In focus: perplexing increase of urinary stone disease in children, adolescent and young adult women and its economic impact

Background Urinary stone disease (USD) historically has affected older men, but studies suggest recent increases in women, leading to a near identical sex incidence ratio. USD incidence has doubled every 10 years, with disproportionate increases amongst children, adolescent, and young adult (AYA) women. USD stone composition in women is frequently apatite (calcium phosphate), which forms in a higher urine pH, low urinary citrate, and an abundance of urinary uric acid, while men produce more calcium oxalate stones. The reasons for this epidemiological trend are unknown. Methods This perspective presents the extent of USD with data from a Canadian Province and a North American institution, explanations for these findings and offers potential solutions to decrease this trend. We describe the economic impact of USD. Findings There was a significant increase of 46% in overall surgical interventions for USD in Ontario. The incidence rose from 47.0/100,000 in 2002 to 68.7/100,000 population in 2016. In a single United States institution, the overall USD annual unique patient count rose from 10,612 to 17,706 from 2015 to 2019, and the proportion of women with USD was much higher than expected. In the 10–17-year-old patients, 50.1% were girls; with 57.5% in the 18–34 age group and 53.6% in the 35–44 age group. The roles of obesity, diet, hormones, environmental factors, infections, and antibiotics, as well as the economic impact, are discussed. Interpretation We confirm the significant increase in USD among women. We offer potential explanations for this sex disparity, including microbiological and pathophysiological aspects. We also outline innovative solutions – that may require steps beyond typical preventive and treatment recommendations

Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey

Background: Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design. Methods: Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated crosssectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382. Findings: Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29–0·54) to 0·06% (0·04–0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17–24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17–24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45–68%, dependent on calendar time. Interpretation: Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards

In-situ electrochemical spectroscopy and probe microscopy studies of electrodeposition

Electrodeposition is widely used for industrial applications to deposit films, coatings, and adhesion layers. The diversity of materials that can be deposited has led to numerous studies of electrodeposition processes. This thesis explores two electrochemical systems: 1) the electrodeposition of chromate to form thin films on Au, and 2) the effect of functionalization and concentration on the behavior of quaternary ammonium levelers proposed for electroplating Cu in through-silicon vias (TSVs). The first study investigates the mechanism and morphology of chromate deposition, a process of which has significant importance both industrially and environmentally. Electrodeposition of chromate on Au was studied using cyclic voltammetry (CV), surface enhanced Raman spectroscopy (SERS), in-situ electrochemical scanning tunneling microscopy (EC-STM), and in-situ electrochemical atomic force microscopy (EC-AFM). CV results show the evolution of the deposited species as a function of scan cycle. SERS reveals the presence of intermediate species during the deposition process as well as the dual mixed CrIII/CrVI nature of the surface oxide film that is formed. In-situ EC-AFM shows that the reduced form of the oxide film, ???-Cr2O3, is oriented in a (3??3)R30?? adlattice relative to the Au(111) surface. A mechanism for the electrodeposition of chromate on Au is proposed based on the results of this study. The second electrochemical system explored in this thesis revolves around Dodecyltrimethyl ammonium bromide (DTAB), benzyldimethylhexadecyl ammonium chloride (BDAC) and thonzonium bromide (ThonB) and their potential use as leveling additives. Electroplating measurements show that while each of the proposed levelers inhibits the onset of bulk Cu deposition at a Cu(poly) disk electrode, the concentration and potential dependence of this behavior depends on the functionalization of the additive. Surface enhanced Raman spectroscopy (SERS) results show that DTAB displays no potential dependent behavior, while both BDAC and ThonB exhibit substantial potential dependent behavior, the nature of which depends on headgroup functionality. This study demonstrates that functionalization of amphiphilic quaternary ammonium surfactants can have a significant impact on the effectiveness of the leveler