Neuropsychological and functional outcomes in recent-onset major depression, bipolar disorder and schizophrenia-spectrum disorders: a longitudinal cohort study

Functional disability is the lead contributor to burden of mental illness. Cognitive deficits frequently limit functional recovery, although whether changes in cognition and disability are longitudinally associated in recent-onset individuals remains unclear. Using a prospective, cohort design, 311 patients were recruited and assessed at baseline. One hundred and sixty-seven patients met eligibility criteria (M = 21.5 years old, s.d. = 4.8) and returned for follow-up (M = 20.6 months later, s.d. = 7.8). Two-hundred and thirty participants were included in the final analysis, comprising clinically stable patients with major depression (n = 71), bipolar disorder (BD; n = 61), schizophrenia-spectrum disorders (n = 35) and 63 healthy controls. Neuropsychological functioning and self-rated functional disability were examined using mixed-design, repeated-measures analysis, across diagnoses and cognitive clusters, covarying for relevant confounds. Clinical, neuropsychological and functional changes did not differ between diagnoses (all P40.05). Three reliable neuropsychological subgroups emerged through cluster analysis, characterized by psychomotor slowing, improved sustained attention, and improved verbal memory. Controlling for diagnosis and changes in residual symptoms, clusters with improved neuropsychological functioning observed greater reductions in functional disability than the psychomotor slowing cluster, which instead demonstrated a worsening in disability (Po0.01). Improved sustained attention was independently associated with greater likelihood of follow-up employment (Po0.01). Diagnosis of BD uniquely predicted both follow-up employment and independent living. Neuropsychological course appears to be independently predictive of subjective and objective functional outcomes. Importantly, cognitive phenotypes may reflect distinct pathophysiologies shared across major psychiatric conditions, and be ideal targets for personalized early intervention

Using a Parallel Ensemble of Sequence-Based Selection Hyper-Heuristics for Electric Bus Scheduling

This is the author accepted manuscript. The final version is available from ACM via the DOI in this recordA Sequence-based Selection Hyper-Heuristic (SSHH) utilises a hidden Markov model (HMM) to generate sequences of low-level heuristics to apply to a given problem. The HMM represents learnt probabilistic relationships in transitioning from one heuristic to the next for generating good sequences. However, a single HMM will only represent one learnt behaviour pattern which may not be ideal. Furthermore, using a single HMM to generate sequences is sequential in manner but most processors are parallel in nature. Consequently, this paper proposes that the effectiveness and speed of SSHH can be improved by using multiple SSHH, an ensemble. These will be able to operate in parallel exploiting multi-core processor resources facilitating faster optimisation. Two methods of parallel ensemble SSHH are investigated, sharing the best found solution amongst SSHH instantiations or combining HMM information between SSHH models. The effectiveness of the methods are assessed using a real-world electric bus scheduling optimisation problem. Sharing best found solutions between ensembles of SSHH models that have differing sequence behaviours significantly improved upon sequential SSHH results with much lower run-times.Innovate UKCity Scienc

An Adaptive Sequence-Based Selection Hyper-Heuristic for Application to Electric Bus Scheduling

This is the author accepted manuscript. The final version is available from ACM via the DOI in this recordBuses are important for public transportation and beneficial for the environment. However, diesel buses are significant polluters emitting greenhouse gases and particulates. Consequently, with the advent of electric vehicles there has been a drive to transition to electric buses. Key to this transition is to optimise electric bus fleets to reduce distance travelled whilst maintaining service levels. This is complex due to the added constraint of the limited range of electric buses. This paper considers the use of a Sequence-based Selection Hyper Heuristic (SSHH) method to solve this problem. Moreover, an adaptive SSHH (A-SSHH) technique is introduced which significantly improves upon SSHH. Indeed, bus fleet non-service distances and sizes are reduced by as much as 10% using A-SSHH over SSHH. Comparing with an optimised diesel bus fleet electric buses reduce carbon dioxide emissions by over 60% and importantly for fleet operators, energy costs are similarly reduced.Innovate UKCity Scienc

The Black River: a comprehensive study of physical and chemical characteristics and their potential management implications.

An analysis of the Black River's biological and physicochemical characteristics was conducted for comparison to the model proposed by the river continuum theory. The theory specifies that the biological fauna, physical characteristics and chemical composition observed, are reflected in river order changes in terms of the presence, absence, or density of producer and consumer communities. The study reflected consistencies between the model and observed physical parameters and chemical attributes, but biological indicators were less corroborating. Physical characteristics such as temperature, depth, width, velocity, discharge, and suspended sediments increased with river mile and trends in the data became apparent. Chemical factors such as nitrates, dissolved oxygen, pH, alkalinity, and hardness, though not as clearly conclusive, show a gradient associated with river order transition. Biological indicators were not as conclusive in supporting the river continuum theory since there was no representation of shredders in the headwaters and predatory species were found at most sites. Management issues of the Black River address the control of soil erosion, species composition, and sedimentation as well as maintaining water temperature.http://deepblue.lib.umich.edu/bitstream/2027.42/54342/1/2778.pd

COVID-19 Clinical Research.

Introduction:While the global COVID-19 pandemic has challenged the entire humanity and health systems, it also triggered researchers to urgently perform clinical trials to assess the safety and efficacy of many agents and modalities to combat COVID-19. As of April 22, over 650 clinical studies have been registered both in USA and internationally. Results from these studies are also coming at a brisk pace in this unprecedented emergency. Areas covered:We searched the NCI website and Medline and summarize various national and international clinical trials and summarize few of the pivotal ones in this paper, including those specific to oncology population. Two hundred and eighty four studies are actively recruiting adults and children with confirmed COVID-19, including 25 are early-phase I/phase I, 72 phase II, 58 phase III, 12 phase IV, and 31 other trials. They can be categorized into four groups: drugs that combat SARS-CoV-2, immunomodulatory agents to counteract cytokine storm, convalescence plasma therapies and vaccines trials. Expert opinion:It is hoped that these efforts will results in a successful treatment to COVID-19, especially in a timely fashion before the second pandemic expected in fall. It is essential to acknowledge the devotion and hard work of the clinical research team and clinical research volunteers

Excavations and the afterlife of a professional football stadium, Peel Park, Accrington, Lancashire: towards an archaeology of football

Association football is now a multi-billion dollar global industry whose emergence spans the post-medieval to the modern world. With its professional roots in late 19th-century industrial Lancashire, stadiums built for the professionalization of football first appear in frequency in the North of England. While many historians of sport focus on consumerism and ‘topophilia’ (attachment to place) regarding these local football grounds, archaeological research that has been conducted on the spectator experience suggests status differentiation within them. Our excavations at Peel Park confirm this impression while also showing a significant afterlife to this stadium, particularly through children’s play

Emotional Processing, P50 Sensory Gating, and Social Functioning in Bipolar Disorder

Emotional processing has been reported to effect sensory gating as measured by the event-related potential known as P50. Because both P50 and emotional processing are dysfunctional in bipolar disorder (BD), we sought to investigate the impact that concurrent emotional processing has on sensory gating in this psychiatric population. P50 was recorded using a pairedclick paradigm. Peak-to-peak amplitudes for stimulus 1 (S1) and stimulus 2 (S2) were acquired during the presentation of disgust and neutral faces to young adults with BD (n = 19) and controls (n = 20). Social functioning and quality-of-life selfreported measures were also obtained. The BD group had significantly larger P50 amplitudes elicited by the S2-disgust response compared with controls, but no significant difference in overall P50 sensory gating was found between the groups. There were also no differences between groups in S1-disgust or in either of the neutral P50 amplitudes. The BD group showed significant associations between sensory gating to disgust and measures of social functioning. Importantly, BD showed impaired filtering of auditory information when paired with an emotionally salient image. Thus, it appears that patients with the greatest impairment in sensory gating also have the most difficulty engaging in social situations

The Chagos Islands cases: the empire strikes back

Good governance requires the accommodation of multiple interests in the cause of decision making. However, undue regard for particular sectional interests can take their toll upon public faith in government administration. Historically, broad conceptions of the good of the commonwealth were employed to outweigh the interests of groups that resisted colonisation. In the decision making of the British Empire, the standard approach for justifying the marginalisation of the interests of colonised groups was that they were uncivilised and that particular hardships were the price to be paid for bringing to them the imperial dividend of industrial society. It is widely assumed that with the dismantling of the British Empire, such impulses and their accompanying jurisprudence became a thing of the past. Even as decolonisation proceeded apace after the Second World War, however, the United Kingdom maintained control of strategically important islands with a view towards sustaining its global role. In an infamous example from this twilight period of empire, in the 1960s imperial interests were used to justify the expulsion of the Chagos islanders from the British Indian Ocean Territory (BIOT). Into the twenty-first century, this forced elision of the UK’s interests with the imperial “common good” continues to take centre stage in courtroom battles over the islanders’ rights, being cited before domestic and international tribunals in order to maintain the Chagossians’ exclusion from their homeland. This article considers the new jurisprudence of imperialism which has emerged in a string of decisions which have continued to marginalise the Chagossians’ interests

Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down's syndrome into NHS maternity care: prospective cohort study in eight diverse maternity units.

OBJECTIVE:  To investigate the benefits and costs of implementing non-invasive prenatal testing (NIPT) for Down's syndrome into the NHS maternity care pathway. DESIGN:  Prospective cohort study. SETTING:  Eight maternity units across the United Kingdom between 1 November 2013 and 28 February 2015. PARTICIPANTS:  All pregnant women with a current Down's syndrome risk on screening of at least 1/1000. MAIN OUTCOME MEASURES:  Outcomes were uptake of NIPT, number of cases of Down's syndrome detected, invasive tests performed, and miscarriages avoided. Pregnancy outcomes and costs associated with implementation of NIPT, compared with current screening, were determined using study data on NIPT uptake and invasive testing in combination with national datasets. RESULTS:  NIPT was prospectively offered to 3175 pregnant women. In 934 women with a Down's syndrome risk greater than 1/150, 695 (74.4%) chose NIPT, 166 (17.8%) chose invasive testing, and 73 (7.8%) declined further testing. Of 2241 women with risks between 1/151 and 1/1000, 1799 (80.3%) chose NIPT. Of 71 pregnancies with a confirmed diagnosis of Down's syndrome, 13/42 (31%) with the diagnosis after NIPT and 2/29 (7%) after direct invasive testing continued, resulting in 12 live births. In an annual screening population of 698 500, offering NIPT as a contingent test to women with a Down's syndrome screening risk of at least 1/150 would increase detection by 195 (95% uncertainty interval -34 to 480) cases with 3368 (2279 to 4027) fewer invasive tests and 17 (7 to 30) fewer procedure related miscarriages, for a non-significant difference in total costs (£-46 000, £-1 802 000 to £2 661 000). The marginal cost of NIPT testing strategies versus current screening is very sensitive to NIPT costs; at a screening threshold of 1/150, NIPT would be cheaper than current screening if it cost less than £256. Lowering the risk threshold increases the number of Down's syndrome cases detected and overall costs, while maintaining the reduction in invasive tests and procedure related miscarriages. CONCLUSIONS:  Implementation of NIPT as a contingent test within a public sector Down's syndrome screening programme can improve quality of care, choices for women, and overall performance within the current budget. As some women use NIPT for information only, the Down's syndrome live birth rate may not change significantly. Future research should consider NIPT uptake and informed decision making outside of a research setting

A sociologist teaches history: some epistemological and pedagogical reflections

This article discusses the concept of ‘historical sociology’ in relation to the teaching of a module on an undergraduate degree in Education Studies at a university in the United Kingdom. The module examines the history of education policy in England from 1870 until the present day. Drawing upon comparisons with Social Foundations of Education programs in the United States, I examine some key epistemological and pedagogical issues raised by the inter-disciplinary approach to teaching and learning followed within the module in which we combine historical and sociological perspectives as a means to understand the evolution of the English education system. In particular, using Bernstein’s concept of the pedagogic device as an analytical framework, I consider the epistemological congruence of sociology and history as the contributory disciplines of the undergraduate module. From a discussion of the concept of historical sociology, I conclude that although sociology and history are distinct subjects, they share a large amount of analytical ground which thus facilitates the inter-disciplinary approach pursued within the module. Following that, I examine some pedagogical issues that have arisen in my experience of teaching upon the module and I discuss how I have addressed these. I conclude the article by making comparisons to relevant examples from pedagogical practices in Social Foundations of Education programs in the United States