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One of the main capabilities of atom probe tomography (APT) is the ability to not only identify but also characterize early stages of precipitation at length scales that are not achievable by other techniques. One of the most popular methods to identify nanoscale clustering in APT data, based on the density-based spatial clustering of applications with noise (DBSCAN), is used extensively in many branches of research. However, it is common that not all of the steps leading to the selection of certain parameters used in the analysis are reported. Without knowing the rationale behind parameter selection, it may be difficult to compare cluster parameters obtained by different researchers. In this work, a simple open-source tool, PosgenPy, is used to justify cluster search parameter selection via providing a systematic sweep through parameter values with multiple randomizations to minimize a false-positive cluster ratio. The tool is applied to several different microstructures: a simulated material system and two experimental datasets from a low-alloy steel . The analyses show how values for the various parameters can be selected to ensure that the calculated cluster number density and cluster composition are accurate.
A recent metanalysis has demonstrated that there are differences in efficacy and acceptability of commonly prescribed anti-depressants (Cipriani et al. 2009). Escitalopram, sertraline, venlafaxine and mirtazapine were the most effective.
We wished to find out whether the data from our own practice corresponded with the data from the metanalysis.
To compare the efficacy of anti-depressant monotherapies in patients with unipolar depression at Bedford Hospital, using discharge rates as the outcome measure.
We included all patients with unipolar depression on an antidepressant monotherapy in Bedford hospital in our analysis (145 in total). We examined the clinical notes for each patient to assess whether they had been discharged from the out-patient clinic after being prescribed the antidepressant. This allowed us to calculate discharge rates for each antidepressant monotherapy.
A higher percentage of patients prescribed Escitalopram were discharged from clinic compared to theother anti-depressant monotherapies.
Our results support the findings of the meta-analysis. The discharge rates from Bedford hospital suggest that Escitalopram in particular is the most efficacious.
This audit in a small group of patients suggests that Escitalopram leads to the highest discharge rate compared to the other monotherapies prescribed.
There are differences in efficacy of commonly prescribed anti-depressants. Escitalopram, sertraline, venlafaxine and mirtazapine (‘the four’) were the most effective.
To compare the efficacy of ‘the four’ with other anti-depressant monotherapies prescribed either for the treatment of unipolar depression or other indications, using discharge rates as the outcome measure.
We studied all patients on an antidepressant monotherapy in Bedford hospital (206 in total). We examined the clinical notes for each patient prescribed antidepressants to assess whether they were discharged from the out-patient clinic. Hence we calculated rates of discharge for ‘the four’ and other antidepressant monotherapies for patients with unipolar depression or another psychiatric condition.
For patients with unipolar depression, discharge rates were higher for ‘The four’. For patients with other indications, discharge rates were higher for other antidepressant monotherapies. A greater percentage of patients with unipolar depression were discharged from clinic compared with people treated for other indications
This suggests that indication for which the antidepressant monotherapy is prescribed will affect the efficacy of treatment, as measured by discharge rates. The fact that a greater percentage of patients with unipolar depression were discharged from clinic compared with people treated for other indications may suggest that people with ‘treatment resistant depression’ may really have another disorder, for example borderline personality disorder, bipolar disorder or PTSD.
This audit suggests that ‘the four’ are more effective for the treatment of unipolar depression compared with other indications, using discharge rates as the outcome measure.
It has been demonstrated that there are differences in efficacy and acceptability of commonly prescribed anti-depressants (Cipriani et al. 2009). Escitalopram, sertraline, venlafaxine and mirtazapine were the most effective.
We wished to see whether our own data showed similar outcomes to the data from the metanalysis using decrease in suicidality as an outcome measure.
To compare the efficacy of anti-depressant monotherapies in patients with unipolar depression at Bedford Hospital, using suicidality (suicidal ideation and behaviour) as the outcome measure.
We included all patients with unipolar depression on an antidepressant monotherapy in Bedford hospital in our analysis (145 in total). We examined the clinical notes for each patient to assess whether they demonstrated suicidality after being prescribed the antidepressant. This allowed us to calculate rates of suicidality for each antidepressant monotherapy.
The prescription of sertraline was associated with the greatest reduction in suicidality, closely followed by citalopram.
Our results support the findings of the meta-analysis. None of the patients on Escitalopram expressed suicidality, so a reduction in suicidality rates could not be demonstrated for this monotherapy.
This audit in a small group of patients suggests that sertraline is associated with the greatest reduction in suicidality compared to the other monotherapies prescribed.
In the case of a first episode of psychosis among members of different associations of families of mentally ill people, little is known about their priorities and how satisfied they are with the help provided to them. A survey was conducted in five European family associations. Respondents emphasized the need for early (ambulant) intervention through outreach with very practical goals directed at creating stability and social functioning. About one-third of the respondents are unsatisfied or very unsatisfied. The highest percentage of unsatisfied respondents was in the following five areas of care: advice on how to handle specific problems; help with preserving or regaining social functioning; help with regaining structure and routine; information; prompt assistance preferably in patientˈs own environment. The agreement of these findings with findings from earlier studies underlines the importance of suggesting specific changes in the delivery of care.
Addictive and psychiatric disorders are a significant barrier to retention in medical care leading to worse outcomes. As part of an HIV care expansion project, the H-STAR intervention was designed to treat substance use and psychiatric disorders for minority patients receiving co-located HIV medical care.
The intervention aim was to increase access to treatment for substance abuse and psychiatric disorders in minority HIV+ patients and reduce substance use.
The H-STAR primary objective was to offer substance and psychiatric evaluation and treatment with an integrated treatment model.
All participants in H-STAR underwent substance abuse screening and evaluation, using DSM-IV-TR criteria. Substance use was measured on the Government Performance Reports Act (GPRA) form at baseline and 6 months. Intensive outpatient treatment (IOP) using the Matrix Model as the behavioral intervention was available to all patients. All patients were offered and scheduled psychiatric evaluation and treatment with an onsite psychiatrist.
Of 123 enrolled persons with both baseline and 6 month GPRAs, the prevalence of substance abuse/dependence disorders were as follows: Alcohol: 32 (24.2%); Opiate: 54 (43.9%); Cocaine: 47(38.2%); and Marijuana: 26(21.1%). Thirty (22.1%) completed IOP. At 6 month follow-up there was statistically significant reduced use of alcohol, heroin and cocaine. Of 136 enrolled participants, seventy-five (55.1%) had psychiatric evaluations; 53 (70.7%) received medication management.
There was a significant reduction in all substance use; cocaine use remained the most prevalent. Despite open access to psychiatric evaluation, not all patients completed evaluation in spite of multiple attempts to reschedule.
In recent years the association between sexual dysfunction (SD) and obesity in the general population has drawn major attention. Although sexual dysfunction is common in psychosis, its relationship with weight gain and obesity remains unclear.
To investigate the association between sexual dysfunction and obesity in a cohort of patients with first episode psychosis.
Sexual function was assessed in a cohort of patients with first episode psychosis using the Sexual Function Questionnaire (SFQ). Anthropometric measures, including weight, BMI, waist, waist–hip ratio were investigated. Additionally, leptin and testosterone were investigated in male patients.
A total of 116 patients (61 males and 55 females) were included. Of these 59% of males and 67.3% of females showed sexual dysfunction (SD) according to the SFQ. In males, higher SFQ scores were significantly correlated with higher BMI (Std. β = 0.36, P = 0.01), higher leptin levels (Std. β = 0.34, P = 0.02), higher waist–hip ratio (Std. β = 0.32, P = 0.04) and lower testosterone levels (Std. β = −0.44, P = 0.002). In contrast, in females, SFQ scores were not associated with any of these factors.
While sexual dysfunction is present in both female and male patients with their first episode of psychosis, only in males is sexual dysfunction associated with increased BMI and waist–hip ratio. The association between SD, BMI, low levels of testosterone and high levels of leptin suggest that policies that lead to healthier diets and more active lifestyles can be beneficial at least, to male patients.
A zirconolite glass-ceramic material is a candidate wasteform for immobilisation of chlorine contaminated plutonium residues, in which plutonium and chlorine are partitioned to the zirconolite and aluminosilicate glass phase, respectively. A preliminary investigation of chlorine speciation was undertaken by analysis of Cl K-edge X-ray Absorption Near Edge Spectroscopy (XANES), to understand the incorporation mechanism. Cl was found to be speciated as the Cl- anion within the glass phase, according to the characteristic chemical shift of the X-ray absorption edge. By comparison with Cl K-edge XANES data acquired from reference compounds, the local environment of the Cl- anion is most closely approximated by the mineral marialite, in which Cl is co-ordinate to 4 x Na and/or Ca atoms.
Agriculture as a social-ecological system embraces many disciplines. This book breaks through the silos of individual disciplines to bring ecologists and economists together to consider agriculture through the lens of resilience. It explores the economic, environmental and social uncertainties that influence the behaviour of agricultural producers and their subsequent farming approach, highlighting the importance of adaptability, innovation and capital reserves in enabling agriculture to persist under climate change and market volatility. The resilience concept and its relation to complexity theory is explained and the characteristics that foster resilience in agricultural systems, including the role of biodiversity and ecosystem services, are explored. The book discusses modelling tools, metrics and approaches for assessing agricultural resilience, highlighting areas where interdisciplinary thinking can enhance the development of resilience. It is suitable for those researching sustainable agriculture or those engaged in agricultural policy decisions and analysis, as well as students of ecology, agriculture and socioeconomics.