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There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.
A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.
Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.
The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
The IntCal09 and Marine09 radiocarbon calibration curves have been revised utilizing newly available and updated data sets from 14C measurements on tree rings, plant macrofossils, speleothems, corals, and foraminifera. The calibration curves were derived from the data using the random walk model (RWM) used to generate IntCal09 and Marine09, which has been revised to account for additional uncertainties and error structures. The new curves were ratified at the 21st International Radiocarbon conference in July 2012 and are available as Supplemental Material at www.radiocarbon.org. The database can be accessed at http://intcal.qub.ac.uk/intcal13/.
Premutation and full-mutation hyperexpansion of CGG-triplets in the X-linked Fragile X Mental Retardation 1 (FMR1) gene have been implicated in fragile X-associated tremor/ataxia syndrome, fragile X-associated primary ovarian insufficiency, and fragile X syndrome (FXS), respectively. The currently available molecular diagnostic tests are either costly or labour-intensive, which prohibits their application as a first-line FMR1 test in large-scale population-based screening programs. In this study, we demonstrate the utility of a simplified closed-tube strategy for rapid first-line screening of FXS based on melt peak temperature (Tm) analysis of direct triplet-primed polymerase chain reaction amplicons (dTP-PCR MCA). In addition, we also evaluated the correlation between Tm and CGG-repeat size based on capillary electrophoresis (CE) of dTP-PCR amplicons. The assays were initially tested on 29 FMR1 reference DNA samples, followed by a blinded validation on 107 previously characterised patient DNA samples. The dTP-PCR MCA produced distinct melt profiles of higher Tm for samples carrying an expanded allele. Among the samples tested, we also observed a good correlation between Tm and CGG-repeat size. In the blinded validation study, dTP-PCR MCA accurately classified all normal and expansion carriers, and the FMR1 genotypic classification of all samples was completely concordant with the previously determined genotypes as well as the dTP-PCR CE results. This simple and cost-effective MCA-based assay may be useful as a first-line FXS screening tool that could rapidly screen out the large majority of unaffected individuals, thus minimising the number of samples that need to be analysed by Southern blot analysis.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
This audit cycle aimed to identify deficiencies in medicines management in an adult psychiatric hospital. The original audit in 2009 highlighted that a number of improvements were needed to enhance prescribing standards. Following implementation of these recommendations, two reaudits were performed to assess both the improvements in medicines management along with evaluating the newly introduced drug prescription chart.
Local, national and international guidelines on medicines management were reviewed in 2009, following which an audit tool was designed. Recommendations from the original audit were taken on board with the introduction of a new medication chart. This chart incorporated many of the recommendations from the original audit into it. Two reaudits were then performed, each over 1 day by four assessors and included all inpatient wards.
The initial audit in 2009 outlined a number of recommendations, namely the introduction of an appropriate ‘fit for purpose’ medication chart, the need for regular postgraduate prescribing education and training and the consideration of a prescribing formulary and/or Drugs & Therapeutics Committee. Results from the reaudits revealed that considerable improvement was made in areas such as patient demographics, pharmacist involvement, generic prescribing, BLOCK capitals, inclusion of Medical Council Registration Number, PRN prescribing and discontinuation procedures.
Although significant improvement was noted, further improvement is required with regards to the need for a review date for PRN medication; the need for improved documentation of allergies, height and weight; and the importance of a working group to assess community medicines management and the need for further reaudits to assess continued improvement in all deficient areas.
We describe the development of a noise-temperature testing capability for phased-array antennas operating in receive mode from 0.7 GHz to 1.8 GHz. Sampled voltages from each array port were recorded digitally as the zenith-pointing array under test was presented with three scenes: (1) a large microwave absorber at ambient temperature, (2) the unobstructed radio sky, and (3) broadband noise transmitted from a reference antenna centred over and pointed at the array under test. The recorded voltages were processed in software to calculate the beam equivalent noise temperature for a maximum signal-to-noise ratio beam steered at the zenith. We introduced the reference-antenna measurement to make noise measurements with reproducible, well-defined beams directed at the zenith and thereby at the centre of the absorber target. We applied a detailed model of cosmic and atmospheric contributions to the radio sky emission that we used as a noise-temperature reference. We also present a comprehensive analysis of measurement uncertainty including random and systematic effects. The key systematic effect was due to uncertainty in the beamformed antenna pattern and how efficiently it illuminates the absorber load. We achieved a combined uncertainty as low as 4 K for a 40 K measurement of beam equivalent noise temperature. The measurement and analysis techniques described in this paper were pursued to support noise-performance verification of prototype phased-array feeds for the Australian Square Kilometre Array Pathfinder telescope.
Carefully timed tandem microbubbles have been shown to produce directional and targeted membrane poration of individual cells in microfluidic systems, which could be of use in ultrasound-mediated drug and gene delivery. This study aims at contributing to the understanding of the mechanisms at play in such an interaction. The dynamics of single and tandem microbubbles between two parallel plates is studied numerically and analytically. Comparisons are then made between the numerical results and the available experimental results. Numerically, assuming a potential flow, a three-dimensional boundary element method (BEM) is used to describe complex bubble deformations, jet formation, and bubble splitting. Analytically, compressibility and viscous boundary layer effects along the channel walls, neglected in the BEM model, are considered while shape of the bubble is not considered. Comparisons show that energy losses modify the bubble dynamics when the two approaches use identical initial conditions. The initial conditions in the boundary element method can be adjusted to recover the bubble period and maximum bubble volume when in an infinite medium. Using the same conditions enables the method to recover the full dynamics of single and tandem bubbles, including large deformations and fast re-entering jet formation. This method can be used as a design tool for future tandem-bubble sonoporation experiments.
A Tonks-Langmuir type model for a one-dimensional low pressure (collisionless) plasma containing at least two species of Maxwellian negative charge carriers is examined. The solutions of this model yield the positive ion energy distribution at the sheath edge without needing to specify the ionization process. This distribution has a width consistent with the potential drop across the plasma, and is shown to satisfy the generalised Bohm criterion for sheath formation. However by assuming a form for the ionization rate in the plasma, the potential profile across the discharge has been calculated. It has been found that for a range of plasma parameters the solution for the potential at which quasineutrality fails becomes triple valued; the physical solution in this regime is identified.
Many plasmas used for materials processing contain negative ions. It is important to understand how these ions influence the positive ion energy distribution at the substrate where the processing occurs.
This work is also of relevance to the behaviour of Langmuir probes in electronegative plasmas.
Emission spectroscopy and laser-induced fluorescence have been used to monitor the field and tail-flame regions of a Hull-design 1 inductively coupled plasma. This plasma is used for a variety of syntheses 2,3 including SiC, TiC, BN, AlN and diamond. Temporallyand spatially-resolved spectra of both pure Ar and Ar/gas mixtures have been studied as a function of RF power, pressure and flow rate. Preliminary data suggest that the system is far from local thermodynamic equilibrium.
We present extensive molecular dynamics simulations of DNA duplexes and duplex dimers based on the Amber force field to determine the distribution of ions as a function of salt (NaCl) concentration over the range 0.2–1.0M. Periodic boundary conditions are used to model an infinite DNA chain, and particle mesh Ewald summation is used to describe long range electrostatic interactions. We have used these simulations to determine the ion distributions associated with a 10 base pair duplex, and we find that the positive and negative ion distributions are identical for distances greater than a radius Rcounter which is on the order of 25 Å from the DNA axis, and which decreases as the bulk salt concentration is varied. Based on the calculated Rcounter, we determine the local counterion concentration as a function of bulk salt concentration. Similar studies of DNA duplex dimers separated by 30–40 Å leads to a determination of the local counterion concentration around these dimers. Here we find that dimerization leads to greatly enhanced counterion concentrations. If this information is combined with the measured results concerning the dependence of DNA melting temperature on bulk salt concentration, we find that dimerization leads to a several degree increase in melting temperature, with the increase being 10°C for a dimer separation of 30 Å. This result provides justification for a recently developed cooperative melting model of DNA duplex aggregates.
Fetuses that grow at rates less than their inherent growth potential have intrauterine growth restriction or IUGR. Such infants, particularly when the IUGR is severe, tend to have significant problems later in life, with structural and functional neurodevelopmental disorders. Animal models confirm that decreased brain neuronal number and dendritic arborization, cognitive capacity, and behavioral function are common when growth at critical early stages of development is restricted. Understanding the basic problems that contribute to IUGR and the characteristics of such infants, therefore, is important to complement other discussions in this textbook about fetal and neonatal brain injury.
Terminology and definitions
IUGR refers to a slower than normal rate of fetal growth. Several terms have been used, often interchangeably, for IUGR. These include fetal growth retardation, fetal mal- or undernutrition, small for gestational age (SGA), small or light for dates, dysmature, placental insufficiency syndrome, “runting” syndrome, and hypotrophy. The term “restriction” is preferred to “retardation,” because parents tend to link “retardation” with mental retardation. Unfortunately, these terms do not all mean the same, which has led to some confusion, both with regard to etiologic classification and to follow-up and outcome. In interpreting studies dealing with IUGR, it is important to know how the term has been defined for the particular study. Most importantly, birthweight does not always determine fetal growth rate. See Table 7.1 for a classification schema of fetal growth that now is standard.
A microbiological investigation of Black infants suffering from severe acute summer gastroenteritis revealed enteropathogenic agents in 30 out of 37 patients (81%). Enterotoxigenic bacteria were isolated from 15 patients (41%). A total of 16 enterotoxigenic strains were isolated, comprising 9 enterotoxigenic Escherichia coli strains secreting labile and stable toxin on their own and in combination, and labile-toxin secreting strains of Klebsiella pneumoniae (4), Enterobacter cloacae (2) and Proteus vulgaris (1). In the case of the latter three species, however, 6 out of the 7 strains were isolated from patients who were excreting other enteric pathogens, whereas only 2 out of 9 enterotoxigenic E. coli patients had concomitant infections with other pathogens. No invasive bacteria were isolated except for 2 shigella strains. Salmonella and shigella strains were found in four patients. No correlation was found between the enteropathogenicity of E. coli and its serotype. Rotavirus was observed by negative staining electron microscopy in only two patients (6%) but using a reverse complement fixation test rotavirus antigen was detected in the stool of 17 out of 35 patients (49%). The low EM detection rate may well be due to the patients being admitted for treatment late in the course of their illness when the degree of viral shedding has decreased below EM detectability. No significant difference in clinical presentation was noted between the various aetiological agents. Only one patient was being solely breast-fed compared to 16% of control non-diarrhoeic infants. Evidence of malnutrition was noted in over half of our patients.