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This work investigated the photophysical pathways for light absorption, charge generation, and charge separation in donor–acceptor nanoparticle blends of poly(3-hexylthiophene) and indene-C60-bisadduct. Optical modeling combined with steady-state and time-resolved optoelectronic characterization revealed that the nanoparticle blends experience a photocurrent limited to 60% of a bulk solution mixture. This discrepancy resulted from imperfect free charge generation inside the nanoparticles. High-resolution transmission electron microscopy and chemically resolved X-ray mapping showed that enhanced miscibility of materials did improve the donor–acceptor blending at the center of the nanoparticles; however, a residual shell of almost pure donor still restricted energy generation from these nanoparticles.
This chapter provides a brief overview of gaming disorder (GD) and its treatment. There are now over twenty different screens for assessing problematic gaming although relatively few have used nationally representative samples. The prevalence rates in these nationally representative studies have ranged from 1.2 percent to 8.5 percent depending upon country and screening instrument used. There have been a number of studies describing treatment of GD, although many of these tend not to distinguish between Internet Use Disorder and GD. In terms of treatment for GD, both psychological and pharmacological approaches have been adopted. More specifically, psychological treatment using a cognitive-behavioral framework (CBT) appears to be the most widely used. Furthermore, pharmacological treatment using opioid receptor antagonists, antidepressants, antipsychotics, opioid receptor antagonists, and psychostimulants has been reported in the literature. It is concluded that standardized and comprehensive methods of diagnosis are at present lacking, and that further research into GD is needed from clinical, epidemiological, cross-cultural, and neurobiological perspectives of GD.
A number of studies suggests that for a small minority of users, excessive engagement with the Internet can lead to Internet addiction. Internet addiction has been linked to specific personality traits. Research indicates that Internet addicts score high on introversion, and low on agreeableness and emotional stability. In terms of populations at risk for developing Internet addiction, university students have been identified. They have free and unlimited access, flexible schedules, and university settings can foster social intimidation and alienation. Sixty percent of students jeopardizes their academic and professional performance because of their Internet habits and in order to cope, they engage in Internet activities excessively. Internet addiction in students is claimed to be as high as 15% in Taiwan, however, no such data exists for English students. In order to fill this gap in knowledge, a web-based study on the prevalence of Internet addiction and its associations with personality traits in UK university students (N = 2257) was conducted. Results indicate that 3.2% of the sample can be classified as potentially addicted to the Internet. A combination of online shopping and neuroticism decreased the risk for Internet addiction, whereas online gaming together with openness to experience increased it. Moreover, frequent usage of online shopping and social online activities, high neuroticism and low agreeableness significantly increased the chances of being addicted to the Internet. Findings and their implications are discussed.
To characterize the prevalence of and seasonal and regional variation in inpatient antibiotic use among hospitalized US children in 2017–2018.
We conducted a cross-sectional examination of hospitalized children. The assessments were conducted on a single day in spring (May 3, 2017), summer (August 2, 2017), fall (October 25, 2017), and winter (January 31, 2018). The main outcome of interest was receipt of an antibiotic on the study day.
The study included 51 freestanding US children’s hospitals that participate in the Pediatric Health Information System (PHIS).
This study included all patients <18 years old who were admitted to a participating PHIS hospital, excluding patients who were admitted solely for research purposes.
Of 52,769 total hospitalized children, 19,174 (36.3%) received antibiotics on the study day and 6,575 of these (12.5%) received broad-spectrum antibiotics. The overall prevalence of antibiotic use varied across hospitals from 22.3% to 51.9%. Antibiotic use prevalence was 29.2% among medical patients and 47.7% among surgical patients. Although there was no significant seasonal variation in antibiotic use prevalence, regional prevalence varied, ranging from 32.7% in the Midwest to 40.2% in the West (P < .001). Among units, pediatric intensive care unit patients had the highest prevalence of both overall and broad-spectrum antibiotic use at 58.3% and 26.6%, respectively (P < .001).
On any given day in a national network of children’s hospitals, more than one-third of hospitalized children received an antibiotic, and 1 in 8 received a broad-spectrum antibiotic. Variation across hospitals, setting and regions identifies potential opportunities for enhanced antibiotic stewardship activities.
The earliest monasteries were founded in fourth-century Egypt, Syria, and Palestine as communities of lay men and women, who withdrew to the desert to pursue lives of asceticism and devotion to God. Inspired by the command to “pray without ceasing” (1 Thess. 5:17), early monks and nuns devoted themselves to prayer and the chanting of the Psalms, whether in their cells (in eremitic communities) or in groups (in cenobitic communities). Early monastic liturgy almost certainly drew on the traditions of urban Christian churches, which had begun to develop public prayer rituals following the conversion of Constantine in 312 and the ensuing legalization of Christianity. Evidence for at least six of the eight hours of the medieval divine office can be found in Eastern sources as early as the fourth century. Prayer, the reading of the Scriptures, and the recitation of the Psalms formed the core of early monastic practice. Celebration of the mass—an essential part of monastic life during the high Middle Ages—does not feature prominently in these early sources.
Non-invasive prenatal testing (NIPT) for the detection of foetal aneuploidy through analysis of cell-free DNA (cfDNA) in maternal blood is offered routinely by many healthcare providers across the developed world. This testing has recently been recommended for evaluative implementation in the UK National Health Service (NHS) foetal anomaly screening pathway as a contingent screen following an increased risk of trisomy 21, 18 or 13. In preparation for delivering a national service, we have implemented cfDNA-based NIPT in our Regional Genetics Laboratory. Here, we describe our validation and verification processes and initial experiences of the technology prior to rollout of a national screening service.
Data are presented from more than 1000 patients (215 retrospective and 840 prospective) from ‘high- and low-risk pregnancies’ with outcome data following birth or confirmatory invasive prenatal sampling. NIPT was by the Illumina Verifi® test.
Our data confirm a high-fidelity service with a failure rate of ~0.24% and a high sensitivity and specificity for the detection of foetal trisomy 13, 18 and 21. Secondly, the data show that a significant proportion of patients continue their pregnancies without prenatal invasive testing or intervention after receiving a high-risk cfDNA-based result. A total of 46.5% of patients referred to date were referred for reasons other than high screen risk. Ten percent (76/840 clinical service referrals) of patients were referred with ultrasonographic finding of a foetal structural anomaly, and data analysis indicates high- and low-risk scan indications for NIPT.
NIPT can be successfully implemented into NHS regional genetics laboratories to provide high-quality services. NHS provision of NIPT in patients with high-risk screen results will allow for a reduction of invasive testing and partially improve equality of access to cfDNA-based NIPT in the pregnant population. Patients at low risk for a classic trisomy or with other clinical indications are likely to continue to access cfDNA-based NIPT as a private test.
A new fossil site in a previously unexplored part of western Madagascar (the Beanka Protected Area) has yielded remains of many recently extinct vertebrates, including giant lemurs (Babakotia radofilai, Palaeopropithecus kelyus, Pachylemur sp., and Archaeolemur edwardsi), carnivores (Cryptoprocta spelea), the aardvark-like Plesiorycteropus sp., and giant ground cuckoos (Coua). Many of these represent considerable range extensions. Extant species that were extirpated from the region (e.g., Prolemur simus) are also present. Calibrated radiocarbon ages for 10 bones from extinct primates span the last three millennia. The largely undisturbed taphonomy of bone deposits supports the interpretation that many specimens fell in from a rock ledge above the entrance. Some primates and other mammals may have been prey items of avian predators, but human predation is also evident. Strontium isotope ratios (87Sr/86Sr) suggest that fossils were local to the area. Pottery sherds and bones of extinct and extant vertebrates with cut and chop marks indicate human activity in previous centuries. Scarcity of charcoal and human artifacts suggests only occasional visitation to the site by humans. The fossil assemblage from this site is unusual in that, while it contains many sloth lemurs, it lacks ratites, hippopotami, and crocodiles typical of nearly all other Holocene subfossil sites on Madagascar.
This work established the feasibility of flexible solution-processed radiation sensors prepared from an organic scintillator (1-phenyl-3-mesityl-2-pyrazoline) and a biocompatible semiconducting polymer (violanthrone-79). Absorbance, steady-state, and time-resolved photoluminescence measurements demonstrated a high efficiency for the transfer of absorbed energy from the scintillator to the semiconductor. Blended nanoparticles containing both materials were fabricated in order to reduce the intermolecular distance between molecules, creating a highly efficient energy transfer pathway. Radiation-sensing devices were then constructed from the materials. These exhibited successful sensitivity for gamma radiation from a 137Cs source that was not present for the control semiconducting polymer alone.
The decontamination of hazardous chemical agents from porous media is an important and critical part of the clean-up operation following a chemical weapon attack. Decontamination is often achieved through the application of a cleanser, which reacts on contact with an agent to neutralise it. While it is relatively straightforward to write down a model that describes the interplay of the agent and cleanser on the scale of the pores in the porous medium, it is computationally expensive to solve such a model over realistic spill sizes.
In this paper, we consider the homogenisation of a pore-scale model for the interplay between agent and cleanser, with the aim of generating simplified models that can be solved more easily on the spill scale but accurately capture the microscale structure and chemical activity. We consider two situations: one in which the agent completely fills local porespaces and one in which it does not. In the case when the agent does not completely fill the porespace, we use established homogenisation techniques to systematically derive a reaction–diffusion model for the macroscale concentration of cleanser. However, in the case where the agent completely fills the porespace, the homogenisation procedure is more in-depth and involves a two-timescale approach coupled with a spatial boundary layer. The resulting homogenised model closely resembles the microscale model with the effect of the porous material being incorporated into the parameters. The two models cater for two different spill scenarios and provide the foundation for further study of reactive decontamination.
We derive a mathematical model for the drawing of a two-dimensional thin sheet of viscous fluid in the direction of gravity. If the gravitational field is sufficiently strong, then a portion of the sheet experiences a compressive stress and is thus unstable to transverse buckling. We analyse the dependence of the instability and the subsequent evolution on the process parameters, and the mutual coupling between the weakly nonlinear buckling and the stress profile in the sheet. Over long time scales, the sheet centreline ultimately adopts a universal profile, with the bulk of the sheet under tension and a single large bulge caused by a small compressive region near the bottom, and we derive a canonical inner problem that describes this behaviour. The large-time analysis involves a logarithmic asymptotic expansion, and we devise a hybrid asymptotic–numerical scheme that effectively sums the logarithmic series.
Age- and sex-based BMI cut-offs are used to define overweight and obesity, but the relationship between BMI and body composition has not been very well studied in children or compared between children of different ethnic groups. Body size and composition in childhood are also influenced by size at birth. Our aim was to compare body size and composition at 2 years in children with different ethnicity and size at birth. We prospectively followed a multi-ethnic cohort of 300 children born with risk factors for neonatal hypoglycaemia (infants of diabetics, large or small at birth or late preterm) to 2 years corrected age. Complete data on weight, height and head circumference and body composition using bioelectrical impedance 24±1 months corrected age were available in 209 children. At birth, compared with European children, Chinese, Indian and other ethnicity children were lighter, and Indian children had smaller head circumferences, but birth lengths were similar in all ethnic groups. At 2 years, Pacific children were heavier and had higher BMI z scores, and Indian children had smaller head circumferences and lower BMI z scores than those from other ethnic groups. However, fat mass and fat-free mass indices were similar in all groups. At median BMI, fat mass:fat-free mass ratio was 23 % lower in Pacific than in Indian children (0·22 v. 0·27, P=0·03). BMI is not a good indicator of adiposity in this multi-ethnic cohort of 2-year-old New Zealand children.
High-rate lithium ion batteries with long cycling lives can provide electricity grid stabilization services in the presence of large fractions of intermittent generators, such as photovoltaics. Engineering for high rate and long cycle life requires an appropriate selection of materials for both electrode and electrolyte and an understanding of how these materials degrade with use. High-rate lithium ion batteries can also facilitate faster charging of electric vehicles and provide higher energy density alternatives to supercapacitors in mass transport applications.
High-rate lithium ion batteries can play a critical role in decarbonizing our energy systems both through their underpinning of the transition to use renewable energy resources, such as photovoltaics, and electrification of transport. Their ability to be rapidly and frequently charged and discharged can enable this energy storage technology to play a key role in stabilizing future low-carbon electricity networks which integrate large fractions of intermittent renewable energy generators. This decarbonizing transition will require lithium ion technology to provide increased power and longer cycle lives at reduced cost. Rate performance and cycle life are ultimately limited by the materials used and the kinetics associated with the charge transfer reactions and ionic and electronic conduction. We review material strategies for electrode materials and electrolytes that can facilitate high rates and long cycle lives and discuss the important issues of cost, resource availability and recycling.
We consider the spreading of a thin viscous droplet, injected through a finite region of a substrate, under the influence of surface tension. We neglect gravity and assume that there is a precursor layer covering the whole substrate and that the rate of injection is constant. We analyse the evolution of the film profile for early and late time, and obtain power-law dependencies for the maximum film thickness at the centre of the injection region and the position of an apparent contact line, which compare well with numerical solutions of the full problem. We relax the conditions on the injection rate to consider more general time-dependent and spatially varying forms. In the case of power-law injection of the form
, we observe a switch in the behaviour of the evolution of the film thickness for late time from increasing to decreasing at a critical value of
. We show that point-source injection can be treated as a limiting case of a finite-injection slot and the solutions exhibit identical behaviours for late time. Finally, we formulate the problem with thickness-dependent injection rate, discuss the behaviour of the maximum film thickness and the position of the apparent contact line and give power-law dependencies for these.
We investigate the Dead Hand Proxy Put, a contractual innovation in corporate debt agreements that may impact hedge fund activism. We find the provision principally in loans, not bonds, and provide evidence linking the adoption of the provision to hedge fund activism. Furthermore, controlling for endogeneity, we find that the provision significantly reduces the cost of loans. Bondholder wealth also increases. Moreover, cross-sectional analysis of share returns reveals that the provision is positively associated with repeat banking relationships and negatively associated with free cash flow problems, suggesting a cost-benefit tradeoff.
Psychosocial disability affects a number of individuals with psychosis and often begins years before the formal onset of disorder. This suggests that for many, their psychosocial disability is enduring, and targeted interventions are therefore needed earlier in their developmental trajectories to ensure that psychosocial disability does not become entrenched. Poor psychosocial functioning also affects individuals with a range of different emerging mental health problems, putting these young people at risk of long-term social marginalisation and economic disadvantage; all of which are known risk factors for the development of psychosis. Identification of the markers of poor psychosocial functioning will help to inform effective treatments. This editorial will discern the early trajectories and markers of poor psychosocial outcome in psychosis, and highlight which individuals are most at risk of having a poor outcome. This editorial will also discuss whether early interventions are currently being targeted appropriately and will propose how intervention and preventative strategies can be implemented, to restore psychosocial trajectories in a way that enables young people to maximise their life chances.
SNP in the vitamin D receptor (VDR) gene is associated with risk of lower respiratory infections. The influence of genetic variation in the vitamin D pathway resulting in susceptibility to upper respiratory infections (URI) has not been investigated. We evaluated the influence of thirty-three SNP in eleven vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4, CYP27A1, LRP2, CUBN and VDR) resulting in URI risk in 725 adults in London, UK, using an additive model with adjustment for potential confounders and correction for multiple comparisons. Significant associations in this cohort were investigated in a validation cohort of 737 children in Manchester, UK. In all, three SNP in VDR (rs4334089, rs11568820 and rs7970314) and one SNP in CYP3A4 (rs2740574) were associated with risk of URI in the discovery cohort after adjusting for potential confounders and correcting for multiple comparisons (adjusted incidence rate ratio per additional minor allele ≥1·15, Pfor trend ≤0·030). This association was replicated for rs4334089 in the validation cohort (Pfor trend=0·048) but not for rs11568820, rs7970314 or rs2740574. Carriage of the minor allele of the rs4334089 SNP in VDR was associated with increased susceptibility to URI in children and adult cohorts in the United Kingdom.
The conservation of threatened species requires information on how management activities influence habitat quality. The Critically Endangered black rhinoceros Diceros bicornis is restricted to savannahs representing c. 5% of its historical range. Fire is used extensively in savannahs but little is known about how rhinos respond to burning. Our aim was to understand rhino responses to fire by studying habitat selection and foraging at multiple scales. We used resource selection functions and locations of 31 rhinos during 2014–2016 to study rhino habitat use in Serengeti National Park, Tanzania. Rhino selectivity was quantified by comparing forage consumption to plant species availability in randomly sampled vegetation plots; rhino diets were subsequently verified through DNA metabarcoding analysis of faecal samples. Rhino habitat use was a unimodal function of fire history, with highly occupied sites having fire frequencies of < 0.6 fires/year and maximum occupancy occurring at a fire frequency of 0.1 fires/year. Foraging stations had characteristic plant communities, with 17 species associated with rhino foraging. Rhinos were associated with, and disproportionately consumed, woody plants, forbs and legumes, all of which decreased in abundance with increasing fire frequency. In contrast to common management practices, multiple lines of evidence suggest that the current fire regime in the Serengeti negatively influences rhino habitat use and foraging and that frequent fire limits access of rhinos to preferred forage. We outline a conceptual model to guide managers and conservationists in the use of fire under variable habitat conditions.