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While paediatric arteriovenous malformations (AVMs) often require aggressive therapeutic intervention due to their high bleeding incidence, choosing a course of treatment for deep and eloquent areas and asymptomatic cases is difficult. Sequelae are a concern in children, as they survive for longer after treatment. The authors have long recommended and implemented staged Gamma Knife radiosurgery (GKRS) in their treatment guidelines to maximise therapeutic effects.
Methods:
Fifty-eight paediatric patients with AVM and ≤15 years old who underwent GKRS under general anesthesia from 2002 to 2020 were followed up for an average of 81·5 months. Obliteration dynamics and clinical outcomes were analysed.
Results:
The mean patient age was 10·5 years. The mean nidus volume was 6·6 cm3, the complete occlusion rate was 69%, the annual post-irradiation bleeding rate was 2·19% and nine (16%) cases had transient radiation-induced changes. One (1·7%) patient had sequela, and three (5·1%) developed encapsulated hematomas and cysts. Additionally, the 3- and 5-year cumulative occlusion rates were 39·0% and 53·3%, respectively. Multivariate analysis showed significantly higher occlusion rates in patients ≤12 years old and with a nidus volume of ≤4 cm3.
Conclusions:
GKRS is a useful treatment for paediatric AVM; however, its use poses some challenges.
The goal-control model of the functional impairment in dementia posits two different underlying mechanisms: decay of task goals (reduced task accomplishment) and poor control over goal execution (high error rates). Here we present a case series in which we explore the effects of a performance-based, functional intervention on two participants. Outcomes were evaluated using the goal-control framework.
Participants and Methods:
Two participants with dementia (CS: age 70, 14 years of education; EM: age 93, 18 years of education) completed neuropsychological tests (scored using age, education, and IQ-adjusted norms) and baseline testing with the Naturalistic Action Task (NAT; a validated performance-based task of everyday function including a Breakfast and Lunch task). The Virtual Kitchen (VK) was used to train, through repeated performance, either the Breakfast (CS) or Lunch (EM) tasks for 30 minutes (or 10 total repetitions) per day over 5 days. After VK training, participants performed the NAT Breakfast and Lunch tasks again to evaluate improvement on the trained and untrained tasks. Baseline and post-training NATs were scored for task accomplishment and errors by two coders observing video recordings. Z scores were derived by calculating accomplishment and error change scores for each participant relative to the mean and standard deviations of change scores from a cohort of 36 healthy controls (mean age: 73.3, SD: 6.44; mean education: 17.42, SD: 2.17).
Results:
Both participants exhibited similar cognitive profiles: high estimated IQ; low MMSE (total = 19 for both CS and EM; 1st percentile); anterograde amnesia, slowed processing speed and impaired executive function; average scores on tests of attention, language, and self-reported depression. Informant report of daily functioning (FAQ) suggested that EM (FAQ=28) exhibited greater functional impairment than CS (FAQ=9). Both participants completed all VK training sessions. Z scores of the change from pre- to post-training showed significant increases in task accomplishment on the trained task (trained condition change z scores: EM = +27.69; CS =+ 6.06), but significantly less improvement or worse task accomplishment on the untrained task (untrained condition change z scores: EM = +4.06; CS = -13.69). The training did not reduce errors, as error rates increased for both participants on the trained task.
Conclusions:
The participants presented in this case study exhibited comparable cognitive profiles, including marked anterograde amnesia. Our results suggest that repeated training in a virtual context can improve specific aspects of functioning on real, life everyday tasks. Further, according to the goal-control framework, repeated practice reduces the decay of the task goal, as represented by greater task accomplishment, but does not improve executive control over the task execution. Important future directions are to determine if people with different cognitive profiles will demonstrate different benefits from VK training and to examine if virtual training of personally relevant, everyday tasks can promote independent living and improve quality of life.
Various issues related to training methods and outcomes of intercultural training are reviewed by employing a typology of intercultural training that integrates aspects of culture-specific and culture-general training with didactic and experiential learning styles. This is followed by a brief discussion of the process of experiential learning, issues pertaining to cognitive affective and behavioral training, how context shapes the selection of methods, and how traditional methods can be updated with technology to meet modern needs. The role of culture in shaping the choice of methods and issues related to training across and about cultures is discussed.How knowledge, skill and attitudes shape the selection of intercultural training methods, and the significance of personal and cultural preferences in mediating training outcomes, and the interaction between desired outcomes, participant data, and situational factors are noted. In addition, 20 intercultural methods –lectures, written materials, online-based training, films, self-assessment, case studies, and critical incidents, role playing, simulation games, and intercultural exercises, contrast culture training, culture assimilator, cross-cultural analysis, cross-cultural dialogues, areas studies, immersion, visual imagery, and art and culture – that are currently employed are analyzed to examine current trends in training, the contexts in which methods are applied, and the factors that affect the choice of one method over another. The analyses include an assessment of strengths and weaknesses, typical outcomes, adaptability, ways the methods have or could be used, availability of the method in off-the-shelf versions, and resources for finding out more about it.Trainers are encouraged to master a variety of methods because no single method will work all of the time in producing the desired outcomes that best suit their client’s needs.
The ALMA twenty-six arcmin2 survey of GOODS-S at one millimeter (ASAGAO) is a deep (1σ ∼ 61μJy/beam) and wide area (26 arcmin2) survey on a contiguous field at 1.2 mm. By combining with archival data, we obtained a deeper map in the same region (1σ ∼ 30μJy/beam−1, synthesized beam size 0.59″ × 0.53″), providing the largest sample of sources (25 sources at 5σ, 45 sources at 4.5σ) among ALMA blank-field surveys. The median redshift of the 4.5σ sources is 2.4. The number counts shows that 52% of the extragalactic background light at 1.2 mm is resolved into discrete sources. We create IR luminosity functions (LFs) at z = 1–3, and constrain the faintest luminosity of the LF at 2 < z < 3. The LFs are consistent with previous results based on other ALMA and SCUBA-2 observations, which suggests a positive luminosity evolution and negative density evolution.
Alumina-pillared fluorine micas were prepared from synthetic highly layer-charged expandable fluorine mica and polyhydroxoaluminium solutions under different solution loadings (Al mmol in solutions per 1.0 g mica) in order to clarify the effects of solution loading on thermal durability and microporous properties. The intercalated Al content of the pillared micas increased with increased solution loading. The intercalated Al content (i.e. the pillar density) of the pillared micas influenced both the thermal durability and specific surface areas of the pillared micas. The pillared micas obtained from the high solution loadings showed better thermal durability than those obtained from the low solution loadings. Through micropore formation upon heating, the pillared micas exhibit cation exchangeability due to the liberation of residual Na+ ions from steric hindrance in the interlayer pillaring space. The amount of the exchangeable ions depends on the heating temperature of the pillared micas.
Highly alkaline environments induced by cement-based materials are likely to cause the physical and/or chemical properties of the bentonite buffer materials in radioactive waste repositories to deteriorate. Assessing long-term alteration of concrete/clay systems requires physicochemical models and a number of input parameters. In order to provide reliability in the assessment of the long-term performance of bentonite buffers under disposal conditions, it is necessary to develop and verify reactive transport codes for concrete/clay systems. In this study, a PHREEQC-based, reactive transport analysis code (MC-CEMENT ver. 2) was developed and was verified by comparing results of the calculations with in situ observations of the mineralogical evolution at the concrete/argillite interface. The calculation reproduced the observations such as the mineralogical changes in the argillite limited to within 1 cm in thickness from the interface, formation of CaCO3 and CSH, dissolution of quartz, decrease of porosity in the argillite and an increase in the concrete. These agreements indicate a possibility that models based on lab-scale (∼1 year) experiments can be applied to longer time scales although confidence in the models is necessary for much longer timescales. The fact that the calculations did not reproduce the dissolution of clays and the formation of gypsum indicates that there is still room for improvement in our model.
Highly alkaline environments induced by cementitious materials in radioactive waste repositories are likely to alter montmorillonite, the main constituent of bentonite buffer materials, and are likely to cause the physical and/or chemical properties of the buffer materials to deteriorate. The deterioration may cause variation in hydraulic conductivity of the buffer. However, empirical data on the variation of hydraulic conductivity are scarce, mainly because the alteration of compacted buffer materials, sand-bentonite mixtures, is extremely slow. In this study, laboratory experiments were performed to observe changes in hydraulic conductivity of sand-bentonite mixtures, accompanied by their alkaline alteration, using NaOH-based solutions at 80–90°C. Series-1 multi-step alteration/water conduction experiments resulted in an increase in the hydraulic conductivity by one order of magnitude over a 200 day period. Series-2 single step alteration/water conduction experiments revealed a decrease in the montmorillonite contents with time and a resulting increase in the hydraulic conductivity by 30 times over the 67 day period. Series-3 simultaneous alteration/water conduction experiment also demonstrated an increase in the hydraulic conductivity by 30 times over the 150 day period. The results proved that the alkaline alteration of the bentonite buffer can increase the hydraulic conductivity. The data obtained in this study are useful for verification of the code that will be used for assessing the alteration.
In order to evaluate the long-term behaviour of the engineered barriers in geological disposal sites for transuranic element-bearing (TRU) waste, an evaluation by numerical analysis is required. Although chemical and hydraulic/mechanical analyses have been conducted independently until now, essentially both type of phenomena occur simultaneously and produce synergistic effects. Therefore, we focused attention on the buffer (bentonite) engineered barrier and conducted a study of which involved incorporating hydraulic/mechanical phenomena into the chemical analysis of bentonite alteration. The simulations employed weakly-coupled chemical and hydraulic/mechanical effects to study the behaviour in one dimension.
The results showed that the dissolution of the montmorillonite is suppressed in the buffer section nearest the cement material. Moreover, in order to achieve a fully coupled analysis in future, the present study also identifies issues that need to be resolved.
We initiated a long-term and highly frequent monitoring project toward 442 methanol masers at 6.7 GHz (Dec >−30 deg) using the Hitachi 32-m radio telescope in December 2012. The observations have been carried out daily, monitoring a spectrum of each source with intervals of 9–10 days. In September 2015, the number of the target sources and intervals were redesigned into 143 and 4–5 days, respectively. This monitoring provides us complete information on how many sources show periodic flux variations in high-mass star-forming regions, which have been detected in 20 sources with periods of 29.5–668 days so far (e.g., Goedhart et al. 2004). We have already obtained new detections of periodic flux variations in 31 methanol sources with periods of 22–409 days. These periodic flux variations must be a unique tool to investigate high-mass protostars themselves and their circumstellar structure on a very tiny spatial scale of 0.1–1 au.
Insufficient nutrition during the perinatal period causes structural alterations in humans and experimental animals, leading to increased vulnerability to diseases in later life. Japanese quail, Coturnix japonica, in which partial (8–10%) egg white was withdrawn (EwW) from eggs before incubation had lower birth weights than controls (CTs). EwW birds also had reduced hatching rates, smaller glomeruli and lower embryo weight. In EwW embryos, the surface condensate area containing mesenchymal cells was larger, suggesting that delayed but active nephrogenesis takes place. In mature EwW quail, the number of glomeruli in the cortical region (mm2) was significantly lower (CT 34.7±1.4, EwW 21.0±1.2); capillary loops showed focal ballooning, and mesangial areas were distinctly expanded. Immunoreactive cell junction proteins, N-cadherin and podocin, and slit diaphragms were clearly seen. With aging, the mesangial area and glomerular size continued to increase and were significantly larger in EwW quail, suggesting compensatory hypertrophy. Furthermore, apoptosis measured by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling analysis was higher in EwWs than in CTs on embryonic day 15 and postnatal day 4 (D4). Similarly, plasma glucocorticoid (corticosterone) was higher (P<0.01) on D4 in EwW quail. These results suggest that although nephrogenic activity is high in low-nutrition quail during the perinatal period, delayed development and increased apoptosis may result in a lower number of mature nephrons. Damaged or incompletely mature mesangium may trigger glomerular injury, leading in later life to nephrosclerosis. The present study shows that birds serve as a model for ‘fetal programming,’ which appears to have evolved phylogenetically early.
Little is known about the economic benefits of cognitive remediation and supported employment (CR + SE). The present study aimed to investigate the cost-effectiveness of CR + SE compared with traditional vocational services (TVS).
Method
Individuals with mental illness and low cognitive function were recruited at six sites in Japan. A total of 111 participants were randomly allocated to the CR + SE group or the TVS group. Clinical and vocational outcomes were assessed at baseline and 12-month follow-up. Service utilization data were collected monthly. The data on outcomes and costs were combined to examine cost-effectiveness.
Results
The data were obtained from a total of 92 participants. The CR + SE group resulted in better vocational and clinical outcomes (employment rate, 62.2%; work tenures, 78.6 days; cognitive improvement, 0.5) than the TVS group (19.1%, 24.9 days and 0.2). There was no significant difference in mean total costs between the groups (CR + SE group: $9823, s.d. = $6372, TVS group: $11 063, s.d. = $11 263) with and without adjustment for covariates. However, mean cost for medical services in the CR + SE group was significantly lower than that in the TVS group after adjusting covariates (Β = −$3979, 95% confidence interval −$7816 to −$143, p = 0.042). Cost-effectiveness acceptability curves for vocational outcomes illustrated the high probabilities (approximately 70%) of the CR + SE group being more cost-effective than TVS when society is not willing to pay additional costs.
Conclusions
CR + SE appears to be a cost-effective option for people with mental illness who have low cognitive functioning when compared with TVS.
We have conducted 1.1 mm ALMA observations of a contiguous 105” × 50” or 1.5 arcmin2 window in the SXDF-UDS-CANDELS. We achieved a 5σ sensitivity of 0.28 mJy, giving a flat sensus of dusty star-forming galaxies with LIR ~6×1011L⊙ (if Tdust=40K) up to z ~ 10 thanks to the negative K-correction at this wavelength. We detected 5 brightest sources (S/N>6) and 18 low-significant sources (5>S/N>4; they may contain spurious detections, though). One of the 5 brightest ALMA sources (S1.1mm = 0.84 ± 0.09 mJy) is extremely faint in the WFC3 and VLT/HAWK-I images, demonstrating that a contiguous ALMA imaging survey uncovers a faint dust-obscured population invisible in the deep optical/near-infrared surveys. We find a possible [CII]-line emitter at z=5.955 or a low-z CO emitting galaxy within the field, allowing us to constrain the [CII] and/or CO luminosity functions across the history of the universe.
Molybdenum disulfide (MoS2), one of the transition-metal dichalcogenides, is a 2-dimensional semiconducting material that has a layered structure. Owing to excellent optical and electronic properties, the ultra-thin MoS2 film is expected to be used for various devices, such as transistors and flexible displays. In this study, we investigated the physical and chemical properties of sputtered-MoS2 film in the sub-10-nm region by Raman spectroscopy and X-ray photoelectron spectroscopy (XPS). As the results of Raman spectroscopy investigations, we observed two Raman modes, E12g and A1g, in the 2-dimensional MoS2 films. As the thickness of the MoS2 film decreased, the peak frequency difference between E12g and A1g modes increased. From the XPS investigations, we confirmed sulfur reductions from the 2-dimensional MoS2 films. Therefore, we considered that the sulfur vacancies in the MoS2 film affected the Raman peak positions. Moreover, we performed the additional sulfurization of sputtered-MoS2 films. From the XPS and Raman investigations, the quality of the sputtered-MoS2 films was improved by the additional sulfurization.
The aim of this study was to estimate genetic correlations between milk yield, somatic cell score (SCS), mastitis, and claw and leg disorders (CLDs) during first lactation in Holstein cows by using a threshold–linear random regression test-day model. We used daily records of milk, fat and protein yields; somatic cell count (SCC); and mastitis and CLD incidences from 46 771 first-lactation Holstein cows in Hokkaido, Japan, that calved between 2000 and 2009. A threshold animal model for binary records (mastitis and CLDs) and linear animal model for yield traits were applied in our multiple trait analysis. For both liabilities and yield traits, additive genetic effects were used as random regression on cubic Legendre polynomials of days on milk. The highest positive genetic correlations between yields and disease incidences (0.36 for milk and mastitis, 0.56 for fat and mastitis, 0.24 for protein and mastitis, 0.32 for milk and CLD, 0.44 for fat and CLD and 0.31 for protein and CLD) were estimated at about the time of peak milk yield (36 to 65 days in milk). Selection focused on early lactation yield may therefore increase the risk of mastitis and CLDs. The positive genetic correlations of SCS with mastitis or CLD incidence imply that selection to reduce SCS in the early stages of lactation would decrease the incidence of both mastitis and CLD.
We investigated the relationships between conception rates (CRs) at first service in Japanese Holstein heifers (i.e. animals that had not yet had their first calf) and cows and their test-day (TD) milk yields. Data included records of artificial insemination (AI) for heifers and cows that had calved for the first time between 2000 and 2008 and their TD milk yields at 6 through 305 days in milk (DIM) from first through third lactations. CR was defined as a binary trait for which first AI was a failure or success. A threshold-linear animal model was applied to estimate genetic correlations between CRs of heifers or cows and TD milk yield at various lactation stages. Two-trait genetic analyses were performed for every combination of CR and TD milk yield by using the Bayesian method with Gibbs sampling. The posterior means of the heritabilities of CR were 0.031 for heifers, 0.034 for first-lactation cows and 0.028 for second-lactation cows. Heritabilities for TD milk yield increased from 0.324 to 0.433 with increasing DIM but decreased slightly after 210 DIM during first lactation. These heritabilities from the second and third lactations were higher during late stages of lactation than during early stages. Posterior means of the genetic correlations between heifer CR and all TD yields were positive (range, 0.082 to 0.287), but those between CR of cows and milk yields during first or second lactation were negative (range, −0.121 to −0.250). Therefore, during every stage of lactation, selection in the direction of increasing milk yield may reduce CR in cows. The genetic relationships between CR and lactation curve shape were quite weak, because the genetic correlations between CR and TD milk yield were constant during the lactation period.
We mapped the NH3 (1,1), (2,2), and (3,3) lines of the molecular cloud associated with the Monkey Head Nebula (MHN) with 1′.6 angular resolution using Kashima 34 m telescope. Its kinetic temperature distribution was contrary to what is expected for a molecular cloud at the edge of an expanding H II region and suggested that the massive star associated with S252A compact HII region formed spontaneously rather than through a sequential process.
An ultra-small tactile sensor with functions of signal processing and digital communication has been prototyped based on MEMS-CMOS integration technology. The designed analog-digital mixed signal ASIC allows many tactile sensors to connect each other on a common bus line, which drastically reduces the number of wire. The ASIC capacitively detects the deformation of a force sensor and sends digital data to the common bus line when the force exceeds a threshold. The digital data contain a physical ID of each sensor, 32-bit sensing data and 16-bit cyclic redundancy check (CRC) code. In this study, a novel wafer-level integration and packaging technology were developed, and a chip-size-packaged tactile sensor with a small footprint (2.5mm×2.5mm) and a low profile (0.27mm) was prototyped and tested. The sensor autonomously sends digital data like a tactile receptor of human.