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This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
Methods
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Results
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
Conclusions
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
Akathisia, dystonia, dyskinesia and parkinsonism, the four main categories of neuroleptic-induced extrapyramidal syndromes (EPS), represent major disadvantages in antipsychotic therapy. In vulnerable patients, acute EPS may progress into potentially irreversible forms such as tardive dystonia and tardive dyskinesia. In the psychiatric clinic, these EPS are often insufficiently recognised or permitted to exist without treatment. In order to ensure a better EPS diagnosis, a simple examination procedure is described. EPS rating scales may serve as an aid in this process. Guidelines are given to prevent and treat EPS. Thus, EPS are best prevented by a course of neuroleptic medication involving as little antidopaminergic D2 effect as possible, including the use of the lowest effective dose (sometimes obtained by addition of a benzodiazepine or carbamazepine) and with antipsychotic drugs which produce low D2 receptor blockade. Treating EPS also consists of using the lowest effective dose and antipsychotics with a low D2 dopamine receptor occupancy. At present, clozapine is the only drug that produces antipsychotic benefits at doses that cause far less D2 receptor antagonism in the basal ganglia of the brain than that seen with standard neuroleptics; however, newer drugs, such as olanzepine, seroquel and sertindole, are on the way.
Precipitation of amorphous silica (SiO2) in geothermal power plants, although a common factor limiting the efficiency of geothermal energy production, is poorly understood and no universally applicable mitigation strategy to prevent or reduce precipitation is available. This is primarily due to the lack of understanding of the precipitation mechanism of amorphous silica in geothermal systems.
In the present study data are presented about microstructures and compositions of precipitates formed on scaling plates inserted at five different locations in the pipelines at the Hellisheiði power station (SW-Iceland). Precipitates on these plates formed over 6 to 8 weeks of immersion in hot (120 or 60ºC), fast-flowing and silica-supersaturated geothermal fluids (~800 ppm of SiO2). Although the composition of the precipitates is fairly homogeneous, with silica being the dominant component and Fe sulfides as a less common phase, the microstructures of the precipitates are highly variable and dependent on the location within the geothermal pipelines. The silica precipitates have grown through aggregation and precipitation of silica particles that precipitated homogeneously in the geothermal fluid. Five main factors were identified that may control the precipitation of silica: (1) temperature, (2) fluid composition, (3) fluid-flow regime, (4) distance along the flow path, and (5) immersion time.
On all scaling plates, a corrosion layer was found underlying the silica precipitates indicating that, once formed, the presence of a silica layer probably protects the steel pipe surface against further corrosion. Yet silica precipitates influence the flow of the geothermal fluids and therefore can limit the efficiency of geothermal power stations.
Results are reported here of an investigation into the effects of three carboxylic acid additives (tartaric, maleic and citric acids) on the precipitation of calcium sulfate phases. Precipitation reactions were followed at pH 7 in the pure CaSO4 system and in experiments with 0–20 ppm carboxylic acids added using in situ UV-VIS spectrophotometry (turbidity). The solid products were characterized in terms of their mineralogical composition, using X-ray diffraction, during and at the end of each reaction, and in terms of their morphological features, by scanning electron microscopy. All additives increased the time needed for turbidity to develop (induction time, start of precipitation) and the comparison between additive and additive-free experiments showed that, at equivalent concentrations, citric acid performed far better than the other two carboxylic acids. In all cases bassanite precipitated first and with time it transformed to gypsum. The addition of citrate stabilized bassanite and changed the final gypsum habit from typical needle-like crystals in the pure CaSO4 system to plates in the citrate-additive experiments.
Preparing and responding to the needs of children during public health emergencies continues to be challenging. The purpose of this study was to assess the usefulness of a tabletop exercise in initiating pediatric preparedness strategies and assessing the impact of the exercise on participants’ understanding of and confidence in their roles during pediatric public health emergencies.
Methods
A tabletop exercise was developed to simulate a public health emergency scenario involving smallpox in a child, with subsequent spread to multiple states. During the exercise, participants discussed and developed communication, collaboration, and medical countermeasure strategies to enhance pediatric public health preparedness. Exercise evaluation was designed to assess participants’ knowledge gained and level of confidence surrounding pediatric public health emergencies.
Results
In total, 22 participants identified over 100 communication and collaboration strategies to promote pediatric public health preparedness during the exercise and found that the most beneficial aspect during the exercise was the partnership between pediatricians and public health officials. Participants’ knowledge and level of confidence surrounding a pediatric public health emergency increased after the exercise.
Conclusion
The tabletop exercise was effective in identifying strategies to improve pediatric public health preparedness as well as enhancing participants’ knowledge and confidence surrounding a potential pediatric public health emergency. (Disaster Med Public Health Preparedness. 2018;12:582–586)
The incorporation of pertechnetate (TcO4–) into feldspathoids produced by alkaline alteration of aluminosilicate clays may offer a potential treatment route for 99Tc-containing groundwater and liquors. Kaolinite was aged in NaOH to determine the effect of base concentration, temperature, and solution composition on mineral transformation and pertechnetate uptake. In all reactions, increased temperature and NaOH concentration increased the rate of kaolinite transformation to feldspathoid phases. In reactions containing only NaOH, sodalite was the dominant alteration product; however, small amounts (6–15%) of cancrinite also formed. In experiments containing NaOH/Cl and NaOH/NO3 mixtures, sodalite and nitrate cancrinite were crystallized (at 70°C), with no reaction intermediates. The addition of SO42– crystallized sulfatic sodalite at 40 and 50°C, but at higher temperatures (60 and 70°C) sulfatic sodalite transforms to vishnevite (sulfatic cancrinite). In experiments where a pertechnetate tracer was added (at ∼1.5 μmol l–1), only 3–5% of the 99Tc was incorporated into the feldspathoid phases. This suggests that the larger pertechnetate anion was unable to compete as favourably for the internal vacancies with the smaller OH–, NO3–, SO42– or Cl– anions in solution, making this method likely to be unsuitable for groundwater treatment.
Throat swabs are neither specific nor sensitive for micro-bacteria causing sore throat symptoms; however, current guidelines suggest they are still useful in some cases.
Method:
Retrospective and prospective analyses were conducted of throat swabs requested within the months of January 2016 and August 2016, respectively.
Results:
The study comprised 247 patients. Fifty-nine (24 per cent) had a positive culture. Forty-six grew group A beta-haemolytic streptococci, with the remainder growing candida (n = 10), coliform (n = 1) and klebsiella (n = 2). There was no significant difference in culture rates between primary or secondary care sources (χ2 = 0.56, p = 0.45). None of the swabs influenced a variation in patient management from local antimicrobial policies. Current practice has an estimated annual financial impact of £3 434 340 on the National Health Service.
Conclusion:
Throat swabs do not influence the antimicrobial treatment for patients with sore throats, even under current guidelines, and incur unnecessary cost. Current clinical guidelines could be reviewed to reduce the number of throat swabs being conducted unnecessarily.
Given the ubiquity of layering in environmental stratifications, an interesting example being double-diffusive staircase structures in the Arctic Ocean, we present the results of a joint theoretical and laboratory experimental study investigating the impact of multiple layering on internal wave propagation. We first present results for a simplified model that demonstrates the non-trivial impact of multiple layering. Thereafter, utilizing a weakly viscous linear model that can handle arbitrary vertical stratifications, we perform a comparison of theory with experiments. We conclude by applying this model to a case study of a staircase stratification profile obtained from the Arctic Ocean, finding a rich landscape of transmission behaviour.
We investigate the accuracy achievable on measurements of the the growth rate of structure f(z) using redshift-space distortions (RSD), when (a) these are measured on the group-galaxy cross correlation function; (b) the latter is expanded over a modified version of the conventional spherical armonics, “truncated multipole moments”. Simulation results give first indications that this combination can push systematic errors on f(z) below 3%, using scales r ⩾ 10h−1 Mpc.
To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.
Design.
Self-administered survey.
Setting.
Residential care facility (facility A).
Participants.
Facility A staff (N = 200).
Methods.
We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used X2 tests to measure differences between staff agreement to questions.
Results.
Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that facility administration encouraged them to stay home when ill with respiratory infection, and 72% reported that ill residents with respiratory infections were separated from well residents. Clinical and nonclinical staff differed in agreement about using waterless hand gel as a substitute for handwashing (96% vs 78%; P = .005) and whether handwashing was done after touching residents (92% vs 75%; P = .04).
Conclusions.
Respondents' knowledge, attitudes, and practices regarding infection control could be improved, especially among nonclinical staff. Facilities caring for children and young adults with neurologic and neurodevelopmental conditions should encourage adherence to infection control best practices among all staff having direct contact with residents.
A heuristic greedy algorithm is developed for efficiently tiling spatially dense redshift surveys. In its first application to the Galaxy and MassAssembly (GAMA) redshift survey we find it rapidly improves the spatial uniformity of our data, and naturally corrects for any spatial bias introduced by the 2dF multi-object spectrograph. We make conservative predictions for the final state of the GAMA redshift survey after our final allocation of time, and can be confident that even if worse than typical weather affects our observations, all of our main survey requirements will be met.
Anthropology is a complex, wide-ranging, and ever-changing field. This clear, coherent, and well-crafted book is a revised version of a very successful text first published in 1986, designed to supplement standard textbooks and monographs. It covers the central concepts, distinctive methodologies, and philosophical as well as practical issues of cultural anthropology, and it is accessible to the anthropological novice, and of value to the professional. The updated version covers current issues in cultural anthropology, and includes topics such as globalization, gender, post-modernism and public issues, and reflects changes in perspective and language.
InxGa1-xN-based LED structures were grown on digital AlxGa1-xN/GaN DBR substrate to enhance emission extraction. Same LED structure was grown on sapphire substrate as a comparison. LEDs grown on DBR substrate exhibited similar IV characteristics to that grown on sapphire substrate but emission-angle-dependent EL spectra were observed. Also, the resonant vertical cavity modes were observed in EL spectra of LEDs with DBR structure and compared to simulated results. Image processing analysis results show that light extraction of LEDs is enhanced with use of DBR substrate.
Distributed Bragg Reflectors (DBRs) are an important component of various optoelectronic devices for ultra violet and visible wavelengths. In the III-Nitride material system, Aluminum Nitride (AlN) and Gallium Nitride (GaN) offer a large contrast in refractive index and are therefore well suited for fabricating DBRs with high reflectivity and wide bandwidths using relatively few periods. However, the large lattice and thermal mismatch leads to cracking in these heterostructures. In this work short period superlattice layers have been used to fabricate high reflectivity (> 94%) nitride based DBRs via Metal Organic Vapor Phase Epitaxy. Short period AlN/GaN superlattices containing three to four monolayers of GaN have been employed as the low refractive index layer in DBRs to minimize cracking. Using this technique, crack-free DBRs reflecting from 440-475 nm with up to 25 periods have been fabricated. The technique has been proven to be versatile and resulted in large area yield DBRs grown on a variety of different sapphire substrates.
This paper deals with some relationships between Javanese modernization, a Javanese ritual called slametan, and a Javanese folk-show called ludruk. I shall illustrate how slametan and ludruk play complementary roles with respect to Javanese modernization.
The LD50 dose of Past. pestis is much greater when tested by the respiratory route than by subcutaneous challenge. This is probably due to trauma inflicted on the airborne particles.
Two forms of plague, both originating in the respiratory tract of the guinea-pig, can develop according to the size of the particle containing Past. pestis presented to the host. Small particles initiate a broncho-pneumonia which leads to septicaemia and death. Large particles establish a septicaemia, and death results more quickly without the development of a pneumonia.
Cross-infection to normal animals occurs irregularly when they are exposed to others developing plague by the respiratory route. Such incident is rare when the initially infected animals are exposed to large particles. Cross-infected animals suffer from the disease characteristic of exposure to large particles. Attempts to establish an epizootic by cross-respiratory infection were abortive, probably due, in some measure, to the type of disease developing in first cross-infections.
Experiments to determine the role of particle size in the infectivity of anthrax spores are described. Clouds of homogeneous particles were produced. The mortality-dosage curves for guinea-pigs and monkeys are given for clouds of various particle sizes. Data are given on the effect of time in the concentration-time relationship. The results are compared with those recorded by other workers on the relationship of particle size to respiratory retention.
Infectivity was highest with single-spore clouds, falling off as particle size increased. Reasons are given for attributing this effect to difference in site of deposition of different-sized particles.
The lectin-inhibitory sugars D-glucosamine (GlcN) and N-acetyl D-glucosamine (GlcNAc) are known to enhance susceptibility of the tsetse fly vector to infection with Trypanosoma brucei. GlcNAc also stimulates trypanosome growth in vitro in the absence of any factor derived from the fly. Here, we show that GlcNAc cannot be used as a direct energy source, nor is it internalized by trypanosomes. It does, however, inhibit glucose uptake by binding to the hexose transporter. Deprivation of D-glucose leads to a switch from a metabolism based predominantly on substrate level phosphorylation of D-glucose to a more efficient one based mainly on oxidative phosphorylation using L-proline. Procyclic form trypanosomes grow faster and to higher density in D-glucose-depleted medium than in D-glucose-rich medium. The ability of trypanosomes to use L-proline as an energy source can be regulated depending upon the availability of D-glucose and here we show that this regulation is a graded response to D-glucose availability and determined by the overall metabolic state of the cell. It appears, therefore, that the growth stimulatory effect of GlcNAc in vitro relates to the switch from D-glucose to L-proline metabolism. In tsetse flies, however, it seems probable that the effect of GlcNAc is independent of this switch as pre-adaptation to growth in proline had no effect on tsetse infection rate.
The present study investigated the presence of a single-nucleotide polymorphism (G > T) at base −8 upstream of ATG in 5′ untranslated region of cytochrome b5 (CYB5A) gene in Swedish pig populations and evaluated the significance of this polymorphism for androstenone and skatole levels, sexual development and performance parameters in pigs. Frequencies of the T allele were 6.7% for Swedish Yorkshire × Landrace crossbred pigs (n = 245), 6.5% for Swedish Yorkshire (n = 99) and 12.8% for Landrace breed (n = 74). No deviations from Hardy–Weinberg equilibrium were observed in the investigated populations. In Swedish Yorkshire × Landrace crossbred entire male pigs (n = 193), plasma samples were analysed for skatole, androstenone, testosterone and oestrone sulphate, and fat samples were analysed for androstenone, skatole and free oestrone. Additionally, testis weight and bulbourethral gland length for crossbred pigs were recorded. Plasma androstenone levels were significantly lower in the G/T genotype at 90 kg live weight compared with the wild G/G genotype at the same live weight (P = 0.006). In heavier pigs, plasma androstenone levels did not differ between genotypes (P = 0.382). Fat androstenone levels were not affected by CYB5A genotype (P = 0.252). Skatole levels in the G/T genotype at 115 kg live weight were lower compared with those in the G/G genotype in plasma (P = 0.048) and fat (P = 0.028), although no differences were observed in lighter pigs. Testis weight, bulbourethral gland length, testosterone and oestrone sulphate levels in plasma, and oestrone levels in fat were not affected by genotype. We concluded that the presence of the T allele in the CYB5A gene resulted in lower androstenone levels in plasma, and lower skatole levels in fat and plasma; this reduction, however, was dependent on the live weight of the animals. Reproductive hormones and growth rate did not differ between the pigs of different genotypes, whereas a higher lean meat content was found in the G/T genotype in comparison with the G/G genotype. The practical application of those results in Sweden is doubtful because of lack of the effect on androstenone in fat and the low frequency of the T allele in the studied Swedish pig populations.