Delayed delivery of surviving triplet after fetal reduction and spontaneous abortion

In multiple pregnancies, survival of remaining fetuses after premature death and delivery of one fetus is uncommon. We report a case of a triplet pregnancy that was reduced to twins at the 14th gestational week and then had preterm premature rupture of membranes and intrauterine fetal death of one twin at the 17th gestational week. To save the surviving fetus, delivery of the dead fetus and ligation of the umbilical cord at the cervical level were performed. We also performed McDonald cervical cerclage to keep the placenta of the dead fetus as well as that of the surviving one in the uterine cavity. After a series of aggressive procedures, including immediate administration of tocolytic agents, and antibiotic prophylaxis to prevent infection and preterm labor, the surviving fetus was delivered vaginally 73 days later due to intractable uterine contractions. After a 10-week hospital stay, the infant boy, weighing 2,500 g, was discharged without any sequelae. To our knowledge, this was the longest interval between deliveries in a triplet pregnancy reported in Taiwan. With adequate intensive management, a satisfactory outcome of the fetus and mother in such cases is possible.     

Ultra-shallow p-junction formation in silicon by excimer laser doping: a heat and mass transfer perspective

Heat and mass transfer at the nanosecond time scale and the nanometer length scale in pulsed laser fabrication of ultra-shallow p⁺-junctions is studied in this work. A new technique is developed to fabricate the ultra-shallow p⁺-junctions with pulsed laser doping of crystalline silicon with a solid spin-on-glass (SOG) dopant, through the nanosecond pulsed laser heating, melting, and boron mass diffusion in the 100 nm thin silicon layer close to the surface. High boron concentration of 10²⁰ atoms cc⁻¹ and the ‘box-like’ junction profile are achieved. The key mechanism determining the ‘box-like’ junction shape is found to be the melt-solid interface limited diffusion. The ultra-shallow p⁺-junctions with the depth from 30 to 400 nm are successfully made by the excimer laser. The optimal laser fluence condition for SOG doping is found about 0.6–0.8 J cm⁻² by studying the ultra-shallow p⁺-junction boron profiles measured by the secondary ion mass spectroscopy (SIMS) vs the laser fluence and the pulse number. The one-dimensional numerical analysis agrees reasonably with the experiment, within the available physical picture. Possible mechanisms such as boron diffusivity dependence on the dopant concentration in the molten silicon are proposed.     

Exceptional convergent evolution in a virus

Replicate lineages of the bacteriophage phiX 174 adapted to growth at high temperature on either of two hosts exhibited high rates of identical, independent substitutions. Typically, a dozen or more substitutions accumulated in the 5.4-kilobase genome during propagation. Across the entire data set of nine lineages, 119 independent substitutions occurred at 68 nucleotide sites. Over half of these substitutions, accounting for one third of the sites, were identical with substitutions in other lineages. Some convergent substitutions were specific to the host used for phage propagation, but others occurred across both hosts. Continued adaptation of an evolved phage at high temperature, but on the other host, led to additional changes that included reversions of previous substitutions. Phylogenetic reconstruction using the complete genome sequence not only failed to recover the correct evolutionary history because of these convergent changes, but the true history was rejected as being a significantly inferior fit to the data. Replicate lineages subjected to similar environmental challenges showed similar rates of substitution and similar rates of fitness improvement across corresponding times of adaptation. Substitution rates and fitness improvements were higher during the initial period of adaptation than during a later period, except when the host was changed.     

A comprehensive approach to the solution of direct-coupledmultislice model of skewed rotor induction motors using time-steppingeddy-current finite element method

Normally a complicated three-dimensional (3-D) approach is needed to study the field pattern of induction machines with skewed rotor bars. In this paper, a time-stepping two-dimensional (2-D) eddy-current finite element method, based on multislice technique, is described to study the steady-state operation and the starting process of skewed rotor induction machines. The fields of the multislices are being solved en bloc simultaneously, and thus, the effects of the eddy current and saturation can be taken into account directly. New forms of the governing equations for the multislice model are derived, which allow the meshes of multislices to be taken as one 2-D mesh so that the algorithm is very similar to that of general 2-D problems. Special techniques required for the mesh generation in the multislice model and the salient structures of the software are also described. The results obtained by using the program being developed have very good correlation with test data     

Preparation of core–shell type nanoparticles of diblock copolymers of poly(L‐lactide)/poly(ethylene glycol) and their characterization in vitro

Core–shell type nanoparticles of poly(L ‐lactide)/poly(ethylene glycol) (LE) diblock copolymer were prepared by a dialysis technique. Their size was confirmed as 40–70 nm using photon correlation spectroscopy. The ¹H‐NMR analysis confirmed the formation of core–shell type nanoparticles and drug loading. The particle size, drug loading, and drug release rate of the LE nanoparticles were slightly changed by the initial solvents that were used. The drug release behavior of LE core–shell type nanoparticles showed an initial burst during the first 12 h and then a sustained release until 100 h. The degradation behavior of LE block copolymer nanoparticles was divided into three phases: the initial rapid degradation phase, the stationary phase, and the rapid degradation phase until complete degradation. It was suggested that lidocaine release kinetics were predominantly governed by the diffusion mechanism in the initial burst phase and after that by both of the diffusion and degradation mechanisms. © 2002 Wiley Periodicals, Inc. J Appl Polym Sci 85: 2625–2634, 2002     

Alcoholism at the time of injury among trauma center patients: Vehicular crash victims compared with other patients

A structured in-depth interview employing standardized criteria was used to determine the prevalence of lifetime and current alcohol dependence (alcoholism) in unselected consecutive patients admitted to a regional Level I trauma center. Of 629 patients, 157 (25.0%) were current alcoholics at the time of injury. An additional 87 (13.8%) were diagnosed as lifetime non-current alcoholics. There was no significant difference in the rates of current alcohol dependence among patients injured in vehicular crashes (23.5%), other unintentional trauma victims (29.3%), and those injured as a result of violence (24.6%). Of BAC + (blood alcohol concentration positive) patients, 54.5% were current alcoholics. However, 14.4% of alcohol-negative patients were also diagnosed as alcohol dependent.     

Social skills and cognitive-relaxation approaches to general anger reduction.

Inductive social skills training (ISST), skill assembly social skills training (SASST), and cognitive relaxation coping skills (CRCS) training were compared with a no-treatment control condition for general anger reduction. At 4-wk follow-up, compared with the control group, all treatment groups showed equivalent reductions of the amount of anger experienced in a wide range of situations. ISST and CRCS Ss reported less anger in their worst ongoing provocation than did control Ss, whereas SASST Ss did not differ from Ss of other groups. Treatment groups enhanced anger control equally relative to the control group, but only the CRCS group significantly lowered outward, negative expression of anger, and only the ISST group reduced anger suppression, although active treatment groups did not differ from one another on these measures. The ISST group lowered day-to-day anger more than other groups. No treatment effects were found for nontargeted trait anxiety and assertiveness. Results are discussed in terms of prior findings and the efficacy and flexibility of ISST. (PsycINFO Database Record (c) 2010 APA, all rights reserved)