Predictability of Arctic sea ice on weather time scales.

The field of Arctic sea ice prediction on "weather time scales" is still in its infancy with little existing understanding of the limits of predictability. This is especially true for sea ice deformation along so-called Linear Kinematic Features (LKFs) including leads that are relevant for marine operations. Here the potential predictability of the sea ice pack in the wintertime Arctic up to ten days ahead is determined, exploiting the fact that sea ice-ocean models start to show skill at representing sea ice deformation at high spatial resolutions. Results are based on ensemble simulations with a high-resolution sea ice-ocean model driven by atmospheric ensemble forecasts. The predictability of LKFs as measured by different metrics drops quickly, with predictability being almost completely lost after 4-8 days. In contrast, quantities such as sea ice concentration or the location of the ice edge retain high levels of predictability throughout the full 10-day forecast period. It is argued that the rapid error growth for LKFs is mainly due to the chaotic behaviour of the atmosphere associated with the low predictability of near surface wind divergence and vorticity; initial condition uncertainty for ice thickness is found to be of minor importance as long as LKFs are initialized at the right locations.

Psychological and pharmacological interventions for depression in patients with diabetes mellitus: an abridged Cochrane review.

AIMS: To summarize and critically evaluate the effectiveness of psychological and pharmacological interventions for depression in patients with both diabetes and depression. METHODS: Randomized controlled trials investigating psychological and pharmacological interventions for depression in adults with diabetes and depression were included. A comprehensive search of primary studies according to Cochrane were conducted. Primary outcomes were depression and glycaemic control. Further, treatment adherence, diabetes complications, mortality, healthcare costs and quality of life were investigated. Two reviewers identified primary studies and extracted data independently. Random-effects model meta-analyses were conducted to compute overall estimates of treatment outcomes. RESULTS: The database search resulted in 3963 references, of which 19 trials were included. Randomized controlled trials of psychological interventions showed positive effects on short- and medium-term depression severity [standardized mean difference short-term range -1.47; -0.14, n = 7; medium-term standardized mean difference -0.42 (95% CI -0.70 to -0.14), n = 3] and depression remission [odds ratio short term 2.88 (95% CI 1.58-5.25), n = 4; odds ratio medium term 2.49 (95% CI 1.44-4.32), n = 2]. Effects on glycaemic control in psychological intervention trials varied substantially (standardized mean difference range -0.97 to 0.47, n = 4). Selective serotonin reuptake inhibitors showed a moderate beneficial effect on short-term depression severity [standardized mean difference -0.39 (95% CI -0.64 to -0.13], n = 5) and depression remission [odds ratio 2.52 (95% CI 1.11-5.75), n = 2]. Glycaemic control improved in randomized controlled trials comparing selective serotonin reuptake inhibitors with placebo at the end of treatment [standardized mean difference -0.38 (95% CI -0.64 to -0.12), n = 5]. CONCLUSIONS: Psychological and pharmacological interventions positively affect depression outcomes in patients with diabetes at the end of treatment. Furthermore, short-term glycaemic control improved moderately in pharmacological trials. Most outcomes have not been investigated sufficiently. Moreover, there is a lack of follow-up data for pharmacological trials limiting the evidence on the sustainability of treatment effects.

Healthcare costs in patients with diabetes mellitus and comorbid mental disorders--a systematic review.

AIMS/HYPOTHESIS: We systematically reviewed the impact of comorbid mental disorders on healthcare costs in persons with diabetes. METHOD: We conducted a comprehensive search for studies investigating adult persons (≥ 18 years old) with diabetes mellitus. All studies that allowed comparison of healthcare costs between diabetic patients with mental disorders and those without were included. RESULTS: We identified 4,273 potentially relevant articles from a comprehensive database search. Of these, 31 primary studies (39 publications) fulfilled inclusion criteria, of which 27 examined comorbid depression. Hospitalisation rates and hospitalisation costs, frequency and costs of outpatient visits, emergency department visits, medication costs and total healthcare costs were mainly increased with small to moderate effect sizes in patients with diabetes and comorbid mental disorders compared with diabetic patients without such problems. Frequency (standardised mean difference [SMD] =0.35-1.26) and costs (SMD =0.33-0.85) of mental health specialist visits were increased in the group with mental health comorbidity. Results regarding diabetes-related preventive services were inconsistent but point to a reduced utilisation rate in diabetic patients with comorbid mental disorders. Statistical heterogeneity between studies was high (I (2) range 64-98%). Pooled overall effects are therefore not reported. Studies included differ substantially regarding sample selection, assessment of diabetes and comorbid mental disorders, as well as in assessment of cost variables. CONCLUSIONS/INTERPRETATION: In light of the increased healthcare costs and inadequate use of preventive services, comorbid mental disorders in patients with diabetes must become a major focus of diabetes healthcare and research.

Simultaneous quantification of total medium- and long-chain fatty acids in human milk by capillary gas chromatography with split injection.

Four different quantification methods for the capillary gas chromatographic determination of medium-chain fatty acids (6:0-12:0) and myristic acid in human milk samples, using a split injector, were compared. Odd-carbon-numbered fatty acids (5:0-17:0) were added as internal standards. Each medium-chain fatty acid and myristic acid was calculated on the basis of: the peak area of the internal standard with one methylene group less; the peak area of the internal standard with one methylene group more; half the sum of the peak areas of the internal standards with one methylene group less and more (bracketting method); the peak area of 17:0. The peak-area ratio of each analyte and 17:0 in a standard was found to be subject to an unacceptably high coefficient of variation. From the methods using internal standards with one methylene group more and less, the bracketting method was found to be the best, resulting in recoveries close to 100%, with the lowest coefficients of variation. The method was applied for the determination of the fatty acid composition of mature milk samples of 47 Curaçaoan women.

Comparison of the fatty acid composition of human milk from mothers in Tanzania, Curacao and Surinam.

Fatty acid composition of mature human milk from Curacao (Netherlands Antilles), Surinam and Tanzania was determined by capillary gas chromatography. In the Curacaoan samples the cholesterol and alpha- and gamma-tocopherol concentrations were also determined. Remarkable differences were found in the fatty acid composition of breastmilk fat from the three countries. The differences in the levels of medium chain fatty acids between Curacao and Tanzania, and between Curacao and Surinam were significant. The mean sum of the essential fatty acids linoleic acid and linolenic acid showed the highest values in Curacao (16.1 g per cent). Mean values for Tanzania and Surinam were 14.9 and 12.7, respectively. The mean level of the docosahexaenoic acid was higher in the Curacaoan and Surinam samples compared with that from Tanzania. In the Curacaoan breastmilk samples the concentrations of cholesterol and alpha- and gamma-tocopherol were about twice as high as those reported for Western countries.

Fatty acid composition of breast milk fat from women in Curacao - abstract

The new-born infant exclusively breastfed receives approximately 52 percent of his energy from fats, 40 percent from carbohydrates and approximately 8 percent from proteins. Dietary fat in young infants not only serves as the most important source of energy but also contains nutrients essential for normal growth and development of the nervous system. In the very young infant, intestinal absorption of fats is, among other factors, dependent on the fatty acid composition of the fat consumed. The nature of the fat consumed by the mother will have an important influence on the fatty acid composition of human milk fat. Samples were obtained from 47 mothers of low to middle social class, who had lived in Curacao for at least 10 years, and given birth to a normal term infant. Milk was collected at least 14 days after birth by manual expression, and deep frozen until analysed by gas chromatography. The relative concentration of the saturated fatty acids (g/100g total fatty acids) were C6:0, 0.1; C8:0, 0.7; C10.0, 3.2; C12:0, 11.7; C14:0, 9.8; C16:0, 16.8; C18:0, 4.8: and for the unsaturated fatty acids C14:1, 0.2; C16:1, 2.5; C18:1, 26.7; C18:2, 18.3; C18.3, 1.7; C20:2, 0.5; C20:3, 0.6; C20:4, 1.4; C22:5, 0.3 and C22:6, 0.6. This pattern is more similar to that found in Tanzanian women, than to that found in women in Great Britain (AU)