Multicentric recurrent parotid pleomorphic adenoma in a child

Mixed tumours of the parotid gland are rare in childhood and recurrence of this tumour is infrequent. Some authors report a higher rate of recurrence with some histological subtypes, like hypocellular variant. Female sex and young age at initial treatment are also risk factor for recurrence. Also the first surgical treatment, tumour enucleation or parotidectomy, has been implicated as a cause for recurrence. We present a case of a multicentric doubly recurrent parotid pleomorphic adenoma, 7 and 14 years after tumour enucleation, in a 9-year-old child. All the nodules resected showed the hypocellular variant of pleomorphic adenoma. We consider the relationships between the choice of treatment, the histologic subtypes of pleomorphic adenomas and multifocal tumours and recurrence. In this case, we believe the recurrence was related to surgical enucleation previously performed and the hypocellular histological subtype. We conclude that tumour enucleation is a risk factor for recurrence and total parotidectomy is the treatment of choice for pleomorphic parotid adenoma also in childhood

Overview of ERA Integrated Technology Demonstration (ITD) 51A Ultra-High Bypass (UHB) Integration for Hybrid Wing Body (HWB)

The NASA Environmentally Responsible Aircraft Project (ERA) was a ve year project broken into two phases. In phase II, high N+2 Technical Readiness Level demonstrations were grouped into Integrated Technology Demonstrations (ITD). This paper describes the work done on ITD-51A: the Vehicle Systems Integration, Engine Airframe Integration Demonstration. Refinement of a Hybrid Wing Body (HWB) aircraft from the possible candidates developed in ERA Phase I was continued. Scaled powered, and unpowered wind- tunnel testing, with and without acoustics, in the NASA LARC 14- by 22-foot Subsonic Tunnel, the NASA ARC Unitary Plan Wind Tunnel, and the 40- by 80-foot test section of the National Full-Scale Aerodynamics Complex (NFAC) in conjunction with very closely coupled Computational Fluid Dynamics was used to demonstrate the fuel burn and acoustic milestone targets of the ERA Project

ReMindCare, an app for daily clinical practice in patients with first episode psychosis: A pragmatic real-world study protocol

[EN] Aim Despite the potential benefits of e-health interventions for patients with psychosis, the integration of these applications into the clinical workflow and analysis of their long-term effects still face significant challenges. To address these issues, we developed the ReMindCare app. This app aims to improve the treatment quality for patients with psychosis. We chose to study the app in real world and pragmatic manner to ensure results will be generalizable. Methods This is a naturalistic empirical study of patients in a first episode of psychosis programme. The app was purpose-designed based on two previous studies, and it offers the following assessments: (a) three daily questions regarding anxiety, sadness and irritability; and (b) 18 weekly questions about medication adherence, medication side effects, medication attitudes and prodromal symptoms. The app offers preset alerts, reminders and the ability for patients to reach out to their clinicians. Data captured by the app are linked to the electronic medical record of the patient. Patients will use the app as part of their ongoing care for a maximum period of 5 years, and assessments will occur at baseline and at the end of the first, second and fifth years of app use. Results Recruitment started in October 2018 and is still ongoing. Conclusions The ReMindCare app represents early real-world use of digital mental health tools that offer direct integration into clinical care. High retention and compliance rates are expected, and this will in turn lead to improved quality of assessments and communication between patients and clinicians.Centro de Investigacion Biomedica en Red de Salud Mental; European Social Fund, Grant/Award Number: 2017/9830; Generalitat Valenciana, Grant/Award Number: PROMETEO/2016/082; Instituto de Salud Carlos III, Grant/Award Numbers: PI01399, PI13/00447, PI17/00402Bonet, L.; Torous, J.; Arce Grilo, AD.; Blanquer Espert, I.; Sanjuán, J. (2021). ReMindCare, an app for daily clinical practice in patients with first episode psychosis: A pragmatic real-world study protocol. Early Intervention in Psychiatry. 15(1):183-192. https://doi.org/10.1111/eip.12960S183192151Abbott, P. A., Foster, J., Marin, H. de F., & Dykes, P. C. (2014). Complexity and the science of implementation in health IT—Knowledge gaps and future visions. International Journal of Medical Informatics, 83(7), e12-e22. doi:10.1016/j.ijmedinf.2013.10.009American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. doi:10.1176/appi.books.9780890425596Appelbaum, S. H., & Wohl, L. (2000). Transformation or change: some prescriptions for health care organizations. Managing Service Quality: An International Journal, 10(5), 279-298. doi:10.1108/09604520010345768Arango, C., Bernardo, M., Bonet, P., Cabrera, A., Crespo-Facorro, B., Cuesta, M. J., … Melau, M. (2017). Cuando la asistencia no sigue a la evidencia: el caso de la falta de programas de intervención temprana en psicosis en España. Revista de Psiquiatría y Salud Mental, 10(2), 78-86. doi:10.1016/j.rpsm.2017.01.001Arango C. Crespo‐Facorro B. Cuesta M. J. González‐Pinto A. Gutiérrez J. R. Lalucat L. &Sanjuán J. Libro blanco de la atención temprana en psicosis.2018. Available at:www.sepsiq.org/file/Enlaces/Libro%20blanco%20de%20la%20Intervenci%C3%B3n%20Temprana%20en%20Espa%C3%B1a%20(2018).pdfAref-Adib, G., O’Hanlon, P., Fullarton, K., Morant, N., Sommerlad, A., Johnson, S., & Osborn, D. (2016). A qualitative study of online mental health information seeking behaviour by those with psychosis. BMC Psychiatry, 16(1). doi:10.1186/s12888-016-0952-0Barnett, I., Torous, J., Staples, P., Sandoval, L., Keshavan, M., & Onnela, J.-P. (2018). Relapse prediction in schizophrenia through digital phenotyping: a pilot study. 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Journal of Dual Diagnosis, 10(4), 197-203. doi:10.1080/15504263.2014.962336Berry, N., Lobban, F., Emsley, R., & Bucci, S. (2016). Acceptability of Interventions Delivered Online and Through Mobile Phones for People Who Experience Severe Mental Health Problems: A Systematic Review. Journal of Medical Internet Research, 18(5), e121. doi:10.2196/jmir.5250Bonet, L., Izquierdo, C., Escartí, M. J., Sancho, J. V., Arce, D., Blanquer, I., & Sanjuan, J. (2017). Utilización de tecnologías móviles en pacientes con psicosis: una revisión sistemática. Revista de Psiquiatría y Salud Mental, 10(3), 168-178. doi:10.1016/j.rpsm.2017.01.003Bonet, L., Llácer, B., Hernandez-Viadel, M., Arce, D., Blanquer, I., Cañete, C., … Sanjuán, J. (2018). Differences in the Use and Opinions About New eHealth Technologies Among Patients With Psychosis: Structured Questionnaire. JMIR Mental Health, 5(3), e51. doi:10.2196/mental.9950Borzekowski, D. L. G., Leith, J., Medoff, D. R., Potts, W., Dixon, L. B., Balis, T., … Himelhoch, S. (2009). Use of the Internet and Other Media for Health Information Among Clinic Outpatients With Serious Mental Illness. Psychiatric Services, 60(9), 1265-1268. doi:10.1176/ps.2009.60.9.1265Brenner, C. J., & Ben-Zeev, D. (2014). Affective forecasting in schizophrenia: Comparing predictions to real-time Ecological Momentary Assessment (EMA) ratings. Psychiatric Rehabilitation Journal, 37(4), 316-320. doi:10.1037/prj0000105Bucci, S., Barrowclough, C., Ainsworth, J., Machin, M., Morris, R., Berry, K., … Haddock, G. (2018). Actissist: Proof-of-Concept Trial of a Theory-Driven Digital Intervention for Psychosis. Schizophrenia Bulletin, 44(5), 1070-1080. doi:10.1093/schbul/sby032Camacho, E., Levin, L., & Torous, J. (2019). Smartphone Apps to Support Coordinated Specialty Care for Prodromal and Early Course Schizophrenia Disorders: Systematic Review. Journal of Medical Internet Research, 21(11), e16393. doi:10.2196/16393Cannon-Spoor, H. E., Potkin, S. G., & Wyatt, R. J. (1982). Measurement of Premorbid Adjustment in Chronic Schizophrenia. Schizophrenia Bulletin, 8(3), 470-484. doi:10.1093/schbul/8.3.470Cresswell, K., & Sheikh, A. (2013). Organizational issues in the implementation and adoption of health information technology innovations: An interpretative review. International Journal of Medical Informatics, 82(5), e73-e86. doi:10.1016/j.ijmedinf.2012.10.007DiFilippo, K. N., Huang, W., & Chapman-Novakofski, K. M. (2017). A New Tool for Nutrition App Quality Evaluation (AQEL): Development, Validation, and Reliability Testing. JMIR mHealth and uHealth, 5(10), e163. doi:10.2196/mhealth.7441Dixon, L. (2017). What It Will Take to Make Coordinated Specialty Care Available to Anyone Experiencing Early Schizophrenia. JAMA Psychiatry, 74(1), 7. doi:10.1001/jamapsychiatry.2016.2665Endicott, J. (1976). The Global Assessment Scale. Archives of General Psychiatry, 33(6), 766. doi:10.1001/archpsyc.1976.01770060086012Firth, J., Cotter, J., Torous, J., Bucci, S., Firth, J. A., & Yung, A. R. (2015). Mobile Phone Ownership and Endorsement of «mHealth» Among People With Psychosis: A Meta-analysis of Cross-sectional Studies. Schizophrenia Bulletin, 42(2), 448-455. doi:10.1093/schbul/sbv132García, S., Martínez-Cengotitabengoa, M., López-Zurbano, S., Zorrilla, I., López, P., Vieta, E., & González-Pinto, A. (2016). Adherence to Antipsychotic Medication in Bipolar Disorder and Schizophrenic Patients. Journal of Clinical Psychopharmacology, 36(4), 355-371. doi:10.1097/jcp.0000000000000523Gay, K., Torous, J., Joseph, A., Pandya, A., & Duckworth, K. (2016). Digital Technology Use Among Individuals with Schizophrenia: Results of an Online Survey. JMIR Mental Health, 3(2), e15. doi:10.2196/mental.5379Gitlow, L., Abdelaal, F., Etienne, A., Hensley, J., Krukowski, E., & Toner, M. (2017). Exploring the Current Usage and Preferences for Everyday Technology among People with Serious Mental Illnesses. Occupational Therapy in Mental Health, 33(1), 1-14. doi:10.1080/0164212x.2016.1211061Granja, C., Janssen, W., & Johansen, M. A. (2018). Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature. Journal of Medical Internet Research, 20(5), e10235. doi:10.2196/10235Hogan, T. P., Awad, A. G., & Eastwood, R. (1983). A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological Medicine, 13(1), 177-183. doi:10.1017/s0033291700050182Instituto Nacional de Estadística (INE).2016. Encuesta sobre equipamiento y uso de tecnologías de información y comunicación en los hogares. Available on:http://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736176741&menu=ultiDatos&idp=1254735976608. Archived at:http://www.webcitation.org/6μ6YxYOTEKannisto, K. A., Adams, C. E., Koivunen, M., Katajisto, J., & Va lima ki, M. (2015). Feedback on SMS reminders to encourage adherence among patients taking antipsychotic medication: a cross-sectional survey nested within a randomised trial. BMJ Open, 5(11), e008574-e008574. doi:10.1136/bmjopen-2015-008574Kimhy, D., Vakhrusheva, J., Liu, Y., & Wang, Y. (2014). Use of mobile assessment technologies in inpatient psychiatric settings. Asian Journal of Psychiatry, 10, 90-95. doi:10.1016/j.ajp.2014.04.004Lal, S., Dell’Elce, J., Tucci, N., Fuhrer, R., Tamblyn, R., & Malla, A. (2015). Preferences of Young Adults With First-Episode Psychosis for Receiving Specialized Mental Health Services Using Technology: A Survey Study. JMIR Mental Health, 2(2), e18. doi:10.2196/mental.4400Lauckner, C., & Whitten, P. (2015). The State and Sustainability of Telepsychiatry Programs. The Journal of Behavioral Health Services & Research, 43(2), 305-318. doi:10.1007/s11414-015-9461-zMacias, C., Panch, T., Hicks, Y. M., Scolnick, J. S., Weene, D. L., Öngür, D., & Cohen, B. M. (2015). Using Smartphone Apps to Promote Psychiatric and Physical Well-Being. Psychiatric Quarterly, 86(4), 505-519. doi:10.1007/s11126-015-9337-7Miller, B. J., Stewart, A., Schrimsher, J., Peeples, D., & Buckley, P. F. (2015). How connected are people with schizophrenia? Cell phone, computer, email, and social media use. Psychiatry Research, 225(3), 458-463. doi:10.1016/j.psychres.2014.11.067Ministerio de sanidad consumo y bienestar social (MSCBS).2019. Plan de calidad para el Sistema Nacional de salud. Available on:https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/home.htm. Archived at:http://www.webcitation.org/787eGSHEqMorisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence. Medical Care, 24(1), 67-74. doi:10.1097/00005650-198601000-00007National Alliance on Mental Illness (NAMI).2014. Health and Technology study. 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Proceedings of the 2016 ACM International Joint Conference on Pervasive and Ubiquitous Computing. doi:10.1145/2971648.2971740Zanaboni, P., Ngangue, P., Mbemba, G. I. C., Schopf, T. R., Bergmo, T. S., & Gagnon, M.-P. (2018). Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews. Journal of Medical Internet Research, 20(6), e10202. doi:10.2196/1020

ReMindCare App for Early Psychosis: Pragmatic Real World Intervention and Usability Study

[EN] Background: eHealth interventions are widely used in clinical trials and increasingly in care settings as well; however, their efficacy in real-world contexts remains unknown. ReMindCare is a smartphone app that has been systematically implemented in a first episode of psychosis program (FEPP) for patients with early psychosis since 2018. Objective: The objective of this study was to assess the efficacy of ReMindCare after 19 months of use in the clinic and varying use by individual patients. Methods: The integration of the ReMindCare app into the FEPP started in October 2018. Patients with early psychosis self-selected to the app (ReMindCare group) or treatment as usual (TAU group). The outcome variables considered were adherence to the intervention and number of relapses, hospital admissions, and visits to urgent care units. Data from 90 patients with early psychosis were analyzed: 59 in the ReMindCare group and 31 in the TAU group. The mean age of the sample was 32.8 (SD 9.4) years, 73% (66/90) were males, 91% (83/90) were White, and 81% (74/90) were single. Results: Significant differences between the ReMindCare and TAU groups were found in the number of relapses, hospitalizations, and visits to urgent care units, with each showing benefits for the app. Only 20% (12/59) of patients from the ReMindCare group had a relapse, while 58% (18/31) of the TAU patients had one or more relapses (chi(2) =13.7, P=.001). Moreover, ReMindCare patients had fewer visits to urgent care units (chi(2) =7.4, P=.006) and fewer hospitalizations than TAU patients (chi(2) =4.6, P=.03). The mean of days using the app was 352.2 (SD 191.2; min/max: 18-594), and the mean of engagement was 84.5 (SD 16.04). Conclusions: To our knowledge, this is the first eHealth intervention that has preliminarily proven its benefits in the real-world treatment of patients with early psychosis.This study was supported by the Sanitary Research Institute of the University Clinic Hospital and the Mental Health Networking Biomedical Centre. It was also supported by the Generalitat Valenciana and the Program for Scientific Research, Technological Development, and Innovation in the Generalitat Valenciana of the European Union (2017/9830). It was also supported by grants from the Generalitat Valenciana (PROMETEO/2016/082, PROMETEO/2020/024), Carlos III Health Institute (PI13/00447; PI17/00402), and European Union through the European Regional Development Fund.Bonet, L.; Torous, J.; Arce Grilo, AD.; Blanquer Espert, I.; Sanjuan, J. (2020). ReMindCare App for Early Psychosis: Pragmatic Real World Intervention and Usability Study. JMIR mHealth and uHealth. 8(11):1-13. https://doi.org/10.2196/22997S113811Firth, J., Cotter, J., Torous, J., Bucci, S., Firth, J. A., & Yung, A. R. (2015). Mobile Phone Ownership and Endorsement of «mHealth» Among People With Psychosis: A Meta-analysis of Cross-sectional Studies. Schizophrenia Bulletin, 42(2), 448-455. doi:10.1093/schbul/sbv132Bonet, L., Izquierdo, C., Escartí, M. J., Sancho, J. V., Arce, D., Blanquer, I., & Sanjuan, J. (2017). Utilización de tecnologías móviles en pacientes con psicosis: una revisión sistemática. Revista de Psiquiatría y Salud Mental, 10(3), 168-178. doi:10.1016/j.rpsm.2017.01.003Kannarkat, J. T., Smith, N. N., & McLeod-Bryant, S. A. (2020). Mobilization of Telepsychiatry in Response to COVID-19—Moving Toward 21st Century Access to Care. Administration and Policy in Mental Health and Mental Health Services Research, 47(4), 489-491. doi:10.1007/s10488-020-01044-zTorous, J., & Keshavan, M. (2020). COVID-19, mobile health and serious mental illness. Schizophrenia Research, 218, 36-37. doi:10.1016/j.schres.2020.04.013Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., … Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40-48. doi:10.1016/j.bbi.2020.04.028Trefflich, F., Kalckreuth, S., Mergl, R., & Rummel-Kluge, C. (2015). Psychiatric patients׳ internet use corresponds to the internet use of the general public. Psychiatry Research, 226(1), 136-141. doi:10.1016/j.psychres.2014.12.037Gay, K., Torous, J., Joseph, A., Pandya, A., & Duckworth, K. (2016). Digital Technology Use Among Individuals with Schizophrenia: Results of an Online Survey. JMIR Mental Health, 3(2), e15. doi:10.2196/mental.5379Bonet, L., Llácer, B., Hernandez-Viadel, M., Arce, D., Blanquer, I., Cañete, C., … Sanjuán, J. (2018). Differences in the Use and Opinions About New eHealth Technologies Among Patients With Psychosis: Structured Questionnaire. JMIR Mental Health, 5(3), e51. doi:10.2196/mental.9950Hau, Y. S., Kim, J. K., Hur, J., & Chang, M. C. (2020). How about actively using telemedicine during the COVID-19 pandemic? Journal of Medical Systems, 44(6). doi:10.1007/s10916-020-01580-zBucci, S., Berry, N., Morris, R., Berry, K., Haddock, G., Lewis, S., & Edge, D. (2019). «They Are Not Hard-to-Reach Clients. We Have Just Got Hard-to-Reach Services.» Staff Views of Digital Health Tools in Specialist Mental Health Services. Frontiers in Psychiatry, 10. doi:10.3389/fpsyt.2019.00344Arango, C., Bernardo, M., Bonet, P., Cabrera, A., Crespo-Facorro, B., Cuesta, M. J., … Melau, M. (2017). Cuando la asistencia no sigue a la evidencia: el caso de la falta de programas de intervención temprana en psicosis en España. Revista de Psiquiatría y Salud Mental, 10(2), 78-86. doi:10.1016/j.rpsm.2017.01.001Camacho, E., Levin, L., & Torous, J. (2019). Smartphone Apps to Support Coordinated Specialty Care for Prodromal and Early Course Schizophrenia Disorders: Systematic Review. Journal of Medical Internet Research, 21(11), e16393. doi:10.2196/16393Correll, C. U., Galling, B., Pawar, A., Krivko, A., Bonetto, C., Ruggeri, M., … Kane, J. M. (2018). Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis. JAMA Psychiatry, 75(6), 555. doi:10.1001/jamapsychiatry.2018.0623Bucci, S., Barrowclough, C., Ainsworth, J., Machin, M., Morris, R., Berry, K., … Haddock, G. (2018). Actissist: Proof-of-Concept Trial of a Theory-Driven Digital Intervention for Psychosis. Schizophrenia Bulletin, 44(5), 1070-1080. doi:10.1093/schbul/sby032Eisner, E., Drake, R. J., Berry, N., Barrowclough, C., Emsley, R., Machin, M., & Bucci, S. (2019). Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse. JMIR mHealth and uHealth, 7(3), e11568. doi:10.2196/11568Ben-Zeev, D., Brian, R., Wang, R., Wang, W., Campbell, A. T., Aung, M. S. H., … Scherer, E. A. (2017). CrossCheck: Integrating self-report, behavioral sensing, and smartphone use to identify digital indicators of psychotic relapse. Psychiatric Rehabilitation Journal, 40(3), 266-275. doi:10.1037/prj0000243Torous, J., Woodyatt, J., Keshavan, M., & Tully, L. M. (2019). A new hope for early psychosis care: the evolving landscape of digital care tools. The British Journal of Psychiatry, 214(5), 269-272. doi:10.1192/bjp.2019.8Torous, J., Lipschitz, J., Ng, M., & Firth, J. (2020). Dropout rates in clinical trials of smartphone apps for depressive symptoms: A systematic review and meta-analysis. Journal of Affective Disorders, 263, 413-419. doi:10.1016/j.jad.2019.11.167Killikelly, C., He, Z., Reeder, C., & Wykes, T. (2017). Improving Adherence to Web-Based and Mobile Technologies for People With Psychosis: Systematic Review of New Potential Predictors of Adherence. JMIR mHealth and uHealth, 5(7), e94. doi:10.2196/mhealth.7088Krzystanek, M., Krysta, K., & Skałacka, K. (2017). Treatment Compliance in the Long-Term Paranoid Schizophrenia Telemedicine Study. Journal of Technology in Behavioral Science, 2(2), 84-87. doi:10.1007/s41347-017-0016-4Arnold, C., Villagonzalo, K.-A., Meyer, D., Farhall, J., Foley, F., Kyrios, M., & Thomas, N. (2019). Predicting engagement with an online psychosocial intervention for psychosis: Exploring individual- and intervention-level predictors. Internet Interventions, 18, 100266. doi:10.1016/j.invent.2019.100266Ross, J., Stevenson, F., Lau, R., & Murray, E. (2016). Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implementation Science, 11(1). doi:10.1186/s13012-016-0510-7Allan, S., Bradstreet, S., Mcleod, H., Farhall, J., Lambrou, M., … Gleeson, J. (2019). Developing a Hypothetical Implementation Framework of Expectations for Monitoring Early Signs of Psychosis Relapse Using a Mobile App: Qualitative Study. Journal of Medical Internet Research, 21(10), e14366. doi:10.2196/14366Palmier-Claus, J. E., Rogers, A., Ainsworth, J., Machin, M., Barrowclough, C., Laverty, L., … Lewis, S. W. (2013). Integrating mobile-phone based assessment for psychosis into people’s everyday lives and clinical care: a qualitative study. BMC Psychiatry, 13(1). doi:10.1186/1471-244x-13-34Kannisto, K. A., Adams, C. E., Koivunen, M., Katajisto, J., & Va lima ki, M. (2015). Feedback on SMS reminders to encourage adherence among patients taking antipsychotic medication: a cross-sectional survey nested within a randomised trial. BMJ Open, 5(11), e008574-e008574. doi:10.1136/bmjopen-2015-008574Torous, J. B. (2018). Focusing on the Future of Mobile Mental Health and Smartphone Interventions. Psychiatric Services, 69(9), 945-945. doi:10.1176/appi.ps.201800308Bonet, L., Torous, J., Arce, D., Blanquer, I., & Sanjuán, J. (2020). ReMindCare , an app for daily clinical practice in patients with first episode psychosis: A pragmatic real‐world study protocol. Early Intervention in Psychiatry, 15(1), 183-192. doi:10.1111/eip.12960Endicott, J. (1976). The Global Assessment Scale. Archives of General Psychiatry, 33(6), 766. doi:10.1001/archpsyc.1976.01770060086012Cannon-Spoor, H. E., Potkin, S. G., & Wyatt, R. J. (1982). Measurement of Premorbid Adjustment in Chronic Schizophrenia. Schizophrenia Bulletin, 8(3), 470-484. doi:10.1093/schbul/8.3.470Greer, B., Robotham, D., Simblett, S., Curtis, H., Griffiths, H., & Wykes, T. (2019). Digital Exclusion Among Mental Health Service Users: Qualitative Investigation. 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Approximating subtree distances between Phylogenies

We give a 5-approximation algorithm to the rooted Subtree-Prune-and-Regraft (rSPR) distance between two phylogenies, which was recently shown to be NP-complete by Bordewich and Semple [5]. This paper presents the first approximation result for this important tree distance. The algorithm follows a standard format for tree distances such as Rodrigues et al. [24] and Hein et al. [13]. The novel ideas are in the analysis. In the analysis, the cost of the algorithm uses a \cascading" scheme that accounts for possible wrong moves. This accounting is missing from previous analysis of tree distance approximation algorithms. Further, we show how all algorithms of this type can be implemented in linear time and give experimental results

External allomorphy and lexical representations

Many cases of allomorphic alternation are restricted to specific lexical items but at the same time show a regular phonological distribution. Standard approaches cannot deal with these cases because they must either resort to diacritic features or list regular phonological contexts as idiosyncratic. These problems can be overcome if we assume that allomorphs are lexically organized as a partially ordered set. If no ordering is established, allomorphic choice is determined by the phonology- in particular, by the emergence of the unmarked (TETU). In other cases, TETU effects are insufficient, and lexical ordering determines the preference for dominant allomorphs

Crecimiento y bienestar en América Latina : nuevos enfoques

La historiografía del bienestar de los países ha ido evolucionando con la incor-poración de nuevos enfoques para aproximarse al tema. Los primeros estudios consideraban que el producto interno bruto (piB) podría ser una buena aproxima-ción para medir el bienestar de los habitantes. Posteriormente, otros autores co-menzaron a cuestionar que el piB solamente estaría reflejando el crecimiento en la producción, excluyendo otras variables que podrían también estar influenciando el bienestar, tales como el grado de educación y la salud que disfrutan los habi-tantes de un país. A partir de esta propuesta se construye el índice de desarrollo humano (iDh), que contempla tres componentes para medir el bienestar: piB, edu-cación y salud. En los últimos años, ha surgido la estatura como una variable que refleja con bastante exactitud el estándar de vida que disfruta una población. La estatura humana depende, por supuesto, de factores genéticos. Pero el potencial de crecimiento está condicionado por el efecto neto de, por un lado, la nutrición, y, por otro, las enfermedades y el esfuerzo físico (por ejemplo, en el trabajo). En consecuencia, los aumentos de estatura en el tiempo son un buen indicador del bienestar de las personas

N plus 2 Supersonic Concept Development and Systems Integration

Supersonic airplanes for two generations into the future (N+2, 2020-2025 EIS) were designed: the 100 passenger 765-072B, and the 30 passenger 765-076E. Both achieve a trans-Atlantic range of about 4000nm. The larger 765-072B meets fuel burn and emissions goals forecast for the 2025 time-frame, and the smaller 765-076E improves the boom and confidence in utilization that accompanies lower seat count. The boom level of both airplanes was reduced until balanced with performance. The final configuration product is two "realistic", non-proprietary future airplane designs, described in sufficient detail for subsequent multi-disciplinary design and optimization, with emphasis on the smaller 765-076E because of its lower boom characteristics. In addition IGES CAD files of the OML lofts of the two example configurations, a non-proprietary parametric engine model, and a first-cycle Finite Element Model are also provided for use in future multi-disciplinary analysis, optimization, and technology evaluation studies