To assess the short-term rebleeding rate associated with the use of a transjugular intrahepatic portosystemic shunt (TIPS) compared with balloon-occluded retrograde transvenous obliteration (BRTO) ...for management of gastric varices (GV).
A single-center retrospective comparison of 50 patients with bleeding from GV treated with a TIPS or BRTO was performed. Of 50 patients, 27 (17 men and 10 women; median age, 55 y; range, 31-79 y) received a TIPS with covered stents, and 23 (12 men and 11 women; median age, 52 y; range, 23-83 y) underwent a BRTO procedure with a foam sclerosant. All study subjects had clinical and endoscopic evidence of isolated bleeding GV and were hemodynamically stable at the time of the procedure. Clinical and endoscopic follow-up was performed. Kaplan-Meier analysis was used to evaluate rebleeding rates from the GV.
The technical success rate was 100% in the TIPS group and 91% in the BRTO group (P = .21). Major complications occurred in 4% of the patients receiving TIPS and 9% of patients the undergoing BRTO (P = .344). Encephalopathy was reported in 4 of 27 (15%) patients in the TIPS group and in none of the patients in the BRTO group (0%; P = .12). At 12 months, the incidence of rebleeding from a GV source was 11% in the TIPS group and 0% in the BRTO group (P = .25).
BRTO appears to be equivalent to TIPS in the short-term for management of bleeding GV. Further comparative studies are warranted to determine optimal management strategies in individual patients.
The objective of this study was to evaluate the incidence of post-balloon-occluded retrograde transvenous obliteration (BRTO) ascites/hepatic hydrothorax and rebleeding rate (variceal and ...non-variceal) in the presence and absence of a transjugular intrahepatic portosystemic shunt (TIPS).
A retrospective audit of consecutive patients undergoing BRTO was performed (August 2007-October 2010). The population was divided into two groups: patients who underwent BRTO only (BRTO-only group) and those who underwent BRTO in the presence of TIPS (BRTO+TIPS group). Post-BRTO rebleeding was categorized for the source of bleeding. Ascites and/or hepatic hydrothorax were categorized according to clinical severity. Comparisons, utilizing the Kaplan-Meier method, between both groups were made for patient survival, incidence of ascites/hydrothorax, and rebleeding.
Thirty-nine patients underwent BRTO (three technical failures of BRTO-only group). Of the 36 technically successful BRTO procedures, 27 patients (75%) underwent BRTO-only and 9 patients (25%) underwent BRTO in the presence of a TIPS. Pre-BRTO ascites/hydrothorax resolved in BRTO-only vs. BRTO+TIPS in 7% (N=2/27) and 56% (N=5/9), respectively (P=0.006). The ascites/hydrothorax free rate at 6, 12, and 24 months after BRTO for BRTO-only vs. BRTO+TIPS was 58%, 43%, 29%, and 100%, 100%, 100%, respectively (P=0.01). Recurrent hemorrhage for BRTO-only vs. BRTO+TIPS groups, and for the same time periods was 9%, 9%, 21% vs. 0%, 0%, 0%, respectively (P=0.03). The 1-year patient survival of both groups (80-88%) was similar (P>0.05).
This study concludes that the presence of TIPS has a protective value against the development of post-BRTO ascites/hydrothorax as well as recurrent hemorrhage but this does not translate to improved patient survival.
Objectives. Osteonecrosis of the femoral head is observed in patients treated with steroids. However, the pathogenesis of femoral head osteonecrosis remains unclear. We established a rat model with ...femoral head osteonecrosis by injecting lipopolysaccharide (LPS) and steroid, and assessed the consequences of this on femoral head histology, the systemic immune response and lipid synthesis. Methods. Male Wistar rats were injected intravenously on days 0 and 1 with 2 mg/kg LPS and intramuscularly with 20 mg/kg methylprednisolone on days 3, 4 and 5. The animals were sacrificed 1, 2, 3 or 4 weeks after the last methylprednisolone injection. Histopathological and biochemical analyses were performed every week. Results. Osteonecrosis of the femoral head was observed in the rats. The plasma triglyceride concentrations had decreased significantly by weeks 2 and 3. The total plasma cholesterol concentrations had increased significantly by week 1 but then decreased significantly by week 4. The plasma concentrations of IL-1β, IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-γ and TNF-α had increased significantly by week 1. These cytokines can all be induced by toll-like receptor 4 (TLR4) signalling. Conclusions. LPS and methylprednisolone induced osteonecrosis of the femoral head in rats and this was associated with a disruption of the innate immune system and lipid synthesis. These findings suggest that the TLR4 signalling pathway plays an important role in the pathogenesis of femoral head osteonecrosis.
Abstract Upper layer thickness (mixing depth) is an essential parameter for estimating the dissolved inorganic carbon and carbon flux at the water surface based on their association with the vertical ...flux of dissolved inorganic carbon. Previous studies quantified the mixing depth without SAV meadow or penetration depth in the SAV meadow without stratification and wind stress. However, mixing depth related to interaction with submerged aquatic vegetations (SAVs), stratification, and wind stress has yet to be quantified in the previous studies. Our study is the first to quantify the theoretical mixing depth with SAVs according to wind stress, SAV height, and drag coefficient. Theoretical mixing depth was quantified from modeled vertical temperature profile, vertical profile of horizontal velocity, and gradient Richardson number ( Ri g,veg ). We found that mixing depth at a Ri g,veg of 100 demonstrated good agreement with numerical results on average, with the mixing depth estimated in this study ( h U ,this study ) showing high applicability to observations at Komuke Lagoon. Moreover, h U ,this study increased with the increasing wind stress and decreasing drag coefficient and SAV height. Further, we found that SAV meadows with stratification and wind stress could be divided into four hydrodynamic regimes: non‐vegetated layers, upper vegetated layers, thermoclines, and benthic boundary layers. Our findings help us estimate mixing depth or vertical flux without complicated numerical simulation and understand flow interaction with SAV, wind stress, and stratification.
Plain Language Summary Upper layer thickness (mixing depth) and flow fields are important to estimate the carbon flux (e.g., “blue carbon”) and the transportation of dissolved materials (e.g., dissolved oxygen, dissolved inorganic carbon, dissolved inorganic nitrogen, etc) in submerged aquatic vegetation (SAV) meadows. However, it may not be easy to estimate mixing depth without complex numerical simulations. Additionally, we have not understood the interaction of SAV meadows with stratification, currents, or waves. Our study is the first to quantify the mixing depth analytically and to show the hydrodynamic regimes in SAV meadows with stratification. Our finding helps us to estimate carbon flux and the transportation rate of dissolved materials easily without complicated numerical simulation.
Key Points Mixing depth with submerged aquatic vegetation (SAV) meadows was estimated using an average gradient Richardson number 100 SAV meadows with stratification and wind stress were divided into four hydrodynamic regimes Wind stress, SAV, and stratification effects were used to accurately estimate the mixing depth
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Iwamoto J, Sato Y, Uzawa M, Takeda T, Matsumoto H. Ther Clin Risk Manag. 2010;6:593–600. The Editor and Publisher of Therapeutics and Clinical Risk Management wish to retract the published article. ...Following publication of the Expression of Concern, this article has been retracted due to acknowledgement of allegations of scientific misconduct regarding data integrity, inappropriate authorship, duplicate reporting, ethical oversight, and data fabrication. In addition, it has been recognised that numerous other publications from this research group have also been retracted. Our decision-making was informed by our policy on publishing ethics and integrity and the COPE guidelines on retraction. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”. This retraction relates to this paper
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
To compare the efficacies of photodynamic therapy (PDT) combined with intravitreal aflibercept (IVA) injections and IVA monotherapy using a treat-and-extend regimen (TAE) for treatment-naïve ...polypoidal choroidal vasculopathy (PCV).
One hundred and nine eyes treated with PDT combined with IVA (PDT+IVA group: 51 eyes) or IVA monotherapy (IVA group: 58 eyes) were assessed for 2 years. The main outcome measures included best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), number of IVA injections, and macular atrophy (MA). Polypoidal lesions before and after the loading phase were assessed using indocyanine green angiography.
In both groups, BCVA significantly improved after the loading phase and was maintained for 2 years. CMT and CCT were significantly reduced in both groups, without significant differences after 2 years between the groups (P=0.2708). The mean number of IVA injections in the IVA and PDT+IVA groups during the 2 years were 13.2±3.3 and 12.7±1.8, respectively, without a significant difference (P=0.06). The frequencies of MA expansion in the IVA and PDT+IVA groups during the 2 years were 25.9% and 33.4%, respectively, with no significant difference in the incidence (odds ratio: 1.40, P=0.4253). The ratios of polyp regression after the loading phase in the IVA and PDT+IVA groups were 55.2% and 94.1%, respectively, with a significant difference (P<0.0001).
PDT combined with IVA injections using a TAE regimen is effective for anatomical and visual function improvement, without a significant difference as compared to IVA monotherapy. It can facilitate complete regression of polyps with higher odds.
The design and performance of the XL-Calibur anticoincidence shield Iyer, N.K.; Kiss, M.; Pearce, M. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
03/2023, Volume:
1048
Journal Article
Peer reviewed
Open access
The XL-Calibur balloon-borne hard X-ray polarimetry mission comprises a Compton-scattering polarimeter placed at the focal point of an X-ray mirror. The polarimeter is housed within a BGO ...anticoincidence shield, which is needed to mitigate the considerable background radiation present at the observation altitude of ∼40 km. This paper details the design, construction and testing of the anticoincidence shield, as well as the performance measured during the week-long maiden flight from Esrange Space Centre to the Canadian Northwest Territories in July 2022. The in-flight performance of the shield followed design expectations, with a veto threshold <100 keV and a measured background rate of ∼0.5 Hz (20–40 keV). This is compatible with the scientific goals of the mission, where %-level minimum detectable polarisation is sought for a Hz-level source rate.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This article provides a model that regards the evolution behavior of the friction coefficient in the cylindrical compression test as a function of true strain on the basis of experimental results, ...allowing the effect of friction on the deformation curve at extremely high strain level to be evaluated and corrected for the first time. The compressive tests were carried out at a stroke rate of 1.2 mm/s on IHS38MSV hypoeutectoid steel with various lubricants at temperatures ranging from 800 °C to 1200 °C. The results showed that the friction coefficient for the compressive process was not constant and the variation could be approximated by an exponential equation along with the true strain. Microstructure observation showed that the stress increase in the later stages of process should be closely related to the large increase in the friction coefficient. The corrected curves were found to correlate well with the microstructure observation.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Summary
The head lift exercise (HLE) is the most common exercise for strengthening the swallowing musculature in clinical situations. This study investigated whether a change in the backrest angle of ...a bed influences swallowing musculature activity and physical strain during the HLE and whether it can generate an appropriate exercise load for swallowing musculature activity for older women compared with younger women. Participants were 10 elderly women and 10 young women, each of whom performed the HLE with a backrest randomly angled at 0°, 15°, 30° and 45°. The activity of the suprahyoid, infrahyoid and sternocleidomastoid muscles was assessed with electromyography. The perception of fatigue was measured with the Borg Rating of Perceived Exertion Scale. The activity of the infrahyoid and sternocleidomastoid muscles in elderly women was significantly lower when the angle of the backrest was raised to 45° vs 0°. In both groups, the Borg rating decreased significantly at the 30° and 45° backrest positions vs the 0° and 15° positions. The activity required for the suprahyoid and infrahyoid muscles in elderly women at a 30° backrest position was almost equal to the activity required by these muscles in young women at a 0° backrest position. In elderly women, it is possible that the HLE with the backrest at a 30° angle may be easier and provide a more appropriate exercise load for strengthening the swallowing muscles.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
We previously hypothesized that depressive and manic states may be consecutive presentations of the same underlying neuronal plasticity, and that moderate impairments in neuronal plasticity cause ...depressive states while further impairment to neuronal plasticity causes manic states. Psychopathological or biological relationships between bipolar disorder and schizophrenia have also been revealed. Therefore, in addition to depressive and manic states, psychosis may also be considered a manifestation resulting from additional impairments to neuronal plasticity. In the present manuscript, we hypothesize that moderate and more severe impairments to neuronal plasticity cause depressive and manic states, respectively, and that more serious impairments to neuronal plasticity cause psychosis.
Many studies have suggested that impairments in neuronal plasticity contribute to schizophrenia and other mental disorders with psychotic features, and that the impairment of neuronal plasticity in schizophrenia is more severe than that in bipolar disorder. Therefore, we hypothesize more specifically that impairments in neuronal plasticity may be more severe in the order of the cases featuring psychosis, mania, and depression. This progression notably overlaps with the arrangement of schizophrenia, bipolar disorder, and depressive disorder in the DSM-5. Psychotic symptoms are thought to appear further towards the base of the psychopathological hierarchy than are manic or depressive symptoms. If impairments to neuronal plasticity contribute to this psychopathological hierarchy, as we contest that they do, our hypothesis may serve as a bridge between clinical psychopathology, diagnosis, and biological psychiatry.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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