127 research outputs found

    Presenting the Compendium Isotoporum Medii Aevi, a multi-isotope database for Medieval Europe

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    Here we present the Compendium Isotoporum Medii Aevi (CIMA), an open-access database gathering more than 50,000 isotopic measurements for bioarchaeological samples located within Europe and its margins, and dating between 500 and 1500 CE. This multi-isotope (δ13C, δ15N, δ34S, δ18O, and 87Sr/86Sr) archive of measurements on human, animal, and plant archaeological remains also includes a variety of supporting information that offer, for instance, a taxonomic characterization of the samples, their location, and chronology, in addition to data on social, religious, and political contexts. Such a dataset can be used to identify data gaps for future research and to address multiple research questions, including those related with studies on medieval human lifeways (i.e. human subsistence, spatial mobility), characterization of paleo-environmental and -climatic conditions, and on plant and animal agricultural management practices. Brief examples of such applications are given here and we also discuss how the integration of large volumes of isotopic data with other types of archaeological and historical data can improve our knowledge of medieval Europe.Background & Summary Methods Data Records Technical Validation Usage Note

    Post-traumatic stress disorder following patient assaults among staff members of mental health hospitals: a prospective longitudinal study

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    BACKGROUND: Violence by patients against staff members in mental health institutions has become an important challenge. Violent attacks may not only cause bodily injuries but can also have posttraumatic consequences with high rates of stress for mental health staff. This study prospectively assessed posttraumatic stress disorder (PTSD) in employees who were severely assaulted by patients in nine German state mental health institutions. METHODS: During the study period of six months 46 assaulted staff members were reported. Each staff member was interviewed three times after the violent incident, using the Impact of Event Scale-Revised (IES-R), a widely used PTSD research tool, as well as the Posttraumatic Stress Disorder Checklist – Civilian (PCL-C). RESULTS: In the baseline assessment following an assault by a patient, eight subjects (17%) met the criteria for PTSD. After two and six months, three and four subjects respectively still met diagnosis criteria. CONCLUSION: A small minority of assaulted employees suffer from PTSD for several months after a patient assault

    Serum anti-NMDA receptor antibodies are linked to memory impairment 12 months after stroke

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    Patients suffering from strokes are at increased risk of developing post-stroke dementia. Serum anti-NMDA receptor autoantibodies (NMDAR1-abs) have been associated with unfavorable post-stroke outcomes. However, their effect on specific cognitive domains remains unclear. We used data from the prospective multicenter DZNE-mechanisms after stroke (DEMDAS) cohort, and measured NMDAR1-abs in serum at baseline. Cognitive function was assessed with a comprehensive neuropsychological test battery at 6- and 12-months follow-up. We employed crude and stepwise confounder adjusted linear and logistic regression models as well as generalized estimating equation models (GEE) to determine the relevance of NMDAR1-abs seropositivity on cognitive function after stroke. 10.2% (58/569) DEMDAS patients were NMDAR1-abs seropositive (IgM:n = 44/IgA:n = 21/IgG:n = 2). Seropositivity was not associated with global cognitive impairment after stroke. However, NMDAR1-abs seropositive patients performed lower in the memory domain (β adjusted = -0.11; 95%CI = -0.57 to -0.03) and were at increased risk for memory impairment (OR=adjusted 3.8; 95%CI = 1.33-10.82) compared to seronegative patients, 12 months after stroke. Further, NMDAR1-abs were linked to memory impairment over time in GEE from 6- to 12-months follow-up (OR=adjusted 2.41; 95%CI = 1.05-5.49). Our data suggests that NMDAR1-abs contribute to memory dysfunction 1 year after stroke while not affecting other cognitive subdomains. Hence, antineuronal autoimmunity may be involved in distinct mechanisms of post-stroke memory impairment. Clinical trial name and registration number: The Determinants of Dementia After Stroke (DEMDAS; study identifier on clinical trials.gov: NCT01334749)

    High prevalence of NMDA receptor IgA/IgM antibodies in different dementia types

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    OBJECTIVE: To retrospectively determine the frequency of N-Methyl-D-Aspartate (NMDA) receptor (NMDAR) autoantibodies in patients with different forms of dementia. METHODS: Clinical characterization of 660 patients with dementia, neurodegenerative disease without dementia, other neurological disorders and age-matched healthy controls combined with retrospective analysis of serum or cerebrospinal fluid (CSF) for the presence of NMDAR antibodies. Antibody binding to receptor mutants and the effect of immunotherapy were determined in a subgroup of patients. RESULTS: Serum NMDAR antibodies of IgM, IgA, or IgG subtypes were detected in 16.1% of 286 dementia patients (9.5% IgM, 4.9% IgA, and 1.7% IgG) and in 2.8% of 217 cognitively healthy controls (1.9% IgM and 0.9% IgA). Antibodies were rarely found in CSF. The highest prevalence of serum antibodies was detected in patients with “unclassified dementia” followed by progressive supranuclear palsy, corticobasal syndrome, Parkinson’s disease-related dementia, and primary progressive aphasia. Among the unclassified dementia group, 60% of 20 patients had NMDAR antibodies, accompanied by higher frequency of CSF abnormalities, and subacute or fluctuating disease progression. Immunotherapy in selected prospective cases resulted in clinical stabilization, loss of antibodies, and improvement of functional imaging parameters. Epitope mapping showed varied determinants in patients with NMDAR IgA-associated cognitive decline. INTERPRETATION: Serum IgA/IgM NMDAR antibodies occur in a significant number of patients with dementia. Whether these antibodies result from or contribute to the neurodegenerative disorder remains unknown, but our findings reveal a subgroup of patients with high antibody levels who can potentially benefit from immunotherapy

    Cross-Sector Partnerships to Address Social Issues: Challenges to Theory and Practice

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    Means versus ends in opaque institutional fields: Trading off compliance and achievement in sustainability standard adoption

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    __Abstract__ The long-standing discussion on decoupling has recently moved from adopters not implementing the agreed-upon policies to compliant adopters not achieving the goals intended by institutional entrepreneurs. This “means-ends decoupling” prevails especially in highly opaque fields, where practices, causality, and performance are hard to understand and chart. I conceptualize the conditions under which the adoption of institutions in relatively opaque fields leads to the achievement of the envisaged goals. Voluntary sustainability standards governing socioenvironmental issues illustrate these arguments. I argue that the lack of field transparency drives institutional entrepreneurs to create and maintain concrete and uniform rules, apply strong incentives, and disseminate “best practices” to ensure substantive adopter compliance. However, such rigid institutions are ill-equipped to deal with the causal complexity and practice multiplicity underlying opacity while they smother adopter agency. The ensuing tension between substantive compliance and goal achievement leads to an inherent trade-off: institutional entrepreneurs who remedy the policy-practice decoupling may enhance the disparity between means and ends, and vice versa. While sustainability standards and other institutions in highly opaque fields can, therefore, not fully achieve the envisaged goals, the trade-off can be reduced through systemically designed institutions that promote goal internalization and contain niche institutions
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