Visualizing Mortality Dynamics in the Lexis Diagram

The goal of this book is simple: We would like to show how mortality dynamics can be visualized in the so-called Lexis diagram. To appeal to as many potential readers as possible, we do not require any specialist knowledge. This approach may be disappointing: Demographers may have liked more information about the mathematical underpinnings of population dynamics on the Lexis surface as demonstrated, for instance, by Arthur and Vaupel in 1984. Statisticians would have probably preferred more information about the underlying smoothing methods that were used. Epidemiologists likewise might miss discussions about the etiology of diseases. Sociologists would have probably expected that our results were more embedded into theoretical frameworks...

Fossil slabs attached to unsubducted fragments of the Farallon plate

As the Pacific–Farallon spreading center approached North America, the Farallon plate fragmented into a number of small plates. Some of the microplate fragments ceased subducting before the spreading center reached the trench. Most tectonic models have assumed that the subducting oceanic slab detached from these microplates close to the trench, but recent seismic tomography studies have revealed a high-velocity anomaly beneath Baja California that appears to be a fossil slab still attached to the Guadalupe and Magdalena microplates. Here, using surface wave tomography, we establish the lateral extent of this fossil slab and show that it is correlated with the distribution of high-Mg andesites thought to derive from partial melting of the subducted oceanic crust. We also reinterpret the high seismic velocity anomaly beneath the southern central valley of California as another fossil slab extending to a depth of 200 km or more that is attached to the former Monterey microplate. The existence of these fossil slabs may force a reexamination of models of the tectonic evolution of western North America over the last 30 My

Characterization of a measurement setup for the thermomechanical characterization of curved shape memory alloy actuators

The bend and free recovery (BFR) test according to ASTM F2082 is a standard method to determine the transition temperatures of Nitinol shape memory alloys (SMAs). Unfortunately, this standard method is limited to SMA wires which are straight in its trained shape. Thus, the standard BFR test is not suitable for thermomechanical characterization of curved Nitinol SMA wires which should serve as actuators in cochlear implants in future. We developed a modified BFR measurement setup to determine the active austenite finish (AF) temperature of these very thin wires (Ø100 μm). The active AF temperature specifies the completion of the shape recovery upon heating. A parametric study of the measurement setup was carried out to investigate the influence of the heating rate on the observed active AF temperature and to verify the repeatability of the measurement setup. First, the curved wire was straightened in a cold water bath before inserting it into a water bath that is gradually heated from 5 °C to 45 °C. The shape change of the previously straightened wire was then recorded throughout the experiment using a digital microscope. Five different heating rates were employed: 0.25 K/min, 0.33 K/min, 0.5 K/min, 1 K/min as well as an unregulated maximum heating rate achievable of approximately 1.5 K/min. Furthermore, an investigation on the test-retest reliability was performed with three wires by repeating the experiment ten times with each wire. The results of this study revealed no influence of the heating rate on the thermomechanical response of the wires. Based on data from this study, a regulated heating rate of 1 K/min is suggested for future investigations, as this reduces the duration of the measurement from four hours to less than an hour. The values obtained from each wire through the test-retest reliability investigation showed a standard deviation of 1.9 K, 1.1 K and 2.1 K respectively. Our developed measurement setup demonstrates appropriate repeatability of the measurements

Traumatized German soldiers with moral injury – value-based cognitive-behavioral group therapy to treat war-related shame

IntroductionDuring deployment, soldiers are confronted with potentially morally injurious events. In many cases, these events violate their personal values and belief systems, resulting in feelings of anger, alienation, guilt, and shame. The psychological distress caused by such transgressions is defined as moral injury. It remains unclear to date, which therapeutic interventions are most appropriate for addressing this specific psychological condition. This study examines the effectiveness of value-based cognitive-behavioral group therapy combining elements of cognitive-behavioral therapy, acceptance and commitment therapy, spiritual care, and adaptive disclosure therapy.Materials and methodsThis controlled study uses the Compass of Shame Scale to assess symptom severity among participants both before and after a three-week inpatient group therapy regimen for moral injury. An intervention group (n = 45) was compared to a waiting-list control group (n = 40). A one-way between subjects ANOVA was conducted to determine the differences between the two measurement points in the intervention group compared to the control group. A positive ethics vote from the Humboldt University Berlin (Charité) was available (No.EA1/092/15).ResultsA significant difference was found on the shame-associated maladaptive strategies subscales of attack self (F (1, 83) = 5.942, p = 0.017, Cohen’s f = 0,27), withdrawal (F (1, 83) = 8.263, p = 0.005, Cohen’s f = 0,32), and attack others (F (1, 83) = 10.552, p = 0.002, Cohen’s f = 0,36) of the Compass of Shame Scale between the intervention group and the control group at the p < 0.05 level in the pre- and post-treatment (t1-t2) comparison.ConclusionThis study suggests that the special therapeutic focus in cognitive-behavioral group therapy can alter shame-based maladaptive coping behaviors in response to war-related moral injury. This study provides further evidence that therapeutic approaches – through fostering a reconciliatory, compassionate, and forgiving approach toward oneself and others – target the underlying mechanisms of moral injury. Therefore, value-based cognitive-behavioral interventions should be considered as a standard element of trauma care in a military setting. Future studies should further examine such interventions in randomized control trials. It would also be particularly valuable for future studies to include a follow-up time point

A PESQUISA EXPLORATÓRIA E DESCRITIVA NA DEFINIÇÃO DOS REQUISITOS DE PROJETO PARA A REUTILIZAÇÃO DE ESTRUTURAS METÁLICAS DE MÓVEIS ESCOLARES INATIVOS EM BICICLETÁRIOS

O presente trabalho descreve as pesquisas efetuadas para a definição dos requisitos de projeto para o bicicletário a ser desenvolvido por meio da reutilização do mobiliário inativo de uma instituição de ensino superior. Foram executadas duas fases de pesquisa: uma descritiva, onde foram efetuados o inventário, para identificar e quantificar o mobiliário inativo disponível; a busca de similares, para catalogar os projetos e soluções existentes de paraciclos e estruturas de apoio; e a Revisão Bibliográfica Sistemática, para identificar e classificar os elementos de segurança, conforto e os comportamentos promovidos pelo uso de bicicletas. E outra exploratória, na qual o Levantamento foi adotado como procedimento metodológico para interrogar os usuários por meio de questionário e entrevista com formulário. Como resultado, a pesquisa descritiva gerou uma análise comparativa das soluções para bicicletários, caracterizou os serviços locais, definiu as características para a estação de reparos e a plataforma online para o compartilhamento de informações e experiências entre os ciclistas. A pesquisa exploratória reconheceu as características e preferências dos usuários e ciclistas da instituição, os impactos do uso da bicicleta em suas rotinas, os grupos de ciclistas locais e os seus meios preferidos de busca e compartilhamento de informações. Pela análise dos dados obtidos, foi definido um conjunto de critérios de qualidade e requisitos funcionais para guiar a posterior etapa de projeto do bicicletário e das suas estruturas complementares.

COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

Background To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. Methods This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network—the Paediatric Tuberculosis Network European Trials Group (ptbnet)—that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. Findings 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5–12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2–11, range 1–34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72–14·87; p=0·0035), male sex (2·12, 1·06–4·21; p=0·033), pre-existing medical conditions (3·27, 1·67–6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16–21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir–ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20–1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support. Interpretation COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed. Funding ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit

GWAS meta-analysis of over 29,000 people with epilepsy identifies 26 risk loci and subtype-specific genetic architecture

Epilepsy is a highly heritable disorder affecting over 50 million people worldwide, of which about one-third are resistant to current treatments. Here we report a multi-ancestry genome-wide association study including 29,944 cases, stratified into three broad categories and seven subtypes of epilepsy, and 52,538 controls. We identify 26 genome-wide significant loci, 19 of which are specific to genetic generalized epilepsy (GGE). We implicate 29 likely causal genes underlying these 26 loci. SNP-based heritability analyses show that common variants explain between 39.6% and 90% of genetic risk for GGE and its subtypes. Subtype analysis revealed markedly different genetic architectures between focal and generalized epilepsies. Gene-set analyses of GGE signals implicate synaptic processes in both excitatory and inhibitory neurons in the brain. Prioritized candidate genes overlap with monogenic epilepsy genes and with targets of current antiseizure medications. Finally, we leverage our results to identify alternate drugs with predicted efficacy if repurposed for epilepsy treatment

Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals

Copy number variants (CNV) are established risk factors for neurodevelopmental disorders with seizures or epilepsy. With the hypothesis that seizure disorders share genetic risk factors, we pooled CNV data from 10,590 individuals with seizure disorders, 16,109 individuals with clinically validated epilepsy, and 492,324 population controls and identified 25 genome-wide significant loci, 22 of which are novel for seizure disorders, such as deletions at 1p36.33, 1q44, 2p21-p16.3, 3q29, 8p23.3-p23.2, 9p24.3, 10q26.3, 15q11.2, 15q12-q13.1, 16p12.2, 17q21.31, duplications at 2q13, 9q34.3, 16p13.3, 17q12, 19p13.3, 20q13.33, and reciprocal CNVs at 16p11.2, and 22q11.21. Using genetic data from additional 248,751 individuals with 23 neuropsychiatric phenotypes, we explored the pleiotropy of these 25 loci. Finally, in a subset of individuals with epilepsy and detailed clinical data available, we performed phenome-wide association analyses between individual CNVs and clinical annotations categorized through the Human Phenotype Ontology (HPO). For six CNVs, we identified 19 significant associations with specific HPO terms and generated, for all CNVs, phenotype signatures across 17 clinical categories relevant for epileptologists. This is the most comprehensive investigation of CNVs in epilepsy and related seizure disorders, with potential implications for clinical practice