Timing of Antidepressant Discontinuation During Pregnancy and Postpartum Psychiatric Outcomes in Denmark and Norway

Importance: Approximately half of women discontinue antidepressant use during pregnancy, yet this could lead to relapse in the postpartum period. Objective: To investigate the associations between longitudinal antidepressant fill trajectories during pregnancy and postpartum psychiatric outcomes. Design and setting, and participants: Cohort study using nationwide registers in Denmark and Norway. Participants included 41,475 liveborn singleton pregnancies in Denmark (1997–2016) and 16,459 in Norway (2009–2018) for women who filled at least one antidepressant prescription within six months before pregnancy. Exposures: Antidepressant prescription fills were obtained from the prescription registers. Antidepressant treatment during pregnancy was modeled using longitudinal k-means. Main outcomes and measures: Initiating psycholeptics, psychiatric emergency, or records of self-harm within one year postpartum. Hazard ratio (HR) of each psychiatric outcome was estimated using Cox regression models. Inverse probability of treatment weighting was used to control for confounding. Country-specific HRs were pooled using random-effects meta-analytic models. Results: Of 57,934 pregnancies (mean maternal age range across countries: 30.7– ?? years), [XL1] our trajectories were identified: early discontinuers (about 30% of the population), late discontinuers (previously stable users) (20–25%), late discontinuers (short-term users) (15–20%), and continuers (25–30%). Early discontinuers and late discontinuers (short-term users) had a lower probability of initiating psycholeptics and having postpartum psychiatric emergencies compared to continuers. We found a moderately increased probability of initiation of psycholeptics among late discontinuers (previously stable users) compared to continuers (HR=1.13, 95% CI: 1.03–1.24). This increase in late discontinuers (previously stable users) was more pronounced among women with previous affective disorders (HR=1.28, 95% CI: 1.12–1.47). No association between antidepressant fill trajectories and postpartum self-harm risk was found. Conclusions and Relevance: Using pooled data from Denmark and Norway, we found a moderately elevated probability of initiation of psycholeptics in late discontinuers (previously stable users) compared to continuers. [XL1]Mean (SD) age of the study population was 30.7(5.3) year

Tidal friction in close-in satellites and exoplanets. The Darwin theory re-visited

This report is a review of Darwin's classical theory of bodily tides in which we present the analytical expressions for the orbital and rotational evolution of the bodies and for the energy dissipation rates due to their tidal interaction. General formulas are given which do not depend on any assumption linking the tidal lags to the frequencies of the corresponding tidal waves (except that equal frequency harmonics are assumed to span equal lags). Emphasis is given to the cases of companions having reached one of the two possible final states: (1) the super-synchronous stationary rotation resulting from the vanishing of the average tidal torque; (2) the capture into a 1:1 spin-orbit resonance (true synchronization). In these cases, the energy dissipation is controlled by the tidal harmonic with period equal to the orbital period (instead of the semi-diurnal tide) and the singularity due to the vanishing of the geometric phase lag does not exist. It is also shown that the true synchronization with non-zero eccentricity is only possible if an extra torque exists opposite to the tidal torque. The theory is developed assuming that this additional torque is produced by an equatorial permanent asymmetry in the companion. The results are model-dependent and the theory is developed only to the second degree in eccentricity and inclination (obliquity). It can easily be extended to higher orders, but formal accuracy will not be a real improvement as long as the physics of the processes leading to tidal lags is not better known.Comment: 30 pages, 7 figures, corrected typo

Shock location and CME 3D reconstruction of a solar type II radio burst with LOFAR

Context. Type II radio bursts are evidence of shocks in the solar atmosphere and inner heliosphere that emit radio waves ranging from sub-meter to kilometer lengths. These shocks may be associated with coronal mass ejections (CMEs) and reach speeds higher than the local magnetosonic speed. Radio imaging of decameter wavelengths (20–90 MHz) is now possible with the Low Frequency Array (LOFAR), opening a new radio window in which to study coronal shocks that leave the inner solar corona and enter the interplanetary medium and to understand their association with CMEs. Aims. To this end, we study a coronal shock associated with a CME and type II radio burst to determine the locations at which the radio emission is generated, and we investigate the origin of the band-splitting phenomenon. Methods. Thetype II shock source-positions and spectra were obtained using 91 simultaneous tied-array beams of LOFAR, and the CME was observed by the Large Angle and Spectrometric Coronagraph (LASCO) on board the Solar and Heliospheric Observatory (SOHO) and by the COR2A coronagraph of the SECCHI instruments on board the Solar Terrestrial Relation Observatory(STEREO). The 3D structure was inferred using triangulation of the coronographic observations. Coronal magnetic fields were obtained from a 3D magnetohydrodynamics (MHD) polytropic model using the photospheric fields measured by the Heliospheric Imager (HMI) on board the Solar Dynamic Observatory (SDO) as lower boundary. Results. The type II radio source of the coronal shock observed between 50 and 70 MHz was found to be located at the expanding flank of the CME, where the shock geometry is quasi-perpendicular with θBn ~ 70°. The type II radio burst showed first and second harmonic emission; the second harmonic source was cospatial with the first harmonic source to within the observational uncertainty. This suggests that radio wave propagation does not alter the apparent location of the harmonic source. The sources of the two split bands were also found to be cospatial within the observational uncertainty, in agreement with the interpretation that split bands are simultaneous radio emission from upstream and downstream of the shock front. The fast magnetosonic Mach number derived from this interpretation was found to lie in the range 1.3–1.5. The fast magnetosonic Mach numbers derived from modelling the CME and the coronal magnetic field around the type II source were found to lie in the range 1.4–1.6

In vitro and in situ activation of the complement system by the fungus Lacazia loboi

Since there are no studies evaluating the participation of the complement system (CS) in Jorge Lobo's disease and its activity on the fungus Lacazia loboi, we carried out the present investigation. Fungal cells with a viability index of 48% were obtained from the footpads of BALB/c mice and incubated with a pool of inactivated serum from patients with the mycosis or with sterile saline for 30 min at 37 ºC. Next, the tubes were incubated for 2 h with a pool of noninactivated AB+ serum, inactivated serum, serum diluted in EGTA-MgCl2, and serum diluted in EDTA. The viability of L. loboi was evaluated and the fungal suspension was cytocentrifuged. The slides were submitted to immunofluorescence staining using human anti-C3 antibody. The results revealed that 98% of the fungi activated the CS by the alternative pathway and no significant difference in L. loboi viability was observed after CS activation. In parallel, frozen histological sections from 11 patients were analyzed regarding the presence of C3 and IgG by immunofluorescence staining. C3 and IgG deposits were observed in the fungal wall of 100% and 91% of the lesions evaluated, respectively. The results suggest that the CS and immunoglobulins may contribute to the defense mechanisms of the host against L. loboi