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A machine learning model was created to predict the electron spectrum generated by a GeV-class laser wakefield accelerator. The model was constructed from variational convolutional neural networks, which mapped the results of secondary laser and plasma diagnostics to the generated electron spectrum. An ensemble of trained networks was used to predict the electron spectrum and to provide an estimation of the uncertainty of that prediction. It is anticipated that this approach will be useful for inferring the electron spectrum prior to undergoing any process that can alter or destroy the beam. In addition, the model provides insight into the scaling of electron beam properties due to stochastic fluctuations in the laser energy and plasma electron density.
The discharge letter is the principal means of communication between the inpatient and the primary care physicians in the UK health care system. Good-quality correspondence between specialist services and general practitioners (GPs) is fundamental to patient care and makes transition from secondary to primary care as smooth as possible for patients
Aim:
The aim of this study was to assess and improve the quality of discharge communication from the specialist substance misuse inpatient unit to general practitioners
Method:
This study was carried out in North Staffordshire Combined Healthcare NHS Trust in July 2013, UK. Fifty three Patients who were admitted to the inpatient unit between March & May 2013 were randomly selected from the Health Informatics Service. A proforma was designed based on approved mental health discharge summary headings from the Royal College of Psychiatrists UK and the results were compared against a previous audit done in 2012 which only looked into some of the component included in the present study
Results:
The study showed that most components of GP details, Patient Demographics, Admission Details, Clinical Details and discharge recommendations were well documented in the discharge letters analysed. The sub components where documentation were not adequate included Gender (0% documented), discharge destination (34% documented), mental capacity (1% documented), allergies (0% documented), Risk assessment (68% documented). However the findings were significant better than the previous audit in most areas.
Conclusion:
This re-audit revealed that the quality and standards achieved for most aspects of discharge summaries were high. However not all aspects met the standards, some very important aspects including risk assessment, drug allergy, details of care coordinator and discharge destinations recordings were poor. There may be reasons for failure to meet the standards; Gender was never recorded in the discharge letters but one could easily assume the gender of the patients from the narrative of the discharge letters. It was noted that discharge destinations were more likely to be recorded if patients were not discharged home. Mental Capacity was not recorded in 98% of cases, as most admissions to the Inpatient unit are planned and patients come on a voluntary basis and have capacity regarding the admission and treatment
In this study the onset of stress-free Boussinesq thermal convection in rotating spherical shells with aspect ratio η = rinner/router = 0.9, Prandtl numbers Pr ∈ [10−4, 10−1], and Taylor numbers Ta ∈ [104, 1012] is considered. We focus on the form of the convective cell pattern that develops, and on its time scales, since this may have observational consequences for thermonuclear burning and the development of burst oscillations in the exploding oceans of accreting neutron stars (Watts (2012)).
Superburst oscillations are high frequency X-ray variations observed during hours’ long superbursts on accreting neutron stars. We investigate a potential mechanism to explain these observations; a buoyant r-mode, excited in the ocean layers of the star. These modes are affected by ash composition in the ocean so are a good probe of nuclear burning processes. The phenomenon could be used in pulse profile modelling as a way of measuring neutron star mass and radius, and so the dense matter equation of state.
There are multiple recent reports of an association between anxious/depressed (A/D) symptomatology and the rate of cerebral cortical thickness maturation in typically developing youths. We investigated the degree to which anxious/depressed symptoms are tied to age-related microstructural changes in cerebral fiber pathways. The participants were part of the NIH MRI Study of Normal Brain Development. Child Behavior Checklist A/D scores and diffusion imaging were available for 175 youths (84 males, 91 females; 241 magnetic resonance imagings) at up to three visits. The participants ranged from 5.7 to 18.4 years of age at the time of the scan. Alignment of fractional anisotropy data was implemented using FSL/Tract-Based Spatial Statistics, and linear mixed model regression was carried out using SPSS. Child Behavior Checklist A/D was associated with the rate of microstructural development in several white matter pathways, including the bilateral anterior thalamic radiation, bilateral inferior longitudinal fasciculus, left superior longitudinal fasciculus, and right cingulum. Across these pathways, greater age-related fractional anisotropy increases were observed at lower levels of A/D. The results suggest that subclinical A/D symptoms are associated with the rate of microstructural development within several white matter pathways that have been implicated in affect regulation, as well as mood and anxiety psychopathology.
We assessed evidence of exposure to viruses and bacteria in an unmanaged and long-isolated population of Soay sheep (Ovis aries) inhabiting Hirta, in the St Kilda archipelago, 65 km west of Benbecula in the Outer Hebrides of Scotland. The sheep harbour many metazoan and protozoan parasites but their exposure to viral and bacterial pathogens is unknown. We tested for herpes viral DNA in leucocytes and found that 21 of 42 tested sheep were infected with ovine herpesvirus 2 (OHV-2). We also tested 750 plasma samples collected between 1997 and 2010 for evidence of exposure to seven other viral and bacterial agents common in domestic Scottish sheep. We found evidence of exposure to Leptospira spp., with overall seroprevalence of 6·5%. However, serological evidence indicated that the population had not been exposed to border disease, parainfluenza, maedi-visna, or orf viruses, nor to Chlamydia abortus. Some sheep tested positive for antibodies against Mycobacterium avium subsp. paratuberculosis (MAP) but, in the absence of retrospective faecal samples, the presence of this infection could not be confirmed. The roles of importation, the pathogen–host interaction, nematode co-infection and local transmission warrant future investigation, to elucidate the transmission ecology and fitness effects of the few viral and bacterial pathogens on Hirta.
Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have the highest co-morbidity rates within the internalizing disorders cluster, yet no Internet-based cognitive behavioural therapy (iCBT) programme exists for their combined treatment.
Method
We designed a six-lesson therapist-assisted iCBT programme for mixed anxiety and depression. Study 1 was a randomized controlled trial (RCT) comparing the iCBT programme (n = 46) versus wait-list control (WLC; n = 53) for patients diagnosed by structured clinical interview with MDD, GAD or co-morbid GAD/MDD. Primary outcome measures were the Patient Health Questionnaire nine-item scale (depression), Generalized Anxiety Disorder seven-item scale (generalized anxiety), Kessler 10-item Psychological Distress scale (distress) and 12-item World Health Organization Disability Assessment Schedule II (disability). The iCBT group was followed up at 3 months post-treatment. In study 2, we investigated the adherence to, and efficacy of the same programme in a primary care setting, where patients (n = 136) completed the programme under the supervision of primary care clinicians.
Results
The RCT showed that the iCBT programme was more effective than WLC, with large within- and between-groups effect sizes found (>0.8). Adherence was also high (89%), and gains were maintained at 3-month follow-up. In study 2 in primary care, adherence to the iCBT programme was low (41%), yet effect sizes were large (>0.8). Of the non-completers, 30% experienced benefit.
Conclusions
Together, the results show that iCBT is effective and adherence is high in research settings, but there is a problem of adherence when translated into the ‘real world’. Future efforts need to be placed on developing improved adherence to iCBT in primary care settings.
Descriptions of the larvae of Lancetes angusticollis (Curtis), L. lanceolatus (Clark), L. subseriatus Zimmermann, L. flavoscutatus Enderlein, L. delkeskampi Ríha, and L. nigriceps (Erichson) are provided. Characters from larval morphology are analyzed to infer the phylogenetic relationships of the genus Lancetes Sharp with other genera of Dytiscidae. A parsimony analysis based on 51 informative larval characteristics was conducted with the program NONA. The most parsimonious tree supports a sister-group relationship between the genus Lancetes and members of the subfamily Dytiscinae. The only unambiguous synapomorphy in support of this hypothesis is the secondary subdivision of some cephalic appendages. Other putative synapomorphies are the proximal articulation of the primary seta CO7 both on meso- and meta-coxa and the presence of additional primary setae on the ventral margin of the tibiae. Based on several character states including the presence of multifragmented urogomphi, the genus Lancetes is monophyletic.
Descriptions are presented of larval instars of three species of the colymbetine tribe Matini Zimmermann (Coleoptera: Dytiscidae), Batrachomatus daemeli (Sharp), Matus bicarinatus (Say), and Allomatus nannup Watts, including a chaetotaxic and porotaxic analysis of the cephalic capsule, head appendages, legs, last abdominal segment, and urogomphi. A parsimony analysis based on 32 informative larval characteristics was conducted with the computer program NONA. Members of the Matini are postulated to share a monophyletic origin based on (i) seta TR2 articulated anteroventroproximally on the trochanter; (ii) seta TR5 elongate on the metatrochanter; (iii) seta TA1 elongate and inserted proximally on the tarsus; (iv) antenomere III with a hole-like ventroapical spinula; (v) prementum with the primary setae LA2, LA3, LA4, LA5, and LA8 spine-like and elongate; (vi) presence of secondary setae on the cephalic appendages; and (vii) presence of additional primary setae on the last abdominal segment. A clade Matini + Colymbetini is postulated based on (i) metafemoral seta FE5; (ii) metafemoral seta FE6; (iii) seta TI6 on tibia, all elongate and hair-like; (iv) one-segmented urogomphus; (v) presence of an occipital suture in first instar; (vi) galea elongate; (vii) presence of natatory setae on legs; and (viii) presence of secondary setae on the urogomphus.
Three studies examine the role that provocative visual stimuli have in eliciting anxiety reactions in people with agoraphobia. Such stimuli elicit more anxiety in agoraphobic patients than control subjects. The effect of visual stimulation appears to be specific: (1) non-visual stimulation is without comparable effect; (2) both control and agoraphobic groups show similar effects of visual stimulation on another reaction such as headache. The anxiety effects of visual stimuli are correlated with the extent to which subjects experience depersonalization and somatic symptoms of agoraphobia, but not correlated with depression or the behavioural or cognitive aspects of agoraphobia. Alternative accounts of the possible role of visual stimulation in the anxiety reactions of agoraphobic patients are discussed.
Several indices of occupational stability are discussed and the importance of controlling for age in assessing occupational stability emphasized. The ability of 6 indices to predict the stable resettlement of psychiatric patients at work after a course of rehabilitation was examined. Though mean job length was a significant predictor, indices based on change of occupation rather than change of job were more successful. Stable resettlement at work was related to how much time people had spent in long jobs but not to how little time they had spent in short jobs. The amount of unemployment during the 2 years before hospital admission predicted return to work immediately after discharge, but did not predict stable resettlement at work.
Resource theory predicts that the relative memory deficit shown by depressed patients should be greater with unstructured than structured material. Previous data using semantic categories word lists supports this, but lists approximating to text have produced the opposite result. Both types of structure were studied in this experiment. The prediction from resource theory was found to hold only when comparing medium and high levels of structure, and to hold more clearly for word lists approximating to text than for semantic categories lists. When word lists of low and medium levels of structure were compared, depressed patients showed relatively greater deficit with the more structured material. Ways in which this could be accommodated in a revised version of resource theory are discussed.