We compared the outcomes of endovascular coiling with microsurgical clipping of aneurysms in a Taiwanese population.
In an ambi-directional cohort design, patient baseline characteristics and ...clinical course after treatment for ruptured subarachnoid aneurysm were abstracted from medical records from three hospitals to examine and compare differences in post-operative outcomes between those treated with endovascular coiling and those treated with microsurgical clipping. Outcomes were measured, using the modified Rankin scale, two months, one year and two years postoperatively.
Of the 642 patients enrolled in the study, 281 underwent endovascular treatment and 361 underwent neurosurgery. The demographics and baseline characteristics of two groups were comparable except for a larger maximum target aneurysm lumen size (p=0.02) in the endovascular group. Patients who underwent the endovascular procedure tended to have a better quality of life than those who had neurosurgery (p<0.01). When the severity of symptom data was pooled into two groups (Rankin values 0–2 and 3–6) a statistically significant relationship was found between the severity of symptoms and age, Hunt and Hess grade, number of target aneurysms detected, and log of maximum target aneurysm lumen size (all p≤0.01). After controlling for potential confounding factors and using the lumped Rankin outcome data, no significant difference in outcome was found between the two procedures at either time point.
Our study indicated that endovascular coiling achieves results comparable to surgical clipping for patients with ruptured subarachnoid aneurysms in a Taiwanese population.
In this work, the degradation of cefalexin, norfloxacin, and ofloxacin was examined via various advanced oxidation processes (AOPs). Direct photolysis by ultraviolet (UV) and vacuum ultra violet ...(VUV) was less effective for the degradation of fluoroquinolone antibiotics such as norfloxacin and ofloxacin than that of cefalexin. Both hydrogen peroxide (H
O
) and potassium persulfate (K
S
O
) assisted UV/VUV process remarkably enhanced fluoroquinolone degradation. The addition of K
S
O
was superior to H
O
under VUV irradiation, with the best removal efficiency of norfloxacin and ofloxacin being almost 100% within 3 min in the presence of VUV/K
S
O
. The ofloxacin degradation rate was accelerated as concentrations of H
O
and K
S
O
was increased to 3 mM, but the degradation rate was slightly decreased with excess H
O
(>3 mM). The performance of modified VUV processes (i.e., VUV/H
O
and VUV/K
S
O
) was inhibited at highly alkaline condition (pH 11). The co-existence of halides (Cl
and Br
) enhanced antibiotics degradation via the modified VUV processes, but the reaction was almost unaffected in the presence of single halides. This study demonstrated that modified VUV processes (especially VUV/K
S
O
) are efficient for eliminating fluoroquinolone antibiotics from water, which can be considered as a clean and green method for the treatment of antibiotics-containing industrial wastewater.
Invasive pneumococcal diseases incur significant mortality, morbidity and economic costs. The most effective strategy currently available to reduce the burden of these diseases is vaccination. In ...this study, we evaluated the protective efficacy of immunizing mice with caseinolytic protease (ClpP) protein antigen whose gene sequences were shown to be highly conserved in different strains of Streptococcus pneumoniae in an invasive-disease model (intraperitoneal infection model), and protection against invasive challenge with 12 different serotypes of S. pneumoniae was assessed in two murine strains. Our findings demonstrated that active immunization with ClpP and passive immunization with antibodies specific for ClpP could elicit serotype-independent protection effectively against invasive pneumococcal infection. Therefore, to our knowledge, this study is the first report that immunization with single pneumococcal ClpP protein antigen could protect against such broad-range pneumococal strains, which thus supports the development of ClpP as a human penumococcal vaccine.
We examine Cluster observations of a so‐called magnetosphere “crater FTE,” employing data from five instruments (FGM, CIS, EDI, EFW, and WHISPER), some at the highest resolution. The aim of doing ...this is to deepen our understanding of the reconnection nature of these events by applying recent advances in the theory of collisionless reconnection and in detailed observational work. Our data support the hypothesis of a stratified structure with regions which we show to be spatial structures. We support the bulge‐like topology of the core region (R3) made up of plasma jetting transverse to reconnected field lines. We document encounters with a magnetic separatrix as a thin layer embedded in the region (R2) just outside the bulge, where the speed of the protons flowing approximately parallel to the field maximizes: (1) short (fraction of a sec) bursts of enhanced electric field strengths (up to ∼30 mV/m) and (2) electrons flowing against the field toward the X line at approximately the same time as the bursts of intense electric fields. R2 also contains a density decrease concomitant with an enhanced magnetic field strength. At its interface with the core region, R3, electric field activity ceases abruptly. The accelerated plasma flow profile has a catenary shape consisting of beams parallel to the field in R2 close to the R2/R3 boundary and slower jets moving across the magnetic field within the bulge region. We detail commonalities our observations of crater FTEs have with reconnection structures in other scenarios. We suggest that in view of these properties and their frequency of occurrence, crater FTEs are ideal places to study processes at the separatrices, key regions in magnetic reconnection. This is a good preparation for the MMS mission.
Women born from a preeclamptic (PE) pregnancy are associated with a lower risk of breast cancer. Prenatal and early-life exposures are hypothesized to influence breast cancer susceptibility through ...their effect on stem cells. We examined stem cell populations in umbilical cord blood from PE pregnancies and compared with those from pregnancies without this condition. We isolated mononuclear cells from 58 PE and 197 normotensive (non-PE) umbilical cord blood samples and examined the different stem cell populations. Hematopoietic (CD34(+) and CD34(+)CD38(-)), endothelial (CD34(+)CD133(+), CD34(+)VEGFR2(+), CD133(+)VEGFR2(+) and CD34(+)CD133(+)VEGFR2(+)), and putative breast (EpCAM(+), EpCAM(+)CD49f(+), EpCAM(+)CD49f(+)CD117(+), CD49f(+)CD24(+), CD24(+)CD29(+) and CD24(+)CD29(+)CD49f(+)) stem/progenitor cell subpopulations were quantified by flow cytometry and compared between PE and non-PE samples. Hematopoietic CD34(+) cell counts were significantly lowered in PE compared with non-PE samples (P = 0.039, Kruskal-Wallis test). Levels of CD34(+)CD133(+) endothelial progenitor cells were also lower in PE samples (P = 0.032, multiple regression analysis). EpCAM(+) and EpCAM(+)CD49f(+) putative breast stem cell levels were significantly lowered in PE subjects (multiple regression analysis: P = 0.038 and 0.007, respectively). Stratifying by newborn gender, EpCAM(+) and EpCAM(+)CD49f(+) stem cells were significantly lowered in PE samples of female, but not male, newborns. Umbilical cord blood samples from pregnancies complicated by preeclampsia thus had significantly lower levels of hematopoietic, endothelial, and putative breast stem cells than non-PE controls. With a lowered breast cancer risk for offspring of a PE pregnancy, our findings provide support to the hypothesis that susceptibility to breast oncogenesis may be affected by conditions and processes during the prenatal period.
Background The variable-stiffness colonoscope incorporates different degrees of stiffness of the insertion tube, which can be adjusted during the examination. Whether its use can lead to reduced ...procedure-related pain and sedative use is unknown. Objective Our purpose was to compare the use of 3 types of colonoscope with different shaft stiffnesses in relation to procedure-related pain and sedative consumption. Design Prospective randomized trial. Setting Endoscopy unit of a university-affilitated hospital. Patients Consecutive patients undergoing ambulatory colonoscopy. Interventions Random assignment was made of patients into 3 groups to receive colonoscopic examinations by one of the 3 types of colonoscope: conventional standard adult size, 1.3-m; 1.6-m; and the new variable-stiffness adult size, full-length (1.6-m) colonoscope. A mixture of propofol and afentanil, delivered by a patient-controlled syringe pump, was used for sedation in all groups. Main Outcome Measures Outcome measures included dose of patient-controlled sedation consumed, pain score, cecal intubation rate, cecal intubation time, requirement of abdominal pressure and change of patients' positions during colonoscopy, and endoscopists and patients' satisfaction scores according to a visual analog scale. Results A total of 335 patients were randomized. Patients in group 3 used significantly less propofol (in milligrams per kilograms, mean SD) compared with the other 2 groups (group 1: 1.00 0.75, group 2: 0.93 0.62, and group 3: 0.75 0.65; P = .02; 1-way analysis of variance). The mean (SD) pain score was also lower in group 3. Limitations The endoscopists were not blinded. Conclusion The use of the new variable-stiffness adult-size colonoscope significantly reduced procedure-related pain and doses of sedative medications during colonoscopy.
Global and regional chemical transport models of the
atmosphere are based on the assumption that chemical species are completely
mixed within each model grid box. However, in reality, these species ...are
often segregated due to localized sources and the influence of
topography. In order to investigate the degree to which the rates of
chemical reactions between two reactive species are reduced due to the
possible segregation of species within the convective boundary layer, we
perform large-eddy simulations (LESs) in the mountainous region of Hong
Kong Island. We adopt a simple chemical scheme with 15 primary and secondary
chemical species, including ozone and its precursors. We calculate the
segregation intensity due to inhomogeneity in the surface emissions of
primary pollutants and due to turbulent motions related to topography. We
show that the inhomogeneity in the emissions increases the segregation
intensity by a factor of 2–5 relative to a case in which the emissions are
assumed to be uniformly distributed. Topography has an important effect on
the segregation locally, but this influence is relatively limited when
considering the spatial domain as a whole. In the particular setting of our
model, segregation reduces the ozone formation by 8 %–12 % compared to the
case with complete mixing, implying that the coarse-resolution models may
overestimate the surface ozone when ignoring the segregation effect.
The association between a new human herpesvirus-like agent and various forms of Kaposi's sarcoma was examined by PCR. The DNA sequences of this agent were detected in 7 of 8 classic Kaposi's sarcoma ...specimens, 12 of 12 AIDS-associated specimens from the United States, and 7 of 10 specimens from African endemic Kaposi's sarcoma. Polymorphism of the herpesvirus-like DNA in the Kaposi's tissue from different populations was observed by both single-strand conformational polymorphism and direct sequencing. Furthermore, the presence and expression of the virus was detected in some Kaposi's tumours by Southern and northern blotting. This herpesvirus may be involved in the pathogenesis of different kinds of Kaposi's sarcoma seen among distinct and unrelated populations.
In this letter we discuss two possible reasons which cause the observed braking indices n of young radio pulsars to be smaller than 3: (a) the evolving spin-down model of the magnetic field component ...$B_{\perp}$ increases with time; (b) the extrinsic braking torque model in which the tidal torques exerted on the pulsar by the fallback disk, and carries away the spin angular momentum from the pulsar. Based on some simple assumptions, we derive the expression of the braking indices, and calculate the spin-down evolutionary tracks of pulsars for different input parameters.
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