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The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.
Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions.
A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49−51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation.
At baseline, the prevalence of VMS (40%, range 13–62%) and depressed mood (26%, 8–41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27–1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47–2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90–1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38–2.34).
Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
We examined associations between access to food venues (farmers’ markets and supermarkets), shopping patterns, fruit and vegetable consumption and health indicators among women of reproductive age in eastern North Carolina, USA.
Access to food venues was measured using a Geographic Information System incorporating distance, seasonality and business hours, to quantify access to farmers’ markets. Produce consumption was assessed by self-report of eating five or more fruits and vegetables daily. BMI and blood pressure were assessed by clinical measurements. Poisson regression with robust variance was used for dichotomous outcomes and multiple linear regression was used for continuous outcomes. As the study occurred in a university town and university students are likely to have different shopping patterns from non-students, we stratified analyses by student status.
Eastern North Carolina.
Low-income women of reproductive age (18–44 years) with valid address information accessing family planning services at a local health department (n 400).
Over a quarter reported ever shopping at farmers’ markets (114/400). A larger percentage of women who shopped at farmers’ markets consumed five or more fruits and vegetables daily (42·1 %) than those who did not (24·0 %; P < 0·001). The mean objectively measured distance to the farmers’ markets where women reported shopping was 11·4 (sd 9·0) km (7·1 (sd 5·6) miles), while the mean distance to the farmers’ market closest to the residence was 4·0 (sd 3·7) km (2·5 (sd 2·3) miles).
Among non-students, those who shopped at farmers’ markets were more likely to consume five or more servings of fruits and vegetables daily. Future research should further explore potential health benefits of farmers’ markets.
Identify trends of enrolment and key challenges when recruiting infants with complex cardiac diseases into a multi-centre, randomised, placebo-controlled drug trial and assess the impact of efforts to share successful strategies on enrolment of subjects.
Rates of screening, eligibility, consent, and randomisation were determined for three consecutive periods of time. Sites collectively addressed barriers to recruitment and shared successful strategies resulting in the Inventory of Best Recruiting Practices. Study teams detailed institutional practices of recruitment in post-trial surveys that were compared with strategies of enrolment initially proposed in the Inventory.
The number of screened patients increased by 30% between the Initial Period and the Intermediate Period (p = 0.007), whereas eligibility decreased slightly by 7%. Of those eligible for entry into the study, the rate of consent increased by 42% (p = 0.025) and randomisation increased by 71% (p = 0.10). During the Final Period, after launch of a competing trial, fewer patients were screened (−14%, p = 0.06), consented (−19%, p = 0.12), and randomised (−34%, p = 0.012). Practices of recruitment in the post-trial survey closely mirrored those in the Inventory.
Early identification and sharing of best strategies of recruitment among all recruiting sites can be effective in increasing recruitment of critically ill infants with congenital cardiac disease and possibly other populations. Strategies of recruitment should focus on those that build relationships with families and create partnerships with the medical providers who care for them. Competing studies pose challenges for enrolment in trials, but fostering trusting relationships with families can result in successful enrolment into multiple studies.
Selective serotonin reuptake inhibitors take several weeks to achieve their full antidepressant effects. Post-synaptic 5-HT2A receptor activation is thought to be involved in this delayed therapeutic effect. Pipamperone acts as a highly selective 5-HT2A/D4 antagonist when administered in low doses. The purpose of this study was to compare citalopram 40 mg once daily plus pipamperone 5 mg twice daily (PipCit) versus citalopram plus placebo twice daily for magnitude and onset of therapeutic effect.
An 8-week, randomized, double-blind study in patients with major depressive disorder was carried out.
The study population comprised 165 patients (citalopram and placebo, n=82; PipCit, n=83) with a mean baseline Montgomery–Asberg Depression Rating Scale (MADRS) score of 32.6 (s.d.=5.5). In the first 4 weeks, more citalopram and placebo than PipCit patients discontinued treatment (18% v. 4%, respectively, p=0.003). PipCit patients had significantly greater improvement in MADRS score at week 1 [observed cases (OC), p=0.021; last observation carried forward (LOCF), p=0.007] and week 4 (LOCF, p=0.025) but not at week 8 compared with citalopram and placebo patients. Significant differences in MADRS scores favoured PipCit in reduced sleep, reduced appetite, concentration difficulties and pessimistic thoughts. Mean Clinical Global Impression–Improvement scores were significantly improved after 1 week of PipCit compared with citalopram and placebo (OC and LOCF, p=0.002).
Although the MADRS score from baseline to 8 weeks did not differ between groups, PipCit provided superior antidepressant effects and fewer discontinuations compared with citalopram and placebo during the first 4 weeks of treatment, especially in the first week.
Evidence regarding the long-term separate and combined impact of adolescent psychiatric disorder and personality disorder (PD) on physical health is absent.
A total of 736 people randomly selected in childhood were contacted for home or telephone interviews four times over 20 years. DSM Axis I disorders and Axis II PDs were assessed at mean age 13.7 years in 1983 and physical health was assessed in 1985–1986, 1991–1994 and 2001–2004.
Comparisons were made between 506 adolescents without Axis I disorder or PD and adolescents with Axis I disorder or PD or both. Adolescents with an Axis I disorder (n=150) had significantly higher odds of pain and physical illness and poorer physical health. Adolescents with a PD (n=149) had higher odds of pain and physical illness and poorer physical health and a more rapid decline in physical health. In addition, the 81 participants with an Axis I disorder without co-morbid PD had poorer physical health, but this effect did not reach statistical significance, whereas the 80 participants with a PD but no Axis I disorder reported significantly more pain and more rapid decline in physical health. However, the 69 participants with co-morbid Axis I disorder and PD had the highest rates of pain and physical illness and the worst physical health.
Co-morbid PD accounted for many of the associations of adolescent Axis I disorder with physical health over the ensuing two decades. Co-morbid adolescent Axis I disorder and PD represent a particularly high risk for physical health.
The Keck Interferometer Nuller (KIN) is one of the major scientific and technical precursors to the Terrestrial Planet Finder Interferometer (TPF-I) mission. KIN's primary objective is to measure the level of exo-zodiacal mid-infrared emission around nearby main sequence stars, which requires deep broad-band nulling of astronomical sources of a few Janskys at 10 microns. A number of new capabilitites are needed in order to reach that goal with the Keck telescopes: mid-infrared coherent recombination, interferometric operation in “split pupil” mode, N-band optical path stabilization using K-band fringe tracking and internal metrology, and eventually, active atmospheric dispersion correction. We report here on the progress made implementing these new functionalities, and discuss the initial levels of extinction achieved on the sky.
The chief activities of the Commission for this period were the organizing of two important meetings. The first was held as Joint Discussion 5 at the Kyoto General Assembly in August 1997. The proceedings have now appeared as “Preserving the Astronomical Windows”, edited by S. Isobe (1997).
Background. Previous studies of oculomotor dysfunction
schizophrenia have tended to
concentrate on abnormalities of smooth pursuit eye tracking in chronic
medicated patients. We
report the results of a study of smooth pursuit, reflexive and
antisaccade performance in drug naive
and antipsychotic treated first-episode schizophrenic patients.
Methods. Smooth pursuit and saccadic eye movements were recorded
in 36 first-episode
schizophrenic patients and 36 controls matched for age and estimated IQ.
patients were divided into drug-naive (N=17) and antipsychotic
treated groups (N=19).
Results. Smooth pursuit velocity gain was significantly
lower than controls only in the drug-naive
patients. The treated patients did not differ significantly from
either the controls or the untreated
group. In an antisaccade paradigm both treated and drug-naive schizophrenic
an increased number of errors, but only drug-naive patients also demonstrated
an increased latency in initiating correct antisaccades.
Conclusions. These impairments are unlikely to be due to a
generalized deficit in oculomotor
function in the schizophrenic groups, as there were no differences
between the groups in saccadic
metrics on a reflexive saccade task. The results show that both smooth
pursuit and saccadic
abnormalities are present at the onset of schizophrenia and are integral
to the disorder.
Heterostructure modulation doped transistors (MODFETs) based on AlGaN/GaN structures have demonstrated impressive DC and microwave performance often despite high transistor access resistance. One approach to reducing the access resistance is to use selective area Si-implantation. While several reports exist on Si-implantation in GaN, little work has been done on implantation in AlGaN. In addition, more information on the annealing of implantation damage in GaN is needed to optimize its use in FETs and thyristors.
We report the electrical and structural properties of Si-implanted Al0.15Ga0.85N based on Hall measurements and Rutherford Backscattering (RBS) spectra, respectively. Al0.15Ga0.85N shows less damage accumulation than GaN for a room temperature Si-implant dose of 5×1015 cm-2 based on the minimum channeling yield (26% for AlGaN as compared to 34% for GaN), however, as with GaN, this damage is difficult to remove by thermal annealing at °C.
In-situ optical reflectance is used to monitor the morphological evolution of the two-step GaN growth on sapphire. The amount of H2 carrier gas used in the growth is observed to strongly influence the morphological evolution of the low temperature buffer layer and the subsequent high temperature nucleation behavior, which in turn affects the structural and electrical properties of the GaN epitaxial films. The optical reflectance transients correlate with the sizes and distributions of nuclei as observed by AFM.
Recent research has shown that some patients with schizophrenia have a severe impairment in the suppression of reflexive saccadic eye movements in the ANTI-saccade task. This saccadic distractibility has previously been found in patients with lesions of dorsolateral prefrontal cortex, implicating an abnormality of prefrontal cortex. The objective of the present study was to determine the contribution of these and other areas to the ANTI-saccadic abnormality in schizophrenia by functional neuroimaging. Using 99mtechnetium-HMPAO high resolution multidetector single-photon emission tomography, regional cerebral blood flow (rCBF) during performance of the ANTI-saccade eye-movement task was compared, by statistical parametric mapping, in ten male schizophrenic patients on stable antipsychotic medication who had a high distractibility error rate on the task, and eight similar patients who had normal distractibility error rates. Compared with the normal error group, the patients with high error rates showed significantly decreased rCBF bilaterally, in the anterior cingulate, insula, and in left striatum. These same patients also had increased perseverative errors on the Wisconsin Card Sort Test.
The effects of dopamine-antagonistic neuroleptic (NL) medication on saccadic eye movements were compared in matched groups of 40 NL-treated and 18 NL-free schizophrenic patients and in 18 NL-treated and 14 NL-free bipolar affective patients. Manipulation of the saccadic paradigm yielded data on four types of saccade: those reflexively elicited by novel stimuli (REFLEX saccades), those directed towards the remembered location of a target now extinguished (REM) or towards the location where a predictably alternating target is expected to appear (PRED), or ANTI saccades, directed away from the stimulus to the mirror image location. Extensive psychiatric, neurological and neuropsychological assessments were also carried out on all subjects. The saccades of NL-treated patients, regardless of diagnosis, were less spatially accurate than those of NL-free patients, with a greater tendency to fall short of the target when generated towards the locus of a mentally represented target. This effect was greatest with a predictably alternating target, especially during periods when target visibility was withdrawn, only a temporal cue remaining. This pattern of impairment which is also found in early stages of Parkinson's disease is likely to be due to deficiency of striatal dopamine. Its best clinical predictors were disease duration, and Webster–Parkinsonism scores. Failure to suppress reflexive saccades to the stimulus in the REM and ANTI paradigms were more closely associated with schizophrenia than with NL treatment and were best predicted by negative symptoms and Wisconsin perseverative errors, both of which are widely regarded as indicators of frontal lobe dysfunction.
Most of the previous research reporting abnormalities of rapid re-fixation eye movements (saccades) in patients with schizophrenia has used patients receiving neuroleptic medication. In this study non-neuroleptically medicated schizophrenics were compared with other psychiatric patients using a variety of saccadic paradigms to determine the specificity of saccadic dysfunction. The patient groups consisted of schizophrenics (N = 18), bipolar affectives (N = 18), anxiety neurotics (N = 10) and normal controls (N = 31), none of whom had received neuroleptic medication for the preceding 6 months. Four behavioural paradigms, reflexive, predictive, remembered and ANTI were used to elicit saccades. The primary abnormality in the schizophrenic group was a significantly increased rate of distractibility in the ANTI (saccades made towards the target rather than in an opposite direction) and REM (saccades made prior to the imperative cue) paradigms. The major neuropsychological variable predictive of these errors was Wisconsin card sort perseverative errors. These data, in conjunction with findings from previous neurological research, would seem to provide converging evidence towards dysfunction of prefrontal cortex in schizophrenia.
Light emitting electroluminescent devices have been studied in which the conjugated light emitting polymer is separated on both sides from the device electrodes by a film of nonconducting polyaniline. The devices operate under an AC applied potential.Aluminum, copper or gold serve as the metal electrodes. Flexible, completely organic polymer dispersed liquid crystal light valves have been fabricated from transparent plastic substrates on which a conducting film of polypyrrole has been deposited. A new concept, “microcontact printing”, is being investigated for patterning the polypyrrole.
Natural organic compounds can play an important role in the transport of radionuclides through the geosphere, but the inclusion of polyelectrolytic fulvic and humic acids into geochemical speciation codes is not straightforward. Schubert ion-exchange experiments have been used to parameterise an equilibrium-based, discrete site-electrostatic model, Model V, which is concerned with predicting trace metal-humic interactions in solution. However, before such a model can be applied to natural groundwaters, its ability to deal with competition between trace cations and anionic ligands has to be tested.
PHREEQEV, which incorporates Model V with the inorganic speciation code PHREEQE, has been used to guide experiments based on a modified Hummel-Dreyer method. To improve speed and precision, these experiments used a HPLC method rather than Sephadex gel, and measured the effect of Ca on Co and Ni binding to fulvic acid. The results were compared with the predictions made by PHREEQEV. Although the system was further complicated by the need to add citric acid to prevent binding of metals to the HPLC column, predictions at pH 5 were good for both metals. At pH 7, the Co binding results were not well predicted and the reasons for this are still unclear. Comparisons between the Schubert and Hummel-Dreyer-type experiments show that the two methods are compatible.