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A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services.
To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology.
The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals.
We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions.
Declaration of interest
The authors declare no competing financial interests.
Highly detailed structural characterization is required to understand the discharge mechanism in order to effectively investigate α-MnO2 structured lithium battery cathode materials. This paper discusses recent findings which elucidate the lithiation mechanism of silver-hollandite, AgxMn8O16. For Ag1.2Mn8O16, the structure is not significantly perturbed during the first 2 equivalents of lithiation and the electrochemistry is highly reversible. Upon 4 equivalents of lithiation, the structure becomes highly distorted, in correlation with capacity fade observed over 40 cycles. Notably, regarding capacity fade, modifications to Ag/Mn ratio are less impactful than modifications to the α-MnO2 crystallite size. This is shown in comparisons of two materials with the same stoichiometry (Ag1.4Mn8O16) and differing crystallite size (10 and 15 nm).
Surface melt on a glacier can perturb the glaciochemical record beyond the natural variability. While the centre of the Greenland ice sheet is usually devoid of surface melt, many high-Arctic and alpine ice cores document frequent summertime melt events. Current hypotheses interpreting melt-affected ice-core chemistry rely on preferential elution of certain major ions. However, the precise nature of chemistry alteration is unknown because it is difficult to distinguish natural variability from melt effects in a perennially melt-affected site. We use eight trace-element snow chemistry records recovered from Summit, Greenland, to study spatial variability and melt effects on insoluble trace chemistry and physical stratigraphy due to artificially introduced meltwater. Differences between non-melt and melt-affected chemistry were significantly greater than the spatial variability in chemistry represented by nearest-neighbour pairs. Melt-perturbed trace elements, particularly rare earth elements, retained their seasonal stratigraphies, suggesting that trace elements may serve as robust chemical indicators for annual layers even in melt-affected study areas. Results suggest trace-element transport via meltwater percolation will deposit eluted material down-pit in refrozen areas below the nearest-surface chemistry peak. In our experiments, snow chemistry analyses are more sensitive to melt perturbations than density changes or unprocessed near-infrared digital imagery.
Accumulation is a key parameter governing the mass balance of the Greenland ice sheet. Several studies have documented the spatial variability of accumulation over wide spatial scales, primarily using point data, remote sensing or modeling. Direct measurements of spatially extensive, detailed profiles of accumulation in Greenland, however, are rare. We used 400 MHz ground-penetrating radar along the 1009 km route of the Greenland Inland Traverse from Thule to Summit during April and May of 2011, to image continuous internal reflecting horizons. We dated these horizons using ice-core chemistry at each end of the traverse. Using density profiles measured along the traverse, we determined the depth to the horizons and the corresponding water-equivalent accumulation rates. The measured accumulation rates vary from ~0.1 m w.e. a–1 in the interior to ~0.7 m w.e. a–1 near the coast, and correspond broadly with existing published model results, though there are some excursions. Comparison of our recent accumulation rates with those collected along a similar route in the 1950s shows a ~10% increase in accumulation rates over the past 52 years along most of the traverse route. This implies that the increased water vapor capacity of warmer air is increasing accumulation in the interior of Greenland.
Background: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions. A central tenet of Patient-Centered Outcomes Research Institute-funded research is stakeholder engagement throughout the research process. However, evidence on how to successfully implement a pragmatic trial that changes systems of care in combination with robust stakeholder engagement is limited. This combination is not without challenges. Methods: We present our approach for broad-based stakeholder engagement in the context of a pragmatic trial with the participation of patients, caregivers, community stakeholders, including the North Carolina Stroke Care Collaborative hospital network, and policy makers. To maximize stakeholder engagement throughout the COMPASS Study, we employed a conceptual model with the following components: (1) Patient and Other Stakeholder Identification and Selection; (2) Patient and Other Stakeholder Involvement Across the Spectrum of Research Activities; (3) Dedicated Resources for Patient and Other Stakeholder Involvement; (4) Support for Patient and Other Stakeholder Engagement Through Organizational Processes; (5) Communication with Patients and Other Stakeholders; (6) Transparent Involvement Processes; (7) Tracking of Engagement; and (8) Evaluation of Engagement. Conclusion: In this paper, we describe how each component of the model is being implemented and how this approach addresses existing gaps in the literature on strategies for engaging stakeholders in meaningful and useful ways when conducting pragmatic trials.
Feather pecking is a serious economic and welfare problem in laying hens. Feather damage occurs mainly through severe feather pecking (SFP). Selection experiments have proved that this behavior is heritable and lines have been divergently selected for high (HFP) and low feather pecking (LFP). The number of bouts of SFP per hen follows a Poisson distribution with a maximum nearby 0. A few studies indicate that the distribution within flocks is not homogenous but contains sub-groups of birds showing extremely high levels of feather pecking (EFP). It was the aim of the current study to re-analyze data on SFP of lines selected for HFP/LFP and their F2 cross so as to uncover hidden sub-populations of EFP birds. Data of seven selection generations of HFP and LFP selection lines as well as their F2 cross have been used. We fitted a two-component mixture of Poisson distributions in order to separate the sub-group of EFP from the remaining birds. HFP and LFP lines differed mainly in mean bouts per bird. The proportion of EFP was only marginal in the LFP as compared with the HFP and the F2 population. Selection for LFP did not result in total elimination of EFP. The presence of even small proportions of EFP may play an important role in initiating outbreaks of feather pecking in large flocks. Further studies on feather pecking should pay special attention to the occurrence of EFP sub-groups.
We have detected four far-infrared emission lines of water vapor toward the evolved star W Hydrae, using the Short Wavelength Spectrometer (SWS) of the Infrared Space Observatory (ISO). This is the first detection of thermal water vapor emission from a circumstellar outflow.
The question of the title of Commission 24, obviously, offers a difficult problem as already mentioned in recent reports. Photographic Astrometry no longer describes the whole scope of the commission. This problem has continued during the last three years especially in view of the preparations for the astrometric tasks of the NASA Space Telescope and of the ESA satellite HIPPARCOS.
One of the continuing problems facing Commission 24 is its name. It has been known and reported for some years that the present title is not suitable for reasons that are all too obvious. This problem has continued during the last three years, despite the growing development and use of non-photographic methods and techniques.
Most of the recent meeting activity in which the Commission and its membership has been involved, has centered on its shared interests with Commission 8 and with the Working Group on reference frames formed at the last General Assembly. Since its inception at that time, C. A. Murray has been appointed to represent the Commission on that group.
Obsessive compulsive disorder (OCD) and social anxiety disorder (SAD) are characterized by biased perception and processing of potentially threatening stimuli. A hyper-reactivity of the fear-circuit [e.g. amygdala, anterior cingulate (ACC)] has been consistently reported using functional magnetic resonance imaging (fMRI) in SAD in comparison with healthy controls (HCs). Studies investigating the processing of specific emotional stimuli in OCD reported mainly orbitofrontal-striatal abnormalities. The goal of this study was to examine similar/common and differential neurobiological responses in OCD and SAD using unspecific emotional stimuli.
Fifty-four subjects participated: two groups (each n = 18) of outpatients with a current diagnosis of OCD or SAD, and 18 HCs. All subjects underwent fMRI while anticipating and perceiving unspecific visual stimuli with prior announced emotional valence (e.g. positive).
Compared to HCs, the combined patient group showed increased activation in amygdala, caudate and prefrontal/orbitofrontal cortex while anticipating unspecific emotional stimuli. Caudate was more active in the combined patient group during perception. A comparison between the OCD and the SAD samples revealed increased amygdala and decreased rostral ACC activation in OCD patients during perception, but no differences in the anticipation phase.
Overall, we could identify common fronto-subcortical hyper-reactivity in OCD and SAD while anticipating and perceiving unspecific emotional stimuli. While differential neurobiological responses between OCD and SAD when processing specific stimuli are evident from the literature, differences were less pronounced using unspecific stimuli. This could indicate a disturbance of emotion regulation common to both OCD and SAD.
Ca/vitamin D supplementation maintains bone health and decreases stress fracture risk during initial military training (IMT); however, there is evidence that Ca may negatively affect the absorption of other critical micronutrients, particularly Fe. The objective of this randomised, double-blind, placebo-controlled trial was to determine whether providing 2000 mg/d Ca and 25µg/d vitamin D in a fortified food product during 9 weeks of military training affects Fe status in young adults. Male (n 98) and female (n 54) volunteers enrolled in US Army basic combat training (BCT) were randomised to receive a snack bar with Ca/vitamin D (n 75) or placebo (snack bar without Ca/vitamin D; n 77) and were instructed to consume 2 snack bars/d between meals throughout the training course. Circulating ionised Ca was higher (P<0·05) following BCT among those consuming the Ca/vitamin D bars compared with placebo. Fe status declined in both groups over the course of BCT. Transferrin saturation, serum ferritin and Hb were reduced (P<0·05) and soluble transferrin receptor increased (P<0·05) following BCT. There were no differences (P>0·05) in markers of Fe status between placebo and Ca/vitamin D groups. Collectively, these data indicate that Ca/vitamin D supplementation through the use of a fortified food product consumed between meals does not affect Fe status during IMT.
In cats, the incidence of obesity and diabetes is increasing, and little is known about specific aspects of the endocrine control of food intake in this species. Recent data suggest that ghrelin has an important role in the control of insulin secretion and vice versa, but this role has never been demonstrated in cats. Here we aimed to improve our understanding about the relationship between insulin, amylin and ghrelin secretion in response to a nutrient load in overweight cats. After a 16 h fast, weekly, six overweight male cats underwent randomly one of the four testing sessions: saline, glucose, arginine and TAG. All solutions were isoenergetic and isovolumic, and were injected intravenously as a bolus. Glucose, insulin, acylated ghrelin (AG), amylin and prolactin were assayed in plasma before and 10, 20, 40, 60, 80 and 100 min after the nutrient load. A linear mixed-effects model was used to assess the effect of bolus and time on the parameters. A parenteral bolus of glucose or arginine increased insulin and ghrelin concentrations in cats. Except for with the TAG bolus, no suppression of ghrelin was observed. The absence of AG suppression after the intravenous load of arginine and glucose may suggest: (1) that some nutrients do not promote satiation in overweight cats; or that (2) AG may be involved in non-homeostatic consumption mechanisms. However, the role of ghrelin in food reward remains to be assessed in cats.
At various times the Roman Republic faced outbreaks of domestic political violence, including riots and intimidation, assassinations and conspiracies to overthrow the government. Violence was particularly noticeable in the Early Republic and the Late Republic. These activities were quite similar to the terrorism and violence used by mobs and groups during the French Revolution and the tactics of fascists and leftists in Europe in the 1920s or 1930s. More accurately, the actions of mobs and others during the French Revolution and leftists and fascists in Europe were very similar to the techniques used in the Roman political system in the last five centuries BCE.
Airbus and Boeing are cooperatively presenting this topic dealing with transport aircraft stalls. The paper will begin by defining a stall, followed by a review of requirements, predictive validation and flight testing. There are various ways of designing modern jet transports for the stall regime such as aerodynamic approaches, flight deck indications, and augmentation control laws to deal with the high angle-of-attack (α) arena. The goal of augmented control laws for high α is common – no full aerodynamic stall or loss of climb performance should occur in the operational flight envelope, in Normal flight control modes. The validation techniques employed in preparation for a flight test campaign will follow. These include flight characteristic predictions based on wind-tunnel data as well as pilot-in-the-loop simulation rehearsals. The preparation for flight testing will be reviewed from both the engineer and pilot viewpoints. This will be followed by a review of various flight testing that has been conducted. The paper will close with a brief foray into what the future of transport stalls could be – perhaps protection features in degraded flight control modes? What are the benefits as well as drawbacks to increased augmentation for high α?