Early assessment of diaphragmatic dysfunction in children in the ITU: chest radiology and phrenic nerve stimulation

Diaphragmatic dysfunction is a common postoperative complication of cardiac surgery in children, with important effects on respiratory morbidity. Its early diagnosis, followed by prompt surgical intervention, has been shown to reduce morbidity. However, the commonest method of diagnosis, based on hemi-diaphragmatic elevation on the chest radiograph, may be less accurate than direct techniques for assessing phrenic nerve function. We have compared electrophysiological and radiological diagnoses of diaphragmatic abnormality in 100 children (aged 3 days to 17.5 yrs) undergoing cardiac surgery, looking at respiratory morbidity as assessed by the duration of ventilation, the time spent on the cardiac intensive care unit (CICU), and the requirement for reintubation. Despite showing good reproducibility, radiological diagnosis was neither sensitive nor specific in identifying patients with electrophysiological phrenic nerve damage. Analysis of the measures of outcome supported the electrophysiological technique. Patients with electrophysiological evidence of damage had a longer duration of ventilation, spent longer on the CICU, and had a greater incidence of reintubation than either radiologically abnormal or "normal" patients. Chest X-rays are not a good method for diagnosing phrenic nerve damage in the early postoperative period in children. If early diagnosis is needed, then direct assessment of phrenic nerve function, such as the measurement of phrenic latency, may be a better technique.     

Pain and dissociation in the cold pressor test: A study of hypnotic analgesia with "hidden reports" through automatic key pressing and automatic talking.

To test whether pain blocked by hypnotic analgesia may still be perceived at some level, 20 highly hypnotizable undergraduates participated in an experiment involving cold pressor pain in the normal condition and in hypnotically suggested analgesia. 3 reports were obtained reflecting felt pain within the hypnotic analgesia condition: the usual verbal report on a numerical scale, a manual report by "automatic key pressing," and a retrospective verbal report through "automatic talking." 9 Ss who were amnesic for both keypressing and automatic talking reported more pain in the automatic (hidden) reports than in their usual verbal reports. 8 of these 9, following release of amnesia, had a clear perception of 2 levels of awareness of the pain: the usual hypnotic experience of pain attenuated by analgesia suggestions, and a knowledge at another level of a more severe pain. In no case, however, did an S give a retrospective report of normal suffering at this "hidden" level. The hypnotically analgesic S may have reported no pain verbally because he was amnesic for it; when amnesia was removed he recalled the sensory pain, but without a suffering component, because suffering apparently did not occur. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The cortisol response to psychological stress in temporomandibular dysfunction

Recombinant antibody fragments can be produced in large quantities using bacterial expression systems and could potentially be useful for the generation of biofilters for the selective removal of viral particles from fluids. A human single chain-Fv antibody library, derived from synthetic repertoires of germ line VH-gene segments rearranged in vitro and paired to a single light chain (Nissim et al., 1994, EMBO J., 13, 692-698), has recently been used to isolate hundreds of different binding specificities by panning with antigen. Antibodies from this library typically have affinities in the 10(6)-10(7) M-1 range. Occasionally, better binders are isolated but at other times the affinities recovered are poor. In the latter situation binding cannot be detected with soluble antibodies, but only by high-avidity display of multiple copies of antibodies on phage. By panning with human cytomegalovirus (HCMV)-coated immunotubes, we have isolated a number of antibody clones from this library that bound to the antigen only if displayed on the filamentous phage, but not in soluble form. One of these clones was selected for an affinity maturation procedure, achieved by combinatorial mutagenesis of the complementarity determining region 3 (CDR3) of the antibody light chain, followed by selection of the resulting library for HCMV binding. By this means, we were able to isolate a number of binders, some of which exhibited specific HCMV binding in soluble form. The clone that gave the strongest ELISA signal was expressed in bacteria, purified in solution, characterised using a novel capture methodology with surface plasmon resonance detection on a BIAcore instrument and used for the production of an immunofilter for the removal of HCMV form human serum. The filter removed more than 99% of applied HCMV in 10 min circulation time, while the amount of HCMV retained non-specifically in a cartridge derivatised with a non-specific antibody was less than 10% under similar conditions.     

The American Community Survey: Warmer (More Current), but Fuzzier (Less Precise) than the Decennial Census

The American Community Survey, which will replace data many planners rely on from the decennial Census long form, is finally in progress. The first nationwide data for places of 65,000 or more was released in the summer of 2006. It has several interesting implications for planning. On the one hand, more current data will eliminate many of the inaccuracies introduced by projection-based updates of stale census data. On the other, smaller sample sizes will mean we will have less precise estimates. Because the ACS will use averaged rather than point-in-time data, it will measure slightly different things than the decennial census. Finally, planners should be alert to the opportunities they will have to improve local data quality by improving the address file from which the sample is drawn.     

空间级联可调谐光滤波器方式实现光分插复用器

提出一种采用空间级联可调谐光滤波器方式实现的OADM.该器件不但具有集成度高、体积小、插入损耗低、信道间插入损耗差异小的特点,而且能够在控制电路的作用下灵活选择上下路波长及其数量,为构建灵活、高性能的WDM网络提供了选择.     

Bandwidth limits of luminescent solar concentrators as detectors in free-space optical communication systems

Luminescent solar concentrators(LSCs)have recently emerged as a promising receiver technology in free-space optical communications due to their inherent ability to collect light from a wide field-of-view and concentrate it into small areas,thus leading to high optical gains.Several high-speed communication systems integrating LSCs in their detector blocks have already been demonstrated,with the majority of efforts so far being devoted to maximising the received optical power and the system's field-of-view.However,LSCs may pose a severe bottleneck on the bandwidth of such communication channels due to the comparably slow timescale of the fluorescence events involved,a situation further aggravated by the inherent reabsorption in these systems,and yet,an in-depth study into such dynamic effects remains absent in the field.To fill this gap,we have developed a comprehensive analytical solution that delineates the fundamental bandwidth limits of LSCs as optical detectors in arbitrary free-space optical links,and establishes their equivalence with simple RC low-pass electrical circuits.Furthermore,we demonstrate a time-domain Monte Carlo simulation platform,an indispensable tool in the multiparameter optimisation of LSC-based receiver systems.Our work offers vital insight into LSC system dynamic behaviour and paves the way to evaluate the technology for a wide range of applications,including visible light communications,high-speed video recording,and real-time biological imaging,to name a few.     

Predictions and Analyses on the Growth Behavior of Oxide Scales Formed on Ferritic–Martensitic in Supercritical Water

Oxidation of Metals - For 9–12Cr ferritic–martensitic steels in supercritical water, the dependencies of the thicknesses of three oxide layers (diffusion, inner, and outer layers) on...     

Body condition score and body weight effects on dystocia and stillbirths and consequent effects on postcalving performance

The objective of this study was to quantify the effect of periparturient body condition score (BCS) and body weight (BW) related traits on the incidence of calving dystocia and stillbirths, and to determine any consequent effect of dystocia and stillbirths on BCS, BW, milk production, udder health, and fertility in grazing Holstein-Friesian dairy cows. Up to 2,384 lactation records with data on calving dystocia or stillbirths were available from one research herd across 15 yr. Mixed models and generalized estimating equations were used to quantify all effects. Body condition score or BW 8 wk precalving or at calving, or change precalving did not significantly affect the odds of a difficult calving or stillbirth. Cows that experienced dystocia lost, on average, more BCS and BW between calving and nadir and had significantly reduced nadir BCS and BW. Incidence of stillbirths did not affect BCS in early lactation, although BW loss postpartum was greater following a stillbirth. A dystocia or stillbirth event was associated with reduced 60-d milk yield (42 and 52 kg less milk produced following a difficult calving or a stillbirth, respectively). The effect of stillbirth on milk yield was independent of dystocia. Cows that experienced dystocia had reduced milk concentration of fat, protein, and lactose, whereas average somatic cell score (natural logarithm of somatic cell count) in the first 60-d postpartum was elevated. There was no significant effect of dystocia or stillbirth on clinical mastitis, but pregnancy rates to first service and throughout the 12-wk breeding season were compromised in cows that had experienced difficulty at calving. The significance of the effects of stillbirth on somatic cell score and reduced fertility were mediated through its association with dystocia. In conclusion, periparturient BCS and BW within the range observed in the current study did not significantly affect incidence of dystocia and stillbirth, but these events negatively affected cow performance in early lactation.     

Proton MR spectroscopy and magnetization transfer ratio in multiple sclerosis: correlative findings of active versus irreversible plaque disease

PURPOSE: To characterize plaques of multiple sclerosis (MS) using both proton MR spectroscopy and magnetization transfer (MT) imaging. METHODS: The magnetization transfer ratio (MTR) was calculated from two series of three-dimensional gradient-recalled acquisition in the steady state (GRASS) images obtained with and without an MT saturation pulse. Proton spectra were acquired using the point-resolved spectroscopy (PRESS) sequence with a voxel size of 1.5 x 1.5 x 1.5 cm3. A total of 28 spectra were obtained in 13 patients who had clinically definitive MS. The spectra were analyzed together with the MTR. RESULTS: A positive relationship was found between the N-acetylaspartate (NAA)/creatine (Cr) ratio and the MTR in MS plaques, whereas no significant correlation was found between the metabolite ratios and the signal intensity on fast spin-echo T2-weighted MR images. CONCLUSION: Small changes in the MTR of MS plaques relative to the MTR of normal white matter may reflect inflammatory changes and edema, whereas larger changes in MTR correlate with decreased NAA/Cr ratio and therefore suggest demyelination and irreversible damage from chronic MS plaques.