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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.
We investigate the effect of constant-vorticity background shear on the properties of wavetrains in deep water. Using the methodology of Fokas (A Unified Approach to Boundary Value Problems, 2008, SIAM), we derive a higher-order nonlinear Schrödinger equation in the presence of shear and surface tension. We show that the presence of shear induces a strong coupling between the carrier wave and the mean-surface displacement. The effects of the background shear on the modulational instability of plane waves is also studied, where it is shown that shear can suppress instability, although not for all carrier wavelengths in the presence of surface tension. These results expand upon the findings of Thomas et al. (Phys. Fluids, vol. 24 (12), 2012, 127102). Using a modification of the generalized Lagrangian mean theory in Andrews & McIntyre (J. Fluid Mech., vol. 89, 1978, pp. 609–646) and approximate formulas for the velocity field in the fluid column, explicit, asymptotic approximations for the Lagrangian and Stokes drift velocities are obtained for plane-wave and Jacobi elliptic function solutions of the nonlinear Schrödinger equation. Numerical approximations to particle trajectories for these solutions are found and the Lagrangian and Stokes drift velocities corresponding to these numerical solutions corroborate the theoretical results. We show that background currents have significant effects on the mean transport properties of waves. In particular, certain combinations of background shear and carrier wave frequency lead to the disappearance of mean-surface mass transport. These results provide a possible explanation for the measurements reported in Smith (J. Phys. Oceanogr., vol. 36, 2006, pp. 1381–1402). Our results also provide further evidence of the viability of the modification of the Stokes drift velocity beyond the standard monochromatic approximation, such as recently proposed in Breivik et al. (J. Phys. Oceanogr., vol. 44, 2014, pp. 2433–2445) in order to obtain a closer match to a range of complex ocean wave spectra.
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.
To achieve their conservation goals individuals, communities and organizations need to acquire a diversity of skills, knowledge and information (i.e. capacity). Despite current efforts to build and maintain appropriate levels of conservation capacity, it has been recognized that there will need to be a significant scaling-up of these activities in sub-Saharan Africa. This is because of the rapid increase in the number and extent of environmental problems in the region. We present a range of socio-economic contexts relevant to four key areas of African conservation capacity building: protected area management, community engagement, effective leadership, and professional e-learning. Under these core themes, 39 specific recommendations are presented. These were derived from multi-stakeholder workshop discussions at an international conference held in Nairobi, Kenya, in 2015. At the meeting 185 delegates (practitioners, scientists, community groups and government agencies) represented 105 organizations from 24 African nations and eight non-African nations. The 39 recommendations constituted six broad types of suggested action: (1) the development of new methods, (2) the provision of capacity building resources (e.g. information or data), (3) the communication of ideas or examples of successful initiatives, (4) the implementation of new research or gap analyses, (5) the establishment of new structures within and between organizations, and (6) the development of new partnerships. A number of cross-cutting issues also emerged from the discussions: the need for a greater sense of urgency in developing capacity building activities; the need to develop novel capacity building methodologies; and the need to move away from one-size-fits-all approaches.
It is increasingly essential for medical researchers to be literate in statistics, but the requisite degree of literacy is not the same for every statistical competency in translational research. Statistical competency can range from ‘fundamental’ (necessary for all) to ‘specialized’ (necessary for only some). In this study, we determine the degree to which each competency is fundamental or specialized.
We surveyed members of 4 professional organizations, targeting doctorally trained biostatisticians and epidemiologists who taught statistics to medical research learners in the past 5 years. Respondents rated 24 educational competencies on a 5-point Likert scale anchored by ‘fundamental’ and ‘specialized.’
There were 112 responses. Nineteen of 24 competencies were fundamental. The competencies considered most fundamental were assessing sources of bias and variation (95%), recognizing one’s own limits with regard to statistics (93%), identifying the strengths, and limitations of study designs (93%). The least endorsed items were meta-analysis (34%) and stopping rules (18%).
We have identified the statistical competencies needed by all medical researchers. These competencies should be considered when designing statistical curricula for medical researchers and should inform which topics are taught in graduate programs and evidence-based medicine courses where learners need to read and understand the medical research literature.
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 red variables whose amplitude is larger than 1.3 mag in the MOA database are studied for the LMC. Among 3 196 such stars, 532 stars are likely to be Miras or red semiregular variables. The period–colour relation of these stars is shown.
A large database of CCD photometry for 1.4 million stars towards both the LMC and the SMC, which has been established by the MOA project, is a useful resource to study variable stars. In our preliminary study, variables identified as β Lyrae type stars and Herbig Ae/Be stars have been found amongst blue stars.
A review of the MOA (Microlensing Observations in Astrophysics) project is presented. MOA is a collaboration of approximately 30 astronomers from New Zealand and Japan established with the aim of finding and detecting microlensing events towards the Magellanic Clouds and the Galactic bulge, which may be indicative of either dark matter or of planetary companions. The observing program commenced in 1995, using very wide band blue and red filters and a nine-chip mosaic CCD camera.
As a by-product of these observations a large database of CCD photometry for 1.4 million stars towards both LMC and SMC has been established. In one preliminary analysis 576 bright variable stars were confirmed, nearly half of them being Cepheids. Another analysis has identified large numbers of blue variables, and 205 eclipsing binaries are included in this sample. In addition 351 red variables (AGB stars) have been found. Light curves have been obtained for all these stars. The observations are carried out on a 61-cm f/6.25 telescope at Mt John University Observatory where a new larger CCD camera was installed in 1998 July. From this latitude (44° S) the Magellanic Clouds can be monitored throughout the year.
Radio interferometric observations of extragalactic radio sources have been made with antennas at the Haystack Observatory in Massachusetts and the Owens Valley Radio Observatory in California during fourteen separate experiments distributed between September 1976 and May 1978. The components of the baseline vector and the coordinates of the sources were estimated from the data from each experiment separately. The root-weighted-mean-square scatter about the weighted mean (“repeatability”) of the estimates of the length of the 3900 km baseline was approximately 7 cm, and of the source coordinates, approximately or less, except for the declinations of low-declination sources. With the source coordinates all held fixed at the best available, a posteriori, values, and the analyses repeated for each experiment, the repeatability obtained for the estimate of baseline length was 4 cm. From analyses of the data from several experiments simultaneously, estimates were obtained of changes in the x component of pole position and in the Earth's rotation (UT1). Comparison with the corresponding results obtained by the Bureau International de l'Heure (BIH) discloses systematic differences. In particular, the trends in the radio interferometric determinations of the changes in pole position agree more closely with those from the International Polar Motion Service (IPMS) and from the Doppler observations of satellites than with those from the BIH.
This paper sets out the detailed stratigraphy and chronology of the palaeolithic rockshelters of Asprochaliko and Kastritsa excavated in the 1960s, the methods used by the original investigators in excavation and classification of the finds, and the general characteristics of the stone industries and fauna. Methods of estimating the density of finds are discussed. Estimates of time density — the number of specimens accumulated per unit area per unit time — are applied to the upper palaeolithic deposits at both sites and reveal major differences in the rate of discard of material, indicating more intensive occupation at Kastritsa. Inter-site differences in the proportion of faunal species and artefact types are analysed in the light of the time-density evidence, and the various factors that could have influenced the pattern of inter-site variation are discussed.
Dopants Y and Zr at 100 ppm levels in high purity, micron grain-size polycrystalline alumina are mainly segregated to the alumina grain boundaries and strongly reduce high temperature creep. Information about this segregation has come from high resolution STEM composition mapping experiments. Information about local structural surroundings of the dopant atoms has come from EXAFS experiments, and information about local bonding of the dopant atoms has come from XANES experiments. Structural models for dopant grain boundary segregation provide a context for these experimental results and for effects of dopant incorporation on grain boundary mediated transport. Recent experimental and theoretical results are discussed in this paper.
Atomic Force Microscopy (AFM) is used to characterize fracture surfaces in silicon oxide / silane adhesion promoter / BCB polymer systems. Fatigue striations were found on some samples, and these were correlated with the crack growth rate per fatigue cycle. X-ray Photoelectron Spectroscopy (XPS) was used to identify the species present on each surface, and it was found that striations only form when the fracture path is through the polymer.
The damage induced in the low-k material upon exposure to dry etch and ash
plasmas is a point of major concern in terms of preservation of the
dielectric properties. There is urgent need to assess, classify and quantify
the extent of such damage to allow the optimization of patterning processes
and conditions. Meander-fork structures with spacings between 250nm and 70nm
are used in this study as vehicle to compare trends in electrical
performance for different dielectrics: SiO2 and two SiOC:H low-k
materials with pristine k values of 3.0 and 2.6. Here we demonstrate that
the ‘electrical equivalent damage’ model is a valid and precise methodology
for assessing dielectric damage upon processing from interline capacitance
evaluation. This analysis allows to distinguish between bulk and sidewall
modification and to quantify the extent of damage. Moreover, it provides an
interpretation for the degradation of leakage current and breakdown field of
the interline dielectric, revealing different trends whether due to only
sidewall or total damage.