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Patients with severe mental disorders in low-resource settings have limited access to services, resulting in overwhelming caregiving burden for families. In extreme cases, this has led to the long-term restraining of patients in their homes. China underwent a nationwide initiative to unlock patients and provide continued treatment. This study aims to quantify household economic burden in families after unlocking and treatment, and to identify factors associated with increased burden due to schizophrenia.
A total of 264 subjects were enrolled from three geographically diverse provinces in 2012. Subjects were patients with schizophrenia who were previously put under restraints and had participated in the ‘unlocking and treatment’ intervention. The primary outcome was the current household economic burden, obtained from past year financial information collected through on-site interview. Patient disease characteristics, treatment, outcomes and family caregiving burden were collected as well. Univariate and multivariate linear regression were used to construct risk factor models for indirect economic burden.
After participating in the intervention, 85% of patients continued to receive mental health services, 70% used medication as prescribed and 80% were never relocked. Family members reported significantly decreased caregiving burden after receiving the intervention. Mean direct and indirect household economic burdens were CNY963 (US$31.7) and CNY11 724 (US$1670) per year, respectively, while family total income was on average CNY12 108 (US$1913) per year. Greater disease severity and poorer patient psychosocial function at time of study were found to be independent factors related to increased indirect burden.
The ‘unlocking and treatment’ intervention has improved the lives of patients and families. Indirect burden due to disease is still a major economic issue that needs to be addressed, potentially through improving treatment and patient functioning. Our findings contribute to the unravelling and eventual elimination of chronic restraining of mentally ill patients in low-resource settings.
Echinococcus granulosus sensu stricto is regarded to have the highest zoonotic potential of all Echinococcus taxa. Globally, human infection due to this species constitutes over 88.44% of the total cystic echinococcosis (CE) burden. Here, we report a CE infection in a Nigerian camel caused by E. granulosus G1 genotype. To the best of our knowledge, this report is the first encounter of the G1 genotype in the West Africa sub-region where the G6 genotype is reportedly prevalent, suggesting that the epidemiology of this highly zoonotic group could have a wider host range and distribution in the sub-region, and emphasizes the need for further investigation into the genetic diversity of Echinococcus spp. in Nigeria and across the sub-region.
Background: Meningiomas are the most commonly occurring benign intracranial tumors. When presenting with peritumoral brain edema (PTBE), surgical treatment can lead to patient morbidity. This retrospective case series aims to describe the conservative medical management of moderate to large meningiomas with large PTBE. Methods: Patients with suspected meningiomas greater than 2.0cm and edema index greater than 2.0 were identified by screening 3345 MRI scans between 2012-2017. Imaging analysis included MR imaging features of suspected meningiomas and clinical data was gathered from the electronic patient record (patient age, sex, patient symptoms, follow-up duration, and follow-up symptoms). Results: We report on 31 patients who received conservative medical management. Presenting complaints included headache, seizure, weakness; many presented asymptomatically. The average follow-up time was 3.96 years. At the final follow-up appointment, 19 (61%) patients were asymptomatic. Among symptomatic patients, seizures were the most common complaint. There was no mortality reported in our cohort and the average tumor progression was 7.04cm3/year. Conclusions: In this retrospective report of meningioma patients with high edema index, we found that most patients remained asymptomatic or had stable symptoms after at least 1-yr follow up after medical treatment. This study provides insight around the surgical decision-making for meningiomas with large spread of edema.
Methods of obtaining large grain size and high crystallinity in absorber materials play an important role in fabrication of high-performance methylammonium lead iodide (MAPbI3) perovskite solar cells. Here we study the effect of adding small concentrations of Cd2+, Zn2+, and Fe2+salts to the perovskite precursor solution used in the single-step solution fabrication process. Enhanced grain size and crystallinity in MAPbI3 films were obtained by using 0.1% of Cd2+ or Zn2+in the precursor solution. Consequently, solar cells constructed with Cd- and Zn-doped perovskite films show a significant improvement in device performance. These results suggest that the process may be an effective and facile method to fabricate high-efficiency perovskite photovoltaic devices.
Monolithic integrated thin film tandem solar cells consisting of a high bandgap perovskite top cell and a low bandgap thin film bottom cell are expected to reach higher power conversion efficiencies (PCEs) with lower manufacturing cost and environmental impacts than the market-dominant crystalline silicon photovoltaics. There have been several demonstrations of 4-terminal and 2-terminal perovskite tandem devices with CuInGaSe2 (CIGS) or CuInSe2 (CIS) and, similar to the other tandem structures, the optimization of this device relies on optimal choice for the perovskite bandgap and thickness. Therefore, further advancement will be enabled by tuning the perovskite absorber to maximize the photocurrent limited by the current match condition. Here, we systematically study the optical absorption and transmission of perovskite thin films with varying absorber band gap. Based on these results, we model the photocurrent generations in both perovskite and CIS subcells and estimate the performances of projected tandem devices by considering the ideally functioning perovskite and CIS device. Our results show that for perovskite layers with 500 nm thickness the optimal bandgap is around 1.6 eV. With these configurations, PCEs above 20% could be achieved by monolithically integrated perovskite/CIS tandem solar cells. Also by modelling the absorption at every layer we calculate the quantum efficiency at each subcell in addition to tracking optical losses.
Auditory verbal hallucinations (AVHs) are one of the most common and severe symptoms of schizophrenia, but the neuroanatomical abnormalities underlying AVHs are not well understood. The present study aims to investigate whether AVHs are associated with cortical thinning.
Participants were schizophrenia patients from four centers across China, 115 with AVHs and 93 without AVHs, as well as 261 healthy controls. All received 3 T T1-weighted brain scans, and whole brain vertex-wise cortical thickness was compared across groups. Correlations between AVH severity and cortical thickness were also determined.
The left middle part of the middle temporal gyrus (MTG) was significantly thinner in schizophrenia patients with AVHs than in patients without AVHs and healthy controls. Inferences were made using a false discovery rate approach with a threshold at p < 0.05. Left MTG thickness did not differ between patients without AVHs and controls. These results were replicated by a meta-analysis showing them to be consistent across the four centers. Cortical thickness of the left MTG was also found to be inversely correlated with hallucination severity across all schizophrenia patients.
The results of this multi-center study suggest that an abnormally thin left MTG could be involved in the pathogenesis of AVHs in schizophrenia.
A field experiment was conducted to quantify changes in soil aggregation and aggregate-associated soil organic carbon (SOC) concentration 1, 3, 5 and 10 years after abandoned, salinized land in the Manasi River Basin was reclaimed for cotton (Gossypium hirsutum L.). Results showed that reclamation significantly increased SOC concentrations and SOC stocks. Specifically, 10 years of cotton production increased SOC concentrations by 45% in the 0–60 cm depth and SOC stocks by 35%. The SOC concentrations and stocks decreased as soil depth increased. Reclamation time, season and soil depth had significant interaction effects on SOC. The SOC concentrations were significantly and positively correlated with available soil nitrogen and available soil phosphorus. Compared with abandoned farmland, macro-aggregate-associated (>250 µm) SOC concentrations in the 0–60 cm depth increased by 47% after 5 years of cotton production and by 53% after 10 years of cotton production. The contribution of macro-aggregate-associated SOC to total SOC in the 0–60 cm depth increased by 87% after 5 years of cotton production and by 69% after 10 years of cotton production. The findings indicate that soil aggregates were more stable after abandoned, salinized farmland was reclaimed for cotton production. Furthermore, cotton production can increase SOC concentrations and sequester C in this arid area.
Enterotoxigenic Escherichia coli (ETEC) is a type of pathogenic bacteria that cause diarrhea in piglets through colonizing pig small intestine epithelial cells by their surface fimbriae. Different fimbriae type of ETEC including F4, F18, K99 and F41 have been isolated from diarrheal pigs. In this study, we performed a genome-wide association study to map the loci associated with the susceptibility of pigs to ETEC F41 using 39454 single nucleotide polymorphisms (SNPs) in 667 F2 pigs from a White Duroc×Erhualian F2 cross. The most significant SNP (ALGA0022658, P=5.59×10−13) located at 6.95 Mb on chromosome 4. ALGA0022658 was in high linkage disequilibrium (r2>0.5) with surrounding SNPs that span a 1.21 Mb interval. Within this 1.21 Mb region, we investigated ZFAT as a positional candidate gene. We re-sequenced cDNA of ZFAT in four pigs with different susceptibility phenotypes, and identified seven coding variants. We genotyped these seven variants in 287 unrelated pigs from 15 diverse breeds that were measured with ETEC F41 susceptibility phenotype. Five variants showed nominal significant association (P<0.05) with ETEC F41 susceptibility phenotype in International commercial pigs. This study provided refined region associated with susceptibility of pigs to ETEC F41 than that reported previously. Further works are needed to uncover the underlying causal mutation(s).
The interferon-inducible transmembrane protein 3 (IFITM3), as one of the key genes involved in the interferon pathway, is critical for defending the host against influenza virus, and the rs12252 T>C variant in IFITM3 might be associated with susceptibility to severe influenza. Owing to contradictory and inconclusive results, we performed a meta-analysis to assess the association between rs12252 T>C polymorphism and severe influenza risk. A comprehensive literature search up to 1 August 2014 was conducted in EMBASE, Pubmed, Web of Science, VIP, Wanfang and CNKI databases. Four eligible studies with a total of 445 influenza patients and 3396 controls were included in this meta-analysis. Overall, our results demonstrated a significant association between the IFITM3 rs12252 T>C polymorphism and influenza risk [C vs. T: odds ratio (OR) 1·68, 95% confidence interval (CI) 1·32–2·13; CC vs. CT+TT: OR 2·38, 95% CI 1·52–3·73; CC+CT vs. TT: OR 1·62, 95% CI 1·18–2·22]. Stratification by ethnicity indicated that the variant C allele was associated with an 88% increased risk of influenza in Asians (C vs. T: OR 1·88, 95% CI 1·34–2·62). Moreover, subjects carrying the variant C allele had an increased risk of developing severe illness upon influenza infection (C vs. T: OR 2·70, 95% CI 1·86–3·94). However, no significant association was observed in patients with mild infection (C vs. T: OR 1·26, 95% CI 0·93–1·71). Our meta-analysis suggests that IFITM3 rs12252 T>C polymorphism is significantly associated with increased risk of severe influenza but not with the chance of initial virus infection.
We present a high precision frequency determination method for digitized NMR FID signals. The method employs high precision numerical integration rather than simple summation as in many other techniques. With no independent knowledge of the other parameters of a NMR FID signal (phase ф, amplitude A, and transverse relaxation time T2) this method can determine the signal frequency f0 with a precision of if the observation time T ≫ T2. The method is especially convenient when the detailed shape of the observed FT NMR spectrum is not well defined. When T2 is +∞ and the signal becomes pure sinusoidal, the precision of the method is which is one order more precise than the ±1 count error induced precision of a typical frequency counter. Analysis of this method shows that the integration reduces the noise by bandwidth narrowing as in a lock-in amplifier, and no extra signal filters are needed. For a pure sinusoidal signal we find from numerical simulations that the noise-induced error in this method reaches the Cramer-Rao Lower Band (CRLB) on frequency determination. For the damped sinusoidal case of most interest, the noise-induced error is found to be within a factor of 2 of CRLB when the measurement time T is 2 or 3 times larger than T2. We discuss possible improvements for the precision of this method.
Grain boundaries (GBs) in polycrystalline silicon (poly-Si) thin film solar cells are frequently found to be detrimental for device performance. Biaxiallytextured silicon with grains that are well-aligned in-plane and out-of-plane can possess fewer GB defects. In this work, we use TCAD Sentaurus device simulator and known experimental work to investigate and quantify the potential performance gains of biaxially-textured silicon. Simulation shows there can be performance gain from well-aligned grains when GB defects dominate carrier recombination or when grains are small. On the other hand, when intra-grain defects dominate recombination and grains are large, well-aligned grains do not lead to much performance gain. Another important result from our simulation is when intra-grain and GB defects are few, Jsc is almost independent of grain size while Voc drops with decreasing grain size.
The false thyroid capsule is an important anatomical structure involved in thyroidectomy, yet it is rarely studied. This study aimed to define the anatomy of the false thyroid capsule, and its clinical significance.
A prospective study was performed involving 151 patients with goitre who underwent thyroid lobectomy. The anatomy of the false thyroid capsule was carefully documented intra-operatively.
The false thyroid capsule enclosed the inferior and middle thyroid veins and the superior thyroid vessels, forming a mesentery-like structure by attaching to the gland. Once the unilateral lobe had been removed, the thyroid mesentery could be seen to have a C-shaped edge. The recurrent laryngeal nerve, inferior thyroid artery and parathyroid glands were located beneath the C-shaped edge of the thyroid mesentery.
The thyroid mesentery is a distinctive structure that can be used as a guide for surgical dissection.
The phylogenetic and epidemic relationships of 104 clinical isolates of Clostridium difficile from three hospitals of different geographical and population sources in China were investigated by multilocus sequence typing. Twenty-two sequence types (STs) were identified, four of which, ST117, ST118, ST119 and ST129, were novel. No geographically specific and host population-specific phylogenetic lineages were found and there was no correlation between geographical origin or host population and strain genotype. ST37 was the dominant type in our survey but the four novel STs underline the high genetic diversity and unique polymorphisms in C. difficile from China.
Oxide-metal-oxide structures are an alternative to single material transparent electrical contacts. Among other advantages, these multilayer systems provide good conductivity and transmittance, even when fabricated at room temperature. Low temperature processing is a requirement for silicon thin-film solar cells on various flexible substrates. The design and fabrication of oxide-metal-oxide structures based on ZnO:Al and Ag are investigated in this work. Further the integration of an optimized multilayer electrode into an amorphous silicon solar cell in substrate configuration was performed. Measurement results and possible loss mechanisms are discussed.
Intermediate layers between silicon and borosilicate glass are investigated for compatibility with a diode laser crystallization technique for fabrication of thin-film polycrystalline silicon solar cells. SiCx, SiNx and SiOx layers or multilayer stacks of these materials have allowed silicon films of 10μm thickness to be successfully crystallized by diode laser irradiation without dewetting, with each option offering different advantages. SiCx allows the most robust crystallization process, while SiOx is the best barrier to contamination and the most stable layer. SiNx offers the best anti-reflection coating for superstrate configured solar cells. Presently, best device performance is achieved with a SiOxintermediate layer with cells achieving up to ∼540 mV open-circuit voltage.
Thin‑film silicon solar cells based on hydrogenated amorphous silicon (a‑Si:H) and hydrogenated microcrystalline silicon (μc‑Si:H) absorber layers are typically deposited using static plasma-enhanced chemical vapor deposition (PECVD) processes. It has been found that the use of very‑high frequencies (VHF) is beneficial for the material quality at high deposition rates when compared to radio-frequency (RF) processes. In the present work a dynamic VHF‑PECVD technique using linear plasma sources is developed. The linear plasma sources facilitate the use of very-high excitation frequencies on large electrode areas without compromising on the homogeneity of the deposition process. It is shown that state-of-the-art a‑Si:H and μc‑Si:H single-junction solar cells can be deposited incorporating intrinsic layers grown dynamically by VHF-PECVD at 0.35 nm/s and 0.95 nm/s, respectively.
We have carried out in-situ measurements of cluster volume fraction in silicon films during deposition by using quartz crystal microbalances (QCM’s) together with a cluster-eliminating filter. The cluster volume fraction in films is deduced from in-situ measurements of film deposition rates with and without silicon clusters using QCM’s. The results show that the higher deposition rate leads to the higher volume fraction of clusters.
The polycrystalline n+/intrinsic silicon thin film stacks with various original intrinsic amorphous silicon layer thicknesses were formed using the multiple pulsed rapid thermal annealing process with the Ni-induced crystallization mechanism. The thick polycrystalline silicon stack was prepared by repeated steps of 1) amorphous silicon thin film deposition, 2) solution oxidation, 3) dehydrogenation, 4) pulsed rapid thermal annealing, and 5) oxide stripping. The poly-Si film properties, such as the grain size, orientation, and volume fraction of the crystalline phase, were related to the original intrinsic silicon film thickness and the total thermal budget. This process is effective in preparing the high volume fraction polycrystalline silicon thin film, which is important for low-cost thin-film solar cells, electronic and optoelectronic devices.