77 research outputs found

    On-sky tests of the CuReD and HWR fast wavefront reconstruction algorithms with CANARY

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    CuReD (Cumulative Reconstructor with domain Decomposition) and HWR (Hierarchical Wavefront Reconstructor) are novel wavefront reconstruction algorithms for the Shack–Hartmann wavefront sensor, used in the single-conjugate adaptive optics. For a high-order system they are much faster than the traditional matrix–vector-multiplication method. We have developed three methods for mapping the reconstructed phase into the deformable mirror actuator commands and have tested both reconstructors with the CANARY instrument. We find out that the CuReD reconstructor runs stably only if the feedback loop is operated as a leaky integrator, whereas HWR runs stably with the conventional integrator control. Using the CANARY telescope simulator we find that the Strehl ratio (SR) obtained with CuReD is slightly higher than that of the traditional least-squares estimator (LSE). We demonstrate that this is because the CuReD algorithm has a smoothing effect on the output wavefront. The SR of HWR is slightly lower than that of LSE. We have tested both reconstructors extensively on-sky. They perform well and CuReD achieves a similar SR as LSE. We compare the CANARY results with those from a computer simulation and find good agreement between the two

    Cross-sectional and longitudinal associations between psychotic and depressive symptoms in depressed adolescents

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    Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11–17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response

    ΠžΡ†Π΅Π½ΠΊΠ° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅Ρ‚ΠΊΠΈ с ΠΏΠΎΠΌΠΎΡ‰ΡŒΡŽ биопсии ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ

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    Computed tomography (CT) guided percutaneous procedures like the fine needle aspiration cytology (FNAC) and fine needle aspiration biopsy (FNAB) are reliable techniques for diagnosing various thoracic diseases. These modalities are used for diagnosis in suspicious lung, pleural, mediastinal and vertebral and pulmonary lesions.The aim. We conducted a study in a Pulmonary Medicine Department of tertiary care hospital to study the efficacy and safety of CT guided FNCA/FNAB in thoracic diseases.Methods. A retrospective study was conducted at a tertiary care center with Information and Ethics committee permission within a total duration of two years. The study included patients presenting with following: 1) mediastinal mass lesions, 2) pulmonary solitary pulmonary nodules/masses, 3) pulmonary cavity, cyst and consolidation of undiagnosed etiology, 4) pleural mass, nodules, loculated collections, 5) extra-pulmonary and spinal tuberculosis suspects with pre/paravertebral abscess. Procedure details, radiological images and pathological and microbiological reports were retrieved from case record book of patients available in department.Results. Study population consisted of 108 patients. Neoplastic diseases were 85 (78.70%) and Non- neoplastic diseases 23 (21.29%). In neoplastic diseases 78.82% patients had lung Cancer of which 85.07% non small cell carcinoma and 14.92% small cell lung cancer. Out of non small cell lung cancer adenocarcinoma of lung was the commonest. The most common non neoplastic diseases was tuberculosis. CT guided biopsy procedure was performed without any complications in 61.11%. The most common complication was pneumothorax (27.77%). The yield of CT guided biopsy was 98.14%.Conclusion. Percutaneous CT-guided lung biopsy is an effective, highly accurate, and safe method of obtaining tissue for the diagnosis of indeterminate pulmonary lesions especially in neoplastic diseases and tuberculosis.ЧрСскоТныС ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Ρ‹ ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ (КВ), Ρ‚Π°ΠΊΠΈΠ΅ ΠΊΠ°ΠΊ Ρ‚ΠΎΠ½ΠΊΠΎΠΈΠ³ΠΎΠ»ΡŒΠ½Π°Ρ аспирационная цитология (fine needle aspiration cytology – FNAC) ΠΈ Ρ‚ΠΎΠ½ΠΊΠΎΠΈΠ³ΠΎΠ»ΡŒΠ½Π°Ρ аспирационная биопсия (fine needle aspiration biopsy – FNAB), ΡΠ²Π»ΡΡŽΡ‚ΡΡ Π½Π°Π΄Π΅ΠΆΠ½Ρ‹ΠΌΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Π°ΠΌΠΈ диагностики Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅Ρ‚ΠΊΠΈ. Π­Ρ‚ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΡŽΡ‚ΡΡ для диагностики ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠΉ Π»Π΅Π³ΠΊΠΈΡ…, ΠΏΠ»Π΅Π²Ρ€Ρ‹, срСдостСния, ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ° ΠΈ Π»Π΅Π³ΠΊΠΈΡ….ЦСлью исслСдования, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ Π² ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹ Ρ‚Ρ€Π΅Ρ‚ΠΈΡ‡Π½ΠΎΠ³ΠΎ уровня, явилось ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ эффСктивности ΠΈ бСзопасности FNCA / FNAB ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ КВ ΠΏΡ€ΠΈ заболСваниях ΠΎΡ€Π³Π°Π½ΠΎΠ² Π³Ρ€ΡƒΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅Ρ‚ΠΊΠΈ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. РСтроспСктивноС исслСдованиС ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡŒ Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 2 Π»Π΅Ρ‚ Π² Ρ†Π΅Π½Ρ‚Ρ€Π΅ Ρ‚Ρ€Π΅Ρ‚ΠΈΡ‡Π½ΠΎΠΉ мСдицинской ΠΏΠΎΠΌΠΎΡ‰ΠΈ с Ρ€Π°Π·Ρ€Π΅ΡˆΠ΅Π½ΠΈΡ ΠšΠΎΠΌΠΈΡ‚Π΅Ρ‚Π° ΠΏΠΎ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΈ этикС. Π’ исслСдованиС Π±Ρ‹Π»ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ ΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹: 1) с новообразованиями срСдостСния; 2) с Π»Π΅Π³ΠΎΡ‡Π½Ρ‹ΠΌΠΈ солитарными ΡƒΠ·Π»Π°ΠΌΠΈ / новообразованиями; 3) с полостями, кистами ΠΈ консолидациСй Π² Π»Π΅Π³ΠΊΠΈΡ… нСвыяснСнной этиологии; 4) с ΠΏΠ»Π΅Π²Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌΠΈ новообразованиями, ΡƒΠ·Π΅Π»ΠΊΠ°ΠΌΠΈ, осумкованными скоплСниями; 5) с ΠΏΠ»Π΅Π²Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌΠΈ массами, ΡƒΠ·Π΅Π»ΠΊΠ°ΠΌΠΈ, осумкованными скоплСниями, ΠΏΠΎΠ΄ΠΎΠ·Ρ€Π΅Π½ΠΈΠ΅ΠΌ Π½Π° Π²Π½Π΅Π»Π΅Π³ΠΎΡ‡Π½Ρ‹ΠΉ Ρ‚ΡƒΠ±Π΅Ρ€ΠΊΡƒΠ»Π΅Π· ΠΈ Ρ‚ΡƒΠ±Π΅Ρ€ΠΊΡƒΠ»Π΅Π· ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ° с ΠΏΡ€Π΅-, ΠΏΠ°Ρ€Π°Π²Π΅Ρ€Ρ‚Π΅Π±Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌ абсцСссом. Π”Π°Π½Π½Ρ‹Π΅ ΠΎ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Π΅, рСнтгСновскиС снимки, патологоанатомичСскиС ΠΈ микробиологичСскиС ΠΎΡ‚Ρ‡Π΅Ρ‚Ρ‹ Π±Ρ‹Π»ΠΈ ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Ρ‹ ΠΈΠ· историй Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΡ…ΡΡ Π² ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠΈ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’Ρ‹Π±ΠΎΡ€ΠΊΡƒ составили 108 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ΠžΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Π΅ заболСвания выявлСны Ρƒ 85 (78,70 %), Π½Π΅ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Π΅ – Ρƒ 23 (21,29 %) ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². Π£ 78,82 % ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹ΠΌΠΈ заболСваниями выявлСн Ρ€Π°ΠΊ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ, Ρƒ 85,07 % ΠΈΠ· Π½ΠΈΡ… – Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅Ρ‚ΠΎΡ‡Π½Ρ‹ΠΉ, Ρƒ 14,92 % – ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅Ρ‚ΠΎΡ‡Π½Ρ‹ΠΉ Ρ€Π°ΠΊ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ. Π£ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅Ρ‚ΠΎΡ‡Π½Ρ‹ΠΌ Ρ€Π°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ часто Π²ΡΡ‚Ρ€Π΅Ρ‡Π°Π»Π°ΡΡŒ Π°Π΄Π΅Π½ΠΎΠΊΠ°Ρ€Ρ†ΠΈΠ½ΠΎΠΌΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ. НаиболСС частым Π½Π΅ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹ΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ являлся Ρ‚ΡƒΠ±Π΅Ρ€ΠΊΡƒΠ»Π΅Π·. Биопсия ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ КВ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° Π±Π΅Π· ΠΊΠ°ΠΊΠΈΡ…-Π»ΠΈΠ±ΠΎ ослоТнСний Π² 61,11 % случаСв. НаиболСС частым ослоТнСниСм (27,77 %) Π±Ρ‹Π» пнСвмоторакс. Биопсия ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ КВ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»Π° ΡƒΡΡ‚Π°Π½ΠΎΠ²ΠΈΡ‚ΡŒ Π΄ΠΈΠ°Π³Π½ΠΎΠ· Π² 98,14 % случаСв.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ЧрСскоТная биопсия Π»Π΅Π³ΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ΄ ΠΊΠΎΠ½Ρ‚Ρ€ΠΎΠ»Π΅ΠΌ КВ являСтся эффСктивным, высокоточным ΠΈ бСзопасным ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ получСния Ρ‚ΠΊΠ°Π½ΠΈ для диагностики Π½Π΅ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½Π½Ρ‹Ρ… ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠΉ Π»Π΅Π³ΠΊΠΈΡ…, особСнно ΠΏΡ€ΠΈ ΠΎΠΏΡƒΡ…ΠΎΠ»Π΅Π²Ρ‹Ρ… заболСваниях ΠΈ Ρ‚ΡƒΠ±Π΅Ρ€ΠΊΡƒΠ»Π΅Π·Π΅

    Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12

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    <p>Abstract</p> <p>Background</p> <p>Due to demographic change, the advanced elderly represent the fastest growing population group in Europe. Health problems tend to be frequent and increasing with age within this cohort.</p> <p>Aims of the study</p> <p>To describe and compare health status of the elderly population in six European countries and to analyze the impact of socio-demographic variables on health.</p> <p>Methods</p> <p>In the European Study of the Epidemiology of Mental Disorders (ESEMeD), representative non-institutionalized population samples completed the EQ-5D and Short Form-12 (SF-12) questionnaires as part of personal computer-based home interviews in 2001-2003. This study is based on a subsample of 1659 respondents aged β‰₯ 75 years from Belgium (n = 194), France (n = 168), Germany (n = 244), Italy (n = 317), the Netherlands (n = 164) and Spain (n = 572). Descriptive statistics, bivariate- (chi-square tests) and multivariate methods (linear regressions) were used to examine differences in population health.</p> <p>Results</p> <p>68.8% of respondents reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (55.2%), followed by mobility (50.0%), usual activities (36.6%), self-care (18.1%) and anxiety/depression (11.6%). The proportion of respondents reporting any problems increased significantly with age in bivariate analyses (age 75-79: 65.4%; age 80-84: 69.2%; age β‰₯ 85: 81.1%) and differed between countries, ranging from 58.7% in the Netherlands to 72.3% in Italy. The mean EQ VAS score was 61.9, decreasing with age (age 75-79: 64.1; age 80-84: 59.8; age β‰₯ 85: 56.7) and ranging from 60.0 in Italy to 72.9 in the Netherlands. SF-12 derived Physical Component Summary (PCS) and Mental Component Summary (MCS) scores varied little by age and country. Age and low educational level were associated with lower EQ VAS and PCS scores. After controlling for socio-demographic variables and reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and Belgium, and lower in Germany than the grand mean.</p> <p>Conclusions</p> <p>More than two thirds of the advanced elderly report impairment of health status. Impairment increases rapidly with age but differs considerably between countries. In all countries, health status is significantly associated with socio-demographic variables.</p

    Where’s WALY? : A proof of concept study of the β€˜wellbeing adjusted life year’ using secondary analysis of cross-sectional survey data

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    Background The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE (https://www.nice.org.uk/process/pmg9/). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. Methods Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson’s and Spearman’s correlations, linear regression, and receiver operating characteristic curves. Results Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R2 being 0.104 for the index and 0.141 for the visual analogue scale). Conclusion The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure – a Wellbeing Adjusted Life Year – is needed
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