3,202 research outputs found

    Probability of the resistive state formation caused by absorption of a single-photon in current-carrying superconducting nano-strips

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    We have studied supercurrent-assisted formation of the resistive state in nano-structured Nb and NbN superconducting films after absorption of a single photon. In amorphous narrow NbN strips the probability of the resistive state formation has a pronounced spectral cut-off. The corresponding threshold photon energy decreases with the bias current. Analysis of the experimental data in the framework of the generalized hot-spot model suggests that the quantum yield for near-infrared photons increases faster than the photon nergy. Relaxation of the resistive state depends on the photon energy making the phenomenon feasible for the development of energy resolving single-photon detectors.Comment: 9 pages, 9 figures, submitted to Eur. Phys. Journa

    New Spirometry Indices for Detecting Mild Airflow Obstruction.

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    The diagnosis of chronic obstructive pulmonary disease (COPD) relies on demonstration of airflow obstruction. Traditional spirometric indices miss a number of subjects with respiratory symptoms or structural lung disease on imaging. We hypothesized that utilizing all data points on the expiratory spirometry curves to assess their shape will improve detection of mild airflow obstruction and structural lung disease. We analyzed spirometry data of 8307 participants enrolled in the COPDGene study, and derived metrics of airflow obstruction based on the shape on the volume-time (Parameter D), and flow-volume curves (Transition Point and Transition Distance). We tested associations of these parameters with CT measures of lung disease, respiratory morbidity, and mortality using regression analyses. There were significant correlations between FEV1/FVC with Parameter D (r = -0.83; p < 0.001), Transition Point (r = 0.69; p < 0.001), and Transition Distance (r = 0.50; p < 0.001). All metrics had significant associations with emphysema, small airway disease, dyspnea, and respiratory-quality of life (p < 0.001). The highest quartile for Parameter D was independently associated with all-cause mortality (adjusted HR 3.22,95% CI 2.42-4.27; p < 0.001) but a substantial number of participants in the highest quartile were categorized as GOLD 0 and 1 by traditional criteria (1.8% and 33.7%). Parameter D identified an additional 9.5% of participants with mild or non-recognized disease as abnormal with greater burden of structural lung disease compared with controls. The data points on the flow-volume and volume-time curves can be used to derive indices of airflow obstruction that identify additional subjects with disease who are deemed to be normal by traditional criteria

    Awake Glidescope® intubation in a patient with a huge and fixed supraglottic mass -A case report-

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    Intubating patients with a huge, fixed supraglottic mass causing an obstruction of the glottis is difficult to most anesthesiologists. We attempted awake fiberoptic orotracheal intubation assisted by Glidescope® Videolaryngoscope (GVL) following topical anesthesia with 4% lidocaine spray and remifentanil infusion. The glottis could not be identified by the GVL view. However, by entering toward the right side of the mass with bronchoscope, the glottis was found. Due to stiffness of the mass, we were unable to further enter the area using the bronchoscope. Alternatively, we attempted to expose the glottis by GVL blade and then successfully intubated the patient by manually pressing the cricoids cartilage. GVL is nonetheless an excellent instrument in airway management compared to fiberoptic bronchoscope for patients with a huge and fixed supraglottic mass

    Two-step stabilization of orbital order and the dynamical frustration of spin in the model charge-transfer insulator KCuF3

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    We report a combined experimental and theoretical study of KCuF3, which offers - because of this material's relatively simple lattice structure and valence configuration (d9, i.e., one hole in the d-shell) - a particularly clear view of the essential role of the orbital degree of freedom in governing the dynamical coupling between the spin and lattice degrees of freedom. We present Raman and x-ray scattering evidence that the phase behaviour of KCuF3 is dominated above the Neel temperature (T_N = 40 K) by coupled orbital/lattice fluctuations that are likely associated with rotations of the CuF6 octahedra, and we show that these orbital fluctuations are interrupted by a static structural distortion that occurs just above T_N. A detailed model of the orbital and magnetic phases of KCuF3 reveals that these orbital fluctuations - and the related frustration of in-plane spin-order-are associated with the presence of nearly degenerate low-energy spin-orbital states that are highly susceptible to thermal fluctuations over a wide range of temperatures. A striking implication of these results is that the ground state of KCuF3 at ambient pressure lies near a quantum critical point associated with an orbital/spin liquid phase that is obscured by emergent Neel ordering of the spins; this exotic liquid phase might be accessible via pressure studies.Comment: 13 pages, 3 figure

    A Case of Synchronous Squamous Cell Carcinoma in the Esophagus and Stomach

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    Synchronous esophageal and gastric cancers with the pathologic features of a squamous cell carcinoma are extremely rare. A 57-year-old male visited our hospital with a history of hematemesis and was diagnosed with a synchronous cancer. He underwent a staging work-up, and the resectable lesion in the stomach was operated on following radiologic and endoscopic evaluations. The pathologic examination revealed a synchronous cancer consisting of squamous cell carcinoma in the distal esophagus and the cardia of the stomach. We report a case of a synchronous cancer that was successfully treated by surgical resection followed by concurrent chemoradiotherapy. We also discuss the hypothesis regarding the origin and presentation of the synchronous cancer and highlight the importance of careful surveillance by physicians at the time of diagnosis

    Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

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    <p><b>Background:</b> Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.</p> <p><b>Methods and Findings:</b> Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.</p> <p><b>Conclusions:</b> Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.</p&gt

    Warfarin-Induced Eosinophilic Pleural Effusion

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    A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea

    A study to explore specific stressors and coping strategies in primary dental care practice

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    Background and Aims: It is widely acknowledged that dentists experience occupational stress. This qualitative study aimed to explore previously identified specific stressors in more detail in order to inform the development of a future stress management programme. Method: Two focus groups of dentists (N: 7 & 6) were conducted to explore, in more detail, nine specific stressors and concepts; being out of one’s comfort zone, zoning out from the patient, celebrating the positive aspects of work, thinking aloud, the effect of hurting patients, the impact of perfectionism, responsibility for patient’s self-care, the emotional impact of difficult situations as a foundation dentist. Participants were also asked for their views on the structure and contents of the proposed stress management package. Verbatim transcripts were subjected to thematic analysis. Results and Discussion: Dentists described the impact of these stressors and their current coping methods; thematic analysis revealed 9 themes which covered the above concepts and a further overall theme of need for control. The findings are elaborated in connection to their relevant stress, coping and emotion psychological theory. Their implications for personal well-being and clinical outcomes are discussed. Conclusion: Dentists’ stressful and coping experiences are complex and it is essential that any stress management programme reflects this and that the skills are easily accessible and sustainable within the context of a busy dental practice
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