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Background It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals. Methods To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects. Results Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects. Conclusions Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.

The main objective is to determine if the infrastructure of critical care units influences the perception of professionals using this handover method.Nursing bedside handover is considered a safe information transfer method that can help reduce communication errors; however, it has some disadvantages expressed by health professionals and patients, related to confidentiality, stress and less rest.Qualitative descriptive study. The perception of nursing professionals who work in a critical care unit with a mixed structure (open and closed boxes) in a tertiary care hospital was evaluated through a semi-structured interview with a battery of common questions (prepared after literature review) and spontaneous questions according to the objectives of the study.Five thematic areas related to the study objectives were observed: patient safety, message content, confidentiality/privacy, intimacy/rest/noise, and patient participation.Nursing bedside handover improves safe communication between professionals, because it avoids errors or distractions by double or triple checking (if we include the patient) as well as empowering the patient and including him in his recovery. Carrying it out in closed boxes increases confidentiality and improves intimacy as there are no other patients or relatives nearby who can hear the message. However, the place or shift where the handover is performed does not interfere with the effectiveness of the communication of the message. The morning shift is the busiest, which could affect the patient's rest, a fact that could be solved if it is carried out in a closed box.Carrying out the handover in individual boxes in intensive care units would provide greater privacy to the patient and reduce the perception of external noise, contributing to the reduction of interruptions and the increase of the patient's rest. It is also a key element in patient safety through verification by double or triple check-up, the structuring of the message and the visualization of devices presented by the patient. In addition, it will allow the professional to start a process of early humanization and participation of the patient in the health process.

We combine consistently dated benthic carbon isotopic records distributed over the entire Atlantic Ocean with numerical simulations performed by a glacial configuration of the Norwegian Earth System Model with active ocean biogeochemistry in order to interpret the observed Cibicides δ13C changes at the stadial–interstadial transition corresponding to the end of Heinrich Stadial 4 (HS4) in terms of ocean circulation and remineralization changes. We show that the marked increase in Cibicides δ13C observed at the end of HS4 between ∼2000 and 4200 m in the Atlantic can be explained by changes in nutrient concentrations as simulated by the model in response to the halting of freshwater input in the high-latitude glacial North Atlantic. Our model results show that this Cibicides δ13C signal is associated with changes in the ratio of southern-sourced (SSW) versus northern-sourced (NSW) water masses at the core sites, whereby SSW is replaced by NSW as a consequence of the resumption of deep-water formation in the northern North Atlantic and Nordic Seas after the freshwater input is halted. Our results further suggest that the contribution of ocean circulation changes to this signal increases from ∼40 % at 2000 m to ∼80 % at 4000 m. Below ∼4200 m, the model shows little ocean circulation change but an increase in remineralization across the transition marking the end of HS4. The simulated lower remineralization during stadials compared to during interstadials is particularly pronounced in deep subantarctic sites, in agreement with the decrease in the export production of carbon to the deep Southern Ocean during stadials found in previous studies.

The calcium-sensing receptor (CaSR) in the distal convoluted tubule (DCT) activates the NaCl cotransporter (NCC). Glucose acts as a positive allosteric modulator of the CaSR. Under physiologic conditions, no glucose is delivered to the DCT, and fructose delivery depends on consumption. We hypothesized that glucose/fructose delivery to the DCT modulates the CaSR in a positive allosteric way, activating the WNK4-SPAK-NCC pathway and thus increasing salt retention.We evaluated the effect of glucose/fructose arrival to the distal nephron on the CaSR-WNK4-SPAK-NCC pathway using HEK-293 cells, C57BL/6 and WNK4-knockout mice,HEK-293 cells exposed to glucose/fructose increased SPAK phosphorylation in a WNK4- and CaSR-dependent manner. C57BL/6 mice exposed to fructose or a single dose of dapagliflozin to induce transient glycosuria showed increased activity of the WNK4-SPAK-NCC pathway. The calcilytic NPS2143 ameliorated this effect, which was not observed in WNK4-KO mice. C57BL/6 mice treated with fructose or dapagliflozin showed markedly increased natriuresis after thiazide challenge.Glycosuria or fructosuria was associated with increased NCC, SPAK, and WNK4 phosphorylation in a CaSR-dependent manner.

International audience; Submarine gravity flow processes on carbonate platform slopes can lead to the deposition of calciturbidite and calcidebrite beds on the adjacent deep-water seafloor. Such deposits have been previously found to occur more frequently during sea-level highstands, leading to increased export of carbonates to the deep sea during interglacial periods. Here, we document a new occurrence of these types of event beds in cores near a series of volcano-cored carbonate platforms in the Mozambique Channel (SW Indian Ocean), describing them from a sedimentological perspective and analyzing the controls on their distribution. 32 event beds, located near four isolated platforms, are composed primarily of uncoated skeletal grains from primarily shallow-water and planktic taxa. Compositional analysis shows that planktic foraminifera are hydrodynamically sorted such that they form a greater proportion of the upper parts of event beds. Age models based on foraminifer δ18O isotope data allow for precise (ky-scale) dating of each gravity flow event; results show that events occurred with frequencies ranging from 2 to 4 events per 100,000 years over the past ~ 800 kyr regardless of the phase within the sea-level cycle (i.e., transgressive, regressive, highstand or lowstand). However, events were most frequent during periods, both relative and absolute, of highest sea level, and are therefore interpreted to be controlled in part by sea-level status or change, though additional causes are also possible.

BACKGROUND The use of kaolin-coated dressings has become common and have efficacy in normal patients, but their increased use will inevitably include use on bleeding patients taking anticoagulants. We hypothesize that kaolin coating material (KCM) will improve clotting regardless of anticoagulation medication. METHODS A prospective study was performed on blood from patients who were on a vitamin K antagonist (VKA), unfractionated heparin (UH), an antiplatelet (AP) agent, a Xa inhibitor (Xa), or a direct thrombin inhibitor (DTI). None were on more than one type of anticoagulation medication. Viscoelastic testing was performed with and without KCM. All p values were adjusted for multiple comparisons. RESULTS The addition of KCM significantly decreased the time for initial clot formation (CT) in all groups. The mean CT for controls was decreased from 692 to 190.8 s (p < 0.0001). KCM decreased the initial clot formation time by about 1.5 times in those on DTI (p = 0.043) and 2.5 times in those taking AP medication (p < 0.001). The most profound effect was seen in those on UH (no KCM 1,602 s vs. KCM 440 s; p < 0.001), VKA (no KCM 1,152 s vs. 232 s; p < 0.01), and Xa (no KCM 1,342 s vs. 287 s; p < 0.001). Analysis of other clot formation parameters revealed that KCM significantly improved the clot formation kinetics (CFT) only in patients taking Xa (p = 0.03). KCM improved maximum clot strength in patients on Xa inhibitors (p = 0.05). Patients on UH had a larger effect size with an increase in clot strength from 24.35 mm to 43.35 mm whereas those on Xa had an increase of 38.7 mm to 49.85 mm. CONCLUSION In this in vitro analysis, the addition of KCM to the blood of patients taking any of these anticoagulation medications significantly improved the time to initial clot formation, indicating that kaolin-based hemostatic dressings will be effective in initiating clot formation in patients on anticoagulants. LEVEL OF EVIDENCE Therapeutic, level IV.

Scope The aim is to identify breastmilk components associated with fecal concentration of SCFAs and to investigate whether they differ between infants with high weight gain (HW) and normal weight gain (NW). Methods and results Breastmilk and fecal samples are collected from mother-infant dyads with HW (n = 11) and NW (n = 15) at 5 and 9 months of age. Breastmilk is profiled on ultra-performance LC-quadrupole TOF-MS platform. Fecal SCFAs are quantified using an isotope-labeled chemical derivatization method. Human milk oligosaccharides (HMOs) are quantified using HPLC after fluorescent derivatization. Lower levels of α-linolenic acid, oleic acid, 3-oxohexadecanoic acid, LPE (P-16:0), LPC (16:0), LPC (18:0), PC (36:2) in breastmilk from mothers from the HW-group at 5 months of age is found. Fecal SCFA concentrations are increased during the transition period from breastfeeding to complementary feeding. Fecal butyrate concentration is higher in the NW-group at 9 months of age. Fecal branched SCFAs are positively associated with breastmilk phospholipid levels, free-fatty acid levels, HMO-diversity, sialylated-HMOs, 6'-sialyllactose, and disialyl-lacto-N-hexaose. Conclusion Fecal branched SCFA concentrations seem to be affected by breastmilk lipid and HMO composition. These differences in breastmilk metabolites may partially explain the excessive weight gain in early life.

Thanks to its optimal location on the North Brazilian margin, core MD09-3257 records both ocean circulation and atmospheric changes. The latter occur locally in the form of increased rainfall on the adjacent continent during the cold intervals recorded in Greenland ice and northern North Atlantic sediment cores (i.e. Greenland stadials). These rainfall events are recorded in MD09-3257 by peaks in ln(Ti / Ca). New sedimentary Pa / Th data indicate that mid-depth western equatorial water mass transport decreased during all the Greenland stadials of the last 45 ky. Using cross-wavelet transforms and spectrogram analysis, we assess the relative phase between the MD09-3257 sedimentary Pa / Th and ln(Ti / Ca) signals. We show that decreased water mass transport between ~ 1300 and 2300 m depth in the western equatorial Atlantic preceded increased rainfall over the adjacent continent by 110 to 400 y at Dansgaard–Oeschger (D–O) frequencies, and by 280 to 980 y at Heinrich-like frequencies. We suggest that the large lead of ocean circulation changes with respect to changes in tropical South American precipitation at Heinrich-like frequencies is related to the effect of a positive feedback involving iceberg discharges in the North Atlantic. In contrast, the absence of widespread ice rafted detrital layers in North Atlantic cores during D–O stadials supports the hypothesis that such a feedback was not triggered in the case of D–O stadials, with circulation slowdowns and subsequent changes remaining more limited during D–O stadials than Heinrich stadials.

It has been demonstrated that almost 28% of the Mexican population presents the GFOD2 SNP rs12449157 that is associated with lipids. Thus, the aim of this study was to assess the presence of this SNP and biochemical parameters in subjects with hypercholesterolemia. We studied 696 Mexican subjects (139 men, 557 women). The number of participants with hypercholesterolemia was 271, from these, 94 subjects (33%) had the GFOD2 SNP. Interestingly, subjects with hypercholesterolemia and the G allele showed lower serum HDL-C concentration than those with the common allele (p