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Background: Status epilepticus (SE) is the most common pediatric neurological emergency. Timely treatment is crucial, yet administration of rescue medications is often delayed and under-dosed. We aim to improve SE management by ensuring that every child at risk of SE in our province has an individualized seizure action plan (SAP) outlining the steps that should be taken during SE. Methods: A survey was distributed to parents of epilepsy patients aged 1 month to 19 years. Primary outcome was percentage of patients with SAPs. Secondary outcome was parental interest in a SAP mobile application. Following chart review, univariate and multivariate analysis was performed to identify variables that predict whether patients have SAPs. Results: Of 192 participants, 61.5% have SAPs. On univariate analysis, history of prior SE and male gender increased likelihood of having a SAP. On logistic regression, Nagelkerke R2 was 0.204 and our model correctly predicted 82.2% of patients with SAPs. 83.3% of parents were interested in a SAP mobile application. Conclusions: This is one of the first studies to examine SAP prevalence in a pediatric epilepsy population. There is a need to increase the percentage of epilepsy patients with SAPs. Most parents would find a SAP mobile application valuable in their child’s management.
Australian tea tree oil (TTO) and its extract terpinen-4-ol (T4O) are found to be effective in moderating demodex-related diseases. Their possible effects are lowering the mite counts, relieving the demodex-related symptoms and modulating the immune system especially the inflammatory response. This review summarizes the topical treatments of TTO and T4O in human demodicosis, their possible mechanism of actions, side-effects and potential resistance in treating this condition. Although current treatments other than TTO and T4O are relatively effective in controlling the demodex mite population and the related symptoms, more research on the efficacy and drug delivery technology is needed in order to assess its potential as an alternative treatment with minimal side-effect profile, low toxicity and low risk of demodex resistance.
Individuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population.
We performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases. We defined paediatric-onset coronary artery anomalies as congenital coronary anomalies and inflammatory arteriopathies of childhood that cause coronary aneurysms. Major cardiovascular events were defined as pulmonary oedema, sustained arrhythmia requiring treatment, stroke, myocardial infarction, cardiac arrest, or death.
A total of 25 surveys were mailed, and 20 were returned (80% response rate). We included 46 articles from the literature, which described cardiovascular outcomes in 82 women (138 pregnancies). These data were amalgamated for a total of 102 women and 194 pregnancies; 59% of women were known to have paediatric-onset coronary artery anomalies before pregnancy. In 23%, the anomaly was unmasked during or shortly after pregnancy. The remainder, 18%, was diagnosed later in life. Major cardiovascular events occurred in 14 women (14%) and included heart failure (n=5, 5%), myocardial infarction (n=7, 7%), maternal death (n=2, 2%), cardiac arrest secondary to ventricular fibrillation (n=1, 1%), and stroke (n=1, 1%). The majority of maternal events (13/14, 93%) occurred in women with no previous diagnosis of coronary disease.
Women with paediatric-onset coronary artery anomalies have a 14% risk of adverse cardiovascular events in pregnancy, indicating the need for careful assessment and close follow-up. Prospective, multicentre studies are required to better define risk and predictors of complications during pregnancy.
Can the people deliberate to set the agenda for direct democracy in large scale states? How might such an institution work? The 2011 California Deliberative Poll piloted a solution to this problem helping to produce proposals that went to the ballot and also to the legislature. The paper reports on how this pilot worked and what it suggests about a possible institution to solve the deliberative agenda setting problem. The legislative proposal passed the legislature but the ballot proposition (Prop 31) failed. However, we show that the proposals actually deliberated on by the people might well have passed if not encumbered by additional elements not deliberated on by the public that drew opposition. The paper ends with an outline of how the process of deliberative agenda setting for the initiative might work, vetting proposals once every two years that could get on the ballot for a greatly reduced cost in signature collections. Adding deliberation to the agenda setting process would allow for a thoughtful and informed public will formation to determine the agenda for direct democracy.
Data-constrained modeling is a method that enables three-dimensional distribution of mineral phases and porosity in a sample to be modeled based on micro-computed tomography scans acquired at different X-ray energies. Here we describe an alternative method for measuring porosity, synchrotron K-edge subtraction using xenon gas as a contrast agent. Results from both methods applied to the same Darai limestone sample are compared. Reasonable agreement between the two methods and with other porosity measurements is obtained. The possibility of a combination of data-constrained modeling and K-edge subtraction methods for more accurate sample characterization is discussed.
A seeded channel approach was developed to avoid the short comings of the conventional SOI structure such as grain or sub-grain boundaries in the channel region, floating substrate effects, etc. In this approach, the gate of each FET is located above its own seed window to insure that single crystalline material is obtained for the channel region. The source and drain regions, however, are located in the recrystallized silicon over Si02 for improved isolation and minimizing junction capacitance. Recrystallization was obtained in 4" silicon wafers by using an Ar laser and a computer controlled X-Y stage with heated substrate holder. Problems encountered in laser recrystallization, such as, reflectivity variations over seed and SOI regions, surface ripples, pittings, etc., were eliminated by optimizing the thin film thickness of the isolation oxide, polysilicon, and the capping oxide. This technology was used successfully to fabricate FET devices using a standard production n-MOS process. Good device characteristics were obtainred using 400Å gate oxide and channel length ranging from 1um to 50um. The measured electron mobility in the channel region is, however still lower than the ideal bulk values.
Synthesis of transition metal nitrides induced by excimer laser irradiation of metal foils immersed in liquid nitrogen was studied. Nitrogen incorporation was found by sputtering Auger Electron Spectroscopy in all six investigated metals (Ti, Zr, Hf, V, Nb and Ta). X-ray diffraction was used to determine the compounds formed. The morphologies of the irradiated surfaces often indicated that the surfaces had gone through a molten state. Micronthick mononitrides were grown on Ti, Zr and Hf, whereas Ta and Nb formed Ta2N and Nb2N respectively. The nitrides on V were not satisfactorily identified. The extent of nitridation correlates with the thermodynamic driving force, i.e. the Gibbs free energy for nitride formation.
We have prepared Y2O3 doped CeO2 thin films on various substrates using electron beam evaporation. Both polycrystalline and single crystal-like textured films were shown by x-ray diffraction and transmission electron microscopy analyses. AC impedance spectroscopy was used to study the electrical properties of the films. The ionic conductivities of the films are dominated by grain boundaries, and higher as compared to that of a bulk material having the same dopant concentration sintered at 1500°C. The grain boundary conductivities of the films were investigated with regard to grain size, grain boundary impurity segregation, space charge on grain boundaries, and grain boundary misorientations. The contribution of grai boundary misorientation to the resistance of the grain boundary is considered to be negligible with respect to those of the impurity layer and space-charge layers. The grain boundary resistance may originate from the oxygen vacancy depletion in the space-charge layers.
The thin films of 4% Y2O3 doped CeO2 have been deposited on different substrates of Pd film/(001) LaAlO3, Pd film/r-cut sapphire, and Pd film/Quartz using an e-beam deposition technique. The microstructures and electrical properties of the films were investigated by means of x-ray diffraction, transmission electron microscopy, and ac impedance spectroscopy. Both textured and polycrystalline films were produced on different substrates. A brick layer model was adopted to correlate the micro structure and electrical property of the films. Only the grain boundary arc was observed in the film complex impedance plots. The conductivities of the films were similar to the conductivity of 6% Y2O3 doped CeO2 bulk grain boundary because of lower preexponential factor, although the activation energies were smaller than that of bulk grain boundary. The resistive gram boundaries were found to dominate the conductivities of the films.
We employed a Monte Carlo technique to simulate the effect of (1) the anisotropic grain boundary energy in the film and (2) the large misfit between the film and substrate on the grain growth of  textured Yba2Cu3Ov7-x (YBCO) films. In terms of remaining grain boundaries of certain misorientations, the simulation results concur with the experimental observation of preferred grain orientations of YBCO on various substrates, such as (001) MgO and (001) Yttria stabilized Zirconia (YSZ). Three factors were identified to influence the grain growth of these  tilt boundaries in the simulation and could help to elucidate the origin of special misorientations observed experimentally. These are (1) the depth of local minima in boundary energy vs. misorientation curve, (2) the number of possible combinations of coincidence epitaxy (CE) orientations contributing to the exact misorientation for each of the high angle but low energy (HABLE) boundaries, and (3) the number of possible combinations of coincidence epitaxy CE orientations within the angular ranges near each of the HABLE boundaries.
Ionic conductivities of solid CeO2:Y203 electrolytes were systematically investigated as a function of dopant concentration and sintering temperatures. The highest lattice conductivity occurred at 6–8% dopant concentration, and maximum grain boundary conductivity was observed at 10% dopant concentration. The sintering temperature was found to have a significant effect on the conductivities of the pellets. The samples sintered at lower temperatures (T≤140°C) showed higher grain boundary conductivity than those sintered at 150°C; this was found to be related to size-dependent-impurity segregation and precipitation at grain boundaries. The grain boundary conductivities as related to the microstructure are discussed by adopting different grain boundary models. Solute segregation and oxygen depletion at grain boundaries, which have been suggested to be responsible for the grain boundary resistivities in these samples, were examined by a microanalytical technique for small-grain-size samples.
The addition of Y2BaCuO5 (211) particles to large grain Yba2Cu3O7−δ (Y123) has significantly improved the critical current (Jc) in this material. Here a systematic quantitative analysis on the effect of the measured 211 present in large grains of Y123 has been performed, after the process of melt texturing, both on a microscopic and a nanoscopic scale with a systematic variation of the initial volume percent of 211 addition. From the correlation between critical current measurements and quantitative microscopy of both (001) and (110) sections, a maximum value of weighted Jc is observed corresponding to a measured Y123 volume percent of 20%. Although an increasing addition of 211 is effective in producing efficient flux pinning sites in the Y123 matrix, percolation paths in the Y123 matrix become limited for supercurrent. Accounting for the loss of liquid phase, we estimate an optimum initial volume of 211 for highest Jc to be 40%. Further correlation between the Jc and the true flux pinning force (Fp) shows a maximum pinning force for an initial 211 addition of 40%. However the pinning efficiency of the superconducting Y123 matrix is found to improve with an increasing 211 addition. Hence an optimum amount of 211 addition is essential for obtaining the best possible electrical characteristics in the superconducting composite.
This paper presents the study of the strength of surface micromachined diaphragms. It is found that the diaphragm strength strongly depends on the diaphragm boundary conditions. A new fabrication technique which does not change the mask and fabrication process is proposed to improve the common step-up boundary condition. Test diaphragms with diameters from 200 µm to 800 µm and three different boundary conditions have been fabricated using silicon nitride/PSG and silicon nitride/polysilicon surface micromachining processes. Experimentally, it is found that the strength of the diaphragms is significantly improved with the new boundary conditions. The application of this technique to other surface micromachined structures is also described.
Drying of gelatin films was studied by an in-situ cantilever beam method combined with spectroscopic ellipsometry, enabling measurement of the stress development, film shrinkage and compositional change during the drying process. Experiments are carried out under different drying conditions (such as drying extent variation, drying rate variation). The film experiences stress relaxation that indicates visco-elastic relaxation or plastic deformation happened during drying process. Plastic deformation is verified by carefully reversing the drying process, however, the plastic deformation accompanied by visco-elastic relaxation complicates the case of finding the value of the yield stress.
ZnO films with orientations of (001), (110), and (100) were fabricated on silicon by different substrate biases at low temperature. Dynamic cathodoluminescence (CL) dependence on electron bombardment revealed unstable Zn-N bonding if N2 was used as a predecessor. CL under various accelerated voltages showed the possible energies of Zn-N. N-related photoluminescence (PL) at low temperature confirmed that nitrogen was released after annealing. These N-doping behaviors agreed to the theoretical calculation.
Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder that affects multiple organ systems, primarily the cardiovascular, ocular and skeletal. It is the most common inherited condition affecting the heart and the aorta, occurring in 1:5000–1:9800 people. There is no ethnic or gender predisposition; 20 to 35% of cases arise from de novo mutations.
Information on the clinical utility of neuropsychological
tests in non-North-American samples is limited. We examined
the diagnostic efficacy of the Consortium to Establish
a Registry for Alzheimer's Disease (CERAD) neuropsychological
battery in Jamaican men and women age 65 and older. A total
of 72 elders were diagnosed as normal and 12 were demented
based on history, physical, and neurological examination.
Independent of this medical examination, participants were
tested with the CERAD battery. Normal controls scored significantly
better than dementia patients on all tests in the CERAD
battery. A discriminant function found that a combination
of Word List Learning Sum Recall and Boston Naming Test
correctly classified a total of 81% of the cases (83% of
the dements and 81% of the normal controls). This study
is the first to demonstrate the clinical utility of the
CERAD neuropsychological battery in the differential diagnosis
of memory disorders of the aged in a non-North-American
sample. (JINS, 1999, 5, 255–259.)
The combined effects of isolation stress, active area size, and SiGe misfit strain on dislocation generation in an advanced SiGe heterojunction bipolar transistor (HBT) process were studied. Eight-inch wafers were patterned with polysilicon-filled deep, and oxide-filled shallow trench isolation similar to that used in IBM's analog SiGe HBT technology. Half of the wafers were subjected to an additional stress-producing oxidation prior to SiGe growth. Si1−xGex films containing 0, 5.5, 9, and 13 at.% Ge were grown epitaxially by ultrahigh vacuum chemical vapor deposition (UHV CVD). The films were of constant thickness with an intrinsic Si cap. Some samples received an additional relaxation anneal following deposition. After the growth and anneal cycles, the dislocation density was determined by transmission electron microscopy (TEM). On nonstressed samples, no dislocations were observed in the device areas, even at Ge concentrations which are not stable to misfit dislocation generation in blanket form. This small area effect has been observed on patterned substrates that do not have functional device isolation. On the stressed-isolation wafers, the compressive stress from the oxidation of the trench sidewalls was found to intensify stress in the SiGe films, and to lower the critical strain at which misfit dislocations appeared. In large active areas on these wafers, two distinct dislocation regions were observed. Defects at the edge resembled those caused by isolation stress, while the defects in the center were more typical of the misfit dislocations associated with lattice-mismatch epitaxial films. It is clear that isolation stress must be minimized when fabricating integrated circuits using SiGe epitaxial films. It is also evident that SiGe films grown on nonstressed isolation exhibit the same increase in critical thickness with decreasing lateral dimension that has been observed on much simpler patterned substrates.