Chemical and structural properties of conducting nanofilaments in TiN/HfO2-based resistive switching structures.

Structural, chemical and electronic properties of electroforming in the TiN/HfO(2) system are investigated at the nanometre scale. Reversible resistive switching is achieved by biasing the metal oxide using conductive atomic force microscopy. An original method is implemented to localize and investigate the conductive region by combining focused ion beam, scanning spreading resistance microscopy and scanning transmission electron microscopy. Results clearly show the presence of a conductive filament extending over 20 nm. Its size and shape is mainly tuned by the corresponding HfO(2) crystalline grain. Oxygen vacancies together with localized states in the HfO(2) band gap are highlighted by electron energy loss spectroscopy. Oxygen depletion is seen mainly in the central part of the conductive filament along grain boundaries. This is associated with partial amorphization, in particular at both electrode/oxide interfaces. Our results are a direct confirmation of the filamentary conduction mechanism, showing that oxygen content modulation at the nanometre scale plays a major role in resistive switching.

Quantitative profiling of SiGe/Si superlattices by time-of-flight secondary ion mass spectrometry: the advantages of the extended Full Spectrum protocol.

The abundance of work on SiGe-based devices demonstrates the importance of the compositional characterization of such materials. However, Secondary Ion Mass Spectrometry (SIMS) characterization of SiGe layers often suffers from matrix effects due to the non-linear variation of ionization yields with Ge content. Several solutions have been proposed in order to overcome this problem, each having its own limitations such as a restricted germanium concentration range, or a weak sensitivity to dopants or impurities. Here, we studied the improvements brought by an alternative protocol: the extended Full Spectrum protocol, which states proportionality between the composition of the secondary ion beam and that of the actual material. Previous studies on this protocol showed that it was extremely precise and reproducible for Ge quantification in a permanent regime, because of minimized matrix effects. In this study we thus investigated its accuracy for the simultaneous quantitative depth profiling of both matrix elements (Si, Ge) and impurities (B, C or P) in strained SiGe/Si superlattices by comparing results with those from more classic protocols. The profiles provided by the extended Full Spectrum protocol were found to be accurate, and to exhibit better properties than classic protocols in terms of signal/noise ratio and signal stability, along with a slight enhancement in depth resolution.

'Complicated migraine-like episodes' in children following cranial irradiation and chemotherapy.

Neurologic sequelae may occur months to years after cranial irradiation. The site of primary damage is probably the vascular endothelium. Over a 2.8-year period, four children with brain tumors, a mean of 11 years of age at diagnosis (range, 6.5 to 15.5 years), had new onset of severe intermittent unilateral headaches associated with nausea, episodic visual loss, hemiparesis, aphasia, or hemisensory loss. The headaches lasted 2 to 24 hours. All patients had previously received whole-brain (2,400 to 3,600 cGy) and additional local boost (1,800 to 3,100 cGy) cranial irradiation, as well as cisplatin-, lomustine-, and vincristine-containing chemotherapy regimens. Symptoms began 1.2 to 2.8 years after the diagnosis, when all had stable disease and were off treatment. MRI studies were unchanged, and CSF cytology, EEGs, echocardiograms, and magnetic resonance angiograms were normal in all. Cerebral angiograms, performed in three children, were normal but led to severe headaches and neurologic deficits (hemiparesis in one and visual loss in two) that resolved after 24 to 48 hours. Response to antimigraine and antiplatelet medications was variable. We conclude that (1) "complicated migraine-like episodes" may occur in children after cranial irradiation and chemotherapy as a sequela of therapy; (2) these headaches may not be the harbinger of impending strokes, severe intracranial vasculitis, or tumor recurrence; and (3) while cerebral angiography may be useful in differential diagnosis, it may cause transient worsening of symptoms.

Treatment of progressive or recurrent pediatric malignant supratentorial brain tumors with herpes simplex virus thymidine kinase gene vector-producer cells followed by intravenous ganciclovir administration.

OBJECT: The outcome for children with recurrent malignant brain tumors is poor. The majority of patients die of progressive disease within months of relapse, and other therapeutic options are needed. The goal of this Phase I study was to evaluate the safety of in vivo suicide gene therapy in 12 children with recurrent, malignant, supratentorial brain tumors. METHODS: After optimal repeated tumor resection, multiple injections of murine vector-producing cells shedding murine replication-defective retroviral vectors coding the herpes simplex virus thymidine kinase type 1 (HSV-Tk1) gene were made into the rim of the resection cavity. Fourteen days after the vector-producing cells were injected, ganciclovir was administered for 14 days. The retroviral vector that was used only integrated and expressed HSV-Tk1 in proliferating cells, which are killed after a series of metabolic events lead to cell death. The median age of the patients was 11 years (range 2-15 years). Treated brain tumors included seven malignant gliomas, two ependyminomas, and three primitive neuroectodermal tumors. The patients were treated with one of three escalating dose concentrations of vector-producer cells. Four transient central nervous system adverse effects were considered possibly related to the vector-producing cells. In no child did permanent neurological worsening or ventricular irritation develop, and tests for replication-competent retroviruses yielded negative findings. CONCLUSIONS: This Phase I study demonstrates that in vivo gene therapy in which a replication-defective retroviral vector in murine vector-producing cells is delivered by brain injections can be performed with satisfactory safety in a select group of children with localized supratentorial brain tumors.

Comparison of three methods to estimate the center of mass during balance assessment.

Evaluation of postural control is generally based on the interpretation of the center of pressure (COP) and the center of mass (COM) time series. The purpose of this study is to compare three methods to estimate the COM which are based on different biomechanical considerations. These methods are: (1) the kinematic method; (2) the zero-point-to-zero-point double integration technique (GLP) and (3) the COP low-pass filter method (LPF). The COP and COM time series have been determined using an experimental setup with a force plate and a 3D kinematic system on six healthy young adult subjects during four different 30 s standing tasks: (a) quiet standing; (b) one leg standing; (c) voluntary oscillation about the ankles and (d) voluntary oscillation about the ankles and hips. To test the difference between the COM trajectories, the root mean square (RMS) differences between each method (three comparisons) were calculated. The RMS differences between kinematic-LPF and GLP-LPF are significantly larger than kinematic-GLP. Our results show that the GLP method is comparable to the kinematic method. Both agree with the unified theory of balance during upright stance. The GLP method is attractive in the clinical perspective because it requires only a force plate to determine the COP-COM variable, which has been demonstrated to have a high reliability.

Validation of the French version of the Bournemouth Questionnaire.

Self questionnaires are an important aspect of the management of neck pain patients. The Bournemouth Questionnaire (BQ), based on the biopsychosocial model, is designed to evaluate patients with neck pain. The validated English version of this questionnaire (BQc-English) has psychometric properties that range from moderate to excellent. The goal of this study is to translate and validate a French version of the Bournemouth Questionnaire for neck pain patients (BQc-f). Its translation and adaptation are performed using the translation back-translation method, generating a consensus among the translators. This validation study was performed on 68 subjects (mean age 41 years old) who participated in a randomized controlled trial regarding the efficiency of manual therapy for neck pain patients. This experimental protocol was designed to generate data in order to evaluate the construct validity, longitudinal validity, test-retest reliability and responsiveness. The BQc-f psychometric properties of construct validity (r = 0.67, 0.61, 0.42) for pre treatment, post treatment and longitudinal validity, respectively), test-retest reliability (r = 0.97) and responsiveness (effect size = 0.56 and mean standardized response = 0.61) are sufficient to suggest it could be used in the management of patients with neck pain.

Kinematic and electromyographic parameters of the cervical flexion-relaxation phenomenon: the effect of trunk positioning.

BACKGROUND: The cervical flexion-relaxation phenomenon (FRP) is a neck extensor myoelectric "silence" that occurs during complete cervical flexion. The aim of this study was to assess the presence of this phenomenon in the cervical region and to explore the kinematics and EMG parameters in two different experimental conditions. PATIENTS AND METHODS: Nineteen young healthy adults (22.2+/-2.4 years), without any cervical pain history, participated in this study and performed each of the experimental conditions. They had to accomplish a cervical flexion from a neutral seated position and from a 45 degrees forward leaning seated position. Neck kinematics was assessed using a kinematic capture device in order to assess onset and cessation angle of the PFR. Cervical paraspinal and trapezius muscles EMG activities were also recorded. All data were compared in order to assess the differences between the two experimental conditions. RESULTS: Eighteen of the nineteen subjects showed a FRP. The phenomenon appears between 72.6 and 76.3% of maximal cervical flexion and disappears during the return to neutral position between 91.9 and 93.1% of maximal cervical flexion. The FRP was observed, at least unilaterally, in 84.2% (67.4% bilaterally) of tasks without forward bending of trunk, and 90.5% (79.0% bilaterally) of tasks with 45 degrees forward bending of trunk. A significant increase in the flexion-relaxation ratio was observed in the 45 degrees forward leaning condition. No significant difference could be observed between the two experimental conditions for the kinematics parameters. CONCLUSION: The results of the present study indicate that cervical spine flexion in healthy subjects is characterized by a flexion-relaxation response. Moreover, the results indicate that trunk inclination might facilitate the evaluation of the cervical FRP.

CNS germ cell tumor (CNSGCT) of childhood: presentation and delayed diagnosis.

OBJECTIVE: To describe the relationship between symptomatology and time to diagnosis of an institutional series of patients with CNS germ cell tumor (CNSGCT) over a 16-year period. METHODS: Thirty consecutive patients newly diagnosed with CNSGCT (mean age 10.9 years; range 6 to 17 years; 70% boys) were evaluated at our institution between 1990 and 2006. RESULTS: Duration of symptoms prior to diagnosis ranged from 5 days to 3 years (mean 8.4 months). Tumor location included pineal (14), suprasellar (8), pineal/suprasellar (3), pineal/thalamic (4), and basal ganglionic/thalamic (3). Five patients had disseminated disease at the time of diagnosis. Features including headache, nausea, vomiting, and visual changes led to earlier diagnosis. Symptoms including movement disorders, enuresis, anorexia, and psychiatric complaints delayed diagnosis in 9 of 30 patients, diagnosed 7 months to 3 years (mean 22.3 months) from symptom onset. In 7 of 9 patients with delayed diagnosis, enuresis was present. Seventeen of 30 patients had signs of endocrine dysfunction at presentation that included diabetes insipidus (4), hypothyroidism (8), and growth hormone deficiency (4). Ophthalmologic findings of decreased visual acuity, visual field deficits, or ocular abnormalities were present in 13 patients. Duration of symptoms did not correlate with tumor subtype or event-free survival. In three patients with basal ganglionic/temporal lobe, thalamic, or pineal/suprasellar signal abnormalities on MRI, neuroradiographic diagnosis was difficult. CONCLUSIONS: Diagnosis of CNS germ cell tumor is often delayed, and presentation may include movement disorders or mimic psychiatric disease. MRI interpretation can be challenging and may require serum/CSF markers and biopsy for diagnosis.