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Disturbances in trait emotions are a predominant feature in schizophrenia. However, less is known about (a) differences in trait emotion across phases of the illness such as the clinical high-risk (CHR) phase and (b) whether abnormalities in trait emotion that are associated with negative symptoms are driven by primary (i.e. idiopathic) or secondary (e.g. depression, anxiety) factors.
To examine profiles of trait affective disturbance and their clinical correlates in individuals with schizophrenia and individuals at CHR for psychosis.
In two studies (sample 1: 56 out-patients diagnosed with schizophrenia and 34 demographically matched individuals without schizophrenia (controls); sample 2: 50 individuals at CHR and 56 individuals not at CHR (controls)), participants completed self-report trait positive affect and negative affect questionnaires, clinical symptom interviews (positive, negative, disorganised, depression, anxiety) and community-based functional outcome measures.
Both clinical groups reported lower levels of positive affect (specific to joy among individuals with schizophrenia) and higher levels of negative affect compared with controls. For individuals with schizophrenia, links were found between positive affect and negative symptoms (which remained after controlling for secondary factors) and between negative affect and positive symptoms. For individuals at CHR, links were found between both affect dimensions and both types of symptom (which were largely accounted for by secondary factors).
Both clinical groups showed some evidence of reduced trait positive affect and elevated trait negative affect, suggesting that increasing trait positive affect and reducing trait negative affect is an important treatment goal across both populations. Clinical correlates of these emotional abnormalities were more integrally linked to clinical symptoms in individuals with schizophrenia and more closely linked to secondary influences such as depression and anxiety in individuals at CHR.
This study revisits the premature autonomy model by examining parents’ use of positive behavior support (PBS) practices on a daily timescale to better understand underlying processes in developmental changes in family disengagement and the implications for adolescent problem behavior and substance use. This study included 151 9th and 10th grade adolescents (61.5% female) and their caregivers, who participated in a baseline assessment, a 21-day daily diary burst, and a 1-year follow-up assessment. Four key findings emerged: (a) on days when parents used more PBS, adolescents felt more close and connected to their caregivers; (b) adolescents who exhibited a larger-magnitude of change in connectedness with caregivers in relation to variation in positive parenting (termed fragile connectedness) were at higher risk for antisocial behavior, deviant peer involvement, and substance use one year later; (c) individual differences in initial levels of antisocial behavior and effortful control accounted for between-person variation in fragile connectedness; and (d) day-level adolescent anger and parent–adolescent conflict predicted within-family variation in parents’ use of PBS. Implications for the premature autonomy model and intervention science are discussed.
Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators’ aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives.
Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies.
The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI.
This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.
Turbulence is commonly observed in nearly collisionless heliospheric plasmas, including the solar wind and corona and the Earth’s magnetosphere. Understanding the collisionless mechanisms responsible for the energy transfer from the turbulent fluctuations to the particles is a frontier in kinetic turbulence research. Collisionless energy transfer from the turbulence to the particles can take place reversibly, resulting in non-thermal energy in the particle velocity distribution functions (VDFs) before eventual collisional thermalization is realized. Exploiting the information contained in the fluctuations in the VDFs is valuable. Here we apply a recently developed method based on VDFs, the field–particle correlation technique, to a
, solar-wind-like, low-frequency Alfvénic turbulence simulation with well-resolved phase space to identify the field–particle energy transfer in velocity space. The field–particle correlations reveal that the energy transfer, mediated by the parallel electric field, results in significant structuring of the VDF in the direction parallel to the magnetic field. Fourier modes representing the length scales between the ion and electron gyroradii show that energy transfer is resonant in nature, localized in velocity space to the Landau resonances for each Fourier mode. The energy transfer closely follows the Landau resonant velocities with varying perpendicular wavenumber
. This resonant signature, consistent with Landau damping, is observed in all diagnosed Fourier modes that cover the dissipation range of the simulation.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
It is often claimed that Adam Smith and Edmund Burke held similar views on matters relating to political economy. One area of tension in their thought, however, was the institutional credibility of Britain’s East India Company. They both argued that the Company corrupted market order in India, but while Smith supported the termination of the firm’s charter, Burke aspired to preserve it. This article examines why they arrived at such divergent conclusions. It argues that the source of Burke and Smith’s friction arose from the dissimilar frames of reference through which they assessed the credibility of the Company. Burke examined the corporation’s legitimacy through the lens of British prescriptive, imperial, and constitutional history, yet Smith evaluated it as part of his larger attack on the mercantile system. These different frames of reference were responsible for the further incongruities in their thought on the Company relating to the role of prescription and imperial honor in political communities, the qualifications of traders to rule, and the appropriate tempo of policy reform. This article concludes that, even with such differences, the two thinkers’ respective criticisms of the Company illustrate the threat that monopolies pose to the liberal order.
Despite the global significance of the Leach’s Storm-petrel Hydrobates leucorhous colony on Baccalieu Island, Newfoundland and Labrador, Canada, the estimate of 3.36 million breeding pairs reported for 1984 by Sklepkovych and Montevecchi stands as the single published population estimate for the world’s largest colony. This study increases knowledge of this population by analysing data from additional independent surveys conducted in 1984 and 1985, and by updating the population status with a survey conducted in 2013. Population estimates were derived by extrapolating occupied burrow densities to the estimated occupied area of four main habitat types (heath, forest, grass and fern), which in turn were based on proportions of habitats observed in plots (1984 and 1985) or by using a Geographic Information System approach (2013). Based on these surveys, the Leach’s Storm-petrel breeding population size on Baccalieu Island was estimated at 5.12 ± 0.73 (SE) and 4.60 ± 0.42 (SE) million pairs in 1984 and 1985 respectively, representing estimates 37–51% greater than the original 1984 survey. While discrepancies among these estimates were largely driven by the way occupied areas were estimated, our study confirms that Baccalieu Island hosts the largest Leach’s Storm-petrel colony in the world. Results from the 2013 survey estimate the current breeding Leach’s Storm-petrel population at 1.95 ± 0.14 (SE) million pairs, representing a 42% decline over 29 years (-1.4% per year), relative to the original published estimate of 3.36 ± 0.12 (SE) million pairs. The most prominent change has occurred in the density of storm-petrel burrows found in forest habitat which dropped by 70% despite forest remaining the second most abundant habitat available to nesting storm-petrels on Baccalieu Island. The cause of this decline remains unknown and is likely multi-faceted. Future research focusing on demographic studies is required to understand what is driving the population decline of this internationally important colony.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Topographic complexity on continental shelves is the catalyst that transforms the barotropic tide into the secondary and residual circulations that dominate vertical and cross-shelf mixing processes. Island wakes are one such example that are observed to significantly influence the transport and distribution of biological and physical scalars. Despite the importance of island wakes, to date, no sufficient, mechanistic description of the physical processes governing their development exists for the general case of unsteady tidal forcing. Controlled laboratory experiments are necessary for the understanding of this complex flow phenomenon. Here, three-dimensional velocity field measurements of cylinder wakes in shallow-water oscillatory flow are conducted across a parameter space that is typical of tidal flow around shallow islands. The wake form in steady flows is typically described in terms of the stability parameter
is the island diameter,
is the water depth and
is the bottom boundary friction coefficient); in tidal flows, there is an additional dependence on the Keulegan–Carpenter number
is the tidal velocity amplitude and
is the tidal period). In this study we demonstrate that when the influence of bottom friction is confined to a Stokes boundary layer the stability parameter is given by
is the ratio of the wavelength of the Stokes bottom boundary layer to the depth. Three classes of wake form are observed with decreasing wake stability: (i) steady bubble for
; (ii) unsteady bubble for
$0.06\lesssim S\lesssim 0.1$
; and (iii) vortex shedding for
. Transitions in wake form and wake stability are shown to depend on the magnitude and temporal evolution of the wake return flow. Scaling laws are developed to allow upscaling of the laboratory results to island wakes. Vertical and lateral transport depend on three parameters: (i) the flow aspect ratio
; (ii) the amplitude of tidal motion relative to the island size, given by
; and (iii) the relative influence of bottom friction to the flow depth, given by
. A model of wake upwelling based on Ekman pumping from the bottom boundary layer demonstrates that upwelling in the near-wake region of an island scales with
and is independent of the wake form. Finally, we demonstrate an intrinsic link between the dynamical eddy scales, predicted by the Ekman pumping model, and the island wake form and stability.
Roles for pharmacists in general practice are developing in Australia. It is known that pharmacists can provide effective smoking cessation services in other settings but evidence in general practice is lacking.
To determine whether a pharmacist can provide effective smoking cessation services within general practice.
Data from smoking cessation consultations were obtained for 66 consecutive patients seen by one practice pharmacist. The pharmacist tailored interventions to the individual. Medication was offered in collaboration with community pharmacists and general practitioners. Quit coaching, based on motivational interviewing, was conducted. Smoking status was ascertained at least 6 months after the intended quit date and verified by a carbon monoxide breath test where possible.
The patients’ median age was 43 years (range 19–74 years); 42 were females (64%). At baseline, the median (i) number of pack years smoked was 20 (range: 1–75); (ii) Fagerstrom Test of dependence score was 6 (1–10); and (iii) number of previous quit attempts was 3 (0–10). Follow-up after at least 6 months determined a self-reported point prevalence abstinence rate of 30% (20/66). Of all patients who reported to be abstinent, 65% (13/20) were tested for carbon monoxide breath levels and were all below 7 ppm. The biochemically verified smoking abstinence rate was therefore 20% overall (13/66). Successful quit attempts were associated with varenicline recommendation (69% v 25%), increased median number of practice pharmacist consultations (4 v 2 per patient) and mental health diagnosis (85% v 51%).
Our observed abstinence rate was comparable or better than those obtained by practice nurses, community pharmacists and outpatient pharmacists, indicating the general practice pharmacist provided an effective smoking cessation intervention. A larger randomised trial is warranted.
This paper describes a model of electron energization and cyclotron-maser emission applicable to astrophysical magnetized collisionless shocks. It is motivated by the work of Begelman, Ergun and Rees [Astrophys. J. 625, 51 (2005)] who argued that the cyclotron-maser instability occurs in localized magnetized collisionless shocks such as those expected in blazar jets. We report on recent research carried out to investigate electron acceleration at collisionless shocks and maser radiation associated with the accelerated electrons. We describe how electrons accelerated by lower-hybrid waves at collisionless shocks generate cyclotron-maser radiation when the accelerated electrons move into regions of stronger magnetic fields. The electrons are accelerated along the magnetic field and magnetically compressed leading to the formation of an electron velocity distribution having a horseshoe shape due to conservation of the electron magnetic moment. Under certain conditions the horseshoe electron velocity distribution function is unstable to the cyclotron-maser instability [Bingham and Cairns, Phys. Plasmas 7, 3089 (2000); Melrose, Rev. Mod. Plasma Phys. 1, 5 (2017)].
Calculated patterns play an essential role in X-ray powder diffraction analysis. This paper gives examples of their use in qualitative analysis for evaluating and supplementing reference patterns in the ICDD Powder Diffraction File (PDF), in quantitative analysis for calculating Reference Intensity Ratios (RIRs), in ceil parameter refinements for indexing of low-symmetry/large unit cell diffractograms, in powder pattern determination for validating intensities and recognizing preferred orientation, in new materials synthesis for verification of structure type and phase purity, and for modeling the effects of solid solution substitution.
In this study I explore the theoretical and linguistic implications of the Kennedy Smith rape trial, using transcriptions of real live testimony as data. I examine theoretically how the logic of inconsistency in trial testimony of the victim and other witnesses activates an interaction among language, law, and culture as an epistemological practice of domination. In microlinguistic detail, I examine the categorization of action, linguistic ideologies, and situated rhythms of legal language through which our sexual identities are constituted to create an apparent inconsistency in the victim's account. Looking at the law-in-action, I hope to show how social actors use language and culture to create meaning in their legal interaction.
A new optical delivery system has been developed for the (scanning) transmission electron microscope. Here we describe the in situ and “rapid ex situ” photothermal heating modality of the system, which delivers >200 mW of optical power from a fiber-coupled laser diode to a 3.7 μm radius spot on the sample. Selected thermal pathways can be accessed via judicious choices of the laser power, pulse width, number of pulses, and radial position. The long optical working distance mitigates any charging artifacts and tremendous thermal stability is observed in both pulsed and continuous wave conditions, notably, no drift correction is applied in any experiment. To demonstrate the optical delivery system’s capability, we explore the recrystallization, grain growth, phase separation, and solid state dewetting of a Ag0.5Ni0.5 film. Finally, we demonstrate that the structural and chemical aspects of the resulting dewetted films was assessed.
Common reed [Phragmites australis (Cav.) Trin. ex Steud.], an aggressive invader in North American wetlands, is likely to undergo a range expansion as the climate changes. Increased atmospheric [CO2] and temperature have been shown to cause morphological and physiological changes in many species, sometimes altering the way they respond to herbicides. To understand how climate-related environmental parameters may impact P. australis management, we grew two P. australis haplotypes (the Gulf Coast type and the Eurasian type) under ambient (400 ppm CO2, 32/21 C) or elevated (650 ppm CO2, 35/24 C) climate conditions. After 6 wk, the Gulf Coast type had reduced leaf area, increased stomatal conductance, and increased transpiration under the elevated conditions. The Eurasian type had lower Vcmax (the maximum carboxylation rate of Rubisco) and lower Jmax (the maximum electron transport rate of RuBP regeneration) under elevated climate conditions. Results likely reflected a greater impact of higher temperatures rather than increased [CO2]. After the 6-wk period, plants were either treated with glyphosate (0.57 kg ae ha−1) or remained an untreated control. Data were collected 30 d after treatment (DAT) and 60 DAT to evaluate herbicide efficacy. Overall, the Gulf Coast type was less responsive to glyphosate applications under the elevated climate conditions than under current climate conditions. The lower leaf area of the Gulf Coast type in these climate conditions may have resulted in less herbicide interception and uptake. Glyphosate efficacy was less impacted by climate treatment for the Eurasian type than for the Gulf Coast type.
Whereas sport had been justified since antiquity for providing soldiers with the physical training they would require in battle, its utilitarian function waned with the English military's gradual adaptation of firearms during the Renaissance. As a result, sports were increasingly condemned as idle and superfluous phenomena — nothing more than futile competitions between men. In Shakespeare's Henry VI, sport figures as a metaphor for war itself, also condemnable as a result of the historical shift from the politics of chivalric idealism to the “politics of reality.” Throughout the trilogy, Shakespeare indicts modern warfare as mere sport for ambitious and corrupt nobles.
To assess variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs).
Descriptive retrospective cohort with nested case-control study.
Pediatric intensive care units (PICUs), cardiac intensive care units (CICUs), and neonatal intensive care units (NICUs) in 6 US hospitals.
Children≤18 years ventilated for≥1 calendar day.
We identified patients with pediatric ventilator-associated conditions (VACs), pediatric VACs with antimicrobial use for≥4 days (AVACs), and possible ventilator-associated pneumonia (PVAP, defined as pediatric AVAC with a positive respiratory diagnostic test) according to previously proposed criteria.
Among 9,025 ventilated children, we identified 192 VAC cases, 43 in CICUs, 70 in PICUs, and 79 in NICUs. AVAC criteria were met in 79 VAC cases (41%) (58% CICU; 51% PICU; and 23% NICU), and varied by hospital (CICU, 20–67%; PICU, 0–70%; and NICU, 0–43%). Type and duration of AVAC antimicrobials varied by ICU type. AVAC cases in CICUs and PICUs received broad-spectrum antimicrobials more often than those in NICUs. Among AVAC cases, 39% had respiratory infection diagnostic testing performed; PVAP was identified in 15 VAC cases. Also, among AVAC cases, 73% had no associated positive respiratory or nonrespiratory diagnostic test.
Antimicrobial use is common in pediatric VAC, with variability in spectrum and duration of antimicrobials within hospitals and across ICU types, while PVAP is uncommon. Prolonged antimicrobial use despite low rates of PVAP or positive laboratory testing for infection suggests that AVAC may provide a lever for antimicrobial stewardship programs to improve utilization.