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Several risk factors for depression in patients with oropharyngeal cancer have been determined. However, it is unknown whether human papillomavirus associated oropharyngeal cancer, which has a distinct clinico-demographic profile, modulates this risk.
A retrospective analysis was conducted of patients with oropharyngeal cancer. These patients had completed a 10-item depression screening questionnaire before receiving treatment for their disease from 2011 to 2014. Associations between patient or disease characteristics and depression screening questionnaire results were investigated.
The study comprised 69 patients, 31 (44.9 per cent) of whom screened positive for depression. There were no significant differences in distributions of clinico-demographic or histopathological characteristics, including human papillomavirus tumour status, by depression screen result.
This population has a high risk for depression, but no obvious risk factors, including human papillomavirus tumour status, were associated with an elevated risk. This inability to risk-stratify patients by clinico-demographic or disease characteristics emphasises the importance of regular depression screening for all patients in this population.
Bloodstream infection (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with considerable morbidity and mortality.
To determine the incidence of MRSA BSI in Canadian hospitals and to identify variables associated with increased mortality.
Prospective surveillance for MRSA BSI conducted in 53 Canadian hospitals from January 1, 2008, through December 31, 2012. Thirty-day all-cause mortality was determined, and logistic regression analysis was used to identify variables associated with mortality.
A total of 1,753 patients with MRSA BSI were identified (incidence, 0.45 per 1,000 admissions). The most common sites presumed to be the source of infection were skin/soft tissue (26.6%) and an intravascular catheter (22.0%). The most common spa types causing MRSA BSI were t002 (USA100/800; 55%) and t008 (USA300; 29%). Thirty-day all-cause mortality was 23.8%. Mortality was associated with increasing age (odds ratio, 1.03 per year [95% CI, 1.02–1.04]), the presence of pleuropulmonary infection (2.3 [1.4–3.7]), transfer to an intensive care unit (3.2 [2.1–5.0]), and failure to receive appropriate antimicrobial therapy within 24 hours of MRSA identification (3.2 [2.1–5.0]); a skin/soft-tissue source of BSI was associated with decreased mortality (0.5 [0.3–0.9]). MRSA genotype and reduced susceptibility to vancomycin were not associated with risk of death.
This study provides additional insight into the relative impact of various host and microbial factors associated with mortality in patients with MRSA BSI. The results emphasize the importance of ensuring timely receipt of appropriate antimicrobial agents to reduce the risk of an adverse outcome.
Infect. Control Hosp. Epidemiol. 2016;37(4):390–397
In an interview recorded shortly before his death in 1987, Maxwell Fry recalled the birth of Modern architecture in Great Britain around a half-century earlier. In the course of discussing the work of the Modern Architectural Research (MARS) Group — the society that he had helped to establish in February 1933 and of which he was then the last surviving founder-member — Fry highlighted the links between architects in Britain and their continental European counterparts. Observing that MARS was first established on the basis of an invitation that Wells Coates had received to form a British chapter of the Congrès Internationaux d’Architecture Moderne (CIAM), he noted that the Group had immediately gained an entrée into an international forum that functioned as a unique gathering point for the architectural avant-garde. At the same time, he asserted that membership brought with it commitments that conferred ‘a very serious responsibility’.
CIAM was not, of course, the only conduit for the links that MARS members had with the wider world, but in many ways it was the MARS Group’s relationship with the ‘international community of modern architects […] made visible in the foundation of CIAM’ which defined it and differentiated it from other architectural groupings of its day. Most other such bodies initially coalesced around a single manifesto or exhibition and then quickly fell apart when their members found that they had little in common apart from an enthusiasm for Modernism. By contrast, MARS retained an enduring purpose through its membership of CIAM.
The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia.
Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor.
Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models.
These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.
There is growing evidence that many offspring of parents with bipolar disorder (BD) will develop moderate to severe forms of psychopathology during childhood and adolescence, including thought problems. The purpose of this study was to evaluate the developmental progression of thought problems within the context of a family risk study. Repeated assessments of thought problems, spanning approximately 15 years, were conducted in offspring (N = 192 from 98 families) of parents diagnosed with BD (O-BD), unipolar depression (O-UNI), or no significant psychiatric or medical problems (O-WELL). Survival analysis showed that the O-BD group had the greatest estimated probability of developing thought problems over time, followed by O-UNI, and then O-WELL and O-BD exhibiting higher levels of persistence than O-WELL. Parent-reported thought problems in childhood and adolescence predicted a range of problems in young adulthood. Disturbances in reality testing and other atypical behaviors are likely to disrupt progression through important developmental periods and to associate with poor outcomes. These findings are likely relevant to preventing the occurrence or progression of problems in offspring of bipolar parents. The study of thought problems across development represents an important area of continued research in children at risk for development of affective disorders.
Background: We currently use the depression subscale (HADD) of the Hospital Anxiety and Depression Scale (HADS) for depression screening in elderly inpatients. Given recent concerns about the performance of the HADD in this age group, we performed a quality-control study retrospectively comparing HADD with the diagnosis of depression by a psychiatrist. We also studied the effect of dementia on the scale's performance.
Methods: HADS produces two 7-item subscales assessing depression or anxiety. The HADD was administered by a neuropsychologist. As “gold standard” we considered the psychiatrist's diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Patients older than 65 years, assessed by both the HADD and the psychiatrist, with a clinical dementia rating (CDR) score lower than 3, were included. The effect of dementia was assessed by forming three groups according to the CDR score (CDR0–0.5, CDR1, and CDR2). Simple and multiple logistic regression models were applied to predict the psychiatrist's depression diagnosis from HADD scores. Areas under the receiver operating characteristics curve (AUC) were plotted and compared by χ2 tests.
Results: On both univariate and multiple analyses, HADD predicted depression diagnosis but performed poorly (univariate: p = 0.009, AUC = 0.60 (95% confidence interval (CI) = 0.53–0.66); multiple: p = 0.007, AUC = 0.65 (95% CI = 0.58–0.71)), regardless of cognitive status. Because mood could have changed between the two assessments (they occurred at different points of the hospital stay), the multiple analyses were repeated after limiting time interval at 28, 21, and 14 days. No major improvements were noted.
Conclusion: The HADD performed poorly in elderly inpatients regardless of cognitive status. It cannot be recommended in this population for depression screening without further study.
We investigated a possible outbreak of H. pylori in a rural Northern Plains community. In a cross-sectional survey, we randomly sampled 244 households from a geocoded emergency medical system database. We used a complex survey design and global positioning system units to locate houses and randomly selected one eligible household member to administer a questionnaire and a 13C-urea breath test for active H. pylori infection (n = 166). In weighted analyses, active H. pylori infection was detected in 55·0% of the sample. Factors associated with infection on multivariate analysis included using a public drinking-water supply [odds ratio (OR) 12·2, 95% confidence interval (CI) 2·9–50·7] and current cigarette smoking (OR 4·1, 95% CI 1·7–9·6). People who lived in houses with more rooms, a possible indicator of decreased crowding in the home, were less likely to have active H. pylori infections (OR 0·7, 95% CI 0·5–0·9 for each additional room).
Neuroimaging research has demonstrated medial prefrontal cortex (mPFC) hyporesponsivity and amygdala hyperresponsivity to trauma-related or emotional stimuli in post-traumatic stress disorder (PTSD). Relatively few studies have examined brain responses to the recollection of stressful, but trauma-unrelated, personal events in PTSD. In the current study, we sought to determine whether regional cerebral blood flow (rCBF) abnormalities in mPFC and amygdala in PTSD could be observed during the recollection of trauma-unrelated stressful personal events.
Participants were 35 right-handed male combat veterans (MCVs) and female nurse veterans (FNVs) who served in Vietnam: 17 (seven male, 10 female) with current military-related PTSD and 18 (nine male, nine female) with no current or lifetime PTSD. We used positron emission tomography (PET) and script-driven imagery to study rCBF during the recollection of trauma-unrelated stressful versus neutral and traumatic events.
Voxelwise tests revealed significant between-group differences for the trauma-unrelated stressful versus neutral comparison in mPFC, specifically in the anterior cingulate cortex (ACC). Functional region of interest (ROI) analyses demonstrated that this interaction in mPFC represented greater rCBF decreases in the PTSD group during trauma-unrelated stressful imagery relative to neutral imagery compared to the non-PTSD group. No differential amygdala activation was observed between groups or in either group separately.
Veterans with PTSD, compared to those without PTSD, exhibited decreased rCBF in mPFC during mental imagery of trauma-unrelated stressful personal experiences. Functional neuroanatomical models of PTSD must account for diminished mPFC responses that extend to emotional stimuli, including stressful personal experiences that are not directly related to PTSD.
The implementation of SiC based sensors and electronics for operation in chemically harsh, high temperature environments depends on understanding the SiO2/SiC interface in field effect devices. We have developed a technique to fabricate wedge polished samples (angle ∼ 1×10−4 rad) that provides access to the SiO2/SiC interface via a surface sensitive probe such as xray photoelectron spectroscopy (XPS). Lateral scanning along the wedge is equivalent to depth profiling. Spatially resolved XPS images of the O 1s and Si 2p core levels were obtained of the interfacial region. Samples consist of device-quality thermally grown oxides on 4H-SiC single crystal substrates. The C 1s spectrum suggests the presence of a graphitic layer on the nominally bare SiC surface following thermal oxidation.
Dendrons and dendrimers containing cyclophosphazenes units in each generation have been synthesised by the convergent route for the first time. We also demonstrate the synthesis of dendrons containing precise numbers of benzyl protected alcohol functionalities.
A TEM study is presented charting the development of a MOVPE growth process for the deposition of CdTe//ZnTe superlattices. In addition, MBE grown (Cd,Zn)Te//CdTe superlattices deposited onto GaAs and InSb substrates are compared.
We report studies of the interface formed when InSb is deposited onto a CdTe substrate in a molecular beam epitaxy chamber and elucidate conditions under which epitaxial growth is possible. We find that a necessary condition for epitaxy at a substrate temperature Ts is that the growth rate exceed a minimum value Ωmin(Ts). Reflection high energy electron diffraction patterns taken in situ and transmission electron micrographs taken ex situ show that interfaces formed when Ω > Ωmin have a short period roughness which is independent of the Sb/In flux ratio and which diminishes with increasing Ω. Raman spectra show no evidence of interfacial compounds. An analysis of Auger spectra of thin layers of InSb grown on CdTe indicates the existence of Te at the surface of the InSb but not in the layer itself. The Te concentration is found to decrease with InSb layer thickness. We propose a model based on a competition between the reaction of free In and Sb with the CdTe surface and the nucleation and growth of InSb. We use this model to account for the existence of Omin, interface roughness, and the presence of Te at the surface of the InSb epilayer.
Small punch (SP) tests on single grained titanium aluminide (Ti-48 at.%Al) specimens with 12° and 80° lamellar orientations with respect to the tensile stress axis were conducted at 1123 K in air. Brittle cracks readily extended through the thickness in the 80° lamellar structure. In a SP specimen with the 12° lamellar structure load-interrupted at the strain of 0.43%, surface cracks with the depth of 15–25 μm were formed along lamellar boundaries. Local oxidation behavior on partly sputtered surfaces in the load-interrupted 12° lamellar specimen was examined using scanning Auger microprobe (SAM). Oxygen enriched regions were observed near cracks and some lamellar layers. The mechanisms of high temperature oxygen-induced cracking are discussed in terms of the local oxidation near cracks and lamellar boundaries.
This paper describes the effect of post-irradiation annealing (PIA: 573-873K for 10 h) on the microhardness and intergranular P segregation in P doped and Cu-P doped iron alloys containing residual S. Hardening and softening occurred during PIA at lower and higher temperatures, respectively. PIA-induced hardening was more profoundly observed in the Cu-P doped alloy. Intergranular P enrichment was achieved by lower temperature PIA and P desegregation associated with S segregation dominated at higher PIA temperatures in both the alloys. Changes in the microhardness and intergranular P segregation induced by the PIA were found to be correlated with each other although the Cu-P doped alloy showed more scatter. The dynamic interaction between solute and defects in the grain interior and near grain boundaries during the PIA is discussed in order to explain the experimental observation.
Iron disilicide shows great promise as a silicon based light emitter operating in the 1.3 to 1.5 μm wavelength range. However, there exists a number of questions related to the band structure and the ability to alloy and controllably dope the material both n and p type. In this paper we present Raman and magneto transport studies on β-FeSi2, β-(Fe1-xCrx)Si2, and β-(Fe1-xCox)Si2 grown by MBE. By comparing the spectra obtained for undoped and doped samples we provide a general overview of the effects of doping on the crystallinity of the material. The temperature dependent (4K<T<300K) magneto transport illustrates that Cr is a p-type dopant and Co is an n-type dopant in β-FeSi2.The temperature dependence of the resistivity indicates that the transport properties at higher temperatures are determined by free carriers whereas at lower temperatures impurity band conduction prevails.
This paper describes examination of in-service coating degradation in land based gasturbine blades by means of a small punch testing (SP) method and scanning Auger microprobe(SAM). SP tests on coated specimens with unpolished surfaces indicated large variations ofthe mechanical properties because of the surface roughness and curvature in gas turbine blades, SP tests on polished specimens better characterized the mechanical degradation of bladecoatings. The coated specimens greatly softened and the room temperature ductility of thecoatings and substrates tended to decrease with increasing operation time. The ductile-brittletransition temperature of the coatings shifted to higher temperatures during the bladeoperation. From SAM analyses on fracture surfaces of unused and used blades, it has beenshown that oxidation and sulfidation near the coating surface, which control the fractureproperties, result from high temperature environmental attack.
Spontaneous atomic ordering is investigated in a series of GaAs1−xSbx epilayers (0.51 < x < 0.71) grown by molecular beam epitaxy (MBE) on GaAs substrates with surface orientations of (001), (001) – 8° toward (111)A, (001) – 8° toward (111)B, (115)A, (115)B, (113)A, and (113)B. Atomic ordering in these epilayers was observed from a decrease in the energy gap measured by Fourier transform infrared (FTIR) absorption spectroscopy and corroborated by superlattice reflections in transmission electron diffraction and Raman spectroscopy. Contrary to previous investigations of ordering in III-V alloys, a marked energy gap reduction corresponding to CuPt-B type ordering is observed in the GaAs1−xSbx grown on (111)A-type orientations.