Paternity analysis of pollen-mediated gene flow for Fraxinus excelsior L. in a chronically fragmented landscape

Paternity analysis based on microsatellite marker genotyping was used to infer contemporary genetic connectivity by pollen of three population remnants of the wind-pollinated, wind-dispersed tree Fraxinus excelsior, in a deforested Scottish landscape. By deterministically accounting for genotyping error and comparing a range of assignment methods, individual-based paternity assignments were used to derive population-level estimates of gene flow. Pollen immigration into a 300ha landscape represents between 43% and 68% of effective pollination, mostly depending on assignment method. Individual male reproductive success is unequal, with 31 of 48 trees fertilising one seed or more, but only three trees fertilising more than ten seeds. Spatial analysis suggests a fat-tailed pollen dispersal curve with 85% of detected pollination occurring within 100m, and 15% spreading between 300m and 1900m from the source. Identification of immigrating pollen sourced from two neighbouring remnants indicates further effective dispersal at 2900m. Pollen exchange among remnants is driven by population size rather than geographic distance, with larger remnants acting predominantly as pollen donors, and smaller remnants as pollen recipients. Enhanced wind dispersal of pollen in a barren landscape ensures that the seed produced within the catchment includes genetic material from a wide geographic area. However, gene flow estimates based on analysis of non-dispersed seeds were shown to underestimate realised gene immigration into the remnants by a factor of two suggesting that predictive landscape conservation requires integrated estimates of post-recruitment gene flow occurring via both pollen and seed

Primary Care and Youth Mental Health in Ireland: Qualitative Study in Deprived Urban Areas

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people\u27s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals\u27 experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16-25 years) in primary care in deprived urban settings in Ireland. METHODS: The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. RESULTS: We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care\u27s longitudinal nature as a key asset in promoting treatment engagement. CONCLUSIONS: Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people\u27s experience and developing complex interventions that promote early intervention are priorities

The most powerful flaring activity from the NLSy1 PMN J0948+0022

We report on multifrequency observations performed during 2012 December-2013 August of the first narrow-line Seyfert 1 galaxy detected in gamma rays, PMN J0948+0022 ($z$ = 0.5846). A gamma-ray flare was observed by the Large Area Telescope on board Fermi during 2012 December-2013 January, reaching a daily peak flux in the 0.1-100 GeV energy range of (155 $\pm$ 31) $\times$10$^{-8}$ ph cm$^{-2}$ s$^{-1}$ on 2013 January 1, corresponding to an apparent isotropic luminosity of about 1.5$\times$10$^{48}$ erg s$^{-1}$. The gamma-ray flaring period triggered Swift and VERITAS observations in addition to radio and optical monitoring by OVRO, MOJAVE, and CRTS. A strong flare was observed in optical, UV, and X-rays on 2012 December 30, quasi-simultaneously to the gamma-ray flare, reaching a record flux for this source from optical to gamma rays. VERITAS observations at very high energy (E > 100 GeV) during 2013 January 6-17 resulted in an upper limit of F (> 0.2 TeV) < 4.0$\times$10$^{-12}$ ph cm$^{-2}$ s$^{-1}$. We compared the spectral energy distribution (SED) of the flaring state in 2013 January with that of an intermediate state observed in 2011. The two SEDs, modelled as synchrotron emission and an external Compton scattering of seed photons from a dust torus, can be modelled by changing both the electron distribution parameters and the magnetic field.Comment: 13 pages, 5 Figures, 5 Tables. Accepted for publication in Monthly Notices of the Royal Astronomical Societ

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Performance aspects of IMS

This paper deals with the tuning of the data base management system IMS. We will look at IMS in some detail; in particular, we will consider those aspects of IMS which are thought to have a measurable effect on performance at an IMS installation. These are: the original design of the data base, the adoption of logical relationships and secondary indexes and the choice of access method. Other features are thought to have a lesser effect but some of these will also be considered. These aspects will be evaluated by their ability to decrease processing time, increase flexibility and/or decrease storage requirements. The proposals presented in the first part of the paper will be further evaluated in the final chapter. The experiences of three IMS users will be incorporated to support or refute these proposals, as well as to provide insight into the kinds of performance studies being done, when they are done and what results are expected.Science, Faculty ofComputer Science, Department ofGraduat

Can general practice help address youth mental health? A retrospective cross-sectional study in Dublin\u27s south inner city

Aims: With general practice potentially having an important role in early intervention of mental and substance use disorders among young people, we aim to explore this issue by determining the prevalence of psychological problems and general practice/health service utilization among young people attending general practice. Methods: A retrospective cross-sectional study of patients attending three general practices in Dublin city. Results: Among a sample of young people (mostly women, 44% general medical services (GMS) eligible), we observed considerable contact with general practice, both lifetime and for the 2 years of the study. The mean consultation rate was 3.9 consultations in 2 years and psychosocial issues (most commonly stress/anxiety and depression) were documented in 35% of cases. Identification of psychosocial issues was associated with GMS eligibility, three or more doctor consultations, and documentation of smoking and drinking status. Conclusions: Psychosocial issues are common among young people attending general practice and more work on their epidemiology and further identification in general practice are advocated.ACCEPTEDpeer-reviewe

Identified mental disorders in older adults in primary care: a cross-sectional database study

Introduction: Identifying and managing mental disorders among older adults is an important challenge for primary care in Europe. Electronic medical records (EMRs) offer considerable potential in this regard, although there is a paucity of data on their use for this purpose. Objectives: To examine the prevalence/treatment of identified mental disorders among older adults (over 55 years) by using data derived from EMRs in general practice. Methods: We utilized data from a cross-sectional study of mental disorders in primary care, which identified patients with mental disorders based on diagnostic coding and prescribed medicines. We collected anonymized data from 35 practices nationally from June 2014 to March 2015, and secondary analysis of this dataset examined the prevalence of mental disorders in adults aged over 55 years. Results: 74,261 patients aged over 55 years were identified, of whom 14,143 had a mental health disorder (prevalence rate of 19.1%). There was considerable variation between practices (range: 3.7–38.9%), with a median prevalence of 23.1%. Prevalence increased with age, from 14.8% at 55–59 years to 28.9% at 80–84 years. Most common disorders were depression (17.1%), panic/anxiety (11.3%), cognitive (5.6%), alcohol (3.8%) and substance use (3.8%). Conclusions: Examining mental disorders among older adults using data derived from EMRs is feasible. Mental disorders are common among older adults attending primary care and this study demonstrates the utility of electronic medical records in epidemiological studies of large populations in primary care

Necrotising fasciitis in the COVID-19 era: A consequence of caution – A case series

Necrotising fasciitis (NF) is a severe soft tissue infection that is associated with a high risk of morbidity and  mortality. During the coronavirus disease 19 (COVID-19) pandemic, the population has been actively discouraged from presenting to emergency medical services unless absolutely necessary. While this was an important  step in allowing for preservation of limited resources in a time of crisis, it may have resulted in immeasurable  ‘secondary victims’ of the pandemic as patients with time-critical conditions delay hospital presentation. In this  case series, we describe three patients that noted symptoms of soft tissue infection, but delayed seeking  healthcare advice due to concerns regarding COVID-19 exposure. All three progressed to NF, requiring highly  morbid wide surgical debridement and prolonged hospital admission, with a high risk of potential mortality. The  findings of this series demonstrate the importance of consistently delivering appropriate and timely healthcare  interventions to patients with non-COVID-19-related conditions. While efforts must be made to ensure preservation of valuable healthcare resources in a global pandemic, patients must also be empowered to seek timely  care for non-COVID-19-related conditions even in this time of crisis. </p

Can general practice help address youth mental health? A retrospective cross-sectional study in Dublin's south inner city

Aims: With general practice potentially having an important role in early intervention of mental and substance use disorders among young people, we aim to explore this issue by determining the prevalence of psychological problems and general practice/health service utilization among young people attending general practice. Methods: A retrospective cross-sectional study of patients attending three general practices in Dublin city. Results: Among a sample of young people (mostly women, 44% general medical services (GMS) eligible), we observed considerable contact with general practice, both lifetime and for the 2 years of the study. The mean consultation rate was 3.9 consultations in 2 years and psychosocial issues (most commonly stress/anxiety and depression) were documented in 35% of cases. Identification of psychosocial issues was associated with GMS eligibility, three or more doctor consultations, and documentation of smoking and drinking status. Conclusions: Psychosocial issues are common among young people attending general practice and more work on their epidemiology and further identification in general practice are advocated