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Little is known about the economic benefits of cognitive remediation and supported employment (CR + SE). The present study aimed to investigate the cost-effectiveness of CR + SE compared with traditional vocational services (TVS).
Individuals with mental illness and low cognitive function were recruited at six sites in Japan. A total of 111 participants were randomly allocated to the CR + SE group or the TVS group. Clinical and vocational outcomes were assessed at baseline and 12-month follow-up. Service utilization data were collected monthly. The data on outcomes and costs were combined to examine cost-effectiveness.
The data were obtained from a total of 92 participants. The CR + SE group resulted in better vocational and clinical outcomes (employment rate, 62.2%; work tenures, 78.6 days; cognitive improvement, 0.5) than the TVS group (19.1%, 24.9 days and 0.2). There was no significant difference in mean total costs between the groups (CR + SE group: $9823, s.d. = $6372, TVS group: $11 063, s.d. = $11 263) with and without adjustment for covariates. However, mean cost for medical services in the CR + SE group was significantly lower than that in the TVS group after adjusting covariates (Β = −$3979, 95% confidence interval −$7816 to −$143, p = 0.042). Cost-effectiveness acceptability curves for vocational outcomes illustrated the high probabilities (approximately 70%) of the CR + SE group being more cost-effective than TVS when society is not willing to pay additional costs.
CR + SE appears to be a cost-effective option for people with mental illness who have low cognitive functioning when compared with TVS.
In this study, we used an online survey to assess knowledge, attitudes, and practices related to environmental cleaning and other infection prevention strategies among environmental services workers (ESWs) at 5 hospitals. Our findings suggest that ESWs could benefit from additional education and feedback as well as new strategies to address workflow challenges.
In the eastern Tibetan plateau both human cystic and alveolar echinococcosis (AE) caused by infection with Echincoccus granulosus or Echinococcus multilocularis, respectively are highly endemic. The domestic dog plays a key role in zoonotic transmission in this region. Our primary objective was to investigate the role of domestic dogs in maintaining transmission of E. multilocularis in Shiqu county, Sichuan. A cohort of 281 dogs was followed up over one year after a single treatment with praziquantel followed by re-infection surveillance at 2, 5 and 12 months post-treatment. Faecal samples were tested by an Echinococcus genus-specific coproantigen ELISA and two species-specific copro-PCR tests. Total Echinococcus coproantigen prevalence in Shiqu at baseline was 21% and 9·6% after 2 months. E. multilocularis copro-PCR was positive in 11·2% of dogs before treatment (vs 3·6% with E. granulosus copro-DNA), 2·9% at 2 months post-treatment, and 0% at 5 month and 12 months. The results suggest that dogs may have the potential to maintain E. multilocularis transmission within local pastoral communities, and thus dog dosing could be an effective strategy to reduce transmission of E. multilocularis as well as E. granulosus in these co-endemic Tibetan communities.
In Russia, both alveolar and cystic echinococcoses are endemic. This study aimed to identify the aetiological agents of the diseases and to investigate the distribution of each Echinococcus species in Russia. A total of 75 Echinococcus specimens were collected from 14 host species from 2010 to 2012. Based on the mitochondrial DNA sequences, they were identified as Echinococcus granulosus sensu stricto (s.s.), E. canadensis and E. multilocularis. E. granulosus s.s. was confirmed in the European Russia and the Altai region. Three genotypes, G6, G8 and G10 of E. canadensis were detected in Yakutia. G6 was also found in the Altai region. Four genotypes of E. multilocularis were confirmed; the Asian genotype in the western Siberia and the European Russia, the Mongolian genotype in an island of Baikal Lake and the Altai Republic, the European genotype from a captive monkey in Moscow Zoo and the North American genotype in Yakutia. The present distributional record will become a basis of public health to control echinococcoses in Russia. The rich genetic diversity demonstrates the importance of Russia in investigating the evolutionary history of the genus Echinococcus.
Oxygen-doped germanium crystals were used to demonstrate the interaction between implanted hydrogen or nitrogen atoms and the oxygen-related defects. The electron trap at Eo-0.26eV associated with the germanium A-center was found to be formed by electron irradiation. Another level at Eo-0.21eV also was observed on annealing at 120 °C. As for the sample implanted with hydrogen ions following electron irradiation, the trap concentration is four times as large as that for electron irradiation alone. It is probable that the germanium A-centers produced by electron irradiation capture hydrogen atoms and increase electrically active centers. After nitrogen implantation following electron irradiation, the Eo-0.26eV level almost annealed out at 140 °C and the trap at Eo-0.21eV wasn't observed. We propose that the reduction in the oxygen-related defect growth is due to the prevention of defect migration with nitrogen atoms.
Silicon-on-insulator films fabricated by the wafer bonding technique were studied with capacitance-voltage (c-V) and deep-level transient spectroscopy (DLTS) measurements. For our experiments, two kinds of SOI wafers were prepared. Many voids were present in one sample (void sample), but few voids were in the other sample (no void sample). Before annealing, two DLTS peaks (E-0.48 eV and Ec-0.38 eV) were observed in the SOI layer of the void sample. For the no void sample, different two DLTS peaks (Ec-0.16 eV and Ec-0.12 eV) were observed. The trap with an activation energy of 0.48 eV was annealed out after 450 °C annealing for 24 h. On the other hand, other traps were annealed out after 450 °C annealing for several hours. During annealing at 450 °C, thermal donors (TDs) were formed simultaneously. In usual CZ sil icon, a DLTS peak of TD was observed around 60 K. In the no void sample, however, a TD peak was observed at a temperature lower than 30 K. This TD was annihilated by rapid thermal annealing. This suggests that the TD with a shallower level was formed in the no void sample after annealing at 450 °C.
Effects of rapid thermal annealing (RTA) with a SiNx encapsulant on molecular beam epitaxial GaAs are studied with deep level transient spectroscopy (DLTS) measurements and x-ray photoelectron spectroscopy (XPS) measurements. The RTA was performed at various temperatures form 800°C to 1100°C for 6sec. The electron trap EL2 is produced by the RTA above 850°C The EL2 depth profile produced after the RTA is fitted with a complementary error function. The SiNx cap layer is more effective to prevent the formation of the EL2 than the SiO* cap layer during the RTA, because the critical temperature of the SiNx cap where the EL2 concentration starts to increase is higher than that of the SiOx cap. Slight increase of the oxidized Ga atoms is observed after the RTA near the cap surface. The enhancement of the EL2 trap is discussed considering the outdiffusion of Ga atoms into the cap layer during the RTA.
Homoepitaxial growth on 4H-SiC Si-face substrates with sizes corresponding to 150 mm was carried out. The influence of growth conditions for uniformity and epitaxial defect density was investigated. A 150 mm size was realized by using two 76.2 mm wafers lined up in a radial direction. C/Si ratio is found to be a major parameter for controlling triangular defect density and the generation of step bunching. As a result, the surface morphology without bunched step structure and the triangular defect density with 0.5 cm−2 were obtained by decreasing C/Si ratio to 1.0 on the size corresponding to 150 mm. Under this condition, good carrier concentration and thickness uniformity of σ/mean =15.2 % and 1.7 % could be obtained.
Metal deposition on a p-sexiphenyl (6P) film was studied by ultraviolet photoelectron spectroscopy (UPS), metastable atom electron spectroscopy (MAES), and X-ray photoelectron spectroscopy (XPS). The deposited metals were Au, Mg, and several alkali metals (K, Na, Rb, and Cs). No chemical reaction between 6P and Au or Mg was observed in the measured spectra, while additional gap states appeared in the UPS and MAES spectra by deposition of the alkali metals. The diffusion of Au and Mg atoms into the 6P film was observed in the MAES spectra. We found the trend of the vacuum level shift is different between the systems of the 6P on the Au and its reversed systems (Au on the 6P film), suggesting the different formation of the interface depending on the deposition sequence.
We have developed a new type of FC which shows high performance at intermediate temperatures to solve the disadvantage of using hydrocarbon as fuel to FC system. This new FC is an ultra-thin proton conductor electrolyte supported by a metal hydrogen membrane. We have named it Hydrogen Membrane Fuel Cell
The HMFC using BaCe0.8Y0.2O3 (BCY) as the electrolyte and pure Palladium as the substrate exhibits a high cell performance of 2.7 A/cm2 @0.5V, 873K and 1.8 A/cm2 @0.5V, 673K. But the BCY cell performance drops rapidly during several hours. It was inferred that this phenomenon is caused by BCY electrolyte dissolved by hydrothermal reaction with H2O vapor which was generated by the fuel cell reaction.
We studied the possibility as HMFC electrolyte of Ba(Ce0.5Zr0.5)0.8YO3 (BCZY) and BaZr0.8Y0.2O3 (BZY) which are exchanged the B site of BCY perovskite ceramic from Ce to Zr to improve the resistance against the hydrothermal dissolution. BCZY and BZY confirmed the resistance against the hydrothermal dissolution improved compared with BCY by analyzing after the hydrothermal treatment. The BCZY cell shows the same level of the performance as the BCY cell and the performance stability has improved over the BCY cell.
It is argued that epitaxial films of ionically-bonded materials are more easily achieved than of covalently bonded materials. Good epitaxy can be achieved despite relatively large lattice mismatch with respect to the substrate. However, the strong influence of interfacial energy can result in difficulty in controlling the orientation of epitaxial films.
The crystallographic orientation of ionically-bonded LiNbO3 films was therefore studied. Growth orientation could be controlled by paying attention to the bonding between octahedra in the structure, and to the formation of the octahedra containing lithium and niobium ions. Lithium concentration could be increased by increasing the rf power, 02 partial pressure and total gas pressure, and decreasing the substrate temperature during deposition.
The orientation of the film changed from (012) to (100) via (110) by increasing the Li concentration in the film. The (012) and (100) films were epitaxial with respect to the substrate. In particular, the (100) films were of exce lent quality, being single crystalline with smooth surfaces.
Kinetics of Ge segregation during molecular beam epitaxial growth is described. It is shown that the Ge segregation is self-limited in Si epitaxial overlayers due to a high concentration effect when the Ge concentration exceeds 0.01 monolayer (ML). As a result, segregation profiles of Ge are found to decay non-exponentially in the growth direction. This unusual Ge segregation was found to be suppressed with an adlayer of strong segregant, Sb, during the kinetic MBE growth. We develop a novel scheme to realize sharp Si/Ge interfaces with strong segregante. Lower limit of the effective amount of Sb for this was found to be 0.75 ML.
We investigated the initial oxidation of MBE-grown Si (100) surfaces with atomic flatness using x-ray photoemission spectroscopy (XPS) and reflection high energy electron diffraction (RHEED). It was found that the MBE-grown surfaces are inert and hardly oxidized even after exposure to molecular oxygen up to 1500 Langmuir (L) at room temperature. At elevated temperatures, the surface oxidation was substantially promoted. On the contrary, the surface oxidation was found to be substantiated on a deliberately corrugated Si surface prepared by low temperature MBE growth, even at room temperature.
We have studied interfacial mixing of Si/Ge strained-layer superlattices during Si molecular beam epitaxy. The mixing has been shown to be primarily due to the surface segregation of Ge atoms during Si overlayer growth. It has been found that only the Ge atoms on the topmost Ge layer dominantly segregate to the growing surface. It has also been found that the surface segregation of Ge is effectively suppressed by depositing Sb atoms on the Ge layers. It has been demonstrated that Si/Ge superlattices with abrupt Si/Ge interfaces can be grown by depositing Sb. The two state exchange model is used to discuss the surface segregation of Ge and the suppression of the segregation by Sb deposition.
The x-ray reflectivity and surface morphology of C/W multilayers fabricated by ion beam sputtering (IBS) method was evaluated. Also the surface roughness and amorphous structure of C and W films fabricated by direct ion beam deposition (DIBD) method were evaluated as a function of ion energy. The reflectivity was measured by the C-K line (4.47nm) and STM was used for surface roughness measurement and root-mean-square value of correlation function of the RHEED pattern was used for evaluation of amorphous structure. The reflectivity of C/W multilayer was about 69% of the theoretical one, and micro-columnar structures were observed from STM images. The film structure and surface roughness of DIBD film were changed with the depositing ion energy. The surface roughness of films becomes smaller as the depositing energy becomes higher in the energy range from 20 to 140eV.
The metal oxide strontium titanate is a promising material for resistive high temperature oxygen sensors (T > 1000 K), that can be applied to control combustion engines. However, a disadvantage of this and of many other metal oxides is the strong temperature dependence of conductivity. In this work, we show that the temperature dependence of Sr(Ti1-x, Fex)O3-δ can be adjusted by the iron content. For x = 0.35 the thermal activation of the conductivity is near zero for a distinct temperature and oxygen partial pressure range (T = 1000 K - 1200 K, PO2 = 10 to 105 Pa). Short response times in the range of 10 ms can be realized by using sensors in thick film technology
The aim of this work is to use biodegradable polymers as a scaffold for self-reconstruction of defective tissue which has the capacity to regenerate; for instance, cartilage, blood vessel, bone, peripheral nervous system, and liver. After seeding parenchymal cells of the target tissue on the scaffold, the cellpolymer composite will be implanted as the core tissue for reconstruction. There is another approach for this purpose, that is, the use of hybrid-type artificial organs, but they have several problems such as poor viability and low capacity. In addition, it is difficult to culture cells on a large enough scale to maintain biofunctionality. However, these problems may be solved if tissue is self-reconstructed in body on a scaffold seeded with the cells originated from the objective tissue