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The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.
Social centers for older people.
664 Chinese older adults with chronic pain.
Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.
For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.
The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.
Intranasal octenidine, an antiseptic alternative to mupirocin, can be used for methicillin-resistant Staphylococcus aureus (MRSA) decolonisation in the prevention of nosocomial transmission. A controlled before–after study was conducted in three extended-care hospitals in Singapore. All inpatients with >48 h stay were screened for MRSA colonisation in mid-2015(pre-intervention) and mid-2016(post-intervention). Hospital A: universal daily chlorhexidine bathing throughout 2015 and 2016, with intranasal octenidine for MRSA-colonisers in 2016. Hospital B: universal daily octenidine bathing and intranasal octenidine for MRSA-colonisers in 2016. Hospital C: no intervention. In 2015, MRSA prevalence was similar among the hospitals (Hospital A: 38.5%, Hospital B: 48.1%, Hospital C: 43.4%, P = 0.288). From 2015 to 2016, MRSA prevalence reduced by 58% in Hospital A (Adj OR 0.42, 95% CI 0.20–0.89) and 43% in Hospital B (Adj OR 0.57, 95% CI 0.39–0.84), but remained similar in Hospital C (Adj OR 1.19, 95% CI 0.60–2.33), after adjusting for age, gender, comorbidities, prior MRSA carriage, prior antibiotics exposure and length of hospital stay. Compared with the change in MRSA prevalence from 2015 to 2016 in Hospital C, MRSA prevalence declined substantially in Hospital A (Adj OR 0.35, 95% CI 0.13–0.97) and Hospital B (Adj OR 0.48, 95% CI 0.22–1.03). Topical intranasal octenidine, coupled with universal daily antiseptic bathing, can reduce MRSA colonisation in extended-care facilities.
Current knowledge of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in relation to epidemiological characteristics is incomplete. We conducted a cross-sectional study at an acute-care tertiary infectious diseases hospital of MRSA isolates identified through routine surveillance from January 2009 to December 2011. We randomly selected 205 MRSA isolates (119 inpatients) from 798 isolates (427 inpatients) for molecular profiling using multilocus sequence typing. Multilevel multinomial logistic regression was used to estimate odds ratio (OR) assessing the predilection of MRSA strains for anatomic sites, and associations of strains with human immunodeficiency virus (HIV) infection. The most frequent sequence types (STs) were 239, 22 and 45. The proportion of ST22 increased over the sampling period, replacing ST239 as the dominant lineage. However, ST239 remained the most prevalent among HIV-seropositive individuals who were six times more likely to be colonised with this strain than non-HIV patients (adjusted OR (aOR) 6.44, 95% confidence interval (CI) 1.94–21.36). ST45 was >24 times more likely to be associated with perianal colonisation than in the nares, axillae and groin sites (aOR 24.20, 95% CI 1.45–403.26). This study underlines the clonal replacement of MRSA in Singapore as previously reported but revealed, in addition, key strain differences between HIV-infected and non-infected individuals hospitalised in the same environment.
Assertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China.
Sixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers.
Based on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life.
Our results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.
be a set of natural numbers. Recent work has suggested a strong link between the additive energy of
(the number of solutions to
) and the metric Poissonian property, which is a fine-scale equidistribution property for dilates of
. There appears to be reasonable evidence to speculate a sharp Khinchin-type threshold, that is, to speculate that the metric Poissonian property should be completely determined by whether or not a certain sum of additive energies is convergent or divergent. In this article, we primarily address the convergence theory, in other words the extent to which having a low additive energy forces a set to be metric Poissonian.
Identification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007–2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.
On 30 May 2012, Surrey and Sussex Health Protection Unit was called by five nurseries reporting children and staff with sudden onset vomiting approximately an hour after finishing their lunch that day. Over the following 24 h 50 further nurseries supplied by the same company reported cases of vomiting (182 children, 18 staff affected). Epidemiological investigations were undertaken in order to identify the cause of the outbreak and prevent further cases. Investigations demonstrated a nursery-level attack rate of 55 out of 87 nurseries (63·2%, 95% confidence interval 52·2–73·3). Microbiological tests confirmed the presence of Bacillus cereus in food and environmental samples from the catering company and one nursery. This was considered microbiologically and epidemiologically consistent with toxin from this bacterium causing the outbreak. Laboratory investigations showed that the conditions used by the caterer for soaking of pearl haricot beans (known as navy bean in the USA) used in one of the foods supplied to the nurseries prior to cooking, was likely to have provided sufficient growth and toxin production of B. cereus to cause illness. This large outbreak demonstrates the need for careful temperature control in food preparation.
The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.
Endothelial dysfunction and arterial stiffness are early predictors of CVD. Intervention studies have suggested that diet is related to vascular health, but most prior studies have tested individual foods or nutrients and relied on small samples of younger adults. The purpose of the present study was to examine the relationships between adherence to the 2010 Dietary Guidelines for Americans and vascular health in a large cross-sectional analysis. In 5887 adults in the Framingham Heart Study Offspring and Third Generation cohorts, diet quality was quantified with the 2010 Dietary Guidelines Adherence Index (DGAI-2010). Endothelial function was assessed via brachial artery ultrasound and arterial stiffness via arterial tonometry. In age-, sex- and cohort-adjusted analyses, a higher DGAI-2010 score (greater adherence) was modestly associated with a lower resting flow velocity, hyperaemic response, mean arterial pressure, carotid–femoral pulse wave velocity (PWV), and augmentation index, but not associated with resting arterial diameter or flow-mediated dilation (FMD). In multivariable models adjusting for cardiovascular risk factors, only the association of a higher DGAI-2010 score with a lower baseline flow velocity and augmentation index persisted (β = − 0·002, P= 0·003 and β = − 0·05 ± 0·02, P< 0·001, respectively). Age-stratified multivariate-adjusted analyses suggested that the relationship of higher DGAI-2010 scores with lower mean arterial pressure, PWV and augmentation index was more pronounced among adults younger than 50 years. Better adherence to the 2010 Dietary Guidelines for Americans, particularly in younger adults, is associated with a lower peripheral blood flow velocity and arterial wave reflection, but not FMD. The present results suggest a link between adherence to the Dietary Guidelines and favourable vascular health.
To express object transfer, Cantonese-speakers use a ‘ditransitive’ ([V–R–T] or [V–T–R] where V=Verb, T=Theme, R=Recipient), or a more complex prepositional/serial-verb (P/SV) construction. Clausal elements in Cantonese datives can be optional (resulting in ‘full’ versus ‘non-full’ forms) or appear in variant orders (full non-canonical and full canonical). We report on usage of dative constructions with the word bei2 ‘to give’ in 86 parents and 53 three-year-old children during conversations. The parents used more P/SV than ditransitive bei2-datives, and vice versa for the children. Both groups showed a similar usage pattern of optional elements and variant structures in their ditransitive and P/SV bei2-datives. The roles of multiple construction types, optional elements and variant structures in children's learning of bei2-dative constructions are described.
AlGaN/GaN high electron mobility transistors (HEMTs) with a polarized Polyvinylidene difluoride (PVDF) film coated on the gate area exhibited significant changes in channel conductance upon exposure to different ambient pressures. The PVDF thin film was deposited on the gate region with an inkjet plotter. Next, the PDVF film was polarized with an electrode located 2 mm above the PVDF film at a bias voltage of 10 kV and 70 °C. Variations in ambient pressure induced changes in the charge in the polarized PVDF, leading to a change of surface charges on the gate region of the HEMT. Changes in the gate charge were amplified through the modulation of the drain current in the HEMT. By reversing the polarity of the polarized PVDF film, the drain current dependence on the pressure could be reversed. Our results indicate that HEMTs have potential for use as pressure sensors.
It is shown that solution-grown ZnO nanostructures exhibit enhanced radiation hardness against neutron irradiation as compared to bulk material. The decrease of the cathodoluminescence intensity after irradiation at a neutron dose of 6 × 1016 cm−2 in ZnO nanostructure is nearly identical to that induced by a dose of 1.5 × 1014 cm−2 in bulk material. The damage introduced by irradiation is shown to change the nature of electronic transitions responsible for luminescence. The change of excitonic luminescence to the luminescence related to the tailing of the density of states caused by potential fluctuations occurs at an irradiation dose around 6×1016 cm−2 and 5×1014 cm−2 in nanostructured and bulk materials, respectively.
Hall measurements before and after annealing determined the effect of dose on resistance, mobility, and carrier concentration. Annealing decreased the sheet resistance, increased the mobility, and increased carrier concentration for all doses. While the concentration of carriers in the control sample increased 200-fold after annealing, the increase was ∼1000-fold for the irradiated samples. Annealed irradiated samples showed a maximum carrier concentration increase of about 60x over the unirradiated sample. Interestingly, neutron irradiation increased the mobility even in the un-annealed samples.
Notified cases of dengue infections in Singapore reached historical highs in 2004 (9459 cases) and 2005 (13 817 cases) and the reason for such an increase is still to be established. We apply a mathematical model for dengue infection that takes into account the seasonal variation in incidence, characteristic of dengue fever, and which mimics the 2004–2005 epidemics in Singapore. We simulated a set of possible control strategies and confirmed the intuitive belief that killing adult mosquitoes is the most effective strategy to control an ongoing epidemic. On the other hand, the control of immature forms was very efficient in preventing the resurgence of dengue epidemics. Since the control of immature forms allows the reduction of adulticide, it seems that the best strategy is to combine both adulticide and larvicide control measures during an outbreak, followed by the maintenance of larvicide methods after the epidemic has subsided. In addition, the model showed that the mixed strategy of adulticide and larvicide methods introduced by the government seems to be very effective in reducing the number of cases in the first weeks after the start of control.
During the SARS outbreak in Taiwan, the number of ambulatory patients and inpatients treated at one medical center decreased by 40%-70% because of the increasing number of SARS patients. A the peak of the epidemic, the amount of hospital infectious waste had increased from a norm of 0.85 kg per patient-day to 2.7 kg per patient-day. However, the hospital was able to return the generation of waste to normal levels within 10 days.
Background and purpose. Depressive symptoms are frequently associated with heart failure (HF), but the brain mechanisms underlying such association are unclear. We hypothesized that the presence of major depressive disorder (MDD) emerging after the onset of HF would be associated with regional cerebral blood flow (rCBF) abnormalities in medial temporal regions previously implicated in primary MDD, namely the hippocampus and parahippocampal gyrus.
Method. Using 99mTc-SPECT, we measured rCBF in 17 elderly MDD-HF patients, 17 non-depressed HF patients, and 18 healthy controls, matched for demographic variables. Group differences were investigated with Statistical Parametric Mapping.
Results. Significant rCBF reductions in MDD-HF patients relative to both non-depressed HF patients and healthy controls were detected in the left anterior parahippocampal gyrus and hippocampus (ANOVA, p=0·008 corrected for multiple comparisons) and the right posterior hippocampus and parahippocampal gyrus (p=0·005 corrected). In the overall HF group, there was a negative correlation between the severity of depressive symptoms and rCBF in the right posterior hippocampal/parahippocampal region (p=0·045 corrected).
Conclusions. These findings are consistent with the notion that the medial temporal region is vulnerable to brain perfusion deficits associated with HF, and provide evidence that such functional deficits may be specifically implicated in the pathophysiology of MDD associated with HF.
In this paper we study a model problem describing the movement of
a glacier under Glen's flow law and investigated by Colinge and
Rappaz [Colinge and Rappaz, ESAIM: M2AN33 (1999) 395–406]. We establish error estimates for finite
element approximation using the results of Chow [Chow, SIAM J. Numer. Analysis29 (1992) 769–780] and
Liu and Barrett [Liu and Barrett, SIAM J. Numer. Analysis33
(1996) 98–106] and give an analysis of the
convergence of the successive approximations used in [Colinge and Rappaz, ESAIM: M2AN33 (1999) 395–406].
Supporting numerical convergence studies are carried out and we
also demonstrate the numerical performance of an a
posteriori error estimator in adaptive mesh refinement
computation of the problem.
Thin films of polythiophene, a kind of polyheterocyclic compound with hydrogen function groups, were deposited by KrF excimer laser ablation of a compressed solid target in a vacuum chamber. The laser pulse fluence was approximately selected at 2 J/cm2 with a pulse duration of 25 ns. The structural, topographic, and electronic properties of the deposited thin films were analyzed by atomic force microscope, x-ray diffraction, and Raman and infrared spectroscopy measurements. Deposited thin films were observed to have good crystal properties and to be composed of crystalline cubes with a uniform size of 0.1 μm. The electronic structure of the deposited thin films should be different from the target materials, resulting from the laser irradiation effects. The influence of the deposition temperature on the structural and electronic properties of the deposited thin films was studied.
Carrier decay transients in 4H-SiC n-type and p-type epilayers have been charac-terized using a non-destructive, non-contact microwave photoconductivity technique. Decay transients show a two-stage exponential decay with first decay constants as high as 400 ns in 10 νm p-type epilayers. The second decay constant increases with temperature and is dominated by interface recombination.
The present status of development of SiC and GaN devices for high-voltage power electronics applications is reviewed. Device structures that are particularly applicable to these two wide bandgap semiconductors are considered and compared to those commonly used in silicon. The simulated and experimental performance of two-terminal rectifiers and three- terminal transistors and thyristors are compared. The effects of material parameters (mobility, ionization coefficients, lifetimes) and defects on device characteristics are pointed out. Similarities and differences between electronic and photonic device development in these semiconductors are discussed.
Low resistance ohmic contacts are difficult to form to p-type GaN and AlGaN due to the unavailability of growth methods for highly p-doped GaN and AlGaN. A p-type carbon-doped GaAs regrowth on p-GaN prior to ohmic metallization has been shown in previous work to improve contact resistance to p-GaN . Applying the regrowth method to the p-base regions of npn structured bipolar transistors, AlGaN/GaN heterojunction bipolar transistors and GaN bipolar junction transistors have been demonstrated. GaN/AlGaN epilayers were grown with a molecular beam epitaxy system. Highly carbon-doped p-GaAs (1020 cm−3) was regrown on the devices (∼500 Å) in the base contact region by metal organic chemical vapor deposition after emitter mesa etching. Emitter and base mesa structures were formed by Inductively Coupled Plasma etching under low damage conditions with a Cl2/Ar chemistry. SiO2 was used for emitter sidewall formation to reduce leakage current to the emitter, as well as for a mask for GaAs base regrowth. Very high current densities were obtained for common base operation in both device types. The devices were operable at 250 °C.