PURPOSE: Diet, a modifiable lifestyle factor, may influence the development of depression. We performed a systematic review of observational studies examining the relationship between dietary ...patterns and depression in healthy adults. METHODS: A literature research was conducted searching various electronic databases up to May 2013. Study selection was based on predefined inclusion and exclusion criteria. Included studies were reviewed, and relevant data were extracted by two independent researchers. Due to a high level of heterogeneity, no meta-analysis was conducted. Therefore, main results are presented in a descriptive way. RESULTS: In total, 16 studies met the inclusion criteria and are part of this review. Dietary patterns most commonly found were traditional/healthy patterns, Western/unhealthy patterns and Mediterranean patterns. The available literature suggests a protective effect of healthy and Mediterranean patterns, as well as a potential positive association of Western patterns and depression. However, comparison of the included studies was difficult, due to differences in relevant study characteristics and methodological limitations. CONCLUSIONS: There are indications that dietary patterns may have influence on the onset of depression, but no firm conclusion can be drawn at this point. Further research is needed to clarify the diet–depression relationship, preferably in the form of methodological strong prospective studies using more homogeneous methods.
•The history of the HELP model and the three current versions are summarized.•Validation studies of HELP 3 concerning covers are summarized.•Measured discharges were compared to simulation results of ...HELP 3.95 D for test fields in covers of two German landfills.•Further improvement of HELP model shall focus on percolation and evapotranspiration.
The Hydrologic Evaluation of Landfill Performance (HELP) model is the most widely applied model to calculate the water balance of cover and bottom liner systems for landfills. The paper summarizes the 30year history of the model from HELP version 1 to HELP 3.95 D and includes references to the three current and simultaneously available versions (HELP 3.07, Visual HELP 2.2, and HELP 3.95 D). A sufficient validation is an essential precondition for the use of any model in planning. The paper summarizes validation approaches for HELP 3 focused on cover systems in the literature. Furthermore, measurement results are compared to simulation results of HELP 3.95 D for (1) a test field with a compacted clay liner in the final cover of the landfill Hamburg-Georgswerder from 1988 to 1995 and (2) a test field with a 2.3m thick so-called water balance layer on the landfill Deetz near Berlin from 2004 to 2011. On the Georgswerder site actual evapotranspiration was well reproduced by HELP on the yearly average as well as in the seasonal course if precipitation data with 10% systematic measurement errors were used. However, the increase of liner leakage due to the deterioration of the clayey soil liner was not considered by the model. On the landfill Deetz HELP overestimated largely the percolation through the water balance layer resulting from an extremely wet summer due to an underestimation of the water storage in the layer and presumably also due to an underestimation of the actual evapotranspiration. Finally based on validation results and requests from the practice, plans for improving the model to a future version HELP 4 D are described.
Die Reihe Beihefte zur Zeitschrift für die neutestamentliche Wissenschaft (BZNW) ist eine der renommiertesten internationalen Buchreihen zur neutestamentlichen Wissenschaft. Seit 1923 publiziert sie ...wegweisende Forschungsarbeiten zum frühen Christentum und angrenzenden Themengebieten. Die Reihe ist historisch-kritisch verankert und steht neuen methodischen Ansätzen, die unser Verständnis des Neuen Testaments befördern, gleichfalls offen gegenüber.
Highlights • We examined the association between overall sleep quality and different measures of obesity in adults. • Poorer sleep quality was associated with obesity and high body fat, adjusted for ...socio-demographic and lifestyle factors. • The association was attenuated after further adjustment for depressive symptoms and somatic comorbidities. • The components sleep latency, sleep disturbances, and daytime dysfunction may be of special importance.
Major depression is a debilitating psychiatric illness that is typically associated with low mood and anhedonia. Depression has a heritable component that has remained difficult to elucidate with ...current sample sizes due to the polygenic nature of the disorder. To maximize sample size, we meta-analyzed data on 807,553 individuals (246,363 cases and 561,190 controls) from the three largest genome-wide association studies of depression. We identified 102 independent variants, 269 genes, and 15 genesets associated with depression, including both genes and gene pathways associated with synaptic structure and neurotransmission. An enrichment analysis provided further evidence of the importance of prefrontal brain regions. In an independent replication sample of 1,306,354 individuals (414,055 cases and 892,299 controls), 87 of the 102 associated variants were significant after multiple testing correction. These findings advance our understanding of the complex genetic architecture of depression and provide several future avenues for understanding etiology and developing new treatment approaches.
Capillary barriers are an interesting alternative component for cover systems of landfills and contaminated sites. Provided they are sufficiently validated, soil hydrological models could be fast and ...powerful tools for the dimensioning of capillary barriers. Outflow rates measured in a 10 m long tipping trough for one material combination and two slopes from stationary periods were compared to simulation results of HYDRUS (2D/3D), Version 2.05. The measured outflow rates show a typical pattern with slope-dependent threshold values indicating the efficiency of the capillary barrier. This flow pattern could not be reproduced with HYDRUS (2D/3D) that for different input setups produced smooth patterns without thresholds. The input setup was varied for different soil hydraulic models (van Genuchten-Mualem vs. Brooks-Corey), homogeneous and heterogeneous transport domains (no scaling vs. stochastically distributed scaling factors considering the Miller-Miller similitude), different HYDRUS versions (standard vs. alternative; i.e., with material properties assigned either to finite element nodes or finite elements, respectively), and different lower boundary conditions (seepage face vs. free drainage). Differences between measured and simulated outflow patterns could be caused by the measurements, the application of the model, or by the model itself. The van Genuchten-Mualem model may not be suitable to describe the soil hydrological relationships of these particular materials. The reason for the mismatch, however, could not be identified yet.
The current study was designed to determine the relation between preoperative cerebral oxygen saturation (Sco2), variables of cardiopulmonary function, mortality, and morbidity in a heterogeneous ...cohort of cardiac surgery patients.
In this study, 1,178 consecutive patients scheduled for on-pump surgery were prospectively studied. Preoperative Sco2, demographics, N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T, clinical outcomes, and 30-day and 1-yr mortality were recorded.
Median additive EuroSCORE was 5 (range: 0-19). Thirty-day and 1-yr mortality and major morbidity (at least two major complications and/or a high-dependency unit stay of at least 10 days) were 3.5%, 7.7%, and 13.3%, respectively. Median minimal preoperative oxygen supplemented Sco2 (Sco2min-ox) was 64% (range: 15-92%). Sco2min-ox was correlated (all: P value <0.0001) with N-terminal pro-B-type natriuretic peptide (ρ: -0.35), high-sensitive troponin T (ρ: -0.28), hematocrit (ρ: 0.34), glomerular filtration rate (ρ: 0.19), EuroSCORE (τ: 0.20), and left ventricular ejection fraction class (τ: 0.12). Thirty-day nonsurvivors had a lower Sco2min-ox than survivors (median 58% 95% CI, 50.7-62% vs. 64% 95% CI, 64-65%; P < 0.0001). Receiver-operating curve analysis of Sco2min-ox and 30-day mortality revealed an area-under-the-curve of 0.71 (95% CI, 0.68-0.73%; P < 0.0001) in the total cohort and an area-under-the-curve of 0.77 (95% CI, 0.69-0.86%; P < 0.0001) in patients with a EuroSCORE more than 10. Logistic regression based on different EuroSCORE categories (0-2; 3-5, 6-10, >10), Sco2min-ox, and duration of cardiopulmonary bypass showed that a Sco2min-ox equal or less than 50% is an independent risk factor for 30-day and 1-yr mortality.
Preoperative Sco2 levels are reflective of the severity of cardiopulmonary dysfunction, associated with short- and long-term mortality and morbidity, and may add to preoperative risk stratification in patients undergoing cardiac surgery.
Postoperative delirium is an important problem in patients undergoing major surgery. Cerebral oximetry is a non-invasive method to detect imbalances in the cerebral oxygen supply/demand-ratio. Low ...preoperative cerebral oxygen saturation (ScO₂) levels have been associated with postoperative delirium in non-cardiac surgery patients. The present prospective observational study determines the relationship between pre- and intra-operative ScO₂ levels and postoperative delirium in patients undergoing on-pump cardiac surgery.
After approval of the local ethical committee and written informed consent, N = 231 patients scheduled for elective/urgent cardiac surgery were enrolled. Delirium was assessed by the confusion-assessment-method for the intensive care unit (CAM-ICU) on the first three days after surgery. ScO₂ was obtained on the day before surgery, immediately before surgery and throughout the surgical procedure. Preoperative cognitive function, demographic, surgery related, and intra- and post-operative physiological data were registered.
Patients with delirium had lower pre- and intra-operative ScO₂ readings, were older, had lower mini-mental-status-examination(MMSE) scores, higher additive EuroScore and lower preoperative haemoglobin-levels. The binary logistic regression identified older age, lower MMSE, neurological or psychiatric disease and lower preoperative ScO₂ as independent predictors of postoperative delirium.
The presented study shows that a low preoperative ScO₂ is associated with postoperative delirium after on-pump cardiac surgery.
Background:
The care of patients with multiple sclerosis (MS) calls for a lifelong guidance and treatment and results in a high resource utilization. Therefore, strategies for the assessment and ...improvement of the care process are crucial. Quality indicators have become a widely used instrument to determine quality in many areas of the healthcare system. The currently available sets of indicators for the quality of MS care are summarized in this review.
Methods:
A literature search was conducted for reports that include statements on quality indicators for the care of people with MS. For the determination of the strength of the underlying evidence of the identified publications appropriate criteria of the PRISMA and AGREE-Statements were used. A further prioritization of the eligible indicators was based on the internal grading by the initial authors.
Results:
Of the 465 included records in the search, 6 sources were finally identified, 3 demonstrating a high and the others a medium strength of evidence. In total, these six reports described 226 quality indicators for the treatment of MS. Of them, 147 were further included in the assessment due to the scope of this article. Among the 101 indicators that originated from reports with a high strength of evidence, 6 also had a high initial internal grading. These six identified quality indicators describe five important characteristics of a high-quality care of MS.
Conclusion:
The search led to a scientifically evident set of six quality indicators for the assessment of care for patients with MS. These should be seen as starting points in the development of comprehensive sets of quality indicators in MS that addresses the individual objective of their use.
Background
Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine.
Methods
We conducted a systematic review and meta-analysis of studies investigating RLS in ...headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations.
Results
We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07–5.71; I2 = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14–1.30; I2 = 0.0%).
Conclusion
Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
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