Congenital coronary artery anomalies in adult population detected using dual source ECG-gated CTA in a single institution

Background: Congenital anomalies of the coronary arteries (CAs) are rare and are often diagnosed incidentally during a conventional coronary angiography. Recently, the incidence of these congenital defects is on the rise particularly after the introduction of the electrocardiography (ECG) gated coronary computed tomographic angiography (CCTA). This innovative radiological screening modality has led to the most precise mapping of the course of the CAs on computed tomographic scan. The aim of the study is to determine the prevalence and describe the CAs congenital anomalies and their variations in Kuwaiti population at a single institution experience. Materials and methods: We analysed the CCTA data obtained consecutively from 842 patients (2013–2014), retrospectively. The inclusion criteria for patients’ selection were: atypical chest pain, equivocal ECG, assessment of patency of coronary stents or grafts and pre-operative screening. Information was acquiesced using a dual-source CT scanner with ECG gating. Results: Data analysis revealed that 22 (2.61%) patients were found to have CA anomalies out of the 842 patients who underwent CCTA. Out of these CA anomalies, 13 cases showed more than two ostia, 7 cases showed the ectopic origin of a CA from opposite sinus or non-aortic sinus, 2 cases showed single coronary ostium and 1 case showed coronary artery with pulmonary fistula. Also, myocardial bridging was identified in 78 (9.26%) patients whereas ramus intermedius branch was identified in 160 (19%) patients. Conclusions: The prevalence of CA anomalies in Kuwait was 2.6%, which is relatively higher than previously reported studies from different countries

Thermal Equilibrium as an Initial State for Quantum Computation by NMR

We present a method of using a nuclear magnetic resonance computer to solve the Deutsch-Jozsa problem in which: (1) the number of molecules in the NMR sample is irrelevant to the number of qubits available to an NMR quantum computer, and (2) the initial state is chosen to be the state of thermal equilibrium, thereby avoiding the preparation of pseudopure states and the resulting exponential loss of signal as the number of qubits increases. The algorithm is described along with its experimental implementation using four active qubits. As expected, measured spectra demonstrate a clear distinction between constant and balanced functions.Comment: including 4 figure

A theoretically based cross-sectional survey on the behaviors and experiences of clinical pharmacists caring for patients with chronic kidney disease.

The literature shows a lack of evidence on pharmacists contributing to chronic kidney disease services. The aim was to determine pharmacists’ behaviors and experiences and perceptions of barriers and facilitators to implementation of models of care. A theoretically informed survey was developed and sent to pharmacist members of the United Kingdom renal pharmacy group. Sections included: demographics, clinical practice and prescribing practice. Questions were of various types; closed type and some open for comments. Attitudinal items on clinical/prescribing used 5-point Likert scale. Development/implementation items were derived from the Consolidated Framework for Implementation Research (CFIR). Analysis used descriptive statistics and open comments were analysed thematically. Ethical approval was granted by an academic institution. Response rate; 50% (n = 71), seven were incomplete and excluded. Respondents provided; inpatient general pharmaceutical care (n = 56, 87.5%), to those receiving dialysis (n = 54, 84.4%) and transplantation. Non-clinical roles; audits (n = 46, 71.9%), patient education (n = 31, 48.4%), only 7.8% (n = 5) doing academic research. For barrier/facilitators most strongly agreed/agreed with most CFIR items relating to clinical practice. A majority (n = 44, 68.7%) disagreed that they had sufficient time to practice clinically and 44 (68.7%) disagreed there was sufficient cover for services. For prescribing roles, 90.5% (n = 48) were currently actively prescribing. Although prescribing related CFIR items were largely positive, 39.6% (n = 19) disagreed about sufficient time to practice and 18.7% (n = 9) were neutral. Two thirds (n = 33, 68.7%) disagreed that there was sufficient cover for the prescribing. The majority of respondents provided general pharmaceutical care to dialysis and transplant patients, were confident in their abilities and tried new ways of working including independent prescribing. Many expressed that lack of resources was the main barrier to providing more advanced care. Further work is needed to explore these matters in more depth

Rapid solution of problems by nuclear-magnetic-resonance quantum computation

We offer an improved method for using a nuclear-magnetic-resonance quantum computer (NMRQC) to solve the Deutsch-Jozsa problem. Two known obstacles to the application of the NMRQC are exponential diminishment of density-matrix elements with the number of bits, threatening weak signal levels, and the high cost of preparing a suitable starting state. A third obstacle is a heretofore unnoticed restriction on measurement operators available for use by an NMRQC. Variations on the function classes of the Deutsch-Jozsa problem are introduced, both to extend the range of problems advantageous for quantum computation and to escape all three obstacles to use of an NMRQC. By adapting it to one such function class, the Deutsch-Jozsa problem is made solvable without exponential loss of signal. The method involves an extra work bit and a polynomially more involved Oracle; it uses the thermal-equilibrium density matrix systematically for an arbitrary number of spins, thereby avoiding both the preparation of a pseudopure state and temporal averaging.Comment: 19 page

First Report of Leishmania tropica from a Classical Focus of L. major in North-Sinai, Egypt

This is the publisher's version, also available electronically from http://www.ajtmh.org/content/81/2/213.long.Cutaneous leishmaniasis (CL) is prevalent in the Egyptian Sinai Peninsula and previous research has consistently documented the etiologic agent to be Leishmania major. We report the first isolation of Leishmania tropica from human cases of CL in a Northern Sinai community bordering Palestine. Parasite culturing, real-time polymerase chain reaction (PCR), gene sequencing, and restriction fragment length polymorphism (RFLP) analyses indicate CL cases in this community were caused by either L. major or L. tropica (three cases each). Two wild-caught rodents (Gerbillus pyramidum floweri) were infected with L. tropica. Phlebotomus papatasi sand flies were found harboring L. major, however only non-infected individuals of Phlebotomus sergenti, a vector for L. tropica, were caught. Patients with L. tropica had not traveled from the region in over a year, suggesting these cases are autochthonous. This scenario is consistent with an incursion of L. tropica from bordering countries and raises concerns about expansion of this parasite further into Egypt

Interaction of Streptavidin-Based Peptide-MHC Oligomers (Tetramers) with Cell-Surface T Cell Receptors

he binding of oligomeric peptide–MHC (pMHC) complexes to cell surface TCR can be considered to approximate TCR–pMHC interactions at cell-cell interfaces. In this study, we analyzed the equilibrium binding of streptavidin-based pMHC oligomers (tetramers) and their dissociation kinetics from CD8[superscript pos] T cells from 2C-TCR transgenic mice and from T cell hybridomas that expressed the 2C TCR or a high-affinity mutant (m33) of this TCR. Our results show that the tetramers did not come close to saturating cell-surface TCR (binding only 10–30% of cell-surface receptors), as is generally assumed in deriving affinity values (K[subscript D]), in part because of dissociative losses from tetramer-stained cells. Guided by a kinetic model, the oligomer dissociation rate and equilibrium constants were seen to depend not only on monovalent association and dissociation rates (k[subscript off] and k[subscript on]), but also on a multivalent association rate (μ) and TCR cell-surface density. Our results suggest that dissociation rates could account for the recently described surprisingly high frequency of tetramer-negative, functionally competent T cells in some T cell responses.National Institutes of Health (U.S.) (Grant P01 CA097296)National Institutes of Health (U.S.) (Grant R01 GM55767)National Institutes of Health (U.S.) (Grant PO1-AI071195)National Institutes of Health (U.S.). Pioneer Awar

A theoretically based cross-sectional survey on the behaviours and experiences of clinical pharmacists caring for chronic kidney disease patients.

Chronic kidney disease (CKD) is a comorbid condition with high economic burden. Patients need multiple medications and pharmacists provide care that improves outcomes. Al Raiisi et al. recently completed a systematic review showing a paucity of information on the structures and processes of clinical pharmacy services (CPS) and a need to define core outcomes. More work is needed to describe renal CPS which reflects developments such as non-medical prescribing (NMP)