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To determine the influence of early pain relief for patients with suspected appendicitis on the diagnostic performance of surgical residents.
A prospective randomized, double-blind, placebo-controlled trial was conducted for patients with suspected appendicitis. The patients were randomized to receive placebo (normal saline intravenous [IV]) infusions over 5 minutes or the study drug (morphine 5 mg IV). All of the clinical evaluations by surgical residents were performed 30 minutes after administration of the study drug or placebo. After obtaining the clinical probability of appendicitis, as determined by the surgical residents, abdominal computed tomography was performed. The primary objective was to compare the influence of IV morphine on the ability of surgical residents to diagnose appendicitis.
A total of 213 patients with suspected appendicitis were enrolled. Of these patients, 107 patients received morphine, and 106 patients received placebo saline. The negative appendectomy percentages in each group were similar (3.8% in the placebo group and 3.2% in the pain control group, p=0.62). The perforation rates in each group were also similar (18.9% in the placebo group and 14.3% in the pain control group, p=0.75). Receiver operating characteristic analysis revealed that the overall diagnostic accuracy in each group was similar (the area under the curve of the placebo group and the pain control group was 0.63 v. 0.61, respectively, p=0.81).
Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
The liquid lens based on MEMS technology can be an appropriate solution to improve the imaging capability of a capsule endoscope because it can be realized small enough and also consume negligible power. In this paper, a cylinder-type liquid lens was designed to minimize the dead area and then fabricated with MEMS technology combining the silicon thin-film process and the wafer bonding process where the multiple dielectric layer of Teflon, silicon nitride and thermal oxide was formed on the cylinder wall. The focal length of the lens module including the fabricated liquid lens was changed reproducibly as a function of the applied voltage. With the change of 30V in the applied bias, the focal length of the constructed lens module could be tuned in the range of about 42cm. The fabricated liquid lens was also proven to be small enough to be adopted in the capsule endoscope, which means the liquid lens can be utilized for the imaging capability improvement of the capsule endoscope.
This paper describes the growth kinetics of an interfacial MgO layer as well as those of an MgB2 layer during ex situ annealing of the evaporated amorphous boron (a-B) film under Mg vapor overpressure. A thin MgO layer is formed at the interface between a-B and Al2O3 substrate before the formation of crystalline MgB2 layer and the interfacial layer is epitaxially related with Al2O3 substrate (MgO (111) // Al2O3 (0001)). The interfacial MgO layer continues to grow during the annealing, and its apparent growth rate is about 0.1 nm/min. The analysis of MgB2 layer growth kinetics using cross-sectional transmission electron microscopy reveals that there exist two distinct growth fronts at both sides of an MgB2 layer. The growth kinetics of the lower MgB2 layer obeys the parabolic rate law during the entire annealing time. The growth of the upper MgB2 layer is controlled by the surface reaction between out-diffused boron and Mg vapor up to 10 min, resulting in a rough surface morphology of MgB2 layer. By considering the mass balance of Mg and boron during ex situ annealing, we obtained the diffusivities of Mg and boron in MgB2 layer which were in the same order range of approximately 10−12 cm2/s.
The reaction sequence and microstructure evolution of a crystalline MgB2 layer were examined during ex situ annealing of evaporated amorphous boron (a-B) with Mg vapor. Mg was found to migrate rapidly into the a-B layer in the initial stage of reaction with a uniform concentration of about 12 at.%. A thin layer of crystalline MgO was observed at the interface between a-B and the Al2O3 substrate. It was identified that an MgB2 layer started to form at the surface by the nucleation and growth process in polycrystalline form. It appears that there exists two distinct growth fronts in the MgB2 layer: one lying at the surface and the other lying at the interface between the MgB2 layer and the a-B. The microstructural evolution of this layer showed significant differences depending on the location of these two growth fronts.
A novel processing sequence for the formation of gated diamond field emitter arrays (triode system) is proposed and the feasibility is tested by investigating the field emission property. The processing scheme is based on the selective deposition of diamond using the well established nucleation enhanced process on silicon substrate, so called bias enhanced nucleation (BEN). Selective deposition of diamond using the same process was also demonstrated on titanium nitride (TIN) electrode layer. Our preliminary results show that the diamond field emitter is turned on at around 97 V/μm with the current level of about several μA.
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