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Fatigue syndromes (FSs) affect large numbers of individuals, yet evidence from epidemiological studies on adverse outcomes, such as premature death, is limited.
Cohort study involving 385 general practices in England that contributed to the Clinical Practice Research Datalink (CPRD) with linked inpatient Hospital Episode Statistics (HES) and Office for National Statistics (ONS) cause of death information. A total of 10 477 patients aged 15 years and above, diagnosed with a FS during 2000–2014, were individually matched with up to 20 comparator patients without a history of having a FS. Prevalence ratios (PRs) were estimated to compare the FS and comparison cohorts on clinical characteristics. Adjusted hazard ratios (HRs) for subsequent adverse outcomes were estimated from stratified Cox regression models.
Among patients diagnosed with FSs, we found elevated baseline prevalence of: any psychiatric illness (PR 1.77; 95% CI 1.72–1.82), anxiety disorders (PR 1.92; 1.85–1.99), depression (PR 1.89; 1.83–1.96), psychotropic prescriptions (PR 1.68; 1.64–1.72) and comorbid physical illness (PR 1.28; 1.23–1.32). We found no significant differences in risks for: all-cause mortality (HR 0.99; 0.91–1.09), natural death (HR 0.99; 0.90–1.09), unnatural death (HR 1.00; 0.59–1.72) or suicide (HR 1.68; 0.78–3.63). We did, however, observe a significantly elevated non-fatal self-harm risk: HR 1.83; 1.56–2.15.
The absence of elevated premature mortality risk is reassuring. The raised prevalence of mental illness and increased non-fatal self-harm risk indicate a need for enhanced assessment and management of psychopathology associated with fatigue syndromes.
Pale soft exudative pork (PSE) is a major problem affecting swine industries worldwide that results in significant economic loss because it reduces processing and saleable product yields. The PSE condition results from a rapid rate of muscle glycolysis early postmortem and a rapid drop in muscle pH while the temperature of the carcass is still high. Stress prior to slaughter can increase the rate of glycolysis and postmortem acidification. Blood acid-base has been used as an indicator of stress in pigs. The objective of this experiment was to investigate the relationship between blood acid-base status at slaughter and fresh meat quality in pigs.
Little is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses.
Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged ⩾16 years who died by suicide during 2002–2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899).
Risk was raised among non-consulting patients, and increased sharply with rising number of consultations in the preceding year [⩾12 consultations v. 1: unadjusted odds ratio (OR) 6.0, 95% confidence interval (CI) 4.9–7.3]. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types (⩾5 types v. 0: OR 62.6, CI 44.3–88.4) and with having several psychiatric diagnoses (⩾4 diagnoses v. 0: OR 31.1, CI 19.3–50.1). Risk was also raised among patients living in more socially deprived localities. The confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing consultation frequency.
A greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-consulters are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties.
Childhood maltreatment and a family history of a schizophrenia spectrum disorder (SSD) are each associated with social-emotional dysfunction in childhood. Both are also strong risk factors for adult SSDs, and social-emotional dysfunction in childhood may be an antecedent of these disorders. We used data from a large Australian population cohort to determine the independent and moderating effects of maltreatment and parental SSDs on early childhood social-emotional functioning.
The New South Wales Child Development Study combines intergenerational multi-agency data using record linkage methods. Multiple measures of social-emotional functioning (social competency, prosocial/helping behaviour, anxious/fearful behaviour; aggressive behaviour, and hyperactivity/inattention) on 69 116 kindergarten children (age ~5 years) were linked with government records of child maltreatment and parental presentations to health services for SSD. Multivariable analyses investigated the association between maltreatment and social-emotional functioning, adjusting for demographic variables and parental SSD history, in the population sample and in sub-cohorts exposed and not exposed to parental SSD history. We also examined the association of parental SSD history and social-emotional functioning, adjusting for demographic variables and maltreatment.
Medium-sized associations were identified between maltreatment and poor social competency, aggressive behaviour and hyperactivity/inattention; small associations were revealed between maltreatment and poor prosocial/helping and anxious/fearful behaviours. These associations did not differ greatly when adjusted for parental SSD, and were greater in magnitude among children with no history of parental SSD. Small associations between parental SSD and poor social-emotional functioning remained after adjusting for demographic variables and maltreatment.
Childhood maltreatment and history of parental SSD are associated independently with poor early childhood social-emotional functioning, with the impact of exposure to maltreatment on social-emotional functioning in early childhood of greater magnitude than that observed for parental SSDs. The impact of maltreatment was reduced in the context of parental SSDs. The influence of parental SSDs on later outcomes of maltreated children may become more apparent during adolescence and young adulthood when overt symptoms of SSD are likely to emerge. Early intervention to strengthen childhood social-emotional functioning might mitigate the impact of maltreatment, and potentially also avert future psychopathology.
Recent advances utilizing forced assembly multilayer coextrusion have led to the development of a new approach to study the structure–property relationships of confined polymer crystallization. Confinement of crystalline polymer materials in layer thicknesses ranging from hundreds to tens of nanometers thick, resulted in multilayer films possessing enhanced gas barrier properties. The enhanced gas barrier has been attributed to nanolayer confinement of the crystalline polymer resulting in a highly ordered intralayer lamellae orientation extending over micron or larger scale areas. Research into the confined crystallization mechanism of the multilayered polymer films has resulted in several material case studies as well as an understanding of the chemical and thermodynamic parameters that control the degree and rate of the confinement in multilayer polymer systems. This review highlights our recent studies on the confinement of poly(ethylene oxide), poly(ε-caprolactone), polypropylene, and poly(vinylidene fluoride) polymers in multilayered films.
Contemporary web-based communication technologies often present a juxtaposition of multiple sources. In January of 2009, for instance, CNN.com and Facebook.com partnered so that internet users could see and hear President Barack Obama's inauguration in one window, and read and write comments about it with myriad other viewers in another window. YouTube.com presents not only videos but also the comments that viewers have posted about the video. Facebook.com supports individuals’ self-descriptive information online, but also “wall postings” by a profile owner's friends, which may enhance, modify, or contradict the self-presentations individuals attempt to make. Sellers on eBay advertise goods online, and other buyers’ ratings of those sellers are a click away. Travel sites offer hotel listings alongside ratings and reviews by previous guests. And in addition to the overt comments and statements left online by people, the computational systems supporting these interactions often provide interesting statistical coefficients summarizing the evaluations or even the electronic footprints users leave behind: How many people rated a product evaluation as useful? How many times has a viral video been viewed, or a journal article been downloaded? How many friends does an individual have on Facebook? In all of these cases, there is a central message, and there are socially generated responses. How do these mutual sources of influence affect users?
New communication technologies are changing the manner of reception by which individuals acquire information from institutional, interpersonal, and peer information sources. Technology changes the temporal and contiguous presentations of these sources, and may in fact change the information processing and social influence dynamics among these sources; that is, the sequence with which sources are sampled or the simultaneity with which they appear may have potent effects on the information processing filters and biases. Such developments in communication technologies are raising new questions and resurrecting old questions about the interplay of interpersonal and mass communication. New technologies blur the boundaries between interpersonal and mass communication events and/or the roles that communicators take using new systems. Arguments have been made that the “convergence” of old and new media demands new and unified perspectives on traditionally segregated processes. “Media convergence” is a term that has been used to connote several phenomena that are brought about by advancements in telecommunication technology that may change some aspect of the communication process. Sometimes the term refers to the blending of previously individuated mass media: one can watch movies on one's computer, for example. We wish to discuss another kind of convergence: the potential for simultaneous communication via computers of both mass and interpersonal channels. Additionally, new and salient sources of information are present, and potentially influential, via contemporary online information systems: peer communication and computational summaries of social behavior. How these forms and sources of information coalesce, confirm, or contradict one another asks for conceptual and analytic frameworks to address them. New technologies invite research that will advance understanding of how individuals conceptualize communication and interpret messages, and how their attitudes are changed as a result of new mediated message forms and content.
A well-known process for thinning of silicon by slicing submicron-thick crystalline films from substrates uses direct implantation of protons. In this paper we describe a different way of delivering hydrogen to a cleavage plane. In our process a defect-rich buried layer is first formed with ion implantation. Defects in the as-implanted silicon work as traps for hydrogen. Next monatomic hydrogen is delivered to the trap layer by electrolytic charging. To check sliceability, the samples were annealed and blistering was observed. Evidence of blistering is a sign of potential cleavage. The electrolytic charging was performed using a simple two-electrode cell. The front side of the as-implanted silicon wafer was exposed to an electrolyte. The backside of the wafer was contacted with an aluminum layer and connected to a current source. The acidic electrolyte was buffered with ethylene glycol. Buffering was used to suppress bubbling on the wafer surface and to improve the uniformity of charging. To increase charging current the wafer was illuminated with visible light. A graphite rod was used as the positive electrode in the cell. A few Coulombs per square centimeter of the wafer were passed through the cell during the hydrogenation process. The depth of blisters is about 1/2 of projection range of the implanted ions. It means that the hydrogen platelets are formed in the region of maximum of vacancy- enriched post-implantation defects. This process of electrolytic hydrogen charging may be used in future to manufacture silicon-on-insulator wafers with very thin top silicon layer. Thin SOI offers important advantages in the production of substrates for mainstream CMOS integrated circuit manufacturing.
Mechanically strong, environmentally stable, and electrically conductive polymeric films and fibers can be fabricated by processing (dry-jet, wet-spinning) solutions of PPBT and metallophthalocyanine molecular metal precursors, followed by chemical or electrochemical oxidation. X-ray diffraction, and resonance Raman measurements on (PPBT)-[Ni(Pc)I]x fibers indicate a microstructure consisting of small Ni(Pc)I crystallites imbedded in a PPBT matrix. Cyclic voltammetry and controlled potential coulometry indicate that PPBT/NiPc films can be reversibly doped.
In this study, we report the synthesis and characterization of a new, systematically designed class of second-order NLO polymers in which the appended chromophoric substituent is modified (hydroxylated) to allow direct chromophore involvement in hydrogen-bonding and crosslinking. Thus, the glassy polymer poly(p-hydroxystyrene) has been functionalized to varying levels with the N-(3-hydroxy-4-nitrophenyl)-(S)-prolinoxy (HNPP) high-β chromophore. The time-dependent second harmonic generation characteristics of thin films of this material have been studied at λ = 1.064 μm as a function of chromophore functionalization level, hydrogen-bonding capacity, and thermal crosslinking. These materials are found to possess high d33 values (up to 34 × 10−9 esu) and long characteristic SHG decay times (longer than a year). Analysis of the decay of the second harmonic signal shows that increasing hydrogen-bonding density substantially increases relaxation times; it is further shown that introduction of crosslinks is yet more effective in imparting SHG temporal stability to these polymeric nonlinear optical materials.
The use of microwave frequency radiation as an alternative energy source for processing materials is currently receiving considerable worldwide attention. The ability of a material to extract energy from the microwave field depends upon its dielectric properties, however these change as the material heats. There is, therefore, a need for obtaining measurements of the microwave dielectric properties at elevated temperatures. This paper outlines some of the current work on high temperature dielectric measurements which is in progress at the University of Nottingham as part of the Materials and Microwave Processing Group initiative and some results on engineering ceramics are presented.
Electrically conducting composite polypyrrole/poly(p-phenyleneterephthalamide) (PPTA or KEVLAR) fibers have been prepared by chemical polymerization of pyrrole within the interstices of the hydrogen-bonded gel structure of never-dried PPTA fibers. The resultant fibers contain a uniform dispersion of polypyrrole, as evidenced by scanning electron microscopy. The temperature dependence of the electrical conductivity of these hybrid fibers is presented. The conductivity is well described by the fluctuation-induced charge transport model over the entire temperature range of interest. However, the low temperature electrical conductivity also exhibits a hoppinglike temperature dependence, and an Arrhenius-like temperature dependence is observed in the high temperature limit. Measurements of the temperaturedependent tbermopower are indicative of a p-type carrier.
To determine the accuracy of fine needle aspiration cytology conducted within a standard ENT out-patients service (rather than a one-stop neck lump clinic), and also to assess the value of ultrasound guidance during fine needle aspiration cytology.
Retrospective study of all patients undergoing fine needle aspiration cytology of a neck lump, from 2005 to 2008 in Leeds teaching hospitals.
Main outcome measures:
Accuracy of fine needle aspiration cytology, compared with the corresponding histology report of the original surgical specimen, and non-diagnostic fine needle aspiration cytology rates with and without ultrasound.
Fine needle aspiration cytology yielded the following respective sensitivity, specificity and accuracy rates: 85, 91 and 87 per cent for lymph nodes; 80, 93 and 89 for salivary glands; and 52, 80 and 69 for thyroid. The proportion of non-diagnostic procedures was 28 per cent, both with and without ultrasound guidance.
Cytologist-led fine needle aspiration cytology would have reduced the time to diagnosis and the number of clinic visits per patient. Fine needle aspiration cytology was accurate for predicting malignancy in salivary gland and lymph node lesions, and for diagnosing lymph node pathology. Study results did not support the use of ultrasound guidance during fine needle aspiration cytology.