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Correct diagnosis of cause of death is necessary to suggest the most effective management interventions to reduce perinatal lamb mortality. Haemorrhage on the surface of the brain has been used as a field diagnostic tool to allocate lambs to a cause of death category, but the usefulness of this method was unclear. This study aimed to evaluate whether gross pathology was related to neuronal death and whether haemorrhage of the central nervous system (CNS) was distinct between differing causes of death, enabling indicators to be used in field diagnoses. Lambs dying from natural causes (n = 64) and from euthanasia (n = 7) underwent postmortem examination, then the brain and spinal cord were extracted and examined histologically. Histological changes consistent with neuronal death were not detected in any lamb. Haemorrhage of the meninges and/or parenchyma of the CNS occurred in all lambs. The age of the haemorrhage indicated that it occurred near the time of death in most lambs. Dilation of blood vessels varied in severity but appeared to be unrelated to causal diagnosis, severity of subcutaneous oedema, breathing or milk status. Moderate or severe dilation of blood vessels and haemorrhage of the CNS did not occur in all lambs with alternative clear indicators of dystocia and occurred in all death classifications, so it could not be used as diagnostic indicators for classification of cause of death. Dilation and haemorrhage were unrelated to neuronal damage and may have been artefactual. In conclusion, haemorrhage of the CNS was not indicative of neuronal damage and could not be used to distinguish between lambs with clear indicators of differing causes of death, so it is not recommended as a field diagnostic tool.
Prolactin (PRL) data from adolescents treated with olanzapine are presented.
Data from 454 adolescents (13-18, mean=15.9 yrs) with schizophrenia or bipolar mania were pooled from 4 olanzapine (2.5-20.0mg/day) studies (4-32 weeks; 2 double-blind, placebo-controlled studies [combined for acute phase endpoint PRL levels] with open-label extensions; 2 open-label studies). Age- and sex-specific Covance reference ranges defined normal PRL; categorical increases were based on multiples of the upper limit of normal (ULN). Baseline-to-endpoint PRL changes in adolescents were compared with data pooled from 84 olanzapine clinical trials in adults with schizophrenia or bipolar disorder.
Olanzapine-treated adolescents had mean PRL increases at both the acute (11.4μg/L) and open-label endpoints (4.7μg/L). Of those patients with normal PRL levels at baseline (N=311), high PRL occurred in 54.7% at anytime; 32.2% at endpoint. The percentage of patients in which PRL levels shifted from normal-to-abnormal was smaller at endpoint than at anytime during treatment; 26.7% shifted to a higher category. Among patients with normal baseline PRL, 32.7% remained <=1X ULN; 32.3% increased to 1¬<=2X; 6.0%, >2-<=3X; and 1.2%, >3X at anytime; 4.6% had at >=1 potentially PRL-related adverse event. Adolescents had significantly higher mean changes at endpoint (p=.004), and a greater incidence of high PRL levels at anytime during olanzapine treatment (p<.001) versus adults.
Incidence of high PRL was significantly higher, and mean increases in PRL were significantly greater in adolescents versus adults. Mean increases and high PRL incidence were lower at the open-label compared with the acute phase endpoint.
The changes in metabolic parameters in olanzapine-treated adolescents were examined.
Data from 454 adolescents (13–18, mean=15.9 years) with schizophrenia or bipolar I disorder were pooled from 4 olanzapine (2.5–20.0mg/day) studies (4–32 weeks). Changes in metabolic parameters in adolescents were compared with those of olanzapine-treated adults (pooled from 84 clinical trials); changes in weight and BMI were compared with US age- and sex-adjusted standardized growth curves.
Olanzapine-treated adolescents had significant increases from baseline-to-endpoint in fasting glucose (p=.021); total cholesterol, LDL, and triglycerides (p<.001); and significant decreases in HDL (p<.001). Significantly more adolescents gained >=7% of their baseline weight versus adults (65.1% vs. 35.6%, p<.001); mean change from baseline-to-endpoint in weight was significantly greater in adolescents (7.0 vs. 3.3kg, p<.001). Adolescents had significantly lower mean changes from baseline-to-endpoint in fasting glucose (0.3 vs. 0.1mmol/L, p=.002) and triglycerides (0.3 vs. 0.2mmol/L, p=.007) versus adults. Significantly more adults experienced treatment-emergent normal-to-high changes at anytime in fasting glucose (4.8% vs. 1.2%, p=.033), total cholesterol (6.9% vs. 1.1%, p=.001), LDL (5.8% vs. 1.5%, p=.014), and triglycerides (25.7% vs. 17.4%, p=.030). Compared with standardized growth curves, olanzapine-treated adolescents had greater increases from baseline-to-endpoint in weight (1.0 vs. 7.1kg, p<.001), height (0.5 vs. 0.7cm, p<.001), and BMI (0.2 vs. 2.2kg/m2, p<.001).
Olanzapine-treated adolescents may gain significantly more weight compared with adults, but may have smaller changes in other metabolic parameters. Clinicians may want to consider both efficacy and changes in metabolic parameters when selecting treatment options for individual adolescent patients.
Negative interactions between people and large carnivores are common and will probably increase as the human population and livestock production continue to expand. Livestock predation by wild carnivores can significantly affect the livelihoods of farmers, resulting in retaliatory killings and subsequent conflicts between local communities and conservationists. A better understanding of livestock predation patterns could help guide measures to improve both human relationships and coexistence with carnivores. Environmental variables can influence the intensity of livestock predation, are relatively easy to monitor, and could potentially provide a useful predictive framework for targeting mitigation. We chose lion predation of livestock as a model to test whether variations in environmental conditions trigger changes in predation. Analysing 6 years of incident reports for Pandamatenga village in Botswana, an area of high human–lion conflict, we used generalized linear models to show that significantly more attacks coincided with lower moonlight levels and temperatures, and attack severity increased significantly with extreme minimum temperatures. Furthermore, we found a delayed effect of rainfall: lower rainfall was followed by a significantly increased severity of attacks in the following month. Our results suggest that preventative measures, such as introducing deterrents or changing livestock management, could be implemented adaptively based on environmental conditions. This could be a starting point for investigating similar effects in other large carnivores, to reduce livestock attacks and work towards wider human–wildlife coexistence.
Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes.
We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews.
Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family's (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia.
Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently.
Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis.
Ninety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3–6 months post-treatment.
Patients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3–6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition.
CR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.
Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.
Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.
Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).
Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.
Historically, alloy development with better radiation performance has been focused on traditional alloys with one or two principal element(s) and minor alloying elements, where enhanced radiation resistance depends on microstructural or nanoscale features to mitigate displacement damage. In sharp contrast to traditional alloys, recent advances of single-phase concentrated solid solution alloys (SP-CSAs) have opened up new frontiers in materials research. In these alloys, a random arrangement of multiple elemental species on a crystalline lattice results in disordered local chemical environments and unique site-to-site lattice distortions. Based on closely integrated computational and experimental studies using a novel set of SP-CSAs in a face-centered cubic structure, we have explicitly demonstrated that increasing chemical disorder can lead to a substantial reduction in electron mean free paths, as well as electrical and thermal conductivity, which results in slower heat dissipation in SP-CSAs. The chemical disorder also has a significant impact on defect evolution under ion irradiation. Considerable improvement in radiation resistance is observed with increasing chemical disorder at electronic and atomic levels. The insights into defect dynamics may provide a basis for understanding elemental effects on evolution of radiation damage in irradiated materials and may inspire new design principles of radiation-tolerant structural alloys for advanced energy systems.
Many adults with autism spectrum disorder (ASD) remain undiagnosed. Specialist assessment clinics enable the detection of these cases, but such services are often overstretched. It has been proposed that unnecessary referrals to these services could be reduced by prioritizing individuals who score highly on the Autism-Spectrum Quotient (AQ), a self-report questionnaire measure of autistic traits. However, the ability of the AQ to predict who will go on to receive a diagnosis of ASD in adults is unclear.
We studied 476 adults, seen consecutively at a national ASD diagnostic referral service for suspected ASD. We tested AQ scores as predictors of ASD diagnosis made by expert clinicians according to International Classification of Diseases (ICD)-10 criteria, informed by the Autism Diagnostic Observation Schedule-Generic (ADOS-G) and Autism Diagnostic Interview-Revised (ADI-R) assessments.
Of the participants, 73% received a clinical diagnosis of ASD. Self-report AQ scores did not significantly predict receipt of a diagnosis. While AQ scores provided high sensitivity of 0.77 [95% confidence interval (CI) 0.72–0.82] and positive predictive value of 0.76 (95% CI 0.70–0.80), the specificity of 0.29 (95% CI 0.20–0.38) and negative predictive value of 0.36 (95% CI 0.22–0.40) were low. Thus, 64% of those who scored below the AQ cut-off were ‘false negatives’ who did in fact have ASD. Co-morbidity data revealed that generalized anxiety disorder may ‘mimic’ ASD and inflate AQ scores, leading to false positives.
The AQ's utility for screening referrals was limited in this sample. Recommendations supporting the AQ's role in the assessment of adult ASD, e.g. UK NICE guidelines, may need to be reconsidered.
Interferometric methods have been used at a number of observatories to improve the spatial resolution of large optical telescopes, approaching and in some cases reaching the diffraction limit. The principal methods used have been speckle interferometry and non-redundant masking (NRM). The MAPPIT (Masked APerture Plane Interference Telescope) instrument has been used for NRM observations at the 3·9 m Anglo-Australian Telescope. This paper describes a proposed instrument, MAPPIT 2, which would use a Shack-Hartmann wavefront sensor in parallel with an interferometer performing NRM or one-dimensional speckle interferometry. The inclusion of the data from the wavefront sensor will enhance the sensitivity of the instrument, especially for the imaging of relatively complex objects (those giving more than a few resolution elements with non-zero intensities). Limiting the instantaneous spatial resolution to one dimension allows available CCD detectors to operate with 100% duty cycle. Observations at a number of position angles allow two-dimensional images to be obtained.
We have successfully demonstrated optical aperture synthesis at the 4-m Anglo-Australian Telescope. By using a multi-hole mask over the (re-imaged) primary mirror and recording the resulting fringe patterns with high time resolution, diffraction-limited images of sufficiently bright objects can be reconstructed. The data processing uses closure phases to overcome the effects of atmospheric turbulence. We show an image of the double star η Oph, with component separation 0″.45.
Four catalogues based on the survey made with the Molonglo Cross-type radio telescope have so far been completed, the largest of which is MCI (Davies, Little and Mills,
1973). These catalogues were noise limited and had a 5α lower limit of about 0.3 Jy. This paper gives an outline of deep surveys that have been made in order to reach significantly fainter sources, but only in a small solid angle of sky.
The Molonglo Observatory Synthesis Telescope (MOST), which at present images a fully synthesised 70′ field in 12 h, is being converted to enable observing modes which extend the field size to 160′. The new observing modes will allow the MOST to survey completely the sky south of δ = −30° to a (5σ) sensitivity limit of about 5 mJy. The result will be a catalogue of over 400,000 radio sources with a spatial density of less than 1 source per 100 beam areas, providing the foundation for a number of novel astronomical and cosmological investigations. The conversion involves construction of 352 low-noise HEMT preamplifiers, 88 digitally controlled UHF quad phase shifters, 88 mixers and IF sections, a new communication and control system, and several other new sub-systems. The project has been funded and developments are well advanced.
We present preliminary results from a programme designed to produce deep images of radio source fields drawn from the Parkes 2700 MHz and Molongolo 408 MHz catalogues using the charge-coupled-device (CCD) camera system built at the Institute of Astronomy, Cambridge. The programme is directed at a search both for faint extensions and nebulosity around radio QSOs and BL Lac objects and for faint objects in otherwise empty radio source fields; a detailed examination of the morphology of selected radio galaxies is also included.
We propose to construct an optical interferometer to produce high resolution images by aperture synthesis. The interferometer, known as the Masked Aperture Pupil-Plane Interference Telescope (MAPPIT), will be mounted at the coudé focus of the Anglo-Australian Telescope. It will use a non-redundant aperture mask, together with closure phase methods developed for radio VLBI, to overcome the wavefront distortions which are introduced by atmospheric turbulence. By using the techniques of pupil-plane interferometry and wavelength dispersion, it is hoped that MAPPIT will have more sensitivity than many other interferometric imaging projects.
The radio source PKS 0511-48 is among the hundred strongest southern sources at low frequencies. It was catalogued in the Parkes survey (Ekers 1969) and mapped with the Molonglo Cross at 408 MHz by Schilizzi and McAdam (1975) with a resolution of 2′ .6 arc. It appeared in that work as a complex source, with an integrated flux density of 8.8 Jy. A search for optical identifications was made by Tritton and Schilizzi (1973), but none were found to a level of B ~ 19. We have inspected the field on the ESO B survey film, and find a group of ~ 20 faint galaxies (approximately 19-20 mag).
Several outbreaks of hepatitis A in men who have sex with men (MSM) were reported in the 1980s and 1990s in Australia and other countries. An effective hepatitis A virus (HAV) vaccine has been available in Australia since 1994 and is recommended for high-risk groups including MSM. No outbreaks of hepatitis A in Australian MSM have been reported since 1996. In this study, we aimed to estimate HAV transmissibility in MSM populations in order to inform targets for vaccine coverage in such populations. We used mathematical models of HAV transmission in a MSM population to estimate the basic reproduction number (R0) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range for R0 of 1·71–3·67 for HAV in MSM and that sustained epidemics cannot occur once the proportion immune to HAV is greater than ~70%. To our knowledge this is the first estimate of R0 and the critical population immunity threshold for HAV transmission in MSM. As HAV is no longer endemic in Australia or in most other developed countries, vaccination is the only means of maintaining population immunity >70%. Our findings provide impetus to promote HAV vaccination in high-risk groups such as MSM.
The continuous trend of achieving more complex microelectronics with smaller nodes yet larger wafer sizes in microelectronics manufacturing lead to aggressive development requirements for chemical mechanical planarization (CMP) process. Particularly, beyond the 14 nm technology the development needs made it a must to introduce high mobility channel materials such as Ge. CMP is an enabler for integration of these new materials into future devices. In this study, we implemented a design of experiment (DOE) methodology in order to understand the optimized CMP slurry parameters such as optimal concentration of surface active agent (sodium dodecyl sulfate-SDS), concentration of abrasive particles and pH from the viewpoint of high removal rate and selectivity while maintaining a defect free surface finish. The responses examined were particle size distribution (slurry stability), zeta potential, material removal rate (MRR) and the surface defectivity as a function of the selected design variables. The impact of fumed silica particle loadings, oxidizer (H2O2) concentration, SDS surfactant concentration and pH were analyzed on Ge/silica selectivity through material removal rate (MRR) surface roughness and defectivity analyses.