Evaluation of cardiovascular risk- lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes

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The southwest Indian Ocean Bathymetric Compilation (swIOBC)

We present a comprehensive regional bathymetric data compilation for the southwest Indian Ocean (swIOBC) covering the area from 4°S to 40°S and 20°E to 45°E with a spatial resolution of 250 m. For this, we used multibeam and singlebeam data as well as data from global bathymetric data compilations. We generated the swIOBC using an iterative approach of manual data cleaning and gridding, accounting for different data qualities and seamless integration of all different kinds of data. In comparison to existing bathymetric charts of this region, the new swIOBC benefits from nearly four times as many data-constrained grid cells and a higher resolution, and thus reveals formerly unseen seabed features. In the central Mozambique Basin a surprising variety of landscapes were discovered. They document a deep reaching influence of the Mozambique Current eddies. Details of the N-S trending Zambezi Channel could be imaged in the central Mozambique Basin. Maps are crucial not only for orientation but also to set scientific processes and local information in a spatial context. For most parts of the ocean seafloor, maps are derived from satellite data with only kilometer resolution. Acoustic depth measurements from ships provide more detailed seafloor information in tens to hundreds of meters resolution. For the southwest Indian Ocean, all available depth soundings from a variety of sources and institutes are combined in one coherent map. Thus, in areas where depth soundings exist, this map shows the seafloor in so-far unknown detail. This detailed map forms the base for subsequent studies of e.g. the direction of ocean currents, geological and biological processes in the southwest Indian Ocean

The Sneeuberg: A new centre of floristic endemism on the Great Escarpment, South Africa

The Sneeuberg mountain complex (Eastern Cape) comprises one of the most prominent sections of the Great Escarpment in southern Africa but until now has remained one of the botanically least known regions. The Sneeuberg is a discrete orographical entity, being delimited in the east by the Great Fish River valley, in the west by the Nelspoort Interval, to the south by the Plains of Camdeboo, and to the north by the Great Karoo pediplain. The highest peaks range from 2278 to 2504 m above sea level, and the summit plateaux range from 1800 to 2100 m. Following extensive literature review and a detailed collecting programme, the Sneeuberg is reported here as having a total flora of 1195 species of which 107 (9%) are alien species, 33 (2.8%) are endemic, and 13 (1.1%) near-endemic. Five species previously reported as Drakensberg Alpine Centre (DAC) endemics are now known to occur in the Sneeuberg (representing range extensions of some 300–500 km). One-hundred-and-five species (8.8%) are DAC near-endemics, with the Sneeuberg being the western limit for most of these. Ten species (0.8%) represent disjunctions across the Karoo Interval from the Cape Floristic Region (CFR) to the Sneeuberg. In all, some 23 significant range extensions, eight new species, and several rediscoveries are recorded. We conclude by recognising the Sneeuberg as a new centre of endemism along the Great Escarpment, with floristic affinities with the Albany Centre and the DAC, and links to the CFR

The Timing of Medical Examination Following an Allegation of Sexual Abuse: is this an Emergency?

Aim: To ascertain the frequency of significant anogenital signs, at medical examination, following an allegation of sexual abuse, in relation to the timing of the examination. Method: A case series of 331 children, who were referred by the police or social services for examination, following an allegation of child sexual abuse or suspicion of this, over a 3½-year period in a defined geographical area. Results: Two hundred and fifty-seven children alleged penetrative abuse, of whom 114 were seen within 7 days of the abuse. Twenty-three children alleged penetrative anal abuse within the previous 7 days; 13 of these had abnormal findings (56.5%) compared with 9 (18%) of the 50 children seen more than 7 days after anal abuse. Ninety-two girls alleged penetrative vaginal abuse within the previous 7 days and of these 46 (50%) had abnormal findings, compared with 31 (30.7%) of the 101 girls seen more than 7 days after the alleged abuse. In addition 33 girls seen within 7 days had other signs associated with probable assault. Abnormal findings were more common in post-pubertal girls. Conclusion: Pubertal and post-pubertal girls are more likely to have significant genital signs if they are examined within 7 days of the last episode of sexual abuse. Our findings suggest that abnormal anal signs are more likely to be present in the acute phase. This study indicates that children should be examined as soon as possible following a referral. This will have implications for clinical practice. Regardless of the lack of accurate history it will always be important to examine the child as soon as possible after disclosure

The relationship between cortisol reactivity and emotional brain function is differently moderated by childhood trauma, in bipolar disorder, schizophrenia and healthy individuals

Childhood trauma is a risk factor for psychotic and mood disorders that is associated with abnormal hypothalamic–pituitary–adrenal (HPA) axis function in response to stress and abnormal social brain function. Here, we aimed to determine whether childhood trauma exposure would differently moderate associations between cortisol reactivity and social brain function, among cases with schizophrenia (SZ), bipolar disorder (BD) and in healthy individuals (HC). Forty cases with SZ, 35 with BD and 34 HCs underwent functional magnetic resonance imaging while performing an emotional face-matching task. Participants completed the Childhood Trauma Questionnaire and cortisol reactivity (i.e. the slope indexing the within-subject difference between pre- and post-imaging salivary cortisol levels) was determined. The severity of childhood trauma moderated the relationship between cortisol reactivity and brain activation in the bilateral temporo-parieto-insular junctions, right middle cingulum, right pre/postcentral gyri, left cerebellum and right lingual gyrus, differently depending on the clinical group. When exposed to high levels of trauma, the cortisol slope was negatively associated with activation in these regions in HC, while the cortisol slope was positively associated with activation in these regions in SZ cases. Similarly, there were differences between the groups in how trauma severity moderated the relationship between cortisol reactivity and functional connectivity between the amygdala and dorsolateral prefrontal cortex. In addition to reflecting typical associations between cortisol reactivity and emotional brain function when not exposed to childhood trauma, these findings provide new evidence that trauma exposure disrupts these relationships in both healthy individuals and in cases with SZ or BD

A Systematic Review of Studies Reporting Data-Driven Cognitive Subtypes across the Psychosis Spectrum

The delineation of cognitive subtypes of schizophrenia and bipolar disorder may offer a means of determining shared genetic markers and neuropathology among individuals with these conditions. We systematically reviewed the evidence from published studies reporting the use of data-driven (i.e., unsupervised) clustering methods to delineate cognitive subtypes among adults diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. We reviewed 24 studies in total, contributing data to 13 analyses of schizophrenia spectrum patients, 8 analyses of bipolar disorder, and 5 analyses of mixed samples of schizophrenia and bipolar disorder participants. Studies of bipolar disorder most consistently revealed a 3-cluster solution, comprising a subgroup with ‘near-normal’ (cognitively spared) cognition and two other subgroups demonstrating graded deficits across cognitive domains. In contrast, there was no clear consensus regarding the number of cognitive subtypes among studies of cognitive subtypes in schizophrenia, while four of the five studies of mixed diagnostic groups reported a 4-cluster solution. Common to all cluster solutions was a severe cognitive deficit subtype with cognitive impairments of moderate to large effect size relative to healthy controls. Our review highlights several key factors (e.g., symptom profile, sample size, statistical procedures, and cognitive domains examined) that may influence the results of data-driven clustering methods, and which were largely inconsistent across the studies reviewed. This synthesis of findings suggests caution should be exercised when interpreting the utility of particular cognitive subtypes for biological investigation, and demonstrates much heterogeneity among studies using unsupervised clustering approaches to cognitive subtyping within and across the psychosis spectrum

Palaeoceanographic changes identified using seismic and radiogenic isotope data from the Mozambique Ridge, SW Indian Ocean

Seismic reflection data from the southern Mozambique Ridge, SW Indian Ocean, show indications for a modification in the oceanic circulation system. In the absence of an age-depth model based on a drill site we used information gathered from the study of radiogenic isotopes of ferromanganese nodules and crusts. Those were recovered via dredges from the Mozambique Ridge to gain knowledge on the origin of the modifications of the oceanic circulation system, which is documented in the distinct change in reflection characteristics. This is found to have occurred at 9 Ma