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Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
Antimicrobial stewardship programs (ASPs) are effective in developed countries. In this study, we assessed the effectiveness of an infectious disease (ID) physician–driven post-prescription review and feedback as an ASP strategy in India, a low middle-income country (LMIC).
Design and setting:
This prospective cohort study was carried out for 18 months in 2 intensive care units of a tertiary-care hospital, consisting of 3 phases: baseline, intervention, and follow up. Each phase spanned 6 months.
Patients aged ≥15 years receiving 48 hours of study antibiotics were recruited for the study.
During the intervention phase, an ID physician reviewed the included cases and gave alternate recommendations if the antibiotic use was inappropriate. Acceptance of the recommendations was measured after 48 hours. The primary outcome of the study was days of therapy (DOT) per 1,000 study patient days (PD).
Overall, 401 patients were recruited in the baseline phase, 381 patients were recruited in the intervention phase, and 379 patients were recruited in the follow-up phase. Antimicrobial use decreased from 831.5 during the baseline phase to 717 DOT per 1,000 PD in the intervention phase (P < .0001). The effect was sustained in the follow-up phase (713.6 DOT per 1,000 PD). De-escalation according to culture susceptibility improved significantly in the intervention phase versus the baseline phase (42.7% vs 23.6%; P < .0001). Overall, 73.3% of antibiotic prescriptions were inappropriate. Recommendations by the ID team were accepted in 60.7% of the cases.
The ID physician–driven implementation of an ASP was successful in reducing antibiotic utilization in an acute-care setting in India.
Solid state batteries are an emerging alternative to traditional liquid electrolyte cells that provide potential for safe and high-energy density power sources. This report describes a self-forming, solid state battery based on the Li/I2 couple using an LiI-rich LiI(3-hydroxypropionitrile)2 electrolyte (LiI–LiI(HPN)2). As the negative and positive active materials are generated in situ, the solid electrolyte–current collector interfaces play a critical role in determining the electrochemical response of the battery. Herein, we report the investigation of solid electrolyte–current collector interfaces with a self-forming LiI–LiI(HPN)2 solid electrolyte and the role of varying interface design in reducing resistance during cycling.
Lithium solid-state composite electrolytes (LiSCEs) provide the opportunity for long life spans, low self-discharge, high reliability, high energy density, and safety. Additionally, this class of electrolytes can be used in electrolytically formed solid-state batteries (EFBs), which may promote reductions in cell manufacturing costs due to their simplicity of design and permit the formation of batteries with diverse architectures. Herein, we provide a discussion of LiSCEs, highlight some of the recent progress in EFB development, and present a forward outlook.
Tourists approaching wild animals can potentially cause disturbance as a result of the perceived predation risk. Risk effects arise when prey alter their behaviour in response to predators. This response may carry costs through its impact on fitness-related activities such as foraging. We recorded behavioural responses of whale sharks Rhincodon typus to experimental vessel and swimmer approaches. We simulated the disturbance caused by ecotourism in the foraging site of this planktivorous fish in Bahia de Los Angeles, Gulf of Baja California, Mexico. Stress-related behaviours (vigilance, change of direction, diving and acceleration) were more common directly after both types of disturbance than before, in particular after approach by a swimmer. Individuals were more likely to be vigilant when they were new to the bay, but we did not find evidence of within-season behavioural habituation. Sharks were 24% more likely to forage before human stimuli than after. Our study highlights negative effects of vessel and swimmer approaches on whale shark behaviour, with a short-term increase in stress-related behaviours potentially carrying energetic costs, combined with a decrease in food intake following the disturbance. Our results indicate concerns about the impact of ecotourism on large fish species. An important next step would be to determine whether these short-term behavioural responses to the perception of predation risk negatively affect fitness. Among other guidelines, we recommend preventing swimmers from approaching if whale sharks stop feeding when a vessel approaches.
Bipolar and more complex morphologies observed in planetary nebulae have been explained by two principal hypotheses: by the existence of a companion producing a circumstellar disk, by the effects of a magnetic field, or by a combination of both. The polarimetric analysis of these objects could give information about the presence of dust grains aligned with any preferential direction, due to a magnetic field or to the action of radiative torques (RAT). We performed polarimetric observations of some planetary nebulae in order to detect linear polarization and (in the best scenario) to detect the signature of an accretion disk in these objects. We observed in the visual region with POLIMA at the San Pedro Mártir observatory, and with POLICAN the NIR polarimeter in the Guillermo Haro observatory. We present the result of these observations in one of these objects: the PN M2-9.
Our aim is to present a new and so far most complete catalog of optically selected young stars. The basis of this work is an extensive literature search for young stars in all the known nearby (< 2 kpc) star forming regions, included in the Handbook of Star Forming Regions [4, 5], and in 67 additional catalogs. We collected data on known young, pre-main-sequence stars detected in optical bands. The catalog contains the celestial coordinates, object names, names of the enclosing star forming region, identification methods, distances, and other information (e.g., references, binarity) for 15208 young stellar objects. It is already in use by the Gaia Photometric Science Alerts Team to identify variable young stars in the Gaia data. Our catalog was cross-correlated with the Gaia DR2 and we obtained flux and distance estimations for 86% of the stars.
The early evolution of Sun-like stars may be interspersed by energetic FU Orionis (FUor) type accretion outbursts. We analysed eight years of photometric and spectroscopic variability of V582 Aur, a bona fide FUor, in outburst. While the accretion rate derived from near-infrared measurements was constant, radical brightness changes occurred due to dust clumps crossing the line of sight. The brightness minima resemble the variability patterns of the UXor phenomenon. Orbiting density enhancements or short-lived clumps moving in and out of the line-of-sight may explain these observations. Our message is that during FUor outbursts the inner disk is a dynamically active place, affecting the initial conditions for planet formation.
Young stellar objects often show photometric variability, which is well examined at optical wavelengths, but more and more infrared data are also available. The wavelength dependence of the variability carries information on the physical cause of the changing brightness. Here, we examine seven T Tauri-type stars known for their large amplitude variability selected from the Campaign 13 field of the Kepler K2 mission. We complemented the K2 light curves by multifilter optical monitoring observations made with the 90 cm Schmidt telescope of Konkoly Observatory, and by 3.6 and 4.5 μm infrared photometry with a 20 hours cadence using the Spitzer Space Telescope. We found that the wavelength dependence of the observed variability is not consistent with changing interstellar extinction. We suggest that the brightness changes are due to variable accretion, causing a variable illumination of the inner disk.
Introduction: Safe and efficient handovers between emergency medical services (EMS) practitioners and emergency nurses are vital as poor transitions may lead to loss of information and place patients at risk for adverse events. We conducted a mixed methods systematic review to a) examine factors that disrupt or improve handovers from EMS practitioners to emergency department nurses, and b) investigate the effectiveness of interventional strategies that lead to improvements in communication and fewer adverse events. Methods: We searched electronic databases (DARE, MEDLINE, EMBASE, Cochrane, CINAHL, Joanna Briggs Institute EBP; Communication Abstracts); grey literature (grey literature databases, organization websites, querying experts in emergency medicine); and reference lists of the included studies. Citation tracking was conducted for the included studies. Two reviewers independently screened titles/abstracts and full-texts for inclusion and methodological quality using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies and the Joanna Briggs Institute Critic Appraisal Checklist for Qualitative Research. Narrative and thematic synthesis were conducted to integrate and explore relationships within the data. Results: Twenty-two studies were included in this review from the 6150 records initially retrieved. Our analysis suggests that qualitative, quantitative, and mixed methods research approaches have been utilized to explore handovers. Studies (n=11) have predominantly explored existing patterns of handovers focusing on barriers and facilitators. Interventions (e.g. multimedia transmission of pre-hospital information, tailored e-learning program) were investigated in five studies. Results suggest that lack of formal handover training, workflow interruptions, workload, and strained working relationships between EMS and nursing are perceived threats to optimal handovers. Conclusion: The findings from this review can inform the development of handover interventions and contribute to a more rigorous approach to researching handovers between EMS practitioners and emergency nurses. Furthermore, there is a need for studies in which specific interventions to optimize handovers are examined.
Diagnosing streptococcal pharyngitis in children on the basis of clinical appearance and throat culture is complicated by high colonisation rates and by the ability of other pathogens to cause clinically similar disease. To characterise the epidemiology of Lancefield Group A, C and G β-haemolytic streptococcus (GAS, GCS and GGS, respectively) in children, we conducted a 2-year prospective study of 307 school children between 7 and 11 years old. GGS and GAS were commonly identified organisms both for silent streptococcal colonisation and symptomatic sore throat, while GCS was uncommonly found. Streptococcal culture positivity at the time of clinical pharyngitis was estimated to reflect true streptococcal pharyngitis in only 26% of instances, with the frequency varying from 54% for children rarely colonised to 1% for children frequently colonised. Numerous GAS emm types were identified, including several types previously associated with severe pharyngitis (e.g. emm types 1, 3 and 28). No severe complications were seen in any child. These data suggest that the clinical diagnosis of streptococcal pharyngitis is likely to remain difficult and that treatment decisions will remain clouded by uncertainty. There remains a need for organism-specific rapid point-of-care streptococcal diagnostic tests and tests that can distinguish between streptococcal colonisation and disease.
We show that on-off intermittency in solar and stellar cycles is a result of amplitude-phase synchronization in multiscale interactions in solar/stellar dynamos or magnetorotational instability which leads to the formation of kinematic and magnetic coherent structures, and the novel techniques of Lagrangian coherent structures can detect transport barriers and vortices such as magnetic flux tubes/ropes in solar and stellar turbulence with high accuracy.
This work reports the synthesis of undoped and alkali metal doped thermochromic vanadium dioxide thin films by sol-gel spin coating and subsequent low-temperature annealing at 450 °C in N2-H2 atmosphere. The effect of sodium and potassium on the phase transition temperature as well as on the solar modulations were investigated. A dopant concentration of 0.3 at% resulted in a reduction of the critical transition temperature (Tc) from 62 °C to 57 °C and 47 °C for the sodium and potassium doped films, respectively. Moreover, both dopants improved the solar modulations (ΔTsol) of the undoped VO2 films from 3.81 to 9.44 and 5.43 %, respectively.
In battery systems, a solid electrolyte interphase (SEI) is formed through electrolyte reaction on an electrode surface. The formation of SEI can have both positive and negative effects on electrochemistry. The initial formation of the layer protects the electrode from further reactivity, which can improve both shelf and cycle life. However, if the layer continues to form, it can impede charge transfer, which increases cell resistance and limits cycle life. The role of SEI is particularly important when studying conversion electrodes, since phase transformations which unveil new electroactive surfaces during reduction/oxidation can facilitate electrolyte decomposition. This manuscript highlights recent developments in the understanding and control of SEI formation for magnetite (Fe3O4) conversion electrodes through electrolyte and electrode modification.