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Hepatitis E virus (HEV) is a major cause of acute jaundice in South Asia. Gaps in our understanding of transmission are driven by non-specific symptoms and scarcity of diagnostics, impeding rational control strategies. In this context, serological data can provide important proxy measures of infection. We enrolled a population-representative serological cohort of 2,337 individuals in Sitakunda, Bangladesh. We estimated the annual risks of HEV infection and seroreversion both using serostatus changes between paired serum samples collected 9 months apart, and by fitting catalytic models to the age-stratified cross-sectional seroprevalence. At baseline, 15% (95 CI: 14–17%) of people were seropositive, with seroprevalence highest in the relatively urban south. During the study, 27 individuals seroreverted (annual seroreversion risk: 15%, 95 CI: 10–21%), and 38 seroconverted (annual infection risk: 3%, 95CI: 2–5%). Relying on cross-sectional seroprevalence data alone, and ignoring seroreversion, underestimated the annual infection risk five-fold (0.6%, 95 CrI: 0.5–0.6%). When we accounted for the observed seroreversion in a reversible catalytic model, infection risk was more consistent with measured seroincidence. Our results quantify HEV infection risk in Sitakunda and highlight the importance of accounting for seroreversion when estimating infection incidence from cross-sectional seroprevalence data.
Adverse childhood experiences (ACEs) contribute to elevations in neuropsychiatric and neurocognitive symptoms in HIV+ adults. Emerging data suggest that exposures to threat-related and deprivation-related ACEs may have differential impacts on function, with threat exposure contributing to neuropsychiatric symptoms, and deprivation contributing to executive dysfunction. Yet, it remains unclear how specific types of ACEs impact neuropsychiatric and neurocognitive symptoms in HIV+ adults. Hence, the current study examined whether these two dimensions of adversity contribute differentially to neuropsychiatric symptoms and executive dysfunction in HIV+ adults.
Methods:
We included a sample of demographically matched HIV+ (N = 72) and HIV-negative (N = 85) adults. Standardized self-report measures assessed threat-related (interpersonal violence) and deprivation-related (poverty/neglect) ACEs, as well as neuropsychiatric symptoms (depression, anxiety, apathy). A brief battery of neuropsychological tests assessed executive functions.
Results:
Compared to HIV-negative participants, HIV+ participants reported significantly higher rates of threat exposure (51% vs. 67%, p = .04), while rates of deprivation did not differ significantly (8% vs. 13%, p = .38). In the HIV+ sample, threat exposure was associated with neuropsychiatric symptoms (p < .01) but not executive dysfunction (p = .75). By contrast, deprivation was associated with executive dysfunction, at a trend level (p = .09), but not with neuropsychiatric symptoms (p = .70).
Conclusions:
Our data suggest that, relative to HIV-negative samples, HIV+ samples experience higher rates of threat-related ACEs, which contribute to neuropsychiatric symptom elevations. Moreover, our preliminary findings suggest that different types of ACEs could be associated with different profiles of neuropsychiatric and neurocognitive difficulty in HIV+ adults, highlighting the importance of considering dimensions of adversity in future studies.
Children with exposure to coronavirus disease 2019 in recent times (asymptomatic or symptomatic infection) approaching congenital heart surgery programme are in increasing numbers. Understanding outcomes of such children will help risk-stratify and guide optimisation prior to congenital heart surgery.
Objective:
The objective of the present study was to determine whether convalescent coronavirus disease 2019 children undergoing congenital heart surgery have any worse mortality or post-operative outcomes.
Design:
Consecutive children undergoing congenital heart surgery from Oct 2020 to May 2021 were enrolled after testing for reverse transcription-polymerase chain reaction or rapid antigen test and immunoglobulin G antibody prior to surgery. Convalescent coronavirus disease 2019 was defined in any asymptomatic patient positive for immunoglobulin G antibodies and negative for reverse transcription-polymerase chain reaction or rapid antigen test anytime 6 weeks prior to surgery. Control patients were negative for any of the three tests. Mortality and post-operative outcomes were compared among the groups.
Results:
One thousand one hundred and twenty-nine consecutive congenital heart surgeries were stratified as convalescence and control. Coronavirus disease 2019 Convalescent (n = 349) and coronavirus disease 2019 control (n = 780) groups were comparable for all demographic and clinical factors except younger and smaller kids in control. Convalescent children had no higher mortality, ventilation duration, ICU and hospital stay, no higher support with extracorporeal membrane oxygenation, high flow nasal cannula, no higher need for re-intubations, re-admissions, and no higher infections as central line-associated bloodstream infection, sternal site infection, and ventilator-associated pneumonia on comparison with coronavirus disease 2019 control children.
Conclusions:
Convalescent coronavirus disease 2019 does not have any unfavourable outcomes as compared to coronavirus disease 2019 control children. Positive immunoglobulin G antibody screening prior to surgery is suggestive of convalescence and supports comparable outcomes on par with control peers.
To assess and compare the quality of life in HIV patients with and without depression.
Methodology:
100 HIV positive subjects were interviewed in a case control study. Subjects were interviewed by a psychiatrist to diagnose depression and HAM-D was used to rate the severity of depression. HAT-QOL was employed to assess Health related Quality of Life in these patients.
Results:
50 HIV patients were diagnosed to be depressed. 23% were mildly depressed, 19% were moderately depressed, 7% were severely depressed and 1% was very severely depressed. Mean QOL scores in depressed HIV patients were found to be significantly lower than that in non-depressed patients in all 9 dimensions.
Conclusion:
HIV itself impairs QOL in HIV patients. Depression further worsens the QOL in these patients. Diagnosing depression in this set of HIV patients is the first step towards improving their Quality of Life.
A substantial number of patients suffering from obsessive compulsive disorder (OCD) report a subjective distressing experience prior to the repetitive behavior, known as sensory phenomena(SP).
Objectives
Need to systematically evaluate SP and the clinical correlates in OCD.
Aims
Assess prevalence of SP and clinical correlates in OCD.
Methods
Subjects (n = 71) fulfilling the criteria for DSM IV-TR OCD were recruited consecutively from a specialty OCD clinic in Southern India and were assessed using the Yale brown obsessive and compulsive scale (YBOCS), dimensional Yale-Brown obsessive compulsive scale (D-YBOCS) and the University of São Paulo Sensory Phenomena Scale (USP-SPS).
Results
The prevalence of the SP was found to be 50.7%. Prevalence of SP is significantly greater in the patients with early age of onset (P = 0.47). In subtypes of SP, Tactile was 12.7%, “just right” for look was 26.8%, “just right” for sound was 9.9%, “just right” for feeling was 16.9%, feeling of incompleteness leading to repetitive behavior was 22.5%, “energy release” sensation leading to repetitive behavior was 4.2% and “urge only” leading to repetitive behavior was 11.3%. SP was found to have significant correlation with symmetry/ordering/arranging/counting dimension (P = 0.003). Significant positive correlation existed between SP severity and the severity of the compulsions (P = 0.02).
Conclusion
Considering its high prevalence in OCD, it might be useful to incorporate SP assessment during the routine clinical assessment of OCD. It might warrant a place in the phenomenological and nosological description of OCD. Additionally, the neurobiological correlates of SP need to be explored.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Similar to omega-3 eggs, chicken meat has great potential to become a functional food for humans. In India, chicken meat is preferred due to its perceived health benefits and affordability. The balance between omega 3 and 6 fatty acids is crucial for its usefulness in animals. At present commercial chicken meat has low omega-3 fatty acid content and higher omega-6 fatty acid content. Published research shows that it is possible to modify the lipid profile of commercial chickens by manipulating the broiler diet. The modern human diet is deficient in n-3 FAs, which has been linked to the increase in several degenerative diseases such as cardiovascular disease, diabetes, arthritis, cancer and mental illness. Therefore omega-3 chicken meat may be an effective means of increasing n-3 FA in the human diet. There are several problems associated with the commercial production of omega-3 chicken meat related to the choice of source of fatty acids in the feed, cost of production, consumer acceptability and stability of the chicken meat that need to be tackled. The present article briefly reviews the studies carried out in this respect, the possible impact of omega-3 chicken meat production on the poultry industry, and on human health.
This study investigated the personality traits of patients with allergic rhinitis. It also examined the association between personality type and the type of allergic rhinitis, and compared this with the general population.
Methods:
A descriptive observational pilot study was carried out on 50 consecutive cases of allergic rhinitis who presented to the allergy clinic between June and October 2010. These patients were compared with a control group comprising 50 individuals from the general population that had no symptoms of allergic rhinitis. Both groups completed the International Personality Disorder Examination questionnaire for the assessment of personality traits.
Results:
Persons falling into cluster C personality type showed a positive correlation with the type and severity of allergic rhinitis. The majority of control group individuals fell into cluster A. This indicated a correlation between allergic rhinitis and a dominant anxious trait compared with the control group.
Conclusion:
In psycho-allergological research, the potential relevance of personality factors in the maintenance and exacerbation of atopic symptoms is still a matter of debate. More attention should be paid to the psychological status of allergic rhinitis patients, and appropriate treatment should be provided to improve their symptoms and quality of life.
Polypropylene–clay (Cloisite Na+) composites with clay contents in weight percentage (wt%) ranging from 1 to 15% were characterized for crystallization mechanism and kinetics. Combination of differential scanning calorimetry, transmission electron microscopy (TEM), and polarized light microscopy was used to investigate the crystallization behavior. Different crystallization mechanisms were observed in the matrix with 1–5 wt% nanoclay compared to the matrix with 10 and 15 wt% of nanoclay additive. TEM micrographs revealed intercalated and flocculated morphology for all the concentrates. At lower wt%, well-dispersed clay platelets acted as antinucleating agent and reduced polymer chain mobility. At high wt%, nucleation rate overcomes the slow diffusion rate. In the case of samples with higher wt% of nanoclay additives, segregation and precipitation of clay was observed in the interspherulite region. On the basis of crystallization kinetics and morphology results, a schematic model of the nanocomposite formation is proposed.
Virtual bronchoscopy is a noninvasive technique which provides an intraluminal view of the tracheobronchial tree. This study aimed to evaluate this technique in comparison with rigid bronchoscopy, in paediatric patients with tracheobronchial foreign bodies undetected by plain chest radiography.
Methods:
Plain chest radiography was initially performed in 40 children with suspected foreign body aspiration. Computed tomography virtual bronchoscopy was performed in the 20 in whom chest radiography appeared normal. Virtual bronchoscopic images were obtained. All patients underwent rigid bronchoscopy performed by an otolaryngologist blinded to the computed tomography virtual bronchoscopy findings, within 24 hours. Virtual bronchoscopic findings were then compared with the results of rigid bronchoscopy.
Results:
In 12 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. In one case, a mucous plug was perceived as a foreign body on virtual bronchoscopy. In another case, a minute foreign body was missed on virtual bronchoscopy. The following parameters were calculated: sensitivity, 92.3 per cent; specificity, 85.7 per cent; validity, 90 per cent; positive likelihood ratio, 6.45; and negative likelihood ratio, 0.089.
Conclusion:
In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.
A theory is described for propagation of vortical waves across alternate rigid and compliant panels. The structure in the fluid side at the junction of panels is a highly vortical narrow viscous structure which is idealized as a wave driver. The wave driver is modelled as a ‘half source cum half sink’. The incoming wave terminates into this structure and the outgoing wave emanates from it. The model is described by half Fourier–Laplace transforms respectively for the upstream and downstream sides of the junction. The cases below cutoff and above cutoff frequencies are studied. The theory completely reproduces the direct numerical simulation results of Davies & Carpenter (J. Fluid Mech., vol. 335, 1997, p. 361). Particularly, the jumps across the junction in the kinetic energy integral, the vorticity integral and other related quantities as obtained in the work of Davies & Carpenter are completely reproduced. Also, some important new concepts emerge, notable amongst which is the concept of the pseudo group velocity.
Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, abscesses in soft tissue and various organs, or as septicaemia.
Case report:
We report a case of a 40-year-old, diabetic man who presented with a neck lump resulting from super-infection of a tuberculosis cavity with B pseudomallei. The patient was successfully managed by drainage along with meticulous excision of the capsule and prolonged antibiotic and anti-tubercular treatment.
Discussion:
Melioidosis may be confused diagnostically with tuberculosis, as both diseases are endemic in the same regions. Our patient was unfortunate to suffer from both endemic diseases simultaneously, perhaps representing the first such case in the world literature.
Conclusion:
Increased awareness of melioidosis is important as, although the organism is easy to culture, it may be dismissed as a contaminant.
In this paper the impact of post deposition annealing in various ambient on electrical properties of hafnium zirconate (HfxZr1-xO2) high-k dielectrics is reported. ALD HfxZr1-xO2 films are annealed in a nitrogen and/or oxygen ambient at 500°C to 1000°C. Devices annealed at 500°C in N2 has lower equivalent oxide thickness (EOT) of 10Å without significant increase in gate leakage (Jg), threshold voltage (Vt) and only a slight decrease in transconductance (Gm) values compared to 500°C O2 annealed devices. Furthermore, the impact of annealing HfxZr1-xO2 films in a reducing ambient (NH3) is studied. Optimized NH3 anneal on HfxZr1-xO2 results in lower CET, improved PBTI, low sub-threshold swing values, comparable high-field Gm with only a minor degradation in peak Gm compared to control HfxZr1-xO2. Finally, the impact of laser annealing vs. RTP annealed HfxZr1-xO2 films are reported. Laser annealing helped further stabilize tetragonal phase of HfxZr1-xO2 without inducing void formation. Good devices with low leakage, low EOT and high mobility are obtained for laser annealed HfxZr1-xO2.
This study aimed to compare outcomes for mastoidotympanoplasty and for tympanoplasty alone in cases of quiescent, tubotympanic, chronic, suppurative otitis media.
Study design:
Single-blinded, randomised, controlled study within a tertiary referral hospital.
Methods:
Sixty-eight cases were randomly allocated into two groups. In group one, 35 ears underwent type one tympanoplasty along with cortical mastoidectomy. In group two, 33 ears underwent type one tympanoplasty alone. Outcome measures were as follows: perforation closure and graft uptake, hearing improvement, disease eradication, and post-operative complications.
Results:
There were no statistically significant differences in hearing improvement, tympanic perforation closure, graft uptake or disease eradication, comparing the two groups at three and six months post-operatively.
Conclusion:
Mastoidotympanoplasty was not found to be superior to tympanoplasty alone over a short term follow-up period. Hence, it may not be necessary to undertake routine mastoid exploration at this stage of disease.
The control of several infectious diseases of animals by vaccination is perhaps the most outstanding accomplishment of veterinary medicine in the last century. Even the eradication of some pathogens is in sight, at least in some parts of the world. However, infectious diseases continue to cost millions of dollars to the livestock industry. One of the reasons for the failure to control certain pathogens is the limited emphasis placed on cell-mediated immunity (CMI) in the design of vaccines against these pathogens. Traditionally, vaccine-induced immunity has been studied in relation to antibody-mediated protection. More recent studies, however, have focused on understanding CMI and developing means of inducing CMI. This review focuses on recent advances made in the study of CMI in general and of cytotoxic T lymphocytes in particular. Parallels from studies in human and mouse immunology are drawn in order to point out implications to bovine immunology, specifically for immunity against bovine herpesvirus 1.
The assessment of the thermal stability across HfO2/Si and HfO2/SiO2 interfaces has been difficult due to lack of thermodynamic data. In this paper, we present the results of thermodynamic calculations intended to fill this gap. A thermodynamic model was developed by assuming that HfSiO4 is an ideal solution of HfO2 and SiO2 to a first order approximation. The theoretical results predict that the HfO2/Si interface is thermodynamically stable up to 1100°C, while the HfO2/SiO2 interface is thermodynamically unstable even at room temperature. Our experimental results from TEM and XPS analysis are consistent with these modeling predictions.
We present experimental results regarding the thermodynamic stability of the high-k dielectrics ZrO2 and HfO2 in contact with Si and SiO2. The HfO2/Si interface is found to be stable with respect to formation of silicides whereas the ZrO2/Si interface is not. The metal oxide/SiO2 interface is marginally unstable with respect to formation of silicates. Cross-sectional transmission electron micrographs expose formation of nodules, identified as silicides, across the polysilicon/ZrO2/Si interfaces but not for the interfaces with HfO2. For both ZrO2 and HfO2, the X-ray photoemission spectra illustrate formation of silicate-like compounds in the MO2/SiO2 interface.
In this study, we investigate the diffusion of mobile ions through thin PSG or SiN layers using secondary ion mass spectrometry (SIMS). The diffusivity of Na through either layer is about 100,000X slower than through SiO2. Hence, thin layers of these materials are effective barriers for short anneals at 400°C. However, there is significant diffusion of both Na and K through these layers at 550°C. This suggests that improved cleans will be required to remove mobile ion contamination after interconnect processes.