Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS

Aim: To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS). Methods: The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences. Results: Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS. Conclusions: Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses

Coccolithophore ecology in the tropical and subtropical Atlantic Ocean: New perspectives from the Atlantic Meridional Transect (AMT) programme

Coccolithophore species composition was determined in 199 samples collected from the upper 300 m of the Atlantic Ocean, spanning temperate, tropical and subtropical waters in both hemispheres during four Atlantic Meridional Transect (AMT) cruises over the period 2003 to 2005. Of the 171 taxa observed, 140 consistently represented less than 5% of total cell numbers, and were classed as rare. Multivariate statistical techniques were used on the common taxa to assess variability in community composition vertically in the water column, horizontally across hydrographic provinces (subtropical gyres, equatorial waters, temperate waters), and temporally between cruises. Sharper gradients of statistical dissimilarity in species composition occurred vertically over a few tens of metres than horizontally over hundreds of kilometres. Three floral groups were identified from analysis of the depth of normalised abundance maxima in the subtropical gyres and equatorial waters: the upper euphotic zone (UEZ, >10% surface irradiance); the lower euphotic zone (LEZ, 10-1% surface irradiance); and the sub-euphotic zone (SEZ, <1% surface irradiance). The LEZ includes the deep chlorophyll maximum (DCM) and nutricline, and was characterised by species such as Emiliania huxleyi and Gephyrocapsa ericsonii which were also abundant at higher latitudes. It is suggested that this pattern reflects similarities in the light (and inorganic nutrient) conditions between the LEZ and temperate waters. The SEZ is below the depth where light is thought to be sufficient to support photosynthesis, suggesting that deep-dwelling species such as Florisphaera profunda and Gladiolithus spp. may be mixotrophic or phagotrophic, although conclusive proof will need to be gained experimentally. Mixotrophy could also be an important nutritional strategy for species abundant (Umbellosphaera spp., holococcolithophores) in the UEZ where inorganic nutrient concentrations are depleted and limiting to growth, although other nutritional strategies, such as the use of organic nutrients, are also possible. Statistical differences were also found in the species composition between the different cruises, with high levels of similarity for similar timed cruises (May or September-October). Few individual taxa showed significant variability in abundance over the time-span of sampling, except species such as E. huxleyi and G. ericsonii at higher latitudes. In subtropical and equatorial waters, high levels of species richness and low levels of species dominance remained throughout the sampling period indicating that seasonal fluctuations reflected differences in the whole coccolithophore community rather than in just one or a few species. Multivariate analyses of the taxa classified as rare also indicated some level of temporal, as well as vertical, zonation. Such insights into coccolithophore ecology and community composition provide important new perspectives that require innovative research to fully understand their impact on ocean biogeochemistry

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally

An Updated Study of Discovering Blawan-Ijen Geothermal Prospect Area Using Gravity and Magnetic Methods

The Blawan-Ijen volcanic complex is located in Bondowoso regencies, East Java province. The complex is expected to have geothermal system which is indicated by the occurrence of Blawan hotspring, acid lake on Ijen Crater and alterations. In 2017, measurements of gravity and magnetic methods have been conducted for the first time through the PITTA 2017 program. In 2018, further measurements are carried out to infill the previous data in order to strengthen the interpretation results. There are 151 stations obtained from each method until 2018. In this study, gravity method is used to detect the contrast density of an anomalous body while magnetic method is applied to discover the location of demagnetization zone. This paper presents the integration of both methods in geothermal exploration to determine the geothermal prospect area. The result of CBA and residual gravity indicated the existence of high gravity anomaly in the center to the southwest of the study area. Moreover, after processing RTP on magnetic data, there is the presence of low magnetic anomaly usually associated with demagnetization zone. Generally, the overall results supported one each other and pointed out the occurrence of the geothermal prospect possibly around the center of the study area

An Updated Study of Discovering Blawan-Ijen Geothermal Prospect Area Using Gravity and Magnetic Methods

The Blawan-Ijen volcanic complex is located in Bondowoso regencies, East Java province. The complex is expected to have geothermal system which is indicated by the occurrence of Blawan hotspring, acid lake on Ijen Crater and alterations. In 2017, measurements of gravity and magnetic methods have been conducted for the first time through the PITTA 2017 program. In 2018, further measurements are carried out to infill the previous data in order to strengthen the interpretation results. There are 151 stations obtained from each method until 2018. In this study, gravity method is used to detect the contrast density of an anomalous body while magnetic method is applied to discover the location of demagnetization zone. This paper presents the integration of both methods in geothermal exploration to determine the geothermal prospect area. The result of CBA and residual gravity indicated the existence of high gravity anomaly in the center to the southwest of the study area. Moreover, after processing RTP on magnetic data, there is the presence of low magnetic anomaly usually associated with demagnetization zone. Generally, the overall results supported one each other and pointed out the occurrence of the geothermal prospect possibly around the center of the study area

Global SEM coccolithophore abundance compilation

Coccolithophores are globally important marine calcifying phytoplankton. They contribute to the organic carbon pump through the primary production and the ballast of organic matter, and to the carbonate pump through the production of calcium carbonate. Here we compiled all available scanning electron microscopy (SEM) coccolithophore abundance observations. Taxa were standardized following NannoTax3 to a species level where possible. Subspecies (e.a. C. leptoporus subsp. leptoporus and C. leptoporus subsp. quadriperforatus) were grouped as single species. The database contains 2556 abundance observations from 35 different publications. The data span the period of 1993-2017, with observations from all ocean basins and all seasons, and at depths ranging from the surface to 5000 m. We limited our compilation to SEM observations (or observations which further identified samples with SEM) because SEM provides greater detail of coccolithophore diversity than more commonly used polarized light microscopy. Although this limits the number of observations, this allows for a more in-depth analysis of coccolithophore ecology, such as the ecological significance of the coccolithophore life cycle