Folie a deux is also known as psychosis of association or shared paranoid disorder. We describe a mother and her two daughters who experienced shared delusions and hallucinations during ...self-quarantine in COVID-19 pandemic. The mother was later diagnosed with schizophrenia and prescribed brexpiprazole, whereas her two daughters were diagnosed with psychosis of association affected by their mother.
Summary
Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. We hypothesised that the ...highly selective α2‐adrenergic agonist, dexmedetomidine, attenuates the systemic inflammatory response. Forty‐two patients were randomly assigned to receive dexmedetomidine or saline after aortic cross‐clamping). The mean (SD) levels of the nuclear protein plasma high‐mobility group box 1 increased significantly from 5.1 (2.2) ng.ml−1 during (16.6 (7.3) ng.ml−1) and after (14.3 (8.2) ng.ml−1) cardiopulmonary bypass in the saline group. In the dexmedetomidine group, the levels increased significantly only during cardiopulmonary bypass (4.0 (1.9) ng.ml−1 baseline vs 10.8 (2.7) ng.ml−1) but not after (7.4 (3.8) ng.ml−1). Dexmedetomidine infusion also suppressed the rise in mean (SD) interleukin‐6 levels after cardiopulmonary bypass (a rise of 124.5 (72.0) pg.ml−1 vs 65.3 (30.9) pg.ml−1). These suppressive effects of dexmedetomidine might be due to the inhibition of nuclear factor kappa B activation and suggest that intra‐operative dexmedetomidine may beneficially inhibit inflammatory responses associated with ischaemia‐reperfusion injury during cardiopulmonary bypass.
Lagrangian particle tracking experiments are conducted to investigate the pathways of deep water in the North Pacific Ocean. The flow field is taken from a state-of-the-art deep circulation ...simulation. An unprecedented number of particles are tracked to quantify the volume transport and residence time. Half of the North Pacific deep water returns to the Southern Ocean, and its principal pathway is along the western boundary current in the Southwest Pacific Basin in the deep layer. About 30% is exported to the Indian Ocean after upwelling to the shallow layer in the western North Pacific Ocean. The rest is transported to the Arctic Ocean through the Bering Strait or evaporates within the Pacific Ocean. Upwelling of deep water is confined in the western North Pacific Ocean owing to the strong vertical mixing. The mean residence time of deep water in the North Pacific Ocean is estimated to be several hundred years, which is consistent with the observed radiocarbon distribution.
Stacking fault energies (SFE) were determined in additively manufactured (AM) stainless steel (SS 316 L) and equiatomic CrCoNi medium-entropy alloys. AM specimens were fabricated via directed energy ...deposition and tensile loaded at room temperature. In situ neutron diffraction was performed to obtain a number of faulting-embedded diffraction peaks simultaneously from a set of (hkl) grains during deformation. The peak profiles diffracted from imperfect crystal structures were analyzed to correlate stacking fault probabilities and mean-square lattice strains to the SFE. The result shows that averaged SFEs are 32.8 mJ/m
for the AM SS 316 L and 15.1 mJ/m
for the AM CrCoNi alloys. Meanwhile, during deformation, the SFE varies from 46 to 21 mJ/m
(AM SS 316 L) and 24 to 11 mJ/m
(AM CrCoNi) from initial to stabilized stages, respectively. The transient SFEs are attributed to the deformation activity changes from dislocation slip to twinning as straining. The twinning deformation substructure and atomic stacking faults were confirmed by electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM). The significant variance of the SFE suggests the critical twinning stress as 830 ± 25 MPa for the AM SS 316 L and 790 ± 40 MPa for AM CrCoNi, respectively.
To better understand and predict the mechanical properties of additive manufacturing (AM) Al–Si–Mg alloys, developing a physically-based constitutive model is crucial. Among different models, the ...dislocation-density-based Kocks-Mecking (K-M) constitutive model has been widely used. Unfortunately, two challenges arise when the K-M model is used for the multiphase Al alloys. Firstly, an accurate K-M model demands the separation of phase stresses. Secondly, a thorough analysis of the K-M model involves the measurement of dislocation density during deformation. In-situ neutron diffraction, a powerful method to measure the phase stress and dislocation density in bulk polycrystalline materials under loading, is employed to investigate the AM AlSi3.5Mg1.5 and AlSi3.5Mg2.5 (wt.%) alloys. Based on the present results and reported data of AlSi10Mg, a multiscale constitutive model is developed for different AM Al–Si–Mg alloys. At the microscale, the evolution of dislocation density in the Al matrix with plastic strain can be well predicted by the K-M model. Meanwhile, the developments of the average stresses in different phases with plastic strain can be well captured by the Voce model. The measured microscopic k2/nc values agree with the theoretical value two of the K-M model quite well. Here, nc is the characteristic factor of the microscale Voce model, while k2 is the coefficient associated with the dynamic recovery process in the microscale K-M model. At the macroscale, the mechanical behavior can also be well reproduced by the K-M model and the Voce model. However, the macroscopic K2/Nc ratio is far away from two, where Nc and K2 are the characteristic factor and coefficient of the macroscale Voce model and K-M model, respectively.
•In-situ neutron diffraction of additive manufactured AlSi3.5Mg1.5 and AlSi3.5Mg2.5 has been conducted.•Crystal-orientation-dependent lattice strains, average phase stresses, and dislocation densities have been measured.•A multiscale Kocks-Mecking model has been developed based on the experimental data.•At the microscale, the determined k2/nc ratio agrees with the theoretical value two of the Kocks-Mecking model quite well.•At the macroscale, the determined K2/Nc ratio is far away from two.
The present study investigated the tensile deformation behavior of quenched and tempered martensite steels at various austenitization and tempering temperatures using in situ neutron diffraction ...experiments. Phase lattice strains in the bcc and cementite (θ) phases and dislocation structures in the bcc phase were analyzed. The phase lattice strain in bcc (εphasebcc) became almost stagnant after yielding as the tempering temperature increased. The phase lattice strain in θ increased linearly with an increase in the flow stress, independent of the austenitization and tempering temperatures. The stress partitioning between bcc and θ was confirmed after the yielding of bcc, which contributed to the work hardening. The phase stresses of bcc and θ and their stress partitioning improve the mechanical properties of martensite steels, which can be summarized by the systematic changes in phase lattice strain and dislocation properties due to the austenitization and tempering temperatures.
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The plastic deformation of the AlSi10Mg alloy manufactured via laser powder bed fusion (LPBF) is incompatible at the microscale, which causes residual strains/stresses and dislocation pile-ups at the ...Al/Si interfaces and grain boundaries. Hence, it is of fundamental significance to clarify these microscopic properties during plastic deformation. Here, in-situ neutron diffraction is employed to explore the residual strains, stresses, and dislocation density in the LPBF AlSi10Mg during loading-unloading-reloading deformation. It is found that the maximum residual stresses of the Al and Si phases in the loading direction reach up to about −115 (compressive) and 832 (tensile) MPa, respectively. A notable dislocation annihilation phenomenon is observed in the Al matrix: the dislocation density decreases significantly during unloading stages, and the amplitude of this reduction increases after experiencing a larger plastic deformation. At the macroscale, this dislocation annihilation phenomenon is associated with the reverse strain after unloading. At the microscale, the annihilation phenomenon is driven by the compressive residual stress in the Al matrix. Meanwhile, the annihilation of screw dislocations during unloading stages contributes to the reduction in total dislocation density.
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•In-situ neutron diffraction of additively manufactured AlSi10Mg during loading-unloading-reloading was conducted.•The residual stresses of Al and Si in the loading direction and their evolutions are quantified.•A notable dislocation annihilation phenomenon during unloading stages is detected and quantified.•Average fraction of edge dislocations increases, and that of screw ones decreases as the plastic deformation proceeds.
In situ neutron diffraction experiments have been performed under loading in cast-wrought (CW) and additively manufactured (AM) equiatomic CoCrNi medium-entropy alloys. The diffraction line profile ...analysis correlated the faulting-embedded crystal structure to the dislocation density, stacking/twin fault probability, and stacking fault energy as a function of strain. The results showed the initial dislocation density of 1.8 × 1013m−2 in CW and 1.3 × 1014m−2 in AM. It significantly increased up to 1.3 × 1015m−2 in CW and 1.7 × 1015m−2 in AM near fracture. The dislocation density contributed to the flow stress of 470 MPa in CW and 600 MPa in AM, respectively. Meanwhile, the twin fault probability of CW (2.7%) was about two times higher than AM (1.3%) and the stacking fault probability showed the similar tendency. The twinning provided strengthening of 360 MPa in CW and 180 MPa in AM. Such a favorable strengthening via deformation twinning in CW and dislocation slip in AM was attributed to the stacking fault energy. It was estimated as 18.6 mJ/m2 in CW and 37.5 mJ/m2 in AM by the strain field of dislocations incorporated model. Dense dislocations, deformation twinning, and atomic-scale stacking structure were examined by using electron backscatter diffraction (EBSD) and transmission electron microscopy (TEM).
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Although critical for methylation reactions, how dietary folate and B vitamins affect global DNA methylation level in colorectal cancers is currently unknown. Long interspersed nucleotide element-1 ...(LINE-1) is an emerging indicator of genome-wide DNA methylation level that has previously been linked to colon cancer survival.
We examined the association between dietary intake of folate, alcohol and B vitamins and LINE-1 hypomethylation in 609 incident colon cancers, utilising the database of two independent prospective cohort studies.
Participants with > or = 400 microg folate intake per day were significantly less likely to develop LINE-1 hypomethylated colon cancers than those reporting <200 microg of folate intake per day (RR=0.57, 95% CI=0.36 to 0.91 for <55% LINE-1 methylated colon tumours; RR=0.74, 95% CI=0.51 to 1.06 for 55-64% LINE-1 methylated colon tumours; and RR=1.08, 95% CI=0.66 to 1.75 for > or = 65% LINE-1 methylated tumours; P(interaction)=0.01). By contrast, high alcohol consumption conferred a higher risk of LINE-1 hypomethylated cancers (> or = 15 g alcohol per day versus none, RR=1.67, 95% CI=1.04 to 2.67 for <55% LINE1 methylated tumours; and RR=1.55, 95% CI=1.10 to 2.18 for 55-64% LINE-1 methylated tumours) but had no association with > or = 65% LINE-1 methylated tumours (RR=1.06, 95% CI=0.69 to 1.62). High intakes of vitamin B(6), B(12) or methionine were not significantly associated with colon cancers, regardless of LINE-1 methylation level.
The influence of dietary folate intake and alcohol consumption on colon cancer risk differs significantly according to tumoral LINE-1 methylation level.
The CpG island methylator phenotype (CIMP), characterised by widespread promoter methylation, is associated with microsatellite instability (MSI) and BRAF mutation in colorectal cancer. The ...independent effect of CIMP, MSI and BRAF mutation on prognosis remains uncertain.
Utilising 649 colon cancers (stage I-IV) in two independent cohort studies, we quantified DNA methylation in eight CIMP-specific promoters (CACNA1G, CDKN2A (p16), CRABP1, IGF2, MLH1, NEUROG1, RUNX3 and SOCS1) as well as CHFR, HIC1, IGFBP3, MGMT, MINT1, MINT31, p14, and WRN by using MethyLight technology. We examined MSI, KRAS and BRAF status. Cox proportional hazard models computed hazard ratios (HRs) for colon cancer-specific and overall mortalities, adjusting for patient characteristics and tumoral molecular features.
After adjustment for other predictors of patient survival, patients with CIMP-high cancers (126 (19%) tumours with >or=6/8 methylated CIMP-specific promoters) experienced a significantly low colon cancer-specific mortality (multivariate HR 0.44, 95% confidence interval (CI) 0.22 to 0.88), whereas the BRAF mutation was significantly associated with a high cancer-specific mortality (multivariate HR 1.97, 95% CI 1.13 to 3.42). A trend toward a low cancer-specific mortality was observed for MSI-high tumours (multivariate HR 0.70, 95% CI 0.36 to 1.37). In stratified analyses, CIMP-high tumours were associated with a significant reduction in colon cancer-specific mortality, regardless of both MSI and BRAF status. The relation between CIMP-high and lower mortality appeared to be consistent across all stages. KRAS mutation was unrelated to prognostic significance.
CIMP-high appears to be an independent predictor of a low colon cancer-specific mortality, while BRAF mutation is associated with a high colon cancer-specific mortality.