Search

Funding Acknowledgements Type of funding sources: None. Background A sodium-glucose cotransporter-2 inhibitor (SGLT2i) improves clinical outcomes in patients with type 2 diabetes (T2DM) and cardiovascular disease. Also use of SGLT2i was associated with a reduction of atrial fibrillation (AF) burden. Purpose We investigated the effect of SGLT2is on clinical outcomes in patients with T2DM and AF Methods This was a retrospective study using a clinical data warehouse (CDW) constructed from 7 medical centers. We analyzed 11,043 patients with AF and T2DM. The patients were classified to the SGLT2i group and the control group according to the SGLT2i use. We performed 1:2 propensity score matching analysis. The primary endpoint was a composite of all-cause death or hospitalization due to heart failure events. The secondary endpoints were acute myocardial infarction, stroke, renal function decline and an initiation of dialysis. Results The propensity score matched population consisted of 467 patients in the SGLT2i group and 848 patients in the control group. During a mean follow up of 31.8 (± 21.0) months, the incidence of the primary endpoint was significantly lower in the SGLT2i group (9.6% vs. 16.9%, hazard ratio [HR] 0.624 [0.446 – 0.873]). SGLT2i was associated with reduced all-cause death (HR 0.292 [0.144 – 0.591]) and non-significantly lower risk of heart failure hospitalization (HR 0.734 [0.509 – 1.060]). There was no significant difference in the incidence of myocardial infarction, ischemic stroke, CKD progression or initiation of dialysis between the two groups. In multivariate analysis, age, renal dysfunction, prior heart failure, and the absence of SGLT2i were independent predictors for the worse outcome. Conclusion SGLT2 inhibitor was associated with a lower incidence of all-cause mortality or heart failure hospitalization in patients with AF and T2DM.

Funding Acknowledgements Type of funding sources: None. Introduction Rhythm control is a therapeutic approach to restore sinus rhythm from atrial fibrillation (AF). Current studies have demonstrated efficacy of rhythm control with radiofrequency catheter ablation (RFCA) for survival, however there is lack of data regarding the long term outcome of patients who refused RFCA. Purpose This study was aimed to compare outcomes, consist of death and stroke, in patients who refused RFCA. Method Patients with AF who had been proposed for RFCA but refused and also any rhythm control strategy were enrolled. The primary outcome was all cause death and incidence of stroke, compared with patients with AF who had been treated with RFCA. Results A total 174 patients who refused AF, 175 patients treated with RFCA were enrolled. Median follow up duration was 1125.1 ± 799.0 days. Of refused AF group, 39 (22.3%) were paroxysmal AF at the time of diagnosis. During follow-up, 9 patients in refused RFCA and 11 patients treated with RFCA group had died (4.1% vs 6.1%, p=0.3 by log rank test). Incidence of stroke was significantly higher in patients who refused RFCA, compared with RFCA group (12.0% vs 1.1% , p =0.001 by log-rank test). Cox Regression model showed refusing RFCA was an independent risk factor for the incidence of stroke (Hazard ratio 6.7, 95% Confidence Interval 1.48 – 30.3, p=0.013). Conclusion In AF patient who had refused rhythm control, incidence of stroke was significantly higher in patients who refused RFCA and rhythm control, compared with who had been treated with RFCA. There was no difference in all-cause mortality between two groups.

Funding Acknowledgements Type of funding sources: None. Introduction Differential pacing (DP) maneuver was generally used to assess bidirectional block of cavotricuspid isthmus (CTI) after catheter ablation. Purpose The purpose of the study is to identify limitation of DP maneuver and suggest continuous sequence (CS) maneuver as a complement of differential pacing. Methods Patients who were diagnosed to typical atrial flutter and underwent catheter ablation were enrolled. CTI conduction block was evaluated by two maneuver, DP and CS maneuver. We tried to identify CTI conduction block for each patient with both maneuvers. With CS maneuver, CTI conduction block was assessed with the recorded sequence of diagnostic catheter. Results Sixty two patients were investigated. Two maneuvers were performed in all patients. There were 8 cases (8/62, 12.9%) of discrepancy between the result of CS and DP maneuver. One of discrepancy cases, CTI conduction block was identified with CS maneuver, but insufficient conduction block with DP maneuver. The rest of discrepancy (11.2%) cases were the opposite. Conclusion DP could not guarantee bidirectional block of CTI because of anatomical complexity and catheter instability. CS maneuver found incomplete block over 10% of conventional maneuver. CS maneuver is simple and can be complement to overcome limitation of DP maneuver.

The absorption by neutral hydrogen in the intergalactic medium (IGM) produces the Ly$\alpha$ forest in the spectra of quasars. The Ly$\alpha$ forest absorbers have a broad distribution of neutral hydrogen column density $N_{\rm HI}$ and Doppler $b$ parameter. The narrowest Ly$\alpha$ absorption lines (of lowest $b$) with neutral hydrogen column density above $\sim 10^{13}{\rm cm^{-2}}$ are dominated by thermal broadening, which can be used to constrain the thermal state of the IGM. Here we constrain the temperature-density relation $T=T_0(\rho/\bar{\rho})^{\gamma-1}$ of the IGM at $1.6, Comment: 18 pages, 5 figures

In der Zahnmedizin gehoren bakteriell verursachte und entzundlich bedingte Erkrankungen wie Parodontitis zu den haufigsten oralen Erkrankungen. Die mechanische Entfernung des supra- und subgingivalen Biofilms und die Etablierung einer guten hauslichen Mundhygiene im Rahmen der antiinfektiosen Therapie sind daher wichtige Ziele der systematischen Parodontitistherapie und fur einen langfristigen Therapieerfolg ausschlaggebend. In der Regel reicht die mechanische Instrumentierung aus, um eine erfolgreiche Parodontitistherapie durchzufuhren. Dennoch konnen Falle vorkommen, in denen eine rein mechanische Therapie nicht zu zufriedenstellenden Ergebnissen fuhrt. In ausgewahlten Fallen kann der Einsatz eines lokalen Antibiotikums, ublicherweise in Kombination mit einer subgingivalen Instrumentierung, in Betracht gezogen werden.

Malaria is still a global challenge with significant morbidity and mortality, especially in the African, South-East Asian and Latin American region. Malaria diagnosis is a crucial pillar in the control and elimination efforts, often accomplished by administration of mass-scale Rapid diagnostic tests (RDTs). The inherent limitations of RDTs-failure of detection in low transmission settings, and deletion of one of the target proteins-Histidine rich protein (HRP) are evident from multiple reports; thus necessitating the need to explore novel diagnostic tools/targets. The present study used peptide microarray to screen potential epitopes from 13 antigenic proteins (CSP, EXP1, LSA1, TRAP, AARP, AMA1, GLURP, MSP1, MSP2, MSP3, MSP4, P48/45, HAP2) of P. falciparum. Three cyclic constrained immunoreactive peptides-C6 (EXP1), A8 (MSP2), B7 (GLURP) were identified from 5,458 cyclic constrained peptides (in duplicate) against P. falciparum infected sera. Peptides (C6, A8, B7-cyclic constrained) and (G11, DSQ, NQN-corresponding linear peptides) were fairly immunoreactive towards P. falciparum-infected sera in dot-blot assay. Using indirect ELISA, cyclic constrained peptides (C6 & B7) were found to be specific to P. falciparum infected sera and further, observed to be significantly reactive towards antibodies from field-collected P. falciparum infected sera. Notably, the structural location of the epitopes defines the reactivity, observed by the preferential recognition of cyclic constrained peptides vs linear peptides and corroborated by the homology modeling analysis of selected proteins. In conclusion, the study identified three cyclic constrained immunoreactive peptides (C6, B7 & A8) from P. falciparum secretory/surface proteins and two of them (C6 & B7) were validated for their diagnostic potential with field-collected P. falciparum infected sera samples.

Accurate imaging is essential for effective treatment planning in periodontology. The aim of this ex vivo study was to investigate the accuracy of cone beam computed tomography (CBCT) and digital periapical radiographs (PA) in imaging periodontal defects. Hypotheses are: 1. That CBCT is a more accurate method than PA concerning vertical measurements of periodontal bone defects2. That CBCT itself is an accurate method to describe vertical periodontal bone loss MATERIAL AND METHODS: In this study, 117 periodontal defects from 10 human cadavers were investigated radiographically by CBCT and PA by one calibrated observer. Afterwards the vertical bone loss was measured with a periodontal probe by the same calibrated observer. Differences between radiographic and clinical measurements were calculated and analyzed. Bland-Altmann plots including 95% limits of agreement were calculated.The 95% limits of agreement ranged from 3.29 to -3.27 mm between clinical measurements and measurements in PAs, and from 2.13 to -1.97 mm in CBCTs. The mean difference between clinical and radiographic measurements was 0.0009 mm for PA and 0.0835 mm for CBCT.When comparing the clinical measurements, CBCT had a higher agreement and less deviations than PAs, and CBCT seems to be an accurate method to describe vertical periodontal bone loss.Accurate description of defects is helpful for accurate treatment planning.

Identifying buccal and oral bone as an important supporting periodontal structure for teeth provides important information for treatment planning in periodontics and orthodontics. This study aims to add evidence to the knowledge of preciseness of cone beam computed tomography (CBCT) measurements of the vertical dimension of buccal and oral bone. The hypothesis is that CBCT is an accurate and reliable method to measure vertical vestibular and oral bone loss.The amount of vertical buccal and oral bone loss (bl) of 260 sites of 10 human cadavers was investigated clinically and radiographically by CBCT. Radiographic measurements were rated by two blinded raters. Measurements and the corresponding differences between clinical and radiological findings are described by medians and quartiles (Q1-Q3). For statistical analysis, Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were calculated.The CCC between the raters was 0.994 (95% confidence interval 0.992-0.995). The median bone loss (bl) distance from the cementoenamel junction (CEJ) to the bony defect (BD) was 3.5 mm (range 3-5 mm). The median bl measured in the CBCT was 3.8 mm (range 3.1-4.8 mm). The median difference of the 2 measurements for all sites included in the study (N = 260) was -0.2 mm (-0.7 to 0.3 mm).CBCT seems to be an accurate and highly reliable method to detect and describe vertical buccal and oral bone loss. It could improve planning and prediction for successful combined periodontal and orthodontic therapies.ZIELSETZUNG: Die Identifizierung von bukkalen und oralen Knochen als wichtige unterstützende parodontale Struktur für Zähne liefert wesentliche Informationen für die Behandlungsplanung in der Parodontologie und Kieferorthopädie. Ziel der Studie ist es, das Wissen über die Genauigkeit von CBCT(„cone beam computed tomography“)-/DVT(digitale Volumentomographie)-Messungen der vertikalen Dimension von bukkalem und oralem Knochen zu erweitern. Die Hypothese ist, dass die DVT eine genaue, zuverlässige Methode zur Messung des vertikalen vestibulären und oralen Knochenverlustes ist.Das Ausmaß des vertikalen bukkalen und oralen Knochenverlusts (bl) an 260 Stellen von 10 menschlichen Leichnamen wurde klinisch und röntgenologisch mittels CBCT untersucht. Die röntgenologischen Messungen wurden von 2 verblindeten Gutachtern bewertet. Die Messwerte und die entsprechenden Unterschiede zwischen klinischen und radiologischen Befunden werden durch Mediane und Quartile (Q1-Q3) beschrieben. Für die statistische Analyse wurden Lins Konkordanzkorrelationskoeffizient (CCC) und Bland-Altman-Plots berechnet.Der CCC zwischen den Ratern betrug 0,994 (95%-Konfidenzintervall 0,992–0,995). Der mediane Knochenverlust (bl) von der Schmelz-Zement-Grenze (CEJ) bis zum Knochendefekt (BD) betrug 3,5 mm (Bereich 3–5 mm). Der in der DVT gemessene mediane bl betrug 3,8 mm (Bereich 3,1–4,8 mm). Die mediane Differenz der beiden Messungen für alle in die Studie einbezogenen Stellen (N = 260) betrug −0,2 mm (−0,7 bis 0,3 mm).Die DVT scheint eine genaue und sehr zuverlässige Methode zur Erkennung und Beschreibung von bukkalem und oralem vertikalen Knochenverlust zu sein. Sie könnte die Planung und Vorhersage für erfolgreiche kombinierte parodontale und kieferorthopädische Therapien verbessern.

The cause of chronic inflammatory periodontitis, which leads to the destruction of periodontal ligament and alveolar bone, is multifactorial. An increasing number of studies have shown the clinical significance of NLRP3-mediated low-grade inflammation in degenerative disorders, but its causal linkage to age-related periodontitis has not yet been elucidated. In this study, we investigated the involvement of the NLRP3 inflammasome and the therapeutic potential of NLRP3 inhibition in age-related alveolar bone loss by using in vivo and in vitro models. The poor quality of alveolar bones in aged mice was correlated with caspase-1 activation by macrophages and elevated levels of IL-1β, which are mainly regulated by the NLRP3 inflammasome, in periodontal ligament and serum, respectively. Aged mice lacking Nlrp3 showed better bone mass than age-matched wild-type mice via a way that affects bone resorption rather than bone formation. In line with this finding, treatment with MCC950, a potent inhibitor of the NLRP3 inflammasome, significantly suppressed alveolar bone loss with reduced caspase-1 activation in aged mice but not in young mice. In addition, our in vitro studies showed that the addition of IL-1β encourages RANKL-induced osteoclastogenesis from bone marrow–derived macrophages and that treatment with MCC950 significantly suppresses osteoclastic differentiation directly, irrelevant to the inhibition of IL-1β production. Our results suggest that the NLRP3 inflammasome is a critical mediator in age-related alveolar bone loss and that targeting the NLRP3 inflammasome could be a novel option for controlling periodontal degenerative changes with age.

In mammalian cells, the bulky DNA adducts caused by ultraviolet radiation are mainly repaired via the nucleotide excision repair (NER) pathway; some defects in this pathway lead to a genetic disorder known as xeroderma pigmentosum (XP). Ribosomal protein S3 (rpS3), a constituent of the 40S ribosomal subunit, is a multi-functional protein with various extra-ribosomal functions, including a role in the cellular stress response and DNA repair-related activities. We report that rpS3 associates with transcription factor IIH (TFIIH) via an interaction with the xeroderma pigmentosum complementation group D (XPD) protein and complements its function in the NER pathway. For optimal repair of UV-induced duplex DNA lesions, the strong helicase activity of the TFIIH complex is required for unwinding damaged DNA around the lesion. Here, we show that XP-D cells overexpressing rpS3 showed markedly increased resistance to UV radiation through XPD and rpS3 interaction. Additionally, the knockdown of rpS3 caused reduced NER efficiency in HeLa cells and the overexpression of rpS3 partially restored helicase activity of the TFIIH complex of XP-D cells in vitro. We also present data suggesting that rpS3 is involved in post-excision processing in NER, assisting TFIIH in expediting the repair process by increasing its turnover rate when DNA is damaged. We propose that rpS3 is an accessory protein of the NER pathway and its recruitment to the repair machinery augments repair efficiency upon UV damage by enhancing XPD helicase function and increasing its turnover rate.

We present a new, uniform analysis of the HI transmitted flux (F) and HI column density (N(HI)) distribution in the low-density IGM as a function of redshift z for 0, Comment: 24 pages, 17 figures, 8 tables, accepted for publication to MNRAS, 5 supplementary online-only tables

Symptoms typical of center rot of onion (Allium cepa L.) were observed in farmers' fields in spring of 2009 and 2010 in Hamyang, South Korea, at an incidence of 30 to 50% (five affected fields representing approximately 6 ha). The symptoms were identical to those reported from infected onions in Georgia in 1997 (1). Harvested bulbs of symptomatic plants had reddish, collapsed scales near the neck. Symptomatic bulb tissues were surface-sterilized by immersing sections of the tissue for 30 s in 1% NaOCl, then rinsing the sections with sterilized, distilled water. Tissues were then macerated in 1 ml of sterilized, distilled water in a 1.5 ml Eppendorf tube using a sterile scalpel. The macerated tissue was left to soak for 10 min, after which a 5 μl suspension from each section was streaked onto plates of nutrient agar (NA). Gram-negative, rod-shaped, yellow bacteria were consistently recovered on NA. Three bacterial isolates recovered were each facultative anaerobes and induced a hypersensitive reaction on tobacco leaves. The biochemical test, API 20E (Biomérieux, Marcy l'Etoile, France), was also used for identification. All three strains tested positive for β-D-galactosidase, utilization of citrate, and production of acetoin, catalase, and indole. All three strains tested negative for ornithine decarboxylase, lysine decarboxylase, urease, and oxidase. All produced acid from arabinose, glucose, mannitol, and sorbitol; while none produced acid from melibiose, inositol, and rhamnose. These characteristics are consistent with those of P. ananatis (1,2). Five bulbs were each surface-disinfested with 70% ethanol, dried, and injected with 50 μl of the appropriate bacterial suspension containing ~108 CFU/ml, using a syringe. The bulbs were placed in plastic boxes with four sheets of wet paper towel to maintain the relative humidity at 100%, and incubated at 25°C for 2 weeks. Three onion bulbs treated similarly but injected with sterilized, distilled water served as replicates of the control treatment. After 1 week of incubation, inoculated onion bulbs developed a brown discoloration and decay of the internal, fleshy scales matching those observed in the original farmers' fields. The control onion bulbs remained asymptomatic. Bacteria reisolated from lesions in the fleshy bulb scales of the inoculated bulbs had the same characteristics as the original isolates inoculated, proving Koch's postulates. Bacteria were not reisolated from any of the control bulbs. To confirm identity of the isolated bacteria, 16S rRNA and recA genes were amplified with primers 27mF: 5′-AGAGTTTGATCMTGGCTCAG-3′ and 1492mR: 5′-GGYTACCTTGTTACGACTT-3′, and PAGRECA21: 5′-GGTGAAGACCGCTCAATGGA-3′ and PAGRECA621: 5′-CACCGATACGGCGGATATCA-3′, respectively (3). Amplification of the 16S rRNA gene generated a 1,506-bp consensus sequence (GenBank Accession No. JQ762264), and amplification of the recA gene generated a consensus sequence of 601 bp (JQ762265). The 16S rRNA and recA gene sequences shared 99% nucleotide identity with those of a P. ananatis strain in GenBank (DQ195523 and AY219004, respectively). Based on symptoms, biochemical tests, and molecular analyses, the bacterium responsible for the onion symptoms in Korea was identified as P. ananatis. To our knowledge, this is the first report of center rot of onion caused by P. ananatis in Korea. References: (1) R. D. Gitaitis and J. D. Gay. Plant Dis. 81:1096, 1997. (2) H. G. Truper and L. de Clari. Int. J. Syst. Bacteriol. 47:908, 1997. (3) A. Wensing et al. Appl. Environ. Microbiol. 76:6248, 2010.

The bias-dependent behavior of the photocurrent (PC) and photoluminescence (PL) of sputtered ZnO layers has been investigated. Based on PC spectroscopy results, the PC intensity of the observed free exciton increased strongly up to electric field of 60 V/cm, after which its rate of increase slightly reduced due to disturbance of field-assisted dissociation of radical ion pairs, which leads to photocarrier generation. Thus, the energy of excitonic PC peaks showed a tendency to red-shift with increasing electric field, being attributed to the induced Stark effect. Therefore, it is concluded that the strong interaction between free excitons and photogenerated PC carriers leads to displacement or widening of the spectrum. In the PL measurements, near-band-edge (NBE) and violet emissions were observed. With increasing electric field, two PL emissions were progressively quenched. The combined PL/PC results reveal that the PL ions associated with the NBE and violet emissions readily interact with the PC carriers of photogenerated electrons and holes. This behavior reduces the recombination ratio and the lifetime of PL ions. So, the PL intensity quenching originates from a decrease in the number of carriers participating in recombination. Consequently, we find that the quenching mechanism of the NBE and violet emissions is strongly related to low external electric field.

The isotope ratio mass spectrometer (IRMS) is an instrument that measures both of the elemental contents and isotope ratios of hydrogen, oxygen, carbon, nitrogen and sulfur in environmental samples at the same time. In this study, we want to try to get two main goals; first, to make up for setting the analytical conditions such as accuracy and precision, second, to apply for comparing of the carbon and nitrogen isotope ratio of sediments in the abandoned mine located in middle province of Korea. For the first goal, a recently introduced IRMS was used to analyze CRM (certified reference materials), which helped to make up the analytical conditions of carbon and nitrogen isotope ratios. So, the accuracy and precision of isotope ratios and elemental contents were also assessed simultaneously, and also the results were very satisfactory. The analytical results of carbon reference materials (EMA-P2) showed an accuracy of -2.801 × 10‰ ± 0.01‰ (2σ) and a precision of 0.009‰ in the mass range from 0.008 μg - 0.162 μg. For nitrogen reference materials (EMA-P2), an accuracy of -1.632‰ ± 0.72‰ (2σ) was obtained in the mass range from 0.082 - 0.162 mg. These values of accuracy and precision are higher than those reported by other studies. For the second goal, carbon and nitrogen isotopes in river sediment near abandoned mines were analyzed based on the established analytical conditions. The result suggested that carbon isotope ratios ranged from -22.5‰ - -7.5‰ and nitrogen isotope ratios from -1.9‰ - 7.9‰. By comparing the isotope ratios and sampling sites of sediment, we know that the nitrogen isotope values in samples of entrance area of mine are greater than those of the farm house area, which is indicating the effects of organic materials. So, we could guess that the newly accumulated organic materials were much more in the farm house area than mine entrance area. And a result of this study, the accuracy and precision tests of IRMS using certified reference materials were very satisfactory and optimum analytical conditions were established well. And also, it was found that the applications of isotopic analysis for environmental samples by using the IRMS could be very useful for the studies on tracing pollution sources.

SETTING The Xpert(®) MTB/RIF assay is endorsed by the World Health Organization for the detection of rifampicin (RMP) resistant tuberculosis (TB). OBJECTIVE To evaluate Xpert for its diagnostic accuracy in detecting RMP-resistant TB and its impact on treatment outcomes. DESIGN Patients with available phenotypic drug susceptibility testing (DST) results and those in whom RMP-resistant pulmonary TB was diagnosed using Xpert were evaluated. The accuracy and turnaround time (TAT) of Xpert for determining RMP-resistant TB was calculated. The TATs for treatment between patients diagnosed with RMP-resistant TB using Xpert and those diagnosed without the assay (phenotypic DST group) were compared. RESULTS In 321 patients, when phenotypic DST was used as the gold standard, Xpert sensitivity and specificity for RMP resistance diagnosis was respectively 100% and 98.7%; the positive and negative predictive values were respectively 86.2% and 100%. The Xpert group had a much shorter interval from initial evaluation to commencing second-line anti-tuberculosis treatment (64 vs. 2 days, P < 0.001), and negative conversion of mycobacterial cultures (197 vs. 62.5 days, P < 0.001) than the phenotypic DST group. CONCLUSION Xpert was accurate at diagnosing RMP resistance in this setting with an intermediate TB burden and a low level of RMP resistance. Xpert might reduce disease transmission by reducing the sputum culture conversion times for patients with RMP-resistant TB.

For the prompt prescription of patients suffering from infectious diseases such as tuberculosis or bloodstream infection, a rapid antimicrobial susceptibility test (RAST) is highly necessary. This paper describe rapid antibiotic susceptibility test system composed of biochips and automated expert system, which can determine the antibiotic susceptibility of bacteria and mycobacteria derived from various parts of body. With RAST, antibiotic susceptibility was available in six hours, which was conventionally taking more than two days. Device design consideration, clinical verification, commercialization, and application of RAST system to infectious diseases are reviewed.

We characterize the properties of the intergalactic medium (IGM) around a sample of galaxies extracted from state-of-the-art hydrodynamical simulations of structure formation in a cosmological volume of 25 Mpc comoving at $z\sim 2$. The simulations are based on two different subresolution schemes for star formation and supernova feedback: the MUlti-Phase Particle Integrator (MUPPI) scheme and the Effective Model. We develop a quantitative and probabilistic analysis based on the apparent optical depth method of the properties of the absorbers as a function of impact parameter from their nearby galaxies: in such a way we probe different environments from circumgalactic medium to low-density filaments. Absorbers' properties are then compared with a spectroscopic observational data set obtained from high-resolution quasar spectra. Our main focus is on the N$_{\rm{ CIV}}$-N$_{\rm { HI}}$ relation around simulated galaxies: the results obtained with MUPPI and the Effective model are remarkably similar, with small differences only confined to regions at impact parameters $b = [1-3] \times r_{\rm {vir}}$. Using $\mbox{C IV}$ as a tracer of the metallicity, we obtain evidence that the observed metal absorption systems have the highest probability to be confined in a region of 150-400 kpc around galaxies. Near-filament environments have instead metallicities too low to be probed by present-day telescopes, but could be probed by future spectroscopical studies. Finally we compute $\mbox{C IV}$ covering fractions which are in agreement with observational data., 25 pages, 20 figures

Background Living-donor liver transplantation (LDLT) has been accepted as feasible treatment for fulminant hepatic failure (FHF), although it has generated several debatable issues. In this study, we investigated the prognostic factors predicting fatal outcome after LDLT for FHF. Methods From April 1999 to April 2011, 60 patients underwent LT for acute liver failure, including 42 patients for FHF at Samsung Medical Center, Seoul, Korea. Among 42 patients, 30 patients underwent LDLT for FHF, and the database of these patients was analyzed retrospectively to investigate the prognostic factors after LDLT for FHF. Results Among 30 patients, 7 patients (23%) died during the in-hospital period within 6 months, and 23 patients (77%) survived until recently. In univariate analyses, donor age (>35 years), graft volume (GV)/standard liver volume (SLV) ( 120 minutes), hepatic encephalopathy (grade IV), hepato-renal syndrome (HRS), and history of ventilator care were associated with fatal outcome after LDLT for FHF. In multivariate analyses, HRS, GV/SLV ( 35 years) were significantly associated with fatal outcome. Although the statistical significance was not shown in this analysis ( P = .059), hepatic encephalopathy grade IV also appears to be a risk factor predicting fatal outcome. Conclusions The survival of patients with FHF undergoing LDLT was comparable to that in published data. In this study, HRS, GV/SLV 35 years are the independent poor prognostic factors.

We study the effect of different feedback prescriptions on the properties of the low redshift ($z\leq1.6$) Ly$\alpha$ forest using a selection of hydrodynamical simulations drawn from the Sherwood simulation suite. The simulations incorporate stellar feedback, AGN feedback and a simplified scheme for efficiently modelling the low column density Ly$\alpha$ forest. We confirm a discrepancy remains between Cosmic Origins Spectrograph (COS) observations of the Ly$\alpha$ forest column density distribution function (CDDF) at $z \simeq 0.1$ for high column density systems ($N_{\rm HI}>10^{14}\rm\,cm^{-2}$), as well as Ly$\alpha$ velocity widths that are too narrow compared to the COS data. Stellar or AGN feedback -- as currently implemented in our simulations -- have only a small effect on the CDDF and velocity width distribution. We conclude that resolving the discrepancy between the COS data and simulations requires an increase in the temperature of overdense gas with $\Delta=4$--$40$, either through additional He$\,\rm \scriptstyle II\ $ photo-heating at $z>2$ or fine-tuned feedback that ejects overdense gas into the IGM at just the right temperature for it to still contribute significantly to the Ly$\alpha$ forest. Alternatively a larger, currently unresolved turbulent component to the line width could resolve the discrepancy., Comment: 16 pages, 8 figures, Accepted to MNRAS

This paper investigates the effect of PVA fiber-reinforcement on the flexural fatigue behavior of concrete subjected to freezing and thawing cycles. Plain and PVA fiber-reinforced concrete specimens were exposed to freezing and thawing cycles, then a flexural fatigue test using a wheel load was performed with a stress level in the range of 0.5–0.9. The effect of PVA fiber reinforcement on the flexural fatigue resistance was evaluated by the stress ratio–fatigue life (S–N) relationship. The flexural fatigue test results showed that repeated freezing and thawing actions not only reduced the static strength but also dramatically diminished the resistance to fatigue failure. In addition, a low interrelationship of the S–N relationship of concrete subjected to freezing and thawing cycles was observed. PVA fiber reinforcement enhanced the flexural fatigue strength of concrete subjected to freezing and thawing cycles due to increase in (1) the resistance for freezing and thawing action and (2) the resistance for flexural fatigue failure. Finally, empirical formulas for the S–N relationship of plain and PVA fiber-reinforced concretes subjected to freezing and thawing cycles are proposed based on the experimental investigation.

A P-doped ZnO surface layer on undoped ZnO wafers was prepared by phosphorus (P) ion implantation. Hall effect measurement revealed p-type conduction in such layers annealed at 800°C. This indicates that acceptor levels are present in P-doped ZnO, even though the ZnO is still n-type. Micro-Raman scattering in −z(xy)z geometry was conducted on P-implanted ZnO. The E 2 high mode shift observed toward the high-energy region was related to compressive stress as a result of P-ion implantation. This compressive stress led to the appearance of an A 1(LO) peak, which is an inactive mode. This A 1(LO) peak relaxed during thermal annealing in ambient oxygen at temperatures higher than 700°C. The P2p3/2 peak observed at 135.6 eV by x-ray photoelectron spectroscopy is associated with chemical bond formation leading to 2(P2O5) molecules. This indicates that implanted P ions substituted Zn sites in the ZnO layer. In photoluminescence spectroscopy, the P-related peaks observed at energies ranging between 3.1 and 3.5 eV originated from (A0, X) emission, because of PZn-2VZn complexes acting as shallow acceptors. The acceptor level was observed to be 126.9 meV above the valence band edge. Observation of this P-related emission indicates that ion implantation results in acceptor levels in the P-doped ZnO layer. This suggests that the P2O5 bonds are responsible for the p-type activity of P-implanted ZnO.

The treatment of choice for combined hepatocellular and cholangiocarcinoma (cHCC-CC) is surgical resection. However, the efficacy of liver transplantation is not clear. We compared the surgical outcome of hepatic resection and liver transplantation for cHCC-CC.From 1995 to 2012, 89 patients were diagnosed with cHCC-CC after hepatic resection and 8 patients diagnosed with cHCC-CC after liver transplantation. We excluded 21 patients who were American Joint Committee on Cancer Staging Stage III or IV and lost to follow-up. The outcomes were reviewed retrospectively.The poor prognostic factors in cHCC-CC patients who underwent hepatectomy were large tumor size (5 cm), small safety margin (2 cm), and low preoperative albumin level. The disease-free survival (DFS) and overall survival (OS) between the hepatectomy group (n = 68) and the liver transplant group (n = 8) was not statistically different (5-year DFS: 26.2% vs 37.5%, P = .333; 5-year OS: 42.1% vs 50%, P = .591). In the small tumor subgroup (tumor size 5 cm), the DFS and OS between the 2 surgical procedures was not different, and in the adequate resection margin subgroup (safety margin2 cm), survival was comparable.In well-selected cases with small tumor size and with preserved liver function, liver resection should be considered when complete resection is possible.

The BK nephropathy (BKN) shows a 10% prevalence among cases of kidney transplantation (KT). We assessed the incidence of BK replication in KT recipients as well as our updated screening strategy and the impact of interventions on BK virus infections.Since September 2007, our screening protocol for BK virus included examination of urine cytology or BK virus DNA real-time polymerase chain reaction (PCR) detection on postoperative days 1, 5, 9, 16, 24, 36, 48 weeks up to 1 year. IR present, we tested urine BK virus DNA PCR quantitation. We applied the updated screening protocol from August 2010. It urine BK DNA PCR quantification was above 10(7) copies/mL, we checked regularly blood the BK virus DNA PCR quantification. In addition, if the blood BK virus DNA load was above 10(4) copies/mL and the serum creatinine elevated, we was performed an allograft biopsy. Between September 2007 and December 2011, the 58 recipients who showed BK viremia were enrolled in the present study in 2 groups according to the period of screening protocol (era I, era II).The time between kidney transplantation and BK viremia detection of era II was shorter than that of era I (16 vs 29 weeks; P = .001). Viremia clearance rate at 6 months in era II was significant higher than that of era I (82% vs 36.8%; P = .001) as well as at 12 months (100% vs 61.1%, P .001) after intervention. Interestingly, viremia clearance at 12 months after intervention was 100% in era II.An updated screening protocol for BK virus allowed early detection and accurate diagnosis of BKN. Early detection of BK virus infection enabled early intervention and improved viral clearance rate.

Introduction We investigated the optimal method for transportation of isolated porcine islets from an isolation facility to a transplant hospital or research center in terms of temperature, oxygen supply, and shaking effect. Methods Commercially available insulator boxes with thermoregulators exposed for 5 hours under two external temperatures (4°C and 37°C) were monitored using HOBO temperature loggers. To find the optimal transport device, we compared islet counts, viability, quality, and function in conical tubes, gas-permeable bags (GPB) and gas-permeable flasks (GPF) after 1, 3 and 5 hours. To evaluate the effects of shaking on islets, we also analyzed the difference between a control and a shaking group in each device with time. Results Commercially available Styrofoam insulators with thermoregulators maintained the internal temperature near the target. Islet recovery rate for GPF, which was higher than other devices, was maintained, while those decreased with time for conical tube and GPB containers adenosine diphosphate/adenosine triphosphate (ADP/ATP) ratio for GPF was lower than other devices, albeit not significantly fluoroscein acrimide/propidium iodide (AO/PI) ratio for GPF was higher than other devices after 5 hours. Glucose stimulated index was not different among the devices. In comparison with the control group, shaking yielded comparable islet survival, viability and function. Conclusion Our study demonstrated that the use of commercially available insulator boxes with thermoregulators maintained internal temperature close to the target value and that GPF was more favorable for islet oxygenation during transportation. This study also suggested negligible impact of shaking on isolated porcine islets during transportation.

ZnCdO oxide thin films have been deposited by using the radiofrequency cosputtering method to prepare ozone sensors for room-temperature operation. The sensors were fabricated in the order: electrode/sensor/glass/illuminant. The mechanisms of photo-assisted oxidation and reduction on the surface of the ZnCdO ozone sensors were investigated. Free electrons and holes were generated by exposure of the surface of the ZnCdO ozone sensor to ultraviolet light, tending to enhance surface absorption of dissociated O2 molecules and dissociation of adsorbed oxygen ions, respectively. Thereby, the sensitivity of the ZnCdO ozone sensor was increased. This photon exposure method can replace the conventional heating mode used in ozone sensors. Moreover, 405-nm light from a light-emitting diode, corresponding to photon energy of 3.061 eV, was found to assist the processes of oxidation and reduction due to the chemical reaction of the ozone gas. We present a possible route for fabrication of portable ZnCdO ozone sensors for room-temperature operation.

The purpose of this study was to determine the changing pattern of Salmonella serotypes causing acute diarrhoea in humans in Gwangju area, Korea, during 2000-2009. A total of 596 Salmonella isolated from culture of 29,896 faecal samples of patients with acute diarrhoea were included in this study. Faecal samples were collected from local hospitals and clinics in Gwangju area during January 2000-December 2009. The mean annual frequency of isolates for the 10 years was 2.0% (range, 0.9-6.0). The isolates were serologically classified into 43 different serotypes. The 10 most common serotypes were Salmonella Enteritidis (47.9%), S. Typhimurium (20.4%), S. Braenderup (3.2%), S. Montevideo (2.9%), S. Paratyphi B (2.9%), S. London (2.3%), S. Bardo (1.7%), S. Virchow (1.7%), S. Infantis (1.5%) and S. Typhi (1.5%), accounting for 86% of all the isolates. Temporal variations were observed in the distribution of different Salmonella serotypes over the years, and only S. Enteritidis and S. Typhimurium were persistent throughout the study period. Although age specificity varied with serotypes, Salmonella was isolated most frequently from children below 5 years of age (179/596, 30.0%). A seasonal trend was apparent, and the highest rates were found in the summer months. This is the first report of the annual frequency of isolation of Salmonella serotypes, and seasonal and age-specific patterns of salmonellosis in humans in Gwangju area, Korea, over a decade-long period.

We investigate the thermal history of the intergalactic medium (IGM) in the redshift interval z=1.7--3.2 by studying the small-scale fluctuations in the Lyman alpha forest transmitted flux. We apply a wavelet filtering technique to eighteen high resolution quasar spectra obtained with the Ultraviolet and Visual Echelle Spectrograph (UVES), and compare these data to synthetic spectra drawn from a suite of hydrodynamical simulations in which the IGM thermal state and cosmological parameters are varied. From the wavelet analysis we obtain estimates of the IGM thermal state that are in good agreement with other recent, independent wavelet-based measurements. We also perform a reanalysis of the same data set using the Lyman alpha forest flux probability distribution function (PDF), which has previously been used to measure the IGM temperature-density relation. This provides an important consistency test for measurements of the IGM thermal state, as it enables a direct comparison of the constraints obtained using these two different methodologies. We find the constraints obtained from wavelets and the flux PDF are formally consistent with each other, although in agreement with previous studies, the flux PDF constraints favour an isothermal or inverted IGM temperature-density relation. We also perform a joint analysis by combining our wavelet and flux PDF measurements, constraining the IGM thermal state at z=2.1 to have a temperature at mean density of T0/[10^3 K]=17.3 +/- 1.9 and a power-law temperature-density relation exponent gamma=1.1 +/- 0.1 (1 sigma). Our results are consistent with previous observations that indicate there may be additional sources of heating in the IGM at z

Background: Cytosine arabinoside-based chemotherapy coupled with anthracycline is currently the first-line treatment for acute myeloid leukaemia (AML), but diverse responses to the regimen constitute obstacles to successful treatment. Therefore, outcome prediction to chemotherapy at diagnosis is believed to be a critical consideration. Methods: The mRNA expression of 12 genes closely involved in the actions of cytosine arabinoside and anthracycline was evaluated by real-time reverse transcriptase PCR (RT–PCR), in 54 diagnostic bone marrow specimens of M2-subtype AML. Results: Low expression levels of ribonucleotide reductase M2 (RRM2) and high expression levels of topoisomerase 2 beta (TOP2B) were correlated with longer survival in a univariate analysis. Another interesting finding is that high ratios of TOP2B/RRM2 and TOP2B/TOP2 alpha (TOP2A) in a combined analysis were also shown to have a prognostic impact for longer survival with improved accuracy. Among the four markers, when adjusted for the influence of other clinical factors in multivariate analysis, the TOP2B/TOP2A ratio was significantly correlated with treatment outcomes; patients with high ratios trended toward longer disease-free survival (HR, 0.24; P=0.002) and overall survival (HR, 0.29; P=0.005). Conclusion: Genes with distinct expression profiles such as TOP2B/TOP2A expression ratio at diagnosis can be employed for outcome prediction after the treatment with standard regimens in AML patients with M2 subtype.

We present a measurement of the Lyman α flux probability distribution function (PDF) obtained from a set of eight high-resolution quasar spectra with emission redshifts in the range 3.3 ≤z≤ 3.8. We carefully study the effect of metal absorption lines on the shape of the PDF. Metals have a larger impact on the PDF measurements at lower redshift, where there are relatively fewer Lyman α absorption lines. This may be explained by an increase in the number of metal lines that are blended with Lyman α absorption lines towards higher redshift, but may also be due to the presence of fewer metals in the intergalactic medium (IGM) at earlier times. We also provide a new measurement of the redshift evolution of the effective optical depth, τeff, at 2.8 ≤z≤ 3.6, and find no evidence for a deviation from a power-law evolution in the log (τeff)–log (1 +z) plane. The flux PDF measurements are furthermore of interest for studies of the thermal state of the IGM at z≃ 3. By comparing the PDF to state-of-the-art cosmological hydrodynamical simulations, we place constraints on the temperature of the IGM and compare our results with previous measurements of the PDF at lower redshift. At redshift z= 3, our new PDF measurements are consistent with an isothermal temperature–density relation, T=T0Δγ− 1, with a temperature at the mean density of T0= 19 250 ± 4800 K and a slope γ= 0.90 ± 0.21 (1σ uncertainties). In comparison, joint constraints with existing lower redshift PDF measurements at z < 3 favour an inverted temperature–density relation with T0= 17 900 ± 3500 K and γ= 0.70 ± 0.12, in broad agreement with previous analyses.

We grew modulated BeZnO layers by hybrid plasma-assisted molecular-beam epitaxy/electron-beam deposition. A wide band-gap investigation of the modulated BexZn1−xO by means of photocurrent (PC) spectroscopy was conducted. The band-gap energy was directly acquired from the wavelength of the PC peak, caused by the band-to-band transition. By increasing x, which was the rate of the Be elements, the optical band-gap energy was empirically fitted by EBeZnO(x) = 6.32(x–1)x + 7.305x + 3.295. We expect that this finding can open new possibilities for wide band-gap engineering of BeZnO layers, which can be utilized as barrier layers in active layers consisting of ZnO/BeZnO quantum well structures and solar-blind ultraviolet photodetectors.

Background : Inositol polyphosphate 5-phosphatase PIPP (INPP5J) has been identified as a suppressor of oncogenic PI3K/Akt signaling in breast cancer.INPP5J depletion increases transformation and accelerates oncogene-driven tumor growth in vivo, while paradoxically reducing cell migration, invasion, and metastasis. Therefore, we hypothesized that INPP5J gene expression in human breast cancer tissues would be prognostic in early breast cancer patients over long-term follow-up. Methods: A total of 478 breast cancer tissue samples collected between 2003 and 2008 was available for analysis. We measured INNPP5J mRNA using a TaqMan gene expression assay. PIK3CA mutation status was evaluated using a TaqMan mutation detection assay. We then investigated the correlations of clinicopathological factors and prognosis with levels of INPP5J mRNA and the PIK3CA mutation status. Results: INPP5J mRNA was expressed at a low level in 30.1% (144/478) and at a medium to high level in the remaining breast cancer samples. Low INPP5J mRNA correlated with larger tumor (p=0.015), high grade (p Conclusion: We shows that the level of INPP5J mRNA expression is prognostics in breast cancer patients and that its prognostic impact is affected by PIK3CA mutation status. Citation Format: Kondo N, Kim T-S, Wanifuchi Y, Hato Y, Hisada T, Nishimoto M, Nishikawa S, Toyama T. The prognostic impact of inositol polyphosphate 5-phosphatase PIPP (INPP5J) expression in breast cancer tissue [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-34.

Summary Aims: Prominent anxiety symptoms are related to poor clinical course and outcome in major depressive disorder (MDD). The aim of this randomised, open-label, controlled study is to compare the efficacy and tolerability of mirtazapine in the form of orally disintegrating tablets against paroxetine in treating MDD patients with anxiety symptoms. Methods: A total of 60 MDD patients with a score above 18 on the Hamilton Anxiety Rating Scale (HARS) were randomly assigned to 8 weeks of fixed dosing treatment with mirtazapine (15–30 mg/day) and paroxetine (10–20 mg/day). Efficacy was primarily assessed with the HARS and with the 17-item Hamilton Depression Rating Scale (HDRS) at weeks 1, 2, 4 and 8 after treatment. Tolerability was assessed from adverse events. Results: The generalised estimating equations (GEE) models showed that the rates of improvement in HDRS scores from baseline to week 8 were similar between mirtazapine and paroxetine groups. However, patients with mirtazapine exhibited earlier improvement in HARS scores at weeks 1 and 2. Week-by-week GEE models showed that these significant differences in improvement of HARS scores between the two treatment groups were detectable from the first evaluation after the treatment (week 1) and maintained through week 2. There was no difference in the overall frequency of adverse events experienced between the two treatment groups. The most common adverse event in the mirtazapine group was somnolence (n = 8), whereas that in the paroxetine group was gastrointestinal discomfort (n = 9). Conclusions: Mirtazapine and paroxetine were equally effective and well tolerated for the depressive symptoms in MDD patients with the high level of anxiety symptoms. Mirtazapine was, however, more effective in reducing the anxiety symptoms than paroxetine in the early weeks of treatment, suggesting that mirtazapine may have an earlier-onset action for the anxiety symptoms in MDD patients.