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Complications from systemic inflammation are reported in neonates following exposure to cardiopulmonary bypass. Although the use of asanguinous primes can reduce these complications, in neonates, this can result in significant haemodilution, requiring addition of blood. This study investigates whether the addition of blood after institution of bypass alters the inflammatory response compared with a blood prime. Neonatal swine were randomised into four groups: blood prime, blood after bypass but before cooling, blood after cooling but before low flow, and blood after re-warming. All groups were placed on central bypass, cooled, underwent low flow, and then re-warmed for a total bypass time of 2 hours. Although haematocrit values between groups varied throughout bypass, all groups ended with a similar value. Although they spent time with a lower haematocrit, asanguinous prime groups did not have elevated lactate levels at the end of bypass compared with blood prime. Asanguinous primes released less tumour necrosis factor α than blood primes (p=0.023). Asanguinous primes with blood added on bypass produced less interleukin 10 and tumour necrosis factor α (p=0.006, 0.019). Animals receiving blood while cool also showed less interleukin 10 and tumour necrosis factor α production than those that received blood warm (p=0.026, 0.033). Asanguinous primes exhibited less oedema than blood primes, with the least body weight gain noted in the end cool group (p=0.011). This study suggests that using an asanguinous prime for neonates being cooled to deep hypothermia is practical, and the later addition of blood reduces inflammation.
In November 2013, national public health agencies in England and Scotland identified an increase in laboratory-confirmed Salmonella Mikawasima. The role of proton pump inhibitors (PPIs) as a risk factor for salmonellosis is unclear; we therefore captured information on PPI usage as part of our outbreak investigation. We conducted a case-control study, comparing each case with two controls. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression. Thirty-nine of 61 eligible cases were included in the study. The median age of cases was 45 years; 56% were female. Of these, 33% were admitted to hospital and 31% reported taking PPIs. We identified an association between PPIs and non-typhoidal salmonellosis (aOR 8·8, 95% CI 2·0–38·3). There is increasing evidence supporting the existence of an association between salmonellosis and PPIs; however, biological studies are needed to understand the effect of PPIs in the pathogenesis of Salmonella. We recommend future outbreak studies investigate PPI usage to strengthen evidence on the relevance of PPIs in Salmonella infection. These findings should be used to support the development of guidelines for patients and prescribers on the risk of gastrointestinal infection and PPI usage.
Our previous observations established the small angular size and high brightness temperature of emission from the v=1, J=1-0 transition of SiO from the circumstellar envelopes of the supergiant VX Sgr and the Mira variable R Cas. We performed a second VLBI experiment on the SiO masers in several late type stars on 31 Oct.-2 Nov. 1978 to compare the physical characteristics of the SiO masers in the v=1 and v=2 states. With an energy separation of 1258 cm-1 (an equivalent temperature of 1753 K) between the two vibrational states, differences in excitation and pumping of the maser states may lead to different maser properties.
A symptom of mild cognitive impairment (MCI) and Alzheimer’s disease
(AD) is a flat learning profile. Learning slope calculation methods vary, and
the optimal method for capturing neuroanatomical changes associated with MCI and
early AD pathology is unclear. This study cross-sectionally compared four
different learning slope measures from the Rey Auditory Verbal Learning Test
(simple slope, regression-based slope, two-slope method, peak slope) to
structural neuroimaging markers of early AD neurodegeneration (hippocampal
volume, cortical thickness in parahippocampal gyrus, precuneus, and lateral
prefrontal cortex) across the cognitive aging spectrum [normal
control (NC); (n=198;
age=76±5), MCI (n=370;
age=75±7), and AD (n=171;
age=76±7)] in ADNI. Within diagnostic group,
general linear models related slope methods individually to neuroimaging
variables, adjusting for age, sex, education, and APOE4 status. Among MCI,
better learning performance on simple slope, regression-based slope, and late
slope (Trial 2–5) from the two-slope method related to larger
parahippocampal thickness (all p-values<.01) and
hippocampal volume (p<.01). Better regression-based
slope (p<.01) and late slope
(p<.01) were related to larger ventrolateral
prefrontal cortex in MCI. No significant associations emerged between any slope
and neuroimaging variables for NC (p-values ≥.05) or
AD (p-values ≥.02). Better learning performances
related to larger medial temporal lobe (i.e., hippocampal volume,
parahippocampal gyrus thickness) and ventrolateral prefrontal cortex in MCI
only. Regression-based and late slope were most highly correlated with
neuroimaging markers and explained more variance above and beyond other common
memory indices, such as total learning. Simple slope may offer an acceptable
alternative given its ease of calculation. (JINS, 2015,
The association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.
To combine original data from studies on the association between post-infarction depression and prognosis into one database, and to investigate to what extent such depression predicts prognosis independently of disease severity.
An individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses.
Sixteen studies participated, creating a database of 10 175 post-infarction cases. Hazard ratios for post-infarction depression were 1.32 (95% CI 1.26–1.38, P<0.001) for all-cause mortality and 1.19 (95% CI 1.14–1.24, P<0.001) for cardiovascular events. Hazard ratios adjusted for disease severity were attenuated by 28% and 25% respectively.
The association between depression following myocardial infarction and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.
Exposure to intrauterine growth restriction (IUGR) is an important risk factor for impaired learning and memory, particularly in males. Although the basis of IUGR-associated learning and memory dysfunction is unknown, potential molecular participants may be insulin-like growth factor 1 (Igf1) and its receptor, IGF1r. We hypothesized that transcript levels and protein abundance of Igf1 and IGF1r in the hippocampus, a brain region critical for learning and memory, would be lower in IUGR male rats than in age-matched male controls at birth (postnatal day 0, P0), at weaning (P21) and adulthood (P120). We also hypothesized that changes in messenger Ribonucleic acid (mRNA) transcript levels and protein abundance would be associated with specific histone marks in IUGR male rats. Lastly, we hypothesized that IUGR male rats would perform poorer on tests of hippocampal function at P120. IUGR was induced by bilateral ligation of the uterine arteries in pregnant dams at embryonic day 19 (term is 21 days). Hippocampal Igf1 mRNA transcript levels and protein abundance were unchanged in IUGR male rats at P0, P21 or P120. At P0 and P120, IGF1r expression was increased in IUGR male rats. At P21, IGF1r expression was decreased in IUGR male rats. Increased IGF1r expression was associated with more histone 3 lysine 4 dimethylation (H3K4Me2) in the promoter region. In addition, IUGR male rats performed poorer on intermediate-term spatial working memory testing at P120. We speculate that altered IGF1r expression in the hippocampus of IUGR male rats may play a role in learning and memory dysfunction later in life.
L’utilisation du tritium dans les réacteurs CANDU (Canada Deutérium Uranium), dans
l’industrie, pour la production de sources et de peintures luminescentes, dans
l’exploration pétrolière et gazière, dans les hôpitaux pour des tests diagnostiques, en
radiothérapie et en recherche, rend le contrôle de ses rejets particulièrement important
au Canada. Ces rejets sont réglementés et étroitement surveillés par la Commission
canadienne de sûreté nucléaire (CCSN). Certains groupes d’intérêt et de citoyens
prétendent cependant que l’incertitude scientifique sur les effets du tritium sur la santé
et l’environnement est telle que la réglementation des installations rejetant ou utilisant
du tritium serait inadéquate. Pour répondre à ces inquiétudes, la CCSN a demandé à son
personnel d’entreprendre le projet intitulé « Études sur le tritium ».
Dans le cadre de ce projet, le devenir du tritium dans l’environnement ainsi que ses
effets sanitaires, ont été étudiés au moyen de mesures directes sur le terrain ainsi qu’à
travers la revue de la littérature scientifique la plus récente sur le sujet. Ce projet a
permis de conclure que les mesures de radioprotection concernant le tritium ainsi que les
mécanismes utilisés pour le réglementer sont adéquats pour protéger la santé et la
sécurité des Canadiens.
Hydrogen peroxide formed by radiolysis of carbonate –bicarbonate media was followed by 13C NMR using dissolved [233UO2(13CO3)3]4- as the alpha source (Dα=12.1 Gy/hr). It is shown that the speciation of the peroxide carbonates (or other species) that are formed in the pH region 5.9 and 11.6 by titration with hydrogen peroxide are common to those formed by hydrogen peroxide generated by radiolysis. Radiolytic generation of hydrogen peroxide was followed by observing the formation of a uranyl peroxide carbonate complex. Complex formation was observed to accelerate for about 1200 hours and to terminate between 1×10-4 and 5×10-4 M. It is assumed that either a steady state H2O2 production rate was established in solution or that some limiting feature of the experiment was responsible for slowing the yield of product.
Some metallization systems consisting of barrier metals and Au-Sn (multiple alternating layers) were studied as a bonding schemes of InP-based laser diodes to the first time used, CVD-diamond submounts. The first system to be studied, which was traditionally used in various other applications was Ti(100nm)/Pt(200nm)/Au(500nm)/Au-Sn(2.5 μm). This structure provided a molten Au-Sn layer of eutectic composition (80:20 wt%) on top of the Ti/Pt metals for about 6 sec, while heated at temperatures of 300 to 350°C, and allowed for efficient bonding of the device to the submount. Longer heating durations, however, led to reaction between Pt and Sn to consume significant amounts of Sn from the solder, thus elevating its melting temperature and resolidifying the solder. With optimum bonding conditions, a high quality bond of the InP-based laser diode to the CVD-diamond submount was observed, and a superior electrical performance of the diode was measured compared to diodes that were bonded with the standard In/BeO configurations. In order to maintain the superior performance of the InP laser diode bonded assembly but improve the thermodynamic stability of the metallurgical system and thus extending the bonding processing window, various metals such as W and Cr were studied as a replacement for the Ti/Pt barrier metals in between the CVD-diamond submount and the Au-Sn solder. While applying the W layer, a thin Ti(10nm) layer was introduced in between it and the Au-Sn to improve the solder wettability. The W layer was found to remain intact after heating at 350°C for durations as long as 5 min, and thus, due to the inert nature of the Au-Sn/W interface, the Au-Sn ratio was kept uniform at the eutectic liquid composition through a long heating duration (up to 5 min). Minimum reaction was observed, as well, at the Au-Sn/Cr interface, while executing a Ti(100nm)/Cr(200nm)/Au-Sn(1.5 μm) system, and thus allowed for an excellent bonding of the InP laser diodes to the CVD-diamond submounts.
Results on the synthesis and characterization of the solid solutions CsBi4-xSbxTe6, CsBi4Te6-ySey, as well as doping experiments on CsBi4Te6 are reported. We report X-ray structural investigations showing that the Sb or Se atoms in these compounds are not uniformly distributed in the lattice but show preferential occupation of specific crystallographic sites. Thermoelectric properties of selected systems are presented.
Low dielectric constant (low-k) materials are currently being incorporated into advanced microelectronic devices to improve or maintain performance. As the dielectric constant is reduced, so are its mechanical properties. These reduced properties have recently been related to chip-package interaction (CPI) failures. Significant effort has focused on eliminating CPI failures through engineering of copper crackstop structures. However, published data suggests that crackstop engineering needs to occur at each technology node to ensure CPI reliability. In this study, the focus is on repairing interfacial delaminations with chemistry specific coupling agents rather than attempting to stop them with a specially designed crackstop structure. Critical adhesion values and corrosion resistance of the repaired interfaces are compared to the original interface. The application of the repair chemistry in an integrated structure is discussed along with the potential impact on reliability.
Little is known about the effects of adult attention deficit hyperactivity disorder (ADHD) on work performance or accidents-injuries.
A survey was administered in 2005 and 2006 to employees of a large manufacturing firm to assess the prevalence and correlates of adult ADHD. Respondents (4140 in 2005, 4423 in 2006, including 2656 in both surveys) represented 35–38% of the workforce. ADHD was assessed with the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS), a validated screening scale for DSM-IV adult ADHD. Sickness absence, work performance and workplace accidents-injuries were assessed with the WHO Health and Work Performance Questionnaire (HPQ).
The estimated current prevalence (standard error) of DSM-IV ADHD was 1.9% (0.4). ADHD was associated with a 4–5% reduction in work performance (χ12=9.1, p=0.001), a 2.1 relative-odds of sickness absence (χ12=6.2, p=0.013), and a 2.0 relative-odds of workplace accidents-injuries (χ12=5.1, p=0.024). The human capital value (standard error) of the lost work performance associated with ADHD totaled US$4336 (676) per worker with ADHD in the year before interview. No data were available to monetize other workplace costs of accidents-injuries (e.g. destruction of equipment). Only a small minority of workers with ADHD were in treatment.
Adult ADHD is a significantly impairing condition among workers. Given the low rate of treatment and high human capital costs, in conjunction with evidence from controlled trials that treatment can reduce ADHD-related impairments, ADHD would seem to be a good candidate for workplace trials that evaluate treatment cost-effectiveness from the employer's perspective.
We consider the problem of optimally stopping a general one-dimensional Itô diffusion X. In particular, we solve the problem that aims at maximising the performance criterion Ex[exp(-∫0τr(Xs)ds)f(Xτ)] over all stopping times τ, where the reward function f can take only a finite number of values and has a ‘staircase’ form. This problem is partly motivated by applications to financial asset pricing. Our results are of an explicit analytic nature and completely characterise the optimal stopping time. Also, it turns out that the problem's value function is not C1, which is due to the fact that the reward function f is not continuous.
Between 1 August and 15 September 2000, 361 cases of Salmonella enterica serotype Typhimurium definitive phage type (DT) 104, resistant to ampicillin, chloramphenicol, streptomycin, sulphonamides, spectinomycin and tetracycline (R-type ACSSuSpT), were identified in England and Wales residents. Molecular typing of 258 isolates of S. Typhimurium DT104 R-type ACSSuSpT showed that, although isolates were indistinguishable by pulsed-field gel electrophoresis, 67% (174/258) were characterized by a particular plasmid profile. A statistically significant association between illness and consumption of lettuce away from home was demonstrated (OR=7·28; 95% CI=2·25–23·57; P=0·0006) in an unmatched case–control study. Environmental investigations revealed that a number of food outlets implicated in the outbreak had common suppliers of salad vegetables. No implicated foods were available for microbiological testing. An environmental audit of three farms that might have supplied salad vegetables to the implicated outlets did not reveal any unsafe agricultural practices. The complexity of the food supply chain and the lack of identifying markers on salad stuffs made tracking salad vegetables back to their origin extremely difficult in most instances. This has implications for public health since food hazard warnings and product withdrawal are contingent on accurate identification of the suspect product.