Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the association between disclosure and sustainable employability and well-being at work is scarce. The aim of this study was to investigate the association between the disclosure decision (yes/no), experiences with the decision (positive/negative) and sustainable employment and well-being at work among military personnel with mental illness (N = 323). Methods A cross-sectional questionnaire study was conducted. Descriptive and regression (linear and ordinal) analyses were performed. Comparisons were made between those with positive and negative disclosure experiences. Results Disclosure decision (yes/no) was not significantly associated with any of the measures of sustainable employability and well-being at work. However, positive disclosure experiences were significantly associated with higher scores on almost all measures of sustainable employability and well-being at work. Those with negative disclosure experiences reported significantly more shame (Mpos = 2.42, Mneg = 2.78, p < .05) and discrimination (Mpos = 1.70, Mneg = 2.84, p < .001). Those with a positive disclosure experience, reported significantly more supervisor support (Mpos = 3.20, Mneg = 1.94, p < .001). Conclusion We did not find evidence that the disclosure decision itself is related to measures of sustainable employment and well-being at work. In contrast, how participants had experienced their (non-)disclosure decision was significantly related to almost all measures. This emphasizes the importance of the work environments reactions to disclosure and mental illness in the workplace. Future research and interventions should focus on increasing the likelihood of positive disclosure experiences through creating a more inclusive work environment, with more supervisor support and less stigma.
In the treatment of organophosphate poisoning atropine sulphate monohydrate (AT) and obidoxime dichloride (OB) play a vital role. Currently, the Austrian Armed Forces use the DOUBLEPEN OA two‐chamber autoinjector (ChemProtect) to administer these two drugs. The autoinjector is a part of military standard equipment as a “Basic CBRN‐First Aid Kit” and contains OB and AT with a declared concentration of 220 mg/2 ml and 2 mg/2 ml, respectively. Especially in the two‐chamber autoinjectors, it is highly possible that not all the content of the antidote solution is administered when the autoinjector is triggered. The purpose of the study was to analyze one hundred DOUBLEPEN OA autoinjectors from two different production batches (1707068 and 1707067) for volume loss, drug content and uniformity of dosage unit. Uniformity of dosage units, assessed by the content uniformity method (Chapter 2.9.40 of the European Pharmacopeia), requires the calculation of an acceptable value to quantify the uniformity of the drug product. An acceptance value for the first 10 dosage units of 15.0% or below is considered acceptable. The loss of volume was calculated by determining the density and mass of the solution after triggering the autoinjector. A quantitative high‐performance liquid chromatography method has been developed and in‐house validated for the determination of the content of two drugs. According to International Council for Harmonisation guidelines, the analytical method was proven to be accurate and repeatable. The obtained results show that the average loss of volume after injection was 5%, and the average content of OB and AT for batch 1707068, was 216.5 and 1.9 mg, while for batch 1707067 it was 224.2 and 2.0 mg, respectively. Although the loss of volume and content were observed, the calculated acceptance value for both production batches met the requirements of uniformity of dosage unit by the European Pharmacopeia.
Background Kenya’s COVID-19 epidemic was seeded early in March 2020 and did not peak until early August 2020 (wave 1), late-November 2020 (wave 2), mid-April 2021 (wave 3), late August 2021 (wave 4), and mid-January 2022 (wave 5). Methods Here, we present SARS-CoV-2 lineages associated with the five waves through analysis of 1034 genomes, which included 237 non-variants of concern and 797 variants of concern (VOC) that had increased transmissibility, disease severity or vaccine resistance. Results In total 40 lineages were identified. The early European lineages (B.1 and B.1.1) were the first to be seeded. The B.1 lineage continued to expand and remained dominant, accounting for 60% (72/120) and 57% (45/79) in waves 1 and 2 respectively. Waves three, four and five respectively were dominated by VOCs that were distributed as follows: Alpha 58.5% (166/285), Delta 92.4% (327/354), Omicron 95.4% (188/197) and Beta at 4.2% (12/284) during wave 3 and 0.3% (1/354) during wave 4. Phylogenetic analysis suggests multiple introductions of variants from outside Kenya, more so during the first, third, fourth and fifth waves, as well as subsequent lineage diversification. Conclusions The data highlights the importance of genome surveillance in determining circulating variants to aid interpretation of phenotypes such as transmissibility, virulence and/or resistance to therapeutics/vaccines.
Epigenetic clocks are widely used aging biomarkers calculated from DNA methylation data, but this data can be surprisingly unreliable. Here we show that technical noise produces deviations up to 9 years between replicates for six prominent epigenetic clocks, limiting their utility. We present a computational solution to bolster reliability, calculating principal components (PCs) from CpG-level data as input for biological age prediction. Our retrained PC versions of six clocks show agreement between most replicates within 1.5 years, improved detection of clock associations and intervention effects, and reliable longitudinal trajectories in vivo and in vitro. This method entails only one additional step compared to traditional clocks, requires no replicates or previous knowledge of CpG reliabilities for training, and can be applied to any existing or future epigenetic biomarker. The high reliability of PC-based clocks is critical for applications to personalized medicine, longitudinal tracking, in vitro studies and clinical trials of aging interventions. Epigenetic clocks are widely used aging biomarkers, but their utility is limited by technical noise. The authors report a method for producing high-reliability clocks for applications such as longitudinal studies and intervention trials.
In this article, we show that sets of three-qubit quantum observables obtained by considering both the classical and skew embeddings of the split Cayley hexagon of order two into the binary symplectic polar space of rank three can be used to detect quantum state-independent contextuality. This reveals a fundamental connection between these two appealing structures and some fundamental tools in quantum mechanics and quantum computation. More precisely, we prove that the complement of a classically embedded hexagon does not provide a Mermin–Peres-like proof of the Kochen–Specker theorem whereas that of a skewly-embedded one does.
Introduction En raison des répercussions sans précédent de la COVID-19, il est nécessaire de réaliser des études visant à évaluer les défis et les facteurs de stress liés à la pandémie. Cette étude avait pour but d’évaluer les principales préoccupations et le bien-être général des membres de l’Équipe de la Défense du Canada, que ce soit le personnel militaire des Forces armées canadiennes ou les employés de la fonction publique du ministère de la Défense nationale (MDN). Méthodologie Le sondage de l’Équipe de la Défense sur la COVID-19 a été soumis par voie électronique au personnel de l’Équipe de la Défense en avril et mai 2020, et 13 688 membres de la Force régulière, 5 985 membres de la Force de réserve et 7 487 employés civils de la fonction publique du MDN y ont répondu. Outre le recueil de données sociodémographiques, le sondage visait à évaluer les modalités de travail, les préoccupations liées à la pandémie, le bien-être général et le soutien social et organisationnel. Des données pondérées ont été utilisées dans toutes les analyses (pour garantir une juste représentation des différents groupes). Résultats La majorité des répondants travaillaient depuis leur domicile et une petite minorité n’était pas en mesure de travailler en raison des restrictions. Les principales préoccupations parmi les nombreuses préoccupations communes à une proportion importante de répondants étaient liées à la santé et au bien-être de leurs proches. La majorité des répondants ont déclaré avoir reçu d’une manière générale un soutien de la part de leur conjoint(e), de leur famille, de leurs superviseurs, de leurs amis, de leurs collègues et de leurs enfants. La moitié du personnel civil du ministère de la Défense nationale et un tiers du personnel militaire ont fait état d’une détérioration de leur santé mentale. Les femmes, les répondants plus jeunes, les répondants ayant des personnes à charge et, dans certains cas, les célibataires sans enfants risquaient davantage un faible degré de bien-être. Conclusion La pandémie a eu des effets négatifs sur une grande partie du personnel de l’Équipe de la Défense. Lors de futures crises, les dirigeants d’organismes devraient fournir un soutien accru aux groupes les plus exposés et aux superviseurs, qui sont très bien placés pour soutenir les employés en période difficile.
Sexual health is an integral part of overall health and should be discussed with all people who seek help. The Vaccination and Prevention working group of the French Infectious Diseases Society (SPILF) and the Migrant Commission of the French AIDS Society (SFLS) developed recommendations to address this issue with migrants presenting vulnerability factors. After defining sexual health and target migrants, practical recommendations were issued. Sexual health can be discussed simply with migrants or people with an immigrant background. Some migrants are exposed to sexual vulnerability due to their migration route, social isolation, administrative and housing insecurity, gender inequalities, and discrimination. Situations of sexual vulnerability, sexual violence, and female genital mutilation should be systematically identified and followed by appropriate care that respects the migrant's needs. Extended screening for HIV and sexually transmitted infections (STI) should be systematically offered as part of a "migrant health checkup" and completed, if necessary, with information on preventing tools for HIV, STIs, unwanted pregnancies, and sexual violence. In this population, it is important to check if vaccinations are up to date. Sexology and addiction counselling is sometimes useful. The specific needs of LGBTQIA+ people with an immigrant background should be taken into account.
Objective This study aimed to estimate the incidence and prevalence of neovascular age related macular degeneration (nAMD) in the French population between 2008 and 2018. Design This was a retrospective longitudinal population study using healthcare consumption data from the French National Health Information database (Système National des Données de Santé [SNDS]), which covers about 99% of the French population. Participants We identified individuals treated for nAMD from the French population aged 50 years and older. Identification criteria were nAMD diagnosis or reimbursement of nAMD treatments (anti-VEGF intravitreal injection, or dynamic phototherapy with verteporfin). Exclusion criteria were high myopia, diagnosis of other retinal diseases, and other treatments for macular diseases (dexamethasone implant, laser, etc.). Methods and outcome measures We calculated incidence and prevalence, based on the age matched general population in France. Adjustment on age and sex was also performed for incidence. Results Between 2008 and 2018, we identified 342,961 nAMD patients (67.5% female). Mean (SD) age at nAMD diagnosis or first treatment increased from 78.8 (8.1) years in 2008 to 81.2 (7.9) years in 2018. In 2018, annual incidence was 0.149% and prevalence was 1.062% for the French population aged ≥50 years. Incidence was stable over the 10-year period. Annual incidence increased with age (0.223%, 0.380% and 0.603% in those aged ≥60, ≥70 and ≥80 years, respectively), with similar trends for prevalence. No major differences observed among the 14 regions of France for incidence nor prevalence. nAMD incidence in 2018 was not impacted by the availability of primary or ophthalmology care in patients’ localities. Conclusions LANDSCAPE provide exhaustive nationwide data on incidence and prevalence of nAMD in France over a 10-year period.
The aim of this article is to present the evolution of the inclusion of the defence policy component in the RA security system and its impact and connection on the reforms implemented in the security and defence sectors of Armenia. The latter is intended for a wide range of readers interested in defence reforms and is aimed at developing knowledge in the field of defence policy. The world experience of building the armed forces shows that each state, setting out to create its own armed forces, first chooses the structure that will guarantee the security of the given state. The article used the qualitative research methodology, collecting and analyzing both primary and secondary sources related to the topic.
The volume of subcortical structures represents a reliable, quantitative, and objective phenotype that captures genetic effects, environmental effects such as trauma, and disease effects such as posttraumatic stress disorder (PTSD). Trauma and PTSD represent potent exposures that may interact with genetic markers to influence brain structure and function. Genetic variants, associated with subcortical volumes in two large normative discovery samples, were used to compute polygenic scores (PGS) for the volume of seven subcortical structures. These were applied to a target sample enriched for childhood trauma and PTSD. Subcortical volume PGS from the discovery sample were strongly associated in our trauma/PTSD enriched sample ( n = 7580) with respective subcortical volumes of the hippocampus ( p = 1.10 × 10 ⁻²⁰ ), thalamus ( p = 7.46 × 10 ⁻¹⁰ ), caudate ( p = 1.97 × 10 ⁻¹⁸ ), putamen ( p = 1.7 × 10 ⁻¹² ), and nucleus accumbens ( p = 1.99 × 10 ⁻⁷ ). We found a significant association between the hippocampal volume PGS and hippocampal volume in control subjects from our sample, but was absent in individuals with PTSD (GxE; (beta = −0.10, p = 0.027)). This significant GxE (PGS × PTSD) relationship persisted ( p < 1 × 10 ⁻¹⁹ ) in four out of five threshold peaks (0.024, 0.133, 0.487, 0.730, and 0.889) used to calculate hippocampal volume PGSs. We detected similar GxE (G × ChildTrauma) relationships in the amygdala for exposure to childhood trauma (rs4702973; p = 2.16 × 10 ⁻⁷ ) or PTSD (rs10861272; p = 1.78 × 10 ⁻⁶ ) in the CHST11 gene. The hippocampus and amygdala are pivotal brain structures in mediating PTSD symptomatology. Trauma exposure and PTSD modulate the effect of polygenic markers on hippocampal volume (GxE) and the amygdala volume PGS is associated with PTSD risk, which supports the role of amygdala volume as a risk factor for PTSD.
Medical countermeasure development under the US Food and Drug Administration animal rule requires validated animal models of acute radiation effects. The key large animal model is the non-human primate, rhesus macaque. To date, only the rhesus macaque has been used for both critical supportive data and pivotal efficacy trials seeking US Food and Drug Administration approval. The potential for use of the rhesus for other high priority studies such as vaccine development underscores the need to identify another non-human primate model to account for the current lack of rhesus for medical countermeasure development. The cynomolgus macaque, Macaca fascicularis, has an existing database of medical countermeasure development against the hematopoietic acute radiation syndrome, as well as the use of radiation exposure protocols that mimic the likely nonuniform and heterogenous exposure consequent to a nuclear terrorist event. The review herein describes published studies of adult male cynomolgus macaques that used two exposure protocols-unilateral, nonuniform total-body irradiation and partial-body irradiation with bone marrow sparing-with the administration of subject-based medical management to assess mitigation against the hematopoietic acute radiation syndrome. These studies assessed the efficacy of cytokine combinations and cell-based therapy to mitigate acute radiation-induced myelosuppression. Both therapeutics were shown to mitigate the myelosuppression of the hematopoietic acute radiation syndrome. Additional studies being presented herein further defined the dose-dependent hematopoietic acute radiation syndrome of cynomolgus and rhesus macaques and a differential dose-dependent effect with young male and female cynomolgus macaques. The database supports the investigation of the cynomolgus macaque as a comparable non-human primate for efficacy testing under the US Food and Drug Administration animal rule. Critical gaps in knowledge required to validate the models and exposure protocols are also identified.
In risk management and portfolio optimization it is important to know which assets move individually or in certain groups to make a diversified portfolio. The statistical uncertainty of the correlation matrix is the main problem into the optimization of a financial portfolio. Indeed, estimates of correlations are often noisy particularly in stress period and unreliable as estimation horizons are always finite. Another drawback in the classical estimation of correlations is that time series are estimated on historical data and prediction based on past data is very difficult, since finding elementary structures in data which are valid and persistent in the future is not really easy. The Markowitz optimization approaches of portfolio suffer from theses estimation errors. From the perspective of machine learning, new approaches have been proposed in the literature of applied finance. Among these techniques, clustering has been considered as a significant method to capture the natural structure of data. The objective of this research is to use data mining approaches for identifying the best clustering indicators for building optimal portfolios. Clustering is an empirical procedure for grouping financial assets into homogeneous groups. The aim of cluster analysis is to maximize similarity within groups of assets and minimize similarity between groups. The similarities and dissimilarities are based on the attribute values and frequently involve distance measures. There are different techniques used for clustering, some are Partitioning based technique, Density based technique, Model based technique, Grid based technique. In this research we consider the symbolic approach based histogram-valued data and clusters as a new approach for investment funds portfolio optimization. Firstly, it is based on aggregating individual level data into group-based summarized by symbols. In our case, symbols are histogram-valued data taking into account variability inside groups. Secondly, for partitioning, we use dynamical clustering which is an extension of K-means where, instead of the means, we use other kinds of centers called ‘kernel’ distributions in our case. After clustering, stock samples are selected from these clusters to create funds of funds optimal portfolios which impose the lowest risk measured in terms of Conditional Value at Risk for a certain return. Funds’ Portfolios are compared during the period of 2008–2016 using the conditional Sharpe ratio and the 2017 year is used to validate our results out of sample. In this research we show that the use of symbolic data clustering algorithms can improve the reliability of the portfolio in terms of the risk adjusted performance.
Background Exclusive breastfeeding is critical for infant survival and development. However, the rate of exclusive breastfeeding in the first 6 months of life is low in sub-Saharan Africa. With the current trend in breastfeeding rates in many countries including in Guinea, the World Health Assembly target of at least 50% of children aged less than 6 months being exclusively breastfeed by 2025 is likely to be compromised and lives a numerous infant that are be at risk. The objective of this study was to identify the individual and contextual determinants of the practice of Exclusive Breastfeeding (EBF) in Guinea. Method We conducted a secondary analysis of data from the 2018 Guinea Demographic and Health Survey (DHS). The study population consisted of women who gave birth between the ages of 15 and 49. Our sample consisted of women who had their last birth six (06) months prior to collection. The enumeration areas were our second level. A multilevel logistic regression was performed using Stata version 15.1 software. Three statistical models were implemented: The final model was obtained using the bottom-up step-by-step method. The intra-class correlation coefficient was calculated. Results On the 851 women included in our study, 33% reported having exclusively breastfed during the first 6 months of life of their children. After a multivariate analysis, the variables associated with exclusive breastfeeding are: children aged 2–3 months (OR = 0.53 CI95% = [0.36–0.79]) and children aged 4–5 months (OR = 0.23 IC95% = [0.14–0.36]), women in the Faranah area (OR = 2.69 IC95% = [1.21–5.94]) and those in Mamou (OR = 2.27 IC95% = [1.00–5.94]), women who gave birth in a health facility (OR = 1.94 IC95% = [1.34–2.80]) and women living in polygamous households (OR = 0.68 IC95% = [0.48–0.98]). Conclusion The practice of exclusive breastfeeding remains low in Guinea. For the achievement of Sustainable Development Goals, particularly the improvement of exclusive breastfeeding practices, the individual and contextual determinants identified in this study should be taken into consideration in policies and programmes.
A growing number of studies have examined alterations in white matter organization in people with posttraumatic stress disorder (PTSD) using diffusion MRI (dMRI), but the results have been mixed which may be partially due to relatively small sample sizes among studies. Altered structural connectivity may be both a neurobiological vulnerability for, and a result of, PTSD. In an effort to find reliable effects, we present a multi-cohort analysis of dMRI metrics across 3047 individuals from 28 cohorts currently participating in the PGC-ENIGMA PTSD working group (a joint partnership between the Psychiatric Genomics Consortium and the Enhancing NeuroImaging Genetics through Meta-Analysis consortium). Comparing regional white matter metrics across the full brain in 1426 individuals with PTSD and 1621 controls (2174 males/873 females) between ages 18–83, 92% of whom were trauma-exposed, we report associations between PTSD and disrupted white matter organization measured by lower fractional anisotropy (FA) in the tapetum region of the corpus callosum (Cohen’s d = −0.11, p = 0.0055). The tapetum connects the left and right hippocampus, for which structure and function have been consistently implicated in PTSD. Results were consistent even after accounting for the effects of multiple potentially confounding variables: childhood trauma exposure, comorbid depression, history of traumatic brain injury, current alcohol abuse or dependence, and current use of psychotropic medications. Our results show that PTSD may be associated with alterations in the broader hippocampal network.
Résumé Les marins sont exposés à de multiples risques physiques et psychiques. Au cours des dernières années, des études ont mis en exergue des pathologies spécifiques comme la fatigue, l’ennui mais aussi des syndromes anxiodépressifs. Les marins sont également à risque de développer des syndromes de stress post-traumatique (piraterie, accidents de navire ou du travail). La pandémie de COVID-19 impacte fortement les marins avec une estimation de 400 000 d’entre eux embarqués autour du monde avec des prolongations de durées de missions, des difficultés de rapatriement, de relève d’équipage et des soucis financiers liés à la baisse du transport maritime et de fait des embarquements et des impayés de salaires.
Geographical time-spaces exhibit a series of properties, including space inversion, that turns any representation effort into a complex task. In order to improve the legibility of the representation and leveraging the advances of three-dimensional computer graphics, the aim of the study is to propose a new method extending time-space relief cartography introduced by Mathis and L’Hostis. The novelty of the model resides in the use of cones to describing the terrestrial surface instead of graph faces, and in the use of curves instead of broken segments for edges. We implement the model on the Chinese space. The Chinese geographical time-space of reference year 2006 is produced by the combination and the confrontation of the fast air transport system and of the 7.5-times slower road transport system. Slower, short range flights are represented as curved lines above the earth surface with longer length than the geodesic, in order to account for a slower speed. The very steep slope of cones expresses the relative difficulty of crossing terrestrial time-space, as well as the comparably extreme efficiency of long-range flights for moving between cities. Finally, the whole image proposes a coherent representation of the geographical time-space where fast city-to-city transport is combined with slow terrestrial systems that allow one to reach any location.
Epigenetic mechanisms play a role in the detrimental effects of traumatic stress and the development of post-traumatic stress disorder (PTSD). However, it is unknown whether successful treatment of PTSD restores these epigenetic marks. This study investigated longitudinal changes of blood-based genome-wide DNA methylation levels in relation to trauma-focused psychotherapy for PTSD in soldiers that obtained remission (N = 21), non-remitted PTSD patients (N = 23), and trauma-exposed military controls (N = 23). In an independent prospective cohort, we then examined whether these DMRs were also relevant for the development of deployment-related PTSD (N = 85). Successful treatment of PTSD was accompanied by significant changes in DNA methylation at 12 differentially methylated regions (DMRs) in the genes: APOB, MUC4, EDN2, ZFP57, GPX6, CFAP45, AFF3, TP73, UBCLP1, RPL13P, and two intergenic regions (p values < 0.0001 were confirmed using permutation and sensitivity analyses). Of the 12 DMRs related to PTSD symptom reduction, consistent prospective evidence was found for ZFP57 methylation changes related to changing PTSD symptoms (B = −0.84, t = −2.49, p = 0.014). Increasing ZFP57 methylation related to PTSD symptom reduction was present over and above the relation with symptoms, suggesting that psychological treatments exert biological effects independent of symptom reduction. Together, these data provide longitudinal evidence that ZFP57 methylation is involved in both the development and successful treatment of deployment-related PTSD. This study is a first step to disentangle the interaction between psychological and biological systems to identify genomic regions relevant for the etiology and treatment of stress-related disorders such as PTSD.
Currently operating new generation aircraft engines are equipped with multi-hole combustion chambers, coated with a thick ZrO2-4 mol% Y2O3 (YpSZ) thermal barrier coating (TBC). The local repair of such multi-hole combustors requires the development of specific deposition methods. This paper describes a modified version of a low power plasma reactor (LPPR), upgraded with two opposite gas flows to prevent cooling channel plugging. The influence of some experimental parameters (plasma power density, spray distance and precursor concentration) on the repaired TBC microstructure is examined. A short spray distance, associated with a low power density and a low concentration of nitrate precursors, led to a suitable microstructure of the deposited YpSZ. Moreover, FTIR spectroscopy and SEM-EDS analysis revealed the efficient conversion of the nitrate precursors into oxide and the good infiltration of the deposited YpSZ into the damaged area. Finally, it is shown that, once the deposition parameters have been optimized, a dual flow system effectively allows local repair to be carried out without plugging the cooling system.
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