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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.
Bathing intensive care unit (ICU) patients with 2% chlorhexidine gluconate (CHG)–impregnated cloths decreases the risk of healthcare-associated bacteremia and multidrug-resistant organism transmission. Hospitals employ different methods of CHG bathing, and few studies have evaluated whether those methods yield comparable results.
To determine whether 3 different CHG skin cleansing methods yield similar residual CHG concentrations and bacterial densities on skin.
Prospective, randomized 2-center study with blinded assessment.
PARTICIPANTS AND SETTING
Healthcare personnel in surgical ICUs at 2 tertiary-care teaching hospitals in Chicago, Illinois, and Boston, Massachusetts, from July 2015 to January 2016.
Cleansing skin of one forearm with no-rinse 2% CHG-impregnated polyester cloth (method A) versus 4% CHG liquid cleansing with rinsing on the contralateral arm, applied with either non–antiseptic-impregnated cellulose/polyester cloth (method B) or cotton washcloth dampened with sterile water (method C).
In total, 63 participants (126 forearms) received method A on 1 forearm (n=63). On the contralateral forearm, 33 participants received method B and 30 participants received method C. Immediately and 6 hours after cleansing, method A yielded the highest residual CHG concentrations (2500 µg/mL and 1250 µg/mL, respectively) and lowest bacterial densities compared to methods B or C (P<.001).
In healthy volunteers, cleansing with 2% CHG-impregnated cloths yielded higher residual CHG concentrations and lower bacterial densities than cleansing with 4% CHG liquid applied with either of 2 different cloth types and followed by rinsing. The relevance of these differences to clinical outcomes remains to be determined.
Considered as a less hazardous piezoelectric material, potassium sodium niobate (KNN) has been in the fore of the search for replacement of lead (Pb) zirconate titanate for piezoelectrics applications. Here, we challenge the environmental credentials of KNN due to the presence of ~60 wt% Nb2O5, a substance much less toxic to humans than Pb oxide, but whose mining and extraction cause significant environmental damage.
Clarification of memory characteristics of tiny cell is important for practical use of resistive random access memory (ReRAM). However, limitation of semiconductor micro-fabrication technology hinders to obtain memory characteristics in tiny cell with an area comparable to the size of filaments. In this paper, we established a method to prepare a very small memory cell by fabricating ReRAM structure on the tip of a cantilever of atomic force microscope (AFM). We also established a method to avoid the overshoot of set current. As a result, reset current was successfully reduced enough to suppress serious damage to the cantilever. The effective cell size was estimated to be less than 10 nm in diameter due to electric field concentration at the tip of the cantilever, which was confirmed by an electric field simulator based on finite element method. We performed a unique experiment to verify the presence of oxygen pool in an anode, by utilizing removable bottom electrode structure. The result was not consistent with resistive switching models that require the anode to play a role as an oxygen reservoir.
A total of 245 patients with confirmed 2009 H1N1 influenza were admitted to the intensive-care units of 28 hospitals (South Korea). Their mean age was 55·3 years with 68·6% aged >50 years, and 54·7% male. Nine were obese and three were pregnant. One or more comorbidities were present in 83·7%, and nosocomial acquisition occurred in 14·3%. In total, 107 (43·7%) patients received corticosteroids and 66·1% required mechanical ventilation. Eighty (32·7%) patients died within 30 days after onset of symptoms and 99 (40·4%) within 90 days. Multivariate logistic regression analysis showed that the clinician's decision to prescribe corticosteroids, older age, Sequential Organ Failure Assessment score and nosocomial bacterial pneumonia were independent risk factors for 90-day mortality. In contrast with Western countries, critical illness in Korea in relation to 2009 H1N1 was most common in older patients with chronic comorbidities; nosocomial acquisition occurred occasionally but disease in obese or pregnant patients was uncommon.
This study was performed to determine the prevalence, distribution of specimen sources, and antimicrobial susceptibility of the Acinetobacter calcoaceticus–Acinetobacter baumannii (Acb) species complex in Singapore. One hundred and ninety-three non-replicate Acb species complex clinical isolates were collected from six hospitals over a 1-month period in 2006. Of these, 152 (78·7%) were identified as A. baumannii, 18 (9·3%) as ‘Acinetobacter pittii’ [genomic species (gen. sp.) 3], and 23 (11·9%) as ‘Acinetobacter nosocomialis’ (gen. sp. 13TU). Carbapenem resistance was highest in A. baumannii (72·4%), followed by A. pittii (38·9%), and A. nosocomialis (34·8%). Most carbapenem-resistant A. baumannii and A. nosocomialis possessed the blaOXA-23-like gene whereas carbapenem-resistant A. pittii possessed the blaOXA-58-like gene. Two imipenem-resistant strains (A. baumannii and A. pittii) had the blaIMP-like gene. Representatives of carbapenem-resistant A. baumannii were related to European clones I and II.
Surveillance for latent tuberculosis in high-risk groups such as healthcare workers is limited by the nonspecificity of the tuberculin skin test (TST) in BCG-vaccinated individuals. The Mycobacterium tuberculosis antigen-specific interferon-γ release assays (IGRAs) show promise for more accurate latent tuberculosis detection in such groups.
To compare the utility of an IGRA, the T-SPOT.TB assay, with that of the TST in healthcare workers with a high rate of BCG vaccination.
Two hundred seven medical students from 2 consecutive cohorts underwent the T-SPOT.TB test and the TST in their final year of study. Subjects with negative baseline test results underwent repeat testing after working for 1 year as junior physicians in Singapore's public hospitals.
The baseline TST result was an induration 10 mm or greater in diameter in 177 of the 205 students who returned to have their TST results evaluated (86.3%), while the baseline T-SPOT.TB assay result was positive in 9 (4.3%) of the students. Repeat T-SPOT.TB testing in 182 baseline-negative subjects showed conversion in 9 (4.9%). A repeat TST in 18 subjects with baseline-negative TST results did not reveal any TST result conversion.
The high rate of positive baseline TST results in our BCG-vaccinated healthcare workers renders the TST unsuitable as a surveillance tool in this tuberculosis risk group. Use of an IGRA has enabled the detection and treatment of latent tuberculosis in this group. Our T-SPOT.TB conversion rate highlights the need for greater tuberculosis awareness and improved infection control practices in our healthcare institutions.
Molecular techniques involving polymerase chain reaction (PCR) and sequencing provide a relatively simple and objective means of identifying microsporidia to species level. We modified previously described methods of DNA extraction and PCR conditions for identification of microsporidia from museum slides, clinical specimens and environmental samples and successfully identified Vittaforma corneae in 11 out of 13 cases of microsporidial infection from used trichrome-stained slides of corneal scrapings from HIV-negative patients with keratoconjunctivitis.
Rising elderly life expectancies imply the need to accumulate sufficient savings for retirement. This paper investigates the role of recent changes in the investment menu of the Singaporean Central Provident Fund (CPF) system. Our research explores the investment patterns of CPF participants and articulates their implications for policymakers. We find that most investors use their money for housing purchase and default the remainder to the CPF investment pool. The bulk of non-housing saving sits in bank accounts paying a low return. A fraction of workers does elect outside investment products, with high-income earners and males taking more risk than low-income earners and females. Since workers who default their money to the CPF fund receive a guaranteed 2.5% return on the Ordinary Account and 4% on the Special Account, hurdle rates for money market and equity funds are substantial. These high hurdle rates help explain why few CPF account holders invest outside the default government investment pool, though inertia probably explains why many employees let their funds sit in bank accounts earning low interest rates. More attention could be devoted to lowering fund expenses and commissions, including the myriad of fees, expenses, loads, and wrap charges; it might also be beneficial to streamline and rationalize the investment menu offered to participants.
The Kawasaki and Dobuyama bentonite deposits in northeastern Japan show contrasting properties even though they are only 5 km apart in a sequence of Neogene sedimentary and pyroclastic rocks. The Kawasaki deposit consists of stratiform bentonite layers up to >50 m thick, and its wall rocks are unaltered shallow marine sedimentary rocks. In contrast, the Dobuyama deposit consists of a funnel-shaped ore body 200 m across, and its wall rocks are hydrothermally altered terrestrial rhyolitic pyroclastic rocks. The Kawasaki and Dobuyama bentonites mainly consist of Na-Ca smectite and Ca smectite, respectively, with subordinate opal-CT, quartz and zeolite. The geological occurrences of the deposits and wall-rock properties suggest that the Kawasaki and Dobuyama deposits were probably formed by diagenesis and low-temperature hydrothermal alteration, respectively. The difference in exchangeable cation ratios of the smectite between the two deposits is attributable to the difference in their sedimentary environments and/or burial depth.
We investigated the effects of V/III flux ratios on the Curie temperature, TC, in Ga1−x Mnx As layers with various Mn mole fractions of x = 0.03 and 0.05. A 75 nm thick GaMnAs layer was grown at the temperature of 250 °C with various V/III flux ratios of 25∼34. The low temperature molecular beam epitaxy (LT-MBE) method for growth of GaMnAs layer caused the defects related by excess As and Mn interstitial, and these leaded the formation of deep level. We investigated that formation of deep level was established with various Mn mole fraction for V/III flux ratio 34. The changes of TC are observed by varying V/III flux ratio with a fixed Mn mole fraction. The TC in the sample grown with a lower V/III flux ratio of 25 is found to be higher comparing to that with higher V/III flux ratio of 34 at a fixed high Mn concentration (x = 0.05). Although the Mn concentration increases, the TC is not much changed when the V/III flux ratio is high of 34. The changes of TC with various V/III flux ratios are explained by the existence of low temperature grown defects, which are clarified by the deep level transient spectroscopy measurement. The prime species of defects are found to be AsGa and MnI etc.
With respect to the operation of a Phase-change Random Access Memory (PRAM or PcRAM), we studied the effect of the contact between the electrode metal and the chalcogenide glass, N2 doped Ge2Sb2Te5 in this report. We investigated a change of the resistance-programming current pulse (R-I) curve varying the contact size and the electrode material. Also we tested the surface oxidation of the electrode. We found that the programming current, the resistance of the programmed state (“RESET”) and the erased state (“SET”) were highly dependent on the above parameters. These results are presented and a more effective way to the high density PRAM will be proposed.
The objective of this research was to establish a new baseline process for obtaining ultra-thin silicon-oxide gate material in a prototype vertical furnace. Of particular concern was the optimization of a process sequence whereby unpatterned 150 mm diameter wafers ‘see’ the same processing steps prior to gate oxidation as patterned device wafers ‘see’. The figures-of-merit for evaluating process optimization include: i) full-wafer current-voltage (I-V) maps using Hg-gate capacitors; ii) the variation in the current or current density at a given bias voltage, extracted from an I-V map; iii) the variation in electrical oxide thickness that is extracted from full-wafer capacitance-voltage measurements using Hg-gate capacitors; and iv) the variation in optical oxide thickness that is extracted from full-wafer spectroscopic ellipsometry measurements. The results from this research demonstrate that: i) the addition of 1% O2 to the usual N2 gas during the ramp-up cycle in the vertical furnace is necessary to achieve acceptable across-the-wafer oxide-thickness uniformity as determined from both electrical and optical figures-of-merit; and ii) a full-wafer response surface of the current at a given bias voltage is a powerful finger print for process development when the question of variation in as-grown silicon-oxide thickness is at issue.
Ar+ ions with 1 keV energy were irradiated on aluminum nitride in an O2 environment and on aluminum oxide in a N2 environment. AlON on AlN and AlN on Al2O3 are formed by the Ar1 irradiation in O2 gas and N2 gas environments, respectively, and the formation of new surface layers is confirmed on the basis of Al2p near core levels and O1s, N1s core levels XPS depth profile analysis. Cu(1000 Å) films were deposited by ion-beam sputtering on Ar+ irradiated/unirradiated AlN surfaces, and the change of the adhesion strength was investigated by a scratch test. Cu films deposited on the irradiated AlN under an O2 environment showed higher bond strength than that on the unirradiated AlN. The improvement of bond strength of Cu films on the AlN surface resulted from the interface bonds between Cu and the surface layers. The bending strength of polycrystalline Al2O3 irradiated by Ar+ ions in N2 environment was also increased and the formation of nitride layer on the alumina was confirmed. A possible new surface layer formation mechanism on ceramics by the ion assisted reaction has been discussed in terms of surface analysis, chemical bond, and mechanical strength.
Ion irradiation on polytetrafluoroethylene (PTFE) has been carried out to improve adhesions to metals and to adhesive cements. Argon ions were irradiated on the polymer, by varying the amount of Ar+ from 1 × 1014 ions/cm2 to 1 × 1017 ions/cm2 at 1 keV, and 4 ml/min of oxygen gas flowed near the polymer surface during the ion irradiation. The wetting angle of water on the PTFE surface was changed from 100° to 70–150°, depending on the ion beam condition. The changes of the wetting angle and effects of Ar+ irradiation in oxygen environment were explained by the changes in surface morphology due to the ion beam irradiation onto PTFE, and formation of a hydrophilic group due to a reaction between the irradiated polymer chain and the blown oxygen. Strongly enhanced adhesion is explained by interlock mechanism, formation of electron acceptor groups on the modified PTFE, and interfacial chemical reactions between the irradiated surface and the deposited materials.
Ion assisted reaction (IAR), which was firstly presented in 1995 MRS Fall meeting, has been reviewed for the surface modifications of polymer and ceramics. The reaction is assisted by energetic ions from 0.5 to 1.5 keV, doses 1014 to 1017 ions/cm2, and blowing rate of oxygen 0 ∼ 8 ml/min. Hydrophilic surfaces of polymers (wetting angle < 20° and surface energy 60 ∼ 70 erg/cm2) have been accomplished by the reaction, and an improvement of wettability and an increment of the surface energy are mainly due to the polar force and hydrophilic functional groups such as C=O, (C=O)-O, C-O, etc., without surface damage. The IAR was also applied on aluminum nitride in an O2 environment and AMON on AIN is formed by the Ar+ irradiation. The improvement of bond strength of Cu films on the AIN surface resulted from the interface bonds between Cu and the surface layers. Comparisons between the conventional surface treatments and the IAR are described in terms of physical bombardment, surface damage, functional group, and chain mobility in polymer.
Copper films on Si(100) were prepared by partially ionized beam at 0 kV and 3 kV acceleration voltages in order to investigate effects of ion energy on electrical property with thickness. X-ray diffraction(XRD) pattern analysis was used to investigate crystallinity of the copper films, microstructure by Scanning electron microscope(SEM) and surface roughness by atomic force microscopy(AFM). The crystallinity of the copper films grown at the 3 kV was more (111) textured than that at the 0 kV. The copper films grown at the both conditions had nearly same grain size below a thickness of 1000 Å. The 1800 Å Cu film grown at the 3 kV was 3 times rough than that at the 0 kV. The resistivity of copper films increased due to surface and grain boundary scattering, and the change of resistivity was discussed in terms of surface roughness, grain size and film density assisted by average depositing energy.
Undoped tin oxide films were grown on Si substrates by a reactive ion-assisted deposition technique in which oxygen ions were irradiated on depositing Sn particles. In order to investigate the oxidation from SnO to SnO2, the effects of initial oxygen contents and heat treatment on the final crystalline structure of tin oxide films were thoroughly examined. Oxygen to Sn metal ratio (No/Nsn) of as-deposited films were controlled from 1.1 to 1.9 by varying the relative arrival ratio (F) of oxygen ion to Sn particle from 0.025 to 0.1. Heat treatment was carried out in two different ways; one was post vacuum-annealing at 400 ∼ 600°C and the other was in-situ annealing 400 ∼ 500°C. Crystalline structure of as-deposited tin oxide films at room temperature was amorphous. After post-annealing at 400°C, only SnO phase was found below No/Nsn= 1.6 in x-ray diffraction and crystalline structure of the films comprising higher oxygen contents still appeared to be amorphous. Even though the films still showed SnO phase until Γ50 after 500°C post-annealing, however, mixed structures of SnO, SnO2, and intermediate Sn2O3/Sn3O4 were observed for the films Γ75 and Γ100 with higher oxygen contents. At 600°C annealing, perfect SnO2 phase was attained for the films having No/Nsn=1.9. On the other hand, pure polycrystalline SnO2 films could be obtained by in-situ annealing at low temperature. The values of No/Nsn and the chemical shifts with the variation of oxidation were carefully determined by the comparison of Sn MNN and O KLL Auger transitions. Surface microstructure of deposited films was also analyzed using a scanning electron microscopy (SEM) and an atomic force microscope (AFM).