Long-term outcomes of esophageal atresia

Esophageal atresia (EA), a common congenital anomaly comprising interrupted esophagus with or without a tracheoesophageal fistula (TEF), affects one in 2840 newborns. Over half have associated anomalies. After EA repair in infancy, gastroesophageal reflux (GER) and esophageal dysmotility and respiratory problems are common. As there exist no previous population-based long-term follow-up-studies on EA, its long-term sequelae are unclear. The aims of this study were to assess the cancer incidence (I), esophageal morbidity and function (II), respiratory morbidity (III), and the spinal defects (IV) in adults with repaired EA. All patients treated for EA at the Hospital for Children and Adolescents, University of Helsinki, from 1947 to 1985 were identified, and those alive with their native esophagus were contacted, and the first hundred who replied made up the study group. The patients were interviewed, they filled in symptom questionnaires, and they underwent esophageal endoscopy and manometry, pulmonary function tests, and a full orthopedic evaluation was performed with radiographs of the spine. The questionnaire was also sent by mail to adults with repaired EA not attending the clinical study, and to 287 general population-derived controls matched for age, gender, and municipality of residence. Incidence of cancer among the study population was evaluated from the population-based countrywide cancer registry. 169 (72%) adults with repaired EA replied; 101 (42%) (58 male) participated in the clinical studies at a median age of 36 years (range, 22-56). Symptomatic GER occurred in 34% and dysphagia in 85% of the patients and in 8% and 2% of the controls (P<0.001 for both). The main endoscopic findings included hiatal hernia (28%), Barrett´s esophagus (11%), esophagitis (8%), and stenotic anastomosis (8%). Histology revealed esophagitis in 25 individuals, and epithelial metaplasia in another 21. At immunohistochemistry, CDX2-positive columnar epithelial metaplasia was present in all 21 individuals, and 6 of these also demonstrated goblet cells and MUC2 positivity. In all histological groups, GER and dysphagia were equally common (P=ns). Esophageal manometry demonstrated non-propagating peristalsis in most of the patients, and low ineffective pressure of the distal esophageal body in all. The changes were significantly worse in those with epithelial metaplasia (P≤0.022). Anastomotic complications (OR 8.6-24, 95%CI 1.7-260, P=0.011-0.008), age (OR 20, 95%CI 1.3-310, P=0.034), low distal esophageal body pressure (OR 2.6, 95%CI 0.7-10, P=0.002), and defective esophageal peristalsis (OR 2.2, 95%CI 0.4-11, P=0.014) all predicted development of epithelial metaplasia. Despite the high incidence of esophageal metaplasia, none of the EA patients had suffered esophageal cancer, according to the Finnish Cancer Registry. Although three had had cancer (SIR, 1.0; 95% CI, 0.20-2.8). The overall cancer incidence among adults with repaired EA did not differ from that of the general Finnish population. Current respiratory symptoms occurred in 11% of the patients and 2% of the controls (P<0.001). Of the patients, 16%, and 6% of the controls had doctor-diagnosed asthma (P<0.001). A total of 56% and 70% of the patients and 20% and 50% of the controls had a history of pneumonia and of bronchitis (P<0.001 for both). Respiratory-related impaired quality of life was observable in 11% of the patients in contrast to 6% of the controls (P<0.001). PFT revealed obstruction in 21 of the patients, restriction in 21, and both in 36. A total of 41 had bronchial hyper-responsiveness (BHR) in HCT, and 15 others had an asthma-like response. Thoracotomy-induced rib fusion (OR 3.4, 95%CI 1.3-8.7, P=0.01) and GER-associated epithelial metaplasia in adulthood (OR 3.0, 95%CI 1.0-8.9, P=0.05) were the most significant risk factors for restrictive ventilatory defect. Vertebral anomalies were evident in 45 patients, predominating in the cervical spine in 38. The most significant risk factor for the occurrence of vertebral anomalies was any additional anomaly (OR 27, 95%C I8-100). Scoliosis (over 10 degrees) was observable in 56 patients, over 20 degrees in 11, and over 45 degrees in one. In the EA patients, risk for scoliosis over 10 degrees was 13-fold (OR 13, 95%CI 8.3-21) and over 20 degrees, 38-fold (OR 38, 95%CI 14-106) when compared to that of the general population. Thoracotomy-induced rib fusion (OR 3.6, 95%CI 0.7-19) and other associated anomalies (OR 2.1, 95%CI 0.9-2.9) were the strongest predictive factors for scoliosis. Significant esophageal morbidity associated with EA extends into adulthood. No association existed between the esophageal symptoms and histological findings. Surgical complications, increasing age, and impaired esophageal motility predicted development of epithelial metaplasia after repair of EA. According to our data, the risk for esophageal cancer is less than 500-fold that of the general population. However, the overall cancer incidence among adults with repaired EA did not differ from that of the general population. Adults with repaired EA have had significantly more respiratory symptoms and infections, as well as more asthma, and allergies than does the general population. Thoracotomy-induced rib fusion and GER-associated columnar epithelial metaplasia were the most significant risk factors for the restrictive ventilatory defect that occurred in over half the patients. Over half the patients with repaired EA are likely to develop scoliosis. Risk for scoliosis is 13-fold after repair of EA in relation to that of the general population. Nearly half the patients had vertebral anomalies. Most of these deformities were diagnosed neither in infancy nor during growth. The natural history of spinal deformities seems, however, rather benign, with spinal surgery rarely indicated.

Low Temperature Synthesis of Nano-Crystalline CaCu3Ti4O12 Through aFuel Mediated Auto-Combustion Pathway

A novel, cost effective,environment-friendly and energetically beneficial alternative method for the synthesis of giant dielectric pseudo-perovskite material CaCu3Ti4O12 (CCTO) is presented. The method involved auto-combustion of an aqueous precursor solution in oxygen atmosphere with the help of external fuels and is capable of producing high amount of CCTO at ultra-low temperature, in the combustion residue itself. The amount of phase generated was observed to be highly dependent on the combustion process i.e. on the nature and amount of external-fuels added for combustion. Two successful fuel combinations capable of producing reasonably higher amount of the desired compound were investigated. On a structural characterization grain size was observed to decrease drastically to nano-dimension compared to submicron-size that was obtained in a traditional sol-gel combustion and subsequent cacination method. Therefore, the method reported can produce nano-crystalline CaCu3Ti4O12 ceramic matrix at an ultra-low temperature and is expected to be applicable for other multifunctional perovskite oxide materials.

Characterization of barium titanate fine powders formed from hydrothermal crystallization

A detailed evaluation of size, shape and microstrains of BaTiO3 crystallites produced by hydrothermal crystallization at 90 – 180 °C and 0.1 – 1.2 MPa, from amorphous TiO2· xH2O (3 < × < 8) gel and aqueous Ba(OH)2 is presented, using X-ray line-broadening and TEM studies. Whereas the concentration of Ba(OH)2 and the acceptor impurities affect the crystallite shape, the stoichimetry with respect to Ba/Ti, donor as well as acceptor impurities, and the temperature of crystallization influence the microstrains. It is shown that strains in the crystallites are related to the point defects in the lattice. Compensation of the residually present hydroxyl ions in the oxygen sublattice by cation vacancies results in strains leading to metastable presence of the cubic phase at room temperature. Studies on the diffuse phase transition behaviour of these submicron powders show that the stable tetragonal phase is produced only on annealing at high temperatures where the mobility of cations vacancies are larger. Heat-treatment reduces anisotropy and strain in undoped samples, whereas annealing is less effective in doped materials. Comparison of the crystillite size by TEM showed better agreement with the Warren—Averbach method.

Ultra-fine Grain Materials by Severe Plastic Deformation: Application to Steels

Severe plastic deformation techniques are known to produce grain sizes up to submicron level. This leads to conventional Hall-Petch strengthening of the as-processed materials. In addition, the microstructures of severe plastic deformation processed materials are characterized by relatively lower dislocation density compared to the conventionally processed materials subjected to the same amount of strain. These two aspects taken together lead to many important attributes. Some examples are ultra-high yield and fracture strengths, superplastic formability at lower temperatures and higher strain rates, superior wear resistance, improved high cycle fatigue life. Since these processes are associated with large amount of strain, depending on the strain path, characteristic crystallographic textures develop. In the present paper, a detailed account of underlying mechanisms during SPD has been discussed and processing-microstructure-texture-property relationship has been presented with reference to a few varieties of steels that have been investigated till date.

Hollow hemisphere and microcapsules of nonionic copolymer

Hemispherical colloidal nanowells or microwells with hollow interiors are becoming increasingly important for the encapsulation of functional materials. There has been rapid progress to develop new methods to obtain such structures. In this work, we present emulsification approach to generate hemisphere and microcapsules of biocompatible organic polymer. The precise control over the size is exhibited by applying variable vortex effect. The hemispheres and microcapsules of a copolymer (BPVA-PVA) were characterized by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). These structures were used for loading of hydrophilic molecules and submicron colloidal particles to demonstrate their potential application. The introduction of hydrophobic groups on poly(vinyl alcohol) was crucial to obtain these structures.

Q-Band beam wave-guide

Consideration is given to a 25-foot long Q-band (8 mm) confocal, zoned dielectric lens beam waveguide. Numerical expressions for the axial and radial fields are presented. The experimental set-up consisted of uniformly spaced zoned dielectric lenses, a transmitting horn and a receiving horn. It was found that: (1) the wave beam is reiterated when confocal, zoned dielectric lenses act as phase transformers in place of smooth surfaced transformers in beam waveguides; (2) the axial field is oscillatory near the source and the oscillation persists for about 25 cm from the source; (3) the oscillation disappears after one lens is used; (4) higher order modes with higher attenuation rates die out faster than fundamental modes; (5) phase transformers do not alter beam modes; (6) without any lens the beam cross-section broadens significantly in the Z-direction; (7) with one lens the beam exhibits the reiteration phenomenon; and (8) inserting a second lens on the axial and cross-sectional field distribution shows further the reiteration principle.

Combustion synthesis of rare earth cuprates

Rare earth cuprates, La2CuO4 Nd2CuO4, La1.8M0.2CuO4 (M=Ca.Sr) and Nd1.85Ce0.15CuO4 have been prepared by the combustion of redox mixtures containing corresponding metal nitrates and maleic hydrazide, C4H4N2O2, at 350°C. The solid combustion products are submicron size amorphous powders which on heat treatment (700°C, 30 minutes) yield crystalline single phase cuprates. Strontium doped lanthanum cuprate, La1.8Sr0.2CuO4, shows an onset of superconductivity at 36K.

Acoustic performance of hoses - A parametric study

Modeling of wave propagation in hoses, unlike in rigid pipes or waveguides, introduces a coupling between the inside medium, the hose wall, and the outside medium, This alters the axial wave number and thence the corresponding effective speed of sound inside the hose resulting in sound radiation into the outside medium, also called the breakout or shell noise, The existing literature on the subject is such that a hose cannot be integrated into the,whole piping system made up of sections of hoses, pipes, and mufflers to predict the acoustical performance in terms of transmission loss (TL), The present paper seeks to fill this gap, Three one-dimensional coupled wave equations are written to account for the presence of a yielding wall with a finite lumped transverse impedance of the hose material, The resulting wave equation can readily be reduced to a transfer matrix form using an effective wave number for a moving medium in a hose section, Incorporating the effect of fluid loading due to the outside medium also allows prediction of the transverse TL and the breakout noise, Axial TL and transverse TL have been combined into net TL needed by designers, Predictions of the axial as well as transverse TL are shown to compare well with those of a rigorous 3-D analysis using only one-hundredth of the computation time, Finally, results of some parametric studies are reported for engineers involved in the acoustical design of hoses. (C) 1996 Institute of Noise Control Engineering.

Aerosol radiative forcing due to enhanced black carbon at an urban site in India

[1] During a comprehensive aerosol field campaign, simultaneous measurements were made of aerosol spectral optical depths, black carbon mass concentration (M-b), total (M-t) and size segregated aerosol mass concentrations over an urban continental location, Bangalore (13 degreesN, 77 degreesE, 960 m msl), in India. Large amounts of BC were observed; both in absolute terms and fraction of total mass (similar to11%) and submicron mass (similar to23%) implying a significantly low single scatter albedo. The aerosol visible optical depth (tau(p)) was in the range 0.24 to 0.45. Estimated surface forcing is as high as -23 W m(-2) and top of the atmosphere (TOA) forcing is +5 Wm(-2) during relatively cleaner periods (tau(p) similar to 0.24). The net atmospheric absorption translates to an atmospheric heating of similar to0.8 K day(-1) for cleaner periods and similar to1.5 K day(-1) for less cleaner periods (tau(p) similar to 0.45). Our observations raise several issues, which may have impacts to regional climate and monsoon.

A waveguide problem involving a thick iris in the theory of electromagnetism

The problem of electromagnetic wave propagation in a rectangular waveguide containing a thick iris is considered for its complete solution by reducing it to two suitable integral equations, one of which is of the first kind and the other is of the second kind. These integral equations are solved approximately, by using truncated Fourier series for the unknown functions. The reflection coefficient is computed numerically from the two integral equation approaches, and almost the same numerical results are obtained. This is also depicted graphically against the wave number and compared with thin iris results, which are computed by using complementary formulations coupled with Galerkin approximations. While the reflection coefficient for a thin iris steadily increases with the wave number, for a thick iris it fluctuates and zero reflection occurs. The number of zeros of the reflection coefficient for a thick iris increases with the thickness. Thus a thick iris becomes completely transparent for some discrete wave numbers. This phenomenon may be significant in the modelling of rectangular waveguides.

Densification and microstructure development in spark plasma sintered WC–6 wt% ZrO2 nanocomposites

In this paper, we report the results of a transmission electron microscopy investigation on WC–6 wt% ZrO2nanocomposite, spark plasma sintered at 1300 °C, for varying times of up to 20 min. The primary aim of this work was to understand the evolution of microstructure during such a sintering process. The investigation revealed the presence of nanocrystalline ZrO2particles (30–50 nm) entrapped within submicron WC grains. In addition, relatively coarser ZrO2(60–100 nm) particles were observed to be either attached to WC grain boundaries or located at WC triple grain junctions. The evidence of the presence of a small amount of W2C, supposed to have been formed due to sintering reaction between WC and ZrO2, is presented here. Detailed structural investigation indicated that ZrO2in the spark plasma sintered nanocomposite adopted an orthorhombic crystal structure, and the possible reasons for o-ZrO2formation are explained. The increase in kinetics of densification due to the addition of ZrO2is believed to be caused by the enhanced diffusion kinetics in the presence of nonstoichiometric nanocrystalline ZrO2.

Microwave preparation and sintering of industrially important perovskite oxides: LaMO3 (M = Cr, Co, Ni)

Perovskite oxides LaMO3 (M = Cr, Co, Ni), have been successfully prepared using microwaves of 2.45 GHz. Microwave preparation is rapid, clean and energy efficient. Preparation of LaCrO3, LaCoO3 and LaNiO3 has been achieved in 3 min, 5 min and 10 min respectively. Direct reaction between component oxides is used for the preparation of LaCrO3 and LaCoO3, whereas nitrates are used as starting materials for LaNiO3 preparation. Products have been characterized using XRD, IR spectroscopy and SEM. Their dc electrical conductivity has also been studied and their fracture behaviour has been examined. All three microwave prepared oxide powders are of submicron size. These perovskite oxides have been sintered to very high densities using microwaves. Possible mechanisms of the microwave-material interaction both during preparation and during sintering have been discussed.

Spectral Finite Element Modeling of Complex Structures for Applications in Real-time Structural Health Monitoring

In this paper we discuss the recent progresses in spectral finite element modeling of complex structures and its application in real-time structural health monitoring system based on sensor-actuator network and near real-time computation of Damage Force Indicator (DFI) vector. A waveguide network formalism is developed by mapping the original variational problem into the variational problem involving product spaces of 1D waveguides. Numerical convergence is studied using a h()-refinement scheme, where is the wavelength of interest. Computational issues towards successful implementation of this method with SHM system are discussed.

Microstructure and texture evolution during accumulative roll bonding of aluminium alloy AA5086

In the present investigation, a strongly bonded strip of an aluminium-magnesium based alloy AA5086 is successfully produced through accumulative roll bonding (ARB). A maximum of up to eight passes has been used for the purpose. Microstructural characterization using electron backscatter diffraction (EBSD) technique indicates the formation of submicron sized (similar to 200-300 nm) subgrains inside the layered microstructure. The material is strongly textured where individual layers possess typical FCC rolling texture components. More than three times enhancement in 0.2% proof stress (PS) has been obtained after 8 passes due to grain refinement and strain hardening. (C) 2011 Elsevier B.V. All rights reserved.

Microstructure evolution and metastable phase formation in laser-ablation-deposited films of Ti5Si3 intermetallic compound

Thin films of Ti62.5Si37.5 composition were deposited by the pulsed-laser ablation technique on single-crystal Nad substrates at room temperature and on ′single-crystal′ superalloy substrates at elevated temperatures. Both vapour and liquid droplets generated by pulsed-laser ablation of the target become quenched on the substrate. Amorphization had taken place in the process of quenching of vapour-plasma as well as small liquid droplets on NaCl substrates at room temperature. In addition to the formation of Ti5Si3, a metastable fcc phase (a 0 = 0.433 nm) also forms in micron-sized large droplets as well as in the medium-sized submicron droplets. The same metastable fcc phase nucleates during deposition from the vapour state at 500°C and at 600°C on a superalloy substrate as well as during crystallization of the amorphous phase. The evolution of the metastable fcc phase in the Ti-Si system during non-equilibrium processing is reported for the first time.