Non-specific symptoms as clues to changes in emotional well-being

Background: Somatic symptoms are a common reason for visits to the family physician. The aim of this study was to examine the relation between non-specific symptoms and changes in emotional well-being and the degree to which the physician considers the possibility of mental distress when faced with such patients. Methods: Patients who complained of two or more symptoms including headache, dizziness, fatigue or weakness, palpitations and sleep disorders over one year were identified from the medical records of a random sample of 45 primary care physicians. A control group matched for gender and age was selected from the same population. Emotional well-being was assessed using the MOS-SF 36 in both groups. Results: The study group and the control group each contained 110 patients. Completed MOS questionnaires were obtained from 92 patients, 48 patients with somatic symptoms and 44 controls. Sixty percent of the patients with somatic symptoms experienced decreased emotional well being compared to 25% in the control group (p =0.00005). Symptoms of dizziness, fatigue and sleep disturbances were significantly linked with mental health impairments. Primary care physicians identified only 6 of 29 patients (21%) whose responses revealed functional limitations due to emotional problems as suffering from an emotional disorder and only 6 of 23 patients (26%) with a lack of emotional well being were diagnosed with an emotional disorder. Conclusions: Non-specific somatic symptoms may be clues to changes in emotional well-being. Improved recognition and recording of mental distress among patients who complain of these symptoms may enable better follow up and treatment

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

IT Evaluation Frameworks – Do They Make a Valuable Contribution? A Critique of Some of the Classic Models for use

Abstract: Given the plethora of frameworks and models available in this area, not all could be evaluated here. This paper takes seven popular frameworks and examines aspects of IT evaluation with particular emphasis on Small to Medium Enterprises (SMEs). The frameworks were selected from the most well known of IT evaluation researc

Calibration of speleothem δ 0-18 with instrumental climate records from Turkey

Stalagmite records of oxygen (δ18O) isotopes, sampled at sub-annual resolution by micro-mill techniques are correlated with climate parameters over the instrumental period (1961 to 2005 AD). The strongest correlations were found between δ18O and total amount of late autumn–winter precipitation (October to January) smoothed by 6 yr, with marginally weaker correlations between the total amount of late autumn– spring precipitation (ONDJF and ONDJFMA) smoothed over the same time period. Two smoothing options were chosen to account for variability in mixing and residence times of stored water in the karst aquifer prior to entering the cave: (1) An average of the last 6 yr of precipitation which yielded a product correlation of − 0.71 for the months ONDJ; and (2) a mixing model of 10% short term/event water (<1 yr) and 90% water of a longer residence time in the karst aquifer (2 to 6 yr) which gave a product correlation of −0.72 for the months ONDJ. Precipitation is calibrated over the instrumental period (1961 to 2004 AD) based on linear regression of δ18O with observed precipitation for the months ONDJ, ONDJF and ONDJFMA using both smoothing methods. An uncertainty of ±31 mm (2 standard errors on the linear regression) is applied to the calibrations. This is the first speleothem calibration of its kind in Turkey

Haskell Communities and Activities Report

Finally, here is the 9th edition of the Haskell Communities and Activities Report (HCAR), almost three weeks after the submission deadline. This delay is entirely my own fault. In fact, I have to thank the many contributors to this report even more than usually: never before did I have to ask and push so little; several entries (and quite a few new entries) landed in my inbox before or on the deadline. Thank you very much! As most of you have probably be waiting for the Report a long time already and are eager to get ahead to the actual contents, let me just enumerate a few technical points: ◦ I am trying to be more strict about the rule that entries that have not been changed twice are removed. If something is removed, it doesn’t mean that is does not exist anymore. But on the other hand, I prefer no content over outdated content, so if in doubt, I remove. All o