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Abstract The nucleolus is essential for ribosome biogenesis and is involved in many other cellular functions. We performed a systematic spatiotemporal dissection of the human nucleolar proteome using confocal microscopy. In total, 1,318 nucleolar proteins were identified; 287 were localized to fibrillar components, and 157 were enriched along the nucleoplasmic border, indicating a potential fourth nucleolar subcompartment: the nucleoli rim. We found 65 nucleolar proteins (36 uncharacterized) to relocate to the chromosomal periphery during mitosis. Interestingly, we observed temporal partitioning into two recruitment phenotypes: early (prometaphase) and late (after metaphase), suggesting phase‐specific functions. We further show that the expression of MKI67 is critical for this temporal partitioning. We provide the first proteome‐wide analysis of intrinsic protein disorder for the human nucleolus and show that nucleolar proteins in general, and mitotic chromosome proteins in particular, have significantly higher intrinsic disorder level compared to cytosolic proteins. In summary, this study provides a comprehensive and essential resource of spatiotemporal expression data for the nucleolar proteome as part of the Human Protein Atlas.

Objectives: To analyse prenatal parameters predicting biventricular (BV) outcome in pulmonary atresia with intact ventricular septum/critical pulmonary stenosis (PAIVS/CPS). Methods: We evaluated 82 foetuses from 01/08 to 10/18 in 3 centres in intervals 1 (< 24 weeks), 2 (24–30 weeks) and 3 (> 30 weeks). Results: 61/82 (74.4%) were livebirths, 5 (8.2%) lost for follow-up, 3 (4.9%) had compassionate care leaving 53 (64.6% of the whole cohort and 86.9% of livebirths) with intention to treat. 9 died, 44/53 (83.0%) survived. 24/38 (63.2%) with information on postnatal outcome had BV outcome, 14 (36.8%) non-BV outcome (2 × 1.5 circulation). One with BV outcome had prenatal valvuloplasty. Best single parameter for BV outcome was tricuspid/mitral valve (TV/MV) ratio (AUC 0.93) in intervals 2 and 3 (AUC 0.92). Ventriculo-coronary-arterial communications (VCAC) were present in 11 (78.6%) in non-BV outcome group vs. 2 (8.3%) in BV outcome group (p < 0.001). Tricuspid insufficiency (TI)-Vmax > 2.5 m/s was present in BV outcome group in75.0% (18/24) vs. 14.3% (2/14) in non-BV outcome group. Including the most predictive markers (VCAC presence, TI- Vmax < 2.5 m/s, TV/MV ratio < cutoff) to a score, non-BV outcome was correctly predicted when > 1 criterion was fulfilled in all cases. After recently published criteria for foetal intervention, only 4/9 (44.4%) and 5/14 (35.7%) in our interval 2 + 3 with predicted non-BV outcome would have been candidates for intervention. Two (1 × intrauterine intervention) in interval 2, two in interval 3 reached BV outcome and one 1.5 circulation without intervention. Conclusion: TV/MV ratio as simple parameter has high predictive value. After our score, non-BV outcome was correctly predicted in all cases. Criteria for foetal intervention must further be evaluated. [ABSTRACT FROM AUTHOR]

The present study entails the phytoremediation potential of different bamboo species on 5-year-old FA-dumped site near Koradi thermal power plant of Nagpur, Maharashtra, India. The selected FA-dumped site was treated with farmyard manure, press mud, and bio fertilizer followed by plantation of six promising species of bamboo namely Bambusa balcooa Roxb., Dendrocalamus stocksii (Munro.) M. Kumar, Remesh and Unnikrishnan, Bambusa bambos (L.) Voss, Bambusa wamin E.G. Camus, Bambusa vulgaris var. striata (Lodd. ex Lindl.) Gamble, and Bambusa vulgaris var. vittata Riviere and Riviere. The experimental results indicated that the organic input in the FA-dumped site nourished the soil by improving its physico-chemical, and biological characteristics. The results revealed the contamination of the site with different trace elements in varied quantity including Cr (89.29 mg kg−1), Zn (84.77 mg kg−1), Ni (28.84 mg kg−1), Cu (22.91 mg kg−1), Li (19.65 mg kg−1), Pb (13.47 mg kg−1), and Cd (2.35 mg kg−1). A drastic reduction in concentration of heavy metals in FA was observed after 1 year of bamboo plantation as compared to the initial condition. The results showed that bamboo species are good excluders of Ba, Co, Cr, Li, Ni, Mn, and Zn, whereas they are good accumulators of Cd, Pb, and Cu. The values of biochemical parameters, such as pH, total chlorophyll, ascorbic acid (AA), and relative water content of all the bamboo leaves ranged from 5.11–5.70, 1.56-6.33 mg g−1, 0.16-0.19 mg g−1, and 60.23–76.68%, respectively. It is thereby concluded that the bamboo plantation with biofertilizers and organic amendments may indicate adaptive response to environmental pollution on FA-dumped site. [ABSTRACT FROM AUTHOR]

Bamboo is a non-timber forest product and one of the most important grass plants of industrial and domestic use. It is widely distributed in tropical countries including India, China and Southeast Asian countries with wide genetic diversity. The diversity in the available genotypes becomes an important resource for the selection and improvement of the plants for ecological and commercial use. This study investigates eight commercially and ecologically important bamboo species of six genera (Bambusa, Dendrocalamus, Thyrsostachys, Vietnamosasa, Cephalostachyum and Indocalamus) from India, Thailand and Laos. These were evaluated for genetic differences by molecular makers, chemo-morphological variation and ability of silicon accumulation. The genetic cluster analyses of eight RAPD primers revealed genetic similarities in the ranges of 24–55%. The total silica content varied from 18.34 to 40.08 ppm in leaves of different bamboo species. Chemical analysis of the silicon content by ICP-OES and secondary metabolite profiling on TLC depicted the prominent distinction among the species. The PCA analysis of quantitative morphological data grouped the species in two major clusters and found to correlate with chemical pattern and genetic similarity to some extent. This is the first report that summarizes species-specific variability of leaf silica content, secondary metabolites, and quantitative morphological data towards delineation of genetic phylogeny of bamboo species. [ABSTRACT FROM AUTHOR]

Spatially resolved wavefront measurements are presented during nonlinear self-collapse and provide the first detailed characterization of wavefront evolution during filament formation. The wavefront dynamics of key nonlinear processes including Kerr self-focusing, ionization and plasma defocusing, and dynamic spatial replenishment are identified and resolved in both the filament core and reservoir regions. These results are analyzed and interpreted with respect to numerical simulations and provide insight into fundamental aspects of filamentation. They also inform applications based on phase manipulation, such as external beam guiding, and present a new method for measuring the nonlinear index of refraction, n2. [ABSTRACT FROM AUTHOR]

Citrus fruits are commercially important fruit crop all over the world. About 50–60% of citrus fruit is considered waste including peels and its handling is costly at municipal and industry levels. Citrus wastes in general show a low pH (3–4), relatively high water content and organic matter. Its composting is not recommended, as it has inherent low pH and presence of high concentration of limonene in essential oils that slow down its biological decomposition due to inhibitory activity. Anaerobic digestion for biogas production seems to be a technically sustainable way to valorise by suitable pre-treatment methods. Present study shows extraction of essential oil in minimum requirement of water (1:1 w/v) for hydro-distillation that yields about 2% essential oil from fresh peels. Further, pre-treatment of left over de-oiled biomass with of 30% Fenton's reagent treatment show biogas and methane production up to 322.63 ml biogas/g VS feed and 122.48 ml methane/g VS feed, respectively under mesophilic condition which is superior to conventional treatment. [ABSTRACT FROM AUTHOR]

Background: Previous investigations assessing the genetic cause of pediatric hypertrophic cardiomyopathy (HCM) found underlying genetic mutations in 50-60% of cases. The purpose of our study was to analyze whether this number can be augmented by applying next-generation sequencing and directing further diagnostics by discussing unsolved cases in a multidisciplinary board.Methods and results: 42 patients with the diagnoses of HCM made before age 18 years were treated in our center from 2000 to 2016. Genetic analysis was performed in 36 subjects, a genetic defect was detected in 29 (78%) patients. 15 individuals (42%) had pathogenic variants in genes encoding sarcomere proteins, and 5 (14%) in genes coding for components of the RAS/MAPK signaling pathway. 4 subjects (11%) had mutations in the GAA gene (Pompe disease), and 3 (8%) had Frataxin repeat expansions (Friedreich's ataxia). One patient each showed a mutation in BAG3 and LMNA. Discussion of unsolved HCM cases after performing next-generation sequencing (28 genes) in an interdisciplinary board unraveled the genetic cause in 9 subjects (25%).Conclusion: A definite genetic diagnosis can be reached in nearly 80% with HCM of childhood onset. Next-generation sequencing in conjunction with a multidisciplinary cooperation can enhance the diagnostic yield substantially. This may be important for risk stratification, treatment planning and genetic counseling. [ABSTRACT FROM AUTHOR]

Integrate-and-fire networks have proven remarkably useful in modelling the dynamics of real world phenomena ranging from earthquakes, to synchrony in neural networks, to cascading activity in social networks. The reset process means that such models are inherently discontinuous. Moreover, for jump interactions, which are a common choice for many physical systems, the models are also nonsmooth. For synchronous network states these processes can occur simultaneously, and care must be taken with the mathematical analysis of solution stability. This leads to an ordering problem, that has no counterpart in smoothly coupled limit cycle systems. Here we develop a set of network saltation matrices that can be used with an appropriate ordering to determine the instability of a synchronous network state. Moreover, we show that smoothed versions of jump interactions do not capture the behaviour of the nonsmooth model. Synchrony in the smoothed model with reset is analysed using a generalised master stability function (MSF), and the eigenspectra for smooth and nonsmooth interactions are compared. We find that the one determined by the MSF organises that found from the analysis of the nonsmooth model, though the latter has further eigenvalues that can destabilise the synchronous state. [ABSTRACT FROM AUTHOR]

Hyperaccumulation of arsenic (As) by brake fern Pteris vittata has been described as an important genetic trait that provides an option for development of a sustainable phytoremediation process for As mitigation. Accumulation of very high concentration of arsenic in above-ground tissues may be the result of arsenic vacuole compartmentalization, but the mechanism(s) of arsenic uptake and transport by underground tissues are largely unknown. In this study, we made an attempt towards understanding the molecular mechanism of As hyperaccumulation in this plant. A time-dependent As accumulation study indicates an exponential accumulation of As from 7 to 30 days of arsenic exposure in fronds, and day 3-7 in roots. Root transcriptome analysis identified 554,973 transcripts. Further, subsets of 824 transcripts were differentially expressed between treated and control samples. Many of the genes of critical As-stress response, transcription factors and metal transporters, biosynthesis of chelating compounds involved in uptake and accumulation mechanisms were identified. The genes that were highly expressed such as cysteine-rich RLK, and ABC transporter G family member 26 needs further studies along with arsenite transmembrane transporter. The analysis of generated transcriptome dataset has provided valuable information and platform for further functional studies. [ABSTRACT FROM AUTHOR]

Background: Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students' knowledge, skills, and attitudes about IPV prevention.Objective: To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students' knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training.Participants: One hundred and seventeen students attending 4 medical schools.Design: Students were randomly assigned to didactic training in adolescent IPV prevention with or without participation as educators in a community-based adolescent IPV prevention program. Students assigned to didactic training alone served as community educators after the study was completed.Measurement: Knowledge, self-assessment of skills and attitudes about intimate partner violence and future plans to pursue outreach work.Results: The baseline mean knowledge score of 10.25 improved to 21.64 after didactic training (p Conclusions: Experience as educators in a community-based program to prevent adolescent IPV improved medical students' confidence and attitudes in recognizing and taking action in situations of adolescent IPV, whereas participation in didactic training alone significantly improved students' knowledge. [ABSTRACT FROM AUTHOR]

The original neural field model of Wilson and Cowan is often interpreted as the averaged behaviour of a network of switch like neural elements with a distribution of switch thresholds, giving rise to the classic sigmoidal population firing-rate function so prevalent in large scale neuronal modelling. In this paper we explore the effects of such threshold noise without recourse to averaging and show that spatial correlations can have a strong effect on the behaviour of waves and patterns in continuum models. Moreover, for a prescribed spatial covariance function we explore the differences in behaviour that can emerge when the underlying stationary distribution is changed from Gaussian to non-Gaussian. For travelling front solutions, in a system with exponentially decaying spatial interactions, we make use of an interface approach to calculate the instantaneous wave speed analytically as a series expansion in the noise strength. From this we find that, for weak noise, the spatially averaged speed depends only on the choice of covariance function and not on the shape of the stationary distribution. For a system with a Mexican-hat spatial connectivity we further find that noise can induce localised bump solutions, and using an interface stability argument show that there can be multiple stable solution branches. [ABSTRACT FROM AUTHOR]

Adults suffering from congenital heart diseases (CHD) represent a challenge to anesthesiologists because of the diverse pathologies, complex pathophysiology and special treatment strategies. Due to improved therapeutic options for CHD, patient quality of life and life expectancy is increasing, leaving them as a growing population including pregnant patients with CHD. This article presents the main principles of the pathophysiology and anesthesiological management of pregnant patients living with a Fontan circulation based on a case report, which was complicated by an aortic coarctation and atonic uterine hemorrhage. [ABSTRACT FROM AUTHOR]

Presented is a retrospective outcome study of a 15-year single institutional experience with a contemporary cohort of patients with hypoplastic left heart syndrome and complex that underwent a 'Giessen Hybrid' stage I as initial palliation. Hybrid approach consisting of surgical bilateral pulmonary artery banding and percutaneous duct stenting with or without atrial septum manipulation was developed from a rescue approach to a first-line procedure. Comprehensive Aristotle score defined pre-operative condition. Fifteen-year follow-up mortality is reported as occurring within the staged univentricular palliation or before and after biventricular repair. Hybrid stage I was performed in 154 patients; 107 should be treated by single ventricle palliation, 33 by biventricular repair (BVR), 7 received heart transplantation, and 7 were treated by comfort care, respectively. Overall 34 children died. The Aristotle score (mean value 18.2 ± 3) classified for univentricular circulations in newborns did not have statistical impact on the outcome. Two patients died during stage I (1.2 %), and the interstage I mortality was 6.7 %, and stage II mortality 9 %, respectively. Stage III was up to now performed in 57 patients without mortality. At 1 year, the overall unadjusted survival of HLHS and variants was 84 % and following BVR 89 %, respectively. The Fifteen-year survival rate for HLHS and variants was 77 %, with no significant impact of birth weight of less than 2.5 kg. In conclusion, Hybrid stage I fulfilled the criteria of life-saving approach. In our institution, Hybrid procedure replaced Norwood-staged palliation with a considerable mid- and long-term survival rate. Considering interstage mortality close surveillance is mandatory. [ABSTRACT FROM AUTHOR]

Endocannabinoids (eCBs) modulate both excitatory and inhibitory neurotransmission in hippocampus via activation of pre-synaptic cannabinoid receptors. Here, we present a model for cannabinoid mediated short-term depression of excitation (DSE) based on our recently developed model for the equivalent phenomenon of suppressing inhibition (DSI). Furthermore, we derive a simplified formulation of the calcium-mediated endocannabinoid synthesis that underlies short-term modulation of neurotransmission in hippocampus. The simplified model describes cannabinoid-mediated short-term modulation of both hippocampal inhibition and excitation and is ideally suited for large network studies. Moreover, the implementation of the simplified DSI/DSE model provides predictions on how both phenomena are modulated by the magnitude of the pre-synaptic cell's activity. In addition we demonstrate the role of DSE in shaping the post-synaptic cell's firing behaviour qualitatively and quantitatively in dependence on eCB availability and the pre-synaptic cell's activity. Finally, we explore under which conditions the combination of DSI and DSE can temporarily shift the fine balance between excitation and inhibition. This highlights a mechanism by which eCBs might act in a neuro-protective manner during high neural activity. [ABSTRACT FROM AUTHOR]

Purpose: Clear recommendations on how to guide patients with cancer on home parenteral nutrition (HPN) are lacking as the use of HPN in this population remains a controversial issue. Therefore, the aims of this study were to rank treatment recommendations and main outcome indicators to ensure high-quality care and to indicate differences in care concerning benign versus malignant patients. Methods: Treatment recommendations, identified from published guidelines, were used as a starting point for a two-round Delphi approach. Comments and additional interventions proposed in the first round were reevaluated in the second round. Ordinal logistic regression with SPSS 2.0 was used to identify differences in care concerning benign versus malignant patients. Results: Twenty-seven experts from five European countries completed two Delphi rounds. After the second Delphi round, the top three most important outcome indicators were (1) quality of life (QoL), (2) incidence of hospital readmission and (3) incidence of catheter-related infections. Forty-two interventions were considered as important for quality of care (28/42 based on published guidelines; 14/42 newly suggested by Delphi panel). The topics 'Liver disease' and 'Metabolic bone disease' were considered less important for cancer patients, together with use of infusion pumps ( p = 0.004) and monitoring of vitamins and trace elements ( p = 0.000). Monitoring of QoL is considered more important for cancer patients ( p = 0.03). Conclusion: Using a two-round Delphi approach, we developed a minimal set of 42 interventions that may be used to determine quality of care in HPN patients with malignancies. This set of interventions differs from a similar set developed for benign patients. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An effort was made to determine the impact of geographic range on genetic richness and chemical constituents of Valeriana jatamansi Jones, an herb indigenous to the northwestern Himalaya. The genetic structure of 16 accessions from two major divisions of Uttarakhand state (Kumaon and Garhwal) was analyzed by ISSR markers. Overall genetic diversity among the populations was 45 %, with a cumulative range of 35-92 % similarity for most of the high-altitude plants and a comparatively narrow range, 50-88 %, for the population below the altitude of 1,800 m. Likewise, a remarkable predictability was evident from the chemical constituents on an individual basis. In principal component analysis, most of the accessions fall into two major groups and are classified as chemotypes based on the percentage of similar chemical constituents; these are mostly correlated to altitude. Geographic distance seems to influence the genetic and chemical variability, indicating the genetic inbreeding within the population. [ABSTRACT FROM AUTHOR]

The taxonomic identity of Capsicum species is found to be difficult as it displays variations at morpho-chemical characters. Twenty-two accessions of six Capsicum species, namely, C. annuum, C. baccatum, C. chinense, C. eximium, C. frutescens, and C. luteum were investigated for phenotypic diversity based on flower color and for genetic differences by molecular makers. The genetic cluster analyses of 27 RAPD and eight ISSR primers, respectively, revealed genetic similarities in the ranges of 23-88% and 11-96%. Principal component analysis of the pooled RAPD and ISSR data further supports the genetic similarity and groupings. Different species showed variations in relation to corolla shade of flower. C. annuum accessions formed a single cluster in the molecular analysis as maintaining their flower characteristic. C. chinense accession shared flower features with the accessions of C. frutescens and were found to be closer at genotypic level. C. luteum was found to be rather closer to C. baccatum complex, both phenotypically and genetically. The only accession of C. eximium presenting purple flowers falls apart from the groupings. The floral characteristics and the molecular markers are found to be useful toward the delineation of the species specificity in Capsicum collection and identification of genetic stock. [ABSTRACT FROM AUTHOR]

We study here the early stage of Ca-induced Ca release (CICR) in the diadic cleft of cardiac ventricular myocytes. A crucial question for this mechanism is whether the activation of the ryanodine receptors (RyRs) is triggered by one or by multiple open L-type Ca channels (LCCs). We address the problem through a modelling approach that allows us to investigate both possibilities. The model is based on a spatially resolved description of a Ca release unit (CaRU), consisting of the junctional sarcoplasmic reticulum and the diadic cleft, with well-defined channel placement. By taking advantage of largely varying time scales of the Ca dynamics in the diadic cleft, the governing equations can be reduced to one ordinary differential equation that describes the Ca fluxes, the electric field due to surface charges and diffusion. Our study shows that the mechanisms of the early stage of CICR shape measurable properties of CICR in a characteristic way. From here we conclude that the activation of RyRs requires multiple open LCCs. [ABSTRACT FROM AUTHOR]

method was developed based on multiple approaches wherein DNA and chemical analysis was carried out toward differentiation of important species of Sida complex that is being used for commercial preparation. Isolated DNA samples were successfully performed through PCR amplification using ISSR markers and degree of genetic diversity among the different species of Sida is compared with that of chemical diversity. For genetic fingerprint investigation, selected 10 ISSR primers generating reproducible banding patterns were used. Among the total of 63 amplicons, 62 were recorded as polymorphic, genetic similarity index deduced from ISSR profiles ranged from 12 to 51%. Based on similarity index, S. acuta and S. rhombifolia found to be most similar (51%). High number of species-specific bands played pivotal role to delineate species at genetic level. Investigation based on HPTLC fingerprints analysis revealed 23 bands representing to characteristic chemicals and similarity index ranged from 73 to 91%. Prominent distinguishable bands were observed only in S. acuta, while S. cordifolia and S. rhombifolia shared most bands making them difficult to identify on chemical fingerprint basis. This report summarizes the genotypic and chemotypic diversity and the use of profiles for authentication of species of Sida complex. [ABSTRACT FROM AUTHOR]

systematic study on the structural characteristics of the 2-pyranone ring containing molecules with bromine, nitrile, and amide substituents at the C-3 position in the ring is conducted in the electronic ground ( S) state by DFT calculations using the B3LYP/6-311++G** method. The geometrical structure of the bromine substituted compound, which shows potent hepatoprotective activity, is studied both in the ground ( S) and first excited singlet ( S) states using RHF/6-311++G** and CIS/6-311++G** methods respectively. The molecules are found to exist in two isomeric forms gauche and trans that have the enthalpy difference of less than 3.32 kcal/mol; the latter is the preferred orientation in the gaseous phase. The S state is a (π,π*) state that arises π-electron transfer from the region of a double bond in the pyranone ring to the region of the internuclear bond connecting the 2-pyranone and benzene rings. A complete vibrational analysis is conducted for the 3-bromo-6-(4-chlorophenyl)-4-thiomethyl-2H-pyran-2-one molecule based on the experimental infrared spectra in the 50-4000 cm region and DFT/6- 311++G** computations of vibrational frequencies for the gauche and trans isomeric forms. Spectral assignments based on the potential energy distribution along the internal coordinates confirm the nonplanar structure of the molecule. [ABSTRACT FROM AUTHOR]

Phenotypic divergence among the 24 accessions belonging to a collection of six species of Capsicum from different geoclimatic regions available in field gene bank of CIMAP, Lucknow, India, was quantified by multivariate analysis for 12 quantitative and qualitative traits. Based on their values, all 24 accessions were grouped into six clusters such that the genetic stocks within cluster had smaller D2 values among themselves than those belonging to different clusters. The accessions of Capsicum annuum were distributed in different clusters in morphotyping representing different species, suggesting that taxonomic characteristics are not always related to agronomic traits. No parallelism/association was found between geographical and phenotypic diversity. Accessions 15 and 23 (clusters V and VI, respectively) had distinct identity. The three characteristics that played the greatest role in differentiation were fruit diameter, number of fruits per plant, and leaf diameter, which can be utilized as conventional/morphological markers for the improvement of chilli yield and obtaining good segregants in chilli breeding programs. [ABSTRACT FROM AUTHOR]

Abstract  We present a bidomain fire-diffuse-fire model that facilitates mathematical analysis of propagating waves of elevated intracellular calcium (Ca2) in living cells. Modeling Ca2 release as a threshold process allows the explicit construction of traveling wave solutions to probe the dependence of Ca2 wave speed on physiologically important parameters such as the threshold for Ca2 release from the endoplasmic reticulum (ER) to the cytosol, the rate of Ca2 resequestration from the cytosol to the ER, and the total [Ca2] (cytosolic plus ER). Interestingly, linear stability analysis of the bidomain fire-diffuse-fire model predicts the onset of dynamic wave instabilities leading to the emergence of Ca2 waves that propagate in a back-and-forth manner. Numerical simulations are used to confirm the presence of these so-called ‘tango waves’ and the dependence of Ca2 wave speed on the total [Ca2]. [ABSTRACT FROM AUTHOR]

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The outcome of patients with hypoplastic left heart (HLH) is determined by many factors, particularly by the first-step palliative procedure in newborns undergoing the Norwood procedure, its Sano modification, or, rarely, through challenging biventricular repairs. Duct stenting combined with bilateral pulmonary artery banding (PAB) is a new method employed as an alternative first-step approach in a number of centers worldwide. We describe this interventional–surgical “hybrid approach” as an additional strategy for the treatment of newborns with HLH syndrome and HLH complex. Between 1998 and April, 2006, 58 newborns underwent ductal stenting and bilateral PAB. These patients underwent surgical bilateral PAB initially, followed by percutaneous duct stenting; the only exception to this were patients in whom duct stenting was performed as a rescue procedure. Various balloon-expandable and self-expandable stents with different widths and lengths were used during the 8-year period of this study. Balloon dilatation of the atrial septum was performed when indicated. This included 5 patients in whom the atrial septum was stented. Aortic arch reconstruction (AAR) combined with a bidirectional cavopulmonary connection (BCPC) was performed at a median age of 4.8 months (range, 2.6–7.5), and total cavopulmonary connection (TCPC) was performed at a median age of 3.1 years (range, 2.5–4). Nine patients were listed for heart transplantation (HTX) and transplanted with AAR when a donor heart was available. Depending on growth of left ventricular structures, biventricular repair (BVR) was performed at a median age of 7.1 months (range, 3.5–10). Overall, 8 of 58 patients (13.8%) treated by the transcatheter–surgical hybrid approach died during the study period. The mortality rate for duct stenting was 1.7% (l/58), and it was 1.7% for bilateral PAB as well. Twenty-seven patients received an AAR/BCPC; 2 of them died (7.4%). Additionally, 1 of 2 patients with AAR/BCPC died while on the waiting list for HTX, resulting in a total mortality rate of 11% with an actuarial survival rate of 89%. One patient is still awaiting AAR + BCPC. Three patients died while on the waiting list for HTX despite successful bilateral PAB and duct stenting. The 30-day mortality rate for TCPC ( n = 11), HTX ( n = 8), and 18 patients with BVR was 0. The actuarial survival rate for patients with BVR is 93%. Postnatal transcatheter–surgical hybrid palliation expands the surgical options for newborns with HLH. Using hybrid palliation, Norwood stage I operation can be avoided in the neonatal period, the waiting period for children scheduled for cardiac transplantation can be extended, and observation for left ventricular growth suitable for biventricular repair as well. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Epidemiology of candidacy for intestinal transplantation (ITx) and timing for referral for ITx are unknown. Patient candidacy and physician attitudes toward ITx were investigated among centers that participated in previous European surveys on home parenteral nutrition (HPN). METHODS: Patients on HPN for benign intestinal failure (IF) were evaluated by a structured questionnaire. Candidacy was assessed by USA Medicare and American Transplantation Society criteria, categorized as: (1) life-threatening HPN complications; (2) high risk of death because of the gastrointestinal disease; (3) IF with high morbidity or patient HPN refusal. Physicians judged candidacy as immediate or potential. RESULTS: Forty-one centers from nine countries enrolled 688 adults (>18 yr) and 166 pediatric patients; 70% of patients were from five countries which collected 60–100% of their HPN patients. Candidacy was 15.7% in adults and 34.3% in pediatrics (HPN failure, 62.1% and 28.1%; gastrointestinal disease, 25.9% and 59.6%; high morbidity IF or HPN refusal, 12.0% and 12.3%, respectively). Immediate candidacy was required for 14.8% of adult and 15.8% of pediatric candidates (<50% of candidates because of HPN-related liver failure). Among centers, the candidacy rate ranged 0–100% and was negatively associated with the number of patients enrolled in the survey ( R=−0.463, p= 0.002). Among the major contributing countries, candidacy ranged 0.3–0.8/million inhabitants for adults and 0.9–2/million inhabitants ≤18 yr for pediatric candidates. CONCLUSIONS: The rate of candidacy and the indications for ITx candidacy differed greatly among age groups and HPN centers; within countries candidacy was more homogeneous; physicians had a generally reserved attitude toward ITx. [ABSTRACT FROM AUTHOR]

The need for higher data rates is ever rising as wireless communications standards move from the third to the fourth generation. Turbo-Codes are the prevalent channel codes for wireless systems due to their excellent forward error correction capability. So far research has mainly focused on components of high throughput Turbo-Decoders. In this paper we explore the Turbo-Decoder design space anew, both under system design and deep-submicron implementation aspects. Our approach incorporates all levels of design, from I/O behavior down to floorplaning taking deep-submicron effects into account. Its scalability allows to derive optimized architectures tailored to the given throughput and target technology. We present results for 3GPP compliant Turbo-Decoders beyond 100 Mbit/s synthesized on a 0.18 μm standard cell library. [ABSTRACT FROM AUTHOR]

Zusammenfassung Epigastrische Schmerzen, Ubelkeit, Erbrechen und eine obere gastrointestinale Blutung werden gelegentlich durch heterotopes Pankreasgewebe der Magenwand verursacht. Trotz moderner diagnostischer Verfahren gestaltet sich die Diagnose heterotopen Pankreasgewebes oftmals schwierig. Daher wird von vielen Autoren die Magenwandresektion und Schnellschnittuntersuchung als diagnostische und therapeutische Ma?nahme befurwortet. Zwei typische Kasuistiken werden im Folgenden mit einer Literaturubersicht vorgestellt. [ABSTRACT FROM AUTHOR]

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Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. Design: Prospective direct comparison of the above two techniques. Setting: Pediatric intensive care unit of a university hospital. Patients: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. Methods: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20 s. Interventions: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. Results: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r=0.98; P<0.001; SEE=0.14 l/min. The bias is absolute values and in percent of average cardiac output was −0.05 l/min or −4.4% with a precision of 0.32 l/ min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. Conclusion: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children. [ABSTRACT FROM AUTHOR]

Although recent technological advances have dramatically improved the survival of preterm infants born at the "limit of viability," coexisting congenital heart disease may limit resuscitation efforts. This case report is the first to describe successful transcatheter relief of right ventricular outflow tract obstruction of an extremely low birth weight infant with tetralogy of Fallot as rescue therapy after closure of the arterial duct. This interventional approach offers bridging to palliative or corrective surgery and could be used in fetal intervention when indicated. [ABSTRACT FROM AUTHOR]

Background: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Objective: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Design: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Participants: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Main Measures: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Key Results: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers.Conclusions: Neighborhood disadvantage has been associated with potentially preventable acute care utilization among Medicare beneficiaries, but this association has not been studied in a Medicaid population, which is important for informing more equitable care and policies for this population.To describe the association between Area Deprivation Index (ADI) and acute care utilization (including potentially preventable utilization) among Medicaid beneficiaries in Washington State.Retrospective cohort study of 100% Medicaid claims. Mixed effects logistic regression was applied to estimate the association between state-level ADI decile and acute care utilization, adjusting for age, sex, self-identified race and ethnicity, Charlson Comorbidity Index, primary spoken language, individual Federal Poverty Level, homelessness, and rurality. Standard errors were clustered at the Census block group level.1.5 million unique adult Medicaid beneficiaries enrolled for at least 11 months of a calendar year during the period 2017–2021.Binary measures denoting receipt of ED visits, low-acuity ED visits, hospitalizations in a calendar year.Increasing levels of neighborhood socioeconomic disadvantage (by ADI decile) were associated with greater odds of any ED visits (adjusted odds ratio (aOR) 1.07, 95% confidence interval (CI) 1.06–1.07), low-acuity ED visits (aOR 1.08, CI 1.08–1.08), and any hospitalizations (aOR 1.02, CI 1.02–1.02).Among Medicaid beneficiaries, greater neighborhood socioeconomic disadvantage was associated with increased acute care utilization, including potentially preventable utilization. These findings signal potential barriers to outpatient care access that could be amenable to future intervention by health systems and payers. [ABSTRACT FROM AUTHOR]

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