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The Mental Health Act 2001 has introduced significant changes to the process of admission to hospital for individuals affected by mental health disorders. This study aimed to determine whether a newly designed smartphone application could result in an improvement in service users’ knowledge of their rights compared with the paper booklet.
This was a randomized study conducted in an outpatient and day-hospital in North Dublin. Participants were randomized to receive the information booklet as either a smartphone application or in the paper form. A questionnaire which was scored from 0 to 10 was devised and was completed at baseline and at 1-week follow-up.
A total of 42 individuals completed the baseline and follow-up questionnaire and of these, 53.7% were female and the mean age was 38.2 years (s.d.±13.5). A total of 34.1% had a diagnosis of a psychotic disorder, 29.3% had a depressive disorder and 22% had bipolar-affective disorder. The mean score before the intervention in the total group was 3.5 (s.d.±2.2) and this increased to 5.8 (s.d.±2.2) at follow-up. Participants randomized to the smartphone application improving by a mean of 2.5 (s.d.±2.5), while those randomized to the booklet improving by a mean of 2.3 (s.d.±2.6), which was not statistically significant.
Both forms of the information booklet showed improvement in service users’ knowledge of their legal rights. It is possible that each individual will have preference for either a paper form or a smartphone form and this study suggests that both forms should be offered to each individual service user.
To review the clinical signs of vocal fold paresis on laryngeal videostroboscopy, to quantify its impact on patients’ quality of life and to confirm the benefit of laryngeal electromyography in its diagnosis.
Twenty-nine vocal fold paresis patients were referred for laryngeal electromyography. Voice Handicap Index 10 results were compared to 43 patients diagnosed with vocal fold paralysis. Laryngeal videostroboscopy analysis was conducted to determine side of paresis.
Blinded laryngeal electromyography confirmed vocal fold paresis in 92.6 per cent of cases, with vocal fold lag being the most common diagnostic sign. The laryngology team accurately predicted side of paresis in 76 per cent of cases. Total Voice Handicap Index 10 responses were not significantly different between vocal fold paralysis and vocal fold paresis groups (26.08 ± 0.21 and 22.93 ± 0.17, respectively).
Vocal fold paresis has a significant impact on quality of life. This study shows that laryngeal electromyography is an important diagnostic tool. Patients with persisting dysphonia and apparently normal vocal fold movement, who fail to respond to appropriate speech therapy, should be investigated for a diagnosis of vocal fold paresis.
An a posteriori granddaughter design was applied to estimate quantitative trait loci genotypes of sires with many sons in the US Holstein population. The results of this analysis can be used to determine concordance between specific polymorphisms and segregating quantitative trait loci. Determination of the actual polymorphisms responsible for observed genetic variation should increase the accuracy of genomic evaluations and rates of genetic gain. A total of 52 grandsire families, each with ⩾100 genotyped sons with genetic evaluations based on progeny tests, were analyzed for 33 traits (milk, fat and protein yields; fat and protein percentages; somatic cell score (SCS); productive life; daughter pregnancy rate; heifer and cow conception rates; service-sire and daughter calving ease; service-sire and daughter stillbirth rates; 18 conformation traits; and net merit). Of 617 haplotype segments spanning the entire bovine genome and each including ~5×106 bp, 5 cM and 50 genes, 608 autosomal segments were analyzed. A total of 19 335 unique haplotypes were found among the 52 grandsires. There were a total of 133 chromosomal segment-by-trait combinations, for which the nominal probability of significance for the haplotype effect was <10−8, which corresponds to genome-wide significance of <10−4. The number of chromosomal regions that met this criterion by trait ranged from one for rear legs (rear view) to seven for net merit. For each of the putative quantitative trait loci, at least one grandsire family had a within-family contrast with a t-value of >3. Confidence intervals (CIs) were estimated by the nonparametric bootstrap for the largest effect for each of nine traits. The bootstrap distribution generated by 100 samples was bimodal only for net merit, which had the widest 90% CI (eight haplotype segments). This may be due to the fact that net merit is a composite trait. For all other chromosomes, the CI spanned less than a third of the chromosome. The narrowest CI (a single haplotype segment) was found for SCS. It is likely that analysis by more advanced methods could further reduce CIs at least by half. These results can be used as a first step to determine the actual polymorphisms responsible for observed quantitative variation in dairy cattle.
We report a case of follicular lymphoma in a healthy individual, which presented as saliva- and serum-proven mumps. The patient presented with a sore throat and parotid and submandibular lymphadenopathy. Fine needle aspiration, undertaken three weeks following presentation, revealed no malignant cells. An excision biopsy of a level two node was performed due to persistent lymphadenopathy, five weeks following presentation. As far as we are aware, this is the first reported case of follicular lymphoma presenting as mumps. This case highlights the importance of follow up in patients in whom lymphadenopathy is persistent despite the proven diagnosis of mumps.
A ferritic steel T91 and an oxide dispersion strengthened (ODS) martensitic steel 9Cr-ODS were irradiated with 5 MeV Ni ions at 500°C at a dose rate of 1.38×10-3 dpa/s to doses of 5, 50 and 150 dpa. Both alloys are iron-based with 9Cr and have been designed for use in higher temperature energy systems. However, the radiation effects on these two alloys are not well characterized. For T91, the irradiated microstructure was dominated by tangled dislocation and precipitates, similar to the unirradiated condition except the presence of large dislocation loops of type a<100>. The microstructure of alloy 9Cr-ODS for both the unirradiated and irradiated cases was dominated by dense dislocations, precipitates and yttrium oxides particles and no dislocation loops were observed. The average size of yttrium oxides particles slightly decreased with dose from 11.8 nm for the unirradiated to 9.1 nm at 150 dpa. No voids were detected for both alloys up to a dose of 150 dpa.
The Fezzan Project completed its five-year fieldwork cycle in 2001. The geographical research team located numerous additional palaeolake sites within the Edeyen Ubari, using a combination of Remote Sensing technology and field visits. Additional samples were taken for analysis and dating from many lake edge locations, relating to both the large Pleistocene lake and to the numerous smaller Holocene lakes that have been identified by the team. The excavations at Old Germa were taken down through Garamantian occupation levels to the natural subsoil below the earliest cultural horizon. The earliest activity, represented by a few mudbrick walls and hearths built directly on the natural soil, is believed to date to c. 400-300 BC. Traces of several phases of Garamantian buildings were uncovered, along with numerous rubbish pits, which yielded a rich assemblage of finds, including, for the first time, examples of Garamantian figurines, small 3-D sculptures of humans and animals. Work on the various classes of finds (pottery, small finds, lithics and other stone artefacts, metallurgical evidence, etc.) complemented the excavation work. In addition, a small amount of further survey work was carried out on sites in the Wadi al-Ajal, along with a contour survey of Old Germa and standing building survey at a number of other sites.
Motivated by complex oriented equivariant
cohomology theories, we give a natural
algebraic definition of an $A$-equivariant
formal group law for any abelian compact
Lie group $A$. The complex oriented
cohomology of the classifying space for
line bundles gives an example.
We also show how the choice of a complete
flag gives rise to a basis and a means of
calculation. This allows us to deduce that
there is a universal ring $L_A$ for
$A$-equivariant formal group laws and that
it is generated by the Euler classes and
the coefficients of the coproduct of the
orientation. We study a number of
topological cases in some detail. 1991 Mathematics Subject Classification:
14L05, 55N22, 55N91, 57R85.
Changes in bulk composition are known to affect both radiation-induced segregation and microstructural development, including void swelling in austenitic stainless steel. In this work, three alloys (designations corresponding to wt%) have been studied: Fe-18Cr-8Ni alloy (bulk composition corresponding to 304 stainless steel), Fe-18Cr-40Ni (bulk composition corresponding to 330 stainless steel), and Fe-16Cr-13Ni (bulk composition corresponding to 316 stainless steel). Following irradiation with high-energy protons, the change in hardness and microstructure (void size distribution and grain boundary composition) due to irradiation was investigated. Increasing the bulk nickel concentration decreases void swelling, increases matrix hardening, and increases grain boundary chromium depletion and nickel enrichment. The analysis shows that decreases in lattice parameter and shear modulus due to radiation- induced segregation (RIS) correlate with decreased void swelling and a decreased susceptibility to irradiation assisted stress corrosion cracking (IASCC). Traditional thinking on IASCC assumed RIS was a contributing factor to cracking. It may, however, be that properly controlled RIS can be used to mitigating cracking.
As part of the shutdown of the EBR-II reactor, structural materials were retrieved to analyze the effects of long-term irradiation on mechanical properties and microstructure. In this work, the effect of low dose rate irradiation (10−7 to 10−8 dpa/s) on grain boundary composition in 316 and 304 stainless steels was analyzed. Samples were taken from surveillance specimens and subassemblies irradiated in the reflector region of EBR-II at temperatures from 371-390°C to maximum doses of 30 dpa. The effects of dose, dose rate, and bulk composition on radiation- induced segregation are analyzed. In 316 stainless steel, changes in grain boundary chromium and nickel concentrations occur faster than changes in iron and molybdenum concentrations. In 304 stainless steel, decreasing the dose rate increases the amount of grain boundary segregation. For a dose of 20 dpa, chromium depletion and nickel enrichment are greater in 304 stainless steel than in 316 stainless steel, the difference most likely due to dose rate. In both 304 and 316 stainless steels, the presence of a grain boundary precipitate significantly changes the composition of the adjacent grain boundary.
The fourth season of the Fezzan Project continued the interdisciplinary approaches of previous seasons. Geographical and environmental work focused principally in sampling sediments for scientific dating and with integrating ground observation with remote sensing data. Excavations continued at Old Germa, where the site has now reached Garamantian levels. In a separate development, the tentative identification has been made of an early mosque at the site, in an area adjacent to the G1 excavation trench. Substantial results were gained from work aimed at enhancing the important data recorded by Charles Daniels in his earlier excavations and survey in the Wadi al-Hayat. The enhancement of the Daniels' survey archive was integrated with completion of the wider prospection being undertaken by the new project. This survey included fieldwalking, standing building survey, analysis of the foggara irrigation systems and recording of rock art scenes. Finds work comprised the finalisation of a pottery type series for the Germa area, the study of small finds from the recent survey work, botanical analysis and completion of lithics recording. A programme of radiocarbon dating is now being undertaken to improve the phasing of sites and monuments. The first two volumes of final reports are now in preparation.
Microstructural examination and in situ post-irradiation annealing studies were carried out on 20% cold-worked 316 stainless steel (SS) hexagonal duct material following irradiation in the reflector region of the EBR-II reactor. Stainless steel hexagonal ducts were used to house reactor subassemblies and provide a valuable source of information on irradiation behavior of reactor structural materials at lower dose-rates (on the order of 10-8 dpa/sec) than previously examined. The microstructural development of samples irradiated to doses of 1, 20 and 30 dpa is examined, while the post-irradiation annealing behavior of a sample irradiated to 20 dpa is described. Annealing studies were performed at 370 and 500°C to examine the kinetics of radiation damage recovery as a function of annealing temperature. The initial (pre-annealed) microstructures consists of a substantial density of irradiation induced chromium-rich M23C6 and M6C carbides which form both on the grain boundaries and within the grain interiors. Recovery of the cold- work is evident in the 1 dpa sample while samples irradiated to 20 and 30 dpa possess dense populations of voids and dislocation structures consisting of networks of line dislocations and faulted dislocation loops. Results indicate that post-irradiation annealing of the samples at 370°C for 1 hour has little effect on the microstructure, while further annealing at 500°C for 1 hour results in void shrinkage, the formation of small cavities, and a reduction in the dislocation loop and network density.
A girl with partial lipodystrophy is described presenting with muscle weakness and developmental delay several years before lipoatrophy became apparent. The patient subsequently developed epilepsy, fatty liver, secondary amenorrhoea, hirsutism, insulin-resistant diabetes mellitus, hyperlipidaemia, and hypothyroidism. She remains weak with poor exercise tolerance. This case illustrates an atypical presentation of the Barraquer–Simon syndrome.
As part of the shutdown of the EBR-II reactor, structural materials were retrieved to analyze the effect of long term, low dose rate irradiation. In this work, the effect of low dose rate (10 to 10−9 dpa/s) irradiation on grain boundary and void surface chemistry is analyzed. These dose rates are comparable to those in light water reactor structural components. The components were irradiated at 375-379°C, temperatures near the highest temperatures experienced in pressurized water reactors. Radiation-induced segregation (RIS) was measured on samples taken from 304 stainless steel hex ducts irradiated to doses between 10 and 12 dpa. Radiation-induced segregation is shown to vary with dose rate, with measured grain boundary chromium concentrations reaching as low as 5 at. % and nickel concentrations reaching as high as 33 at. %. For some radiation conditions, significant grain boundary precipitation occurs, possibly leaving components susceptible to environmental attack.
Changes in mechanical and corrosion properties caused by the development of radiation-induced microstructures have relevance to the aging and lifetime extension of light water reactors (LWR‘s). However, much of the current data related to microstructural development in irradiated metals are generated from studies carried out at much higher dose-rates than encountered in LWR‘s. An opportunity exists to study the influence of low dose-rate irradiation on microstructural development for a variety of structural and surveillance materials extracted from the experimental breeder reactor EBR-lI. In this study, irradiated 304 stainless steel hexagonal “hex” duct material is examined in order to compare microstructures in the dose-rate range of 10−7 - 10−9 dpa/sec. The samples, taken from the reflector locations in EBR-II, experienced a total dose between 10 and 12 dpa at a temperature of ∼375 °C. Transmission electron microscopy (TEM) analysis reveals that there is a moderate dose-rate effect on microstructural development for samples irradiated in the range of 2 × 10−8 to 4 × 10−8. dpa/sec, however a substantial dose-rate effect exists between dose-rates of 2 × 10−8 and 1 × 10−9 dpa/sec Results detail the development of the microstructure in terms of radiation-induced cavities, dislocations, and precipitates.