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In recent years, several cognitive behavioral therapies have been developed to meet the specific challenges involved in treating personality disorders. Cognitive and behavioral treatment (CBT) is best represented as a family of therapies, including manualized treatment packages (or “branded” CBTs) and principle-driven interventions. This chapter reviews cognitive and behavioral intervention options for patients suffering from personality dysfunction. First, the authors provide an overview of the “branded” CBTs tested with personality disorder populations, including dialectical behavior therapy, schema focused therapy, and cognitive therapy for personality disorders. For clinicians who wish to use a cognitive behavioral approach, they then discuss how CBT case conceptualization can be used to inform a flexible and responsive treatment based on the empirically-supported treatments for personality disorders. In this approach, clinicians would formulate a treatment plan that applies cognitive and behavioral strategies, interventions, and principles of change from these empirically-supported “branded” CBTs. For example, the authors discuss ways in which the CBT principle of exposure may be considered for application across different personality disorders. Finally, they discuss the potential value in application of mindfulness and acceptance strategies with personality disorders.
The commentaries from Gold, Yen, Hughes and Rizvi highlight the challenges associated with using cognitive behavioral therapies to treat individuals with personality disorders (PDs). In this rejoinder, the authors extend upon these observations by arguing the importance of a modular, principle-driven approach to assessment and treatment of PDs. First, they discuss how there is a greater demand for treatments beyond the current “branded” CBTs and their empirical basis. In light of this limitation, clinicians need to flexibly use empirically-supported principles of change to treat processes underlying personality dysfunction. This approach requires careful case formulation and identification of behaviorally-specific targets of treatment using validated screening tools. This approach to treatment may be a useful way of meeting the demands for both patient care and current trends in national health care payor reform.
A variety of paediatric tracheostomy tubes are available. This article reviews the tubes in current use at Great Ormond Street Hospital for Children and Evelina London Children's Hospital.
Methods
This paper outlines our current preferences, and the particular indications for different tracheostomy tubes, speaking valves and other attachments.
Results
Our preferred types of tubes have undergone significant design changes. This paper also reports further experience with certain tubes that may be useful in particular circumstances. An updated sizing chart is included for reference purposes.
Conclusion
The choice of a paediatric tracheostomy tube remains largely determined by individual clinical requirements. Although we still favour a small range of tubes for use in the majority of our patients, there are circumstances in which other varieties are indicated.
To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation.
Method:
A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016.
Results:
A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3.99 years. The median balloon size was 8 mm, the median balloon inflation pressure was 10 atm, and the mean balloon inflation time was 65.1 ± 18.6 seconds. No significant unexpected events occurred. The Pearson correlation co-efficient for the relationship between patient age and balloon size was 0.85 (p = 0.001), suggesting a strongly positive correlation.
Conclusion:
This study demonstrated that balloon dilatation is a safe procedure for airway stenosis. The results suggest using a balloon diameter that is equal to the outer diameter of the age-appropriate endotracheal tube +1 mm for the larynx and subglottis and +2 mm for the trachea.
This paper describes the design and fabrication of a range of ‘gas cell’ microtargets produced by the Target Fabrication Group in the Central Laser Facility (CLF) for academic access experiments on the Orion laser facility at the Atomic Weapons Establishment (AWE). The experiments were carried out by an academic consortium led by Imperial College London. The underlying target methodology was an evolution of a range of targets used for experiments on radiative shocks and involved the fabrication of a precision machined cell containing a number of apertures for interaction foils or diagnostic windows. The interior of the cell was gas-filled before laser irradiation. This paper details the assembly processes, thin film requirements and micro-machining processes needed to produce the targets. Also described is the implementation of a gas-fill system to produce targets that are filled to a pressure of 0.1–1 bar. The paper discusses the challenges that are posed by such a target.
This work considers debris disks whose spectra can be modelled by dust emission at two different temperatures. These disks are typically assumed to be a sign of multiple belts, but only a few cases have been confirmed via high resolution observations. We derive the properties of a sample of two-temperature disks, and explore whether this emission can arise from dust in a single narrow belt. While some two-temperature disks arise from single belts, it is probable that most have multiple spatial components. These disks are plausibly similar to the outer Solar System's configuration of Asteroid and Edgeworth-Kuiper belts separated by giant planets. Alternatively, the inner component could arise from inward scattering of material from the outer belt, again due to intervening planets. For either scenario, the ratio of warm/cool component temperatures is indicative of the scale of outer planetary systems, which typically span a factor of about ten in radius.
This article describes the fabrication of a suite of laser targets by the Target Fabrication group in the Central Laser Facility (CLF), STFC Rutherford Appleton Laboratory for the first academic-access experiment on the Orion laser facility (Hopps et al., Appl. Opt. 52, 3597–3601 (2013)) at Atomic Weapons Establishment (AWE). This experiment, part of the POLAR project (Falize et al., Astrophys. Space Sci. 336, 81–85 (2011); Busschaert et al., New J. Phys. 15, 035020 (2013)), studied conditions relevant to the radiation-hydrodynamic processes occurring in a remarkable class of astrophysical star systems known as magnetic cataclysmic variables. A large number of complex fabrication technologies and research and development activities were required to field a total of 80 high-specification targets. Target design and fabrication procedures are described and initial alignment and characterization data are discussed.
Colloids with anisotropic shape and properties can enable the assembly of advanced materials otherwise not attainable by microfabrication. In this study, we present a convenient method using common microfabrication tools to generate a diverse array of non-spherical microparticles with well-defined shapes, sizes, electromagnetic properties for self-assembly applications. Projection photolithography onto SU-8 photoresist enabled the production of large aspect ratio microparticles such as cubes, cuboids, cylinders, hexagonal prisms, and parallelepipeds. We characterized these particles to confirm their anisotropic shape and size monodispersity. Fluorescent stains (e.g., Nile red) were mixed into the photoresist prepolymer to enhance the visualization of particle orientation. Particles designed for passive self-assembly were prepared by conventional photolithographic techniques. Particles designed for active assembly were then decorated with metallic patches in precise locations along the surface (e.g., top, side or multiple sides) using electron beam metal evaporation. This metal deposition process can enable orientational control of particles during their assembly in directed fields. After fabrication, large particles (e.g., 1,000 µm3) were released from the substrate via gentle sheer forces, whereas small particles (e.g., 10 µm3) were released by the dissolution of a sacrificial layer underneath the SU-8. Suspending the particles in water with surfactant (or other suitable solvents) provided amenable conditions for their assembly in static or dynamic systems. These conventional methods have the potential to catalyze new research in the fabrication and assembly of anisotropic patchy particles with controllable properties for the hierarchical development of self-assembled micromirrors, biosensors, and photonic crystals as examples.
Whilst debris discs orbiting main-sequence stars are well studied, very little is known regarding their fate when the star evolves onto the giant branch. For intermediate mass (A-type) stars, giants provide a unique opportunity to detect planets using the radial velocity technique, otherwise prohibited by high jitter levels and rotationally broadened lines in main-sequence intermediate mass (A-type) stars. Such stars can provide key insights into the structure of planetary systems around intermediate mass stars. In our Herschel OT1 program (PI Bonsor) we searched for the presence of debris discs orbiting a sample of 36 subgiants, half of which have RV detected companions. Our best detection is the resolved debris disc orbiting κ CrB.
This contribution summarises the first characterisation of the 12 μm warm dust (“exo-Zodi”) luminosity function around Sun-like stars, focussing on the dustiest systems that can be identified by the WISE mission (Kennedy & Wyatt 2013). We use the sample of main-sequence stars observed by Hipparcos within 150pc as an unbiased sample, and report the detection of six new warm dust candidates. The ages of five of these new sources are unknown, meaning that they may be sites of terrestrial planet formation or rare analogues of other old warm dust systems. We show that the dustiest old (> Gyr) systems such as BD+20 307 are 1 in 10,000 occurrences. Bright warm dust is much more common around young (<120 Myr) systems, with a ~1% occurrence rate. We show that a two component in situ model where all stars have initially massive warm disks and in which warm debris is also generated at some random time along the stars' main-sequence lifetime, perhaps due to a collision, can explain the observations. However, if all stars only have initially massive warm disks these would not be visible at Gyr ages, and random collisions on the main-sequence are too infrequent to explain the high disk occurrence rate for young stars. That is, neither component can explain the observations on their own. Despite these conclusions, we cannot rule out an alternative dynamical model in which comets are scattered in from outer regions because the distribution of systems with the appropriate dynamics is unknown. Our in situ model predicts that the fraction of stars with exo-Zodi bright enough to cause problems for future exo-Earth imaging attempts is at least roughly 10%, and is higher for populations of stars younger than a few Gyr. This prediction of roughly 10% also applies to old stars because bright systems like BD+20 307 imply a population of fainter systems that were once bright, but are now decaying through fainter levels. Our prediction should be strongly tested by the Large Binocular Telescope Interferometer, which will provide valuable constraints and input for more detailed evolution models. A detection fraction lower than our prediction could indicate that the hot dust in systems like BD+20 307 has a cometary origin due to the quirks of the planetary dynamics. Population models of comet delivery need to be developed to help distinguish between different possible origins of warm dust.
The eccentric orbits of the known extrasolar giant planets provide evidence that most planet-forming environments undergo violent dynamical instabilities. Here, we numerically simulate the impact of giant planet instabilities on planetary systems as a whole. We find that populations of inner rocky and outer icy bodies are both shaped by the giant planet dynamics and are naturally correlated. Strong instabilities – those with very eccentric surviving giant planets – completely clear out their inner and outer regions. In contrast, systems with stable or low-mass giant planets form terrestrial planets in their inner regions and outer icy bodies produce dust that is observable as debris disks at mid-infrared wavelengths. Fifteen to twenty percent of old stars are observed to have bright debris disks (at λ ~ 70μm) and we predict that these signpost dynamically calm environments that should contain terrestrial planets.
The planetary system of HD 69830 is uniquely constrained by observations of (i)
an infrared excess indicative of a debris disk with warm dust and (ii) radial
velocity variations indicative of three planets. This presents a valuable
opportunity to test planet formation models by integrating dynamical models of
planetary formation and migration with those for the sculpting of a
dust-producing planetesimal disk. We perform n-body
simulations and investigate the excitation of both planet and planetesimal
eccentricities, the accretion of planetesimals onto the planets, and the
clearing of a planetesimal disk by the planets as they grow in mass and migrate
through the disk. In simulations tuned to closely follow previous semi-analytic
models for the growth and migration of the planets, we find that the inner
planet accretes significantly more planetesimals than previously estimated. We
find that eccentricity excitation due to mutual planetary perturbations during
and after the migration do not naturally produce the observed eccentricities.
Our simulations suggest that this discrepancy may be reduced or possibly
reconciled if the planets are significantly more massive
than expected (possible if the planetary system's angular
momentum were nearly parallel to our line of sight). Even if the planets are
significantly more massive than previously assumed, we find that the migrating
planets are inefficient at clearing the outer planetesimal disk and that a
significant fraction of the planetesimal population beyond 1 AU remains bound on
moderately eccentric and inclined orbits. While much of the remaining
planetesimal belt would have eroded via a collisional cascade and radiation
pressure, we explore whether some of the highly excited planetesimals may be
able to persist over the age of the central star,
producing the dust observed in the HD 69830 system.
Polycrystalline Cd1-xMgxTe (CMT) thin films are a potential absorber material for two-junction thin-film tandem solar cell applications because the desired top cell bandgap range of 1.6 to 1.8 eV is readily obtained using CMT with only small resultant changes in the lattice constant from that of CdTe. Tandem devices require the top cell to have a transparent back contact to transmit the sub-bandgap spectrum to the bottom cell. Sputtered Cu-doped ZnTe (ZnTe:Cu) thin films, which offer potential as a transparent back contact interface layer, have been used successfully in CdTe devices. We apply ZnTe:Cu back contacts to CMT devices to continue development toward a transparent top cell. We describe the effects of depositing ZnTe:Cu at different temperatures and with different Cu contents on the net acceptor concentration, minority carrier lifetime, and device performance. We present here the highest reported CMT device efficiency of 9.6% at a bandgap of 1.57 eV.
Several wet-processing steps are used in fabricating high-efficiency CdTe/CdS solar cells. These steps can hinder in-line processing; thus, developing an all-dry processing option is attractive for a manufacturing-friendly process. In this study, we systematically modified the baseline process used in our laboratory to replace CdS deposited by chemical-bath deposition (CBD) with sputter-deposited CdS and Cu-doped graphite paste back-contact with Cu-doped ZnTe deposited by radio-frequency sputtering. In addition to CdTe deposited by close-spaced sublimation, we also used conventionally evaporated CdTe. The results show that replacing only CBD CdS with oxygenated CdS deposited by sputtering produces devices with performance comparable to baseline devices if the front bilayer SnO2 is replaced by a Cd2SnO4/ZnSnO alloy. Replacing the graphite paste back-contact with sputter-deposited Cu-doped ZnTe resulted in device performance comparable to baseline devices. Incorporating both dry processing steps gave performance comparable to the devices with sputtered CdS with a SnO2 front contact. We used capacitance-voltage and minority-carrier lifetime measurements to analyze the factors affecting device performance and we present the results here.
To investigate whether young adults born very preterm (VPT) (<33 weeks) are at increased risk for psychiatric illness in adulthood and whether a family history of psychiatric disorder further increases this risk.
Methods
We assessed 169 VPT and 101 term born individuals using the Clinical Interview Schedule – Revised.
Results
Young adults born VPT had an increased risk for psychiatric disorder compared to controls (OR = 3.1, 95% CI = 1.1–8.6, p = 0.03). Those born VPT who had a history of psychiatric disorder in a first-degree relative, had an increase in risk for psychiatric disorder compared to those born VPT without a family history (OR = 5.2, 95% CI = 1.8–14.9, p = 0.002).
Conclusion
Individuals born VPT are at increased risk of psychiatric illness in young adulthood compared to controls. In addition, a family history of psychiatric disorder in a first-degree relative may leave young adults born VPT particularly vulnerable to psychiatric illness.
from
Part III
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Mineralogy and Remote Sensing of Rocks, Soil, Dust, and Ices
By
P. R. Christensen, Planetary Exploration Laboratory Arizona State University Moeur Building 110D Tempe, AZ 85287, USA,
J. L. Bandfield, Arizona State University, MC 6305 Mars Space Flight Facility Tempe, AZ, USA,
A. D. Rogers, Department of Geosciences, SUNY at Stony Brook Stony Brook, NY 11794, USA,
Glotch R. T. D., Department of Geosciences, SUNY at Stony Brook Stony Brook, NY 11794, USA,
V. E. Hamilton, Hawaii Institute of Geophysics & Planetology, University of Hawaii, 1680 East-West Road, Honolulu, HI 96822, USA,
S. W. Ruff, Mars Space Flight Facility Arizona State University Moeur Building, Room 131 Tempe, AZ 85287-6305, USA,
M. B. Wyatt, Brown University, Department of Geological Science, 324 Brook Street Providence, RI 02912-1846, USA
The Thermal Emission Spectrometer (TES) on Mars Global Surveyor (MGS) mapped the surface, atmosphere, and polar caps of Mars from 1997 through 2006. TES provided the first global mineral maps of Mars, and showed that the surface is dominated by primary volcanic minerals (plagioclase feldspar, pyroxene, and olivine) along with high-silica, poorly crystalline materials. Differences in the abundances of these minerals were initially grouped into two broad compositional categories that correspond to basalt and basaltic andesite. Additional analysis has identified four surface compositional groups that are spatially coherent, revealing variations in the composition of the primary crust-forming magmas through time. In general, plagioclase, high-Ca clinopyroxene, and high-silica phases are the dominant mineral groups for most regions, with lesser amounts of orthopyroxene, olivine, and pigeonite. One of the fundamental results from the TES investigation was the identification of several large deposits of crystalline hematite, including those in Meridiani Planum, that were interpreted to indicate the presence of liquid water for extended periods of time. This interpretation led to the selection of Meridiani as the target for the Opportunity rover, the first time that a planetary landing site was selected on the basis of mineralogic information. Aqueous weathering may have formed some of the high-silica phases seen in TES spectra at high latitudes, and the Mars Express Observatoire pour la Minéralogie, l'Eau, les Glaces et l'Activité (OMEGA) spectrometer has detected phyllosilicates and sulfates, typically formed by aqueous weathering and deposition, in several locations.
from
Part III
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Mineralogy and Remote Sensing of Rocks, Soil, Dust, and Ices
By
S. W. Ruff, Mars Space Flight Facility Arizona State University, Moeur Building, Room 131 Tempe, AZ 85287-6305, USA,
P. R. Christensen, Planetary Exploration Laboratory Arizona State University, Moeur Building 110D Tempe, AZ 85287, USA,
T. D. Glotch, Department of Geosciences, SUNY at Stony Brook Stony Brook, NY 11794, USA,
D. L. Blaney, JPL MS 183-501 4800 Oak Grove Drive Pasadena, CA 91109, USA,
J. E. Moersch, Department of Earth & Planetary Science University of Tennessee, 1412 Circle Drive, Room 306 Knoxville, TN 37996, USA,
M. B. Wyatt, Brown University, Department of Geological Science, 324 Brook Street Providence, RI 02912-1846, USA
Two Miniature Thermal Emission Spectrometers (Mini-TES) operated successfully onboard the two Mars Exploration Rovers (MER) on the Martian surface, one at Gusev crater and the other at Meridiani Planum. Designed to provide remotely sensed information on the bulk mineralogy of surface materials, the Mini-TES instruments served to guide the rovers to targets of interest and extrapolate the observations made by the rovers' mechanical-arm-mounted instruments. The Mini-TES on the Spirit rover in Gusev crater observed a flat plain covered by rocks with an olivine-rich ((Mg,Fe)2SiO4) mineralogy and a soil-like unit mantled by airfall dust occurring between the rocks. The dust is a spectral match to dust observed at Meridiani Planum and across the globe. The soil is basaltic in composition, dominated by plagioclase (NaAlSi3O8–CaAl2Si2O8), pyroxene (Ca(Mg,Fe)Si2O6–(Mg,Fe)SiO3), and olivine that probably was produced in part from the breakdown of local rocks. Approximately 2.5 km from the Spirit lander, the Columbia Hills contain a remarkably diverse set of rocks distinct from the plains. Basaltic glass appears to dominate the mineralogy of various outcropping rocks while plagioclase dominates the float rocks that cover most of the north side of Husband Hill, the tallest of the Columbia Hills. Numerous exotic (out of place) rocks dot the hillside that likely were emplaced as impact ejecta in some cases and perhaps as volcanic intrusions in other cases. Onboard the Opportunity rover in Meridiani Planum, the Mini-TES observed a nearly rock-free plain covered in hematite (Fe2O3) spherules and basaltic sand.