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Non-invasive prenatal testing (NIPT) using cell-free foetal DNA has been widely accepted in recent years for detecting common foetal chromosome aneuploidies, such as trisomies 13, 18 and 21, and sex chromosome aneuploidies. In this study, the practical clinical performance of our foetal DNA testing was evaluated for analysing all chromosome aberrations among 7113 pregnancies in Italy.
This study was a retrospective analysis of collected NIPT data from the Ion S5 next-generation sequencing platform obtained from Altamedica Medical Centre in Rome, Italy.
In this study, NIPT showed 100% sensitivity and 99.9% specificity for trisomies 13, 18 and 21. Out of the 7113 samples analysed, 74 cases (1%) were positive by NIPT testing; foetal karyotyping and follow-up results validated 2 trisomy 13 cases, 5 trisomy 18 cases, 58 trisomy 21 cases and 10 sex chromosome aneuploidy cases. There were no false-negative results.
In our hands, NIPT had high sensitivity and specificity for common chromosomal aneuploidies such as trisomies 13, 18 and 21.
We completely classify the possible extensions between semistable vector bundles on the Fargues–Fontaine curve (over an algebraically closed perfectoid field), in terms of a simple condition on Harder–Narasimhan (HN) polygons. Our arguments rely on a careful study of various moduli spaces of bundle maps, which we define and analyze using Scholze’s language of diamonds. This analysis reduces our main results to a somewhat involved combinatorial problem, which we then solve via a reinterpretation in terms of the Euclidean geometry of HN polygons.
Schizophrenia is associated with altered neural development. We assessed neurological soft signs (NSS) and dermatoglyphic anomalies (total a–b ridge count (TABRC) and total finger ridge count) in 15 pairs of twins concordant and discordant for schizophrenia. Within-pair differences in both NSS and TABRC scores were significantly greater in discordant compared to concordant monozygotic pairs. There was no significant difference in NSS and TABRC scores between subjects with schizophrenia and their co-twins without the illness. However, monozygotic discordant twins with schizophrenia had higher ABRCs on their right hands compared to their co-twins without the illness. These findings suggest that an unidentified environmental event acting between weeks 6 and 15 of gestation affects the development of monozygotic twins who go on to develop schizophrenia but does not have a corresponding effect on their co-twins who do not develop the illness. The effect of such an event on dermatoglyphic profiles appears lateralised to the right hand in affected twins.
The transmission rate of methicillin-resistant Staphylococcus aureus (MRSA) to gloves or gowns of healthcare personnel (HCP) caring for MRSA patients in a non–intensive care unit setting was 5.4%. Contamination rates were higher among HCP performing direct patient care and when patients had detectable MRSA on their body. These findings may inform risk-based contact precautions.
Neuroanatomical abnormalities in first-episode psychosis (FEP) tend to be subtle and widespread. The vast majority of previous studies have used small samples, and therefore may have been underpowered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, the findings reported in the existing literature are highly heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP that are expressed consistently across several independent samples.
Structural Magnetic Resonance Imaging data were acquired from a total of 572 FEP and 502 age and gender comparable healthy controls at five sites. Voxel-based morphometry was used to investigate differences in grey matter volume (GMV) between the two groups. Statistical inferences were made at p < 0.05 after family-wise error correction for multiple comparisons.
FEP showed a widespread pattern of decreased GMV in fronto-temporal, insular and occipital regions bilaterally; these decreases were not dependent on anti-psychotic medication. The region with the most pronounced decrease – gyrus rectus – was negatively correlated with the severity of positive and negative symptoms.
This study identified a consistent pattern of fronto-temporal, insular and occipital abnormalities in five independent FEP samples; furthermore, the extent of these alterations is dependent on the severity of symptoms and duration of illness. This provides evidence for reliable neuroanatomical alternations in FEP, expressed above and beyond site-related differences in anti-psychotic medication, scanning parameters and recruitment criteria.
Research on psychotic illness is loosening emphasis on diagnostic stringency in favour of including a more dimensionally based conceptualization of psychopathology and pathobiology. However, to clarify these notions requires investigation of the full scope of psychotic diagnoses.
The Cavan–Monaghan First Episode Psychosis Study ascertained cases of first episode psychosis across all 12 DSM-IV psychotic diagnoses via all routes to care: public, private or forensic; home-based, outpatient or inpatient. There was no arbitrary upper age cut-off and minimal impact of factors associated with variations in social milieu, ethnicity or urbanicity. Cases were evaluated epidemiologically and assessed for psychopathology, neuropsychology, neurology, antecedent factors, insight and quality of life.
Among 432 cases, the annual incidence of any DSM-IV psychotic diagnosis was 34.1/100 000 of population and encompassed functional psychotic diagnoses, substance-induced psychopathology and psychopathology due to general medical conditions, through to psychotic illness that defied contemporary diagnostic algorithms. These 12 DSM-IV diagnostic categories, including psychotic disorder not otherwise specified, showed clinical profiles that were consistently more similar than distinct.
There are considerable similarities and overlaps across a broad range of diagnostic categories in the absence of robust discontinuities between them. Thus, psychotic illness may be of such continuity that it cannot be fully captured by operational diagnostic algorithms that, at least in part, assume discontinuities. This may reflect the impact of diverse factors each of which acts on one or more overlapping components of a common, dysfunctional neuronal network implicated in the pathobiology of psychotic illness.
To date, there are no published data on the association of patient-centered outcomes and accurate public-safety answering point (PSAP) dispatch in an American population. The goal of this study is to determine if PSAP dispatcher recognition of out-of-hospital cardiac arrest (OHCA) is associated with neurologically intact survival to hospital discharge.
This retrospective cohort study is an analysis of prospectively collected Quality Assurance/Quality Improvement (QA/QI) data from the San Antonio Fire Department (SAFD; San Antonio, Texas USA) OHCA registry from January 2013 through December 2015. Exclusion criteria were: Emergency Medical Services (EMS)-witnessed arrest, traumatic arrest, age <18 years old, no dispatch type recorded, and missing outcome data. The primary exposure was dispatcher recognition of cardiac arrest. The primary outcome was neurologically intact survival (defined as Cerebral Performance Category [CPC] 1 or 2) to hospital discharge. The secondary outcomes were: bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and prehospital return of spontaneous return of circulation (ROSC).
Of 3,469 consecutive OHCA cases, 2,569 cases were included in this analysis. The PSAP dispatched 1,964/2,569 (76.4%) of confirmed OHCA cases correctly. The PSAP dispatched 605/2,569 (23.6%) of confirmed OHCA cases as another chief complaint. Neurologically intact survival to hospital discharge occurred in 99/1,964 (5.0%) of the recognized cardiac arrest group and 28/605 (4.6%) of the unrecognized cardiac arrest group (OR = 1.09; 95% CI, 0.71–1.70). Bystander CPR occurred in 975/1,964 (49.6%) of the recognized cardiac arrest group versus 138/605 (22.8%) of the unrecognized cardiac arrest group (OR = 3.34; 95% CI, 2.70–4.11).
This study found no association between PSAP dispatcher identification of OHCA and neurologically intact survival to hospital discharge. Dispatcher identification of OHCA remains an important, but not singularly decisive link in the OHCA chain of survival.
Academic interest in the concept of insight in psychosis has increased markedly over the past 30 years, prompting this selective appraisal of the current state of the art. Considerable progress has been made in terms of measurement and confirming a number of clinical associations. More recently, the relationship between insight and involuntary treatment has been scrutinised more closely alongside the link between decision-making capacity and insight. Advances in the clinical and cognitive neurosciences have influenced conceptual development, particularly the field of ‘metacognition’. New therapies, including those that are psychologically and neurophysiologically based, are being tested as ways to enhance insight.
We studied the association between chlorhexidine gluconate (CHG) concentration on skin and resistant bacterial bioburden. CHG was almost always detected on the skin, and detection of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant Enterococcus on skin sites was infrequent. However, we found no correlation between CHG concentration and bacterial bioburden.
Wildlife is an essential component of all ecosystems. Most places in the globe do not have local, timely information on which species are present or how their populations are changing. With the arrival of new technologies, camera traps have become a popular way to collect wildlife data. However, data collection has increased at a much faster rate than the development of tools to manage, process and analyse these data. Without these tools, wildlife managers and other stakeholders have little information to effectively manage, understand and monitor wildlife populations. We identify four barriers that are hindering the widespread use of camera trap data for conservation. We propose specific solutions to remove these barriers integrated in a modern technology platform called Wildlife Insights. We present an architecture for this platform and describe its main components. We recognize and discuss the potential risks of publishing shared biodiversity data and a framework to mitigate those risks. Finally, we discuss a strategy to ensure platforms like Wildlife Insights are sustainable and have an enduring impact on the conservation of wildlife.
Impairments of contextual processing and theory of mind (ToM) have both been offered as accounts of the deviant language characterising formal thought disorder (FTD) in schizophrenia. This study investigated these processes in patients' dialogue. We predicted that FTD patients would show a decrement in linguistic alignment, associated with impaired ToM in dialogue.
Speech samples were elicited via participation in an interactive computer-based task and a semi-structured interview to assess contextual processing abilities and ToM skills in dialogue, respectively, and from an interactive card-sorting task to measure syntactic alignment. Degree of alignment in dialogue and the syntactic task, and evidence of ToM in (i) dialogue and (ii) a traditional ToM task were compared across schizophrenia patients with FTD (n = 21), non-FTD patients (n = 22) and healthy controls (n = 21).
FTD patients showed less alignment than the other two groups in dialogue, and than healthy controls on the syntactic task. FTD patients showed poorer performance on the ToM task than the other two groups, but only compared to the healthy controls in dialogue. The FTD group's degree of alignment in dialogue was correlated with ToM performance in dialogue but not with the traditional ToM task or with syntactic alignment.
In dialogue, FTD patients demonstrate an impairment in employing available contextual information to facilitate their own subsequent production, which is associated with a ToM deficit. These findings indicate that a contextual processing deficit impacts on exploiting representations via the production system impoverishing the ability to make predictions about upcoming utterances in dialogue.
Pity the poor soul who, more than twenty years ago, would have predicted that hard-core street cops would be sitting down with serious violent offenders, telling them politely to cease and desist, asking them what they and their families need, and going to extreme lengths to keep them safe and out of jail. Exactly that has in fact become standard practice with police officers nationally; beyond that, and not coincidentally, that standard practice is increasingly understood to work very well indeed. The “focused deterrence” strategies piloted in Boston in the mid-1990s and implemented since then in a range of other jurisdictions are racking up impressive results in preventing violent crime and have become essentially mainstream. What was once seen as at best innovative – but more often to be fringe bordering on the bizarre, as in the face-to-face meetings between authorities and offenders that the Boston strategy invented – is now standard practice and routine not just for special interventions but as a philosophy of policing: it is, one hears police chiefs say, “what we do.”
CompStat tributes are extensive. Compstat has been described as “perhaps the single most important organizational/administrative innovation in policing during the latter half of the 20th century” (Kelling & Sousa, 2001: 6). A Criminology and Public Policy journal editor termed Compstat “arguably one of the most significant strategic innovations in policing in the last couple of decades” (Weisburd et al., 2003: 419). The authors of a major study note that Compstat “has already been recognized as a major innovation in American policing” (Weisburd et al., 2003: 422). In 1996, Compstat was awarded the prestigious Innovations in American Government Award from the Ford Foundation and the John F. Kennedy School of Government at Harvard University. Former New York City Mayor Giuliani proclaimed Compstat as his administration’s “crown jewel” (Giuliani, 2002: 7).
In this volume, a group of leading scholars presented contrasting perspectives on eleven major innovations in American policing developed over the course of the last three decades. Police departments needed to improve their performance and relationships with the community and innovation provided the opportunity to make these improvements. These innovations represent fundamental changes to the business of policing. However, as many of our authors point out, improving police performance through innovation is often not straightforward. Police departments are highly resistant to change and police officers often experience difficulty in implementing new programs (Sparrow, Moore, & Kennedy, 1990; Bayley & Nixon, 2010; Maguire, 2014; Lum & Koper, 2017). The available evidence on key dimensions of police performance associated with these innovations, such as crime control effectiveness and community satisfaction with services provided, is sometimes limited. These observations are not unique to the policing field. For example, as Elmore (1997) suggests, the field of education was awash in innovation during the 1990s, but there is little evidence examining whether those innovations advanced the performance of schools, students, or graduates.
For nearly forty years, policymakers within law enforcement, commercially motivated interest groups, and scholars have made the case for an augmented implementation of technology in policing, particularly information technologies. The prominent discourse is efficiency and cost-effectiveness of operations, as technology is hypothesized to improve the quality of law enforcement on a wide range of outcomes and outputs. Prima facie, technology can revolutionize law enforcement; ample examples indicate where this is the case. Research areas in support of technology in policing include computers, GPS-based technologies, video recording of crime scenes, and forensic evidence, such as DNA testing. Our collective view should be that the pertinent question is one of scale: why not more? Why are information technologies not more pronounced in law enforcement? What stopped the information revolution from establishing a more prominent place in policing?
The concept of community policing is very popular with politicians and the general public – so popular that few police chiefs want to be caught without some program they can call community policing. As early as 1997, a survey of police departments conducted by the Police Foundation found that 85 percent reported they had adopted community policing or were in the process of doing so (Skogan, 2005). The biggest reason they gave for not doing so was that community policing was “impractical” for their community. In my own tabulations of the data, this reply was mostly from small departments with only a few officers. Bigger cities included in the survey (those with populations greater than 100,000) all claimed to have adopted community policing – half (they recalled) by 1991 and the other half between 1992 and 1997. The most recent similar figures come from a national survey of departments conducted in 2013. In my tabulations, about 95 percent of the departments in cities of more than 250,000 in population that had an official mission statement included a commitment to community policing (Bureau of Justice Statistics, 2015).