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The ability to precisely engineer nanostructures underpins a wide range of applications in areas such as electronics, optics, and biomedical sciences. Here we present a novel approach for the growth of nanoparticle assemblies that leverages the unique properties of superfluid helium. Unlike viscous solvents at or near room temperature, superfluid helium provides an unperturbed and cold environment in which weak van der Waals interactions between molecular templates and metal atoms become significant and can define the spatial arrangement of nanoparticles. To demonstrate this concept, diol and porphyrin-based molecules are employed as templates to grow gold nanoparticle assemblies in superfluid helium droplets. After soft-landing on a solid surface to remove the helium, transmission electron microscopy (TEM) imaging shows the growth of gold nanoparticles at specific binding sites within the molecular templates where the interaction between gold atoms and the molecular template is at its strongest.
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INTRODUCTION: Diagnosis of asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and interstitial lung disease (ILD) can be convoluted, and limited data exist on understanding the experience of diagnosis from a patient perspective. AIM: To investigate a patient's 'route to diagnosis', particularly focusing on the time prior to seeking healthcare, and perceived experiences of the diagnostic pathway. METHODS: An online survey was distributed via the UK Taskforce for Lung Health and member mailing lists to patients as well as the website and social media accounts from 23 May 2022 to 5 July 2022. Analysis was descriptive; χ2 tests were performed to make comparisons across diseases. RESULTS: There were 398 valid responses (COPD=156, asthma=119, ILD=67 and bronchiectasis=56). While only 9.2% of respondents who were eventually diagnosed with asthma had not heard of their disease, the corresponding percentages for COPD, ILD and bronchiectasis were 34.0%, 74.6% and 69.6%, respectively. 33.9% of people with bronchiectasis believed their delayed diagnosis was due to the health professionals' lack of expertise or knowledge-24.4% for asthma, 19.2% for COPD and 17.9% for ILD.People with COPD were more likely (37.2%) and patients with asthma less likely (10.9%) to report they did not know the signs of potential lung disease (p<0.001). People with COPD were more likely to report that they did not appreciate the severity or urgency of the situation (58.3%) than people with asthma (32.8%), ILD (43.3%) or bronchiectasis (28.6%, p<0.001). The proportion of patients reporting that they were being initially treated for another lung condition was higher in people with bronchiectasis (44.6%) and lower in people with asthma (8.4%, p<0.001). CONCLUSIONS: Perceived reasons for diagnostic delay can help health professionals promote early diagnosis and management. Patients' limited knowledge of respiratory diseases also played a factor, indicating the necessity to promote patients' knowledge to encourage earlier help seeking.
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Asma , Bronquiectasia , Doenças Pulmonares Intersticiais , Doença Pulmonar Obstrutiva Crônica , Humanos , Diagnóstico Tardio , Asma/complicações , Asma/diagnóstico , Bronquiectasia/diagnóstico , Doenças Pulmonares Intersticiais/diagnóstico , Inquéritos e QuestionáriosRESUMO
Infrared spectra of C60+ and C120+, obtained via helium messenger spectroscopy, are reported. For C60+, new absorption features have been found just above the discrete vibrational spectrum of the ion. The absorption profile, which is broad and contains little structure, is assigned to one or more electronic absorption transitions and is in good agreement with predictions from time-dependent density functional theory. It seems likely that the transitions observed correspond to excitation from the 2A1u electronic ground state to one or both of the low-lying 2E1u and 2E2u electronic states previously identified as dark states of C60+. These states presumably become optically bright through vibronic coupling and specifically the Jahn-Teller effect. In the case of C120+, the simplest positively charged oligomer of C60, we present the first vibrational spectrum of this ion. Through a comparison with theory, vibrational features are best explained by a peanut-shaped structure for C120+, maintained by covalent bonding between the two C60 units. We have also discovered electronic transitions for C120+, which, similar to C60+, lie just above the vibrational spectrum.
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Background: Traumatic brain injury (TBI) is a major public health problem that may be associated with numerous behavioral problems, including impulsivity, aggression and violence. Rates of self-reported TBI are high within offender populations, but the extent to which TBI is causally implicated in causing illegal behavior is unclear. This study examined the psychological and functional correlates of histories of traumatic brain injury in a sample of impulsive violent offenders. Methods: Study participants, all men, had been recruited to participate in a randomized controlled trial of sertraline to reduce recidivism. Study entry criteria were an age of at least 18 years, a documented history of two or more violent offenses and a score of 70 or above on the Barratt Impulsiveness Scale. An extensive list of standardized questionnaires was administered to obtain information on previous TBI and other neuropsychiatric conditions or symptoms. Results: In the sample of 693 men, 66% were aged between 18 and 35 years old, and 55% gave a history of TBI ("TBI+"). Overall, 55% of study participants reported at least one TBI. High levels of neuropsychiatric symptomatology were reported. In 75% of TBI+ individuals, their most severe TBI (by self-report) was associated with loss of consciousness (LOC) < 30 min. Compared to TBI- (those without history of TBI) participants, TBI+ individuals were more impulsive (Eysenck Impulsivity), irritable, angry, and reported higher levels of assaultive behavior, depressive symptomology, alcohol use disorder, suicidal ideation, suicide attempts, and lower quality of life. Potential "dose effects" of TBI severity and frequency in terms of neuropsychiatric symptomatology were identified. Conclusion: Like other studies of offender populations, single and multiple TBIs were very common. The associations of TBI, TBI severity, and TBI frequency (i.e., TBI "burden") with adverse neuropsychiatric phenomena suggest TBI contributes importantly to offender morbidity but the select nature of the sample and cross-sectional study design constrain the interpretation of these findings.
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Background: Olfactory deficits have a diverse etiology and can be detected with simple olfactory tests. Key olfactory pathways are located within the frontal and temporal lobes where they are vulnerable to damage due to head trauma. Orbitofrontal cortex (OFC) integrity is important for olfaction and aspects of behavioral regulation. We measured olfactory identification ability in a sample of impulsive violent offenders to determine its associations with history of traumatic brain injury (TBI) and a range of neuropsychiatric indices, including proxies for cognitive ability, impulsivity and social connectedness. Methods: Male participants were drawn from the ReINVEST study, a randomized controlled trial of sertraline to reduce recidivism in violent impulsive offenders. Criteria for participation in the study included a minimum age of 18 years, a documented history of two or more violent offenses, and a score of 70 or above on the Barratt Impulsiveness Scale (BIS-11). The 16-item "Sniffin sticks" (SS) odor identification test (OI) was administered as were standardized questionnaires regarding previous TBI, additional measures to screen cognition [word reading test of the Wechsler Individuals Achievement Test (WIAT), social connectedness (the Duke Social Support Scale), and a range of other neuropsychiatric conditions or symptoms]. The sample SS scores were compared against published age-specific norms. Univariate and multivariate analyses were performed with SS score (linear regression, within those without hyposmia) or hyposmia (logistic regression) as the outcome. Results: The mean OI scores were lower than population norms and 16% of participants were classified as hyposmic. Univariate analyses showed associations of SS score with age, WIAT score, impulsivity, TBI and TBI severity, social connectedness, childhood sexual abuse, suicidality and current use of heroin. In multivariate analyses, age, TBI severity and WIAT remained as significant independent predictors of SS score (within the normosmic range) or hyposmia (logistic regression). Conclusion: Olfactory performance was associated with multiple behavioral phenomena in a pattern that would be consistent with this serving as a proxy for orbitofrontal functioning. As such, OI testing may have utility in further studies of offenders. In future, we will examine whether olfactory score predicts recidivism or response to the administration of sertraline, in terms of reducing recidivism.
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Background: There is considerable variation in reported chronic obstructive pulmonary disease (COPD) prevalence internationally, partly due to differing definitions in use. Accurate estimates of disease prevalence are important for allocation of health-care resources, yet UK estimates of COPD prevalence have not been updated for a decade. We calculated yearly COPD prevalence in England between 2000 and 2019 using different definitions of COPD. Methods: We used routinely collected primary care electronic healthcare record (EHR) data from the Clinical Practice Research Datalink (CPRD) Aurum database linked with secondary care data from the Hospital Episode Statistics (HES) Admitted Patient Care (APC) database. Mid-year point prevalence was calculated yearly from 2000 to 2019 in English adults aged ≥40 years using 5 definitions: (i) validated COPD, (ii) Quality and Outcomes Framework (QOF) COPD, (iii) COPD symptoms, inhaler prescription, and no asthma diagnosis, (iv) hospitalisation with COPD as any diagnosis, (v) hospitalisation with COPD as primary or secondary diagnosis. Prevalence was further stratified by gender, age group, and region. Results: A total of 12,745,793 people were included over the 20-year period. Annual cohort sizes ranged from 4,373,538 in 2000 to 6,159,496 in 2019. Estimates of COPD prevalence increased every year from 2000 and the difference in estimated prevalence between the validated and QOF definitions has grown over time. In 2019, a COPD prevalence of 4.9% was found using validated events in either primary or secondary care (definition 1 or definition 5). Additionally, including potentially undiagnosed cases (definition 3) in the COPD definition produced an increased prevalence of 6.7%. Conclusion: Common definitions of COPD (eg, QOF codes), may underestimate the true prevalence. The extent of this underestimate has increased over time and could lead to under-allocation of resources where need is estimated based on these definitions. Standardisation of COPD coding in routine EHRs and metrics such as spirometry is key to accurate disease monitoring.
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Asma , Doença Pulmonar Obstrutiva Crônica , Adulto , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Prevalência , Inglaterra/epidemiologia , HospitaisRESUMO
We experimentally demonstrated, for, it is believed, the first time, high-capacity polarization- and mode-division multiplexing free-space optical transmission with adequate strong turbulence resiliency. A compact spatial light modulator-based polarization multiplexing multi-plane light conversion module was employed to emulate strong turbulent links. By employing advanced successive interference cancellation multiple-input multiple-output decoder and redundant receive channels, the strong turbulence resiliency was significantly improved in a mode-division multiplexing system. As a result, we achieved a record-high line rate of 689.2 Gbit/s, channel number of 10, and net spectral efficiency of 13.9 bit/(s Hz) in a single-wavelength mode-division multiplexing system with strong turbulence.
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ComunicaçãoRESUMO
Importance: Ischemic heart disease remains the leading cause of mortality following hip and knee arthroplasty. Due to its antiplatelet and cardioprotective properties, aspirin has been proposed as an agent that could reduce mortality when used as venous thromboembolism (VTE) prophylaxis following these procedures. Objective: To compare aspirin with enoxaparin in reducing 90-day mortality for patients undergoing hip or knee arthroplasty procedures. Design, Setting, and Participants: This study was a planned secondary analysis of the CRISTAL cluster randomized, crossover, registry-nested trial performed across 31 participating hospitals in Australia between April 20, 2019, and December 18, 2020. The aim of the CRISTAL trial was to determine whether aspirin was noninferior to enoxaparin in preventing symptomatic VTE following hip or knee arthroplasty. The primary study restricted the analysis to patients undergoing total hip or knee arthroplasty for a diagnosis of osteoarthritis only. This study includes all adult patients (aged ≥18 years) undergoing any hip or knee arthroplasty procedure at participating sites during the course of the trial. Data were analyzed from June 1 to September 6, 2021. Interventions: Hospitals were randomized to administer all patients oral aspirin (100 mg daily) or subcutaneous enoxaparin (40 mg daily) for 35 days after hip arthroplasty and 14 days after knee arthroplasty procedures. Main Outcomes and Measures: The primary outcome was mortality within 90 days. The between-group difference in mortality was estimated using cluster summary methods. Results: A total of 23â¯458 patients from 31 hospitals were included, with 14â¯156 patients allocated to aspirin (median [IQR] age, 69 [62-77] years; 7984 [56.4%] female) and 9302 patients allocated to enoxaparin (median [IQR] age, 70 [62-77] years; 5277 [56.7%] female). The mortality rate within 90 days of surgery was 1.67% in the aspirin group and 1.53% in the enoxaparin group (estimated difference, 0.04%; 95% CI, -0.05%-0.42%). For the subgroup of 21â¯148 patients with a nonfracture diagnosis, the mortality rate was 0.49% in the aspirin group and 0.41% in the enoxaparin group (estimated difference, 0.05%; 95% CI, -0.67% to 0.76%). Conclusions and Relevance: In this secondary analysis of a cluster randomized trial comparing aspirin with enoxaparin following hip or knee arthroplasty, there was no significant between-group difference in mortality within 90 days when either drug was used for VTE prophylaxis. Trial Registration: http://anzctr.org.au Identifier: ACTRN12618001879257.
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Artroplastia de Quadril , Artroplastia do Joelho , Tromboembolia Venosa , Adulto , Humanos , Feminino , Adolescente , Idoso , Masculino , Enoxaparina/uso terapêutico , Enoxaparina/efeitos adversos , Aspirina/uso terapêutico , Tromboembolia Venosa/tratamento farmacológico , Artroplastia do Joelho/efeitos adversos , Artroplastia de Quadril/efeitos adversosRESUMO
Little is known about how rotating molecular ions interact with multiple ^{4}He atoms and how this relates to microscopic superfluidity. Here, we use infrared spectroscopy to investigate ^{4}He_{N}â¯H_{3}O^{+} complexes and find that H_{3}O^{+} undergoes dramatic changes in rotational behavior as ^{4}He atoms are added. We present evidence of clear rotational decoupling of the ion core from the surrounding helium for N>3, with sudden changes in rotational constants at N=6 and 12. In sharp contrast to studies on small neutral molecules microsolvated in helium, accompanying path integral simulations show that an incipient superfluid effect is not needed to account for these findings.
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Background: The Covid-19 pandemic has highlighted weaknesses in the National Health Service critical care provision including both capacity and infrastructure. Traditionally, healthcare workspaces have failed to fully incorporate Human-Centred Design principles resulting in environments that negatively affect the efficacy of task completion, patient safety and staff wellbeing. In the summer of 2020, we received funds for the urgent construction of a Covid-19 secure critical care facility. The aim of this project was to design a pandemic resilient facility centred around both staff and patient requirements and safety, within the available footprint. Methods: We developed a simulation exercise, underpinned by Human-Centred Design principles, to evaluate intensive care designs through Build Mapping, Tasks Analysis and Qualitative data. Build Mapping involved taping out sections of the design and mocking up with equipment. Task Analysis and qualitative data were collected following task completion. Results: 56 participants completed the build simulation exercise generating 141 design suggestions (69 task related, 56 patient and relative related, 16 staff related). Suggestions translated to 18 multilevel design improvements; five significant structural changes (Macro level) including wall moves and lift size change. Minor improvements were made at a Meso and Micro design level. Critical care design drivers identified included functional drivers (visibility, Covid-19 secure environment, workflow, and task efficiency) and behavioural drivers (learning and development, light, humanising intensive care and design consistency). Conclusion: Success of clinical tasks, infection control, patient safety and staff/patient wellbeing are highly dependent on clinical environments. Primarily, we have improved clinical design by focusing on user requirements. Secondly, we developed a replicable approach to exploring healthcare build plans revealing significant design changes, that may have only been identified once built.
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While evidence shows that dental erosion (DE) is often caused by gastroesophageal reflux disease (GERD), the relationship of DE severity to a patient's symptoms and receipt of appropriate medical treatment for GERD is not clearly understood. The purpose of this study was to evaluate the association between DE and GERD. Eighty participants underwent a Basic Erosive Wear Examination for DE and completed the Patient-Reported Outcomes Measurement Information System (PROMIS) survey on symptoms of gastrointestinal reflux (PROMIS Scale v1.0, Gastrointestinal Gastroesophageal Reflux 13a) in English. Patients with observed erosive patterns were referred for gastroenterologic evaluation. The association between DE and GERD was assessed using multiple regression. The results showed that the extent of DE was positively associated with GERD symptoms (B = 0.585; 95% CI, 0.21-0.96), as measured by the PROMIS survey, in participants without a current diagnosis of GERD. Of the 80 patients in the study, 28 with more severe DE were evaluated in the gastroenterology department. A diagnosis of GERD was established for 27 of the 28, 9 of whom denied a past history of the disease. Twenty patients with GERD underwent upper endoscopy, and esophageal lesions were found in 6 patients (erosive esophagitis in 5 and Barrett esophagus in 1). Patients with clinically identified DE may benefit from medical evaluation and, if necessary, management of GERD. For a subset of patients, DE may be the only clinical indication of untreated or undertreated GERD, which could lead to serious esophageal changes. Dentists should consider referring patients with DE to primary care providers or gastrointestinal specialists to ensure that systemic conditions are identified and managed appropriately.
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Esôfago de Barrett , Esofagite Péptica , Refluxo Gastroesofágico , Humanos , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Esofagite Péptica/complicações , Esofagite Péptica/diagnóstico , Esôfago de Barrett/complicações , Esôfago de Barrett/diagnósticoRESUMO
We propose a kernel-based adaptive filtering method to suppress the phase noise (PN) arising from small deviations from ideal counter-phasing in the dual-pump fibre-based optical phase conjugation (OPC) of pilot-free quadrature-amplitude modulation (QAM) signals. We demonstrate experimentally and numerically that the proposed scheme achieves signal-to-noise ratio improvement over conventional PN compensation under optimised pump dithering settings in the OPC device and features no performance penalty across a range of pump-phase mismatch values, when it is used with a 16-QAM signal in an optical back-to-back configuration. We also illustrate the applicability of the method to the 64-QAM modulation format, and evaluate its performance in a transmission setup with mid-link OPC by means of numerical simulations.
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Importance: There remains a lack of randomized trials investigating aspirin monotherapy for symptomatic venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA) or total knee arthroplasty (TKA). Objective: To determine whether aspirin was noninferior to enoxaparin in preventing symptomatic VTE after THA or TKA. Design, Setting, and Participants: Cluster-randomized, crossover, registry-nested trial across 31 hospitals in Australia. Clusters were hospitals performing greater than 250 THA or TKA procedures annually. Patients (aged ≥18 years) undergoing hip or knee arthroplasty procedures were enrolled at each hospital. Patients receiving preoperative anticoagulation or who had a medical contraindication to either study drug were excluded. A total of 9711 eligible patients were enrolled (5675 in the aspirin group and 4036 in the enoxaparin group) between April 20, 2019, and December 18, 2020. Final follow-up occurred on August 14, 2021. Interventions: Hospitals were randomized to administer aspirin (100 mg/d) or enoxaparin (40 mg/d) for 35 days after THA and for 14 days after TKA. Crossover occurred after the patient enrollment target had been met for the first group. All 31 hospitals were initially randomized and 16 crossed over prior to trial cessation. Main Outcomes and Measures: The primary outcome was symptomatic VTE within 90 days, including pulmonary embolism and deep venous thrombosis (DVT) (above or below the knee). The noninferiority margin was 1%. Six secondary outcomes are reported, including death and major bleeding within 90 days. Analyses were performed by randomization group. Results: Enrollment was stopped after an interim analysis determined the stopping rule was met, with 9711 patients (median age, 68 years; 56.8% female) of the prespecified 15â¯562 enrolled (62%). Of these, 9203 (95%) completed the trial. Within 90 days of surgery, symptomatic VTE occurred in 256 patients, including pulmonary embolism (79 cases), above-knee DVT (18 cases), and below-knee DVT (174 cases). The symptomatic VTE rate in the aspirin group was 3.45% and in the enoxaparin group was 1.82% (estimated difference, 1.97%; 95% CI, 0.54%-3.41%). This failed to meet the criterion for noninferiority for aspirin and was significantly superior for enoxaparin (P = .007). Of 6 secondary outcomes, none were significantly better in the enoxaparin group compared with the aspirin group. Conclusions and Relevance: Among patients undergoing hip or knee arthroplasty for osteoarthritis, aspirin compared with enoxaparin resulted in a significantly higher rate of symptomatic VTE within 90 days, defined as below- or above-knee DVT or pulmonary embolism. These findings may be informed by a cost-effectiveness analysis. Trial Registration: ANZCTR Identifier: ACTRN12618001879257.
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Anticoagulantes , Artroplastia de Quadril , Artroplastia do Joelho , Aspirina , Enoxaparina , Tromboembolia Venosa , Idoso , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Aspirina/efeitos adversos , Aspirina/uso terapêutico , Austrália , Quimioprevenção , Enoxaparina/efeitos adversos , Enoxaparina/uso terapêutico , Feminino , Humanos , Masculino , Osteoartrite/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Embolia Pulmonar/etiologia , Embolia Pulmonar/prevenção & controle , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controleRESUMO
We employ commercial mode-selective photonic lanterns to implement mode multiplexing and demultiplexing for high-capacity free-space optical communications. Moreover, we design a time-division-multiplexed frame structure to efficiently emulate multiple independent transmitters with channelized precoding using only one transmitter. To maximize the throughput of the system, we optimize the modes selected for carrying data, and apply adaptive loading to different channels. By leveraging mode- and polarization-division multiplexing, the free-space optical data link comprising multiple independent channels provides an aggregate net data rate of 1.1 Tbit/s and net spectral efficiency of 28.35 bit/s/Hz. Different from many previous demonstrations based on delayed or partially delayed copies of identical data streams, to the best of our knowledge, ours is a record-high net data rate and net spectral efficiency achieved by a single-wavelength mode-division multiplexed free-space optical communication system with fully independent channels. Moreover, all key devices used in this work, including optical transponder, multiplexer, and demultiplexer are commercially available.
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We experimentally demonstrate 10-channel mode-division multiplexed free-space optical transmission with five spatial modes, each carrying 19.6925-Gbaud dual-polarization quadrature phase shift keying signals. Strong inter-mode cross talk is observed in our commercially available photonic lantern based system when using a complete orthogonal mode set as independent channels. A successive interference cancellation based multiple-input multiple-output digital signal processing (DSP) algorithm is first applied to mitigate the inter-mode cross talk in mode-division multiplexed systems. The DSP also supports unequal transmit and receive channel numbers to further improve the cross talk resiliency. Compared to the conventional minimum mean square error DSP, the required optical signal-to-noise ratio of the successive interference cancellation DSP is decreased by approximately 5 dB at the hard-decision forward error correction limit. As a result, this system demonstrates a record-high independent channel number of 10 and spectral efficiency of 13.7 b/s/Hz in mode-division multiplexed free-space optical systems.
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The dimerization of molecules in helium nanodroplets is known to preferentially yield structures of higher energy than the global energy minimum structure for a number of quite different monomers. Here, we explore dimerization in this environment using an atomistic model within statistically converged molecular dynamics (MD) trajectories, treating the solvent implicitly through the use of a thermostat, or more explicitly by embedding one monomer in a He100 cluster. The focus is on the two simplest carboxylic acids, formic and acetic, both of which have been studied experimentally. While the global minimum structure, which comprises two COâ¯HO hydrogen bonds, is predicted to be the most abundant dimer in the absence of the helium solvent, this is no longer the case once helium atoms are included. The simulations confirm the importance of kinetic trapping effects and also shed light on the occurrence of specific dynamical effects, leading to the occasional formation of high-energy structures away from minima, such as saddle configurations. Theoretically predicted infrared spectra, based on the MD statistics, are in good agreement with the experimental spectra.
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The earliest reports of atypical femur fractures (AFF) emerged from Asia. In the West, epidemiologic studies report a greater incidence of AFFs among subjects of Asian background. Asian ethnicity is an established risk factor for AFF, but clear mechanisms to explain this risk and implications for the general development of AFF are open questions. Ethno-specific differences in bisphosphonate action and femoral geometry have been proposed as hypotheses. In a retrospective cohort of 163 female patients presenting with AFFs or typical femur fractures (TFF), relative contributions of Asian ethnicity, proximal femoral geometry, and bisphosphonate use in AFF status were examined. There was a fourfold higher proportion of Asian subjects in the AFF compared with TFF groups (31.6%, 30/95 versus 7.4%, 5/68). Asian subjects had smaller femurs in femoral head, neck, and axial dimensions. A multiple logistic regression model for AFF status was fitted adding Asian ethnicity to three previously reported independent predictors of AFF including femoral geometry, which together comprise the Sydney AFF Score (age ≤80 years, femoral neck width <37 mm than non-Asian, lateral cortical width at lesser trochanter ≥5 mm). Asian ethnicity was a robust independent predictor of AFF, imparting sevenfold increase in the odds of AFF after adjusting for all three variables (95% confidence interval [CI] 2.2-23.2, p = 0.001) or for overall AFF score (95% CI 2.2-22.3 p = 0.001). Overall Asian subjects had higher rates of bisphosphonate use than non-Asian subjects (67.6% versus 47.2%, p = 0.034). Among AFF bisphosphonate users, Asian subjects had lower AFF scores than non-Asians (Sydney AFF Score ≤1, 45.5% Asian subjects versus 22.2% non-Asian subjects, p = 0.05). Asian ethnicity is a strong independent risk factor for AFF, unaccounted for by ethno-specific differences in proximal femoral geometry. Bisphosphonate use may be associated with a greater predisposition for AFF in Asian subjects compared with non-Asian subjects. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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In this paper, we review different designs of distributed Raman amplifiers which have been proposed to minimize the signal power profile asymmetry in mid-link optical phase conjugation systems. We demonstrate how the symmetrical signal power profiles along the fiber can be achieved using various distributed Raman amplification techniques in the single-span and more realistic multi-span circumstances. In addition, we show the theoretically predicted results of the Kerr nonlinear product reduction with different Raman techniques in mid-link optical phase conjugator systems, and then in-line/long-haul transmission performance using numerical simulations.
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Background: An association exists between psychosis and criminal offending, which evidence suggests can be reduced by effective mental health care for this vulnerable population. However mental health services often lose contact with people after diagnosis. The association between the first episode of psychosis and criminal offending highlights the need for effective mental health care for this vulnerable population. Aims: To investigate the association between the first diagnosis of psychosis (FDP) in prison or hospital and subsequent mental health service contact following release from prison or discharge from hospital. Materials and methods: Individuals with a FDP either in prison (n = 492) or hospital setting (n = 24,910) between July 2006 and December 2011 in NSW (Australia), were followed post-release or discharge until their first mental health service contact in the community, the occurrence of an offence, death, or completion of the study period at the end of December 2012. Cox regression models were used to examine the predictors for the mental health service contacts following release or discharge. Results: Over 70% of those with a FDP in prison or hospital had a psychosis-related or any community-based mental health service contact following release or discharge between July 2006 and December 2012. Those with a FDP in prison were more likely to have no contact with mental health services than those in hospital with no prior offence record (hazard ratio, HR = 3.14, 95% CI: 2.66-3.72 and adjusted hazard ratio, aHR = 3.05, 95% CI: 2.56-3.63) within a median follow-up time of 25 days for the prison group and 26 days for hospital group. Males, individuals of Aboriginal heritage and individuals diagnosed with substance-related psychoses compared to those with schizophrenia and related psychoses were less likely to have a mental health service contact following release or discharge in both the univariable and multivariable analysis. Conclusion: This study suggests that prior offending or a previous prison episode represents a barrier to mental health service contact in the community for those with a FDP. Effective rehabilitation planning while exiting prison and discharge planning from hospital are essential to the successful reintegration of these individuals with a FDP.