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Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV.
Methods
We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184).
Results
In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care.
Conclusion
The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.
White dwarfs are useful objects with which to study the local interstellar medium (ISM). High ionisation state absorption features that cannot be attributed to the photosphere or the ISM have been observed along the line-of-sight to a number of white dwarf stars. Suggested origins of these lines include ionisation from past supernovae, stellar winds, circumstellar disks, photoionisation from nearby hot stars or also from the white dwarf itself. In this study we consider the origin of these non-photospheric highly ionised lines in two stars towards a rarefied region of the galaxy known as the extended β CMa Tunnel. We present preliminary results from our analysis of the first of these two stars.
The expansion of genetic and genomic testing in clinical practice and research and the growing market for at home personal genome testing has led to increased awareness about the impact of this form of testing on insurance. Genetic or genomic information can be requested by providers of mutually rated insurance products, who may then use it when setting premiums or determining eligibility for cover under a particular product. Australian insurers are subject to relevant legislation and an industry standard that was updated in late 2016. In 2018, the Human Genetics Society of Australasia updated its position statement on genetic testing and life insurance to account for these changes and to increase the scope of the statement to include a wider scope of insurance products that are not rated according to community risk, such as life, critical care, and income protection products. Recommendations include that providers of professional education involving genetics should include ethical, legal, and social aspects of insurance discrimination in their curricula; that the Australian government take a more active role in regulating use of genetic information in personal insurance, including enacting a moratorium on use of genetic test results; that information obtained in the course of a research project be excluded; and that there is improved engagement between the insurance industry, regulators, and the genetics profession.
Shone’s syndrome is a complex consisting of mitral valve stenosis in addition to left ventricle outflow obstruction. There are a few studies evaluating the long-term outcomes in this population. We sought to determine the long-term outcomes in our paediatric population with Shone’s syndrome and the factors associated with left heart growth.
Methods
All patients diagnosed with Shone’s syndrome with biventricular circulation treated between 1978 and 2010 were reviewed. Baseline echocardiograms and data from catheterisations were also reviewed. Number of interventions (surgical+transcatheter), incidence of mitral valve replacement, and incidence of heart transplantation were tracked. Survival of the population and left heart structural growth were also reviewed.
Results
A total of 121 patients with Shone’s syndrome presented at a median age of 28 days (0–17.3 years) and were followed-up for 7.2 years (0.01–35.5 years). These patients underwent 258 interventions during the study period, and the presence of coarctation was associated with repeat left heart interventions. The 10-year, transplant-free survival was 86%. Presence of pulmonary hypertension was associated with mortality. Left heart structural growth was seen for mitral and aortic valve annuli and left ventricular end-diastolic dimension over time.
Conclusions
Shone’s syndrome patients undergo a number of left heart interventions. Coarctation of the aorta is associated with an increased likelihood for repeat interventions. Survival appears to be more favourable than expected. Significant left heart growth will occur in the population. Pulmonary hypertension is associated with an increased risk of mortality.
The industrial sector accounts for about 30% of the global final energy use and accounts for about 115 EJ of final energy use in 2005. Cement, iron and steel, chemicals, pulp and paper and aluminum are key energy intensive materials that account for more than half the global industrial use.
There is a shift in the primary materials production with developing countries accounting for the majority of the production capacity. China and India have high growth rates in the production of energy intensive materials like cement, fertilizers and steel (12–20%/yr). In different economies materials demand is seen to grow initially with income and then stabilize. For instance in industrialized countries consumption of steel seems to saturate at about 500 kg/ capita and 400–500 kg/capita for cement.
The aggregate energy intensities in the industrial sectors in different countries have shown steady declines – due to an improvement in energy efficiency and a change in the structure of the industrial output. As an example for the EU-27 the final energy use by industry has remained almost constant (13.4 EJ) at 1990 levels. Structural changes in the economies explain 30% of the reduction in energy intensity with the remaining due to energy efficiency improvements.
In different industrial sectors adopting the best achievable technology can result in a saving of 10–30% below the current average. An analysis of cost cutting measures for motors and steam systems in 2005 indicates energy savings potentials of 2.2 EJ for motors and 3.3 EJ for steam.
The interactions of fully stripped Argon-40 heavy ion beams with 140 MeV/nucleon with a series of increasingly polygonal carbon onions are investigated by high-resolution transmission electron microscopy and thermogravimetric analysis. The experimentally observed graphene layer linking is compared with expected results from the displacement and dislocation migration models. The results suggest that dislocation-driven mechanisms may play a significant role in graphene layer linking induced by heavy ion interactions with carbon onions.
The metal-catalyst-free growth of carbon nanotubes (CNTs) using chemical vapor deposition and the application in field-effect transistors (FETs) is presented. The CNT growth process used a 3-nm-thick Ge layer on SiO2 that was subsequently annealed to produce Ge nanoparticles. Raman measurements show the presence of radial breathing mode (RBM) peaks and the absence of the disorder induced D-band, indicating single walled CNTs (SWNTs) with a low defect density. The synthesized CNTs are used to fabricate CNTFETs and the best device has a state-of-the-art on/off current ratio of 3×108 and a steep sub-threshold slope of 110 mV/decade.
We report evidence for graphene layer rearrangements in heavy ion interactions with carbon onions at 140 MeV and 70 MeV per nucleon kinetic energies. Graphene layer rearrangements have been recently predicted in spherical and cylindrical multi-layer graphene systems. The implications of graphene layer rearrangement on the tribological performance of multi-layer nano-carbons in extreme environments are discussed.
Commission 36 covers all the physics of stellar atmospheres. The scientific activity in this large field has been very intense during the last triennium and led to the publication of a large number of papers which makes an exhaustive report practically not feasible. As a consequence we decided to keep the format of the preceding report: first a list of areas of current research, then web links for obtaining further information.
The identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.
Aims
To determine the value of two rating scales to measure fluctuating confusion.
Method
The agreement between the clinician-rated scale and the scale completed by a non-clinician was determined. Correlations between the two scales were calculated; variability in attention was calculated on a computerised cognitive assessment and variability in delta rhythm on an electroencephalogram (EEG).
Results
The Clinician Assessment of Fluctuation and the computerised cognitive assessment were completed for 155 patients (61 Alzheimer's disease, 37 dementia with Lewy bodies, 22 vascular dementia, 35 elderly controls). A subgroup (n=40) received a further evaluation using the One Day Fluctuation Assessment Scale and an EEG. The two scales correlated significantly with each other, and with the neuropsychological and electrophysiological measures of fluctuation.
Conclusions
Both scales are useful instruments for the clinical assessment of fluctuation in dementia.
Chemical analysis on a microscopic scale was performed on a TiN particle sample on silicon and on two patterned samples using a synchrotron source scanning photoemission microscope. For all the experiments, we exploit the ability, developed in our experimental system, to reach specific locations on the wafer and analyze the local chemical state.
The sensitivity to UV-B (290–320 nm) radiation of common phylloplane yeasts from two contrasting UV-B environments was compared in the laboratory using mixtures of white light (PAR: 400–700 nm) and UV-B radiation from artificial lamp sources. Sporidiobolus salmonicolor, Rhodotorula mucilaginosa and Cryptococcus sp., the dominant yeasts on leaves of tea (Camellia sinensis), were isolated in Sri Lanka (SL), while Sporidiobolus sp. and Bullera alba, dominant on faba bean (Vicia faba), were isolated in the U.K. Dose responses were determined separately for each yeast. UV-B reduced colony forming units (due to cell mortality or inactivation) and colony size (due to reduced multiplication) of all yeasts. The LD50 values and doses causing 50% reduction of cells per colony were higher for SL isolates than U.K. isolates. Results indicated that each yeast is somewhat vulnerable to UV-B doses representative of its natural habitat. The relative insensitivity of SL isolates was shown when SL and U.K. isolates were irradiated simultaneously with the same dose of UV-B. Of the two U.K. yeasts, B. alba was significantly more sensitive than Sporidiobolus sp. to UV-B. Except for R. mucilaginosa from SL, all yeasts demonstrated some photorepair in the presence of white light. White light provided relatively little protection for the U.K. isolate of Sporidiobolus sp. although it allowed increased colony size.
The spectral responses of Sporidiobolus sp. (U.K.) and of B. alba (U.K.) were broadly similar. Wavelengths longer than 320 nm had no measurable effect on colony forming units. However, colony survival was significantly reduced at 310 nm and all shorter wavebands. No colonies were counted at 290 nm or below.
Ozone (O3), ultra-violet (UV) radiation and climate change
The earth's atmosphere contains about 3 nl l-1 O3, that fraction being continuously turned over. Approximately 10% is dispersed in the troposphere, which extends 15 km above the ground, and 90% in the stratosphere, which extends up to 50 km. While man's activities are causing some increase in tropospheric O3, mainly around major urban areas, they are depleting stratospheric O3 on a global scale (Anon., 1993a,b). Depletion occurs because of the release of chlorine-containing compounds, such as chlorofluorocarbons and carbon tetrachloride, that promote O3 breakdown.
Solar radiation includes wavelengths as short as 200 nm but that below approximately 290 nm is absorbed in the atmosphere, mainly by O3. Since energy per quantum of radiation increases as wavelength decreases, O3 protects organisms from the most energy-rich, and potentially most damaging, wavelengths in solar radiation. The efficiency with which ozone absorbs UV decreases as wavelength increases, so progressive thinning of the O3 layer will allow shorter wavelengths to reach the earth's surface as well as allowing higher fluxes to be transmitted of the wavelengths already penetrating. It is significant that the cut-off wavelength is not constant but varies with season and time of day. For example, in Reading, England (51.5° N), the shortest detectable wavelength varied from 302 nm in January to 294 nm in July, and from 294 nm at noon to 300 nm at 17.00 hours in July (Anon., 1993b).
The early 1990's heralded the deployment of vastly improved space instruments in the ultraviolet (HST) and X-ray (ROSAT) bands, where thermal inhomogeneities in high-excitation chromospheres and coronae are seen in their most favorable light. The infrared spectrum provides a key complementary view of inhomogeneities, but only recently has begun to be seriously exploited for studies of the solar chromosphere and the outer atmospheres of other late-type stars.
The degree of thermal heterogeneity at the base of the solar chromosphere is substantially beyond that simulated in the best-available multi-component models; casting serious doubts on inferences drawn from them.