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Effective preventive strategies could reduce disability and the long term social and health complications associated with depression, but options are limited. Cognitive bias modification (CBM) is a novel, simple, and safe intervention that corrects the attentional and interpretive biases associated with depression.
To determine if CBM decreases the one-year onset of major depression in adults at risk.
This randomised controlled trial will recruit adults with subsyndromal depression living in Australia (parallel design, 1:1 allocation ratio). The intervention will be delivered via the internet over 52 weeks. The primary outcome of interest is the onset of a major depression according to DSM-IV-TR criteria. Secondary outcomes of interest include change in the severity of depressive (Patient Health Questionnaire, PHQ-9) and changes in attention and interpretive biases. Outcomes will be collected 3, 6, 9 and 12 months after randomisation.
Preliminary data on a subsample of 20 participants showed that the mean±SE PHQ-9 score of controls was 7.5±0.9 at study entry and 7.1±1.5 at week 6 (paired t-test=0.29, p=0.779), whereas the mean±SE score of active CBM participants was 7.4±1.0 and 4.4±1.1, respectively (paired t=6.00, p<0.001). The mean PHQ-9 difference between control and active CBM participants over 6 weeks was 2.6±1.5 points (t=1.79, p=0.090). One of 11 controls (9.1%) and 0/9 active CBM participants showed evidence of clinically significant depressive symptoms at week 6 (i.e., PHQ-9≥15).
By March 2015, 6-months preliminary data will be available on 165 participants.
Retinoblastoma is the most common primary intraocular tumor of childhood with >95% survival rates in the US. Traditional therapy for retinoblastoma often included enucleation (removal of the eye). While much is known about the visual, physical, and cognitive ramifications of enucleation, data are lacking about survivors' perception of how this treatment impacts overall quality of life.
Qualitative analysis of an open-ended response describing how much the removal of an eye had affected retinoblastoma survivors' lives and in what ways in free text, narrative form.
Four hundred and four retinoblastoma survivors who had undergone enucleation (bilateral disease = 214; 52% female; mean age = 44, SD = 11) completed the survey. Survivors reported physical problems (n = 205, 50.7%), intrapersonal problems (n = 77, 19.1%), social and relational problems (n = 98, 24.3%), and affective problems (n = 34, 8.4%) at a mean of 42 years after diagnosis. Three key themes emerged from survivors' responses; specifically, they (1) continue to report physical and intrapersonal struggles with appearance and related self-consciousness due to appearance; (2) have multiple social and relational problems, with teasing and bullying being prominent problems; and (3) reported utilization of active coping strategies, including developing more acceptance and learning compensatory skills around activities of daily living.
Significance of results
This study suggests that adult retinoblastoma survivors treated with enucleation continue to struggle with a unique set of psychosocial problems. Future interventions can be designed to teach survivors more active coping skills (e.g., for appearance-related issues, vision-related issues, and teasing/bullying) to optimize survivors' long-term quality of life.
An experimental study of bluff bodies in confinement is presented. Two Reynolds matched rigs (pipe diameters:
) are used to derive a picture of the flow topology of the primary-shedding mode (Kármán vortex, mode-I). Confined bluff bodies create an additional spectral mode (mode-II). This is caused by the close coupling of the shedder blockage and the wall and is unique to the confined bluff-body problem. Under certain conditions, modes-I and II can interact, resulting in a lock-on, wherein the modes cease to exist at independent frequencies. The topological effects of mode interaction are demonstrated using flow visualisation. Furthermore, the scaling of mode-II is explored. The two experimental facilities span Reynolds numbers (based on the shedder diameter,
and bulk Mach numbers
. Bluff bodies with a constant blockage ratio (
), forebody shape and various splitter-plate lengths (
) and thicknesses (
) are used. Results indicate that the flow topology changes substantially between short (
) and long (
) tailed geometries. Surface flow visualisation indicates that the primary vortex becomes anchored on the tail when
). This criterion prohibits the development of such a topology for short-tailed geometries. When mode interaction occurs, which it does exclusively in long-tailed cases, the tail-anchored vortex pattern is disrupted. The onset of mode-II occurs at approximately the same Reynolds number in both rigs, although the associated dimensionless frequency is principally a function of Mach number. Accordingly, mode interaction is avoided in the larger-scale rig, due to the increased separation of the modal frequencies.
Starbursts are finite periods of intense star formation (SF) that can dramatically impact the evolutionary state of a galaxy. Recent results suggest that starbursts in dwarf galaxies last longer and are distributed over more of the galaxy than previously thought, with star formation efficiencies (SFEs) comparable to spiral galaxies, much higher than those typical of non-bursting dwarfs. This difference might be explainable if the starburst mode is externally triggered by gravitational interactions with other nearby systems. We present new, sensitive neutral hydrogen observations of 18 starburst dwarf galaxies, which are part of the STARburst IRregular Dwarf Survey (STARBIRDS) and each were mapped with the Green Bank Telescope (GBT) and/or Parkes Telescope in order to study the low surface brightness gas distributions, a common tracer for tidal interactions.
We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. Trial registration: ISRCTN84130388.
Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.
TCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
Vaccination is increasingly being recognised as a potential tool to supplement ‘stamping out’ for controlling foot-and-mouth disease (FMD) outbreaks in non-endemic countries. Infectious disease simulation models provide the opportunity to determine how vaccination might be used in the face of an FMD outbreak. Previously, consistent relative benefits of specific vaccination strategies across different FMD simulation modelling platforms have been demonstrated, using a UK FMD outbreak scenario. We extended this work to assess the relative effectiveness of selected vaccination strategies in five countries: Australia, New Zealand, the USA, the UK and Canada. A comparable, but not identical, FMD outbreak scenario was developed for each country with initial seeding of Pan Asia type O FMD virus into an area with a relatively high density of livestock farms. A series of vaccination strategies (in addition to stamping out (SO)) were selected to evaluate key areas of interest from a disease response perspective, including timing of vaccination, species considerations (e.g. vaccination of only those farms with cattle), risk area vaccination and resources available for vaccination. The study found that vaccination used with SO was effective in reducing epidemic size and duration in a severe outbreak situation. Early vaccination and unconstrained resources for vaccination consistently outperformed other strategies. Vaccination of only those farms with cattle produced comparable results, with some countries demonstrating that this could be as effective as all species vaccination. Restriction of vaccination to higher risk areas was less effective than other strategies. This study demonstrates consistency in the relative effectiveness of selected vaccination strategies under different outbreak start up conditions conditional on the assumption that each of the simulation models provide a realistic estimation of FMD virus spread. Preferred outbreak management approaches must however balance the principles identified in this study, working to clearly defined outbreak management objectives, while having a good understanding of logistic requirements and the socio-economic implications of different control measures.
Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities.
Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined.
HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior.
Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
Children with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded.
Psychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress.
Exclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up.
We detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.
It is unclear which of four popular contemporary diet patterns is best for weight maintenance among postmenopausal women. Four dietary patterns were characterised among postmenopausal women aged 49–81 years (mean 63·6 (sd 7·4) years) from the Women’s Health Initiative Observational Study: (1) a low-fat diet; (2) a reduced-carbohydrate diet; (3) a Mediterranean-style (Med) diet; and (4) a diet consistent with the US Department of Agriculture’s Dietary Guidelines for Americans (DGA). Discrete-time hazards models were used to compare the risk of weight gain (≥10 %) among high adherers of each diet pattern. In adjusted models, the reduced-carbohydrate diet was inversely related to weight gain (OR 0·71; 95 % CI 0·66, 0·76), whereas the low-fat (OR 1·43; 95 % CI 1·33, 1·54) and DGA (OR 1·24; 95 % CI 1·15, 1·33) diets were associated with increased risk of weight gain. By baseline weight status, the reduced-carbohydrate diet was inversely related to weight gain among women who were normal weight (OR 0·72; 95 % CI 0·63, 0·81), overweight (OR 0·67; 95 % CI 0·59, 0·76) or obese class I (OR 0·63; 95 % CI 0·53, 0·76) at baseline. The low-fat diet was associated with increased risk of weight gain in women who were normal weight (OR 1·28; 95 % CI 1·13, 1·46), overweight (OR 1·60; 95 % CI 1·40, 1·83), obese class I (OR 1·73; 95 % CI 1·43, 2·09) or obese class II (OR 1·44; 95 % CI 1·08, 1·92) at baseline. These findings suggest that a low-fat diet may promote weight gain, whereas a reduced-carbohydrate diet may decrease risk of postmenopausal weight gain.
In the article above there is a spelling mistake in the Figure 3 legend. Largge should be Large. The correct Figure 3 legend is shown below:-
Figure 3 Biomass values of herbivorous fish functional groups – browsers, grazers and detritivores, and scrapers and small excavators – for each island. Large excavators and bioeroders were not observed, and thus are not included in the graph.
Page 5, right column in the ‘Ecological perspective and management implications section’, in the second paragraph the third sentence should read . . .One potential management tool that considers these needs and limitations is the installation of composting toilets, after due consideration of local cultural sensitivities. . .
Small-island coral reef ecosystems are usually closely coupled to the activities of human inhabitants. Ahus Island (Papua New Guinea) is an isolated Pacific island with a rapidly growing population, heavy reliance on marine resources and limited infrastructure. We hypothesized that untreated sewage was driving distinct benthic assemblages around Ahus and neighbouring uninhabited Onetah. At sites with varying proximities to beach toilets, fore-reef herbivorous fish biomass and benthic composition were measured alongside reef-flat sedimentary oxygen consumption (SOC); a high SOC rate reflects high organic input into coastal waters, thus serving as a potential indicator of sewage input. Fish biomass was low (17.1–20.1 g m–2), but consistent between sites. However, cyanobacteria dominated the fore-reef closest to toilets (62 ± 3%) with highest reef-flat SOC, whereas hard corals dominated furthest away (63 ± 1%), where SOC was lowest. To our knowledge, this is the first study that used SOC to detect local differences in sewage pollution. The results indicate that whilst corals can maintain their dominance on overfished reefs, additional sewage stress may drive pronounced benthic shifts, highlighting the urgency to improve small-island waste management.
The ready availability of full-field velocity measurements in present-day experiments has kindled interest in using such data for force estimation, especially in situations where direct measurements are difficult. Among the methods proposed, a formulation based on impulse is attractive, for both practical and physical reasons. However, evaluation of the impulse requires a complete description of the vorticity field, and this is particularly hard to achieve in the important region close to a body surface. This paper presents a solution to the problem. The incomplete experimental-vorticity field is augmented by a vortex sheet on the body, with strength determined by the no-slip boundary condition. The impulse is then found from the sum of vortex-sheet and experimental contributions. Components of physical interest can straightforwardly be recognised; for example, the classical ‘added mass’ associated with fluid inertia is represented by an explicit term in the formulation for the vortex sheet. The method is implemented in the context of two-dimensional flat-plate flow, and tested on velocity-field data from a translating wing experiment. The results show that the vortex-sheet contribution is significant for the test data set. Furthermore, when it is included, good agreement with force-balance measurements is found. It is thus recommended that any impulse-based force calculation should correct for (likely) data incompleteness in this way.
Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly interconnected high-density structures, termed the ‘rich-club’, represents an important network for integration of brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory analyses.
We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical structures defined the neuroanatomical networks. Next, we examined between-group differences in features of graph properties and sub-networks.
Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and thalamus.
This graph theory analysis presents a thorough investigation of topological features of connectivity in euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically specific evidence for distributed dysconnectivity as a trait feature of BD.
Transmitted light and scanning electron imaging of sectioned specimens of Conularia and Paraconularia, prepared using HCl etching and critical point drying, revealed that their periderm is composed of extremely thin (approximately 0.5–3 µm), variably distinct microlamellae that are alternately organic poor and organic rich. Organic-rich microlamellae are cross-connected by slender strands of organic matter originally embedded in calcium phosphate, which in etched specimens has been dissolved. Microlamellae may be organized in thicker (approximately 5–75 µm) layers, or macrolamellae, that vary in color and organic matter content, possibly owing to changes in the ambient paleoenvironment. Thickening of the periderm to form transverse ribs and internal carinae was achieved through gradual thickening of individual microlamellae. In the core of the transverse ribs and internal carinae the distinction between organic-rich and organic-poor microlamellae may be reduced, owing to organic material becoming dominant over (former) mineral matter or vice versa. Combined with observations of plicated aperture closure in thin-walled conulariids, including Archaeoconularia slateri (Reed, 1933) (Upper Ordovician, Scotland) showing smooth folding of midline carinae through angles greater than 90°, these results suggest a structure and original flexibility in the organic-rich biocomposite forming the conulariid periderm that supports its homology to the chitinous lamellar periderm of coronate scyphozoans.
The tropopause, typically at 16 to 18 km altitude at the lower latitudes, dips down to only 8 km in the polar regions, allowing access to the cold, dry and nonturbulent lower stratosphere by tethered aerostats. These can float as high as 12 km, have long operating lifetimes, and are extremely reliable. In contrast to free-flying balloons, they can stay on station for weeks at a time, and payloads can be safely recovered for maintenance and adjustment and relaunched in a matter of hours. We propose to use such a platform, located first near Fairbanks, Alaska, and later in the Antarctic, to operate a new-technology 4 m telescope with diffraction-limited performance in the near infrared. Thanks to the low ambient temperature (~200 K), thermal emission from the optics is of the same order as that of the zodiacal light in the 2–3 μm band. Since this wavelength interval is the darkest part of the zodiacal light spectrum from optical wavelengths to 100 μm, the combination of high-resolution images and a very dark sky make it the spectral region of choice for observing galaxies, QSOs and clusters of galaxies at the formation epoch of galaxies.
This cluster has two notable characteristics: it contains more than 80 variables, and relative to its NP half its SF half is covered by a cloud absorbing up to a magnitude in the blue. These properties make it an ideal object for determining the ratio Av/E of V absorption to colour excess—one simply compares mean colours and magnitudes of variables in the obscured part with those in the clear part.