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Clinical high-risk for psychosis (CHR-P) states exhibit diverse clinical presentations, prompting a shift towards broader outcome assessments beyond psychosis manifestation. To elucidate more uniform clinical profiles and their trajectories, we investigated CHR-P profiles in a community sample.
Methods
Participants (N = 829; baseline age: 16–40 years) comprised individuals from a Swiss community sample who were followed up over roughly 3 years. latent class analysis was applied to CHR-P symptom data at baseline and follow-up, and classes were examined for demographic and clinical differences, as well as stability over time.
Results
Similar three-class solutions were yielded for both time points. Class 1 was mainly characterized by subtle, subjectively experienced disturbances in mental processes, including thinking, speech and perception (basic symptoms [BSs]). Class 2 was characterized by subthreshold positive psychotic symptoms (i.e., mild delusions or hallucinations) indicative of an ultra-high risk for psychosis. Class 3, the largest group (comprising over 90% of participants), exhibited the lowest probability of experiencing any psychosis-related symptoms (CHR-P symptoms). Classes 1 and 2 included more participants with functional impairment and psychiatric morbidity. Class 3 participants had a low probability of having functional deficits or mental disorders at both time points, suggesting that Class 3 was the healthiest group and that their mental health and functioning remained stable throughout the study period. While 91% of Baseline Class 3 participants remained in their class over time, most Baseline Classes 1 (74%) and Class 2 (88%) participants moved to Follow-up Class 3.
Conclusions
Despite some temporal fluctuations, CHR-P symptoms within community samples cluster into distinct subgroups, reflecting varying levels of symptom severity and risk profiles. This clustering highlights the largely distinct nature of BSs and attenuated positive symptoms within the community. The association of Classes 1 and 2 with Axis-I disorders and functional deficits emphasizes the clinical significance of CHR-P symptoms. These findings highlight the need for personalized preventive measures targeting specific risk profiles in community-based populations.
The Kessler Psychological Distress Scales (K10 and K6) are used as screening tools to assess psychological distress and are the first-line assessment of need for help in the Headspace services.
Objectives
Thus, we studied the psychometric properties of their German versions in a Swiss community sample to evaluate their potential usefulness to screen for mental disorders or relevant mental problems in low threshold transdiagnostic German-speaking services.
Methods
The sample consisted of 829 citizens of the Swiss canton Bern of age 19-43 years. K10/K6 were validated against Mini-International Neuropsychiatric Interview (M.I.N.I.) diagnoses, questionnaires about health status and quality of life. Receiver Operating Characteristic (ROC) curve analyses were used to test for general discriminative ability and to select optimal cut-offs of the K10 and K6 for non-psychotic full-blown and subthreshold mental disorders.
Results
Cronbach’s alphas were 0.81 (K10) and 0.70 (K6). ROC analyses indicated much lower optimal thresholds than earlier suggested; 10 for K10 and 6 for K6. At these thresholds, against M.I.N.I. diagnoses, Cohen’s Kappa (<=0.173) and correspondence rates (<=58.14%) were insufficient throughout. Values were higher at the earlier suggested threshold, yet, at the cost of sensitivity that was below 0.5 in all but three, and below 0.3 in all but six cases.
Conclusions
For the lack of sufficient validity and sensitivity, respectively, our findings suggest that both K10 and K6 would only be of limited use in a low-threshold transdiagnostic mental health service – comparable to Headspace – for young adults in Switzerland and likely other German-speaking countries.
The upper Bartonian–Priabonian shallow-marine deposits in the Biga Peninsula (NW Turkey) contain some hyaline larger benthic foraminifers (LBF) with a test architecture similar to ‘orbitoidiform’ foraminifers, but displaying some distinctive and complex morphological features that are recorded here for the first time. These coarsely porous specimens are characterized by a flat, disc-shaped, fragile, and smooth test with a layer of equatorial chambers/chamberlets, surrounded by poorly developed lateral chamberlets, never forming a discrete layer on either side of the equatorial layer. The nepionic stage is very distinctive because the bilocular embryonic apparatus is followed by a semi-rounded, notably large auxiliary chamber with a characteristic wavy outline, and consecutive cyclical chambers. The cyclical chamber arrangement is later transformed into annular cycles with numerous, complex arcuate- to cup-shaped chamberlets, as observed in equatorial sections. Bigaella orbitoidiformis Özcan, Mitchell, Pignatti, Simmons, and Yücel, n. gen. n. sp., is established for these specimens, and placed within the family Eoannulariidae Ferràndez-Cañadell and Serra-Kiel, emended herein. The new genus occurs together with Caudriella Haman and Huddleston and Epiannularia Caudri (both originally established from the American bioprovince) and the genus Linderina Schlumberger (found both in the Tethys and the American bioprovinces), together with other typical Western Tethyan LBFs. A comparison of the new genus with the aforementioned taxa is given.
Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.
Methods:
Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
Results:
We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).
Conclusions:
PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.
Extracorporeal membrane oxygenation has been widely used after paediatric cardiac surgery due to increasing complex surgical repairs in neonates and infants having complex CHDs.
Materials and methods:
We reviewed retrospectively the medical records of all patients with CHD requiring corrective or palliative cardiac surgery at King Abdulaziz University Hospital that needed extracorporeal membrane oxygenation support between November 2015 and November 2018.
Results:
The extracorporeal membrane oxygenation population was 30 patients, which represented 4% of 746 children who had cardiac surgery during this period. The patients’ age range was from 1 day to 20.33 years, with a median age of 6.5 months. Median weight was 5 kg (range from 2 to 53 kg). Twenty patients were successfully decannulated (66.67%), and 12 patients (40%) were survived to hospital discharge. Patients with biventricular repair tended to have better survival rate compared with those with single ventricle palliation (55.55 versus 16.66%, p-value 0.058). During the first 24 hours of extracorporeal membrane oxygenation support, the flow rate was significantly reduced after 4 hours of extracorporeal membrane oxygenation connection in successfully decannulated patients.
Conclusion:
Survival to hospital discharge in patients requiring extracorporeal membrane oxygenation support after paediatric cardiac surgery was better in those who underwent biventricular repair than in those who had univentricular palliation. Capillary leak on extracorporeal membrane oxygenation could be a risk of mortality in patients after paediatric cardiac surgery.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Design
Outbreak investigation.
Setting
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Methods
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
Results
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
Conclusions
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
Demonstrating the equivalence of constructs is a key requirement for cross-cultural empirical research. The major purpose of this paper is to demonstrate how to assess measurement and functional equivalence or invariance using the 9-item, 3-factor Love of Money Scale (LOMS, a second-order factor model) and the 4-item, 1-factor Pay Level Satisfaction Scale (PLSS, a first-order factor model) across 29 samples in six continents (N = 5973). In step 1, we tested the configural, metric and scalar invariance of the LOMS and 17 samples achieved measurement invariance. In step 2, we applied the same procedures to the PLSS and nine samples achieved measurement invariance. Five samples (Brazil, China, South Africa, Spain and the USA) passed the measurement invariance criteria for both measures. In step 3, we found that for these two measures, common method variance was non-significant. In step 4, we tested the functional equivalence between the Love of Money Scale and Pay Level Satisfaction Scale. We achieved functional equivalence for these two scales in all five samples. The results of this study suggest the critical importance of evaluating and establishing measurement equivalence in cross-cultural studies. Suggestions for remedying measurement non-equivalence are offered.
Certain influenza outbreaks, including the 2009 influenza A(H1N1) pandemic, can predominantly affect school-age children. Therefore the use of school absenteeism data has been considered as a potential tool for providing early warning of increasing influenza activity in the community. This study retrospectively evaluates the usefulness of these data by comparing them with existing syndromic surveillance systems and laboratory data. Weekly mean percentages of absenteeism in 373 state schools (children aged 4–18 years) in Birmingham, UK, from September 2006 to September 2009, were compared with established syndromic surveillance systems including a telephone health helpline, a general practitioner sentinel network and laboratory data for influenza. Correlation coefficients were used to examine the relationship between each syndromic system. In June 2009, school absenteeism generally peaked concomitantly with the existing influenza surveillance systems in England. Weekly school absenteeism surveillance would not have detected pandemic influenza A(H1N1) earlier but daily absenteeism data and the development of baselines could improve the timeliness of the system.
Three rates of phosphate (0, 25 and 60 kg/ha P2O5) were applied for 7 years to phosphate-deficient grassland at Tel Hadya, north Syria. Liveweight, milk yield, wool production and supplementary feeding of Awassi sheep were monitored for six seasons (1985/86 to 1990/91). The experiment was grazed at low (0·8 sheep/ha per year) and high (1·7 sheep/ha per year) stocking rates from the second to the fourth season, while in the fifth to seventh seasons stocking rates were increased to 1·1 and 2·3 sheep/ha per year, respectively. The experimental site was typical of communally owned, degraded grasslands within the cereal zone of west Asia, where cropping is not possible because of shallow, stony soils and steep slopes.
The results showed that annual applications of phosphate, even at 25 kg/ha, improved pasture and sheep productivity. Liveweights were higher on fertilized plots in five out of six years, significantly so in the last three. Milk production was also higher on phosphate-treated plots, and the need for supplementary feeding was reduced, especially in the last three years, when rainfall was below average. The results suggest that stocking rates can be significantly increased by annual applications of small amounts of superphospate, and that doing so is profitable.
Use of the results depends on the presence of native legumes, the level of soil phosphate, and the ability of farmers to control grazing of these communally owned grasslands. A strategy to fulfil these criteria is suggested.
Measurements were made of the recovery and germination rates of seed of eight species of annual medic (Medicago spp.) and three of clover (Trifolium spp.) after ingestion by sheep. Recovery of medic seed was measured as the number of seeds collected from faeces after feeding, in addition to a basal diet, either (i) 200 g of pods at a single meal, or (ii) a quantity of pods estimated to contain 30000 seeds at a single meal or (iii) 200 g of pods daily for 21 days. Only the first method was applied to the clovers.
There were large differences (P < 0·001) in seed recovery between species, from < 2% to nearly 20% in medics, and up to 59% in T. campestre, which has low single-seed mass. Although there was a curvilinear decrease in seed recovery as single-seed mass increased (r2 = 0·80), the high recovery of M. rotata, a fairly large-seeded species, suggests that there are important differences between species, irrespective of seed size.
When 200 g of medic pods was offered to sheep at a single meal, mean seed recovery was slightly lower than when 200 g of medic pods was offered daily for 21 days. Seed recovery of medics was much higher (P < 0·001) when 30000 seeds were offered at one meal.
Germination rate before ingestion was 1·9–6·5% (P < 0·001) for hard-seeded medics and 2·7–9·7% (P < 0·001) for clovers with low single-seed mass; passage through the digestive tract increased (P < 0·001) germination rate in both medics and clovers.
In a field experiment sunflower plants were subjected to soil water stress (SWS) at — 15 bar during stages of slow elongation, rapid elongation, flowering and ripening.
Significant decreases in yield, 100-seed weight and oil content were found as a result of SWS. The treatment resulted too in less evapotranspiration and a better water economy for production of seeds and oil.
The iodine value but not the acid or saponification values of the oil was affected by SWS. No qualitative differences in oil composition occurred at different treatments. However, percentage of oleic acid was higher than that of linoleic acid; SWS resulted in a clear tendency for an increase in the ratio of oleic/linoleic acids especially for plants subjected to SWS during elongation stage.
Sunflower plants were more sensitive to SWS during the elongation and flowering stages than during ripening stage
Measurement of extremely new phenomena during the interaction of laser pulses with terawatt and higher power and picoseconds with plasmas arrived at drastically different anomalies in contrast to the usual observations if the laser pulses were very clean with a contrast ratio higher than 108. This was guaranteed by the suppression of prepulses during less than dozens of ps before the arrival of the main pulse resulting in the suppression of relativistic self-focusing. This anomaly was confirmed in many experimental details, and explained and numerically reproduced as a nonlinear force acceleration of skin layers generating quasi-neutral plasma blocks with ion current densities above 1011 A/cm2. This may support the requirement to produce a fast ignition deuterium tritium fusion at densities not much higher than the solid state by a single shot PW-ps laser pulse. With the aim to achieve separately studied ignition conditions, we are studying numerically how the necessary nonlinear force accelerated plasma blocks may reach the highest possible thickness by using optimized dielectric properties of the irradiated plasma. The use of double Rayleigh initial density profiles results in many wavelength thick low reflectivity directed plasma blocks of modest temperatures. Results of computations with the genuine two-fluid model are presented.
The introduction of forage or hay crops into fallow land represents a means of increasing feed supplies for small ruminants in north Africa and west Asia. Such fallows lie between zones planted with food crops and traditional grazing areas. Mixtures of vetch with barley, oats or triticale, and peas with barley, were cut at the 10% flowering, 100% flowering (100F) and full pod (FP) stages of the legume component. Effects of crop maturity, weather conditions and cutting height on yield, the chemical composition of the standing crop and re-growth were measured. Barley–vetch mixtures yielded 8147 kg dry matter ha−1 of standing crop at the FP stage in 1983 but only 2283 kg dry matter ha−1 in 1984 under drought conditions. Hay yields were 4377 and 1640 kg dry matter ha−1, respectively. The highest yielding mixture, grown in 1983, was oat–vetch which yielded 8670 kg dry matter ha−1 of standing crop and 4285 kg dry matter ha−1 of hay at the FP stage. Cutting at the 100F or FP stage maximized dry matter yield and minimized the risk of rainfall prolonging hay making. Rain caused slight damage to some hays cut at early stages of maturity. Voluntary intakes and digestibilities of field-cured hays were determined. The voluntary intakes of triticale–vetch hay at the FP stage and all barley–pea hays were low compared with other hays. Hays contained sufficient estimated metabolizable energy (ME) for use in sheep diets during pregnancy and middle or late lactation. ME values averaged 9.2 megajoules per kg dry matter in both 1983 and 1984.
Acute mastoiditis, a destructive bacterial infection of the mastoid bone and air cell system, is relatively uncommon today but remains a potentially serious condition. There is a lack of information in the literature regarding the long term otological problems that children may face following an episode of this condition.
Objectives:
Our aim was to examine the presentation, complications and hospital course in this patient population, and to ascertain whether these patients had long term otological problems.
Methods:
We retrospectively reviewed the medical records of all patients presenting with acute mastoiditis between January 1990 and December 2005. Patients' parents were contacted by telephone and questioned about further otological problems.
Results:
Twenty-nine patients were included in the study, and 27 of these patients' parents were contactable to complete the telephone questionnaire. Sixty-nine per cent of children had no previous history of acute otitis media prior to presentation. Forty-five per cent of patients had received oral antibiotics prior to presentation. Sixty-two per cent of patients developed complications, i.e. a subperiosteal abscess or failure to respond to medical therapy, resulting in the need for surgical intervention (in the form of incision and drainage of periosteal abscess, cortical mastoidectomy, or grommet insertion). Mean follow up of patients was eight years and one month; five (17 per cent) patients had been followed up for less than one year. Two (7 per cent) patients developed a further episode of mastoiditis within six weeks of initial presentation, both of whom required cortical mastoidectomy. Three (10 per cent) patients had further problems with recurrent acute otitis media, requiring tympanostomy tube insertion. One patient required a modified radical mastoidectomy for cholesteatoma (15 years later). Twenty-two patients (91 per cent) had been followed up for longer than one year; these patients had subjectively normal hearing and were asymptomatic at the time of study.
Conclusion:
The majority of patients who had suffered an episode of acute mastoiditis had no adverse long term otological sequelae.
In this paper we present the analytical description of two processes
dealing with the skin-layer ponderomotive acceleration method of fast ion
generation by a short laser pulse: ion density rippling in the underdense
plasma region and generation of ion beams by trapped electromagnetic field
in plasma. Some numerical examples of hydrodynamic simulation illustrating
these processes are shown. The effect of using the laser pulse consisting
of different frequency components on the ion density rippling and on
phenomena connected with trapped electromagnetic field is analyzed.
The measurement of very narrow high density plasma blocks of high ion
energy from targets irradiated with ps-TW laser pulses based on a new skin
depth interaction process is an ideal tool for application of ion
implantation in materials, especially of silicon, GaAs, or conducting
polymers, for micro-electronics as well as for low cost solar cells. A
further application is for ion sources in accelerators with most
specifications of many orders of magnitudes advances against classical ion
sources. We report on near band gap generation of defects by implantation
of ions as measured by optical absorption spectra. A further connection is
given for studying the particle beam transforming of n-type semiconductors
into p-type and vice versa as known from sub-threshold particle beams. The
advantage consists in the use of avoiding aggressive or rare chemical
materials when using the beam techniques for industrial applications.
Generation of high speed dense plasma blocks is well known from
hydrodynamic theory and computations (PIC) with experimental confirmation
by Badziak et al. (2005) since ps laser
pulses with power above TW are available. These blocks may be used for
fusion flame generation (thermonuclear propagation) in uncompressed solid
state deuterium and tritium for very high gain uncomplicated operation in
power stations. Hydrodynamic theory from computations from the end of
1970s to recent, genuine two fluid computations support the skin layer
accelerations (SLA), by nonlinear (ponderomotive) forces as measured now
in details under the uniquely selected conditions to suppress relativistic
self-focusing by high contrast ratio and to keep plane geometry
interaction. It is shown how the now available PW-ps laser pulses may
provide the very extreme conditions for generating the fusion flames in
solid state density DT.
In this paper the results of numerical computations of rippling
smoothing basing on the broad-band laser irradiation method for the laser
intensity range 1016−1017 W/cm2
and short-pulse (<10 ps) interaction with plasma are described.
Studies of single-event laser-target interaction for fusion reaction
schemes leading to volume ignition are discussed. Conditions were explored
where single-event ns-laser pulses give rise to temperatures sufficient
for volume ignition. Thus, ignition is possible, particularly if X-ray
reabsorption is sufficiently high. Unfortunately, this scheme requires
laser pulses with energies above 5 MJ and target densities of compressed
DT above 1000 g/cm−3. Both requirements are quite
demanding for near term systems. Nevertheless the present state technology
and the detailed knowledge about volume ignition at direct drive are a
basis. Systems as NIF or LMJ can well confirm these physics-clarified
conditions and the technology for large laser systems with sufficient
repetition rate and for a drastic reduction of the size and costs is
necessary and possible and by physics similar to the known reductions in
transistor development.