A female doctor (medica) at Augusta Emerita (Mérida)? Re-examining CIL II 497 from humanist readings to the latest digital epigraphy techniques

This paper provides a critical re-examination of a funerary altar (CIL ii 497) from Augusta Emerita (Mérida, Spain). It explores the strengths and weaknesses of all previous editions of the text from its first publication in 1633 to the present day, providing a critical review of the development of epigraphic scholarship on Mérida during this long period. Given the problems of all previous editions, including CIL ii 497, it then re-examines the altar using traditional epigraphic methods alongside the latest digital techniques (especially Morphological Residual Modelling, M.R.M.) to provide a new edition of the text, while setting the presence of a female doctor at the provincial capital of Lusitania into the broader social context of medical practitioners in Rome’s western provinces

The impact of 36 years of grazing management on soil nitrogen (N) supply rate and Salix repens N status and internal cycling in dune slacks

Aims: To determine the impact of long-term rabbit and sheep grazing on Salix repens N status (green and abscised leaf N content and C:N ratio), internal N dynamics and soil N supply rate in dune slacks. Methods: Herbivore exclosures were erected in dune slacks at Ainsdale Sand Dunes NNR, creating three grazing treatments: rabbit grazing; rabbits excluded for 36 years; rabbit grazing followed by sheep and rabbit grazing for 18 years. Soil N supply rate was analysed using ion exchange membranes; leaf N dynamics of S. repens were measured over one summer. Results: Soil N supply rate was higher in ungrazed plots. There was no difference in green leaf NMASS or C:N ratio between treatments, but N dynamics differed. Adding sheep to existing rabbit grazing reduced S. repens N resorption efficiency (REFF) from 67 to 37 %; excluding rabbits had no impact. Litter NMASS was lower and C:N ratio higher in ungrazed plots. Conclusions: Grazing can impact significantly on leaf N resorption, but this impact depends on the grazing regime

Post-Traumatic Stress Disorder (PTSD) Symptoms Predict Delay to Hospital in Patients with Acute Coronary Syndrome

Background: Increased delay to hospital presentation with acute coronary syndrome (ACS) is associated with poor outcomes. While demographic factors associated with this delay have been well described, scarce data are available on the role of modifiable factors, such as psychosocial disorders, on pre-hospital delay. Patients with symptoms of post-traumatic stress disorder (PTSD) often avoid stressful situations and may delay presenting for care when they experience cardiac symptoms. It is unknown, however, whether PTSD symptoms negatively impact the time to presentation during an ACS. Methods: We assessed the relationship between PTSD symptoms and pre-hospital delay in 241 adults with an ACS in the ongoing Prescription Use, Lifestyle, Stress Evaluation (PULSE) study. Results: Overall, 66 % of patients were male; 40 % were Hispanic or Latino. The mean age was 61.9611.6 years old. PTSD symptoms were present in 17.8 % of patients. Pre-hospital delay was longer for patients with PTSD symptoms compared to those without [geometric mean: 25.8 hours (95 % CI 13.8 – 44.8) vs. 10.7 hours (95 % CI 8.3 – 13.8)]; P = 0.005. After multivariable adjustment for age, sex, ethnicity, depression, left ventricular ejection fraction and history of myocardial infarction, the mean pre-hospital delay was 173 % (95 % CI: 36 % –450%) longer for patients with versus without PTSD symptoms. Conclusion: Among patients presenting with an ACS, PTSD symptoms were independently associated with longer prehospita

Association of acute coronary syndrome-induced posttraumatic stress disorder symptoms with self-reported sleep

Background Symptoms of posttraumatic stress disorder (PTSD) after acute coronary syndrome (ACS) are associated with recurrent ACS events and mortality. Poor sleep may be a mechanism, but the association between PTSD and sleep after ACS is unknown. Purpose This study aims to estimate the association between ACS-induced PTSD symptoms and self-reported sleep. Methods ACS-induced PTSD symptoms were assessed 1-month post-ACS in 188 adults using the Impact of Events Scale-Revised. Sleep was assessed using the Pittsburgh Sleep Quality Index. Linear and logistic regression models were used to determine whether PTSD symptoms were associated with self-reported sleep, independent of sociodemographic and clinical covariates. Results In adjusted models, ACS-induced PTSD symptoms were associated with worse overall sleep (β = 0.22, p = 0.003) and greater impairment in six of seven components of sleep (all p values <0.05). Conclusions ACS-induced PTSD symptoms may be associated with poor sleep, which may explain why PTSD confers increased cardiovascular risk after ACS

Posttraumatic stress disorder and risk for coronary heart disease: A meta-analytic review

Objective The aim of this study was to estimate the association of posttraumatic stress disorder (PTSD) with risk for incident coronary heart disease (CHD). Design A systematic review and meta-analysis were used as study designs. Data Sources Articles were identified by searching Ovid MEDLINE, PsycINFO, Scopus, Cochrane Library, PILOTS database, and PubMed Related Articles and through a manual search of reference lists (1948-present). Study Selection All studies that assessed PTSD in participants initially free of CHD and subsequently assessed CHD/cardiac-specific mortality were included. Data Extraction Two investigators independently extracted estimates of the association of PTSD with CHD, as well as study characteristics. Odds ratios were converted to hazard ratios (HRs), and a random-effects model was used to pool results. A secondary analysis including only studies that reported estimates adjusted for depression was conducted. Results Six studies met our inclusion criteria (N = 402,274); 5 of these included depression as a covariate. The pooled HR for the magnitude of the relationship between PTSD and CHD was 1.55 (95% CI 1.34-1.79) before adjustment for depression. The pooled HR estimate for the 5 depression-adjusted estimates (N = 362,950) was 1.27 (95% CI 1.08-1.49). Conclusion Posttraumatic stress disorder is independently associated with increased risk for incident CHD, even after adjusting for depression and other covariates. It is common in both military veterans and civilian trauma survivors, and these results suggest that it may be a modifiable risk factor for CHD. Future research should identify the mechanisms of this association and determine whether PTSD treatment offsets CHD risk

Meta-Analysis of Perceived Stress and Its Association With Incident Coronary Heart Disease

Most studies examining potential associations between psychological factors and cardiovascular outcomes have focused on depression or anxiety. The effect of perceived stress on incident coronary heart disease (CHD) has yet to be reviewed systematically. We conducted a systematic review and meta-analysis of the association between perceived stress and incident CHD. Ovid, MEDLINE, and PsycINFO were searched as data sources. Prospective observational cohort studies were selected that measured self-reported perceived stress and assessed incident CHD at ≥6 months. We extracted study characteristics and estimates of the risk of incident CHD associated with high perceived stress versus low perceived stress. We identified 23 potentially relevant articles, of which 6 met our criteria (n = 118,696). Included studies measured perceived stress with validated measurements and nonvalidated simple self-report surveys. Incident CHD was defined as new diagnosis of, hospitalization for, or mortality secondary to CHD. Meta-analysis yielded an aggregate risk ratio of 1.27 (95% confidence interval 1.12 to 1.45) for the magnitude of the relation between high perceived stress and incident CHD. In conclusion, this meta-analysis suggests that high perceived stress is associated with a moderately increased risk of incident CHD

Association of social support during emergency department evaluation for acute coronary syndrome with subsequent posttraumatic stress symptoms

We examined the associations of different aspects of social support during emergency department (ED) evaluation for an acute cardiac event with perceptions of threat in the ED and subsequent posttraumatic stress symptoms (PSS) in 484 patients. Participants were enrolled in the ED where they reported on their perceptions of threat in the ED. Social support in the ED and PSS were assessed at inpatient bedside or by telephone a median of 3 days later. Positive aspects of social support were not associated with subsequent PSS. Anxiety-provoking social support was significantly associated with increased PSS at follow-up. Greater ED threat perception partially mediated that relationship

An inexpensive device for monitoring patients' weights via automated hovering

Daily weight monitoring is integral to the management of heart failure (HF) [1]. Indeed, weight gain is a marker of HF decompensation, and daily weight monitoring has been associated with favorable prognosis [2]. Until now, assessment of weight has required patients to attend an in-person visit, which provides only an infrequent snapshot of their weight. Remote hovering practices have gained considerable traction during the past several years [3–7], but their use outside of research settings has been limited

Vitamin D Supplementation for Depressive Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials

OBJECTIVE: The aim of this study was to review the effects of vitamin D supplementation on depressive symptoms in randomized controlled trials. Although low vitamin D levels have been observationally associated with depressive symptoms, the effect of vitamin D supplementation as an antidepressant remains uncertain. METHODS: MEDLINE, CINAHL, AMED, PsycINFO, Scopus, The Cochrane Library, and references of included reports (through May 2013) were searched. Two independent reviewers identified and extracted data from randomized trials that compared the effect of vitamin D supplementation on depressive symptoms to a control condition. Two additional reviewers assessed study quality using The Cochrane Risk of Bias Tool. Seven trials (3191 participants) were included. RESULTS: Vitamin D supplementation had no overall effect on depressive symptoms (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], -0.33 to 0.05, p = .16), although considerable heterogeneity was observed. Subgroup analysis showed that vitamin D supplementation for participants with clinically significant depressive symptoms or depressive disorder had a moderate, statistically significant effect (2 studies: SMD, -0.60; 95% CI, -1.19 to -0.01; p = .046), but a small, nonsignificant effect for those without clinically significant depression (5 studies: SMD, -0.04; 95% CI, -0.20 to 0.12; p = .61). Most trials had unclear or high risk of bias. Studies varied in the amount, frequency, duration, and mode of delivery of vitamin D supplementation. CONCLUSIONS: Vitamin D supplementation may be effective for reducing depressive symptoms in patients with clinically significant depression; however, further high-quality research is needed

Preliminary assessment of the irradiation behaviour of the FeCrMnNi High-Entropy Alloy for nuclear applications

In the search for new nuclear materials with improved radiation tolerance and behavior, the high-entropy alloys (HEAs) have arisen as new candidates for structural components in nuclear reactors due to their suspected superior stability under irradiation. The metallurgical definition of HEAs is any alloy with multiple elements, five or more all in equiatomic compositions. The basic principle is the high mixing entropy of its solid solution lowers the Gibbs free energy giving a strong enhancement of the microstructural stability at low and high temperatures. The objective of this project is to assess the irradiation behaviour of the FeCrMnNi HEA system in order to investigate whether the high entropy effect is responsible for a microstructure with better radiation resistance compared to conventional alloys. In this work transmission electron microscopy (TEM) with in-situ ion irradiation has been used at the MIAMI-1 facility at the University of Huddersfield, UK: a 100 kV ion accelerator coupled with a JEOL JEM-2000FX TEM. This methodology allows the evolution of the HEA microstructure to be studied on the nanoscale during the ion irradiation