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Studies on community-acquired pneumonia (CAP) and pneumococcal pneumonia (PP) related to the 13-valent pneumococcal conjugate vaccine (PCV13) introduction in Asia are scarce. This study aimed to investigate the epidemiological and microbiological determinants of hospitalised CAP and PP after PCV13 was introduced in Japan. This observational hospital-based surveillance study included children aged ⩽15 years, admitted to hospitals in and around Chiba City, Japan. Participants had bacterial pneumonia based on a positive blood or sputum culture for bacterial pathogens. Serotype and antibiotic-susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae isolates from patients with bacterial pneumonia were assessed. The CAP hospitalisation rate per 1000 child-years was 17.7, 14.3 and 9.7 in children aged <5 years and 1.18, 2.64 and 0.69 in children aged 5–15 years in 2008, 2012 and 2018, respectively. There was a 45% and 41% reduction in CAP hospitalisation rates, between the pre-PCV7 and PCV13 periods, respectively. Significant reductions occurred in the proportion of CAP due to PP and PCV13 serotypes. Conversely, no change occurred in the proportion of CAP caused by H. influenzae. The incidence of hospitalised CAP in children aged ⩽15 years was significantly reduced after the introduction of PCV13 in Japan. Continuous surveillance is necessary to detect emerging PP serotypes.
A reformulation of the Social Brain Theory of schizophrenia is proposed that contends that schizophrenia is a novel human phenomenon that arose following the establishment of large permanent human settlements and the abandonment of the hunter-gatherer way of life. It is contended that the blurring of the demarcation between ingroup and outgroup membership and living in close proximity to strangers is a stressor that leads to perturbation in the development of the social brain in vulnerable individuals leading to the syndrome of schizophrenia. Contrary to previous authors who have considered schizophrenia to be an inherently human condition that has existed throughout human history we suggest that schizophrenia is a relatively recent phenomenon and that the vulnerability to it remained hidden amongst hunter-gatherers. Hence, we contend that schizophrenia is the result of a mismatch between the post-Neolithic human social environment and the design of the social brain. The importance of the distinction between ingroup and outgroup membershipin human evolutionary history lies at the heart of inter-group conflict, violence and xenophobia. This formulation explains a range of epidemiological findings on schizophrenia related to the risk of migration and urbanisation. The present hypothesis can therefore, account for a range of disparate findings regarding schizophrenia that have thus far defied explanation by other extant theories. However, as this formulation claims to have identified the ultimate causation of schizophrenia the hypothesis does not specify the proximate mechanisms that lead to it. We conclude with a number of testable and refutable predictions.
A variety of hereditary spinocerebellar ataxia (SCA) develops a broad spectrum of both ataxia and non-ataxia symptoms. Cognitive and affective changes are one such non-ataxia symptoms, but have been described only in hereditary SCAs with exonic CAG gene expansion.
We newly found intronic hexanucleotide GGCCTG gene expansion in NOP56 gene as the causative mutation (=SCA36) in nine unrelated Japanese familial SCA originating from Asida river area in the western part of Japan, thus nicknamed Asidan for this mutation. These patients show unique clinical balance of cerebellar ataxia and motor neuron disease (MND), locating on the crossroad of these two diseases. We examined cognitive and affective analyses on 12 Asidan patients who agreed to join the examination.
The 12 Asidan patients demonstrated a significant decrease in their frontal executive functions measured by frontal assessment battery (FAB) and Montreal cognitive assessment (MoCA) compared with age- and gender-matched controls, whilst mini-mental state examination (MMSE) and Hasegawa dementia score-revised (HDS-R) were within normal range. the decline of frontal executive function was related to their disease duration and scale for the assessment and rating of ataxias (SARA). They also demonstrated mild depression and apathy. Single-photon emission tomography (SPECT) analysis showed that these Asidan patients showed decline of regional cerebral blood flow (rCBF) in a particular areas of cerebral cortices such as Brodmann areas 24 and 44-46.
These data suggest the patients with Asidan mutation show unique cognitive and affective characteristics different from other hereditary SCAs with exonal CAG expansion or MND.
This paper describes and analyzes a new technique used in Q-slot antenna to generate circular polarization (CP). The CP characteristics were investigated carefully by studying the surface current distribution, the phase difference between the left hand circular polarization (LHCP) and right hand circular polarization (RHCP) at some resonant frequencies, and the measured values of the axial ratio bandwidth (ARBW). Normal arms (E1 and E2) were cut in the upper elliptical feeding strip line to form an open-mouth structure. The arms E1 and E2 were made equal in length and set perpendicular to each other to have normal electric fields, leading to the generation of CP radiation. A formula was modified for the dual resonant frequencies f1, f2 of the modes TM010 and TM001. The measured values of the ARBW indicated that the antenna has a wide ARBW of 4.8–5.93 GHz, which is approximately 52% of the 3rd operating band of 4.7–6.8 GHz. The wide ARBW in a small size indicated that the design of the Q-slot antenna overcame the limits of designing antennas with wide ARBW in small size and low profile. A formula for normalized field was driven according to the complementary of the Q-slot antenna.
A cross-sectional survey was carried out in primary schools to determine prevalence, intensity and spatial co-distribution of Schistosomiasis and soil transmitted helminths (STH) infections in Ogun State, Nigeria. A total of 2148 pupils from 42 schools were examined for Schistosoma and STH infections from urine and fresh fecal samples respectively. Ethyl ether concentration method prepared in sodium acetate – acetic acid – formalin ether was used to concentrate parasites’ ova before microscopic examination. The overall prevalence of schistosomiasis and STH infections were 4.0% (95% CI = 3.21–4.92) and 34.64% (95% CI = 32.62–36.69) respectively. Schistosoma haematobium and Ascaris lumbricoides were the most prevalent across the study area among the Schistosoma and STH species respectively. Overall, intensity of infection was higher in males than in females for all Schistosoma and STH infections, but with no significant difference (P > 0.05), except for Trichuris trichiura (χ2 = 6.490, P < 0.05). Infection intensity was significantly inversely correlated (χ2 = 12.953, P < 0.05) with an increase in age group. Co-distribution of Schistosoma and STH infections occurred in 15 (35.7%) out of 42 schools, and only 30 children (1.4%) had co-infection of Schistosoma and STH. This study provides information on the prevalence and spatial risk of schistosomiasis and STH in Ogun State. This will serve as decision-support tool for Ogun State programme managers to help facilitate integration of schistosomiasis and STH control.
To determine whether a cardioprotective dietary intervention based on UK dietary guidelines was more expensive than a conventional UK diet.
Cost analysis of food records collected at baseline and after a 12-week dietary intervention of a cardioprotective diet v. conventional UK diet.
A randomized controlled dietary intervention study (CRESSIDA; ISRCTN 92382106) investigating the impact of following a diet consistent with UK dietary guidelines on CVD risk.
Participants were healthy UK residents aged 40–70 years. A sub-sample of participants was randomly selected from those who completed the cardioprotective dietary intervention (n 20) or the conventional UK dietary intervention (n 20).
Baseline diet costs did not differ between groups; mean daily food cost for all participants was £6·12 (sd £1·83). The intervention diets were not more expensive: at end point the mean daily cost of the cardioprotective diet was £6·43 (sd £2·05) v. the control diet which was £6·53 (sd £1·53; P=0·86).
There was no evidence that consumption of a cardioprotective diet was more expensive than a conventional dietary pattern. Despite the perception that healthier foods are less affordable, these results suggest that cost may not be a barrier when modifying habitual intake and under tightly controlled trial conditions. The identification of specific food groups that may be a cost concern for individuals may be useful for tailoring interventions for CVD prevention for individuals and populations.
We report on the formation of shallow junctions with high activation in both n+/p and p+/n Ge junctions using ion implantation and Flash Lamp Annealing (FLA). The shallowest junction depths (Xj) formed for the n+/p and p+/n junctions were 7.6 nm and 6.1 nm with sheet resistances (Rs) of 860 ohms/sq. and 704 ohms/sq., respectively. By reducing knocked-on oxygen during ion implantation in the n+/p junctions, Rs was decreased by between 5% and 15%. The lowest Rs observed was 235 ohms/sq. with a junction depth of 21.5 nm. Hall measurements clearly revealed that knocked-on oxygen degraded phosphorus activation (carrier concentration). In the p+/n Ge junctions, we show that ion implantation damage induced high boron activation. Using this technique, Rs can be reduced from 475 ohms/sq. to 349 ohms/sq. These results indicate that the potential for forming ultra-shallow n+/p and p+/n junctions in the nanometer range in Ge devices using FLA is very high, leading to realistic monolithically-integrated Ge CMOS devices that can take us beyond Si technology.
The concept of cognitive reserve (CR) hypothesizes that intellectually stimulating activities provide resilience against brain pathology/disease. Whereas brain abnormalities and cognitive impairment are frequently reported in bipolar disorder (BD), it is unknown whether the impact of brain alterations can be lessened by higher CR in BD.
We tested if higher CR would reduce the influence of total volumes of deep white matter hypointensities (WMH), ventricular cerebrospinal fluid (CSF), and prefrontal cortex on memory, executive, and attention/speed functions in patients with BD (n = 75). Linear regression models with interaction terms for CR and brain volumes were applied to directly test if CR reduces the influence of brain pathology on cognitive domains.
CR reduced the influence of total volumes of deep WMH (β = −0.38, Q = 0.003) and ventricular CSF (β = −41, Q = 006) on executive functions.
The interactions between CR and total volumes of deep WMH/ventricular CSF appear to account for executive functioning in BD. The results suggest that the concept of CR is applicable in BD. Higher reserve capacity in BD alters the relationship between brain pathology and clinical presentation.
Documenting past changes in the East Antarctic surface mass balance is important to improve ice core chronologies and to constrain the ice-sheet contribution to global mean sea-level change. Here we reconstruct past changes in the ratio of surface mass balance (SMB ratio) between the EPICA Dome C (EDC) and Dome Fuji (DF) East Antarctica ice core sites, based on a precise volcanic synchronization of the two ice cores and on corrections for the vertical thinning of layers. During the past 216 000 a, this SMB ratio, denoted SMBEDC/SMBDF, varied between 0.7 and 1.1, being small during cold periods and large during warm periods. Our results therefore reveal larger amplitudes of changes in SMB at EDC compared with DF, consistent with previous results showing larger amplitudes of changes in water stable isotopes and estimated surface temperature at EDC compared with DF. Within the last glacial inception (Marine Isotope Stages, MIS-5c and MIS-5d), the SMB ratio deviates by up to 0.2 from what is expected based on differences in water stable isotope records. Moreover, the SMB ratio is constant throughout the late parts of the current and last interglacial periods, despite contrasting isotopic trends.
This study aimed to determine the relationship between quality of life and satisfaction with care among cancer patients in palliative care in Saudi Arabia.
A total of 130 palliative cancer patients were invited to participate in our cross-sectional study. Patients were recruited from a large tertiary hospital within the Ministry of Health in Saudi Arabia. All eligible participants answered a three-part questionnaire that included demographic data and the validated European Organization for Research and Treatment of Cancer (EORTC QLQ–C15–PAL) and (EORTC IN-PATSAT32) questionnaires.
Participants were mostly female (103/130, 79%) and married (93/130, 71%), and more than half had breast cancer (69/130, 53%). They were between 17 and 86 years of age (mean = 46.7, SD = 16.50). The correlation test showed that the relationship with physical function was weak, while emotional function and global health status had a moderate relationship with general satisfaction (r = 0.21, p < 0.01; r = 0.32, p < 0.001; r = 0.26, p < 0.01, respectively). Our results suggest that emotional function is the more important factor in predicting satisfaction with care among palliative cancer patients. An increase in emotional function leads to increased general satisfaction.
Significance of results:
The emotional function of palliative cancer patients was more closely associated with overall satisfaction with care than physical function or global health status. All palliative care team members are thus required to provide adequate psychosocial support. It is recommended that interdisciplinary and collaborative approaches be integrated in palliative care of cancer patients.
Remingtonocetidae are Eocene archaeocetes that represent a unique experiment in cetacean evolution. They possess long narrow skulls, long necks, fused sacra, and robust hind limbs. Previously described remingtonocetids are known from middle Eocene Lutetian strata in Pakistan and India. Here we describe a new remingtonocetid, Rayanistes afer, n. gen. n. sp., recovered from a middle to late Lutetian interval of the Midawara Formation in Egypt. The holotype preserves a sacrum with four vertebral centra; several lumbar and caudal vertebrae; an innominate with a complete ilium, ischium, and acetabulum; and a nearly complete femur. The ilium and ischium of Rayanistes are bladelike, rising sharply from the body of the innominate anterior and posterior to the acetabulum, and the acetabular notch is narrow. These features are diagnostic of Remingtonocetidae, but their development also shows that Rayanistes had a specialized mode of locomotion. The expanded ischium is larger than that of any other archaeocete, supporting musculature for powerful retraction of the hind limbs during swimming. Posteriorly angled neural spines on lumbar vertebrae and other features indicate increased passive flexibility of the lumbus. Rayanistes probably used its enhanced lumbar flexibility to increase the length of the power stroke during pelvic paddling. Recovery of a remingtonocetid in Egypt broadens the distribution of Remingtonocetidae and shows that protocetids were not the only semiaquatic archaeocetes capable of dispersal across the southern Tethys Sea.
In traditional transit timing variations (TTVs) analysis of multi-planetary systems, the individual TTVs are first derived from transit fitting and later modelled using n-body dynamic simulations to constrain planetary masses. We show that fitting simultaneously the transit light curves with the system dynamics (photo-dynamical model) increases the precision of the TTV measurements and helps constrain the system architecture. We exemplify the advantages of applying this photo-dynamical model to a multi-planetary system found in K2 data very close to 3:2 mean motion resonance, K2-19. In this case the period of the larger TTV variations (libration period) is much longer (>1.5 years) than the duration of the K2 observations (80 days). However, our method allows to detect the short period TTVs produced by the orbital conjunctions between the planets that in turn permits to uniquely characterise the system. Therefore, our method can be used to constrain the masses of near-resonant systems even when the full libration curve is not observed.
We have achieved a drastic improvement of the performance as thin film transistor (TFT) for solution-processed IGZO thin film by controlling drying temperature of solvents containing the precursor solution. The IGZO-precursor solution was prepared by mixing of metal nitrates and two kinds of organic solvents, 2-methoxyethanol (2ME) and 2,2,2-trifluoroethanol (TFE). 2ME was used for dissolving metal nitrates. TFE was added as a solvent for reducing surface tension as small as possible, leading to improvement of the wettability of the precursor solution on the surface of the substrate. In order to discuss the relationship between morphology and drying process, the spin-coated IGZO-precursor films were dried at room temperature and 140 °C on a hotplate, respectively. Annealing of the both films was carried out at 300 °C in an electric oven for 60 min after each drying process. Drying at room temperature provides a discontinuous film, resulting in a large variation of the TFT performance. On the other hand, drying at 140 °C provides a continuous film, resulting in the higher TFT performance and a minor variation. The difference in surface morphologies would be derived from the evaporation rate of the organic solvents. The rapid evaporation at 140 °C brings about rapid pinning of the spin-coated precursor layer on the substrate. Preparation process via the drying at 140 °C gave ∼ 1 cm2 V-1 s-1 of the saturated mobility, quite small hysteresis, and 107∼ 108 of the on-off ratio.
The supposed universality of the incidence and prevalence of schizophrenia has been seriously challenged. It is now widely accepted that the life-time prevalence and incidence of this disorder vary considerably in time and place. As a result, there has been renewed interest in environmental causation of schizophrenia. There are few extant formulations that have successfully integrated the available new evidence into a coherent theory for its causation. The outgroup intolerance hypothesis is an attempt to integrate this evidence. It proposes that schizophrenia is the result of a mismatch between the social brain as shaped by evolution and the new social conditions of the post-neolithic. The hypothesis can provide an explanation for (i) the higher risk to migrants, (ii) the ethnic density phenomenon, (iii) the increased risk to individuals who have grown up in cities and (iv) the putative low risk in hunter-gatherer societies. Evidence is presented from a range of disciplines and sources including epidemiology, psychopathology, social psychology and clinical trials in support of this hypothesis. A range of testable predictions follow from the hypothesis.
A discharge-emission spectrometer and a cavity ringdown spectrometer have been developed to aid in the solution to the diffuse interstellar band (DIB) problem. A hollow cathode was used to generate molecular ions in a discharge because it has been suggested that molecular ions are probable DIB candidates. The discharge was produced by a pulsed voltage of 1300–1500 V. A wide wavelength range of optical emission from the discharge was examined by a HORIBA Jobin Yvon iHR320 monochromator. The dispersed discharge emission was detected by a photomultiplier and was recorded via a lock-in amplifier. The 2B3u–X2B2g electronic transition of the butatriene cation H2CCCCH2+ was observed in the discharge emission of 2-butyne H3CCCCH3. The frequency of the electronic transition was measured to be 20381 cm−1, and a comparison study was made with known DIB spectra.
The resolution of the discharge-emission spectrometer is insufficient to make precise comparisons between laboratory frequencies and astronomically observed DIB spectra. We therefore developed the cavity ringdown spectrometer using the same hollow cathode. The high sensitivity of this spectrometer was confirmed by the observation of the forbidden band of O2.
We investigated the relationships between conception rates (CRs) at first service in Japanese Holstein heifers (i.e. animals that had not yet had their first calf) and cows and their test-day (TD) milk yields. Data included records of artificial insemination (AI) for heifers and cows that had calved for the first time between 2000 and 2008 and their TD milk yields at 6 through 305 days in milk (DIM) from first through third lactations. CR was defined as a binary trait for which first AI was a failure or success. A threshold-linear animal model was applied to estimate genetic correlations between CRs of heifers or cows and TD milk yield at various lactation stages. Two-trait genetic analyses were performed for every combination of CR and TD milk yield by using the Bayesian method with Gibbs sampling. The posterior means of the heritabilities of CR were 0.031 for heifers, 0.034 for first-lactation cows and 0.028 for second-lactation cows. Heritabilities for TD milk yield increased from 0.324 to 0.433 with increasing DIM but decreased slightly after 210 DIM during first lactation. These heritabilities from the second and third lactations were higher during late stages of lactation than during early stages. Posterior means of the genetic correlations between heifer CR and all TD yields were positive (range, 0.082 to 0.287), but those between CR of cows and milk yields during first or second lactation were negative (range, −0.121 to −0.250). Therefore, during every stage of lactation, selection in the direction of increasing milk yield may reduce CR in cows. The genetic relationships between CR and lactation curve shape were quite weak, because the genetic correlations between CR and TD milk yield were constant during the lactation period.