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Prior studies suggest that the influenza vaccine is protective against some outcomes in hospitalized patients infected with influenza despite vaccination. We utilized surveillance data from Columbus, Ohio to investigate this association over multiple influenza seasons and age groups. Data on laboratory-confirmed influenza-associated hospitalizations were collected as a part of the Influenza Hospitalization Surveillance Project for the 2012–2013, 2013–2014, and 2014–2015 influenza seasons. The association between influenza vaccination status was examined in relation to the outcomes of severe influenza and diagnosis of pneumonia among patients receiving antiviral treatment. Data were analyzed using multivariable logistic regression. We observed no overall association between influenza vaccination status and severe influenza among hospitalized patients. During the 2013–2014 season, those who were vaccinated were 41% less likely to be diagnosed with pneumonia compared with those who were unvaccinated (OR = 0·59 95% CI 0·41–0·86). The influenza vaccine may provide a secondary preventive function against pneumonia among influenza cases requiring hospitalization. However, a protective effect was only observed in 2013–2014, an influenza H1N1 dominant year. Differences in circulating influenza virus strains and vaccine matching to the circulating strains during influenza seasons may impact this association.
Cu(In,Ga)Se2 (CIGS) photovoltaic absorbers frequently develop Ga gradients during growth. These gradients vary as a function of growth recipe, and are important to device performance. Prediction of Ga profiles using classic diffusion equations is not possible because In and Ga atoms occupy the same lattice sites and thus diffuse interdependently, and there is not yet a detailed experimental knowledge of the chemical potential as a function of composition that describes this interaction. We show how diffusion equations can be modified to account for site sharing between In and Ga atoms. The analysis has been implemented in an Excel spreadsheet, and outputs predicted Cu, In, and Ga profiles for entered deposition recipes. A single set of diffusion coefficients and activation energies are chosen, such that simulated elemental profiles track with published data and those from this study. Extent and limits of agreement between elemental profiles predicted from the growth recipes and the spreadsheet tool are demonstrated.
Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion.
Data were extracted from an anonymised database comprising the electronic medical records of patients within a large South London mental health trust. Two cohorts were derived, (1) a PICU cohort comprising all patients transferred from general adult acute wards to a non-forensic PICU ward between April 2008 and April 2013 (N = 986) and a randomly selected group of patients admitted to general adult wards within this period who were not transferred to PICU (N = 994), and (2) a seclusion cohort comprising all seclusion episodes occurring in non-forensic PICU wards within the study period (N = 990) and a randomly selected group of patients treated in these wards who were not secluded (N = 1032). Demographic and clinical factors (age, sex, ethnicity, diagnosis, admission status and time since admission) and behavioural precursors (potentially relevant behaviours occurring in the 3 days preceding PICU transfer/seclusion or random sample date) were extracted from electronic medical records. Mixed effects, multivariable logistic regression analyses were performed with all variables included as predictors.
PICU cases were significantly more likely to be younger in age, have a diagnosis of bipolar disorder and to be held on a formal section compared with patients who were not transferred to PICU; female sex and longer time since admission were associated with lower odds of transfer. With regard to behavioural precursors, the strongest predictors of PICU transfer were incidents of physical aggression towards others or objects and absconding or attempts to abscond. Secluded patients were also more likely to be younger and legally detained relative to non-secluded patients; however, female sex increased the odds of seclusion. Likelihood of seclusion also decreased with time since admission. Seclusion was significantly associated with a range of behavioural precursors with the strongest associations observed for incidents involving restraint or shouting.
Whilst recent behaviour is an important determinant, patient age, sex, admission status and time since admission also contribute to risk of PICU transfer and seclusion. Alternative, less coercive strategies must meet the needs of patients with these characteristics.
We show and discuss results and prospects of high-resolution imaging of the supermassive black hole candidate Sgr A*. We also briefly review the latest observational and theoretical progress for this source. The latest millimeter-VLBI observations show compact radio emission from within a region of about 15 Schwarzschild radii. This compact component is most likely responsible for the so-called sub-mm bump in the spectrum and perhaps even for the recently discovered circular polarization discovered up to 43 GHz and some X-ray emission through synchrotron self-Compton emission. Most importantly, however, the sub-mm emission from Sgr A* opens the door to observe, for the first time, the event horizon of a black hole directly with VLBI at sub-mm wavelengths.
The current state of neutron star structure calculations is reviewed. Uncertainties in the equation of state for matter at and above nuclear density remain. The role of the delta resonance, pion condensates, and quark matter is reviewed. Despite uncertainties, we find that recent models yield stable neutron star masses which are consistent with observational estimates.
Human anthrax cases reported in the country of Georgia increased 75% from 2011 (n = 81) to 2012 (n = 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by residence and gender to investigate risk factor(s) for infection during the month before case onset. Independent predictors most strongly associated with disease in the multivariable modelling were slaughtering animals [odds ratio (OR) 7·3, 95% confidence interval (CI) 2·9–18·1, P < 0·001] and disposing of dead animals (OR 13·6, 95% CI 1·5–119·8, P = 0·02). Participants owning or working with livestock (n = 131) were additionally interviewed about livestock management practices during the previous 6 months: 53 (44%) of 121 respondents vaccinated livestock against anthrax; 19 (16%) of 116 moved livestock >1 km; 15 (12%) of 125 had sick livestock; and 11 (9%) of 128 respondents reported finding dead livestock. We recommend joint public health and veterinary anthrax case investigations to identify areas of increased risk for livestock anthrax outbreaks, annual anthrax vaccination of livestock in those areas, and public awareness education.
This study aims to examine the longitudinal effects of a small-scale nursing home model on the change rates of psychological outcomes by comparing green house (GH) and traditional nursing home residents.
A total of 242 residents (93 GH and 149 traditional home residents) who resided at the home least 6 months from admission. Four minimum dataset assessments every six months from admission were included. The main psychological outcomes were depressive mood, and social engagement. The main independent variable was the facility type that the resident resided in: a GH or traditional unit. Age, gender, ADL function, and cognitive function at admission were controlled in the model. A zero-inflated Poisson (ZIP) growth curve model was utilized to compare change rates of two psychological outcomes between the two groups taking into account many zero counts of two outcome measures.
A rate of increase in depressive symptoms for GH home residents was higher than that of traditional home residents (β = 0.135, p-value = 0.025). GH home residents had a lower rate of increase of the probability of “not being socially engaged” over time compared to traditional home residents (β = −0.274, p-value = 0.010).
The GH nursing home model had a longitudinal effect on increasing the probability of residents’ social engagement over time, but also increasing the recognition of depressive symptoms compared to traditional nursing homes.
The aim of this study was to examine if family system dynamics (e.g., parent mental health, marriage quality, conflict, and cohesion) that have often been overlooked when studying Latino families play a more important role in predicting adolescent internalizing symptoms than acculturation processes. Data comes from the Latino Acculturation and Health Project, a longitudinal investigation of acculturation in Latino families in North Carolina and Arizona (Smokowski & Bacallao, 2006, 2010). Researchers conducted in-depth, community-based interviews with 258 Latino adolescents and 258 of their parents in metropolitan, small-town, and rural areas. Interviews were conducted at four time points at intervals of approximately 6 months. Parent and adolescent ratings of the adolescent's internalizing symptoms were used as the dependent variable in a longitudinal hierarchical linear model with a rater effects structure. Results showed that parent–adolescent conflict and parent mental health (fear/avoidance of social situations and humiliation sensitivity) were significant predictors of adolescent internalizing symptoms. Acculturation scales were not significant predictors; however, internalizing symptoms decreased with time spent in the United States. Females and adolescents from lower socioeconomic status families reported more internalizing symptoms, while participants who had been in the United States longer reported fewer internalizing symptoms. Implications were discussed.
Although fear of falling is prevalent among older adults recovering from hip fracture, current instruments are inadequate due to focus on specific situations and measurement of self-efficacy rather than fear.
The authors revised and tested a form of the Fear of Falling Questionnaire with three groups of older adults: 405 recovering from hip fracture, 89 healthy community dwelling, and 42 with severe fear of falling. Test-retest reliability was evaluated in a subsample of 16 hip fracture patients. Internal consistency was compared across all groups. Construct validity was established through factor analysis, convergent validity with a measure of fall-related self-efficacy, and discriminant validity with measures of depression and affect.
A revised two-factor, six-item scale appears to have adequate psychometric properties. Scores were lower in the healthy comparison group relative to the hip fracture and fear of falling groups. Cronbach's α ranged from 0.72–0.83, with test-retest reliability of 0.82. Correlations with a measure of fall-related self-efficacy were moderate for the hip fracture group (0.42) and high with the healthy comparison (0.68) and fear of falling (0.70) groups. Correlations with depression and negative and positive affect were low to moderate.
The Fear of Falling Questionnaire – Revised shows promise as a self-report measure of fear of falling, and is one of the first to be tested in older adults recovering from hip fracture. Advantages are that it is global rather than situation-specific and measures fear rather than self-efficacy. Future research on this scale is recommended in other older adult samples for whom fear of falling is relevant.
Although the cadmium chloride treatment is an essential process for high efficiency thin film cadmium telluride photovoltaic devices, the precise mechanisms involved that improve the cadmium telluride layer are not well understood. In this investigation we apply advanced micro-structural characterization techniques to study the effect of varying the time of the cadmium chloride annealing treatment on the micro-structure of cadmium telluride solar cells deposited by close spaced sublimation (CSS) and relate this to cell performance. A range of techniques has been used to observe the morphological changes to the micro-structure as well as the chemical and crystallographic changes as a function of treatment parameters. Electrical tests that link the device performance with the micro-structural properties of the cells have also been undertaken. Techniques used include Transmission Electron Microscopy (TEM) for sub-grain analysis and XPS for composition-depth profiling. The study provides a new insight in to the mechanisms involved in the initiation and the subsequent complete re-crystallization of the cadmium telluride layer.
Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode.
Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months.
A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies.
We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.
The Australian Square Kilometre Array Pathfinder (ASKAP) will give us an unprecedented opportunity to investigate the transient sky at radio wavelengths. In this paper we present VAST, an ASKAP survey for Variables and Slow Transients. VAST will exploit the wide-field survey capabilities of ASKAP to enable the discovery and investigation of variable and transient phenomena from the local to the cosmological, including flare stars, intermittent pulsars, X-ray binaries, magnetars, extreme scattering events, interstellar scintillation, radio supernovae, and orphan afterglows of gamma-ray bursts. In addition, it will allow us to probe unexplored regions of parameter space where new classes of transient sources may be detected. In this paper we review the known radio transient and variable populations and the current results from blind radio surveys. We outline a comprehensive program based on a multi-tiered survey strategy to characterise the radio transient sky through detection and monitoring of transient and variable sources on the ASKAP imaging timescales of 5 s and greater. We also present an analysis of the expected source populations that we will be able to detect with VAST.
It is well known that the cadmium chloride annealing treatment is an essential step in the manufacture of efficient thin film cadmium telluride solar cells. It has been recognized that the combination of annealing at ∼4000C together with the addition of cadmium chloride at the surface induces re-crystallisation of the cadmium telluride layer and also affects the n-type cadmium sulfide. We have applied advanced micro-structural characterization techniques to distinguish the effect of the annealing and the cadmium chloride treatments on the properties of the cadmium telluride deposited via close space sublimation (CSS) and relate these observations to device performance. Transmission electron microscopy (TEM) has shown a variation in stacking fault density with annealing temperature and annealing time. Stacking faults observed within the cadmium telluride grains in TEM were partially removed post annealing; these findings show that temperature alone has a role in the reduction of stacking faults. However, since we have previously observed almost complete removal of stacking faults with annealing in combination with cadmium chloride, the cadmium chloride is essential to defect removal and high efficiency cells.
We are developing a purely commensal survey experiment for fast (<5 s) transient radio sources. Short-timescale transients are associated with the most energetic and brightest single events in the Universe. Our objective is to cover the enormous volume of transients parameter space made available by ASKAP, with an unprecedented combination of sensitivity and field of view. Fast timescale transients open new vistas on the physics of high brightness temperature emission, extreme states of matter and the physics of strong gravitational fields. In addition, the detection of extragalactic objects affords us an entirely new and extremely sensitive probe on the huge reservoir of baryons present in the IGM. We outline here our approach to the considerable challenge involved in detecting fast transients, particularly the development of hardware fast enough to dedisperse and search the ASKAP data stream at or near real-time rates. Through CRAFT, ASKAP will provide the testbed of many of the key technologies and survey modes proposed for high time resolution science with the SKA.
Recent evidence points to partially shared genetics of neuropsychiatric disorders.
We examined risk of intellectual disability and other neuropsychiatric outcomes in 3174 children of mothers with schizophrenia, bipolar disorder or unipolar major depression compared with 3129 children of unaffected mothers.
We used record linkage across Western Australian population-based registers. The contribution of obstetric factors to risk of intellectual disability was assessed.
Children were at significantly increased risk of intellectual disability with odds ratios (ORs) of 3.2 (95% CI 1.8–5.7), 3.1 (95% CI 1.9–4.9) and 2.9 (95% CI 1.8–4.7) in the maternal schizophrenia, bipolar disorder and unipolar depression groups respectively. Multivariate analysis suggests familial and obstetric factors may contribute independently to the risk. Although summated labour/delivery complications (OR = 1.4, 95% CI 1.0–2.0) just failed to reach significance, neonatal encephalopathy (OR = 7.7, 95% CI 3.0–20.2) and fetal distress (OR = 1.8, 95% CI 1.1–2.7) were independent significant predictors. Rates of rare syndromes in children of mothers with mental disorder were well above population rates. Risk of pervasive developmental disorders, including autism, was significantly elevated for children of mothers with bipolar disorder. Risk of epilepsy was doubled for children of mothers with unipolar depression.
Our findings provide epidemiological support for clustering of neuropsychiatric disorders. Further larger epidemiological studies are warranted.
Silicon nanowires (NWs) are promising thermoelectric materials as they offer large reductions in thermal conductivity over bulk Si without a significant decrease in the Seebeck coefficient or electrical conductivity. In this work, interference lithography was used to pattern a square lattice photoresist template over 2 cm x 2 cm Si substrates. The resulting vertical Si NW arrays were 1 μm tall with a packing density of ~15%, and the diameter of the Si NWs were 80 - 90 nm. The Si NW arrays were then embedded in spin-on glass (SOG) to form a dense composite material with a measured thermal conductivity of 1.45 W/m-K at 300 K. Devices were fabricated for cross-plane Seebeck coefficient measurements and the Si NW/SOG composite was found to have a Seebeck coefficient of roughly -284 μV/K, which is similar to bulk Si with the same doping. We also report a combined power generation of 29.3 μW from both the Si NW array and Si substrate with a temperature difference of 56 K and 50 μm x 50 μm device area.
A new magnetron sputtering strategy is introduced that utilizes high plasma density (~5mA.cm-2) to avoid or reduce high temperature processing. The technique uses magnetrons of opposing magnetic polarity to create a “closed field” in which the plasma density is enhanced without the need for high applied Voltages. A batch system has been used which employs a rotating vertical drum as the substrate carrier and a symmetrical array of linear magnetrons. The magnetrons are fitted with target materials for each of the thin films required in the photovoltaic (PV) stack including the CdTe absorber layer, CdS window layer, metal contact using the conventional superstrate configuration. The “closed field” sputtering technology allows scale up not only for larger batch system designs but it is also configurable for “in-line” or “roll to roll” formats for large scale production. The morphology of each of the layers is characterized using a variety of structural and optical techniques including Field Emission Gun SEM and X-ray diffraction (XRD).