In the 21st century, groundwater depletion is posing a serious threat to humanity throughout the world, particularly in developing nations. India being the largest consumer of groundwater in the ...world, dwindling groundwater storage has emerged as a serious concern in recent years. Consequently, the judicious and efficient management of vital groundwater resources is one of the grand challenges in India. Groundwater modeling is a promising tool to develop sustainable management strategies for the efficient utilization of this treasured resource. This study demonstrates a pragmatic framework for predicting seasonal groundwater levels at a large scale using real-world data. Three relatively powerful Machine Learning (ML) techniques viz., ANFIS (Adaptive Neuro-Fuzzy Inference System), Deep Neural Network (DNN) and Support Vector Machine (SVM) were employed for predicting seasonal groundwater levels at the country scale using in situ groundwater-level and pertinent meteorological data of 1996–2016. ANFIS, DNN and SVM models were developed for 18 Agro-Ecological Zones (AEZs) of India and their efficacy was evaluated using suitable statistical and graphical indicators. The findings of this study revealed that the DNN model is the most proficient in predicting seasonal groundwater levels in most AEZs, followed by the ANFIS model. However, the prediction ability of the three models is ‘moderate’ to ‘very poor’ in 3 AEZs ‘Western Plain and Kutch Peninsula’ in Western India, and ‘Deccan Plateau (Arid)’ and ‘Eastern Ghats and Deccan Plateau’ in Southern India. It is recommended that groundwater-monitoring network and data acquisition systems be strengthened in India in order to ensure efficient use of modeling techniques for the sustainable management of groundwater resources.
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•Scientific framework is developed to predict groundwater levels at large scales.•Efficacy of the ANFIS, DNN and SVM models is assessed in predicting groundwater levels.•The models predict groundwater levels in each Agro-Ecological Zone (AEZ) of India.•The DNN model's prediction ability is superior for most AEZs followed by the ANFIS model.•The study calls for improved groundwater-monitoring and data acquisition across India.
ABSTRACT In Hubble Space Telescope (HST) imaging taken on 2014 November 10, four images of supernova (SN) "Refsdal" (redshift z = 1.49) appeared in an Einstein-cross-like configuration (images S1-S4) ...around an early-type galaxy in the cluster MACS J1149.5+2223 (z = 0.54). Almost all lens models of the cluster have predicted that the SN should reappear within a year in a second host-galaxy image created by the cluster's potential. In HST observations taken on 2015 December 11, we find a new source at the predicted position of the new image of SN Refsdal approximately from the previous images S1-S4. This marks the first time the appearance of a SN at a particular time and location in the sky was successfully predicted in advance! We use these data and the light curve from the first four observed images of SN Refsdal to place constraints on the relative time delay and magnification of the new image (SX) compared to images S1-S4. This enables us, for the first time, to test "blind" lens model predictions of both magnifications and time delays for a lensed SN. We find that the timing and brightness of the new image are consistent with the blind predictions of a fraction of the models. The reappearance illustrates the discriminatory power of this blind test and its utility to uncover sources of systematic uncertainty. From planned HST photometry, we expect to reach a precision of 1%-2% on the time delay between S1-S4 and SX.
Posttraumatic stress disorder (PTSD) is a chronic and disabling disorder, for which available pharmacotherapies have limited efficacy. The authors' previous proof-of-concept randomized controlled ...trial of single-dose intravenous ketamine infusion in individuals with PTSD showed significant and rapid PTSD symptom reduction 24 hours postinfusion. The present study is the first randomized controlled trial to test the efficacy and safety of repeated intravenous ketamine infusions for the treatment of chronic PTSD.
Individuals with chronic PTSD (N=30) were randomly assigned (1:1) to receive six infusions of ketamine (0.5 mg/kg) or midazolam (0.045 mg/kg) (psychoactive placebo control) over 2 consecutive weeks. Clinician-rated and self-report assessments were administered 24 hours after the first infusion and at weekly visits. The primary outcome measure was change in PTSD symptom severity, as assessed with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), from baseline to 2 weeks (after completion of all infusions). Secondary outcome measures included the Impact of Event Scale-Revised, the Montgomery-Åsberg Depression Rating Scale (MADRS), and side effect measures.
The ketamine group showed a significantly greater improvement in CAPS-5 and MADRS total scores than the midazolam group from baseline to week 2. At week 2, the mean CAPS-5 total score was 11.88 points (SE=3.96) lower in the ketamine group than in the midazolam group (d=1.13, 95% CI=0.36, 1.91). Sixty-seven percent of participants in the ketamine group were treatment responders, compared with 20% in the midazolam group. Among ketamine responders, the median time to loss of response was 27.5 days following the 2-week course of infusions. Ketamine infusions were well tolerated overall, without serious adverse events.
This randomized controlled trial provides the first evidence of efficacy of repeated ketamine infusions in reducing symptom severity in individuals with chronic PTSD. Further studies are warranted to understand ketamine's full potential as a treatment for chronic PTSD.
ASASSN-15lh: A highly super-luminous supernova Dong, Subo; Shappee, B. J.; Prieto, J. L. ...
Science (American Association for the Advancement of Science),
01/2016, Letnik:
351, Številka:
6270
Journal Article
Recenzirano
Odprti dostop
We report the discovery of ASASSN-15lh (SN 2015L), which we interpret as the most luminous supernova yet found. At redshift z = 0.2326, ASASSN-15lh reached an absolute magnitude of Mu,AB = −23.5 ± ...0.1 and bolometric luminosity Lbol = (2.2 ± 0.2) × 10⁴⁵ ergs s⁻¹, which is more than twice as luminous as any previously known supernova. It has several major features characteristic of the hydrogen-poor super-luminous supernovae (SLSNe-l), whose energy sources and progenitors are currently poorly understood. In contrast to most previously known SLSNe-l that reside in star-forming dwarf galaxies, ASASSN-15lh appears to be hosted by a luminous galaxy (MK ≈ −25.5) with little star formation. In the 4 months since first detection, ASASSN-15lh radiated (1.1 ± 0.2) × 10⁵² ergs, challenging the magnetar model for its engine.
Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, ...whether patient outcomes differ between male and female physicians is largely unknown.
To determine whether mortality and readmission rates differ between patients treated by male or female physicians.
We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014. We examined the association between physician sex and 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital fixed effects (effectively comparing female and male physicians within the same hospital). As a sensitivity analysis, we examined only physicians focusing on hospital care (hospitalists), among whom patients are plausibly quasi-randomized to physicians based on the physician's specific work schedules. We also investigated whether differences in patient outcomes varied by specific condition or by underlying severity of illness.
Patients' 30-day mortality and readmission rates.
A total of 1 583 028 hospitalizations were used for analyses of 30-day mortality (mean SD patient age, 80.2 8.5 years; 621 412 men and 961 616 women) and 1 540 797 were used for analyses of readmission (mean SD patient age, 80.1 8.5 years; 602 115 men and 938 682 women). Patients treated by female physicians had lower 30-day mortality (adjusted mortality, 11.07% vs 11.49%; adjusted risk difference, -0.43%; 95% CI, -0.57% to -0.28%; P < .001; number needed to treat to prevent 1 death, 233) and lower 30-day readmissions (adjusted readmissions, 15.02% vs 15.57%; adjusted risk difference, -0.55%; 95% CI, -0.71% to -0.39%; P < .001; number needed to treat to prevent 1 readmission, 182) than patients cared for by male physicians, after accounting for potential confounders. Our findings were unaffected when restricting analyses to patients treated by hospitalists. Differences persisted across 8 common medical conditions and across patients' severity of illness.
Elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists. These findings suggest that the differences in practice patterns between male and female physicians, as suggested in previous studies, may have important clinical implications for patient outcomes.
Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals.
To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals ...across a broad range of medical and surgical conditions.
Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older.
Hospital teaching status: major teaching hospitals (members of the Council of Teaching Hospitals), minor teaching hospitals (other hospitals with medical school affiliation), and nonteaching hospitals (remaining hospitals).
Primary outcome was 30-day mortality rate for all hospitalizations and for 15 common medical and 6 surgical conditions. Secondary outcomes included 30-day mortality stratified by hospital size and 7-day mortality and 90-day mortality for all hospitalizations as well as for individual medical and surgical conditions.
The sample consisted of 21 451 824 total hospitalizations at 4483 hospitals, of which 250 (5.6%) were major teaching, 894 (19.9%) were minor teaching, and 3339 (74.3%) were nonteaching hospitals. Unadjusted 30-day mortality was 8.1% at major teaching hospitals, 9.2% at minor teaching hospitals, and 9.6% at nonteaching hospitals, with a 1.5% (95% CI, 1.3%-1.7%; P < .001) mortality difference between major teaching hospitals and nonteaching hospitals. After adjusting for patient and hospital characteristics, the same pattern persisted (8.3% mortality at major teaching vs 9.2% at minor teaching and 9.5% at nonteaching), but the difference in mortality between major and nonteaching hospitals was smaller (1.2% 95% CI, 1.0%-1.4%; P < .001). After stratifying by hospital size, 187 large (≥400 beds) major teaching hospitals had lower adjusted overall 30-day mortality relative to 76 large nonteaching hospitals (8.1% vs 9.4%; 1.2% difference 95% CI, 0.9%-1.5%; P < .001). This same pattern of lower overall 30-day mortality at teaching hospitals was observed for medium-sized (100-399 beds) hospitals (8.6% vs 9.3% and 9.4%; 0.8% difference between 61 major and 1207 nonteaching hospitals 95% CI, 0.4%-1.3%; P = .003). Among small (≤99 beds) hospitals, 187 minor teaching hospitals had lower overall 30-day mortality relative to 2056 nonteaching hospitals (9.5% vs 9.9%; 0.4% difference 95% CI, 0.1%-0.7%; P = .01).
Among hospitalizations for US Medicare beneficiaries, major teaching hospital status was associated with lower mortality rates for common conditions compared with nonteaching hospitals. Further study is needed to understand the reasons for these differences.
Background We compared outcomes and postpancreatectomy quality of life (QOL) in paired cohorts of patients undergoing conventional open pancreaticoduodenectomy (OPD) or laparoscopic-assisted ...pancreaticoduodenectomy (LAPD). Methods Comparative analysis of QOL was performed in a matched cohort of 53 patients after OPD or LAPD between 2010 and 2013. The Medical Outcomes Study Short Form-36 Health Survey and the Karnofsky score were used. Results Physical component score, mental component score, and Karnofsky scores were calculated at multiple time points for OPD ( n = 25) and LAPD ( n = 28). Operative times, complications, and readmission rates were equivalent. Time to starting adjuvant therapy trended toward clinical importance in LAPD (61 vs 110 days, P = .0878). Duration of stay was less in LAPD (7.10 vs 9.44 days, P = .02). LAPD had a superior QOL centered on functional status compared with OPD (physical component score 49.09 vs 38.4, P = .04; Karnofsky 92.22 vs 66.92%, P = .003). These statistical differences were not observed beyond 6 months. Conclusion LAPD provided a more favorable QOL within the first 6 months and shorter length of stay compared with conventional OPD. LAPD may serve as an alternative operative therapy to potentially minimize delays in receipt of and enhance tolerability of adjuvant therapies.
Plants face variable environmental stresses that negatively affect plant growth and productivity. The multiplicity of responses is an important aspect of the complexity of stress signalling. Abscisic ...acid (ABA) is a broad-spectrum phytohormone involved not only in regulating stomatal opening, growth and development but also in coordinating various stress signal transduction pathways in plants during abiotic stresses. The both ABA-dependent and ABA-independent signal transduction pathways from stress signal perception to gene expression involve different transcription factors such as DREB, MYC/MYB, AREB/ABF, NAM, ATAF1,2, CUC and their corresponding cis-acting elements DRE, MYCRS/MYBRS, ABRE, NACRS. Genetic analysis of ABA mutants has given insight that ABA-dependent and ABA-independent pathways for osmotic stress and cold stress interact and converge. This review focuses on ABA-dependent and ABA-independent transcriptional components and cascades, their specificity and crosstalk in stress gene regulation.
We present 2603 spectra of 462 nearby Type Ia supernovae (SNe Ia), including 2065 previously unpublished spectra, obtained during 1993-2008 through the Center for Astrophysics Supernova Program. ...Based on nebular spectra of 27 SNe Ia, we find no relation between the FWHM of the iron emission feature at ~4700A and delta msub 15(B) after removing the two low-luminosity SN 1986G and SN 1991bg, suggesting that the peak luminosity is not strongly dependent on the kinetic energy of the explosion for most SNe Ia. Finally, we confirm the correlation of velocity shifts in some nebular lines with the intrinsic B-V color of SNe Ia at maximum light, although several outliers suggest a possible non-monotonic behavior for the largest blue-shifts.
We investigated the impact of mindfulness training (MT) on attentional performance lapses associated with task-unrelated thought (i.e., mind wandering). Periods of persistent and intensive demands ...may compromise attention and increase off-task thinking. Here, we investigated if MT may mitigate these deleterious effects and promote cognitive resilience in military cohorts enduring a high-demand interval of predeployment training. To better understand which aspects of MT programs are most beneficial, three military cohorts were examined. Two of the three groups were provided MT. One group received an 8-hour, 8-week variant of Mindfulness-based Mind Fitness Training (MMFT) emphasizing engagement in training exercises (training-focused MT, n = 40), a second group received a didactic-focused variant emphasizing content regarding stress and resilience (didactic-focused MT, n = 40), and the third group served as a no-training control (NTC, n = 24). Sustained Attention to Response Task (SART) performance was indexed in all military groups and a no-training civilian group (CIV, n = 45) before (T1) and after (T2) the MT course period. Attentional performance (measured by A', a sensitivity index) was lower in NTC vs. CIV at T2, suggesting that performance suffers after enduring a high-demand predeployment interval relative to a similar time period of civilian life. Yet, there were significantly fewer performance lapses in the military cohorts receiving MT relative to NTC, with training-focused MT outperforming didactic-focused MT at T2. From T1 to T2, A' degraded in NTC and didactic-focused MT but remained stable in training-focused MT and CIV. In sum, while protracted periods of high-demand military training may increase attentional performance lapses, practice-focused MT programs akin to training-focused MT may bolster attentional performance more than didactic-focused programs. As such, training-focused MT programs should be further examined in cohorts experiencing protracted high-demand intervals.
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