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Depression contributes to persistent opioid analgesic use (OAU). Treating depression may increase opioid cessation.
To determine if adherence to antidepressant medications (ADMs) v. non-adherence was associated with opioid cessation in patients with a new depression episode after >90 days of OAU.
Patients with non-cancer, non-HIV pain (n = 2821), with a new episode of depression following >90 days of OAU, were eligible if they received ≥1 ADM prescription from 2002 to 2012. ADM adherence was defined as >80% of days covered. Opioid cessation was defined as ≥182 days without a prescription refill. Confounding was controlled by inverse probability of treatment weighting.
In weighted data, the incidence rate of opioid cessation was significantly (P = 0.007) greater in patients who adhered v. did not adhered to taking antidepressants (57.2/1000 v. 45.0/1000 person-years). ADM adherence was significantly associated with opioid cessation (odds ratio (OR) = 1.24, 95% CI 1.05–1.46).
ADM adherence, compared with non-adherence, is associated with opioid cessation in non-cancer pain. Opioid taper and cessation may be more successful when depression is treated to remission.
The discussion on global change has led to increased interest in glacier mass balance since glaciers can be used as climatic indicators. To meet the need for high-quality mass-balance data requires critical examination of traditional mass-balance methods and their possible errors. One issue regarding mass-balance measurements that has received little attention is internal accumulation. Our study shows that internal accumulation in the firn layer of Storglaciären, Sweden, significantly affects the mass balance of the glacier. This occurs because the winter cold wave penetrates below the previous year’s summer surface and into underlying firn. We estimated internal accumulation from measurements of temperature and water content in firn. The depth of the 0°C isotherm correlated with snow depth and air temperature, so that low snow depth and low air temperature separately cause a deeper 0°C isotherm. We determined irreducible gravimetric water content in firn to 2–3%, which corresponds to an irreducible water saturation of 6–8%. Our value for firn is relatively high compared with that for snow, probably due to trapped water in isolated firn pores. Refreezing of percolating meltwater in spring accounted for ~30% of annual internal accumulation. The remaining 70% was due to re-freezing of retained capillary water in firn pores during winter. Disregarding internal accumulation would lead to underestimation of annual net mass balance by 0.04–0.06 m w.e., corresponding to 3–5% of annual accumulation of the entire glacier in an average year. Hence, internal accumulation potentially becomes a source for systematic error if not accounted in mass-balance measurements.
Critical to the development of improved HIV elimination efforts is a greater understanding of how social networks and their dynamics are related to HIV risk and prevention. In this paper, we examine network stability of confidant and sexual networks among young black men who have sex with men (YBMSM). We use data from uConnect (2013–2016), a population-based, longitudinal cohort study. We use an innovative approach to measure both sexual and confidant network stability at three time points, and examine the relationship between each type of stability and HIV risk and prevention behaviors. This approach is consistent with a co-evolutionary perspective in which behavior is not only affected by static properties of an individual's network, but may also be associated with changes in the topology of his or her egocentric network. Our results indicate that although confidant and sexual network stability are moderately correlated, their dynamics are distinct with different predictors and differing associations with behavior. Both types of stability are associated with lower rates of risk behaviors, and both are reduced among those who have spent time in jail. Public health awareness and engagement with both types of networks may provide new opportunities for HIV prevention interventions.
The continentality index is a good measure of the nature of the climate in a region, as it reflects not only the temperature but also the large-scale circulation. It correlates well with glacier mass-balance parameters. The climate along the west–east transect slightly north of the Arctic Circle across the Scandinavian Caledonides is governed by the prevailing westerlies; however, during winter the eastern part of the Caledonides is influenced by weather systems from the southeast. The differences in continentality meant by temperature and precipitation have a major impact on the response times of glaciers. The climatic change in this area has been dominated by increased summer mean temperatures (1910–20) and increased maritime influence since the 1980s. The slower-reacting glaciers on the Swedish side of the mountains are still adapting to the temperature increase at the beginning of the 20th century, and the increase in maritime influence gradually becomes less important towards the west. Thus, differences in the behaviour of glacier fronts along the west–east transect mirror differences in continentality.
The hydraulic properties of the firn on Storglaciären, Sweden, were investigated in firn cores by water-table measurements and pumping tests. The mean density of the firn was 800 850 kg m3, giving an effective porosity of 0.073. The lower part of the firn layer was saturated with water, producing a maximum saturated layer of 5 m in late July. Hydraulic conductivity of the firn aquifer was determined from pumping tests to be 4.9 × 105 m s1. Percolation velocity, calculated from the time lag of maximal water input at the glacier surface and the water-level peaks, was 0.25 m h1. Percolation velocity increased over the ablation season, indicating a widening of the percolation pathways. A decrease in percolation velocity with percolation depth was found, reflecting decreasing permeability. The firn–water table responded to water input at the glacier surface with a delay of about 3 days. No diurnal variations were found in an area which was not influenced by fast drainage, indicating a diffusion of diurnal variations in meltwater production. One borehole intersected a water-filled cavity. Water level in this cavity showed diurnal variations, which probably were caused by diurnally produced meltwater waves moving fast through englacial conduits.
The Two Micron All-Sky Survey was conceived over a decade ago for the express purpose of mapping the Milky Way and the Universe nearby. 2MASS is now complete and the final data products, including the extended source catalog (XSC), have been released. The XSC contains nearly a million galaxies to the stated completeness goal of K=13.5. While the catalog becomes incomplete at the faintest magnitudes and lowest galactic latitudes due to confusion, at the bright end the catalog is essentially complete down to very low latitudes (b less than 5 degrees), which makes it an excellent survey for the distribution of matter in the nearby Universe. Redshift information is now nearly complete for the 24,000 galaxies brighter than K=11.25 and above |b|=5°. We now have an amazing census of galaxy (baryonic mass) concentrations over the whole sky and inside z=0.04. Several new structures are elucidated and the characteristics of the structures are described. We also examine the match between the predicted gravitational velocity vector of the Local Group and the motions determined by other experiments including the CMB dipole.
A synthesis of the upper Moscovian sedimentological and palaeontological record of terrestrial habitats across the Variscan foreland and adjacent intramontane basins (an area which is referred to here as Variscan Euramerica) suggests a contraction and progressive westward shift of the coal swamps. These changes can be correlated with pulses of tectonic activity (tectonic phases) resulting from the northwards migration of the Variscan Front. This tectonic activity caused disruption to the landscapes and drainage patterns where the coal swamps were growing, which became less suitable to growth of the dominant plants of the swamps, the arborescent lycopsids. They were progressively replaced by vegetation dominated by marattialean ferns, which through a combination of slower growth and larger canopies resulted in less evapo-transpiration. This in turn caused localised reductions in rainfall, which further affected the ability of the lycopsids to dominate the swamp vegetation. These changes were initially localised and where the coal swamps were able to survive the lycopsids and pteridosperms show little change in either species diversity or biogeography, indicating that at this time there was minimal regional-scale climate change taking place. By Asturian times, however, the process had accelerated and the swamps in Variscan Euramerica became progressively replaced by predominantly conifer and cordaite vegetation that favoured much drier substrates. Except in localised pockets in intramontane basins of the Variscan Mountains, the last development of coal swamps in Variscan Euramerica was of early Cantabrian age. Further west, lycopsid-dominated coal swamps persisted for a little longer. The last remnants of the lycopsid-dominated coal swamps in the Illinois Basin disappeared probably by middle-late Cantabrian times, as the cycle of contracting wetlands and regional reductions in rainfall generated its own momentum, and no longer needed the impetus of tectonic instability. This tectonically-driven decline in the Euramerican coal swamps was probably responsible for an annual increase in atmospheric CO2 of c. 0.37 ppm, and may have been implicated in the marked increase in global temperatures near the Moscovian – Kasimovian boundary, and the onset of the Late Pennsylvanian interglacial.
Oblique angle deposition (OAD) is a self-organizing physical vapor deposition (PVD) technique that has been used to grow sculpted 3D nanostructures including helices, slanted rods, and zigzag structures, and other shapes. OAD structures can be fabricated from virtually any material that can be deposited using PVD including: polymers, metals, semiconductors, oxides, and nitrides. The control over the nano-scale structural anisotropy of these materials allows one to tailor their electrical, magnetic, mechanical, crystalline, and optical properties. Through the careful design of the OAD structure and material selection this technique can be used to create photonic materials (1D, 2D, and 3D) with unique properties. We will discuss ongoing work using OAD to develop oxide thin film interference filters that can withstand extreme temperatures (800-1000° C) at mTorr vacuum levels, which are being developed for thermal photovoltaic applications.
We studied the viability of the embedded wafer level ball grid array (eWLB) package environment as an antenna platform for 77 GHz automotive radar sensors and the effects of package fabrication tolerances on the antenna performance. The investigation of different antenna concepts in the eWLB package and their characterization methods are addressed. The design procedures for electrically large, differentially fed loop antennas in a multilayer package structure are introduced. Two different planar antennas are developed and measured in an eWLB package showing promising results such as a gain of 9 GHz and an impedance bandwidth of 8 GHz. An acceptable antenna performance is recorded within the tolerance limits. Therefore, the eWLB package is seen as an appropriate platform for mm-wave antennas and as a good candidate for an antenna-in-package (AiP) concept.
Despite providing significant benefits for human health, energy systems also negatively affect global health in major ways today, causing directly perhaps as many as five million premature deaths annually and more than 5% of all illhealth (measured as lost healthy life years). Air pollution from incomplete combustion of fossil fuels and biomass fuels is by far the single major reason that energy systems negatively affect global health, although ash, sulfur, mercury, and other contaminants in fossil fuels also play a role. Effects on workers in energy industries are the second biggest health impact globally.
The largest exposures to energy-related air pollution occur in and around households, particularly in developing countries where unprocessed biomass (wood and agricultural wastes) and coal are used for cooking and heating in simple appliances.
This chapter does not focus on differences in impacts among alternative energy systems that have minor impacts on global health; rather, the focus is on the most significant impacts of energy systems on health. The important positive impacts of energy systems on health are mostly addressed in Chapter 2.
Given the importance of avoiding climate change, there is secondary focus on the ways that mitigating climate change through changes in energy systems might achieve important health improvements: co-benefits.
Unless major policy interventions are introduced, energy systems are expected to continue contributing significantly to the global burden of disease for years to come.
Neurologically normal individuals show a bias toward the left side of space, referred to as pseudoneglect due to its similarity to clinical hemispatial neglect. The left bias appears to be stronger in the lower visual field during free-viewing, which could result from preferential dorsal stream processing. The current experiments used modified greyscales tasks, incorporating motion and isoluminant color, to explore whether targeting dorsal or ventral stream processing influenced the strength of the left bias. It was expected that the left bias would be stronger on the motion task than on a task incorporating isoluminant color. In Study 1, similar left biases were observed during prolonged viewing for luminance, motion and red, but not green color. The unexpected finding of a leftward bias for red under prolonged viewing was replicated in Study 2. A leftward bias for motion was also evident during 150 ms viewing in Study 2. In Study 3, the left bias was not apparent when using a blue/yellow condition, suggesting the left bias for red under prolonged viewing was likely unique to red. Furthermore, the leftward bias for red disappeared under brief viewing conditions. It is suggested that dorsal stream processing likely underlies visual field differences in pseudoneglect. (JINS, 2012, 18, 251–259)
To assess healthcare personnel (HCP) perceptions regarding implementation of sensor-based electronic systems for automated hand hygiene adherence monitoring.
Using a mixed-methods approach, structured focus groups were designed to elicit quantitative and qualitative responses on familiarity, comfort level, and perceived impact of sensor-based hand hygiene adherence monitoring
A university hospital, a Veterans Affairs hospital, and a community hospital in the Midwest.
Focus groups were homogenous by HCP type, with separate groups held for leadership, midlevel management, and frontline personnel at each hospital.
Overall, 89 HCP participated in 10 focus groups. Levels of familiarity and comfort with electronic oversight technology varied by HCP type; when compared with frontline HCP, those in leadership positions were significantly more familiar with (P<.01) and more comfortable with (P<.01) the technology. The most common concerns cited by participants across groups included lack of accuracy in the data produced, such as the inability of the technology to assess the situational context of hand hygiene opportunities, and the potential punitive use of data produced. Across groups, HCP had decreased tolerance for electronic collection of spatial-temporal data, describing such oversight as Big Brother.
While substantial concerns were expressed by all types of HCP, participants' recommendations for effective implementation of electronic oversight technologies for hand hygiene monitoring included addressing accuracy issues before implementation and transparent communication with frontline HCP about the intended use of the data.
The magnetostriction of as-sputtered and annealed 400 nm thick Co films has been studied in longitudinal and transverse magnetic fields. The appreciable change of the magnetostriction behavior after annealing above 250 °C is correlated to grain growth and to the related change of the texture (from nearly randomly distributed hcp-Co crystallites to a c-axes texture perpendicular to the film plane). The magnetostriction behavior in the annealed samples cannot be explained by a domain magnetization within the film plane. It is assumed that a rotation of the spontaneous magnetization out of the film plane occurs due to the development of a perpendicular magnetic anisotropy.
A three dimensional thermal imaging system is being developed for measuring temperature profiles in MEMS-biomedical devices. These devices rely on a thermal microablation of the dead-skin layer in order to sample transdermal fluids. This is accomplished using microheaters embedded into a PDMS microchannel device. In order to determine the proper functioning as well as long-term safety of the devices, a temperature profile of the device and the skin in contact with the heaters is needed. The results of simple analytical models are used to optimize a proto- type device. Using a three-dimensional chemical imaging microscope and temperature-depend- ent fluorophores, the temperature profile in a sample can be determined quantitatively as well. We demonstrate the technique on a model sample, and discuss extension to other applications such as thermal imaging in biological systems.
Thin films of YBCO were prepared using a mass-spectrometer controlled coevapora-tion/MBE process with atomic oxygen. Under the conditions of low pressure, necessary for mass-spectrometer rate control, it is shown that an atomic oxygen beam source can be utilized in order to grow high quality thin films of YBCO as well as multi-layer structures involving YBCO and Y2O3. Values of Tc = 88.5 K and Jc = 6–106 A/cm2 at 77 K were determined for a strip with a width of 10 μm of YBCO deposited on a LaAlO3 substrate. Film structure is analyzed by XRD and rocking curve measurements. Magnetic characterization of films and multi-layer structures are reported.