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The electron runaway phenomenon in plasmas depends sensitively on the momentum- space dynamics. However, efficient simulation of the global evolution of systems involving runaway electrons typically requires a reduced fluid description. This is needed, for example, in the design of essential runaway mitigation methods for tokamaks. In this paper, we present a method to include the effect of momentum-dependent spatial transport in the runaway avalanche growth rate. We quantify the reduction of the growth rate in the presence of electron diffusion in stochastic magnetic fields and show that the spatial transport can raise the effective critical electric field. Using a perturbative approach, we derive a set of equations that allows treatment of the effect of spatial transport on runaway dynamics in the presence of radial variation in plasma parameters. This is then used to demonstrate the effect of spatial transport in current quench simulations for ITER-like plasmas with massive material injection. We find that in scenarios with sufficiently slow current quench, owing to moderate impurity and deuterium injection, the presence of magnetic perturbations reduces the final runaway current considerably. Perturbations localised at the edge are not effective in suppressing the runaways, unless the runaway generation is off-axis, in which case they may lead to formation of strong current sheets at the interface of the confined and perturbed regions.
Peace settlements are notoriously difficult to reach in religiously associated conflicts, particularly in intra-state armed conflicts where the religious identity and nature of the state is at stake. Despite that apparent intractability, however, some peace settlements have been crafted for contemporary intra-state armed conflicts where there have been religious incompatible claims and aspirations. This chapter explores the legal tools developed in such settlements and discusses their wider applicability as conflict resolution mechanisms. The analysis identifies seven specific conflict resolution mechanisms that have been utilised to address the religious dimensions of armed conflicts: constitutional secularism, religious freedom, religious power-sharing, religious autonomy, legalisation of religious political parties, inclusion of religious civil society actors and religious bonding. These seven mechanisms are analysed as part of two fundamentally different approaches to conflict resolution of religious dimensions: division vs integration; and reinforcement or decrease in the role of religion. The chapter demonstrates how religiously defined conflicts can also be transformed and brought to peaceful, negotiated endings.
Synchrotron radiation images from runaway electrons (REs) in an ASDEX Upgrade discharge disrupted by argon injection are analysed using the synchrotron diagnostic tool Soft and coupled fluid-kinetic simulations. We show that the evolution of the runaway distribution is well described by an initial hot-tail seed population, which is accelerated to energies between 25–50 MeV during the current quench, together with an avalanche runaway tail which has an exponentially decreasing energy spectrum. We find that, although the avalanche component carries the vast majority of the current, it is the high-energy seed remnant that dominates synchrotron emission. With insights from the fluid-kinetic simulations, an analytic model for the evolution of the runaway seed component is developed and used to reconstruct the radial density profile of the RE beam. The analysis shows that the observed change of the synchrotron pattern from circular to crescent shape is caused by a rapid redistribution of the radial profile of the runaway density.
Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P (30%), G12P (25%) and G12P (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.
Connecting calendar ages to radiocarbon (14C) ages, i.e. constructing a calibration curve, requires 14C samples that represent, or are closely connected to, atmospheric 14C values and that can also be independently dated. In addition to these data, there is information that can serve as independent tests of the calibration curve. For example, information from ice core radionuclide data cannot be directly incorporated into the calibration curve construction as it delivers less direct information on the 14C age–calendar age relationship but it can provide tests of the quality of the calibration curve. Furthermore, ice core ages on 14C-dated volcanic eruptions provide key information on the agreement of ice core and radiocarbon time scales. Due to their scarcity such data would have little impact if directly incorporated into the calibration curve. However, these serve as important “anchor points” in time for independently testing the calibration curve and/or ice-core time scales. Here we will show that such information largely supports the new IntCal20 calibration record. Furthermore, we discuss how floating tree-ring sequences on ice-core time scales agree with the new calibration curve. For the period around 40,000 years ago we discuss unresolved differences between ice core 10Be and 14C records that are possibly related to our limited understanding of carbon cycle influences on the atmospheric 14C concentration during the last glacial period. Finally, we review the results on the time scale comparison between the Greenland ice-core time scale (GICC05) and IntCal20 that effectively allow a direct comparison of 14C-dated records with the Greenland ice core data.
The present chapter is influenced by critical heritage scholars who understand heritage as a ‘process’ rather than a particular object, place or practice, or, differently put, understand heritage as a verb and as something that both discursively and materially transforms places and practices. It illustrates the complex and changing rural heritagescape in China through a case study of Xinye village in Zhejiang province. The focus is on how the heritagisation process has involved and given rise to multiple stakeholders and actors with different social and cultural capital in and outside the village, and the different ways they engage with and make sense of heritage. It pays particular attention to how the heritage is mediated and visualised on film, analysing a range of different TV productions, and how performance and entertainment are essential aspects of the heritagisation process.
This chapter is influenced by the work of critical heritage scholars who pay particular attention to issues of power and agency in heritage work and understand heritage as a ‘process’ rather than a particular object, place or practice, or, differently put, understand heritage as a verb and as something that both discursively and materially transforms places and practices (e.g., Harrison 2013; Harvey 2001; Smith 2006). The heritagisation process almost inevitably puts heritage on display and draws our attention to issues of performance, mediatisation, and entertainment/spectacle (Haldrup & Bærenholdt 2015). The chapter will illustrate the complex and changing rural heritagescape in China through a case study of Xinye village in Zhejiang province, which the author has regularly visited since 2003. The focus is on how the heritagisation process has involved and given rise to multiple stakeholders and actors with different social and cultural capital in and outside the village, and the different ways they engage with and make sense of heritage. The chapter addresses both top-down and bottom-up processes and interactions as well as changes over time. It pays particular attention to how the heritage is mediated and visualised on film, analysing a range of different TV productions, and how performance and entertainment has come to constitute an essential aspect of the heritagisation process.
Veterinarians often give advice in a persuasive form, a style that has been shown to evoke resistance to change in clients experiencing psychological ambivalence (i.e. those who see both advantages and disadvantages to changing). With this style of communication, veterinarians run the risk of counteracting their purpose to encourage clients to follow recommendations. Motivational interviewing (MI) is a client-centered communication methodology that aims to facilitate clients’ internal motivation to change. In MI, Change Talk represents clients’ own statements expressing consideration of, motivation for or commitment to behavior change and has been shown to be strongly correlated with behavior change. Sustain Talk is corresponding statements related to maintaining the status quo. The aim of this exploratory study was to evaluate the potential of MI to facilitate behavior change in veterinary herd health management (VHHM) by investigating the effect of dairy cattle veterinarians’ MI skills on client Change and Sustain Talk. We recorded VHHM consultancies on 170 Swedish cattle farms performed by 36 veterinarians, randomly distributed into 2 groups: MI veterinarians (n = 18) had received 6-month training in MI and control veterinarians (n = 18) had not received any training. Veterinarians’ MI skills were assessed using the Motivational Interviewing Treatment Integrity coding system 4.2.1 and categorized as poor_untrained, poor_trained, near moderate and moderate. Client communication was coded using the Client Language Easy Rating coding system. The effect of MI skills on Change Talk, Sustain Talk and Proportion of Change Talk(Change Talk divided by the sum of Sustain Talk plus Change Talk) was investigated using cross-classified regression models with random intercepts for veterinarian and client (farm). The models also included additional explanatory variables (e.g. type of veterinarian and client’s satisfaction with the consultation). The veterinarian’s MI skills were associated with the client’s Change Talk, but results regarding Sustain Talk or Proportion of Change Talk were inconclusive. Clients of veterinarians reaching the highest (i.e. moderate) MI skills expressed 1.5 times more Change Talk than clients of untrained veterinarians. Clients of general large animal practitioners expressed less Sustain Talk than clients of animal health veterinarians and had higher Proportion of Change Talk. Results indicate that learning to practice MI may be one means to improve adherence to veterinary recommendations and to improve efficiency in VHHM services.
Quetiapine immediate release (quetiapine IR) improves PANSS total, positive, negative and general psychopathology scores in schizophrenia. This study (D1444C00132) evaluated the efficacy of once-daily extended release quetiapine fumarate (quetiapine XR) in patients with acute schizophrenia.
This was a 6-week, double-blind, randomised study (n=588) comparing quetiapine XR (400, 600 or 800 mg/day) and quetiapine IR (400 mg/day) with placebo. Efficacy was assessed using ANCOVA analyses of the change from baseline to study endpoint (Day 42) for: PANSS total score; positive, negative and general psychopathology subscale scores; and aggression and depression cluster scores (modified ITT population, LOCF). Changes in individual PANSS item scores were assessed post hoc.
At Day 42, there were statistically significant reductions (ie two-sided p-value <0.05) versus placebo with all doses of quetiapine XR for the change in PANSS total, positive, general psychopathology and aggression cluster scores. Changes in negative and depression cluster scores were statistically significant versus placebo for quetiapine XR 600 mg/day and 800 mg/day. There was statistically significant separation from placebo with quetiapine XR 600 mg/day and 800 mg/day for the change in 6/7 PANSS positive items, 5/7 negative items, and 12/16 general psychopathology items. For those items with no statistically significant separation from placebo, baseline scores were generally low.
Once-daily quetiapine XR is effective across a broad range of symptoms in acute schizophrenia, including positive and negative symptoms, as well as symptoms of general psychopathology, aggression and depression.
A total of 28 long-term mentally ill patients, the majority schizophrenic, treated with cognitive therapy in the context of milieu-therapy and group therapy, were investigated at admission and discharge with regard to changes in symptomatology, quality of life, global functioning, need for medication, and perceived target complaints. The results showed a significant relief in perceived burden of illness and an improvement in quality of life. A better pre-admission functioning with regard to social functioning, occupational function, and symptoms predicted a more favourable outcome.
To evaluate efficacy and tolerability of quetiapine sustained release (SR) in a 6-week study (D1444C00132).
588 patients with acute schizophrenia (PANSS total ≥70; CGI-S ≥4) were randomised to fixed-dose quetiapine SR 400, 600 or 800 mg/day (once-daily), quetiapine immediate release (IR) 400 mg/day (200 mg twice-daily; 5-day dose-escalation schedule), or placebo. Quetiapine SR doses: 400, 600 mg reached by Day 2; 800 mg by Day 3. Primary endpoint: change from baseline to Day 42 in PANSS total score (LOCF; ANCOVA). Other assessments: PANSS response rate (% patients with ≥30% reduction in total score from baseline); CGI-I response rate (% patients with rating ≤3); CGI-S; AEs.
446 patients (76%) completed the study (similar across groups). LS mean change from baseline in PANSS total score at Day 42 showed significant improvement versus placebo (-18.8): -24.8 (p=0.03), -30.9 (p<0.001), and -31.3 (p<0.001), quetiapine SR 400, 600, and 800 mg, respectively; -26.6 (p=0.004), quetiapine IR. Statistical separation from placebo at Day 42 for: change from baseline in CGI-S (quetiapine SR 600 and 800 mg; IR); PANSS and CGI-I response rates (all active treatments). Most common AEs with quetiapine: somnolence and dizziness. There were no unexpected AEs with quetiapine SR. Incidence of EPS-related AEs was similar to placebo. Two quetiapine SR and two IR patients discontinued due to AEs in Week 1.
Once-daily quetiapine SR (400-800 mg) was effective versus placebo in patients with acute schizophrenia. Rapid dose escalation was well tolerated, with a therapeutically effective dose reached by Day 2.
To examine the efficacy and tolerability of quetiapine SR in patients with schizophrenia switched from quetiapine IR.
Randomised, double-blind study (D1444C00146) using dual-matched placebo. Patients clinically stable on fixed doses of quetiapine IR received twice-daily quetiapine IR 400, 600 or 800 mg/day for 4 weeks. Stable patients were then randomised (1:2) to continue taking quetiapine IR or switch to the same total dose of quetiapine SR (active dose once-daily in the evening) for 6 weeks. Primary analysis: % of patients (modified ITT population) discontinuing due to lack of efficacy or with PANSS total increase ≥20% at any visit, using a 6% non-inferiority margin for the upper 95% CI of the treatment difference. Per-protocol (PP) analysis was also performed.
497 patients were randomised (quetiapine SR 331, IR 166); completion rates were 91.5% and 94.0%, respectively. Few patients discontinued due to lack of efficacy or had a PANSS increase ≥20% in both the MITT (n=496) and PP populations (n=393): 9.1% and 5.3% for quetiapine SR and 7.2% and 6.2% for quetiapine IR, respectively. Quetiapine SR was non-inferior to quetiapine IR in the PP population (treatment difference: -0.83% [95% CI -6.75, 3.71]; p=0017) but not in the MITT population (treatment difference: 1.86% [95% CI -3.78, 6.57]; p=0.0431). The incidence (quetiapine SR 38.7%; IR 35.5%) and profile of AEs were similar in both groups.
Clinically-stable patients receiving quetiapine IR can be switched, without titration, to an equivalent once-daily dose of quetiapine SR without any clinical deterioration or compromise in tolerability.
There has been a growing interest in the quality of life (QoL) of the mentally ill, subsequently a number of instruments to measure QoL have been developed. One of the measures of QoL which has received considerable attention is the Lancashire QoL Profile (LQOLP). The present study investigated test-retest reliability and internal consistency in the Swedish translation of the LQOLP using a cross-sectional sample of 29 inpatients. The results showed that test-retest reliability of subjective life satisfaction in the nine life domains covered by the LQOLP was satisfactory in seven of the domains, and acceptable in two (social relations and religion). Test-retest reliability for total subjective satisfaction score, global well-being, and an interviewer rated QoL were all on a satisfactory level (r > 0.80). The internal consistency and homogeneity of the total subjective QoL scale and the nine life domain subscales was satisfactory except for the social relations scale, where it was somewhat low.
Twenty-eight schizophrenic and other long-term mentally ill patients who were given cognitive therapy sessions twice a week in the context of a comprehensive inpatient treatment program were assessed every 5 weeks regarding perceived curative factors. The assessments were made by a self-rating questionnaire (Curative Factors Questionnaire [CFQ]) and a qualitative assessment from the patients of what they perceived as helpful in treatment. The results showed that milieu therapeutic elements and therapy sessions were perceived as the most helpful throughout the treatment period. No correlations were found between patient characteristics and perceived curative factors. The factors “instillation of hope”, “problem solution” and “learning I’m not alone” as rated in the initial phase of treatment showed a positive relationship with a favourable outcome of treatment at discharge.
A randomised study (D1444C00004) to show superior relapse prevention with quetiapine sustained release (SR) versus placebo.
327 patients with schizophrenia were switched to open-label, once-daily quetiapine SR dosed at 300 mg on Day 1, 600 mg on Day 2, then 400-800 mg for a 16-week stabilisation period. Stable patients (clinically and by dose) were randomised (n=197; double-blind phase) to either quetiapine SR (400-800 mg/day) or placebo. Primary endpoint: time from randomisation to psychiatric relapse (hospitalisation for worsening schizophrenia, PANSS increase ≥30%, CGI-I score ≥6, or need for additional antipsychotics). An independent Data Safety Monitoring Board (DSMB) monitored the study. Planned analyses: interim, after 45 and 60 relapses (to permit termination if a significant treatment difference in primary endpoint was observed); final, after 90 relapses.
Early termination occurred after the first interim analysis (following DSMB recommendation) as quetiapine SR (mean dose 669 mg/day; mean randomised-treatment period 4 months) was significantly superior to placebo for time to relapse: HR 0.16 (95% CI 0.08, 0.34; p<0.001). Numbers (%) of relapses were: 9 (10.7%), quetiapine SR; 36 (41.4%), placebo (interim ITT population). Estimated relapse rate at 6 months was: 14.3%, quetiapine SR; 68.2%, placebo (difference 54% [95% CI 42.5, 65.4; p<0.001]). Incidence of: treatment-related AEs 18% (quetiapine SR), 21% (placebo); total EPS-related AEs 1.1% and 1%, respectively. One patient in each group withdrew due to AEs.
Once-daily quetiapine SR (400-800 mg/day) was effective versus placebo in preventing relapse in patients with clinically-stable schizophrenia and was well tolerated during longer-term use.
To explore safety, tolerability, treatment response and hospitalizations in adult patients with schizophrenia treated with long-acting injectable risperidone (RLAI) or oral antipsychotic standard of care (oAP) in routine clinical practice.
Prospective one-year open-label non-interventional study exploring flexible doses of RLAI and oAPs. Primary outcome was the number of hospitalizations from baseline to endpoint. Additional outcomes were changes in the Clinical Global Impression of Schizophrenia (CGI-SCH), patient functioning (Global Assessment of Functioning) and treatmentemergent adverse events (TEAEs).
The intent-to-treat analysis included 561 patients on RLAI and 522 patients on oAPs (44% female gender, mean age (±SD) 42.2±13.1 years). Demographics and baseline characteristics were comparable, yet RLAI-treated patients had higher disease severity, lower baseline functioning and more substance abuse. The number of hospitalizations did not differ between the two groups while median duration of hospitalization was significantly shorter with RLAI (12.3 vs 20.6 days). Positive, negative, cognitive symptoms, disease severity, patient functioning and medication satisfaction improved significantly better with RLAI than oAPs. The most frequently reported TEAEs (=2% in any group) for RLAI and oral APs were increase of body weight (5.0%; 5.6%), psychotic disorder (2.7%; 4.0%), schizophrenia (2.5%; 3.1%), anxiety (2.3%; 2.7%), insomnia (0.9%; 3.1%) and somnolence (0.4%; 2.5%), respectively.
This one-year non-interventional study supports results of recent randomized controlled trials that treatment with RLAI is associated with less days spent in hospital, better symptomatic and functional outcomes and higher patient satisfaction with medication compared to oral APs.
Studies on the behaviour of the African lorisiforms are scarce, but there are clear morphological, ecological and behavioural differences between the robust pottos (Perodicticus spp.) and the smaller, gracile angwantibos (Arctocebus spp.). Pottos have a wide distribution across the African rainforest zone, while angwantibos are restricted to the forests of western equatorial Africa.
Lichens are widely acknowledged to be a key component of high latitude ecosystems. However, the time investment needed for full inventories and the lack of taxonomic identification resources for crustose lichen and lichenicolous fungal diversity have hampered efforts to fully gauge the depth of species richness in these ecosystems. Using a combination of classical field inventory and extensive deployment of chemical and molecular analysis, we assessed the diversity of lichens and associated fungi in Glacier Bay National Park, Alaska (USA), a mixed landscape of coastal boreal rainforest and early successional low elevation habitats deglaciated after the Little Ice Age. We collected nearly 5000 specimens and found a total of 947 taxa, including 831 taxa of lichen-forming and 96 taxa of lichenicolous fungi together with 20 taxa of saprotrophic fungi typically included in lichen studies. A total of 98 species (10.3% of those detected) could not be assigned to known species and of those, two genera and 27 species are described here as new to science: Atrophysma cyanomelanos gen. et sp. nov., Bacidina circumpulla, Biatora marmorea, Carneothele sphagnicola gen. et sp. nov., Cirrenalia lichenicola, Corticifraga nephromatis, Fuscidea muskeg, Fuscopannaria dillmaniae, Halecania athallina, Hydropunctaria alaskana, Lambiella aliphatica, Lecania hydrophobica, Lecanora viridipruinosa, Lecidea griseomarginata, L. streveleri, Miriquidica gyrizans, Niesslia peltigerae, Ochrolechia cooperi, Placynthium glaciale, Porpidia seakensis, Rhizocarpon haidense, Sagiolechia phaeospora, Sclerococcum fissurinae, Spilonema maritimum, Thelocarpon immersum, Toensbergia blastidiata and Xenonectriella nephromatis. An additional 71 ‘known unknown’ species are cursorily described. Four new combinations are made: Lepra subvelata (G. K. Merr.) T. Sprib., Ochrolechia minuta (Degel.) T. Sprib., Steineropsis laceratula (Hue) T. Sprib. & Ekman and Toensbergia geminipara (Th. Fr.) T. Sprib. & Resl. Thirty-eight taxa are new to North America and 93 additional taxa new to Alaska. We use four to eight DNA loci to validate the placement of ten of the new species in the orders Baeomycetales, Ostropales, Lecanorales, Peltigerales, Pertusariales and the broader class Lecanoromycetes with maximum likelihood analyses. We present a total of 280 new fungal DNA sequences. The lichen inventory from Glacier Bay National Park represents the second largest number of lichens and associated fungi documented from an area of comparable size and the largest to date in North America. Coming from almost 60°N, these results again underline the potential for high lichen diversity in high latitude ecosystems.
Post-traumatic stress disorder (PTSD) is debilitating for patients and society. There are a number of treatment methods albeit not all patients respond to these and an interesting method using electroencephalography-based neurofeedback (EEG-NF) has become more prominent in recent years. This systematic review aimed to assess whether EEG-NF, compared with sham NF, other treatment, or no treatment, is effective for PTSD. Primary outcomes were self-harm, PTSD symptoms, level of functioning and health-related quality of life.
Systematic literature searches for randomized controlled trials (RCTs) were conducted in six databases. Random effects meta-analysis was performed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation.
Four RCTs were included (123 participants). Suicidal thoughts were significantly reduced after EEG-NF compared with a waiting list in a small study. PTSD symptoms were assessed in all studies with different instruments. Results were consistently in favor of EEG-NF with large effect sizes (standardized mean difference −2.30 (95% confidence interval: −4.37 to −0.24). One study reported significantly improved level of executive functioning and one study a reduction in use of psychotropic medication. Complications were scarcely reported. Certainty of evidence was assessed as very low for the four assessed outcomes.
Based on four RCTs, with several study limitations and imprecision, it is uncertain whether EEG-NF reduces suicidal thoughts, PTSD symptoms, medication use, or improves function. Although all studies showed promising results, further studies are needed to increase the certainty of evidence.
Carnivores play an important role in ecosystem functioning as apex predators. However, most carnivore species are threatened or have been extirpated in human-dominated landscapes. The Mediterranean region of central Chile is a biodiversity hotspot, but expansion of agricultural areas such as vineyards is degrading wildlife habitat. We estimated the species richness and composition of carnivore communities in remnant fragments of sclerophyllous forest-shrubland in the vineyard landscapes of central Chile to evaluate the effects of human disturbance at different spatial scales. We tested two hypotheses: (1) vineyard landscapes with higher levels of human disturbance support a lower diversity of native carnivores in fragments of remnant native vegetation compared to landscapes with larger areas of natural habitat, and (2) habitat specialists and generalists respond differentially to human influence at the habitat vs landscape spatial scale. We used camera traps at 12 sites across the study area and evaluated the impact of human disturbance indicators on the richness and detection frequency of carnivore species. We found that human population density negatively affected carnivore richness and was associated with a lower detection frequency of the Vulnerable guiña Leopardus guigna. The presence of domestic dogs also had a negative effect on the detection frequency of the guiña and the two native species of foxes, the culpeo Lycalopex culpaeus and South American grey fox Lycalopex griseus. We conclude that protecting remnants of native forest in vineyard landscapes is crucial for carnivore conservation in central Chile.