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Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
Introduction: Literature suggests that up to 25% of people with HIV in North America are unaware of their status and are at risk to transmit the virus unknowingly. A high proportion of HIV patients are diagnosed when the disease is more advanced, with CD4 counts < 200. This study examined the rates of HIV testing, detection, and treatment of clients at an inner city shelter and detoxification centre after the introduction of a point of care testing (POCT) program by on-site community paramedics (CP). Methods: In 2013, in collaboration with a regional HIV program, CP received training and instituted an HIV POCT program and post-test counselling initiative. A retrospective electronic database review from October 16, 2013 to October 15, 2014 of adult patients who received testing was performed. Demographic and testing details of each patient encounter were abstracted and select variables were compared to a historic population who received POC HIV testing at an inner city emergency department (ED) in the same city. Results: 1,207 HIV POC tests were performed on 997 patients during the pilot. 57% of the patients tested were less than 40 years of age (range 18-73 years) compared to 55% in the historic ED population. A total of 9 reactive cases were identified in the study population including 3 new cases, 5 previously known cases, and 1 false reactive result. The mean age of the new cases was 47 years, vs 44 in the historical control. All 3 new cases were referred to a local HIV clinic for further care and treatment. New HIV cases represented 0.25% of total tests performed, which is less than the expected prevalence rate of 1% for this population, as well as the rate of 1.4% found in the ED population. Conclusion: Despite lower than expected reactive rates, the large scale implementation of a CP HIV POCT program in an inner city shelter and detoxification centre is feasible. All patients with new reactive tests were immediately connected to care. Future research will focus on risk factors and barriers to testing.
We compare first-order (refractive) ionospheric effects seen by the MWA with the ionosphere as inferred from GPS data. The first-order ionosphere manifests itself as a bulk position shift of the observed sources across an MWA field of view. These effects can be computed from global ionosphere maps provided by GPS analysis centres, namely the CODE. However, for precision radio astronomy applications, data from local GPS networks needs to be incorporated into ionospheric modelling. For GPS observations, the ionospheric parameters are biased by GPS receiver instrument delays, among other effects, also known as receiver DCBs. The receiver DCBs need to be estimated for any non-CODE GPS station used for ionosphere modelling. In this work, single GPS station-based ionospheric modelling is performed at a time resolution of 10 min. Also the receiver DCBs are estimated for selected Geoscience Australia GPS receivers, located at Murchison Radio Observatory, Yarragadee, Mount Magnet and Wiluna. The ionospheric gradients estimated from GPS are compared with that inferred from MWA. The ionospheric gradients at all the GPS stations show a correlation with the gradients observed with the MWA. The ionosphere estimates obtained using GPS measurements show promise in terms of providing calibration information for the MWA.
GLEAM, the GaLactic and Extragalactic All-sky MWA survey, is a survey of the entire radio sky south of declination + 25° at frequencies between 72 and 231 MHz, made with the MWA using a drift scan method that makes efficient use of the MWA’s very large field-of-view. We present the observation details, imaging strategies, and theoretical sensitivity for GLEAM. The survey ran for two years, the first year using 40-kHz frequency resolution and 0.5-s time resolution; the second year using 10-kHz frequency resolution and 2 s time resolution. The resulting image resolution and sensitivity depends on observing frequency, sky pointing, and image weighting scheme. At 154 MHz, the image resolution is approximately 2.5 × 2.2/cos (δ + 26.7°) arcmin with sensitivity to structures up to ~ 10° in angular size. We provide tables to calculate the expected thermal noise for GLEAM mosaics depending on pointing and frequency and discuss limitations to achieving theoretical noise in Stokes I images. We discuss challenges, and their solutions, that arise for GLEAM including ionospheric effects on source positions and linearly polarised emission, and the instrumental polarisation effects inherent to the MWA’s primary beam.
The Murchison Widefield Array is a Square Kilometre Array Precursor. The telescope is located at the Murchison Radio–astronomy Observatory in Western Australia. The MWA consists of 4 096 dipoles arranged into 128 dual polarisation aperture arrays forming a connected element interferometer that cross-correlates signals from all 256 inputs. A hybrid approach to the correlation task is employed, with some processing stages being performed by bespoke hardware, based on Field Programmable Gate Arrays, and others by Graphics Processing Units housed in general purpose rack mounted servers. The correlation capability required is approximately 8 tera floating point operations per second. The MWA has commenced operations and the correlator is generating 8.3 TB day−1 of correlation products, that are subsequently transferred 700 km from the MRO to Perth (WA) in real-time for storage and offline processing. In this paper, we outline the correlator design, signal path, and processing elements and present the data format for the internal and external interfaces.
The science cases for incorporating high time resolution capabilities into modern radio telescopes are as numerous as they are compelling. Science targets range from exotic sources such as pulsars, to our Sun, to recently detected possible extragalactic bursts of radio emission, the so-called fast radio bursts (FRBs). Originally conceived purely as an imaging telescope, the initial design of the Murchison Widefield Array (MWA) did not include the ability to access high time and frequency resolution voltage data. However, the flexibility of the MWA’s software correlator allowed an off-the-shelf solution for adding this capability. This paper describes the system that records the 100 μs and 10 kHz resolution voltage data from the MWA. Example science applications, where this capability is critical, are presented, as well as accompanying commissioning results from this mode to demonstrate verification.
We present the results of an approximately 6 100 deg2 104–196 MHz radio sky survey performed with the Murchison Widefield Array during instrument commissioning between 2012 September and 2012 December: the MWACS. The data were taken as meridian drift scans with two different 32-antenna sub-arrays that were available during the commissioning period. The survey covers approximately 20.5 h < RA < 8.5 h, − 58° < Dec < −14°over three frequency bands centred on 119, 150 and 180 MHz, with image resolutions of 6–3 arcmin. The catalogue has 3 arcmin angular resolution and a typical noise level of 40 mJy beam− 1, with reduced sensitivity near the field boundaries and bright sources. We describe the data reduction strategy, based upon mosaicked snapshots, flux density calibration, and source-finding method. We present a catalogue of flux density and spectral index measurements for 14 110 sources, extracted from the mosaic, 1 247 of which are sub-components of complexes of sources.
Here we present the installation and successful commissioning of an L'-band Annular Groove Phase Mask (AGPM) coronagraph on VLT/NACO. The AGPM is a vector vortex coronagraph made from diamond subwavelength gratings tuned to the L' band. The vector vortex coronagraph enables high contrast imaging at very small inner working angle (here 0″.09, the diffraction limit of the VLT at L'), potentially being the key to a new parameter space. During technical and science verification runs, we discovered a late-type companion at two beamwidths from an F0V star (Mawet et al. 2013), and imaged the inner regions of β Pictoris down to the previously unexplored projected radius of 1.75 AU. The circumstellar disk was also resolved from ≃ 1″ to 5″ (see J. Milli et al., these proceedings). These results showcase the potential of the NACO L-band AGPM over a wide range of spatial scales.
The Apodizing Phase Plate (APP) coronagraph has been used to image the exoplanet β Pictoris b and the protoplanet candidate around HD 100546, and is currently in use in surveys with NaCo at the VLT. Its success is due to its tolerance to tip-tilt pointing errors in current AO systems, which degrade the performance of nearly all other coronagraphs. Currently the sensitivity of the APP is limited by non-common path errors in the science camera systems and by its chromatic behaviour. We present the achromatized Vector APP coronagraph and address how we will measure and minimise non-common path errors with Focal Plane Wavefront Sensing algorithms.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
The Murchison Widefield Array (MWA) is one of three Square Kilometre Array Precursor telescopes and is located at the Murchison Radio-astronomy Observatory in the Murchison Shire of the mid-west of Western Australia, a location chosen for its extremely low levels of radio frequency interference. The MWA operates at low radio frequencies, 80–300 MHz, with a processed bandwidth of 30.72 MHz for both linear polarisations, and consists of 128 aperture arrays (known as tiles) distributed over a ~3-km diameter area. Novel hybrid hardware/software correlation and a real-time imaging and calibration systems comprise the MWA signal processing backend. In this paper, the as-built MWA is described both at a system and sub-system level, the expected performance of the array is presented, and the science goals of the instrument are summarised.
We investigate the evolution of the Hα equivalent width, EW(Hα), with redshift and its dependence on stellar mass, using the first data from the 3D-HST survey, a large spectroscopic Treasury program with the HST-WFC3. Combining our Hα measurements of 854 galaxies at 0.8<z<1.5 with those of ground based surveys at lower and higher redshift, we can consistently determine the evolution of the EW(Hα) distribution from z=0 to z=2.2. We find that at all masses the characteristic EW(Hα) is decreasing towards the present epoch, and that at each redshift the EW(Hα) is lower for high-mass galaxies. We find EW(Hα) ~ (1+z)1.8 with little mass dependence. Qualitatively, this measurement is a model-independent confirmation of the evolution of star forming galaxies with redshift. A quantitative conversion of EW(Hα) to sSFR (specific star-formation rate) is model dependent, because of differential reddening corrections between the continuum and the Balmer lines. The observed EW(Hα) can be reproduced with the characteristic evolutionary history for galaxies, whose star formation rises with cosmic time to z ~ 2.5 and then decreases to z = 0. This implies that EW(Hα) rises to 400 Å at z = 8. The sSFR evolves faster than EW(Hα), as the mass-to-light ratio also evolves with redshift. We find that the sSFR evolves as (1+z)3.2, nearly independent of mass, consistent with previous reddening insensitive estimates. We confirm previous results that the observed slope of the sSFR-z relation is steeper than the one predicted by models, but models and observations agree in finding little mass dependence.
Early design studies for the future Exo-Planet Imaging Camera and Specrotgraph (EPICS) on the European Extremely Large Telescope (E-ELT) show the ability to probe the region of super-Earths in the habitable zone of stars within 5pc (including Gilese 581d). However, these planets will be lost to us if the correct choice of integral field spectrograph (IFS) technology is not selected for such an instrument the ability to fit and remove the speckle noise that remains is crucial to reaching these contrasts.
We conclusively demonstrate, though the use of an experimental setup producing an artificial speckle, that slicer based IFSs and post-processing using spectral deconvolution can achieve speckle rejection factors exceeding 103. Contrary to popular belief, we do not find any evidence that this choice of IFS technology limits the achievable contrast. Coupled with extreme adaptive optics and high performance coronographs, a slicer based integral field spectrograph could achieve contrasts exceeding 109, enabling these super-Earths to be detected in the habitable zone of nearby stars, making it an attractive option for the next generation of instruments being designed for the direct detection of extra solar planets.
To assess Clostridium difficile infection (CDI)-related colectomy rates by CDI surveillance definitions and over time at multiple healthcare facilities.
Five university-affiliated acute care hospitals in the United States.
Design and Methods.
Cases of CDI and patients who underwent colectomy from July 2000 through June 2006 were identified from 5 US tertiary care centers. Monthly CDI-related colectomy rates were calculated as the number of CDI-related colectomies per 1,000 CDI cases, and cases were categorized according to recommended surveillance definitions. Logistic regression was performed to evaluate risk factors for CDI-related colectomy.
In total, 8,569 cases of CDI were identified, and 75 patients underwent CDI-related colectomy. The overall colectomy rate was 8.7 per 1,000 CDI cases. The CDI-related colectomy rate ranged from 0 to 23 per 1,000 CDI episodes across hospitals. The colectomy rate for healthcare-facility-onset CDI was 4.3 per 1,000 CDI cases, and that for community-onset CDI was 16.5 per 1,000 CDI cases (P < .05). There were significantly more CDI-related colectomies at hospitals B and C (P < .05).
The overall CDI-related colectomy rate was low, and there was no significant change in the CDI-related colectomy rate over time. Onset of disease outside the study hospital was an independent risk factor for colectomy.
We report on a measles outbreak originating in an anthroposophic community in Austria, 2008. A total of 394 (94·9%) cases fulfilled the outbreak case definition including 168 cases affiliated to the anthroposophic community. The source case was a school pupil from Switzerland. The Austrian outbreak strain was genotype D5, indistinguishable from the Swiss outbreak strain. A school-based retrospective cohort study in the anthroposophic school demonstrated a vaccine effectiveness of 97·3% in pupils who had received a single dose of measles-containing vaccine and 100% in those who had received two doses. The vaccination coverage of the cases in the anthroposophic community was 0·6%. Of the 226 outbreak cases not belonging to the anthroposophic community, the 10–24 years age group was the most affected. Our findings underline the epidemiological significance of suboptimal vaccination coverage in anthroposophic communities and in older age groups of the general population in facilitating measles virus circulation. The findings of this outbreak investigation suggest that the WHO European Region is unlikely to achieve its 2010 target for measles and rubella elimination.
It is probable that ‘The Farm Beneath the Sand’ will come to stand for a revolution in archaeological investigation. The authors show that a core of soil from an open field can provide a narrative of grazing animals, human occupation and their departure, just using DNA and AMS dating. In this case the conventional archaeological remains were nearby, and the sequence obtained by the old methods of digging and faunal analysis correlated well with the story from the core of ancient ‘dirt’ DNA. The potential for mapping the human, animal and plant experience of the planet is stupendous.
This paper presents the status of the EPICS project, an Earth-like Planets Imaging Camera Spectrograph for OWL. We present the Top-Level-Requirements of the instrument and we describe the baseline of the Adaptive Optics system with optimized wave-front sensor. The expected performance in rejection of starlight in the near infrared and in the visible is given. The instruments concepts for detection and characterization of exo-planets will be briefly described. The Signal-to-Noise ratio estimation shows that Earth-like planets can be detected up to 20 pc in a reasonable amount of time. The extremely challenging requirements in terms of static residual errors and differential aberrations are discussed.
Information processing speed and episodic memory are two commonly
affected cognitive abilities in MS. Insights into the mechanisms of and
relationships between these abilities have recently come from structural
neuroimaging techniques, but few studies have used fluid-attenuated
inversion recovery (FLAIR), a neuroimaging sequence known to be sensitive
to cortical and juxtacortical lesions in MS. We hypothesized that a
volumetric index of FLAIR total lesion volume (TLV) would be associated
with slowed processing speed and verbal memory dysfunction in MS. Twenty
MS patients underwent FLAIR imaging and were administered measures of
verbal memory and processing speed. Correlational and regression analyses
indicated that TLV was directly and independently related to measures of
processing speed and verbal memory, and TLV accounted for 56% of the
variance in cognitive performance. These findings, considered in the
context of prior work, suggest that FLAIR TLV is a useful predictor of
commonly impaired cognitive functions in MS, and shows promise as a
functionally relevant biomarker for disease status. (JINS, 2005,
Heterogeneous strain in Si/SiGe for CMOS mobility enhancement may result in device yield losses or IC performance limitations. This lateral heterogeneity in strain can be uniquely measured by Raman spectroscopy. UV Raman and Visible Raman can measure this heterogeneity respectively in the thin Si cap and in the SiGe underlayer. Both UV and Visible Raman are useful. While UV Raman is optimized for the Si channel layer, Visible Raman of the SiGe underlayer provides diagnostic information when trying to understand and reduce the heterogeneity in the Si channel. In principle Visible Raman can also measure the heterogeneity of the strain in the Si channel, but in practice this is very time consuming and not as sensitive as UV Raman. This paper focuses on the kind of heterogeneity strain information available from Visible Raman.