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To compare functional endoscopic sinus surgery with a combined approach (functional endoscopic sinus surgery plus Caldwell–Luc procedure) for the treatment of paediatric antrochoanal polyp, in terms of antrochoanal polyp recurrence and safety.
Method
This retrospective case series comprises 27 paediatric patients with recurrent antrochoanal polyp, treated from January 2010 to January 2018.
Results
The average age of the patients at the time of diagnosis was 10.4 ± 2.49 years. The recurrence rate after functional endoscopic sinus surgery alone was 72.9 per cent, compared with 12.5 per cent after functional endoscopic sinus surgery plus the Caldwell–Luc procedure (p < 0.00001). No complications were reported during surgery or follow up.
Conclusion
The correct identification of the origin of the antrochoanal polyp and an adequate returning of maxillary ventilation by widening the ostium can prevent recurrences. Although functional endoscopic sinus surgery continues to be the ‘gold standard’ for antrochoanal polyp treatment, in cases of revision surgery, a combined approach could ensure the complete removal of the polyp through the two openings.
Urban slum environments in the tropics are conducive to the proliferation and the spread of rodent-borne zoonotic pathogens to humans. Calodium hepaticum (Brancroft, 1893) is a zoonotic nematode known to infect a variety of mammalian hosts, including humans. Norway rats (Rattus norvegicus) are considered the most important mammalian host of C. hepaticum and are therefore a potentially useful species to inform estimates of the risk to humans living in urban slum environments. There is a lack of studies systematically evaluating the role of demographic and environmental factors that influence both carriage and intensity of infection of C. hepaticum in rodents from urban slum areas within tropical regions. Carriage and the intensity of infection of C. hepaticum were studied in 402 Norway rats over a 2-year period in an urban slum in Salvador, Brazil. Overall, prevalence in Norway rats was 83% (337/402). Independent risk factors for C. hepaticum carriage in R. norvegicus were age and valley of capture. Of those infected the proportion with gross liver involvement (i.e. >75% of the liver affected, a proxy for a high level intensity of infection), was low (8%, 26/337). Sixty soil samples were collected from ten locations to estimate levels of environmental contamination and provide information on the potential risk to humans of contracting C. hepaticum from the environment. Sixty percent (6/10) of the sites were contaminated with C. hepaticum. High carriage levels of C. hepaticum within Norway rats and sub-standard living conditions within slum areas may increase the risk to humans of exposure to the infective eggs of C. hepaticum. This study supports the need for further studies to assess whether humans are becoming infected within this community and whether C. hepaticum is posing a significant risk to human health.
Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.
Aims
To investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.
Method
Primary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).
Results
A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.
Conclusions
Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.
Presso il Centro di Diagnosi Prenatale all'Università Cattolica del Sacro Cuore di Roma, sono state osservate 95 pazienti con gravidanza complicata da idrope fetale non immunologica. Nove pazienti presentavano una gravidanza gemellare. La sopravvivenza dei 95 feti osservati è stata del 27.7%. Nessun feto gemellare idropico è sopravvissuto. Nei 9 casi di gravidanza gemellare è stato possibile diagnosticare ecograficamente una placenta monocoriale in 6 casi e monoamniotica in 3 casi. La causa dell'idrope fetale è stata riferita in 3 casi a trasfusione feto-fetale; in 2 casi a cardiopatia fetale ed 1 caso a malformazione genito-urinaria e 3 casi di n.d.d. La morte del feto idropico è avvenuta tra la 21a e la 35a settimana di gravidanza. Dei feti gemellari non idropici la sopravvivenza è stata del 57.1% (4 su 7).
Otto delle gravidanze gemellari sono state osservate prima del 1988, epoca in cui nella nostra Istituzione, non era possibile un approccio diagnostico e terapeutico intrava-scolare mediante cordocentesi. Tale possibilità diagnostica e terapeutica può con molta probabilità migliorare la sopravvivenza dei feti idropici nelle gravidanze gemellari come avvenuta nelle gravidanze singole, dove è passata dal 25% (1980-88) al 36.8% (1988-93).
This study investigated the influence of soil factors on the structure, richness and distribution of woody Cerrado species within the National Forest of Paraopeba, Minas Gerais State, Brazil. Individuals with basal stem circumference ≥ 10 cm were sampled in five plots of 20 × 100 m. The study was conducted in five environments with different physiognomies and types of soils. A total of 132 species were recorded. The species with the greatest importance values varied between different areas, as did structure. Canonical correspondence analysis ordination showed three different groups closely related to soil fertility and Al levels. These relations were also confirmed by Pearson’s correlation where richness was positively related to pH, K, Ca, Mg and P and negatively to Al. The basal area was positively correlated with levels of P, Mg, Ca and T (base saturation) and negatively with Al, also using Pearson’s correlation. Likewise, density was positively correlated with Mg and negatively with Al. The analysis shows that soil fertility and the concentration of Al are two of the most important factors responsible for structural and floristic variation and for differentiating dystrophic and mesotrophic Cerradão.
Determining age is an important step when assessing growth, mortality, and yield of
cultivated and wild populations, but studies linking shell growth marks in the pearl
oyster Pteria sterna with the age of individuals are lacking. Thirty
juveniles (20.0 ± 1.2 mm shell height), collected from a winter spatfall, were marked with
the fluorochrome calcein and kept in the field in culture containers. After day 16, the
juveniles were cleaned and their shells cut along the sagittal axis to determine
periodicity of micro growth bands formed in the inner shell layers and to estimate age.
During this trial, fluorescent calcein marking succeeded in individuals larger than 20 mm
shell height; these formed an average of 15 micro growth bands over the 16 days,
representing 1 band per day. The marker created a wide fluorescent band containing three
micro growth marks, suggesting that calcein was incorporated into the shell over the first
three days. The use of calcein was found to be an accurate method for validating the micro
growth band frequency of formation in P. sterna juveniles, which in turn
can help to estimate age.
Twenty eruptive events from the Northeast Crater of Stromboli volcano recorded by a thermal monitoring camera in early 2004 were analysed in order to understand the eruptive dynamics. Selected events were chosen to be typical of explosions that characterize the steady activity of Stromboli in terms of jet height and duration. Most of the explosions consisted of clast-rich single bursts, originating from the same vent inside the Northeast Crater. Conspicuous ash emission was scarce. Eruptions were preceded by the flashing of a perturbation wave characterized by low temperatures and an average propagation velocity of about 35–100 m s−1. This perturbation was thought to be caused by the bursting of the gas slug at the bottom of the crater and is interpreted as an air wave. This was immediately followed by the expansion of a jet of ‘hot’ gas and particles, at a velocity of 35–75 m s−1. Ejecta coarser than 138 cm appeared ~1.6–2 s after the onset of the explosion, moving at a variable velocity (30–60 m s−1). Eruptive events were either vertical or inclined 7–13° towards the NNW. This inclination is thought to be a consequence either of the morphology of the conduit, following modest rock falls that partially obstructed the uppermost part of the crater, or of the displacement of the internal conduit due to the explosive activity of the volcano. The instability of the summit area is a further possible cause of the deformation of the conduit.
Ag thin films were deposited by pulsed laser ablation in a controlled Ar atmosphere. The deposition process was performed at different Ar pressure values in the range between 10 and 100 Pa to investigate the influence of ambient gas pressure on the plasma expansion dynamics and on the film structural properties. Position, velocity and volume of the laser generated plasma as functions of time were obtained by time resolved fast photography. The morphological properties of the films were investigated by transmission electron microscopy which shows that film growth proceeds via aggregation on the substrates of nanoclusters formed in the expanding plume. The formation of nanoparticles takes place as a consequence of plasma confinement induced by the interaction with ambient gas species. Data from fast photography analysis were used as input parameters to calculate the size of the nanoparticles using a model that takes into account the collisional nature of the laser generated silver plasma.
Inner-ear malformations are frequently found in patients with sensorineural hearing loss. However, isolated anomalies of the vestibular part of the inner ear are seldom described, and for this reason their impact on balance is poorly understood.
Care report:
We present the case of a 38-year-old Caucasian man with recurrent vestibular complaints, with a sensation of linear tilting, but no hearing impairment. Clinical and neuro-otological examinations showed peripheral involvement of the vestibular system, while audiological investigation was within normal limits. High-resolution magnetic resonance imaging of the inner ear, with three-dimensional reconstruction, demonstrated isolated vestibular anomalies involving both the lateral semicircular canal and the utricle.
Conclusions:
Bearing in mind this case, we speculate that isolated vestibular malformation may not be as rare as previously thought, and should be investigated with the aid of sophisticated imaging techniques. A review of the relative literature, focussing attention on the molecular aspects, is also reported.
The dynamics of the expansion plasma produced by excimer laser
ablation of a silicon target into oxygen and mixed O2/Ar
atmosphere were studied by means of time-resolved imaging of the expanding
plume. Experiments were performed in pure oxygen, ranging between 0.13 and
13.33 Pa, and at different O2/Ar ratios at a fixed total
pressure of 13.33 Pa. The occurrence of a shock wave (SW) generated by the
supersonic expansion of the plasma was observed at high pressure values.
The presence of the SW had a strong influence on the structure of
SiOx thin films. In fact, silicon dioxide thin films were always
obtained in presence of the SW, irrespective of the oxygen content in the
gaseous mixture. On the contrary, suboxide thin films were obtained when
the expansion occurred at lower pressure values (no SW presence). The
temperature rise following the developing of the SW, is supposed to
enhance the oxygen molecules dissociation by increasing the efficiency of
the silicon oxidation reaction.
The NUGA project is a high-resolution (0.5″−1″) CO survey of low luminosity AGN including the full sequence of activity types (Seyferts, LINERs and transition objects). NUGA aims to systematically study the different mechanisms for gas fueling of AGNs in the Local Universe. In this paper we discuss the latest results of this recently completed survey, which now includes newly acquired subarcsec resolution observations for all targets of the sample. The large variety of circumnuclear disk morphologies found in NUGA galaxies (m = 1, m = 2 and stochastic instabilities) is a challenging result that urges the refinement of current dynamical models. In this paper we report on new results obtained in 4 study cases for NUGA: NGC 4826, NGC 7217, NGC 4579 and NGC 6951.To search for other articles by the author(s) go to: http://adsabs.harvard.edu/abstract_service.html
Surface modification of polyimides has been used to obtain better interaction with an inorganic material. Copper sulfide incorporation onto the surface of commercial Kapton® polyimide showed that treatment with base was necessary for adherence of the copper sulfide to the polymeric matrix. The optimized conditions for composite preparation, obtained by response surface methodology, was pH 1.4 at 80 °C for 3.67 h. Using these conditions, we obtained electrical resistance as low as 1.0 ohm for CuS\Kapton® composites. These optimized conditions were used to prepare other low-resistance polyimide composites. The resulting composites were analyzed by photoelectron spectroscopy. The presence of S(2p) and Cu(2p) peaks demonstrated the incorporation of copper sulfide onto the polyimide surface. Scanning electron microphotographs and the images from atomic force microscopy showed a homogeneous CuS distribution in all composites.
RuO2 thin films have been produced on silicon-based substrates by in situ pulsed laser deposition for the first time. The electrical properties, the surface characteristics, the crystalline structure, and the film-substrate interface of deposited samples have been investigated by 4-probe resistance versus temperature technique, scanning electron microscopy, x-ray photoelectron spectroscopy, x-ray diffraction, and transmission electron microscopy, respectively. The films show good electrical properties. The RuO2-substrate interface is very thin (≈3 nm), since it is not degraded by any annealing process. These two characteristics render our films suitable to be used as electrodes in PZT-based capacitors.
Upper Triassic/Lower Jurassic organic-rich shales and interbedded carbonates (Rhaetian → Sinemurian) are widespread in the subsurface of southeastern Sicily where important oil fields have been found hosted in Triassic reservoirs. Core samples from wells drilled offshore and onshore were studied from petrographie and geochemical viewpoints.
In the Hettangian/Sinemurian shale-carbonate sequences, which accumulated in a rapidly subsiding basin, the micritic aragonitic mud is still largely preserved. Mixed-layer I/S has remained randomly interstratified to a depth > 4000 m. Diagenetic carbonates are non-stoichiometric finely crystalline, pore-filling dolomite and/or calcite. The carbonate component exhibits a high Sr content and fair amounts of Fe and Mn. Carbon and oxygen isotopic values suggest a subsurface interstitial formation for the digenetic carbonates in an essentially closed system. Based on all accumulated data it is suggested that anoxic marine waters were retained in the sediment pores for a long time after deposition, thus enhancing the preservation of significant amounts of the original organic matter.
In contrast, Rhaetian tidal-flat deposits hosting black shales display a clay component characterized by ordered illite-rich I/S and a carbonate mineralogy dominated by low-Mg calcite in the uppermost beds and by near-stoichiometric dolomite in the lowermost ones. Petrographie, chemical and isotopic data indicate early cementation in an oxidizing phreatic environment and lower down in the sequence pervasive dolomitization in a sabkha-type environment.
The characterization of clay mineral assemblages in the diatomite-dominated Tripoli Formation (Lower Messinian, central Sicily) has resulted in delineation of suites dominated by generally well-crystallized dioctahedral smectite and illite of low crystallinity, with lesser amounts of kaolinite and chlorite. These minerals are thought to have a mainly detrital origin related to the calcareous and marly formations exposed in the margins of the depositional area. Vertical fluctuations of the montmorillonite/illite ratio and changes of the crystallinity and chemical composition of these phyllosilicates support environmental interpretations from isotopic data of associated carbonates, and point to a wide variability of depositional conditions ranging from evaporating to brackish. Early diagenesis of the clay minerals was controlled by the primary composition of the sediment which, in turn, affected the porewater chemistry.