A comparison of popular fertility awareness methods to a DBN model of the woman's monthly cycle

Fertility Awareness Methods are effective, safe, and low-cost techniques for identifying the fertile days of a menstrual cycle. In this paper, we compare the effectiveness of predicting the fertile days by a Dynamic Bayesian Network model of the monthly cycle to 11 existing Fertility Awareness Methods. We base our comparison on a real data set of 7,017 cycles collected by 881 women. We demonstrate that the DBN model is more accurate than the best modern Fertility Awareness Methods, based on the observation of mucus, marking reasonably high percentage of days of the cycle as infertile. We argue that the DBN approach offers other advantages, such as predicting the ovulation day and being able to adjust its predictions to each woman's individual cycle

Clinical: Managing depression in children and young people

Key learning points - How to identify the signs and symptoms of depression in children and adolescents - Treatment options for young people experiencing depression - The Nurse (primary care/Health Visitors/School Nurse) role in supporting young people experiencing depressio

Modeling dynamic systems with memory: What is the right time-order?

Most practical uses of Dynamic Bayesian Networks (DBNs) involve temporal inuences of the first order, i.e., inuences between neighboring time steps. This choice is a convenient approximation inuenced by the existence of efficient algorithms for first order models and limitations of available tools. We focus on the question whether constructing higher time-order models is worth the effort when the underlying system's memory goes beyond the current state. We present the results of an experiment with a series of DBN models monitoring woman's monthly cycle. We show that higher order models are significantly more accurate. However, we have also observed overfitting and a resulting decrease in accuracy when the time order chosen is too high

Additional records of scaphitid ammonites from the basal upper Maastrichtian (Upper Cretaceous) of eastern Poland

New records of rare and/or poorly known scaphitid ammonites are presented from the basal upper Maastrichtian (Upper Cretaceous) white chalk exposed at Chelm quarry, Lublin Upland (eastern Poland). The described and illustrated material comprises four specimens, all preserved as composite moulds, and includes a well-preserved microconch of Hoploscaphites schmidi (BIRKELUND, 1982), fragmentary specimens of H. felderi KENNEDY, 1987 and Acanthoscaphites (Euroscaphites) varians blaszkiewiczi JAGT, KENNEDY & MACHALSKI, 1999, as well as a pathological macroconch of Hoploscaphites constrictus lvivensis MACHALSKI, 2005b

Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression

Unipolar major depressions (MD) emerge markedly during adolescence. National Institute for Health and Care Excellence (NICE) UK recommends psychological therapies, with accompanying selective serotonin reuptake inhibitors (SSRIs) prescribed in severe cases only. Here, we seek to determine the extent and rationale of SSRI prescribing in adolescent MD before entering a randomised clinical trial. SSRI prescribing, together with their clinical characteristics was determined in 465 adolescent patients with MD prior to receiving a standardised psychological therapy as part of the Improving mood with psychoanalytic and cognitive therapies (IMPACT) clinical trial. Overall, 88 (19 %) had been prescribed antidepressants prior to psychological treatment. The clinical correlates varied by gender: respectively, depression severity in boys and self-harming behaviours in girls. Prescribing also differed between clinical research centres. Medical practitioners consider severity of depression in boys as an indicator for antidepressant prescribing. Self-injury in girls appears to be utilised as a prescribing aid which is inconsistent with past and current revised UK NICE guidelines

Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial.

$\textbf{BACKGROUND}$: Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. $\textbf{METHODS}$: We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. $\textbf{FINDINGS}$: Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and differentiation were established between the three interventions. The median number of treatment sessions differed significantly between patients in the brief psychosocial intervention group (n=6 [IQR 4-11]), CBT group (n=9 [5-14]), and short-term psychoanalytical therapy group (n=11 [5-23]; p<0·0001), but there was no difference between groups in the average duration of treatment (27·5 [SD 21·5], 24·9 [17·7], 27·9 [16·8] weeks, respectively; Kruskal-Wallis p=0·238). Self-reported depression symptoms did not differ significantly between patients given CBT and those given short-term psychoanalytical therapy at weeks 36 (treatment effect 0·179, 95% CI -3·731 to 4·088; p=0·929), 52 (0·307, -3·161 to 3·774; p=0·862), or 86 (0·578, -2·948 to 4·104; p=0·748). These two psychological treatments had no superiority effect compared with brief psychosocial intervention at weeks 36 (treatment effect -3·234, 95% CI -6·611 to 0·143; p=0·061), 52 (-2·806, -5·790 to 0·177; p=0·065), or 86 (-1·898, -4·922 to 1·126; p=0·219). Physical adverse events (self-reported breathing problems, sleep disturbances, drowsiness or tiredness, nausea, sweating, and being restless or overactive) did not differ between the groups. Total costs of the trial interventions did not differ significantly between treatment groups. $\textbf{INTERPRETATION}$: We found no evidence for the superiority of CBT or short-term psychoanalytical therapy compared with a brief psychosocial intervention in maintenance of reduced depression symptoms 12 months after treatment. Short-term psychoanalytical therapy was as effective as CBT and, together with brief psychosocial intervention, offers additional patient choice for psychological therapy, alongside CBT, for adolescents with moderate to severe depression who are attending routine specialist CAMHS clinics.National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and the Department of Health

Recent developments in the treatment of major depressive disorder in children and adolescents.

Major depressive disorder in adolescents is an important public health concern. It is common, a risk factor for suicide and is associated with adverse psychosocial consequences. The UK National Institute for Health and Care Excellence guidelines recommend that children and young people with moderate-to-severe depression should be seen within Child and Adolescent Mental Health Services and receive specific psychological interventions, possibly in combination with antidepressant medication. Cognitive behavioural therapy (in some studies) and interpersonal psychotherapy have been demonstrated to be more effective than active control treatments for depressed adolescents. For children with depression, there is some evidence that family focused approaches are more effective than individual therapy. Fluoxetine is the antidepressant with the greatest evidence for effectiveness compared with placebo. Treatment with antidepressants and/or psychological therapy is likely to reduce suicidality, although in some young people, selective serotonin reuptake inhibitors lead to increased suicidality. There is limited evidence that combination of specific psychological therapy and antidepressant medication is better than treatment with monotherapy. There are methodological limitations in the published literature that make it difficult to relate study findings to the more severely ill clinical population in Child and Adolescent Mental Health Services. Young people should have access to both evidence-based psychological interventions and antidepressants for paediatric depression. Collaborative decisions on treatment should be made jointly by young people, their carers and clinicians, taking into account individual circumstances and potential benefits, risks and availability of treatment

Chamber arrangement versus wall structure in the high-rank phylogenetic classification of Foraminifera

Foraminiferal wall micro/ultra-structures of Recent and well-preserved Jurassic (Bathonian) foraminifers of distinct foraminiferal high-rank taxonomic groups, Globothalamea (Rotaliida, Robertinida, and Textulariida), Miliolida, Spirillinata and Lagenata, are presented. Both calcite-cemented agglutinated and entirely calcareous foraminiferal walls have been investigated. Original test ultra-structures of Jurassic foraminifers are given for the first time. “Monocrystalline” wall-type which characterizes the class Spirillinata is documented in high resolution imaging. Globothalamea, Lagenata, porcelaneous representatives of Tubothalamea and Spirillinata display four different major types of wall-structure which may be related to distinct calcification processes. It confirms that these distinct molecular groups evolved separately, probably from single-chambered monothalamids, and independently developed unique wall types. Studied Jurassic simple bilocular taxa, characterized by undivided spiralling or irregular tubes, are composed of miliolid-type needle-shaped crystallites. In turn, spirillinid “monocrystalline” test structure has only been recorded within more complex, multilocular taxa possessing secondary subdivided chambers: Jurassic Paalzowella and Recent Patellina. More integrated molecular and structural studies are needed in order to better understand taxonomic position and phylogeny of tubular taxa. Unilocular and multichambered Lagenata (Lagenidae and Nodosariidae, respectively) show identical test micro and ultra-structure which suggests their close phylogenetic relationship and questions most recent theories of their separate evolutionary history and origins. A comparison of Recent, Cretaceous, and Jurassic foraminiferal test structure indicates that test characteristics at particular higher-rank taxonomic levels change very little over time and thus can serve as good proxies for the taxonomic designations of fossil taxa, when their state of preservation is appropriate for microstructural observations

Possible hominin footprints from the late Miocene (c. 5.7 Ma) of Crete?

© 2017 The Geologists' Association. We describe late Miocene tetrapod footprints (tracks) from the Trachilos locality in western Crete (Greece), which show hominin-like characteristics. They occur in an emergent horizon within an otherwise marginal marine succession of Messinian age (latest Miocene), dated to approximately 5.7 Ma (million years), just prior to the Messinian Salinity Crisis. The tracks indicate that the trackmaker lacked claws, and was bipedal, plantigrade, pentadactyl and strongly entaxonic. The impression of the large and non-divergent first digit (hallux) has a narrow neck and bulbous asymmetrical distal pad. The lateral digit impressions become progressively smaller so that the digital region as a whole is strongly asymmetrical. A large, rounded ball impression is associated with the hallux. Morphometric analysis shows the footprints to have outlines that are distinct from modern non-hominin primates and resemble those of hominins. The interpretation of these footprints is potentially controversial. The print morphology suggests that the trackmaker was a basal member of the clade Hominini, but as Crete is some distance outside the known geographical range of pre-Pleistocene hominins we must also entertain the possibility that they represent a hitherto unknown late Miocene primate that convergently evolved human-like foot anatomy

Biocalcification in porcelaneous foraminifera

Living organisms control the formation of mineral skeletons and other structures through biomineralization. Major phylogenetic groups usually consistently follow a single biomineralization pathway. Foraminifera, which are very efficient marine calcifiers, making a substantial contribution to global carbonate production and global carbon sequestration, are regarded as an exception. This phylum has been commonly thought to follow two contrasting models of either in situ ‘mineralization of extracellular matrix’ attributed to hyaline rotaliid shells, or ‘mineralization within intracellular vesicles’ attributed to porcelaneous miliolid shells. Our previous results on rotaliids along with those on miliolids in this paper question such a wide divergence of biomineralization pathways within the same phylum of Foraminifera. We have found under a high-resolution scanning electron microscopy (SEM) that precipitation of high-Mg calcitic mesocrystals in porcelaneous shells takes place in situ and form a dense, chaotic meshwork of needle-like crystallites. We have not observed calcified needles that already precipitated in the transported vesicles, what challenges the previous model of miliolid mineralization. Hence, Foraminifera probably utilize less divergent calcification pathways, following the recently discovered biomineralization principles. Mesocrystalline chamber walls in both models are therefore most likely created by intravesicular accumulation of pre-formed liquid amorphous mineral phase deposited and crystallized within the extracellular organic matrix enclosed in a biologically controlled privileged space by active pseudopodial structures. Both calcification pathways evolved independently in the Paleozoic and are well conserved in two clades that represent different chamber formation modes.</jats:p