‘Pole Test’ Measurements in Critical Leg Ischaemia

AbstractBackgroundFor the quantification of critical limb ischaemia (CLI) most vascular surgery units use sphygmo-manometric and transcutaneous oxygen pressure (TcPO2) measurements. However, measurements obtained by cuff-manometry can be overestimated especially in diabetic patients because of medial calcification that makes leg arteries less compressible. TcPO2 measurements present a considerable overlap in the values obtained for patients with different degrees of ischaemia and its reproducibility has been questioned. Arterial wall stiffness has less influence on the pole test, based on hydrostatic pressure derived by leg elevation, and this test seems to provide a reliable index of CLI.ObjectiveThe objective of this study was to evaluate the pole pressure test for detection of critical lower limb ischaemia, correlating results with cuff-manometry and transcutaneous oxygen pressure.DesignUniversity hospital-prospective study.Materials and methodsSeventy-four patients (83 legs) with rest pain or gangrene were evaluated by four methods: pole test, cuff-manometry, TcPO2 and arteriography. CLI was present if the following criteria were met: (a) important arteriographic lesions+rest pain with an ankle systolic pressure (ASP) ≤40mmHg and/or a TcPO2 ≤30mmHg, or (b) important arteriographic lesions+tissue loss with an ASP ≤60mmHg and/or a TcPO2 ≤40mmHg. Fifty-seven lower limbs met the criteria for CLI.ResultsMeasurements obtained by cuff-manometry were significantly higher to those obtained by pole test (mean pressure difference: 40mmHg, p<0.001). The difference between the two methods remained statistically significant for both diabetics (50.73, p<0.001) and non-diabetics (31.46, p<0.001). Mean TcPO2 value was 15.51mmHg and there was no important difference between patients with and without diabetes. Overall, there was a correlation between sphygmomanometry and pole test (r=0.481). The correlation persisted for patients without diabetes (r=0.581), but was not evident in patients with diabetes. Correlation between pole test and TcPO2 was observed only for patients with diabetes (r=0.444). There was no correlation between cuff-manometry and TcPO2. The pole test offered an accuracy of 88% for the detection of CLI. The sensitivity of this test was 95% and the specificity 73%

Carcinomes nasopharynges localement avances

Les carcinomes nasopharyngés représentent une entité spécifique différente des cancers de la tête et du cou. L’incidence est plus élevée en Asie du Sud-Est et en Afrique du Nord. Le pronostic reste sombre pour les stades localement avancés (IIB—IVB), plus d’un tiers des cas présenteront une récidive locale et/ou métastatique, la survie globale à cinq ans tous stades confondus est estimée à 50—70 %. L’objectif de ce travail est de préciser les aspects cliniques, diagnostiques, thérapeutiques et pronostiques chez 100 malades porteur de carcinome nasopharyngé localement avancé traités à l’Institut Salah Azaiz (ISA) et de préciser l’impact de la chimiothérapie neoadjuvante (CNA) ainsi que les séquelles thérapeutiques à court et à long terme.Mots clés : carcinome nasopharyngé - chimiothérapie - radiothérapieNasopharyngeal carcinoma represents a specific entity different from cancers of head and neck. The incidence is highest in South- East Asia and North Africa. The prognosis remains poor for locally advanced stages (IIB -IVB), more than one third of cases presented locally recurrent and / or metastatic disease, the overall five-year survival for all stages is estimated at 50-70%. The objective of this study is to clarify the impact of neoadjuvant chemotherapy on long-term survival among 100 patients treated in Institut of Salah Azaiz by neo adjuvant chemotherapy followed by locoregional radiotherapy for locally advanced nasopharyngeal carcinoma, and identify prognostic factors and clinical long term effect.Key words: nasopharyngeal carcinoma – chemotherapy - radiotherap

Binding cooperativity of membrane adhesion receptors

The adhesion of cells is mediated by receptors and ligands anchored in apposing membranes. A central question is how to characterize the binding affinity of these membrane-anchored molecules. For soluble molecules, the binding affinity is typically quantified by the binding equilibrium constant K3D in the linear relation [RL] = K3D [R][L] between the volume concentration [RL] of bound complexes and the volume concentrations [R] and [L] of unbound molecules. For membrane-anchored molecules, it is often assumed by analogy that the area concentration of bound complexes [RL] is proportional to the product [R][L] of the area concentrations for the unbound receptor and ligand molecules. We show here (i) that this analogy is only valid for two planar membranes immobilized on rigid surfaces, and (ii) that the thermal roughness of flexible membranes leads to cooperative binding of receptors and ligands. In the case of flexible membranes, the area concentration [RL] of receptor-ligand bonds is proportional to the square of [R][L] for typical lengths and concentrations of receptors and ligands in cell adhesion zones. The cooperative binding helps to understand why different experimental methods for measuring the binding affinity of membrane-anchored molecules have led to values differing by several orders of magnitude.Comment: 9 pages, 4 figures; to appear in Soft Matte

Evaluating QBF Solvers: Quantifier Alternations Matter

We present an experimental study of the effects of quantifier alternations on the evaluation of quantified Boolean formula (QBF) solvers. The number of quantifier alternations in a QBF in prenex conjunctive normal form (PCNF) is directly related to the theoretical hardness of the respective QBF satisfiability problem in the polynomial hierarchy. We show empirically that the performance of solvers based on different solving paradigms substantially varies depending on the numbers of alternations in PCNFs. In related theoretical work, quantifier alternations have become the focus of understanding the strengths and weaknesses of various QBF proof systems implemented in solvers. Our results motivate the development of methods to evaluate orthogonal solving paradigms by taking quantifier alternations into account. This is necessary to showcase the broad range of existing QBF solving paradigms for practical QBF applications. Moreover, we highlight the potential of combining different approaches and QBF proof systems in solvers.Comment: preprint of a paper to be published at CP 2018, LNCS, Springer, including appendi

Role of the dimerized gap due to anion ordering in spin-density wave phase of (TMTSF)2_2ClO4_4 at high magnetic fields

Magnetoresistance measurements have been carried out along the highly conducting a axis in the FISDW phase of hydrogened and deuterated (TMTSF)$_2$ClO$_4$ for various cooling rates through the anion ordering temperature. With increasing the cooling rate, a) the high field phase boundary $\beta_{\rm {HI}}$, observed at 27 T in hydrogened samples for slowly cooled, is shifted towards a lower field, b) the last semimetallic SDW phase below $\beta_{\rm {HI}}$ is suppressed, and c) the FISDW insulating phase above $\beta_{\rm {HI}}$ is enhanced in both salts. The cooling rate dependence of the FISDW transition and of $\beta_{\rm {HI}}$ in both salts can be explained by taking into account the peculiar SDW nesting vector stabilized by the dimerized gap due to anion ordering.Comment: 6pages,6figures(EPS), accepted for publication in PR

The Nature of Electronic States in Atomically Thin MoS2 Field-Effect Transistors

We present low temperature electrical transport experiments in five field effect transistor devices consisting of monolayer, bilayer and trilayer MoS2 films, mechanically exfoliated onto Si/SiO2 substrate. Our experiments reveal that the electronic states in all films are localized well up to the room temperature over the experimentally accessible range of gate voltage. This manifests in two dimensional (2D) variable range hopping (VRH) at high temperatures, while below \sim 30 K the conductivity displays oscillatory structures in gate voltage arising from resonant tunneling at the localized sites. From the correlation energy (T0) of VRH and gate voltage dependence of conductivity, we suggest that Coulomb potential from trapped charges in the substrate are the dominant source of disorder in MoS2 field effect devices, which leads to carrier localization as well.Comment: 10 pages, 5 figures; ACS Nano (2011

Excitonic optical transitions characterized by Raman excitation profiles in single-walled carbon nanotubes

We examine the excitonic nature of the E33 optical transition of the individual free-standing index-identified (23, 7) single-walled carbon nanotube by means of the measurements of its radial-breathing-mode and G-mode Raman excitation profiles. We confirm that it is impossible to determine unambiguously the nature of its E33 optical transition (excitonic vs band to band) based only on the excitation profiles. Nevertheless, by combining Raman scattering, Rayleigh scattering, and optical absorption measurements on strictly the same individual (23, 7) single-walled carbon nanotube, we show that the absorption, Rayleigh spectra, and Raman excitation profiles of the longitudinal and transverse G modes are best fitted by considering the nature of the E33 transition as excitonic. The fit of the three sets of data gives close values of the transition energy E33 and damping parameter G33. This comparison shows that the fit of the Raman excitation profiles provides with good accuracy the energy and damping parameter of the excitonic optical transitions in single-walled carbon nanotubes

Assessment of Aesthetic Control in Qatar’s Urban Design

Aesthetic control is concerned with the visual appearance of the built environment, specifically in the urban setting. The built environment aesthetics can directly influence place identity, property values and the business owners’ financial status in the area. People’s behavior in terms of choosing a place to live or do business is also affected by the locality’s aesthetics. Qatar has invested heavily in the built environment over the last two decades, which has shed light on the importance of government adopted aesthetic control measures to preserve the identity of Qatar’s built form. This paper reviews the current control measures and provides some directions to adopt in the building permit process in support of Qatar’s National Master Plan 2032. The paper recommends a strategy to the Ministry of Municipality and Environment for a swift implementation of aesthetic/design control in Qatar until a fully integrated solution is adopted to align with the built environment as proposed in the Qatar National Master Plan 2032. Digital tools can foster designs that can restore the quality of compromised ecosystems. A partnership platform can be created between the building permit unit and pre-selected private design-oriented consultants. Lastly, this research initiative could be used by other countries subject to similar development dynamics as a precedent to further develop their own aesthetic control measures