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Pain sensitivity as a state marker and predictor for adolescent non-suicidal self-injury.
Get PDFBACKGROUND
The pain analgesia hypothesis suggests that reduced pain sensitivity (PS) is a specific risk factor for the engagement in non-suicidal self-injury (NSSI). Consistent with this, several studies found reduced PS in adults as well as adolescents with NSSI. Cross-sectional studies in adults with borderline personality disorder (BPD) suggest that PS may (partially) normalize after remission or reduction of BPD symptoms. The objective of the present study was to investigate the development of PS over 1 year in a sample of adolescents with NSSI and to investigate whether PS at baseline predicts longitudinal change in NSSI.
METHODS
N = 66 adolescents who underwent specialized treatment for NSSI disorder participated in baseline and 1-year follow-up assessments, including heat pain stimulation for the measurement of pain threshold and tolerance. Associations between PS and NSSI as well as BPD and depressive symptoms were examined using negative binomial, logistic, and linear regression analyses.
RESULTS
We found that a decrease in pain threshold over time was associated with reduced NSSI (incident rate ratio = 2.04, p = 0.047) and that higher pain tolerance at baseline predicted lower probability for NSSI (odds ratio = 0.42, p = 0.016) 1 year later. However, the latter effect did not survive Holm correction (p = 0.059). No associations between PS and BPD or depressive symptoms were observed.
CONCLUSION
Our findings suggest that pain threshold might normalize with a decrease in NSSI frequency and could thus serve as a state marker for NSSI
The Impact of Cerebral Embolic Protection Devices on Characteristics and Outcomes of Stroke Complicating TAVR.
No full textBACKGROUND
Acute ischemic stroke remains a serious complication of transcatheter aortic valve replacement (TAVR). Cerebral embolic protection devices (CEPD) were developed to mitigate the risk of acute ischemic stroke complicating TAVR (AISCT). However, the existing body of evidence does not clearly support CEPD efficacy in AISCT prevention.
OBJECTIVES
In a cohort of patients with AISCT, we aimed to compare the characteristics and outcomes of patients who have had unprotected TAVR (CEPD-) vs CEPD-protected TAVR (CEPD+).
METHODS
Data were derived from an international multicenter registry focusing on AISCT. We included all patients who experienced ischemic stroke within 72 hours of TAVR. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Primary outcomes were neurologic disability status according to the modified Rankin Score at 30 days, and 6-month all-cause death. Propensity score matched analysis was used to control for differences between groups.
RESULTS
In 18,725 TAVR procedures, 416 AISCT (2.2%) within 72 hours were documented, of which 376 were in the CEPD- TAVR group and 40 in the CEPD+ TAVR group. Although the middle cerebral artery stroke rate was similar in both groups (29.7% CEPD- vs 33.3% CEPD+; P = 0.71), AISCT in the CEPD+ group was characterized by a lower rate of internal carotid artery occlusion (0% vs 4.7%) and higher rate of vertebrobasilar system strokes (15.4% vs 5.7%; P = 0.04). AISCT was severe (NIHSS ≥15) in 21.6% CEPD- and 23.3% CEPD+ AISCT (P = 0.20). Disabling stroke rates (modified Rankin Score >1 at 30 days) were 47.3% vs 42.5% (P = 0.62), and 6-month mortality was 31.3% vs 23.3% (P = 0.61), in the CEPD- and CEPD+ groups, respectively. In the propensity score matched cohort, disabling stroke rates were 56.5% vs 41.6% (P = 0.16), and 6-month mortality was 33% vs 19.5% (P = 0.35), in the CEPD- and CEPD+ groups, respectively.
CONCLUSIONS
In a large cohort of patients with AISCT, the use of CEPD had little effect on stroke distribution, severity, and outcomes
Assessing pesticide residues occurrence and risks in water systems: A Pan-European and Argentina perspective
Get PDFFreshwater ecosystems face a particularly high risk of biodiversity loss compared to marine and terrestrial systems. The use of pesticides in agricultural fields is recognized as a relevant stressor for freshwater environments, exerting a negative impact worldwide on the overall status and health of the freshwater communities. In the present work, part of the Horizon 2020 funded SPRINT project, the occurrence of 193 pesticide residues was investigated in 64 small water bodies of distinct typology (creeks, streams, channels, ditches, rivers, lakes, ponds and reservoirs), located in regions with high agricultural activity in 10 European countries and in Argentina. Mixtures of pesticide residues were detected in all water bodies (20, median; 8–40 min-max). Total pesticide levels found ranged between 6.89 and 5860 ng/L, highlighting herbicides as the dominant type of pesticides. Glyphosate was the compound with the highest median concentration followed by 2,4-D and MCPA, and in a
lower degree by dimethomorph, fluopicolide, prothioconazole and metolachlor(-S). Argentina was the site with the highest total pesticide concentration in water bodies followed by The Netherlands, Portugal and France. One or more pesticides exceeded the threshold values established in the European Water Framework Directive for surface water in 9 out of 11 case study sites (CSS), and the total pesticide concentration surpassed the reference value of 500 ng/L in 8 CSS. Although only 5 % (bifenthrin, dieldrin, fipronil sulfone, permethrin, and terbutryn) of the individual pesticides denoted high risk (RQ > 1), the ratios estimated for pesticide mixtures suggested potential environmental risk in the aquatic compartment studied
Motivationsverzicht und Perspektivwechsel: Kellers Märtyrerinnenlegenden und die Faszination des Unerzählbaren
Get PDFCharacterizing and Removing Ultra-Violet Contamination in Ion Observations on Board Tianwen-1
Get PDFThe Mars Ion and Neutral Particle Analyzer (MINPA) onboard Tianwen-1 aims to study the
interaction between Mars and the solar wind via in situ ion measurement and energetic neutral atom
imaging. Despite the efforts for Ultra-Violet suppression in MINPA design, 0.48% of ion observations
from November 2021 to July 2022 were identified as UV-contaminated. The UV emissions primarily
penetrate into the instrument through the ENA entrance. Statistically, the distribution of the UV
contamination in phase space typically spans 3 to 4 azimuth sectors. The contamination is uniformly
distributed across the polar dimension while, in the energy and mass dimensions, it is proportional to
the time-of-flight duration. Comparisons between the in-flight performance and ground calibration
suggest that azimuthal broadening and intensity variations of the contamination may result from
differing responses across the azimuthal sectors. Based on the characteristics of the UV impact on
MINPA ion observations, a removal algorithm is proposed to reduce contamination while preserving
valid signals, which improves the data quality effectively and benefits the interpretation of MINPA’s
ion measurements in the Martian space environment. The cause, effect, and distribution of the UV
contamination obtained by this study may serve as a reference for other space ion observations
Concluding Remarks – Coordinates for the Future of Digitalised Archaeology
Get PDFThe diverse contributions in this book show that the main challenges for the field are a lack of standardisation, interoperability and open-source solutions, as well as of long-term archiving solutions. The contributions also show that efforts are being made to sustainably integrate 3D technologies into the field of archaeology. Within the broader context of digital archaeology, it is argued that, in addition to technical issues, attention must be paid to ethical considerations about the nature of technology, cultural heritage and accessibility. Finally, the entanglements of technology with violent contexts must also be critically assessed
Supporting Error Management and Safety Climate in Ambulatory Care Practices: The CIRSforte Study.
Get PDFBACKGROUND
To improve patient safety, it is important that healthcare facilities learn from critical incidents. Tools such as reporting and learning systems and team meetings structure error management and promote learning from incidents. To enhance error management in ambulatory care practices, it is important to promote a climate of safety and ensure personnel share views on safety policies and procedures. In contrast to the hospital sector, little research has been dedicated to developing feasible approaches to supporting error management and safety climate in ambulatory care. In this study, we developed, implemented, and evaluated a multicomponent intervention to address how error management and safety climate can be improved in ambulatory care practices.
METHODS
In a prospective 1-group pretest-posttest implementation study, we sought to encourage teams in German ambulatory practices to use proven methods such as guidelines, workshops, e-learning, (online) meetings, and e-mail newsletters. A pretest-posttest questionnaire was used to evaluate level and strength of safety climate and psychological behavioral determinants for systematic error management. Using 3 short surveys, we also assessed the state of error management in the participating practices. In semistructured interviews, we asked participants for their views on our intervention measures.
RESULTS
Overall, 184 ambulatory care practices nationwide agreed to participate. Level of safety climate and safety climate strength (rwg) improved significantly. Of psychological behavioral determinants, significant improvements could be seen in "action/coping planning" and "action control." Seventy-six percent of practices implemented a new reporting and learning system or modified their existing system. The exchange of information between practices also increased over time. Interviews showed that the introductory workshop and provided materials such as report forms or instructions for team meetings were regarded as helpful.
CONCLUSIONS
A significant improvement in safety climate level and strength, as well as participants' knowledge of how to analyze critical incidents, derive preventive measures and develop concrete plans suggest that it is important to train practice teams, to provide practical tips and tools, and to facilitate the exchange of information between practices. Future randomized and controlled intervention trials should confirm the effectiveness of our multicomponent intervention.Trial registration: Retrospectively registered on 18. November 2019 in German Clinical Trials Register No. DRKS00019053
67Zn and 111Cd labelled green manure to determine the fate and dynamics of zinc and cadmium in soil-fertilizer-crop systems.
Get PDFIsotope source tracing enables to accurately determine the fate of nutrients that are applied with fertilizers to soils. While this approach is well established for major nutrients such as nitrogen, it is not yet established for trace metals. Here, we aimed to determine the fate of the micronutrient zinc (Zn) and the contaminant cadmium (Cd) that were applied with an organic fertilizer to a soil-wheat system. A pot study was conducted in which wheat was grown on an alkaline soil. The soils received green manure and/or soluble Zn fertilizer and were compared with non-fertilized control treatments (n = 4 experimental replicates). The green manure was labelled with the stable isotopes 67Zn and 111Cd. For an efficient sample throughput, a method was provided and validated to determine enriched stable isotope ratios (67Zn:66Zn and 111Cd:110Cd) and the Zn and Cd concentrations in one analytical run. To this end, single collector ICP-MS analyses and stable isotope mass balances calculations were combined. Applying this method revealed that the addition of green manure increased neither Zn nor Cd concentrations in wheat grains due to biomass dilution effects. Isotope source tracing showed that the largest fraction of these metals in the wheat shoots derived from the soil in all treatments (Zn 87-99 %, Cd 94-98 %). Moreover, the addition of green manure increased the transfer of Zn and Cd from soil to wheat by a factor 1.9 for both elements. This increased transfer was likely related to a nitrogen fertilization effect that increased root and shoot biomass and thereby the soil exploration of the wheat. This study demonstrated how the fate and dynamics of multiple trace metals can be efficiently determined in soil-fertilizer-crop systems using isotope source tracing
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