IMPORTANCE Beginning in 2005, the incidence of suicide deaths in the US military began to sharply increase. Unique stressors, such as combat deployments, have been assumed to underlie the increasing ...incidence. Previous military suicide studies, however, have relied on case series and cross-sectional investigations and have not linked data during service with postservice periods. OBJECTIVE To prospectively identify and quantify risk factors associated with suicide in current and former US military personnel including demographic, military, mental health, behavioral, and deployment characteristics. DESIGN, SETTING, AND PARTICIPANTS Prospective longitudinal study with accrual and assessment of participants in 2001, 2004, and 2007. Questionnaire data were linked with the National Death Index and the Department of Defense Medical Mortality Registry through December 31, 2008. Participants were current and former US military personnel from all service branches, including active and Reserve/National Guard, who were included in the Millennium Cohort Study (N = 151 560). MAIN OUTCOMES AND MEASURES Death by suicide captured by the National Death Index and the Department of Defense Medical Mortality Registry. RESULTS Through the end of 2008, findings were 83 suicides in 707 493 person-years of follow-up (11.73/100 000 person-years 95% CI, 9.21-14.26). In Cox models adjusted for age and sex, factors significantly associated with increased risk of suicide included male sex, depression, manic-depressive disorder, heavy or binge drinking, and alcohol-related problems. None of the deployment-related factors (combat experience, cumulative days deployed, or number of deployments) were associated with increased suicide risk in any of the models. In multivariable Cox models, individuals with increased risk for suicide were men (hazard ratio HR, 2.14; 95% CI, 1.17-3.92; P = .01; attributable risk AR, 3.5 cases/10 000 persons), and those with depression (HR, 1.96; 95% CI, 1.05-3.64; P = .03; AR, 6.9/10 000 persons), manic-depressive disorder (HR, 4.35; 95% CI, 1.56-12.09; P = .005; AR, 35.6/10 000 persons), or alcohol-related problems (HR, 2.56; 95% CI, 1.56-4.18; P <.001; AR, 7.7/10 000 persons). A nested, matched case-control analysis using 20:1 control participants per case confirmed these findings. CONCLUSIONS AND RELEVANCE In this sample of current and former military personnel observed July 1, 2001-December 31, 2008, suicide risk was independently associated with male sex and mental disorders but not with military-specific variables. These findings may inform approaches to mitigating suicide risk in this population.
Certain few intervals with high- beta plasma (ratio of gas pressure to magnetic pressure) have been interpreted as containing turbulent fluctuations with wave vectors that are confined to very ...oblique angles with respect to the mean magnetic field. The fluctuations are theorized to be Kinetic Alfven Waves (KAWs) engaged in an energy cascade that dissipates primarily at electron scales. Dissipation by ions, and by cyclotron damping in particular, is argued to be minimal to non-existent. This interpretation is not supported, generally, by the analysis of larger data sets using other data analysis methods. These prior studies, however, were not conducted for specific beta ranges. In this study, we reconsider the analysis for a moderately large set ofhigh- beta intervals. The analysis includes magnetic variance, the Bieber ratio test, the cross-helicity versus magnetic helicity correlation, and the implied break frequency versus angle relationship. In our analysis, the results do not support the exclusive KAW interpretation as applied generally to solar wind intervals of high- beta while the results do support the presence of cyclotron damping at a significant level.
There is a debate as to the identity of the fluctuations which constitute the relatively high‐frequency plasma turbulence observed in the solar wind. One school holds that these modes are kinetic ...Alfvén waves, whereas another opinion is that they are whistler modes. Here linear kinetic theory for electromagnetic fluctuations in homogeneous, collisionless, magnetized plasmas is used to compute two dimensionless transport ratios, the electron compressibility Ce and the magnetic compressibility C for these two modes. The former is a measure of the amplitude of density fluctuations, and the latter indicates the relative energy in magnetic fluctuations in the component parallel to the background magnetic field Bo. For βe ≪ 1, CAlfven ≪ Cwhistler, and the latter quantity is of order 0.5 at whistler propagation strongly oblique to Bo. Such values of C are sometimes measured at relatively high frequencies and βe ≪ 1 in the solar wind; thus, it is concluded that such observations correspond to whistler mode turbulence. But other solar wind observations indicate that kinetic Alfvén fluctuations also contribute to relatively high‐frequency solar wind turbulence.
Autosomal dominant polycystic kidney disease (ADPKD) is marked by gradual renal cyst and kidney enlargement and ultimately renal failure. Magnetic resonance–based, height-adjusted total kidney volume ...(htTKV) over 600 cc/m predicts the development of CKD stage 3 within 8 years in the Consortium for Radiologic Imaging in Polycystic Kidney Disease cohort. Here we compared simultaneous ultrasound and magnetic resonance imaging to determine whether ultrasound and kidney length (KL) predict future CKD stage 3 over longer periods of follow-up. A total of 241 ADPKD patients, 15–46 years, with creatinine clearance of 70 ml/min and above had iothalamate clearance, magnetic resonance, and ultrasound evaluations. Participants underwent an average of five repeat clearance measurements over a mean follow-up of 9.3 years. Ultrasound and magnetic resonance-based TKV and KL were compared using Bland–Altman plots and intraclass correlations. Each measure was tested to predict future CKD stage 3. Relatively strong intraclass correlations between ultrasound and magnetic resonance were found for both htTKV and KL (0.81 and 0.85, respectively). Ultrasound and magnetic resonance-based htTKV and KL predicted future CKD stage 3 similarly (AUC of 0.87, 0.88, 0.87, and 0.88, respectively). An ultrasound kidney length over 16.5 cm and htTKV over 650 ml/min had the best cut point for predicting the development of CKD stage 3. Thus, kidney length alone is sufficient to stratify the risk of progression to renal insufficiency early in ADPKD using either ultrasound or magnetic resonance imaging.
Global climate models predict increases in the frequency and severity of drought worldwide, directly affecting most ecosystem types. Consequently, drought legacy effects (drought-induced alterations ...in ecosystem function postdrought) are expected to become more common in ecosystems varying from deserts to grasslands to forests. Drought legacies in grasslands are usually negative and reduce ecosystem function, particularly after extended drought. Moreover, ecosystems that respond strongly to drought (high sensitivity) might be expected to exhibit the largest legacy effects the next year, but this relationship has not been established. We quantified legacy effects of a severe regional drought in 2012 on postdrought (2013) aboveground net primary productivity (ANPP) in six central US grasslands. We predicted that (1) the magnitude of drought legacy effects measured in 2013 would be positively related to the sensitivity of ANPP to the 2012 drought, and (2) drought legacy effects would be negative (reducing 2013 ANPP relative to that expected given normal precipitation amounts). The magnitude of legacy effects measured in 2013 was strongly related (r² = 0.88) to the sensitivity of ANPP to the 2012 drought across these six grasslands. However, contrary to expectations, positive legacy effects (greater than expected ANPP) were more commonly observed than negative legacy effects. Thus, while the sensitivity of ANPP to drought may be a useful predictor of the magnitude of legacy effects, short-term (1-year) severe droughts may cause legacy effects that are more variable than those observed after multiyear droughts.
During the 1930s Dust Bowl drought in the central United States, species with the C₃ photosynthetic pathway expanded throughout C₄-dominated grasslands. This widespread increase in C₃ grasses during ...a decade of low rainfall and high temperatures is inconsistent with well-known traits of C₃ vs. C₄ pathways. Indeed, water use efficiency is generally lower, and photosynthesis is more sensitive to high temperatures in C₃ than C₄ species, consistent with the predominant distribution of C₃ grasslands in cooler environments and at higher latitudes globally. We experimentally imposed extreme drought for 4 y in mixed C₃/C₄ grasslands in Kansas and Wyoming and, similar to Dust Bowl observations, also documented three- to fivefold increases in C₃/C₄ biomass ratios. To explain these paradoxical responses, we first analyzed long-term climate records to show that under nominal conditions in the central United States, C₄ grasses dominate where precipitation and air temperature are strongly related (warmest months are wettest months). In contrast, C₃ grasses flourish where precipitation inputs are less strongly coupled to warm temperatures. We then show that during extreme drought years, precipitation–temperature relationships weaken, and the proportion of precipitation falling during cooler months increases. This shift in precipitation seasonality provides a mechanism for C₃ grasses to respond positively to multiyear drought, resolving the Dust Bowl paradox. Grasslands are globally important biomes and increasingly vulnerable to direct effects of climate extremes. Our findings highlight how extreme drought can indirectly alter precipitation seasonality and shift ecosystem phenology, affecting function in ways not predictable from key traits of C₃ and C₄ species.
The COVID-19 pandemic has affected university students globally. Our study investigated mental health indicators among higher degree by research (HDR) students at a regional university in Queensland, ...Australia. A total of 231 HDR students (female = 137, male = 94) completed the Brunel Mood Scale to assess the constructs of Tension, Depression, Anger, Vigor, Fatigue, and Confusion. A subset of 11 students participated in three focus groups to explore their experiences. Results showed that reported mood among HDR students was generally more negative than population norms, although more positive than moods reported previously during the pandemic. A total of 52 participants (22.5%) reported mood profiles that indicated elevated risk of mental ill-health. Mood profiles varied significantly by gender, age, study mode (full-time/part-time), location (on-campus/online), and citizenship (domestic/international). Quantitative data were supported by focus group findings, which identified mental health and wellbeing as key themes of concern to HDR students. Our findings indicate that support mechanisms to safeguard the mental health and wellbeing of HDR students should be a priority for universities.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Hepatic artery stenosis (HAS) after liver transplantation can progress to hepatic artery thrombosis (HAT) and a subsequent 30% to 50% risk of graft loss. Although endovascular treatment of severe HAS ...after liver transplantation has emerged as the dominant method of treatment, the potential risks of these interventions are poorly described.
A retrospective review of all endovascular interventions for HAS after liver transplantation between August 2009 and March 2016 was performed at a single institution, which has the largest volume of liver transplants in the United States. Severe HAS was identified by routine surveillance duplex ultrasound imaging (peak systolic velocity >400 cm/s, resistive index <0.5, and presence of tardus parvus waveforms).
In 1129 liver transplant recipients during the study period, 106 angiograms were performed in 79 patients (6.9%) for severe de novo or recurrent HAS. Interventions were performed in 99 of 106 cases (93.4%) with percutaneous transluminal angioplasty alone (34 of 99) or with stent placement (65 of 99). Immediate technical success was 91%. Major complications occurred in eight of 106 cases (7.5%), consisting of target vessel dissection (5 of 8) and rupture (3 of 8). Successful endovascular treatment was possible in six of the eight patients (75%). Ruptures were treated with the use of a covered coronary balloon-expandable stent graft or balloon tamponade. Dissections were treated with placement of bare-metal or drug-eluting stents. No open surgical intervention was required to manage any of these complications. With a median of follow-up of 22 months, four of eight patients (50%) with a major complication progressed to HAT compared with one of 71 patients (1.4%) undergoing a hepatic intervention without a major complication (P < .001). One patient required retransplantation. Severe vessel tortuosity was present in 75% (6 of 8) of interventions with a major complication compared with 34.6% (34 of 98) in those without (P = .05). In the complication cohort, 37.5% (3 of 8) of the patients had received a second liver transplant before intervention compared with 12.6% (9 of 71) of the patients in the noncomplication cohort (P = .097).
Although endovascular treatment of HAS is safe and effective in most patients, target vessel injury is possible. Severe tortuosity of the hepatic artery and prior retransplantation were associated with a twofold to threefold increased risk of a major complication. Acute vessel injury can be managed successfully using endovascular techniques, but these patients have a significant risk of subsequent HAT and need close surveillance.
Drift‐resonance wave‐particle interaction is a fundamental collisionless plasma process studied extensively in theory. Using cross‐spectral analysis of electric field, magnetic field, and ion flux ...data from the Van Allen Probe (Radiation Belt Storm Probes) spacecraft, we present direct evidence identifying the generation of a fundamental mode standing poloidal wave through drift‐resonance interactions in the inner magnetosphere. Intense azimuthal electric field (Eφ) oscillations as large as 10mV/m are observed, associated with radial magnetic field (Br) oscillations in the dawn‐noon sector near but south of the magnetic equator at L∼5. The observed wave period, Eφ/Br ratio and the 90° phase lag between Br and Eφ are all consistent with fundamental mode standing Poloidal waves. Phase shifts between particle fluxes and wave electric fields clearly demonstrate a drift resonance with ∼90 keV ring current ions. The estimated earthward gradient of ion phase space density provides a free energy source for wave generation through the drift‐resonance instability. A similar drift‐resonance process should occur ubiquitously in collisionless plasma systems. One specific example is the “fishbone” instability in fusion plasma devices. In addition, our observations have important implications for the long‐standing mysterious origin of Giant Pulsations.
Key Points
Unambiguous identification of drift‐resonance in magnetosphere
Broad implications for ring current and ground observations
Drift‐resonance similar to fishbone instability in Tokamak
Cavity mode oscillations (CMOs) are basic magnetohydrodynamic eigenmodes in the magnetosphere predicted by theory and are expected to occur following the arrival of an interplanetary shock. However, ...observational studies of shock‐induced CMOs have been sparse. We present a case study of a dayside ultralow‐frequency wave event that exhibited CMO properties. The event occurred immediately following the arrival of an interplanetary shock at 0829 UT on 15 August 2015. The shock was observed in the solar wind by the Time History of Events and Macroscale Interactions during Substorms‐B and ‐C spacecraft, and magnetospheric ultralow‐frequency waves were observed by multiple spacecraft including the Van Allen Probe‐A and Van Allen Probe‐B spacecraft, which were located in the dayside plasmasphere at L ∼1.4 and L ∼ 2.4, respectively. Both Van Allen Probes spacecraft detected compressional poloidal mode oscillations at ∼13 mHz (fundamental) and ∼26 mHz (second harmonic). At both frequencies, the azimuthal component of the electric field (Eϕ) lagged behind the compressional component of the magnetic field (Bμ) by ∼90°. The frequencies and the Eϕ‐Bμ relative phase are in good agreement with the CMOs generated in a dipole magnetohydrodynamic simulation that incorporates a realistic plasma mass density distribution and ionospheric boundary condition. The oscillations were also detected on the ground by the European quasi‐Meridional Magnetometer Array, which was located near the magnetic field footprints of the Van Allen Probes spacecraft.
Key Points
An interplanetary shock excited magnetospheric ULF oscillations
The oscillations were observed in the dayside plasmasphere by Van Allen Probes
The oscillations exhibited properties consistent with cavity mode oscillations
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