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Pyriform aperture stenosis is a rare form of congenital nasal obstruction; it poses a management dilemma for otolaryngologists and physicians alike. It can result in poor weight gain and potentially life-threatening airflow obstruction. The challenge lies in the difficulty to predict which patients will require invasive operative management versus conservative therapy alone.
This case demonstrates the successful use of high-flow nasal cannula therapy in a young child with pyriform aperture stenosis.
Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.
The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.
Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.
The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.
In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.
For treatment of patients diagnosed with schizophrenia, comparative
long-term effectiveness of antipsychotic drugs to reduce relapses when
minimising adverse effects is of clinical interest, hence prompting this
To evaluate the comparative long-term effectiveness of antipsychotic
We systematically searched electronic databases for reports of randomised
controlled trials (RCTs) of antipsychotic monotherapy aimed at reducing
relapse risks in schizophrenia. We conducted network meta-analysis of 18
antipsychotics and placebo.
Studies of 10 177 patients in 56 reports were included; treatment
duration averaged 48 weeks (range 4–156). Olanzapine was significantly
more effective than chlorpromazine (odds ratio (OR) 0.35, 95% CI
0.14–0.88) or haloperidol (OR=0.50, 95% CI 0.30–0.82); and fluphenazine
decanoate was more effective than chlorpromazine (OR=0.31, 95% CI
0.11–0.88) in relapse reduction. Fluphenazine decanoate, haloperidol,
haloperidol decanoate and trifluoperazine produced more extrapyramidal
adverse effects than olanzapine or quetiapine; and olanzapine was
associated with more weight gain than other agents.
Except for apparent superiority of olanzapine and fluphenazine decanoate
over chlorpromazine, most agents showed intermediate efficacy for relapse
prevention and differences among them were minor. Typical antipsychotics
yielded adverse neurological effects, and olanzapine was associated with
weight gain. The findings may contribute to evidence-based treatment
selection for patients with chronic psychotic disorders.
Lutein benefits human health significantly, including that of the eyes, skin and heart. Therefore, increasing lutein content in soybean seeds is an important objective for breeding programmes. However, no information about soybean lutein-related quantitative trait loci (QTL) has been reported, as of 2016. The aim of the present study was to identify QTLs underlying the lutein content in soybean seeds. A population including 129 recombinant inbred lines was developed from the cross between ‘Dongnong46’ (lutein 13·10 µg/g) and ‘L-100’ (lutein 23·96 µg/g), which significantly differed in seed lutein contents. This population was grown in ten environments including Harbin in 2012, 2013, 2014 and 2015; Hulan in 2013, 2014 and 2015; and Acheng in 2013, 2014 and 2015. A total of 213 simple sequence repeat markers were used to construct the genetic linkage map, which covered approximately 3623·39 cM, with an average distance of 17·01 cM between markers. In the present study, eight QTLs associated with lutein content were found initially, which could explain 1·01–19·66% of the observed phenotypic variation in ten different tested environments. The phenotypic contribution of qLU-1 (located near BARC-Satt588 on chromosome 9 (Chr 9; linkage group (LG) K)) was >10% across seven tested environments, while qLU-2 (located near Satt192 of Chr 12 (LG H)) and qLU-3 (located near Satt353 of Chr12 (LGH)) could explain 5–10% of the observed phenotypic variation in more than seven environments, respectively. qLU-5, qLU-6, qLU-7 and qLU-8 could be detected in more than four environments. These eight QTLs were novel, and have considerable potential value for marker-assistant selection of higher lutein content in soybean lines.
Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are co-morbid and associated with similar neural disruptions during emotion regulation. In contrast, the lack of optimism examined here may be specific to GAD and could prove an important biomarker for that disorder.
Unmedicated individuals with GAD (n = 18) and age-, intelligence quotient- and gender-matched SAD (n = 18) and healthy (n = 18) comparison individuals were scanned while contemplating likelihoods of high- and low-impact negative (e.g. heart attack; heartburn) or positive (e.g. winning lottery; hug) events occurring to themselves in the future.
As expected, healthy subjects showed significant optimistic bias (OB); they considered themselves significantly less likely to experience future negative but significantly more likely to experience future positive events relative to others (p < 0.001). This was also seen in SAD, albeit at trend level for positive events (p < 0.001 and p < 0.10, respectively). However, GAD patients showed no OB for positive events (t17 = 0.82, n.s.) and showed significantly reduced neural modulation relative to the two other groups of regions including the medial prefrontal cortex (mPFC) and caudate to these events (p < 0.001 for all). The GAD group further differed from the other groups by showing increased neural responses to low-impact events in regions including the rostral mPFC (p < 0.05 for both).
The neural dysfunction identified here may represent a unique feature associated with reduced optimism and increased worry about everyday events in GAD. Consistent with this possibility, patients with SAD did not show such dysfunction. Future studies should consider if this dysfunction represents a biomarker for GAD.
Relativistic collisionless shock charged particle acceleration is considered as a possible origin of high-energy cosmic rays. However, it is hard to explore the nature of relativistic collisionless shock due to its low occurring frequency and remote detecting distance. Recently, there are some works attempt to solve this problem by generating relativistic collisionless shock in laboratory conditions. In laboratory, the scheme of generation of relativistic collisionless shock is that two electron–positron pair plasmas knock each other. However, in laboratory, the appropriate pair plasmas have been not generated. The 10 PW laser pulse maybe generates the pair plasmas that satisfy the formation condition of relativistic collisionless shock due to its ultrahigh intensity and energy. In this paper, we study the positron production by ultraintense laser high Z target interaction using numerical simulations, which consider quantum electrodynamics effect. The simulation results show that the forward positron beam up to 1013/kJ can be generated by 10 PW laser pulse interacting with lead target. The estimation of relativistic collisionless shock formation shows that the positron yield satisfies formation condition and the positron divergence needs to be controlled. Our results indicate that the generation of relativistic collisionless shock by 10 PW laser facilities in laboratory is possible.
Social anxiety disorder involves fear of social objects or situations. Social referencing may play an important role in the acquisition of this fear and could be a key determinant in future biomarkers and treatment pathways. However, the neural underpinnings mediating such learning in social anxiety are unknown. Using event-related functional magnetic resonance imaging, we examined social reference learning in social anxiety disorder. Specifically, would patients with the disorder show increased amygdala activity during social reference learning, and further, following social reference learning, show particularly increased response to objects associated with other people's negative reactions?
A total of 32 unmedicated patients with social anxiety disorder and 22 age-, intelligence quotient- and gender-matched healthy individuals responded to objects that had become associated with others’ fearful, angry, happy or neutral reactions.
During the social reference learning phase, a significant group × social context interaction revealed that, relative to the comparison group, the social anxiety group showed a significantly greater response in the amygdala, as well as rostral, dorsomedial and lateral frontal and parietal cortices during the social, relative to non-social, referencing trials. In addition, during the object test phase, relative to the comparison group, the social anxiety group showed increased bilateral amygdala activation to objects associated with others’ fearful reactions, and a trend towards decreased amygdala activation to objects associated with others’ happy and neutral reactions.
These results suggest perturbed observational learning in social anxiety disorder. In addition, they further implicate the amygdala and dorsomedial prefrontal cortex in the disorder, and underscore their importance in future biomarker developments.
Outbreak of Mycobacterium tuberculosis infections associated with acupuncture has not been reported. Thirteen patients with a painful swollen lump were referred to our hospital. The index patient received acupuncture and paraspinal muscular injection at a local acupuncture clinic in April 2011 and was diagnosed with M. tuberculosis 1 month later. From May 2011 to August 2011, 12 more patients with a swollen lump on the nuchal region or in the lower back or the buttocks region were referred to our hospital. Tuberculin skin test (TST), T-SPOT.TB, acid-fast stain, M. tuberculosis culture, chest radiograph, and lump magnetic resonance imaging (MRI) were performed and the patients were diagnosed with tuberculous abscess of the lump. All 13 patients received intramuscular injection at the paraspinal muscle by two acupuncturists at a local clinic and reported a swollen lump at the injection site. The needles and syringes were reused after autoclave sterilization. The TST was positive in all patients. Twelve patients had positive acid-fast stains. Mycobacterial cultures of abscess specimens were positive in all 13 patients. T-SPOT.TB tests were positive in all patients who underwent the test. The lesions and biopsies were subjected to polymerase chain reaction (PCR) and gene sequencing by the Disease Control Center of Zhejiang Province, China and the causative agent was identified as M. tuberculosis, Beijing type. In conclusion, physicians should consider the possibility of mycobacterial infections, apart from other bacterial agents, in patients with a swollen paraspinal lump following intramuscular injection.
The responses to an incident plane SH wave on or near a surface irregularity which is embedded in an elastic half-plane are investigated. The surface irregularity represents a canyon, an alluvial valley or a hill. The wave function expansion method has been employed to solve surface irregularities, such as a semi-cylindrical canyon, a semi-cylindrical alluvial valley, or a semi-elliptical canyon and a semi-elliptical alluvial valley. These solutions to the scattering problem of SH wave can be used to test the accuracy of the other numerical methods. But solutions for surface irregularities with arbitrarily shapes cannot be found easily. A hybrid method combines the finite element method with series expansion is applied to solve scattering problems in this study. A subregion encloses the surface irregularity with a semi-circular auxiliary boundary can be meshed by the finite element method. By using the transfinite interpolation (TFI) produces excellent grid mesh on the subregion. The advantage of TFI is the flexibility to facilitate modeling of the subregion. On the other hand, the boundary data can be formulated by using a series representation with unknown coefficients. The Lamb's solution which satisfies the traction free condition and the radiation condition at infinity is implemented to be the basis function. The unknown coefficients can be obtained by satisfying the continuity conditions of the semi-circular auxiliary boundary between the subregion and the half-plane. The hybrid method that combines TFI with series expansion is successfully herein to solve the scattering problem by a surface irregularity. Numerical results in this study for special cases agree well with those in the published literatures. In this study, the steps and skills of hybrid method are described systematically and completely to solve the surface irregularity.
Impairments in learning and recall have been well established in amnestic mild cognitive impairment (aMCI). However, a relative dearth of studies has examined the profiles of memory strategy use in persons with aMCI relative to those with Alzheimer's disease (AD). Participants with aMCI, nonamnestic MCI, AD, and healthy older adults were administered the California Verbal Learning Test-II (CVLT-II). Measures of semantic clustering and recall were obtained across learning and delayed recall trials. In addition, we investigated whether deficits in semantic clustering were related to progression from healthy aging to aMCI and from aMCI to AD. The aMCI group displayed similar semantic clustering performance as the AD participants, whereas the AD group showed greater impairments on recall relative to the aMCI participants. Control participants who progressed to aMCI showed reduced semantic clustering at the short delay at baseline compared to individuals who remained diagnostically stable across follow-up visits. These findings show that the ability to engage in an effective memory strategy is compromised in aMCI, before AD has developed, suggesting that disruptions in semantic networks are an early marker of the disease. (JINS, 2014, 20, 1–11)
Recent experimental evidence on nano-particle and nano-wire silicon anodes showed an initial rapid velocity of reaction front at the initial stage of lithiation, followed by an apparent slowing or even halting of the reaction front propagation. This intriguing phenomenon is attributed to the lithiation-induced mechanical stresses across the reaction front which is believed to play an important role in the kinetics of reaction at the front. Here, through theoretical formulation, we presented a comprehensive study on lithiation-induced stress field and its contribution to the driving force of lithiation in hollow spherical anodes with different boundary conditions at the inner surface of the particle. Our results reveal that hollow spherical silicon anodes can be lithiated more easily than solid spherical silicon particles and thus may serve as an optimal design of high performance anodes of lithium-ion battery.
Molecular pathways underlying carcinogenesis: apoptosis
Xinchen Teng, Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA,
J. Marie Hardwick, Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
Programmed cell death (also known as PCD) is generally defined as a regulated process by which cells contribute to their own demise. Apoptosis is the best-characterized form of programmed cell death, but alternative non-apoptotic cell-death pathways important in human physiology and disease pathology are now actively studied. Regarding apoptosis, there are two general pathways, the extrinsic pathways and the intrinsic pathways, depending on whether the molecular factor that initiates the death pathway is extra-cellular or intra-cellular. Both extrinsic and intrinsic pathways lead to activation of caspases, the proteases that cleave many key protein targets inside cells, resulting in apoptotic cell morphology and cell death within a few minutes to hours. Although there may be alternative molecular pathways that cause apoptosis-like cell morphology, the term apoptosis most often refers to caspase-dependent cell death.
The extrinsic and intrinsic pathways activate different initiator caspases. Each initiator caspase is activated by a unique complex of proteins. The intrinsic death pathway involves mitochondria and is controlled by pro- and anti-apoptotic Bcl-2-family proteins that facilitate or inhibit the release of cytochrome c from the mitochondrial inter-membrane space. In turn, cytosolic cytochrome c and ATP/ADP bind Apaf-1, inducing oligomerization of Apaf-1 into a heptameric ring structure known as the apoptosome. The apoptosome activates caspase-9, which in turn cleaves and activates caspases-3 and -7 to mediate apoptosis during normal development and to prevent cancer. Other intrinsic apoptotic pathways are initiated by assembly of alternative caspase-activating complexes in response to intra-cellular factors, such as the PIDDosome complex, which activates caspase-2, and the inflammasome, which activates caspase-1 (originally known as ICE, IL-1β-converting enzyme).
Multi-coaxial relativistic backward wave oscillator that generates the beating wave of high power microwave pulse driven by a single accelerator and a single guiding magnet system is presented. Making use of the coaxial annular cathodes that can synchronously produce three annular beams at one shot, the average power of 5.88 GW consisting of two frequency components 9.0 and 9.7 GHz is obtained under the diode voltage and current 724 and 19.57 kA, corresponding to the conversion efficiency 41.5%. The conversion efficiency and the beating frequency are considerably stable with the diode voltage. The coaxial transmission supporter developed from our previous experimental research is employed to conductively connect the coaxial structure and to incoherently combine the microwave pulse of two frequencies with little reflection. It is found that the equipotential connection of the coaxial structure modifies the field distribution in the diode structure to facilitate the operation of the coaxial annular cathodes. The coaxial cathodes of different lengths are proved to be efficient at depressing the space charge effect in order to prevent the explosive emission of the inner cathode from being shielded by the outer annular beams.
Coaxial relativistic backward wave oscillator with the rippled inner conductor not only increases the output efficiency but also results in the serious phenomenon of pulse shortening in experiments. Our research indicates that the two main mechanisms leading to the pulse shortening are the electron beam interruption and combining effects of the explosive field electron emission and the secondary electron multipactor on the surface of the slow-wave structure. In order to enhance its power capacity the electrodynamic structure is modified by detailed analysis of the field distribution in the coaxial slow-wave structure. The appropriate resonant reflector and the electron collector are developed for the application of the coaxial relativistic backward wave oscillator. A series of surface treatment is applied to enhance the power capacity of the coaxial RBWO. In the experiment, the microwave pulse duration is increased from less than 10 ns to 20 ns, and the output efficiency is enhanced from less than 20% to 34% employing the electron beam pulse of the full width at half maximum 28 ns. The peak power of 1.01 GW at the frequency of 7.4 GHz is achieved. It is found that the output efficiency of the coaxial RBWO is likely to be advanced if its power capacity can be boosted further.
Based on expansion technique, the dynamic stress concentration of a cylindrical cavity buried in an elastic half-plane is studied in the paper. The cavity and the half-plane are excited by a harmonic standing Goodier-Bishop stress wave which, as a result of taking the normalized frequency tends to zero, is equivalent to a simple uniform static tension parallel to the ground surface. In the formulation, the scattered waves are represented by a series expansion, and their associated modal fields of the expansion satisfy the boundary conditions on the ground surface as well as the radiation condition at infinity. As a consequence, the scattering problem is reduced to the determination of the expansion coefficients by matching the boundary conditions on the cavity. The numerical technique based on the steepest descent method is used to calculate the integral representation of potential functions in wave-number domain. Numerical results for the dynamic hoop stresses around the wall of the cavity and the dynamic stress concentration factors with various buried depth and excitation frequencies are presented.
This paper proposes a complete basis set for analyzing elastic wave scattering in half-space. The half-space is an isotropic, linear, and homogeneous medium except for a finite inhomogeneity. The wave bases are obtained by combining buried source functions and their reflected counter-waves generated from the infinite-plane boundary. The source functions are the vector wave functions of infinite-space. Based on the source functions expressed in the Fourier expansion form, the reflected counter-waves are easily obtained by solving the infinite-plane boundary conditions. Few representations adopt Wely's integration, but the Fourier expansion is developed from it and applied to decouple the angular-differential terms of the vector wave functions. In addition to the scattering of the finite inhomogeneity, the transition matrix method is extended to express the surface boundary conditions. For the numerical application in this paper, the P- and the SV- waves are assumed as the incoming fields. As an example, this paper computes stress concentrations around a cavity. The steepest-descent path method yielding the optimum integral paths is used to ensure the numerical convergence of the wave bases in the Fourier expansion. The resultant patterns from these approaches are compared with those obtained from numerical simulations.
We report an interesting property of carbon dots: they emit light under charge injection. We synthesized carbon dots in diameter about 20 nm using wet chemistry methods. The photoluminescence quantum efficiency of the carbon dots dissolved in water was about 11%. We observed strong electrogenerated chemiluminescence (ECL) from the sample. This observation of ECL from carbon dots indicates that they could be a good candidate material for carbon-based electroluminescent devices.
The layout design of a satellite module is a complex mechanical layout problem. Its main difficulties lie in combinatorial explosion of computational complexity, engineering complexity, and applicability in engineering practice. Inspired by the human-computer cooperation ideas, a human–computer co-operative co-evolutionary method for optimising layout design of a satellite module is developed. This method constructs the diversity reference set by using the diversity intelligence solutions (DIs) that are created by using the combinatorial operators of differential evolution (DE) and the blend crossover operator (BLX-a). During the co-evolution process of the presented method, the AIs, the DIs and the algorithm solutions are expressed by unified encoding strings and incorporated together to create new co-operative solutions. An instance of a satellite module layout design is presented to demonstrate the feasibility and effectiveness of the proposed method. Compared with the co-evolutionary approach and the all-at-once optimisation approaches, computational results show that the proposed method not only can produce better solutions, but also can better balance the conflicting objectives on the trade-off issues.
We present the temporal and spatial characterization of X-ray sources (at ~1 keV) driven by a 200 TW, 30 fs, 800 nm laser pulse on SILEX-I laser facility at Research Center of Laser Fusion. For laser copper foil interaction with laser intensity between 6 × 1018 W/cm2 and 3 × 1019 W/cm2, the X-ray images show cone-like jet structures. While the yield of X-rays is strongly dependent on the laser intensity, the plasma expansion length is weakly dependent on the laser intensity, and the open angle of the cone-like jet is not correlated to the laser intensity. The formation of the jet structure is attributed to the plasma transverse confine by the self-induced quasi-static magnetic field. An X-ray pedestal 4 ns preceding the main pulse was observed. The correlation between X-ray pedestal and collimated proton beam generation was found.
We applied the deactivation treatments to p-type single crystalline silicon solar cells for deactivating the recombination-active boron-oxygen complex. The methods we used include thermal annealing treatment, capacitively couple plasma (CCP) treatment, and plasma immersion ion implantation (PIII) treatment. The results showed that all the deactivation treatments were working and the energy transfer efficiency (Eff) was thereby increased by more than 1% absolute compared to the degraded state base on the increasing of the open-circular voltage (Voc) and short-current density (Jsc). The CCP deactivated treatment got better efficiencies than PIII treatment because the PIII treatment damaged the surface of solar cells. After the forming gas treatment, the samples could be improved to close to the PIII samples due to the surface damage repairing. However, the increased efficiency could not be kept and would be degraded again after illumination.