Together alone: Social dysfunction in neuropsychiatric disorders

In chapter 2, we examined social functioning among 2952 NESDA-participants (healthy controls N=650, individuals remitted from anxiety and/or depressive disorder N=621, patients with anxiety disorder only N=540, depressive disorder only N=393 or comorbid anxiety and depressive disorders N=748) using affective and behavioral indicators. We found significant social dysfunction in patients with anxiety disorders, and to an even higher degree in those with depressive disorders, and most prominently in patients with comorbid anxiety and depressive disorders. In addition, our study also showed that both affective and behavioral aspects of social dysfunction were compromised, with affective aspects being the more severely impaired in all groups as compared to healthy controls. The affective indicators loneliness and perceived social disability, in addition to the behavioral indicator social network size, showed the largest effect sizes for the patients with comorbid anxiety and depression, as compared to healthy controls (Cohen’s d ranging from 0.81- 1.76). We also described that even after remission of affective psychopathology, residual impairments in social functioning tended to remain in social network size, social support, loneliness, and perceived social disability. Importantly, we also established that perceived social disability among patients is predictive of a depressive and/or anxiety diagnosis as much as two years later. Chapter 3 describes social dysfunction in schizophrenia and Alzheimer’s disease patients (N=164) using behavioral and affective indicators of social dysfunction. Building on the findings of the NESDA study described above, we used perceived social disability and loneliness as affective indicators of social dysfunction, and we added a rater-perceived social disability questionnaire. The individual subscales of the Social Functioning Scale and its total score were used as behavioral indicators of social dysfunction. In this PRISM sample, both SZ (N=56) and AD (N=50) patients exhibited more social dysfunction when compared with age- and sex matched HC participants (HC younger N=29; HC older N=28). As compared to HC, both behavioral and affective social functioning were poorer in SZ patients (Cohens d’s 0.81-1.69), whereas AD patients exhibited poorer behavioral social function (Cohen’s d’s 0.65-1.14). Comparing the patient groups exclusively, we found that the behavioral aspects of social functioning were fairly similar, with the affective indices being less favorable for the SZ patients, who were found to have greater feelings of loneliness and perceived social disability than did the AD patients. Chapter 4 examines whether DMN connectional integrity among MDD patients (N=74) covaries with individual scores on an integrated social dysfunction composite, composed of behavioral and affective features. Building on findings described above, we used the network size as behavioral indicator and we used perceived social disability and loneliness as our affective indicators of social dysfunction. The analyses cautiously linked greater social dysfunction among MDD patients to diminished DMN connectivity, specifically within the rostromedial prefrontal cortex and posterior superior frontal gyrus. These effects were most prominent when high and low social dysfunctioning MDD groups were compared, with the dimensional effects being more subtle. In chapter 5, we explored DMN integrity as a function of social dysfunction among SZ (N=48) and AD (N=47) patients, as well as age-matched healthy controls (HC; N=55). Social dysfunction was operationalized using the SFS as behavioral indicator of social dysfunction and loneliness as an affective indicator. Our analyses interestingly showed that affective and behavioral indicators of social dysfunction are independently associated with diminished DMN connectional integrity, specifically within rostromedial prefrontal subterritories of the DMN. The combined average effect of these indicators on diminished DMN connectivity was even more pronounced (both spatially and statistically), comprising large sections of rostromedial and dorsomedial prefrontal cortex

Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection An international audit by ESCP and S-ECCO

Background Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. Aim To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. This study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, re-operation, surgical site infection and length of stay at hospital. Multivariable binary logistic regression analyses were used to produce odds ratios (OR) and 95% confidence intervals (CI). Results Three hundred and seventy five resections in 375 patients were included. The median age was 37 and 57.1% were female. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36 95% CI 1.10-4.97)], urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intraoperative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, CI [1.08-1.61]) and those who had urgent/expedited operations (OR 1.21, CI [1.07-1.37]). Conclusion Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intraoperative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients

GOES I/M image navigation and registration

Image Navigation and Registration (INR) is the system that will be used on future Geostationary Operational Environmental Satellite (GOES) missions to locate and register radiometric imagery data. It consists of a semiclosed loop system with a ground-based segment that generates coefficients to perform image motion compensation (IMC). The IMC coefficients are uplinked to the satellite-based segment, where they are used to adjust the displacement of the imagery data due to movement of the imaging instrument line-of-sight. The flight dynamics aspects of the INR system is discussed in terms of the attitude and orbit determination, attitude pointing, and attitude and orbit control needed to perform INR. The modeling used in the determination of orbit and attitude is discussed, along with the method of on-orbit control used in the INR system, and various factors that affect stability. Also discussed are potential error sources inherent in the INR system and the operational methods of compensating for these errors

Asymptotic Behavior of Ext functors for modules of finite complete intersection dimension

Let $R$ be a local ring, and let $M$ and $N$ be finitely generated $R$-modules such that $M$ has finite complete intersection dimension. In this paper we define and study, under certain conditions, a pairing using the modules \Ext_R^i(M,N) which generalizes Buchweitz's notion of the Herbrand diference. We exploit this pairing to examine the number of consecutive vanishing of \Ext_R^i(M,N) needed to ensure that \Ext_R^i(M,N)=0 for all $i\gg 0$. Our results recover and improve on most of the known bounds in the literature, especially when $R$ has dimension at most two