To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
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.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.
The provision of healthcare education in developing countries is a complex problem that simulation has the potential to help. This study aimed to evaluate the effectiveness of a low-cost ear surgery simulator, the Ear Trainer.
The Ear Trainer was assessed in two low-resource environments in Cambodia and Uganda. Participants were video-recorded performing four specific middle-ear procedures, and blindly scored using a validated measurement tool. Face validity, construct validity and objective learning were assessed.
The Ear Trainer provides a realistic representation of the ear. Construct validity assessment confirmed that experts performed better than novices. Participants displayed improvement in all tasks except foreign body removal, likely because of a ceiling effect.
This study validates the Ear Trainer as a useful training tool for otological microsurgical skills in developing world settings.
During the recent Ebola crisis in West Africa, individual person-level details of disease onset, transmissions, and outcomes such as survival or death were reported in online news media. We set out to document disease transmission chains for Ebola, with the goal of generating a timely account that could be used for surveillance, mathematical modeling, and public health decision-making. By accessing public web pages only, such as locally produced newspapers and blogs, we created a transmission chain involving two Ebola clusters in West Africa that compared favorably with other published transmission chains, and derived parameters for a mathematical model of Ebola disease transmission that were not statistically different from those derived from published sources. We present a protocol for responsibly gleaning epidemiological facts, transmission model parameters, and useful details from affected communities using mostly indigenously produced sources. After comparing our transmission parameters to published parameters, we discuss additional benefits of our method, such as gaining practical information about the affected community, its infrastructure, politics, and culture. We also briefly compare our method to similar efforts that used mostly non-indigenous online sources to generate epidemiological information.
The Parkes 64 m telescope has been used to survey a complete sample of nearby red giants (i.e. not members of close binaries or showing strong emission lines of CaII). The sample consisted of all 82 stars in the Bright Star Catalogue within 30 pc having spectral types G, K, M and luminosity classes I, II, III south of the celestial equator.
Our knowledge of the universe comes from recording the photon and particle fluxes incident on the Earth from space. We thus require sensitive measurement across the entire energy spectrum, using large telescopes with efficient instrumentation located on superb sites. Technological advances and engineering constraints are nearing the point where we are recording as many photons arriving at a site as is possible. Major advances in the future will come from improving the quality of the site. The ultimate site is, of course, beyond the Earth’s atmosphere, such as on the Moon, but economic limitations prevent our exploiting this avenue to the degree that the scientific community desires. Here we describe an alternative, which offers many of the advantages of space for a fraction of the cost: the Antarctic Plateau.
The Figaro data reduction system was originally written for DEC VAXes running VMS, and little attention was paid to making it portable. Recently, however, a cooperative effort between the AAO, MSSSO, UNSW, the UK Starlink network and Caltech has resulted in a version for UNIX. This new version has been run under VMS and three different versions of UNIX. The files produced by any version may be read directly by any other version, although Figaro has a particularly complex file format which contains an extensible, self-defining, hierarchical structure of data items. This complexity has allowed the addition of error and quality data, as well as specific structures used, for example, for echelle data. Figaro is written mainly in Fortran (with numerous DEC extensions) but there is also a significant use of C. While C and Fortran are reasonably portable, the way one is called from the other is less portable and needs careful handling. Ports to other systems are possible, with effort; a Macintosh version is being considered.
The University of NSW’s Automated Patrol Telescope is a modified Baker-Nunn satellite tracking camera, now used for CCD imaging of astronomical objects. The f/1 Baker-Nunn optical design gives a 30° field of view with an approximately spherical focal surface of radius ≈500 mm. While the focal plane curvature is tolerable across the 1.4° × 1.0° field of the present CCD, it becomes unacceptable when a larger CCD is used. In addition, the use of glass filters in the highly convergent beam produces intolerable spherical aberration. We present a design modification to the original Baker-Nunn which enables a 5° diameter flat field to be produced when using B, V, R or I filters. By making this modification, we plan to perform multicolour imaging, using a new large-format CCD with a 2.9° × 1.9° field of view.
We describe the application of Peltier effect cooling to charge coupled device (CCD) detectors. We are developing this technique to produce a CCD camera which requires low maintenance, yet has sufficiently small dark-current for long exposure imaging. This camera will be used in an automated imaging telescope at Siding Spring Observatory. The design principles used to maximise cooling of the detector, and hence minimise dark-current, are discussed. A small dark-current can be obtained only if great care is taken to reduce or eliminate convective, conductive and radiative heating of the chip. In addition, a path of high thermal conductivity must be provided for the heat removed from the CCD. A recent laboratory test of our cooling system demonstrates that careful design can lead to sufficiently low CCD dark-current for many astronomical applications.
This paper presents the results of a multiwavelength observational study of the active young F-type star HR 1817. The star was monitored at 4.80 and 8.64 GHz over 2 × 12 h allocations with the Australia Telescope Compact Array on 8 and 9 December, 2000. The Anglo-Australian Telescope was used for simultaneous optical spectropolarimetry during a 2 h period on 9 December.
The low levels of observed radio emission have characteristics that are similar to those seen in other active stars, and a gyrosynchrotron mechanism is proposed to explain them; this is supported by the relatively low fractions of circular polarisation measured in HR 1817.
Comparison of the emissions from 4.80 and 8.64 GHz shows a very strong cross-correlation peak, indicative of a common origin, although the shift of this peak indicates that 8.64 GHz variations tend to precede those at 4.80 GHz by, typically, ˜20 min.
The optical spectropolarimetry reveals polarisation signals characteristic of surface magnetic fields, with profile changes indicating a complex dynamo-type magnetic topology is present on the star. This result makes HR 1817 the star with the earliest spectral type on which dynamo magnetic fields have been detected directly up to now.
We present evidence to show that changes in the Sun's equatorial rotation rate are synchronized with changes in its orbital motion about the barycentre of the Solar System. We propose that this synchronization is indicative of a spin–orbit coupling mechanism operating between the Jovian planets and the Sun. However, we are unable to suggest a plausible underlying physical cause for the coupling. Some researchers have proposed that it is the period of the meridional flow in the convective zone of the Sun that controls both the duration and strength of the Solar cycle. We postulate that the overall period of the meridional flow is set by the level of disruption to the flow that is caused by changes in Sun's equatorial rotation speed. Based on our claim that changes in the Sun's equatorial rotation rate are synchronized with changes in the Sun's orbital motion about the barycentre, we propose that the mean period for the Sun's meridional flow is set by a Synodic resonance between the flow period (∼22.3 yr), the overall 178.7-yr repetition period for the solar orbital motion, and the 19.86-yr synodic period of Jupiter and Saturn.
Radio and optical observations from December 2001 and January 2002 of the active RS CVn-like binary CC Eri are presented. The star was monitored at 4.80 and 8.64 GHz over 3 × 12 h allocations with the Australia Telescope Compact Array on 28 to 30 December 2001. The Anglo-Australian Telescope was used for simultaneous optical spectropolarimetry during a 0.5 h period on 30 December. Data from four nights of broadband photometry gathered around the same period are also included in this present multiwavelength study.
The low levels of radio emission were circularly polarised at ∼20% with slightly positive spectral indices of ∼0.26. Two flare-like increases were observed on successive nights with steep positive spectral indices and no detectable polarisation. Cross-correlation analysis of the 4.80 and 8.64 GHz intensities over the stronger flare showed that the higher frequency emission preceded that at the lower frequency by ∼5 min, a result consistent with the propagation of a hydromagnetic disturbance outwards through the corona. On the same night, a significant cross-correlation in the ‘quiescent’ emission indicates the presence of micro-flaring, although its low intensity does not permit the evaluation of a time delay. The emission parameters on the three nights are compatible with a gyrosyncrotron mechanism, in which the radio source becomes optically thick during strong flaring. We develop a simple model, which is based on assuming that the number of radiating electrons is a given function of the magnetic field in the source region, and derive feasible values for the field, source radius, and number of emitting electrons, which are not strongly dependent on the field modelling function or the aspect ratio of the source. Spectropolarimetry demonstrates the presence of a strong surface magnetic field. Optical photometry, covering a sufficient amount of the orbit, indicates a maculation region of significant size (∼14° radius).
The results help develop a three-dimensional picture of a large stellar magnetically active region and encourage more detailed follow-up multiwavelength studies of this and similar stars.
High-resolution spectroscopy and spectropolarimetry have been undertaken at the Anglo-Australian Telescope in order to identify suitable targets for magnetic studies of young Sun-like stars, for the proxy study of early solar evolution. This study involved the investigation of some variable late F- / early G-type Sun-like stars originally identified by the Hipparcos mission. Of the 38 stars observed for this study, HIP 31021, HIP 64732, HIP 73780 were found to be spectroscopic binary stars, while HIP 19072, HIP 67651 and HIP 75636 are also likely to be binaries and HIP 33111 could even be a triple system. Magnetic fields were detected on a number of the survey stars: HIP 21632, HIP 43720, HIP 48770, HIP 62517, HIP 71933, HIP 77144, HIP 89829, HIP 90899 and HIP 105388, making these stars good candidates for follow-up Zeeman Doppler imaging studies.
Vegetable oils (VO) have become the predominant substitute for fish oil (FO) in aquafeeds; however, the resultant lower content of n-3 long-chain ( ≥ C20) PUFA (n-3 LC-PUFA) in fish has put their use under scrutiny. The need to investigate new oil sources exists. The present study tested the hypothesis that in Atlantic salmon (Salmo salar L.), a high intake of stearidonic acid (SDA) from Echium oil (EO) would result in increased n-3 LC-PUFA biosynthesis due to a lower requirement for Δ6 desaturase. Comparisons were made with fish fed on diets containing rapeseed oil (RO) and FO in freshwater for 112 d followed by 96 d in seawater. EO fish had higher whole-carcass SDA and eicosatetraenoic acid (ETA) in freshwater and prolonged feeding on the EO diet in seawater resulted in higher SDA, ETA, EPA and docosapentaenoic acid (DPA) compared with RO fish. Fatty acid mass balance of freshwater fish indicated higher biosynthesis of ETA and EPA in EO fish compared with fish fed on the other diets and a twofold increase in n-3 LC-PUFA synthesis compared with RO fish. In seawater, n-3 biosynthetic activity was low, with higher biosynthesis of ETA in EO fish and appearance of all desaturated and elongated products along the n-3 pathway. SDA-enriched VO are more suitable substitutes than conventional VO from a human consumer perspective due to the resulting higher SDA content, higher total n-3 and improved n-3:n-6 ratio obtained in fish, although both VO were not as effective as FO in maintaining EPA and DHA content in Atlantic salmon.