Summary
In patients with haemophilia A, repeated occurrences of haemarthrosis and synovitis lead to limitations in range of motion (ROM) of major joints. However, the effect of limitations in joint ...ROM on health‐related quality of life (HRQOL) in these patients has not been studied previously. The aim of this study was to assess the impact of ROM limitations of 10 major joints (bilateral shoulders, elbows, hips, knees and ankles), combined with other possibly influential factors, on HRQOL in patients with haemophilia A. The ROM limitations in 13 movements and pain intensity of the 10 major joints were measured. The socio‐demographic and clinical data were recorded. Short‐Form 36 was used as the HRQOL measurement. Eighteen patients (mean age: 36.9 years) were included. Hip ROM limitations, knee ROM limitations and hip pain intensity predicted physical functioning scale (P < 0.001; adjusted R2 = 0.553). Shoulder ROM limitations and age predicted role limitation were due to emotional problems scale (P < 0.001; adjusted R2 = 0.373). Elbow ROM limitations and haemophilia severity predicted mental health scale (P = 0.001; adjusted R2 = 0.320). Hip ROM limitations predicted social functioning scale (P = 0.041; adjusted R2 = 0.091). Educational level and elbow ROM limitations predicted vitality scale (P < 0.001; adjusted R2 = 0.416). The ROM limitations of hip, knee, shoulder and elbow could be predictors for HRQOL in patients with haemophilia A. Improving ROM of major joints could be an appropriate treatment strategy to enhance HRQOL in these patients.
Generating ion-photon entanglement is a crucial step for scalable trapped-ion quantum networks. To avoid the crosstalk on memory qubits carrying quantum information, it is common to use a different ...ion species for ion-photon entanglement generation such that the scattered photons are far off-resonant for the memory qubits. However, such a dual-species scheme can be subject to inefficient sympathetic cooling due to the mass mismatch of the ions. Here we demonstrate a trapped-ion quantum network node in the dual-type qubit scheme where two types of qubits are encoded in the S and F hyperfine structure levels of
Yb
ions. We generate ion photon entanglement for the S-qubit in a typical timescale of hundreds of milliseconds, and verify its small crosstalk on a nearby F-qubit with coherence time above seconds. Our work demonstrates an enabling function of the dual-type qubit scheme for scalable quantum networks.
Blood loss during liver surgery is found to be correlated with central venous pressure (CVP). The aim of the current retrospective study is to find out the cutoff value of CVP and stroke volume ...variation (SVV), which may increase the risk of having intraoperative blood loss of more than 100 mL during living liver donor hepatectomies.
Twenty-seven adult living liver donors were divided into 2 groups according to whether they had intraoperative blood loss of less (G1) or more than 100 mL (G2). The mean values of the patients' CVP and SVV at the beginning of the transaction of the liver parenchyma was used as the cutoff point. Its correlation to intraoperative blood loss was evaluated using the χ2 test; P < .001 was regarded as significant.
The cutoff points of CVP and SVV were 8 mm Hg and 13% respectively. The odds ratio of having blood loss exceeding 100 mL was 91.25 (P < .001) and 0.36 (P < .001) for CVP and SVV, respectively.
CVP less than 5 mm Hg, as suggested by most authors, is not always clinical achievable. Our results show that a value of less than 8 mm Hg or SVV 13% is able to achieve a minimal blood loss of 100 mL during parenchyma transaction during a living donor hepatectomy. Measurements used to lower the CVP or increased SVV in our serial were intravenous fluids restriction and the use of a diuretic.
•Blood loss in liver surgery is found to be correlated with central venous pressure (CVP).•A CVP less than 5 mm Hg is suggested in the literature.•A CVP less than 5 mm Hg as suggested by most authors is not always clinically achievable. Our results show that a CVP of less than 8 mm Hg or an SVV of 13% can achieve minimal blood loss of 100 mL during parenchyma transactions in living donor hepatectomy.
The strong spectral dependence of light absorption of brown carbon (BrC) aerosol is regarded to influence aerosol's radiative forcing significantly. The Absorption Angstrom Exponent (AAE) method has ...been widely used in previous studies to attribute light absorption of BrC at shorter wavelengths for ambient aerosols, with a theoretical assumption that the AAE of "pure" black carbon (BC) aerosol equals to 1.0. In this study, the AAE method was applied to both urban and rural environments in the Pearl River Delta (PRD) region of China, with an improvement of constraining the realistic AAE of "pure" BC through statistical analysis of on-line measurement data. A three-wavelength photo-acoustic soot spectrometer (PASS-3) and aerosol mass spectrometers (AMS) were used to explore the relationship between the measured AAE and the relative abundance of organic aerosol to BC. The regression and extrapolation analysis revealed that more realistic AAE values for "pure" BC aerosol (AAEBC) were 0.86, 0.82, and 1.02 between 405 and 781 nm, and 0.70, 0.71, and 0.86 between 532 and 781 nm, in the campaigns of urbanwinter, urbanfall, and ruralfall, respectively. Roadway tunnel experiments were conducted and the results further confirmed the representativeness of the obtained AAEBC values for the urban environment. Finally, the average light absorption contributions of BrC ( relative uncertainties) at 405 nm were quantified to be 11.7 % ( 5 %), 6.3 % ( 4 %), and 12.1 % ( 7 %) in the campaigns of urbanwinter, urbanfall, and ruralfall, respectively, and those at 532 nm were 10.0 % ( 2 %), 4.1 % ( 3 %), and 5.5 % ( 5 %), respectively. The relatively higher BrC absorption contribution at 405 nm in the ruralfall campaign could be reasonably attributed to the biomass burning events nearby, which was then directly supported by the biomass burning simulation experiments performed in this study. This paper indicates that the BrC contribution to total aerosol light absorption at shorter wavelengths is not negligible in the highly urbanized and industrialized PRD region.
Summary
Background Quantitative analysis of intravenous immunoglobulin (IVIg) treatment against toxic epidermal necrolysis (TEN) is lacking.
Objectives To provide a meta‐analysis evidence‐based ...examination of IVIg efficacy against TEN.
Methods A systematic review and meta‐analysis of literature published before 31 July 2011 was conducted. In observational controlled studies with at least eight patients with TEN receiving IVIg treatment, a pooled estimate of mortality risk was determined, comparing IVIg and supportive care. Statistical analyses were performed on raw data to compare the clinical differences between (i) high‐dose and low‐dose IVIg treatment in adult patients and (ii) paediatric and adult patients treated with IVIg.
Results Seventeen studies met inclusion criteria. Overall mortality rate of patients with TEN treated with IVIg was 19·9%. The pooled odds ratio (OR) for mortality from six observational controlled studies comparing IVIg and supportive care was 1·00 95% confidence interval (CI) 0·58–1·75; P = 0·99. The pooled OR for mortality in patients treated with high‐dose IVIg vs. supportive care was 0·63 (95% CI 0·27–1·44; P = 0·27). Adults treated with high‐dose IVIg exhibited significantly lower mortality than those treated with low‐dose IVIg (18·9% vs. 50%, respectively; P = 0·022); however, multivariate logistic regression model adjustment indicated that IVIg dose does not correlate with mortality (high vs. low dose: OR 0·494; 95% CI 0·106–2·300; P = 0·369). Paediatric patients treated with IVIg had significantly lower mortality than adults (0% vs. 21·6%; P = 0·001).
Conclusions Although high‐dose IVIg exhibited a trend towards improved mortality and children treated with IVIg had a good prognosis, the evidence does not support a clinical benefit of IVIg. Randomized controlled trials are necessary.
See also the Commentary by Walsh and Creamer
The purpose of this study was to explore the effect of a new cardiac rehabilitation mode on the cardiac function, mental state and quality of life of patients with acute myocardial infarction (AMI) ...after percutaneous coronary intervention (PCI) with atorvastatin calcium tablets.
A total of 120 AMI patients treated with PCI and atorvastatin calcium tablets between January 2018 and January 2019 were recruited and assigned 1:1 to receive either novel cardiac rehabilitation (experimental group) or conventional cardiac rehabilitation (control group), with 60 cases in each group. Outcome measures for evaluating the effectiveness of the novel cardiac rehabilitation mode included cardiac function indices, 6 minutes walking distance test (6MWD), adverse mental state, quality of life (QOL), incidence of complications, and satisfaction on recovery.
Patients after novel cardiac rehabilitation care showed better cardiac function than those with conventional care (p<0.001). Patients had longer 6MWD and higher QOL after novel cardiac rehabilitation care vs. those given conventional care (p<0.001). The lower scores of adverse mental state in the experimental group suggested a better psychological status of patients after receiving novel cardiac rehabilitation care when compared with those with conventional care (p<0.001). Patients were also more satisfied with the novel modality of cardiac rehabilitation care than with conventional care (p<0.05).
The new cardiac rehabilitation mode can effectively improve the cardiac function of AMI patients after PCI plus atorvastatin calcium tablets, enhance their cardiac function, mitigate their negative emotions, and reduce the risk of complications. Further trials are required prior to clinical promotion.
Abstract Extravillus trophoblast (EVT) invasion plays a critical role in placental development. Integrins bind to extracellular matrix (ECM) proteins to mediate EVT cell adhesion, migration, and ...invasion. Changes in O -glycans on β1-integrin have been found to regulate cancer cell behavior. We hypothesize that O -glycosyltransferases can regulate EVT invasion through modulating the glycosylation and function of β1-integrin. Here, we found that the GALNT1 and GALNT2 mRNA were highly expressed in HTR8/SVneo and first trimester EVT cells. Immunohistochemstry and immunofluorescence staining showed that GALNT2 was expressed in subpopulations of EVT cells in deciduas, but not in syncytiotrophoblasts and cytotrophoblasts of placental villi. The percentage of GALNT2-positive EVT cells increased with gestational ages. Overexpression of GALNT2 in HTR8/SVneo cells significantly enhanced cell-collagen IV adhesion, but suppressed cell migration and invasion. Notably, we found that GALNT2 increased the expression of Tn antigen (GalNAc-Ser/Thr) on β1-integrin as revealed by Vicia Villosa agglutinin (VVA) binding. Furthermore, GALNT2 suppressed the phosphorylation of focal adhesion kinase (FAK), a crucial downstream signaling molecule of β1-integrin. Our findings suggest that GALNT2 is a critical initiating enzyme of O -glycosylation for regulating EVT invasion.
Although most studies of the effects of electromagnetic ion cyclotron (EMIC) waves on Earth's outer radiation belt have focused on events in the afternoon sector in the outer plasmasphere or plume ...region, strong magnetospheric compressions provide an additional stimulus for EMIC wave generation across a large range of local times and L shells. We present here observations of the effects of a wave event on 23 February 2014 that extended over 8 h in UT and over 12 h in local time, stimulated by a gradual 4 h rise and subsequent sharp increases in solar wind pressure. Large‐amplitude linearly polarized hydrogen band EMIC waves (up to 25 nT p‐p) appeared for over 4 h at both Van Allen Probes, from late morning through local noon, when these spacecraft were outside the plasmapause, with densities ~5–20 cm−3. Waves were also observed by ground‐based induction magnetometers in Antarctica (near dawn), Finland (near local noon), Russia (in the afternoon), and in Canada (from dusk to midnight). Ten passes of NOAA‐POES and METOP satellites near the northern foot point of the Van Allen Probes observed 30–80 keV subauroral proton precipitation, often over extended L shell ranges; other passes identified a narrow L shell region of precipitation over Canada. Observations of relativistic electrons by the Van Allen Probes showed that the fluxes of more field‐aligned and more energetic radiation belt electrons were reduced in response to both the emission over Canada and the more spatially extended emission associated with the compression, confirming the effectiveness of EMIC‐induced loss processes for this event.
Key Points
Compression‐induced EMIC waves were observed across 12 h of local time
EMIC‐triggered emissions appeared during the strongest compression
Intense EMIC waves outside the plasmasphere depleted the radiation belts
A 36‐year‐old woman who presented with upper limb distal weakness since the age of 15 years, with gradual progression to the lower limbs, is reported. Hereditary motor neuropathy was initially ...suspected based on distal weakness and hyporeflexia; however, whole exome sequencing accidentally revealed a compound heterozygous variant in the GNE gene, and ultrasound revealed increased homogeneous echogenicity in the involved muscles, which is characteristic of myopathic changes. Muscle magnetic resonance imaging revealed fatty infiltration in all limb muscles, sparing the triceps brachii, vastus lateralis and vastus medialis. Muscle biopsy revealed intracytoplasmic rimmed vacuole, supporting the diagnosis of GNE myopathy.
Alloys with ultra-high strength and sufficient ductility are highly desired for modern engineering applications but difficult to develop. Here we report that, by a careful controlling alloy ...composition, thermomechanical process, and microstructural feature, a Co-Cr-Ni-based medium-entropy alloy (MEA) with a dual heterogeneous structure of both matrix and precipitates can be designed to provide an ultra-high tensile strength of 2.2 GPa and uniform elongation of 13% at ambient temperature, properties that are much improved over their counterparts without the heterogeneous structure. Electron microscopy characterizations reveal that the dual heterogeneous structures are composed of a heterogeneous matrix with both coarse grains (10∼30 μm) and ultra-fine grains (0.5∼2 μm), together with heterogeneous L1
-structured nanoprecipitates ranging from several to hundreds of nanometers. The heterogeneous L1
nanoprecipitates are fully coherent with the matrix, minimizing the elastic misfit strain of interfaces, relieving the stress concentration during deformation, and playing an active role in enhanced ductility.
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