The epidemiology of excess mortality in people with mental illness

Objective: To investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. Method: We conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. Results: There is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. Conclusions: Without the development of alternative approaches to promoting and treating the physical health of people with mental illness, it is possible that the disparity in mortality outcomes will persist

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Stability and nonlinear adjustment of vortices in Keplerian flows

We investigate the stability, nonlinear development and equilibrium structure of vortices in a background shearing Keplerian flow. We make use of high-resolution global two-dimensional compressible hydrodynamic simulations. We introduce the concept of nonlinear adjustment to describe the transition of unbalanced vortical fields to a long-lived configuration. We discuss the conditions under which vortical perturbations evolve into long-lived persistent structures and we describe the properties of these equilibrium vortices. The properties of equilibrium vortices appear to be independent from the initial conditions and depend only on the local disk parameters. In particular we find that the ratio of the vortex size to the local disk scale height increases with the decrease of the sound speed, reaching values well above the unity. The process of spiral density wave generation by the vortex, discussed in our previous work, appear to maintain its efficiency also at nonlinear amplitudes and we observe the formation of spiral shocks attached to the vortex. The shocks may have important consequences on the long term vortex evolution and possibly on the global disk dynamics. Our study strengthens the arguments in favor of anticyclonic vortices as the candidates for the promotion of planetary formation. Hydrodynamic shocks that are an intrinsic property of persistent vortices in compressible Keplerian flows are an important contributor to the overall balance. These shocks support vortices against viscous dissipation by generating local potential vorticity and should be responsible for the eventual fate of the persistent anticyclonic vortices. Numerical codes have be able to resolve shock waves to describe the vortex dynamics correctly.Comment: 12 pages, 10 figure

Human Infection Caused by Leptospira fainei

We report a human case of leptospirosis in which the spirochete was detected by dark-field microscopy examination of cerebrospinal fluid (CSF) and isolated from both CSF and blood. Leptospira fainei was identified by sequencing the 16S rDNA gene, which had been amplified by polymerase chain reaction. This case confirms the role of L. fainei as a human pathogen and extends its distribution to southern Europe