A Robust Compositional Architecture for Autonomous Systems

Space exploration applications can benefit greatly from autonomous systems. Great distances, limited communications and high costs make direct operations impossible while mandating operations reliability and efficiency beyond what traditional commanding can provide. Autonomous systems can improve reliability and enhance spacecraft capability significantly. However, there is reluctance to utilizing autonomous systems. In part this is due to general hesitation about new technologies, but a more tangible concern is that of reliability of predictability of autonomous software. In this paper, we describe ongoing work aimed at increasing robustness and predictability of autonomous software, with the ultimate goal of building trust in such systems. The work combines state-of-the-art technologies and capabilities in autonomous systems with advanced validation and synthesis techniques. The focus of this paper is on the autonomous system architecture that has been defined, and on how it enables the application of validation techniques for resulting autonomous systems

Enhanced ozone loss by active inorganic bromine chemistry in the tropical troposphere

Abstract Bromine chemistry, particularly in the tropics, has been suggested to play an important role in tropospheric ozone loss (Theys et al., 2011) although a lack of measurements of active bromine species impedes a quantitative understanding of its impacts. Recent modelling and measurements of bromine monoxide (BrO) by Wang et al. (2015) have shown current models under predict BrO concentrations over the Pacific Ocean and allude to a missing source of BrO. Here, we present the first simultaneous aircraft measurements of atmospheric bromine monoxide, BrO (a radical that along with atomic Br catalytically destroys ozone) and the inorganic Br precursor compounds HOBr, BrCl and Br2 over the Western Pacific Ocean from 0.5 to 7 km. The presence of 0.17-€“1.64 pptv BrO and 3.6-8 pptv total inorganic Br from these four species throughout the troposphere causes 10-20% of total ozone loss, and confirms the importance of bromine chemistry in the tropical troposphere; contributing to a 6 ppb decrease in ozone levels due to halogen chemistry. Observations are compared with a global chemical transport model and find that the observed high levels of BrO, BrCl and HOBr can be reconciled by active multiphase oxidation of halide (Br- and Cl-ˆ’) by HOBr and ozone in cloud droplets and aerosols. Measurements indicate that 99% of the instantaneous free Br in the troposphere up to 8 km originates from inorganic halogen photolysis rather than from photolysis of organobromine species

Safetxt: a safer sex intervention delivered by mobile phone messaging on sexually transmitted infections (STI) among young people in the UK - protocol for a randomised controlled trial.

INTRODUCTION: Young people aged 16 to 24 have the highest prevalence of genital chlamydia and gonorrhoea compared with other age groups and re-infection rates following treatment are high. Long-term adverse health effects include subfertility and ectopic pregnancy, particularly among those with repeated infections. We developed the safetxt intervention delivered by text message to reduce sexually transmitted infection (STI) by increasing partner notification, condom use and (STI) testing among young people in the UK. METHODS AND ANALYSIS: A single-blind randomised trial to reliably establish the effect of the safetxt intervention on chlamydia and gonorrhoea infection at 1 year. We will recruit 6250 people aged 16 to 24 years who have recently been diagnosed with chlamydia, gonorrhoea or non-specific urethritis from health services in the UK. Participants will be allocated to receive the safetxt intervention (text messages designed to promote safer sexual health behaviours) or to receive the control text messages (monthly messages asking participants about changes in contact details) by an automated remote online randomisation system. The primary outcome will be the cumulative incidence of chlamydia and gonorrhoea infection at 1 year assessed by nucleic acid amplification tests. Secondary outcomes include partner notification, correct treatment of infection, condom use and STI testing prior to sex with new partners. ETHICS AND DISSEMINATION: Ethics approval was obtained from NHS Health Research Authority - London - Riverside Research Ethics Committee (REC reference: 15/LO/1665) and the London School of Hygiene & Tropical Medicine. We will submit the results of the trial for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: International Standard Randomised Controlled Trials Number: ISRCTN64390461. Registered on 17th March 2016. WHO trial registration data set available at: http://apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN64390461. TRIAL PROTOCOL VERSION: 12, 19th July 2018

Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial

BACKGROUND: There is a large treatment gap with few community services for people with schizophrenia in low income countries largely due to the shortage of specialist mental healthcare human resources. Community based rehabilitation (CBR), involving lay health workers, has been shown to be feasible, acceptable and more effective than routine care for people with schizophrenia in observational studies. The aim of this study is to evaluate whether a lay health worker led, Collaborative Community Based Care (CCBC) intervention, combined with usual Facility Based Care (FBC), is superior to FBC alone in improving outcomes for people with schizophrenia and their caregivers in India. METHODS/DESIGN: This trial is a multi-site, parallel group randomised controlled trial design in India.The trial will be conducted concurrently at three sites in India where persons with schizophrenia will be screened for eligibility and recruited after providing informed consent. Trial participants will be randomly allocated in a 2:1 ratio to the CCBC+FBC and FBC arms respectively using an allocation sequence pre-prepared through the use of permuted blocks, stratified within site. The structured CCBC intervention will be delivered by trained lay community health workers (CHWs) working together with the treating Psychiatrist. We aim to recruit 282 persons with schizophrenia. The primary outcomes are reduction in severity of symptoms of schizophrenia and disability at 12 months. The study will be conducted according to good ethical practice, data analysis and reporting guidelines. DISCUSSION: If the additional CCBC intervention delivered by front line CHWs is demonstrated to be effective and cost-effective in comparison to usually available care, this intervention can be scaled up to expand coverage and improve outcomes for persons with schizophrenia and their caregivers in low income countries. TRIAL REGISTRATION: The trial is registered with the International Society for the Registration of Clinical Trials and the allocated unique ID number is ISRCTN 56877013

Effectiveness of a behavioural intervention delivered by text messages (safetxt) on sexually transmitted reinfections in people aged 16-24 years: randomised controlled trial.

OBJECTIVE: To quantify the effects of a series of text messages (safetxt) delivered in the community on incidence of chlamydia and gonorrhoea reinfection at one year in people aged 16-24 years. DESIGN: Parallel group randomised controlled trial. SETTING: 92 sexual health clinics in the United Kingdom. PARTICIPANTS: People aged 16-24 years with a diagnosis of, or treatment for, chlamydia, gonorrhoea, or non-specific urethritis in the past two weeks who owned a mobile phone. INTERVENTIONS: 3123 participants assigned to the safetxt intervention received a series of text messages to improve sex behaviours: four texts daily for days 1-3, one or two daily for days 4-28, two or three weekly for month 2, and 2-5 monthly for months 3-12. 3125 control participants received a monthly text message for one year asking for any change to postal or email address. It was hypothesised that safetxt would reduce the risk of chlamydia and gonorrhoea reinfection at one year by improving three key safer sex behaviours: partner notification at one month, condom use, and sexually transmitted infection testing before unprotected sex with a new partner. Care providers and outcome assessors were blind to allocation. MAIN OUTCOME MEASURES: The primary outcome was the cumulative incidence of chlamydia or gonorrhoea reinfection at one year, assessed by nucleic acid amplification tests. Safety outcomes were self-reported road traffic incidents and partner violence. All analyses were by intention to treat. RESULTS: 6248 of 20 476 people assessed for eligibility between 1 April 2016 and 23 November 2018 were randomised. Primary outcome data were available for 4675/6248 (74.8%). At one year, the cumulative incidence of chlamydia or gonorrhoea reinfection was 22.2% (693/3123) in the safetxt arm versus 20.3% (633/3125) in the control arm (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). The number needed to harm was 64 (95% confidence interval number needed to benefit 334 to ∞ to number needed to harm 24) The risk of road traffic incidents and partner violence was similar between the groups. CONCLUSIONS: The safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years. More reinfections occurred in the safetxt group. The results highlight the need for rigorous evaluation of health communication interventions. TRIAL REGISTRATION: ISRCTN registry ISRCTN64390461. CORRECTION: The first two points of the what this study adds in the box should read: The safetxt intervention using a mobile phone and targeting safer sex behaviours did not reduce the incidence of chlamydia or gonorrhoea at one year; more infections occurred in the intervention group. Safetex increased some self-reported measures of sexual health, such as self-efficacy in condom use and condom use in itself

Behavioural intervention to reduce sexually transmitted infections in people aged 16–24 years in the UK: the safetxt RCT

BACKGROUND: The prevalence of genital chlamydia and gonorrhoea is higher in the 16–24 years age group than those in other age group. With users, we developed the theory-based safetxt intervention to reduce sexually transmitted infections. OBJECTIVES: To establish the effect of the safetxt intervention on the incidence of chlamydia/gonorrhoea infection at 1 year. DESIGN: A parallel-group, individual-level, randomised superiority trial in which care providers and outcome assessors were blinded to allocation. SETTING: Recruitment was from 92 UK sexual health clinics. PARTICIPANTS: Inclusion criteria were a positive chlamydia or gonorrhoea test result, diagnosis of non-specific urethritis or treatment started for chlamydia/gonorrhoea/non-specific urethritis in the last 2 weeks; owning a personal mobile phone; and being aged 16–24 years. ALLOCATION: Remote computer-based randomisation with an automated link to the messaging system delivering intervention or control group messages. INTERVENTION: The safetxt intervention was designed to reduce sexually transmitted infection by increasing partner notification, condom use and sexually transmitted infection testing before sex with new partners. It employed educational, enabling and incentivising content delivered by 42–79 text messages over 1 year, tailored according to type of infection, gender and sexuality. COMPARATOR: A monthly message regarding trial participation. Main outcomes: The primary outcome was the incidence of chlamydia and gonorrhoea infection at 12 months, assessed using nucleic acid amplification tests. Secondary outcomes at 1 and 12 months included self-reported partner notification, condom use and sexually transmitted infection testing prior to sex with new partner(s). RESULTS: Between 1 April 2016 and 23 November 2018, we assessed 20,476 people for eligibility and consented and randomised 6248 participants, allocating 3123 to the safetxt intervention and 3125 to the control. Primary outcome data were available for 4675 (74.8%) participants. The incidence of chlamydia/gonorrhoea infection was 22.2% (693/3123) in the intervention group and 20.3% (633/3125) in the control group (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). There was no evidence of heterogeneity in any of the prespecified subgroups. Partner notification was 85.6% in the intervention group and 84.0% in the control group (odds ratio 1.14, 95% confidence interval 0.99 to 1.33). At 12 months, condom use at last sex was 33.8% in the intervention group and 31.2% in the control group (odds ratio 1.14, 95% confidence interval 1.01 to 1.28) and condom use at first sex with most recent new partner was 54.4% in the intervention group and 48.7% in the control group (odds ratio 1.27, 95% confidence interval 1.11 to 1.45). Testing before sex with a new partner was 39.5% in the intervention group and 40.9% in the control group (odds ratio 0.95, 95% confidence interval 0.82 to 1.10). Having two or more partners since joining the trial was 56.9% in the intervention group and 54.8% in the control group (odds ratio 1.11, 95% confidence interval 1.00 to 1.24) and having sex with someone new since joining the trial was 69.7% in the intervention group and 67.4% in the control group (odds ratio 1.13, 95% confidence interval 1.00 to 1.28). There were no differences in safety outcomes. Additional sensitivity and per-protocol analyses showed similar results. LIMITATIONS: Our understanding of the mechanism of action for the unanticipated effects is limited. CONCLUSIONS: The safetxt intervention did not reduce chlamydia and gonorrhoea infections, with slightly more infections in the intervention group. The intervention increased condom use but also increased the number of partners and new partners. Randomised controlled trials are essential for evaluating health communication interventions, which can have unanticipated effects

Archaeological investigations along the Ruby Pipeline.

405 pages : illustrations (some color), maps ; 26 cm.The Ruby Pipeline originates in Opal, Wyoming, travels westward across Utah and Nevada, and terminates in Malin, Oregon. Almost 360 miles of the line is in Nevada, where it crosses through some of the most remote, sparsely populated land in the lower 48 states. Despite the remote nature of this corridor, it has produced a rich archaeological record reflecting a dynamic history of land-use pattern changes over a period of at least 13,000 years. Archaeological excavations were conducted at 578 prehistoric sites prior to construction of the pipeline. The sites were distributed across four ecological regions, including (from west to east): the High Rock Country, Upper Lahontan Basin, Upper Humboldt Plains, and Thousand Springs Valley. First evidence of human occupation dates to the Paleoindian (14,500-12,800 cal b.p.) and Paleoarchaic (12,800-7800 cal b.p.) periods, when people spent most of their time in the High Rock Country where important economic resources reached their highest densities. Paleoindian findings are limited to a series of Great Basin Concave Base projectile points and small obsidian flaked stone concentrations. Paleoarchaic sites are much more common, and tend to be represented by Great Basin Stemmed projectile points, bifaces, and a limited number of other flaked stone tools. Most of these assemblages reflect small groups of hunters refurbishing their tool kits as they traveled through the area. An important exception to this pattern was found at Five Mile Flat along the west end of pluvial Lake Parman where two significant habitation sites dating to 11,180 cal b.p. were discovered. One of these sites includes a house floor, which is the oldest ever found in the Great Basin. Despite the warm-dry conditions that characterized much of the middle Holocene, it appears that human populations nearly doubled during the Post-Mazama Period (7800-5700 cal b.p.). Most activity remained concentrated in the High Rock Country, but evidence for occupation begins to trickle out into the Upper Lahontan Basin and Upper Humboldt Plains regions as well. Most of the artifact assemblages remain rather narrow, often composed of Northern Side-notched and Humboldt Concave Base points, bifaces, and debitage, and reflect use of the region by mobile groups of hunters. Major changes took place with the arrival of the Early Archaic (5700-3800 cal b.p.) and continued forward into the Middle Archaic Period (3800-1300 cal b.p.). Early Archaic projectile points are largely represented by Humboldt and Gatecliff forms. It appears that population densities increased almost fourfold from the preceding interval, and all four regions experienced significant occupation for the first time. Simultaneous to this population increase and dispersal, a full complement of site types began to emerge, with large-scale residential areas becoming significant for the first time. This trend continued forward into the Middle Archaic Period where the relative frequency of residential sites almost doubled compared with the Early Archaic interval. Plant macrofossil and archaeofaunal assemblages also become more abundant and diversified at this time, probably marking a broadening of the diet breadth. This general trajectory extends into the Late Archaic (1300-600 cal b.p.) and Terminal Prehistoric periods, as people continued to expand into a wider range of habitats. This was particularly case for the latter interval, as the habitat preferences that made sense for over 12,000 years were upended, with population densities highest in the Upper Humboldt Plains and Thousand Springs Valley. This reorientation corresponds to the arrival of Numic speaking populations, especially the Western Shoshone who appear to have reached northern Nevada much earlier than the Northern Paiute, and is probably linked to a greater emphasis on small-seeded plants that are abundantly present in their territory. Although low ranked compared to many other foods, with the proper technology and work organization, small seeds could support higher population densities than was the case earlier in time. Finally, the discovery of obsidian in multiple Terminal Prehistoric sites from sources located much further away than any other time in the past may signal the earliest use of horses in northern Nevada

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Variation in neurosurgical management of traumatic brain injury: A survey in 68 centers participating in the CENTER-TBI study

Background Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care