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Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.
Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician–patient interaction.
Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.
All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician–patient interaction.
The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician–patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.
Both internet-based cognitive–behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.
To determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.
Economic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.
The primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76%, compared with TAU.
From a primary care perspective, both ICBT and physical exercise for depression are likely to be cost-effective compared with TAU.
The integrated Sachs-Wolfe effect was recently detected at a level of 4.4σ by [Granett et al. (2008)], by stacking compensated CMB temperature patches corresponding to superstructures in the universe. We test the reported signal using realistic gaussian random realizations of the CMB sky, based on the temperature power spectrum predicted by the concordance ΛCDM model. Such simulations provide a complementary approach to the largely used N-body simulations and allow to include the contaminant effects due to small-scale temperature fluctuations. We also apply our pipeline to foreground-cleaned CMB sky maps using the [Granett et al. (2008)] voids/clusters catalog. We confirm the detection of a signal, which depart from the null hypothesis by 3.5σ, and we report a tension with our theoretical estimates at a significance of about 2.5σ.
The global shape, or topology, of the universe is not constrained by the equations of General Relativity, which only describe the local universe. As a consequence, the boundaries of space are not fixed and topologies different from the trivial infinite Euclidean space are possible. The cosmic microwave background (CMB) is the most efficient tool to study topology and test alternative models. Multi-connected topologies, such as the 3-torus, are of great interest because they are anisotropic and allow us to test a possible violation of isotropy in CMB data. We show that the correlation function of the coefficients of the expansion of the temperature and polarization anisotropies in spherical harmonics encodes a topological signature. This signature can be used to distinguish an infinite space from a multi-connected space on sizes larger than the diameter of the last scattering surface (DLSS). With the help of the Kullback-Leibler divergence, we set the size of the edge of the biggest distinguishable torus with CMB temperature fluctuations and E-modes of polarization to 1.15 DLSS. CMB temperature fluctuations allow us to detect universes bigger than the observable universe, whereas E-modes are efficient to detect universes smaller than the observable universe.
The formal commissioning of the IRWG occurred at the 1991 Buenos Aires General Assembly, following a Joint Commission meeting at the IAU GA in Baltimore in 1988 that identified the problems with ground-based infrared photometry. The meeting justification, papers, and conclusions, can be found in Milone (1989). In summary, the challenges involved how to explain the failure to achieve the milli-magnitude precision expected of infrared photometry and an apparent 3% limit on system transformability. The proposed solution was to redefine the broadband Johnson system, the passbands of which had proven so unsatisfactory that over time effectively different systems proliferated, although bearing the same “JHKLMNQ” designations; the new system needed to be better positioned and centered in the spectral windows of the Earth's atmosphere, and the variable water vapour content of the atmosphere needed to be measured in real time to better correct for atmospheric extinction.
Within the Herschel key project “The Warm And Dense ISM” (WADI) we systematically observe
a number of prominent photon-dominated regions (PDRs) to measure the impact of varying UV
fields on the energy balance, the chemical and dynamical structure of heated molecular
Here we present the results of a 3 mm survey of 23 galaxies, obtained with the EMIR
receiver at the IRAM 30 m telescope. Emission of the main molecular species is compared
with existing chemical models, in order to find and test molecular signatures of galaxy
evolution and to compare them to IR evolutionary tracers.