Controlling tetragonality and crystalline orientation in BaTiO3 nano-layers grown on Si.

A hybrid growth process was developed in order to epitaxially integrate nano-layers of the multi-functional perovskite BaTiO3 onto Si(001) substrates. In particular, we combined molecular beam epitaxy (MBE) with radio-frequency sputtering. Due to its strong influence on the functional properties, the crystalline structure of the layers was thoroughly investigated throughout our study. MBE-grown seed layers are tetragonal and c-axis oriented up to a thickness of 20 nm. A transition into a-axis films is visible for thicker layers. When the seed layer thickness exceeds 6 nm, subsequently sputtered BaTiO3 films are epitaxial. However, their crystalline structure, their orientation with respect to the substrate, and their morphology are strongly dependent on the deposition and post-deposition thermal budget. Consistently with their crystalline symmetry, thin MBE BaTiO3 films are piezo- and ferroelectric with a spontaneous polarization perpendicular to the surface. Also for thick films, the functional response, as determined via piezo-force microscopy, is in good agreement with the structural properties.

Effects of low energy emission therapy in chronic psychophysiological insomnia.

The treatment of chronic psychophysiological insomnia presents a challenge that has not been met using currently available pharmacotherapy. Low energy emission therapy (LEET) has been developed as a potential alternative therapy for this disorder. LEET consists of amplitude-modulated electromagnetic fields delivered intrabuccally by means of an electrically conducting mouthpiece in direct contact with the oral mucosa. The effect of LEET on chronic psychophysiological insomnia was assessed with polysomnography (PSG) and sleep rating forms on a total of 106 patients at two different centers. Active or inactive LEET was administered for 20 minutes in late afternoon three times a week for a total of 12 treatments. Primary efficacy endpoints evaluating the results were changes from baseline in PSG-assessed total sleep time (TST) and sleep latency (SL). Secondary endpoints were changes in sleep efficiency (SE), sleep stages, and reports by the subjects of SL and TST. There was a significant increase in TST as assessed by PSG between baseline and post-treatment values for the active treatment group (76.0 +/- 11.1 minutes, p = 0.0001). The increase for the inactive treatment group was not statistically significant. The TST improvement was significantly greater for the active group when compared to the inactive group (adjusted for baseline TST; p = 0.020. R1 = 0.20). There was a significant decrease in SL as assessed by PSG between baseline and post-treatment values for the active treatment group (-21.6 +/- 5.9 minutes, p = 0.0006), whereas the decrease noted for the inactive treatment group was not statistically significant. The difference in SL decrease between the two treatment groups was marginally significant (adjusted for baseline SL and center, p = 0.068, R2 = 0.60). The number of sleep cycles per night increased by 30% after active treatment (p = 0.0001) but was unchanged following inactive treatment. Subjects did not experience rebound insomnia, and there were no significant side effects. The data presented in this report indicate that LEET administered for 20 minutes three times a week increased TST and reduced SL in chronic psychophysiological insomnia. LEET is safe and well tolerated and it effectively improved the sleep of chronic insomniacs given 12 treatments over a 4-week period by increasing the number of sleep cycles without altering the percentage of the various sleep stages during the night. The therapeutic action of LEET differs from that of currently available drug therapies in that the sleep pattern noted in insomniacs following LEET treatment more closely resembles nocturnal physiological sleep. This novel treatment may offer an attractive alternative therapy for chronic insomnia.

Cervical spondylolisthesis.

Cervical spondylolisthesis is a rare, unusual finding in patients with neck pain. Cervical pain without neurological deficit is most often seen with this abnormality. It usually involves a defect in the pedicle of the sixth cervical vertebra. Anterior interbody cervical fusion is recommended as the treatment of choice.

Living with a permanent cardiac pacemaker.

Responses of 30 cardiac pacemaker recipients showed that 90 per cent were aware of warning signs and symptoms prior to pacemaker implantation, but only 37 per cent sought medical attention when the initial warning signs were evident. The group which sought care experienced more symptoms per patient than the other groups which did not seek early treatment. The most commonly occurring symptoms experienced by the patients prior to pacemaker insertion were blackouts and slow regarding pacemaker implantation were made by the physician alone. Patients took inventory after implantation, and 60 per cent reported that they were fortunate to have received a pacemaker. During the inventory and long-term recovery stages, patients who thought they had experienced few life-style changes after receiving a cardiac pacemaker reported positive feelings about living with a cardiac pacemaker. Many of the patients' problems in adjusting to a permanently implanted cardiac pacemaker and participating in its maintenance were related to a lack of accurate information about what to expect or how to assure normal functioning of the pacemaker.

Neuronal ceroid-lipofuscinosis in a domestic cat: clinical, morphological and immunohistochemical findings.

A 9-month-old domestic shorthair cat was humanely killed because of uncoordinated gait, myoclonus, seizures and reduced vision. Histological, immunohistochemical and ultrastructural examination revealed a neuronal storage disease consistent with neuronal ceroid-lipofuscinosis (NCL). Neurons contained Sudan black- and luxol fast blue-positive material which was autofluorescent. Immunohistochemically, the storage material was found to contain subunit c of mitochondrial ATP synthase, a protein recently recognized as the main component of the storage material in NCL. Ultrastructurally, the material consisted of curvilinear and fingerprint bodies, which are indicative of NCL.

Relationship of field dependence-independence to documentation of nursing-process components by registered nurses in a clinical setting.

Scores on the Group Embedded Figures Test of 56 registered staff nurses were correlated with percentage of components of nursing process documented on care plans and progress notes. Education, age, and work experience were control variables. The mean embedded figures scores for associate degree, diploma, and baccalaureate nurses were 11.47, 9.47, and 12.83, respectively. Baccalaureate nurses had the most success in documenting components and diploma nurses had the least. A significant correlation was observed between test scores and percentage of nursing process chains completed by diploma nurses. For associate-degree nurses, a significant inverse correlation was observed between test scores and percentage of components used and percentage of chains with a nursing diagnosis.

El recién nacido expuesto a cocaína antenatal: una propuesta de intervención médica y psicosocial integrada / The newborn exposed to antenatal cocaine: a proposal for integrated medical and psychosocial intervention

Introducción: El consumo de cocaína durante la gestación gatilla isquemia, muerte y licuefacción celular en el cerebro fetal, consolidando en la infancia grados variables de retraso mental. El presente estudio busca identificar mediante test de drogas en orina los recién nacidos (RN) expuestos a cocaína en el embarazo y describir el procedimiento clínico y social a seguir. Metodología: Estudio de cohorte prospectivo enero 2016 y enero 2018 en RN con exposición antenatal a cocaína, Unidad de Neonatología del Hospital Clínico San Borja Arriarán. Resultados: Se estudió a 64 RN con test en orina positivo a cocaína. El 42% fue pequeño para la edad gestacional, 33% tenía microcefalia. Se encontraron malformaciones en sistema nervioso y vías urinarias, trastornos del ritmo cardíaco e hipoacusia. Solo 32,8% de las madres controló su embarazo y 52% rechazó la rehabilitación. Servicio Social interpuso medidas de protección a los RN e instó a las madres a programas de rehabilitación. El 12,5% de los RN no tenía familia de apoyo y debió ser derivado a instituciones gubernamentales. Conclusiones: Las consecuencias de la exposición a cocaína antenatal en el RN son devastadoras. Este trabajo permite orientar la pesquisa, estudio y pasos legales a seguir con los RN afectados y sus madres.

Introduction: The consumption of cocaine during pregnancy triggers events such as ischemia, death and cell liquefaction in the fetal brain, consolidating varying degrees of intellectual disability. This study proposed to identify by urine drug test the newborns (NB) with antenatal exposure to and describe the clinical and social procedure to follow with them and their mothers until neonatal discharge. Methodology: Prospective cohort study, conducted in RN who met criteria for risk of antenatal exposure to cocaine, Neonatology Unit of the San Borja Arriaran Clinical Hospital between January 2016 -2018. Results: Antenatal exposure to cocaine was confirmed on 64 NB. Forty-two percent of them were small for gestational age and 33% had microcephaly. Malformations were found in the nervous system urinary tract, as well as disorders in the rhythm of the heart and loss of hearing. Only 32% of mothers controlled her pregnancy, none of them was derived to the secondary. Social Services implemented all the NB protective measures in place and urged mothers to participate in rehabilitation programs. Fifty-two percent rejected rehabilitation and 12.5% of the NB have not family support and had to be referred to government institutions. Conclusions: The consequences of exposure to antenatal cocaine in the NB are devastating. This work allows orienting the research with the NB and showing the legal steps should be taken with the RN and their mothers.

Central neurogenic pulmonary edema: with a review of its pathogenesis and treatment.

One of the unusual signs of sudden increase in intracranial pressure is central neurogenic pulmonary edema. This pulmonary edema produces a capillary-aveolar block resulting in hypoxia complicating the underlying neurologic condition. Good success in treating this problem has been obtained with controlled ventilation and positive end expiratory pressure respiration.