Differential patterns of activity and functional connectivity in emotion processing neural circuitry to angry and happy faces in adolescents with and without suicide attempt

Background - Neural substrates of emotion dysregulation in adolescent suicide attempters remain unexamined. Method - We used functional magnetic resonance imaging to measure neural activity to neutral, mild or intense (i.e. 0%, 50% or 100% intensity) emotion face morphs in two separate emotion-processing runs (angry and happy) in three adolescent groups: (1) history of suicide attempt and depression (ATT, n = 14); (2) history of depression alone (NAT, n = 15); and (3) healthy controls (HC, n = 15). Post-hoc analyses were conducted on interactions from 3 group × 3 condition (intensities) whole-brain analyses (p < 0.05, corrected) for each emotion run. Results - To 50% intensity angry faces, ATT showed significantly greater activity than NAT in anterior cingulate gyral–dorsolateral prefrontal cortical attentional control circuitry, primary sensory and temporal cortices; and significantly greater activity than HC in the primary sensory cortex, while NAT had significantly lower activity than HC in the anterior cingulate gyrus and ventromedial prefrontal cortex. To neutral faces during the angry emotion-processing run, ATT had significantly lower activity than NAT in the fusiform gyrus. ATT also showed significantly lower activity than HC to 100% intensity happy faces in the primary sensory cortex, and to neutral faces in the happy run in the anterior cingulate and left medial frontal gyri (all p < 0.006,corrected). Psychophysiological interaction analyses revealed significantly reduced anterior cingulate gyral–insula functional connectivity to 50% intensity angry faces in ATT v. NAT or HC. Conclusions - Elevated activity in attention control circuitry, and reduced anterior cingulate gyral–insula functional connectivity, to 50% intensity angry faces in ATT than other groups suggest that ATT may show inefficient recruitment of attentional control neural circuitry when regulating attention to mild intensity angry faces, which may represent a potential biological marker for suicide risk.

Watermark-only security attack on DM-QIM watermarking:vulnerability to guided key guessing

This paper addresses the security of a specific class of common watermarking methods based on Dither modulation-quantisation index modulation (DM-QIM) and focusing on watermark-only attacks (WOA). The vulnerabilities of and probable attacks on lattice structure based watermark embedding methods have been presented in the literature. DM-QIM is one of the best known lattice structure based watermarking techniques. In this paper, the authors discuss a watermark-only attack scenario (the attacker has access to a single watermarked content only). In the literature it is an assumption that DM-QIM methods are secure to WOA. However, the authors show that the DM-QIM based embedding method is vulnerable against a guided key guessing attack by exploiting subtle statistical regularities in the feature space embeddings for time series and images. Using a distribution-free algorithm, this paper presents an analysis of the attack and numerical results for multiple examples of image and time series data.

Watermark-only security attack on DM-QIM watermarking:vulnerability to guided key guessing

This paper addresses the security of a specific class of common watermarking methods based on Dither modulation-quantisation index modulation (DM-QIM) and focusing on watermark-only attacks (WOA). The vulnerabilities of and probable attacks on lattice structure based watermark embedding methods have been presented in the literature. DM-QIM is one of the best known lattice structure based watermarking techniques. In this paper, the authors discuss a watermark-only attack scenario (the attacker has access to a single watermarked content only). In the literature it is an assumption that DM-QIM methods are secure to WOA. However, the authors show that the DM-QIM based embedding method is vulnerable against a guided key guessing attack by exploiting subtle statistical regularities in the feature space embeddings for time series and images. Using a distribution-free algorithm, this paper presents an analysis of the attack and numerical results for multiple examples of image and time series data.

Government preparedness:using simulation to prepare for a terrorist attack

The heightened threat of terrorism has caused governments worldwide to plan for responding to large-scale catastrophic incidents. In England the New Dimension Programme supplies equipment, procedures and training to the Fire and Rescue Service to ensure the country's preparedness to respond to a range of major critical incidents. The Fire and Rescue Service is involved partly by virtue of being able to very quickly mobilize a large skilled workforce and specialist equipment. This paper discusses the use of discrete event simulation modeling to understand how a fire and rescue service might position its resources before an incident takes place, to best respond to a combination of different incidents at different locations if they happen. Two models are built for this purpose. The first model deals with mass decontamination of a population following a release of a hazardous substance—aiming to study resource requirements (vehicles, equipment and manpower) necessary to meet performance targets. The second model deals with the allocation of resources across regions—aiming to study cover level and response times, analyzing different allocations of resources, both centralized and decentralized. Contributions to theory and practice in other contexts (e.g. the aftermath of natural disasters such as earthquakes) are outlined.

The role of suicide risk in the decision for psychiatric hospitalization after a suicide attempt

BACKGROUND: Suicide prevention can be improved by knowing which variables physicians take into account when considering hospitalization or discharge of patients who have attempted suicide. AIMS: To test whether suicide risk is an adequate explanatory variable for predicting admission to a psychiatric unit after a suicide attempt. METHODS: Analyses of 840 clinical records of patients who had attempted suicide (66.3% women) at four public general hospitals in Madrid (Spain). RESULTS: 180 (21.4%) patients were admitted to psychiatric units. Logistic regression analyses showed that explanatory variables predicting admission were: male gender; previous psychiatric hospitalization; psychiatric disorder; not having a substance-related disorder; use of a lethal method; delay until discovery of more than one hour; previous attempts; suicidal ideation; high suicidal planning; and lack of verbalization of adequate criticism of the attempt. CONCLUSIONS: Suicide risk appears to be an adequate explanatory variable for predicting the decision to admit a patient to a psychiatric ward after a suicide attempt, although the introduction of other variables improves the model. These results provide additional information regarding factors involved in everyday medical practice in emergency settings.

Neurophysiological investigations for the diagnosis of non-epileptic attack disorder in neuropsychiatry services:from safety standards to improved effectiveness

OBJECTIVE: The discipline of clinical neuropsychiatry currently provides specialised services for a number of conditions that cross the traditional boundaries of neurology and psychiatry, including non-epileptic attack disorder. Neurophysiological investigations have an important role within neuropsychiatry services, with video-electroencephalography (EEG) telemetry being the gold standard investigation for the differential diagnosis between epileptic seizures and non-epileptic attacks. This article reviews existing evidence on best practices for neurophysiology investigations, with focus on safety measures for video-EEG telemetry. METHODS: We conducted a systematic literature review using the PubMed database in order to identify the scientific literature on the best practices when using neurophysiological investigations in patients with suspected epileptic seizures or non-epileptic attacks. RESULTS: Specific measures need to be implemented for video-EEG telemetry to be safely and effectively carried out by neuropsychiatry services. A confirmed diagnosis of non-epileptic attack disorder following video-EEG telemetry carried out within neuropsychiatry units has the inherent advantage of allowing diagnosis communication and implementation of treatment strategies in a timely fashion, potentially improving clinical outcomes and cost-effectiveness significantly. CONCLUSION: The identified recommendations set the stage for the development of standardised guidelines to enable neuropsychiatry services to implement streamlined and evidence-based care pathways.

Quality of the written information about suicide attempters

INTRODUCTION: The aim of the study was to assess the quality of the clinical records of the patients who are seen in public hospitals in Madrid after a suicide attempt in a blind observation. METHODS: Observational, descriptive cross-sectional study conducted at four general public hospitals in Madrid (Spain). Analyses of the presence of seven indicators of information quality (previous psychiatric treatment, recent suicidal ideation, recent suicide planning behaviour, medical lethality of suicide attempt, previous suicide attempts, attitude towards the attempt, and social or family support) in 993 clinical records of 907 patients (64.5% women), ages ranging from 6 to 92 years (mean 37.1±15), admitted to hospital after a suicide attempt or who committed an attempt whilst in hospital. RESULTS: Of patients who attempted suicide, 94.9% received a psychosocial assessment. All seven indicators were documented in 22.5% of the records, whilst 23.6% recorded four or less than four indicators. Previous suicide attempts and medical lethality of current attempt were the indicators most often missed in the records. The study found no difference between the records of men and women (z=0.296; p=0.767, two tailed Mann-Whitney U test), although clinical records of patients discharged after an emergency unit intervention were more incomplete than the ones from hospitalised patients (z=2.731; p=0.006), and clinical records of repeaters were also more incomplete than the ones from non-repeaters (z=3.511; p<0.001). CONCLUSIONS: Clinical records of patients who have attempted suicide are not complete. The use of semi-structured screening instruments may improve the evaluation of patients who have self- harmed.