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Several factors have long been known to affect the intensity measurements of X-ray powder diffraction. The characterization of these effects has been impeded by difficulties in their isolation and the statistical nature of the data in which they manifest themselves. The most celebrated, and most detrimental, of the these effects is that of preferred orientation. This error can be eliminated with the spherical agglomeration of the sample (1). The spray drying process offers this result and is considered to have the broadest range of applicability to materials encountered by the powder diffractionist.
As evidence for the second process of the Embracing factor, the target article characterizes being moved as a mixed emotion linked to sadness through metonymy. We question these characterizations and argue that emotions should not be equated with their vernacular labels.
Background and Objective Pain is a frequent symptom in Parkinson’s disease (PD), and the therapeutic alternatives are scarce. The goal of this trial was to measure the effects of botulinum toxin type A (BTXA) in the treatment of limb pain in advanced PD. Methods A randomized double-blind crossover versus placebo study of BTXA for limb pain in advanced Parkinson’s disease was conducted. Subjects received individualized BTXA/placebo dosing per pain distribution in limbs. The primary outcome was a measure of change in global pain on a numeric rating scale (NRS) at 4 and 12 weeks postinjection and on a visual analogue scale 12 weeks after treatment. Secondary outcomes included the percentage of responders, physician-rated clinical global impressions, MDS–UPDRS and PDQ–39 scores, and adverse events. Results A total of 12 subjects completed the trial. Treatment with BTXA (average dose=241.66 U) produced a significant reduction in NRS score 4 weeks after the injections (–1.75 points, range from –3 to 7, p=0.033). However, there was no significant difference compared to placebo (p=0.70). Participants with dystonic pain showed a greater reduction in NRS score after 4 weeks when treated with BTXA (2.66 points vs. 0.75 for placebo). There were no significant differences for any of the secondary outcomes or significant adverse events. Conclusions Targeted BTXA injections were safe in patients with limb pain and advanced PD; however, the present study failed to show a significant effect when compared to placebo. Further studies may be focused on evaluating the effect of BTXA particularly in dystonic pain.
This paper analyzes in detail the role of environmental and economic shocks in the migration of the 1930s. The 1940 US Census of Population asked every inhabitant where they lived five years earlier, a unique source for understanding migration flows and networks. Earlier research documented migrant origins and destinations, but we will show how short-term and annual weather conditions at sending locations in the 1930s explain those flows, and how they operated through agricultural success. Beyond demographic data, we use data about temperature and precipitation, plus data about agricultural production from the agricultural census. The widely known migration literature for the 1930s describes an era of relatively low migration, with much of the migration that did occur radiating outward from the Dust Bowl region and the cotton South. Our work about the complete United States will provide a fuller examination of migration in this socially and economically important era.
Where did the modern lineages of placental mammals originate? Recent molecular data seemingly have overturned not only schemata of placental relationships based on morphological data, but also hypotheses about the time and place of origin of the modern lineages. The original hypothesis of Northern Hemisphere origin, based on the fossil record, has been replaced by a “Garden of Eden” hypothesis of origins on a southern continent, based on molecular phylogenies. But, do the molecular data really support this new view of placental mammal origins?
This was the fifth International Congress on Child Abuse and Neglect that I have attended, others have been held in Geneva, Paris, Amsterdam and London. The 5th International Congress of Child Abuse and Neglect was held in Montreal, Quebec, Canada in September 1984. In keeping with the Congress theme, which emphasised community responsibility for the prevention of child abuse and neglect, organisers, agencies, professionals and citizens who contributed to the congress and represented different levels of Government and various sectors of the community; thus a broad cross section of the people involved. Prevention is the only way of reducing child abuse and neglect. The aim of the conference was to bring together preventative strategies from both professionals and self help agencies. Child abuse is a community responsibility. Every child has the right to be protected “against all forms of neglect, cruelty and exploitation”. Workers inthefield recognise that the help they bring to families is too little too late, and that we cannot rely on judicial strategies to reduce child abuse. Times are difficult, resources are strained, this affects service delivery, and brings increasing stress to the family, making them more vulnerable to breakdown. The U.S.A. spends $2 billion a year on treating the problem and only $2 million a year on preventative activities.
To determine macronutrients and micronutrients in foods served to and consumed by children at child-care centres in Oklahoma, USA and compare them with Dietary Reference Intakes (DRI).
Observed lunch nutrients compared with one-third of the age-based DRI (for 1–3 years-olds and 4–8-year-olds).
Oklahoma child-care centres (n 25), USA.
Children aged 3–5 years (n 415).
Regarding macronutrients, children were served 1782 (sd 686) kJ (426 (sd 164) kcal), 22·0 (sd 9·0) g protein, 51·5 (sd 20·4) g carbohydrate and 30·7 (sd 8·7) % total fat; they consumed 1305 (sd 669) kJ (312 (sd 160 kcal), 16·0 (sd 9·1) g protein, 37·6 (sd 18·5) g carbohydrate and 28·9 (sd 10·6) % total fat. For both age-based DRI: served energy (22–33 % of children), protein and carbohydrate exceeded; consumed energy (7–13 % of children) and protein exceeded, while carbohydrate was inadequate. Regarding micronutrients, for both age-based DRI: served Mg (65·9 (sd 24·7) mg), Zn (3·8 (sd 11·8) mg), vitamin A (249·9 (sd 228·3) μg) and folate (71·9 (sd 40·1) µg) exceeded; vitamin E (1·4 (sd 2·1) mg) was inadequate; served Fe (2·8 (sd 1·8) mg) exceeded only in 1–3-year-olds. Consumed folate (48·3 (sd 38·4) µg) met; Ca (259·4 (sd 146·2) mg) and Zn (2·3 (sd 3·0) mg) exceeded for 1–3-year-olds, but were inadequate for 4–8-year-olds. For both age-based DRI: consumed Fe (1·9 (sd 1·2) mg) and vitamin E (1·0 (sd 1·7) mg) were inadequate; Mg (47·2 (sd 21·8) mg) and vitamin A (155·0 (sd 126·5) µg) exceeded.
Lunch at child-care centres was twice the age-based DRI for consumed protein, while energy and carbohydrate were inadequate. Areas of improvement for micronutrients pertain to Fe and vitamin E for all children; Ca, Zn, vitamin E and folate for older pre-schoolers. Adequate nutrients are essential for development and the study reveals where public health nutrition experts, policy makers and care providers should focus to improve the nutrient density of foods.
The impact of discontinuing contact precautions for patients with MRSA and VRE colonization/infection on device-associated hospital-acquired infection rates at an academic medical center was investigated in this before-and-after study. In the setting of a strong horizontal infection prevention platform, discontinuation of contact precautions had no impact on device-associated hospital-acquired infection rates.
Infect. Control Hosp. Epidemiol. 2015;36(8):978–980
Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) is a primary systemic vasculitis that affects medium to small sized vessels throughout the body. It often presents with symptoms and signs involving the ear, nose, and head and neck area.
To highlight salient features of ENT-related issues in granulomatosis with polyangiitis, and raise awareness of the condition.
A case report of a patient with limited disease and an insidious onset is presented, along with a review of the current literature. In addition, basic initial management is described.
Eighty-six publications were used to describe salient features of ENT-related issues in granulomatosis with polyangiitis.
The time to diagnosis has not reduced significantly in the last 10 years in the UK. A high index of suspicion is required for an earlier diagnosis of granulomatosis with polyangiitis.
In this paper, we address two different aspects relevant to the growth of GaN. The first part concerns alternative nitrogen source whereas in the second part, we report experimental results on Mg doping. Several nitrogen precursors have been used for the growth of GaN in MOVPE. To produce active species from N2 or NH3, a remote Plasma Enhanced Chemical Vapour Deposition (RPECVD) process has been implemented. In addition, nitrogen organic precursors, triethylamine and t-butylamine were also used. To accurately control the critical parameters of the MOVPE of GaN, we have implemented a laser reflectometry, which allows a real time in situ monitoring of the different steps of the growth. MeCp2Mg was used as Mg precursor for the p doping study. The dependence on the partial pressure of Mg precursor of dopant incorporation, electrical activity and growth rate are reported.
To assess the feasibility and accuracy of otolaryngologist-performed ultrasound in evaluating head and neck pathology.
An ENT trainee, who had undergone basic training in neck ultrasonography, performed this on patients referred with suspected neck pathology. The trainee recorded the presence and nature of any abnormality. Findings were compared with those from a repeated scan performed by an experienced head and neck radiologist.
The study included 250 patients. The absence or presence of lesion as reported by the trainee correlated with the radiologist's findings in 207 cases (83 per cent). There were 144 true positives, 63 true negatives, 32 false negatives and 11 false positives, yielding a sensitivity of 82 per cent, specificity of 85 per cent and accuracy of 83 per cent. Of the 144 true positive lesions, 81 per cent were interpreted concordantly with the radiologist.
Neck ultrasonography performed by an otolaryngologist is less accurate than that performed by an experienced radiologist, but is still a useful adjunct to clinical assessment, facilitating assessment in a ‘one-stop’ clinical setting.
Dipodal silanes possess two silicon atoms that can covalently bond to a surface. They offer a distinctive advantage over conventional silanes in terms of maintaining the integrity of surface coatings, adhesive primers and composites in aqueous and aggressive environments. The improved durability of such dipodal silanes is associated with an increased crosslink density of the interphase and the inherent resistance to hydrolysis, as they can form six, rather than three, Si-O bonds to the substrate. This study examines dipodal silanes with hydrophobic alkyl functionality and compares them with similar functionality on conventional silane coupling agents. It also introduces new structural dipodal silanes containing “pendant” and “bridged” functionality and then examines their stability in aqueous environments. In strongly acidic and brine environments, dipodal silanes clearly demonstrate improved resistance to hydrolysis compared to conventional silane coupling agents.
The major lymphatic vessels may be damaged during neck dissection or other cervical surgery, resulting in chyloma or chyle fistula. While commonly considered to be predominantly a complication of left-sided surgery, the thoracic duct may be damaged on either side of the neck due to the extreme variability in the anatomy of the central lymphatic system.
Method and results:
This paper reviews the variable anatomy and embryology of the thoracic and right lymphatic ducts, particularly aspects relevant to head and neck surgery.
The Hayes-Martin manoeuvre involves ligation of the posterior facial vein and superior reflection of the investing fascia below the mandible to preserve the marginal mandibular nerve. The peri-facial nodes thus remain undissected. We perform this manoeuvre routinely during modified radical neck dissection for metastatic oropharyngeal squamous cell cancer. Here, we review the oncological safety and marginal mandibular nerve preservation rates of this manoeuvre from 2004 to 2009.
Retrospective review of the head and neck oncology database (2004–2009) at Addenbrooke's Hospital, Cambridge, UK, a tertiary referral centre for head and neck oncology.
Thirty-four patients underwent modified radical neck dissection for metastatic oropharyngeal squamous cell carcinoma. The primary tumour included the tonsil in 19 cases, base of tongue in 10 and posterior pharyngeal wall in 5. The neck nodal status was N1 in 4 cases, N2a in 11, N2b in 10, N2c in 4 and N3 in 5. All patients had adjuvant radiotherapy. Median follow up was four years (range, two to five). No peri-facial nodal region recurrences were seen. Four patients had temporary marginal mandibular nerve weakness; beyond two months, no weakness was seen.
In neck dissections for oropharyngeal squamous cell carcinoma, the marginal mandibular nerve and accompanying facial nodes can be safely preserved without oncological risk using the Hayes-Martin manoeuvre.
Intramuscular haemangiomas of the digastric muscle are often misdiagnosed due to their low incidence and non-specific manifestation. Only two out of six previously reported cases were diagnosed correctly before excision. Ultrasound may not reveal their vascularity, and fine-needle aspiration biopsy is unhelpful as it reveals only blood.
A case of intramuscular haemangioma of the posterior belly of the digastric muscle is described. Previously reported cases are reviewed. Investigations used to diagnose the lesions and reasons for their common failure are discussed.
Core-needle biopsy led to the correct histological diagnosis, and magnetic resonance imaging precisely located the lesion within the digastric muscle.
Core-needle biopsy was safely used in the diagnosis of an intramuscular haemangioma. The combination of core-needle biopsy and meticulous review of magnetic resonance imaging enables accurate diagnosis pre-operatively.
Nasogastric tube insertion is often difficult, due to a variety of reasons, e.g. skewed laryngeal anatomy. We present a previously unreported method of facilitating nasogastric tube insertion, using a flexible nasendoscope.
The nasogastric tube is anchored to a flexible nasendoscope using sodium alginate dressing ties. The nasendoscope is then passed into the upper oesophagus, along with the nasogastric tube. Once the nasogastric tube has passed the cricopharyngeus, gentle traction on the nasendoscope releases it from the nasogastric tube. The nasendoscope can then be withdrawn. A previous safety study of sodium alginate ingestion showed no adverse effects.
This method enables nasogastric tube insertion under direct vision, and allows the tube to be guided past the larynx and into the upper oesophagus.
Ewing's sarcoma is a rare, malignant tumour predominantly affecting young adolescent males. We describe a unique case of an isolated extra-skeletal metastasis from a skeletal Ewing's sarcoma primary, arising in the right sinonasal cavity of a young man who presented with severe epistaxis and periorbital cellulitis.
Histologically, the lesion comprised closely packed, slightly diffuse, atypical cells with round, hyperchromatic nuclei, scant cytoplasm and occasional mitotic figures, arranged in a sheet-like pattern. Immunohistochemical analysis showed positive staining only for cluster of differentiation 99 glycoprotein. Fluorescent in situ hybridisation identified the Ewing's sarcoma gene, confirming the diagnosis.
Complete surgical resection was achieved via a minimally invasive endoscopic transnasal approach; post-operative radiotherapy. Ten months post-operatively, there were no endoscopic or radiological signs of disease.
Metastatic Ewing's sarcoma within the head and neck is incredibly rare and can pose significant diagnostic and therapeutic challenges. An awareness of different clinical presentations and distinct histopathological features is important to enable early diagnosis. This case illustrates one potential management strategy, and reinforces the evolving role of endoscopic transnasal approaches in managing sinonasal cavity and anterior skull base tumours.
Silver-nickel multilayers have been prepared by cathodic sputtering on glass, silicon and carbon-covered mica substrates kept at 100 K. X-ray diffraction experiments show that highly textured, polycrystalline superlattices are formed. There exists a critical number of atomic planes nc = 3, below which non-crystalline samples are obtained. This critical number can even be lowered in samples with non-equal numbers of Ag and Ni atomic planes. The simulation of the X-ray spectra assuming sharp interfaces and Ag and Ni (111) distances slightly larger than the bulk values leads to a good agreement with the experimental spectra. Transmission x-ray and electron diffraction experiments show that equivalent crystallographic directions are aligned in the Ag and Ni (111) planes, with a noticeable relaxation of the in-plane distances at the interfaces. Preliminary high-resolution electron microscopy results are also presented.