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Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.
Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.
The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.
PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.
Data came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.
The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.
Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.
A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7–27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29–23·4) and 5·65 (95% CI 1·09–29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.
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.
Cryptosporidium is a protozoan parasite of humans and animals and has a worldwide distribution. The parasite has a unique epidemiology in Middle Eastern countries where the IId subtype family of Cryptosporidium parvum dominates. However, there has been no information on Cryptosporidium species in Yemen. Thus, this study was conducted in Yemen to examine the distribution of Cryptosporidium species and subtype families. Fecal samples were collected from 335 patients who attended hospitals in Sana'a city. Cryptosporidium species were determined by PCR and sequence analysis of the 18 s rRNA gene. Cryptosporidium parvum and C. hominis subtypes were identified based on sequence analysis of the 60 kDa glycoprotein (gp60) gene. Out of 335 samples, 33 (9·9%) were positive for Cryptosporidium. Of them, 97% were identified as C. parvum whilst 1 case (3%) was caused by C. hominis. All 7 C. parvum isolates subtyped belonged to the IIaA15G2R1 subtype. The common occurrence of the zoonotic IIa subtype family of C. parvum highlights the potential occurrence of zoonotic transmission of cryptosporidiosis in Yemen. However, this postulation needs confirmation with future molecular epidemiological studies of cryptosporidiosis in both humans and animals in Yemen.
GaN films have been grown atop Si-terminated 3C-SiC intermediate layer on Si(111) substrates using low pressure metalorganic chemical vapor deposition (LP-MOCVD). The SiC intermediate layer was grown by chemical vapor deposition (CVD) using tetramethylsilane (TMS) as the single source precursor. The Si terminated SiC surface was obtained by immediately flow of SiH4 gas after growth of SiC film. LP-MOCVD growth of GaN on 3C-SiC/Si(111) was carried out with trimethylgallium (TMG) and NH3. Single crystalline hexagonal GaN layers can be grown on Si terminated SiC intermediate layer using an AlN or GaN buffer layer. Compared with GaN layers grown using a GaN buffer layer, the crystal qualities of GaN films with AlN buffer layers are extremely improved. The GaN films were characterized by x-ray diffraction (XRD), photoluminescence (PL) and scanning electron microscopy (SEM). Full width at half maximum (FWHM) of double crystal x-ray diffraction (DCXD) rocking curve for GaN (0002) on 3C-SiC/Si(111) was 890 arcsec. PL near band edge emission peak position and FWHM at room temperature are 3.38 eV and 79.35 meV, respectively.
A total of 245 patients with confirmed 2009 H1N1 influenza were admitted to the intensive-care units of 28 hospitals (South Korea). Their mean age was 55·3 years with 68·6% aged >50 years, and 54·7% male. Nine were obese and three were pregnant. One or more comorbidities were present in 83·7%, and nosocomial acquisition occurred in 14·3%. In total, 107 (43·7%) patients received corticosteroids and 66·1% required mechanical ventilation. Eighty (32·7%) patients died within 30 days after onset of symptoms and 99 (40·4%) within 90 days. Multivariate logistic regression analysis showed that the clinician's decision to prescribe corticosteroids, older age, Sequential Organ Failure Assessment score and nosocomial bacterial pneumonia were independent risk factors for 90-day mortality. In contrast with Western countries, critical illness in Korea in relation to 2009 H1N1 was most common in older patients with chronic comorbidities; nosocomial acquisition occurred occasionally but disease in obese or pregnant patients was uncommon.
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.
Nanoscale superlattice-like (SLL) dielectric was employed to reduce the power consumption of the Phase-change random access memory (PCRAM) cells. In this study, we have simulated and found that the cells with the SLL dielectric have a higher peak temperature compared to that of the cells with the SiO2 dielectric after constant pulse activation, due to the interface scattering mechanism. Scaling of the SLL dielectric has resulted in higher peak temperatures, which can be even higher after material/structural modifications. Furthermore, the SLL dielectric has good material properties that enable the cells to have high endurance. This shows the effectiveness of the SLL dielectric for advanced memory applications.
The whole body concentration ratio (CR) of 137Cs, 85Sr and 65Zn for Chinese minnow (P. oxycephalus) and earthworm (E. andrei) were experimentally measured in a laboratory. The mean CR (Bq/kg fresh per Bq/l) of Chinese minnow was 3.5 for 137Cs, 11.0 for 85Sr, and 9.8 for 65Zn, respectively. The mean CR (Bq/kg fresh per Bq/kg) of earthworm was 4.4 × 10−4 for 137Cs, 1.7 × 10−3 for 85Sr, and 1.4 × 10−3 for 65Zn, respectively.
We report an extremely rare case of a fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa.
A 62-year-old woman was referred for evaluation of a mass lesion in the left sphenoid sinus and infratemporal fossa. Endoscopic examination of the nasal cavity was unremarkable. Computed tomography showed a non-enhancing, expansile mass with calcifications in the sphenoid and infratemporal fossa; T2-weighted magnetic resonance imaging revealed marked hypointense signals within the sphenoid sinus mass, with an intermediate signal intensity. A presumptive diagnosis of a mucocele was made. During surgery, a profuse amount of yellow fluid was drained from the mucocele. Clay-like material was noted within the mucocele, corresponding to the hypointense magnetic resonance imaging signals; this was identified as aspergillus on histopathological examination. Radiological findings for a fungus ball within a mucocele can be similar to those for allergic fungal sinusitis, which shows mixed low and high attenuation on computed tomography and low-signal intensity on T2-weighted magnetic resonance imaging, within an expansile, cystic lesion.
Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions.
During the early phase of the influenza pandemic in 2009, all cases of laboratory-confirmed pandemic (H1N1) 2009 (pH1N1) infection required compulsory isolation in hospital. These cases were offered oseltamivir treatment and only allowed to be discharged from the hospital when three consecutive respiratory specimens were negative for the virus by reverse transcription–polymerase chain reaction (RT–PCR). We reviewed the case records of these patients to assess the viral shedding kinetics of the pH1N1 virus. We defined viral shedding duration as the interval from illness onset date to the date of collection of the last positive specimen from the patients. Fifty-six patients were included in the study, of whom 96% received oseltamivir. The median viral shedding duration of pH1N1 virus by viral culture and RT–PCR were 3 days and 4 days, respectively. Patients who started oseltamivir treatment >48 h after onset had a significantly longer median viral shedding duration by viral culture than those who started treatment within 48 h of onset (4 days vs. 2 days, P=0·014).
The Ultra-Fast Flash Observatory (UFFO) is a space mission to detect the early moments of an explosion from Gamma-ray bursts (GRBs), thus enhancing our understanding of the GRB mechanism. It consists of the UFFO Burst & Trigger telescope (UBAT) for the recognition of GRB positions using hard X-ray from GRBs. It also contains the Slewing Mirror Telescope (SMT) for the fast detection of UV-optical photons from GRBs. It is designed to begin the UV-optical observations in less than a few seconds after the trigger. The UBAT is based on a coded-mask X-ray camera with a wide field of view (FOV) and is composed of the coded mask, a hopper and a detector module. The SMT has a fast rotatable mirror which allows a fast UV-optical detection after the trigger. The telescope is a modified Ritchey-Chrétien telescope with the aperture size of 10 cm diameter, and an image intensifier readout by CCD. The UFFO pathfinder is scheduled to launch into orbit on 2012 June by the Lomonosov spacecraft. It is a scaled-down version of UFFO in order to make the first systematic study of early UV/optical light curves, including the rise phase of GRBs. We expect UBAT to trigger ~44 GRBs/yr and expect SMT to detect ~10 GRBs/yr.
The growth of GaN films on Si substrates is very attractive work because of irreplaceable merits of Si wafer such as low cost, high surface quality, large area wafer availability, high conductivity and well-established processing techniques.
In this work, we studied the effect of buffer layers to grow high quality GaN films on 3C- SiC/Si(111) substrates. GaN films were grown on 3C-SiC/Si(111) by metalorganic chemical vapor deposition (MOCVD) using various buffer layers (GaN, AlN, and superlattice). The surface morphology and structural and optical properties of GaN films were investigated with atomic force microscopy (AFM), x-ray diffraction (XRD), Raman spectroscopy, and Photoluminescence (PL), respectively. GaN films grown using superlattice buffer layer showed only c-oriented (0002) plane of GaN from the XRD analysis. Raman spectra showed that the E2 high mode agreed with the selection rule was well observed in all GaN films. The A1(TO) and E1(TO) mode were appeared for GaN grown without buffer layer, whereas the E1(TO) mode was additionally appeared in the GaN films grown with GaN buffer layer. In the PL spectra at low temperature, the peaks associated with band edge emission and donor-accepter pair (D0A0) were observed in GaN films grown without buffer layer or with GaN buffer layer and AlN buffer layer. GaN films grown with superlattice buffer layer showed band edge and very weak D0A0 emission. The root mean square (RMS) roughness of the GaN film grown on superlattice buffer layer was only 4.21 Å Our experimental results indicated that the buffer layer affects crucially the qualities of GaN films grown on the 3C-SiC/Si substrate. Superlattice buffer layer improved the surface morphology as well as structural and optical properties of GaN films.
A multilevel metal interconnect with air-gap has been developed to reduce RC delay time for quick turn-around-time foundry manufacturing. The air-gap method has been successfully applied to 0.25 νm foundry technology. Measurements on ring oscillators confirm that the smallest delay time is indeed achieved with the air-gap method, compared with that using either conventional high-density-plasma (HDP) oxide or low-dielectric-constant spin-on-glass (SOG). In addition, we have also developed fitting equations for the delay time, thus provide a handy method for predicting the RC delay time. The oscillator delay time is also found to be critically dependent on not only the size, but also the position of the air-gap. Best delay time reduction is obtained when the air-gap is positioned in extended both above and below the metal lines to effectively reduce the fringing capacitance.
A 2,3-dibutoxy-1,4-phenylenevinylene comonomer was incorporated into a distyrylbenzene derivative 11. Novel 1,2-disubstituted-3,6-dibromobenzene comonomers 15 and 18 were prepared by directed metallation. Copolymerization of 11with a 9,9-dioctylfluorene-2,7-diboronate ester 1 yielded a green fluorescent polymer while copolymerization of 15 and 18 with the 9,9-dihexylfluorene-2,7-diboronate 22 afforded promising blue fluorescent polymers 23 and 24 respectively.
This paper reports on the structures and properties of Y1Ba2Cu3O9−x samples prepared in precisely controlled oxygen environments using a solid-state ionic technique. By titrating out oxygen at low temperatures, orthorhombic Y1Ba2Cu3O9−x samples were prepared with oxygen contents below 6.50. Resistivity and magnetometry studies indicated that these reduced, orthorhombic samples were marginally superconducting, with their superconductivity probably arising from local regions of higher oxygen content.
The influence of iron on the the microstructure and properties of B2 NiAl has been investigated using electrical resistivity, magnetic susceptibility, microhardness and transmission electron microscopy. The resistivity data suggest that quenched-in vacancies (1) enhance iron rearrangement at low temperatures (600–800 K) and (2) annihilate above 800 K. These effects depend strongly on Ni/Al ratio and are greatest for Ni/Al=1. It is also shown that these data correlate directly with the results obtained using the other experimental techniques.
A 2-D model for boron implantation into (100) silicon through overlying oxide layers has been developed and implemented into the process simulator FLOOPS. This model is both accurate and computationally efficient and shows explicit dependencies on all of the key implant parameters: energy, dose, tilt and rotation angles, oxide layer thickness, mask height, mask edge orientation, and rotation of the wafer during implantation.