To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To define optimal thromboprophylaxis strategy after stent implantation in superior or total cavopulmonary connections.
Stent thrombosis is a rare complication of intravascular stenting, with a perceived higher risk in single-ventricle patients.
All patients who underwent stent implantation within superior or total cavopulmonary connections (caval vein, innominate vein, Fontan, or branch pulmonary arteries) were included. Cohort was divided into aspirin therapy alone versus advanced anticoagulation, including warfarin, enoxaparin, heparin, or clopidogrel. Primary endpoint was in-stent or downstream thrombus, and secondary endpoints included bleeding complications.
A total of 58 patients with single-ventricle circulation underwent 72 stent implantations. Of them 14 stents (19%) were implanted post-superior cavopulmonary connection and 58 (81%) post-total cavopulmonary connection. Indications for stenting included vessel/conduit stenosis (67%), external compression (18%), and thrombotic occlusion (15%). Advanced anticoagulation was prescribed for 32 (44%) patients and aspirin for 40 (56%) patients. Median follow up was 1.1 (25th–75th percentile, 0.5–2.6) years. Echocardiograms were available in 71 patients (99%), and advanced imaging in 44 patients (61%). Thrombosis was present in two patients on advanced anticoagulation (6.3%) and none noted in patients on aspirin (p = 0.187). Both patients with in-stent thrombus underwent initial stenting due to occlusive left pulmonary artery thrombus acutely post-superior cavopulmonary connection. There were seven (22%) significant bleeding complications for advanced anticoagulation and none for aspirin (p < 0.001).
Antithrombotic strategy does not appear to affect rates of in-stent thrombus in single-ventricle circulations. Aspirin alone may be sufficient for most patients undergoing stent implantation, while pre-existing thrombus may warrant advanced anticoagulation.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
We have built a radio-echo sounder which utilizes a low-frequency broad-band impulse transmitter and a microprocessor-based digital-recording system. The unit is mounted on skis and power is delivered by a small generator and batteries. The receiver uses a portable digital storage oscilloscope which passes data via a microprocessor unit to a cassette tape for off-line analysis on a personal computer. Though originally intended primarily for sounding temperate ice, the system has been tested in the Antarctic during the 1987–88 field season with good results. The radar performed well there and also in field tests and subsequent studies on South Cascade Glacier, Washington, and many interesting results were obtained. An oblique incidence profile, where transmitter-receiver separation varied, was used to study the dielectric permittivity of the ice and to locate internal layers at shallow depths. The sounder was also deployed in conjunction with hot-water drilling experiments attempting to create cavities at known locations within the ice. Wave forms from different transmitter–receiver orientations around the bore hole were combined in the off-line analysis to produce a more directional synthetic aperture emphasizing returns from the bore-hole region. Changes in the radar echoes from within the ice were not seen during these experiments, possibly because the drilling was not able to create regions with dimensions or orientations approximating those of naturally occurring cavities.
New drugs against Trypanosoma brucei, the causative agent of Human African Trypanosomiasis, are urgently needed to replace the highly toxic and largely ineffective therapies currently used. The trypanosome alternative oxidase (TAO) is an essential and unique mitochondrial protein in these parasites and is absent from mammalian mitochondria, making it an attractive drug target. The structure and function of the protein are now well characterized, with several inhibitors reported in the literature, which show potential as clinical drug candidates. In this review, we provide an update on the functional activity and structural aspects of TAO. We then discuss TAO inhibitors reported to date, problems encountered with in vivo testing of these compounds, and discuss the future of TAO as a therapeutic target.
People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low- and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g. depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n = 13), Asia (n = 7), and the Middle East (n = 2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n = 18), family-level (n = 2), and pharmacological (n = 2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and 11 preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.
We present the first measurement of the evolution of the apparent projected shape of galaxy clusters from 0.2≲ z≲2. We measure the ellipticities (εcl) of homogeneously selected galaxy clusters over this wide redshift range. We confirm the predictions of N-body simulations that clusters are more elongated at higher redshift, finding the mean projected ellipticity changes linearly from 0.36±0.01 to 0.25±0.01 over that range. The fraction of relaxed clusters (defined as having εcl<0.2) is 9+5-3% at z∼1.8, steadily increasing to 42+7-6% by z∼0.3. Because more spherical clusters have a higher degree of virialization, our result shows significant evolution in the degree of cluster virialization over cosmic time.
The ferromagnetic bulk metallic glass (BMG) Nd60Fe30Al10system exhibits extremely large coercivities at low temperature and moderate coercivities near room temperature. The magnetic hardness, as best evidenced by the onset of magnetic irreversibility, was studied in bulk suction-cast and melt-spun alloys with the nominal composition Nd60Fe30Al10. Systematic x-ray diffraction studies of the degree of crystallinity performed as a function of position within the bulk suction-cast samples is found to correlate with the variation in the room-temperature magnetic hysteresis character. X-ray diffraction data clearly shows the presence of both crystallites and amorphous material on the samples' outmost surfaces; the amorphous phase content increases with distance into the cast sample. These results underscore the importance of solidification conditions and attendant nanophase selection, on the resultant magnetic properties of this class of alloys.
Using a novel melt-spinning technique, we have produced highly disordered NdBa2Cu3O7−x and GdBa2Cu3Oy−x materials. Samples which were melt-spun in an O2 environment consist of nanocrystals with the tetragonal REBa2Cu3O7−x structure: samples which were processed in an N2 environment consist of an amorphous matrix with small amounts of crystalline BaCu2O2, as shown by x-ray diffraction and electron microscopy. High temperature XRD studies indicate that the BaCu2O2 is eliminated during heating to 500°C in O2 and that the REBa2Cu3O7−x Phase recrystallizes directly from the amorphous matrix at temperatures below 800°C. Preliminary magnetization measurements show that higher temperature heat treatments are needed to restore superconductivity.
In this paper, we propose the design and fabrication of buried silicon optical interconnect technology, the sub-surface silicon optical bus (S3B). The proposed approach relies on engineering the dispersion properties of embedded silicon three-dimensional photonic crystals to create sub-micron routing channels and control light propagation. Further, we present a method for the fabrication of buried three-dimensional (3D) photonic-crystal structures using conventional planar silicon micromachining. The method utilizes a single planar etch mask coupled with time-multiplexed, sidewall-passivating, deep anisotropic reactive-ion etching, to create an array of spherical voids with three-dimensional symmetry. Preliminary results are presented that demonstrate the feasibility of realizing chip-scale optical interconnects using our proposed approach.
Mass spectroscopy has been used to diagnose plasma processing atmospheres by detailing the flux of neutral and ion species and the energy distribution of ions impinging upon a substrate immersed in a glow discharge. The institution of a diagnostic tool to investigate the chemical (reactive neutral) and physical (ion) aspects involved in plasma processing is necessary to improve control and reliability in thin film materials processing. Research has focussed on ion-enhanced etching of tungsten thin films in NF3/O2 and the deposition of tungsten by the reaction of WF6 and H2 in rf glow discharge reactions.
In electronic packages consisting of glass-alumina composite dielectric layers and thick film conductors, Au and Ag conductors on separate layers may alloy. Alloys are formed by Ag+ ion diffusion through the intervening dielectric. The extent of alloy formation is dependent upon whether the Au and Ag conductors are electrically isolated or connected. When the Au and Ag conductors are electrically isolated, alloying is self-limiting and occurs by reduction of Ag+ ions and dissolution of the metallic Ag into the Au. In this case, the reduction of Ag+ is accompanied by oxidation of the lattice oxygen anions forming O2 gas which accumulates to form blisters. If the Au and Ag conductors are electrically connected, then the alloying is not self-limiting and occurs without the formation of O2. In this study, we quantitatively characterize the alloying reactions which occur during firing and propose mechanisms for specific dielectric and conductor packages. The presence of these alloying reactions can affect the reliability and the performance of the electronic ceramic package.
A kinetic model for the dissolution of borosilicate glass, incorporated into the EQ3/6 geochemical modeling code, is used to predict the dissolution rate of a nuclear waste glass. In the model, the glass dissolution rate is controlled by the rate of dissolution of an alkalidepleted amorphous surface (gel) layer. Assuming that the gel layer dissolution affinity controls glass dissolution rates is similar to the silica saturation concept of Grambow  except that our model predicts that all components concentrated in the surface layer, not just silica, affect glass dissolution rates. The good agreement between predicted and observed elemental dissolution rates suggests that the dissolution rate of the gel layer limits the overall rate of glass dissolution. The model predicts that the long-term rate of glass dissolution will depend mainly on ion concentrations in solution, and therefore on the secondary phases which precipitate and control ion concentrations.
A low temperature process for the oxidation of amorphous and polycrystalline silicon was studied using a helical resonator plasma source. Constant current anodization of amorphous silicon was performed at 350°C and 30 mtorr in an oxygen plasma. Oxidation rate data were analyzed by both parabolic and power law expressions: parabolic rate coefficient B = 23.45 nm2/min and power law rate coefficients α = 0.3807 and C* = 7.3 nm/minα. Oxidation at substrate floating conditions yielded thin oxides; the growth rate saturated after 20 mins, at a thickness of about 10 nm. For TFr fabrication, a two layer oxide was used. The first layer was grown by plasma oxidation to a thickness of about 10 nm to ensure a good interface, and the second layer deposited by PECVD to the final thickness of 35 nm. Electrical properties of control oxides grown on c-Si at the same conditions were promising, with a fixed oxide charge of 1.98 × 1011 charges/cm2 and a mean breakdown field of 5.3 MV/cm after post metallization anneal. The TF's had an average effective electron mobility of 31.1 V/cm2 and an average threshold voltage of 4.6 V.