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We have developed the bispectral electroencephalography (BSEEG) method for detection of delirium and prediction of poor outcomes.
To improve the BSEEG method by introducing a new EEG device.
In a prospective cohort study, EEG data were obtained and BSEEG scores were calculated. BSEEG scores were filtered on the basis of standard deviation (s.d.) values to exclude signals with high noise. Both non-filtered and s.d.-filtered BSEEG scores were analysed. BSEEG scores were compared with the results of three delirium screening scales: the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), the Delirium Rating Scale-Revised-98 (DRS) and the Delirium Observation Screening Scale (DOSS). Additionally, the 365-day mortalities and the length of stay (LOS) in the hospital were analysed.
We enrolled 279 elderly participants and obtained 620 BSEEG recordings; 142 participants were categorised as BSEEG-positive, reflecting slower EEG activity. BSEEG scores were higher in the CAM-ICU-positive group than in the CAM-ICU-negative group. There were significant correlations between BSEEG scores and scores on the DRS and the DOSS. The mortality rate of the BSEEG-positive group was significantly higher than that of the BSEEG-negative group. The LOS of the BSEEG-positive group was longer compared with that of the BSEEG-negative group. BSEEG scores after s.d. filtering showed stronger correlations with delirium screening scores and more significant prediction of mortality.
We confirmed the usefulness of the BSEEG method for detection of delirium and of delirium severity, and prediction of patient outcomes with a new EEG device.
This paper explores dependencies between operational risks and between operational risks and other risks such as market, credit and insurance risk. The paper starts by setting the regulatory context and then goes into practical aspects of operational risk dependencies. Next, methods of modelling operational risk dependencies are considered with a simulation study exploring the sensitivity of diversification benefits arising from dependency models. The following two sections consider how correlation assumptions may be set, highlighting some generic dependencies between operational risks and with non-operational risks to assist in the assessment of dependencies and correlation assumptions. Supplementary appendices provide further detail on generic dependencies as well as a case study of how business models can lead to operational risks interacting with other risks. Finally, the paper finishes with a literature review of operational risk dependency papers including correlation studies and benchmark reports.
We present the case of transcatheter aortic valve replacement in a 20-year-old woman with severe bicuspid aortic stenosis and Schmike immuno-osseous dysplasia who was unfit for surgical aortic valve replacement. Meticulous pre-procedural planning and a multidisciplinary team approach can enable successful transcatheter aortic valve replacement in complex patients with genetic syndromes.
We are trying to reduce the largest uncertainties in using white dwarf stars as Galactic chronometers by understanding the details of carbon crystalliazation that currently result in a 1–2 Gyr uncertainty in the ages of the oldest white dwarf stars. We expect the coolest white dwarf stars to have crystallized interiors, but theory also predicts hotter white dwarf stars, if they are massive enough, will also have some core crystallization. BPM 37093 is the first discovered of only a handful of known massive white dwarf stars that are also pulsating DAV, or ZZ Ceti, variables. Our approach is to use the pulsations to constrain the core composition and amount of crystallization. Here we report our analysis of 4 hours of continuous time series spectroscopy of BPM 37093 with Gemini South combined with simultaneous time-series photometry from Mt. John (New Zealand), SAAO, PROMPT, and Complejo Astronomico El Leoncito (CASLEO, Argentina).
We present photometry and spectroscopy of the peculiar Type II supernova SN 2010jp, also named PTF10aaxi. The light curve exhibits a linear decline with a relatively low peak absolute magnitude of only −15.9 (unfiltered), and a low radioactive decay luminosity at late times that suggests a low synthesized nickel mass of about 0.003 M⊙ or less. Spectra of SN 2010jp display an unprecedented triple-peaked Hα line profile, showing: (1) a narrow central component that suggests shock interaction with a dense circumstellar medium (CSM); (2) high-velocity blue and red emission features centered at −12,600 and +15,400 km s−1; and (3) very broad wings extending from −22,000 to +25,000 km s−1. We propose that this line profile indicates a bipolar jet-driven explosion, with the central component produced by normal SN ejecta and CSM interaction at mid and low latitudes, while the high-velocity bumps and broad line wings arise in a nonrelativistic bipolar jet. Jet-driven SNe II are predicted for collapsars resulting from a wide range of initial masses above 25 M⊙, especially at the sub-solar metallicity consistent with the SN host environment. It also seems consistent with the apparently low 56Ni mass that may accompany black hole formation. We speculate that the jet survives to produce observable signatures because the star's H envelope was very low mass, having been mostly stripped away by the previous eruptive mass loss.
Principal challenges to direct fabrication of high performance a-Si:H transistor arrays on flexible substrates include automated handling through bonding-debonding processes, substrate-compatible low temperature fabrication processes, management of dimensional instability of plastic substrates, and planarization and management of CTE mismatch for stainless steel foils. In collaboration with our industrial and academic partners, we have developed viable solutions to address these challenges, as described in this paper.
Dietary studies are often conducted as longitudinal intervention or crossover trials using multiple days of measurement on each subject during each of several measurement periods, and determining the required numbers of days and subjects is important in designing these studies. Linear mixed statistical models were used to derive equations for precision, statistical power and sample size (number of days and number of subjects) and to obtain estimates of between-subject, period-to-period, and day-to-day variation needed to apply the equations. Two cohorts of an on-going exercise intervention study, and a crossover study of Olestra, each with 14 d of measurement/subject per period, were used to obtain estimates of variability for energy and macronutrient intake. Numerical examples illustrate how the equations for calculating the number of days or number of subjects are applied in typical situations, and sample SAS code is given. It was found that between-subject, period-to-period, and day-to-day variation all contributed significantly to the variation in energy and macronutrient intake. The ratio of period-to-period and day-to-day standard deviations controls the trade-off between the number of days and the number of subjects, and this remained relatively stable across studies and energy and macronutrient intake variables. The greatest gains in precision were seen over the first few measurement days. Greater precision and fewer required days were noted in the study (Olestra) that exerted greater control over the subjects and diets during the feeding protocol.
We have recently discovered self-assembled chains of C60 molecules contained within single wall carbon nanotubes (SWNTs). Using in situ transmission electron microscopy studies, we show a route by which such ‘peapod’ structures can be synthesized. The results indicate that exterior C60 molecules arrive at the nanotubes from the vapor phase and subsequently enter, presumably through open ends or sidewall defects. The methods discussed in this work provide a means for the bulk production of these molecular assemblies.
Carbon silicon nitride (CSixNy), and carbon boron nitride (CBxNy) thin films have been grown by pulsed laser deposition (PLD) of various carbon (silicon/boron) (nitride) targets using an additional nitrogen RF plasma source on  oriented silicon substrates without additional heating. The CSixNy and CBxNy thin films were amorphous and showed nano hardness up to 23 GPa compared to 14 GPa for silicon and maximum nitrogen content of 30 at%. The maximum nanohardness was achieved for 10% Si and 10% B content in the films. The lower hardness of this films compared to the nanohardness of 30-50 GPa of DLC films indicates a lower amount of covalent carbon-nitrogen bonding in the films. However, in contrast to DLC films, the CSixNy and CBxNy films can be grown to thickness above 3 μm due to lower internal compressive stress. XPS of CSixNy and CBxNy film surfaces shows clear correlation of binding energy and intensity of N ls, C ls, and Si 2p peaks to composition of the PLD-targets and to nitrogen flow through plasma source, indicating soft changes of binding structure due to variation of PLD parameters. The results demonstrate the capability of the plasma assisted PLD process to deposit hard amorphous CSixNy, and CBxNy thin films with adjustable properties.
It is well established that the structural characteristics of graphite nanofibers can be controlled by several factors including, the chemical nature of the catalyst, the composition of the reactant gas mixture and temperature at which the growth process is performed. In the current investigation we have endeavored to modify the behavior of the catalyst by dispersing the active metals on different support media. We have found that the strength of the metal-support interaction exerts a significant impact not only on the average size of the nanofibers generated by such a procedure, but also results in major changes in the architecture of the carbon materials. The support imposes certain geometrical constraints on the metal particles and these features are manifested in modifications in the degree of crystalline perfection and arrangement of the graphite sheets constituting the nanofibers. In addition, there is also the possibility that the support can induce electronic perturbations in the metal particles, a feature that will be most pronounced with a conductive carrier.
Metal-doped diamond-like carbon films were produced for the purpose of an electrochemical nano-electrode. In this study we use Z-contrast scanning transmission electron microscopy to directly observe metal cluster formation and distributions within the chromium-doped carbon films. At low doping (∼6at%Cr), Cr is uniformly distributed; at high doping (∼12at%Cr), Cr-rich clusters are formed. Using electron energy loss spectroscopy, we find that the Cr clusters tend to be metallic-like at low doping levels and carbide-like at high doping levels according to the Cr L2.3 white line ratios. The carbon is more diamond-like at low doping and more graphite/carbide like at high doping according to the sp2/sp3 electron percentage measurements.
Nanostructured carbon films have been grown by deposition of supersonic cluster beams. A novel pulsed microplasma cluster source allows to obtain cluster beams of high intensity and stability. Cluster growth and beam formation have been charaterized. Separation effects typical of supersonic expansions cause inhomogeneities of cluster distribution in the beam, depending on their masses. This effect, observed for the first time, has been carefully characterized. The deposited films have a low density porous structure based on nanometer-size grains. The coordination is essentially three-fold with a large number of defects. Film density, morphology and surface roughness can be controlled by varying the precursor cluster mass distribution. Applications of cluster-assembled carbon films will be presented.
The phonon density of states of single-wall carbon nanotubes (SWNT) was measured by inelastic neutron scattering (INS) in a large energy range (0 to 120 meV). New information on the vibrational dynamics of SWNT is reported and compared with calculated density-of-sates. At lower frequencies (< 12 meV) we observe a peculiar energy dependence which we attribute to contributions from inter-tube modes in the 2D lattice of SWNT bundles, and also from effects of intertube coupling on the intra-tube excitations.
Knowledge of the mechanical properties of interlevel dielectric films and their impact on sub-micron interconnect reliability is becoming more and more important as critical dimensions in ULSI circuits are scaled down. For example, lateral aluminum (Al) extrusions into spaces between metal lines, which become a more of a concern as the pitches shrink, appear to depend partially on properties of SiO2 underlayers. In this paper, the mechanical properties of several common interlevel dielectric SiO2 films such as undoped silica glass using a silane (SiH4) precursor, undoped silica glass using a tetraethylorthosilicate (TEOS) precursor, phosphosilicate glass (PSG) deposited by plasma-enhanced chemical vapor deposition (PECVD) and borophosphosilicate glass (BPSG) deposited by sub-atmosphere chemical vapor deposition (SACVD) were studied. Among the four common interlevel layers, BPSG exhibits the smallest modulus (E), hardness (H) and the highest the coefficients of thermal expansion (CTE). BPSG again has the lowest as-deposited compressive stress and the lowest local Si-O-Si strain before annealing. Stress interactions between the various SiO2 underlayers and the Al metal film are further investigated. The impact of dielectric elastic properties on interconnect reliability during thermal cycles is proposed.
Mass-selected ion-beam deposition using 120 eV C+ ions has been used to grow a carbon film on a Si substrate held at 200° C. The structure of the film has been characterized by transmission electron microscopy and electron energy loss spectroscopy. The film is graphitic and highly oriented with the c-axis lying parallel to the substrate. Moreover, the film is under significant biaxial stress such that the graphitic layer spacing is reduced by 4% from that of ambient pressure graphite. This oriented structure evolves due to the mobility of the carbon atoms at 200 °C. The material is sufficiently crystalline on the nanometer scale so as to produce Bragg diffraction discs in a convergent beam electron diffraction pattern using a 2.5 nm probe.
The saddle-field glow discharge is modeled and electron multiplication and energy spectra are presented. The roles of the ion substrate current and ion energy at the substrate on the growth rate, hydrogen content, sp2 content and energy gap are discussed and the effects of atmospheric aging and high temperature annealing are described.
CVD diamond films, ET 100 of Norton Diamond Film, were treateds in ultrahigh purity O2 from 420 to 575°C at 95 kPa. Auger and x-ray photoelectron spectra were collected from CVD and natural diamond surfaces. The Auger KVV line shapes of the CVD diamond with various surface conditions were compared to those of natural diamonds and sp2-bound graphite (HOPG) and glassy carbon. Comparisons were made on the peak shape of A1, which is the major satellite peak of carbon KVV. Auger KVV line shaped of oxidized CVD diamonds were more similar to that of natural diamond than either HOPG or glassy carbon. XPS is more sensitive to the change of surface chemisorbed species. The C Is binding energy of oxygenated and oxidized CVD diamonds (287.3 eV) was higher than that of natural diamond (285.7 eV), graphite (283.0 eV) and glassy carbon (284.2 eV). Auger and XPS findings indicated that when treated in O2 from 420 to 575°C at 95 kPa, direct oxidation of CVD diamond occurred without graphitization
Computations of isomeric fullerenes are performed at semiempirical and ab initio quantum-chemical levels: C36, C72, C88. C36 fullerenes and quasi-fullerenes are computed at the SAM1 level, and then at the B3LYP/6-31G* level. Altogether 598 cages are considered. The SAM1 method is also applied to C72, i.e., the solitary isolated-pentagon-rule (IPR) structure and several non-IPR isomers. Finally, the complete set of thirty five topologically different IPR isomers of C88 is computed. In all the cases, energetics is combined with entropy contributions based on the harmonic-oscillator and rigid-rotator model. Considerable temperature effects on the relative stabilities in the systems are found. Relationships to available observed data are discussed throughout and a good agreement is found.