In Australia more than 85% of newly diagnosed HIV infections in 1999-2003 were homosexually acquired. In contrast, among people from culturally and linguistically diverse backgrounds, there is a much ...higher proportion of heterosexual exposure and many of the heterosexually acquired infections are diagnosed 'late', with people sometimes presenting with symptoms of AIDS. This paper reports on circumstances of late HIV diagnosis, meaning of an HIV-positive diagnosis and perceptions of risk among HIV-positive people from a variety of cultural and ethnic backgrounds in Sydney. The focus was on commonalities across cultures and ethnicities. Data were collected through semi-structured in-depth interviews with clients of the Multicultural HIV/AIDS and Hepatitis C Service and a sexual health clinic. Regular HIV tests were the exception in this group. Testing was usually motivated by a serious health crisis. Participants interpreted their diagnosis in the context of their knowledge and experiences with HIV/AIDS in their country of birth and the perceptions of HIV/AIDS in their ethnic communities in Australia. Many were not aware of the relationship between HIV and AIDS. Risk was perceived in terms of 'risk group' membership not in terms of practices and behaviours. Late diagnosis cannot be explained solely by association with country of birth, race or ethnicity. Rather, it is located within complex sets of social and cultural relations: the values attributed to HIV/AIDS and those infected and the social and cultural relations of ethnic communities in Australia and the dominant culture. These are enacted in healthcare seeking behaviour, perceptions of people with HIV and perceptions of being 'at risk'.
Several studies have shown promising results for the use of self-expandable intracranial stents for the treatment of acute ischemic stroke. This new technique combines immediate flow restoration ...after stent deployment with high recanalization rates. In the present study, the safety and efficacy of the new Aperio clot-removal device was tested in comparison with the Solitaire AB device.
The experiments were performed in swine with a weight of 35-50 kg following established models. The experimental thrombi were prepared by using a new flow model (Thrombus Loop) to produce radiopaque thrombi. Thrombi were cut into lengths of 10 mm and injected into the target vessel. The occlusion was verified by DSA and rated with the help of the TICI score. A microcatheter was placed distal to the thrombus. The devices were placed with the proximal third within the thrombus and were retrieved under continuous aspiration in their released state into the guiding sheath. We performed 23 procedures with the Aperio device and 18 procedures with the Solitaire AB and FR devices. Control angiograms were obtained 3 and 5 minutes after device deployment to evaluate the flow restoration. The number of attempts to reach a TICI 2/3 score was recorded as well as the time to recanalization and the device-related complications. Vasospasm, vascular perforation, intramural arterial dissection, or embolization of a previously uninvolved territory was defined as a device-related complication.
Defined radiopaque thrombi from whole blood could reliably be created by using the Thrombus Loop. Both devices demonstrated a high recanalization rate of 100% (TICI 3) in the target vessel with no device-related complications. No significant differences were found between the 2 devices.
In this small study, we could show that radiopaque thrombi of whole blood with a defined diameter could be reliably created by using the Thrombus Loop. The new "stent-retriever" (Aperio System) seems to be a very efficient and safe addition to the existing repertoire of clot-removal devices.
Germinal matrix hemorrhage is a frequent complication of prematurity and can be associated with adverse neurodevelopmental outcome, depending on its severity. In addition to parenchymal damage, ...intraventricular residues of hemorrhage and hydrocephalus MR imaging findings include superficial siderosis. The purpose of this study was to investigate the prevalence and location of superficial siderosis in patients with a history of germinal matrix hemorrhage.
We retrospectively identified patients with a history of germinal matrix hemorrhage who underwent MR imaging in our institution between 2008 and 2016. Imaging was evaluated for the presence and location of superficial siderosis. The presence of subependymal siderosis and evidence of hydrocephalus were assessed.
Thirty-seven patients with a history of germinal matrix hemorrhage were included; 86.5% had preterm births. The mean age at the first MR imaging was 386 days (range 2-5140 days). The prevalence of superficial siderosis was 67.6%. Superficial siderosis was detected significantly more often when MR imaging was performed within the first year of life (82.8% versus 12.5%, P < .000). When present, superficial siderosis was located infratentorially in all cases, while additional supratentorial superficial siderosis was detectable in 27%.
Here we report that superficial siderosis is a common MR imaging finding in the first year of life of patients with a history of germinal matrix hemorrhage, but it dissolves and has a low prevalence thereafter. A prospective analysis of its initial severity and speed of dissolution during this first year might add to our understanding of the pathophysiology of neurodevelopmental impairment after germinal matrix hemorrhages.
P- and n-doped bismuth telluride (Bi2Te3) polycrystalline nanostructures were prepared on structured PECVD-oxide-layers using magnetron sputtering and a lithography independent deposition and ...back-etching step. The resulting polycrystalline spacer-structures have adjustable dimensions with heights of 350 to 450 nm, a widths of 200 to 220 nm and a fix length of 1240 μm and 4020 μm. This paper presents the production of Bi2Te3 structures and how annealing affects the electrical conductivity in order to improve their potential in thermoelectric applications. In addition to temperature variation and multiple annealing the influence of different atmospheres during the annealing step has been investigated. It is shown that the electrical conductivity of the p-doped material increases by a factor of 1.8, while it decreases for the n-doped material.
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•Lithography idependent deposition and back-etching process for Bi2Te3 structures•Anisotropic dry etching of Bi2Te3 using argon plasma•Increase in electrical conductivity due to annealing for p-type Bi2Te3•Decrease in electrical conductivity due to annealing for n-type Bi2Te3•Oxidation of Bi2Te3 during a resist stripping step in O2-atmosphere
In this feasibility study, we tested whether prehospital diagnostic stroke workup enables rational decision-making regarding treatment and the target hospital in persons with suspected stroke.
A ...mobile stroke unit that delivers imaging (including multimodal brain imaging with CT angiography and CT perfusion), point-of-care-laboratory analysis, and neurologic expertise directly at the emergency site was analyzed for its use in prehospital diagnosis-based triage of suspected stroke patients.
We present 4 complementary cases with suspected stroke who underwent prehospital diagnostic workup that enabled direct diagnosis-based treatment decisions and reliable triage regarding the most appropriate medical facility for that individual, e.g., a primary hospital vs specialized centers of a tertiary hospital.
This preliminary report demonstrates the feasibility of prehospital diagnostic stroke workup for immediate etiology-specific decision-making regarding the necessary time-sensitive stroke treatment and the most appropriate target hospital.
Microsporidia are intracellular parasites, frequently infecting the planktonic crustacean Daphnia. Questioning the ability to detect and identify microsporidia with conventional microscopic ...techniques, we applied molecular methods in order to investigate the distribution and co-infection patterns of this parasite among 8 communities of the Daphnia longispina hybrid complex. Eight microsporidian taxa were detected, including 3 that previously had not been characterized genetically. Microsporidian communities from nearby lakes were found to be more similar to each other, apparently due to short distance dispersal via secondary hosts. Moreover, we detected seasonal (but not interannual) changes in microsporidian community structure. With some microsporidia being host-specific, these changes might have resulted from seasonal changes in host taxon and clonal composition. The 2 dominant and closely related parasite species were found mainly in single infections, whereas another pair of related microsporidians was found predominantly in co-infections; suggesting species-level differences in the ability to colonize infected hosts. By applying molecular methods, we were not only able to unambiguously identify parasite taxa but also to reveal multiple infections that otherwise would have remained undetected. Given the increased level of accuracy and sensitivity, we highly recommend molecular approaches in future parasite surveys of Daphnia infections.
OBJECTIVE To analyse the spectrum of congenital heart malformations, the frequency of extracardiac malformations, and the proportion of chromosome aberrations among fetuses sent for necropsy. ...MATERIAL Necropsies were performed on 815 fetuses—448 induced abortions (55%), 220 spontaneous abortions (27%), and 147 stillbirths (18%)—during a seven year period (1991–97) in the department of pathology of the Charité Medical Centre in Berlin. A congenital heart defect was identified in 129 cases (16%). For all 129 fetuses, karyotyping and an ultrasound examination had been performed. RESULTS Congenital heart defects were present in 22% of induced abortions (99 cases), 9% of spontaneous abortions (20 cases), and 7% of stillbirths (10 cases). The heart malformations were classified into 13 categories. A fetus with more than one defect was included only in the category of the most serious defect. The malformations in order of frequency were: ventricular septal defect (VSD) (28%), atrioventricular septal defect (AVSD) (16%), hypoplastic left heart (HLH) (16%), double outlet right ventricle (DORV) (12%), coarctation of the aorta (CoA) (6%), transposition of the great arteries (TGA) (4%), aortic valve stenosis (AoVS) (4%), tetralogy of Fallot (TOF) (3%), truncus arteriosus communis (TAC) (3%), pulmonary valve stenosis/pulmonary valve atresia (PaVS/PaVA) (3%), tricuspid atresia (TA) (3%), single ventricle (SV) (1.5%), and atrial septal defect (ASD) (0.5%). The most common congenital heart defects were VSD, AVSD, HLH, and DORV, which made up 72% of all the cases. In 11 cases the heart defect was isolated (no other cardiovascular or extracardiac malformations present), 85 cases (66%) were associated with additional cardiac malformations, 85 cases (66%) were associated with extracardiac malformations, and chromosome anomalies were detected in 43 cases (33%). CONCLUSIONS Fetal congenital heart malformations are common. These defects are often associated with other cardiovascular and extracardiac malformations, as well as with chromosome anomalies. Complex heart defects such as AVSD, HLH, and DORV are frequent in fetuses, as they often lead to spontaneous abortion or stillbirth or, after prenatal diagnosis, to deliberate termination of pregnancy.
The resolution of infections with the protozoan parasite Leishmania major in mice requires a Th1 response that is closely associated with the expression of IL-12, IFN-gamma, and inducible NO ...synthase. Previous Ab neutralization studies or the use of mice deficient for both TNF receptors suggested that TNF plays only a limited role in the control of parasite replication in vivo. In this study we demonstrate that resistant C57BL/6 (B6.WT) mice locally infected with L. major rapidly succumb to progressive visceral leishmaniasis after deletion of the TNF gene by homologous recombination. A reduction of the parasite inoculum to 3000 promastigotes did not prevent the fatal outcome of the disease. An influence of the altered morphology of secondary lymphoid organs in C57BL/6-TNF(-/-) (B6.TNF(-/-)) mice on the course of disease could be excluded by the generation of reciprocal bone marrow chimeras. Although infected B6.TNF(-/-) mice mounted an L. major-specific IFN-gamma response and expressed IL-12, the onset of the immune reaction was delayed. After in vitro stimulation, B6.TNF(-/-) inflammatory macrophages released 10-fold less NO in response to IFN-gamma than B6.WT cells. However, in the presence of a costimulus, e.g., L. major infection or LPS, the production of NO by B6.WT and B6.TNF(-/-) macrophages was comparable. In vivo, inducible NO synthase protein was readily detectable in skin lesions and draining lymph nodes of B6.TNF(-/-) mice, but its expression was more disperse and less focal in the absence of TNF. These are the first data to demonstrate that TNF is essential for the in vivo control of L. major.
We experimentally demonstrate by time-resolved scanning magneto-optical Kerr microscopy the possibility to locally excite multiple spin-wave beams in the dipolar-dominated regime in metallic NiFe ...films. For this purpose we employ differently shaped nonuniform microwave antennas consisting of several coplanar waveguide sections different in size, thereby adapting an approach for the generation of spin-wave beams in the exchange-dominated regime suggested by Gruszecki et al. Sci. Rep. 6, 22367 (2016). The occurring spin-wave beams are diffractive and we show that the width of the beam and its widening as it propagates can be tailored by the shape and the length of the nonuniformity. Moreover, the propagation direction of the diffractive beams can be manipulated by changing the bias field direction.
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