Tin whiskers formation and growth on immersion sn surface finish under external stresses by bending

Deposited tin (Sn) layers used as lead-free solderable finish on the semiconductor devices are known to form whiskers. These whiskers are a single crystal of tin that spontaneously grows from the surface of tin within weeks to years. Thus, they can cause shorts and the failure of a whole electronic circuit. In this research, the effect of external stresses applied by bending on the tin whiskers formation and growth was investigated on immersion Sn surface finish. The plating time was 10 minutes to produce 1.4 μm coating thickness on the copper substrate and exposed for 1, 4, and 8 weeks under the environment of 30°C/60% RH for bent and non-bent samples. It was found that the non-bent Sn surface had uniform ts distributed on the entire surface. Unlike the non-bent Sn surface, the surface of bent samples had non-uniform tin whiskers distribution. The tin whiskers formed more and grew longer at the lower stress region of the bent surface as compared to the higher stress region, based on the micrograph observed using the field emission scanning electron microscopy (FESEM)

Manifestations ophtalmologiques du lupus chez l’enfant

Le lupus  à début pédiatrique est une maladie souvent sévère, dont la morbidité à long terme est importante. Ses manifestations ophtalmologiques sont variées et peuvent être révélatrices.  Elles sont  représentées par les nodules cotonneux avec ou sans hémorragies intra rétiniennes. Les auteurs rapportent l'observation d'un enfant  ayant un lupus érythémateux disséminé qui a présenté une vascularite  rétinienne

Evaluation of the feasibility, diagnostic yield, and clinical utility of rapid genome sequencing in infantile epilepsy (Gene-STEPS): an international, multicentre, pilot cohort study

BACKGROUND: Most neonatal and infantile-onset epilepsies have presumed genetic aetiologies, and early genetic diagnoses have the potential to inform clinical management and improve outcomes. We therefore aimed to determine the feasibility, diagnostic yield, and clinical utility of rapid genome sequencing in this population. METHODS: We conducted an international, multicentre, cohort study (Gene-STEPS), which is a pilot study of the International Precision Child Health Partnership (IPCHiP). IPCHiP is a consortium of four paediatric centres with tertiary-level subspecialty services in Australia, Canada, the UK, and the USA. We recruited infants with new-onset epilepsy or complex febrile seizures from IPCHiP centres, who were younger than 12 months at seizure onset. We excluded infants with simple febrile seizures, acute provoked seizures, known acquired cause, or known genetic cause. Blood samples were collected from probands and available biological parents. Clinical data were collected from medical records, treating clinicians, and parents. Trio genome sequencing was done when both parents were available, and duo or singleton genome sequencing was done when one or neither parent was available. Site-specific protocols were used for DNA extraction and library preparation. Rapid genome sequencing and analysis was done at clinically accredited laboratories, and results were returned to families. We analysed summary statistics for cohort demographic and clinical characteristics and the timing, diagnostic yield, and clinical impact of rapid genome sequencing. FINDINGS: Between Sept 1, 2021, and Aug 31, 2022, we enrolled 100 infants with new-onset epilepsy, of whom 41 (41%) were girls and 59 (59%) were boys. Median age of seizure onset was 128 days (IQR 46-192). For 43 (43% [binomial distribution 95% CI 33-53]) of 100 infants, we identified genetic diagnoses, with a median time from seizure onset to rapid genome sequencing result of 37 days (IQR 25-59). Genetic diagnosis was associated with neonatal seizure onset versus infantile seizure onset (14 [74%] of 19 vs 29 [36%] of 81; p=0·0027), referral setting (12 [71%] of 17 for intensive care, 19 [44%] of 43 non-intensive care inpatient, and 12 [28%] of 40 outpatient; p=0·0178), and epilepsy syndrome (13 [87%] of 15 for self-limited epilepsies, 18 [35%] of 51 for developmental and epileptic encephalopathies, 12 [35%] of 34 for other syndromes; p=0·001). Rapid genome sequencing revealed genetic heterogeneity, with 34 unique genes or genomic regions implicated. Genetic diagnoses had immediate clinical utility, informing treatment (24 [56%] of 43), additional evaluation (28 [65%]), prognosis (37 [86%]), and recurrence risk counselling (all cases). INTERPRETATION: Our findings support the feasibility of implementation of rapid genome sequencing in the clinical care of infants with new-onset epilepsy. Longitudinal follow-up is needed to further assess the role of rapid genetic diagnosis in improving clinical, quality-of-life, and economic outcomes. FUNDING: American Academy of Pediatrics, Boston Children's Hospital Children's Rare Disease Cohorts Initiative, Canadian Institutes of Health Research, Epilepsy Canada, Feiga Bresver Academic Foundation, Great Ormond Street Hospital Charity, Medical Research Council, Murdoch Children's Research Institute, National Institute of Child Health and Human Development, National Institute for Health and Care Research Great Ormond Street Hospital Biomedical Research Centre, One8 Foundation, Ontario Brain Institute, Robinson Family Initiative for Transformational Research, The Royal Children's Hospital Foundation, University of Toronto McLaughlin Centre

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Electrocoagulation technque in enhancing COD and suspended solids removal to improve wastewater quality

This paper presents a preliminary study for the removal of COD and suspended solids in wastewater treatment by combining magnetic field and electrocoagulation (EC) technology. The experiments were carried out using batch apparatus and setup in the static method. Batch experiments with two monopolar iron (Fe) plate anodes and cathodes were employed as electrodes. Wastewater samples were prepared from milk powder with an initial COD of 1,140 mgL-1 and suspended solids of 1,400 mgL-1 and acidic conditions were employed (pH ~ 3). DC current was varied from 0.5–0.8 A and operating times were between 30 and 50 min. The results show that the effluent wastewater was very clear (turbidity ~9 NTU) and its quality exceeded the direct discharge standard. The suspended solids and COD removal efficiencies were as high as 30.6 and 75.5%, respectively. In addition, the experimental results also show that the electrocoagulation could neutralise the pH of wastewater

Psychogenic non-epileptic seizures as a frequent diagnostic problem

Introduction: Psychogenic non-epileptic seizures represent a paroxysmal event followed by a sudden change of behavior, cognition or consciousness, mostly of short duration, which resemble or can be understood as epileptic seizures. They occur in persons without epilepsy and in patients with epilepsy. They are not associated with abnormal EEG discharges because their cause is a psychic disorder. Case report: A 20-year-old patient has been suffering of occasional 'morning short-lasting jerking hand movements, staring and fainting' since the age of 14 years. Beside a symptomatic anamnesis for epilepsy and non-specifically changed standard EEG, antiepileptic therapy (valproate and lamotrigine) was introduced. Because of non-response to antiepileptic therapy, the patient was forwarded for further clinical examination involving video EEG telemetry, which indicated that this was a case of psychogenic non-epileptic seizures. A successive withdrawal of antiepileptic drugs was initiated, and also, a psychologist and psychiatrist were included into treatment, which resulted in the reduction of seizures and improvement of the patient's general condition. Conclusion: Psychogenic non-epileptic seizures represent a frequent diagnostic problem requiring team's work, while the video EEG telemetry is the method of choice for diagnosis