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This chapter describes material and immaterial labour in the context of the industrial production, resource extraction, and global circulation of the silvery-alkali metal known as lithium. It focuses on the different kinds of material labour involved in lithium’s extraction from local sites in and around the Atacama Desert in Latin America, as well as less visible forms of labour underpinning the mining industry, including the labour of social reproduction and colonial dispossession. In this context, it asks: how do narrative arts document the violence of lithium’s extraction as it materialises in damaged and dispossessed bodies and environments, as well as those less visible traces of lithium’s circulation around the world, and the different affective economies it inhabits? I suggest that a contradiction or tension between materiality and immateriality, between what is seen and unseen, defines every level of lithium’s transformation into a commodity, as registered within global networks of labour. These larger systems, I argue, are rendered invisible; just as lithium silently provides the charge for iPhone and Tesla, it is a vanishing mediator to what some thinkers have described as ‘new extractive imperialism’. This, however, becomes visible—precisely as a kind of ideological dissimulation—across a whole range of narrative forms.
Lithium treatment is associated with reduced mortality in bipolar disorder (BD), but the role of treatment continuity remains underexplored. This study investigated the association between patterns of lithium exposure and all-cause mortality in a population-based cohort.
Methods
We analyzed electronic health records from 15,384 individuals with BD in Catalonia, Spain (2010–2019). Patients were classified as having sustained, partial/intermittent, or no lithium exposure based on annual defined daily doses (DDDs). All-cause mortality was the primary outcome. Kaplan–Meier and Cox regression analyses (adjusted for sociodemographic, clinical, and treatment-related variables) estimated hazard ratios (HRs) for mortality risk. Interaction and sensitivity analyses were conducted to assess the role of comorbidity burden and dose effects.
Results
Over the study period, 715 deaths were recorded. In fully adjusted models, sustained lithium exposure was associated with a significantly lower mortality risk compared to no exposure (HR = 0.69, 95% confidence interval [CI]: 0.51–0.93, p = 0.016). In the lithium-exposed subgroup, sustained use was also protective compared to partial/intermittent exposure (HR = 0.70, 95% CI: 0.51–0.97, p = 0.03). No significant interaction was observed between sustained lithium use and comorbidity burden. Sensitivity analyses confirmed this effect at lower dose thresholds but not at higher ones.
Conclusions
Sustained lithium use is associated with improved survival in BD. Discontinuous exposure does not confer the same benefit. Ensuring treatment continuity may maximize lithium’s protective effect and improve long-term outcomes.
Since the 1980s, state capacity has been a major explanation for countries leaving the middle-income trap. However, this literature is unable to explain the failed experiences of countries with relatively high state capacity. This was the case of Chile after the unsuccessful enaction of a series of policies in the mid-2010s to upgrade the country’s position in the lithium value chain. To understand this failure, we combine the literature on developmental states and the literature on business power. We use the concept of institutional business power to understand how business actions erode state capacities leading to countries’ persistent inability to leave the middle-income trap. In the case of Chile, despite the relatively high levels of state capacity, previous processes of deregulation and privatization in the country configured a situation favorable to business’ monopolization of information and technical knowledge about lithium production and innovation processes that directly affected the capacity of the state to regulate the sector, let alone implement policies designed to upgrade the industry. The article highlights the need to investigate further the role of not just the state, but of the private sector in either facilitating or blocking value chain upgrading in countries caught in the middle-income trap.
The scramble to extract critical energy transition minerals creates risk of widespread negative human rights impacts. A just transition in the extraction of critical minerals must involve deep examination of the mine-community interface to gain a better understanding of the drivers of successful engagement between mining companies and communities. Drawing on fieldwork in South America’s lithium triangle, this paper finds that the nature of the corporate-community relationship is increasingly key to enabling a just transition whereby communities participate in the benefits of extraction with negative impacts mitigated. It establishes that key success factors are related to empowerment of Indigenous communities and have the potential to maximise positive outcomes for communities in the context of lithium extraction. Governments and companies must embed a more bottom-up process with an end goal of communities themselves defining the parameters of what a just transition means in the critical minerals context.
Humankind came to substances early. Poppy pods have been found with Neanderthal burials and spiritual and other group practices, still seen today but with millennia behind them, bear witness to the role of induced experiential change in human social evolution. Despite generations of history, the knowledge to unlock what mind-altering substances might do and the substrates through which they do it has only started to reveal itself within living memory through development of innovative investigative methods and an expanding cast of centrally acting compounds with clinical and laboratory potential.
A widening, if somewhat artificial, distinction has emerged where those who seek to modify brain systems with patients are considered psychopharmacologists, while those seeking to unravel mechanisms are considered neuropharmacologists. Expertise may differ, but the quest of clinician and basic scientist is the same, each benefitting from knowledge of the other.
This was a happy and productive time. Increase in writing and work productivity. Explored theories for my illness, and did lots of music, reading, and socialising, with generally elevated mood. Diagnosis was revised again to bipolar disorder, well controlled on lithium. Further ECT continued as an out-patient; unilateral treatment has less affect on memory.
Increasing pressure to return to work coupled with increasing feelings of inadequacy. Reached rock bottom, and was persuaded to start lithium, and after all this time, started to slowly improve.
Started work as a core psychiatric trainee in the Scottish Borders, with very supportive staff, although still had to work full-time. It was still a difficult switch from being patient to psychiatrist; Passed MRCGP exam, then became pregnant again. I then became pregnant again.
Aggression is often defined with reference to the intended consequences of an act exhibited by a person, or as any behaviour exhibited by a person where they intentionally acted to cause harm to another. Behaviours which cause harm but without associated intent tend not to be defined as aggression. Some people with intellectual disability may engage in behaviours with intent to cause harm to another, while for others, especially those with severe to profound intellectual disability, an absence of intent may exist. Aggressive behaviour exhibited by people with intellectual disability can take the form of verbal threats, physical aggression directed towards others including punching, kicking, slapping and biting, amongst other behaviours, as well as property damage and destruction. Aggressive behaviour can cause serious harm to others which may be life-threatening and result in social exclusion and a reduced quality of life. This chapter provides an overview of severe aggression and self-injurious behaviour relevant to people with disorders of intellectual development, and focuses on the evidence base for the various challenging behaviours and whether there is benefit from medication or alternative approaches.
The Prof pegmatite is located NW of Revelstoke, British Columbia, Canada on Boulder Mountain. Due to the abundance of petalite, the pegmatite is classified as a petalite subtype Li-Cs-Ta pegmatite or a Group one pegmatite. The Prof pegmatite contains a suite of minerals indicative of a highly evolved pegmatite melt including petalite, elbaite, lepidolite and Nb–Ta oxides. Four textural zones are present: (1) border; (2) intermediate, including (2.1) graphic texture dominant and (2.2) overgrowth dominant, where diverse minerals form rims around one another; (3) central; and (4) quartz. The border zone has a similar mineralogy to the intermediate zone and is interpreted to represent a chilled margin. The intermediate zone has a feldspar, mica, garnet and dravite–schorl dominant composition. The central zone hosts an evolved pegmatite core, which contains the majority of the lithium mineralisation composed of petalite, elbaite and lepidolite. The tourmaline, Nb–Ta oxides and mica within the pegmatite record the geochemical evolution of the melt from more primitive Fe- and Mg-rich minerals to a Li-, Mn- and Nb-rich assemblage indicative of a highly evolved geochemical system. The various pegmatitic textures and extremely fractionated geochemical composition of the pegmatite indicate that the melt was undercooled and crystallised rapidly. Three phases of metasomatism are recognised in the Prof pegmatite: an albitisation event observed cutting primary orthoclase; followed by a transition to a Na–Li–F-rich event mostly containing secondary albite, trilithionite and elbaites; and a sericitisation event.
The Prof pegmatite has a similar mineralogy to known pegmatites at Mount Begbie, 15 km to the south, in particular the notable presence of the rare mineral qitianlingite, petalite, lepidolite and elbaite. Together, these pegmatite bodies form part of an extensive, poorly mapped pegmatite field. Additional work is required to assess the extent and nature of mineralisation within this field.
The structure of a lepidolite-2M1 from Biskupice, Czechoslovakia, has been redetermined. Violations of systematic extinctions and of monoclinic equivalences plus the results of a second harmonic generation test indicate that the true symmetry most likely is C1̄. The deviation of the data set from C2/c symmetry, however, proved to be too small to permit a statistically significant refinement in C1̄. Refinement in C2/c symmetry indicated no ordering of tetrahedral cations but ordering of octahedral cations so that M(1) = Li0.93R2+0.06Fe3+0.01 and M(2) = Al0.58Li0.35□0.07. The tetrahedra are elongated to form trigonal pyramids with a rotation angle of 6.2°. The anomalous orientation of the thermal ellipsoid for the F,OH anion plus the large equivalent isotropic B value of 2.58 for F,OH and of 1.74 for the interlayer K cation, whose position is partly restricted in C2/c symmetry, suggest a lower symmetry than C2/c.
The compositions of this sample and of a second lepidolite-2M1 from Western Australia fall outside the stability field of lepidolite-2M1 in the synthetic system. Structural control of the stacking sequence is discounted on the basis of the structural similarity of the lepidolite unit layers. Crystallization parameters are considered more important than composition or the structure of the unit layer in determining the stability and occurrence of different layer-stacking sequences in lepidolite.
Cross-linking of Li-montmorillonite by hydroxy-aluminum oligomers was performed in a specially constructed mixing apparatus. Observations on flocculation and solution composition were carried out during and after the cross-linking reaction; the dry product was studied by scanning electron microscopy.
Flocculation was most pronounced at Al/montmorillonite ratios between 0.98 and 2.45 mM/g; below and above this range, flocculation was much less intensive. These observations can be explained by heterocoagulation and protecting colloid action. A complete neutralization of the montmorillonite charge was estimated at 1.9 mM adsorbed Al per g clay, and in order to account for the electrical charge of the hydroxy-Al, polymers with an average charge of 0.5 per Al atom must be assumed on the montmorillonite surface. Assuming that the hydroxy-aluminum form in the unreacted solution is Al6(OH)3+12, the adsorbed polymer will be Al24(OH)12+60. Alternatively, assuming Al6(OH)3+15 in the unreacted solution, this form will remain unchanged upon adsorption onto the montmorillonite surface.
Differences in the microfabric of dry Al-CLM as a function of Al/montmorillonite ratio can be explained along the lines of the interpretation of the flocculation studies.
Edited by
Allan Young, Institute of Psychiatry, King's College London,Marsal Sanches, Baylor College of Medicine, Texas,Jair C. Soares, McGovern Medical School, The University of Texas,Mario Juruena, King's College London
This chapter focuses on how recent advances in neuroimaging methods have increased our understanding of a key treatment for bipolar disorder, lithium. Structural magnetic resonance imaging (sMRI) studies suggest that lithium normalises both global and regional reductions in grey matter volume associated with bipolar disorder, while diffusion-weighted imaging (dMRI) studies have shed light on lithium’s potential to rectify abnormalities in white matter integrity. We describe the advent of direct imaging of lithium distribution in the brain using multinuclear MRI techniques (7Li-MRI) which is the first report of noninvasive imaging of a psychoactive drug in its target organ. The spatially heterogenous distribution of the 7Li-MR signal may suggest that lithium directly influences brain structure and function based on lithium tissue concentrations and initial work combining 7Li-MRI and dMRI support this hypothesis. Future directions of research are discussed, including harnessing the potential of multi-modal imaging and longitudinal study designs to develop combined biomarkers or biosignatures of response to treatment. Using lithium as an example, technological and scientific advances in brain imaging can facilitate treatment development and a personalised medicine approach in bipolar disorder.
Accumulating studies have assessed mortality risk associated with mood-stabilizers, the mainstay treatment for bipolar disorder (BD). However, existing data were mostly restricted to suicide risk, focused on lithium and valproate and rarely adequately adjusted for potential confounders. This study aimed to assess comparative mortality risk with all, natural and unnatural causes between lithium, valproate and three frequently prescribed second-generation antipsychotics (SGA), with adjustment for important confounders.
Methods
This population-based cohort study identified 8137 patients with first-diagnosed BD, who had exposed to lithium (n = 1028), valproate (n = 3580), olanzapine (n = 797), quetiapine (n = 1975) or risperidone (n = 757) between 2002 and 2018. Data were retrieved from territory-wide medical-record database of public healthcare services in Hong Kong. Propensity-score (PS)-weighting method was applied to optimize control for potential confounders including pre-existing chronic physical diseases, substance/alcohol use disorders and other psychotropic medications. PS-weighted Cox proportional-hazards regression was conducted to assess risk of all-, natural- and unnatural-cause mortality related to each mood-stabilizer, compared to lithium. Three sets of sensitivity analyses were conducted by restricting to patients with (i) length of cumulative exposure to specified mood-stabilizer ≥90 days and its medication possession ratio (MPR) ≥90%, (ii) MPR of specified mood-stabilizer ≥80% and MPR of other studied mood-stabilizers <20% and (iii) monotherapy.
Results
Incidence rates of all-cause mortality per 1000 person-years were 5.9 (95% confidence interval [CI]: 4.5–7.6), 8.4 (7.4–9.5), 11.1 (8.3–14.9), 7.4 (6.0–9.2) and 12.0 (9.3–15.6) for lithium-, valproate-, olanzapine-, quetiapine- and risperidone-treated groups, respectively. BD patients treated with olanzapine (PS-weighted hazard ratio = 2.07 [95% CI: 1.33–3.22]) and risperidone (1.66 [1.08–2.55]) had significantly higher all-cause mortality rate than lithium-treated group. Olanzapine was associated with increased risk of natural-cause mortality (3.04 [1.54–6.00]) and risperidone was related to elevated risk of unnatural-cause mortality (3.33 [1.62–6.86]), relative to lithium. The association between olanzapine and increased natural-cause mortality rate was consistently affirmed in sensitivity analyses. Relationship between risperidone and elevated unnatural-cause mortality became non-significant in sensitivity analyses restricted to low MPR in other mood-stabilizers and monotherapy. Valproate- and lithium-treated groups did not show significant differences in all-, natural- or unnatural-cause mortality risk.
Conclusion
Our data showed that olanzapine and risperidone were associated with higher mortality risk than lithium, and further supported the clinical guidelines recommending lithium as the first-line mood-stabilizer for BD. Future research is required to further clarify comparative mortality risk associated with individual SGA agents to facilitate risk-benefit evaluation of alternative mood-stabilizers to minimize avoidable premature mortality in BD.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Bipolar disorder is an affective disorder defined on the basis of the presence of periods of elevated mood. Patients often present with depression, and previous episodes of elevated mood may be missed if not specifically explored during assessment. Bipolar disorder may be difficult to differentiate from other conditions causing mood instability and impulsivity. It is important to identify comorbidities such as substance use, neurodiversity and physical illnesses. The first-line treatment for mania is antipsychotic medication. Antidepressants are reported to have little to no efficacy in treating bipolar depression on average. Lithium is not the only long-term prophylactic agent, but it remains the gold standard, with good evidence that it reduces mood episodes and adverse outcomes. Monitoring is required to ensure lithium level is optimised and potential side-effects minimised.
Edited by
Nevena V. Radonjić, State University of New York Upstate Medical University,Thomas L. Schwartz, State University of New York Upstate Medical University,Stephen M. Stahl, University of California, San Diego
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Classification of drug treatments for depression is described noting the ambiguities of current terminology and the move towards standardised nomenclature based on pharmacology and mode of action, such as that proposed by the Neuroscience-based Nomenclature group. Antidepressant drugs are described in terms of background, mechanism of action, pharmacokinetics, side effects, interactions, contraindications and toxicity in overdose. Groups include selective serotonin re-uptake inhibitors (SSRI), serotonin and noradrenaline re-uptake inhibitors (SNRI), tricyclics, noradrenergic and specific serotoninergic antidepressants (NaSSA), monoamine oxidase inhibitors (MAOI) and others such as buproprion, agomelatine, reboxetine, trazadone and vortioxetine. Augmentary medications are also described, including antipsychotics, antiepileptics and lithium. Developments with the use of ketamine and other compounds are discussed.
The classification of physical treatments for depression is into neuromodulatory (e.g. electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation and phototherapy) and neuroablative techniques (e.g. stereotactic psychosurgery).
Li-bearing smectite minerals occurring as hydrothermal alteration products of magnesium silicate minerals in skarns associated with the Moldova Nouǎ, Romania, porphyry copper deposit were examined by X-ray powder diffraction, infrared spectroscopy, and thermal and chemical analyses. Li-bearing smectite containing 0.45–0.50 Li/unit cell is common, whereas smectite containing 0.21–0.33 Li/unit cell is less common. Both materials coexist with talc and kerolite. The Li-bearing smectite minerals (b = 9.111 Å) contains semi-ordered or ordered stacking and is highly crystalline, similar to saponite. After 3-yr storage under laboratory conditions in an air-dried state (RH = 50%) or after heating for 2 hr at 100°, 200°, 300°, or 400°C, the Li-bearing smectite minerals showed charactenstics of a regular 1:1 interstratification of anhydrous and dihydrate layers. Some segregation of the anhydrous, monohydrate, and dihydrate layers was noted.
The amount of Li-for-Mg substitution was found to be close to that in hectorite, and the number of octahedral vacancies was similar to that in stevensite. This Li-bearing smectite apparently formed directly from colloidal suspensions at atmospheric temperature and pressure.
Sedimentologic zones that are differentiated by changes in lithology, mineralogy, chemical composition, and crystal morphology observable in scanning electron micrographs occur in Missouri high-alumina clay deposits. These properties and changes suggest that the high-alumina materials originated from Pennsylvanian-age, paludal sediments deposited in depressions underlying Paleozoic carbonate rocks. Alumina was relatively enriched in zones of the deposits by leaching of silica and of alkali and alkaline earth metals from the sediments. The most intense leaching occurred on the highest parts of the Ozark Dome.
Diaspore is the predominant high-alumina mineral. Boehmite, although far less abundant than diapsore, may have paragenetically preceded diaspore in some deposits. Chlorite, presumably an Al-rich variety because the content of MgO is typically <0.5%, is also present. Li, which is sporadically present, is inferred to have accumulated in the chlorite which may be a proto-variety of cookeite. Because Li+ and Al3+ are similar in size, Li is inferred to have accompanied Al as a resistate element in contrast to K and Na which were leached from parent phyllosilicates.
Lithium-bearing donbassite and tosudite were found in veins in hydrothermally altered granite (Beauvoir granite) in the northern part of the Massif Central, France. The two minerals are characterized by their high Li contents and low Mg and Fe contents; their structural formulae are: $${\left( {S{i_{3.81}}A{l_{0.19}}} \right)_{\Sigma = 4.00}}{O_{10}}{\left( {A{l_{3.81}}L{i_{0.52}}Fe_{0.01}^{2 + }C{a_{0.02}}M{g_{0.01}}} \right)_{\Sigma - 4.38}}{\left( {OH} \right)_8}{\left( {N{a_{0.07}}{K_{0.04}}} \right)_{\Sigma = 0.11}}$$ for donbassite and $${\left( {S{i_{3.50}}A{l_{0.50}}} \right)_{\Sigma = 4.00}}{O_{10}}{\left( {A{l_{2.95}}L{i_{0.22}}Fe_{0.01}^{3 + }T{i_{0.01}}} \right)_{\Sigma = 3.19}}{\left( {OH} \right)_5}{\left( {C{a_{0.01}}N{a_{0.15}}{K_{0.18}}} \right)_{\Sigma = 0.34}}$$ for tosudite.
These chemical compositions indicate that the donbassite is an intermediate member of the donbassite-cookeite solid solution series and that the tosudite consists of interstratified Li-donbassite and beidellite. Both Li-bearing minerals show thermal behavior distinct from those previously reported for dioctahedral chlorite and tosudite.
Petrographie investigation of drill cuttings from the Echassières area indicates that the two minerals were formed in an intermediate stage of hydrothermal alteration following an early stage characterized by formation of muscovite (2M1) at >350°C and before the latest stage characterized by deposition of kaolinite and randomly interstratified illite/smectite at < 100°C. Moreover, tosudite occurs in the upper part of the granite, whereas donbassite is restricted to the lower part, suggesting the formation of tosudite at lower temperatures.