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Incorporation of metallic nanoparticles (NPs) in polymer matrix has been used to enhance and control dissolution and release of drugs, for targeted drug delivery, as antimicrobial agents, localized heat sources, and for unique optoelectronic applications. Gold NPs in particular exhibit a plasmonic response that has been utilized for photothermal energy conversion. Because plasmonic nanoparticles typically exhibit a plasmon resonance frequency similar to the visible light spectrum, they present as good candidates for direct photothermal conversion with enhanced solar thermal efficiency in these wavelengths. In our work, we have incorporated ∼3-nm-diameter colloidal gold (Auc) NPs into electrospun polyethylene glycol (PEG) fibers to utilize the nanoparticle plasmonic response for localized heating and melting of the polymer to release medical treatment. Auc and Auc in PEG (PEG+Auc) both exhibited a minimum reflectivity at 522 nm or approximately green wavelengths of light under ultraviolet-visible (UV-Vis) spectroscopy. PEG+Auc ES fibers revealed a blue shift in minimum reflectivity at 504 nm. UV-Vis spectra were used to calculate the theoretical efficiency enhancement of PEG+Auc versus PEG alone, finding an approximate increase of 10 % under broad spectrum white light interrogation, and ∼14 % when illuminated with green light. Auc enhanced polymers were ES directly onto resistance temperature detectors and interrogated with green laser light so that temperature change could be recorded. Results showed a maximum increase of 8.9 °C. To further understand how gold nanomaterials effect the complex optical properties of our materials, spectroscopic ellipsometry was used. Using spectroscopic ellipsometry and modeling with CompleteEASE® software, the complex optical constants of our materials were determined. The complex optical constant n (index of refraction) provided us with optical density properties related to light wavelength divided by velocity, and k (extinction coefficient) was used to show the absorptive properties of the materials.
The CIF NOLA “river market” represents an important but opaque forward market that serves Gulf exporters and elevators. CIF NOLA bids function similarly to traditional forward contracts; however, like a futures market, firms can offset their forward contractual obligations by offsetting positions in a liquid off-exchange paper market. Analysis shows grain sellers pay a risk premium for fall harvest delivery contracts. However, outside of fall harvest, contract liquidity, coupled with a good institutional balance of long and short market participants, mostly removes the pricing bias commonly found in farmer forward contracting in corn and soybeans.
Anomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac arrest/death in young athletes in the United States of America. Limited data are available regarding family history in this patient population.
Patients were evaluated prospectively from 12/2012 to 02/2017 in the Coronary Anomalies Program at Texas Children’s Hospital. Relevant family history included the presence of CHD, sudden cardiac arrest/death, arrhythmia/pacemaker use, cardiomyopathy, and atherosclerotic coronary artery disease before the age of 50 years. The presence of one or more of these in 1st- or 2nd-degree relatives was considered significant.
Of 168 unrelated probands (171 patients total) included, 36 (21%) had significant family history involving 19 (53%) 1st-degree and 17 (47%) 2nd-degree relatives. Positive family history led to cardiology referral in nine (5%) patients and the presence of abnormal tests/symptoms in the remaining patients. Coronary anomalies in probands with positive family history were anomalous right (27), anomalous left (five), single right coronary artery (two), myocardial bridge (one), and anomalous circumflex coronary artery (one). Conditions present in their family members included sudden cardiac arrest/death (15, 42%), atherosclerotic coronary artery disease (14, 39%), cardiomyopathy (12, 33%), CHD (11, 31%), coronary anomalies (3, 8%), myocardial bridge (1, 3%), long-QT syndrome (2, 6%), and Wolff–Parkinson–White (1, 3%).
In patients with anomalous aortic origin of a coronary artery and/or myocardial bridges, there appears to be familial clustering of cardiac diseases in approximately 20% of patients, half of these with early occurrence of sudden cardiac arrest/death in the family.
Tropical glaciers constitute an important source of water for downstream populations. However, our understanding of glacial melt processes is still limited. One observed process that has not yet been quantified for tropical glaciers is the enhanced melt caused by the longwave emission transfer. Here, we use high-resolution surface temperatures obtained from the thermal infrared imagery of the Cuchillacocha Glacier, in the Cordillera Blanca, Peru in June 2014 to calculate a margin longwave flux. This longwave flux, reaching the glacier margin from the adjacent exposed rock, varies between 81 and 120 W m−2 daily. This flux is incorporated into a physically-based melt model to assess the net radiation budget at the modeled glacier margin. The simulation results show an increase in the energy available for melt by an average of 106 W m−2 during the day when compared with the simulation where the LWmargin flux is not accounted for. This value represents an increase in ablation of ~1.7 m at the glacier margin for the duration of the dry season. This study suggests that including the quantification of the glacier margin longwave flux in physically-based melt models results in an improved assessment of tropical glacier energy budget and meltwater generation.
The tropical glaciers of the Cordillera Blanca, Peru, are rapidly retreating, resulting in complex impacts on the hydrology of the upper Río Santa watershed. The effect of this retreat on water resources is evaluated by analyzing historical and recent time series of daily discharge at nine measurement points. Using the Mann-Kendall nonparametric statistical test, the significance of trends in three hydrograph parameters was studied. Results are interpreted using synthetic time series generated from a hydrologic model that calculates hydrographs based on glacier retreat sequences. The results suggest that seven of the nine study watersheds have probably crossed a critical transition point, and now exhibit decreasing dry-season discharge. Our results suggest also that once the glaciers completely melt, annual discharge will be lower than present by 2-30% depending on the watershed. The retreat influence on discharge will be more pronounced during the dry season than at other periods of the year. At La Balsa, which measures discharge from the upper Río Santa, the glacier retreat could lead to a decrease in dry-season average discharge of 30%.
Anomalous origin of the left coronary artery from the right pulmonary artery in single ventricles is a very rare congenital anomaly. Failure to recognise it preoperatively may lead to adverse outcomes, including death. We report the case of a neonate with a univentricular heart in the form of a double-outlet right ventricle, mitral atresia with discrete coarctation of the aorta, and an incidental intraoperative finding of an anomalous origin of the left coronary artery from the right pulmonary artery. The patient underwent a successful repair with an uneventful postoperative course.
Persistence of the fifth aortic arch is a very rare anomaly, but is clinically relevant when it is associated with coarctation. We report a case of a neonate with type A interrupted aortic arch and severe coarctation of a persistent fifth aortic arch, which was discovered after repair of a left congenital diaphragmatic hernia. The combination of anomalies was discovered intra-operatively following left thoracotomy, and was treated with aortic arch advancement. The postoperative course was uneventful.
Children with cancer are potentially at a high risk of plasma 25-hydroxyvitamin D (25(OH)D) inadequacy, and despite UK vitamin D supplementation guidelines their implementation remains inconsistent. Thus, we aimed to investigate 25(OH)D concentration and factors contributing to 25(OH)D inadequacy in paediatric cancer patients. A prospective cohort study of Scottish children aged <18 years diagnosed with, and treated for, cancer (patients) between August 2010 and January 2014 was performed, with control data from Scottish healthy children (controls). Clinical and nutritional data were collected at defined periods up to 24 months. 25(OH)D status was defined by the Royal College of Paediatrics and Child Health as inadequacy (<50 nmol/l: deficiency (<25 nmol/l), insufficiency (25–50 nmol/l)), sufficiency (51–75 nmol/l) and optimal (>75 nmol/l). In all, eighty-two patients (median age 3·9, interquartile ranges (IQR) 1·9–8·8; 56 % males) and thirty-five controls (median age 6·2, IQR 4·8–9·1; 49 % males) were recruited. 25(OH)D inadequacy was highly prevalent in the controls (63 %; 22/35) and in the patients (64 %; 42/65) at both baseline and during treatment (33–50 %). Non-supplemented children had the highest prevalence of 25(OH)D inadequacy at every stage with 25(OH)D median ranging from 32·0 (IQR 21·0–46·5) to 45·0 (28·0–64·5) nmol/l. Older age at baseline (R −0·46; P<0·001), overnutrition (BMI≥85th centile) at 3 months (P=0·005; relative risk=3·1) and not being supplemented at 6 months (P=0·04; relative risk=4·3) may have contributed to lower plasma 25(OH)D. Paediatric cancer patients are not at a higher risk of 25(OH)D inadequacy than healthy children at diagnosis; however, prevalence of 25(OH)D inadequacy is still high and non-supplemented children have a higher risk. Appropriate monitoring and therapeutic supplementation should be implemented.
Cover crops are suites of non-marketable plants grown to improve soil tilth and reduce erosion. Despite these agronomic benefits, the use of cover crops is often limited because they do not provide a direct source of revenue for producers. Integrating livestock to graze cover crops could provide both an expeditious method for cover crop termination and an alternative source of revenue. However, there has been little research on the agronomic impacts of grazing for cover crop termination, especially in horticultural market-gardens. We conducted a 3-year study comparing the effects of sheep grazing to terminate a four species cover crop (buckwheat, sweetclover, peas and beets) with those of mowing on soil quality indicators, cover crop termination efficacy, and subsequent cash-crop yields. In addition, we tested the nutritional quality of the cover crop as forage. Compared with mowing, sheep grazing did not affect soil chemistry, temperature or moisture. Our study demonstrates that sheep grazing removed more cover crop biomass than mowing at termination. The assessment of nutritional indices suggests that the four-species cover crop mixture could provide high-quality forage with a potential value of US$144.00–481.80 ha−1 of direct revenue as a grazing lease. Cash-crop yields did not differ between previously grazed and previously mowed plots in the subsequent growing season. We conclude that integrating sheep grazing into market vegetable garden operations could make cover crops more economically viable without having adverse effects on subsequent cash crops.
The effect that cosmic rays and the Alfvén waves generated by them have on the structure of the plasma distribution perpendicular to the galactic disc in a hydrostatic model is examined. It is shown that the plasma distribution exhibits two length scales, essentially because the cosmic rays and Alfvén waves lift the gas up and stretch it out beyond the galactic plane. The predicted gas density far from the galactic plane indicates that models involving hydrostatic equilibrium should be replaced by those allowing for a galactic wind.
Background: Epileptic encephalopathy (EE) is a severe condition in which epileptic activity itself may contribute to severe cognitive and behavioural impairments above and beyond what might be expected from the underlying pathology alone. Next generation sequencing technologies such as whole exome sequencing (WES) can detect underlying genetic causes of in EE. Methods: This report describes genotype-phenotype correlation of 29 subjects with unexplained epileptic encephalopathy, in whom WES, targeting a list of 557 epilepsy-associated genes was performed. Epilepsy phenotyping was done according to current ILAE recommendations. Results: Median age at seizure onset was 14 months (range 1-48). Electroclinical syndromes were applicable for 16/29, 8/16 had a definite/likely diagnosis. 6/8 subjects with West syndrome had variants in ALG13, STXBP1, PAFAH1B1, SLC35A2, CDKL5 and ADSL. 2 patients with Dravet syndrome had variants in SCN1A and PCDH19 respectively. 4/29 had unspecified EE and definite/likely diagnosis due to STXBP1, POLG, and KCNQ2 (2) variants. 4/29 had a possible diagnosis involving GABRB3, ARHGEF9, PCDH19 and SCN3A variants. Conclusions: The high diagnostic yield (definite/likely diagnosis in 11/29 = 38%), involving a broad variety of epilepsy-associated genes in different electroclinical syndromes justifies the diagnostic approach of early onset EE by next generation sequencing.
A recent paper by Webb et al. (J. Plasma Phys., vol. 80, 2014, pp. 707–743) on multi-symplectic magnetohydrodynamics (MHD) using Clebsch variables in an Eulerian action principle with constraints is further extended. We relate a class of symplecticity conservation laws to a vorticity conservation law, and provide a corrected form of the Cartan–Poincaré differential form formulation of the system. We also correct some typographical errors (omissions) in Webb et al. (J. Plasma Phys., vol. 80, 2014, pp. 707–743). We show that the vorticity–symplecticity conservation law, that arises as a compatibility condition on the system, expressed in terms of the Clebsch variables is equivalent to taking the curl of the conservation form of the MHD momentum equation. We use the Cartan–Poincaré form to obtain a class of differential forms that represent the system using Cartan’s geometric theory of partial differential equations
There has been a recent move in psychiatry towards the use of electronic discharge (e-discharge) summaries in an effort to improve the efficiency of communication between primary and secondary care, but there are little data on how this affects the quality of information exchanged.
To evaluate the quality of psychiatric discharge summaries before and after the introduction of the e-discharge summary system.
A retrospective analysis of 50 dictated discharge summaries from 1 January to 1 July 2010 and of 50 e-discharge summaries from 1 January to 1 July 2012, evaluating for the inclusion of 15 key items of clinical information.
The average total score of the dictated summaries (mean=9.5, s.d.=2.0) was significantly higher (p<0.001) than the e-discharge summaries (mean=6.7, s.d.=1.8). There were statistically significant differences in five of the standards: findings of physical examination (p<0.001), ICD-10 code (p<0.001), forensic history (p<0.001), alcohol history (p<0.001) and drug history (p<0.001).
Our results revealed a decline in the quality of discharge summaries following the introduction of an electronic system. The reasons for this are unclear and require further analysis. Specific suggestions will depend on the local need, but include improvements in software design and layout as well as better education and training.
Data were extracted from the case records of UK patients admitted with laboratory-confirmed influenza A(H1N1)pdm09. White and non-White patients were characterized by age, sex, socioeconomic status, pandemic wave and indicators of pre-morbid health status. Logistic regression examined differences by ethnicity in patient characteristics, care pathway and clinical outcomes; multivariable models controlled for potential confounders. Whites (n = 630) and non-Whites (n = 510) differed by age, socioeconomic status, pandemic wave of admission, pregnancy, recorded obesity, previous and current smoking, and presence of chronic obstructive pulmonary disease. After adjustment for a priori confounders non-Whites were less likely to have received pre-admission antibiotics [adjusted odds ratio (aOR) 0·43, 95% confidence interval (CI) 0·28–0·68, P < 0·001) but more likely to receive antiviral drugs as in-patients (aOR 1·53, 95% CI 1·08–2·18, P = 0·018). However, there were no significant differences by ethnicity in delayed admission, severity at presentation for admission, or likelihood of severe outcome.
A multi-symplectic formulation of ideal magnetohydrodynamics (MHD) is developed based on the Clebsch variable variational principle in which the Lagrangian consists of the kinetic minus the potential energy of the MHD fluid modified by constraints using Lagrange multipliers that ensure mass conservation, entropy advection with the flow, the Lin constraint, and Faraday's equation (i.e. the magnetic flux is Lie dragged with the flow). The analysis is also carried out using the magnetic vector potential Ã where α=Ã⋅dx is Lie dragged with the flow, and B=∇×Ã. The multi-symplectic conservation laws give rise to the Eulerian momentum and energy conservation laws. The symplecticity or structural conservation laws for the multi-symplectic system corresponds to the conservation of phase space. It corresponds to taking derivatives of the momentum and energy conservation laws and combining them to produce n(n−1)/2 extra conservation laws, where n is the number of independent variables. Noether's theorem for the multi-symplectic MHD system is derived, including the case of non-Cartesian space coordinates, where the metric plays a role in the equations.
Longitudinal studies reporting the association between cannabis use and developing depression provide mixed results. The objective of this study was to establish the extent to which different patterns of use of cannabis are associated with the development of depression using meta-analysis of longitudinal studies.
Peer-reviewed publications reporting the risk of developing depression in cannabis users were located using searches of EMBASE, Medline, PsychINFO and ISI Web of Science. Only longitudinal studies that controlled for depression at baseline were included. Data on several study characteristics, including measures of cannabis use, measures of depression and control variables, were extracted. Odds ratios (ORs) were extracted by age and length of follow-up.
After screening for 4764 articles, 57 articles were selected for full-text review, of which 14 were included in the quantitative analysis (total number of subjects = 76058). The OR for cannabis users developing depression compared with controls was 1.17 [95% confidence interval (CI) 1.05–1.30]. The OR for heavy cannabis users developing depression was 1.62 (95% CI 1.21–2.16), compared with non-users or light users. Meta-regression revealed no significant differences in effect based on age of subjects and marginal difference in effect based on length of follow-up in the individual studies. There was large heterogeneity in the number and type of control variables in the different studies.
Cannabis use, and particularly heavy cannabis use, may be associated with an increased risk for developing depressive disorders. There is need for further longitudinal exploration of the association between cannabis use and developing depression, particularly taking into account cumulative exposure to cannabis and potentially significant confounding factors.