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Iraq and Afghanistan Veterans with posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) history have high rates of performance validity test (PVT) failure. The study aimed to determine whether those with scores in the invalid versus valid range on PVTs show similar benefit from psychotherapy and if psychotherapy improves PVT performance.
Veterans (N = 100) with PTSD, mild-to-moderate TBI history, and cognitive complaints underwent neuropsychological testing at baseline, post-treatment, and 3-month post-treatment. Veterans were randomly assigned to cognitive processing therapy (CPT) or a novel hybrid intervention integrating CPT with TBI psychoeducation and cognitive rehabilitation strategies from Cognitive Symptom Management and Rehabilitation Therapy (CogSMART). Performance below standard cutoffs on any PVT trial across three different PVT measures was considered invalid (PVT-Fail), whereas performance above cutoffs on all measures was considered valid (PVT-Pass).
Although both PVT groups exhibited clinically significant improvement in PTSD symptoms, the PVT-Pass group demonstrated greater symptom reduction than the PVT-Fail group. Measures of post-concussive and depressive symptoms improved to a similar degree across groups. Treatment condition did not moderate these results. Rate of valid test performance increased from baseline to follow-up across conditions, with a stronger effect in the SMART-CPT compared to CPT condition.
Both PVT groups experienced improved psychological symptoms following treatment. Veterans who failed PVTs at baseline demonstrated better test engagement following treatment, resulting in higher rates of valid PVTs at follow-up. Veterans with invalid PVTs should be enrolled in trauma-focused treatment and may benefit from neuropsychological assessment after, rather than before, treatment.
Medical responders are at-risk of experiencing a wide range of negative psychological health conditions following a disaster.
Published literature was reviewed on the adverse psychological health outcomes in medical responders to various disasters and mass casualties in order to: (1) assess the psychological impact of disasters on medical responders; and (2) identify the possible risk factors associated with psychological impacts on medical responders.
A literature search of PubMed, Discovery Service, Science Direct, Google Scholar, and Cochrane databases for studies on the prevalence/risk factors of posttraumatic stress disorder (PTSD) and other mental disorders in medical responders of disasters and mass casualties was carried out using pre-determined keywords. Two reviewers screened the 3,545 abstracts and 28 full-length articles which were included for final review.
Depression and PTSD were the most studied outcomes in medical responders. Nurses reported higher levels of adverse outcomes than physicians. Lack of social support and communication, maladaptive coping, and lack of training were important risk factors for developing negative psychological outcomes across all types of disasters.
Disasters have significant adverse effects on the mental well-being of medical responders. The prevalence rates and presumptive risk factors varied among three different types of disasters. There are certain high-risk, vulnerable groups among medical responders, as well as certain risk factors for adverse psychological outcomes. Adapting preventive measures and mitigation strategies aimed at high-risk groups would be beneficial in decreasing negative outcomes.
Capacity building is essential in low- and middle-income countries (LMICs) to address the gap in skills to conduct and implement research. Capacity building must not only include scientific and technical knowledge, but also broader competencies, such as writing, disseminating research and achieving work–life balance. These skills are thought to promote long-term career success for researchers in high-income countries (HICs) but the availability of such training is limited in LMICs.
This paper presents the contextualisation and implementation of the Academic Competencies Series (ACES). ACES is an early-career researcher development programme adapted from a UK university. Through consultation between HIC and LMIC partners, an innovative series of 10 workshops was designed covering themes of self-development, engagement and writing skills. ACES formed part of the African Mental Health Research Initiative (AMARI), a multi-national LMIC-led consortium to recruit, train, support and network early-career mental health researchers from four sub-Saharan African countries.
Of the 10 ACES modules, three were HIC-LMIC co-led, four led by HIC facilitators with LMIC training experience and three led by external consultants from HICs. Six workshops were delivered face to face and four by webinar. Course attendance was over 90% and the delivery cost was approximately US$4500 per researcher trained. Challenges of adaptation, attendance and technical issues are described for the first round of workshops.
This paper indicates that a skills development series for early-career researchers can be contextualised and implemented in LMIC settings, and is feasible for co-delivery with local partners at relatively low cost.
To determine the ability of a novel responder mental health self-triage system to predict post-traumatic stress disorder (PTSD) in emergency medical responders after a disaster.
Participants in this study responded to Typhoon Haiyan, which struck the Philippines in November 2013. They completed the Psychological Simple Triage and Rapid Treatment (PsySTART) responder triage tool, the PTSD Checklist (PCL-5) and the Patient Health Questionnaire-8 (PHQ-8) shortly after responding to this disaster. The relationships between these 3 tools were compared to determine the association between different risk exposures while providing disaster medical care and subsequent levels of PTSD or depression.
The total number of PsySTART responder risk factors was closely related to PCL-5 scores ≥38, the threshold for clinical PTSD. Several of the PsySTART risk factors were predictive of clinical levels of PTSD as measured by the PCL-5 in this sample of deployed emergency medical responders.
The presence of a critical number and type of PsySTART responder self-triage risk factors predicted clinical levels of PTSD and subclinical depression in this sample of emergency medical workers. The ability to identify these disorders early can help categorize an at-risk subset for further timely “stepped care” interventions with the goals of both mitigating the long-term consequences and maximizing the return to resilience. (Disaster Med Public Health Preparedness. 2018;12:19–22)
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
Experiments on the National Ignition Facility show that multi-dimensional effects currently dominate the implosion performance. Low mode implosion symmetry and hydrodynamic instabilities seeded by capsule mounting features appear to be two key limiting factors for implosion performance. One reason these factors have a large impact on the performance of inertial confinement fusion implosions is the high convergence required to achieve high fusion gains. To tackle these problems, a predictable implosion platform is needed meaning experiments must trade-off high gain for performance. LANL has adopted three main approaches to develop a one-dimensional (1D) implosion platform where 1D means measured yield over the 1D clean calculation. A high adiabat, low convergence platform is being developed using beryllium capsules enabling larger case-to-capsule ratios to improve symmetry. The second approach is liquid fuel layers using wetted foam targets. With liquid fuel layers, the implosion convergence can be controlled via the initial vapor pressure set by the target fielding temperature. The last method is double shell targets. For double shells, the smaller inner shell houses the DT fuel and the convergence of this cavity is relatively small compared to hot spot ignition. However, double shell targets have a different set of trade-off versus advantages. Details for each of these approaches are described.
We describe a laboratory plasma physics experiment at Los Alamos National Laboratory that uses two merging supersonic plasma jets formed and launched by pulsed-power-driven railguns. The jets can be formed using any atomic species or mixture available in a compressed-gas bottle and have the following nominal initial parameters at the railgun nozzle exit: ne ≈ ni ~ 1016 cm−3, Te ≈ Ti ≈ 1.4 eV, Vjet ≈ 30–100 km/s, mean charge
≈ 1, sonic Mach number Ms ≡ Vjet/Cs > 10, jet diameter = 5 cm, and jet length ≈20 cm. Experiments to date have focused on the study of merging-jet dynamics and the shocks that form as a result of the interaction, in both collisional and collisionless regimes with respect to the inter-jet classical ion mean free path, and with and without an applied magnetic field. However, many other studies are also possible, as discussed in this paper.
Rapid mental health surveillance during the acute phase of a disaster response can inform the allocation of limited clinical resources and provide essential household-level risk estimates for recovery planning.
To describe the use of the PsySTART Rapid Mental Health Triage and Incident Management System for individual-level clinical triage and traumatic exposure assessment in the aftermath of a large-scale disaster.
We conducted a cross-sectional, comparative review of mental health triage data collected with the PsySTART system from survivors of the September 2009 earthquake-tsunami in American Samoa. Data were obtained from two sources—secondary triage of patients and a standardized community assessment survey—and analyzed descriptively. The main outcome measures were survivor-reported traumatic experiences and exposures—called triage factors—associated with risk for developing severe distress and new mental health disorders following disasters.
The most common triage factors reported by survivors referred for mental health services were “felt extreme panic/fear” (93%) and “felt direct threat to life” (93%). The most common factor reported by persons in tsunami-affected communities was “felt extreme panic or fear” (75%). Proportions of severe triage factors reported by persons living in the community were consistently lower than those reported by patients referred for mental health services.
The combination of evidence-based mental health triage and community assessment gave hospital-based providers, local public health officials, and federal response teams a strategy to match limited clinical resources with survivors at greatest risk. Also, it produced a common operating picture of acute and chronic mental health needs among disaster systems of care operating in American Samoa.(Disaster Med Public Health Preparedness. 2013;7:327-331)
Listeriosis is a foodborne disease associated with significant mortality. This study attempts to identify risk factors for sporadic listeriosis in Australia. Information on underlying illnesses was obtained from cases' treating doctors and other risk factors were elicited from the patient or a surrogate. We attempted to recruit two controls per case matched on age and primary underlying immune condition. Between November 2001 and December 2004 we recruited 136 cases and 97 controls. Of perinatal cases, living in a household where a language other than English was spoken was the main risk factor associated with listeriosis (OR 11·3, 95% CI 1·5–undefined). Of non-perinatal cases we identified the following risk factors for listeriosis: prior hospitalization (OR 4·3, 95% CI 1·0–18·3), use of gastric acid inhibitors (OR 9·4, 95% CI 2·4–37·4), and consumption of camembert (OR 4·7, 95% CI 1·1–20·6). Forty percent of cases with prior hospitalization were exposed to high-risk foods during hospitalization.
Dark matter haloes formed in ∧CDM cosmologies exhibit a characteristic dependence of density on distance from the centre (Chapter 2). Early studies [721; 1501] established ρDM ∼ r−3 or r−4 at large radii and ρDM ∼ r−1 inside the virial radius. On still smaller scales, the form of ρDM(r) was little more than an ansatz since the relevant scales were barely resolved in the N-body simulations. A debate ensued as to whether the profiles were indeed universal and, if so, what power of the radius described the dark matter density in the limit r → 0. Subsequent studies found central profiles both steeper [666; 940; 1247; 1471] and shallower [1431; 1503; 1504] than r−1.
The focus of this chapter is the dark matter distribution on sub-parsec scales. At these radii, the gravitational force in many galaxies is known to be dominated by the observed baryonic components (stellar bulge, nuclear star cluster) and by the supermassive black hole. Dark matter densities at these radii are barely constrained observationally; however, they could plausibly be orders of magnitude higher than the local value at the solar circle (∼10−2M⊙ pc−3), owing both to the special location at the centre of the halo and to interactions between dark matter and baryons during and after formation of the galaxy. High dark matter densities make the centres of galaxies preferred targets for indirect detection studies, in which secondary particles and photons from the annihilation or decay of supersymmetric dark matter particles are detected on the Earth (Chapter 24).
This chapter describes the range and timeline of typical reactions, approaches for screening, triage, and referral, preventing and managing psychological injuries, and integrated strategies to support disaster responders. Disasters and acts of terrorism produce a spectrum of common physiological, psychological, social, behavioral, emotional, cognitive, and spiritual reactions. An emerging incident management model for disaster mental and behavioral health is composed of three major components to enable a common operational picture for participating entities and jurisdictions. The components include community-based disaster systems of care, a common system for incident/event-specific rapid triage, and information technology for near-real-time data linkage. Psychological impact and resulting levels of psychiatric disorders may vary as a function of event characteristics, such as terrorism using weapons that can cause mass casualties and societal disruption. Using leadership, public messaging, and education greatly improves the mental and behavioral health of communities impacted by disasters and mass violence.
Vertical movements of Earth's surface and the rocks that lie beneath it occur around many parts of the globe in response both to tectonic and non-tectonic processes (e.g. glacial unloading, igneous intrusion). Upward vertical movement (uplift) forms topography, which generally results in erosion; and downward vertical movement (subsidence) creates accommodation space, which generally results in burial. In return, particularly over long timescales, feedbacks occur such that erosion and burial may enhance uplift and subsidence, respectively. Thus, it is vitally important to understand the fundamental drivers of uplift and subsidence (e.g. tectonic or non-tectonic) and the relationship with erosion and burial.
For nuclear facilities, the impacts of uplift and erosion generally are more significant than the impacts of subsidence and burial (McKinley and Chapman, Chapter 24, this volume). Furthermore, given the rates of vertical movement (typically < 10mma−1) and the timescales of interest for different kinds of nuclear facilities, their impacts are most significant for geological repositories for long-lived radioactive waste. The potential impacts of uplift, subsidence, erosion and burial on geological repositories are described in McKinley and Chapman (Chapter 24, this volume) and McKinley and Alexander (Chapter 22, this volume). Briefly, the key factors of interest are: (i) the average regional rate of uplift or subsidence (on a scale on the order of tens or hundreds of kilometers); (ii) the magnitude of differential uplift and erosion (on a scale of 100m to several kilometers); (iii) the potential for extreme, localized erosion or burial; and (iv) the balance between uplift and erosion, and subsidence and burial.
Supermassive black holes are common in centers of galaxies. Among the active galaxies, quasars are the most extreme, and their black hole masses range as high as to 6⋅1010M⊙. Binary black holes are of special interest but so far OJ287 is the only confirmed case with known orbital elements. In OJ287, the binary nature is confirmed by periodic radiation pulses. The period is twelve years with two pulses per period. The last four pulses have been correctly predicted with the accuracy of few weeks, the latest in 2007 with the accuracy of one day. This accuracy is high enough that one may test the higher order terms in the Post Newtonian approximation to General Relativity. The precession rate per period is 39°.1 ± 0°.1, by far the largest rate in any known binary, and the (1.83 ± 0.01)⋅1010M⊙ primary is among the dozen biggest black holes known. We will discuss the various Post Newtonian terms and their effect on the orbit solution. The over 100 year data base of optical variations in OJ287 puts limits on these terms and thus tests the ability of Einstein's General Relativity to describe, for the first time, dynamic binary black hole spacetime in the strong field regime. The quadrupole-moment contributions to the equations of motion allows us to constrain the ‘no-hair’ parameter to be 1.0 ± 0.3 which supports the black hole no-hair theorem within the achievable precision.
We study the formation, growth, and co-evolution of single and multiple supermassive black holes (SMBHs) and compact objects like neutron stars, white dwarfs, and stellar mass black holes in galactic nuclei and star clusters, focusing on the role of stellar dynamics. In this paper we focus on one exemplary topic out of a wider range of work done, the study of orbital parameters of binary black holes in galactic nuclei (binding energy, eccentricity, relativistic coalescence) as a function of initial parameters. In some cases the classical evolution of black hole binaries in dense stellar systems drives them to surprisingly high eccentricities, which is very exciting for the emission of gravitational waves and relativistic orbit shrinkage. Such results are interesting to the emerging field of gravitational wave astronomy, in relation to a number of ground and space based instruments designed to measure gravitational waves from astrophysical sources (VIRGO, Geo600, LIGO, LISA). Our models self-consistently cover the entire range from Newtonian dynamics to the relativistic coalescence of SMBH binaries.
The focus of this paper is the electrical characterization of coplanar waveguide (CPW) transmission lines that are printed onto nonwoven textile substrates using conductive inks, to determine their suitability for wide-band applications, e.g. digital signaling. The conductive ink line characterization tests included the defining of DC and Time-Domain Reflectometry metrics. The transmission line test samples were screen printed onto two different types of nonwoven textile substrates using two different conductive inks, i.e. inks with different viscosities. Tests showed that the variations in the continuity of the transmission lines varied, giving rise to geometrical variations in the CPW structure; and in the characterization of the same.
Microbial biofilm formation can be influenced by many physiological and genetic factors. The conventional microtiter plate assay provides useful but limited information about biofilm formation. With the fast expansion of the biofilm research field, there are urgent needs for more informative techniques to quantify the major parameters of a biofilm, such as adhesive strength and total biomass. It would be even more ideal if these measurements could be conducted in a real-time, non-invasive manner. In this study, we used quartz crystal microbalance (QCM) and microjet impingement (MJI) to measure total biomass and adhesive strength, respectively, of S. mutans biofilms formed under different sucrose concentrations. In conjunction with confocal laser scanning microscopy (CLSM) and the COMSTAT software, we show that sucrose concentration affects the biofilm strength, total biomass, and architecture in both qualitative and quantitative manners. Our data correlate well with previous observations about the effect of sucrose on the adherence of S. mutans to the tooth surface, and demonstrate that QCM is a useful tool for studying the kinetics of biofilm formation in real time and that MJI is a sensitive, easy-to-use device to measure the adhesive strength of a biofilm.
A method is described for the fabrication of arrays of conducting, high aspect-ratio microwires for use as electrodes. The electrode arrays are fabricated by electrochemical deposition of metals, including Ni, Pt, Ag, Au and Rh, in channel glass templates having parallel, uniform, hollow channels with diameters that range from sub-micrometer to over 100 micrometers. The metals completely fill the hollow channels, yielding highly uniform electrodes with aspect ratios on the order of 1000 or more. The glass template electrically insulates the electrodes from one another. The electrode array wafers are cut and polished to a thickness ranging from about 100 to 2000 micrometers. The overall surface area is as large as 1 square centimeter. Alternatively, the wafers can be partially etched with acid to remove some of the glass matrix surrounding the electrodes, exposing an array of bare, solid wire stubs. The high aspect ratio microelectrode arrays were initially fabricated in order to provide the electrical interface for an intraocular retinal prosthesis, but have additional applications including biological and chemical sensing. Arrays with different channel sizes, different electrode spacing (with pitch from approximately 3R to 20R, where R is the electrode radius), and different geometrical arrangement are presented.