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Less intense daily precipitation maxima in regional compared to global gridded products
Get PDFA consistent approach to evaluate the annual wettest day (Rx1day) across global and regional gridded observational datasets is presented using IPCC AR6 to define climatological regions. Global daily 1° × 1° latitude/longitude gridded products available from the Frequent Rainfall on Grids (FROGS) database are compared with regional high-resolution (~1km to 25km) daily gridded rainfall datasets using several interpolation methods and order of operation. Climatologies are calculated for each global product and region using the overlapping period 2001–2016, with global datasets then organized into in situ, satellite and reanalyses groupings and compared with each other and the regional reference. Our findings show that reanalyses (especially CFSR and MERRA2) tend to be amongst the wetter products for precipitation extremes in most regions and that reanalysis groupings also have the largest spread. Perhaps surprisingly, regional datasets are often amongst the drier, if not the driest products in many regions (especially south-east Asia, Eurasia and the Middle East), and are almost always drier than reanalyses except in a few cases. Rx1day is significantly positively correlated in most regions and products except in a handful of cases where data issues are likely to affect correlations. Rx1day timing deviates substantially between products but agreement is highest among in situ products (40%–70% of the time) especially in data dense regions with least agreement among reanalyses (10%–40% of the time). Despite uncertainties, the mean relative long-term trend estimates in Rx1day averaged across global land areas, with respect to increases in global mean temperature is close to 7%/°
The ILIA study:protocol for a randomized-controlled multicenter clinical trial on smartphone- and web-based relapse monitoring for patients with schizophrenia or schizoaffective disorder
Get PDFBACKGROUND: Despite the proven efficacy of antipsychotics in relapse prevention in schizophrenia and schizoaffective disorder, every third patient experiences a relapse within less than one year. Relapses can worsen psychosocial and treatment related outcomes and lead to substantial economic costs, primarily due to frequent and prolonged hospitalizations. The aim of this project is to evaluate a smartphone- and web-based digital solution for detecting early warning signs of schizophrenia and schizoaffective disorder to reduce relapses and subsequent hospitalizations.METHODS: This randomized controlled trial compares the add-on use of a smartphone-based app for monitoring relapse warning signs in patients with schizophrenia and schizoaffective disorders (ICD-10 F20/F25) used within the routine psychiatric outpatient treatment against treatment as usual (TAU) without any further study-related intervention. Patients in the intervention group use the app for one year, fill in the weekly ten-item Early Warning Signs Questionnaire (EWSQ-10P) and obtain in-app feedback. Clinicians can access the symptom trajectory via a browser-accessible dashboard. If a threshold is exceeded in the inbuilt automatic algorithm, an alert is sent to both, the clinician and patient, enabling timely contact and, as part of a shared decision-making process, an optional adjustment of treatment decision. A total of 110 outpatients are recruited across eight study sites.DISCUSSION: Continuous monitoring of early warning signs is expected to lead to behavioral changes and to decrease the necessity and duration of psychiatric hospital stays, thereby lowering healthcare costs. Additionally, the intervention could reduce symptom severity, alleviate medication adherence, shared decision-making, patient activation or quality of life. Qualitative data is collected to better understand patient needs and preferences regarding app usage and relapses. Insights gained from this study can be integrated into routine psychiatric care, improving the long-term treatment of patients with schizophrenia or schizoaffective disorder.TRIAL REGISTRATION: German Clinical Trials Register (ID: DRKS00034991; registration date: 30.08.2024).</p
Dysregulated Expression of Canonical and Non-Canonical Glycolytic Enzyme Isoforms in Peripheral Blood from Subjects with Alcohol Use Disorder and from Individuals with Acute Alcohol Consumption:Antioxidants
Get PDFGlycolysis is primarily involved in ATP production but also modulates oxidative stress. Chronic alcohol consumption is correlated with an increased incidence of multiple diseases, including cancer and neurodegenerative diseases (NDDs), though the underlying mechanisms remain unclear. Guided by a literature review and bioinformatics analysis, we evaluated the expression of 22 genes encoding various isoforms of seven glycolytic enzymes (GEs) in the peripheral blood of patients with alcohol use disorder (AUD), individuals with acute alcohol consumption (AAC), and their respective control groups using qPCR. In parallel, we evaluated the expression of selected genes coding for GEs linked to NDDs, as well as astrocytic markers in primary mouse astrocyte cultures exposed to ethanol. Thirteen GE-related genes, including non-canonical isoforms, were significantly dysregulated in AUD patients; notably, eight of these genes showed similar alterations in individuals with AAC. Several enzymes encoded by these genes are known to be regulated by oxidative stress. Ethanol-exposed astrocytes also showed altered expression of glycolytic genes associated with NDDs and astrocyte function. These findings indicate that glycolytic dysregulation is driven by ethanol intake, regardless of exposure duration or organic damage, highlighting a link between ethanol-driven redox imbalance and glycolytic remodeling, which could contribute to organ damage
Baseline Characteristics of the TOPaZ Study: Randomised Trial of Teriparatide and Zoledronic Acid Compared with Standard Care in Adults with Osteogenesis Imperfecta
Get PDFIntroductionOsteogenesis imperfecta (OI) is a rare disorder causing multiple fractures throughout life. No treatment has been shown to reduce the risk of fractures in OI. Here, we present the baseline characteristics of participants in the Treatment of Osteogenesis Imperfecta with Parathyroid Hormone and Zoledronic Acid (TOPaZ) trial. The aim of the trial is to determine whether teriparatide and zoledronic acid are superior to standard care in reducing the risk of clinical fractures.MethodsWe summarised data on the baseline characteristics of TOPaZ participants, including demographics, genetic diagnosis, clinical features, bone density measurements, previous treatments, and fracture history.ResultsWe recruited 350 adults with a clinical diagnosis of OI in 27 European referral centres between June 2017 and October 2022. Overall, 266 (76.2%) had type I OI, 55 (15.8%) had type IV, and 19 (5.4%) had type III. The type was unknown in 9 (2.6%). Blue sclera were noted in 80.8%, and 35.8% had dentinogenesis imperfecta. Bisphosphonates had been administered to 28.1% in the 2 years prior to enrolment. Pathogenic variants in COL1A1 or COL1A2 were found in 87.6%. Fractures occurring in the 2 years prior to enrolment were not associated with bone density.ConclusionsThe TOPaZ population represents a unique cohort with which to study the genetic epidemiology and outcome of OI in relation to bone density and biochemical markers of bone turnover. When the trial reports, it will also provide new insights into the effect of an anabolic therapy, followed by antiresorptive treatment in the management of OI
Review of Abortion Law in Scotland:Expert Group Report
Get PDFIn the 2023-24 Programme for Government, the Scottish Government committed to undertaking a review of abortion law in Scotland ‘to identify potential proposals for reforms to ensure that abortion services are first and foremost a healthcare matter’. In following the Scottish Government’s instructions in this regard, an independent Expert Group comprising lawyers with expertise in medical/abortion law, clinicians responsible for delivering abortion services in Scotland and academics and representatives of women’s groups representing the voice of ‘lived experience’ met monthly over the course of one full year. In reaching the recommendations presented in this report the Group took into account the complexities of the current law, examples of recently revised abortion laws from other countries, a wealth of evidence published in academic journals and other reliable sources and paid careful consideration to the views of around 50 stakeholders including many who believe that access to abortion in the UK should be more restrictive. It has been a complex process and in this report the Group presents the detailed justification for every recommendation that they make
Intensive community and home-based treatments for eating disorders:A scoping review
Get PDFBackgroundIntensive community treatment (ICT) and home-based treatment (HBT) have emerged as valuable alternatives to institution-based intensive treatments (inpatient or day patient) for severe mental illnesses. Although potential benefits of ICT and HBT for eating disorders (EDs) have been proposed, this area of research remains largely unexplored.MethodA scoping review was conducted to map the available literature. Four databases (PubMed, PsycInfo, MEDLINE, Web of Science), grey literature, and trial registries were searched. Sources were included if they presented treatments offering more than two planned therapeutic contacts per week for at least part of the program, excluding physical monitoring contacts, for patients diagnosed with any ED across all ages.ResultsForty-six sources met the inclusion criteria (ICT: n = 31; HBT: n = 15), with most studies from Europe (n = 23) and the USA (n = 18). Among these, 28 reported quantitative data, six reported qualitative data, and three employed a mixed-methods approach. The remainder were either protocol papers or service descriptions only. The majority focused on anorexia nervosa (AN) or mixed EDs, with varying study designs and predominantly low to moderate evidence quality. There were no randomized controlled trials. HBTs primarily targeted children and adolescents with AN, emphasizing family-based approaches, while ICTs exhibited greater variability in age groups and diagnoses, frequently combining cognitive behavioral and dialectical behavioral therapies, often alongside family-based components for children and adolescents. Despite high variability in design, quality, and measurements, studies frequently reported improvements in clinical outcomes. Programs were often described as feasible and acceptable, noting patient satisfaction, strong adherence, and cost-effectiveness due to reduced hospital admissions.ConclusionsEven though there was variability in implementation and methodologies, ICTs and HBTs appear to be promising alternatives to traditional institution-based intensive treatments. Future research requires higher-quality large-scale randomized trials with improved reporting of treatment characteristics and outcomes to enable robust investigations of effectiveness
Hospitalizations for eating disorders and other mental, behavioral, and neurodevelopmental disorders before and during COVID-19 in Canada
Get PDFPurpose: We assessed hospital admission rates for anorexia nervosa (AN)/atypical AN (AAN) relative to other mental, behavioral, and neurodevelopmental disorders across age groups before and 1-year postpandemic onset. Methods: Using the Canadian Discharge Abstracts Database, we analyzed admissions for AN/AAN and mental, behavioral, and neurodevelopmental disorders in ages 10–84-year-olds, grouped into 10–24, 25–44, and 45+ year olds. Data spanned fiscal years (FY) 2006–2021. Results: AN/AAN admissions increased in the 10–24-year-old group, while remaining stable in older age groups. In FY2019, AN/AAN constituted 2.6% (95% confidence interval 2.4–2.8) of psychiatric admissions, increasing to 4.1% (95% confidence interval 3.9–4.3) in FY2020. Odds ratio for FY2019-FY2020 hospitalizations in 10–24 group was 1.61 (p < .0001), 25–44 was 1.15 (p = .31), and 45+ was 0.61 (p = .03). Discussion: AN/AAN admissions surged among 10–24 year-olds during the pandemic's onset, underscoring the need for early interventions and preparedness to support adolescents and young adults with AN/AAN.</p
Women's football and political propaganda in North Korea:Socialist patriotism, communist feminism, and state patriarchy
Get PDFIn 2024, the North Korean women's football team achieved a significant milestone. This study concerns how the despotic communist regime in this country exploits these sporting triumphs to promulgate its ruling ideologies. It examines political messages embedded in the North Korean newspaper coverage of women’s football. The communist state is surely a footballing powerhouse. Their production and articulation of political propaganda through sports is second to none in the world. From the reinforcement of socialism to the idolization of the political leader, the case of North Korea offers the prototype of the intersection between politics and football under authoritarian regime
Intravenous thrombolysis in patients with acute ischemic stroke and cerebral microbleeds:results from the ENCHANTED trial
Get PDFOBJECTIVE: To determine associations between cerebral microbleeds (CMB) and intracerebral hemorrhage (ICH) as well as functional recovery after thrombolysis in participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).METHODS: ENCHANTED recruited acute ischemic stroke (AIS) patients eligible for thrombolytic therapy from 111 clinical centres in 13 countries. We included those with T2*-weighted or susceptibility-weighted brain magnetic resonance imaging within 6 hours after AIS. Associations between CMB (primary predictor), burden (0, 1, 2-4, or ≥5 CMBs), and location (deep, lobar, mixed) and any intracerebral hemorrhage (ICH) (primary outcome), symptomatic ICH (sICH), 90-day disability or death (modified Rankin scale [mRS] score 2-6), and other unfavorable functional outcomes (mRS 3-6, 6, and shift) were explored in logistic regression models, and in a stratification by alteplase dose.RESULTS: Of 311 eligible AIS participants, 111 (35.7%) had CMB(s) and this was not associated with an increase in any ICH (adjusted odds ratio 1.49, 95% confidence interval [CI] 0.87-2.54) or sICH (2.05, 0.92-4.56). However, the presence of CMB(s) was associated with 90-day disability or death (1.75, 1.04-2.94) and other unfavorable functional outcomes. Comparable associations were seen between CMB burden (defined ordinally categorical; any ICH 1.16 [0.90-1.50]; mRS 2-6 1.44 [1.11-1.87]) or mixed deep-lobar distribution (any ICH 1.42 [0.61-3.29]; mRS 2-6 3.66 [1.48-9.05]) and these outcomes. There were no differences in associations between CMB presence/burden/distribution and outcomes between two different alteplase doses (Pinteraction >0.087).CONCLUSIONS: In ENCHANTED, CMB(s) was associated with 90-day unfavorable function recovery but not with a significantly increased likelihood of ICH in post-intravenous thrombolytic AIS. Low-dose alteplase may not offer a better profile for AIS with CMB(s).REGISTRATION NO: Clinicaltrials.gov (identifier no. NCT01422616).</p
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