Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessive-compulsive disorder in young people

Objective: Obsessive-compulsive disorder (OCD) in young people can be effectively treated with Cognitive Behavior Therapy (CBT). Practice guidelines in the United Kingdom recommend that CBT be delivered with parental or family involvement; however, there is no evidence from randomized trials that this enhances effectiveness. The aim of this trial was to assess if CBT with high parental involvement was more effective than CBT with low parental involvement (individual CBT) in reducing symptoms of OCD. Method: Fifty young people ages 12–17 years with OCD were randomly allocated to individual CBT or parent-enhanced CBT. In parent-enhanced CBT parents attended all treatment sessions; in individual CBT, parents attended only Sessions 1, 7, and the final session. Participants received up to 14 sessions of CBT. Data were analyzed using intent-to-treat and per-protocol methods. The primary outcome measure was the Children’s Yale-Brown Obsessive Compulsion Scale (Scahill et al., 1997). Results: Both forms of CBT significantly reduced symptoms of OCD and anxiety. Change in OCD symptoms was maintained at 6 months. Per-protocol analysis suggested that parent-enhanced CBT may be associated with significantly larger reductions in anxiety symptoms. Conclusions: High and low parental involvement in CBT for OCD in young people were both effective, and there was no evidence that 1 method of delivery was superior on the primary outcome measure. However, this study was small. Future trials should be adequately powered and examine interactions with the age of the young person and comorbid anxiety disorders.

Enforcing service level agreements using an economically enhanced resource manager

Traditional resource management has had as its main objective the optimisation of throughput, based on parameters such as CPU, memory, and network bandwidth. With the appearance of Grid Markets, new variables that determine economic expenditure, benefit and opportunity must be taken into account. The SORMA project aims to allow resource owners and consumers to exploit market mechanisms to sell and buy resources across the Grid. SORMA’s motivation is to achieve efficient resource utilisation by maximising revenue for resource providers, and minimising the cost of resource consumption within a market environment. An overriding factor in Grid markets is the need to ensure that desired Quality of Service levels meet the expectations of market participants. This paper explains the proposed use of an Economically Enhanced Resource Manager (EERM) for resource provisioning based on economic models. In particular, this paper describes techniques used by the EERM to support revenue maximisation across multiple Service Level Agreements.

Enforcing service level agreements using an economically enhanced resource manager

Traditional resource management has had as its main objective the optimisation of throughput, based on pa- rameters such as CPU, memory, and network bandwidth. With the appearance of Grid Markets, new variables that determine economic expenditure, benefit and opportunity must be taken into account. The SORMA project aims to allow resource owners and consumers to exploit market mechanisms to sell and buy resources across the Grid. SORMA’s motivation is to achieve efficient resource utilisation by maximising revenue for resource providers, and minimising the cost of resource consumption within a market environment. An overriding factor in Grid markets is the need to ensure that desired Quality of Service levels meet the expectations of market participants. This paper explains the proposed use of an Economically Enhanced Resource Manager (EERM) for resource provisioning based on economic models. In particular, this paper describes techniques used by the EERM to support revenue maximisation across multiple Service Level Agreements.

An enhanced model for small-signal analysis of the phase-shifted full-bridge converter

This paper presents an in-depth critical discussion and derivation of a detailed small-signal analysis of the Phase-Shifted Full-Bridge (PSFB) converter. Circuit parasitics, resonant inductance and transformer turns ratio have all been taken into account in the evaluation of this topology’s open-loop control-to-output, line-to-output and load-to-output transfer functions. Accordingly, the significant impact of losses and resonant inductance on the converter’s transfer functions is highlighted. The enhanced dynamic model proposed in this paper enables the correct design of the converter compensator, including the effect of parasitics on the dynamic behavior of the PSFB converter. Detailed experimental results for a real-life 36V-to-14V/10A PSFB industrial application show excellent agreement with the predictions from the model proposed herein.1

Enhanced three-factor security protocol for consumer USB mass storage devices

The Universal Serial Bus (USB) is an extremely popular interface standard for computer peripheral connections and is widely used in consumer Mass Storage Devices (MSDs). While current consumer USB MSDs provide relatively high transmission speed and are convenient to carry, the use of USB MSDs has been prohibited in many commercial and everyday environments primarily due to security concerns. Security protocols have been previously proposed and a recent approach for the USB MSDs is to utilize multi-factor authentication. This paper proposes significant enhancements to the three-factor control protocol that now makes it secure under many types of attacks including the password guessing attack, the denial-of-service attack, and the replay attack. The proposed solution is presented with a rigorous security analysis and practical computational cost analysis to demonstrate the usefulness of this new security protocol for consumer USB MSDs.

An enhanced fall detection system for elderly person monitoring using consumer home networks

Various fall-detection solutions have been previously proposed to create a reliable surveillance system for elderly people with high requirements on accuracy, sensitivity and specificity. In this paper, an enhanced fall detection system is proposed for elderly person monitoring that is based on smart sensors worn on the body and operating through consumer home networks. With treble thresholds, accidental falls can be detected in the home healthcare environment. By utilizing information gathered from an accelerometer, cardiotachometer and smart sensors, the impacts of falls can be logged and distinguished from normal daily activities. The proposed system has been deployed in a prototype system as detailed in this paper. From a test group of 30 healthy participants, it was found that the proposed fall detection system can achieve a high detection accuracy of 97.5%, while the sensitivity and specificity are 96.8% and 98.1% respectively. Therefore, this system can reliably be developed and deployed into a consumer product for use as an elderly person monitoring device with high accuracy and a low false positive rate.

Preference and consumption of a taste enhanced meat meal by older hospital patients: a pilot study

BACKGROUND: Older hospital patients are considered to be at risk of malnutrition due to insufficient dietary intake. OBJECTIVE: To determine whether taste enhancement, using ingredients naturally high in umami compounds, increases preference and consumption of a meal by older hospital patients. METHODS: 31 patients (65–92 years) on elderly carewards in aUKNHS Trust hospital took part in a single-blinded preference and consumption study. They tasted two meats (control and enhanced, presented in balanced order) and stated their preference. At lunch, control and enhanced cottage pie and gravy were served concurrently; patients were asked to consume ad libitum and intake was measured. RESULTS: Taste enhanced meat was significantly preferred (P = 0.001). Although mean consumption was higher for the enhanced compared to control meal (137 g versus 119 g), with higher levels of energy (103 kcal versus 82 kcal) and protein (4.6 g versus 3.4 g) consumed; differences were not significant. CONCLUSIONS: Natural ingredients rich in umami taste compounds can successfully be used to increase preference of meat based meals by older hospital patients. Larger trials are needed to determine whether such increases in preference can significantly increase consumption.

Enhanced affective brain representations of chocolate in cravers vs. non-cravers

To examine the neural circuitry involved in food craving, in making food particularly appetitive and thus in driving wanting and eating, we used fMRI to measure the response to the flavour of chocolate, the sight of chocolate and their combination in cravers vs. non-cravers. Statistical parametric mapping (SPM) analyses showed that the sight of chocolate produced more activation in chocolate cravers than non-cravers in the medial orbitofrontal cortex and ventral striatum. For cravers vs. non-cravers, a combination of a picture of chocolate with chocolate in the mouth produced a greater effect than the sum of the components (i.e. supralinearity) in the medial orbitofrontal cortex and pregenual cingulate cortex. Furthermore, the pleasantness ratings of the chocolate and chocolate-related stimuli had higher positive correlations with the fMRI blood oxygenation level-dependent signals in the pregenual cingulate cortex and medial orbitofrontal cortex in the cravers than in the non-cravers. To our knowledge, this is the first study to show that there are differences between cravers and non-cravers in their responses to the sensory components of a craved food in the orbitofrontal cortex, ventral striatum and pregenual cingulate cortex, and that in some of these regions the differences are related to the subjective pleasantness of the craved foods. Understanding individual differences in brain responses to very pleasant foods helps in the understanding of the mechanisms that drive the liking for specific foods and thus intake of those foods.

Enhanced biodiversity and pollination in UK agroforestry systems

Monoculture farming systems have had serious environmental impacts such as loss of biodiversity and pollinator decline. The authors explain how temperate agroforestry systems show potential in being able to deliver multiple environmental benefits.

Any response? How demand response could be enhanced based on early UK experience

Policy makers are in broad agreement that demand response should play a major role in EU electricity systems and provide much needed future system flexibility. Yet, little demand response has been forthcoming in member states to date. This paper identifies some of the technical potential for demand response, based on empirical data from one UK demand aggregator. Half-hourly electricity readings of demand during normal operation and during response events have been analysed for different industry and service sectors. We review these findings in the context of ongoing EU policy developments with particular focus on the role appropriate arrangements to enhance the available resource. We conclude that in some sectors appropriate policy and regulation could triple the available response capacity and thereby lead to stronger commercial uptake of demand response.

Impact of the enhanced permeability and retention (EPR) effect and cathepsins levels on the activity of polymer-drug conjugates

Polymer-drug conjugates have demonstrated clinical potential in the context of anticancer therapy. However, such promising results have, to date, failed to translate into a marketed product. Polymer-drug conjugates rely on two factors for activity: (i) the presence of a defective vasculature, for passive accumulation of this technology into the tumour tissue (enhanced permeability and retention (EPR) effect) and (ii) the presence of a specific trigger at the tumour site, for selective drug release (e.g., the enzyme cathepsin B). Here, we retrospectively analyse literature data to investigate which tumour types have proved more responsive to polymer-drug conjugates and to determine correlations between the magnitude of the EPR effect and/or expression of cathepsin B. Lung, breast and ovarian cancers showed the highest response rate (30%, 47% and 41%, respectively for cathepsin-activated conjugates and 31%, 43%, 40%, across all conjugates). An analysis of literature data on cathepsin content in various tumour types showed that these tumour types had high cathepsin content (up to 3835 ng/mg for lung cancer), although marked heterogeneity was observed across different studies. In addition, these tumour types were also reported as having a high EPR effect. Our results suggest that a pre-screening of patient population could bring a more marked clinical benefit.

Enhanced MALDI MS sensitivity by weak base additives and glycerol sample coating

The concept of rationally designing MALDI matrices has been extended to the next “whole sample” level. These studies have revealed some unexpected and exploitable insights in improving MALDI sensitivity. It is shown that (i) additives which only provide additional laser energy absorption are best to be avoided; (ii) the addition of proton donors in the form of protonated weak bases can be highly beneficial; (iii) the addition of glycerol for coating crystalline samples is highly recommended. Overall, analytical sensitivity has been significantly increased compared to the current “gold” standards in MALDI MS, and new insights into the mechanisms and processes of MALDI have been gained.

The economics of enhanced landfill mining: private and societal performance drivers

This paper addresses the economics of Enhanced Landfill Mining (ELFM) both from a private point of view as well as from a society perspective. The private potential is assessed using a case study for which an investment model is developed to identify the impact of a broad range of parameters on the profitability of ELFM. We found that especially variations in Waste-to-Energy (WtE efficiency, electricity price, CO2-price, WtE investment and operational costs) and ELFM support explain the variation in economic profitability measured by the Internal Rate of Return. To overcome site-specific parameters we also evaluated the regional ELFM potential for the densely populated and industrial region of Flanders (north of Belgium). The total number of potential ELFM sites was estimated using a 5-step procedure and a simulation tool was developed to trade-off private costs and benefits. The analysis shows that there is a substantial economic potential for ELFM projects on the wider regional level. Furthermore, this paper also reviews the costs and benefits from a broader perspective. The carbon footprint of the case study was mapped in order to assess the project’s net impact in terms of greenhouse gas emissions. Also the impacts of nature restoration, soil remediation, resource scarcity and reduced import dependence were valued so that they can be used in future social cost-benefit analysis. Given the complex trade-off between economic, social and environmental issues of ELFM projects, we conclude that further refinement of the methodological framework and the development of the integrated decision tools supporting private and public actors, are necessary.

Events of enhanced convection and related dayside auroral activity

In this paper we study the high-latitude plasma flow variations associated with a periodic (∼8 min) sequence of auroral forms moving along the polar cap boundary, which appear to be the most regularly occuring dayside auroral phenomenon under conditions of southward directed interplanetary magnetic field. Satellite data on auroral particle precipitation and ionospheric plasma drifts from DMSP F10 and F11 are combined with ground-based optical and ion flow measurements for January 7, 1992. Ionospheric flow measurements of 10-s resolution over the range of invariant latitudes from 71° to 76° were obtained by operating both the European incoherent scatter (EISCAT) UHF and VHF radars simultaneously. The optical site (Ny Ålesund, Svalbard) and the EISCAT radar field of view were located in the postnoon sector during the actual observations. The West Greenland magnetometers provided information about temporal variations of high-latitude convection in the prenoon sector. Satellite observations of polar cap convection in the northern and southern hemispheres show a standard two-cell pattern consistent with a prevailing negative By component of the interplanetary magnetic field. The 630.0 nm auroral forms located poleward of the persistent cleft aurora and the flow reversal boundary in the ∼1440–1540 MLT sector were observed to coincide with magnetosheath-like particle precipitation and a secondary population of higher energy ions, and they propagated eastward/tailward at speeds comparable with the convection velocity. It is shown that these optical events were accompanied by bursts of sunward (return) flow at lower latitudes in both the morning and the afternoon sectors, consistent with a modulation of Dungey cell convection. The background level of convection was low in this case (Kp =2+). The variability of the high-latitude convection may be explained as resulting from time-varying reconnection at the magnetopause. In that case this study indicates that time variations of the reconnection rate effectively modulates ionospheric convection.

Phosphorescence quantum yield enhanced by intermolecular hydrogen bonds in Cu4I4 clusters in the solid state

Organo-copper(I) halide complexes with a Cu4I4 cubane core and cyclic amines as ligands have been synthesized and their crystal structures have been defined. Their solid state photophysical properties have been measured and correlated with the crystal structure and packing. A unique and remarkably high luminescence quantum yield (76%) has been measured for one of the complexes having the cubane clusters arranged in a columnar structure and held together by N–HI hydrogen bonds. This high luminescence quantum yield is correlated with a slow radiationless deactivation rate of the excited state and suggests a rather strong enhancement of the cubane core rigidity bestowed by the hydrogen bond pattern. Some preliminary thin film deposition experiments show that these compounds could be considered to be good candidates for applications in electroluminescent devices because of their bright luminescence, low cost and relatively easy synthesis processes