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The 13-valent pneumococcal conjugate vaccine (PCV) has been part of routine immunisation in a 2 + 1 schedule (two primary infant doses and one booster during the second year of life) in the UK since 2010. Recently, the UK's Joint Committee on Vaccination and Immunisation recommended changing to a 1 + 1 schedule while conceding that this will increase disease burden; however, uncertainty remains on how much pneumococcal burden – including invasive pneumococcal disease (IPD) and non-invasive disease – will increase. We built a dynamic transmission model to investigate this question. The model predicted that a 1 + 1 schedule would incur 8777–27 807 additional cases of disease and 241–743 more deaths over 5 years. Serotype 19A caused 55–71% of incremental IPD cases. Scenario analyses showed that booster dose adherence, effectiveness against carriage and waning in a 1 + 1 schedule had the most influence on resurgence of disease. Based on the model assumptions, switching to a 1 + 1 schedule will substantially increase disease burden. The results likely are conservative since they are based on relatively low vaccine-type pneumococcal transmission, a paradigm that has been called into question by data demonstrating an increase of IPD due to several vaccine serotypes during the last surveillance year available.
Hyphal cells of filamentous fungi grow at their tips in a method analogous to pollen tube and root hair elongation. This process, generally referred to as tip growth, requires precise regulation of the actin cytoskeleton, and characterizing the various actin structures in these cell types is currently an active area of research. Here, the actin marker Lifeact was used to document actin dynamics in the filamentous fungus Aspergillus nidulans. Contractile double rings were observed at septa, and annular clusters of puncta were seen subtending growing hyphal tips, corresponding to the well-characterized subapical endocytic collar. However, Lifeact also revealed two additional structures. One, an apical array, was dynamic on the face opposite the tip, while a subapical web was dynamic on the apical face and was located several microns behind the growth site. Each was observed turning into the other over time, implying that they could represent different localizations of the same structure, although hyphae with a subapical web grew faster than those exhibiting an apical array. The subapical web has not been documented in any filamentous fungus to date, and is separate from the networks of F-actin seen in other tip-growing organisms surrounding septa or stationary along the plasmalemma.
The role of interfacial exchange coupling in the magnetic behavior of metal oxide materials has been investigated through the study of Fe3O4/NiO superlattices. We report results on a series of superlattices grown where one bilayer constituent was held to a fixed thickness while varying the other from single unit cell dimensions upward. High crystalline quality was confirmed by XRD, RHEED and neutron diffraction. Magnetization profiles show substantial deviations from bulklike iron oxide results, with an increase in domain rotation energies observed in the superlattices over that of bulk iron oxide (increasing with NiO layer thickness) indicating the strong nature of Fe3O4/NiO interfacial linkage. Neutron scattering at elevated temperatures shows that the NiO remains ordered above the 523 K bulk Néel temperature. This suggests that at least a portion of the NiO within a layer remains ordered well above the Néel temperature, with an increase in effective Néel transition temperature that approaches the Fe3O4 Curie temperature in the limit of very thin NiO layers. Although the exchange coupling dominates these effects, strain also plays an important role.
It has been suggested that childhood obsessive-compulsive disorder (OCD) may be a risk factor for the development of an eating disorder (ED) later in life, but prospective studies are lacking. We aimed to determine the prevalence of ED at follow-up and clinical predictors in a longitudinal clinical sample of adolescents/young adults diagnosed with OCD in childhood.
All contactable (n=231) young people with OCD assessed over 9 years at a national and specialist paediatric OCD clinic were included in this study. At follow-up, 126 (57%) young people and parents completed the ED section of the Developmental and Well-being Assessment. Predictors for ED were investigated using logistic regression.
In total, 16 participants (12.7%) had a diagnosis of ED at follow-up. Having an ED was associated with female gender and persistent OCD at follow-up. There was a trend for family history of ED being predictive of ED diagnosis. Five (30%) of those who developed an ED at follow-up had ED symptoms or food-related obsessions/compulsions at baseline. A difference in predictors for an ED versus other anxiety disorders at follow-up was identified.
This study provides initial evidence that baseline clinical predictors such as female gender and family history of ED might be specific to the later development of ED in the context of childhood OCD. Clinicians should be alert to ED subthreshold symptoms in young girls presenting with OCD. Future longitudinal studies are needed to clarify the relationship between childhood OCD and later ED.
The relationship between the morphologies and crystal structures of sputter-deposited MoS2 films and their lubricating capabilities is discussed. In particular, aspects of plastic deformation processes are presented. Scanning elecron microscopy (top surface and cross sectional), transmission electron microscopy (lattice imaging and dark field), and x-ray diffraction techniques were used to characterize film structure. The asdeposited morphology, which can be described in terms of zone models, was found to influence the initial nature of the wear debris and the loadbearing capabilities of the films. In many cases a highly deformed region confined to the surface of the films was found. Applied stress was found to reorient crystallites and to induce crystallization, with the degree of both processes being related to the initial structure of the film. Criteria are presented for selecting the film type and preparation conditions to fit various applications.
A survey was conducted of existing technologies for moving mechanical assemblies used in spacecraft applications. The purpose was to identify areas where future requirements for lifetimes in excess of ten years with anticipated speeds, loads, and temperatures might not be satisfied. Some specific mechanisms, such as momentum/reaction wheels, high-speed turbines, pointing and tracking mechanisms, despin mechanisms, and gimbal mechanisms, were identified as areas for potential application of existing but unused technologies. Two major problem areas identified involve boundary-regime lubrication and lubricant supply (active or passive) for long life. Areas where substantial, near-term improvements appear practical include the use of hybrid bearings, new synthetic fluid lubricants, new bearing retainer materials, and properly designed solid-film lubricants.
Crystal damage of GaAs(100) caused by Reactive Ion Etching (RIE) using a mixture of Cl2 and Ar gas has been assessed using Surface Roughness (Ra), Resonant Raman Spectroscopy (RRS), Schottky diodes, and Spectroscopic Ellipsometry (SE). Plasma conditions for minimum induced damage have been determined and compared to optimised RIE processes using plasma gases SiCl4, CH4-H2, CCl2F2 and Ar. The SiCl4 plasma was found to produce the least crystal damage.
AuTiAlTi, AuPdAlTi and AuAlTi ohmic contacts to AlGaN/GaN layers rapid thermal annealed at temperatures up to 950°C have been characterised using conventional and chemical transmission electron microscopy techniques. The relationship between the as-deposited metallic structure, annealing temperature, post-anneal interfacial microstructure and contact resistance is examined.
The presence of a TiN interfacial layer is found to correlate with the onset of ohmic behaviour. Ti and Pd barrier layers are found to be ineffective at stopping the diffusion of Au to the interface. Au is implicated in the development of the inclusions, which are associated with threading dislocations. Once activated, the presence of the inclusions has little influence on the ohmic behaviour of the sample.
Many U.S. Army systems, such as ground vehicles and fully equipped soldiers, are comprised of multiple subcomponents which each typically perform unique functions. Combining these functions into single, multifunctional components could reduce mass and improve overall system efficiency. In particular, creating structural materials that also provide power generating or energy storing capacity could provide significant weight savings over a range of platforms. In this study, structural composite batteries, fuel cells, and capacitors are proposed. To ensure performance benefits, these multifunctional composites are designed so that the materials involved in power and energy processes are also load bearing, rather than simply packaged within monofunctional structural materials. Fabrication and design details for these multifunctional systems, as well as structural and power/energy performance results, are reported. Critical material properties and fabrication considerations are highlighted, and important technical challenges are identified.
Obsessive–compulsive disorder (OCD) often starts in childhood and adolescence and can be a chronic disorder with high persistence rates. There are few prospective long-term follow-up studies.
To follow up young people with OCD to clarify persistence rates and relevant predictors, presence of other psychiatric disorders, functional impairment, service utilisation and perceived treatment needs.
All young people with OCD assessed over 9 years at the National and Specialist Paediatric OCD clinic, Maudsley Hospital, London, were included. Sixty-one per cent (142 of 222) of all contactable young people and parents completed computerised diagnostic interviews and questionnaires.
We found a persistence rate of OCD of 41%; 40% of participants had a psychiatric diagnosis other than OCD at follow-up. The main predictor for persistent OCD was duration of illness at assessment. High levels of baseline psychopathology predicted other psychiatric disorders at follow-up. Functional impairment and quality of life were mildly to moderately affected. Approximately 50% of participants were still receiving treatment and about 50% felt a need for further treatment.
This study confirms that paediatric OCD can be a chronic condition that persists into adulthood. Early recognition and treatment might prevent chronicity. Important challenges for services are ensuring adequate treatment and a smooth transition from child to adult services.
Defining the causal relationship between a microbe and encephalitis is complex. Over 100 different infectious agents may cause encephalitis, often as one of the rarer manifestations of infection. The gold-standard techniques to detect causative infectious agents in encephalitis in life depend on the study of brain biopsy material; however, in most cases this is not possible. We present the UK perspective on aetiological case definitions for acute encephalitis and extend them to include immune-mediated causes. Expert opinion was primarily used and was supplemented by literature-based methods. Wide usage of these definitions will facilitate comparison between studies and result in a better understanding of the causes of this devastating condition. They provide a framework for regular review and updating as the knowledge base increases both clinically and through improvements in diagnostic methods. The importance of new and emerging pathogens as causes of encephalitis can be assessed against the principles laid out here.
Increasingly serious shortages of water make it imperative to improve the efficiency of irrigation in agriculture, horticulture and in the maintenance of urban landscapes. The main aim of the current review is to identify ways of meeting this objective. After reviewing current irrigation practices, discussion is centred on the sensitivity of crops to water deficit, the finding that growth of many crops is unaffected by considerable lowering of soil water content and, on this basis, the creation of improved means of irrigation scheduling. Subsequently, attention is focused on irrigation problems associated with spatial variability in soil water and the often slow infiltration of water into soil, especially the subsoil. As monitoring of soil water is important for estimating irrigation requirements, the attributes of the two main types of soil water sensors and their most appropriate uses are described. Attention is also drawn to the contribution of wireless technology to the transmission of sensor outputs. Rapid progress is being made in transmitting sensor data, obtained from different depths down the soil profile across irrigated areas, to a PC that processes the data and on this basis automatically commands irrigation equipment to deliver amounts of water, according to need, across the field. To help interpret sensor outputs, and for many other reasons, principles of water processes in the soil–plant system are incorporated into simulation models that are calibrated and tested in field experiments. Finally, it is emphasized that the relative importance of the factors discussed in this review to any particular situation varies enormously.
Pathological lesions confined to the internal auditory canal (IAC) commonly present with cochleovestibular symptoms; sensorineural hearing loss, tinnitus and balance disturbance. The commonest lesion of the IAC is vestibular schwannoma. Other lesions include meningioma, facial neuroma, cavernous haemangioma, lipoma and arachnoid cyst. Presentation with facial palsy and an intracanalicular lesion is suggestive of pathology other than acoustic neuroma. Magnetic resonance imaging (MRI) cannot reliably distinguish intracanalicular vestibular schwannomas from meningiomas. Particular care is required for surgery of these lesions: the facial nerve typically does not lie in a protected anterior position within the IAC.