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We describe the baseline characteristics and complications of individuals with influenza in the US FDA’s Sentinel System by antiviral treatment timing.
Retrospective cohort design.
Individuals aged ≥6 months with outpatient diagnoses of influenza in June 2014–July 2017, 3 influenza seasons.
We identified the comorbidities, vaccination history, influenza testing, and outpatient antiviral dispensings of individuals with influenza using administrative claims data from 13 data partners including the Centers for Medicare and Medicaid Services, integrated delivery systems, and commercial health plans. We assessed complications within 30 days: hospitalization, oxygen use, mechanical ventilation, critical care, ECMO, and death.
There were 1,090,333 influenza diagnoses in 2014–2015; 1,005,240 in 2016–2017; and 578,548 in 2017–2018. Between 49% and 55% of patients were dispensed outpatient treatment within 5 days. In all periods >80% of treated individuals received treatment on the day of diagnosis. Those treated on days 1–5 after diagnosis had higher prevalences of diabetes, chronic obstructive pulmonary disease, asthma, and obesity compared to those treated on the day of diagnosis or not treated at all. They also had higher rates of hospitalization, oxygen use, and critical care. In 2014–2015, among those aged ≥65 years, the rates of hospitalization were 45 per 1,000 diagnoses among those treated on day 0; 74 per 1,000 among those treated on days 1–5; and 50 per 1,000 among those who were untreated.
In a large, national analysis, approximately half of people diagnosed with influenza in the outpatient setting were treated with antiviral medications. Delays in outpatient dispensed treatment were associated with higher prevalence of comorbidities and higher rates of complication.
Frowning expresses negative emotions like anger, fear, and sadness. According to the facial feedback hypothesis, suppression of frowning will also diminish the corresponding negative emotions. Hence, mood improvement has been observed in patients who underwent treatment of glabellar frown lines with botulinum neurotoxin. This observation suggests the possibility that the intervention may be employed for the management of psychiatric disorders associated with negative emotions. Preliminary data from an open case series indicate that the intervention might improve the symptoms of depression.
Aims & objectives
To test whether an onabotulinumtoxinA injection into the glabellar region is benefical as an adjunctive treatment of major depression within a clinical trial.
We used a randomized, double-blinded, placebo-controlled study design (n = 30; ClinicalTrials.gov, number, NCT00934687).
We show that a single onabotulinumtoxinA treatment shortly leads to a strong and sustained improvement in partly chronic major depression that did not respond sufficiently to previous treatment. As for the primary end-point, Hamilton Depression Rating Scale (HAM-D17) six weeks after treatment compared to baseline, scores of onabotulinumtoxinA recipients showed 37.9% (8.34 points) more improvement than those of placebo-treated participants (F = 12.30, p = 0.002, η2 = 0.31, d = 1.28).
Our findings support the concept that the facial musculature not only expresses, but also regulates, mood states. As it stands, treatment of glabellar frown lines with botulinum neurotoxin can be considered for depressed patients with the objective of inducing mood-lifting effects.
In Denmark, medical students can apply for an optional, one-year, pre-graduate research programme. The programme has existed for 25 years. However, little is known about the main quantitative outcomes; namely scientific publications and continuation to a PhD.-programme. Also, little is known about the distribution of students between the medical specialties, including psychiatry.
We included all medical students enrolled in the pre-graduate research programme (n=687) from 2003-2012 at Aarhus University, Denmark. We made a systematic literature search on the publications of a sub-group of the students (n=227). Students were characterized in terms of age, sex, and years of medical school completed at the time of embarking the programme. Students affiliated with psychiatric departments (n=12) were characterized and compared with their peers.
All together the 227 students published 224 papers. Of these, 90% were original articles and 43% had a student as first author. Fifty-two percent published ≥1 papers. Twelve out of 687 students (2%) were enrolled at a psychiatric department. Of these, 1 student published 1 paper as second author and none continued in a PhD. Overall, publication was associated with (i) fast completion of the programme, (ii) having a male main supervisor and (iii) continuing to a PhD.
Scientific publishing and PhD.-recruitment was associated with fast completion and early enrolment in the pre-graduate research programme. A relatively low proportion of students were affiliated with psychiatric departments.
To examine the quality of life (QOL) of parents of children with a specific mental disorder (any age).
Relevant articles were searched using different databases. Articles were included that compared the QOL of parents with mentally-ill children to parents of healthy controls or norm values or provided the required data for this comparison. A meta-analysis was conducted to obtain an overall mean effect size estimate. Additional analyses were performed to assess publication bias and moderation.
Twenty-six out of 10 548 articles met the pre-defined inclusion criteria. Most of these studies focused on attention-deficit/hyperactivity disorder or autism spectrum disorder, used clinical samples that mainly included males and young children and studied the QOL of mothers. The meta-analysis revealed that parents of mentally-ill children are experiencing a clinically relevant reduction in their QOL relative to parents of healthy children and norm values (g = −0.66).
The compromised QOL of parents of mentally-ill children needs to be considered and addressed by health professionals who are in contact with them. The paper provides insights into existing research gaps and suggests improvements for subsequent work.
Sufficient vitamin D status during infancy is important for child health and development. Several initiatives for improving vitamin D status among immigrant children have been implemented in Norway. The present study aimed to evaluate the vitamin D status and its determinants in children of immigrant background in Oslo.
Child health clinics in Oslo.
Healthy children with immigrant background (n 102) aged 9–16 months were recruited at the routine one-year check-up from two child health clinics with high proportions of immigrant clients. Blood samples were collected using the dried blood spot technique and analysed for serum 25-hydroxyvitamin D (s-25(OH)D) concentration using LC–MS/MS.
Mean s-25(OH)D was 52·3 (sd 16·7) nmol/l, with only three children below 25 nmol/l and none below 12·5 nmol/l. There was no significant gender, ethnic or seasonal variation in s-25(OH)D. However, compared with breast-fed children, s-25(OH)D concentration was significantly higher among children who were about 1 year of age and not breast-fed. About 38 % of the children were anaemic, but there was no significant correlation between s-25(OH)D and Hb (Pearson correlation, r=0·1, P=0·33).
Few children in the study had vitamin D deficiency, but about 47 % of the children in the study population were under the recommended s-25(OH)D sufficiency level of ≥50 nmol/l.
In November 2009, we initiated a multistate investigation of Salmonella Montevideo infections with pulsed-field gel electrophoresis pattern JIXX01.0011. We identified 272 cases in 44 states with illness onset dates ranging from 1 July 2009 to 14 April 2010. To help generate hypotheses, warehouse store membership card information was collected to identify products consumed by cases. These records identified 19 ill persons who purchased company A salami products before onset of illness. A case-control study was conducted. Ready-to-eat salami consumption was significantly associated with illness (matched odds ratio 8·5, 95% confidence interval 2·1–75·9). The outbreak strain was isolated from company A salami products from an environmental sample from one manufacturing plant, and sealed containers of black and red pepper at the facility. This outbreak illustrates the importance of using membership card information to assist in identifying suspect vehicles, the potential for spices to contaminate ready-to-eat products, and preventing raw ingredient contamination of these products.
The influence of the type of alumina used as catalyst support on the evolution, activity, and lifetime of the catalyst during water-assisted CVD growth (or ‘supergrowth') of single-walled carbon nanotube (SWNT) carpets has been studied. The catalyst consisted of a thin Fe film supported on alumina films deposited by different methods: atomic layer deposition (ALD), e-beam, and magnetron sputtering. In order to fully understand the influence of the type of alumina on SWNT carpet growth, crystalline alumina (c-cut sapphire) and annealed alumina deposited by e-beam were also used as catalyst supports. The activity and lifetime of Fe catalyst during SWNT carpet growth showed a strong dependence on the type of alumina used as support. Fe supported on sputtered alumina (sputtered/Fe) showed the highest catalytic activity and lifetime, which was closely followed by e-beam/Fe while Fe supported on sapphire (sapphire/Fe) showed the least catalytic activity and lifetime. AFM, XPS depth profile, variable angle spectroscopic ellipsometry (VASE) studies revealed that the catalyst evolution and the porosity of the different alumina supports correlate with the lifetime and activity of the catalysts.
An epidemiological investigation was conducted to identify risk factors related to hygiene and husbandry practices which determine the introduction of Campylobacter spp. into broiler chicken flocks. All 176 broiler farms in an area in southeastern Norway participated in the study. Each farm was represented by one flock selected at random during a one-year period. The flocks were examined for Campylobacter colonization at slaughter, and the flock managers were sub-sequently interviewed about hygiene and husbandry practices. Campylobacter spp. were recovered from 32 (18%) of the flocks. The proportion of colonized flocks varied geographically and seasonally with a peak in the autumn. The following variables were found to be independently associated with an increased risk of Campylobacter colonization using logistic regression analysis: (i) feeding the broilers undisinfected water (odds ratio (OR) = 3·42, P = 0·045), (ii) tending other poultry prior to entering the broiler house (OR = 6·43, P = 0·007), (iii) tending pigs before entering the house (OR = 4·86, P = 0·037), (iv) geographic region (Hedmark versus Østfold county) (OR = 2·91), P = 0·023, (v) season (autumn versus other seasons) (OR = 3·43, P = 0·008). Presence of rats on the farm was associated with an increased risk, but this factor did not reach statistical significance (OR = 3·96, P = 0·083). Preventive measures should include dis-infection of drinking water and strict hygienic routines when the farm workers enter the rearing room. The results indicated that disinfection of drinking water is the preventive measure most likely to have the greatest impact on the prevalence of Campylobacter among broiler chicken flocks in the study area (population attributable fraction = 0·53).
EURECA (European Underground Rare Event Calorimeter Array) is an
astro-particle physics facility aiming to directly detect galactic dark
matter. The Laboratoire Souterrain de Modane has been selected as host
laboratory. The EURECA collaboration unites CRESST, EDELWEISS and the
Spanish-French experiment ROSEBUD, thus concentrating and focussing effort
on cryogenic detector research in Europe into a single facility. EURECA will
use a target mass of up to one ton, enough to explore WIMP – nucleon scalar
scattering cross sections in the region of 10-9 – 10-10 picobarn.
A major advantage of EURECA is the planned use of more than just one target
material (multi target experiment for WIMP identification).
In the nip or substrate configuration thin film silicon solar cells, the choice of front TCO contact is critical because there is a trade off between its transparency which influences the current in the solar cell and its conductivity which influences the series resistance. Here, we investigate the optical behavior of two different TCO front contacts, either a 70 nm thick, nominally flat ITO or a 2 μm thick rough LPCVD ZnO. The back contact consists of LP-CVD ZnO with random texture. First we investigate the influence of the rough and flat front TCOs in μc-Si:H and a-Si:H solar cells. With the back contact geometries used in this work, the antireflection properties of ITO are effective at providing as much light trapping as the rough LP-CVD ZnO. In the second part, we demonstrate that total of 25 to 26 mA/cm2is achievable in nip micromorph tandem cells and show short circuit current up to 11.7 mA/cm2 using an SIO based intermediate reflector.
For thin film silicon solar cells it is vital to increase the optical path of light in the absorber because this allows for thinner cells with better stability and higher production throughput. We discuss the effect of periodically textured interfaces for the case of thin film silicon solar cells in n-i-p configuration using embossed plastic substrate which allows us studying the effect of a wide range of random or periodic textures. Due to the moderate thickness of the individual layers the texture is carried into each interface with a high degree of conformity even for the front contact which is the last layer. Solar cells on periodic structures show excellent performance; in a microcrystalline cell on a simple sinusoidal grating we achieved a gain in current density of 30%. Furthermore, the periodicity serves as a useful tool for the study of light management because the underlying phenomena like diffraction or grating coupling to plasma excitations of the metallic back reflector are governed by a relatively low number of well defined parameters like the periodicity and the amplitude of the grating.
We present the adaptive optics assisted, near-infrared VLTI instrument GRAVITY for precision narrow-angle astrometry and interferometric phase referenced imaging of faint objects. With its two fibers per telescope beam, its internal wavefront sensors and fringe tracker, and a novel metrology concept, GRAVITY will not only push the sensitivity far beyond what is offered today, but will also advance the astrometric accuracy for UTs to 10 μas. GRAVITY is designed to work with four telescopes, thus providing phase referenced imaging and astrometry for 6 baselines simultaneously. Its unique capabilities and sensitivity will open a new window for the observation of a wide range of objects, and — amongst others — will allow the study of motion within a few times the event horizon size of the Galactic Center black hole.
Carbon nanotubes (CNTs) are of great interest because of several unsurpassable physical (mechanical, electrical, thermal, and chemical) properties. Especially their large elastic modulus and breaking strength make them highly attractive for their use as reinforced agents in forming a new class of multifunctional advanced materials - onanocomposites, in addition to high conductivity (either in semiconducting or metallic regimes) achieved through lower percolation thresholds for several electronic applications. Among the known conducting polymers, polyaniline (PANI) has a high potential due to its ease of synthesis, excellent environmental, and thermal stability and reversible control of its electrical/electronic properties. In this work, PANI-single-/multiwalled NTs composites films containing different nanotube content of both kinds were synthesized by spin-cast preceded by ultrasonic mixing of the constituents. They were characterized using complementary techniques including scanning electron microscopy, X-ray diffraction, infrared and Raman spectroscopy, and conductivity revealing their microscopic structure and physical properties thus helping in establishing process-structure-property correlations. The present work will discuss some of these findings in terms of a) self-alignment of nanotubes in conducting polymer b) their optical and electrical properties, and c) their design with a view to electronic and sensor applications, all ascribed due to long range π-π interaction between the constituents.
Electron spin resonance investigations on the angular dependence of carbon nanotubes are reported. It is proved that the resonance line is a convolution of three lines one due to electron delocalized over carbon nanotubes, the second assigned either to amorphous carbon or to conducting electrons in interaction with metallic impurities, and the last one originating from catalyst residues.
Progressive switching of grains in ferroelectric materials leads to internal stresses, which may give rise to degradation of the material or even fracture. Here we propose a two-dimensional multigrain model for ferroelectric polycrystal. The numerical computations employ the nonlinear micromechanics model of Huber et al.  for each grain. Results for the macroscopic response, butterfly and hysteresis loops, as well as internal stress and electric field distributions are presented.
Cu(In, Ga)Se2 (CIGS) layers were grown with different vacuum evaporation recipes and the effects of sodium on the grain growth were investigated by scanning electron microscopy. A reduced grain size mainly in the lower part of films grown with the 3-stage process was observed when Na was available during growth. The growth kinetics were found to be influenced during the second stage of the process. In contrast, no clear change in grain size could be observed for CIGS layers grown with constant evaporation rates, with a bi-layer and with an ’extreme’ bi-layer process. A mechanism for the action of Na is proposed, which is based on the assumption that Na passivates CIGS grain boundaries and that this results in a surfactant effect. The mechanism explains the different influences of Na on CIGS growth for different evaporation recipes, the occurrence of reduced grain size in the 3-stage process and the surface smoothing effect observed mainly for CIGS grown with the bi-layer process.
In-diffusion of Na after CIGS growth is shown to be an alternative Na incorporation method that does not reduce the CIGS grain size. A conversion efficiency improvement from 10.4% to 14.2% was achieved due to the post-deposition treatment on CIGS absorbers grown without Na at a maximum substrate temperature of 450°C.
Neat Fibers of HiPco single wall carbon nanotubes extruded from strong acid suspensions exhibit preferred orientation along fiber axes. We characterize the extrusion-induced alignment using x-ray fiber diagrams and polarized Raman scattering, using a model which allows for some fraction of the sample to remain completely unaligned. We show that both x-ray and Raman data are required for a complete texture analysis of SWNT fibers.
No controlled trial of treatment of generalised social phobia has been conducted in general practice.
To examine the efficacy of sertraline or exposure therapy, administered alone or in combination in this setting.
Study was of a randomised, double-blind design. Patients (n=387) received sertraline 50–150 mg or placebo for 24 weeks. Patients were additionally randomised to exposure therapy or general medical care.
Sertraline-treated patients were significantly more improved than non-sertraline-treated patients (χ2=12.53, P<0.001; odds ratio=0.534; 95% CI 0.347–0.835). No significant difference was observed between exposure— and non-exposure-treated patients (χ2=2.18, P=0.140; odds ratio=0.732; 95% CI 0.475–1.134). In the pairwise comparisons, combined sertraline and exposure (χ2=12.32; P<0.001) and sertraline (χ2=10.13; P=0.002) were significantly superior to placebo.
Sertraline is an effective treatment for generalised social phobia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary care.
Low substrate temperatures have to be used for polymer substrates. Therefore, using soda- lime glass (SLG) substrates with and without an alkali barrier (Al2O3), a three-step CIGS coevaporation process for a substrate temperature of 450 °C has been developed and compared to film deposition with constant evaporation rates. The three-step process was found to enhance grain nucleation. An efficiency of 14.0 % has been achieved with this process for solar cells on SLG. Since polymers in general do not contain Na, a way of Na addition to the absorber is needed. It is shown that NaF coevaporation can be used to control the Na content in CIGS. Also incorporation of Na in CIGS by diffusion from a NaCl layer through a polyimide is demonstrated. With such SLG/NaCl/polyimide structures flexible solar cells can be obtained using a lift-off process. A cell efficiency of 11.6 % (0.99 cm2 area) has been achieved.