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Background: Cervical cancer is a notable vaccine-preventable disease. Previous studies support a two-pronged approach incorporating human papillomavirus (HPV) vaccination and cervical screening. Diagrams enabling the visual evaluation of cervical cancer control by displaying the HPV vaccination and cervical screening rates are lacking in both small jurisdictions and at the nation/country level. This study generated a simple scatter chart displaying both rates, enabling the identification of a relevant area in which to investigate concrete primary and secondary prophylactic measures. Methods: Data on HPV vaccination and cervical screening from local governments in Wakayama, Japan, were obtained from e-Stat for the following populations: the target population for HPV vaccination in 2013, vaccinated people, and women aged ≥ 20 years who had undergone cervical screening. The relationship between the HPV vaccination and cervical screening rates was analysed in eight public health centre units, and a scatter chart was created with prefectural average values. Then, one local government with relatively high HPV vaccination and cervical screening rates was selected for a historical case study with archived documents. Findings: HPV vaccination and cervical screening rates differed substantially among the relevant units (highest: 47.1% and 50.4%; lowest: 8.1% and 36.8%). We constructed scatter charts with four profiles of vaccination and screening rates (high-high, high-low, low-high, and low-low). Good-practice areas were characterised by the systematic implementation of community- and school-based cervical cancer awareness programmes and personalised information provision. Interpretation: This scatter chart visualises the two-pronged approach to primary and secondary cervical cancer prophylaxis for cervical cancer control in relevant areas. Such charts can help local governments prioritise measures for cervical cancer control among target residents. To promote cervical cancer control, a plan-do-check-act cycle should be implemented in the relevant cancer control area through a person-centred perspective for target residents, especially those who have missed HPV vaccinations. Funding: None. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: Not applicable.

Physiological coronary lesion assessment by fractional flow reserve (FFR) improves clinical outcomes. It remains elusive why physiological assessment of coronary lesions has the potential to predict the risk of acute coronary syndrome [(1)][1]. Histologic studies suggested that plaque ruptures

The aim of the present study was to investigate the association between plaque rupture (PR) assessed by optical coherence tomography (OCT), and the transmural extent of infarction (TEI) assessed by contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI).PR is associated with larger infarct size as assessed by cardiac enzymes in STEMI patients. CE-CMR is a favorable method to assess TEI, which can predict the prognosis of STEMI patients.First, STEMI patients with primary PCI within 12 h after onset were enrolled and divided into 2 groups according to presence (n = 71) or absence (n = 32) of PR at the culprit lesion as assessed by pre-intervention OCT. CE-CMR was performed at 1 week after primary PCI.The frequency of no-reflow phenomenon (37% vs. 16%; p = 0.032) and distal embolization (24% vs. 6%; p = 0.032) was significantly higher in the rupture group compared with the non-rupture group. TEI grade was significantly greater in the rupture group (28% vs. 15% in grade 3 and 45% vs. 13% in grade 4; p 0.001). Microvascular obstruction was more frequently seen in the rupture group (39% vs. 19%; p = 0.039). Multivariate analysis identified PR (odds ratio: 6.60, 95% confidence interval: 2.19 to 21.69; p 0.001) and no statin use before admission (odds ratio: 3.37, 95% confidence interval: 1.06 to 11.19; p = 0.039) as independent predictors of TEI grade 3 or 4.PR as assessed by OCT is associated with greater TEI as assessed by CE-CMR in STEMI patients after primary PCI.

Statin-related myopathy (SRM) is a clinically important adverse reaction. Recent pharmacogenetic research, mainly in non-Asian populations, have indicated clinical relevance of some of genetic biomarkers to SRM, but predictive markers for SRM in Asian populations including Japanese has not yet been established. This study was aimed to identify clinically important genetic markers associated with SRM in Japanese patients. Allele frequencies of the three reported candidate markers — SLCO1B1 rs4149056, RYR2 rs2819742, and GATM rs9806699 — and carrier frequencies of HLA types were compared between patients with SRM patients (n = 52) and healthy Japanese subjects (n = 2878 or 86 (for rs9806699) as controls). No significant association of RYR2, SLCO1B1, and GATM variants with SRM were observed in our Japanese patients, but a significant association was detected for HLA-DRB1*04:06 with SRM (odds ratio: 3.19; 95% confidence interval: 1.53–6.66). This study suggested that HLA-DRB1*04:06 might be associated with SRM onset in a Japanese population. Further studies are required to validate these results.

Cpf1 is an RNA-guided endonuclease of a type V CRISPR-Cas system that has been recently harnessed for genome editing. Here, we report the crystal structure of Acidaminococcus sp. Cpf1 (AsCpf1) in complex with the guide RNA and its target DNA, at 2.8 Å resolution. AsCpf1 adopts a bilobed architecture, with the RNA–DNA heteroduplex bound inside the central channel. The structural comparison of AsCpf1 with Cas9, a type II CRISPR-Cas nuclease, reveals both striking similarity and major differences, thereby explaining their distinct functionalities. AsCpf1 contains the RuvC domain and a putative novel nuclease domain, which are responsible for the cleavage of the non-target and target strands, respectively, and jointly generate staggered DNA double-strand breaks. AsCpf1 recognizes the 5′-TTTN-3′ protospacer adjacent motif by base and shape readout mechanisms. Our findings provide mechanistic insights into RNA-guided DNA cleavage by Cpf1, and establish a framework for rational engineering of the CRISPR-Cpf1 toolbox.

To meet rising demand for rice, it is estimated that the global rice production needs to increase by 116 million tons by 2035. Much of the increase has to come from smallholder rice farmers in developing countries. In this article, we review 25 evaluation studies on new rice technologies and practices that have been tried and used by smallholder rice farmers in developing countries. Stress-tolerant rice varieties are found among promising new rice varieties. African farmers benefit from New Rice for Africa (NERICA) varieties. Some natural resource management (NRM) practices have been evaluated in farmer trials and found beneficial. However, the NRM evaluation studies faced with difficulties in defining NRM “technology” and “adoption”, and the difficulties remain as future challenges for evaluation studies.

It is necessary to accurately predict the diffusion and deposition range of a large amount of sand dumped from a hopper barge for efficient reclamation in a coastal area. Many previous studies have proposed useful models to simulate the diffusion behavior of sand in fluid; however, most of their models have not considered the deposition of sand. This study proposes a particle-based numerical model that includes fluid-sand interaction. The model utilizes two methods to track the sand: an elastoplastic model for a sand layer and an advection-diffusion model for suspended sediments. These two techniques for sand tracking enable the evaluation of diffusion and deposition more accurately in a series of sand processes from inside the hopper to the seafloor. The proposed model was validated with a dam-break simulation using fluid and saturated sand. In this validation, the time histories of the runout distance of the dam-break flow and the final deposition shape of the sand were compared, and they agreed well with previous experimental results. Thereafter, we conducted an experiment in which sand was dumped from a split hopper, and the model was validated using the results of this experiment. The performance of the model was examined, focusing on the spread of the suspended sediments, the velocity field of the fluid, and the deposition of sand. The flow characteristics induced by the dumped sand were revealed from the calculated results.

Highlights • Smoking in young adulthood is more common among those from households with smokers. • Being from smoking households is linked to low educational levels in young adulthood. • More childhood household smokers corresponds to worse outcomes for young adults. • Exposure to household smokers in childhood appears to perpetuate health inequality., Smoking in young adulthood is a risk factor for future health-related disabilities and a cause of expanding health inequalities. Education and smoking are inversely associated. Using population-based representative data, this study aimed to clarify how the presence of household smokers during childhood related to both current smoking status and educational attainment among young adults. Surveys were distributed to young adults (19–20 years) invited to coming-of-age ceremonies in 2014–2017 in a rural area in Japan. Data were collected on low educational attainment (defined as ≤ 12 years of education), current smoking status, and childhood household smoking status. We used logistic regression models to calculate odds ratios (ORs) of low educational attainment for household smoking status. A total of 17.6% of men (n = 1077) and 3.8% of women (n = 1021) were current smokers. Current smoking was more common among participants from households with smokers (P

A fundamental challenge of biology is to understand the vast heterogeneity of cells, particularly how cellular composition, structure, and morphology are linked to cellular physiology. Unfortunately, conventional technologies are limited in uncovering these relations. We present a real-time machine intelligence technology based on a radically new architecture that realizes real-time image-based intelligent cell search and sorting at an unprecedented rate. The technology integrates high-throughput cell imaging, cell focusing, and cell sorting on a hybrid software-hardware data management infrastructure, enabling real-time automated operation for data acquisition, data processing, decision making, and actuation. Specifically, we use it to demonstrate real-time sorting of microalgal and blood cells based on intracellular protein localization and cell-cell interaction from large heterogeneous populations for studying photosynthesis and atherothrombosis, respectively. Our technology is highly versatile and expected to enable machine-based scientific discovery in biological, pharmaceutical, and medical sciences.

Background Previous studies have suggested that vasa vasorum (VV) is associated with plaque progression and vulnerability. Objectives The aim of this study was to investigate the relationship between coronary neovascularization structures and plaque characteristics. Methods We included 53 patients who underwent optical coherence tomography to observe the proximal left anterior descending coronary artery. Patients were classified into 5 groups according to lesion characteristics: normal; fibrous plaque (FP); fibroatheroma (FA); plaque rupture (PR); and fibrocalcific plaque (FC). We defined signal-poor tubuloluminal structures recognized in cross-sectional and longitudinal profiles located in adventitial layer as VV, and within plaque as intraplaque neovessels. Two types of longitudinal microvascular structure (external running and internal running) and a particular type of intraplaque neovessels (a coral tree pattern) were noted. All VV and intraplaque neovessels were manually segmented followed by quantification with Simpson method. Results Among the groups, there was significant difference (expressed as median [interquartile range (IQR)]) in VV volume (normal: 0.329 [IQR: 0.209 to 0.361] mm3, FP: 0.433 [IQR: 0.297 to 0.706] mm3, FA: 0.288 [IQR: 0.113 to 0.364] mm3, PR: 0.160 [IQR: 0.141 to 0.193] mm3, and FC: 0.106 [IQR: 0.053 to 0.165] mm3; p = 0.003) and intraplaque neovessels volume (normal: 0.00 [IQR: 0.00 to 0.00] mm3, FP: 0.00 [IQR: 0.00 to 0.00] mm3, FA: 0.028 [IQR: 0.019 to 0.041] mm3, PR: 0.035 [IQR: 0.026 to 0.042] mm3, and FC: 0.010 [IQR: 0.005 to 0.014] mm3; p Conclusions VV increase with fibrous plaque volume and intraplaque neovessels with particular structures are associated with plaque vulnerability. Imaging for microvasculature could become a new window for plaque vulnerability.

Background and aims It remains unclear whether glycemic fluctuation can affect plaque rupture in acute myocardial infarction (AMI). Here we investigate the impact of glucose fluctuation on plaque rupture, as observed by optical coherence tomography (OCT), and monocyte subsets in patients with AMI. Methods and results We studied 37 consecutive patients with AMI. All patients underwent OCT examination, which revealed 24 patients with plaque rupture and 13 patients without plaque rupture at the culprit site. Peripheral blood sampling was performed on admission. Three monocyte subsets (CD14 + CD16 − , CD14 bright CD16 + , and CD14 dim CD16 + ) were assessed by flow cytometry. Glycemic variability, expressed as the mean amplitude of glycemic excursion (MAGE), was determined by a continuous glucose monitoring system 7 days after the onset of AMI. MAGE was significantly higher in the rupture patients than in the non-rupture patients ( P =0.036). Levels of CD14 bright CD16 + monocytes from the rupture patients were significantly higher than those from the non-rupture patients ( P =0.042). Of interest, levels of CD14 bright CD16 + monocytes correlated positively and significantly with MAGE ( r =0.39, P =0.02). Conclusion Dynamic glucose fluctuation may be associated with coronary plaque rupture, possibly through the preferential increase in CD14 bright CD16 + monocyte levels.

The CRISPR-associated endonuclease Cas9 can be targeted to specific genomic loci by single guide RNAs (sgRNAs). Here, we report the crystal structure of Streptococcus pyogenes Cas9 in complex with sgRNA and its target DNA at 2.5 Å resolution. The structure revealed a bilobed architecture composed of target recognition and nuclease lobes, accommodating the sgRNA:DNA heteroduplex in a positively charged groove at their interface. Whereas the recognition lobe is essential for binding sgRNA and DNA, the nuclease lobe contains the HNH and RuvC nuclease domains, which are properly positioned for cleavage of the complementary and noncomplementary strands of the target DNA, respectively. The nuclease lobe also contains a carboxyl-terminal domain responsible for the interaction with the protospacer adjacent motif (PAM). This high-resolution structure and accompanying functional analyses have revealed the molecular mechanism of RNA-guided DNA targeting by Cas9, thus paving the way for the rational design of new, versatile genome-editing technologies., Japan. Science and Technology Agency (PRESTO), Japan Society for the Promotion of Science, National Institutes of Health (U.S.) (NIH Director’s Pioneer Award (5DP1-MH100706))

A 77-year-old woman was diagnosed with congestive heart failure and broad anterior acute myocardial infarction that had occurred 10 days prior to her presentation in our hospital. A flat and immobile thrombus was widely attached to the luminal surface of the left ventricular antero-apical wall with dyskinetic motion. For treatment-resistant heart failure, the patient underwent percutaneous coronary intervention (PCI), with intravenous heparin, supporting an intra-aortic balloon pump. Echocardiography obtained 3h after the procedure revealed that the left ventricular mural thrombus had changed to a centrally hollow, ball-like shape of 4cm in diameter. The thrombus was surgically removed and left ventriculo-plasty was simultaneously performed without any systemic embolic events. Physicians should be aware that a relatively fresh left ventricular mural thrombus, even with no protrusion or immobility, may peel away from the endocardium after introducing an intra-aortic balloon pump under an optimal anticoagulation for performing PCI.

Summary The number of private schools has increased by more than four times since the introduction of the Free Primary Education (FPE) policy in 2003 in Kenya. With the help of panel data obtained from rural Kenya, we observed that the proportion of children attending private primary schools increased from 4.6% in 2004 to 11.5% in 2007. The estimation results suggest that parents react to the quality of public education, as measured by the pupil–teacher ratios of public schools, by attending private schools and transferring to different schools. Their reaction also depends on the wealth of households and gender.

Summary We examine the roles of local and personal networks in the employment process and the emergence and development of the labor market in Ethiopia’s growing cut flower industry. Using primary survey data of 320 workers randomly sampled from all 64 farms, we find that workers who were recruited informally using the social ties were paid less than the formally-recruited workers at hiring. However, these workers quickly increased their productivity, and the effect of social ties on wages disappeared over time. Further, we find that the development of labor market for this newly-emerged industry took place particularly within the industrial cluster.

Optical coherence tomography (OCT) has been introduced as a high-resolution imaging modality for the coronary arteries. The current OCT system, however, has a serious limitation in that the image acquisition method requires a soft balloon occlusion to avoid signal scattering from red blood cells.The purpose of this study was to compare OCT images from the conventional balloon occlusion method and a non-occlusion image acquisition method, the continuous-flushing method, in the clinical setting.OCT was performed with the conventional balloon occlusion method and the continuous-flushing method sequentially in 23 patients with stable angina. The image quality and quantitative measurements of OCT images were directly compared between the two methods.There were no adverse events related to the OCT procedure in any patients. There were no changes in systolic blood pressure and heart rate during the OCT procedure. ST-segment elevation (2 mm) was recorded in 22 of 23 (96%) patients with the balloon occlusion method, but it was only observed in 1 of 23 (4%) patients with the continuous-flushing method (p0.01). There were no differences in the visible length (the balloon occlusion method 28.6±2.3 mm vs. the continuous-flushing method 29.2±1.6 mm, p=0.49), image quality, or quantitative measurements between the two methods.OCT imaging with the continuous-flushing method could be performed safely and obtained similar quality images compared with the balloon occlusion method. OCT can be used to observe the proximal site of coronary arteries with this new technique.

A fundamental challenge of biology is to understand the vast heterogeneity of cells, particularly how cellular composition, structure, and morphology are linked to cellular physiology. Unfortunately, conventional technologies are limited in uncovering these relations. We present a machine-intelligence technology based on a radically different architecture that realizes real-time image-based intelligent cell sorting at an unprecedented rate. This technology, which we refer to as intelligent image-activated cell sorting, integrates high-throughput cell microscopy, focusing, and sorting on a hybrid software-hardware data-management infrastructure, enabling real-time automated operation for data acquisition, data processing, decision-making, and actuation. We use it to demonstrate real-time sorting of microalgal and blood cells based on intracellular protein localization and cell-cell interaction from large heterogeneous populations for studying photosynthesis and atherothrombosis, respectively. The technology is highly versatile and expected to enable machine-based scientific discovery in biological, pharmaceutical, and medical sciences., 世界初のIntelligent Image-Activated Cell Sorterを開発 --細胞画像の深層学習により高速細胞選抜を実現--. 京都大学プレスリリース. 2018-09-05.

This study attempts to identify the major factors affecting farm and nonfarm income by using panel data of 894 rural households, interviewed in 2003 and 2005 in rural Uganda. We supplement the panel data with household-level soil fertility data and road distance data to the nearest urban center on three road types: tarmac, loose-surface, and dirt roads. The results suggest that soil fertility, measured by the soil organic matter (SOM) content, is positively associated with crop income but not with livestock and nonfarm income. We also find that the total road distance to the nearest urban center and the road quality have strong negative associations with the crop income.

Summary An increased information flow due to mobile phone network expansions is expected to reduce marketing costs of agricultural commodities. We investigate this using panel data of 856 Ugandan households in 94 communities, where the number of communities covered by mobile phone networks increased from 41 to 87 between surveys in 2003 and 2005, respectively. After the expansion of coverage, we find increased sales of banana in remote communities but not of maize. The mobile phone coverage expansion seems to induce the market participation of farmers in remote areas who produce perishable crops.

ObjectivesThe purpose of this study was to investigate whether microvascular resistance index (MVRI) immediately after primary percutaneous coronary intervention (PCI) can predict the transmural extent of infarction (TEI) defined by contrast-enhanced cardiac magnetic resonance (ce-CMR) in patients with anterior acute myocardial infarction (MI).BackgroundThe degree of microvascular damage is an important determinant of myocardial viability and clinical outcomes in acute MI. A novel dual-sensor (pressure and Doppler velocity) guidewire has the ability to evaluate microvascular damage. ce-CMR can accurately discriminate transmural from nontransmural MI, and the TEI by ce-CMR can predict future improvement in contractile function.MethodsIn 27 patients immediately after primary PCI for a first anterior acute MI, MVRI, coronary flow reserve (CFR), deceleration time of diastolic velocity (DDT), and zero flow pressure (Pzf) were measured with a dual-sensor guidewire. TEI was graded from 1 to 4 based on the transmural extent of hyperenhanced tissue (1 = 0% to 25% of left ventricular wall thickness, 2 = 26% to 50%, 3 = 51% to 75%, and 4 = 76% to 100%). Infarct size by ce-CMR was also calculated.ResultsPeak creatine kinase-myocardial band values were significantly correlated with MVRI (r = 0.77, p < 0.0001), CFR (r = −0.69, p < 0.0001), DDT (r = −0.75, p = 0.0001), and Pzf (r = 0.75, p < 0.0001). Also, infarct size by ce-CMR was significantly correlated with MVRI (r = 0.78, p < 0.0001), CFR (r = −0.67, p < 0.0001), DDT (r = −0.70, p < 0.0001), and Pzf (r = 0.72, p = 0.0002). Receiver-operating characteristic curve analyses of MVRI, CFR, DDT, and Pzf for predicting transmural MI (TEI-grade 4) demonstrated that the area under the curve tended to be higher for MVRI (0.885) than those for CFR (0.848), DDT (0.862), and Pzf (0.853). The best cut-off value for MVRI was 3.25 mm Hg·cm−1·s (sensitivity 75%, specificity 89%). Moreover, increased MVRI was significantly related to increased TEI-grade (p < 0.0001).ConclusionsMVRI measured immediately after primary PCI is a useful predictor for the TEI in patients with anterior acute MI.

Objectives The aim of the present study was to compare lesion morphologies after sirolimus-eluting stent (SES) implantation between patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) with the use of optical coherence tomography (OCT). Background The lesion morphologies before and after coronary stenting have been proposed as important predictors of clinical outcome. The high resolution of OCT provides detailed information of coronary vessel wall. Methods We enrolled 55 patients (UAP: n = 24, SAP: n = 31), and examined lesion morphologies by using OCT at pre- and post-SES implantation and 9 months9 follow-up. Results The incidence of plaque rupture (42% vs. 3%, p Conclusions Serial OCT examinations demonstrated markedly different vascular response up to 9 months after SES implantation between UAP and SAP patients. Although the inadequate lesion morphologies after stenting were observed more frequently in UAP patients, these findings were not associated with adverse outcomes in patients with antiplatelet therapy.

While some governments in Sub-Saharan Africa have abolished tuition to achieve universal primary education (UPE), few studies have examined the impacts of the UPE policy beyond school enrolment. This study estimates the impact of the UPE policy in Uganda on overall primary education attainments by using data including 940 rural households. We find that UPE has decreased delayed enrolments and increased grade completion rates up to the fifth grade and its effects are especially large among girls in poor households. Yet, schools in Uganda still face further challenges in terms of low internal efficiency and the unequal quality of education.

Objectives The purpose of this study was to assess the relationship between plaque color evaluated by coronary angioscopy and fibrous cap thickness estimated by optical coherence tomography (OCT) in vivo. Background Yellow color intensity of coronary plaque evaluated by coronary angioscopy might be associated with plaque vulnerability. Methods Seventy-seven coronary artery plaques in patients with acute coronary syndrome were observed by angioscopy and OCT. Plaque color was graded as white, light yellow, yellow, or intensive yellow. Results There were significant differences among the groups classified by plaque color with respect to the fibrous cap thickness estimated by OCT: 389 ± 74 μm in white plaques, 228 ± 51 μm in light yellow plaques, 115 ± 28 μm in yellow plaques, and 59 ± 14 μm in intensive yellow plaques (p l 0.0001). In Spearman rank-order correlation analysis, there was a significant negative correlation between yellow color intensity and fibrous cap thickness (p l 0.0001). Furthermore, 80% of intensive yellow plaques were thin cap fibroatheroma with a cap thickness of ≤65 μm. Conclusions The plaque color in coronary angioscopy was determined by the fibrous cap thickness, which was assessed by OCT. Although coronary angioscopy remains a specialized research tool, it might allow us to evaluate plaque vulnerability.

Objectives The aim of the present study was to evaluate the ability of optical coherence tomography (OCT) for assessment of the culprit lesion morphology in acute myocardial infarction (AMI) in comparison with intravascular ultrasound (IVUS) and coronary angioscopy (CAS). Background Optical coherence tomography is a new intravascular imaging method with a high resolution of approximately 10 μm. This may allow us to assess the vulnerable plaques in detail in vivo. Methods We enrolled 30 patients with AMI, and analyzed the culprit lesion by OCT, CAS, and IVUS. Results The average duration from the onset of symptom to OCT imaging was 3.8 ± 1.0 h. The incidence of plaque rupture observed by OCT was 73%, and it was significantly higher than that by CAS (47%, p = 0.035) and IVUS (40%, p = 0.009). Furthermore, OCT (23%) was superior to CAS (3%, p = 0.022) and IVUS (0%, p = 0.005) in the detection of fibrous cap erosion. The intracoronary thrombus was observed in all cases by OCT and CAS, but it was identified in 33% by IVUS (vs. OCT, p Conclusions Optical coherence tomography is a feasible imaging modality in patients with AMI and allows us to identify not only plaque rupture, but also fibrous cap erosion, intracoronary thrombus, and TCFA in vivo more frequently compared with conventional imaging techniques.

A large lipid core is one of characteristics of vulnerable coronary plaque. Although optical coherence tomography (OCT) is a very high resolution imaging device, OCT does not facilitate detection of a lipid plaque. The reason is that while commercially-available OCT systems use near-infrared light

Heavily calcified lesions in coronary arteries have been known as a cause of stent under expansion, which increases the risk of in-stent restenosis. The aim of the present optical coherent tomography (OCT) study was to investigate clinical impacts of coronary calcium fracture by percutaneous

Using a two-year panel of 1,422 Kenyan households surveyed in 1997 and 2000, we measure how working-age adult mortality affects rural households’ size and composition, crop production, asset levels, and off-farm income. We also use adult mortality rates from available data on an HIV-negative sample to predict the proportion of deaths observed during 1997–2000 due to AIDS. Difference-in-differences estimations indicate that the effects of adult mortality are highly sensitive to the gender and position of the deceased family member in the household and to the household’s initial asset levels. Results indicate that relatively poor households do not recover quickly from head-of-household adult mortality; effects on crop and nonfarm incomes do not decay at least over the three-year survey interval.

Restenosis in reference segments adjacent to the proximal and distal border of the stent (so-called “stent edge restenosis [SER]”) remains a potential limitation of drug-eluting stents. The aim of this study was to determine optical coherence tomography (OCT) predictors for angiographic late SER

Patient initials or identifier number N.T ### Relevant clinical history and physical exam A 70’s-yearold man with hypertension and dyslipidemia underwent coronary angiography (CAG)due to unstable angina 14 years ago. CAG showed severe triple vessel disease. Heunderwent coronary aorta bypass

Patient initials or identifier number I.M. ### Relevant clinical history and physical exam A 70’s-year old man with hypertension and dyslipidemiaunderwent a sirolimus-eluting stent (SES) (3.0 * 18 mm) implantation in theproximal left anterior descending artery (LAD) 8 years ago. He had no

This paper provides a micro-level foundation for discussions of land allocation and its relation to income poverty within the smallholder sectors of Eastern and Southern Africa. Results are drawn from nationally-representative household surveys between 1990 and 2000 in five countries: Ethiopia, Kenya, Rwanda, Mozambique, and Zambia. The paper shows that farm sizes are declining over time; that roughly a quarter of the agricultural households in each country are virtually landless, controlling less than 0.10 hectares per capita, including rented land; that non-farm income shares are below 40% even for the households in the bottom land quartile; and that because of this, there is a strong relationship between access to land and household income, particularly for farm sizes below 1.0 hectares per capita. Land distribution within these small-farm sectors appears to be becoming more concentrated over time, and their Gini coefficients are comparable to those of many Asian countries at the time of their green revolutions. Lastly, the largest part of the variation in per capita farm sizes within the small-farm sectors is, in every country, predominantly within-village rather than between-village. Realistic discussions of poverty alleviation strategies in Africa need to be grounded in the context of these land distribution patterns and trends.

This study determines the factors underlying the allocations of food aid in Ethiopia. We focus on regional differences in targeting criteria, and targeting accuracy according to per capita income. Data are drawn from two linked rural household surveys in 1995–96. We find large differences in food aid allocations across regions that cannot be explained by observable regional characteristics such as per capita income and rainfall. These differences are consistent with speculation that food aid is being used by the Ethiopian government to transfer resources to favored regions. We also find wide variations in the criteria used to identify recipient households across regions. We identify measurable indicators that could be used by food aid authorities to improve targeting effectiveness in the future, both across and within regions. Finally, we present simulation results on targeting accuracy under various targeting strategies and discuss potential benefits and shortcomings of those strategies.

A 78-year-old female with a history of polycythemia vera (PV) was admitted due to sudden severe chest pain at rest. She had been treated with 500 mg/day of hydroxycarbamide for PV (platelet counts ranging from 480,000 to 600,000/μl, leukocyte counts ranging from 14,500 to 18,000/μl, and hematocrit levels ranging from 37 to 42%), and 100 mg/day of cilostazol for previous cerebral transient ischemia attack. Physical examination revealed no specific findings except splenomegaly. Anterior ST-segment elevation myocardial infarction (STEMI) was diagnosed by electrocardiography. Echocardiography

Heavily calcified lesions in coronary arteries have been known to cause stent underexpansion, which increases the risk of in-stent restenosis [(1,2)][1]. Plaque modification before stent implantation is considered to be the key for treatment of calcified lesions [(3)][2]. We hypothesized that

Computed tomography (CT) angiography provides high sensitivity for detection of coronary stenosis, while the specificity is relatively low. Therefore, we hypothesized that combination of coronary flow velocity reserve (CFVR)/CT angiography might be helpful. This study aimed to determine the

The use of fractional flow reserve (FFR) for assessing intermediate coronary lesions has gained worldwide acceptance in the cardiology community. The severity of non-culprit coronary artery stenosis during the acute phase of acute coronary syndrome (ACS) also can be reliably assessed by FFR. FFR

Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by optical coherence tomography (OCT

Atheroma with thin-fibrous cap thickness