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Pathways to professional mental care in the Swiss young adult community: a case-control study.
Get PDFTreatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the 'Bern Epidemiological At-Risk' (BEAR) study on 16-40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the 'WHO pathway-to-care questionnaire', from which the outcome 'most intensive MH professional contact' was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The 'most intensive MH professional contact' was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, 'substance misuse' and 'central-vegetative problems' increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome
More than fulfilled expectations: An electrophysiological investigation of varying cause-effect relationships and schizotypal personality traits as related to the sense of agency.
No full textThe sense of agency (SoA) is central to human experience. The comparator model, contrasting sensory prediction and action feedback, is influential but limited in explaining SoA. We investigated mechanisms beyond the comparator model, focusing on the processing of unpredictable stimuli, perimotor components of SoA, and their relation to schizotypy. ERPs were recorded from 18 healthy participants engaged in button-pressing tasks while perceiving tones with varying causal relationships with their actions. We investigated the processing of non-causally related tones, contrasted this to causally related tones, and examined perimotor correlates of subjective expectancy and experience of agency. We confirmed N100 attenuation for self-generated stimuli but found similar effects for expectancy-dependent processing of random tones. SoA also correlated with perimotor ERP components, modulated by schizotypy. Thus, neural processes preceding actions contribute to the formation of SoA and are associated with schizotypy. Unpredictable events also undergo sensory attenuation, implying additional mechanisms contributing to SoA
Endovascular aortic repair in patients with marfan and Loeys-Dietz syndrome is safe and durable when employed by a multi-disciplinary aortic team.
No full textOBJECTIVES
The aim of this study was to report on mid-term outcomes after endovascular aortic repair in patients with Marfan (MFS) or Loeys-Dietz (LDS) syndrome.
METHODS
We analyzed data from two European centers of patients with MFS and LDS undergoing endovascular aortic repair. Patients were analyzed based on (1) timing of the procedure (planned vs emergency procedure) and (2) the nature of the landing zone (safe vs non-safe). The primary end-point was freedom from reintervention. Secondary end-points were freedom from stroke, bleeding and death.
RESULTS
A population of 419 patients with MFS (n = 352) or LDS (n = 67) was analyzed for the purpose of this study. Thirty-nine patients (9%) underwent endovascular aortic repair. Indications for TEVAR or EVAR were aortic dissection in 13 (33%) patients, aortic aneurysm in 22 (57%) patients and others (intercostal patch aneurysm, penetrating atherosclerotic ulcer, pseudoaneurysm, kinking of FET) in 4 (10%) patients. Thoracic endovascular repair was performed in 34 patients, abdominal endovascular aortic repair was performed in 5 patients. Mean age at 1st TEVAR/EVAR was 48.5 ± 15.4y. Mean follow-up after 1st TEVAR/EVAR was 5.9 ± 4.4 y. There was no statistically significant difference in the rate of re-interventions between patients with non-safe landing zone and the patients with safe proximal landing zone (P = 0.609). Furthermore, there was no increased probability for reintervention after planned endovascular intervention compared to emergency procedures (P = 0.916). Mean-time to reintervention, either open surgical or endovascular, after planned endovascular intervention was in median 3.9 y [95% CI 2.0-5.9y] and 2.0 y [95% CI -1.1-5.1y] (P = 0.23) after emergency procedures.
CONCLUSIONS
Endovascular aortic repair in patients with MFS and LDS and a safe landing zone is feasible and safe. Endovascular treatment is a viable option when employed by a multi-disciplinary aortic team even if the landing zone is in native tissue
The neuroanatomy of visual extinction following right hemisphere brain damage: Insights from multivariate and Bayesian lesion analyses in acute stroke.
Get PDFMulti-target attention, that is, the ability to attend and respond to multiple visual targets presented simultaneously on the horizontal meridian across both visual fields, is essential for everyday real-world behaviour. Given the close link between the neuropsychological deficit of extinction and attentional limits in healthy subjects, investigating the anatomy that underlies extinction is uniquely capable of providing important insights concerning the anatomy critical for normal multi-target attention. Previous studies into the brain areas critical for multi-target attention and its failure in extinction patients have, however, produced heterogeneous results. In the current study, we used multivariate and Bayesian lesion analysis approaches to investigate the anatomical substrate of visual extinction in a large sample of 108 acute right hemisphere stroke patients. The use of acute stroke patient data and multivariate/Bayesian lesion analysis approaches allowed us to address limitations associated with previous studies and so obtain a more complete picture of the functional network associated with visual extinction. Our results demonstrate that the right temporo-parietal junction (TPJ) is critically associated with visual extinction. The Bayesian lesion analysis additionally implicated the right intraparietal sulcus (IPS), in line with the results of studies in neurologically healthy participants that highlighted the IPS as the area critical for multi-target attention. Our findings resolve the seemingly conflicting previous findings, and emphasise the urgent need for further research to clarify the precise cognitive role of the right TPJ in multi-target attention and its failure in extinction patients
Flow of mangrove ecosystem services to coastal communities in the Brazilian Amazon
Get PDFMangrove forests are broadly recognized to support a variety of ecosystem services on coastal margins worldwide. These services may significantly contribute to the wellbeing of millions of people, but there is limited information about their importance in the Global South. This study mapped for the first time the flow of ecosystem services in Brazilian Amazon mangroves, which represent over 700,000Â ha of mangroves in the country. We also identified the spatial changes in the flow of services across coastal landscapes, including urban, agricultural upland areas and coastal natural protected areas. Our matrix model indicated that mangroves, waterbodies, sandflats and mudflats are critical to the flow of multiple ecosystem services, including provisioning (fish, mariculture), cultural (historical and intrinsic value, research, and education), and regulation (climate, flood control, nursery, and breeding grounds). Social economic context, occupation, education, and residence time are important factors influencing villagers to identify the flow of ecosystem services, which could be compared across other coastal marine reserves in South America that have similar management of natural resources. Adjacent coastal upland habitats such as forests and croplands are important to support many provisioning ecosystem services to coastal villagers that would otherwise be obtained from mangroves, suggesting that protecting these connected habitats and supporting small-scale agriculture may help to avoid deforestation of mangrove forests. As over 80 of the mangroves in the country are managed as extractive reserves and may support communities with comparable socio-economic characteristics, we provide a foundation for the development and replication of ecosystem services assessments in Brazilian mangroves, which cover an area of over 1 million hectares. Our work highlights the importance of mangrove forests in providing food, and cultural services and to increase local climate resilience of coastal villages in the Amazon coast
A New Database of Giant Impacts over a Wide Range of Masses and with Material Strength: A First Analysis of Outcomes
Get PDFIn the late stage of terrestrial planet formation, planets are predicted to undergo pairwise collisions known as giant impacts. Here, we present a high-resolution database of giant impacts for differentiated colliding bodies of iron–silicate composition, with target masses ranging from 1 × 10−4M⊕ up to super-Earths (5 M⊕). We vary the impactor-to-target mass ratio, core–mantle (iron–silicate) fraction, impact velocity, and impact angle. Strength in the form of friction is included in all simulations. We find that, due to strength, the collisions with bodies smaller than about 2 ×10−3M⊕ can result in irregular shapes, compound-core structures, and captured binaries. We observe that the characteristic escaping velocity of smaller remnants (debris) is approximately half of the impact velocity, significantly faster than currently assumed in N-body simulations of planet formation. Incorporating these results in N-body planet formation studies would provide more realistic debris–debris and debris–planet interactions
Internet of Forestry Things (IoFT) Technologies and Applications in Forest Management
No full textForests play a crucial role in sustaining the planet and human societies, offering a wide range of benefits like climate and water cycle regulation, biodiversity conservation, and the provision of essential resources. However, forests face significant challenges, such as deforestation, forest degradation, and the impacts of climate change, jeopardizing their long-term sustainability. To tackle these pressing issues, innovative solutions are required, and the internet of things (IoT) emerges as a promising avenue. By leveraging IoT technologies in forest management, also known as the internet of forestry things (IoFT), a transformative approach to forest management can be achieved. The IoFT technology empowers real-time data collection on forest conditions, encompassing parameters like temperature, humidity, and soil moisture. Additionally, it facilitates monitoring the movement and location of various forest assets, including wildlife, carbon stock, personnel, and equipment. This chapter presents a comprehensive overview of the current state of IoFT technologies and their applications in forest management. The chapter explores the potential benefits of IoFT technology in forest management, highlighting its ability to enhance the efficiency, effectiveness, significance, and sustainability of forest ecosystems. It draws upon a collection of studies, reports, and articles to elucidate the various applications of IoFT technologies in forest management. These applications encompass monitoring forest health, predicting and detecting forest fires, and identifying illegal logging activities, among others. IoFT technologies also offer opportunities for optimizing forest operations such as harvesting and transportation while improving the safety of forest workers. However, the chapter also acknowledges the challenges and limitations associated with IoFT technologies in forest management. Concerns over data privacy, security, and interoperability are discussed, emphasizing the need for careful consideration and robust solutions to address these issues. In conclusion, the study provides recommendations for future research endeavors aimed at addressing the challenges and advancing the utilization of IoFT technologies in forest management. By doing so, the potential of IoFT technologies can be harnessed to their fullest extent, paving the way for sustainable and effective forest management practices
Is There a Cumulative Effect for Congenital Heart Defects in Monochorionic Twins after Assisted Reproduction? - A Retrospective Analysis at a Tertiary Referral Center.
Get PDFINTRODUCTION
The aim of our study was to compare maternal, chorionicity and neonatal complications in monochorionic (MC) twins between spontaneously conceived (SC) and assisted reproductive technologies (ART) pregnancies.
MATERIAL AND METHODS
This was a retrospective cohort study between January 2010 to December 2019 at a tertiary referral University center. All consecutive pregnancies with MC twins that delivered at our University hospital were included. Maternal, chorionicity and neonatal complications were recorded and compared between SC and ART pregnancies.
RESULTS
393 MC pregnancies were included for final analysis, including 353 (89.8%) SC and 40 (10.2%) pregnancies conceived after ART. Hypothyroidism was the only maternal condition seen significantly more often in ART pregnancies (35.0% vs 12.5%, p = 0.001). There were no significant differences in chorionicity complications, such as twin-twin transfusion syndrome, selective fetal growth restriction and twin anemia-polycythemia sequence (40.0% in ART pregnancies vs 31.6% in SC pregnancies, p = 0.291). At least one congenital anomaly in one twin was seen significantly more often in ART pregnancies (18.8% vs 8.1%, p = 0.004), especially congenital heart defects (16.3% vs 6.2%, p = 0.005). There were no other significant differences in neonatal outcomes between both groups, however, there were non-significant trends in gestational age at delivery (34 weeks in ART pregnancies vs 35 weeks, p = 0.078) and birthweight (1951 g ± 747 in ART pregnancies vs 2143 g ± 579, p = 0.066).
CONCLUSION
This is the largest cohort study to date comparing maternal, chorionicity and neonatal complications between MC twin pregnancies after ART and after SC. Hypothyroidism was the only maternal condition occurring more frequently in pregnancies conceived after ART. There were no significant differences in chorionicity complications, in contrast to previously reported studies. While MC twins and ART pregnancies per se are known to be at risk for congenital heart defects, there seems to be a cumulative effect in MC pregnancies conceived after ART
Silicon-rhodamine functionalized evocalcet probes (EvoSiR) potently and selectively label calcium sensing receptors (CaSR) in vitro, in vivo and ex vivo
Get PDFThe calcium sensing receptor (CaSR) is a ubiquitously expressed G-protein coupled receptor (GPCR) that regulates extracellular calcium signals via the parathyroid glands. CaSR has recently also been implicated in non-calcitropic pathophysiologies like asthma, gut inflammation and cancer. To date, molecular tools that enable the bioimaging of CaSR in tissues are lacking. Based on in silico analyses of available structure-activity relationship data on CaSR ligands, we designed and prepared silicon-rhodamine (SiR) conjugates of the clinically approved drug evocalcet. The new probes EvoSiR4 and EvoSiR6, with differing linker lengths at the evocalcet carboxyl end, both showed a 6-fold and 3-fold increase in potency towards CaSR (EC50<45 nM) compared to evocalcet and the evocalcet-linker conjugate, respectively, in a FLIPR®-based cellular functional assay. The specificity of the EvoSiR probes towards CaSR binding and the impact of albumin was evaluated in live cell experiments. Both probes showed strong albumin binding, which facilitated the clearance of nonspecific binding interactions. Accordingly, in zebrafish embryos, EvoSiR4 specifically labelled the high CaSR expressing neuromasts of the lateral line in vivo. EvoSiR4 was also assessed in human parathyroid tissues ex vivo, showing a specific absolute CaSR associated fluorescence compared to parathyroid autofluorescence. In summary, functionalization of evocalcet by SiR led to the preparation of potent and specific fluorescent CaSR probes. EvoSiR4 is a versatile small molecular probe that can be employed in CaSR-related biomedical analyses where antibodies are not applicable
A persistent prefrontal reference frame across time and task rules.
Get PDFBehavior can be remarkably consistent, even over extended time periods, yet whether this is reflected in stable or 'drifting' neuronal responses to task features remains controversial. Here, we find a persistently active ensemble of neurons in the medial prefrontal cortex (mPFC) of mice that reliably maintains trajectory-specific tuning over several weeks while performing an olfaction-guided spatial memory task. This task-specific reference frame is stabilized during learning, upon which repeatedly active neurons show little representational drift and maintain their trajectory-specific tuning across long pauses in task exposure and across repeated changes in cue-target location pairings. These data thus suggest a 'core ensemble' of prefrontal neurons forming a reference frame of task-relevant space for the performance of consistent behavior over extended periods of time
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