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Seasonal influenza virus epidemics have a major impact on healthcare systems. Data on population susceptibility to emerging influenza virus strains during the interepidemic period can guide planning for resource allocation of an upcoming influenza season. This study sought to assess the population susceptibility to representative emerging influenza virus strains collected during the interepidemic period. The microneutralisation antibody titers (MN titers) of a human serum panel against representative emerging influenza strains collected during the interepidemic period before the 2018/2019 winter influenza season (H1N1-inter and H3N2-inter) were compared with those against influenza strains representative of previous epidemics (H1N1-pre and H3N2-pre). A multifaceted approach, incorporating both genetic and antigenic data, was used in selecting these representative influenza virus strains for the MN assay. A significantly higher proportion of individuals had a ⩾four-fold reduction in MN titers between H1N1-inter and H1N1-pre than that between H3N2-inter and H3N2-pre (28.5% (127/445) vs. 4.9% (22/445), P < 0.001). The geometric mean titer (GMT) of H1N1-inter was significantly lower than that of H1N1-pre (381 (95% CI 339–428) vs. 713 (95% CI 641–792), P < 0.001), while there was no significant difference in the GMT between H3N2-inter and H3N2-pre. Since A(H1N1) predominated the 2018–2019 winter influenza epidemic, our results corroborated the epidemic subtype.
Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
Ten compounds are found in the Ba0-Y203-CuOx system. High temperature (≈950-1000°C) phases identified as Ba4Y2O7 , Ba2Y2O5 , Ba3Y4O9 , BaY2O4 , Y2Cu2O5 , BaCuO2+x, Ba3YCu2OZ BaY2Cu05 and BazYCu306+x are formed in this temperature range. In addition, a new compound with composition of 2BaO:CuO, which possibly has a melting point below 950°C, was prepared at 850°C. A summary o£ the crystallographic data of these 10 phases is given. In particular, results of x-ray studies pertaining to four compounds, BazYCu306+x, which is currently the most promising high To' superconductor material, Ba2Cu03 , BaY2Cu05 , and Ba3YCu20Z are reviewed.
Multidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs.
From July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE. Environmental contamination by MRDOs, such as methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum β-lactamse (ESBL)–producing Enterobacteriaceae, was evaluated using specimens collected from communal areas at baseline, then twice weekly. The volume of alcohol-based hand rub (ABHR) consumed per resident per week was measured.
The overall environmental contamination of communal areas was culture-positive for MRSA in 33 of 100 specimens (33%), CRA in 26 of 100 specimens (26%), and ESBL-producing Enterobacteriaceae in 3 of 100 specimens (3%) in intervention and nonintervention RCHEs at baseline. Serial monitoring of environmental specimens revealed a significant reduction in MRSA (79 of 600 [13.2%] vs 197 of 600 [32.8%]; P<.001) and CRA (56 of 600 [9.3%] vs 94 of 600 [15.7%]; P=.001) contamination in the intervention arm compared with the nonintervention arm during the study period. The volume of ABHR consumed per resident per week was 3 times higher in the intervention arm compared with the baseline (59.3±12.9 mL vs 19.7±12.6 mL; P<.001) and was significantly higher than the nonintervention arm (59.3±12.9 mL vs 23.3±17.2 mL; P=.006).
The direct observation of hand hygiene of residents could reduce environmental contamination by MDROs in RCHEs.
Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.
The crystal structure and powder patterns were prepared for the distorted perovskite series R(Co3/4Ti1/4)O3 (R = La, Pr, Nd, Sm, Eu, Gd, Dy, Ho). The R(Co3/4Ti1/4)O3 members are isostructural with each other and are crystallized in the orthorhombic crystal system with space group Pnma, Z = 4. From R = La to Ho, the lattice parameters a range from 5.4614(3) to 5.5368(2) Å, b range from 7.7442(4) to 7.4859(2) Å, and c range from 5.5046(3) to 5.2170(2) Å. The unit-cell volumes, V which range from 232.81(2) to 216.237(11) Å3 follow the trend of “lanthanide contraction”. The structure distortion of these compounds is evidenced in the tilt angles θ, ϕ, and ω, which represent rotations of an octahedron about the pseudo-cubic perovskite p, p and p axes. All three tilt angles increase across the lanthanide series (for R = La to R = Ho: θ increases from 8.34° to 17.00°, ϕ from 6.24° to 8.53°, and ω from 10.41° to 18.96°), indicating a greater octahedral distortion as the ionic radius of R3+ [r(R3+)] decreases. The bond valence sum values for the (Co/Ti) site and the R site of R(Co3/4Ti1/4)O3 reveal no significant bond strain in these compounds. X-ray diffraction patterns of the R(Co3/4Ti1/4)O3 samples were submitted to the Powder Diffraction File.
Deposit formation on turbine hardware in propulsion turbine engines can occur in many arid regions globally. Characterising crystalline deposits on metallic substrates can aid in component resilience and health monitor algorithms during particle ingestion. This study has developed two statistical empirical models for prediction from acquired experimental data for the onset of deposits. The prediction models are for crystalline particulate (Arizona Road Test Dust) deposits on a flat rectangular Hastelloy-X test coupon. Particle impingement angles varied between 20° and 80° in experimental flow temperatures of 1,000–1,100°C. Averaged deposits are methodically quantified through normalised particle deposit tallies per area and percent coverage of the surface using microscopic imaging and image processing programs. Deposit accumulation is a quadratic function of both near-surface coupon temperature and coupon angle.
The structure of a series of lanthanide iron cobalt perovskite oxides, R(Fe0.5Co0.5)O3 (R = Pr, Nd, Sm, Eu, and Gd), have been investigated. The space group of these compounds was confirmed to be orthorhombic Pnma (No. 62), Z = 4. From Pr to Gd, the lattice parameter a varies from 5.466 35(13) Å to 5.507 10(13) Å, b from 7.7018(2) to 7.561 75(13) Å, c from 5.443 38(10) to 5.292 00(8) Å, and unit-cell volume V from 229.170(9) Å3 to 220.376(9) Å3, respectively. While the trend of V follows the trend of the lanthanide contraction, the lattice parameter “a” increases as the ionic radius r(R3+) decreases. X-ray diffraction (XRD) and transmission electron microscopy confirm that Fe and Co are disordered over the octahedral sites. The structure distortion of these compounds is evidenced in the tilt angles θ, ϕ, and ω, which represent rotations of an octahedron about the pseudocubic perovskite p, p, and p axes. All three tilt angles increase across the lanthanide series (for R = Pr to R = Gd: θ increases from 12.3° to 15.2°, ϕ from 7.5° to 15.8°, and ω from 14.4° to 21.7°), indicating a greater octahedral distortion as r(R3+) decreases. The bond valence sum for the sixfold (Fe/Co) site and the eightfold R site of R(Fe0.5Co0.5)O3 reveal no significant bond strain. Density Functional Theory calculations for Pr(Fe0.5Co0.5)O3 support the disorder of Fe and Co and suggest that this compound to be a narrow band gap semiconductor. XRD patterns of the R(Fe0.5Co0.5)O3 samples were submitted to the Powder Diffraction File.
To study the association between gastrointestinal colonization of carbapenemase-producing Enterobacteriaceae (CPE) and proton pump inhibitors (PPIs).
We analyzed 31,526 patients with prospective collection of fecal specimens for CPE screening: upon admission (targeted screening) and during hospitalization (opportunistic screening, safety net screening, and extensive contact tracing), in our healthcare network with 3,200 beds from July 1, 2011, through December 31, 2015. Specimens were collected at least once weekly during hospitalization for CPE carriers and subjected to broth enrichment culture and multiplex polymerase chain reaction.
Of 66,672 fecal specimens collected, 345 specimens (0.5%) from 100 patients (0.3%) had CPE. The number and prevalence (per 100,000 patient-days) of CPE increased from 2 (0.3) in 2012 to 63 (8.0) in 2015 (P<.001). Male sex (odds ratio, 1.91 [95% CI, 1.15–3.18], P=.013), presence of wound or drain (3.12 [1.70–5.71], P<.001), and use of cephalosporins (3.06 [1.42–6.59], P=.004), carbapenems (2.21 [1.10–4.48], P=.027), and PPIs (2.84 [1.72–4.71], P<.001) in the preceding 6 months were significant risk factors by multivariable analysis. Of 79 patients with serial fecal specimens, spontaneous clearance of CPE was noted in 57 (72.2%), with a median (range) of 30 (3–411) days. Comparing patients without use of antibiotics and PPIs, consumption of both antibiotics and PPIs after CPE identification was associated with later clearance of CPE (hazard ratio, 0.35 [95% CI, 0.17–0.73], P=.005).
Concomitant use of antibiotics and PPIs prolonged duration of gastrointestinal colonization by CPE.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
Prevalence of vancomycin-resistant enterococci (VRE) and use of daptomycin are increasing in Asia. To determine the prevalence of daptomycin non-susceptible enterococci (DNSE) and understand factors associated with reduced daptomycin susceptibility in VRE, we conducted a case-control study in a 1600-bed adult tertiary hospital in Singapore. All VRE isolates from inpatients in 2012 were tested for daptomycin susceptibility. Patients with VRE isolates of daptomycin minimum inhibitory concentration (MIC) ⩾3 µg/ml were classified as daptomycin-reduced susceptible VRE (DRS-VRE) and those with daptomycin MIC <3 µg/ml classified as daptomycin-susceptible VRE (DS-VRE). Medical records were reviewed for clinical and epidemiological data. None of 243 VRE isolates had MIC >4 µg/ml (DNSE). About half (135, 55%) had reduced susceptibility to daptomycin (MIC 3–4 µg/ml). None in the DS-VRE group had prior exposure to daptomycin. After adjusting for age, gender, comorbidity, hospitalization duration, surgical history, indwelling device use, and duration of antibiotic exposure in the prior 3 months, >1 movement between wards [odds ratio (OR) 0·35, 95% confidence interval (CI) 0·16–0·74, P = 0·006] and minocycline resistance (OR 0·45, 95% CI 0·25–0·84, P = 0·011) were independently associated with DRS-VRE. Our study suggests that daptomycin exposure, >1 movement between wards, and resistance to minocycline, were associated with reduced daptomycin susceptibility in VRE.
Carbapenem-resistant Acinetobacter baumannii (CRAB) with diverse multilocus sequence typing emerged among our nursing home residents (6.5%) with a high background rate of MRSA (32.2%). Rectal swabs yielded a higher rate of CRAB detection than axillary or nasal swabs. Bed-bound status, use of adult diapers, and nasogastric tube were risk factors for CRAB colonization.
X-ray structural characterization and X-ray reference powder patterns have been determined for two series of iron- and cobalt-containing layered compounds (BaxSr1−x)2Co2Fe12O22 (x = 0.2, 0.4, 0.6, 0.8) and (BaxSr1−x)Co2Fe16O27 (x = 0.2, 0.4, 0.6, 0.8). The (BaxSr1−x)2Co2Fe12O22 series of compounds crystallized in the space group R
m (No. 166), with Z = 3. The structure is essentially that of the Y-type hexagonal ferrite, BaM2+Fe63+O11. The lattice parameters range from a = 5.859 15(8) to 5.843 72(8) Å, and c = 43.4975(9) to 43.3516(9) Å for x = 0.2 to 0.8, respectively. The (BaxSr1−x)Co2Fe16O27 series (W-type hexagonal ferrite) crystallized in the space group P63/mmc (No. 194) and Z = 2. The lattice parameters range from a = 5.902 05(12) to 5.8979(2) Å and c = 32.9002(10) to 32.8110(13) Å for x = 0.2 to 0.8. Results of measurements of the Seebeck coefficient and resistivity of these two sets of samples indicated that they are insulators. Powder X-ray diffraction patterns of these two series of compounds have been submitted to be included in the Powder Diffraction File.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
Predicting which chronic rhinosinusitis patients have nasal obstruction due to reversible mucosal inflammation could prevent unnecessary surgery.
To investigate whether the change in nasal peak inspiratory flow following maximal decongestion (i.e. mucosal reversibility) at first visit predicts the response to topical steroids in chronic rhinosinusitis patients, as measured by the 22-item Sinonasal Outcome Test.
Prospective study of 128 consecutive new adult patients presenting with nasal obstruction due to chronic rhinosinusitis (January 2008 to July 2010). The 22-item Sinonasal Outcome Test questionnaire was administered and the nasal peak inspiratory flow assessed. Following maximal nasal decongestion, the nasal peak inspiratory flow was again tested and the difference calculated. Topical steroids were administered for at least six weeks. The 22-item Sinonasal Outcome Test was then repeated and the difference calculated.
Data were analysed using means and correlation studies (Spearman's rank correlation). There was no correlation between the pre- versus post-decongestion nasal peak inspiratory flow difference and the pre- versus post-steroid 22-item Sinonasal Outcome Test difference, in chronic rhinosinusitis patients with or without nasal polyps.
The difference between pre- and post-decongestion nasal peak inspiratory flow does not predict chronic rhinosinusitis patients' response to topical steroids.
Nanoscale superlattice-like (SLL) dielectric was employed to reduce the power consumption of the Phase-change random access memory (PCRAM) cells. In this study, we have simulated and found that the cells with the SLL dielectric have a higher peak temperature compared to that of the cells with the SiO2 dielectric after constant pulse activation, due to the interface scattering mechanism. Scaling of the SLL dielectric has resulted in higher peak temperatures, which can be even higher after material/structural modifications. Furthermore, the SLL dielectric has good material properties that enable the cells to have high endurance. This shows the effectiveness of the SLL dielectric for advanced memory applications.
GaNAs and GaInNAs growths are subjects of considerable interest due to its technological importance in long wavelength lasers emitting within the optical-fiber communication wavelength window (1.31 – 1.55 m m). We study GaNAs and GaInNAs materials growth on (100) semi-insulating GaAs substrate with high nitrogen compositions (>2%) using a solid source molecular beam epitaxy (SSMBE) system in conjunction with a RF plasma source. GaNAs layer with high nitrogen compositions of 4.85% and 6% with good XRD peak intensities were successfully grown. GaInNAs quantum wells (QWs) were then grown with reference to the nitrogen compositions measured in the GaNAs materials to obtain nitrogen compositions > 2%. The photoluminescence (PL) peak positions of the GaInNAs QWs blueshifted after annealing at 840°C and 10min. It was found that the blueshift of PL peaks are highly dependent on nitrogen compositions.
Rapid thermal annealing (RTA) of 1000Å GaNAs films grown on (100) oriented GaAs substrate by radio frequency (RF) plasma assisted solid-source molecular beam epitaxy was studied by low-temperature photoluminescence (PL) and high-resolution x-ray diffraction (HRXRD). Samples with nitrogen content of 13 and 2.2% have shown an overall blueshift in energy of 67.7meV and an intermediate redshift of 42.2meV in the PL spectra when subjected to RTA at 525–850°C for 10min. It is also shown that the sample, which is annealed at temperature range of 700–750°C, has the highest photoluminescence efficiency (1.7–2.1 times increase in integrated PL intensity as compared to the as-grown sample). Reciprocal space mapping of the as-grown GaNAs samples obtained by using triple-crystal HRXRD shows the presence of interstitially incorporated of N atoms with no lattice relaxation in the direction parallel to the growth surface. These results have significant implication on the growth and post-growth treatment of nitride compound semiconductor materials for high performance optoelectronics devices.