Introduction
The objective of this study was to determine the normal anal position index (API) in neonates and in a group of older children with chronic constipation, and to identify the incidence of ...anterior ectopic anus (AEA) in the two groups.
Materials and methods
A prospective random study was carried out in two European hospitals determining the API in 1,012 neonates (529 in Group A, and 483 in Group B) and in 64 children suffering chronic constipation of ages between 3 months and 12 years (Group C). The API is defined as the ratio between the fourchette-anal and fourchette-coccygeal distances in girls and the scroto-anal and scroto-coccygeal distances in boys. The gestational age, weight, meconium evacuation and anal calibre were recorded in Groups A and B, and age, sex, and API in Group C. Statistical comparisons were made using Student’s
t
test and Welch’s
t
test for independent sample groups.
Results
The mean API in Group A was 0.53 ± 0.06 in males and 0.40 ± 0.05 in females, and in Group B 0.51 ± 0.06 in males and 0.39 ± 0.08 in females, with significant differences between the sexes (
p
< 0.0001) in both groups; 1.7% of the neonates in Group A and 2.4% of Group B presented AEA. 4/13 newborns females with AEA presented with severe constipation during their first months of life. For the 64 patients in Group C: 59.3% were female; the mean API was 0.47 ± 0.1 in males and 0.36 ± 0.1 in females (
p
< 0.0001). The incidence of AEA was 47% in females and 35% in males.
Conclusions
In the neonates (Groups A and B), the position of the anus in the perineum was more anterior in females than in males (
p
< 0.0001); 31% of the newborns females with AEA presented with constipation in their first months of life. In the Group C patients, there was a high incidence of AEA, especially in the females, and we consider it to be the probable cause of this defecation disorder.
Imperforate anus represents a wide spectrum of anorectal malformations associated with urologic, neurologic and orthopedic malformations. The outcome from the various corrective measures has improved ...due to new surgical techniques as well as to a better understanding of the pathology. Other factors which influence the overall outcome include the degree of patient acceptance, family support as well as the ability of the health care structure to support the patient's needs on a clinical, functional and psychologic level.
Assess (with the new techniques available) the quality of life in the adult patient with ARM and compare it to that experienced by a younger patient; also we wish to determine the correlation between the observed abnormalities with the functional, neurologic and urologic outcome.
Sixty-six patients were subjected to PSARP (36 M; 30 F). Six presented with cloaca and 60 with ARM (23 high and 37 low). All patients underwent the same workup to include L/S MRI diagnostics, evaluation for incontinence (urinary and bowel), a urology screening, and if required, a subsequent urodynamic study with rehabilitation and/or bowel management. All answered questionnaires (AIMAR: Italian parent's association of ARM) in order to assess their satisfaction with the current health condition, with the information received and with the treatment and follow-up sessions. The patients were classified into one of two groups. Group A, totaled 33 patients (4 cloacae) with an age range between 2 and 12 years who were operated after 1995. The second, group B, was made up of 33 patients who had been surgically treated before 1995 (age range 15-41 years), had followed the study protocol and had also a neuropsychiatry consult.
Overall fecal continence was 69% and of this number 37% were clean without constipation. Twe2nty-one patients (32%) suffered from some form of constipation. Constipation was the most common functional disorder observed in patients who have undergone PSARP. The highest incidence of constipation was found in the ARM (low type), a favorable prognostic group with 43% constipation. Patient with "high" defects and a cloaca had a lower incidence of constipation (18%). Of the 59 patients evaluated, 85% were urinary continent and 15% were incontinent. All of the incontinent patients were in the unfavorable prognostic group of malformations. Urodynamic studies showed 7 neurogenic bladders (NB) and 2 patients with a neurovescical dysfunction (NVD). Of the 50 "dry" patients. 20 had voiding disturbances due to a voiding dysfunction, in the absence of neurologic abnormalities, and presented occasional daytime or nighttime wetting. There was no correlation between the level of the anatomic defect and the urodynamic patterns in the group. Abnormal MRI findings were observed in thirty out of fifty-two patients evaluated. The MRI findings were classified as follows. Severe abnormalities: 7 patients (13%) presented with a combination of skeletal (sacral/lumbar) and spinal cord anomalies. Only spinal cord abnormalities: 12 patients (21%). Only skeletal abnormalities: 11 (19%) patients. Patients were divided into high, low and cloacal malformations. A high degree of statistical correlation was noted between the patients belonging to the cloacae and high defect groups and the abnormal MRI findings. No significant correlation was found between the low defect group and dysrafism, abnormal MRI results and the severity of the malformation. The incidence of Tethered Cord (TC) in our limited number of patients was limited in our study (9% in the high and 7% in the low defect group) when compared to the current literature. Furthermore there was no statistically conclusive evidence that TC by itself affects the urinary or fecal control in our patients. Our recommendation is nevertheless to obtain an MRI study in all patients with ARM.
All patients 17 and older reported a "good quality of life". Four are married, two with children. Aclose working relationship with the medical personnel is not only necessary but is also well received by the family particularly when younger patients are involved. The adult patient easily adapts even when information is initially scarce. He quickly reaches autonomy with personalized solutions but prefers a longer follow-up time during which, specialized medical facilities will play an important role in the treatment of ARM. Our findings illustrate the importance of both global disease-specific functioning and perceived psychosocial competencies for enhancing the QL of these patients.
Our recent paper (Tamburini et al 2012 New J. Phys. 14 033001), which presented results from outdoor experiments that demonstrate that it is physically feasible to simultaneously transmit different ...states of the newly recognized electromagnetic (EM) quantity orbital angular momentum (OAM) at radio frequencies into the far zone and to identify these states there, has led to a comment (Tamagnone et al 2012 New J. Phys. 14 118001). These authors discuss whether our investigations can be regarded as a particular implementation of the multiple-input-multiple-output (MIMO) technique. Clearly, our experimental confirmation of a theoretical prediction, first made almost a century ago (Abraham 1914 Phys. Z. XV 914-8), that the total EM angular momentum (a pseudovector of dimension length × mass × velocity) can propagate over huge distances, is essentially different from-and conceptually incompatible with-the fact that there exist engineering techniques that can enhance the spectral capacity of EM linear momentum (an ordinary vector of dimension mass × velocity). Our OAM experiments (Tamburini et al 2012 New J. Phys. 14 033001; Tamburini et al 2011 Appl. Phys. Lett. 99 204102-3) confirm the availability of a new physical layer for real-world radio communications based on EM rotational degrees of freedom. The next step is to develop new protocols and techniques for high spectral density on this new physical layer. This includes MIMO-like and other, more efficient, techniques.
Bioprobes immobilization methods that elevate the probes from the substrate are generally preferred in microarray technology because they prevent steric limitations during the hybridization of the ...target to probes. A versatile approach to control the thickness of a polymeric coating based on click chemistry to obtain covalently linked layer-by-layer coatings for surface functionalization is presented. By alternating cycles of coating using copolymers bearing click groups, the thickness of the film increases, while remaining functional and stable. Click chemistry reactions provide numerous advantages over standard conjugation procedures typically used in microarrays. They include: quantitative yields and insensitivity of the reaction to pH and hydrolysis. Moreover, click reactions do not interfere with organic groups naturally present in DNA, proteins and peptides such as amino and carboxyl groups allowing orthogonal and chemoselective probe immobilization. In addition to the formation of multilayers, click reactions allow to bind biomolecules to polymer chains generating so-called polymeric probes, which are then immobilized on microarray supports. In a microarray assay of clinical relevance, this methodology provides a miniaturized, tri-dimensional multilayer with higher density of capture probe, improved hybridization efficiency and sensitivity.
Abstract
The experimental fusion reactor ITER will feature two (or three) heating neutral beam injectors (NBI) capable of delivering 33(or 50) MW of power into the plasma. A NBI consists of a plasma ...source for production of negative ions (extracted negative ion current up to 329 A/m
2
in H and 285 A/m
2
in D) then accelerated up to 1 MeV for one hour. The negative ion beam is neutralized, and the residual ions are electrostatically removed before injection. The beamline was designed for a beam divergence between 3 and 7 mrad.
The ion source in ITER NBIs relies on RF-driven, Inductively-Coupled Plasmas (ICP), based on the prototypes developed at IPP Garching; RF-driven negative-ion beam sources have never been employed in fusion devices up to now. The recent results of SPIDER, the full size ITER NBI ion source operating at NBTF in Consorzio RFX, Padova, measure a beamlet divergence minimum of 12mrad and highlighted beam spatial non-uniformity. SPIDER results confirmed the experimental divergence found in smaller prototype sources, which is larger compared to filament-arc ion sources. Although prototype experiments have shown that the extracted current requirement can be achieved with minor design improvements, the beamlet divergence is expected to marginally achieve the design value of 7 mrad, which in multi-grid long accelerators results in unexpected heat loads over the accelerator grids. A contributor to the beam divergence is the energy/temperature of the extracted negative ions, so it is believed that plasma differences between the two source types play a role. Research is focused on the plasma parameters in the ion source.
One RF driver, identical to the ones used in SPIDER, installed in a relatively small-scale experimental set-up, inherently more flexible than large devices, is starting operations devoted to the investigation of the properties of RF-generated plasmas, so as to contribute to the assessment of negative ion precursors, and of their relationship with the plasma parameters, particularly when enhancing plasma confinement. The scientific questions, that have arisen from the preliminary results of SPIDER, guided the design of the test stand, which are described in this contribution, together with the diagnostic systems and related simulation tools. The test stand, which shares with the larger experiment all the geometrical features and constraints, will allow technological developments and optimized engineering solutions related to the ICP design for the ITER NBIs.
In this paper we report the results from outdoor experiments showing that it is possible to increase the data transmission capacity using at least three coherent, orthogonal beams on the same ...frequency, 17.128 GHz, each in a unique orbital angular momentum state. Each beam was encoded with the digital modulations used in present‐day telecommunications. We achieved an error‐free throughput of 3 × 11 Mbit/s with four‐Quadrature Amplitude Modulation over a 7 MHz bandwidth over 100 m and 150 m long links.
Key Point
Experimental results of a triple radio link with OAM beams
We introduce a new optical vortex coronagraph (OVC) method to determine the angular distance between two sources when the separation is sub-Rayleigh. We have found a direct relationship between the ...position of the minima and the source angular separation. A priori knowledge about the location of the two sources is not required. The superresolution capabilities of an OVC, equipped with an ℓ = 2 N-step spiral phase plate in its optical path, were investigated numerically. The results of these investigations show that a fraction of the light, increasing with N, from the secondary source can be detected with a sub-Rayleigh resolution of at least 0.1 λ/D.
The development of high brilliance X-ray sources coupled with advances
in manufacturing technologies has led to significant improvements in submicrometre
probes for spectroscopy, diffraction and ...imaging applications. The generation
of a small beam spot size is commonly based on three principles:
total reflection (as used in optical elements involving mirrors or capillaries),
refraction (such as in refractive lenses) and diffraction.
The latter effect is employed in Bragg-Fresnel or Soret lenses, commonly
known as Fresnel zone plate lenses. These lenses currently give the best spatial
resolution, but are traditionally limited to rather soft X-rays-at high
energies, their use is still limited by their efficiency. Here we report the
fabrication of high-efficiency, high-contrast gold and nickel multistep (quaternary)
Fresnel zone plates using electron beam lithography. We achieve a maximum
efficiency of 55% for the nickel plate at 7 keV. In addition to their
high efficiency, the lenses offer the advantages of low background signal
and effective reduction of unwanted diffraction orders. We anticipate that
these lenses should have a significant impact on techniques such as microscopy, micro-fluorescence and micro-diffraction,
which require medium resolution (500-100 nm) and high flux at
fixed energies.
The GALILEO γ-ray array at the Legnaro National Laboratories Goasduff, A.; Mengoni, D.; Recchia, F. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
11/2021, Letnik:
1015
Journal Article
Recenzirano
Odprti dostop
GALILEO, a new 4π high-resolution γ-detection array, based on HPGe detectors, has been developed and installed at the Legnaro National Laboratories. The GALILEO array greatly benefits from a ...fully-digital read-out chain, customized DAQ, and a variety of complementary detectors to improve the resolving power by the detection of particles, ions or high-energy γ-ray transitions. In this work, a full description of the array, including electronics and DAQ, is presented together with its complementary instrumentation.
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