In Hong Kong, universal varicella vaccination started in July 2014. Before this, children could receive varicella vaccine via the private market. We analysed the epidemiology of varicella and zoster ...before universal vaccination. We estimated varicella vaccination coverage through surveys in preschool children. We estimated the burden of varicella and zoster with varicella notifications from 1999/00 to 2013/14, Accident and Emergency Department (A&E) attendance and inpatient admissions to public hospitals from 2004/05 to 2013/14. We fitted a catalytic model to serological data on antibodies against varicella-zoster virus to estimate the force of infection. We found that varicella vaccination coverage gradually increased to about 50% before programme inception. In children younger than 5 years, the annual rate of varicella notifications, varicella admission and zoster A&E attendance generally declined. The annual notification, A&E attendance and hospitalisation rate of varicella and zoster generally increased for individuals between 10 and 59 years old. Varicella serology indicated an age shift during the study period towards a higher proportion of infections in slightly older individuals, but the change was most notable before vaccine licensure. In conclusion, we observed a shift in the burden of varicella to slightly older age groups with a corresponding increase in incidence but it cannot necessarily be attributed to private market vaccine coverage alone. Increasing varicella vaccination uptake in the private market might affect varicella transmission and epidemiology, but not to the level of interrupting transmission.
P-type point contact (PPC) high-purity germanium detectors are an important technology in astroparticle and nuclear physics due to their superb energy resolution, low noise, and pulse shape ...discrimination capabilities. Analysis of data from the Majorana Demonstrator, a neutrinoless double-β decay experiment deploying PPC detectors enriched in 76Ge, has led to several novel improvements in the analysis of PPC signals. In this work we discuss charge trapping in PPC detectors and its effect on energy resolution. Small dislocations or impurities in the crystal lattice result in trapping of charge carriers from an ionization event of interest, attenuating the signal, and degrading the measured energy. We present a modified digital pole-zero correction to the signal energy estimation that counters the effects of charge trapping and improves the energy resolution of the Majorana Demonstrator by approximately 30 % to around 2.4 keV full width at half-maximum at 2039 keV, the 76Ge Q value. An alternative approach achieving similar resolution enhancement is also presented.
Observation of growing phase space density (PSD) peak in the outer electron radiation belt has been considered evidence for local wave‐driven acceleration as a primary cause of radiation belt ...enhancement. However, recent studies showed that strong substorm‐associated MeV electron injections can also cause significant radiation belt enhancements on fast timescales (∼10s min). Such rapid enhancements pose challenges for determining true spatial PSD profiles. To address this, we conduct a detailed spatiotemporal analysis of electron flux and PSD during an enhancement event, using Van Allen Probes data. Our analysis reveals rapid and intermittent flux enhancements. During these rapid enhancements, inbound spacecraft observed false PSD peaks, due to spacecraft's relatively slow movement. However, we identify time intervals of stable fluxes between enhancements, enabling us to determine quasi‐stationary PSD profiles with no noticeable peaks. This study provides new insights into accurate PSD analysis, critical for understanding the mechanisms underlying radiation belt enhancements.
Plain Language Summary
Radiation belt physics studies the origin and dynamics of high‐energy electrons trapped in the Earth's radiation belts. The radial profiles of these electrons' phase space density (PSD) are essential parameters for investigating their origin and dynamics. Outward‐increasing PSD profiles indicate that electrons have been transported radially (injections) from outside the radiation belt, while locally peaked profiles suggest that they were generated locally within the belt. Obtaining accurate PSD profiles is challenging due to significant temporal changes in electron flux, particularly rapid flux enhancements from injections as observed in recent studies. To examine the impact of rapid flux enhancements on PSD analysis, we closely tracked electron flux changes in space and time during an enhancement event using data from NASA's Van Allen Probes. Our results show that inbound spacecraft can observe falsely peaked PSD profiles during rapid flux enhancements, which are temporal artifacts from relatively slower spacecraft motion. By identifying time intervals of stable electron flux between enhancements, we were able to determine the true spatial PSD profiles, which overall exhibited outward‐increasing trends, consistent with injections. Our findings offer new perspective on accurately determining PSD radial profiles, which is essential for unraveling the origins of high‐energy electrons in the Earth's radiation belts.
Key Points
Rapid and intermittent electron enhancement pattern significantly impacts phase space density (PSD) analysis
Inbound spacecraft can observe a temporal PSD peak during rapid electron enhancements driven by injections
Quasi‐stationary time intervals between enhancements enable accurate determination of PSD radial profiles
The incidence of non-steroidal anti-inflammatory drug-related ulcer complications remains high despite the availability of potent anti-ulcer drugs and selective cyclo-oxygenase-2 inhibitors. ...Non-steroidal anti-inflammatory drug-related ulcer complications can be minimized by prospective assessment of patients' baseline risk, rational choice and use of non-steroidal anti-inflammatory drugs, and selective use of co-therapy strategies with gastroprotectives. Current recommendations regarding strategies using anti-ulcer drugs and cyclo-oxygenase-2 inhibitors for prevention of clinical non-steroidal anti-inflammatory drug upper gastrointestinal events are largely derived from studies using surrogates such as endoscopic ulcers, erosions, and symptoms in low- to average-risk patients. Conclusions based on surrogate and potentially manipulatable end-points are increasingly suspect with regard to applicability to clinical situations. This article reviews the risks associated with non-steroidal anti-inflammatory drugs including aspirin and includes the effect of the patients' baseline risk, and the confounding effects of Helicobacter pylori infection. In addition, uncertainties regarding the clinical efficacy of anti-ulcer drugs and cyclo-oxygenase-2 inhibitors against non-steroidal anti-inflammatory drug-related ulcer complications are put into perspective. We propose management strategies based on the risk category: low risk (absence of risk factors) (least ulcerogenic non-steroidal anti-inflammatory drug at lowest effective dose), moderate risk (one to two risk factors) (as above, plus an antisecretory agent or misoprostol or a cyclo-oxygenase-2 inhibitor), high risk (multiple risk factors or patients using concomitant low-dose aspirin, steroids, or anticoagulants) (cyclo-oxygenase-2 inhibitor alone with steroids, plus misoprostol with warfarin, or plus a proton pump inhibitors or misoprostol with aspirin), and very high risk (history of ulcer complications) (avoid all non-steroidal anti-inflammatory drugs, if possible or a cyclo-oxygenase-2 plus a proton pump inhibitors and/or misoprostol). The presence of H. pylori infection increases the risk of upper gastrointestinal complications in non-steroidal anti-inflammatory drug users by two- to fourfold suggesting that all patients requiring regular non-steroidal anti-inflammatory drug therapy be tested for H. pylori.
Burning of joss paper and incense is still a very common traditional custom in countries with a majority Chinese population. The Hungry Ghost Festival which is celebrated in the 7 month of the ...Chinese calendar is one of the events where joss paper and incense are burned as offerings. This study investigates the impact of the Ghost Month Festival (open burning event) on air quality by analysis of the chemical composition of particulate matter (PM) and rainwater samples collected during this event, compared with data collected throughout the year, as well as bottom ash samples from burning the original joss paper and incense. The results showed that the change in the chemical composition of the rainwater and PM2.5 (PM ≤ 2.5 μm) atmospheric samples could be correlated directly with burning events during this festival, with many elements increasing between 18% and 60% during August and September compared to the yearly mean concentrations. The order of percentage increase in elemental composition (in rain water and PM2.5) during the Hungry Ghost Festival is as follows: Zn > Ca > K > Mg > Fe > Al > Na ∼ Mn ∼ Ti ∼ V > Cu > As > Ni > Co > Cd > Cr > Pb. The chemical composition of the original source materials (joss paper and incense for combustion) and their associated bottom ash were analysed to explain the impact of burning on air quality.
We present new limits on exotic keV-scale physics based on 478 kg d of Majorana Demonstrator commissioning data. Constraints at the 90% confidence level are derived on bosonic dark matter (DM) and ...solar axion couplings, Pauli exclusion principle violating (PEPV) decay, and electron decay using monoenergetic peak signal limits above our background. Our most stringent DM constraints are set for 11.8 keV mass particles, limiting g_{Ae}<4.5×10^{-13} for pseudoscalars and (α^{'}/α)<9.7×10^{-28} for vectors. We also report a 14.4 keV solar axion coupling limit of g_{AN}^{eff}×g_{Ae}<3.8×10^{-17}, a 1/2β^{2}<8.5×10^{-48} limit on the strength of PEPV electron transitions, and a lower limit on the electron lifetime of τ_{e}>1.2×10^{24} yr for e^{-}→ invisible.
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