Adolescent suicidal ideation: a comparison of incarcerated and school-based samples

and risk-taking behavior. RESULTS: Suicidal ideations during the past year were reported by 21.5% of detained males, compared to 6.7% in the general population. In females, 58.1% of detained individuals reported suicidal thoughts during the past year, compared to 14.4% of the general population. In girls and boys from the general population, both internalizing and externalizing problems were higher in suicidal ideators than in non-suicidal youth, while in the detention group mainly internalizing problems were higher in suicidal ideators. When comparing detention suicidal ideators with those from the general population, male suicidal ideators scored higher on delinquency, while detained female suicidal ideators also scored higher on posttraumatic stress, but lower on prosocial beliefs. LIMITATIONS: Information used in this study was solely based on self-report measures only and limited to Flemish adolescents. CONCLUSION: Since suicidal ideation is a frequent problem in detained youth, adequate recognition and treatment seems clinically relevant. While both internalizing and externalizing psychopathology may be an indicator of suicidal ideation in the general population, internalizing problems may be the main clinical predictor in detained yout

Metabolic Reconstruction for Metagenomic Data and Its Application to the Human Microbiome

Microbial communities carry out the majority of the biochemical activity on the planet, and they play integral roles in processes including metabolism and immune homeostasis in the human microbiome. Shotgun sequencing of such communities' metagenomes provides information complementary to organismal abundances from taxonomic markers, but the resulting data typically comprise short reads from hundreds of different organisms and are at best challenging to assemble comparably to single-organism genomes. Here, we describe an alternative approach to infer the functional and metabolic potential of a microbial community metagenome. We determined the gene families and pathways present or absent within a community, as well as their relative abundances, directly from short sequence reads. We validated this methodology using a collection of synthetic metagenomes, recovering the presence and abundance both of large pathways and of small functional modules with high accuracy. We subsequently applied this method, HUMAnN, to the microbial communities of 649 metagenomes drawn from seven primary body sites on 102 individuals as part of the Human Microbiome Project (HMP). This provided a means to compare functional diversity and organismal ecology in the human microbiome, and we determined a core of 24 ubiquitously present modules. Core pathways were often implemented by different enzyme families within different body sites, and 168 functional modules and 196 metabolic pathways varied in metagenomic abundance specifically to one or more niches within the microbiome. These included glycosaminoglycan degradation in the gut, as well as phosphate and amino acid transport linked to host phenotype (vaginal pH) in the posterior fornix. An implementation of our methodology is available at http://huttenhower.sph.harvard.edu/human​n. This provides a means to accurately and efficiently characterize microbial metabolic pathways and functional modules directly from high-throughput sequencing reads, enabling the determination of community roles in the HMP cohort and in future metagenomic studies.National Institutes of Health (U.S.) (U54HG004968

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Increasing soil organic carbon content can enhance the long-term availability of phosphorus in agricultural soils

The stocks of phosphorus (P) in soil resulting from decades of over-fertilisation can be used as a long-term source of P provided that crop P bioavailability is ensured. This study was set up to identify to what extent soil organic matter (SOM) affects the long-term availability of these stocks, the premise being that OM may limit irreversible P fixation in soil by blocking P sorption sites on sesquioxides. An ensemble of 42 agricultural soils, composed from experimentally amended soils (field and incubation trials) and soils with contrasting properties, was subjected to 288 days of P depletion with anion exchange membranes as a P sink; this method was previously shown to yield P pools with agronomic significance. Cumulative P desorption data were fitted with a two-pool kinetic desorption model, yielding estimates for a fast (labile) and total desorbable P pool. On average, 42% of oxalate extractable P (P-ox) associated with poorly crystalline iron (Fe) and aluminium (Al) (oxy)hydroxides (Fe-ox and Al-ox) were desorbable and 25% of that fraction (i.e. 11% of P-ox) was labile. That labile P pool matched well with the 24 h isotopically exchangeable P (E value) in these soils (R-2 = 0.74). Both the fast and total desorbable fraction of P-ox were larger at higher degrees of phosphorus saturation (DPS). In soils with a low DPS (<0.30), the labile fraction of P-ox increased as the ratio of soil organic carbon to Fe-ox + Al-ox increased (R-2 = 0.70; p < 0.001), but soils with a higher DPS did not exhibit that trend. These results adhere to soil chemical views that enhanced SOM contents reduce fixation of P by competitive sorption and prevention of P diffusion into micropores. No such effects occur in more P saturated soils, probably because orthophosphate sorption and electrostatic effects outcompete effective SOM sorption. The findings suggest that simultaneous application of OM with P fertilisers could keep P better available in the long term, but that this OM application does not affect P fixation when soils are excessively dosed with P. Highlights Long-term availability of P in soil was assessed in contrasting soils in a P depletion experiment. A high ratio of organic C to Fe and Al in soil enhances the P fraction that is readily available. The positive effect of organic matter on soil P availability is only found at low soil P saturation. Residual P in European soils can sustain adequate P for crops for 5-55 years depending on the soil