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We perform ultrafast pump-probe nano-spectroscopic imaging of WSe2-SiO2 interfaces. From transient phonon softening as a local probe of substrate temperature, we resolve heterogeneity in ps thermalization and quantify interfacial boundary conductance.

Nanoscale infrared (IR) resonators with sub-diffraction limited mode volumes and open geometries have emerged as new platforms for implementing cavity quantum electrodynamics (QED) at room temperature. The use of infrared (IR) nano-antennas and tip nanoprobes to study strong light-matter coupling of molecular vibrations with the vacuum field can be exploited for IR quantum control with nanometer and femtosecond resolution. In order to accelerate the development of molecule-based quantum nano-photonic devices in the mid-IR, we develop a generally applicable semi-empirical quantum optics approach to describe light-matter interaction in systems driven by mid-IR femtosecond laser pulses. The theory is shown to reproduce recent experiments on the acceleration of the vibrational relaxation rate in infrared nanostructures, and also provide physical insights for the implementation of coherent phase rotations of the near-field using broadband nanotips. We then apply the quantum framework to develop general tip-design rules for the experimental manipulation of vibrational strong coupling and Fano interference effects in open infrared resonators. We finally propose the possibility of transferring the natural anharmonicity of molecular vibrational levels to the resonator near-field in the weak coupling regime, to implement intensity-dependent phase shifts of the coupled system response with strong pulses. Our semi-empirical quantum theory is equivalent to first-principles techniques based on Maxwell's equations, but its lower computational cost suggests its use a rapid design tool for the development of strongly-coupled infrared nanophotonic hardware for applications ranging from quantum control of materials to quantum information processing., 18 pages, 7 figures

Growth of electricity generation from variable renewable resources like wind and solar has raised questions about future grid stability. This paper used several renewable energy penetration scenarios to determine when an electric grid might be more vulnerable to frequency contingencies, such as a generator outage. Unit commitment and dispatch modeling was used to quantify system inertia, an established proxy for grid stability. A case study of the Electric Reliability Council of Texas grid was used to illustrate the method. Results from the modeled scenarios showed that the Texas grid is resilient to major grid changes, even with relatively high penetrations ( ∼ 30% of annual energy generation compared to 18% in 2017) of renewable energy. However, retiring nuclear power plants and private-use networks in the model led to unstable inertia levels in our results. When the system inertia was constrained to meet a minimum threshold in our model, multiple coal and natural gas combined-cycle plants were dispatched at part-load or at their minimum operating level to maintain stable system inertia levels. This behavior is expected to expand with higher renewable energy penetrations and could occur on other electric grids that are reliant on synchronous generators for inertia support.

Ultrafast infrared nano-imaging has demonstrated access to ultrafast carrier dynamics on the nanoscale in semiconductor, correlated-electron, or polaritonic materials. However, mostly limited to short-lived transient states, the contrast obtained has remained insufficient to probe important long-lived excitations, which arise from many-body interactions induced by strong perturbation among carriers, lattice phonons, or molecular vibrations. Here, we demonstrate ultrafast infrared nano-imaging based on excitation modulation and sideband detection to characterize electron and vibration dynamics with nano- to micro-second lifetimes. As an exemplary application to quantum materials, in phase-resolved ultrafast nano-imaging of the photoinduced insulator-to-metal transition in vanadium dioxide, a distinct transient nano-domain behavior is quantified. In another application to lead halide perovskites, transient vibrational nano-FTIR spatially resolves the excited-state polaron-cation coupling underlying the photovoltaic response. These examples show how heterodyne pump-probe nano-spectroscopy with low-repetition excitation extends ultrafast infrared nano-imaging to probe elementary processes in quantum and molecular materials in space and time.

Scattering scanning near-field optical microscopy (s-SNOM) provides spectroscopic imaging from molecular to quantum materials with few nanometer deep subdiffraction limited spatial resolution. However, in its conventional implementation s-SNOM is slow to effectively acquire a series of spatio-spectral images, especially with large fields of view. This problem is further exacerbated for weak resonance contrast or when using light sources with limited spectral irradiance. Indeed, the generally limited signal-to-noise ratio prevents sampling a weak signal at the Nyquist sampling rate. Here, we demonstrate how acquisition time and sampling rate can be significantly reduced by using compressed sampling, matrix completion, and adaptive random sampling, while maintaining or even enhancing the physical or chemical image content. We use fully sampled real data sets of molecular, biological, and quantum materials as ground-truth physical data and show how deep under-sampling with a corresponding reduction of acquisition time by 1 order of magnitude or more retains the core s-SNOM image information. We demonstrate that a sampling rate of up to 6× smaller than the Nyquist criterion can be applied, which would provide a 30-fold reduction in the data required under typical experimental conditions. Our smart s-SNOM approach is generally applicable and provides systematic full spatio-spectral s-SNOM imaging with a large field of view at high spectral resolution and reduced acquisition time.

Objective To determine usefulness of the "speckle sign" in the diagnosis of deep invasive endometriosis. Materials and methods This HIPAA-compliant, institutional review board-approved retrospective study with informed consent waived included 25 women (mean age 20-69 years) with histopathologically confirmed posterior cul-de-sac endometriosis between 2013 and 2018. Transvaginal ultrasound exams of these patients were reviewed by 2 expert radiologists searching for the "speckle sign," defined as irregular obliteration of the posterior cul-de-sac and bright (hyperechoic) internal echoes. The frequency of additional findings such as "kissing ovaries," endometriomas in the adnexa, bowel tethering in the posterior pelvic compartment, retroflexed uterus, adenomyosis, and pelvic free fluid were also analyzed. Data regarding clinical features, histopathologic findings and management were collected through a review of the medical record. Results Reader one identified posterior compartment endometriosis in 20/25 patients, and reader two in 22/25 patients, with 96% agreement. Adnexal endometriomas were found in 21/25 patients for both readers (k = 0.70) and were bilateral in 23% of patients. The ovaries were adherent to each other in the midline ("kissing ovaries") in 50% of patients; the bowel was tethered anteriorly in 20%; the presence of adenomyosis was seen in about 27%, and a retroflexed uterus was seen in 24% of patients. Conclusions The speckle sign could be helpful in making the diagnosis of posterior compartment endometriosis, and the sign is often found in conjunction with other imaging features of endometriosis.

Self-propelled micro- and nanoscale motors are capable of autonomous motion typically by inducing local concentration gradients or thermal gradients in their surrounding medium. This is a result of the heterogeneous surface of the self-propelled structures that consist of materials with different chemical or physical properties. Here we present a self-thermophoretically driven Au–silica Janus particle that can simultaneously stretch and partially melt a single double-stranded DNA molecule. We show that the effective force acting on the DNA molecule is in the ∼pN range, well suited to probe the entropic stretching regime of DNA, and we demonstrate that the local temperature enhancement around the gold side of the particle produces partial DNA dehybridization.

Endometriosis is a condition with variable location, size, and lesion composition which poses a diagnostic imaging challenge for the practicing gynecologist. Transvaginal ultrasound and magnetic resonance imaging are the most frequent imaging techniques used for its evaluation, but transvaginal ultrasound should be the first-line approach, as it is often sufficient, followed by modified ultrasound techniques. Magnetic resonance imaging should be considered when a diagnosis has not been achieved by sonographic means or when the renal system needs to be concurrently evaluated. Computed tomography has no role in the routine evaluation of endometriosis except in very few particular scenarios.

Conventional sonographic evaluation of the cervix and vagina is compromised by inattention, poor subject contrast, and obscuring artifacts. We describe a technique involving distention of the vaginal canal and fornices with ultrasound gel, providing an acoustic window for improved definition of the cervix and vagina. This exam is usually performed in concert with transvaginal sonography, but a transabdominal or transperineal approach may be more useful in selected scenarios. A wide variety of formerly sonographically inconspicuous conditions are demonstrable with this technique, many of which were undetected or inadequately characterized on the physical exam. Cervical polyps were the most commonly seen abnormality.

This work explores the dependability tradeoffs provided by the most common types of central power plants in the United States. Historically, the electricity sector has lacked consensus on how reliability, resilience, and vulnerability differ and how those metrics change depending on the power plant fleet composition. We propose distinct definitions for these metrics and an analytical framework to evaluate power plant fleet dependability. Using data analysis and literature review, we identify fifteen dependability attributes across which we rank eleven power plant types relative to natural gas combined-cycle (NGCC) plants. We use NGCC as the benchmark because it is common to many locations and is of relatively recent vintage. The framework shows that each power plant type has unique dependability benefits and drawbacks. We provide examples of how researchers may use the framework to evaluate grid dependability qualitatively under different scenarios. We find that assuming all attributes that contribute to grid dependability are equally important and additive, electric grid dependability is best supported when power plant fleets include a mixture of power generation technologies. Then, we discuss scenario characteristics that could alter the prioritization and relationships of attributes. We also find that if current capacity installation trends continue to favor low- and zero-carbon power plants, US power grids may benefit from increased resilience and reduced vulnerability at the cost of decreased reliability. We conclude by recommending methods for adapting the framework and quantifying relationships between attributes in individual scenarios.

Infrared (IR) spectroscopy has evolved into a powerful analytical technique to probe molecular and lattice vibrations, low-energy electronic excitations and correlations, and related collective surface plasmon, phonon, or other polaritonic resonances. In combination with scanning probe microscopy, near-field infrared nano-spectroscopy and -imaging techniques have recently emerged as a frontier in imaging science, enabling the study of complex heterogeneous materials with simultaneous nanoscale spatial resolution and chemical and quantum state spectroscopic specificity. Here, we describe synchrotron infrared nano-spectroscopy (SINS), which takes advantage of the low-noise, broadband, high spectral irradiance, and coherence of synchrotron infrared radiation for near-field infrared measurements across the mid- to far-infrared with nanometer spatial resolution. This powerful combination provides a qualitatively new form of broadband spatio-spectral analysis of nanoscale, mesoscale, and surface phenomena that were previously difficult to study with IR techniques, or even any form of micro-spectroscopy in general. We review the development of SINS, describe its technical implementations, and highlight selected examples representative of the rapidly growing range of applications in physics, chemistry, biology, materials science, geology, and atmospheric and space sciences.

Energy storage technologies can enable nuclear power plants to follow electricity demand throughout the day and minimize cycling costs. Several dynamic performance requirements and heuristics (such as cost and environmental impact) are presented in this chapter to compare energy storage technologies that could be integrated with nuclear power. These characteristics are compared to suggest potential energy storage integration options for Plant Vogtle units 3 and 4, two pressurized-water nuclear reactors being built in the United States. This chapter suggests that thermal energy storage technologies such as hot and cold water storage might be the most favorable for integration with a nuclear power plant due to their low cost and limited environmental impact.

High penetrations of non-synchronous renewable energy generation can decrease overall grid stability because these units do not provide rotational inertia in the same way as traditional synchronously-connected generators. Many recent studies have investigated 100% renewable energy generation scenarios, but few have explored the trade-offs associated with an electricity grid dominated by non-synchronous generation (i.e. wind and solar). Fast frequency response from grid-forming inverters—along with other technology changes—could help mitigate low system inertia levels, but the impact of this response is unknown. An inertia-constrained unit commitment and dispatch model was used to study the stability of future grid scenarios with high penetrations of non-synchronous renewable energy generation under a variety of technology scenarios. The Texas grid (the Electric Reliability Council of Texas – ERCOT) was used as a test case and instances when the system inertia fell below 100 GW · s (the grid’s current minimum level) were recorded. When the modeled critical inertia limit was reduced to 80 GW · s to represent changes in grid operation, no critical inertia hours occurred for renewable energy penetrations up to 93% of annual energy. The critical inertia limit could drop to 60 GW · s if the largest generators in ERCOT (two co-located nuclear plants) were retired, but emissions increased by ~ 25% in these scenarios. If the critical inertia limit was kept the same (100 GW · s), adding 525 MW of fast frequency response from wind, solar, and energy storage could reduce the number of critical inertia hours by up to 95%. These results show that changes to grid operating practices and generator retirements reduced critical inertia hours more than fast frequency response from inverter-connected resources. Each of these mitigation pathways has associated trade-offs, so the transition to a grid dominated by non-synchronous energy generation should be handled with care, but high renewable energy penetrations (i.e. >80%) might be feasible in Texas.

A new thermal imaging technique is characterized that uses an optically trapped erbium oxide nanoparticle cluster of approximately 150 nm. This technique can measure absolute temperature and has an imaging spatial resolution of the trapped particle. Scanning optical probe thermometry has been used to thermally image a cluster of gold nanowires that were excited with the trapping laser. Following a deconvolution of the measured thermal profile, a point spread function of the imaging technique has been determined to be a Gaussian with a FWHM of 165 nm. This width is a function of the clustering of Er2O3 nanoparticles used to image the nanowire. Optical probe thermometry has further been used to measure the temperature of nucleation events where a dichotomy of temperature for nucleated water occurs from degassed water and native water. Degassed water has been measured to nucleate at 555K confirming water adjacent to the gold nanoparticle superheats to the spinodal decomposition temperature before nucleating into a water vapor bubble. Following this event, the temperature inside the vapor bubble rises to the melting point of the gold nanoparticle, 1300 K which is followed by temperature stabilization. The rapid and significant temperature increase is attributed to the loss of a thermal dissipation pathway, to the surrounding water, previously available to the gold nanoparticle due to the insulator nature of the growing vapor envelope around the gold nanoparticle.

This study explores the relationship between delay to surgical debridement and deep infection in a series of 364 consecutive patients with 459 open fractures treated at an academic level one trauma hospital in North America. The mean delay to debridement for all fractures was 10.6 hours (0.6 to 111.5). There were 46 deep infections (10%). There were no infections among the 55 Gustilo-Anderson grade I open fractures. Among the grade II and III injuries, a statistically significant increase in the rate of deep infection was found for each hour of delay (OR = 1.033: 95% CI 1.01 to 1.057). This relationship shows a linear increase of 3% per hour of delay. No distinct time cut-off points were identified. Deep infection was also associated with tibial fractures (OR = 2.44: 95% CI 1.26 to 4.73), a higher Gustilo-Anderson grade (OR = 1.99: 95% CI 1.004 to 3.954), and contamination of the fracture (OR = 3.12: 95% CI 1.36 to 7.36). These individual effects are additive, which suggests that delayed debridement will have a clinically significant detrimental effect on more severe open fractures. Delayed treatment appeared safe for grade 1 open fractures. However, when the negative prognostic factors of tibial site, high grade of fracture and/or contamination are present we recommend more urgent operative debridement. Cite this article: Bone Joint J 2014;96-B:379–84.

Conventional sonographic evaluation of the cervix and vagina is compromised by inattention, poor subject contrast, and obscuring artifacts. We describe a technique involving distention of the vaginal canal and fornices with ultrasound gel, providing an acoustic window for improved definition of the cervix and vagina. This exam is usually performed in concert with transvaginal sonography, but a transabdominal or transperineal approach may be more useful in selected scenarios. A wide variety of formerly sonographically inconspicuous conditions are demonstrable with this technique, many of which were undetected or inadequately characterized on the physical exam. Cervical polyps were the most commonly seen abnormality.

A new optical probe technique using a laser-trapped erbium oxide nanoparticle (size ~150 nm) is introduced that can measure absolute temperature with a spatial resolution on the size of the trapped nanoparticle. This technique (scanning optical probe thermometry) is used to collect a thermal image of a gold nanodot prepared with hole-mask colloidal lithography. A convolution analysis of the thermal profile shows that the point spread function of our measurement is a Gaussian with a FWHM of 165 nm. We attribute the width of this function to clustering of Er2O3 nanoparticles in solution. The scanning optical probe thermometer is used to measure the temperature where vapor nucleation occurs in degassed water (555 K), confirming that a nanoscale object heated in water will superheat the surrounding water to the spinodal decomposition temperature. Subsequently, the temperature inside the vapor bubble rises to the melting point of the gold nanostructure (~1300) where a temperature plateau is observed. The rise in temperature is attributed to inhibition of thermal transfer to the surrounding liquid by the thermal insulating vapor cocoon.

Objective The purpose of this study was to examine the usefulness of the endometrial trilaminar pattern and thickness in the diagnosis of ectopic pregnancy. Study design We reviewed patient records for clinical and ultrasonographic data for patients with the suspicion of ectopic pregnancy. The trilaminar pattern and endometrial thickness were tested as predictors for the diagnosis of ectopic pregnancy. Results The trilaminar pattern had a specificity of 94% and sensitivity of 38% (n=403 women). The mean endometrial thickness was thinner in patients with ectopic, compared with normal pregnancy (9.5 ± 5.7 mm vs 12.4 ± 5.9 mm; P =.035). Patients with normal pregnancy or first-trimester losses had comparable thicknesses (12.4 ± 5.9 mm vs 12.5 ± 8.0 mm). The receiver operator curve showed that there was no thickness value useful for the diagnosis of ectopic pregnancy. Conclusion The trilaminar pattern is specific for the diagnosis of ectopic pregnancy, but it is associated with low sensitivity. The endometrial thickness tends to be thinner in patients with an ectopic pregnancy.

Knowledge of the morphologic features and ligamentous attachments of the ovaries, the relationship of the ovary to the ureter, and the course of the ovarian vein and artery is necessary for confident recognition of the ovaries and differentiation between ovarian and nonovarian masses with computed tomography (CT). The suspensory ligament attaches the ovary to the pelvic sidewall and transmits the ovarian vein and artery. This ligament may be seen at CT as a linear or fan-shaped soft-tissue band leading to the ovary. The utero-ovarian ligament is occasionally visualized with CT as a soft-tissue band between the uterus and ovary. The ovaries are usually located anterior or anteromedial to the pelvic ureters, whereas iliac lymph nodes are lateral or posterolateral to the ureters. Therefore, an ovarian mass displaces the ureter posteriorly or posterolaterally, whereas a large lymph node mass displaces the ureter medially or anteromedially. An ovarian mass may be draped by ovarian parenchyma, thus revealing the origin of the mass. Tracking the ovarian vein from near the level of the renal vessels caudally to the pelvis leads to the suspensory ligament region and is often helpful in identifying the ovary and differentiating ovarian and nonovarian masses.

This review article divides postarthroplasty hip dysfunction into four subsets of complications: aseptic implant loosening, septic implant loosening, structural implant failure, and tumor. These subsets usually develop as late postoperative complications. The serious perioperative complications of w

We present the first case of inguinal Merkel cell carcinoma of unknown primary origin in a patient with vulvar Paget's disease. Correlation with immune suppression of both entities warrants further investigation. Additionally, this case highlights the value of ultrasound scanning in the detection of inguinal metastasis.

Background: Primary closure of skin wounds after debridement of open fractures is controversial. The purpose of the present study was to determine whether primary skin closure for grade-IIIA or lower-grade open extremity fractures is associated with a lower deep-infection rate. Methods: We identified 349 Gustilo-Anderson grade-I, II, or IIIA fractures treated at our level-I academic trauma center from 2003 to 2007. Eighty-seven injuries were treated with delayed primary closure, and 262 were treated with immediate closure after surgical debridement. After application of a propensity score-matching algorithm to balance prognostic factors, 146 open fractures (seventy-three matched pairs) were analyzed. Results: After application of a propensity score-matching algorithm with adjustment for age, sex, time to debridement, American Society of Anesthesiologists (ASA) class, fracture grade, evidence of gross contamination, and a tibial fracture rather than a fracture at another anatomic site, the two treatment groups were compared with respect to the prevalence of infection. Deep infection developed at the sites of three of the seventy-three fractures treated with immediate closure (infection rate, 4.1%; 95% confidence interval [CI], 0.86 to 11.5) compared with thirteen in the matched group of seventy-three fractures treated with delayed primary closure (infection rate, 17.8%; 95% CI, 9.8 to 28.5) (McNemar test, p = 0.0001). Conclusions: Immediate closure of carefully selected wounds by experienced surgeons treating grade-I, II, and IIIA open fractures is safe and is associated with a lower infection rate compared with delayed primary closure. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.Methods: A retrospective analysis of 27 pelvic abscesses in 22 consecutive women undergoing transvaginal drainage, including 13 tuboovarian abscesses (TOAs) and 14 postoperative abscesses (POAs). All patients received broad-spectrum intravenous antibiotics from the time infection was diagnosed to resolution of signs and symptoms. Chart review and examination of ultrasound files were utilized to extract demographic clinical, laboratory, and outcome data.Results: The mean age for the study group was 30 years old. Mean duration from diagnosis to drainage was 5.6 days (TOA) and 2.0 days (POA), P < 0.01. The mean diameter of the abscesses was 86 mm. The volume of purulent material drained ranged from 70–750 mL. Perceived adequacy of drainage was correlated with lack of abscess septation. Cultures for aerobic and anaerobic pathogens were positive in 51% of cases (79% POA versus 23% TOA, P < 0.05) with 1.9 organisms/ positive culture. Transvaginal drainage was successful in 25 of 27 abscesses. No complications were reported.Conclusion: In skilled hands, transvaginal guided aspiration of pelvic abscess is a highly successful technique with minimal risk to the patient. Follow-up studies are needed to assess the long-term sequelae, such as frequency of infertility, ectopic pregnancy, and chronic pelvic pain. Infect. Dis. Obstet. Gynecol. 7:216–221, 1999.

Purpose We report the gray-scale, color, and power Doppler findings in 3 cases of postpartum ovarian vein thrombophlebitis (PPOVT), an uncommon but potentially lethal disorder. Methods A retrospective review of medical records revealed 3 patients with PPOVT who had pelvic sonography performed during the disease course. Results The sonographic findings of PPOVT included a tubular, hypoechoic mass identified anterior to the psoas muscle in all cases. Perivenous phlegmon formation resulted in hydronephrosis and obstructive periureteritis in 1 case. Inferior vena cava involvement was detected in 2 cases. Decreases in the sizes of the thrombus and the phlegmon were seen on post-treatment studies. Conclusions The long course of the thrombosed ovarian vein and the presence of inferior vena cava thrombus are sonographic signs helpful in distinguishing PPOVT from other inflammatory conditions. Sonography cannot be proposed as a primary tool in the diagnosis of PPOVT because it successfully diagnosed only 1 of our 3 cases. However, sonography may be useful in monitoring the response to anticoagulant therapy. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound26:143–149, 1998.

An optical nanothermometer technique based on laser trapping, moving and targeted attaching an erbium oxide nanoparticle cluster is developed to measure the local temperature. The authors apply this new nanoscale temperature measuring technique (limited by the size of the nanoparticles) to measure the temperature of vapor nucleation in water. Vapor nucleation is observed after superheating water above the boiling point for degassed and nondegassed water. The average nucleation temperature for water without gas is 560 K but this temperature is lowered by 100 K when gas is introduced into the water. The authors are able to measure the temperature inside the bubble during bubble formation and find that the temperature inside the bubble spikes to over 1000 K because the heat source (optically-heated nanorods) is no longer connected to liquid water and heat dissipation is greatly reduced.

Abnormalities of the female reproductive tract are associated with a multitude of intrapartum complications. In the case that follows, we report the complicated pregnancy course of a woman diagnosed postpartum with the uncommon syndrome of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) associated with a complete septate uterus.A 19-year-old nulliparous woman with a history of a right nephrectomy secondary to multicystic dysplastic kidney disease presented with premature rupture of membranes at 30 weeks' gestation. After failed induction of labor at 34 weeks' gestation, a uterine anomaly was discovered at the time of cesarean section. Magnetic resonance imaging performed postpartum revealed a complete septate uterus, longitudinal vaginal septum, and obstructed right hemivagina.The OHVIRA syndrome is classically associated with uterus didelphys, not complete septate uterus as in this woman. This case illustrates the potential for intrapartum complications in women with abnormalities of the urogenital tract.

There is now strong evidence that fetal events can significantly impact postnatal health and disease development. Doppler velocimetry can identify some early pathologic changes in pregnancy. Many investigators have tried to delineate the normal and pathologic models of the uterine circulation in the first trimester, but much has yet to be defined. A discrete amount of confusion derives from the incomplete knowledge of the initial placental development, and particularly the development of the intervillous circulation. This article comprehensively reviews the literature on first-trimester Doppler in both normal and complicated pregnancies, and briefly discusses potential future areas of application.

Over a period of 6.5 years (January 1983 through August 1989) 124 fine-needle aspirations (FNAs) were performed on 95 patients with prior documented primary malignancies of the cervix, ovary, endometrium, and vulva. The significance of clinicopathologic factors which influenced the FNA results was analyzed by statistical methods. The factors studied included the initial patient clinical stage, the time interval between staging and disease recurrence, the treatment modalities, the neoplasm type, the aspiration site, the target lesion size, and the type of radiologic guidance. Primary aspiration sites were pelvic wall and organs (40%), lymph nodes (36%), and liver (21%); 64% were positive, 5% suspicious, 15% negative, and 16% unsatisfactory. The specificity was 100%; sensitivity, 96.3%; predictive value of a positive test, 100%; and predictive value of a negative test, 84.2%. Statistically significant clinicopathologic factors which influenced the FNA results included the target lesion size (P = 0.026) and the aspiration site (P = 0.033). The primary neoplasm type, the time interval between staging and disease recurrence, the initial patient clinical stage, the treatment modalities, and the type of radiologic guidance were not statistically significant. FNA is a reliable procedure in the management of gynecologic malignancy and its results are influenced by clinicopathologic factors.

A five-year sales projection in 1961 showed considerable growth potential for S. C. Johnson & Son's European operations. After considering several alternatives, and keeping in mind the changing business environment, the firm decided to build a single facility—Europlant—to supply the. EEC market. Accordingly, a uniquely designed plant was constructed in the Netherlands How has Europlant fared since its opening. in 1964? There were, of course, some early problems. With these overcome, Johnson's EEC sales went on to exceed the planning forecasts. A key feature in Europlant is a production. planning control and distribution system. linked to a computer. The labor climate is sound, and the. striking architecture is a source of pride to both company and community.

We experimentally demonstrate a nonlinear metasurface comprising plasmonic resonators coupled to multi-quantum well transition. Due to MQW saturation, the metasurface provides a giant j(3) on the order of 3x10-13 m2/V2 with ~2 ps response time.