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Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population.
Methods
We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview–Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors.
Results
At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14–14.38), depression (aOR = 3.92, CI = 1.79–8.62), and generalized anxiety (aOR = 2.27, CI = 1.21–4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98–4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90–3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81–9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year.
Conclusions
Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.
Stretching for 1.5km and consisting of approximately 5200 precisely aligned holes, Monte Sierpe in southern Peru is a remarkable construction that likely dates to at least the Late Intermediate Period (AD 1000–1400) and saw continued use by the Inca (AD 1400–1532). Yet its function remains uncertain. Here, the authors report on new analyses of drone imagery and sediment samples that reveal numerical patterns in layout, potential parallels with Inca knotted-string records and the presence of crops and wild plants. All this, the authors argue, suggests that Monte Sierpe functioned as a local, Indigenous system of accounting and exchange.
Yellow toadflax is an invasive perennial broadleaf weed that negatively affects forage production and wildlife habitat. Few herbicides effectively manage this weed. Glyphosate is a nonselective herbicide that can help manage yellow toadflax but is rarely used in pasture/rangeland because it may injure desirable vegetation. The effectiveness of wiper-applied glyphosate followed by (fb) applications of either chlorsulfuron or picloram was evaluated on yellow toadflax grown in a greenhouse. Glyphosate was applied with a wiper at 0% or 50% diluted concentrate. Chlorsulfuron (26 g ai ha−1) was applied alone or immediately after the wiper application of glyphosate. Picloram (560 g ae ha−1) was applied in a similar manner. At 3 mo after herbicide treatments, estimates of injury to yellow toadflax were greatest with glyphosate, glyphosate fb chlorsulfuron, and glyphosate fb picloram (77% to 86%) compared with chlorsulfuron or picloram applied alone (52% to 56%). The response of subsequently harvested biomass was not different after herbicide treatments. One month after treatment, flowering and regrowth of biomass and root biomass were quantified. Flowering, regrowth, and root biomass demonstrated the greatest (>50%) recovery with wiper-applied glyphosate and wiper-applied glyphosate fb broadcast-applied chlorsulfuron or picloram compared with <50% recovery with broadcast applications of chlorsulfuron or picloram. The results of the experiment suggest that wiper-applied glyphosate fb broadcast applications of chlorsulfuron or picloram can help manage yellow toadflax regrowth compared with single herbicide treatments.
Field experiments were conducted near Beresford and South Shore, South Dakota, in 2023 and 2024, to determine weed control and soybean yield with 2,4-D and glufosinate applied individually, together, and sequentially. Herbicides were sequentially applied 12 d after an initial application. 2,4-D + glufosinate additively controlled and reduced the height of all tested weed species. Sequential applications resulted in greater control of common lambsquarters, waterhemp, redroot pigweed, and velvetleaf compared with 2,4-D or glufosinate applied alone, or 2,4-D + glufosinate applied in a mixture. The order in which herbicides were sequentially applied did not influence broadleaf weed control. Yellow foxtail control was greater with sequential applications of glufosinate. Soybean yield at Beresford was similar across all treatments. Yields were generally greater at South Shore with sequential herbicide applications when glufosinate was initially applied. The experiment results suggest that weed control and soybean yield are greater with 2,4-D + glufosinate or sequential application treatments that include 2,4-D and glufosinate.
In sub-Saharan Africa’s endemic areas for urogenital schistosomiasis, male genital schistosomiasis (MGS) can cause significant morbidity. As part of the Hybridization in UroGenital Schistosomiasis investigation, an MGS sub-study examined a cohort of adult men over a calendar year to better ascertain general infection dynamics and putative zoonotic schistosome transmission. During follow-up, demographic, health and socio-economic data were collected through individual questionnaire interviews. Collected urine and semen were analysed using urine filtration, urine and semen microscopy and molecular DNA analyses of semen. Ten participants with reported MGS-associated symptoms had Schistosoma eggs in their urine and semen at 6-month follow-up, with seven at 12 months. Ten out of 11 participants with Schistosoma haematobium eggs on semen microscopy at baseline had persistent infection at 6-month follow-up, together with 6 new participants, giving an MGS prevalence of 84·2% (n = 19). Two also had Schistosoma mattheei eggs co-infection. Four of the 13 participants at 12-month follow-up had S. haematobium eggs in their semen which were persistent at all the time points. Using semen PCR, 14 participants (73·7%) had Schistosoma infection at 6 months, with only 2 participants being infected for first time. Upon DNA analysis, three participants also had hybrid co-infection at this time point. At 12 months, only 6 participants had Schistosoma infection with no hybrids detected. In summary, like S. haematobium and despite praziquantel treatment, both zoonotic and hybrid schistosomes can continue to cause MGS, which pose a further tangible challenge in future management and control measures.
Urogenital schistosomiasis (UGS) caused by zoonotic or hybrid schistosome infection(s) is an emerging public health concern in Malawi, and we describe a 1-year clinical sub-study with 3 inspection time points for female genital schistosomiasis (FGS) upon selecting 86 women with proven UGS. This sub-study was set within a broader 2-year longitudinal ‘Hybridization in UroGenital Schistosomiasis (HUGS)’ investigation. A detailed cervicovaginal examination with a portable colposcope was conducted, examining cervicovaginal lavage (CVL), cervical swab, cervical biopsy and urine with traditional parasitological and molecular diagnostic methods. At baseline, overt FGS by colposcopy was 72.1%, 64.3% by CVL real-time PCR and 51.2% by both colposcopy and CVL-PCR, noting urine-microscopy could often be negative. Human papillomavirus was detected in 31.0% of the cervical swabs, with 8.3% women also FGS positive by colposcopy and real-time PCR. Over the year, FGS prevalence by colposcopy increased by 32.7% during the study to 84.6%, homogenous yellow and grainy sandy patches being very common in the youngest 18–25 age group, where 51.9% were positive. FGS appears widespread locally and we discuss difficulties in its detection without invasive sampling. In addition to the presence of S. haematobium, S. mattheei was noted alongside key concurrent sexually transmitted infections. From our findings, we point out that improved prevention and management of FGS is required, foremost, better availability and regular accessibility to praziquantel treatment is needed. Furthermore, targeted health education, raised community awareness and dovetailing synergistic public health activities within Sexual and Reproductive Health services and local HIV/AIDS programmes could develop an appropriate holistic health intervention package.
As governments across the GCC strive to implement labour policies which accelerate the transition to 'post oil' knowledge-based economies, this volume provides insights into the size of this challenge, along with analysis of progress to date.
With a comprehensive coverage of the region (each GCC member is included in some respect), this new work provides unique insights into how the domestic policy agenda is shifting the region's moribund labour markets inexorably towards greater productivity, positivity, sustainability and efficiency.
We introduce a set of axioms for locally topologically ordered quantum spin systems in terms of nets of local ground state projections, and we show they are satisfied by Kitaev’s Toric Code and Levin-Wen type models. For a locally topologically ordered spin system on $\mathbb {Z}^{k}$, we define a local net of boundary algebras on $\mathbb {Z}^{k-1}$, which provides a mathematically precise algebraic description of the holographic dual of the bulk topological order. We construct a canonical quantum channel so that states on the boundary quasi-local algebra parameterize bulk-boundary states without reference to a boundary Hamiltonian. As a corollary, we obtain a new proof of a recent result of Ogata [Oga24] that the bulk cone von Neumann algebra in the Toric Code is of type $\mathrm {II}$, and we show that Levin-Wen models can have cone algebras of type $\mathrm {III}$. Finally, we argue that the braided tensor category of DHR bimodules for the net of boundary algebras characterizes the bulk topological order in (2+1)D, and can also be used to characterize the topological order of boundary states.
Academic health centers (AHC) characterized by an integrated mission serving education, research and clinical care reflect these values in the institution’s vision, decision-making and culture. Embracing this strategy, the University of Alabama at Birmingham (UAB) created a novel, competitive funding initiative through its faculty practice with the Health Services Foundation General Endowment Fund (HSF-GEF). This partnership with the faculty practice leveraged faculty and staff creativity to inform and lead capacity-building and innovation in patient-oriented and laboratory research, clinical care development and education aligned with the best interests of the enterprise. Since 1996, the HSF-GEF has invested over $66M in 442 peer-reviewed proposals led by transdisciplinary teams representing strategic advances with strong potential to generate future extramural support, to improve healthcare delivery, to enhance research capacity and to promote active learning. Beyond financial return on investment, program evaluation revealed benefit on culture, collaboration, camaraderie and infrastructure. By engaging the broad workforce to articulate, select and implement projects, UAB has fostered a purpose-driven culture of collaboration within the AHC that thrives on broad representation, enthusiasm, and ingenuity as well as peer engagement across multiple schools in the academic community.
Functional impairment in daily activities, such as work and socializing, is part of the diagnostic criteria for major depressive disorder and most anxiety disorders. Despite evidence that symptom severity and functional impairment are partially distinct, functional impairment is often overlooked. To assess whether functional impairment captures diagnostically relevant genetic liability beyond that of symptoms, we aimed to estimate the heritability of, and genetic correlations between, key measures of current depression symptoms, anxiety symptoms, and functional impairment.
Methods
In 17,130 individuals with lifetime depression or anxiety from the Genetic Links to Anxiety and Depression (GLAD) Study, we analyzed total scores from the Patient Health Questionnaire-9 (depression symptoms), Generalized Anxiety Disorder-7 (anxiety symptoms), and Work and Social Adjustment Scale (functional impairment). Genome-wide association analyses were performed with REGENIE. Heritability was estimated using GCTA-GREML and genetic correlations with bivariate-GREML.
Results
The phenotypic correlations were moderate across the three measures (Pearson’s r = 0.50–0.69). All three scales were found to be under low but significant genetic influence (single-nucleotide polymorphism-based heritability [h2SNP] = 0.11–0.19) with high genetic correlations between them (rg = 0.79–0.87).
Conclusions
Among individuals with lifetime depression or anxiety from the GLAD Study, the genetic variants that underlie symptom severity largely overlap with those influencing functional impairment. This suggests that self-reported functional impairment, while clinically relevant for diagnosis and treatment outcomes, does not reflect substantial additional genetic liability beyond that captured by symptom-based measures of depression or anxiety.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
Despite the influence of key figures like Henry Sigerist and the Rockefeller Foundation, social medicine achieved a formal presence at only a handful of medical schools in the US, partly reflecting the political context in which “social medicine” was often heard as “socialized medicine.” Work that might otherwise have been called social medicine had to pass under other names. Does “social medicine” in the US only include those who self-identified with social medicine or does it include people who worked in the spirit of social medicine? Beginning with the recognized work of Sigerist and the Rockefeller, we then examine several Black social theorists whose work can now be recognized as social medicine. The Cold War context challenged would-be proponents of social medicine but different threads endured. The first, clinically oriented, focused on community health. The second, based in academic departments, applied the interpretive social sciences to explore the interspace between the clinical and the social. These threads converged in the 1990s and 2000s in new forms of social medicine considered as healthcare committed to social justice and health equity.
Epilepsy is a relatively common condition that affects approximately 4–5 per 1000 individuals in Ontario, Canada. While genetic testing is now prevalent in diagnostic and therapeutic care plans, optimal test selection and interpretation of results in a patient-specific context can be inconsistent and provider dependent.
Methods:
The first of its kind, the Ontario Epilepsy Genetic Testing Program (OEGTP) was launched in 2020 to develop clinical testing criteria, curate gene content, standardize the technical testing criteria through a centralized testing laboratory, assess diagnostic yield and clinical utility and increase genetics literacy among providers.
Results:
Here we present the results of the first two years of the program, demonstrating the overall 20.8% diagnostic yield including pathogenic sequence and copy number variation detected by next-generation sequencing panels. Routine follow-up testing of family members enabled the resolution of ambiguous findings. Post-test outcomes were collected as reported by the ordering clinicians, highlighting the clinical benefits of genetic testing.
Conclusion:
This programmatic approach to genetic testing in epilepsy by OEGTP, together with engagement of clinical and laboratory stakeholders, provided a unique opportunity to gather insight into province-wide implementation of a genetic testing program.
Objectives/Goals: Digital recruitment can improve participant engagement in medical research, but its potential to introduce demographic and socioeconomic biases is unclear. This study investigates pathways participants took during a digital recruitment workflow in neurology, examining potential associations with socioeconomic and demographic factors. Methods/Study Population: As part of an ongoing study aiming to remotely capture speech from patients with neurologic disease, most participants seen in neurology on our campus are invited to complete a self-administered speech examination. We exported participant data from Epic (semi-automated identification and invitation), Qualtrics (eligibility screening), the participant tracking database (consent), and the recording platform (completion) for March to July 2024. Data visualization was performed using a Sankey diagram. Socioeconomic status was assessed using the housing-based socioeconomic status (HOUSES) index and area deprivation index (ADI) national rank. Kruskal–Wallis and Wilcoxon rank-sum tests were used to compare the median age, socioeconomic indices, and time taken to reach different steps of the study. Results/Anticipated Results: Of the 5846 invited participants, 57% were from urban areas, 23% from rural areas, and 20% from urban clusters. Most did not read/respond (2739) or declined (1749) the initial invitation via Epic. Of the 1358 interested participants, 415 completed the study. Participants from urban areas completed enrollment steps faster than those from rural areas and urban clusters, though the variance was large (42.6 ± 41.4 days vs. 50.6 ± 42.2 days and 50 ± 43.9 days, respectively; p = 0.030). Female participants took longer to complete enrollment than males (48.7 ± 44 days vs. 40.5 ± 38.8 days; p = 0.026). Participants who successfully finished the study had significantly lower ADI national ranks compared to other common pathways (40.6 ± 19; p = 0.0021). No associations were found with the HOUSES indices. Discussion/Significance of Impact: Our findings support differences in participant engagement, with urban participants and males more likely to complete enrollment steps. Those who finished the study were less disadvantaged suggesting potential bias in digital recruitment. These findings can inform strategies to improve digital recruitment in neurology research.
Contemporary Screen Ethics focuses on the intertwining of the ethical with the socio-political, considering such topics as: care, decolonial feminism, ecology, histories of political violence, intersectionality, neoliberalism, race, and sexual and gendered violence. The collection advocates looking anew at the global complexity and diversity of such ethical issues across various screen media: from Netflix movies to VR, from Chinese romcoms to Brazilian pornochanchadas, from documentaries to drone warfare, from Jordan Peele movies to Google Earth. The analysis exposes the ethical tension between the inclusions and exclusions of global structural inequality (the identities of the haves, the absences of the have nots), alongside the need to understand our collective belonging to the planet demanded by the climate crisis. Informing the analysis, established thinkers like Deleuze, Irigaray, Jameson and Rancière are joined by an array of different voices - Ferreira da Silva, Gill, Lugones, Milroy, Muñoz, Sheshadri-Crooks, Vergès - to unlock contemporary screen ethics.
An online survey was distributed to South Dakota stakeholders to understand how noxious weeds are currently being managed. The response rate was 26%; 129 stakeholders completed the survey of the 491 stakeholders who opened the survey. Eighty percent of respondents stated noxious weeds were a problem. Canada thistle [Cirsium arvense (L.) Scop.], leafy spurge (Euphorbia esula L.), and absinth wormwood (Artemisia absinthium L.) were the most common and troublesome, but all statewide noxious weeds were reported. The most common singular response to manage noxious weeds was herbicides alone (25%), but respondents utilized two (27%) to three (24%) other tactics as well. Most respondents (47%) were somewhat satisfied with management tactics, while others were completely satisfied (9%), neither satisfied nor dissatisfied (20%), somewhat unsatisfied (11%), or very unsatisfied (15%). A covariate analysis showed that the more management tactics individual stakeholders utilized, the less satisfied they were with control (P < 0.0001). The most common barrier of adopting new tactics was effectiveness (26%) followed by a combination of effectiveness + current production practices + cost + labor (13%). An additional covariate analysis showed that the increase in management tactics increased the barriers of adoption (P = 0.04) and increasing the number of barriers of adoption resulted in stakeholders being dissatisfied with control (P = 0.0003). Overall, the results of the survey suggest that statewide noxious weeds remain a problem, and multiple tactics are used to manage these weeds. However, Cooperative extension efforts need to address how to use current management and implement new management strategies to increase effectiveness.
Sea ice is a mushy layer, a porous material whose properties depend on the relative proportions of solid and liquid. The growth of sea ice is governed by heat transfer through the ice together with appropriate boundary conditions at the interfaces with the atmosphere and ocean. The salinity of sea ice has a major effect on its thermal properties so might naïvely be expected to have a major effect on its growth rate. However, previous studies observed a low sensitivity throughout the winter growth season. The goal of this study is to identify the controlling physical mechanisms that explain this observation. We develop a simplified quasi-static framework by applying a similarity transformation to the underlying heat equation and neglecting the explicit time dependence. We find three key processes controlling the sensitivity of growth rate to salinity. First, the trade-off between thermal conductivity and (latent) heat capacity leads to low sensitivity to salinity even at moderately high salinity and brine volume fraction. Second, the feedback on the temperature profile reduces the sensitivity relative to models that assume a linear profile, such as zero-layer Semtner models. Third, thicker ice has the opposite sensitivity of growth rate to salinity compared with thinner ice, sensitivities that counteract each other as the ice grows. Beyond its use in diagnosing these sensitivities, we show that the quasi-static approach offers a valuable sea-ice model of intermediate complexity between zero-layer Semtner models and full partial-differential-equation-based models such as Maykut–Untersteiner/Bitz–Lipscomb and mushy-layer models.
Outdoor studies were conducted to determine the extent of leafy spurge biomass reduction resulting from broadcast application of 2,4-D (2,244 g ae ha−1) with and without wiper-applied glyphosate. Glyphosate (575 g ae L−1) was applied at 0%, 33%, 50%, and 75% diluted concentrate with a wiper 24 h after 2,4-D was broadcast-applied. Injury estimates and shoot biomass did not differ between plants treated with 2,4-D only or when glyphosate was wiper-applied 21 d after treatment. Shoot regrowth biomass of plants treated with 2,4-D only was approximately 560% greater than nontreated plants 3 mo after treatment. Plants treated with wiper-applied glyphosate exhibited shoot regrowth biomass of less than 10% compared with nontreated plants 3 mo after treatment. Root biomass of plants treated with 2,4-D only (160% of nontreated plants) exhibited a similar pattern of shoot regrowth biomass. Root biomass of plants treated with wiper-applied glyphosate exhibited approximately 50% reductions compared with nontreated plants. All vegetative metrics were equally reduced with all tested concentrations of glyphosate; therefore, all labeled concentrations should be effective. The results of the experiment indicate that broadcast-applied 2,4-D is more effective at reducing leafy spurge biomass with the addition of wiper-applied glyphosate.
Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.
Garbarino et al. (J Econ Sci Assoc. https://doi.org/10.1007/s40881-018-0055-4, 2018) describe a new method to calculate the probability distribution of the proportion of lies told in “coin flip” style experiments. I show that their estimates and confidence intervals are flawed. I demonstrate two better ways to estimate the probability distribution of what we really care about—the proportion of liars—and I provide R software to do this.