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BACKGROUND: Neuromodulation is a therapeutic option to improve limb salvage in end-stage peripheral arterial disease (PAD), but there is no consensus on its indication for spinal cord stimulation (SCS) in PAD patients. OBJECTIVE: The aim of this study was to present the outcome of end-stage PAD patients treated with SCS. METHODS: This study is a retrospective analysis based on a local prospective registry. Neuromodulation was performed if there was: 1) no revascularisation option, 2) no septicemia, 3) and Rutherford stage 4–6. The primary endpoint of the study was limb salvage. Secondary endpoints were reduction in pain or simply pain reduction pain (assessed using a visual anlog scale/VAS) and improvement in walking distance. RESULTS: Limb salvage was reached in 30/34 patients (88%). Patients reported a significant reduction in pain on the 10-point VAS scale from baseline (median = 7.5, IQR = 7–8) to follow-up at 2 years (median = 0, IQR 0–2.75), p

The paper raises the question whether Web 2.0 can be seen as a technological or a social innovation and describes interdependencies between these two phenomena. The paper argues that the core innovation of Web 2.0 is the communication of “user generated content” as a new social routine, which is largely congruent with the definition of “Web 2.0” in the communication science discourse (which the authors speak for). The authors distinguish between a technological and a social layer of this innovation. The concrete usage by a broad and heterogeneous audience of the different technologies is seen as the main driver for the spread of web 2.0 and the paradigmatic changes it exerts on numerous fields of life. While technology is seen as a “catalyst”, the innovation itself (user generated content) is considered a social one. In a final step, the paper describes the usage of social media in the field of adult learning and the way web 2.0 based learning principles can contribute to social inclusion. In “telecentres”, social media have started to prove their potential as easy-to-use applications for activating and integrating target groups with low ICT skills into the “digital society”.

© 2017, American Association for the Advancement of Science. All rights reserved. Estimates of climate change damage are central to the design of climate policies. Here, we develop a flexible architecture for computing damages that integrates climate science, econometric analyses, and process models. We use this approach to construct spatially explicit, probabilistic, and empirically derived estimates of economic damage in the United States from climate change. The combined value of market and nonmarket damage across analyzed sectors - agriculture, crime, coastal storms, energy, human mortality, and labor - increases quadratically in global mean temperature, costing roughly 1.2% of gross domestic product per +1°C on average. Importantly, risk is distributed unequally across locations, generating a large transfer of value northward and westward that increases economic inequality. By the late 21st century, the poorest third of counties are projected to experience damages between 2 and 20% of county income (90% chance) under business-as-usual emissions (Representative Concentration Pathway 8.5).

To report a large multi-institutional series of laparoendoscopic single-site (LESS) nephroureterectomy (NU).Data on all cases of LESS-NU performed between 2008 and 2012 at 15 institutions were retrospectively gathered. The main demographic data and perioperative outcomes were analysed.The study included 101 patients whose mean (SD) age was 66.4 (9.9) years and mean (SD) body mass index was 24.8 (4) kg/m², and of whom 29.7% had undergone previous abdominal/pelvic surgery. The mean (SD) operating time was 221.4 (73.7) min, estimated blood loss 231.7 (348.0) mL. A robot-assisted LESS technique was applied in 25.7% of cases. An extra trocar was inserted in 28.7% of cases to complete the procedure. Conversion to open surgery was necessary in three cases (3.0%). There was no bladder cuff excision in 20.8% of cases, and excision was carried out using a variety of techniques in the remaining cases. Six intra-operative complications occurred (5.9%). The mean (SD) length of hospital stay was 6.3 (3.5) days. The overall postoperative complication rate was 10.0%, and most of the complications were low grade (Clavien grades 1 and 2). The mean tumour size was 3.1 (1.9) cm. Pathological staging was pTis in two patients, pTa in 12 patients, pT1 in 42 patients, pT2 in 20 patients, pT3 in 23 patients and pT4 in two patients. Pathological grade was high in 71 and low in 30 patients. At a mean follow-up of 14 months, six patients (5.9%) had died. Disease recurrence (including distant and bladder recurrence) was detected in 22.8% of patients, with a mean time to recurrence of 11.5 months.This study reports the largest multi-institutional experience of LESS-NU to date. Peri-operative outcomes mirror those of published standard laparoscopy series. Despite encouraging early findings, longer follow-up is needed to determine the oncological efficacy of the procedure.

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Concentrations of soluble CD44 standard (sCD44std) and CD44 variant 6 (sCD44v6) isoforms were determined in the sera of 59 patients with distant metastasis from breast cancer receiving second line hormone- or chemotherapy, in comparison to 46 breast cancer patients without detectable recurrent disease and 21 healthy blood donors. The sera of non-metastatic breast cancer, patients contained sCD44std and sCD44v6 concentrations similiar to those of healthy blood donors. In sera of patients with distant metastasis from recurrent breast cancer the median values of sCD44std and sCD44v6 were significantly higher (sCD44std: 502 ng/ml, p=0.03; sCD44v6: 193 ng/ml, p = 0.002) in comparison to healthy blood donors and patients with non-metastatic disease (p0.001 for both parameters). A significant correlation was observed between sCD44v6 serum concentrations and the number of metastasized organs (p=0.0018), serum LDH concentrations (p0.0001), tumor grading (p=0.025) and the presence of hepatic metastasis (p=0.028). Furthermore, sCD44v6 expression was associated with the patient's responsiveness to second line hormone- or chemotherapy. Non-responders had significantly higher sCD44v6 levels compared with the responder group (median: 447 ng/ml vs 171 ng/ml; p=0.0007). Logistic regression analysis indicated that sCD44v6 serum levels above 250 ng/ml (p =0.033) and the presence of hepatic metastasis (p=0.009) were independent factors predicting an unfavourable response to therapy.

Different groups of mice were exposed to flurothyl vapors immediately 5, 60, 360, and 720 min after a one-trial passive avoidance learning procedure. The first three groups 24 hours later showed a marked retention deficit, but retest performance of the 6 hour group was significantly less impaired than the first three. The 12 hour group was not significantly different from the control group. When only clonic seizures were elicited, performance was just as impaired as in mice which had exhibited tonic convulsions. The effective intervals at which RA was produced were similar for both flurothyl and ECS. However, the temporal gradient of RA to the flurothyl treatment was significantly flatter than that produced by a 15 mA-ECS under otherwise identical conditions.

We report the case of a 61-year-old patient admitted to our hospital owing to recent nonspecific abdominal pain. Five years earlier he had been treated with a graft owing to thoracic and abdominal aortic aneurysm with dissection. He now showed a left renal vein aneurysm with a diameter of 11x7.5 cm. This case demonstrates that contrast enhanced ultrasound (CEUS), employed in addition to computed tomography angiography, offers a promising new option for diagnosis and preoperative treatment planning in patients with abdominal vascular diseases. The results were compared with operative findings.

Processes of severe plastic deformation (SPD) are defined as metal forming processes in which a very large plastic strain is imposed on a bulk process in order to make an ultra-fine grained metal. The objective of the SPD processes for creating ultra-fine grained metal is to produce lightweight parts by using high strength metal for the safety and reliability of micro-parts and for environmental harmony. In this keynote paper, the fabrication process of equal channel angular pressing (ECAP), accumulative roll-bonding (ARB), high pressure torsion (HPT), and others are introduced, and the properties of metals processed by the SPD processes are shown. Moreover, the combined processes developed recently are also explained. Finally, the applications of the ultra-fine grained (UFG) metals are discussed.