Time and spatially resolved VIS-NIR hyperspectral imaging as a novel monitoring tool for laser-based spectroscopy to mitigate radiation damage on paintings.

The increased adoption of non-invasive laser-based techniques for analysis of cultural assets has recently called into question the non-invasiveness of the techniques in practical operation. The methods to assess the occurrence of radiation-induced alteration on paintings are very limited and none of them can predict damage. Here we present a novel multimodal imaging approach to understand the time and spatial evolution and types of laser-induced surface alterations, through simultaneous monitoring using visible and near infrared (VIS-NIR) reflectance hyperspectral imaging (HSI) and thermal imaging during Raman spectroscopy. The resultant physical and chemical changes were examined in detail by optical coherence tomography and synchrotron based micro-X-ray powder diffraction. HSI was found to be the most sensitive in detecting laser induced alternations compared with conventional methods. It is orders of magnitude more sensitive than Raman spectroscopy and even synchrotron-based micro-X-ray powder diffraction. In cases of thermally driven alterations, transient and reversible reflectance changes were found to be the first indications of laser-induced modifications and can therefore be used as precursors to prevent damage. VIS-NIR reflectance spectroscopy should be used to monitor laser-based analysis and potentially other radiation-based techniques in situ to mitigate laser induced alteration.

Shared Cultural Values Influence Mental Health Help-Seeking Behaviors in Asian and Latinx College Students.

The current study sought to understand the influence of cultural values on mental health attitudes and help-seeking behaviors in college students of diverse ethnic backgrounds. Asian and Latinx college students (N = 159) completed an online survey in which they reported on their adherence to cultural values as measured by ethnicity-specific cultural values and general attitudes towards mental health. Factor analysis revealed two common factors of cultural values irrespective of ethnicity: Interdependent Orientation (IO) and Cultural Obligation (CO). Regardless of ethnicity, the more students endorsed IO values, the less likely they were to perceive a need for mental health treatment. IO value adherence was also predictive of more negative attitudes towards mental health. CO values were not predictive of perceived need or help-seeking behaviors. Findings highlight the importance of understanding shared cultural values across ethnic-racial groups and considering how the multidimensionality of culture may help explain shared mental health behaviors crossing lines of ethnic group membership.

Density-Driven Flows in Evaporating Binary Liquid Droplets.

In the evaporation of microlitre liquid droplets, the accepted view is that surface tension dominates and the effect of gravity is negligible. We report, through the first use of rotating optical coherence tomography, that a change in the flow pattern and speed occurs when evaporating binary liquid droplets are tilted, conclusively showing that gravitational effects dominate the flow. We use gas chromatography to show that these flows are solutal in nature, and we establish a flow phase diagram demonstrating the conditions under which different flow mechanisms occur.

Liver fibrosis and fatty liver in Asian HIV-infected patients.

BACKGROUND: Little is known about the importance of liver fibrosis and fatty liver in HIV-monoinfected individuals without hepatitis virus co-infection, particularly among the Asian population. AIM: To evaluate prevalence and risk factors for liver fibrosis and fatty liver in Asian HIV-monoinfected individuals. METHODS: Eighty asymptomatic HIV-monoinfected individuals (tested negative for HBV/HCV) were compared with 160 matched HIV-uninfected healthy controls. Transient elastography and proton-magnetic resonance spectroscopy ((1) H-MRS) were performed to measure liver stiffness and hepatic steatosis respectively. Blood samples were analysed for metabolic profiles and markers of steatohepatitis (e.g. cytokeratin-18). RESULTS: All HIV-infected individuals (mean ± s.d. age 54 ± 11 years, male 93%, Chinese 94%; diagnosis median duration 8 (IQR 4-13 years) were stable on anti-retrovirals (PI-based 58.7%, NNRTI-based 25.0% integrase-inhibitors 16.3%); diabetes, dyslipidaemia, and metabolic syndrome were common. Fatty liver disease was detected in 28.7%. There was significantly higher degree of liver stiffness [4.9 (IQR 4.1-6.2) kPa vs. 4.2 (IQR 3.6-5.0) kPa, P < 0.001], and greater proportions developed significant fibrosis (7.0 kPa, 14.3% vs. 3.1%, P = 0.001) and cirrhosis (10.3 kPa, 5.2% vs. 0.6%, P = 0.040) compared with controls. HIV infection was an independent risk factor for significant fibrosis (adjusted OR 4.00, 95% CI 1.29-12.41, P = 0.016). HIV-infected individuals with fatty liver had excessive liver stiffness and fibrosis. Two cases of asymptomatic hepatocellular carcinoma were detected. CONCLUSIONS: HIV-monoinfected patients are at risk for liver fibrosis and cirrhosis. HIV-related mechanisms and fatty liver disease may play important roles. Screening and intervention to prevent severe outcomes should be considered.

High resolution Fourier domain optical coherence tomography in the 2 µm wavelength range using a broadband supercontinuum source: erratum.

We correct a mistake in the OCT system sensitivity given in our recent paper [Opt. Express23(3), 1992 (2015)].

Ultra-high resolution Fourier domain optical coherence tomography for old master paintings.

In the last 10 years, Optical Coherence Tomography (OCT) has been successfully applied to art conservation, history and archaeology. OCT has the potential to become a routine non-invasive tool in museums allowing cross-section imaging anywhere on an intact object where there are no other methods of obtaining subsurface information. While current commercial OCTs have shown potential in this field, they are still limited in depth resolution (> 4 µm in paint and varnish) compared to conventional microscopic examination of sampled paint cross-sections (~1 µm). An ultra-high resolution fiber-based Fourier domain optical coherence tomography system with a constant axial resolution of 1.2 µm in varnish or paint throughout a depth range of 1.5 mm has been developed. While Fourier domain OCT of similar resolution has been demonstrated recently, the sensitivity roll-off of some of these systems are still significant. In contrast, this current system achieved a sensitivity roll-off that is less than 2 dB over a 1.2 mm depth range with an incident power of ~1 mW on the sample. The high resolution and sensitivity of the system makes it convenient to image thin varnish and glaze layers with unprecedented contrast. The non-invasive 'virtual' cross-section images obtained with the system show the thin varnish layers with similar resolution in the depth direction but superior clarity in the layer interfaces when compared with conventional optical microscope images of actual paint sample cross-sections obtained micro-destructively.

High resolution Fourier domain optical coherence tomography in the 2 µm wavelength range using a broadband supercontinuum source.

A 220 nm bandwidth supercontinuum source in the two-micron wavelength range has been developed for use in a Fourier domain optical coherence tomography (FDOCT) system. This long wavelength source serves to enhance probing depth in highly scattering material with low water content. We present results confirming improved penetration depth in high opacity paint samples while achieving the high axial resolution needed to resolve individual paint layers. This is the first FDOCT developed in the 2 µm wavelength regime that allows fast, efficient capturing of 3D image cubes at a high axial resolution of 13 µm in air (or 9 µm in paint).

Optical coherence tomography in the 2-µm wavelength regime for paint and other high opacity materials.

An optical coherence tomography system using a compact fiber source emitting amplified spontaneous emission at central wavelength of 1960 nm with bandwidth of 40 nm is developed to enhance the probing depth in a highly scattering material with low water content. Examples of application to paint are used to demonstrate significantly improved penetration depth in high opacity materials in the 2-µm wavelength regime.

Stress and anxiety-depression levels following first-trimester miscarriage: a comparison between women who conceived naturally and women who conceived with assisted reproduction.

OBJECTIVE: To compare the psychological impact following early miscarriage between women who conceived naturally and women who conceived following assisted reproduction. DESIGN: Prospective cohort study. SETTING: Assisted reproduction clinic and general gynaecological unit in a university-affiliated, tertiary referral hospital. POPULATION: A cohort of 150 women (75 after natural conception; 75 after assisted reproduction). METHODS: Completed semi-structured interviews using two standard questionnaires [the 12-item General Health Questionnaire (GHQ-12) and the 22-item Revised Impact of Events Scale (IES-R)], at 1, 4, and 12 weeks after a diagnosis of first-trimester miscarriage. MAIN OUTCOME MEASURES: The GHQ-12 and IES-R scores for the two groups of women. RESULTS: The GHQ-12 and IES-R scores were significantly higher in the assisted reproduction group than the scores in the natural conception group, at 4 weeks and 12 weeks after miscarriage. Further breakdown of the scores revealed significantly higher hyperarousal symptoms at 4 and 12 weeks in the assisted reproduction group, indicating the traumatic effect of miscarriage to these women. CONCLUSIONS: Following first-trimester miscarriage, subfertile women who conceived after assisted reproduction had higher stress and anxiety-depression levels, and experienced more traumatic impact from the event, than those after natural conception. A timely support and psychological intervention would be beneficial in the management of this group of women.

Size distribution of EC, OC and particle-phase PAHs emissions from a diesel engine fueled with three fuels.

The size distribution of elemental carbon (EC), organic carbon (OC) and particle-phase PAHs emission from a direct injection diesel engine fueled with a waste cooking biodiesel, ultra low sulfur diesel (ULSD, 10-ppm-wt), and low sulfur diesel (LSD, 400-ppm-wt) were investigated experimentally. The emission factor of biodiesel EC is 90.6 mg/kh, which decreases by 60.3 and 71.7%, compared with ULSD and LSD respectively and the mass mean diameter (MMD) of EC was also decreased with the use of biodiesel. The effect of biodiesel on OC emission might depend on the engine operation condition, and the difference in OC size distribution is not that significant among the three fuels. For biodiesel, its brake specific emission of particle-phase PAHs is obviously smaller than that from the two diesel fuels, and the reduction effect appears in almost all size ranges. In terms of size distribution, the MMD of PAHs from biodiesel is larger than that from the two diesel fuels, which could be attributed to the more effective reduction on combustion derived PAHs in nuclei mode. The toxicity analysis indicates that biodiesel could reduce the total PAHs emissions, as well as the carcinogenic potency of particle-phase PAHs in almost all the size ranges.

Observation of increases in emission from modern vehicles over time in Hong Kong using remote sensing.

In this study on-road gaseous emissions of vehicles are investigated using remote sensing measurements collected over three different periods. The results show that a high percentage of gaseous pollutants were emitted from a small percentage of vehicles. Liquified Petroleum Gas (LPG) vehicles generally have higher gaseous emissions compared to other vehicles, particularly among higher-emitting vehicles. Vehicles with high vehicle specific power (VSP) tend to have lower CO and HC emissions while petrol and LPG vehicles tend to have higher NO emissions when engine load is high. It can be observed that gaseous emission factors of petrol and LPG vehicles increase greatly within 2 years of being introduced to the vehicle fleet, suggesting that engine and catalyst performance deteriorate rapidly. It can be observed that LPG vehicles have higher levels of gaseous emissions than petrol vehicles, suggesting that proper maintenance of LPG vehicles is essential in reducing gaseous emissions from vehicles.

What is the relationship between the Glasgow coma scale and airway protective reflexes in the Chinese population?

AIM: To describe the relationship of gag and cough reflexes to Glasgow coma score (GCS) in Chinese adults requiring critical care. METHOD: Prospective observational study of adult patients requiring treatment in the trauma or resuscitation rooms of the Emergency Department, Prince of Wales Hospital, Hong Kong. A long cotton bud to stimulate the posterior pharyngeal wall (gag reflex) and a soft tracheal suction catheter were introduced through the mouth to stimulate the laryngopharynx and elicit the cough reflex. Reflexes were classified as normal, attenuated or absent. RESULTS: A total of 208 patients were recruited. Reduced gag and cough reflexes were found to be significantly related to reduced GCS (p=0.014 and 0.002, respectively). Of 33 patients with a GCS≤8, 12 (36.4%) had normal gag reflexes and 8 (24.2%) had normal cough reflexes. 23/62 (37.1%) patients with a GCS of 9-14 had absent gag reflexes, and 27 (43.5%) had absent cough reflexes. In patients with a normal GCS, 22.1% (25/113) had absent gag reflexes and 25.7% (29) had absent cough reflexes. CONCLUSIONS: Our study has shown that in a Chinese population with a wide range of critical illness (but little trauma or intoxication), reduced GCS is significantly related to gag and cough reflexes. However, a considerable proportion of patients with a GCS≤8 have intact airway reflexes and may be capable of maintaining their own airway, whilst many patients with a GCS>8 have impaired airway reflexes and may be at risk of aspiration. This has important implications for airway management decisions.

On-board gaseous emissions of LPG taxis and estimation of taxi fleet emissions.

Instantaneous CO, NO, and HC emissions and exhaust flow rates from four LPG taxis, which adhered to Euro 2-4 emission standards, were measured using a sophisticated portable emission measurement system (PEMS). Instantaneous air/fuel ratios, emission rates, and emission factors at different operating modes were derived to explore the emission characteristics of these four taxis. Results show that gaseous emissions from these four taxis exceed emission standards, due to extended vehicle use and poor maintenance. NO emissions from newer taxis are lower whilst CO and HC emissions of the Euro 4 taxi are similar to those of Euro 2 taxis during idling and low speed travel. The taxis emit lower amounts of gaseous pollutants whilst idling and emit the highest amounts of CO and NO whilst accelerating. Large fluctuations in air/fuel ratios can be observed from the Euro 4 taxi during idling, indicating a malfunction of fuel supply control to the engine. Such fluctuations are not observed from the other taxis. This shows that a Euro 4 taxi is not necessarily cleaner than a Euro 3 taxi. Emission factors derived from on-board measurements are applied to estimate gaseous emissions from the taxi fleet; these results show that emissions are higher during peak hour traffic conditions. An estimate of the taxi fleet's emissions whilst the older taxis are replaced is also calculated. It can be seen that faster replacement of older taxis can lead to reductions in gaseous emissions from the taxi fleet. This study shows that the PEMS is an adequate tool for measuring emissions from LPG vehicles and that there is an urgent need to enforce emission standards on taxis. This study also shows that on-board measurements should be incorporated in the estimation of emissions from other vehicle types. This would result in better emission estimations under local traffic conditions.

Disease severity prediction for nursing home-acquired pneumonia in the emergency department.

BACKGROUND: Prediction rules exist for the assessment of community-acquired pneumonia but their use in nursing home-acquired pneumonia (NHAP) remains undefined. The objectives of this study were to compare the prognostic ability for severe NHAP of five prediction rules (PSI, CURB-65, M-ATS, R-ATS, España rule), and to evaluate their usefulness to identify patients with less severe disease in the emergency department for outpatient care. METHODS: A prospective observational study of consecutive NHAP patients was conducted at a university teaching hospital emergency department in Hong Kong between January 2004 and June 2005. The primary outcome was severe pneumonia (defined as combined 30-day mortality and/or intensive care unit (ICU) admission). RESULTS: 767 consecutive NHAP patients were included. Mean (SD) age was 83.4 (9.0) years; 350 (45.6%) were male and 644 (84.0%) had coexisting illness. 95 patients died within 30 days (12.4%), five patients were admitted to the ICU (0.7%) and 98 patients had severe pneumonia (12.8%). Sensitivity and specificity of each decision rule ranged from 37.8% to 95.9% and 15.1% to 87.6% respectively. The overall predictive performance of each rule was between 0.627 and 0.712. The negative likelihood ratios of PSI (0.27) and CURB-65 (0.23) were lower than M-ATS (0.71), R-ATS (0.45) and España (0.39). After excluding 204 patients with either poor functional status or those >90 years of age, sensitivities of M-ATS (96.0%) and R-ATS (100%) improved greatly with negative likelihood ratios of <0.1. CONCLUSION: PSI and CURB-65 are useful for identification of patients with less severe NHAP.

FGF8b oncogene mediates proliferation and invasion of Epstein-Barr virus-associated nasopharyngeal carcinoma cells: implication for viral-mediated FGF8b upregulation.

The fibroblast growth factor 8b (FGF8b) oncogene is known to be primarily involved in the tumorigenesis and progression of hormone-related cancers. Its role in other epithelial cancers has not been investigated, except for esophageal cancer, in which FGF8b overexpression was mainly found in tumor biopsies of male patients. These observations were consistent with previous findings in these cancer types that the male sex-hormone androgen is responsible for FGF8b expression. Nasopharyngeal carcinoma (NPC) is a highly metastatic cancer of head and neck commonly found in Asia. It is etiologically associated with Epstein-Barr Virus (EBV) infection, inflammatory tumor microenvironment and relatively higher male predominance. Here, we reported for the first time that FGF8b is overexpressed in this EBV-associated non-hormone-related cancer of the head and neck, NPC. More importantly, overexpression of FGF8b mRNA and protein was detected in a large majority of NPC tumors from both male and female genders, in addition to multiple NPC cell lines. We hypothesized that FGF8b overexpression may contribute to NPC tumorigenesis. Using EBV-associated NPC cell lines, we demonstrated that specific knockdown of FGF8b by small interfering RNA inhibited cell proliferation, migration and invasion, whereas exogenous FGF8b stimulated these multiple phenotypes. Further mechanistic investigation revealed that in addition to NF-κB signaling (a major inflammatory signaling pathway known to be activated in NPC), an important EBV oncoprotein, the latent membrane protein 1 (LMP1), was found to be a direct inducer of FGF8b overexpression in NPC cells, whereas androgen (testosterone) has minimal effect on FGF8b expression in EBV-associated NPC cells. In summary, our study has identified LMP1 as the first viral oncogene capable of directly inducing FGF8b (an important cellular oncogene) expression in human cancer cells. This novel mechanism of viral-mediated FGF8 upregulation may implicate a new role of oncoviruses in human carcinogenesis.

Investigation on the gaseous and particulate emissions of a compression ignition engine fueled with diesel-dimethyl carbonate blends.

The effect of dimethyl carbonate (DMC) on the gaseous and particulate emissions of a diesel engine was investigated using Euro V diesel fuel blended with different proportions of DMC. Combustion analysis shows that, with the blended fuel, the ignition delay and the heat release rate in the premixed combustion phase increase, while the total combustion duration and the fuel consumed in the diffusion combustion phase decrease. Compared with diesel fuel, with an increase of DMC in the blended fuel, the brake thermal efficiency is slightly improved but the brake specific fuel consumption increases. On the emission side, CO increases significantly at low engine load but decreases at high engine load while HC decreases slightly. NO(x) reduces slightly but the reduction is not statistically significant, while NO(2) increases slightly. Particulate mass and number concentrations decrease upon using the blended fuel while the geometric mean diameter of the particles shifts towards smaller size. Overall speaking, diesel-DMC blends lead to significant improvement in particulate emissions while the impact on CO, HC and NO(x) emissions is small.

Predictors of important neurological causes of dizziness among patients presenting to the emergency department.

OBJECTIVES: Dizziness is a common presenting complaint in the emergency department (ED). This prospective study describes the incidence, causes and outcome of ED patients presenting with dizziness and tries to identify predictors of central neurological causes of dizziness. METHODS: Single-centre prospective observational study in a university teaching hospital ED in Hong Kong. All ED patients (> or = 18 years old) presenting with dizziness were recruited for 1 month. Symptoms, previous health, physical findings, diagnosis and disposition were recorded. The outcome at 3 months was evaluated using hospital records and telephone interviews. Follow-up was also performed at 55 months using computerised hospital records to identify patients with subsequent stroke and those who had died. RESULTS: 413 adults (65% female, mean 57 years) were recruited. The incidence of dizziness was 3.6% (413/11 319). Nausea and/or vomiting (46%) and headache (20%) were the commonest associated findings. Hypertension (33%) was the commonest previous illness. Central neurological causes of dizziness were found in 6% (23/413) of patients. Age > or = 65 years (OR=6.13, 95% CI 1.97 to 19.09), ataxia symptoms (OR=11.39, 95% CI 2.404 to 53.95), focal neurological symptoms (OR=11.78, 95% CI 1.61 to 86.29), and history of previous stroke (OR=3.89, 95% CI 1.12 to 13.46) and diabetes mellitus (OR=3.57, 95% CI 1.04 to 12.28) predicted central causes of dizziness. CONCLUSIONS: Most dizzy patients had benign causes. Several clinical factors favoured a diagnosis of central neurological causes of dizziness.

Experimental investigation on regulated and unregulated emissions of a diesel/methanol compound combustion engine with and without diesel oxidation catalyst.

The use of methanol in combination with diesel fuel is an effective measure to reduce particulate matter (PM) and nitrogen oxides (NOx) emissions from in-use diesel vehicles. In this study, a diesel/methanol compound combustion (DMCC) scheme was proposed and a 4-cylinder naturally-aspirated direct-injection diesel engine modified to operate on the proposed combustion scheme. The effect of DMCC and diesel oxidation catalyst (DOC) on the regulated emissions of total hydrocarbons (THC), carbon monoxide (CO), NOx and PM was investigated based on the Japanese 13 Mode test cycle. Certain unregulated emissions, including methane, ethyne, ethene, 1,3-butadiene, BTX (benzene, toluene, xylene), unburned methanol and formaldehyde were also evaluated based on the same test cycle. In addition, the soluble organic fraction (SOF) in the particulate and the particulate number concentration and size distribution were investigated at certain selected modes of operation. The results show that the DMCC scheme can effectively reduce NOx, particulate mass and number concentrations, ethyne, ethene and 1,3-butadiene emissions but significantly increase the emissions of THC, CO, NO(2), BTX, unburned methanol, formaldehyde, and the proportion of SOF in the particles. After the DOC, the emission of THC, CO, NO(2), as well as the unregulated gaseous emissions, can be significantly reduced when the exhaust gas temperature is sufficiently high while the particulate mass concentration is further reduced due to oxidation of the SOF.

Emissions characteristics of a diesel engine operating on biodiesel and biodiesel blended with ethanol and methanol.

Euro V diesel fuel, pure biodiesel and biodiesel blended with 5%, 10% and 15% of ethanol or methanol were tested on a 4-cylinder naturally-aspirated direct-injection diesel engine. Experiments were conducted under five engine loads at a steady speed of 1800 r/min. The study aims to investigate the effects of the blended fuels on reducing NO(x) and particulate. On the whole, compared with Euro V diesel fuel, the blended fuels could lead to reduction of both NO(x) and PM of a diesel engine, with the biodiesel-methanol blends being more effective than the biodiesel-ethanol blends. The effectiveness of NO(x) and particulate reductions is more effective with increase of alcohol in the blends. With high percentage of alcohol in the blends, the HC, CO emissions could increase and the brake thermal efficiency might be slightly reduced but the use of 5% blends could reduce the HC and CO emissions as well. With the diesel oxidation catalyst (DOC), the HC, CO and particulate emissions can be further reduced.

Contributors to surgical in-patient satisfaction--development and reliability of a targeted instrument.

OBJECTIVE: Patient satisfaction is an important indicator of healthcare system performance. High patient satisfaction is associated with greater trust in caregivers, improved compliance with treatment recommendations and a better quality of life (QOL). There are few validated instruments to measure surgical patients satisfaction. The aim of this study was to develop a culturally-specific patient satisfaction instrument, for use as an outcome measure in evaluating surgical services. DESIGN: Patient focus groups were convened to explore dimensions of the peri operative hospital experience. Forums uncovered pertinent domains of interest and identified terminology understood by patients. A preliminary set of items reflecting patient satisfaction was developed. Test-retest reliability of a new surgical patient satisfaction instrument was assessed in 42 subjects at hospital discharge. RESULTS: Domains that emerged included; admission processes and hospital environment, information provision, nursing care, doctor and nurse interaction, and ancillary staff services. Staff attitudes and human qualities were highly valued, as was prompt attention to requests for assistance. Clarity or quality of medical information did not appear to influence in-patient satisfaction. A new measure of surgical patient satisfaction, Hong Kong Index of Inpatient Happiness (HK2Happ), was developed from focus group consultation. Test-retest generated an Intra Class Correlation of 0.868-0.935, indicating a highly stable tool. CONCLUSION: The initial version of HK2Happ was reliable in assessing surgical patient satisfaction. The measure is now undergoing validity testing across different surgical patient populations for generalization and generation of a short form of discriminant items.