Association of the tumor necrosis factor -308 A/G promoter polymorphism with Tourette syndrome

Several lines of evidence suggest that certain subtypes of obsessive-compulsive and tic disorders might be paediatric manifestations of post-streptococcal autoimmunity caused by cross-reactive autoantibodies. As tumor necrosis factor (TNF) is known to play a seminal role in coordinating the humoral immune response, TNF gene polymorphisms have been proposed as genetic risk factors both in obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). The aim of this study was to investigate two TNF promoter polymorphisms (-238 A/G: rs361525 and -308 A/G: rs1800629) on the genetic susceptibility to OCD and TS in a child psychiatric sample (102 patients with OCD and 117 patients with TS). In the case-control set-up, the genotype and allele frequencies were compared to a control group from the general population (n = 405). As a control child psychiatric sample, 194 children with attention-deficit hyperactivity disorder were also genotyped. Our results revealed that the TNF -308 G-allele was more frequent in children with TS compared to controls (90.2% vs 84.8%, P = 0.037). For confirmation of this genetic association, a family-based analysis, the transmission disequilibrium test was used, which showed preferential transmission of the G-allele to patients with TS (nominal P-value 0.011). Moreover, this allele was also transmitted more frequently to children with tic symptoms (nominal P-value 0.039). No association was found between OCD or obsessive-compulsive symptoms and the studied TNF polymorphisms. Based on these findings, the TNF -308 G-allele can be associated with Tourette syndrome, highlighting the potential pathophysiological role of TNF dysregulation

Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis

Background:Depression is common in haemodialysis (HD) patients and associated with poor outcomes. Purpose:To evaluate whether depression symptoms predict survival and transplantation in a large sample of haemodialysis patients using cause-specific survival models. Methods:Survival data was collected between April 2013 and November 2015, as part of the screening phase of a multicentre randomised placebo-controlled trial of sertraline in HD patients. Depression was measured using the Beck Depression Inventory-II (BDI-II) and the Patient Health Questionnaire-9 (PHQ-9). Demographic and clinical data were collected via a self-report questionnaire and medical records. Competing risk survival analysis involved cause-specific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including co-morbidity and C-reactive protein (CRP) in a subanalysis. Results:Of 707 cases available for analysis, there were 148 deaths. The mean survival time was 787.5 days. Cumulative survival at 12 months was 88.5%. During the study follow-up period, there were 92 transplants. The cumulative transplant event rate at 12 months was 7.8%. In separate adjusted models, depression symptoms predicted mortality (BDI-II HR = 1.03 95% CI 1.01, 1.04; PHQ-9 HR = 1.04 95% CI 1.01, 1.06). With respect to screening cut-off scores, a PHQ-9 ≥ 10 was associated with mortality (HR = 1.51 95% CI 1.01, 2.19) but not a BDI-II ≥ 16. Depression symptoms were not associated with time to transplantation in either cause-specific or subdistribution model. Conclusions:Consistent with past findings in HD patients, depression symptoms predicted survival but were not associated with kidney transplantation. Suitable treatments for depression need further evaluation, and their impact upon quality of life and clinical outcomes determined. Trial Registration Number:(ISRCTN06146268)

Ocean-induced Melting of Greenland Ice Shelves

The Greenland glaciers have been experiencing ongoing acceleration and significant calving events during the last two decades. Ocean-induced melt is a potential trigger for destabilizing the glaciers and ice shelves, and consequently contributing to global sea level rise. However, its mechanism is still uncertain.In this dissertation, we employ observational and numerical methods to improve our under- standings of ocean-induced melt under major Greenland glaciers. Using improved remote sensing data, we calculate melt rates with an improved accuracy. We then employ the Mas- sachusetts Institute of Technology general circulation model (MITgcm) to study ice-ocean interactions beneath an ice shelf in a 2-D configuration at a high resolution. We include ther- mal forcing from the ocean, cavity shape, and for the first time subglacial water discharge at the grounding line. We optimize the heat and salt transfer coefficients to match observed results. The model replicates the general pattern of melting: high near the grounding zone, decreasing rapidly downstream. Melt increases below linear with subglacial discharge and above linear with thermal forcing from the ocean. Next, we investigate the role of the slope of the ice shelf draft in controlling ice shelf melt. The simulations indicate that the melt rate is sensitive to the slope, hence is larger for steeper ice shelves; and the location of the region of high melt migrates toward the grounding line as the slope becomes steeper. In the limit case of a vertical wall, no ice shelf, we know that the locus of ice melt undercuts the glacier.This study provides major new insights on the sensitivity of ice shelf melt to (1) subglacial water discharge: a direct product of ice sheet surface melt (2) thermal forcing from the ocean: a direct product of changes in ocean circulation as a result of wind forcing, and (3) a time-evolving cavity which affects the melt regimes: shallow, nearly flat cavities do not favor high melt; deep, steep cavities favor high melt. These results are important to interpret recent changes on the ice shelves and to inform ice sheet numerical models how to parameterize ice shelf melt in a changing climate

Impact of Subglacial Freshwater Discharge on Pine Island Ice Shelf

Satellite-based estimates of ice shelf melt rates reach similar to 200 m yr-1 close to the grounding line of Pine Island Glacier, in West Antarctica. However, ocean simulations have not yet been able to reproduce such high melt rates, even with high-resolution models. Here, we use a regional model of Pine Island ice shelf cavity and study the impact of subglacial freshwater discharge on simulated ice shelf melt rates and ocean circulation in the cavity. We show that subglacial freshwater discharge substantially enhances ice shelf melting close to the grounding line, successfully simulating high ice shelf melt rates suggested by observations. The buoyant mixture of glacial meltwater plume rises to similar to 27.4 isopycnal surfaces, following topographically constrained current, and spreads into mid-depths at the ice shelf front. The role of freshwater discharge is likely to remain unchanged over the coming decades given the projected evolution of runoff and rainfall over Pine Island basin

A New Institutional Sustainability Index Regarding Local Governments: The Case of Istanbul

The literature on institutional sustainability has largely focused on global-based analysis, and it has generally ignored to examine local-based analyses. The main purpose of this study was to measure the institutional sustainability of local governments. In this research, the intention was to develop an institutional sustainability index based on the district municipalities in the province of Istanbul, which is one of the most significant metropolises in the world. A total of 48 variables were used in the calculation of the General Institutional Sustainability Index (social dimension with 26 variables, economic dimension with 15 variables, and environmental dimension with 7 variables). The index consists of 3 sub-indexes comprising the general institutional sustainability index. The social dimension was examined in 6 sub-dimensions, the economic dimension in 5 sub-dimensions, and the environmental dimension in 4 sub-dimensions. The results indicate that Istanbul municipalities achieved low economic and environmental sustainability index scores. Decision-makers will be able to assess the general institutional sustainability index results for their own municipalities and to observe strong and weak aspects with the sub-indexes. In the process of developing the index, missing value analysis, cluster analysis, principal component analysis, and the composite index calculation methods were applied to data from 39 district municipalities in the province of Istanbul

Latent class analysis for measuring Turkish People's future expectations for Turkey

The aim of this study is to classify the Turkish People and measure the probability of their positive or negative expectations according to their 5-year expectations on Turkish Economy, Social Rights and Freedom, Rendering of the Public Services, Government Transparency and Turkey's Reputation. For this purpose latest data from the Turkish Statistical Institute's Life Satisfaction Survey 2011 was used and latent class analysis (LCA) was utilized on this data. For this study, unrestricted and restricted models of LCAs were performed, and it is observed that the three-class unrestricted model was found to be the best fit. Latent Class probabilities were interpreted and each class was named based on the calculated conditional probabilities

A New Institutional Sustainability Index Regarding Local Governments: The Case of Istanbul

The literature on institutional sustainability has largely focused on global-based analysis, and it has generally ignored to examine local-based analyses. The main purpose of this study was to measure the institutional sustainability of local governments. In this research, the intention was to develop an institutional sustainability index based on the district municipalities in the province of Istanbul, which is one of the most significant metropolises in the world. A total of 48 variables were used in the calculation of the General Institutional Sustainability Index (social dimension with 26 variables, economic dimension with 15 variables, and environmental dimension with 7 variables). The index consists of 3 sub-indexes comprising the general institutional sustainability index. The social dimension was examined in 6 sub-dimensions, the economic dimension in 5 sub-dimensions, and the environmental dimension in 4 sub-dimensions. The results indicate that Istanbul municipalities achieved low economic and environmental sustainability index scores. Decision-makers will be able to assess the general institutional sustainability index results for their own municipalities and to observe strong and weak aspects with the sub-indexes. In the process of developing the index, missing value analysis, cluster analysis, principal component analysis, and the composite index calculation methods were applied to data from 39 district municipalities in the province of Istanbul