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This article investigates the career trajectories of Hong Kong solicitors during two historical turning points, specifically 1994–1997 and 2018–2021, when hundreds of lawyers left private practice to pursue alternative career options such as business and finance, government and politics, or relocation to other countries. Data are sourced from the career mobility records of law firm partners reported in 336 monthly issues of the Hong Kong Lawyer journal between 1994 and 2021, as well as other relevant archival sources. The research examines the underlying forces that led these law firm partners to abandon their high-status positions and pursue alternative career paths during these pivotal moments in Hong Kong’s history. The findings suggest that the career trajectories of these elite professionals are not solely based on individual choices but are also shaped by their social origins and the physical and social spaces that influence their careers over time. This study contributes original insights into the complex interplay between individual, spatial and temporal factors that drive career mobility among legal professionals.
Adolescents with depression have distinct affective reactions to daily events, but current research is controversial. The emotional context insensitivity theory suggests blunted reactivity in depression, whereas the hypotheses of negative potentiation and mood brightening effect suggest otherwise. While nonlinear associations between depression severity and affective reactivity have been observed, studies with a separate subclinical group remain rare. Subthreshold depression (SD), defined by two to four symptoms lasting for two weeks or more, provides a dimensional view to the underpinnings of affective reactivity. In this study, we compared positive affect (PA) and negative affect (NA) reactivity to positive and negative daily events (uplifts and stress) among adolescents with Major Depressive Disorder (MDD), SD and healthy controls (HC) using experience sampling methods (ESM).
Objectives
We hypothesized a stepped difference in affective reactivity along the depression spectrum: the MDD group will have the strongest reactivity of PA and NA to uplifts and stress, followed by SD and HC.
Methods
Three groups (MDD, SD, and HC) of adolescents were recruited from an epidemiologic sample entitled ‘Hong Kong Child and Adolescent Psychiatric Epidemiologic Survey: Age 6 to 17’. Group status was determined by the Diagnostic Interview Schedule for Children Version 5. They completed an experience sampling diary on smartphone for 14 consecutive days, with 5-10 entries per day. Momentary levels of PA (happy, relaxed, contented), NA (irritated, low, nervous), uplifts and stress experienced before the entry were measured on a 1-7 Likert scale.
Results
The sample consisted of 19 adolescents with MDD, 30 with SD, and 59 HC. The M:F ratio was 17:19. The age range was 12-18 with a mean of 14.8. The overall ESM completion rate was 46%. The MDD group had the highest levels of stress and NA, and the lowest levels of uplifts and PA, followed by the SD and HC groups respectively (p<0.01). Across groups, levels of PA were positively associated with uplifts and negatively associated with stress, whereas levels of NA were positively associated with stress and negatively associated with uplifts. The Group x Uplift interaction effect on PA was significant, with greater PA reactivity in SD (p<0.01) and MDD (p=0.07) when compared with HC. The Group x Uplift interaction effect on NA was significant, with greater NA reactivity in SD than HC (p<0.01). The Group x Stress interaction effect on PA was significant, with greater PA reactivity in SD than HC (p<0.01) and MDD (p<0.01). The Group x Stress interaction effect with NA is non-significant.
Conclusions
Contrary to our hypothesis, adolescents with SD experienced strongest PA and NA reactivity in uplifts and PA reactivity in stress. It provides evidence towards a nonlinear relationship between severity of depression and affective reactivity.
Background: Elevated BMI has been proposed as a risk factor for the development of meningioma. The relationship between body mass index (BMI) and disease control in high-grade meningioma has not yet been examined. A retrospective cohort study was performed to assess the relationship between high-grade meningioma recurrence and BMI. Methods: This is a retrospective cohort study of patients with Grade 2 or Grade 3 meningioma at a single tertiary care center between 2008 and 2017. We collected clinical data including age, sex, BMI, location, Simpson grade, brain invasion, and radiation treatments. Disease control was monitored on followup MRI scans. We stratified patients by BMI greater than or less than 25. Results: A total of 45 patients were included. Recurrence was observed in 15 patients (33.3%). There were 32 (71.1%) patients with BMI > 25, and 13 (28.9%) patients with normal BMI. Patients with elevated BMI had higher risk of recurrence (p=0.04). Multivariate analysis identified BMI as an independent predictor of recurrence. Conclusions: Our results suggest that overweight patients with a Grade 2 or Grade 3 meningioma are at higher risk of recurrence than patients with normal BMI. The explanation for this association unknown. Further research is suggested to confirm and better characterize this association.
Background: Cerebrospinal fluid (CSF) leak is a common complication of minimally invasive tubular microdiscectomy (MIM). However, it is not known whether patients with CSF leak can be safely discharged home the same day. Methods: This is a retrospective cohort study of patients with incidental durotomy after MIM from January, 2009 to August, 2023. Patient demographic information, surgery information, CSF leak management, and postoperative outcomes were recorded. Results: There were 16 patients (53%) who were admitted to hospital and 14 (47%) patients discharged home the same day post CSF leak. There were no differences in patient demographics between the two groups at baseline. Twenty-nine out of 30 (97%) of the patients had onlay duraplasty, and one (3%) patient was repaired using sutures. The hospitalized group was kept on bed rest overnight or 24 hours. The discharge group was kept on best rest for 2 hours or mobilized immediately after surgery. The average length of admission for the hospitalized group was 2.4 ± 4.0 days. No patients in either group required readmission or revision surgery for CSF leak. Conclusions: Patients with CSF leak post minimally invasive tubular microdiscectomy can be safely discharged home the same day provided that duraplasty or primary repair was performed intraoperatively.
Sulfosalt assemblages in a specimen from the Boliden Au–Cu–(As) deposit in northern Sweden, comprise micrometre to nanometre scale intergrowths of Se-rich izoklakeite and tintinaite with average formulae and calculated homologue number (N) given as: (Cu1.88Fe0.18)2.06(Pb22.92Ag1.47Cd0.01Zn0.01)24.41(Sb13.12Bi8.69)21.8(S50.19Se6.43Te0.12)56.73,N = 3.83, and (Cu1.31Fe0.74)2.05(Pb10.58Ag0.18Cd0.05Zn0.02)10.83(Sb10.2Bi5.23)15.43(S32.22Se2.46)34.7, N = 2.05, respectively. Tintinaite coexists with (Bi, Se)-rich jamesonite. High-angle annular dark field scanning transmission electron microscopy (HAADF STEM) imaging reveals chessboard structures comprising PbS and SnS modules with the number of atoms in the octahedral (M) sites counted as: n1 = 18 and n2 = 8 for tintinaite and n1 = 30 and n2 = 16 for izoklakeite. The homologue number can be calculated using the formula: N = (n1/6)–1 and N = n2/4 for PbS and SnS modules giving NTti = 2 and NIz = 4. A new N = 3 homologue, defined by n = 12 and n = 24 SnS and PbS modules, respectively, is identified as single or double units within areas with intergrowths between kobellite and izoklakeite. HAADF STEM imaging also reveals features attributable to lone electron pair micelles within the Sb-rich kobellite homologues. Atomic-resolution EDS STEM chemical mapping of Pb–Bi–Sb-sulfosalts shows a correlation with crystal structural modularity. The maps also highlight sites in the SnS modules of tintinaite in which Sb > Bi. Coherent nanoscale intergrowths between tintinaite and izoklakeite define jigsaw patterns evolving from chessboard structures and are considered to have formed during co-crystallisation of the two phases. Displacement textures and crosscutting veinlets (a few nm in width) are interpreted as evidence for superimposed syn-metamorphic deformation and are associated with the redistribution of Bi and Se. Imaging and mapping using HAADF STEM techniques is well suited to characterisation of Pb–Sb–Bi-sulfosalt phases, offering largely untapped potential to unravel the evolution of chessboard structures with applications across mineralogy but also extending into allied fields.
Children with prolonged hospital admissions for CHD often develop delirium. Antipsychotic medications (APMs) have been used to treat delirium but are known to prolong the QTc duration. There is concern for prolongation of the QTc interval in cardiac patients who may be more vulnerable to electrocardiogram (ECG) changes and may have postoperative QTc prolongation already. The goal of this study was to determine the effect of APM on QTc duration in postoperative paediatric cardiac patients and determine the effect of quetiapine and risperidone in treating delirium and QTc prolongation.
Design:
Retrospective study, July 1, 2017–May 31, 2022.
Setting:
Tertiary children’s hospital.
Patients:
Included were patients admitted to the paediatric cardiac ICU at Children’s Healthcare of Atlanta.
Interventions:
None.
Measurements and Main Results:
ECGs, delirium scores, and drug information were collected. Delirium was defined as Cornell Assessment of Pediatric Delirium (CAPD) score >9. Mixed effect models were performed to evaluate the effect of surgery on QTc change and the effect of antipsychotics on QTc and CAPD changes. There were 139 children, 55% male and 67% surgical admissions. Median age was 5.9 months. Mean QTc increased after cardiac surgery by 18 ms (p = 0.014, 95% CI 3.65–32.4). There was no significant change in QTc after antipsychotic administration (p = 0.064). The mean CAPD score decreased (12.5–7.2; p < 0.001). Quetiapine had the most improvement in delirium, and risperidone had the least improvement (77.8%, n = 14; 37.8%, n = 34, respectively; p = 0.002).
Conclusions:
The QTc interval did not have a statistically significant change after the administration of antipsychotics, while there was improvement in the CAPD score. APMs may be administered safely without significant prolongation of the QTc and are an effective treatment for delirium.
Ultrafast optical probing is a widely used method of underdense plasma diagnostic. In relativistic plasma, the motion blur limits spatial resolution in the direction of motion. For many high-power lasers the initial pulse duration of 30–50 fs results in a 10–15 μm motion blur, which can be reduced by probe pulse post-compression. Here we used the compression after compressor approach [Phys.-Usp. 62, 1096 (2019); JINST 17 P07035 (2022)], where spectral broadening is performed in thin optical plates and is followed by reflections from negative-dispersion mirrors. Our initially low-intensity probe beam was down-collimated for a more efficient spectral broadening and higher probe-to-self-emission intensity ratio. The setup is compact, fits in a vacuum chamber and can be implemented within a short experimental time slot. We proved that the compressed pulse retained the high quality necessary for plasma probing.
Medical resuscitations in rugged prehospital settings require emergency personnel to perform high-risk procedures in low-resource conditions. Just-in-Time Guidance (JITG) utilizing augmented reality (AR) guidance may be a solution. There is little literature on the utility of AR-mediated JITG tools for facilitating the performance of emergent field care.
Study Objective:
The objective of this study was to investigate the feasibility and efficacy of a novel AR-mediated JITG tool for emergency field procedures.
Methods:
Emergency medical technician-basic (EMT-B) and paramedic cohorts were randomized to either video training (control) or JITG-AR guidance (intervention) groups for performing bag-valve-mask (BVM) ventilation, intraosseous (IO) line placement, and needle-decompression (Needle-d) in a medium-fidelity simulation environment. For the interventional condition, subjects used an AR technology platform to perform the tasks. The primary outcome was participant task performance; the secondary outcomes were participant-reported acceptability. Participant task score, task time, and acceptability ratings were reported descriptively and compared between the control and intervention groups using chi-square analysis for binary variables and unpaired t-testing for continuous variables.
Results:
Sixty participants were enrolled (mean age 34.8 years; 72% male). In the EMT-B cohort, there was no difference in average task performance score between the control and JITG groups for the BVM and IO tasks; however, the control group had higher performance scores for the Needle-d task (mean score difference 22%; P = .01). In the paramedic cohort, there was no difference in performance scores between the control and JITG group for the BVM and Needle-d tasks, but the control group had higher task scores for the IO task (mean score difference 23%; P = .01). For all task and participant types, the control group performed tasks more quickly than in the JITG group. There was no difference in participant usability or usefulness ratings between the JITG or control conditions for any of the tasks, although paramedics reported they were less likely to use the JITG equipment again (mean difference 1.96 rating points; P = .02).
Conclusions:
This study demonstrated preliminary evidence that AR-mediated guidance for emergency medical procedures is feasible and acceptable. These observations, coupled with AR’s promise for real-time interaction and on-going technological advancements, suggest the potential for this modality in training and practice that justifies future investigation.
Plant growth requires the integration of internal and external cues, perceived and transduced into a developmental programme of cell division, elongation and wall thickening. Mechanical forces contribute to this regulation, and thigmomorphogenesis typically includes reducing stem height, increasing stem diameter, and a canonical transcriptomic response. We present data on a bZIP transcription factor involved in this process in grasses. Brachypodium distachyon SECONDARY WALL INTERACTING bZIP (SWIZ) protein translocated into the nucleus following mechanostimulation. Classical touch-responsive genes were upregulated in B. distachyon roots following touch, including significant induction of the glycoside hydrolase 17 family, which may be unique to grass thigmomorphogenesis. SWIZ protein binding to an E-box variant in exons and introns was associated with immediate activation followed by repression of gene expression. SWIZ overexpression resulted in plants with reduced stem and root elongation. These data further define plant touch-responsive transcriptomics and physiology, offering insights into grass mechanotranduction dynamics.
Helicopters are used in complex and harsh operational environments, such as search and rescue missions and firefighting, that require operating in ground proximity, tracking targets while avoiding impacting obstacles, namely a combination of point tracking (positive) and boundary avoidance (negative) objectives. A simulation task representing simplified helicopter dynamics is used to investigate point tracking and boundary avoidance tasks. The variance and regression analysis are used to study the effects of task conditions on participants’ tracking errors and input aggression. The overall tracking error shows a negative correlation with input aggression. The participants tend to have higher input aggression and lower tracking error near the boundaries, exposing the switching of manipulation input strategies under different task conditions. It also suggests a potential way of designing simulation tasks for human operators manipulating helicopters and a trigger for investigating pilots’ biodynamic feedthrough.
Our earth is immersed in the near-earth space plasma environment, which plays a vital role in protecting our planet against the solar-wind impact and influencing space activities. It is significant to investigate the physical processes dominating the environment, for deepening our scientific understanding of it and improving the ability to forecast the space weather. As a crucial part of the National Major Scientific and Technological Infrastructure–Space Environment Simulation Research Infrastructure (SESRI) in Harbin, the Space Plasma Environment Research Facility (SPERF) builds a system to replicate the near-earth space plasma environment in the laboratory. The system aims to simulate the three-dimensional (3-D) structure and processes of the terrestrial magnetosphere for the first time in the world, providing a unique platform to reveal the physics of the 3-D asymmetric magnetic reconnection relevant to the earth's magnetopause, wave–particle interaction in the earth's radiation belt, particles’ dynamics during the geomagnetic storm, etc. The paper will present the engineering design and construction of the near-earth space plasma simulation system of the SPERF, with a focus on the critical technologies that have been resolved to achieve the scientific goals. Meanwhile, the possible physical issues that can be studied based on the apparatus are sketched briefly. The earth-based system is of great value in understanding the space plasma environment and supporting space exploration.
Functional montmorillonite can be dispersed in polymer coatings and organic species and polymers can be intercalated into the interlayer space or grafted onto the surface of the functional montmorillonite. The addition of functional montmorillonite into polymer-based coatings can significantly improve anti-corrosion, refractory, super-hydrophobicity, antibacterial activity, and absorption of solar radiation by the resulting montmorillonite/polymer coatings. Montmorillonite can be functionalized for this purpose by ion exchange, intercalation, exfoliation, or combinations of these treatments. The rigid montmorillonite layers interspersed within the polymer matrix inhibit the penetration of corrosive substances, minimize the impact of high-temperature airflow, and thereby lead to strong resistance of the coating to corrosion and fire. The combination of polymers and dispersed montmorillonite nanolayers, which are modified by metal ions, metal oxides, and hydrophobic organic species, allows the resulting composite coating to have quite a rough surface and a much smaller surface free energy so that the montmorillonite/polymer coating possesses superhydrophobicity. The interlayer space of functional montmorillonite can also host or encapsulate antibacterial substances, phase-change materials, and solar energy-absorbing materials. Moreover, it can act as a template to make these guest species exist in a more stable and ordered state. Literature surveys suggest that future work on the functional montmorillonite/polymer coatings should be targeted at the manufacture of functional montmorillonite nanolayers by finding more suitable modifiers and tuning the dispersion and funtionalities of montmorillonite in the coatings.
To accelerate high-intensity heavy-ion beams to high energy in the booster ring (BRing) at the High-Intensity Heavy-Ion Accelerator Facility (HIAF) project, we take the typical reference particle 238U35+, which can be accelerated from an injection energy of 17 MeV/u to the maximal extraction energy of 830 MeV/u, as an example to study the basic processes of longitudinal beam dynamics, including beam capture, acceleration, and bunch merging. The voltage amplitude, the synchronous phase, and the frequency program of the RF system during the operational cycle were given, and the beam properties such as bunch length, momentum spread, longitudinal beam emittance, and beam loss were derived, firstly. Then, the beam properties under different voltage amplitude and synchronous phase errors were also studied, and the results were compared with the cases without any errors. Next, the beam properties with the injection energy fluctuation were also studied. The tolerances of the RF errors and injection energy fluctuation were dictated based on the CISP simulations. Finally, the effect of space charge at the low injection energy with different beam intensities on longitudinal emittance and beam loss was evaluated.
Modification of the surfaces of montmorillonite (Mnt) by organic molecules is an effective method for improving their affinity toward non-aqueous substances, and has resulted in extensive industrial applications as rheological control agents, drilling fluids, and other functional materials used in applications ranging from environmental remediation to coatings. The present study reviewed recent progress in organo-modification of Mnt, and provides state-of-the-art insights into proposed modification mechanisms and the peculiar functionalities of the resulting organo-montmorillonite (OMnt). Several routes have been employed to modify Mnt, including ion exchange with organic ions, surface adsorption, and grafting of organics. Commonly used organic modifiers include cationic, anionic, zwitterionic, non-ionic, and polymeric species. Organo-modification is driven by multiple interactions: van der Waals forces, cation exchange, electrostatic interaction, hydrogen bonds, and ion–dipole interaction. OMnt, in general, exhibits synergistic and/or antagonistic effects when used in oil-based drilling fluids, environmental remediation, or layered silicate/polymer nanocomposites. The detailed mechanisms of non-ionic and zwitterionic modification of Mnt remain unclear. This literature survey suggests that future work should emphasize deeper understanding of interactions between the Mnt and the organic modifiers, and meanwhile expand the applications of OMnt into catalysis, drug carriers, and the biomedical field.
We investigated experimentally the settling behaviour of vertically aligned spherical particles within various quiescent media at different release frequencies. The particles had a diameter of $d = 4$ mm and density of $\rho _s = 2200$ kg m$^{-3}$, and were released near the free surface of water, ethanol, a G60 water–glycerine mixture (60 % glycerine by weight) and oil media at frequencies of $f_P = 4$, 6 and 8 Hz, thereby allowing study of Galileo numbers, $Ga \in [16, 976]$. Particle tracking velocimetry quantified the motion of nearly 800 particles in a 600 mm high tank, and particle image velocimetry examined flow patterns around the particles. Results revealed that the centre of mass of the particle trajectories exhibited preferential in-plane motions, with significant lateral dispersion and large $Ga$ in water and ethanol, and nearly vertical paths with low $Ga$ in the G60 mixture and oil media. Varying degrees of particle separation resulted in higher terminal velocities than for a single particle. Hence, particle drag decreased in all cases, with the oil medium showing the highest drag reduction under the closest particle separation, reaching up to nearly 70 % of that for the single particle. The vertical and lateral pair dispersions, $R^2_z$ and $R^2_L$, exhibited ballistic scaling, with dependences on the initial separation, $r_0$, and the type of medium. With large $Ga$, $R^2_z$ displayed a ballistic regime followed by a slower rate, whereas with small $Ga$, $R^2_z$ maintained a consistent ballistic regime throughout settling. Finally, normalized $R^2_z$ demonstrated distinct scaling (exponent 2/3 and 1) dependent on the normalized initial separation and $Ga$.
A continuous-wave (CW) single-longitudinal-mode (SLM) Raman laser at 1240 nm with power of up to 20.6 W was demonstrated in a free-running diamond Raman oscillator without any axial-mode selection elements. The SLM operation was achieved due to the spatial-hole-burning free nature of Raman gain and was maintained at the highest available pump power by suppressing the parasitic stimulated Brillouin scattering (SBS). A folded-cavity design was employed for reducing the perturbing effect of resonances at the pump frequency. At a pump power of 69 W, the maximum Stokes output reached 20.6 W, corresponding to a 30% optical-to-optical conversion efficiency from 1064 to 1240 nm. The result shows that parasitic SBS is the main physical process disturbing the SLM operation of Raman oscillator at higher power. In addition, for the first time, the spectral linewidth of a CW SLM diamond Raman laser was resolved using the long-delayed self-heterodyne interferometric method, which is 105 kHz at 20 W.
The target backsheath field acceleration mechanism is one of the main mechanisms of laser-driven proton acceleration (LDPA) and strongly depends on the comprehensive performance of the ultrashort ultra-intense lasers used as the driving sources. The successful use of the SG-II Peta-watt (SG-II PW) laser facility for LDPA and its applications in radiographic diagnoses have been manifested by the good performance of the SG-II PW facility. Recently, the SG-II PW laser facility has undergone extensive maintenance and a comprehensive technical upgrade in terms of the seed source, laser contrast and terminal focus. LDPA experiments were performed using the maintained SG-II PW laser beam, and the highest cutoff energy of the proton beam was obviously increased. Accordingly, a double-film target structure was used, and the maximum cutoff energy of the proton beam was up to 70 MeV. These results demonstrate that the comprehensive performance of the SG-II PW laser facility was improved significantly.
The prolonged COVID-19 pandemic has created unique and complex challenges in operational and capacity planning for pediatric emergency departments, as initial low pediatric patient volumes gave way to unpredictable patient surges during Delta and Omicron variants. Compounded by widespread hospital supply chain issues, staffing shortages due to infection and attrition, and a concurrent pediatric mental health crisis, the surges have pushed pediatric emergency department leaders to re-examine traditionally defined clinical processes, and adopt innovative operational strategies. This study describes the strategic surge response and lessons learned by 3 major freestanding academic pediatric emergency departments in the western United States to help inform current and future pediatric pandemic preparedness.
Background: Tuberculosis is an airborne disease caused by Mycobacterium Tuberculosis. Intracranial tuberculoma is a rare complication of extrapulmonary tuberculosis due to hematogenous spread to subpial and subependymal regions. Intracranial tuberculoma can occur with or without meningitis. Methods: A 3-year-old male who recently emigrated from Sudan presented to the emergency department with right-sided seizures lasting 30 minutes which were aborted with levetiracetam and midazolam. CT head revealed a multilobulated left supratentorial mass, with solid and cystic components measuring 8.0 x 4.8 x 6.5 cm. The patient had successful surgical resection of the mass which was positive for Mycobacterium Tuberculosis. He was started on rifampin, isoniazid, pyrazinamide, ethambutol, and fluoroquinolone and discharged home in stable condition. Results: Literature review on pediatric intracranial tuberculoma was performed which included 48 studies (n=49). The mean age was 8.8 ± 5.4 years with slight female predilection (59%). Predominant solitary tuberculomas (63%) were preferentially managed with both surgical resection and antitubercular therapy (ATT) compared to multifocal tuberculomas that were preferentially managed with ATT. Conclusions: Intracranial tuberculoma is a rare but treatable cause of space-occupying lesions in children. Clinicians should maintain high-level of suspicion in patients from endemic regions and involve infectious disease service early in patient’s care.
Background: Toxoplasma gondii is a protozoan parasite with the ability to infect any nucleated cell in humans. Most immunocompetent infected individuals are asymptomatic. Latent toxoplasma can become reactivated in immunocompromised individuals though this is exceptionally rare in HIV-negative individuals. Methods: We present the case of a 47-year-old male with chronic immunosuppression secondary to marginal zone lymphoma and steroid therapy. Results: The patient presented to hospital with a 1-week history of word-finding difficulties, intermittent right facial numbness and leg weakness, and tonic-clonic seizures. CT head showed a left temporal heterogenous mass measuring 2.8 × 2.8 × 3.5 cm. Biopsy of the lesion showed Multiple tachyzoites and rare bradyzoites with strong positivity for the toxoplasma specific immunostain. The patient was treated with trimethoprim/sulfamethoxazole which resulted in complete neurologic recovery. Conclusions: Our literature review included 32 cases of cerebral toxoplasmosis in HIV-negative patients with an overall mortality rate of 48%. Cerebral toxoplasmosis has a predilection for immunosuppressed patients with an underlying hematologic malignancy (74%, n= 23). Successful treatment requires early recognition of the disease and prompt treatment with sulfamethoxazole and trimethoprim, pyrimethamine, or sulfadiazine. Patients who recover from acute toxoplasmosis should remain on lifelong suppressive antibiotic therapy to prevent relapse.