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Background: Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy characterized by abrupt sleep-related hypermotor seizures (SRHS) with complex semiology. Although difficult to localize within the frontal lobe recent studies using intracerebral EEG recordings have suggested the existence of four distinct semiology patterns (SP) organized in a rostro-caudal manner. It remains unclear however if these SP are clinically useful. Methods: We aimed to estimate the inter-rater reliability (IR) of classifying SP in SHE amongst epilepsy and sleep medicine experts. Following a short training session, ten experts were asked to review and classify 40 videos of SRHS in patients with confirmed SHE. IR was calculated using Kappa statistics. Results: SP1 and SP4, who are at the opposite ends of the SHE semiology spectrum, had substantial IR (0.82 and 0.67, respectively). Meanwhile, SP2 and SP3 showed fair agreement (0.25 and 0.35, respectively) and represented the major source of variance, with a small difference favouring epilepsy experts. Conclusions: Amongst epilepsy and sleep medicine experts, IR of classifying SRHS into four SP was only mildly satisfactory. SP1 and SP4 were shown to be easily recognizable while SP2 and SP3 were frequently confounded. Improvements in SP recognition are needed before widespread clinical use.
The ‘Landscapes of Production and Punishment’ project aims to examine how convict labour from 1830–1877 affected the built and natural landscapes of the Tasman Peninsula, as well as the lives of the convicts themselves.
Despite lessons learned from the recent Ebola epidemic, attempts to survey and determine non-health care worker, industry-specific needs to address highly infectious diseases have been minimal. The aircraft rescue and fire fighting (ARFF) industry is often overlooked in highly infectious disease training and education, even though it is critical to their field due to elevated occupational exposure risk during their operations.
Supervisors perceived Frontline respondents to be more willing and comfortable to encounter potential highly infectious disease scenarios than the Frontline indicated. More than one-third of respondents incorrectly marked transmission routes of viral hemorrhagic fevers. There were discrepancies in self-reports on the existence of highly infectious disease orientation and skills demonstration, employee resources, and personal protective equipment policies, with a range of 7.5%-24.0% more Supervisors than Frontline respondents marking activities as conducted.
There are deficits in highly infectious disease knowledge, skills, and abilities among ARFF members that must be addressed to enhance member safety, health, and well-being. (Disaster Med Public Health Preparedness. 2018;12:675-679)
Computerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans.
We studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18–75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety.
Patients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues® CCBT programme or usual care from their primary care doctor.
Compared with White participants, African Americans were less likely to start the CCBT programme (P=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (P=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: −6.6 v. −5.5; P=0.06) and similar decrease in anxiety symptoms (−5.3 v. −5.6; P=0.80) compared with White participants.
CCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.
The first two catalogues produced from test observations made with the Carlsberg Automatic Transit Circle (CATC) at the Copenhagen University Observatory in the period 1981/83 have internal mean errors of 0″.21 in right ascension and 0″.22 in declination. In 1983 the CATC was moved to the international Observatorio del Roque de los Muchachos where it will begin a programme of differential and fundamental astrometry in 1984.
The development of an economic capital model requires a decision to be made regarding how to aggregate capital requirements for the individual risk factors while taking into account the effects of diversification. Under the Individual Capital Adequacy Standards framework, UK life insurers have commonly adopted a correlation matrix approach due to its simplicity and ease in communication to the stakeholders involved, adjusting the result, where appropriate, to allow for non-linear interactions. The regulatory requirements of Solvency II have been one of the principal drivers leading to an increased use of more sophisticated aggregation techniques in economic capital models. This paper focusses on a simulation-based approach to the aggregation of capital requirements using copulas and proxy models. It describes the practical challenges in parameterising a copula including how allowance may be made for tail dependence. It also covers the challenges associated with fitting and validating a proxy model. In particular, the paper outlines how insurers could test, communicate and justify the choices made through the use of some examples.
We present subarcsecond observations at 2.7 and 1.4 mm of a sample of massive young stellar objects made with the BIMA millimetre array. For most sources the continuum emission on the smallest scales at 2.7 mm is dominated by free-free emission from the stellar wind or jet. Strong emission at 1.4 mm shows the presence of significant dust associated with Cep A and GL 490 but our resolution is not sufficient to resolve any structure. The 2.7-mm emission from GL 490 is resolved but it is not clear whether we are seeing a single circumstellar disk or a secondary companion, although near-infrared data support the disk hypothesis. Estimates of the dust mass yield values of ∼1–4 M⊙ within radii of 150 to 1000 AU.
To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features.
A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet.
The survey was sent to and completed by site representatives of each ETC.
The survey was sent to all 55 ETCs; 47 (85%) responded.
Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children’s hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site.
Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.
Infect. Control Hosp. Epidemiol. 2016;37(3):313–318
Information-processing biases may contribute to the intergenerational transmission of depression. There is growing evidence that children of depressed mothers exhibit attentional biases for sad faces. However, findings are mixed as to whether this bias reflects preferential attention toward, versus attentional avoidance of, sad faces, suggesting the presence of unmeasured moderators. To address these mixed findings, we focused on the potential moderating role of genes associated with hypothalamic–pituitary–adrenal axis reactivity. Participants included children (8–14 years old) of mothers with (n = 81) and without (n = 81) a history of depression. Eye movements were recorded while children passively viewed arrays of angry, happy, sad, and neutral faces. DNA was obtained from buccal cells. Children of depressed mothers exhibited more sustained attention to sad faces than did children of nondepressed mothers. However, it is important that this relation was moderated by children's genotype. Specifically, children of depressed mothers who carried reactive genotypes across the corticotropin-releasing hormone type 1 receptor (CHRH1) TAT haplotype and FK506 binding protein 5 (FKBP5) rs1360780 (but not the solute carrier family C6 member 4 [SLC6A4] of the serotonin transporter linked polymorphic region [5-HTTLPR]) exhibited less sustained attention to sad faces and more sustained attention to happy faces. These findings highlight the role played by specific genetic influences and suggest that previous mixed findings may have been due to genetic heterogeneity across the samples.
For a well-read medieval monk, as Guillaume de Deguileville must have been, remembering what he read involved memory techniques centered on the visualization of unusual, if not bizarre and startling, scenes and figures. Thus, as a writer who wanted his writing to be remembered, Deguileville conveyed the content of his three Pèlerinages through vivid and detailed descriptions of unusual figures and scenes, including interactions between personifications and biblical characters, which beg for visualization. Apparently unwilling to rely entirely on the reader's ability to create these memory-images in the imagination, the author himself planned for some illustrations, though we cannot know whether he devised complete programs of miniatures or supervised the production of any illustrated manuscripts. Each of his three French pilgrimage poems appeared individually with illustrations, but manuscripts that collect all three Pèlerinages include some of the most ambitious programs of illustration. It is as if the desire for uniformity stimulated designers and artists to continue the dense level of visualization frequently found in manuscripts of the PVH into the other two poems. Images, in fact, provide the most striking evidence for the high level of familiarity with Deguileville's three Pèlerinages from the late fourteenth to mid-fifteenth centuries: in the book of hours known as the Hours of Isabella Stuart (Cambridge, Fitzwilliam Museum MS 62), picture cycles for each of the poems – in the unusual sequence PJC, PVH, PA – accompany not Deguileville's poems but the familiar cycle of texts found in this personal book of hours, an indication that the images alone enabled readers to recall the poems.
As Fabienne Pomel's contribution to this volume demonstrates vividly, Deguileville's corpus reads like nothing so much as a collection of legal documents. The saga of Deguileville's poetic persona. Here distinguished by the Latinized name Guillermus de Deguilevilla, resembles a case file; both narrator and author are put on trial repeatedly, and poetic and juridical authority are closely related. Two instances of judgment stand out in particular, found respectively in PVH2 and in PA. First, in PVH2. Guillermus loses a judgment aboard the Ship of Religion, from which he is exiled as a result and deprived of his good name. Because of the poet's insistence on the (pseudo-) autobiographical nature of the episode, modern scholars have usually seen in it a reflection of Deguileville's own legal troubles, presumably at the hands of fellow monks at Chaalis. And because Deguileville linked this affair to the high-profile literary scandals of other authors – namely, Abelard and Ovid – it is plausible that he suffered for something he wrote. If so, this would doubtless have been the earlier PVH1, which the 1355 version (PVH2) was destined to correct and supplement.