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Laser-induced breakdown spectroscopy has been exploited to investigate the laser-produced lead plasma with and without external magnetic field. Plasma on the lead surface was generated by focusing a beam of a Nd:YAG laser (532 nm). An external magnetic field was applied across the laser-produced plasma; its value was varied from 0.3 to 0.7 T and the time-integrated spectra were captured at different time delays. Maximum enhancement in the neutral and ionic line intensities have been observed at 130 mJ laser energy. The neutral line of Pb at 368.34 nm reveals an enhancement factor of nearly 1.3, 1.6, and 2.3 at 0.3, 0.5, and 0.7 T, whereas the Pb ionic line at 424.49 nm shows enhancement factor of approximately 2.8 and 4.2 at 0.3 and 0.7 T. The magnetic field effects on various plasma parameters such as plasma temperature, electron number density, and emission line intensities have also been investigated. The plasma parameter “β” is found to be <1 in all the experimental conditions which signifies that the enhancement in the signal intensity is due to the plasma confinement. The increase in the emission signal intensity, number density as well as plasma temperature is observed with increasing laser energy and magnetic field. The spatial and temporal behavior reveals that the plasma temperature and electron number density decrease slowly in the applied magnetic field due to the deceleration of the plasma plume. The optimized conditions for the maximum plasma confinement and the emission intensity enhancement are observed at 130 mJ laser energy at 0.7 T magnetic field.
Adenoid hypertrophy is a common cause of upper airway obstruction, and adenoidectomy is one of the most frequently performed operations in children. Topical nasal steroids can act directly on nasopharyngeal lymphoid tissue to decrease its reactive inflammatory changes and potentially reduce its size.
To study the light microscopic changes in adenoidal lymphoid tissue after one month of topical steroid use.
Twenty-six children with adenoid hypertrophy grade 3 scheduled for adenoidectomy were randomly divided into two equal groups: one group received mometasone furoate aqueous nasal spray (Nasonex) 100 mcg/day for four weeks, and a control group received nasal normal saline 0.9 per cent for four weeks. The removed adenoids were examined histopathologically.
Adenoidal tissue from the mometasone group had less reactive germinal centres and less spongiosis compared to the control group. The latter showed proliferating, reactive, variable sized and shaped lymphoid follicles, with congested blood vessels in the interfollicular areas.
The use of intranasal mometasone furoate aqueous nasal spray (Nasonex) for one month reduced adenoidal tissue reactive cellular changes and its vascularity. This is, however, a pilot study; a longer treatment period is needed to assess the effect of treatment on adenoidal size.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
Objectives: The Addenbrooke’s Cognitive Examination (ACE) is a common cognitive screening test for dementia. Here, we examined the relationship between the most recent version (ACE-III) and its predecessor (ACE-R), determined ACE-III cutoff scores for the detection of dementia, and explored its relationship with functional ability. Methods: Study 1 included 199 dementia patients and 52 healthy controls who completed the ACE-III and ACE-R. ACE-III total and domain scores were regressed on their corresponding ACE-R values to obtain conversion formulae. Study 2 included 331 mixed dementia patients and 87 controls to establish the optimal ACE-III cutoff scores for the detection of dementia using receiver operator curve analysis. Study 3 included 194 dementia patients and their carers to investigate the relationship between ACE-III total score and functional ability. Results: Study 1: ACE-III and ACE-R scores differed by ≤1 point overall, the magnitude varying according to dementia type. Study 2: a new lower bound cutoff ACE-III score of 84/100 to detect dementia was identified (compared with 82 for the ACE-R). The upper bound cutoff score of 88/100 was retained. Study 3: ACE-III scores were significantly related to functional ability on the Clinical Dementia Rating Scale across all dementia syndromes, except for semantic dementia. Conclusions: This study represents one of the largest and most clinically diverse investigations of the ACE-III. Our results demonstrate that the ACE-III is an acceptable alternative to the ACE-R. In addition, ACE-III performance has broader clinical implications in that it relates to carer reports of functional impairment in most common dementias. (JINS, 2018, 24, 854–863)
Nutrient profiling (NP) is a method for evaluating the healthfulness of foods. Although many NP models exist, most have not been validated. This study aimed to examine the content and construct/convergent validity of five models from different regions: Australia/New Zealand (FSANZ), France (Nutri-Score), Canada (HCST), Europe (EURO) and Americas (PAHO). Using data from the 2013 UofT Food Label Information Program (n15342 foods/beverages), construct/convergent validity was assessed by comparing the classifications of foods determined by each model to a previously validated model, which served as the reference (Ofcom). The parameters assessed included associations (Cochran–Armitage trend test), agreement (κ statistic) and discordant classifications (McNemar’s test). Analyses were conducted across all foods and by food category. On the basis of the nutrients/components considered by each model, all models exhibited moderate content validity. Although positive associations were observed between each model and Ofcom (all Ptrend<0·001), agreement with Ofcom was ‘near perfect’ for FSANZ (κ=0·89) and Nutri-Score (κ=0·83), ‘moderate’ for EURO (κ=0·54) and ‘fair’ for PAHO (κ=0·28) and HCST (κ=0·26). There were discordant classifications with Ofcom for 5·3 % (FSANZ), 8·3 % (Nutri-Score), 22·0 % (EURO), 33·4 % (PAHO) and 37·0 % (HCST) of foods (all P<0·001). Construct/convergent validity was confirmed between FSANZ and Nutri-Score v. Ofcom, and to a lesser extent between EURO v. Ofcom. Numerous incongruencies with Ofcom were identified for HCST and PAHO, which highlights the importance of examining classifications across food categories, the level at which differences between models become apparent. These results may be informative for regulators seeking to adapt and validate existing models for use in country-specific applications.
Microscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view.
An open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n = 28) or a microscopic underlay technique (n = 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months’ post-operatively.
Graft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air–bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p > 0.05). Mean air–bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p > 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (both p < 0.05).
The endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less operative time.
To assess whether pre-operative assessment with a bone conduction hearing device on a softband is an accurate predictor of performance with one of two transcutaneous hearing implants.
Cohort study comparing pre-and post-operative speech audiometry using correlation analysis.
Pre-operative pure tone audiometry and aided half optimum speech recognition thresholds were compared with post-operative aided results for each ear that had undergone implantation. Data were collected prospectively.
Full data were available in 24 ears. In 19 out of 24 ears (79 per cent), the difference between pre- and post-operative speech scores was less than 10 dB, demonstrating a good clinical correlation. The Pearson correlation coefficient was calculated at 0.66 (95 per cent confidence interval = 0.357–0.842), indicating a strong statistical correlation.
Pre-operative softband testing shows good clinical correlation and strong statistical correlation with hearing implant performance. The findings suggest there is value in using the test to predict performance and guide patients’ expectations.
Improving understanding of the pathogen-specific seasonality of enteric infections is critical to informing policy on the timing of preventive measures and to forecast trends in the burden of diarrhoeal disease. Data obtained from active surveillance of cohorts can capture the underlying infection status as transmission occurs in the community. The purpose of this study was to characterise rotavirus seasonality in eight different locations while adjusting for age, calendar time and within-subject clustering of episodes by applying an adapted Serfling model approach to data from a multi-site cohort study. In the Bangladesh and Peru sites, within-subject clustering was high, with more than half of infants who experienced one rotavirus infection going on to experience a second and more than 20% experiencing a third. In the five sites that are in countries that had not introduced the rotavirus vaccine, the model predicted a primary peak in prevalence during the dry season and, in three of these, a secondary peak during the rainy season. The patterns predicted by this approach are broadly congruent with several emerging hypotheses about rotavirus transmission and are consistent for both symptomatic and asymptomatic rotavirus episodes. These findings have practical implications for programme design, but caution should be exercised in deriving inferences about the underlying pathways driving these trends, particularly when extending the approach to other pathogens.
We present an investigation into the influence of upstream shear on the viscous flow around a steady two-dimensional (2-D) symmetric airfoil at zero angle of attack, and the corresponding loads. In this computational study, we consider the NACA 0012 airfoil at a chord Reynolds number
in an approach flow with uniform positive shear with non-dimensional shear rate varying in the range 0.0–1.0. Results show that the lift force is negative, in the opposite direction to the prediction from Tsien’s inviscid theory for lift generation in the presence of positive shear. A hypothesis is presented to explain the observed sign of the lift force on the basis of the asymmetry in boundary layer development on the upper and lower surfaces of the airfoil, which creates an effective airfoil shape with negative camber. The resulting scaling of the viscous effect with shear rate and Reynolds number is provided. The location of the leading edge stagnation point moves increasingly farther back along the airfoil’s upper surface with increased shear rate, a behaviour consistent with a negatively cambered airfoil. Furthermore, the symmetry in the location of the boundary layer separation point on the airfoil’s upper and lower surfaces in uniform flow is broken under the imposed shear, and the wake vortical structures exhibit more asymmetry with increasing shear rate.
Unavailability of irrigation water for early sowing has remained a constant problem in cold arid deserts of Ladakh. In order to get a solution to this problem, a 2-yr farmers’ participatory research trial with best bet agronomic management on artificial glacier water harvesting technology was conducted. The technology involves collecting water from natural glaciers that melt during late December. The water is diverted toward a shed constructed with stone embankments set up at regular intervals. The area is chosen where there is minimum interference of solar radiation, generally between two mountain slopes or ridge that is on the leeward side. The melted water is that melts from the natural glacier impeded by the embankments and get frozen here. This frozen water starts melting in late March and is used for both pre sowing and initial crop water requirement. It also ensures early sowing of wheat by creating additional 45-day window which leads to introduction of long- and medium-duration wheat varieties to replace decades old locally grown short-duration varieties. The work was initiated with a benchmark survey of 100 farmers to get an understanding of present irrigation scenario, crop management practices and date of sowing. Data from 99 farmer participating trial of wheat conducted after or from bench mark survey clearly indicated that the effect of water shortage can be seen on yield and yield attributing characters due to unavailability of pre sowing irrigation and water requirement at imperative growth stages and may also lead to terminal heat stress in wheat crop. Out of total number of irrigations applied, initial two irrigations can be compensated by artificial glacier water harvesting technique, leading to a revolution in the agriculture scenario of the tribal population by introduction of long- and medium-duration wheat varieties in cold arid desert of Ladakh for the very first time. It was observed that wheat seeding done in first fortnight of April gave better yields in comparison to late seeded wheat. Moreover, the long-duration varieties (LDVs) or medium-duration varieties (MDVs) sown under late condition gave better yield in comparison to locally grown short-duration varieties sown at same time. Yield potential of LDVs and MDVs of wheat under late sowing was found quite low in comparison to early-sown wheat, still when compared with the performance of locally grown wheat the yields were more even if the local varieties were sown early. The outcome of this study will help the farmers of tribal, cold arid community in harvesting better wheat yields by timely sowing of the wheat crop accompanied with better bet agronomic management practices. Government initiative is further required to ensure better outreach of complete crop management strategies to the tribal farming community of the region in order to ensure food security and improve their socioeconomic status.
In this paper, a compact tri-band asymmetric coplanar strip (ACS)-fed meander-line antenna for wireless communications is proposed. Two inverted-L-shaped resonators are added to a simple meandered radiator for standard tri-band operation. Parametric studies indicate that operating frequencies of the proposed antenna are determined by the dimensions of the two inverted-L-shaped resonators. The measured results show that the proposed antenna can achieve three frequency bands; i.e. 1.48–1.63, 2.25–2.48, and 4.22–6.0 GHz. These bands can successfully cover the global positioning system L1, wireless local area network (WLAN), and HIPERLAN/2 operation bands, respectively. The proposed antenna exhibits good radiation patterns with reasonable gain and high radiation efficiency across the operating bands. In addition, the proposed antenna has compact size and simple feeding scheme, which make it suitable to be integrated within the portable device for wireless communications.
Spatial confinement effects on plasma parameters and surface morphology of laser-ablated Mg are studied by introducing a metallic blocker as well as argon (Ar) gas at different pressures. Nd: YAG laser at various fluences ranging from 7 to 28 J/cm2 was employed to generate Mg plasma. Confinement effects offered by metallic blocker are investigated by placing the blocker at different distances of 6, 8, and 10 mm from the target surface; whereas spatial confinement offered by environmental gas is explored under four different pressures of 5, 10, 20, and 50 Torr. Laser-induced breakdown spectroscopy analysis revealed that both plasma parameters, that is, excitation temperature and electron number density initially are strongly dependent upon both pressures of environmental gases and distances of blockers. The maximum electron temperature of Mg plasma is achieved at Ar gas pressure of 20 Torr, whereas maximum electron number density is achieved at 50 Torr. It is also observed that spatial confinement offered by metallic blocker is responsible for the significant enhancement of both electron temperature and electron number density of Mg plasma. Maximum values of electron temperature and electron number density without blocker are 8335 K and 2.4 × 1016 cm−3, respectively, whereas these values are enhanced to 12,200 K and 4 × 1016 cm−3 in the presence of blocker. Physical mechanisms responsible for the enhancement of Mg plasma parameters are plasma compression, confinement and pronounced collisional excitations due to reflection of shock waves. Scanning electron microscope analysis was performed to explore the surface morphology of laser-ablated Mg. It reveals the formation of ripples and channels that become more distinct in the presence of blocker due to plasma confinement. The optimum combination of blocker distance, fluence and Ar pressure can identify the suitable conditions for defining the role of plasma parameters for surface structuring.
Urinary tract infection (UTI) is common in children aged <5 years with diarrhoea, but little is known about risk factors, aetiology and outcome of such children. We aimed to evaluate these knowledge gaps of UTI in children aged <5 years with diarrhoea. We enrolled all children aged <5 years with diarrhoea admitted to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, between May 2011 and April 2013, who had history of fever (⩾38 °C) and obtained a urine sample for culture. Diarrhoea with UTI (confirmed by culture) constituted cases (n = 26) and those without UTI constituted controls (n = 78). Threefold controls were randomly selected. The case-fatality rate was comparable in cases and controls (4% vs. 1%, P = 0·439). Escherichia coli (69%) and Klebsiella (15%) were the most commonly isolated pathogens. Persistent diarrhoea, pneumonia and prior antibiotics use were identified as risk factors for UTI in logistic regression analysis (P < 0·05 for all). Thus, children with diarrhoea presenting with persistent diarrhoea, pneumonia, and prior antibiotic use should be investigated for UTI for their prompt management that may reduce morbidity.
LASER induced breakdown spectroscopy (LIBS) has been used for the quantitative analysis of Cu–Ni alloy of known composition (75% Cu, 25% Ni) using the one line calibration free-LIBS (OLCF-LIBS), self-calibration-LIBS (SC-LIBS), calibration free LIBS (CF-LIBS), time of flight-mass spectroscopy (TOF-MS), energy dispersive X-ray spectroscopy (EDX) and X-ray fluorescence spectroscopy (XRF). For the LIBS-based studies, the plasma was generated by focusing the beam of a Q-switched Nd:YAG laser (532 nm, pulse energy about 200 mJ, 5 ns pulse duration) while the sample was placed in air at an atmospheric pressure. Plasma temperature about (9500 ± 300) K was calculated by the Boltzmann plot method using the neutral lines of Cu and Ni whereas the electron number density was calculated (2.0 ± 0.5) × 1016 cm−3 from the Stark broadening of an isolated Cu line as well as using the relative intensities of the neutral and singly ionized optically thin lines in the Saha–Boltzmann equation. The elemental compositions determined by different LIBS methods and standard techniques are; OLCF-LIBS (69% Cu and 31% Ni), SC-LIBS (72% Cu and 28% Ni), CF-LIBS (74% Cu and 26% Ni), TOF (74% Cu and 26% Ni), EDX (75% Cu and 24.5% Ni), XRF (73% Cu and 24.7% Ni), and LA-TOF (74% Cu and 26% Ni). It is demonstrated that the CF-LIBS method gives compositions comparable with that determined by LA-TOF, EDX, or XRF, which is also in agreement with the certified reported composition.
We conducted a longitudinal assessment in 466 underweight and 446 normal-weight children aged 6–24 months living in the urban slum of Dhaka, Bangladesh to determine the association between vitamin D and other micronutrient status with upper respiratory tract infection (URI) and acute lower respiratory infection (ALRI). Incidence rate ratios of URI and ALRI were estimated using multivariable generalized estimating equations. Our results indicate that underweight children with insufficient and deficient vitamin D status were associated with 20% and 23–25% reduced risk of URI, respectively, compared to children with sufficient status. Underweight children, those with serum retinol deficiency were at 1·8 [95% confidence interval (CI) 1·4–2·4] times higher risk of ALRI than those with retinol sufficiency. In normal-weight children there were no significant differences between different vitamin D status and the incidence of URI and ALRI. However, normal-weight children with zinc insufficiency and those that were serum retinol deficient had 1·2 (95% CI 1·0–1·5) times higher risk of URI and 1·9 (95% CI 1·4–2·6) times higher risk of ALRI, respectively. Thus, our results should encourage efforts to increase the intake of retinol-enriched food or supplementation in this population. However, the mechanisms through which vitamin D exerts beneficial effects on the incidence of childhood respiratory tract infection still needs further research.
Objective: Idiopathic normal pressure hydrocephalus (INPH) is a neurological disorder presenting with gait, cognitive, and bladder symptoms in the context of ventricular enlargement. Although gait is the primary indicator for treatment candidacy and outcome, additional monitoring tools are needed. Line Tracing Test (LTT) and Serial Dotting Test (SDT), two psychomotor tasks, have been introduced as potential outcome measures but have not been widely studied. This preliminary study examined whether LTT and SDT are sensitive to motor dysfunction in INPH and determined if accuracy and time are important aspects of performance. Methods: Eighty-four INPH subjects and 36 healthy older adults were administered LTT and SDT. Novel error scoring procedures were developed to make scoring practical and efficient; interclass correlation showed good reliability of scoring procedures for both tasks (0.997; p<.001). Results: The INPH group demonstrated slower performance on SDT (p<.001) and made a greater number of errors on both tasks (p<.001). Combined Time/Error scores revealed poorer performance in the INPH group for original-LTT (p<.001), modified-LTT (p≤.001) and SDT (p<.001). Conclusions: These findings indicate LTT and SDT may prove useful for monitoring psychomotor skills in INPH. While completion time reflects impaired processing speed, reduced accuracy may suggest planning and self-monitoring difficulties, aspects of executive functioning known to be compromised in INPH. This is the first study to underscore the importance of performance accuracy in INPH and introduce practical/reliable error scoring for these tasks. Future work will establish reliability and validity of these measures and determine their utility as outcome tools. (JINS, 2016, 22, 341–349)