We report differential measurements of Ar++ ion momentum distributions from nonsequential double ionization in phase-stabilized few-cycle laser pulses. The distributions depend strongly on the ...carrier-envelope (CE) phase. Via control over the CE phase one is able to direct the nonsequential double-ionization dynamics. Data analysis through a classical model calculation reveals that the influence of the optical phase enters via (i) the cycle dependent electric field ionization rate, (ii) the electron recollision time, and (iii) the accessible phase space for inelastic collisions. Our model indicates that the combination of these effects allows a look into single cycle dynamics already for few-cycle pulses.
We have peformed three searches for high-frequency signals in the solar neutrino flux measured by the Sudbury Neutrino Observatory (SNO), motivated by the possibility that solar g-mode oscillations ...could affect the production or propagation of solar {sup 8}B neutrinos. The first search looked for any significant peak in the frequency range l/day to 144/day, with a sensitivity to sinusoidal signals with amplitudes of 12% or greater. The second search focused on regions in which g-mode signals have been claimed by experiments aboard the SoHO satellite, and was sensitive to signals with amplitudes of 10% or greater. The third search looked for extra power across the entire frequency band. No statistically significant signal was detected in any of the three searches.
Patients infected with hepatitis C virus (HCV) genotype 2 or 3 have sustained virologic response rates of approximately 80% after receiving treatment with peginterferon and ribavirin for 24 weeks. We ...conducted a large, randomized, multinational, noninferiority trial to determine whether similar efficacy could be achieved with only 16 weeks of treatment with peginterferon alfa-2a and ribavirin.
We randomly assigned 1469 patients with HCV genotype 2 or 3 to receive 180 mug of peginterferon alfa-2a weekly, plus 800 mg of ribavirin daily, for either 16 or 24 weeks. A sustained virologic response was defined as an undetectable serum HCV RNA level (<50 IU per milliliter) 24 weeks after the end of treatment.
The study failed to demonstrate that the 16-week regimen was noninferior to the 24-week regimen. The sustained virologic response rate was significantly lower in patients treated for 16 weeks than in patients treated for 24 weeks (62% vs. 70%; odds ratio for 16 weeks vs. 24 weeks, 0.67; 95% confidence interval, 0.54 to 0.84; P<0.001). In addition, the rate of relapse (a detectable HCV RNA level during follow-up in patients who had undetectable HCV RNA at the end of treatment) was significantly greater in the 16-week group (31%, vs. 18% in the 24-week group; P<0.001). The sustained virologic response rates in patients with a pretreatment serum HCV RNA level of 400,000 IU per milliliter or less was 82% with the 16-week regimen and 81% with the 24-week regimen. Among patients with a rapid virologic response (an undetectable HCV RNA level by week 4), sustained virologic response rates were 79% in the 16-week group and 85% in the 24-week group (P=0.02).
Treatment with peginterferon and ribavirin for 16 weeks in patients infected with HCV genotype 2 or 3 results in a lower overall sustained virologic response rate than treatment with the standard 24-week regimen. (ClinicalTrials.gov number, NCT00077636 ClinicalTrials.gov.).
Background
Since the publication of the first European Federation of Neurological Societies (EFNS) guidelines in 2005 on the management of restless legs syndrome (RLS; also known as Willis‐Ekbom ...disease), there have been major therapeutic advances in the field. Furthermore, the management of RLS is now a part of routine neurological practice in Europe. New drugs have also become available, and further randomized controlled trials have been undertaken. These guidelines were undertaken by the EFNS in collaboration with the European Neurological Society and the European Sleep Research Society.
Objectives
To provide an evidence‐based update of new treatments published since 2005 for the management of RLS.
Methods
First, we determined what the objectives of management of primary and secondary RLS should be. We developed the search strategy and conducted a review of the scientific literature up to 31 December 2011 (print and electronic publications) for the drug classes and interventions employed in RLS treatment. Previous guidelines were consulted. All trials were analysed according to class of evidence, and recommendations made according to the 2004 EFNS criteria for rating.
Recommendations
Level A recommendations can be made for rotigotine, ropinirole, pramipexole, gabapentin enacarbil, gabapentin and pregabalin, which are all considered effective for the short‐term treatment for RLS. However, for the long‐term
treatment for RLS, rotigotine is considered effective, gabapentin enacarbil is probably effective, and ropinirole, pramipexole and gabapentin are considered possibly effective. Cabergoline has according to our criteria a level A recommendation, but the taskforce cannot recommend this drug because of its serious adverse events.
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Background
Right ventricular (RV) dysfunction has been commonly reported in patients with Coronavirus disease 2019 (COVID-19), and is associated with mortality in mixed cohorts of patients requiring ...and not requiring invasive mechanical ventilation (IMV). Using RV-speckle tracking echocardiography (STE) strain analysis, we aimed to identify the prevalence of RV dysfunction (diagnosed by abnormal RV-STE) in patients with COVID-19 that are exclusively undergoing IMV, and assess association between RV dysfunction and 30 day mortality. We performed a prospective multicentre study across 10 ICUs in Scotland from 2/9/20 to 22/3/21. One-hundred-and-four echocardiography scans were obtained from adult patients at a single timepoint between 48 h after intubation, and day 14 of intensive care unit admission. We analysed RV-STE using RV free-wall longitudinal strain (RVFWLS), with an abnormal cutoff of > −20%. We performed survival analysis using Kaplan–Meier, log rank, and multivariate cox-regression (prespecified covariates were age, gender, ethnicity, severity of illness, and time since intubation).
Results
Ninety-four/one-hundred-and-four (90.4%) scans had images adequate for RVFWLS. Mean RVFWLS was −23.0% (5.2), 27/94 (28.7%) of patients had abnormal RVFWLS. Univariate analysis with Kaplan–Meier plot and log-rank demonstrated that patients with abnormal RVFWLS have a significant association with 30-day mortality (
p
= 0.047). Multivariate cox-regression demonstrated that abnormal RVFWLS is independently associated with 30-day mortality (Hazard-Ratio 2.22 1.14–4.39,
p
= 0.020).
Conclusions
Abnormal RVFWLS (> −20%) is independently associated with 30-day mortality in patients with COVID-19 undergoing IMV. Strategies to prevent RV dysfunction, and treatment when identified by RVFWLS, may be of therapeutic benefit to these patients.
Trial Registration
: Retrospectively registered 21st Feb 2021. ClinicalTrials.gov Identifier: NCT04764032.
Nociceptin/orphanin FQ (N/OFQ) is an opioid-like neuropeptide that binds and signals through a G-protein-coupled receptor called the N/OFQ peptide (NOP) receptor. N/OFQ and the NOP receptor are ...expressed in the midbrain and have been implicated in the pathogenesis of Parkinson’s disease (PD). Genetic removal of the N/OFQ precursor partially protects midbrain dopaminergic neurons from 1-methyl-4-phenylpyridine-induced toxicity, suggesting that endogenous N/OFQ may be detrimental to dopaminergic neurons. However, whether N/OFQ directly affects the survival and growth of dopaminergic neurons is unknown. Here, we show that N/OFQ has a detrimental effect on the survival of dopaminergic neurons and the growth of their axons in primary cultures of the E14 rat ventral mesencephalon. N/OFQ potentiates the effects of the neurotoxins 6-hydroxydopamine and 1-methyl-4-phenylpyridinium through p38-MAPK signalling. We also show that like α-synuclein, there is a significant reduction in N/OFQ messenger RNA (mRNA) expression in the midbrain of patients with Parkinson’s disease. These results demonstrate for the first time that N/OFQ is detrimental to the survival and growth of dopaminergic neurons and that its expression is altered in the midbrain of patients with Parkinson’s disease.
It has been suggested that Asian patients have reduced survival after liver transplantation because of greater recurrence of hepatitis B virus (HBV). We analyzed the outcome of Asian and non‐Asian ...patients receiving transplants for chronic hepatitis B between May 1988 and March 1994. Baseline Child‐Pugh score and United Network for Organ Sharing (UNOS) status, HBV recurrence, and survival were compared between the two groups. All but one patient received variable doses of hepatitis B immune globulin. Mean follow‐up of surviving patients was 28 months (range, 3‐71 months). Fifteen Asians and 20 non‐Asians underwent transplantation. Six of 15 Asians (40%) and 4 of 20 non‐Asians (20%) died during the study period. Although Asians had a lower 1‐year survival than non‐Asians (59% for Asians and 94% for non‐Asians), the 5‐year actuarial survival was not different (59% and 57% for Asians and non‐Asians, respectively). The causes of death in 5 of 6 Asians were factors other than recurrent hepatitis B, and 4 of 5 deaths occurred within 60 days after transplantation. Eighty percent of Asian patients were Child‐Pugh class C at referral, compared with 50% of non‐Asians, and Asians were more likely to be status 1 at transplantation (40% vs. 10%; P < .05). By contrast, all four deaths in non‐Asians occurred late and were secondary to recurrent HBV infection. Of patients surviving more than 60 days after transplantation, 7 of 11 Asians (64%) and 10 of 20 non‐Asians (50%) developed recurrent HBV infection (NS). Late mortality attributable to HBV recurrence was lower but not significantly different in Asians (1 of 7 14%) than in non‐Asians (4 of 10 40%). In summary, HBV recurrence and late HBV‐related mortality in Asians and non‐Asians is similar after liver transplantation for chronic hepatitis B. Late referral and more advanced chronic liver disease at the time of transplantation probably account for the lower 1‐year survival of Asians after liver transplantation.
Despite recent improvements in analgesia, pain control during dressing changes continues to be a major challenge in patients with burns. We investigated two different dressing modalities to compare ...how much pain the patient experienced during and after the dressing change. Patients with partial-thickness burns that required only topical wound care were assigned randomly to treatment with Acticoat (Smith and Nephew USA, Largo, FL) or silver sulfadiazine (AgSD). The outcome variable was pain during wound care, which was measured using visual analog pain scores. The mean visual analog pain scores for the wounds treated with Acticoat or AgSD wounds were 3.2 and 7.9, respectively (P < .0001; paired Student's t-test). In 41 of the 47 paired pain score observations, the pain in the wound treated with AgSD was perceived as greater than in the wound treated with Acticoat. Burn wound care with Acticoat is less painful than burn wound care with AgSD in patients with selected partial-thickness burns.
The measurement of chemical, physical and biological parameters is important for the characterization of streams health. Thus, cost-effective and targeted water quality (WQ) monitoring programmes are ...required for proper assessment, restoration and protection of such systems. This research proposes a WQ monitoring network for the Limpopo River Basin (LRB) in Mozambique located in Southern Africa, a region prone to severe droughts. In this Basin both anthropogenic and natural driven processes, exacerbated by the increased water demand by the four riparian countries (Botswana, South Africa, Zimbabwe and Mozambique) are responsible for the degradation of surface waters, impairing their downstream use, either for aquatic ecosystem, drinking, industrial or irrigation. Hence, physico-chemical, biological and microbiological characteristics at 23 sites within the basin were studied in November 2006 and January 2007. The physico-chemical and microbiological samples were analyzed according to American Public Health Association (APHA) standard methods, while the biological monitoring working party method (BMWP) was used for biological assessment. The assessment of the final WQ condition at sampled points was done taking into account appropriate indexes, the Mozambican standards for receiving waters and the WHO guidelines for drinking WQ. The assessed data indicated that sites located at proximities to the border with upstream countries were contaminated with heavy metals. The Elephants subcatchment was found with a relatively better WQ, whereas the Changane subcatchment together with the effluent point discharges in the basin were found polluted as indicated by the low dissolved oxygen and high total dissolved solids, electric conductivity, total hardness, sodium adsorption ratio and low benthic macroinvertebrates taxa. Significant differences (
p
<
0.05) were found for some parameters when the concentrations recorded in November and January were tested, therefore, indicating possible need for monthly monitoring of WQ. From this study it was concluded that a systematic WQ monitoring network composed of 16 stations would fit the conditions of the LRB. Ambient, earl warning, operational and effluents are the main monitoring types recommended. Additional research at a Basin scale was also recommended to identify the major sources of pollution, their transport and impacts to the downstream ecosystem.
An improved silicon-on-insulator (SOI) approach offers devices and circuits operating to 10 GHz by providing formerly unattainable capabilities in bulk silicon: reduced junction-to-substrate ...capacitances in FETs and bipolar transistors, inherent electrical isolation between devices, and low-loss microstrip lines. The concept, called MICROX (patent pending), is based on the SIMOX process, but uses very-high-resistivity (typically>10000 Omega -cm) silicon substrates, MICROX NMOS transistors of effective gate length 0.25 mu m give a maximum frequency of operation, f/sub max/, of 32 GHz and f/sub T/ of 23.6 GHz in large-periphery (4 mu m*50 mu m) devices with no correction for the parasitic effects of the pads. The measured minimum noise figure is 1.5 dB at 2 GHz with associated gain of 17.5 dB, an improvement over previously reported values for silicon FETs.< >
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