enhance our understanding of African biogeography and wildlife conservation, ecology and management. Edited by four researchers experienced in different aspects of the African buffalo's biology, this volume provides an exhaustive compilation of knowledge on an emblematic species that stands out as an important component of African natural and human ecosystems. It delivers a global view of the African buffalo and all known aspects of its ecology and management. This book will appeal to students, scholars, scientists and wildlife managers as well as those enthusiastic about the charismatic species. This title is also available as Open Access on Cambridge Core.
The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken. This resulted in 18 triage, eight life support and damage control interventions, and 23 process consensus statements. These findings will be utilized in the development of evidence-based prehospital mass-casualty incident response tools and guidelines.