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Importance The Patient Health Questionnaire depression module (PHQ-9) is a 9-item self-administered instrument used for detecting depression and assessing severity of depression. The Patient Health Questionnaire-2 (PHQ-2) consists of the first 2 items of the PHQ-9 (which assess the frequency of depressed mood and anhedonia) and can be used as a first step to identify patients for evaluation with the full PHQ-9. Objective To estimate PHQ-2 accuracy alone and combined with the PHQ-9 for detecting major depression. Data sources MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-May 2018). Study selection Eligible data sets compared PHQ-2 scores with major depression diagnoses from a validated diagnostic interview. Data extraction and synthesis Individual participant data were synthesized with bivariate random-effects meta-analysis to estimate pooled sensitivity and specificity of the PHQ-2 alone among studies using semistructured, fully structured, or Mini International Neuropsychiatric Interview (MINI) diagnostic interviews separately and in combination with the PHQ-9 vs the PHQ-9 alone for studies that used semistructured interviews. The PHQ-2 score ranges from 0 to 6, and the PHQ-9 score ranges from 0 to 27. Results Individual participant data were obtained from 100 of 136 eligible studies (44 318 participants; 4572 with major depression [10%]; mean [SD] age, 49 [17] years; 59% female). Among studies that used semistructured interviews, PHQ-2 sensitivity and specificity (95% CI) were 0.91 (0.88-0.94) and 0.67 (0.64-0.71) for cutoff scores of 2 or greater and 0.72 (0.67-0.77) and 0.85 (0.83-0.87) for cutoff scores of 3 or greater. Sensitivity was significantly greater for semistructured vs fully structured interviews. Specificity was not significantly different across the types of interviews. The area under the receiver operating characteristic curve was 0.88 (0.86-0.89) for semistructured interviews, 0.82 (0.81-0.84) for fully structured interviews, and 0.87 (0.85-0.88) for the MINI. There were no significant subgroup differences. For semistructured interviews, sensitivity for PHQ-2 scores of 2 or greater followed by PHQ-9 scores of 10 or greater (0.82 [0.76-0.86]) was not significantly different than PHQ-9 scores of 10 or greater alone (0.86 [0.80-0.90]); specificity for the combination was significantly but minimally higher (0.87 [0.84-0.89] vs 0.85 [0.82-0.87]). The area under the curve was 0.90 (0.89-0.91). The combination was estimated to reduce the number of participants needing to complete the full PHQ-9 by 57% (56%-58%). Conclusions and relevance In an individual participant data meta-analysis of studies that compared PHQ scores with major depression diagnoses, the combination of PHQ-2 (with cutoff ≥2) followed by PHQ-9 (with cutoff ≥10) had similar sensitivity but higher specificity compared with PHQ-9 cutoff scores of 10 or greater alone. Further research is needed to understand the clinical and research value of this combined approach to screening.

This study used CD obesity-prone (OP) and obesity-resistant (OR) rats to examine how weight gain and fat accretion relate to fermentation levels and microbiota composition after feeding resistant starch (RS).After feeding OP rats and OR rats a high-fat (HF) diet for 4 weeks, rats were stratified into three groups: they were fed either an HF diet (group 1: HF-HF) or were switched to a low-fat (LF) diet (group 2: HF-LF) or an LF diet supplemented with 20% RS by weight for 4 weeks (group 3: HF-LFRS). Energy intake, body weight, fermentation variables, and microbiota composition were determined.In OP rats, RS elicited robust fermentation (increased cecal contents, short-chain fatty acids, and serum glucagon-like peptide 1). Total bacteria, species of the Bacteroidales family S24-7, and the archaean Methanobrevibacter smithii increased. The robust fermentation did not elicit higher weight or fat accretion when compared with that of control rats fed the same isocaloric diets (HF-LF ± RS). In OR rats, body weight and fat accretion were also not different between HF-LF ± RS diets, but RS elicited minimal changes in fermentation and microbiota composition.Robust fermentation did not contribute to greater weight. Fermentation levels and changes in microbiota composition in response to dietary RS differed by obesity phenotype.

The corrosion behavior of bearing steels was screened using potentiodynamic scans in seawater. The results of electrochemical testing provided a relative ranking of the bearing steels when tested in aqueous chloride-containing solution. The corrosion behavior of bearing steels in the lubricant environment has been observed to be quite different than in aqueous solution. Both the amount of water contamination in oil and chloride content of the water impact the observed corrosion rates in oil-water mixtures. All steel compositions tested demonstrated localized corrosion damage when exposed to oil with water added; however, inherently less corrosion-resistant alloys had more widespread shallow attack, whereas higher Cr-containing alloys displayed more localized severe attack. The mechanism of corrosion in the two-phase, oil plus aqueous phase system appears to be controlled by an aqueous corrosion process dependent on steel microstructure and emulsified or free water and likely limited by oxygen availability...

A new thermo-chemical, low-temperature nitridation method was successfully used to introduce interstitial nitrogen into the passive layer aluminum alloy 2024 to enhance corrosion resistance. The nitridation process is based on treating the aluminum samples in potassium nitrate salt in an ultra pure nitrogen atmosphere at 475 °C. Electrochemical linear polarization and cyclic voltammetry measurements, combined with characterization of surface morphology, were used to evaluate the coating performance after two weeks of immersion in 3.5% NaCl solution. Electrochemical testing and sample examination after immersion in NaCl solution indicated that the treatment improved the resistance of AA2024 to localized corrosion, but there did not appear to be a statistically significant change in general corrosion. The effect of the quenching after nitridation was also studied. It is shown through polarization resistance, Rp, measurements that quenching increases the Rp measurably, suggesting quenching provides improved coating properties.

Newly developed low-temperature nitride synthesis route was used to introduce interstitial nitrogen into the passive layer of as-received and as-polished 316L stainless steel. The new thermochemical route is based on treating the stainless steel samples in potassium nitrate melt in an ultra pure nitrogen atmosphere at 450 °C. Electrochemical impedance spectroscopy (EIS) and dc polarization measurements have been used to evaluate the nitride layer performance in 3.5% NaCl solution. Results showed a marked increase in the corrosion resistance of nitrided stainless steel even after maintaining two weeks in NaCl solution. The effect of the treatment temperature was also studied. Data showed that the as-polished samples nitrided at 450 °C have the highest corrosion resistance. The polarization resistance ( R p ) for the as-polished and as-received blank stainless steel samples was estimated by EIS were approximately 4.0 × 10 4 Ω cm 2 and 2.0 × 10 4 Ω cm 2 , respectively. The R p increased by a factor of 2.5–5 for the nitrided samples. Increasing the nitriding temperature from 450 to 600 °C affects negatively the corrosion resistance of stainless steel in NaCl solution. The R p of the samples nitrided at 600 °C decreased sharply being almost 1/30 of the R p of the samples nitrided at 450 °C. Linear polarization measurements showed that the lowest corrosion rates and highest polarization resistances obtained from the as-polished nitrided samples at 450 °C. It has been found from the potentiodynamic measurements that the E corr of the as-polished nitrided samples at 450 °C is nobler than that measured from the other groups. The surface morphology was analysed by optical microscope and SEM-EDS under different nitriding conditions.

The reaction kinetics of ZrN and HfN immersed in a quaternary salt of composition of 28.5% LiCl–36.3% KCl–29.4% NaCl–5.8% UCl 3 (in weight percent) were assessed. Coupons of ZrN and HfN were exposed to the quaternary salt at 525–900 °C for 4–485 h. The reaction kinetics of the salt-refractory interactions were assessed through physical and microstructural characterization including scanning electron microscopy, X-ray diffraction and mass spectrometry. The results indicated that ZrN and HfN lose weight under all conditions investigated. While multiple mechanisms were evident, it is proposed that dissolution and oxidation were the dominant reactions that influence the weight loss. For the overall reaction, negative apparent activation energy values of −46 and −28 kJ/mol were observed in ZrN and HfN, respectively. These seemingly anomalous activation energies were associated with the simultaneous occurrence of electrochemical dissolution and surface oxide formation.

A high energy ball milling process was used to produce dysprosium nitride and cerium nitride powders at room temperature. Dysprosium and cerium metal flakes were milled in a 275 kPa nitrogen atmosphere for 24 h at ambient temperatures. X-ray diffraction confirmed the formation of phase pure dysprosium nitride and cerium nitride powders. The median particle size of the resultant dysprosium nitride was measured as 4 μm using a laser scattering technique. The particle size of the cerium nitride was not measured due to its reactive nature.

The miniaturization of analytical instruments and packaging of novel sensors is an area that has attracted significant research interest and offers many opportunities for product commercialization. Electrochemical sensors have been used to detect a wide variety of compounds including toxic gases. A miniature electrochemical cell has been designed, constructed, and tested for functionality. The cell will be used in identifying and selecting chemical species in solutions. The cell was constructed of low temperature co-fired ceramic (LTCC) material using gold for the electrodes. Tests performed in sulfuric acid and sea water solutions show that the cell is functioning based on cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) analysis. Miniaturization allows the cell to be deployed as a sensor in many different environments.

The characteristics of densification and distortion of a 80W–14Ni–6Cu alloy during liquid-phase sintering (LPS) were investigated in relation to the liquid-phase formation. By means of differential thermal analysis (DTA), the melting process of the Ni–Cu matrix in a die-pressed compact was examined and compared with that in a loose powder mixture. It was revealed that enhanced inter-diffusion and in situ alloying occur between the tightly compacted elemental Cu and Ni powders during heating, leading to an extended temperature range for Ni–Cu liquid formation. Dilatometry and furnace sintering tests showed that the early melting of the Ni–Cu matrix results in an onset of liquid-phase sintering at a lower temperature with die compaction. Full densification of the compact, together with satisfactory microstructure, can be achieved prior to full melting of the Ni–Cu matrix. Distortion is delayed until the end of liquid-phase formation.

This paper aims to correlate the densification and distortion behaviors of liquid-phase sintered 80W-14Ni-6Cu and 80W-14Ni-6Fe heavy alloys with the melting characteristics of the Ni-Cu and Ni-Fe matrices. Differential thermal analysis (DTA) of die-pressed compacts reveals that the melting range of the Ni-Cu matrix is extended from 1235°C to 1453°C by the in situ alloying between elemental Cu and Ni powders, whereas the melting of the Ni-Fe matrix is limited to a narrow temperature range between 1464°C and 1480°C. Dilatometry and furnace sintering tests show that densification due to liquid-phase sintering of 80W-14Ni-6Cu starts at 1287°C and proceeds at a low rate to 1450°C, where full densification without distortion is achieved. In contrast, densification due to liquid-phase sintering of 80W-14Ni-6Fe occurs at a very high rate above 1475°C, and full density can be obtained at 1500°C. For both alloy compacts, distortion is induced by prolonging the sintering time or elevating the sintering temperature after full densification. Crack-like voids develop in the 80W-14Ni-6Cu compact to accommodate the gravity-induced distortion, while spherical pores are dominantly formed in the 80W-14Ni-6Fe compact as a result of water vapor entrapment.

Densification behavior is investigated by means of dilatometry for powder-injection-molded (PIM) and die-compacted 17-4 PH stainless steel during sintering in pure H2 and H2 + N2. The corresponding microstructural evolution is examined by quenching in a vertical furnace at various stages of sintering. The results show that in comparison with pure H2, the H2 + N2 atmosphere retards densification and produces a lower shrinkage rate above 1220 °C. The X-ray diffraction (XRD) analysis reveals the presence of a stabilized austenitic microstructure during H2 + N2 sintering. In pure H2, however, δ ferrite forms and grows above 1220 °C, producing a higher shrinkage rate. In terms of the atomic diffusivity, δ-ferrite formation is beneficial to pore shrinkage and densification.

Carbon contamination from the thermoplastic binder is an inherent problem with the metal powder injection molding process. Residual carbon in the compacts after debinding has a strong impact on the sintering process, microstructure, and mechanical properties. In this study, injection molded 17-4 PH stainless steel was debound to two levels of residual carbon, 0.203 ± 0.014 wt% and 0.113 ± 0.008 wt%, by elevating the debinding temperature from 450°C to 600°C. Dilatometry in H2 atmosphere shows that the 600°C-debound compacts shrink much faster than those debound at 450°C when the sintering temperature rises to over 1200°C. Density measurements for tensile bars sintered between 1260°C and 1380°C confirm the beneficial effect of low residual carbon content on sintering shrinkage. Quantitative metallography reveals that more δ-ferrite forms along austenite grain boundaries during sintering of the 600°C-debound compacts. In both samples, density gradients across the compact section are correlated with the residual carbon content and corresponding δ-ferrite formation. Finally, tensile tests show that the 600°C-debound compacts have lower tensile strength but higher ductility than those debound at 450°C. The relevant mechanisms are discussed with a focus on the effects of residual carbon content, δ-ferrite amount, and porosity.

A high energy, low-temperature, ball-milling route was used to directly produce uranium nitride. Pure uranium metal particles (∼100 μm) were ball milled under a 420 kPa nitrogen atmosphere for 24 h at ambient temperature to yield phase pure U 2 N 3 powder as confirmed by X-ray diffraction and energy dispersive spectroscopy. The median particle size was measured to be approximately 6 μm.

Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p.001), and, for functional impairment, 76% versus 3% (p.001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.

An electrochemical sensor has been constructed for detecting changes in the electrical responses of oil/metal systems. The sensor was used to make electrochemical impedance spectroscopy (EIS) measurements and the impedance responses are compared as a function of oil additive. This work uses the base stock oil (no additives) as the baseline for comparison of the various additives. Of the four additives tested, only the metal deactivator additive was found to increase the impedance. The full formulation oil (containing all additives) displays the lowest impedance, indicating possible additive interaction. A basic Randle's circuit was used to fit the impedance data. This type of fit provides information pertaining to the properties of the bulk oil and contributions due to the interactions at the oil/metal interface

The miniaturization of analytical instruments and packaging of novel sensors is an area that has attracted significant research interest and offers many opportunities for product commercialization. Low temperature co-fired ceramics (LTCC) is a materials system composed of alumina and glass in an organic binder. LTCC is a good choice for sensor development because of the ease of incorporating features in the 'green' or unfired state such as electrical traces, fluidic pathways and passive electrical components. After a firing cycle, what remains is a robust, monolithic device with features embedded in the package. In order for LTCC to be a successful medium for small scale sensors or lab-in-package devices, fluid flow through channels and inlet/outlet ports must be perfected. Device inlet/outlet ports have been demonstrated by embedding sapphire tubes in LTCC, allowing external connections using compression fittings. Channels and cavities have been fabricated through the use of sacrificial carbon tapes and pastes. A field flow fractionation device used for separating or concentrating constituent components in a fluid and a multi-electrode electrochemical cell were fabricated with the techniques described in this paper.

The different tasks that have been carried out under the current program are as follows: (1) Theoretical and experimental assessment of general corrosion of iron/steel in borate buffer solutions by using electrochemical impedance spectroscopy (EIS), ellipsometry and XPS techniques; (2) Development of a damage function analysis (DFA), which would help in predicting the accumulation of damage due to pitting corrosion in an environment prototypical of DOE liquid waste systems; (3) Experimental measurement of crack growth rate, acoustic emission signals, and coupling currents for fracture in carbon and low alloy steels as functions of mechanical (stress intensity), chemical (conductivity), electrochemical (corrosion potential, ECP), and microstructural (grain size, precipitate size, etc) variables in a systematic manner, with particular attention being focused on the structure of the noise in the current and its correlation with the acoustic emissions; (4) Development of fracture mechanisms for carbon and low alloy steels that are consistent with the crack growth rate, coupling current data and acoustic emissions; (5) Inserting advanced crack growth rate models for SCC into existing deterministic codes for predicting the evolution of corrosion damage in DOE liquid waste storage tanks; (6) Computer simulation of the anodic and cathodic activity on the surface of the steel samples in order to exactly predict the corrosion mechanisms; (7) Wavelet analysis of EC noise data from steel samples undergoing corrosion in an environment similar to that of the high level waste storage containers, to extract data pertaining to general, pitting and stress corrosion processes, from the overall data. The work has yielded a number of important findings, including an unequivocal demonstration of the role of chloride ion in passivity breakdown on nickel in terms of cation vacancy generation within the passive film, the first detection and characterization of individual micro fracture events in stress corrosion cracking, and the determination of kinetic parameters for the generation and annihilation of point defects in the passive film on iron. The existence of coupling between the internal crack environment and the external cathodic environment, as predicted by the coupled environment fracture model (CEFM), has also been indisputably established for the AISI 4340/NaOH system. It is evident from the studies that analysis of coupling current noise is a very sensitive tool for studying the crack tip processes in relation to the chemical, mechanical, electrochemical, and microstructural properties of the system. Experiments are currently being carried out to explore these crack tip processes by simultaneous measurement of the acoustic activity at the crack tip in an effort to validate the coupling current data. These latter data are now being used to deterministically predict the accumulation of general and localized corrosion damage on carbon in prototypical DOE liquid waste storage tanks. Computer simulation of the cathodic and anodic activity on the steel surfaces is also being carried out in an effort to simulate the actual corrosion process. Wavelet analysis of the coupling current data promises to be a useful tool to differentiate between the different corrosion mechanisms. Hence, wavelet analysis of the coupling current data from the DOE waste containers is also being carried out to extract data pertaining to general, pitting and stress corrosion processes, from the overall data which is bound to contain noise fluctuations due to any or all of the above mentioned processes.

Logging is a dangerous occupation, as documented through reported injuries and fatalities. Accidents in the logging industry account for pain, suffering, employee turnover, and high insurance costs. Worker injuries and high insurance costs, in addition to other factors, may be minimized and reduced through safety education and improved logging practices. Furthermore, the injured logger, or logger with a disability may return to logging or other employment through development of viable medical and vocational rehabilitation planing. This article addresses the economic impact of logging, reviews logging injuries, describes a safety program designed to reduce logging injures, discusses rehabilitation considerations for specific injuries, and outlines particular reemployment prospects for loggers with disabilities.