Final Results of GERDA on the Two-Neutrino Double-β Decay Half-Life of ^{76}Ge

We present the measurement of the two-neutrino double-β decay rate of ^{76}Ge performed with the GERDA Phase II experiment. With a subset of the entire GERDA exposure, 11.8 kg yr, the half-life of the process has been determined: T_{1/2}^{2ν}=(2.022±0.018_{stat}±0.038_{syst})×10^{21}  yr. This is the most precise determination of the ^{76}Ge two-neutrino double-β decay half-life and one of the most precise measurements of a double-β decay process. The relevant nuclear matrix element can be extracted: M_{eff}^{2ν}=(0.101±0.001).

Search for tri-nucleon decays of 76Ge in GERDA

We search for tri-nucleon decays of 76 Ge in the dataset from the GERmanium Detector Array (GERDA) experiment. Decays that populate excited levels of the daughter nucleus above the threshold for particle emission lead to disintegration and are not considered. The ppp-, ppn-, and pnn-decays lead to 73 Cu, 73 Zn, and 73 Ga nuclei, respectively. These nuclei are unstable and eventually proceed by the beta decay of 73 Ga to 73 Ge (stable). We search for the 73 Ga decay exploiting the fact that it dominantly populates the 66.7 keV 73 m Ga state with half-life of 0.5 s. The nnn-decays of 76 Ge that proceed via 73 m Ge are also included in our analysis. We find no signal candidate and place a limit on the sum of the decay widths of the inclusive tri-nucleon decays that corresponds to a lower lifetime limit of 1.2× 1026  yr  (90% credible interval). This result improves previous limits for tri-nucleon decays by one to three orders of magnitude.

Liquid argon light collection and veto modeling in GERDA Phase II

The ability to detect liquid argon scintillation light from within a densely packed high-purity germanium detector array allowed the Gerda experiment to reach an exceptionally low background rate in the search for neutrinoless double beta decay of76 Ge. Proper modeling of the light propagation throughout the experimental setup, from any origin in the liquid argon volume to its eventual detection by the novel light read-out system, provides insight into the rejection capability and is a necessary ingredient to obtain robust background predictions. In this paper, we present a model of the Gerda liquid argon veto, as obtained by Monte Carlo simulations and constrained by calibration data, and highlight its application for background decomposition.

Caries Incidence Is Associated with Wasting among Cambodian Children

Evidence suggests that dental caries is associated with chronic and acute malnutrition, manifested as stunting and wasting in children. However, studies have not always appropriately accounted for confounding factors or for the temporal ordering between exposure and outcome. This study examined relationships between the development of caries lesions with subsequent stunting and wasting outcomes using data from a population-based cohort in Cambodia. Caries incidence was assessed based on the presence of a new cavitated carious lesion or a new pulpally involved lesion across a 6-mo observation period. Anthropometric measurements were taken at regular intervals. Effects of carious lesions on stunting and wasting were assessed using inverse probability treatment weighting, adjusting for potential confounders, using z scores for height-for-age (HAZ) and weight-for-height (WHZ) as outcomes. In total, 894 children (mean age 20 mo at baseline) were followed over 2 y. At baseline, 350 (39.1%) were identified as having stunting malnutrition. At follow-up, 58 (6.5%) had a new pulpally involved lesion. There was no association between incidence of cavitated or pulpally involved carious lesions at follow-up and stunting (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.75, 1.50). The incidence of pulpally involved carious lesions had an effect on wasting prevalence (WHZ <-2; RR = 1.35; 95% CI: 0.70, 2.62) and WHZ scores (average treatment effect = -0.294; 95% CI: -0.538, -0.050). This study offers evidence that the development of pulpally involved carious lesions has an effect on WHZ scores. Oral health promotion and clinical prevention and management of dental caries should be explored as interventions to promote normal growth and development among preschool children, particularly in low-income settings.

Omega-3 and Omega-6 fatty acids and risk of psychotic outcomes in the ALSPAC birth cohort

BACKGROUND

Long chain polyunsaturated fatty acid (PUFA) levels have been implicated in the pathology of psychotic disorders. We investigated the relationship between childhood PUFA levels and later psychotic experiences (PE's) in a large birth cohort.

METHODS

Plasma levels of Ω-3 and Ω-6 fatty acids (FA's) were assayed at ages 7 and 16 years. PE's were assessed at ages 12 and 18 years using a semi-structured interview. Primary outcome was any PE's at 18 years; sensitivity analyses examined incident PE's between ages 12 and 18 years, persistent PE's (at 12 and 18) and psychotic disorder at 18 years. Genetic instruments for Ω-3 and Ω-6 were derived and used in a multivariable Mendelian Randomization analysis.

RESULTS

Higher levels of Ω-6 FA's AA, OA and AdA at age 7 years were weakly associated with a reduced risk for PE's at 18 years, however, effect sizes were small and attenuated after adjusting for confounders (strongest evidence for OA; adjusted OR, 0.842; 95% CI, 0.711, 0.998; p, 0.048). Total Ω-6 levels at age 16 years were associated with an increased odds of psychotic disorder at age 18 years. However, there was no association between Ω-6/Ω-3 ratio and psychosis outcomes, nor with genetic instruments of total Ω-3 or Ω-6 levels.

CONCLUSIONS

There is no strong evidence that total plasma Ω-3 FA levels or Ω-6/Ω-3 ratios in childhood and mid-adolescence are associated with increased risk for PE's or psychotic disorder, but very marginal evidence that alterations in the Ω-6 pathway at developmental time points might influence risk2.

0774 Factors Associated With The Continuous Use Of Psychotropic Treatments For Narcolepsy

Introduction

Narcolepsy is a debilitating disorder characterized by excessive sleepiness and cataplexy episodes. There is no cure for this disease. Current treatments focus on controlling the symptoms with CNS stimulants for sleepiness and antidepressants and/or CNS depressants for cataplexy. This study examines the factors that can contribute to the cessation of narcolepsy treatment.

Methods

The study includes 291 narcoleptic individuals who were interviewed twice, approximately five to seven years apart, in Wave 1 (W1) and Wave 2 (W2). Telephone interviews were conducted with the help of the Sleep-EVAL system; narcolepsy individuals were initially evaluated and diagnosed by a Sleep Specialist.

Results

At W1, 49.2% of narcoleptic individuals were taking a CNS stimulant; at W2, 37% of narcoleptic individuals were taking a CNS stimulant. The use was chronic (i.e., present at W2 and W1) for 52.7% of the W2 subjects. CNS depressants were used by 19.1% at W1 and 17% at W2. Of the W1 subjects, 67.6% still reported using CNS depressants at W2. In terms of antidepressants, 38.6% and 29.6% of subjects reported using these medications at W1 and W2 respectively. Of those taking antidepressants at W2, 58.9% reported chronic use (ie, were also on antidepressants at W1). At least one of the aforementioned medication classes was used by 72% of participants at W1 and 56.1% at W2. Chronicity of nocturnal awakenings (RR: 2.7), the frequency of cataplexy episodes (RR: 2.3) and the chronicity of hypnopompic hallucinations (RR: 2.8) were associated with long-term use of narcolepsy treatment.

Conclusion

Narcolepsy treatments are mostly taken to long term. Some narcoleptics individuals were able to reduce or stop treatment either because the intensity of symptoms decreased or because they developed coping mechanisms to deal with the symptoms.

Support

NIH (R01NS044199), the Arrillaga Foundation and Jazz Pharmaceuticals Inc.

Vasomotor symptoms and the risk of incident venous thrombosis in postmenopausal women

Essentials Vasomotor symptoms have been proposed as markers of changing cardiovascular risk. In this cohort study, we evaluated these symptoms as markers of venous thrombosis (VT) risk. We found no evidence that vasomotor symptom presence or severity were associated with VT risk. Among these postmenopausal women, vasomotor symptoms are not a useful marker of VT risk.

SUMMARY

Background Vasomotor symptoms may be markers of changes in cardiovascular risk, but it is unknown whether these symptoms are associated with the risk of venous thrombosis (VT). Objective To evaluate the association of vasomotor symptom presence and severity with incident VT risk among postmenopausal women, independent of potential explanatory variables. Methods This cohort study included participants of the Women's Health Initiative (WHI) Hormone Therapy Trials (n = 24 508) and Observational Study (n = 87 783), analyzed separately. At baseline, women reported whether hot flashes or night sweats were present and, if so, their severity. Using Cox proportional hazards models, we estimated the VT risk associated with vasomotor symptom presence and severity, adjusted for potential explanatory variables: age, body mass index, smoking status, race/ethnicity, and time-varying current hormone therapy use. Results At baseline, WHI Hormone Therapy Trial participants were aged 64 years and WHI Observational Study participants were aged 63 years, on average. In the WHI Hormone Therapy Trials over a median of 8.2 years of follow-up, 522 women experienced a VT event. In the WHI Observational Study, over 7.9 years of follow-up, 1103 women experienced a VT event. In adjusted analyses, we found no evidence of an association between vasomotor symptom presence (hazard ratio [HR]adj  0.91, 95% confidence interval [CI] 0.75-1.1 in the WHI Hormone Therapy Trials; HRadj  1.1, 95% CI 0.99-1.3 in the WHI Observational Study) or severity (HRadj for severe versus mild 0.99, 95% CI 0.53-1.9 in the WHI Hormone Therapy Trials; HRadj  1.3, 95% CI 0.89-2.0) in the WHI Observational Study) and the risk of incident VT. Conclusions Although vasomotor symptoms have been associated with the risk of other cardiovascular events in published studies, our findings do not suggest that vasomotor symptoms constitute a marker of VT risk.

How economic contexts shape calculations of yield in biodiversity offsetting

We examined and analyzed methods used to create numerical equivalence between sites affected by development and proposed conservation offset sites. Application of biodiversity offsetting metrics in development impact and mitigation assessments is thought to standardize biodiversity conservation outcomes, sometimes termed yield by those conducting these calculations. The youth of biodiversity offsetting in application, however, means little is known about how biodiversity valuations and offset contracts between development and offset sites are agreed on in practice or about long-term conservation outcomes. We examined how sites were made commensurable and how biodiversity gains or yields were calculated and negotiated for a specific offset contract in a government-led pilot study of biodiversity offsets in England. Over 24 months, we conducted participant observations of various stages in the negotiation of offset contracts through repeated visits to 3 (anonymized) biodiversity offset contract sites. We conducted 50 semistructured interviews of stakeholders in regional and local government, the private sector, and civil society. We used a qualitative data analysis software program (DEDOOSE) to textually analyze interview transcriptions. We also compared successive iterations of biodiversity-offsetting calculation spreadsheets and planning documents. A particular focus was the different iterations of a specific biodiversity impact assessment in which the biodiversity offsetting metric developed by the U.K.'s Department for Environment, Food and Rural Affairs was used. We highlight 3 main findings. First, biodiversity offsetting metrics were amended in creative ways as users adapted inputs to metric calculations to balance and negotiate conflicting requirements. Second, the practice of making different habitats equivalent to each other through the application of biodiversity offsetting metrics resulted in commensuration outcomes that may not provide projected conservation gains. Third, the pressure of creating value for money diminished projected conservation yields.

Patterns of human–crocodile conflict in Queensland: a review of historical estuarine crocodile (Crocodylus porosus) management

Context In Queensland, the management of estuarine crocodiles (Crocodylus porosus) by the government is important for ensuring public safety, especially along the populated east coast, where there is a large human population. Aims The present study aimed to determine historical, temporal and spatial patterns of human–crocodile conflict in Queensland. Methods The study used Queensland Government records of estuarine crocodile attacks (1971–2015), sightings by the general public (2003–2015), and removals and relocations for management purposes (1985–2015) to develop General Linear Models describing historical, temporal and spatial patterns. Key results The highest number of attacks, sightings, removals and relocations occurred along the populated east coast between Townsville and the Daintree during wet season months (November–February). There have been 35 crocodile attacks in Queensland since 1971 (total 0.8 per year; fatal 0.3 per year), mostly involving local people or regular visitors (77.1%), specifically adult males (71.4%; mean age 44). There has been an increase in the rate of crocodile attacks over time, with an average of 1.3 per year since 1996, most of which were non-fatal (84%). The number of crocodile sightings has been increasing annually (with a mean of 348 per year since 2011), while the number of crocodiles removed or relocated for management purposes (n = 608) has fluctuating widely each year (range 1–57). Conclusions The level of human–crocodile conflict in Queensland is increasing, and this is likely to be a consequence of increasing human and crocodile populations. While conflict is highest during the wet season, estuarine crocodiles pose a threat to public safety year round. Implications With the increase in conflict, the ongoing management of estuarine crocodiles, through targeted removals in and around areas of higher human habitation and through education, is essential for ensuring public safety into the future.

Mood, anxiety and psychotic phenomena measure a common psychopathological factor

BACKGROUND

Psychotic phenomena are common in the general population but are excluded from diagnostic criteria for mild to moderate depression and anxiety despite their co-occurrence and shared risk factors. We used item response theory modelling to examine whether the co-occurrence of depressive, anxiety and psychotic phenomena is best explained by: (1) a single underlying factor; (2) two separate, uncorrelated factors; (3) two separate yet linked factors; or (4) two separate domains along with an underlying 'common mental distress' (CMD) factor. We defined where, along any latent continuum, the psychopathological items contributed most information.

METHOD

We performed a secondary analysis of cross-sectional, item-level information from measures of depression, anxiety and psychotic experiences in 6617 participants aged 13 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort and 977 participants aged 18 years from the ROOTS schools-based sample. We replicated results from one sample in the other and validated the latent factors against an earlier parental measure of mental state.

RESULTS

In both cohorts depression, anxiety and psychotic items were best represented as a bi-factor model with a single, unitary CMD factor on which psychotic items conveyed information about the more severe end (model 4); residual variation remained for psychotic items. The CMD factor was significantly associated with the prior parental measure.

CONCLUSIONS

Psychotic phenomena co-occur with depression and anxiety in teenagers and may be a marker of severity in a single, unitary dimension of CMD. Psychotic phenomena should be routinely included in epidemiological assessments of psychiatric morbidity, otherwise the most severe symptomatology remains unmeasured.

Common versus psychopathology-specific risk factors for psychotic experiences and depression during adolescence

BACKGROUND

An argument often used to support the view that psychotic experiences (PEs) in general population samples are a valid phenotype for studying the aetiology of schizophrenia is that risk factors for schizophrenia show similar patterns of association with PEs. However, PEs often co-occur with depression, and no study has explicitly tested whether risk factors for schizophrenia are shared between PEs and depression, or are psychopathology specific, while jointly modelling both outcomes.

METHOD

We used data from 7030 subjects from a birth cohort study. Depression and PEs at age 18 years were assessed using self-report questionnaires and semi-structured interviews. We compared the extent to which risk factors for schizophrenia across sociodemographic, familial, neurodevelopmental, stress-adversity, emotional-behavioural and substance use domains showed different associations with PEs and depression within bivariate models that allowed for their correlation.

RESULTS

Most of the exposures examined were associated, to a similar degree, with an increased risk of both outcomes. However, whereas female sex and family history of depression showed some discrimination as potential risk factors for depression and PEs, with stronger associations in the former, markers of abnormal neurodevelopment showed stronger associations with PEs.

CONCLUSIONS

The argument that PEs are valid markers for studying the aetiology of schizophrenia, made simply on the basis that they share risk factors in common, is not well supported. PEs seem to be a weak index of genetic and environmental risk for schizophrenia; however, studies disentangling aetiological pathways to PEs from those impacting upon co-morbid psychopathology might provide important insights into the aetiology of psychotic disorders.

Chemical immobilisation and satellite tagging of free-living southern cassowaries

BACKGROUND

The southern cassowary (Casuarius casuarius johnsonii) attains 1.8 m in height and over 80 kg in weight. These large birds are equipped with large claws and, although not a direct threat to humans, they have caused serious injury to handlers and members of the public.

METHODS AND RESULTS

This study describes chemical immobilisation, restraint, transport and post-monitoring (satellite tracking) methodologies for adult and juvenile southern cassowaries, captured and released from their natural environment.

CONCLUSIONS

The described methods have improved the management and research opportunities for the southern cassowary and may be transferable to other species of large ratite.

Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention

Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18-23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many 'non-changers' were engaged in non-stable 'on and off' relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. 'Non-changers' also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child's father, as well as elaborating on the intersection of substance use and risky sexual decision-making.

Marfan syndrome and vascular dissections during pregnancy

Pregnancy in a patient with Marfan syndrome may pose significant maternal and fetal risks, and pregnancy outcome is most impacted by the extent of cardiovascular involvement present at conception. This review addresses principles to guide preconception counseling of a Marfan patient, in addition to antepartum and intrapartum management considerations. Multidisciplinary care is recommended during pregnancy, given the potential for multiorgan involvement and various complications which may occur. Mode of delivery planning is guided by the degree of aortic root dilatation. Dissection of a dilated aortic root can present a surgical emergency during pregnancy, and principles for cardiopulmonary bypass in a pregnant patient are reviewed.

Genomics and population biology of Cryptosporidium species

We describe recent advances in the genomics and population biology of Cryptosporidium parvum and C. hominis, the causative agents of cryptosporidiosis in humans and animals. Many basic aspects of the biology of Cryptosporidium species remain to be investigated and effective drugs to control cryptosporidiosis are not available. Sequencing and annotation of the genome of C. parvum and C. hominis has uncovered unique features of the metabolism of these species. The recently sequenced genome of the gastric species C. muris is providing new insights into the evolution of the genus. Cryptosporidian sequence information has facilitated the identification of polymorphic genetic markers. Genotyping of oocysts excreted by human and animal hosts using such markers has revealed many new species and genotypes, and is leading to a better understanding of the epidemiology of cryptosporidiosis.