113 research outputs found

    Torsion of a cylinder of partially molten rock with a spherical inclusion: Theory and simulation

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    The processes that are involved in migration and extraction of melt from the mantle are not yet fully understood. Gaining a better understanding of material properties of partially molten rock could help shed light on the behavior of melt on larger scales in the mantle. In this study, we simulate three-dimensional torsional deformation of a partially molten rock that contains a rigid, spherical inclusion. We compare the computed porosity patterns to those found in recent laboratory experiments. The laboratory experiments show emergence of melt-rich bands throughout the rock sample, and pressure shadows around the inclusion. The numerical model displays similar melt-rich bands only for a small bulk-to-shear-viscosity ratio (five or less). The results are consistent with earlier two-dimensional numerical simulations; however, we show that it is easier to form melt-rich bands in three dimensions compared to two. The addition of strain-rate dependence of the viscosity causes a distinct change in the shape of pressure shadows around the inclusion. This change in shape presents an opportunity for experimentalists to identify the strain-rate dependence and therefore the dominant deformation mechanism in torsion experiments with inclusions.This work was supported by the UK Natural Environment Research Council under grants NE/I023929/1 and NE/I026995/1. Computations were performed on the ARCHER UK National Supercomputing Service (http://www.archer.ac.uk). We thank Chris Richardson for all his support with running the simulations on ARCHER. Katz thanks the Leverhulme Trust for support.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1002/2015GC00606

    Torsion of a cylinder of partially molten rock with a spherical inclusion: Theory and simulation

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    The processes that are involved in migration and extraction of melt from the mantle are not yet fully understood. Gaining a better understanding of material properties of partially molten rock could help shed light on the behavior of melt on larger scales in the mantle. In this study, we simulate three-dimensional torsional deformation of a partially molten rock that contains a rigid, spherical inclusion. We compare the computed porosity patterns to those found in recent laboratory experiments. The laboratory experiments show emergence of melt-rich bands throughout the rock sample, and pressure shadows around the inclusion. The numerical model displays similar melt-rich bands only for a small bulk-to-shear-viscosity ratio (five or less). The results are consistent with earlier two-dimensional numerical simulations; however, we show that it is easier to form melt-rich bands in three dimensions compared to two. The addition of strain-rate dependence of the viscosity causes a distinct change in the shape of pressure shadows around the inclusion. This change in shape presents an opportunity for experimentalists to identify the strain-rate dependence and therefore the dominant deformation mechanism in torsion experiments with inclusions

    Pharmacological prevention of postictal agitation after electroconvulsive therapyā€”A systematic review and meta-analysis

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    BackgroundPostictal agitation (PIA) after electroconvulsive therapy (ECT) is a serious clinical problem estimated to occur in 7ā€“36% of patients and recur in 19ā€“54% of patients. PIA has the potential to cause dangerous situations for the patient and staff members aside from the financial impact. To date, it is unclear which pharmacological interventions should be used in the management of PIA. This study aimed to systematically review the (preventative) pharmacological treatment options for PIA after ECT.MethodA systematic search was done in PubMed, EMBASE, PsycINFO, and Web of Science from inception until 10 November 2022. We included randomized trials with any pharmacological intervention or comparison and a predefined outcome measure on PIA. Studies that solely included patients with neurodegenerative disorders or stroke were excluded. Data quality was assessed with the RoB2 and GRADE. Meta-analysis was performed if possible. This study was registered on PROSPERO under CRD42021262323.ResultsWe screened 2,204 articles and included 14 studies. Dexmedetomidine was investigated in 10 studies. Alfentanil, lignocaine, esmolol, midazolam, propofol, ketamine, haloperidol, and diazepam were each studied in only one study. Meta-analysis revealed an OR of 0.45 (0.32ā€“0.63), a moderate effect size, in favor of dexmedetomidine than placebo to prevent PIA with very low heterogeneity (I2 = 0%). The certainty of the evidence was moderate. The other interventions studied were all found to have low certainty of evidence.ConclusionFor clinical practice, we believe that our results indicate that dexmedetomidine should be considered for the prevention of PIA in patients that have previously experienced PIA

    Transient Cognitive Impairment and White Matter Hyperintensities in Severely Depressed Older Patients Treated With Electroconvulsive Therapy

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    BACKGROUND: Although electroconvulsive therapy (ECT) is a safe and effective treatment for patients with severe late life depression (LLD), transient cognitive impairment can be a reason to discontinue the treatment. The aim of the current study was to evaluate the association between structural brain characteristics and general cognitive function during and after ECT. METHODS: A total of 80 patients with LLD from the prospective naturalistic follow-up Mood Disorders in Elderly treated with Electroconvulsive Therapy study were examined. Magnetic resonance imaging scans were acquired before ECT. Overall brain morphology (white and grey matter) was evaluated using visual rating scales. Cognitive functioning before, during, and after ECT was measured using the Mini Mental State Examination (MMSE). A linear mixed-model analysis was performed to analyze the association between structural brain alterations and cognitive functioning over time. RESULTS: Patients with moderate to severe white matter hyperintensities (WMH) showed significantly lower MMSE scores than patients without severe WMH (F(1,75.54)ā€Æ=ā€Æ5.42, pā€Æ=ā€Æ0.02) before, during, and post-ECT, however their trajectory of cognitive functioning was similar as no time Ɨ WMH interaction effect was observed (F(4,65.85)ā€Æ=ā€Æ1.9, pā€Æ=ā€Æ0.25). Transient cognitive impairment was not associated with medial temporal or global cortical atrophy (MTA, GCA). CONCLUSION: All patients showed a significant drop in cognitive functioning during ECT, which however recovered above baseline levels post-ECT and remained stable until at least 6 months post-ECT, independently of severity of WMH, GCA, or MTA. Therefore, clinicians should not be reluctant to start or continue ECT in patients with severe structural brain alterations

    Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

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    OBJECTIVE: Apathy symptoms are defined as a lack of interest and motivation. Patients with late-life depression (LLD) also suffer from lack of interest and motivation and previous studies have linked apathy to vascular white matter hyperintensities (WMH) of the brain in depressed and nondepressed patients. The aim of this study was to investigate the relationship between apathy symptoms, depressive symptoms, and WMH in LLD. We hypothesize that late-onset depression (LOD; first episode of depression after 55 years of age) is associated with WMH and apathy symptoms. METHODS: Apathy scores were collected for 87 inpatients diagnosed with LLD. Eighty patients underwent brain magnetic resonance imaging. Associations between depressive and apathy symptoms and WMH were analyzed using linear regression. RESULTS: All 3 subdomains of the 10-item Montgomeryā€“Ć…sberg Depression Rating Scale correlated significantly with the apathy scale score (all P < .05). In the total sample, apathy nor depressive symptoms were related to specific WMH. In LOD only, periventricular WMH were associated with depression severity (Ī² = 5.21, P = .04), while WMH in the left infratentorial region were associated with apathy symptoms (Ī² coefficient = 5.89, P = .03). CONCLUSION: Apathy and depressive symptoms are highly overlapping in the current cohort of older patients with severe LLD, leading to the hypothesis that apathy symptoms are part of depressive symptoms in the symptom profile of older patients with severe LLD. Neither apathy nor depressive symptoms were related to WMH, suggesting that radiological markers of cerebrovascular disease, such as WMH, may not be useful in predicting these symptoms in severe LLD

    The impact of a history of child abuse on cognitive performance:a cross-sectional study in older patients with a depressive, anxiety, or somatic symptom disorder

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    Background: Child abuse is a major global burden with an enduring negative impact on mental and physical health. A history of child abuse is consistently associated with worse cognitive performance among adults; data in older age groups are inconclusive. Since affective symptoms and cognitive functioning are interrelated among older persons, a synergistic effect can be assumed in patients with affective symptoms who also have suffered from child abuse. This study examines the association between a history of child abuse and cognitive performance in such patients. Methods: Cross-sectional data were collected from the ā€˜Routine Outcome Monitoring for Geriatric Psychiatry & Scienceā€™ project, including 179 older adults (age 60ā€“88 years) with either a unipolar depressive, any anxiety, or somatic symptom disorder referred to specialized geriatric mental health care. A history of physical, sexual, and psychological abuse, and emotional neglect was assessed with a structured interview. Cognitive functioning was measured with three paper and pencils tests (10-words verbal memory test, Stroop Colour-Word test, Digit Span) and four tests from the computerized Cogstate Test Battery (Detection Test, Identification Test, One Card Learning Test, One Back Test). The association between a history of child abuse and cognitive performance was examined by multiple linear regression analyses adjusted for covariates. Results: Principal component analyses of nine cognitive parameters revealed four cognitive domains, i.e., visual-verbal memory, psychomotor speed, working memory and interference control. A history of child abuse was not associated with any of these cognitive domains. However, when looking at the specific types of child abuse separately, a history of physical abuse and emotional neglect were associated with poorer interference control. A history of physical abuse was additionally associated with better visual-verbal memory. Conclusions: The association between a history of child abuse and cognitive performance differs between the different types of abuse. A history of physical abuse might particularly be a key determinant of cognitive performance in older adults with a depressive, anxiety, or somatic symptom disorder. Future studies on the impact of these disorders on the onset of dementia should take child abuse into account. Trial registration: ROM-GPS is registered at the Dutch Trial Register (NL6704 at www.trialregister.nl)

    An online network tool for quality information to answer questions about occupational safety and health: usability and applicability

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    <p>Abstract</p> <p>Background</p> <p>Common information facilities do not always provide the quality information needed to answer questions on health or health-related issues, such as Occupational Safety and Health (OSH) matters. Barriers may be the accessibility, quantity and readability of information. Online Question & Answer (Q&A) network tools, which link questioners directly to experts can overcome some of these barriers. When designing and testing online tools, assessing the usability and applicability is essential. Therefore, the purpose of this study is to assess the usability and applicability of a new online Q&A network tool for answers on OSH questions.</p> <p>Methods</p> <p>We applied a cross-sectional usability test design. Eight occupational health experts and twelve potential questioners from the working population (workers) were purposively selected to include a variety of computer- and internet-experiences. During the test, participants were first observed while executing eight tasks that entailed important features of the tool. In addition, they were interviewed. Through task observations and interviews we assessed applicability, usability (effectiveness, efficiency and satisfaction) and facilitators and barriers in use.</p> <p>Results</p> <p>Most features were usable, though several could be improved. Most tasks were executed effectively. Some tasks, for example searching stored questions in categories, were not executed efficiently and participants were less satisfied with the corresponding features. Participants' recommendations led to improvements. The tool was found mostly applicable for additional information, to observe new OSH trends and to improve contact between OSH experts and workers. Hosting and support by a trustworthy professional organization, effective implementation campaigns, timely answering and anonymity were seen as important use requirements.</p> <p>Conclusions</p> <p>This network tool is a promising new strategy for offering company workers high quality information to answer OSH questions. Q&A network tools can be an addition to existing information facilities in the field of OSH, but also to other healthcare fields struggling with how to answer questions from people in practice with high quality information. In the near future, we will focus on the use of the tool and its effects on information and knowledge dissemination.</p

    Exploring resting state connectivity in patients with psychotic depression

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    BACKGROUND: Severe depression is associated with high morbidity and mortality. Neural network dysfunction may contribute to disease mechanisms underlying different clinical subtypes. Here, we apply resting-state functional magnetic resonance imaging based measures of brain connectivity to investigate network dysfunction in severely depressed in-patients with and without psychotic symptoms. METHODS: A cohort study was performed at two sites. Older patients with major depressive disorder with or without psychotic symptoms were included (n = 23 at site one, n = 26 at site two). Resting state 3-Tesla functional MRI scans, with eyes closed, were obtained and Montgomery-ƅsberg Depression Rating Scales were completed. We denoised data and calculated resting state networks in the two groups separately. We selected five networks of interest (1. bilateral frontoparietal, 2.left lateralized frontoparietal, 3.right lateralized frontoparietal, 4.default mode network (DMN) and 5.bilateral basal ganglia and insula network) and performed regression analyses with severity of depression, as well as presence or absence of psychotic symptoms. RESULTS: The functional connectivity (FC) patterns did not correlate with severity of depression. Depressed patients with psychotic symptoms (n = 14, 61%) compared with patients without psychotic symptoms (n = 9, 39%) from site one showed significantly decreased FC in the right part of the bilateral frontoparietal network (p = 0.002). This result was not replicated when comparing patients with (n = 9, 35%) and without (n = 17, 65%) psychotic symptoms from site two. CONCLUSION: Psychotic depression may be associated with decreased FC of the frontoparietal network, which is involved in cognitive control processes, such as attention and emotion regulation. These findings suggest that FC in the frontoparietal network may be related to the subtype of depression, i.e. presence of psychotic symptoms, rather than severity of depression. Since the findings could not be replicated in the 2nd sample, replication is needed before drawing definite conclusions

    An online expert network for high quality information on occupational safety and health: cross-sectional study of user satisfaction and impact

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    <p>Abstract</p> <p>Background</p> <p>Many people have difficulties finding information on health questions, including occupational safety and health (OSH) issues. One solution to alleviate these difficulties could be to offer questioners free-of-charge, online access to a network of OSH experts who provide tailored, high-quality information. The aim of this study was to assess whether network quality, respectively information quality, as perceived by the questioners, is associated with questioners' overall satisfaction and to explore the impact of the information received on questioners' knowledge, work and work functioning.</p> <p>Methods</p> <p>We evaluated the experiences of OSH questioners with the online network ArboAntwoord.com over a two-year period. In this network, approximately 80 qualified experts are available to answer OSH questions. By means of a questionnaire, we assessed questioners' overall satisfaction with the network, whether the network was user-friendly, easily accessible and easy to handle and whether the information provided was complete, applicable and received in a timely manner. The impact of the information on questioners' knowledge, work or work functioning was explored with seven questions. In the study period, 460 unique OSH questioners asked 851 OSH questions. In total, 205 of the 460 questioners completed the questionnaire (response rate 45%).</p> <p>Results</p> <p>Of the responders, 71% were satisfied with the ArboAntwoord network. Multiple logistic regression analysis showed that the applicability of the information had a positive influence on the questioners' overall satisfaction (OR = 16.0, 95% CI: 7.0-36.4). Also, user friendliness of the network (OR = 3.3, 95% CI: 1.3-8.6) and completeness of the information provided (OR = 3.0, 95% CI: 1.3-6.8) were positively related to the questioners' satisfaction. For 74% of the questioners, the information helped to increase their knowledge and understanding. Overall, 25% of the questioners indicated that the received information improved their work, work functioning or health.</p> <p>Conclusions</p> <p>A free-of-charge, online expert network in the field of OSH can be a useful strategy to provide OSH questioners with applicable, complete and timely information that may help improve safety and health at work. This study provides more insight in how to satisfy network questioners and about the potential impact of provided information on OSH.</p

    Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

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    Background: Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers.Methods: An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared.Results: The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers.Conclusions: Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. Ā© 2013 van Dongen et al.; licensee BioMed Central Ltd
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