A semi-structured interview to assess visual hallucinations in older people

OBJECTIVE: Visual hallucinations are under-reported by patients and are often undiscovered by health professionals. There is no gold standard available to assess hallucinations. Our objective was to develop a reliable, valid, semi-structured interview for identifying and assessing visual hallucinations in older people with eye disease and cognitive impairment. METHODS: We piloted the North-East Visual Hallucinations Interview (NEVHI) in 80 older people with visual and/or cognitive impairment (patient group) and 34 older people without known risks of hallucinations (control group). The informants of 11 patients were interviewed separately. We established face validity, content validity, criterion validity, inter-rater agreement and the internal consistency of the NEVHI, and assessed the factor structure for questions evaluating emotions, cognitions, and behaviours associated with hallucinations. RESULTS: Recurrent visual hallucinations were common in the patient group (68.8%) and absent in controls (0%). The criterion, face and content validities were good and the internal consistency of screening questions for hallucinations was high (Cronbach alpha: 0.71). The inter-rater agreements for simple and complex hallucinations were good (Kappa 0.72 and 0.83, respectively). Four factors associated with experiencing hallucinations (perceived control, pleasantness, distress and awareness) were identified and explained a total variance of 73%. Informants gave more 'don't know answers' than patients throughout the interview (p = 0.008), especially to questions evaluating cognitions and emotions associated with hallucinations (p = 0.02). CONCLUSIONS: NEVHI is a comprehensive assessment tool, helpful to identify the presence of visual hallucinations and to quantify cognitions, emotions and behaviours associated with hallucinations.

Semi-automatic segmentation of fetal cardiac cavities: progress towards an automated fetal echocardiogram

OBJECTIVE: To develop a novel application of a tool for semi-automatic volume segmentation and adapt it for analysis of fetal cardiac cavities and vessels from heart volume datasets. METHODS: We studied retrospectively virtual cardiac volume cycles obtained with spatiotemporal image correlation (STIC) from six fetuses with postnatally confirmed diagnoses: four with normal hearts between 19 and 29 completed gestational weeks, one with d-transposition of the great arteries and one with hypoplastic left heart syndrome. The volumes were analyzed offline using a commercially available segmentation algorithm designed for ovarian folliculometry. Using this software, individual 'cavities' in a static volume are selected and assigned individual colors in cross-sections and in 3D-rendered views, and their dimensions (diameters and volumes) can be calculated. RESULTS: Individual segments of fetal cardiac cavities could be separated, adjacent segments merged and the resulting electronic casts studied in their spatial context. Volume measurements could also be performed. Exemplary images and interactive videoclips showing the segmented digital casts were generated. CONCLUSION: The approach presented here is an important step towards an automated fetal volume echocardiogram. It has the potential both to help in obtaining a correct structural diagnosis, and to generate exemplary visual displays of cardiac anatomy in normal and structurally abnormal cases for consultation and teaching.

Droughts and famines: The underlying factors and the causal links among agro-pastoral households in semi-arid Makueni district, Kenya

Famines are often linked to drought in semi-arid areas of Sub-Saharan Africa where not only pastoralists, but also increasingly agro-pastoralists are affected. This study addresses the interplay between drought and famine in the rural semi-arid areas of Makueni district, Kenya, by examining whether, and how crop production conditions and agro-pastoral strategies predispose smallholder households to drought-triggered food insecurity. If this hypothesis holds, then approaches to deal with drought and famine have to target factors causing household food insecurity during non-drought periods. Data from a longitudinal survey of 127 households, interviews, workshops, and daily rainfall records (1961–2003) were analysed using quantitative and qualitative methods. This integrated approach confirms the above hypothesis and reveals that factors other than rainfall, like asset and labour constraints, inadequate policy enforcement, as well as the poverty-driven inability to adopt risk-averse production systems play a key role. When linking these factors to the high rainfall variability, farmer-relevant definitions and forecasts of drought have to be applied.

Evaluating retraining rules for semi-supervised learning in neural network based cursive word recognition

Training a system to recognize handwritten words is a task that requires a large amount of data with their correct transcription. However, the creation of such a training set, including the generation of the ground truth, is tedious and costly. One way of reducing the high cost of labeled training data acquisition is to exploit unlabeled data, which can be gathered easily. Making use of both labeled and unlabeled data is known as semi-supervised learning. One of the most general versions of semi-supervised learning is self-training, where a recognizer iteratively retrains itself on its own output on new, unlabeled data. In this paper we propose to apply semi-supervised learning, and in particular self-training, to the problem of cursive, handwritten word recognition. The special focus of the paper is on retraining rules that define what data are actually being used in the retraining phase. In a series of experiments it is shown that the performance of a neural network based recognizer can be significantly improved through the use of unlabeled data and self-training if appropriate retraining rules are applied.

How do subordinate and dominant species in semi-natural mountain grasslands relate to productivity and land-use change?

Changes in agricultural practices of semi-natural mountain grasslands are expected to modify plant community structure and shift dominance patterns. Using vegetation surveys of 11 sites in semi-natural grasslands of the Swiss Jura and Swiss and French Alps, we determined the relative contribution of dominant, subordinate and transient plant species in grazed and abandoned communities and observed their changes along a gradient of productivity and in response to abandonment of pasturing. The results confirm the humpbacked diversity–productivity relationship in semi-natural grassland, which is due to the increase of subordinate species number at intermediate productivity levels. Grazed communities, at the lower or higher end of the species diversity gradient, suffered higher species loss after grazing abandonment. Species loss after abandonment of pasturing was mainly due to a higher reduction in the number of subordinate species, as a consequence of the increasing proportion of dominant species. When plant biodiversity maintenance is the aim, our results have direct implications for the way grasslands should be managed. Indeed, while intensification and abandonment have been accelerated since few decades, our findings in this multi-site analysis confirm the importance of maintaining intermediate levels of pasturing to preserve biodiversity.

Theoretical models of planetary system formation: mass vs. semi-major axis

Context. Planet formation models have been developed during the past years to try to reproduce what has been observed of both the solar system and the extrasolar planets. Some of these models have partially succeeded, but they focus on massive planets and, for the sake of simplicity, exclude planets belonging to planetary systems. However, more and more planets are now found in planetary systems. This tendency, which is a result of radial velocity, transit, and direct imaging surveys, seems to be even more pronounced for low-mass planets. These new observations require improving planet formation models, including new physics, and considering the formation of systems. Aims: In a recent series of papers, we have presented some improvements in the physics of our models, focussing in particular on the internal structure of forming planets, and on the computation of the excitation state of planetesimals and their resulting accretion rate. In this paper, we focus on the concurrent effect of the formation of more than one planet in the same protoplanetary disc and show the effect, in terms of architecture and composition of this multiplicity. Methods: We used an N-body calculation including collision detection to compute the orbital evolution of a planetary system. Moreover, we describe the effect of competition for accretion of gas and solids, as well as the effect of gravitational interactions between planets. Results: We show that the masses and semi-major axes of planets are modified by both the effect of competition and gravitational interactions. We also present the effect of the assumed number of forming planets in the same system (a free parameter of the model), as well as the effect of the inclination and eccentricity damping. We find that the fraction of ejected planets increases from nearly 0 to 8% as we change the number of embryos we seed the system with from 2 to 20 planetary embryos. Moreover, our calculations show that, when considering planets more massive than ~5 M⊕, simulations with 10 or 20 planetary embryos statistically give the same results in terms of mass function and period distribution.