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Background: After a transient ischemic attack (TIA) or minor stroke, the long-term risk of subsequent stroke is uncertain. Methods: Electronic databases were searched for observational studies reporting subsequent stroke during a minimum follow-up of 1 year in patients with TIA or minor stroke. Unpublished data on number of stroke events and exact person-time at risk contributed by all patients during discrete time intervals of follow-up were requested from the authors of included studies. This information was used to calculate the incidence of stroke in individual studies, and results across studies were pooled using random-effects meta-analysis. Results: Fifteen independent cohorts involving 129794 patients were included in the analysis. The pooled incidence rate of subsequent stroke per 100 person-years was 6.4 events in the first year and 2.0 events in the second through tenth years, with cumulative incidences of 14% at 5 years and 21% at 10 years. Based on 10 studies with information available on fatal stroke, the pooled case fatality rate of subsequent stroke was 9.5% (95% CI, 5.9 – 13.8). Conclusions: One in five patients is expected to experience a subsequent stroke within 10 years after a TIA or minor stroke, with every tenth patient expected to die from their subsequent stroke.
With many non-human primates (NHPs) showing continued population decline, there is an ongoing need to better understand their ecology and conservation threats. One such threat is the risk of disease, with various bacterial, viral and parasitic infections previously reported to have damaging consequences for NHP hosts. Strongylid nematodes are one of the most commonly reported parasitic infections in NHPs. Current knowledge of NHP strongylid infections is restricted by their typical occurrence as mixed infections of multiple genera, which are indistinguishable through traditional microscopic approaches. Here, modern metagenomics approaches were applied for insight into the genetic diversity of strongylid infections in South-East and East Asian NHPs. We hypothesized that strongylid nematodes occur in mixed communities of multiple taxa, dominated by Oesophagostomum, matching previous findings using single-specimen genetics. Utilizing the Illumina MiSeq platform, ITS-2 strongylid metabarcoding was applied to 90 samples from various wild NHPs occurring in Malaysian Borneo and Japan. A clear dominance of Oesophagostomum aculeatum was found, with almost all sequences assigned to this species. This study suggests that strongylid communities of Asian NHPs may be less species-rich than those in African NHPs, where multi-genera communities are reported. Such knowledge contributes baseline data, assisting with ongoing monitoring of health threats to NHPs.
To evaluate the frequency of antibiotic prescribing for common infections via telemedicine compared to face-to-face visits.
Design:
Systematic literature review and meta-analysis.
Methods:
We searched PubMed, CINAHL, Embase (Elsevier platform) and Cochrane CENTRAL to identify studies comparing frequency of antibiotic prescribing via telemedicine and face-to-face visits without restrictions by publish dates or language used. We conducted meta-analyses of 5 infections: sinusitis, pharyngitis, otitis media, upper respiratory infection (URI) and urinary tract infection (UTI). Random-effect models were used to obtain pooled odds ratios (ORs). Heterogeneity was evaluated with I2 estimation and the Cochran Q statistic test.
Results:
Among 3,106 studies screened, 23 studies (1 randomized control study, 22 observational studies) were included in the systematic literature review. Most of the studies (21 of 23) were conducted in the United States. Studies were substantially heterogenous, but stratified analyses revealed that providers prescribed antibiotics more frequently via telemedicine for otitis media (pooled odds ratio [OR], 1.26; 95% confidence interval [CI], 1.04–1.52; I2 = 31%) and pharyngitis (pooled OR, 1.16; 95% CI, 1.01–1.33; I2 = 0%). We detected no significant difference in the frequencies of antibiotic prescribing for sinusitis (pooled OR, 0.86; 95% CI, 0.70–1.06; I2 = 91%), URI (pooled OR, 1.18; 95% CI, 0.59–2.39; I2 = 100%), or UTI (pooled OR, 2.57; 95% CI, 0.88–7.46; I2 = 91%).
Conclusions:
Telemedicine visits for otitis media and pharyngitis were associated with higher rates of antibiotic prescribing. The interpretation of these findings requires caution due to substantial heterogeneity among available studies. Large-scale, well-designed studies with comprehensive assessment of antibiotic prescribing for common outpatient infections comparing telemedicine and face-to-face visits are needed to validate our findings.
This study aimed to clarify the association between both hypoxia-inducible factor-1α and glucose transporter type-1 expression and survival outcome in advanced pharyngeal cancer without human papillomavirus infection.
Method
Twenty-five oropharyngeal and 55 hypopharyngeal cancer patients without human papillomavirus infection were enrolled. All patients had stage III–IV lesions and underwent concurrent chemoradiotherapy or surgery. Hypoxia-inducible factor-1α and glucose transporter type-1 expression were investigated in primary lesions by immunohistochemistry.
Results
There were 41 and 39 cases with low and high hypoxia-inducible factor-1α expression, and 28 and 52 cases with low and high glucose transporter type-1 expression, respectively. There was no significant correlation between hypoxia-inducible factor-1α and glucose transporter type-1 expression. In univariate analysis, nodal metastasis, clinical stage and high hypoxia-inducible factor-1α expression, but not glucose transporter type-1 expression, predicted significantly worse prognosis. In multivariate analysis, hypoxia-inducible factor-1α overexpression was significantly correlated with poor overall survival, disease-specific survival and recurrence-free survival.
Conclusion
High hypoxia-inducible factor-1α expression was an independent risk factor for poor prognosis for advanced human papillomavirus-unrelated pharyngeal cancer.
Precise instrumental calibration is of crucial importance to 21-cm cosmology experiments. The Murchison Widefield Array’s (MWA) Phase II compact configuration offers us opportunities for both redundant calibration and sky-based calibration algorithms; using the two in tandem is a potential approach to mitigate calibration errors caused by inaccurate sky models. The MWA Epoch of Reionization (EoR) experiment targets three patches of the sky (dubbed EoR0, EoR1, and EoR2) with deep observations. Previous work in Li et al. (2018) and (2019) studied the effect of tandem calibration on the EoR0 field and found that it yielded no significant improvement in the power spectrum (PS) over sky-based calibration alone. In this work, we apply similar techniques to the EoR1 field and find a distinct result: the improvements in the PS from tandem calibration are significant. To understand this result, we analyse both the calibration solutions themselves and the effects on the PS over three nights of EoR1 observations. We conclude that the presence of the bright radio galaxy Fornax A in EoR1 degrades the performance of sky-based calibration, which in turn enables redundant calibration to have a larger impact. These results suggest that redundant calibration can indeed mitigate some level of model incompleteness error.
A series of direct numerical simulations of a fully developed turbulent channel flow is conducted in order to clarify the effects of travelling wave-like wall blowing and suction on dissimilar heat transfer enhancement. While the wave form is kept sinusoidal and its amplitude is set to be 5 % of the bulk mean velocity, the wavelength and phase speed of the travelling wave are systematically changed in a wide parameter space. As a result, the global optimum of the parameter set for maximizing the analogy factor, which is defined as the ratio between the Stanton number and the skin-friction coefficient, is identified. Interestingly, the obtained globally optimal mode agrees well with that predicted from the optimal control theory taking into account the future dynamics within a limited time horizon by Yamamoto et al. (J. Fluid Mech., vol. 733, 2013, pp. 189–220). The instantaneous velocity and thermal fields are decomposed into coherent and random components in order to evaluate the contribution from each component to dissimilar heat transfer enhancement. The detailed mechanisms of dissimilarity are explained by the budget analyses of the coherent and random contributions. Also, their relationships with the near-wall turbulent structures modified by the applied control are discussed through flow visualization. It is found that the random component makes a dominant contribution to dissimilarity, and this can be explained by an indirect effect through the modification of the coherent field by the applied control. Based on the above mechanisms, we propose a simple unsteady Reynolds-averaged Navier–Stokes (URANS) approach, where the phase-averaged velocity and thermal fields are solved directly whereas the effects of the random component are modelled by the Boussinesq eddy viscosity and diffusivity hypothesis. It is shown that the present URANS can capture the overall trend of dissimilar heat transfer enhancement in a wide parameter range. The present results also explain why the optimal control theory with a limited time horizon succeeds in predicting the globally optimal control mode.
We apply two methods to estimate the 21-cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly spaced triangles of antenna tiles, as well as an estimate based on data gridded to the uv-plane. The direct and gridded bispectrum estimators are applied to 21 h of high-band (167–197 MHz; z = 6.2–7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point-source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 h, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21-cm bispectrum may be accessible in less time than the 21-cm power spectrum for some wave modes, with detections in hundreds of hours.
Recently, an epoch-making printing technology called “SuPR-NaP (Surface Photo-Reactive Nanometal Printing)” that allows easy, high-speed, and large-area manufacturing of ultrafine silver wiring patterns has been developed. Here we demonstrate low-voltage operation of organic thin-film transistors (OTFTs) composed of printed source/drain electrodes that are produced by the SuPR-NaP technique. We utilize an ultrathin layer of perfluoropolymer, Cytop, that functions not only as a base layer for producing patterned reactive surface in the SuPR-NaP technique but also as an ultrathin gate dielectric layer of OTFTs. By the use of 22 nm-thick Cytop gate dielectric layer, we successfully operate polycrystalline pentacene OTFTs below 2 V with negligible hysteresis. We also observe the improvement of carrier injection by the surface modification of printed silver electrodes. We discuss that the SuPR-NaP technique allows the production of high-capacitance gate dielectric layers as well as high-resolution printed silver electrodes, which provides promising bases for producing practical active-matrix OTFT backplanes.
Here we discuss requirements for high performance and solution processable organic semiconductors, by presenting a systematic investigation of 7-alkyl-2-phenyl[1]benzothieno[3,2-b][1]benzothiophenes (Ph-BTBT-Cn’s). We found that the solubility and thermal properties of Ph-BTBT-Cn’s depend systematically on the substituted alkyl-chain length n. The observed features are well understood in terms of the change of molecular packing motif with n: The compounds with n ≤ 4 do not form independent alkyl chain layers, whereas those with n ≥ 5 form isolated alkyl chain layers. The latter compounds afford a series of isomorphous bilayer-type crystal structures that form two-dimensional carrier transport layers within the crystals. We also show that the Ph-BTBT-C10 afford high performance single-crystalline field-effect transistors the mobility of which reaches as high as 15.9 cm2/Vs. These results demonstrate a crucial role of the substituted alkyl chain length for obtaining high performance organic semiconductors and field-effect transistors.
Polymeric nanoparticles having redox-active catechol moieties, a common structural motif found in naturally-occurring antioxidants, were developed. We synthesized an amphiphilic catechol-bearing polymer that self-assembled to form nanoparticles with a diameter of 126 nm. The nanoparticles showed enhanced ROS-scavenging activity compared to the small catecholic compound dopamine. Furthermore, the nanoparticles inhibited ROS-mediated angiogenesis as shown by the endothelial cell tube formation assay and the chicken chorioallantoic membrane (CAM) assay.
As a method to evaluate high-temperature equation of state (EOS) data of fissile materials precisely and safely, we numerically examined an experimental setup based on a sub-range fissile target and a high-intensity short-pulsed heavy-ion beam. As an example, we calculated one-dimensional hydrodynamic motion of a uranium target with ρ = 0.03ρsolid (ρsolid ≡ solid density = 19.05 g/cm3) induced by a pulsed 23Na+ beam with a duration of 2 ns and a peak power of 5 GW/mm2. The projectile stopping power was calculated using a density- and temperature-dependent dielectric response function. To heat the target uniformly, we optimized the experimental condition so that the energy deposition could occur almost at the top of the Bragg peak. The energy deposition inhomogeneity could be reduced to ±5% by adjusting the incident energy and the target thickness to be 2.02 MeV/u and 180 μm, respectively. The target could be heated homogeneously up to kT =7 eV well before the arrival of the rarefaction waves at the center of the target. In principle, the EOS data can be evaluated by iteratively adjusting the data embedded in the hydro code until the measured hydrodynamic motion is reproduced by the calculation. This method is consistent with the conditions of nuclear nonproliferation, because a very small amount of fissile material is enough to perform the experiment, and no shock compression occurs in the target.
Recent epidemiological data suggest a link between the consumption of bovine offal products and Shiga toxin-producing Escherichia coli (STEC) infection in Japan. This study thus examined the prevalence of STEC in various types of these foods. PCR screened 229 bovine offal products for the presence of Shiga toxin (stx) gene. Thirty-eight (16·6%) samples were stx positive, of which eight were positive for rfbEO157 and three were positive for wzyO26. Four O157 and one O26 STEC isolates were finally obtained from small-intestine and omasum products. Notably, homogenates of bovine intestinal products significantly reduced the extent of growth of O157 in the enrichment process compared to homogenates of beef carcass. As co-incubation of O157 with background microbiota complex from bovine intestinal products in buffered peptone water, in the absence of meat samples, tended to reduce the extent of growth of O157, we reasoned that certain microbiota present in offal products played a role. In support of this, inoculation of generic E. coli from bovine intestinal products into the homogenates significantly reduced the extent of growth of O157 in the homogenates of bovine intestinal and loin-beef products, and this effect was markedly increased when these homogenates were heat-treated prior to inoculation. Together, this report provides first evidence of the prevalence of STEC in a variety of bovine offal products in Japan. The prevalence data herein may be useful for risk assessment of those products as a potential source of human STEC infection beyond the epidemiological background. The growth characteristic of STEC O157 in offal products also indicates the importance of being aware when to test these food products.
The most common eruptions observed by humans, and by far the most dangerous to human populations, are those from volcanoes above the world's subduction zones (Simkin and Siebert, 2000). Population growth and development of technology are also concentrated in areas such as the Pacific Rim, where subduction-zone volcanism is prevalent. Many new and proposed nuclear facilities are therefore located in regions of active subduction (Connor et al., Chapter 3, this volume). Because nuclear facilities require low-risk sites, and because some nuclear facilities, such as high-level radioactive waste repositories, require very long performance periods, it is necessary to understand the nature of volcanism in subduction zones from a regional, plate tectonic perspective. This perspective will allow us to develop more robust hazard models for future volcanic activity on a variety of timescales, and to better assess assumptions made by these volcanic hazard models. The goal of this chapter is to provide state-of-the-art information about the geological processes operating on a regional scale in subduction zones. Subduction zones are locations where oceanic plates subduct into the mantle; they are characterized geomorphologically by deep ocean trenches and volcanic arcs or continental margins, seismically by landward-dipping deep seismic zones and magmatically by arcuate belts of volcanoes. Subduction and arc magmatism are fundamental processes in the evolution of the Earth, because they play crucial roles in the present-day differentiation of Earth's materials and are believed to be major sites of continental crust generation that have operated throughout geologic time (e.g. Taylor, 1967; Arculus, 1981; Gill, 1981; Eiler, 2003; Rudnick and Gao, 2003).
An ion source for generation of low-charged heavy ions has been
developed using low-power KrF excimer and frequency-doubled Nd:YAG
lasers. The ion source was examined with two experimental modes of
low-voltage DC extraction at ∼20 kV and high-voltage pulse
extraction at 150 kV. Normalized emittance of extracted beams composed
of Cu+ and Cu2+ ions was measured to be about
0.05 and 0.8 πmm-mrad for the DC extraction and the pulse
extraction, respectively. Electron temperature was observed by means of
a single probe method to be 0.8 to 2.5 eV, depending on the intensity
of the KrF laser.
The interaction process between fast heavy ions and dense plasma
was experimentally investigated. We injected 4.3-MeV/u or
6.0-MeV/u iron ions into a z-pinch-discharge helium
plasma and measured the energy loss of the ions by the time
of flight method. The energy loss of 4.3-MeV/u ions fairly
agreed with theoretical prediction when the electron density
of the target was on the order of 1018 cm−3.
With increasing electron density beyond 1019
cm−3, the difference between the experiment
and the theory became remarkable; the experimental energy loss
was 15% larger than the theoretical value at the peak density.
For 6.0-MeV/u ions, the deviation from the theory appeared
even at densities below 1019 cm−3.
These discrepancies indicated that density effects such as ladderlike
ionization caused the enhancement of the projectile mean charge in the
target.
Activities of research and development on repetitive induction
voltage modulators in the Tokyo Institute of Technology–High
Energy Accelerator Research Organization group are presented
along with a discussion of the magnetic response of ferro-magnetic
materials to fast magnetization and a transient beam loading
in the modulators. The modulator is composed of independently
driven modules switched by field effect transistors. To make
waveform control, the induced voltages are stacked and synthesized
in the induction unit. A proof-of-principle experiment shows
that the module elements are successfully operated up to megahertz
levels with good reproducibility. For the evaluation of magnetic
core response, magnetic characteristics are investigated over
a wide range of parameters, and an empirical core loss scaling
is derived at minor-hysteresis loops. Using the prototype induction
module, we have also investigated the effect of beam loading.
Results indicate that the effect depends not only on the impedance
of the driving circuit but on nonlinearity of the magnetic-core
response. This means that the response of the induction modulator
depends on the time scale of domain motion and operating point
in the B-H plane of magnetic materials. Based on the progress
of the component technology in the induction accelerator and
database of magnetic materials, a system design has been developed.
The charge-state distribution and the energy loss of oxygen
ions in a laser-produced hydrogen plasma have been investigated
experimentally. The plasma target had a maximum electron density
of 5 × 1018 cm−3 and a maximum
electron temperature of 13 eV. The mean charge state of the oxygen
ions in the hydrogen plasma was measured to be 5.1, which was considerably
higher than that in hydrogen gas. The energy loss of oxygen ions in
the plasma of a density less than 1 × 1018
cm−3 in the plasma showed a large enhancement compared
with that in hydrogen gas. However, the energy loss in the plasma of a
density above 1 × 1018 cm−3 showed no
enhancement.
This article reports on the interaction between slow
ions and a partially ionized plasma. Temporal evolutions
of energy loss and charge distribution of 2.4 MeV oxygen
beams in the laser-induced polyethylene plasma were measured.
The charge distribution showed strong stripping ability
in the early phase of the plasma. Stopping power deduced
from the experimental energy loss was 1.9 times larger
than that for the solid. The effective charge of the projectile
ion was estimated from the yields of 4+ and 6+ states.
The peak value of the effective charge was 1.4 times larger
than that of the solid. The stopping power equation given
by Sigmund was extended for the partially ionized plasma
and it could reproduce the measured energy loss.
An energy loss of 240 MeV argon ions in a Z-pinch
helium plasma has been for the first time observed throughout
the entire pinching process. Standard Stark broadening
analysis gives an electron density ranging from 4 to 6
× 1017 cm−3 during the
pinch. To deduce stopping power from the energy loss, the
target thickness of the helium plasma has been evaluated
assuming the mean charge of helium based on thermal equilibrium.
The observed electron density and the mean charge of helium
give a target thickness of 30 ± 3 μg cm−2
from 1 μs to 1.8 μs after the discharge ignition.
The measured stopping power exceeds a tabulated value for
cold helium gas by a factor of 2 to 3 around the time of
the first pinch. The experimental stopping power is compared
with theoretical values calculated using an equation of
stopping power for a partially ionized plasma.
Magnetic properties of Co-doped rutile (Ti1-xCoxO2) film in combinatorial composition-spread form have been surveyed by means of a Scanning Superconducting-quantum-interference-device Microscope (SSM). As a consequence, we found magnetic domains in the spatial regions with x>0.05 without external field, giving strong evidence for ferromagnetism with finite spontaneous magnetization. The magnetic moment was monotonously increased with increasing doping level x from 0.05 to ∼ 0.13. On the other hand, it was almost unchanged for x > ∼ 0.13, suggesting that Co does not dissolve into rutile film beyond x ∼ 0.13. The SSM results on the rutile Ti0.95Co0.05O2 thin films with different thickness showed that the magnetic moment is proportional to film thickness, leading to a conclusion that the presently observed ferromagnetism does not result from Co or Co-based oxide particles on the film surface.