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'Phase-only Fresnel holograms', which can be displayed on a single SLM without the need of lenses or complicated optical accessories, substantially simplifies the 3-D holographic display system. Exploring essential concepts, theories and formulations of these phase-only Fresnel holograms, this book provides comprehensive coverage of modern methods for generating such holograms, which pave the way for commercial products such as compact holographic projectors, head-up display, and data security enhancement. Relevant MATLAB® codes are provided for readers to implement and evaluate the theories and formulations of different methods, and can be used as a quick start framework for further research and development. For students and researchers in electrical and electronic engineering, computer science/engineering, applied physics, information technology and multimedia technology as well as engineers and scientists in industry developing new products on 3-D display and holographic projection, this is a crucial and up-to-date treatment of Phase-only Fresnel holograms.
From midlife to old age, women are influenced differently by developmental transitions compared with men. These transitions range from menopause to subjective experiences such as appearance-related changes and caregiving responsibilities. More importantly, cultural and personal factors may impact how people understand these transitions. As such, cultural differences may be reflected in the expression, subjective experiences, and consequences of these developmental transitions. Concerning menopause, cultures influence the expression of menopausal symptoms and their psychological consequences. Moreover, cultural factors also impact women’s perceptions of appearance-related changes, and their appraisals of the caregiving experiences. Future developmental studies on women might focus on the moderating role of culture in the ways women interpret and cope with developmental changes in the second half of life.
One of the commonly used analytical approaches for measuring oxygen isotope ratios δ18O of solids (organic and inorganic) is to pyrolyze the samples to gaseous phases and then send the gas into an isotope ratio mass spectrometer system. Solid samples for δ18O measurements are usually stored in silver cups because of its low reactivity towards oxygen and other oxidants. Samples in silver cups can be dropped directly into the carbon column of the pyrolysis furnace. However, the silver cups can tarnish and then be oxidized over a prolonged storage period. We find that while a small amount of silver oxides does not affect measurements with appreciable sample sizes, it can skew isotope results of small samples. We thus recommend careful storage of samples in silver cups to minimize oxidation, such as under an air-isolated condition, and avoiding prolonged storage for accurate δ18O measurements.
Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.
Imprinting, characterized by unequal expression of the offspring's genes in a parent-of-origin dependent manner, has been functionally implicated in brain development and in psychiatric disorders. In this study, unambiguous distortion in paternal but not maternal transmission of the disease-associated single-nucleotide polymorphism (SNP) rs6556547 (T/G) clearly indicated the presence of parent-of-origin effect (POE) in the GABAA receptor β2 subunit gene (GABRB2). ‘Flipping’ of allelic mRNA expression in heterozygotes of SNP rs2229944 (C/T) and the observed two-tiered distribution of mRNA expression levels in heterozygotes of the disease-associated SNP rs1816071 (G/A) furnished important support for the occurrence of imprinting at GABRB2. Imprinting in effect introduced heterozygotes from different parents-of-origin endowed with dissimilar mRNA expression capabilities. The deficit of upper-tiered expressions accounted for the lowered mRNA expression levels in the schizophrenic heterozygotes. This pointed to the necessity of differentiating between two kinds of heterozygotes of different parental origins in disease association studies on GABRB2. Bisulfite sequencing revealed hypermethylation in the neighborhood of SNP rs1816071, and methylation differences between controls and schizophrenia patients. Notably, allele-specific methylation was observed at the disease-associated SNPs rs6556547 and rs1816071. These findings raised the possibility that CpG methylation status of these sites could have an impact on the expression of GABRB2 and the risk of schizophrenia. Furthermore, the occurrence of imprinting and allele-specific methylation in the schizophrenia candidate gene GABRB2 was compatible with the epigenetic hypothesis for schizophrenia pathophysiology, thereby calling for the need to explore the role of epigenetic factors in mediating susceptibility to schizophrenia.
Previously the GABA(A) receptor beta-2 subunit gene GABRB2 was found to be associated with schizophrenia (SCZ). for SNPs and haplotypes in GRBRB2, the associations with bipolar disorder (BPD), the functional consequences on GABRB2 expression and their relationship to demographic and clinical characteristics in BPD and SCZ remain to be elucidated.
Case-control analysis was performed for association study of GABRB2 with BPD, and its mRNA expression in postmortem BPD brains was examined using quantitative real-time PCR. Quantitative trait analysis was subsequently employed to assess the covariate effects of demographic and clinical characteristics on genotypic correlation of GABRB2 expression in SCZ and BPD.
Significant association of GABRB2 with BPD and reduction in GABRB2 mRNA expression in BPD brains were observed in the present study. Duration of illness (DOI) was found to be a significant covariate for the correlation of the disease-associated SNPs rs1816071, rs1816072 and rs187269 with GABRB2 expression in both SCZ and BPD. for individuals with homozygous major genotypes of these SNPs, while GABRB2 expression increased with age in the controls, it decreased with DOI and age in SCZ, and with DOI in BPD. with age of onset as covariate, these three SNPs were significantly correlated with antipsychotic dosage in SCZ.
These results have thus revealed correlations of GABRB2 SNPs and expression not only with the occurrence of SCZ and BPD, but also with the clinical characteristics of patients, therefore providing support for a shared etiological role played by the gene in both diseases.
GABRB2, the gene for β2 subunit of the gamma-aminobutyric acid type A (GABAA) receptor, is known to display two splicing isoforms in the brain, namely β2L containing Exon 10 and β2S devoid of Exon 10. Previously, the expressions of these isoforms were correlated with both schizophrenia and various sequence polymorphisms of the gene. in the present study, a series of deletions made on Intron 9 of a minigene construct affected the expression of Exon 10, and generated additional splicing variations suggesting the existence of additional splicing variants of β2subunit. A search among brain cDNAs uncovered the two novel short forms: β2S1which is devoid of Exons 10 and 11 and bears an extended Exon 9, and β2S2 which is devoid of Exon 10 and bears a shortened Exon 11.Real-time quantitative polymerase chain reaction, performed with a cohort of 31 schizophrenics, 30 bipolar disorder and 31 controls of US population, showed that the level of β2S2 was significantly decreased in bipolar disorder, and marginally decreased in schizophrenia, while β2S1 was marginally increased in both of these psychotic disorders. Significant genotypic effects of rs1816071, rs1816072 and rs187269 on β2S2 level were observed in male schizophrenic and bipolar patients. These findings pointed to the neighborhood of Exon 10 as an alternate-splicing hot-spot, and underlined the relevance of β2 subunit isoforms to the etiology of psychotic disorders.
Animal assisted therapy (AAT) is becoming increasingly utilized for psychiatric patients with suboptimal response to traditional therapies. Larger animals, such as horses, may be especially effective therapy enhancers for some patients.
We have introduced AAT at a 500 bed psychiatric hospital in New Jersey. We previously conducted a randomized control trial (n=103) of ten weekly AAT group therapy sessions, comparing canine assisted therapy, equine facilitated therapy (EFT), enhanced psychosocial therapy, and standard treatment in highly regressed and/or violent patients. Initial analyses indicated that the EFT group had fewer violence-related incidents during the 3 months following the intervention compared with the other groups (p< 0.05).
We have initiated a second randomized controlled study comparing EFT with standard hospital treatment in a similar sample.
Based on observations that patients with trauma/abuse histories may find AAT beneficial, this partial replication study is assessing whether trauma history and perceptions relate to symptomatic and functional outcome with EFT.
Preliminary post-session interviews over several weeks for a subgroup of four patients with reported trauma histories (rates comparable to persons with PTSD on the Traumatic Life Events Questionnaire) elicited explicit trauma-related themes (e.g., recollection of past abuse) as well as putative indirect references such as identifying with the horses as understanding their pain and representing “hope.”
The presentation reviews the evolution and refinement of the intervention at our hospital, challenges to implementation, therapeutic course, preliminary outcome assessments, quantitative and qualitative, comparing EFT with standard treatment in the studies.
To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong.
A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed.
From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 × 106 copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 × 106 copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient’s chin with or without wearing a surgical mask.
Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.
Adults aged > 50 years, which make up to 40% of the European population, are vulnerable to low vitamin B12 (B12) status due to age-related factors that impair digestion and absorption of protein-bound B12 from natural food sources. Older adults are recommended to meeting their dietary B12 intake through the consumption of B12-fortified foods or supplements because these products contain free B12. B12 seems most bioavailable from milk products compared to other food sources, showcasing dairy as a potential vehicle for B12 food fortification. Yogurt is a versatile, popular dairy product, making it a promising food vehicle for B12 fortification to enhance the availability of B12-fortified foods for population groups at risk of B12 deficiency. With the overall goal to develop a novel, B12-fortified dairy product, the objective of this project was to compare the shelf-life stability of different chemical forms of B12 added to yogurt either in isolated or in encapsulated form. For both fortification strategies, we compared methylcobalamin (MeCB), a naturally-occurring B12 form, and cyanocobalamin (CnCB), the synthetic form of B12. Encapsulated microparticles were created by spray-drying a maize starch-derived polymeric material (EUDRAGUARD Natural®) with 1% (w/V) MeCB or CnCB. The release of B12 from encapsulated microparticles was confirmed by in vitro simulated gastrointestinal digestion; maximum B12 release (103% recovery) was achieved under conditions simulating the small intestine, where B12 is absorbed in the human body. Yogurts were produced by incubating whole milk (3.25% milk fat) with yogurt starter bacteria at 43°C overnight; after fermentation and cooling down, isolated (I-MeCB or I-CnCB) or encapsulated B12 powders (E-MeCB or E-CnCB) in the concentration of 50μg of B12/175 g of yogurt were added, creating stirred yogurt. Yogurts were stored at 4°C for eight weeks, with intermittent sampling for B12 stability testing using RIDASCREEN immunoassay. For CnCB-fortified yogurts, I-CnCB and E-CnCB had similar B12 concentrations at baseline (48.3μg and 48.2μg, respectively) and week 8 (53.9μg and 51.4μg, respectively). Difference in B12 content between I-CnCB and E-CnCB was < 5% for both time-points. For MeCB, similar concentrations were found for I-MeCB (64.1μg) and E-MeCB (65.0μg) at baseline; however, at week 8, E-MeCB remained stable (69.8μg) while a pronounced decrease in B12 was observed with I-MeCB (33.3μg). At week 8, I-MeCB B12 concentrations were 52% lower than E-MeCB. In conclusion, CnCB was shown to be the more stable fortificant throughout shelf-life. Encapsulation techniques are a viable option to increase MeCB stability in fortified yogurts.
Short-term survival after paediatric cardiac surgery has improved significantly over the past 20 years and increasing attention is being given to measuring and reducing incidence of morbidities following surgery. How to best use routinely collected data to share morbidity information constitutes a challenge for clinical teams interested in analysing their outcomes for quality improvement. We aimed to develop a tool facilitating this process in the context of monitoring morbidities following paediatric cardiac surgery, as part of a prospective multi-centre research study in the United Kingdom.
We developed a prototype software tool to analyse and present data about morbidities associated with cardiac surgery in children. We used an iterative process, involving engagement with potential users, tool design and implementation, and feedback collection. Graphical data displays were based on the use of icons and graphs designed in collaboration with clinicians.
Our tool enables automatic creation of graphical summaries, displayed as a Microsoft PowerPoint presentation, from a spreadsheet containing patient-level data about specified cardiac surgery morbidities. Data summaries include numbers/percentages of cases with morbidities reported, co-occurrences of different morbidities, and time series of each complication over a time window.
Our work was characterised by a very high level of interaction with potential users of the tool, enabling us to promptly account for feedback and suggestions from clinicians and data managers. The United Kingdom centres involved in the project received the tool positively, and several expressed their interest in using it as part of their routine practice.
The earliest colonisation of oceanic islands by Homo sapiens occurred ~50 000–30 000 years ago in the Western Pacific, yet how this was achieved remains a matter of debate. With a focus on East Asia, the research presented here tests the hypothesis that bamboo rafts were used for these early maritime migrations. The authors review the evidence for Palaeolithic seafaring in East Asia as the context for an experimental archaeology project to build two bamboo watercraft. Sea trials demonstrate the unsuitability of bamboo, at least in East Asia, indicating that more sophisticated and durable vessels would have been required to traverse the Kuroshio Current.
A higher incidence of psychotic disorders has been consistently reported among black and other minority ethnic groups, particularly in northern Europe. It is unclear whether these rates have changed over time.
We identified all individuals with a first episode psychosis who presented to adult mental health services between 1 May 2010 and 30 April 2012 and who were resident in London boroughs of Lambeth and Southwark. We estimated age-and-gender standardised incidence rates overall and by ethnic group, then compared our findings to those reported in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) study that we carried out in the same catchment area around 10 years earlier.
From 9109 clinical records we identified 558 patients with first episode psychosis. Compared with ÆSOP, the overall incidence rates of psychotic disorder in southeast London have increased from 49.4 (95% confidence interval (CI) 43.6–55.3) to 63.1 (95% CI 57.3–69.0) per 100 000 person-years at risk. However, the overall incidence rate ratios (IRR) were reduced in some ethnic groups: for example, IRR (95% CI) for the black Caribbean group reduced from 6.7 (5.4–8.3) to 2.8 (2.1–3.6) and the ‘mixed’ group from 2.7 (1.8–4.2) to 1.4 (0.9–2.1). In the black African group, there was a negligible difference from 4.1 (3.2–5.3) to 3.5 (2.8–4.5).
We found that incidence rates of psychosis have increased over time, and the IRR varied by the ethnic group. Future studies are needed to investigate more changes over time and determinants of change.
Hyperbaric oxygen therapy (HBOT) shows promising results in treating radionecrosis (RN) but there is limited evidence for its use in brain RN. The purpose of this study is to report the outcomes of using HBOT for symptomatic brain RN at a single institution.
This was a retrospective review of patients with symptomatic brain RN between 2008 and 2018 and was treated with HBOT. Demographic data, steroid use, clinical response, radiologic response and toxicities were collected. The index time for analysis was the first day of HBOT. The primary endpoint was clinical improvement of a presenting symptom, including steroid dose reduction.
Thirteen patients who received HBOT for symptomatic RN were included. The median time from last brain radiation therapy to presenting symptoms of brain RN was 6 months. Twelve patients (92%) had clinical improvement with median time to symptom improvement of 33 days (range 1–109 days). One patient had transient improvement after HBOT but had recurrent symptomatic RN at 12 months. Of the eight patients with evaluable follow-up MRI, four patients had radiological improvement while four had stable necrosis appearance. Two patients had subsequent deterioration in MRI appearances, one each in the background of initial radiologic improvement and stability. Median survival was 15 months with median follow-up of 10 months. Seven patients reported side effects attributable to HBOT (54%), four of which were otologic in origin.
HBOT is a safe and effective treatment for brain RN. HBOT showed clinical and radiologic improvement or stability in most patients. Prospective studies to further evaluate the effectiveness and side effects of HBOT are needed.
To report an outbreak of measles with epidemiological link between Hong Kong International Airport (HKIA) and a hospital.
Epidemiological investigations, patients’ measles serology, and phylogenetic analysis of the hemagglutinin (H) and nucleoprotein (N) genes of measles virus isolates were conducted.
In total, 29 HKIA staff of diverse ranks and working locations were infected with measles within 1 month. Significantly fewer affected staff had history of travel than non–HKIA-related measles patients [10 of 29 (34.5%) vs 28 of 35 (80%); P < .01]. Of 9 airport staff who could recall detailed exposure history, 6 (66.7%) had visited self-service food premises at HKIA during the incubation period, where food trays, as observed during the epidemiological field investigation, were not washed after use. Furthermore, 1 airport baggage handler who was admitted to hospital A before rash onset infected 2 healthcare workers (HCWs) known to have 2 doses of MMR vaccination with positive measles IgG and lower viral loads in respiratory specimens. Infections in these 2 HCWs warranted contact tracing of another 168 persons (97 patients and 71 HCWs). Phylogenetic comparison of H and N gene sequences confirmed the clonality of outbreak strains.
Despite good herd immunity with overall seroprevalence of >95% against measles, major outbreaks of measles occurred among HKIA staff having daily contact with many international pssengers. Lessons from severe acute respiratory syndrome (SARS) and measles outbreaks suggested that an airport can be a strategic epidemic center. Pre-exanthem transmission of measles from airport staff to HCWs with secondary vaccine failure poses a grave challenge to hospital infection control.
It has been over 5 years since the last special issue of Twin Research and Human Genetics on ‘Twin Registries Worldwide: An Important Resource for Scientific Research’ was published. Much progress has been made in the broad field of twin research since that time, and the current special issue is a follow-up to update the scientific community about twin registries around the globe. The present article builds upon our 2013 Registry description by summarizing current information on the Washington State Twin Registry (WSTR), including history and construction methods, member characteristics, available data, and major research goals. We also provide a section with brief summaries of recently completed studies and discuss the future research directions of the WSTR. The Registry has grown in terms of size and scope since 2013; highlights include recruitment of youth pairs under 18 years of age, extensive geocoding work to develop environmental exposures that can be linked to survey and administrative health data such as death records, and expansion of a biobank with specimens collected for genotyping, DNA methylation, and microbiome based-studies.
We consider the steady flow of a granular current over a uniformly sloped surface that is smooth upstream (allowing slip for
) but rough downstream (imposing a no-slip condition on
), with a sharp transition at
. This problem is similar to the classical Blasius problem, which considers the growth of a boundary layer over a flat plate in a Newtonian fluid that is subject to a similar step change in boundary conditions. Our discrete particle model simulations show that a comparable boundary-layer phenomenon occurs for the granular problem: the effects of basal roughness are initially localised at the base but gradually spread throughout the depth of the current. A rheological model can be used to investigate the changing internal velocity profile. The boundary layer is a region of high shear rate and therefore high inertial number
; its dynamics is governed by the asymptotic behaviour of the granular rheology for high values of the inertial number. The
rheology (Jop et al., Nature, vol. 441 (7094), 2006, pp. 727–730) asserts that
, but current experimental evidence is insufficient to confirm this. We show that this rheology does not admit a self-similar boundary layer, but that there exist generalisations of the
rheology, with different dependencies of
, for which such self-similar solutions do exist. These solutions show good quantitative agreement with the results of our discrete particle model simulations.
Civil emergencies occurring with little warning can quickly produce mass casualties. To develop an Emergency Department’s surge capacity, medical student involvement in the disaster response has been advocated. Duke-NUS Medical School in Singapore is located in proximity to Singapore General Hospital (SGH) and represents an untapped manpower resource. With appropriate training, medical students can be leveraged upon as ready and reasonably qualified manpower.
This review provides a snapshot of the conceptualization and setting up of the Disaster Volunteer Corps (DVC) program. We discuss the overall strategy and benefits to stakeholders, emphasizing the close symbiotic relationship between academia and healthcare services.
Duke-NUS medical students will be recruited to receive training from SGH emergency physicians. The frequency of training will be four times yearly, with ad hoc participation in disaster simulation exercises. A call-tree will be employed for DVC activation. The DVC curriculum includes disaster response principles, HAZMAT, crowd control, marshaling, logistics, psychological support, and basic first aid. Teaching methods include didactic lectures, case discussions, involvement in event medical cover, and participation in disaster simulation exercises and response planning.
To date, there are 10 medical students and four emergency physician faculty volunteers involved in the program. Support is provided by adjunct instructors from nursing, nuclear medicine, social work, and security, for training in decontamination, radiological disasters, psychological first aid, and crowd control measures respectively. Assessment by faculty will be conducted to ensure the quality of training and competency of skills.
The DVC provides a unique way of teaching medical students disaster medicine principles in a hands-on experiential format, while simultaneously enhancing the operational readiness of the hospital in times of disaster. This model of close collaboration between university educational and healthcare services provides a feasible model of structured volunteerism that could be replicated in other similar settings.