Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants in Pregnancy and Congenital Anomalies: Analysis of Linked Databases in Wales, Norway and Funen, Denmark

Background: Hypothesised associations between in utero exposure to selective serotonin reuptake inhibitors (SSRIs) and congenital anomalies, particularly congenital heart defects (CHD), remain controversial. We investigated the putative teratogenicity of SSRI prescription in the 91 days either side of first day of last menstrual period (LMP). Methods and Findings: Three population-based EUROCAT congenital anomaly registries- Norway (2004–2010), Wales (2000–2010) and Funen, Denmark (2000–2010)—were linked to the electronic healthcare databases holding prospectively collected prescription information for all pregnancies in the timeframes available. We included 519,117 deliveries, including foetuses terminated for congenital anomalies, with data covering pregnancy and the preceding quarter, including 462,641 with data covering pregnancy and one year either side. For SSRI exposures 91 days either side of LMP, separately and together, odds ratios with 95% confidence intervals (ORs, 95%CI) for all major anomalies were estimated. We also explored: pausing or discontinuing SSRIs preconception, confounding, high dose regimens, and, in Wales, diagnosis of depression. Results were combined in meta-analyses. SSRI prescription 91 days either side of LMP was associated with increased prevalence of severe congenital heart defects (CHD) (as defined by EUROCAT guide 1.3, 2005) (34/12,962 [0.26%] vs. 865/506,155 [0.17%] OR 1.50, 1.06–2.11), and the composite adverse outcome of 'anomaly or stillbirth' (473/12962, 3.65% vs. 15829/506,155, 3.13%, OR 1.13, 1.03–1.24). The increased prevalence of all major anomalies combined did not reach statistical significance (3.09% [400/12,962] vs. 2.67% [13,536/506,155] OR 1.09, 0.99–1.21). Adjusting for socio-economic status left ORs largely unchanged. The prevalence of anomalies and severe CHD was reduced when SSRI prescriptions were stopped or paused preconception, and increased when >1 prescription was recorded, but differences were not statistically significant. The dose-response relationship between severe CHD and SSRI dose (meta-regression OR 1.49, 1.12–1.97) was consistent with SSRI-exposure related risk. Analyses in Wales suggested no associations between anomalies and diagnosed depression. Conclusion: The additional absolute risk of teratogenesis associated with SSRIs, if causal, is small. However, the high prevalence of SSRI use augments its public health importance, justifying modifications to preconception care

Lessons learned from practical approaches to reconcile mismatches between biological population structure and stock units of marine fish

Recent advances in the application of stock identification methods have revealed inconsistencies between the spatial structure of biological populations and the definition of stock units used in assessment and management. From a fisheries management perspective, stocks are typically assumed to be discrete units with homogeneous vital rates that can be exploited independently of each other. However, the unit stock assumption is often violated leading to spatial mismatches that can bias stock assessment and impede sustainable fisheries management. The primary ecological concern is the potential for overexploitation of unique spawning components, which can lead to loss of productivity and reduced biodiversity along with destabilization of local and regional stock dynamics. Furthermore, ignoring complex population structure and stock connectivity can lead to misperception of the magnitude of fish productivity, which can translate to suboptimal utilization of the resource. We describe approaches that are currently being applied to improve the assessment and management process for marine fish in situations where complex spatial structure has led to an observed mismatch between the scale of biological populations and spatially-defined stock units. The approaches include: (i) status quo management, (ii) "weakest link" management, (iii) spatial and temporal closures, (iv) stock composition analysis, and (v) alteration of stock boundaries. We highlight case studies in the North Atlantic that illustrate each approach and synthesize the lessons learned from these real-world applications. Alignment of biological and management units requires continual monitoring through the application of stock identification methods in conjunction with responsive management to preserve biocomplexity and the natural stability and resilience of fish species.</p

Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study.

OBJECTIVES: Assessing the burden of maternal mortality is important for tracking progress and identifying public health gaps. This paper provides an overview of the burden of maternal mortality in the Eastern Mediterranean Region (EMR) by underlying cause and age from 1990 to 2015. METHODS: We used the results of the Global Burden of Disease 2015 study to explore maternal mortality in the EMR countries. RESULTS: The maternal mortality ratio in the EMR decreased 16.3% from 283 (241-328) maternal deaths per 100,000 live births in 1990 to 237 (188-293) in 2015. Maternal mortality ratio was strongly correlated with socio-demographic status, where the lowest-income countries contributed the most to the burden of maternal mortality in the region. CONCLUSION: Progress in reducing maternal mortality in the EMR has accelerated in the past 15 years, but the burden remains high. Coordinated and rigorous efforts are needed to make sure that adequate and timely services and interventions are available for women at each stage of reproductive life

Multi-sensor satellite monitoring of ash and SO2 volcanic plume in support to aviation control

info:eu-repo/semantics/nonPublishe

Individual Differences in How Desirable People Think They Are as a Mate

Mate value is an important concept in mate choice research although its operationalization and understanding are limited. Here, we reviewed and evaluated previously established conceptual and methodological approaches measuring mate value and presented original research using individual differences in how people view themselves as a face-valid proxy for mate value in long- and short-term contexts. In data from 41 nations (N = 3895, Mage = 24.71, 63% women, 47% single), we tested sex, age, and relationship status effects on self-perceived mate desirability, along with individual differences in the Dark Triad traits, life history strategies, peer-based comparison of desirability, and self-reported mating success. Both sexes indicated more short-term than long-term mate desirability; however, men reported more long-term mate desirability than women, whereas women reported more short-term mate desirability than men. Further, individuals who were in a committed relationship felt more desirable than those who were not. Concerning the cross-sectional stability of mate desirability across the lifespan, in men, short- and long-term desirability rose to the age of 40 and 50, respectively, and decreased afterward. In women, short-term desirability rose to the age of 38 and decreased afterward, whereas long-term desirability remained stable over time. Our results suggest that measuring long- and short-term self-perceived mate desirability reveals predictable correlates