3,481 research outputs found
Comorbidities Associated with Large Abdominal Aortic Aneurysms
BACKGROUND:
Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm.
METHODS:
We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis.
RESULTS:
The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significantly higher American Society of Anesthesiology score (2.84 vs. 2.63; p = 0.015) and were more likely to have coronary artery disease (p < 0.001), congestive heart failure (p < 0.001), or chronic obstructive pulmonary disease (p < 0.001). Aneurysm patients were more likely to be former (p = 0.034) or current (p = 0.006) smokers and had a significantly higher number of pack years (p < 0.001). Aneurysm patients also had a significantly poorer lung function. In multivariate analysis, the following factors were associated with aneurysms: chronic obstructive pulmonary disease (odds ratio, OR = 12.24; p = 0.002), current smoking (OR = 4.14; p = 0.002), and coronary artery disease (OR = 2.60; p = 0.020).
CONCLUSIONS:
Our comprehensive analysis identified several comorbidities associated with abdominal aortic aneurysms. These results could help to recognize aneurysms earlier by targeting individuals with these comorbidities for screening
Benchmarking a semiclassical impurity solver for dynamical-mean-field theory: self-energies and magnetic transitions of the single-orbital Hubbard model
An investigation is presented of the utility of semiclassical approximations
for solving the quantum-impurity problems arising in the dynamical-mean-field
approach to the correlated-electron models. The method is based on performing a
exact numerical integral over the zero-Matsubara-frequency component of the
spin part of a continuous Hubbard-Stratonovich field, along with a
spin-field-dependent steepest descents treatment of the charge part. We test
this method by applying it to one or two site approximations to the single band
Hubbard model with different band structures, and comparing the results to
quantum Monte-Carlo and simplified exact diagonalization calculations. The
resulting electron self-energies, densities of states and magnetic transition
temperatures show reasonable agreement with the quantum Monte-Carlo simulation
over wide parameter ranges, suggesting that the semiclassical method is useful
for obtaining a reasonable picture of the physics in situations where other
techniques are too expensive.Comment: 14 pages, 15 figure
Probing molecular free energy landscapes by periodic loading
Single molecule pulling experiments provide information about interactions in
biomolecules that cannot be obtained by any other method. However, the
reconstruction of the molecule's free energy profile from the experimental data
is still a challenge, in particular for the unstable barrier regions. We
propose a new method for obtaining the full profile by introducing a periodic
ramp and using Jarzynski's identity for obtaining equilibrium quantities from
non-equilibrium data. Our simulated experiments show that this method delivers
significant more accurate data than previous methods, under the constraint of
equal experimental effort.Comment: 4 pages, 3 figure
Clinical Resistome Screening of 1,110 Escherichia coli Isolates Efficiently Recovers Diagnostically Relevant Antibiotic Resistance Biomarkers and Potential Novel Resistance Mechanisms
Multidrug-resistant pathogens represent one of the biggest global healthcare challenges.
Molecular diagnostics can guide effective antibiotics therapy but relies on validated,
predictive biomarkers. Here we present a novel, universally applicable workflow for rapid
identification of antimicrobial resistance (AMR) biomarkers from clinical Escherichia coli
isolates and quantitatively evaluate the potential to recover causal biomarkers for observed
resistance phenotypes. For this, a metagenomic plasmid library from 1,110 clinical E. coli
isolates was created and used for high-throughput screening to identify biomarker
candidates against Tobramycin (TOB), Ciprofloxacin (CIP), and Trimethoprim Sulfamethoxazole (TMP-SMX). Identified candidates were further validated in vitro and
also evaluated in silico for their diagnostic performance based on matched genotype phenotype data. AMR biomarkers recovered by the metagenomics screening approach
mechanistically explained 77% of observed resistance phenotypes for Tobramycin, 76%
for Trimethoprim-Sulfamethoxazole, and 20% Ciprofloxacin. Sensitivity for Ciprofloxacin
resistance detection could be improved to 97% by complementing results with AMR
biomarkers that are undiscoverable due to intrinsic limitations of the workflow. Additionally,
when combined in a multiplex diagnostic in silico panel, the identified AMR biomarkers
reached promising positive and negative predictive values of up to 97 and 99%, respectively.
Finally, we demonstrate that the developed workflow can be used to identify potential
novel resistance mechanisms
Quantum dots – a versatile tool in plant science?
An optically stable, novel class of fluorophores (quantum dots) for in situ hybridisation analysis was tested to investigate their signal stability and intensity in plant chromosome analyses. Detection of hybridisation sites in situ was based on fluorescence from streptavidin-linked inorganic crystals of cadmium selenide. Comparison of quantum dots (QDs) with conventional detection systems (Alexa 488) in immunolabeling experiments demonstrated greater sensitivity than the conventional system. In contrast, detection of QDs in in situ hybridisation of several plant chromosomes, using several high-copy sequences, was less sensitve than Alexa 488. Thus, semiconductor nanocrystal fluorophores are more suitable for immunostaining but not for in situ hybridisation of plant chromosomes
Retrospective analysis of free temporoparietal fascial flap for defect reconstruction of the hand and the distal upper extremity
Introduction: Soft tissue reconstruction of the hand and distal upper extremity is challenging to preserve the function of the hand as good as possible. Therefore, a thin flap has been shown to be useful. In this retrospective study, we aimed to show the use of the free temporoparietal fascial flap in soft tissue reconstruction of the hand and distal upper extremity. Methods We analysed the outcome of free temporoparietal fascial flaps that were used between the years 2007and 2016 at our institution. Major and minor complications, defect location and donor site morbidity were the main fields of interest. Results: 14 patients received a free temporoparietal fascial flap for soft tissue reconstruction of the distal upper extremity. Minor complications were noted in three patients and major complications in two patients. Total flap necrosis occurred in one patient. Conclusion The free temporoparietal fascial flap is a useful tool in reconstructive surgery of the hand and the distal upper extremity with a low donor site morbidity and moderate rates of major and minor complications
Communication and signal exchange in the Rhizobium bradyrhizobium legume system
A new comprehensive communication concept in the Rhizobium/Bradyrhizobium legume symbiosis was developed. It includes a root zone specific flavonoid exudation, the differential activity of phenylpropane/acetate pathway derivatives on chemotaxis, nod-gene inducing activity and phytoalexin resistance induction on the microsymbiont side (Bradyrhizobium). Nod factor production from the microsymbiont affects the host plant in root hair curling and meristem induction. Phytoalexin production in the host plant is also an early response, however repressed to a low level after a few hours. Another strategy of the microsymbiont to overcome phytoalexin effects is degradation of phytoalexins in Rhizobium leguminosarum bv. vicieae. Competitiveness within the same infection group of the microsymbiont was studied with gus-gene fusion, using the blue coloured nodules to easily discriminate marked strains from unmarked competitors. New exopolysaccharide (EPS) mutants of Bradyrhizobium japonicum were reconstructed homologous with a DNA region to exoB gene of Rhizobium meliloti. Their clearly reduced competitiveness of nodulation, demonstrates that exopolysaccharides of Bradyrhizohium japonicum also have an important function during the early stages of this symbiotic interaction
Changes in prescribed medicines in older patients with multimorbidity and polypharmacy in general practice
Background: Treatment complexity rises in line with the number of drugs, single doses, and administration methods, thereby threatening patient adherence. Patients with multimorbidity often need flexible, individualised treatment regimens, but alterations during the course of treatment may further increase complexity. The objective of our study was to explore medication changes in older patients with multimorbidity and polypharmacy in general practice.
Methods: We retrospectively analysed data from the cluster-randomised PRIMUM trial (PRIoritisation of MUltimedication in Multimorbidity) conducted in 72 general practices. We developed an algorithm for active pharmaceutical ingredients (API), strength, dosage, and administration method to assess changes in physician-reported medication data during two intervals (baseline to six-months: ∆1; six- to nine-months: ∆2), analysed them descriptively at prescription and patient levels, and checked for intervention effects.
Results: Of 502 patients (median age 72 years, 52% female), 464 completed the study. Changes occurred in 98.6% of patients (changes were 19% more likely in the intervention group): API changes during ∆1 and ∆2 occurred in 414 (82.5%) and 338 (67.3%) of patients, dosage alterations in 372 (74.1%) and 296 (59.2%), and changes in API strength in 158 (31.5%) and 138 (27.5%) respectively. Administration method changed in 79 (16%) of patients in both ∆1 and ∆2. Simvastatin, metformin and aspirin were most frequently subject to alterations.
Conclusion: Medication regimens in older patients with multimorbidity and polypharmacy changed frequently. These are mostly due to discontinuations and dosage alterations, followed by additions and restarts. These findings cast doubt on the effectiveness of cross-sectional assessments of medication and support longitudinal assessments where possible.
Trial registration.: 1. Prospective registration: Trial registration number: NCT01171339 ; Name of registry: ClinicalTrials.gov; Date of registration: July 27, 2010; Date of enrolment of the first participant to the trial: August 12, 2010. 2. Peer reviewed trial registration: Trial registration number: ISRCTN99526053 ; Name of registry: Controlled Trials; Date of registration: August 31, 2010; Date of enrolment of the first participant to the trial: August 12, 2010
The new Felsenkeller 5 MV underground accelerator
The field of nuclear astrophysics is devoted to the study of the creation of
the chemical elements. By nature, it is deeply intertwined with the physics of
the Sun. The nuclear reactions of the proton-proton cycle of hydrogen burning,
including the 3He({\alpha},{\gamma})7Be reaction, provide the necessary nuclear
energy to prevent the gravitational collapse of the Sun and give rise to the by
now well-studied pp, 7Be, and 8B solar neutrinos. The not yet measured flux of
13N, 15O, and 17F neutrinos from the carbon-nitrogen-oxygen cycle is affected
in rate by the 14N(p,{\gamma})15O reaction and in emission profile by the
12C(p,{\gamma})13N reaction. The nucleosynthetic output of the subsequent phase
in stellar evolution, helium burning, is controlled by the
12C({\alpha},{\gamma})16O reaction.
In order to properly interpret the existing and upcoming solar neutrino data,
precise nuclear physics information is needed. For nuclear reactions between
light, stable nuclei, the best available technique are experiments with small
ion accelerators in underground, low-background settings. The pioneering work
in this regard has been done by the LUNA collaboration at Gran Sasso/Italy,
using a 0.4 MV accelerator.
The present contribution reports on a higher-energy, 5.0 MV, underground
accelerator in the Felsenkeller underground site in Dresden/Germany. Results
from {\gamma}-ray, neutron, and muon background measurements in the
Felsenkeller underground site in Dresden, Germany, show that the background
conditions are satisfactory for nuclear astrophysics purposes. The accelerator
is in the commissioning phase and will provide intense, up to 50{\mu}A, beams
of 1H+, 4He+ , and 12C+ ions, enabling research on astrophysically relevant
nuclear reactions with unprecedented sensitivity.Comment: Submitted to the Proceedings of the 5th International Solar Neutrino
Conference, Dresden/Germany, 11-14 June 2018, to appear on World Scientific
-- updated version (Figure 2 and relevant discussion updated, co-author A.
Domula added
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