Deaths from Tick-Borne Encephalitis,Sweden

We assessed standardized mortality ratio in tick-borne encephalitis (TBE) in Sweden, 2004–2017. Standardized mortality ratio for TBE was 3.96 (95% CI 2.55–5.90); no cases in patients <40 years of age were fatal. These results underscore the need for further vaccination efforts in populations at risk for TBE.     

Concentration gradients in evaporating binary droplets probed by spatially resolved Raman and NMR spectroscopy

Understanding the evaporation process of binary sessile droplets is essential for optimizing various technical processes, such as inkjet printing or heat transfer. Liquid mixtures whose evaporation and wetting properties may differ significantly from those of pure liquids are particularly interesting. Concentration gradients may occur in these binary droplets. The challenge is to measure concentration gradients without affecting the evaporation process. Here, spectroscopic methods with spatial resolution can discriminate between the components of a liquid mixture. We show that confocal Raman microscopy and spatially resolved NMR spectroscopy can be used as complementary methods to measure concentration gradients in evaporating 1-butanol/1-hexanol droplets on a hydrophobic surface. Deuterating one of the liquids allows analysis of the local composition through the comparison of the intensities of the C–H and C–D stretching bands in Raman spectra. Thus, a concentration gradient in the evaporating droplet was established. Spatially resolved NMR spectroscopy revealed the composition at different positions of a droplet evaporating in the NMR tube, an environment in which air exchange is less pronounced. While not being perfectly comparable, both methods—confocal Raman and spatially resolved NMR experiments—show the presence of a vertical concentration gradient as 1-butanol/1-hexanol droplets evaporate.

Evaporating droplets occur in various contexts such as inkjet printing (1, 2), heat transfer, or daily phenomena such as drying coffee stains (3, 4). In many applications, such as painting (5), cleaning, gluing, or printing (6), where liquid mixtures are used, the evaporation of a droplet is a complex process because the concentration profile within the droplet varies over time. To improve the controllability and predictability of the technical processes, it is essential to characterize the transport phenomena during the drying process. The measurement of the droplet composition is a crucial element and has to be carried out with sufficient spatial and temporal resolution. In particular, spectroscopic methods are promising tools for contactless concentration measurements of liquid mixtures.The evaporation of a droplet is governed by physical properties such as surface tension (7), density (8–10), vapor pressure (11), and boiling temperature. Additionally, concentration gradients can evolve in liquid mixtures (12). These gradients are driven by thermal gradients due to the enthalpy of evaporation (droplet cooling) or on heated surfaces, by surface tension gradients induced by preferential evaporation of one component or by density gradients for droplets composed of liquids with different densities like water and glycerol (13). The evaporation rates of the components can vary over the droplet surface. For sessile droplets with contact angles smaller than 90°, for example, the evaporation rates are higher at the three-phase contact line (14). These thermal or surface tension gradients can induce flow inside the droplet called Marangoni flow. This flow leads to concentration gradients across the droplet (7–10). The direction of the gradient depends on the density and surface tension. A direct application of this principle is, for instance, Marangoni cleaning in semiconductor technology (15).The investigation of the composition of sessile drops on the microliter scale, as they occur in inkjet printing or other technical processes, poses a challenge because the typical length scales of interest are smaller than the capillary length. In bulk samples, the composition can be examined in a straightforward manner with chromatographic methods such as gas chromatography and high-performance liquid chromatography or spectroscopic methods such as NMR spectroscopy, infrared spectroscopy, and Raman spectroscopy. However, for the investigation of sessile droplets, a high spatial and temporal resolution is required. For this purpose, confocal Raman spectroscopy and spatially resolved NMR spectroscopy are powerful tools. For both techniques, concentration determination is straightforward if at least two signals of the components of interest are baseline-separated. NMR is intrinsically calibration-free, whereas Raman spectroscopy requires calibration through reference experiments (16–18). Both approaches allow the quantification of concentration gradients in sessile droplets, as is shown here.In Raman microscopy, good spatial resolution can be achieved in a confocal setup. The components of mixtures can be distinguished via specific vibrations for different functional groups or through a careful analysis of the Raman signals in the fingerprint region (<1,500 cm⁻¹). For example, binary mixtures of ethanol and water can be characterized in a straightforward manner (17). If, however, both liquids have a similar chemical structure, the discrimination of the components might be hampered by signal overlap in the C–H stretching region (2,800 to 3,000 cm⁻¹); e.g., in such cases, Raman signals in the fingerprint region (<1,500 cm⁻¹) might be used for the identification of the species. However, these signals often provide a poor signal-to-noise ratio, which makes large integration times necessary. Thus, the image rate or resolution is so low that even slow diffusion processes are hardly resolved. Here, Raman stable isotope probing (SIP), which has been developed to monitor metabolic processes in microbiology, offers a solution (19). The basic idea of Raman SIP is to replace the proton in the C–H with deuterium in one of the mixture components such that the C–D stretching region occurs at roughly 1/2 times the C–H stretching and falls into a region with very weak or even without signals from the protonated liquid component. Thus, the concentration in a binary mixture can be calculated in a straightforward manner from the ratio of the integrated Raman intensities ICD/ICH of the respective stretching vibrations.Compared to Raman microscopy, where localization is achieved by scanning the focal point across the region of interest, in NMR experiments localization is achieved by using magnetic field gradients. Usually, one avoids phase boundaries (especially liquid–gas interfaces) in NMR experiments because they disturb the magnetic field homogeneity and reduce the spectral quality in terms of line shape and baseline separation of the resonances. Nevertheless, it has been shown that MRI can be used to characterize freezing water droplets (20), the infiltration of water into asphalts (21), and the evaporation of sessile droplets from porous surfaces (22–24). Additionally, NMR can be used to quantify the composition of binary droplets during evaporation (25).Thus, the use of both complementary approaches to characterize evaporating binary droplets may be beneficial. In this article, we discuss the capabilities of Raman SIP and NMR techniques to analyze the evolution of the composition of an evaporating sessile binary droplet. As a model system, a binary mixture of 1-butanol and 1-hexanol was used. This mixture shows a low volatility such that the evaporation process can be captured with both Raman and NMR spectroscopies. With Raman spectroscopy, it was possible to observe concentration gradients of 1-butan-d₉-ol over the height of the droplet during evaporation. NMR techniques were examined in terms of the capability to observe the evaporation of 1-butanol and yield time-dependent droplet composition with spatially resolved ¹H-NMR spectra. Furthermore, the contours of the evaporating droplets were tracked by optical measurements to characterize the time-dependent changes in the droplet dimensions. Flows induced by the concentration gradients were confirmed by astigmatic particle tracking velocimetry.     

Experiences of parents whose children participated in a longitudinal follow‐up study

BackgroundLong‐term follow‐up is necessary to understand the impact of perinatal interventions. Exploring parents'' motives and experiences in consenting to their children taking part in longitudinal studies and understanding what outcomes are important to families may enhance participation and mitigate the loss to follow‐up. As existing evidence is largely based on investigators'' perspectives using Western samples, the present pilot study explored parents'' perspectives in a multicultural New Zealand context.MethodsData were generated using semi‐structured interviews with parents whose children had participated in a longitudinal study after neonatal recruitment. Parents'' experiences of being part of the study were analysed thematically using an inductive approach.ResultsParents (n = 16) were generally happy with the outcomes measured. Additionally, parents were interested in lifelong goals such as the impact of parental diabetes. We identified three themes: (1) Facilitators: Research participation was aided by motives and parent and research characteristics such as wishing to help others and straightforward recruitment; (2) Barriers: A hesitancy to participate was due to technical and clinical research aspects, participation burden and cultural barriers, such as complex wording, time commitment and nonindigenous research and (3) Benefits: Children and parents experienced advantages such as the opportunity for education.ConclusionsParents reported positive experiences and described the unexpected benefit of increasing families'' health knowledge through participation. Improvements for current follow‐up studies were identified. Different ethnicities reported different experiences and perspectives, which warrants ongoing research, particularly with indigenous research participants.Patient or Public ContributionNo active partnership with parents of patients took place.     

Refeeding Syndrome: A Critical Reality in Patients with Chronic Disease

Malnutrition is one of the most frequent metabolic challenges in the population of chronically ill patients. This results in increased administration of nutritional therapy in inpatient settings, which poses the risk of side effects, in particular, the development of refeeding syndrome. If not managed accordingly, it leads to a significant rise in morbidity and mortality. However, despite its importance, evidence-based recommendations on the management of refeeding syndrome are largely lacking, and only a few randomized controlled trials have been conducted. In light of this, the aim of this review is to raise awareness of refeeding syndrome in chronically ill patients by critically reviewing recent literature and providing a short overview as well as diagnosis and treatment algorithms of this underreported metabolic condition. In summary, recent findings suggest undergoing risk assessment and stratification for every patient receiving nutritional therapy. According to this, adaptation of energy and fluid support during the replenishment phase should be implemented in the nutritional therapy for patients at high risk. Additionally, continuous monitoring should take place, and appropriate actions should be initiated when necessary.     

Indirect Measurement of Electron Energy Relaxation Time at Room Temperature in Two-Dimensional Heterostructured Semiconductors

Hot carriers are a critical issue in modern photovoltaics and miniaturized electronics. We present a study of hot electron energy relaxation in different two-dimensional electron gas (2DEG) structures and compare the measured values with regard to the dimensionality of the semiconductor formations. Asymmetrically necked structures containing different types of AlGaAs/GaAs single quantum wells, GaAs/InGaAs layers, or bulk highly and lowly doped GaAs formations were investigated. The research was performed in the dark and under white light illumination at room temperature. Electron energy relaxation time was estimated using two models of I-V characteristics analysis applied to a structure with n-n⁺ junction and a model of voltage sensitivity dependence on microwave frequency. The best results were obtained using the latter model, showing that the electron energy relaxation time in a single quantum well structure (2DEG structure) is twice as long as that in the bulk semiconductor.     

Laparoscopic Mesh Versus Open Preperitoneal Mesh Versus Conventional Technique for Inguinal Hernia Repair: A Randomized Multicenter Trial (SCUR Hernia Repair Study)

OBJECTIVE: To evaluate the influence of the laparoscopic technique in hernia repair regarding time to full recovery and return to work, complications, recurrence rate, and economic aspects. SUMMARY BACKGROUND DATA: Several studies have shown advantages in terms of less pain and faster recovery after laparoscopic hernia repair, whereas others have not, and the cost-effectiveness has been questioned. The laparoscopic technique must be thoroughly compared with the open procedures before its true place in hernia surgery can be defined. METHODS: Six hundred thirteen male patients aged 40 to 75 years were randomized to the conventional procedure, preperitoneal mesh placed by the open technique, or laparoscopic preperitoneal mesh (TAPP). Follow-up was after 7 days, 8 weeks, and 1 year. RESULTS: Of 613 patients undergoing surgery, 604 (98.5%) were followed for 1 year. Patients who underwent TAPP gained full recovery after 18.4 days, compared with 24.2 days for open mesh (p < 0.001) and 26.4 days for the conventional procedure (p < 0.001). Patients who underwent TAPP returned to work after 14.7 days, compared with 17.7 days for open mesh (p = 0.05) and 17.9 days for the conventional procedure (p = 0.04). They also had significantly less restriction in physical activities after 7 days. The TAPP procedure was more expensive, mainly as a result of longer surgical time and equipment costs, even after compensation for earlier return to work. Complications were more common in the TAPP group, with a varying pattern between the groups. Four recurrences in the conventional, 11 in the open mesh, and 4 in the TAPP group were recorded after 1 year (p = n.s.). CONCLUSION: The laparoscopic technique results in both shorter time to full recovery and shorter time to return to work, at the price of substantially increased costs.     

Development of a multiplex TaqMan real-time PCR assay for the detection of Chlamydia psittaci and Chlamydia pneumoniae in human clinical specimens

Diagnosis of Chlamydia psittaci and Chlamydia pneumoniae infections has traditionally relied on serological assays. We developed a multiplex real-time PCR assay for detection of C. psittaci, C. pneumoniae and an internal control. Results of this assay demonstrated 100% concordance compared to results of previously tested human clinical specimens.     

Recovery concept in a Norwegian setting to be examined by the assertive community treatment model and mixed methods

Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open‐ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the “Users interview users” method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society.     

Psychotic Experiences,Childhood Trauma,and Alcohol-Related Self-Efficacy in a Nonpsychiatric Sample of Individuals in Alcohol Dependence Treatment: A Pilot Study

There is a substantial co-occurrence between alcohol dependence and psychiatric symptoms. Moreover, research suggests that such symptoms, including psychotic experiences, are continuously distributed in the population. There is a lack of research concerning psychotic symptoms in otherwise non-psychiatric populations with alcohol dependence. The aim of this study was to investigate the prevalence of psychotic symptoms in this population, and to relate this to childhood trauma and management of alcohol dependence. From a population with alcohol dependence two sub-groups were extracted, with low and high levels of psychotic experiences respectively. These were compared concerning childhood trauma and management of dependence using ANOVA, and the resulting model was examined using binary logistic regression. There was a sub-group of 14,3% of the population with elevated levels of psychotic experiences. This group displayed higher degree of self-reported childhood trauma as well as difficulties in managing alcohol dependence, when compared to a sub-group with low levels of psychotic experiences. There may be a substantial sub-group in the otherwise non-psychiatric population with alcohol dependence, with significant difficulties concerning psychotic symptoms, trauma and management of dependence, where anxiety may have a mediating function. If so, this group calls for broader assessment and treatment than standard alcohol interventions.