We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The rate of bleeding complications following arterial switch operation is too low to independently justify a prospective randomised study for benefit from recombinant factor VIIa. We aimed to evaluate factor VIIa in a pilot study.
Methods:
We performed a retrospective cohort study of patients undergoing arterial switch operation from 2012 to 2017. Nearest-neighbour propensity score matching on age, gender, weight, and associated cardiac defects was used to match 27 controls not receiving recombinant factor VIIa to 30 patients receiving recombinant factor VIIa. Fisher’s exact test was performed to compare categorical variables. Wilcoxon’s rank-sum test was used to compare continuous variables between cohorts.
Results:
Post-operative thrombotic complications were not associated with factor VIIa administration (Odds Ratio (OR) 0.28, 95% CI 0.005–3.77, p = 0.336), nor was factor VIIa administration associated with any re-explorations for bleeding. No intraoperative transfusion volumes were different between the recombinant factor VIIa cohort and controls. Post-operative prothrombin time (10.8 [10.3–12.3] versus 15.9 [15.1–17.2], p < 0.001) and international normalised ratio (0.8 [0.73–0.90] versus 1.3 [1.2–1.4], p < 0.001]) were lower in recombinant factor VIIa cohort relative to controls.
Conclusions:
In spite of a higher post-bypass packed red blood cell transfusion requirement, patients receiving recombinant factor VIIa had a similar incidence of bleeding post-operatively. With no difference in thrombotic complications, and with improved post-operative laboratory haemostasis, a prospective randomised study is warranted to evaluate recombinant factor VIIa.
Review a single-centre experience with pulmonary artery sling repair and evaluate risk factors for re-intervention.
Methods:
Patients with surgically repaired pulmonary artery sling at a single institution between 1996 and 2018 were retrospectively reviewed. A univariate Cox regression analysis was used to evaluate variables for association with freedom from re-intervention.
Results:
Eighteen patients had pulmonary artery sling repair. At operation, median age and weight were 6.9 months (interquartile range 4.1–18.1) and 9.5 kg (interquartile range 6.5–14.5), respectively. A median hospital length of stay was 12 days (interquartile range 5.8–55.3). Twelve patients (67%) had complete tracheal rings, of whom six (50%) underwent tracheoplasty (five concurrently with pulmonary artery sling repair). Airway re-intervention was required in five (83%) of the six patients who underwent tracheoplasty. One patient had intraoperative diagnosis and repair of pulmonary artery sling during unrelated lesion repair and required tracheoplasty 24 days post-operatively. One patient died 55 days after pulmonary artery sling repair and tracheoplasty following multiple arrests and re-interventions. Median post-operative follow-up for surviving patients was 6.3 years (interquartile range 11 months–13 years), at which time freedom from re-intervention was 61%. When controlling for patient and tracheal size, initial tracheoplasty was associated with decreased freedom from re-intervention (hazard ratio 21.9, 95% confidence interval 1.7–284.3, p = 0.018).
Conclusions:
In patients with pulmonary artery sling, tracheoplasty is associated with decreased freedom from re-intervention. In select patients with pulmonary artery sling and complete tracheal rings, conservative management without tracheoplasty is feasible. Further study is necessary to delineate objective indications for tracheoplasty.
The resection of a subaortic membrane remains far from a curative operation. We sought to examine factors associated with reoperation and the degree of aortic valve regurgitation as a potential long-term source for reoperation.
Methods:
All patients who underwent resection of an isolated subaortic membrane between 1995 and 2018 were included. Patients who underwent other procedures were excluded. Paired categorical data were compared using McNemar’s test. Univariate time-to-event analyses were performed using Kaplan–Meier methods with log-rank tests for categorical variables and univariate Cox models for continuous variables.
Results:
A total of 84 patients (median age 6.6, 31% females) underwent resection of isolated subaortic membrane. At a median follow-up of 9.3 years (interquartile range 0.6–22.5), 12 (14%) patients required one reoperation and 1 patient required two reoperations. Median time to first reoperation was 4.6 years. The degree of aortic valve regurgitation improved post-operatively from pre-operatively (p = 0.0007); however, the degree of aortic valve regurgitation worsened over the course of follow-up (p = 0.010) to equivalence with pre-operative aortic valve regurgitation (p = 0.18). Performance of a septal myectomy was associated with longer freedom from reoperation (p = 0.004).
Conclusions:
In patients with isolated subaortic membranes, performance of a septal myectomy can minimise risk for reoperation. Patients should be serially monitored for degradation of the aortic valve, even if aortic regurgitation is not present post-operatively.
Moderately well-preserved Middle Triassic radiolarians were recovered from bedded limestone exposed at about 3 km west of Kefamenanu, West Timor, Indonesia. This limestone probably from the Aitutu Formation is considered to be an allochthonous block and is embedded in the Neogene Bobonaro Complex. The radiolarian fauna in this limestone is characterized by abundant radiolarians of typical Tethyan forms and is identical to that of the early Fassanian (early Ladinian) of European Tethys and other related faunas reported from the Philippines, Russian Far East, and Japan. The Aitutu Formation is thought to be deposited in an ocean environment dominated by a warm-water current system originating from the low latitude Tethyan realm. Fifty-nine species belonging to 34 genera, including five unidentified genera, are systematically treated, among them, five new species; Parentactinia suparkai, Pseudostylosphaera timorensis, Cryptostephanidium? megaspinosum, Tetrarchiplagia compacta, and Planospinocyrtis kefaensis.
Four microseconds long Ar3+ beam with injection energy of 15 keV/u has been injected into the Digital Accelerator of the High-Energy Accelerator Research Organization. Beam production, transportation, and injection are described as well as machine properties. Results of a free running experiment under static magnetic field and longitudinal confinement and acceleration under a fast ramping magnetic field are presented in detail with a brief discussion on the beam lifetime.
The purpose of the present study was to examine the clinical outcomes of using tracheoesophageal diversion for preventing intractable aspiration.
Method:
We retrospectively reviewed 25 patients who underwent tracheoesophageal diversion from 2003 to 2009 at our hospital (median age, 25 years; range, 0–78 years). End-to-side anastomosis was used in 16 cases and side-to-side anastomosis was used in 9.
Results:
The average operative time was 141 minutes for end-to-side anastomosis and 191 minutes for side-to-side anastomosis. Peri-operative complications were observed in only two (8 per cent) cases: one with infection and one with haematoma. No fistulas were observed. Aspiration was prevented in all cases, but the nutritional route depended on the swallowing function of the patient. Oral feeding was the main nutritional route after surgery in only four patients (16 per cent).
Conclusion:
This procedure is well suited to patients who lack speech communication and are at high risk of aspiration.
In the present report, we describe the use of narrow band imaging during video-laryngomicrosurgery for laryngeal papillomatosis.
Case report:
It is difficult to peri-operatively locate all the superficial papillomatous lesions when the disease is widespread, which then results in tumor recurrence. Therefore, we have constructed a narrow band imaging video-laryngomicrosurgery system, which we have used for two cases of laryngeal papillomatosis.
Conclusion:
Our narrow band imaging-assisted video-laryngomicrosurgery system to visualise superficial laryngeal papillomatosis more clearly.
Human rotavirus strains from Kenya, from children with gastroenteritis in an urban area (Nairobi) and three rural areas were characterized by antigenic and genomic analysis. While in all areas strains with subgroups II and G serotype 1 antigens were most common, two unusual strains were detected. One strain (NK59: subgroup II. G serotype 4) possessed an additional RNA band on polyacrylamide gel electrophoresis, the other (D202) which had antigenic specificity of subgroup II and G serotype 1 showed a ‘short’ RNA pattern. The latter strain was adapted to growth in cell culture.
Eight strains of influenza C virus isolated in various areas of Japan between January 1985 and January 1989 were compared using monoclonal antibodies to the haemagglutinin-esterase (HE) glycoproteins and by oligonucleotide mapping of total vRNA. Five of six strains isolated during 1986–9 were closely related to one another and also resembled the virus, C/Aichi/1/81, isolated in 1981 in Aichi prefecture. This suggests that the C/Aichi/l/81-related viruses had an epidemiological advantage over any co-circulating viruses at least during that period. One of two 1985 isolates (C/Nara/1/85) was antigenically indistinguishable from the C/Mississippi/1/80 strain though their oligonucleotide patterns were markedly different from each other. This raises the possibility that C/Nara/1/85 may be a recombinant virus which receives its HE gene from the C/Mississippi/l/80-related parent.
To investigate two clusters of diarrhoea cases observed in our geriatric hospital wards, the faecal specimens were analysed. Reversed passive latex agglutination assay revealed that 63·2% and 41·7% of the faecal specimens from each cluster were positive for Clostridium perfringens enterotoxin. PCR assay revealed that 71·4% and 68·8% of C. perfringens isolates from each cluster were positive for the enterotoxin gene (cpe). These observations suggested that both the clusters were outbreaks caused by enterotoxigenic C. perfringens. Subsequent pulsed-field gel electrophoresis analysis revealed that the two outbreaks were caused by different C. perfringens isolates. However, these outbreak isolates as well as other sporadic diarrhoea isolates shared a 75-kb plasmid on which the cpe gene and the tcp locus were located. The 75-kb plasmid had horizontally spread to various C. perfringens isolates and had caused outbreaks and sporadic infections. However, the site and time of the plasmid transfer are unclear.
Hot-wire chemical vapor deposition (HWCVD) technique was used to deposit nanocrystalline silicon (nc-Si) thin film transistors (TFT) on thin polyimide sheets. Two straight tantalum filaments at 1850°C with a substrate to filament distance of 4 cm was used to deposit HWCVD nc-Si with no thermal damage to plastic sheet. Top-gate staggered TFTs were fabricated at 150°C and 250°C using a HWCVD nc-Si channel, PECVD silicon nitride gate dielectric, and microcrystalline n+ drain/source contacts. Leakage current of 3.3×10-12 A, switching current ratio of 3×106, and sub threshold swing of 0.51 V/decade were obtained for TFTs with aspect ratio of 1400 µm / 100 µm fabricated at 150°C. The highest electron field effect mobility was found to be 0.3 cm2/V.s observed for TFTs deposited at lower substrate temperature. Measurements showed superior threshold voltage stability of HW nc-Si TFTs over their amorphous silicon (a-Si) counterparts.
Nanocrystalline silicon (nc-Si:H) films were deposited by hot-wire chemical vapor deposition (HWCVD) directly onto Corning glass and polyimide (Kapton E) substrates. The effect of silane concentration (in hydrogen carrier gas) on film crystallinity and conductivity were studied for a constant substrate growth temperature of 220°C.Raman spectroscopy, X-ray diffraction and cross-sectional transmission electron microscopy (XTEM) showed that nc-Si:H (grain-size 20-65 nm) was observed for silane concentrations below 5.8 %. Similar to previous reports, closer inspection using XTEM found that there was an initial growth of an amorphous interfacial layer which then crystallized into a randomly-oriented polycrystalline material after 10 - 100 nm of growth..However, unlike previous reports, there was no detectable difference in the structure or conductivity for films grown on the two types of substrates. In both cases, the dark conductivity decreased with increasing silane concentration while the photo-conductivity was uniform for all films at values between 2 and 4×10-5 S/cm.
The propagation of intense laser pulses and the generation of high-energy electrons from underdense plasmas are investigated using two-dimensional particle-in-cell simulations. It is shown that quasi-monoenergetic electron beams are generated in the regime where the laser pulse length is much longer than the plasma wavelength, when the condition of the focusing is appropriately controlled.
Three-dimensional electron motion in a linearly polarized tightly focused laser field is numerically calculated. A high-intensity laser pulse focused on the free electrons in vacuum generates relativistic electron bunches whose length is shorter than the laser wavelength. The extremely short electron bunches with low-energy spread less than 1% are generated for a wide range of the laser parameters.
We have demonstrated the acceleration of a monoenergetic electron beam by a laser-produced wakefield. Experiments were performed by focusing 2-TW laser pulses of 50 fs on supersonic gas-jet targets. The focused intensity was 5 × 1018 W/cm2 (a0 = 1.5). At an electron density of 1.5 × 1020 cm−3, the clear monoenergetic electron beam from the plasma was obtained at 7 to 15 MeV. The Stokes satellite peak in the forward scattering explained the energy spectra of electrons at various plasma densities well. Although the wakefield propagated 500 microns, which was far beyond the dephasing length, monoenergetic electron beams were obtained.
Microcrystalline silicon was deposited by hot-wire chemical vapor deposition (HWCVD) using a graphite filament with and without a thin 50 nm microcrystalline silicon seed layer. Increasing silane concentration diluted in H2 led to a decrease in crystalline fraction as well in a decrease in dark conductivity and photo-conductivity. In addition, films deposited with a seed layer were found to have higher dark conductivity and photo-conductivity than those without a seed layer but deposited at slower growth rates. However, Raman spectroscopy showed that use of a seed layer resulted in only a small increase in crystalline fraction at the surface of the films which had thicknesses between 250-400nm. TEM measurements confirmed the crystalline nature of deposited films showing average grain sizes of 25 nm.
CeO2 thin films as insulating layers for high-temperature superconducting digital devices were studied. The dependence on substrate temperature and oxygen pressure of the surface morphology and crystallinity of CeO2 thin films prepared by pulsed laser deposition were investigated. CeO2 thin films with a flat and closely grained surface were obtained at a relatively low oxygen pressure of 3.6 Pa, whereas higher oxygen pressure led to CeO2 thin films with a rough surface and columnar grains. The recovery of oxygen content in superconducting layers was examined for multilayer structures with CeO2 thin films. Enough oxygen was supplied to the upper and lower superconducting layers when the multilayer was cooled slowly in 3 × 10−4 Pa oxygen pressure after deposition. Resistively shunted junction type I-V characteristics were confirmed for interface-engineered ramp-edge junctions in a multilayer structure including four superconducting layers with CeO2 thin films.
Y0.9Ba1.9La0.2Cu3Oy (La-YBCO) thin films were prepared by an off-axis magnetron sputtering method on MgO substrates with and without a BaZrO3 buffer layer. Insertion of BaZrO3 buffer layer was effective for obtaining La-YBCO films with pure c-axis orientation and in-plane alignment at low temperatures below 600 °C. We prepared La-YBCO thin films on BaZrO3-buffered MgO substrates using a temperature-gradient method, in which a template La-YBCO layer was first deposited at 600 °C, and then the temperature was continuously raised to 700 °C. By this method, La-YBCO thin films with improved crystallinity were successfully prepared. It was also proved that the insertion of the BaZrO3 buffer layer enables us to prepare high-quality La-YBCO films with high reproducibility.
The dielectric properties of the Ba(Ti1–xZrx)O3 (BT1–xZx) ceramics with various compositions were investigated under various DC bias fields. In BT0.94Z0.06 ceramics, the dielectric constants (ε) vs temperature (T) curves without DC bias showed no frequency dependence. Its DC bias dependence exhibited that with increasing DC bias fields, the dielectric constants were suppressed while phase transition peaks slightly shifted to high temperature. In BT0.58Z0.42 ceramics, the ε vs T curves without DC bias showed a broad peak with a clear frequency dependence, which revealed that BT0.58Z0.42 ceramics were the relaxor. Its DC bias dependence exhibited that with increasing DC bias fields, the dielectric constants were suppressed while the phase transition peak largely shifted to low temperatures. In BT0.79Z0.21 ceramics, the ε vs T curves without DC bias showed a broad peak without frequency dependence. Its DC bias dependence revealed that the dielectric peak shifted to high temperature and broadened with increasing DC bias. To explain the above phenomena, it was considered that the role of Zr ions on BT1−xZx ceramics is to make the depth of the potential well shallow successively.