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Microsupercapacitors (MSCs) are miniaturized energy storage devices that can be integrated in an on-chip platform as a component of a power supply for Internet of things’ sensors. Integration of these on-chip MSCs require them to be fabricated through CMOS compatible fabrication techniques such as spin coating. One of the biggest challenges in spin coated MSCs is the poor surface adhesion. In this work, we present a CMOS compatible electrode deposition process with enhanced adhesion and retention for reduced graphene oxide (rGO) using spin coating. In order to improve the adhesion and surface uniformity of the deposited electrode material, the surface of Si/SiO2 wafers was subjected to roughening through Fe nanoparticle formation. A 4 nm thick Fe layer deposition substantially magnified the average mean surface roughness of the substrates. In comparison with substrates without the Fe deposition, the treated ones have more than 300% improvement in surface coverage and rGO mass retention after sonication testing. These results suggest that the surface roughening has a positive influence on electrode deposition via a spin-coating method.
We reviewed all patients who were supported with extracorporeal membrane oxygenation and/or ventricular assist device at our institution in order to describe diagnostic characteristics and assess mortality.
A retrospective cohort study was performed including all patients supported with extracorporeal membrane oxygenation and/or ventricular assist device from our first case (8 October, 1998) through 25 July, 2016. The primary outcome of interest was mortality, which was modelled by the Kaplan–Meier method.
A total of 223 patients underwent 241 extracorporeal membrane oxygenation runs. Median support time was 4.0 days, ranging from 0.04 to 55.8 days, with a mean of 6.4±7.0 days. Mean (±SD) age at initiation was 727.4 days (±146.9 days). Indications for extracorporeal membrane oxygenation were stratified by primary indication: cardiac extracorporeal membrane oxygenation (n=175; 72.6%) or respiratory extracorporeal membrane oxygenation (n=66; 27.4%). The most frequent diagnosis for cardiac extracorporeal membrane oxygenation patients was hypoplastic left heart syndrome or hypoplastic left heart syndrome-related malformation (n=55 patients with HLHS who underwent 64 extracorporeal membrane oxygenation runs). For respiratory extracorporeal membrane oxygenation, the most frequent diagnosis was congenital diaphragmatic hernia (n=22). A total of 24 patients underwent 26 ventricular assist device runs. Median support time was 7 days, ranging from 0 to 75 days, with a mean of 15.3±18.8 days. Mean age at initiation of ventricular assist device was 2530.8±660.2 days (6.93±1.81 years). Cardiomyopathy/myocarditis was the most frequent indication for ventricular assist device placement (n=14; 53.8%). Survival to discharge was 42.2% for extracorporeal membrane oxygenation patients and 54.2% for ventricular assist device patients. Kaplan–Meier 1-year survival was as follows: all patients, 41.0%; extracorporeal membrane oxygenation patients, 41.0%; and ventricular assist device patients, 43.2%. Kaplan–Meier 5-year survival was as follows: all patients, 39.7%; extracorporeal membrane oxygenation patients, 39.7%; and ventricular assist device patients, 43.2%.
This single-institutional 18-year review documents the differential probability of survival for various sub-groups of patients who require support with extracorporeal membrane oxygenation or ventricular assist device. The indication for mechanical circulatory support, underlying diagnosis, age, and setting in which cannulation occurs may affect survival after extracorporeal membrane oxygenation and ventricular assist device. The Kaplan–Meier analyses in this study demonstrate that patients who survive to hospital discharge have an excellent chance of longer-term survival.
The polysaccharide alginate has received most extensive attention as bioink in bioprinting applications due to its ability to undergo gelation under cell-friendly conditions. However, absence of cell-binding motifs and the erratic degradation of alginate hydrogels have remained their persistent limitations. Honey is a conveniently available natural material, known for its role in wound healing and skin tissue regeneration. However, honey blending to improve biological response of alginate-based bioprinted scaffolds has not been yet reported. In the present work, honey-alginate bioinks were evaluated for their printability property (shape fidelity). It was found that honey blending reduced alginate viscosity, which gradually affected bioprinting fidelity. Therefore, the concentration that provides for acceptable bioprinting along with improvement in cell proliferations is determined. It is concluded that honey blending improves cell response of alginate bioinks and can be a facile approach to obtain bioinks especially for in situ skin tissue engineering applications.
Survival for hypoplastic left heart syndrome patients following the Norwood procedure is 71–90%. Mortality in patients with Turner’s syndrome and hypoplastic left heart syndrome after conventional palliation (Norwood operation) has been reported as high as 80%. This questions the approach of traditional staged palliation. Here, we report a patient with hypoplastic left heart syndrome and Turner’s syndrome bridged to orthotopic heart transplantation following a hybrid procedure.
The ageing of populations is an unprecedented worldwide phenomenon that has created anxiety about labour and skill shortages in many developed countries. One way to address these concerns is to extend the working lives of seniors through appropriate retirement, retention and recruitment policies. This paper utilises official policy documentation and employment data to compare the policies, practices and predicaments of senior employment in Hong Kong and Singapore, two of developed Asia's most ageing economies. It finds that while labour force participation rates among Hong Kong seniors have declined since the early 1990s, older workers in Singapore remain largely confined to the secondary labour market. This paper examines why these trends are occurring and whether longer working lives will lead to greater opportunities for ‘active ageing’ in employment or, conversely, force older workers into a reserve army of labour to maintain their incomes.
This paper presents a model to study the two prominent coexisting instabilities, stimulated Raman (SRS), and stimulated Brillouin scattering (SBS) in the presence of background axial magnetic field. In the context of laser-produced plasmas, this model is very useful in the situations where a self-generated axial magnetic field is present as well as where an external axial magnetic field is applied. Due to the interplay between both the scattering processes, the behavior of one scattering process is greatly modified in the presence of another coexisting scattering process. The impact of this coexisting phenomenon and axial magnetic field on the back reflectivity of scattered beams has been explored. It has been demonstrated that the back reflectivity gets modified significantly due to the coexistence of both the scattering processes (SRS and SBS) as well as due to the axial magnetic field. Results are also compared with the three-wave interaction case (isolated SRS or SBS case).
Bisphenol-A (BPA) is a widely used endocrine-disrupting chemical. Prenatal exposure to BPA is known to affect birth weight, but its impact on the cardiovascular system has not been studied in detail. In this study, we investigated the effects of prenatal BPA treatment and its interaction with postnatal overfeeding on the cardiovascular system. Pregnant sheep were given daily subcutaneous injections of corn oil (control) or BPA (0.5 mg/kg/day in corn oil) from day 30 to day 90 of gestation. A subset of female offspring of these dams were overfed to increase body weight to ~30% over that of normal fed controls. Cardiovascular function was assessed using non-invasive echocardiography and cuff blood pressure (BP) monitoring at 21 months of age. Ventricular tissue was analyzed for gene expression of cardiac markers of hypertrophy and collagen at the end of the observation period. Prenatal BPA exposure had no significant effect on BP or morphometric measures. However, it increased atrial natriuretic peptide gene expression in the ventricles and reduced collagen expression in the right ventricle. Overfeeding produced a marked increase in body weight and BP. There were compensatory increases in left ventricular area and internal diameter. Prenatal BPA treatment produced a significant increase in interventricular septal thickness when animals were overfed. However, it appeared to block the increase in BP and left ventricular area caused by overfeeding. Taken together, these results suggest that prenatal BPA produces intrinsic changes in the heart that are capable of modulating morphological and functional parameters when animals become obese in later life.
Background: Seizures and epilepsy are well-recognized complications after stroke. However, the reported incidence varies and so does their management. Methods: We conducted a systematic review and sought observational studies that reported incidence of seizures and/or epilepsy following arterial ischemic stroke in adults, and those that reported the management of epilepsy, specifically the use of EEG to determine the diagnosis, timing of initiation of anti-epileptic drug (AED), and the treatment response to AEDs. We systematically searched in Medline including Pre-Medline and EMBASE databases from their inception to October 1, 2015. First the titles and then the articles were reviewed and rated by two independent reviewers, and disagreements were resolved by consultation with a third reviewer. A pre-set data abstraction form was used for extracting the information of interest. Results: A total of 11,815 titles were found from the initial search strategy across all databases following de-duplication. Of these 130 studies are included for full text review. The adjudication process is underway and the reviewers are sifting through these studies to select the studies that will be included in the final review. Conclusions: Understanding incidence and management of post-stroke epilepsy is important to improve the quality of life of stroke survivors.
Background: Stroke leads to a substantial societal economic burden. We aimed to characterize productivity and factors associated with employability in Canadian stroke survivors. Methods: We used the Canadian Community Health Survey (CCHS) 2010-2011 to identify stroke survivors and employment status. We used multivariable models to determine the impact of stroke on employment and factors associated with employability. We used the Heckman model to estimate the effect of stroke on productivity (number of hours worked/week and hourly wages). Results: We included data from 91,633 respondents between 18 and 70 years and identified 923 (1%) stroke survivors. Stroke survivors were less likely to be employed (adjusted Odds Ratio 0.39, 95% CI 0.33 to 0.46) and had hourly wages 17.7% (95% CI 8.3% to 27.1%) lower compared to the general population, although there was no association between work hours and being a stroke survivor. Older age, being single and having medical comorbidities were associated with lower odds of employment in stroke survivors. Conclusions: Stroke survivors are less likely to be employed and earn a lower hourly wage than the general population. Interventions such as dedicated vocational rehabilitation and policies around return to work could be considered to address this lost productivity among stroke survivors.
Complete UBV light-curves of RR-Lep and RX-Hya have been obtained during 1983-87 seasons. Preliminary elements were computed using modified Wellmann’s method. With these parameters as inputs Wilson-Devinney program was executed for Blue and Yellow passbands simultaneously in detached and semi-detached modes for both the systems. The semidetached mode fitted better than the other solution for both the systems. For RR-Lep, the absolute dimensions were computed by assuming the primary to be a slightly evolved main sequence star. For RX-Hya, the absolute dimensions were computed using Struve’s spectroscopic data. The following table gives all the elements for both the systems. The secondaries of both the systems are overluminous for their masses suggesting that they have lost considerable mass.
Interplanetary Scintillation (IPS) is a diffraction phenomenon in which coherent electro-magnetic radiation, from a distant radio source, passes through the solar wind, which is a turbulent refracting medium, and suffers scattering. This results in random temporal variations of the signal intensity (scintillation) at the Earth. IPS observations to monitor the interplanetary medium (IPM), to measure solar wind velocities in the directions of a number of compact extra-galactic radio sources and to estimate the angular diameters of their compact components have been carried out for many years at 103 MHz using the IPS facility (Alurkar et al. 1989) of the Physical Research Laboratory (PRL), Ahmedabad, India. Over a period of approximately 10 years of such observations, it has been seen that PSR 0950+08 has always remained well within the noise level. We observed a sudden enhancement in its flux (Deshpande et al. 1994) on 29 July, 1992. The ionospheric observations which are being carried out on a regular basis at PRL using an ionosonde also recorded a steep increase in the absorption index Fmin, which is an indicator of the excess ionization produced due to X-rays. During this period, the Sun was exceptionally quiet, thereby raising the question about the origin of the X-ray flux responsible for the observed steep rise in Fmin during the transit of PSR 0950+08.
We report in this paper a novel miniaturized (12 × 18 × 1.6 mm3) microstrip fed UWB antenna with tunable notched band characteristics. The proposed antenna covers the tunable notched band for IEEE 802.11a wireless local area network operating in the frequency band of 5.15–5.825 GHz. The design of proposed antenna includes annular ring radiating patch with two T-shaped strips present inside it. The band notching is obtained by adjusting coupling between T-shaped strips placed inside the annular ring. In order to achieve larger bandwidth the ground plane of the microstrip antenna is modified. The simulated return loss of the proposed antenna has been verified in fabricated antenna experimentally, which has been in good agreement.
In search of a suitable resource conservation technology under pigeonpea (Cajanus cajan L.)–wheat (Triticum aestivum L.) system in the Indo-Gangetic Plains, the effects of conservation agriculture (CA) on crop productivity and water-use efficiency (WUE) were evaluated during a 3-year study. The treatments were: conventional tillage (CT), zero tillage (ZT) with planting on permanent narrow beds (PNB), PNB with residue (PNB + R), ZT with planting on permanent broad beds (PBB) and PBB + R. The PBB + R plots had higher pigeonpea grain yield than the CT plots in all 3 years. However, wheat grain yields under all plots were similar in all years except for PBB + R plots in the second year, which had higher wheat yield than CT plots. The contrast analysis showed that pigeonpea grain yield of CA plots was significantly higher than CT plots in the first year. However, both pigeonpea and wheat grain yields during the last 2 years under CA and CT plots were similar. The PBB + R plots had higher system WUE than the CT plots in the second and third years. Plots under CA had significantly higher WUE and significantly lower water use than CT plots in these years. The PBB + R plots had higher WUE than PNB + R and PNB plots. Also, the PBB plots had higher WUE than PNB in the second and third years, despite similar water use. The interactions of bed width and residue management for all parameters in the second and third years were not significant. Those positive impacts under PBB + R plots over CT plots were perceived to be due to no tillage and significantly higher amount of estimated residue retention. Thus, both PBB and PBB + R technologies would be very useful under a pigeonpea–wheat cropping system in this region.
Biologic therapies have revolutionized nearly every discipline of medicine. As our understanding of the relevant immunologic pathways of cancer, rheumatologic disease, hematopoietic and solid organ transplantation has evolved, so has the discovery of new monoclonal antibodies for targeted therapy. Currently, over 100 monoclonal antibodies have been approved for clinical use. This chapter highlights two commonly used monoclonal antibodies and their associated infectious complications. We outline the immunologic mechanism of action and indications of use of these important biologic therapies. We also examine the commonly reported infectious complications and summarize the role for pre-implementation diagnostics, post-implementation surveillance, and antimicrobial prophylaxis.
Monoclonal antibodies that target surface proteins found on lymphocytes including alemtuzumab (humanized chimeric monoclonal antibody that recognizes CD52) and rituximab (chimeric murine/human monoclonal antibody directed against the CD20) have been used successfully in the management of lymphoproliferative disorders and autoimmune diseases. We focus on rituximab because of the propensity of available data. Rituximab is constructed with human IgG1 and kappa-chain constant regions and heavy and light chain variable regions from a murine antibody to the CD20 antigen, a hydrophobic transmembrane protein which is present on mature B lymphocytes but absent from the surface of normal plasma cells. Rituximab eliminates mature B cells. Although the CD20 antigen is absent from the surface of mature plasma cells, rituximab can be complicated by hypogammaglobulinemia; the precise mechanism is incompletely understood. Rituximab is currently approved for the treatment of non-Hodgkin's lymphoma (NHL), follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia (CLL), and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. In addition, rituximab is approved as second-line therapy for rheumatoid arthritis (RA) not responsive to tumor necrosis factor (TNF)-blocking agents. This anti-CD20 monoclonal antibody has also been widely used off-label for lupus, autoimmune hematologic diseases (including primary idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia), multiple sclerosis, bullous dermatologic disorders, immune-mediated glomerular disease, and cryoglobulinemia.
Microelectromechanical systems (MEMS) are increasingly at our fingertips. To understand and thereby improve their performance, especially given their ever-decreasing sizes, it is crucial to measure their functionality in situ. Atomic force microscopy (AFM) is well suited for such studies, allowing nanoscale lateral and vertical resolution of static displacements, as well as mapping of the dynamic response of these physically actuating microsystems. In this work, the vibration of a tuning fork based viscosity sensor is mapped and compared to model experiments in air, liquid, and a curing collagen gel. The switching response of a MEMS switch with nanosecond time-scale activation is also monitored – including mapping resonances of the driving microcantilever and the displacement of an overhanging contact structure in response to periodic pulsing. Such nanoscale in situ AFM investigations of MEMS can be crucial for enhancing modeling, design, and the ultimate performance of these increasingly important and sophisticated devices.
Youth mental health services are poised for a paradigm shift. Recent epidemiological evidence confirms the seriousness of adolescence as a risk period for mental ill-health - 50% of all adult mental disorders begin before the age of 16% and 75% before the age of 25. Here, we identify issues with transition of care between CAMHS-AMHS service, and effectiveness of early intervention services.
We provide a selective review providing evidence of adolescence as a risk period, discuss CAMHS-AMHS service transition problems, and discuss avenues for change to implement the early intervention model across youth mental health.
Traditional service structures,with paediatric -adult split at 16–18 years increasingly appear not fit for purpose. A radical redesign of youth mental health services is not only necessary, it is also feasible and achievable, as illustrated by a pilot Birmingham youth service – Youthspace.
Pilot youth mental projects currently underway can help radically redesign the existing child and adolescent services. This will in turn lead to an improvement in the young people's experience of engagement with the services so that they too have a positive future.