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Invasive meningococcal disease has high morbidity and mortality, with infants and young children among those at greatest risk. This phase III, open-label, randomised study in toddlers aged 12–23 months evaluated the immunogenicity and safety of meningococcal tetanus toxoid-conjugate vaccine (MenACYW-TT), a tetanus toxoid conjugated vaccine against meningococcal serogroups A, C, W and Y, when coadministered with paediatric vaccines (measles, mumps and rubella [MMR]; varicella [V]; 6-in-1 combination vaccine against diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b [DTaP-IPV-HepB-Hib] and pneumococcal conjugate vaccine [PCV13])(NCT03205371). Immunogenicity to each meningococcal serogroup was assessed by serum bactericidal antibody assay using human complement (hSBA). Vaccine safety profiles were described up to 30 days post-vaccination. A total of 1183 participants were enrolled. The proportion with seroprotection (hSBA ≥1:8) to each meningococcal serogroup at Day 30 was comparable between the MenACYW-TT and MenACYW-TT + MMR + V groups (≥92 and ≥96%, respectively), between the MenACYW-TT and MenACYW-TT + DTaP-IPV-HepB-Hib groups (≥90% for both) and between the MenACYW-TT and MenACYW-TT + PCV13 groups (≥91 and ≥84%, respectively). The safety profiles of MenACYW-TT, and MMR + V, DTaP-IPV-HepB-Hib, and PCV13, with or without MenACYW-TT, were generally comparable. Coadministration of MenACYW-TT with paediatric vaccines in toddlers had no clinically relevant effect on the immunogenicity and safety of any of the vaccines.
The study examined the developmental trajectories of deliberate self-harm behavior (e.g. of non-suicidal self-injury, suicidality and substance use) in a community sample of 514 adolescents from 14.5 to 16.5 years of age. Data were taken from the German sample of the Saving and Empowering Young Lives in Europe study (SEYLE; Wasserman et al., 2010) and its consecutive follow-up assessments. Using general growth mixture modeling, distinctive classes for each self-harm behavior were identified. The high risk non-suicidal self-injury class as well as the high risk suicidality class demonstrated high initial values with a gradual decrease over adolescence. The substance use high risk class had a low initial value and presented acceleration with time. The high overlap between the three high-risk classes supports the notion that certain personality traits such as affective dysregulation or impulsivity may underlie these three behaviors. Compared to the low or moderate risk classes, individuals belonging to high risk classes revealed significantly higher scores in the SCID-II questionnaire for DSM-IV borderline personality disorder.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services.
The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system.
In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas.
The functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
Background: NEDA is a composite measure that may ultimately influence clinical decisions concerning switches of disease modifying therapy (DMT) for relapsing remitting multiple sclerosis (RRMS) patients. Cohort studies from MS clinics suggest NEDA is not sustained over time in most patients despite DMT but may be limited by referral bias. We investigated NEDA in a population-based RRMS cohort. Methods: We identified all incident cases of RRMS in Olmsted County from 01/01/2000-12/31/2011. Retrospective chart review was conducted to determine persistence of NEDA -following RRMS diagnosis. NEDA failure was defined as new MRI activity, relapse, or expanded disability status scale (EDSS) -worsening. Results: There were 93 incident cases of RRMS with 82 individuals having sufficient follow-up to determine persistence of NEDA. Prior to NEDA failure 44 were not on DMT, 37 were on first-tier, injectable DMT, and 1 received mitoxantrone. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years. Disability measured by EDSS was no different at 10 years in patients maintaining NEDA versus those that failed NEDA at one year (p=0.3). Conclusions: Maintenance of NEDA beyond 2 years is infrequent among a population-based cohort of newly diagnosed RRMS patients and similar to prior clinic-based cohorts.
This study aimed to identify the effect of lateral neck dissection on voice change in thyroidectomised patients.
Medical records from 264 patients who underwent thyroidectomy with (n = 65) or without (n = 199) lateral neck dissection were reviewed. Clinical and voice evaluation data were compared between the two groups.
Patients who underwent surgery that included lateral neck dissection had lower fundamental frequencies and speaking fundamental frequencies. They also had a higher incidence of asymmetric mucosal wave and vocal fold oedema on videostroboscopy during the first month after surgery, with the incidence of vocal fold oedema remaining significantly higher at three months. Self-assessed voice quality scores were significantly higher in lateral neck dissection patients at both one and three months after surgery.
In thyroidectomised patients, lateral neck dissection lowers the vocal pitch in the initial period after surgery and induces vocal fold oedema that persists for several months. Although most objective parameters improved within a month, subjective symptoms lasted for longer.
Obsessive-compulsive disorder (OCD) is a chronic, relapsing mental illness. Selective serotonin reuptake inhibitors block serotonin transporters (SERTs) and are the mainstay of treatment for OCD. SERT abnormalities are reported in drug-free patients with OCD, but it is not known what happens to SERT levels during treatment. This is important as alterations in SERT levels in patients under treatment could underlie poor response, or relapse during or after treatment. The aim of the present study was first to validate a novel approach to measuring SERT levels in people taking treatment and then to investigate SERT binding potential (BP) using [11C]DASB PET in patients with OCD currently treated with escitalopram in comparison with healthy controls.
Twelve patients and age- and sex-matched healthy controls were enrolled. The patients and healthy controls underwent serial PET scans after administration of escitalopram and blood samples for drug concentrations were collected simultaneously with the scans. Drug-free BPs were obtained by using an inhibitory Emax model we developed previously.
The inhibitory Emax model was able to accurately predict drug-free SERT BP in people taking drug treatment. The drug-free BP in patients with OCD currently treated with escitalopram was significantly different from those in healthy volunteers [Cohen's d = 0.03 (caudate), 1.16 (putamen), 1.46 (thalamus), −5.67 (dorsal raphe nucleus)].
This result extends previous findings showing SERT abnormalities in drug-free patients with OCD by indicating that altered SERT availability is seen in OCD despite treatment. This could account for poor response and the high risk of relapse in OCD.
Genetic alteration of cyclin-dependent kinase inhibitors has been associated with carcinogenesis mechanisms in various organs.
This study aimed to evaluate the expression and mutational analysis of Cip/Kip family cyclin-dependent kinase inhibitors (p21CIP1/WAF1, p27KIP1 and p57KIP2) in early glottic cancer.
Expressions of Cip/Kip family and p53 were determined by quantitative reverse transcription polymerase chain reaction and densitometry. For the analysis of p21 inactivation, sequence alteration was assessed using single-strand conformational polymorphism polymerase chain reaction. Additionally, the inactivation mechanism of p27 and p57 were investigated using DNA methylation analysis.
Reduced expression of p27 and p57 were detected in all samples, whereas the expression of p21 was incompletely down-regulated in 6 of 11 samples. Additionally, single-strand conformational polymorphism polymerase chain reaction analysis showed the p53 mutation at exon 6. Methylation of p27 and p57 was detected by DNA methylation assay.
Our results suggest that the Cip/Kip family may have a role as a molecular mechanism of carcinogenesis in early glottic cancer.
A single-grained Pb(Zr,Ti)O3 (PZT) was successfully grown for the gate dielectric of polycrystalline-silicon (poly-Si) thin-film transistor (TFT). The total structure was MoW/PZT/HfO2/poly-Si/glass. The giant single-grained PZT was obtained by controlling the artificial nucleation formed by Pt dots in a desirable location and enlarging the nucleated seed until it covers the poly-Si channel. The single-grained diameter size was 40 μm with a (100) dominated texture. The poly-Si memory device with single-grained PZT showed an excellent ferroelectric, electrical and reliability properties comparing with poly-Si memory device with poly-grained PZT. Moreover, eliminating the grain boundary in PZT film showed the fatigue and retention characteristics with only 1.1 % after 1013 cycles and 22 % after 1 month, respectively.
Alcohol consumption is a possible co-factor of high-risk human papillomavirus (HR-HPV) persistence, a major step in cervical carcinogenesis, but the association between alcohol and continuous HPV infection remains unclear. This prospective study identified the association between alcohol consumption and HR-HPV persistence. Overall, 9230 women who underwent screening during 2002–2011 at the National Cancer Center, Korea were analysed in multivariate logistic regression. Current drinkers [odds ratio (OR) 2·49, 95% confidence interval (CI) 1·32–4·71] and drinkers for ⩾5 years (OR 2·33, 95% CI 1·17–4·63) had a higher risk of 2-year HR-HPV persistence (HPV positivity for 3 consecutive years) than non-drinkers and drinkers for <5 years, respectively (vs. HPV negativity for 3 consecutive years). A high drinking frequency (⩾twice/week) and a high beer intake (⩾3 glasses/occasion) had higher risks of 1-year (OR 1·80, 95% CI 1·01–3·36) HPV positivity for 2 consecutive years) and 2-year HR-HPV persistence (OR 3·62, 95% CI 1·35–9·75) than non-drinkers. Of the HPV-positive subjects enrolled, drinking habit (OR 2·68, 95% CI 1·10–6·51) and high consumption of beer or soju (⩾2 glasses/occasion; OR 2·90, 95% CI 1·06–7·98) increased the risk of 2-year consecutive or alternate HR-HPV positivity (vs. consecutive HPV negativity). These findings suggest that alcohol consumption might increase the risk of cervical HR-HPV persistence in Korean women.
Breast cancer metastasis to bone continues to be a major clinical problem, and patient-to-patient variability in rates of disease progression and metastasis complicate treatment even further. This may be due to differences in the cancer cells, the osteoclasts, or the pre-metastatic niche, but all of these contribute to proteolytic remodeling necessary for osteolytic lesion establishment, primarily through secretion of cathepsin K, the most powerful human collagenase. There is debate about the relative contributions of breast cancer cells and osteoclasts and synergism between the two in altering the biochemical and biomechanical properties of the colonized bone, as these are difficult to parse with animal models. To quantify the relative contributions of breast cancer cells and osteoclasts in bone resorption, we have been developing engineered bone microenvironment tissue surrogates by adapting a poly(ester urethane) urea system embedded with microbone particles. Here, we report their use with MDA-MB-231 breast cancer cells and RAW264.7 derived osteoclasts, to provide temporal, multiscale reporters of bone resorption that can be measured non-destructively: 1) collagen degradation measured by C-terminal collagen fragment release, 2) mineral dissolution by measuring calcium released with the calcium arsenazo assay, and also show their beneficial effects in upregulating cathepsin K expression compared to tissue culture polystyrene controls. These more natural derived bone surrogates may be useful tools in mimicking bone metastatic niche and determining differences between proteolytic activity of different patients’ tumor and bone resident cells in a controlled manner.
Donor-acceptor mixed-stack charge-transfer (CT) compounds can be regarded as a model system for charge carrier separation in molecular-scale donor-acceptor heterojunctions. Here we investigated fundamental photocarrier generation characteristics in single crystals of a donoracceptor mixed-stack system, phenothiazine-tetracyanoquinodimethane (PTZ-TCNQ). The laser beam-induced current (LBIC) measurement on the crystals allowed the discrimination between the exciton and the photocarrier diffusion on the basis of the observed spatial decay profiles. We found that the photocarriers are directly generated by higher-lying CT band excitation and exhibit extremely long diffusion length reaching more than 10 μm. We discuss the origin of the efficient photocarrier generation in terms of the geminate electron-hole pair formation.
The Burst Observer and Optical Transient Exploring System (BOOTES), is a global robotic
observatory network, which started in 1998 with Spanish leadership devoted to study
optical emissions from gamma ray bursts (GRBs) that occur in the Universe. We present shot
history and current status of BOOTES network. The Network philosophy, science and some
details of 117 GRBs followed-up are discussed.
Hypermucoviscous (HV) isolates of Klebsiella pneumoniae have been linked to virulence potential in experimental infections. We examined 33 isolates of K. pneumoniae from patients with bacteraemia for the HV phenotype on agar culture, and determined their virulence potential by screening for capsular (K) serotype by polymerase chain reaction and the presence of seven virulence factor genes. Fourteen (42·4%) isolates expressed the HV phenotype and 11 of these were serotype K1 or K2; these serotypes were not identified in HV-negative isolates. The genes rmpA, rmpA2, aerobactin, wabG and allS were significantly more frequent in HV than non-HV isolates. Multilocus sequence typing identified 21 sequence types (ST), eight of which were found in HV-positive isolates and the clonal relatedness of isolates of the most frequent types (ST23 and ST11) from different hospitals was confirmed by pulsed-field gel electrophoresis. The HV phenotype was more associated with community-acquired infection with a lower frequency of fatal underlying illness, but with significantly more focal infections, notably liver abscesses. Clinicians should be aware of such clinical impacts of the HV phenotype.
We have studied the effect of pentacene purity and evaporation rate on low-voltage organic thin-film transistors (OTFTs) prepared solely by dry fabrication techniques. The maximum field-effect mobility of 0.07 cm2/Vs was achieved for the highest pentacene evaporation rate of 0.32 Å/s and four-time purified pentacene. Four-time purified pentacene also led to the lowest threshold voltage of -1.1 V and inverse subthreshold slope of ∼100 mV/decade. In addition, pentacene surface was imaged using atomic force microscopy, and the transistor channel and contact resistances for various pentacene evaporation rates were extracted and compared to field-effect mobilities.
Transparent conductive oxide less flexible dye-sensitized solar cells (TCO-less DSC) with flat and cylinder shapes are reported. The cell consists of a plastic cover, a flexible titania/dye sheet back contacted with a metal mesh sheet, a gel electrolyte sheet, and Pt layer on a Ti sheet. How to increase the efficiency were discussed. We concluded that making a titania/dye layer on a metal mesh sheet thinner and using a thinner electrolyte layer were effective for increasing the efficiency. A flat TCO-less DSC with 6.1 % efficiency and a cylindrical TCO-less DSC with 5.1 % efficiency are reported.
A comparison of the photocurrent spectra of organic bulk heterojunction solar cells of various thicknesses is presented. Increasing the thickness of the active layer in both MDMO-PPV /PCBM and P3HT/PCBM solar cells reduces the magnitude of the photocurrent due to the low mobility of the photogenerated holes. Measurements show that the photocurrent reduction is predominately due to a loss in carriers generated at the polymer absorption maximum, while the low energy response is relatively unaffected. In a thick enough sample, the low energy response (1.5-2 eV) dominates, and a photocurrent peak is no longer observed at the main absorption maximum (2.6 eV). The results imply that hole transport is blocked for carriers generated in the polymer at higher energy. Because these holes are generated at the absorption maximum their low mobility could be a major factor limiting solar cell efficiency.
To improve the conversion efficiency of polymer photodetectors (PDs) fabricated by solution process, the properties of fluorene-type polymer photodetectors doped with iridium (Ir) and platinum (Pt) complexes were investigated. The devices based on poly(dioctylfluorene) and poly(dioctylfluorene-co-benzothiadiazole) (F8BT) had violet and blue sensitivity, respectively. Triplet materials can enhance the incident-photon-to-current conversion efficiency of the devices utilizing the fluorene-type polymers when their triplet levels are lower than the lowest excited singlet states of the host and higher than the lowest excited triplet states of the host. The transmission of a moving picture was successfully demonstrated using the bilayer F8BT device with green Ir complex as an opto-electrical conversion device. We demonstrate that the polymer PDs fabricated by solution process can be applied to short-range optical communication fields, such as opto-electrical conversion devices for optical links.
In this paper we study the density of states in n-type N,N’-ditridecylperylene-3,4,9,10-tetracarboxylic diimide organic semiconductor using two different methods. The first one is based on the temperature dependence of the channel conductance in field-effect transistors. The second one is based on the subgap optical absorption coefficient measured using the Photothermal Deflection Spectroscopy technique. Both techniques allow estimating the distribution of localized states in the band gap of the semiconductor.