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Cystic fibrosis is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene. Novel, highly effective, modulator therapies correcting and potentiating CFTR function are changing the course of the disease. We present an ethical dilemma involving an 11-year-old child with CF and end stage lung disease. Shortly after starting treatment with Elexacaftor-Tezacaftor-Ivacaftor, the family received notification that a matched donor lung had been allocated. Clinical decision-making in this case is challenging as definitive data to medically support one treatment option over the other is limited. A survey of CF center team members was conducted for the purpose of this manuscript. Ethical principles that may guide us in these situations are discussed. Overall, results of the survey present a lack of agreement as to the best approach in this situation. Physicians, when compared to other team members, are more likely to provide a specific recommendation vs. to present the information and let the family decide (odds ratio (95% confidence interval)=4.0 (1.2-12.8), p=0.021). A shared decision-making model, stressing our moral obligation as clinicians to respect autonomy by appreciating family values while offering to participate in the decision-making process and ensuring non-maleficence, is presented. In summary, CFTR modulators affect the outcomes of CF disease and influence clinical decision-making. Current lack of data on long-term outcomes, in young patients with CF receiving effective modulator therapy, should not preclude CF team participation in decision-making. Shared decision-making which is focused on respecting autonomy is our preferred approach in these situations.

Objectives Previous studies suggest that exposure to inflammation in infancy may increase the risk for attention-deficit and hyperactivity disorder (ADHD). We studied the ADHD manifestations among 124 familial Mediterranean fever (FMF) patients and examined the relationship between FMF patient characteristics and ADHD. Methods Clinical, demographic, and genetic data were abstracted from patients’ medical records and supplemented by information obtained during clinic visits. ADHD manifestations were assessed using the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) questionnaire. Results ADHD was diagnosed in 42 (32.8%) FMF patients, a rate significantly higher than in unselected populations (∼8%). A majority (n = 27, 64.3%) had combined inattentive, hyperactive-impulsive manifestations. Eight (19%) had predominantly hyperactive-impulsive, and seven (16.6%) had predominantly inattentive symptoms. FMF patients with severe manifestations reported more ADHD symptoms. FMF patients with ADHD symptoms were less adherent to their treatment regimen, with only 61.9% of the patients with ADHD symptoms adhering to colchicine therapy compared to 92.7% of the patients without ADHD symptoms. Conclusion The high prevalence of ADHD characteristics in children with FMF may support the neuroimmune hypothesis that chronic inflammation increases the risk for ADHD. Children with FMF should be screened for ADHD as its presence may adversely affect adherence to treatment.

This work discusses nuclear magnetic relaxation effects in glycerol subject to a strong electric field. The methods used are 1.5 T magnetic resonance imaging (MRI), referenced by 9.4 T nuclear magnetic resonance (NMR). While MRI allows a glycerol probe to be sampled with a high voltage (HV) of 16 kV applied to the probe, NMR provides precise molecular data from the sample, but the sample cannot be tested under HV. Using MRI, the recording of magnetic relaxation times was possible while HV was applied to the glycerol. NMR spectroscopy was used to confirm that MRI provides a reasonably accurate estimation of temperature. The applied HV was observed to have a negligible effect on the spin–lattice relaxation time T1, which represents the energy release to the thermal bath or system enthalpy. In contrast to that, the spin–spin relaxation time T2, which does represent the local entropy of the system, shows a lower response to temperature while the liquid is electrically stressed. These observations point toward a proton population in electrically stressed glycerol that is more mobile than that found in the bulk, an observation that is in agreement with previously published results for water.

Background Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children in foster care or domestically adopted are at greater risk for FASD. The aim of this study was to determine the prevalence or risk for FASD in a selected population of foster and adopted children. Methods Children between 2 and 12 years who were candidates for adoption in foster care were evaluated for clinical manifestations and historical features of fetal alcohol spectrum disorder based on established criteria for FASD. Results Of the 89 children evaluated, 18 had mothers with a confirmed history of alcohol consumption during pregnancy. Two children had fetal alcohol syndrome and one had partial fetal alcohol syndrome. In addition, five had alcohol-related neurodevelopmental disorder, one had alcohol-related birth defects, and a single child had manifestations of both. Of the 71 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD were a history of maternal alcohol consumption obtained. Conclusions In a population of high-risk children seen in an adoption clinic, many had manifestations associated with FASD especially where prenatal alcohol exposure was established. The reported prevalence in this study is higher than that reported in our previous study of younger children. This is most likely due to the higher number of children diagnosed with alcohol-related neurodevelopmental disorders that typically manifest at an older age.

Pyogenic sacroiliitis (PS) is rare with less than 100 pediatric cases reported in the medical literature. To better characterize PS in the pediatric population, we investigated a series of children presenting with PS. Retrospective data analysis was done at an academic tertiary center between the years of 2000 and 2017. All hospitalized children ≤ 16 years of age with PS were evaluated. Of the 894 children hospitalized with osteoarticular infections, 18 were diagnosed with PS (2%) and are included in the review. Two clinically distinct groups were identified. PS in infants (n = 13, 72.2%, mean age 1.1 years) had an indolent course and a faster recovery without any bacterial source identified. In contrast, the group of older children (n = 5, 27.8%, mean age 11.6 years) had a more complicated course and a higher rate of identified bacterial infections.Conclusion: We describe an under-recognized entity of PS in infants with a mild clinical course and fast recovery that differ from the "classical" septic sacroiliitis. Infants with PS did not suffer from invasive complications, and pathogen characteristics of older children were not identified. Infants with fever, irritability, decreased range of motion in the pelvic area, and pain during diapering should alert the clinician to this diagnosis. What is Known: • Pediatric pyogenic sacroiliitis is an extremely rare condition usually caused by Staphylococcus aureus with highest incidence in adolescents. • The diagnosis of PS is challenging due to its rarity and difficulty in assessing the sacroiliac joint. What is New: • We describe an under-recognized entity of PS in infants with a mild clinical course, without invasive complications and with fast recovery that differ from "classical" septic sacroiliitis. • Infants with fever, irritability, decreased range of motion in the pelvic area and pain during diapering should raise clinical suspicion of this diagnosis.

ObjectiveColchicine has been considered a lifelong therapy for familial Mediterranean fever (FMF). Recent studies describe patients who discontinued colchicine, but there is a lack of data pertaining to predictors of success. The aims of our study were to describe a cohort of pediatric patients with FMF who discontinued colchicine therapy, and to identify factors predicting successful termination of colchicine.MethodsThis study describes a cohort of pediatric patients with FMF who discontinued colchicine therapy following a relatively prolonged attack-free period (> 6 months), and identifies factors predicting successful termination. Data collected included demographic, clinical, and laboratory characteristics of children diagnosed with FMF aged < 16 years who underwent a trial of colchicine discontinuation. Data from patients who successfully ceased colchicine therapy were compared to those of patients who relapsed.ResultsOf 571 patients with FMF, 59 (10.3%) discontinued colchicine therapy. The average attack-free period before enrollment was 0.97 ± 1.4 years. Follow-up after ceasing colchicine was 5.0 ± 3.05 years, during which time 11 (20%) patients had an attack. The most common symptoms were fever (100%) and abdominal pain (80%). For those failing discontinuation, colchicine was restarted within 1.3 years (range 0.3–5.0, median 0.7 yrs). A longer attack-free period prior to colchicine discontinuation predicted success. Myalgia and arthritis prior to colchicine cessation were more common among children who required renewal of colchicine.ConclusionCessation of colchicine therapy should be considered following prolonged remission in a select group of patients. Patients with arthritis or myalgia are more likely to have an attack after ceasing colchicine therapy.

Childhood cases of cyanoacrylates generally do not cause moderate or severe gastrointestinal complications. We report the case of a 3-year-old boy referred to our pediatric emergency room and admitted to the pediatric department with signs of upper gastrointestinal obstruction that required invasive intervention. Although it is rare, cyanoacrylate ingestion may injure esophageal and gastric mucosa in the pediatric population.

The attention of the world is focused on the coronavirus disease-2019 (COVID-19) pandemic. There is s general awareness that certain population groups are at greater risk. However, some other populations may be transparent and may not be receiving the attention they warrant. We focused on those with intellectual disability explaining why they are vulnerable during the current pandemic and require special attention.

A horizontal electrohydrodynamic (EHD) liquid bridge (also known as a “floating water bridge”) is a phenomenon that forms when high voltage DC (kV·cm−1) is applied to pure water in two separate beakers. The bridge, a free-floating connection between the beakers, acts as a cylindrical lens and refracts light. Using an interferometric set-up with a line pattern placed in the background of the bridge, the light passing through is split into a horizontally and a vertically polarized component which are both projected into the image space in front of the bridge with a small vertical offset (shear). Apart from a 100 Hz waviness due to a resonance effect between the power supply and vortical structures at the onset of the bridge, spikes with an increased refractive index moving through the bridge were observed. These spikes can be explained by an electrically induced liquid–liquid phase transition in which the vibrational modes of the water molecules couple coherently.

Trans-coronal radio observations were taken during the 2011 observing campaign of the Akatsuki spacecraft through superior conjunction. The observed X-band (8.4 GHz) signals exhibit frequency fluctuations (FF) that are produced by temporal variations in electron density along the radio ray path. A two-component model for interpretation of the FF is proposed: FF scales largely with acoustic wave amplitude through the inner coronal regions where the sound speed dwarfs the solar wind outflow speed, while FF in the region of solar wind acceleration is dominated by the increased density oscillation frequency on the sensing path that results from bulk advection of the plasma inhomogeneities. An estimate of fractional electron density fluctuation is obtained from the mid-corona. A radial profile of slow solar wind speed is determined in the extended corona using mass-flux continuity principles. The coronal sonic point for slow solar wind is estimated to range from 4 to 5 solar radii from the heliocenter.

In this work, we present a feasibility study of integrated optofluidic chips to measure the ionic content in water using differential absorption spectroscopy. The second overtone of the OH-stretch vibration of water is used as indicator for both the type and concentration of the dissolved ions. The optofluidic chips are based on silicon nitride (TripleX) containing Mach&ndash, Zehnder interferometers (MZI) with two 5 cm sensing paths for the sample and reference arms, respectively. Simulations show that, theoretically, the determination of both the type and concentration of a mixture of four electrolytes is possible with the techniques presented. However, the performance of the chips deviated from the expected results due to the insufficient reproducibility and precision in the fabrication process. Therefore, at this early stage, the chips presented here could only determine the ion concentration, but not differentiate between the different ion types. Still, this work represents the first steps towards the realization of an online and real-time sensor of ionic content in water.

Integrated optofluidic absorption spectroscopy has the potential to be used in the real-time identification and quantification of ionic content in drinking water. Such an approach requires single mode operation in combination with low propagation and bend losses. The design criteria for the realization of an integrated Near-infrared (NIR) sensor platform fabricated using silicon waveguide based technology is presented. The cross-section of TriPleX waveguides was optimized for a spectral region between 940 and 1040nm. The waveguide structure provides single mode operation, high sensitivity combined with reasonable tolerance for fabrication deviations and

Currently available groundwater flow prediction tools and methods are limited by insufficient spatial resolution of subsurface data and the unknown local heterogeneity. In this field study, fiber Bragg grating (FBG) sensors were installed in an extraction well field to investigate its potential to measure groundwater flow velocity. Reference in-situ pore pressure and temperature measurements were used to identify possible sources of FBG responses. FBG strain sensors were able to detect soil consolidation caused by groundwater extraction from 250 m distance. The results show that FBG responses were influenced by interface friction between soil and FBG packaging. FBG packaging slipped in soil and the effect was more pronounced during higher groundwater flow around a nearby well. These FBG fibers could be applied for indirect flow monitoring that does not require any tracer and provide real-time and long-term data during regular operation of extraction wells.

Here, we report on the feasibility and use of magnetic resonance imaging-based methods to the study of electrohydrodynamic (EHD) liquid bridges. High-speed tomographic recordings through the longitudinal axis of water bridges were used to characterize the mass transfer dynamics, mixing, and flow structure. By filling one beaker with heavy water and the other with light water, it was possible to track the spread of the proton signal throughout the total liquid volume. The mixing kinetics are different depending on where the light nuclei are located and proceeds faster when the anolyte is light water. Distinct flow and mixing regions are identified in the fluid volumes, and it is shown that the EHD flow at the electrodes can be counteracted by the density difference between water isotopes. MR phase contrast imaging reveals that within the bridge section, two separate counter-propagating flows pass one above the other in the bridge.

Nephrogenic diabetes insipidus (NDI) is a urinary concentrating defect resulting from resistance of the collecting duct to the antidiuretic action of vasopressin (AVP). The X-linked recessive form is the most frequent genetic cause of inherited NDI and can be caused by mutations in the gene encoding the V2 vasopressin receptor (AVPR2). A Palestinian male infant presented in the neonatal period with failure to thrive, vomiting, irritability, fever, and polyuria, and had biochemical findings consistent with NDI. The diagnosis of NDI was established based on the clinical picture, absent response to desmopressin, and a similarly affected elder brother. Sequencing of the AVPR2 gene for the patient and his affected brother revealed a novel missense mutation with replacement of G by A in codon 82 located in exon 2 (TGC → TAC), causing a cysteine to tyrosine substitution (C82Y). Testing of the mother showed that she was the carrier of that mutation. This is the identified AVPR2 mutation in a Palestinian family. Knowledge of these mutations will allow genetic counseling and early diagnosis of affected males.

The authors wish to make the following corrections to this paper [1]: In all instances mentioning “2 kG·m−1”, these gradients should be replaced by “770 G·m−1 (WCM 62081992) and 740 G·m−1 (WCM 62083545)”: Abstract, page 1, line 4; Chapter 1 [...]

We have measured the quasi-elastic neutron scattering (QENS) of an electrohydrodynamic liquid bridge formed between two beakers of pure water when a high voltage is applied, a setup allowing to investigate water under high-voltage without high currents. From this experiment two proton populations were distinguished: one consisting of protons strongly bound to oxygen atoms (immobile population, elastic component) and a second one of quasi-free protons (mobile population, inelastic component) both detected by QENS. The diffusion coefficient of the quasi-free protons was found to be D = (26 ± 10) × 10(-5) cm(2) s(-1) with a jump length lav ∼ 3 Å and an average residence time of τ0 = 0.55 ± 0.08 ps. The associated proton mobility in the proton channel of the bridge is ∼9.34 × 10(-7) m(2) V(-1) s(-1), twice as fast as diffusion-based proton mobility in bulk water. It also matches the so-called electrohydrodynamic or "apparent" charge mobility, an experimental quantity which so far has lacked molecular interpretation. These results further corroborate the proton channel model for liquid water under high voltage and give new insights into the molecular mechanisms behind electrohydrodynamic charge transport phenomena and delocalization of protons in liquid water.

The use of cannabis as both a therapeutic agent and recreational drug is common, and its availability is increasing as a result of legalization in many countries. Among older children, the manifestations of cannabis intoxication are numerous and include both neurological and systemic manifestations that are frequently non-specific. There have been only a few reports detailing cannabis intoxication in infants and toddlers. We describe three infants who presented to the emergency department with encephalopathic signs without prominent systemic manifestations. During the initial interview of caregivers, no history of exposure to neurotoxic agents was obtained. All three patients were subsequently diagnosed with cannabis intoxication based on urine toxic screens for delta-9-tetrahydrocannabinol (THC). The infants recovered with supportive care that included fluids and monitoring. The non-specific symptomatology of cannabis intoxication in infants together with the wide differential for unexplained acute onset encephalopathy may delay diagnosis and lead to inappropriate procedures and interventions such as antimicrobial treatments and imaging studies.Healthcare personnel of emergency rooms, urgent care centers, and general clinics should be aware of the potential risk of cannabis ingestion in young infants. A thorough medical history and toxic screen are warranted in all infants with unexplained decreased sensorium.

Approximately 300,000 men around the globe self-identify as Ashkenazi Levites, of whom two thirds were previously shown to descend from a single male. The paucity of whole Y-chromosome sequences precluded conclusive identification of this ancestor’s age, geographic origin and migration patterns. Here, we report the variation of 486 Y-chromosomes within the Ashkenazi and non-Ashkenazi Levite R1a clade, other Ashkenazi Jewish paternal lineages, as well as non-Levite Jewish and non-Jewish R1a samples. Cumulatively, the emerging profile is of a Middle Eastern ancestor, self-affiliating as Levite, and carrying the highly resolved R1a-Y2619 lineage, which was likely a minor haplogroup among the Hebrews. A star-like phylogeny, coalescing similarly to other Ashkenazi paternal lineages, ~1,743 ybp, suggests it to be one of the Ashkenazi paternal founders; to have expanded as part of the overall Ashkenazi demographic expansion, without special relation to the Levite affiliation; and to have subsequently spread to non-Ashkenazi Levites.

Biofouling causes performance loss in spiral wound nanofiltration (NF) and reverse osmosis (RO) membrane operation for process and drinking water production. The development of biofilm formation, structure and detachment was studied in-situ, non-destructively with Optical Coherence Tomography (OCT) in direct relation with the hydraulic biofilm resistance and membrane performance parameters: transmembrane pressure drop (TMP) and feed-channel pressure drop (FCP). The objective was to evaluate the suitability of OCT for biofouling studies, applying a membrane biofouling test cell operated at constant crossflow velocity (0.1 m s(-1)) and permeate flux (20 L m(-2)h(-1)). In time, the biofilm thickness on the membrane increased continuously causing a decline in membrane performance. Local biofilm detachment was observed at the biofilm-membrane interface. A mature biofilm was subjected to permeate flux variation (20 to 60 to 20 L m(-2)h(-1)). An increase in permeate flux caused a decrease in biofilm thickness and an increase in biofilm resistance, indicating biofilm compaction. Restoring the original permeate flux did not completely restore the original biofilm parameters: After elevated flux operation the biofilm thickness was reduced to 75% and the hydraulic resistance increased to 116% of the original values. Therefore, after a temporarily permeate flux increase the impact of the biofilm on membrane performance was stronger. OCT imaging of the biofilm with increased permeate flux revealed that the biofilm became compacted, lost internal voids, and became more dense. Therefore, membrane performance losses were not only related to biofilm thickness but also to the internal biofilm structure, e.g. caused by changes in pressure. Optical Coherence Tomography proved to be a suitable tool for quantitative in-situ biofilm thickness and morphology studies which can be carried out non-destructively and in real-time in transparent membrane biofouling monitors.

The prevalence of attention deficit hyperactivity disorders (ADHD) among individuals with Down syndrome (DS) has been difficult to ascertain. This is because many of the phenotypic features of DS may resemble the clinical manifestations of DS and the myriad methodological challenges in diagnosing ADHD in children with intellectual disabilities (ID). With this in mind, the authors set to determine the prevalence of ADHD symptomatology in a cohort of children and young adults in a DS clinic. Subjects were 83 children and adults, ages 5–38, who were attending the Down Syndrome Center at the Hadassah Mount Scopus University Medical Center. All were screened for ADHD. Screening methods included review of medical files, telephone interviews, and use of the ADHD module of the Autism-Tics, Attention-Deficit/Hyperactivity disorder, and other Comorbidities questionnaire. It was found that 26 (31.3%) of the subjects fulfilled the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) criteria for ADHD. Of these, 17 (65.4%) were diagnosed as predominantly inattentive type. Four (15.4%) were predominantly impulsive-hyperactive, and five (19.2%) had the combined type. No statistically significant association was found between ADHD and age, sex, number of siblings, presence of heart disease, thyroid dysfunction, sleep disorders, or a family history of ADHD. The prevalence of ADHD symptomatology among individuals with DS in this representative sample is high compared with the general population. ADHD may be underdiagnosed in this special population, hence the need for systematic screening.

Protein–water interaction plays a crucial role in protein dynamics and hence function. To study the chemical environment of water and proteins with high spatial resolution, synchrotron radiation-Fourier transform infrared (SR-FTIR) spectromicroscopy was used to probe skeletal muscle myofibrils. Observing the OH stretch band showed that water inside of relaxed myofibrils is extensively hydrogen-bonded with little or no free OH. In higher-resolution measurements obtained with single isolated myofibrils, the water absorption peaks were relatively higher within the center region of the sarcomere compared to those in the I-band region, implying higher hydration capacity of thick filaments compared to the thin filaments. When specimens were activated, changes in the OH stretch band showed significant dehydrogen bonding of muscle water; this was indicated by increased absorption at ∼3480 cm–1 compared to relaxed myofibrils. These contraction-induced changes in water were accompanied by splitting of the amide I (C=O) peak, implying that muscle proteins transition from α-helix to β-sheet-rich structures. Hence, muscle contraction can be characterized by a loss of order in the muscle–protein complex, accompanied by a destructuring of hydration water. The findings shed fresh light on the molecular mechanism of muscle contraction and motor protein dynamics.

A modified version of the membrane fouling simulator (MFS) was developed for assessment of (i) hydraulic biofilm resistance, (ii) performance parameters feed-channel pressure drop and transmembrane pressure drop, and (iii) in situ spatial visual and optical observations of the biofilm in the transparent monitor, e.g. using optical coherence tomography. The flow channel height equals the feed spacer thickness enabling operation with and without feed spacer. The effective membrane surface area was enlarged from 80 to 200 cm2 by increasing the monitor width compared to the standard MFS, resulting in larger biomass amounts for analysis. By use of a microfiltration membrane (pore size 0.05 μm) in the monitor salt concentration polarization is avoided, allowing operation at low pressures enabling accurate measurement of the intrinsic hydraulic biofilm resistance. Validation tests on e.g. hydrodynamic behavior, flow field distribution, and reproducibility showed that the small-sized monitor was a represe...

Objective A pilot study of an experimental instrument extending the ‘verbal shift’ hypothesis indicating HFASD bias towards language over nonverbal cues (Grossman, Klin, Carter & Volkmar, 2000). We hypothesized HFASD differentiates from ADHD in social video interpretation in the degree of reliance on semantic content for correct responses. Method 68 children ages 7-13 were recruited from the community (21 HFASD, 20 ADHD, 27 Control). Children viewed video pairs of social interaction. A “masked” version preserved prosody and visual cues, but not words. An “unmasked” version was naturalistic, with interpretable spoken language. Three questions were asked following each video scene (masked presented first): 1) the emotion of an actor, 2) a question to verify child was attending, 3) prediction about what might happen next. MANCOVA with post-hoc analysis was used to examine the between-group differences on performance as measured by the number of correct responses gained when the videos were unmasked. Results There were no group differences in age, gender, and WASI PRI. With WASI VCI controlled, emotion recognition and prediction questions differed significantly between groups (F = 3.907, p = .025, pEta2 = .109; F = 4.725, p = .012, pEta2 = .129), with ASD having the largest unmasked>masked correct gain compared to ADHD (p = .05; p = .029) and controls (p = .009; p = .004) There were no differences between ADHD and controls. The attention question did not differ among groups; focus on the details of the videos was similar in participants regardless of diagnosis. Conclusions Results of this pilot study indicate that emotion recognition and event prediction may be useful diagnostic predictors when differentiating HFASD from ADHD using naturalistic video stimuli.

An understanding of groundwater flow near drinking water extraction wells is crucial when it comes to avoiding well clogging and pollution. A promising new approach to groundwater flow monitoring is the deployment of a network of optical fibers with fiber Bragg grating (FBG) sensors. In preparation for a field experiment, a laboratory scale aquifer was constructed to investigate the feasibility of FBG sensors for this application. Multiparameter FBG sensors were able to detect changes in temperature, pressure, and fiber shape with sensitivities influenced by the packaging. The first results showed that, in a simulated environment with a flow velocity of 2.9 m/d, FBG strain effects were more pronounced than initially expected. FBG sensors of a pressure-induced strain implemented in a spatial array could form a multiplexed sensor for the groundwater flow direction and magnitude. Within the scope of this research, key technical specifications of FBG interrogators for groundwater flow sensing were also identified.

When a high-voltage direct-current is applied to two beakers filled with water or polar liquid dielectrica, a horizontal bridge forms between the two beakers. This experiment was first carried out by Lord Armstrong in 1893 and then forgotten until recently. Such bridges are stable by the action of electrohydrodynamic (EHD) forces caused by electric field gradients counteracting gravity. Due to these gradients a permanent pumping of liquid from one beaker into the other is observed. At macroscopic scale several of the properties of a horizontal water bridge can be explained by modern electrohydrodynamics, analyzing the motion of fluids in electric fields. Whereas on the molecular scale water can be described by quantum mechanics, there is a conceptual gap at mesoscopic scale which is bridged by a number of theories including quantum mechanical entanglement and coherent structures in water – theories that we discuss here. Much of the phenomenon is already understood, but even more can still be learned from it, since such “floating” liquid bridges resemble a small high voltage laboratory of their own: The physics of liquids in electric fields of some kV/cm can be studied, even long time experiments like neutron or light scattering are feasible since the bridge is in a steady-state equilibrium and can be kept stable for hours. It is also an electro-chemical reactor where compounds are transported through by the EHD flow, enabling the study of electrochemical reactions under potentials which are otherwise not easily accessible. Last but not least the bridge provides the experimental biologist with the opportunity to expose living organisms such as bacteria to electric fields without killing them, but with a significant influence on their behavior, and possibly, even on their genome.

Insulated rail joints are designed in a similar way to butt jointed steel structural systems, the difference being a purpose made gap between the main rail members to maintain electrical insulation for the proper functioning of the track circuitry at all times of train operation. When loaded wheels pass the gap, they induce an impact loading with the corresponding strains in the railhead edges exceeding the plastic limit significantly, which lead to metal flow across the gap thereby increasing the risk of short circuiting and impeding the proper functioning of the signalling and broken rail identification circuitries, of which the joints are a critical part. The performance of insulated rail joints under the passage of the wheel loading is complex due to the presence of a number of interacting components and hence is not well understood. This paper presents a dynamic wheel-rail contact-impact modelling method for the determination of the impact loading; a brief description of a field experiment to capture strain signatures for validating the predicted impact loading is also presented. The process and the results of the characterisation of the materials from virgin, in-service and damaged insulated rail joints using neutron diffraction method are also discussed.

In this experiment liquid water is subject to an inhomogeneous electric field (${\nabla}^2 E_a {\approx} 10^{10} \frac{V}{m^2}$ ) using a high voltage (20 kV) point-plane electrode system. With interferometry it was found that the application of a strong electric field gradient to water generates local changes in the refractive index of the liquid, polarizes the surface and creates a downward moving electro-convective jet. A maximum temperature difference of 1 {\deg}C is measured in the immediate vicinity of the point electrode. Raman spectroscopy on water reveals an enhancement of the vibrational collective modes (3250 $cm^{-1}$) as well as an increase in the local mode (3490 $cm^{-1}$) energy. This bimodal enhancement indicates the spectral changes are not due to temperature. The intense field gradient thus establishes an excited subpopulation of vibrational oscillators far from thermal equilibrium. Delocalization of the collective vibrational mode spatially expands this excited population beyond the microscale. Hindered rotational freedom due to electric field pinning of molecular dipoles retards heat flow and generates a chemical potential gradient. These changes are responsible for the observed changes in refractive index and temperature. It is demonstrated that polar liquids can thus support local non-equilibrium thermodynamic transient states critical to biochemical and environmental processes.

In 2012 Coey proposed a theory on the mechanism of magnetic water treatment based on the gradient of the applied field rather than its absolute strength. We tested this theory by measuring the effect of very weak field magnets (≤ 10 G) containing strong magnetic inhomogeneities (ΔB = 770 G·m−1 (WCM 62081992) and 740 G·m−1 (WCM 62083545)) on tap water samples by the use of electric impedance spectroscopy (EIS) and laser scattering. Our results show an increased formation of nm-sized prenucleation clusters (dynamically ordered liquid like oxyanion polymers or “DOLLOPs”) due to the exposure to the magnetic field and thus are consistent with Coey’s theory which is therefore also applicable to very weak magnetic fields as long as they contain strong gradients.

Over time ancient scripture, paintings and also medical reports on the effect of alcohol on the newborn have strongly suggested a link between maternal drinking during pregnancy and birth defects or cognitive disabilities. In the 1970s the fetal alcohol syndrome was described by French and American research groups. Maternal alcohol abuse during pregnancy can result in a specific pattern of malformations and neurocognitive deficits characteristics of this syndrome. Diagnostic criteria and classifications have been developed, and in the 1990s reports showed the long-term consequences for these children.

A 17-year-old patient with GSD type 1a (von Gierke disease) was hospitalized with an extremely elevated serum lactate following an intercurrent infection and interruption of his frequent intake of carbohydrates. The patient developed shock, oliguric renal failure, and cardiorespiratory failure requiring mechanical ventilation and inotropes. At the peak of metabolic decompensation and clinical instability, serum lactate reached a level of 47.6 mmol/L which was accompanied by a severe anion gap metabolic acidosis with a pH of 6.8 and bicarbonate of 4 meq/L. The patient was stabilized with massive infusions of sodium bicarbonate (45 meq/h) and glucose and recovered without the need for dialysis. This patient illustrates pathophysiologic mechanisms involved in the development of extreme mixed type A and type B lactic acidemia, reflecting altered metabolic pathways in GSD type 1, combined with tissue hypoperfusion. The rationale for the specific interventions in this case is outlined.

Design and optimization of integrated photonic NIR absorbance based sensors for identification and quantification of aqueous electrolytes was performed by simulation in MATLAB and Optodesigner. Ten designs are presented and compared for suitability.

We report the energy relaxation of the OH stretch vibration of HDO molecules contained in an HDO:D(2)O water bridge using femtosecond mid-infrared pump-probe spectroscopy. We found that the vibrational lifetime is shorter (~630 ± 50 fs) than for HDO molecules in bulk HDO:D(2)O (~740 ± 40 fs). In contrast, the thermalization dynamics following the vibrational relaxation are much slower (~1.5 ± 0.4 ps) than in bulk HDO:D(2)O (~250 ± 90 fs). These differences in energy relaxation dynamics strongly indicate that the water bridge and bulk water differ on a molecular scale.

When a high-voltage direct-current is applied to two beakers filled with polar liquid dielectrica like water or methanol, a horizontal bridge forms between the two beakers. By repeating a version of Pellat’s experiment, it is shown that a horizontal bridge is stable by the action of electrohydrodynamic pressure. Thus, the static and dynamic properties of the phenomenon called a ‘floating water bridge’ can be explained by the gradient of Maxwell pressure, replenishing the liquid within the bridge against any drainage mechanism. It is also shown that a number of liquids can form stable and long horizontal bridges. The stability of such a connection, and the asymmetry in mass flow through such bridges caused by the formation of ion clouds in the vicinity of the electrodes, is also discussed by two further experiments.

Background Systemic treatments for gingivitis frequently are inadequate for controlling specific sites of severe gingival inflammation. The authors conducted a study to test site-specific therapy using a transmucosal herbal periodontal patch (THPP) that was impregnated with plant extracts reported to reduce inflammatory response. Methods The study was a single-center, randomized, placebo-controlled, double-masked, longitudinal phase II trial involving participants with clinically diagnosed gingivitis. Participants who were enrolled in the study received either THPPs or placebo patches (PP) for three days. The authors evaluated gingival inflammation visually using the gingival index (GI) and by measuring gingival crevicular fluid β-glucuronidase (BG) enzymatic activity at baseline (day one) and on days two, four, eight and 15. Results The authors randomly assigned 53 participants to receive the THPP or the PP. Participants who received the THPPs had a greater reduction in mean GI scores than did those who received the PPs. This finding was significant on days four and 15. The percentage of participants whose GI scores decreased by one or more was higher among those receiving the THPP than among those receiving the PP, as assessed on days four and 15. The average decrease in BG levels (fluorescence units) for participants receiving the THPP was significantly greater on days four and eight than they were for those receiving the PP. No serious adverse events were associated with the use of the THPP. Conclusions Topical treatment by means of the THPP may be effective and safe in reducing topical gingival inflammation. Further studies are needed to confirm these findings and determine the best method for administering the THPP and the appropriate dosing. Clinical Implications Site-specific treatment of gingival inflammation is feasible and could be used as an adjunct for systemic therapeutic interventions.