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Sex-related differences in psychopathology are known phenomena, with externalizing and internalizing symptoms typically more common in boys and girls, respectively. However, the neural correlates of these sex-by-psychopathology interactions are underinvestigated, particularly in adolescence.
Participants were 14 years of age and part of the IMAGEN study, a large (N = 1526) community-based sample. To test for sex-by-psychopathology interactions in structural grey matter volume (GMV), we used whole-brain, voxel-wise neuroimaging analyses based on robust non-parametric methods. Psychopathological symptom data were derived from the Strengths and Difficulties Questionnaire (SDQ).
We found a sex-by-hyperactivity/inattention interaction in four brain clusters: right temporoparietal-opercular region (p < 0.01, Cohen's d = −0.24), bilateral anterior and mid-cingulum (p < 0.05, Cohen's d = −0.18), right cerebellum and fusiform (p < 0.05, Cohen's d = −0.20) and left frontal superior and middle gyri (p < 0.05, Cohen's d = −0.26). Higher symptoms of hyperactivity/inattention were associated with lower GMV in all four brain clusters in boys, and with higher GMV in the temporoparietal-opercular and cerebellar-fusiform clusters in girls.
Using a large, sex-balanced and community-based sample, our study lends support to the idea that externalizing symptoms of hyperactivity/inattention may be associated with different neural structures in male and female adolescents. The brain regions we report have been associated with a myriad of important cognitive functions, in particular, attention, cognitive and motor control, and timing, that are potentially relevant to understand the behavioural manifestations of hyperactive and inattentive symptoms. This study highlights the importance of considering sex in our efforts to uncover mechanisms underlying psychopathology during adolescence.
There is compelling evidence for gradient effects of household income on school readiness. Potential mechanisms are described, yet the growth curve trajectory of maternal mental health in a child's early life has not been thoroughly investigated. We aimed to examine the relationships between household incomes, maternal mental health trajectories from antenatal to the postnatal period, and school readiness.
Prospective data from 505 mother–child dyads in a birth cohort in Singapore were used, including household income, repeated measures of maternal mental health from pregnancy to 2-years postpartum, and a range of child behavioural, socio-emotional and cognitive outcomes from 2 to 6 years of age. Antenatal mental health and its trajectory were tested as mediators in the latent growth curve models.
Household income was a robust predictor of antenatal maternal mental health and all child outcomes. Between children from the bottom and top household income quartiles, four dimensions of school readiness skills differed by a range of 0.52 (95% Cl: 0.23, 0.67) to 1.21 s.d. (95% CI: 1.02, 1.40). Thirty-eight percent of pregnant mothers in this cohort were found to have perinatal depressive and anxiety symptoms in the subclinical and clinical ranges. Poorer school readiness skills were found in children of these mothers when compared to those of mothers with little or no symptoms. After adjustment of unmeasured confounding on the indirect effect, antenatal maternal mental health provided a robust mediating path between household income and multiple school readiness outcomes (χ2 126.05, df 63, p < 0.001; RMSEA = 0.031, CFI = 0.980, SRMR = 0.034).
Pregnant mothers with mental health symptoms, particularly those from economically-challenged households, are potential targets for intervention to level the playing field of their children.
To assess the effectiveness of infection control preparedness for human infection with influenza A H7N9 in Hong Kong.
A descriptive study of responses to the emergence of influenza A H7N9.
A university-affiliated teaching hospital.
Healthcare workers (HCWs) with unprotected exposure (not wearing N95 respirator during aerosol-generating procedure) to a patient with influenza A H7N9.
A bundle approach including active and enhanced surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and extensive contact tracing for HCWs with unprotected exposure was implemented. Seventy HCWs with unprotected exposure to an index case were interviewed especially regarding their patient care activities.
From April 1, 2013, through May 31, 2014, a total of 126 (0.08%) of 163,456 admitted patients were tested for the H7 gene by reverse transcription-polymerase chain reaction per protocol. Two confirmed cases were identified. Seventy (53.8%) of 130 HCWs had unprotected exposure to an index case, whereas 41 (58.6%) and 58 (82.9%) of 70 HCWs wore surgical masks and practiced hand hygiene after patient care, respectively. Sixteen (22.9%) of 70 HCWs were involved in high-risk patient contacts. More HCWs with high-risk patient contacts received oseltamivir prophylaxis (P=0.088) and significantly more had paired sera collected for H7 antibody testing (P<0.001). Ten (14.3%) of 70 HCWs developed influenza-like illness during medical surveillance, but none had positive results by reverse transcription-polymerase chain reaction. Paired sera was available from 33 of 70 HCWs with unprotected exposure, and none showed seroconversion against H7N9.
Despite the delay in airborne precautions implementation, no patient-to-HCW transmission of influenza A H7N9 was demonstrated.
The challenges associated with meeting 20nm technology requirements for better Cu CMP process uniformity and lower defectivity have been studied. Required improvements in uniformity were obtained through platen process optimization along with evaluation & selection of specific Cu slurries and pads and their performance reported. The principal factors influencing defect formation, including Cu barrier metallurgy, interconnect pattern density and process queue times were studied. Specific new post CMP clean chemistries were evaluated to assess their capability to suppress defect formation and their performance reported. The trade off between uniformity and defect suppression as a function slurry, pad and post Cu CMP clean chemistry is described.
The aim of tympanoplasty graft preparation is to stiffen the fascia or perichondrium and thereby to optimise ease of manipulation. We report 39 cases utilising a novel technique in which the graft is prepared in ear drops containing polyethylene glycol, flumetasone pivalate (0.02 per cent) and clioquinol (1 per cent). This technique is useful in reducing the risk of desiccation if placement is delayed, and may pose less risk of infection and mechanical damage than alternative methods.
Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.
Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.
Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.
Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.
An outbreak of typhoid caused by Salmonella typhi of the same Vi-phage type (D1) and of the same antibiogram was reported in a large psychiatric institution in Singapore. A total of 95 (4·8%) of the 1965 inmates were infected, 47 with symptoms and 48 asymptomatic. Transmission was through close person-to-person contact and not through contaminated food or water. The source of infection could not be established. The outbreak was brought under control by maintaining a high standard of environmental sanitation, active search for fever and diarrhoeal cases, identification of asymptomatic cases by rectal swabbing, and isolation of those found to be infected. Mass immunization with two doses of heat-phenol inactivated typhoid vaccine was also carried out concurrently. The vaccine was found to have an efficacy of 65·8% in preventing clinical illness.
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.
Two-dimensional hexagonal photonic crystals of air columns in a wax substrate were fabricated by jet-based methods. By modifying the structure of the photonic crystals (PC), electromagnetic waves can be controlled, enabling the design of novel devices for waveguides, filters, and couplers. The jet-based processing is a solid freeforming method that can fabricate complex 2D or 3D photonic structures quickly and easily as compared to micro-machining and lithographic methods. The resolution of our 3D Systems ThermoJet® solider object printer is 300 × 400 × 600 dpi (XYZ) with the layer thickness of 0.042 mm. The wax used is a thermopolymer build material, similar to production investment casting wax material. The periodicity of the lattice of our 2D PC structures was designed to form bandstop filters in the 0.1–0.3 THz range. Transmission spectra of the structures were measured with a Bruker IFS 66v FT-IR interferometer. Photonic band gaps were observed at 0.17 THz and 0.23 THz along the Γ-M direction for both the TM and TE polarized incident beam for the PC structures with lattice constant of 0.787 mm and 0.586 mm, respectively. The location and width of the bandgaps agree with theoretical calculation based on a block-iterative frequency-domain method for Maxwell's equations in a planewave basis. To the best of our knowledge, this is the first time a jet-based process has been used successfully to fabricate PC structures at these high frequencies. However, the ThermoJet® printer as well as other current available solid freeforming technologies lack the resolution to PC structures operating in the terahertz regime. To extend this technology to terahertz applications, such as terahertz lasers, waveguides, and imaging system, a 10-fold increase in machine resolution is required to produce finer structures. Engineering materials with lower electromagnetic absorption and higher dielectric constants at terahertz frequencies are also critical to developing THz photonic bandgap technology.
A detailed study of zinc oxide (ZnO) films prepared by filtered cathodic vacuum arc (FCVA) technique was carried out. To deposit the films, a pure zinc target was used and O2 was fed into the chamber. The electrical properties of both undoped and Al-doped ZnO films were studied. For preparing the Al-doped films, a Zn-Al alloy target with 5 wt % Al was used. The resistivity, Hall mobility and carrier concentration of the samples were measured. The lowest resistivity that can be achieved with undoped ZnO films was 3.4×10-3 Ωcm, and that for Al-doped films was 8×10-4 Ωcm. The carrier concentration was found to increase with Al doping.
Superhard and elastic carbon nitride films with hardness and elastic recovery of 47 GPa and 87.5%, respectively, were synthesized by using a double-bend filtered cathodic vacuum arc combined with radio-frequency nitrogen ion beam source. The bombardment of energetic nitrogen atom onto the growing film surface results in the high atomic ratio of N/C (0.4), which contributes to the high sp2 content and the formation of a five-membered ring structure in the carbon nitride film at room temperature. The buckling of the five-membered ring basal planes may facilitate cross-linking between the planes through sp3 coordinated carbon atoms. A rigid three-dimensional network is formed, which contributes to the high hardness and elastic recovery of the deposited films.
The results of the development and characterization of a new relaxor ceramic with nominal composition (x)Pb2(In,Nb)O6(1 − x)Pb(Mg1/3Nb2/3)O3 solid solution with x = 0.4 are reported. The structural characteristics, including the long-range and short-range order, forbidden reflections, and the existence of mixed ordering, were studied by transmission electron microscopy. The most prominent microstructural feature of this compound, which has composition variations in the micro- and nano-regions, was investigated. The presence of the pyrochlore phase and the complex arrangement of inclusions that originate from processing are illustrated. The electrical characteristics of the compound including pyroelectric, piezoelectric, electrostrictive and hysteresis properties are reported. Notable properties of the compound include a reduced hysteresis loop and nonlinear behavior at high field.
We have carried out experiments on dual-damascene Cu interconnects with different lengths. We find that at short lengths, similar to Al-based interconnects, the reliability of Cubased interconnects improves. Also like Al interconnects, some short Cu segments do not form voids that cause failure before back-stresses prevent the further growth of voids. However, unlike Al-based interconnects, there is no apparent deterministic current-density line-length product (jL) for which all lines are immortal. This is related to the absence of a conducting refractory-metal overlayer in Cu-technology that can shunt current around small voids. Also unlike Al, we find that at long lengths a sub-population of Cu lines is immortal. We propose that this is the result of rupture of the thin refractory metal liner at the base of the dual-damascene Cu vias. As a consequence of this complex behavior, median times to failure and lifetime variations are minimum at intermediate line lengths.
The electron emission switching property of the multilayer structures, which constitute of nitrogen doped tetrahedral amorphous carbon (n+-ta-C) film and intrinsic ta-C layer fabricated by the filtered cathodic vacuum arc (FCVA) technique has been investigated. Low voltage DC bias (9V) was applied between the top and bottom layers in conjunction with the conventional electric field applied between the cathode and anode. It has been demonstrated that by varying the low DC bias polarity, the on-set electric field for the electron emission can be varied by ∼ ±6 V/μm compared to the unbiased situation. A possible mechanism for the multilayer field emission and the switching property is proposed.
A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the selective diathermy technique as opposed to the ligation technique. One hundred and five patients had one tonsillar fossa haemostasis secured by unipolar diathermy and the opposite side by ligation technique. There was significantly less pharyngeal pain on the diathermy side in the first post-operative day. However, there was no significant difference between the two sides, both in pharyngeal discomfort and otalgia for the rest of the post-operative period. There was no difference in the incidence of haemorrhage between the two techniques.
A prospective study on the dynamics of tympanic membrane atelectasis during the treatment for glue ear was performed in a sample of 115 ears of 83 children aged between one and 11 years. The progression in the degree of pars tensa atelectasis was analysed in relation to six potentially relevant factors. Multivariate analysis showed that the factor with the most predictive value on the progression of the pars tensa retraction was the grade of atelectasis at initial detection (p<0.0001). The use of grommets did not have any significant influence on the outcome grade of atelectasis. There was an association between previous grommet insertion and localized retractions in the inferior segment of the pars tensa (P<0.0001). However, localized retractions in the postero-superior quadrant were not associated with previous grommet insertion (P<0.02). Although the hearing thresholds of atelectatic ears were significantly worse than normal ears especially at 4 kHz (p<0.006), the difference was less than 5 dB.
Cervical heterotopic salivary tissues are rare and are predominantly found in the anterior triangle of the neck especially at the anterior border of the sternocleidomastoid muscl. We report a case of pleomorphic adenoma arising in the left posterior triangle of the neck.
A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the electrodissection technique as opposed to the blunt dissection and ligation technique. One hundred and four patients, each serving as his or her own control, were randomized to have either the right or left tonsil removed by electrodissection. There was significantly less pharyngeal pain on the electrodissection side in the first postoperative day in adult patients. This, however, was transient as there was increased pharyngeal discomfort and otalgia, both in severity and duration, on the electrodissection side by the end of first week. There was no difference in the incidence of haemorrhage between the two techniques.