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To use a Machine Learning (ML) approach to compare Neuropsychiatric Symptoms (NPS) in participants of a longitudinal study who developed dementia and those who did not.
Mann-Whitney U and ML analysis. Nine ML algorithms were evaluated using a 10-fold stratified validation procedure. Performance metrics (accuracy, recall, F-1 score, and Cohen’s kappa) were computed for each algorithm, and graphic metrics (ROC and precision-recall curves) and features analysis were computed for the best-performing algorithm.
Primary care health centers.
128 participants: 78 cognitively unimpaired and 50 with MCI.
Diagnosis at baseline, months from the baseline assessment until the 3rd follow-up or development of dementia, gender, age, Charlson Comorbidity Index, Neuropsychiatric Inventory-Questionnaire (NPI-Q) individual items, NPI-Q total severity, and total stress score and Geriatric Depression Scale-15 items (GDS-15) total score.
30 participants developed dementia, while 98 did not. Most of the participants who developed dementia were diagnosed at baseline with amnestic multidomain MCI. The Random Forest Plot model provided the metrics that best predicted conversion to dementia (e.g. accuracy=.88, F1=.67, and Cohen’s kappa=.63). The algorithm indicated the importance of the metrics, in the following (decreasing) order: months from first assessment, age, the diagnostic group at baseline, total NPI-Q severity score, total NPI-Q stress score, and GDS-15 total score.
ML is a valuable technique for detecting the risk of conversion to dementia in MCI patients. Some NPS proxies, including NPI-Q total severity score, NPI-Q total stress score, and GDS-15 total score, were deemed as the most important variables for predicting conversion, adding further support to the hypothesis that some NPS are associated with a higher risk of dementia in MCI.
Human trafficking is a crime and a human rights violation that involves various and simultaneous traumatic events (sexual and physical violence, coercion). Yet, it is unknown how the patterning of violence and coercion affects the mental health of female and male trafficking survivors.
We conducted a cross-sectional study using a sample of 1015 female and male survivors of trafficking who received post-trafficking assistance services in Cambodia, Thailand or Vietnam. We assessed symptoms of anxiety and depression with the Hopkins Symptoms Checklist and symptoms of post-traumatic stress disorder (PTSD) with the Harvard Trauma Questionnaire. Violence was measured with questions from the World Health Organization International Study on Women's Health. Latent class analysis (LCA) was used to identify distinct patterns of violence and coercion in females and males. Novel multi-step mixture modelling techniques were employed to assess the association of the emergent classes with anxiety, depression and PTSD in females and males.
LCA identified two distinct classes of violence and coercion experiences in females (class I: severe sexual and physical violence and coercion (20%); class II: sexual violence and coercion (80%)) and males (class I: severe physical violence and coercion (41%); class II: personal coercion (59%)). Females in class I had a two-fold increase in the odds of anxiety (OR = 2.10; 95% CI: 1.57–2.81) and PTSD (OR = 2.07; 95% CI: 1.03–4.17) compared with females in class II, but differences in the prevalence of anxiety, depression and PTSD were not significant when comparing males in class I to class II.
Specific patterns of violence and coercion provide a more in-depth understanding of the role of gender in the experience of violence and coercion and its association with mental health in survivors of trafficking. This information could be useful to target comprehensive mental health services for female and male trafficking survivors.
We have continued to improve and update the OPAL opacity code. Addition of intermediate coupling has further increased the opacity over earlier LS coupling results. A ‘corresponding states’ method has been used to extend the tables in both X and Z. This has allowed the calculation and distribution of extensive opacity tables for several different sets of metal abundance.
Aliphatic and polycyclic aromatic hydrocarbons (AHs and PAHs) were investigated in soil and meltwater stream sediments near the Uruguayan Artigas Research Station (BCAA). Gas chromatography with flame ionization detection and gas chromatography mass spectrometry were used to determine the composition of AHs and PAHs, respectively. Total AH concentrations were in the range 0.57–2333 µg g-1, while total PAH concentrations were in the range 1.36–51 650 ng g-1. Based on AH and PAH concentrations, sites in the service area and next to the boat storeroom are highly contaminated, while the other sites sampled have moderate to low contamination levels or are not impacted. High unresolved complex mixture concentrations indicate the occurrence of previous petrogenic contamination, but the dominance of low molecular weight and alkyl PAHs indicate recent oil introductions. Anthropogenic hydrocarbons dominate and are related to diesel fuel and organic residue combustion, fuel storage and boat traffic. Petrogenic contamination is relatively high, as at other Antarctic stations, but is restricted to the boat storeroom and the service area where the incinerator, the generator room and fuel tanks are located. Improvements made in fuel management procedures and the dismantling of the old fuel tanks will reduce the risk of diesel leaks and their impact on the environment near the BCAA. This study provides reference information for future environmental monitoring.
Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative–convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures
eV and electron densities
. The iron will be probed using continuum X-rays emitted in a
diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design,
of the NIF beams deliver 500 kJ to the
mm diameter hohlraum, and the remaining
directly drive the CH capsule with 200 kJ. Calculations indicate this capsule backlighter should outshine the iron sample, delivering a point-projection transmission opacity measurement to a time-integrated X-ray spectrometer viewing down the hohlraum axis. Preliminary experiments to develop the backlighter and hohlraum are underway, informing simulated measurements to guide the final design.
A candidate Tidal Dwarf Galaxy, ce-61, was identified in the merger system IC 1182 in the Hercules supercluster. The multi-wavelength data we obtained so far do not prove, however, that it is kinematically detached from the IC 1182 system and gravitationally bound.
The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1–100%, P < 0·001) and maintenance (51·1–72·1%, P = 0·029) of CVCs; and the use of chlorhexidine for skin disinfection was implemented at insertion (35·7–65·4%, P < 0·001) and maintenance (33·3–45·9%, P < 0·197) of CVCs. There were 266 CR BSI incidents recorded with an annual incidence density of 5·75/1000 catheter-days in the first year, 4·38 in the second year [rate ratio (RR) 0·76, 95% confidence interval (CI) 0·57–1·01] and 3·46 in the third year (RR 0·60, 95% CI 0·44–0·81). The education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs.
Our aim is to study the Star Formation Rate (SFR) by galaxy components such as bulges, bars and disks in a representative sample of nearby galaxies. A 2-dimensional (2D) photometric decomposition approach (GASP2D) is used to obtain these components. The availability of IFS data for the CALIFA galaxies makes possible to go one step further as we can apply the previous decompositions over 3D datacubes to disentangle the spatial distribution of the SFR over different components free from the limitations associated to narrow-band imaging.
Binary toxin (BT) has been associated with strains causing more severe Clostridium difficile infection (CDI), such as ribotype 027. Data on the outcome of patients having BT present in ribotypes other than 027 are scarce. Our objective was to investigate the association between BT isolates and outcome of CDI in a non-027 ribotype setting. We prospectively included CDI episodes (January–June 2013 and March–June 2014) from symptomatic patients aged >2 years. Epidemiological and clinical data were recorded. BT genes were detected using multiplex PCR. During the study period, we identified 326 episodes of CDI, of which 319 were available for molecular analysis. Of these, 54 (16·9%) were caused by C. difficile strains with BT. Most (90·7%) isolates with BT were ribotype 078/126. CDI patients with BT-positive strains did not differ from those with BT-negative strains in terms of recurrence (13·0% vs. 15·5%, P = 0·835), treatment failure (0·0% vs. 2·3%, P = 0·594), overall mortality (11·1% vs. 9·1%, P = 0·612), or CDI-related mortality (0·0% vs. 1·9%, P = 0·612). Multivariate regression revealed no association between BT and poor outcome. In conclusion, in a non-027 setting, we found that most BT isolates were 078/126 and were not associated with poor outcome.
We explore the connection between the black hole mass and its relativistic jet for a sample of radio-loud AGN (z < 1), in which the relativistic jet parameters are well estimated by means of long term monitoring with the 14m Metsähovi millimeter wave telescope and the Very Long Base-line Array (VLBA). NIR host galaxy images taken with the NOTCam on the Nordic Optical Telescope (NOT) and retrieved from the 2MASS all-sky survey allowed us to perform a detailed surface brightness decomposition of the host galaxies in our sample and to estimate reliable black hole masses via their bulge luminosities. We present early results on the correlations between black hole mass and the relativistic jet parameters. Our preliminary results suggest that the more massive the black hole is, the faster and the more luminous jet it produces.
Wolf-Rayet HII galaxies are local metal-poor star-forming galaxies, observed when the most massive stars are evolving from O stars to WR stars, making them template systems to study distant starbursts. We have been performing a program to investigate the interplay between massive stars and gas in WR HII galaxies using IFS. Here, we highlight some results from the first 3D spectroscopic study of Mrk 178, the closest metal-poor WR HII galaxy, focusing on the origin of the nebular HeII emission and the aperture effects on the detection of WR features.
The formation of uranyl peroxide phases was identified as a corrosion product of spent fuel by Hanson et al . The subsequent analysis of this phase showed that metastudtite retained 241Am, 237Np and 239Pu . In this study, the retention of radionuclide Pu4+ and An3+, released from the spent fuel matrix into studtite structure, has been evaluated by the precipitation of studtite from uranyl dissolution with variable concentrations of REE (Th, Nd, Sm and Eu). Three different precipitation conditions parameters were studied: media of synthesis, time of synthesis and REE concentration. Synthesized phases were characterized by XRD and the cell parameter was calculated. The REE incorporation was determined by ICP-MS analysis. The results showed that studtite could incorporate 63% of Th in solution during its precipitation. Changes in the “a” cell parameter were identified. The results suggest that studtite coprecipitated with REE could play a role as a limiting for the REE mobility.
Objectives: The aim of this study was to identify risk points in the different stages of the smart infusion pump implementation process to prioritize improvement measures.
Methods: Failure modes and effects analysis (FMEA) in the pediatric intensive care unit (PICU) of a General and Teaching Hospital. A multidisciplinary team was comprised of two intensive care pediatricians, two clinical pharmacists and the PICU nurse manager. FMEA was carried out before implementing CareFusion infusion smart pumps and eighteen months after to identify risk points during three different stages of the implementation process: creating a drug library; using the technology during clinical practice and analyzing the data stored using Guardrails® CQI v4.1 Event Reporter software.
Results: Several actions for improvement were taken. These included carrying out periodical reviews of the drug library, developing support documents, and including a training profile in the system so that alarms set off by real programming errors could be distinguished from those caused by incorrect use of the system. Eighteen months after the implementation, these measures had helped to reduce the likelihood of each risk point occurring and increase the likelihood of their detection.
Conclusions: Carrying out an FMEA made it possible to detect risk points in the use of smart pumps, take action to improve the tool, and adapt it to the PICU. Providing user training and support tools and continuously monitoring results helped to improve the usefulness of the drug library, increased users’ compliance with the drug library, and decreased the number of unnecessary alarms.
Heliciculture is an excellent alternative to obtain edible snails but its viability is seriously threatened by pathogens. A parasitological survey was conducted in 3 mixed system-based heliciculture farms in Galicia (NW Spain), with the species Tetrahymena rostrata, Tetrahymena limacis, Tetratrichomonas limacis, Cryptobia helicogenae, Brachylaima aspersae (metacercariae and sporocysts), Alloionema appendiculatum, Nemhelix bakeri, and Riccardoella limacum being commonly found infecting Helix aspersa aspersa (petit-gris) snails. With the exception of C. helicogenae, N. bakeri, and B. aspersae sporocysts, all species were also detected in Helix aspersa maxima (gros-gris) snails, although generally with lower parameters. Most monoxenous infections, and consequently multiple parasitism, exhibited a rising trend during the first 2 months of intensive mating, with tendencies being slowed down or even reversed during the third month as a result of accumulated mortality and a sampling-derived reduction in host density. No parasites were vertically transmitted and infections were initially acquired from invading gastropod and micromammal reservoirs during fattening. Finally, artificial hibernation reduced significantly the prevalence of most species. These results confirm the importance of parasites in heliciculture and emphasize the need to prevent the entry of wild reservoirs into the farms and to rapidly remove the carcasses of dead snails from the reproduction units and fattening pens.
For improving the accuracy of the performance assessment studies related to the spent fuel safety under storage conditions it is necessary to develop a new matrix alteration model. These models must be based on laboratory experiences and they should be capable to extrapolate to storing environmental conditions. Most of recently models developed included the oxidation and dissolution process of the spent fuel matrix, but the influence of a possible process of secondary phase formation over the spent fuel surface is not taken into account yet. This is a key process that could produce a reduction of the matrix dissolution rate, radiation shielding behaviour; however, the surface precipitation of the secondary phase could induce a localized corrosion process, which in this case dissolution rate of the spent fuel would be increased. This paper is focussed on microstructural characterization of secondary phases formed in coprecipitation experiments performed under anoxic conditions in granitic-bentonitic simulated groundwater. In order to simulate the influence of the container material, the coprecipitation experiments were performed in absence and presence of iron powder. The solid phases formed were characterized using the following techniques: XRD; SEM-EDX and TEM-EDX. The XRD diffraction pattern showed that under anoxic conditions a mixture of phases were obtained (sodium and potassium uranate and schoepite), whereas uranate phases were detected when only iron was present. The characterization study indicates that the U secondary phase formed (under reducing conditions and presence of iron powder) growth from iron surface. The crystal size of the secondary phase is independent of the presence of iron powder (and it is always less than 3 μm). Furthermore, the microstructural study showed the growing of U phases over iron powder.