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Microscopic examination of blood smears remains the gold standard for laboratory inspection and diagnosis of malaria. Smear inspection is, however, time-consuming and dependent on trained microscopists with results varying in accuracy. We sought to develop an automated image analysis method to improve accuracy and standardization of smear inspection that retains capacity for expert confirmation and image archiving. Here, we present a machine learning method that achieves red blood cell (RBC) detection, differentiation between infected/uninfected cells, and parasite life stage categorization from unprocessed, heterogeneous smear images. Based on a pretrained Faster Region-Based Convolutional Neural Networks (R-CNN) model for RBC detection, our model performs accurately, with an average precision of 0.99 at an intersection-over-union threshold of 0.5. Application of a residual neural network-50 model to infected cells also performs accurately, with an area under the receiver operating characteristic curve of 0.98. Finally, combining our method with a regression model successfully recapitulates intraerythrocytic developmental cycle with accurate lifecycle stage categorization. Combined with a mobile-friendly web-based interface, called PlasmoCount, our method permits rapid navigation through and review of results for quality assurance. By standardizing assessment of Giemsa smears, our method markedly improves inspection reproducibility and presents a realistic route to both routine lab and future field-based automated malaria diagnosis.
Both childhood maltreatment and insecure attachment are known to be associated with depression in adulthood. The extent insecure attachment increases the risk of adult clinical depression over that of parental maltreatment among women in the general population is explored, using those at high risk because of their selection for parental maltreatment together with an unselected sample.
Methods
Semi-structured interviews and investigator-based measures are employed.
Results
Insecure attachment is highly associated with parental maltreatment with both contributing to the risk of depression, with attachment making a substantial independent contribution. Risk of depression did not vary by type of insecure attachment, but the core pathways of the dismissive and enmeshed involved the whole life course in terms of greater experience of a mother's physical abuse and their own anger as an adult, with both related to adult depression being more often provoked by a severely threatening event involving humiliation rather than loss. By contrast, depression of the insecure fearful and withdrawn was more closely associated with both current low self-esteem and an inadequately supportive core relationship. In terms of depression taking a chronic course, insecure attachment was again a key risk factor, but with this now closely linked with the early experience of a chaotic life style but with this involving only a modest number of women.
Conclusions
Both insecure attachment and parental maltreatment contribute to an increased risk of depression with complex effects involving types of insecure attachment.
The Parkes pulsar data archive currently provides access to 144044 data files obtained from observations carried out at the Parkes observatory since the year 1991. Around 105 files are from surveys of the sky, the remainder are observations of 775 individual pulsars and their corresponding calibration signals. Survey observations are included from the Parkes 70 cm and the Swinburne Intermediate Latitude surveys. Individual pulsar observations are included from young pulsar timing projects, the Parkes Pulsar Timing Array and from the PULSE@Parkes outreach program. The data files and access methods are compatible with Virtual Observatory protocols. This paper describes the data currently stored in the archive and presents ways in which these data can be searched and downloaded.
Pharmacological antioxidant vitamins have previously been investigated for a prophylactic effect against exercise-induced oxidative stress. However, large doses are often required and may lead to a state of pro-oxidation and oxidative damage. Watercress contains an array of nutritional compounds such as β-carotene and α-tocopherol which may increase protection against exercise-induced oxidative stress. The present randomised controlled investigation was designed to test the hypothesis that acute (consumption 2 h before exercise) and chronic (8 weeks consumption) watercress supplementation can attenuate exercise-induced oxidative stress. A total of ten apparently healthy male subjects (age 23 (sd 4) years, stature 179 (sd 10) cm and body mass 74 (sd 15) kg) were recruited to complete the 8-week chronic watercress intervention period (and then 8 weeks of control, with no ingestion) of the experiment before crossing over in order to compete the single-dose acute phase (with control, no ingestion). Blood samples were taken at baseline (pre-supplementation), at rest (pre-exercise) and following exercise. Each subject completed an incremental exercise test to volitional exhaustion following chronic and acute watercress supplementation or control. The main findings show an exercise-induced increase in DNA damage and lipid peroxidation over both acute and chronic control supplementation phases (P< 0·05 v. supplementation), while acute and chronic watercress attenuated DNA damage and lipid peroxidation and decreased H2O2 accumulation following exhaustive exercise (P< 0·05 v. control). A marked increase in the main lipid-soluble antioxidants (α-tocopherol, γ-tocopherol and xanthophyll) was observed following watercress supplementation (P< 0·05 v. control) in both experimental phases. These findings suggest that short- and long-term watercress ingestion has potential antioxidant effects against exercise-induced DNA damage and lipid peroxidation.
The inconclusiveness of the literature on the role of loss of parent in influencing psychiatric disorder in adulthood is well known. A number of reasons involving sampling, location and other methodological features, are given to account for these contradictory findings. A study specially designed to cope with these features is then described and basic results are reported. These indicate that, in a sample of women aged 18–65, loss of mother before the age of 17, either by death or by separation of one year or more, was associated with clinical depression in the year of interview. Loss of father by death was in no way associated with current depression, but separation from father showed a trend which, however, did not reach statistical significance. Control for other possible confounding factors did not change this patterning of results; these were further supported when psychiatric episodes earlier in adulthood were examined. Examination of the caregiving arrangements in childhood suggests that it is ‘lack of care’, defined in terms of neglect rather than simply hostile parental behaviour, which accounts for the raised rate of depression. Such ‘lack of care’ is more frequent after loss of mother than after loss of father.
Low self-esteem, defined as negative evaluation of self (NES), has been shown to play a significant role in the development of depression at a case level (Brown et al. 1986). This study investigated the stability of this risk factor in 102 women over a 7-year period and examined psychosocial factors that might influence change. At the end of the 7 years about half of those originally identified as having NES no longer had it, but very few moved in the reverse direction to NES. Level of depressive symptomatology also decreased but this was not a sufficient explanation for the substantial improvement in self-esteem. Life changes that involved an improvement in the quality of close relationships or an increase in work status appeared to be the most important factors in positive NES change. Ratings made at the time of first contact of environmental difficulties and positive evaluation of self (measured independently of NES) were related to positive NES change, but only via their link with positive life changes occurring in the 7-year follow-up period.
This paper addresses the critique which maintains that loss of parent in a sample of female adults plays no role in determining current depression over and above that of low social class position with which such loss is associated. It examines a series of variables which combine to determine current social class position and which seem to stem from lack of adequate replacement care following loss of mother. The experience of a premarital pregnancy and the way in which women cope with it emerge as critical in this process. The relationship of low social class to the onset of depression is discussed in the light of better-known vulnerability factors such as low confiding in, and undependability of, marital partner, employment outside the home and number of children. It is concluded that a current low social class position, far from explaining away the association between loss of mother and current depression, may itself be brought about by a chain of circumstances stemming from the loss. Once again, the quality of replacement care is shown to play a critical role.
An earlier survey of a random sample of women in Camberwell in South London has shown that the majority of new occurrences of depressive disorders were brought about by certain kinds of life event and ongoing difficulty (provoking agent) and that the risk was increased under these circumstances by the presence of certain other social factors (vulnerability factors). Working-class women were much more likely to develop depression because they experienced more of these factors. A new survey in a rural population in the Outer Hebrides has confirmed the importance of these factors in the genesis of depression, although provoking agents occurred much less frequently in this rural setting. However, integration into the traditional way of life, rather than a middle-class status, was related to a lower chance of developing depression, and this appears to be explained by the relationship of provoking agents and vulnerability factors to such integration in the Outer Hebrides, and to social class status in Camberwell.
The notions of loss and danger are briefly described. Two groups of raters in London and Canberra were shown to be reliable in rating the degree of loss and the degree of danger associated with a sample of life events previously rated as ‘severe’ on a contextual measure of long-term threat. The life events were reported by 164 young women attending a general practitioner in London. The women were interviewed by a psychiatrist using the Present State Examination. Their psychiatric symptoms were rated by a team of raters who were ignorant of the life events reported by the young women. Three types of cases of psychiatric disorder of recent onset were diagnosed: depression, anxiety, and mixed depression/anxiety. The frequency of life events reported by these three types of cases as occurring in the year before the onset of their disorder was compared with the frequency of events in the same time period reported by a group of women without severe psychiatric disorder. The results were used to argue that severe loss was a causal agent in the onset of depressive disorder and severe danger was a causal agent in the onset of anxiety states in this sample. Cases of mixed depression/anxiety were more likely to report both a severe loss and a severe danger before onset. This supported the argument for recognizing a distinct group of mixed disorders in the classification of depressive illnesses.
Many of the criticisms of our work made by Tennant & Bebbington in the current edition of this journal touch on issues which have already been discussed in our recent book Social Origins of Depression. We do not think that any of their points pose significant threats to our aetiological model of depression. We welcome this opportunity to clarify their questions about our data, and to use their re-analysis of our material as a basis for a wider discussion of certain general aspects of the statistical analysis and interpretation of data and the pitfalls which await the unwary.
The diagnoses were reviewed of 866 women interviewed in 5 community surveys carried out by the Bedford College team. The diagnoses matched commonly held conceptions of who is a case in terms of both severity and type of syndrome. Two methods of replicating the diagnoses are presented, one based on discriminant function analysis and the other based on a simple checklist.