A comparison of two high spatial resolution imaging techniques for determining carbide precipitate type and size in ferritic 9Cr-1Mo steel.

Two high spatial resolution imaging techniques, focused gallium ion beam imaging in conjunction with XeF2 gas (FIB/XeF2) and high-speed atomic force microscopy (HS-AFM), were used to analyse 9Cr-1Mo ferritic steel samples, which had been exposed for extended periods to hot CO2 gas containing traces of CO, H2, H2O and CH4. The carbide precipitates embedded in the metal matrix were observed and their morphology, size and spatial distribution were quantified using these two techniques. The lower resolution of the FIB/XeF2 imaging technique suggested that small carbide precipitates (<50 nm) may be missed, while the existence of a limited flow layer introduced by sample preparation may influence the HS-AFM results. The gallium ion beam was used to remove a thin oxide layer of approximately 50 nm from sample surfaces prior to FIB/XeF2 imaging, avoiding the influence of surface contamination. HS-AFM provided higher resolution (∼5 nm) than FIB/XeF2 imaging. A quantitative comparison of the experimental data confirmed the value of both FIB/XeF2 and HS-AFM for imaging carbide precipitates, while clarifying their strengths and limitations.

Cascading processes in a changing environment: Disturbances on fluvial ecosystems in Chile and implications for hazard and risk management.

The compound hazard effects of multiple process cascades severely affect Chilean river systems and result in a large variety of disturbances on their ecosystems and alterations of their hydromorphologic regimes leading to extreme impacts on society, environment and infrastructure. The acute, neo-tectonically pre-determined susceptibility to seismic hazards, the widespread volcanic activity, the increasing glacier retreat and the continuous exposure to forest fires clearly disturb entire riverine systems and concur to trigger severe floods hazards. With the objective to refine the understanding of such cascading processes and to prospect feasible flood risk management strategies in such a rapidly changing environment we first classify the large river basins according to a set of disturbances (i.e. volcanic eruptions, earthquakes, glacier lake outburst floods, wild fires and mass movements). Then, we describe emblematic cases of process cascades which affected specific Chilean drainage basins and resulted in high losses as tangible examples of how the cascading processes may unfold in other river basins with similar characteristics. As an attempt to enrich the debate among management authorities and academia in Chile, and elsewhere, on how to sustainably manage river systems, we: a) highlight the pivotal need to determine the possible process cascades that may profoundly alter the system and b) we suggest to refine hazard and risk assessments accordingly, accounting for the current and future exposure. We advocate, finally, for the adoption of holistic approaches promoting anticipatory adaptation which may result in resilient system responses.

The Singaporean public beliefs about the causes of mental illness: results from a multi-ethnic population-based study.

AIMS: To identify the common causal beliefs of mental illness in a multi-ethnic Southeast Asian community and describe the sociodemographic associations to said beliefs. The factor structure to the causal beliefs scale is explored. The causal beliefs relating to five different mental illnesses (alcohol abuse, depression, obsessive-compulsive disorder (OCD), dementia and schizophrenia) and desire for social distance are also investigated. METHODS: Data from 3006 participants from a nationwide vignette-based study on mental health literacy were analysed using factor analysis and multiple logistic regression to address the aims. Participants answered questions related to sociodemographic information, causal beliefs of mental illness and their desire for social distance towards those with mental illness. RESULTS: Physical causes, psychosocial causes and personality causes were endorsed by the sample. Sociodemographic differences including ethnic, gender and age differences in causal beliefs were found in the sample. Differences in causal beliefs were shown across different mental illness vignettes though psychosocial causes was the most highly attributed cause across vignettes (endorsed by 97.9% of respondents), followed by personality causes (83.5%) and last, physical causes (37%). Physical causes were more likely to be endorsed for OCD, depression and schizophrenia. Psychosocial causes were less often endorsed for OCD. Personality causes were less endorsed for dementia but more associated with depression. CONCLUSIONS: The factor structure of the causal beliefs scale is not entirely the same as that found in previous research. Further research on the causal beliefs endorsed by Southeast Asian communities should be conducted to investigate other potential causes such as biogenetic factors and spiritual/supernatural causes. Mental health awareness campaigns should address causes of mental illness as a topic. Lay beliefs in the different causes must be acknowledged and it would be beneficial for the public to be informed of the causes of some of the most common mental illnesses in order to encourage help-seeking and treatment compliance.

Association between recognition and help-seeking preferences and stigma towards people with mental illness.

AIMS: The ability to recognise a mental illness has important implications as it can aid in timely and appropriate help-seeking, and ultimately improve outcomes for people with mental illness. This study aims to explore the association between recognition and help-seeking preferences and stigmatising attitudes, for alcohol abuse, dementia, depression, obsessive-compulsive disorder (OCD) and schizophrenia, using a vignette-based approach. METHODS: This was a population-based, cross-sectional survey conducted among Singapore Residents (n = 3006) aged 18-65 years. All respondents were asked what they think is wrong with the person in the vignette and who they should seek help from. Respondents were also administered the Personal and Perceived sub scales of the Depression Stigma Scale and the Social Distance Scale. Weighted frequencies and percentages were calculated for categorical variables. A series of multiple logistic and linear regression models were performed separately by vignette to generate odd ratios and 95% confidence intervals for the relationship between help-seeking preference, and recognition and beta coefficients and 95% confidence intervals for the relationship between stigma and recognition. RESULTS: Correct recognition was associated with less preference to seek help from family and friends for depression and schizophrenia. Recognition was also associated with increased odds of endorsing seeking help from a psychiatric hospital for dementia, depression and schizophrenia, while there was also an increased preference to seek help from a psychologist and psychiatrist for depression. Recognition was associated with less personal and perceived stigma for OCD and less personal stigma for schizophrenia, however, increased odds of social distancing for dementia. CONCLUSION: The ability to correctly recognise a mental illness was associated with less preference to seek help from informal sources, whilst increased preference to seek help from mental health professionals and services and less personal and perceived stigma. These findings re-emphasise the need to improve mental health literacy and reinforce the potential benefits recognition can have to individuals and the wider community in Singapore.

Stigma towards people with mental disorders and its components - a perspective from multi-ethnic Singapore.

AIMS: The current study aimed to: (i) describe the extent of overall stigma as well as the differences in stigma towards people with alcohol abuse, dementia, depression, schizophrenia and obsessive compulsive disorder, as well as (ii) establish the dimensions of stigma and examine its correlates, in the general population of Singapore, using a vignette approach. METHODS: Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. The study population comprised Singapore Residents (Singapore Citizens and Permanent Residents) aged 18-65 years who were living in Singapore at the time of the survey. All respondents were administered the Personal and Perceived scales of the Depression Stigma scale and the Social Distance scale to measure personal stigma and social distance, respectively. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Exploratory structural equation modelling and confirmatory factor analysis were used to establish the dimensions of stigma. Multivariable linear regressions were conducted to examine factors associated with each of the stigma scale scores. RESULTS: The mean age of the respondents was 40.9 years and gender was equally represented (50.9% were males). The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising 'weak-not-sick' and 'dangerous/unpredictable' while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores. Those administered the alcohol abuse vignette were associated with higher social distance scores. CONCLUSION: This population-wide study found significant stigma towards people with mental illness and identified specific groups who have more stigmatising attitudes. The study also found that having a friend or family member with similar problems was associated with having lower personal as well as social distance stigma. There is a need for well-planned and culturally relevant anti-stigma campaigns in this population that take into consideration the findings of this study.

Gitelman syndrome disclosed by calcium pyrophosphate deposition disease: early diagnosis by ultrasonographic study.

Gitelman's syndrome is a rare autosomal-recessive tubular disorder characterized by hypomagnesemia and hypocalciuria associated to hypokalemia. The clinical spectrum is wide and usually characterized by chronic fatigue, cramps, muscle weakness and paresthesiae. We describe a case of a 43 year-old male patient with early onset of knee arthritis and no other symptoms. Ultrasound revealed diffuse and confluent hyperechoic deposits in cartilage, fibrocartilage of the menisci and synovium and calcium pyrophosphate crystals were observed in the synovial fluid of the knee. The concomitant presence of hypomagnesemia, hypocalciuria and hypokalemia made clear the diagnosis of Gitelman's syndrome associated with chondrocalcinosis.

Large area high-speed metrology SPM system.

We present a large area high-speed measuring system capable of rapidly generating nanometre resolution scanning probe microscopy data over mm(2) regions. The system combines a slow moving but accurate large area XYZ scanner with a very fast but less accurate small area XY scanner. This arrangement enables very large areas to be scanned by stitching together the small, rapidly acquired, images from the fast XY scanner while simultaneously moving the slow XYZ scanner across the region of interest. In order to successfully merge the image sequences together two software approaches for calibrating the data from the fast scanner are described. The first utilizes the low uncertainty interferometric sensors of the XYZ scanner while the second implements a genetic algorithm with multiple parameter fitting during the data merging step of the image stitching process. The basic uncertainty components related to these high-speed measurements are also discussed. Both techniques are shown to successfully enable high-resolution, large area images to be generated at least an order of magnitude faster than with a conventional atomic force microscope.

Development of nanomanipulator using a high-speed atomic force microscope coupled with a haptic device.

The atomic force microscope (AFM) has been widely used for surface fabrication and manipulation. However, nanomanipulation using a conventional AFM is inefficient because of the sequential nature of the scan-manipulation scan cycle, which makes it difficult for the operator to observe the region of interest and perform the manipulation simultaneously. In this paper, a nanomanipulation technique using a high-speed atomic force microscope (HS-AFM) is described. During manipulation using the AFM probe, the operation is periodically interrupted for a fraction of a second for high-speed imaging that allows the topographical image of the manipulated surface to be periodically updated. With the use of high-speed imaging, the interrupting time for imaging can be greatly reduced, and as a result, the operator almost does not notice the blink time of the interruption for imaging during the manipulation. This creates a more intuitive interface with greater feedback and finesse to the operator. Nanofabrication under real-time monitoring was performed to demonstrate the utility of this arrangement for real-time nanomanipulation of sample surfaces under ambient conditions. Furthermore, the HS-AFM is coupled with a haptic device for the human interface, enabling the operator to move the HS-AFM probe to any position on the surface while feeling the response from the surface during the manipulation.

Improving the signal-to-noise ratio of high-speed contact mode atomic force microscopy.

During high-speed contact mode atomic force microscopy, higher eigenmode flexural oscillations of the cantilever have been identified as the main source of noise in the resultant topography images. We show that by selectively filtering out the frequencies corresponding to these oscillations in the time domain prior to transforming the data into the spatial domain, significant improvements in image quality can be achieved.

Modelling oscillatory flexure modes of an atomic force microscope cantilever in contact mode whilst imaging at high speed.

Understanding the modal response of an atomic force microscope is important for the identification of image artefacts captured using contact-mode atomic force microscopy (AFM). As the scan rate of high speed AFM increases, these modes present themselves as ever clearer noise patterns as the frequency of cantilever vibration falls under the frequency of pixel collection. An Euler-Bernoulli beam equation is used to simulate the flexural modes of the cantilever of an atomic force microscope as it images a hard surface in contact mode. Theoretical results are compared with experimental recordings taken in the high speed regime, as well as previous analytical results. It is shown that the model can capture the mode shapes and resonance properties of the first four eigenmodes.

High-speed atomic force microscopy in slow motion--understanding cantilever behaviour at high scan velocities.

Using scanning laser Doppler vibrometer we have identified sources of noise in contact mode high-speed atomic force microscope images and the cantilever dynamics that cause them. By analysing reconstructed animations of the entire cantilever passing over various surfaces, we identified higher eigenmode oscillations along the cantilever as the cause of the image artefacts. We demonstrate that these can be removed by monitoring the displacement rather than deflection of the tip of the cantilever. We compare deflection and displacement detection methods whilst imaging a calibration grid at high speed and show the significant advantage of imaging using displacement.

Methods for imaging DNA in liquid with lateral molecular-force microscopy.

Shear force microscopy is not normally associated with the imaging of biomolecules in a liquid environment. Here we show that the recently developed scattered evanescent wave (SEW) detection system, combined with custom-designed vertically oriented cantilevers (VOCs), can reliably produce true non-contact images in liquid of DNA molecules. The range of cantilever spring constants for successful shear force imaging was experimentally identified between 0.05 and 0.09 N m(-1). Images of λ-DNA adsorbed on mica in distilled water were obtained at scan rates of 8000 pixels s(-1). A new constant-height force mapping mode for VOCs is also presented. This method is shown to control the vertical position of the tip in the sample plane with better than 1 nm accuracy. The force mode is demonstrated by mapping the shear force above λ-DNA molecules adsorbed on mica in a liquid environment at different tip-sample separations.

Experimental observation of contact mode cantilever dynamics with nanosecond resolution.

We report the use of a laser Doppler vibrometer to measure the motion of an atomic force microscope contact mode cantilever during continuous line scans of a mica surface. With a sufficiently high density of measurement points the dynamics of the entire cantilever beam, from the apex to the base, can be reconstructed. We demonstrate nanosecond resolution of both rectangular and triangular cantilevers. This technique permits visualization and quantitative measurements of both the normal and lateral tip sample interactions for the first and higher order eigenmodes. The ability to derive quantitative lateral force measurements is of interest to the field of microtribology/nanotribology while the comprehensive understanding of the cantilever's dynamics also aids new cantilever designs and simulations.

Mapping real-time images of high-speed AFM using multitouch control.

Conventional AFM is highly restricted by its scan rate, a problem that has been overcome by the development of high-speed AFM systems. As the technology to produce higher scan rates has developed it has pushed forward the design of control software. However, the user interface has not evolved at the same rate, limiting the user to sequential control steps. In this paper we demonstrate the integration of HSAFM with a multitouch interface to produce a highly intuitive and responsive control environment. This enables nanometre resolution to be maintained whilst scanning the sample over tens of microns, and arbitrary paths to be traversed. We illustrate this by scanning around two chromosomes in water, before scanning on top of the chromosome, showing the surface structure.

A new detection system for extremely small vertically mounted cantilevers.

Detection techniques currently used in scanning force microscopy impose limitations on the geometrical dimensions of the probes and, as a consequence, on their force sensitivity and temporal response. A new technique, based on scattered evanescent electromagnetic waves (SEW), is presented here that can detect the displacement of the extreme end of a vertically mounted cantilever. The resolution of this method is tested using different cantilever sizes and a theoretical model is developed to maximize the detection sensitivity. The applications presented here clearly show that the SEW detection system enables the use of force sensors with sub-micron size, opening new possibilities in the investigation of biomolecular systems and high speed imaging. Two types of cantilevers were successfully tested: a high force sensitivity lever with a spring constant of 0.17 pN nm(-1) and a resonant frequency of 32 kHz; and a high speed lever with a spring constant of 50 pN nm(-1) and a resonant frequency of 1.8 MHz. Both these force sensors were fabricated by modifying commercial microcantilevers in a focused ion beam system. It is important to emphasize that these modified cantilevers could not be detected by the conventional optical detection system used in commercial atomic force microscopes.

High-speed AFM of human chromosomes in liquid.

Further developments of the previously reported high-speed contact-mode AFM are described. The technique is applied to the imaging of human chromosomes at video rate both in air and in water. These are the largest structures to have been imaged with high-speed AFM and the first imaging in liquid to be reported. A possible mechanism that allows such high-speed contact-mode imaging without significant damage to the sample is discussed in the context of the velocity dependence of the measured lateral force on the AFM tip.

[Quality assurance and cost control in invasive and interventional cardiology]. / Quality assurance e controllo dei costi in cardiologia invasiva ed interventistica.

We report our experience of Quality Assurance in a Cardiac Catheterization Laboratory of the National Health Service. An attempt was made to apply these criteria to the medical activities as well as to the management and economic aspects of our work. Limits and perspectives of this experience are discussed as a contribution to ongoing debate among cardiologists and public health Authorities.

[Elective coronary angioplasty in total absence of heart surgery]. / Angioplastica coronarica elettiva in totale assenza di cardiochirurgia.

BACKGROUND: One-hundred consecutive procedures of elective coronary angioplasty were attempted in 95 patients, in the absence of any surgical stand-by. All patients had angina and/or signs of inducible ischemia. METHODS: All patients and attending physicians were informed that no surgical coverage was available, and gave their consent. The choice was made on the basis of the estimate, on clinical and angiographic grounds, of the consequences of vessel occlusion, of the possible help offered by percutaneous bail-out techniques, and of the applicability of surgical stand-by. RESULTS: A primary success was achieved in 92 cases: in 5 cases a Palmaz-Schatz stent was implanted. In 6 cases the procedure was unsuccessful, with no complications. Two patients sustained a myocardial infarction without new Q-waves. No patient died, nor underwent cardiac surgery within 1 month of discharge. CONCLUSIONS: Our initial experience suggests that, in the absence of surgical stand-by, elective coronary angioplasty can be performed in selected patients at an acceptable risk.

[Diagnostic hemodynamics in day-hospital care]. / Emodinamica diagnostica in regime di day-hospital.

Our initial experience with 180 consecutive cases of transfemoral cardiac catheterization in ambulatory patients is presented. It accounts for 21% of 864 diagnostic cardiac catheterization procedures in our laboratory in the first 12 months of activity. There were no complications. Patient satisfaction was high, and a substantial reduction of unnecessary overnight admissions in the cardiology ward could be achieved. This confirms the safety and the advantages of this practice. Implications for the organization of the Catheterization Laboratory are also discussed, as well as possible causes for the sofar limited use of ambulatory cardiac catheterization in our country.