30,012 research outputs found
Impact of large-scale dynamic versus thermodynamic climate conditions on contrasting tropical cyclone genesis frequency
Significant advances have been made in understanding the key climate factors responsible for tropical cyclone (TC) activity, yet any theory that estimates likelihood of observed TC formation rates from mean climate states remains elusive. The present study investigates how the extremes of observed TC genesis (TCG) frequency during peak TC seasons are interrelated with distinct changes in the large-scale climate conditions over different ocean basins using the global International Best Track Archive for Climate Stewardship (IBTrACS) dataset and ERA-Interim for the period 1979–2014. Peak TC seasons with significantly high and low TCG frequency are identified for five major ocean basins, and their substantial spatial changes in TCG are noted with regionally distinct differences. To explore the possible climate link behind such changes, a suite of potentially relevant dynamic and thermodynamic climate conditions is analyzed. Results indicate that the observed changes in extreme TCG frequency are closely linked with distinct dominance of specific dynamic and thermodynamic climate conditions over different regions. While the combined influences of dynamic and thermodynamic climate conditions are found to be necessary for modulating TC formation rate over the North Atlantic, eastern Pacific, and southern Indian Oceans, significant changes in large-scale dynamic conditions appear to solely control the TCG frequency over the western Pacific and South Pacific basins. Estimation of the fractional changes in genesis-weighted climate conditions also indicates the coherent but distinct competing effects of different climate conditions on TCG frequency. The present study further points out the need for revising the existing genesis indices for estimating TCG frequency over individual basins
Suppressing sensorimotor activity modulates the discrimination of auditory emotions but not speaker identity
Our ability to recognize the emotions of others is a crucial feature of human social cognition. Functional neuroimaging studies indicate that activity in sensorimotor cortices is evoked during the perception of emotion. In the visual domain, right somatosensory cortex activity has been shown to be critical for facial emotion recognition. However, the importance of sensorimotor representations in modalities outside of vision remains unknown. Here we use continuous theta-burst transcranial magnetic stimulation (cTBS) to investigate whether neural activity in the right postcentral gyrus (rPoG) and right lateral premotor cortex (rPM) is involved in nonverbal auditory emotion recognition. Three groups of participants completed same-different tasks on auditory stimuli, discriminating between the emotion expressed and the speakers' identities, before and following cTBS targeted at rPoG, rPM, or the vertex (control site). A task-selective deficit in auditory emotion discrimination was observed. Stimulation to rPoG and rPM resulted in a disruption of participants' abilities to discriminate emotion, but not identity, from vocal signals. These findings suggest that sensorimotor activity may be a modality-independent mechanism which aids emotion discrimination. Copyright © 2010 the authors
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Effective patient–clinician interaction to improve treatment outcomes for patients with psychosis: a mixed-methods design
BACKGROUND:At least 100,000 patients with schizophrenia receive care from community mental health teams (CMHTs) in England. These patients have regular meetings with clinicians, who assess them, engage them in treatment and co-ordinate care. As these routine meetings are not commonly guided by research evidence, a new intervention, DIALOG, was previously designed to structure consultations. Using a hand-held computer, clinicians asked patients to rate their satisfaction with eight life domains and three treatment aspects, and to indicate whether or not additional help was needed in each area, with responses being graphically displayed and compared with previous ratings. In a European multicentre trial, the intervention improved patients’ quality of life over a 1-year period. The current programme builds on this research by further developing DIALOG in the UK. RESEARCH QUESTIONS:(1) How can the practical procedure of the intervention be improved, including the software used and the design of the user interface? (2) How can elements of resource-oriented interventions be incorporated into a clinician manual and training programme for a new, more extensive ‘DIALOG+’ intervention? (3) How effective and cost-effective is the new DIALOG+ intervention in improving treatment outcomes for patients with schizophrenia or a related disorder? (4) What are the views of patients and clinicians regarding the new DIALOG+ intervention? METHODS:We produced new software on a tablet computer for CMHTs in the NHS, informed by analysis of videos of DIALOG sessions from the original trial and six focus groups with 18 patients with psychosis. We developed the new ‘DIALOG+’ intervention in consultation with experts, incorporating principles of solution-focused therapy when responding to patients’ ratings and specifying the procedure in a manual and training programme for clinicians. We conducted an exploratory cluster randomised controlled trial with 49 clinicians and 179 patients with psychosis in East London NHS Foundation Trust, comparing DIALOG+ with an active control. Clinicians working as care co-ordinators in CMHTs (along with their patients) were cluster randomised 1 : 1 to either DIALOG+ or treatment as usual plus an active control, to prevent contamination. Intervention and control were to be administered monthly for 6 months, with data collected at baseline and at 3, 6 and 12 months following randomisation. The primary outcome was subjective quality of life as measured on the Manchester Short Assessment of Quality of Life; secondary outcomes were also measured. We also established the cost-effectiveness of the DIALOG intervention using data from the Client Service Receipt Inventory, which records patients’ retrospective reports of using health- and social-care services, including hospital services, outpatient services and medication, in the 3 months prior to each time point. Data were supplemented by the clinical notes in patients’ medical records to improve accuracy. We conducted an exploratory thematic analysis of 16 video-recorded DIALOG+ sessions and measured adherence in these videos using a specially developed adherence scale. We conducted focus groups with patients (n = 19) and clinicians (n = 19) about their experiences of the intervention, and conducted thematic analyses. We disseminated the findings and made the application (app), manual and training freely available, as well as producing a protocol for a definitive trial. RESULTS:Patients receiving the new intervention showed more favourable quality of life in the DIALOG+ group after 3 months (effect size: Cohen’s d = 0.34), after 6 months (Cohen’s d = 0.29) and after 12 months (Cohen’s d = 0.34). An analysis of video-recorded DIALOG+ sessions showed inconsistent implementation, with adherence to the intervention being a little over half of the possible score. Patients and clinicians from the DIALOG+ arm of the trial reported many positive experiences with the intervention, including better self-expression and improved efficiency of meetings. Difficulties reported with the intervention were addressed by further refining the DIALOG+ manual and training. Cost-effectiveness analyses found a 72% likelihood that the intervention both improved outcomes and saved costs. LIMITATIONS:The research was conducted solely in urban east London, meaning that the results may not be broadly generalisable to other settings. CONCLUSIONS:(1) Although services might consider adopting DIALOG+ based on the existing evidence, a definitive trial appears warranted; (2) applying DIALOG+ to patient groups with other mental disorders may be considered, and to groups with physical health problems; (3) a more flexible use with variable intervals might help to make the intervention even more acceptable and effective; (4) more process evaluation is required to identify what mechanisms precisely are involved in the improvements seen in the intervention group in the trial; and (5) what appears to make DIALOG+ effective is that it is not a separate treatment and not a technology that is administered by a specialist; rather, it changes and utilises the existing therapeutic relationship between patients and clinicians in CMHTs to initiate positive change, helping the patients to improve their quality of life. FUTURE RESEARCH:Future studies should include a definitive trial on DIALOG+ and test the effectiveness of the intervention with other populations, such as people with depression. TRIAL REGISTRATION:Current Controlled Trials ISRCTN34757603. FUNDING:The National Institute for Health Research Programme Grants for Applied Research programme
High mass star formation in the infrared dark cloud G11.11-0.12
We report detection of moderate to high-mass star formation in an infrared
dark cloud (G11.11-0.12) where we discovered class II methanol and water maser
emissions at 6.7 GHz and 22.2 GHz, respectively. We also observed the object in
ammonia inversion transitions. Strong emission from the (3,3) line indicates a
hot (~60 K) compact component associated with the maser emission. The line
width of the hot component (4 km/s), as well as the methanol maser detection,
are indicative of high mass star formation. To further constrain the physical
parameters of the source, we derived the spectral energy distribution (SED) of
the dust continuum by analysing data from the 2MASS survey, HIRAS, MSX, the
Spitzer Space Telescope, and interferometric 3mm observations. The SED was
modelled in a radiative transfer program: a) the stellar luminosity equals 1200
L_sun corresponding to a ZAMS star of 8 M_sun; b) the bulk of the envelope has
a temperature of 19 K; c) the mass of the remnant protostellar cloud in an area
8x10^17 cm or 15 arcsec across amounts to 500M_sun, if assuming standard dust
of the diffuse medium, and to about 60 M_sun, should the grains be fluffy and
have ice mantles; d) the corresponding visual extinction towards the star is a
few hundred magnitudes. The near IR data can be explained by scattering from
tenuous material above a hypothetical disk. The class II methanol maser lines
are spread out in velocity over 11 km/s. To explain the kinematics of the
masing spots, we propose that they are located in a Kepler disk at a distance
of about 250 AU. The dust temperatures there are around 150 K, high enough to
evaporate methanol--containing ice mantles.Comment: 10 pages, 6 figures, Accepted for publication in Astronomy &
Astrophysics Journa
Prevalence and Factors Associated with Potential Drug-Drug Interactions in Older Community-Dwelling Adults: A Prospective Cohort Study
Background: Older patients are at increased risk of drug-drug interactions (DDIs) due to polypharmacy. Cardiovascular and central nervous system (CNS) drugs are commonly implicated in serious DDIs. Objectives: This study aimed to determine the prevalence and factors associated with potential ‘severe’ cardiovascular and CNS DDIs among older (≥ 70 years) community-dwellers. Methods: This was a prospective cohort study using linked data from a national pharmacy claims database and waves 1 and 2 of The Irish LongituDinal study on Ageing (TILDA). ‘Severe’ cardiovascular and CNS DDIs were identified using the British National Formulary 77 and Stockley’s Drug Interactions. The prevalence of ‘severe’ DDIs (any DDI vs. none) was calculated. Logistic regression was used to examine the association between sociodemographic, functional ability, and medication-related factors and the risk of DDI exposure between waves 1 and 2. Results: A total of 1466 patients were included [mean age (standard deviation) = 78 (5.5) years; female n = 795, 54.2%]. In total, 332 community-dwellers aged ≥ 70 years [22.65%, 95% confidence interval (CI) 20.58–24.86] were potentially exposed to at least one ‘severe’ cardiovascular or CNS DDI, with more than half (54.82%) of this cohort dispensed the same DDI for a prolonged time (≥ 3 consecutive claims). Aspirin-warfarin was the most frequently dispensed (co-prescribed) DDI (n = 34, 10.24%, 95% CI 7.39–14.00), followed by atorvastatin-clarithromycin (n = 19, 5.72%, 95% CI 3.64–8.81). Polypharmacy [≥ 10 vs. < 5 drugs, odds ratio (OR) 13.40, 95% CI 8.22–21.85] and depression (depressed vs. not, OR 2.12, 95% CI 1.34–3.34) were significantly associated with these DDIs, after multivariable adjustment. Conclusion: ‘Severe’ cardiovascular and CNS DDIs are prevalent in older community-dwellers in Ireland, and those with polypharmacy and depression are at a significantly increased risk
Space station automation of common module power management and distribution
The purpose is to automate a breadboard level Power Management and Distribution (PMAD) system which possesses many functional characteristics of a specified Space Station power system. The automation system was built upon 20 kHz ac source with redundancy of the power buses. There are two power distribution control units which furnish power to six load centers which in turn enable load circuits based upon a system generated schedule. The progress in building this specified autonomous system is described. Automation of Space Station Module PMAD was accomplished by segmenting the complete task in the following four independent tasks: (1) develop a detailed approach for PMAD automation; (2) define the software and hardware elements of automation; (3) develop the automation system for the PMAD breadboard; and (4) select an appropriate host processing environment
Spectral Energy Distributions of 6.7 GHz methanol masers
The 6.7 GHz maser transition of methanol has been found exclusively towards
massive star forming regions. A majority of the masers have been found to lack
the presence of any associated radio continuum. This could be due to the maser
emission originating prior to the formation of an HII region around the central
star, or from the central object being too cool to produce a HII region. One
way to distinguish between the two scenarios is to determine and model the
spectral energy distributions (SEDs) of the masers. We observed a sample of 20
6.7 GHz methanol masers selected from the blind Arecibo survey, from centimeter
to submillimeter wavelengths. We combined our observations with existing data
from various Galactic plane surveys to determine SEDs from centimeter to
near-infrared wavelengths. We find that 70% of the masers do not have any
associated radio continuum, with the rest of the sources being associated with
hypercompact and ultracompact HII regions. Modeling the SEDs shows them to be
consistent with rapidly accreting massive stars, with accretion rates well
above 10^{-3} M_sun/yr. The upper limits on the radio continuum are also
consistent with any ionized region being confined close to the stellar surface.
This confirms the paradigm of 6.7 GHz methanol masers being signposts of early
phases of massive star formation, mostly prior to the formation of a
hypercompact HII region.Comment: 15 pages, 4 figures; Accepted by A&
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