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Adults with congenital heart disease face psychological challenges although an understanding of depression vs. anxiety symptoms is unclear. We analyzed the prevalence of elevated symptoms of anxiety and depression and explored associations with demographic and medical factors as well as quality of life.
Adults with congenital heart disease enrolled from an outpatient clinic completed the Hospital Anxiety and Depression Scale and two measures of quality of life: the Linear Analogue Scale and the Satisfaction with Life Scale. Medical data were obtained by chart review.
Of 130 patients (median age = 32 years; 55% female), 55 (42%) had elevated anxiety symptoms and 16 (12%) had elevated depression symptoms on subscales of the Hospital Anxiety and Depression Scale. Most patients with elevated depression symptoms also had elevated anxiety symptoms (15/16; 94%). Of 56 patients with at least one elevated subscale, 37 (66%) were not receiving mental health treatment. Compared to patients with 0 or 1 elevated subscales, patients with elevations in both (n=15) were less likely to be studying or working (47% vs. 81%; p=0.016) and reported lower scores on the Linear Analogue Scale (60 vs. 81, p<0.001) and the Satisfaction with Life Scale (14 vs. 28, p<0.001).
Among adults with congenital heart disease, elevated anxiety symptoms are common and typically accompany elevated depressive symptoms. The combination is associated with unemployment and lower quality of life. Improved strategies to provide psychosocial care and support appropriate engagement in employment are required.
Using a physics-based approach, we infer the impact of the coherence of atmospheric turbulence on the power fluctuations of wind farms. Application of the random-sweeping hypothesis reveals correlations characterized by advection and turbulent diffusion of coherent motions. Those contribute to local peaks and troughs in the power spectrum of the combined units at frequencies corresponding to the advection time between turbines, which diminish in magnitude at high frequencies. Experimental inspection supports the results from the random-sweeping hypothesis in predicting spectral characteristics, although the magnitude of the coherence spectrum appears to be over-predicted. This deviation is attributed to the presence of turbine wakes, and appears to be a function of the turbulence approaching the first turbine in a pair.
OBJECTIVES/SPECIFIC AIMS: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) recurrence ranges from 16% to 43% and presents significant challenges to clinicians, patients, and families. This comparative effectiveness research study aims to disseminate, implement and evaluate whether an existing intervention, consisting of decolonization and decontamination procedures, which has been determined to be effective in hospital intensive care unit settings, can be implemented by Community Health Workers (CHWs) or “promotoras” conducting home visits prevent recurrence of CA-MRSA and transmission within their households for patients presenting to primary care with SSTIs. METHODS/STUDY POPULATION: In partnership with 3 Community Health Centers and 4 community hospitals in NYC, this study will recruit patients (n=278) with confirmed MRSA SSTIs and their household members. Participants are randomized to receive either a CHW/Promotora-delivered decolonization-decontamination intervention or usual care, which includes hygiene education. The highly engaged stakeholder team meets monthly to review interim results, identify areas for refinement and new research questions, and develop and implement strategies to improve participant engagement and retention. RESULTS/ANTICIPATED RESULTS: MRSA and MSSA were found in 19% and 21.1% of wound cultures, respectively. 59.5% with MRSA+ wound culture had one or more MRSA+ surveillance culture; 67.8% with MSSA+ wound culture had one or more MSSA+ surveillance culture. The “warm handoff” approach, developed and implemented by the stakeholder team to engage patients from their initial consent to return of lab results and scheduling of the home visits, helped improve completion of baseline home visits by 14%, from 45% to 59% of eligible participants. Home visits have demonstrated that 60% of households had at least one surface contaminated with S. aureus. Of the surfaces that tested positive in the households, nearly 20% were MRSA and 81% were MSSA; 32.5% of household members had at least one surveillance culture positive for S. aureus (MRSA: 7.7%, MSSA: 92.3%). DISCUSSION/SIGNIFICANCE OF IMPACT: This study aims to understand the systems-level, patient-level, and environmental-level factors associated with SSTI recurrence and household transmission, and to examine the interactions between bacterial genotypic and clinical/phenotypic factors on decontamination, decolonization, SSTI recurrence and household transmission. This study will evaluate the barriers and facilitators of implementation of home visits by CHWs in underserved populations, and aims to strengthen the weak evidence base for implementation of strategies to reduce SSTI recurrence and household transmission.
Late life depression (LLD) confers significant morbidity and mortality but is well recognized that it often goes undetected or untreated. The objective of this study is to quantify the burden of untreated depression and death ideation (DI) at a population level.
Cross-sectional study ascertaining the prevalence of, and factors associated with, untreated depression and DI.
This study, embedded within the Irish Longitudinal Study on Ageing, involves over 7,000 community-dwelling people aged ≥50 years.
Depression was defined as Centre for Epidemiological Studies Depression scale ≥16 indicating current clinically relevant depressive symptoms or Composite International Diagnostic Interview indicative of major depressive episode within the last year. Participants not prescribed antidepressants/antipsychotics were defined as untreated. To define DI, participants were asked “In the last month, have you felt like you would rather be dead?”
In total, 12% (839/7,055) met criteria for depression with 29% (241/839) on pharmacological therapy. Those with untreated depression were less likely to endorse symptoms of persistent low mood or worthlessness, but there was no difference in age or general practitioner (GP) visits compared to those on treatment. Over 3% (223/7,055) of participants had DI and less than one-third had visited their GP within the last year.
This study demonstrates that two-thirds of depressed older people are not prescribed antidepressant/antipsychotic therapy. It is important to raise awareness of depression among older people and healthcare professionals, with particular focus on the fact that LLD is not an inevitable consequence of ageing and effective treatment is available.
The full theory of polarized SiO maser emission from the near-circumstellar environment of Asymptotic Giant Branch stars has been the subject of debate, with theories ranging from classical Zeeman origins to predominantly non-Zeeman anisotropic excitation or propagation effects. Features with an internal electric vector position angle (EVPA) rotation of ∼π/2 offer unique constraints on theoretical models. In this work, results are presented for one such feature that persisted across five epochs of SiO ν = 1, J = 1 − 0 VLBA observations of TX Cam. We examine the fit to the predicted dependence of linear polarization and EVPA on angle (θ) between the line of sight and the magnetic field against theoretical models. We also present results on the dependence of mc on θ and their theoretical implications. Finally, we discuss potential causes of the observed differences, and continuing work.
CCD uVJIC photometry was obtained for three eclipsing binaries in the Magellanic Clouds and the preliminary analyses of their light curves has been made using a modified Wilson code. The LMC system, MACHO*05:36:48.7-69:17:00, is detached and eccentric, most likely comprising of two similar stars. The system has apsidal motion with a period of 100 ± 5 years. Initial results for two other systems in the SMC, MOA J005018.4–723855 and MOA J005623.5–722123, indicate circular orbits with the former semi-detached and the latter detached with two stars of very similar temperature.
We are painfully aware: Psychiatry in some states of the international community is often used to subvert the political and legal guarantees of the freedom of the individual and to violate seriously his human and legal rights (Daes,1986).
It can be politically convenient to incarcerate political opponents in a psychiatric hospital. It saves any potential political embarrassment that a judicial trial may present. It also undermines the credibility of opponents by labelling them with the stigma of being mentally insane. For this to occur, there has to be the acquiescence of mental health professionals and a subservient legal system.
This article examines the abuse of psychiatry in two authoritarian systems, Russia and China.
New diagnostic categories such as sluggish schizophrenia were created to facilitate the silencing of dissenters and were a source of self-deception for psychiatrist to placate their consciences as they operated as a tool of oppression on behalf of a political system.
If we do not know the past, we will be condemned to repeat it.
Commercially deposited titanium nitride (TIN) thin films have been available daring recent years. These TiN films possess high hardness and have good wear resistance; however, the deposition process typically requires a temperature of 500°C or higher. In many cases, due to substrate characteristics, a deposition temperature below 150°C is required in order to exploit TiN coating properties.
The objective of this work is to demonstrate that ion beam assisted deposition (IBAD) makes it possible to deposit gold-color TiN films with good adhesion onto a variety of substrates including plastics at temperatures below 150°C. These films have physical and mechanical properties as good as those produced at high temperatures. Samples have also been examined by nanohardness techniques to accurately determine the hardness of the films and relate them to process parameters and crystal sizes. Our results indicate that, by controlling the grain size of TiN, it is possible to fabricate TiN coatings at room temperature with hardness as high as 25.5 ± 1 GPa.
Typical high-temperature thin-film deposition techniques are not suitable for certain substrates such as polymers and thermally-sensitive steels. In this work, ion beam assisted deposition (IBAD) was used to deposit ceramic and metallic films at temperatures below 150°C with nanocrystalline (< 100Å diameter) grain size. Nanoindentation studies of these films have shown hardnesses 50 to 100% greater than larger-grained films and, in some cases, fracture toughness approaching that of Si3N4.
By combining chromium evaporation with nitrogen beam bombardment, hard, adherent CrN films without any porosity have been produced at low temperatures with a N/Cr arrival ratio of about 1. The grain size is typically smaller than 100Å and hardness is typically higher than 25 GPa. For a N/Cr arrival ratio slightly less than 1, we observed possible grain boundary porosity. However, even with porosity, hardness is typically 20 to 24 GPa for grain sizes smaller than 100Å. For a N/Cr arrival ratio of 1/4 we deposited elemental Cr with a grain size of 300 to 500Å and a hardness greater than that of silicon (12 GPa). Using Ar ions and a N backfill, we produced elemental Cr containing a mixture of coarse (120 to 150Å) and fine (25 to 30Å) grains. For high-temperature deposition of CrN, the grain size increases (200 to 600Å) with a noticeable decrease in hardness. Mechanical properties of CrN are greatly influenced by impurities, as well as by surface conditioning of the substrate.
TiN films having gold color and grain sizes from 50 to 1000Å have been produced at low temperatures. Nanoindentation measurements of hardness and fracture toughness indicate that impurity-free TiN (with grains smaller than 100Å) has a hardness higher than 25 GPa and a fracture toughness close to that of Si3N4, but with higher wear resistance. Mechanical properties of our TiN films are greatly influenced by impurities, particularly oxygen, although it does not influence the gold color of TiN.
Magnetic circular dichroism in the Fe 2p x-ray absorption is observed in multilayers of (Fe9.5Å/Pt9.5Å)92. The Magnetization and helicity are both in the plane of this multilayer which is prepared by magnetron sputter deposition. This sample is part of a study to examine magnetization in the ternary multilayer system of FeCo/Pt. Lattice and layer pair spacings are measured using x-ray scattering. The atomic concentration profiles of the multilayer films are characterized using Auger electron spectroscopy coupled with depth profiling. Conventional and high resolution transmission electron microscopy are used to examine the thin film, growth morphology and atomic structure.
Here is reported observation of magnetic circular dichroism in both x-ray absorption and core-level photoemission of ultra thin magnetic films using circularly polarized x-rays. Iron films (1–4 ML) grown on a Cu (001) substrate at 150 K and magnetized perpendicular to the surface show dramatic changes in the L2,3 absorption branching ratio for different x-ray polarizations. For linearly-polarized x-rays perpendicular to the magnetic axis of the sample the branching ratio was 0.75. For films ≥ 2 ML, this ratio varied from 0.64 to 0.85 for photon spin parallel and anti-parallel, respectively, to the magnetic axis. This effect was observed either by changing the x-ray helicity for a fixed magnetic axis, or by reversing the magnetic axis for a fixed x-ray helicity. Our observation can be analyzed within a simple one-electron picture, if the raw branching ratios are normalized so that the linear value becomes statistical. Furthermore, warming the films to -300 K eliminated this effect, indicating a loss of magnetization in the film over a temperature range of -30 K. Finally, reversing the relative orientation of the photon spin and the magnetic axis from parallel to anti-parallel allowed measurement with photoemission of the exchange splitting of the Fe 2p and 3p core levels which were found to be 03 eV and 0.2 eV, respectively. These results are consistent with earlier studies, but the use of off-plane circularly-polarized x-rays from a bending magnet monochromator offers -2 orders of magnitude greater intensity than typical spin-polarization measurements. Finally, we have performed preliminary x-ray absorption studies of UFe2, demonstrating the feasibilty of MCD Measurements in 5f as well as 3d Materials.
Mechanical and tribological properties of chromium-nitrogen films deposited by ion beam assisted deposition (IBAD) were investigated. The films were deposited reactively, i.e., via chromium evaporation with concurrent nitrogen ion beam bombardment, on stainless steel substrates at low deposition temperatures (<200°C). Two primary deposition regimes, with differing Cr/N atom-to-ion arrival ratios, were investigated: approximately 0.8–1.0 and 2.5–3.0. Rutherford Backscattering Spectroscopic analysis showed the lower arrival ratio films to be essentially stoichiometric CrN, whereas films deposited at higher arrival ratios were Cr-rich with Cr/N ratios of about 3:1. Both films were fine grained polycrystalline (typically 5–20 nanometer crystal dimension). The stoichiometric films were approximately two times harder than the Cr-rich films., based on nanohardness indentation measurements, and possessed higher residual stress levels. Both film types substantially improved the wear resistance of stainless steel disks, based on the results of ball-ondisk wear tests against ruby balls. The best performance was obtained with Cr-rich films, which exhibited a very low wear rate and lower friction than either the stoichiometric film or the uncoated steel.
Against a backdrop of the latest ITRS predictions for CMOS junctions, we compare methods for dopant introduction and activation, methods for making contact to these regions, and methods for measurement of material and device properties. As activation without diffusion (sub-melt laser, capacitor discharge flash, or solid phase epitaxy) becomes more feasible, the burden on Xj, Rsh and abruptness falls on the implanters, and the process margin appears slim, opening the door for other methods of doping. For contact resistance, a major component of transistor parasitics, we find that either a move to a different substrate, or from a single midgap silicide to two band-edge metals/silicides can be quite beneficial. Through the use of simple test structures, we describe a means of extracting each component of the parasitic resistance, facilitating development of materials for CMOS junctions.
This paper presents UV imaging results for a 256×256 AlGaN Focal Plane Array that uses a back-illuminated AlGaN heterostructure p-i-n photodiode array, with 30×30 μm2 unit cells, operating at zero bias voltage, with a narrow-band UV response between 310 and 325 nm. The 256×256 array was fabricated from a multilayer AlGaN film grown by MOCVD on a sapphire substrate. The UV response operability (>0.4×average) was 94.8%, and the UV response uniformity (σ/μ) was 16.8%. Data are also presented for back-illuminated AlGaN p-i-n photodiodes from other films with cutoff wavelengths ranging between 301 and 364 nm. Data for variable-area diagnostic arrays of p-i-n AlGaN photodiodes with a GaN absorber (cutoff=364 nm) show: (1) high external quantum efficiency (50% at V=0 and 62% at V=-9 V); (2) the dark current is proportional to junction area, not perimeter; (3) the forward and reverse currents are uniform (σ/μ=50% for forty 30×30 μm2 diodes at V=−40 V); (4) the reverse-bias dark current data versus temperature and bias voltage can be fit very well by a hopping conduction model; and (5) capacitance versus voltage data are consistent with nearly full depletion of the unintentionally-doped 0.4 μm thick GaN absorber layer and imply a donor concentration of 3-4×1016 cm−3.
X-Ray Absorption Spectroscopy (XAS) and Photoelectron Spectroscopy (PES) have been performed upon highly radioactive samples, particularly Plutonium, at the Advanced Light Source in Berkeley, CA, USA. First results from alpha and delta Plutonium are reported as well as a detailed analysis of sample quality.
Introduction rates of dominant defects have been determined for electron-irradiated, p-type silicon as a function of oxygen and boron concentration. Samples included those with oxygen content ranging from 8 × 1015 to 7 × 1017 cm−3. Initial results are described for samples with measured carbon content varying from 2 × 1015 to 6 × 1016 cm−3. Competing defect reactions involving the interstitial defects, Bi and Ci, and oxygen, boron, and carbon are observed. The identities of an electron trap (Bi-Oi) and a hole trap (Bi-Bs) have been clarified.
Plutonium, because of its radioactive nature, ages from the “inside out” by means of self-irradiation damage and thus produces nanoscale internal defects. The self-irradiation induced defects come in the form of Frenkel-type defects (vacancies and self-interstitial atoms), helium in-growth, and defect clusters. At present there are neither experimental nor theoretical models describing the changes in the electronic structure caused by the aging in Pu. This fact appears to be associated primarily with the absence of reasonably convincing spectroscopic evidence of the changes. This paper demonstrates that Resonant Photoemission, a variant of Photoelectron Spectroscopy, has strong sensitivity to aging of Pu samples. The spectroscopic results are correlated with an extra-atomic screening model, and are shown to be the fingerprint of mesoscopic or nanoscale internal damage in the Pu physical structure. This means that a spectroscopic signature of internal damage due to aging in Pu has been established.
The standard method to determine the band structure of a condensed phase material is to (1) obtain a single crystal with a well defined surface and (2) map the bands with angle resolved photoelectron spectroscopy (occupied or valence bands) and inverse photoelectron spectroscopy (unoccupied or conduction bands). Unfortunately, in the case of Pu, the single crystals of Pu are either nonexistent, very small and/or having poorly defined surfaces. Furthermore, effects such as electron correlation and a large spin-orbit splitting in the 5f states have further complicated the situation. Thus, we have embarked upon the utilization of unorthodox electron spectroscopies, to circumvent the problems caused by the absence of large single crystals of Pu with well-defined surfaces. Our approach includes the techniques of resonant photoelectron spectroscopy , x-ray absorption spectroscopy [1,2,3,4], electron energy loss spectroscopy [2,3,4], Fano Effect measurements , and Bremstrahlung Isochromat Spectroscopy , including the utilization of micro-focused beams to probe single-crystallite regions of polycrystalline Pu samples. [2,3,6]