Fatal autonomic failure due to premanifesting Parkinson's disease only diagnosed at autopsy

A 46‐year‐old male had 11‐year history of cryptic autonomic dysfunction. He developed a fatal autonomic failure with diffuse hypoxic brain injury. Histology examination of medulla oblongata and the celiac ganglion revealed many α‐synuclein immunoreactive Lewy bodies confirming the diagnosis of premanifesting Parkinson's disease (PD). PNS involvement in PD is underappreciated

Cleaving-temperature dependence of layered-oxide surfaces

The surfaces generated by cleaving non-polar, two-dimensional oxides are often considered to be perfect or ideal. However, single particle spectroscopies on Sr2RuO4, an archetypal non-polar two dimensional oxide, show significant cleavage temperature dependence. We demonstrate that this is not a consequence of the intrinsic characteristics of the surface: lattice parameters and symmetries, step heights, atom positions, or density of states. Instead, we find a marked increase in the density of defects at the mesoscopic scale with increased cleave temperature. The potential generality of these defects to oxide surfaces may have broad consequences to interfacial control and the interpretation of surface sensitive measurements

Epitaxial influence on the ferromagnetic semiconducotor EuO

From first principles calculations we investigate the electronic structure and the magnetic properties of EuO under hydrostatic and epitaxial forces. There is a complex interdependence of the O 2p and Eu 4f and 5d bands on the magnetism in EuO, and decreasing lattice parameters is an ideal method to increase the Curie temperature, T_c. Compared to hydrostatic pressure, the out-of-plane compensation that is available to epitaxial films influences this increase in T_c, although it is minimized by the small value of poisson's ratio for EuO. We find the semiconducting gap closes at a 6% in-plane lattice compression for epitaxy, at which point a significant conceptual change must occur in the active exchange mechanisms

high INtensity Interval Training In pATiEnts with intermittent claudication (INITIATE):a qualitative acceptability study

INTRODUCTION: A novel high-intensity interval training (HIIT) programme has demonstrated feasibility for patients with intermittent claudication (IC). The aim of this study was to explore patient perspectives of the HIIT programme to inform refinement and future research.METHODS: All patients screened and eligible for the 'high intensity interval training in patients with intermittent claudication (INITIATE)' study, were eligible to take part in a semi-structured interview. A convenience subsample of patients was selected from three distinct groups: 1) those who completed the HIIT programme, 2) those who prematurely discontinued the HIIT programme and 3) those who declined the HIIT programme. Interviews considered patients views of the programme and experiences of undertaking and/or being invited to undertake it. Interviews were audio recorded, transcribed verbatim and analysed via thematic analysis.RESULTS: Eleven out of 31 participants who completed the programme and twelve out of 38 decliners were interviewed. No participants who withdrew from the programme agreed to interview. The three key themes were; personal reflections of the programme; programme facilitators and barriers; and perceived benefits. Completers enjoyed taking part, reported symptomatic improvement and would complete it again. Practical and psychological barriers exist, such as transport and motivation. Changes to the programme were suggested.CONCLUSION: Findings support the acceptability of this novel HIIT programme, which in combination with the feasibility findings, suggest that a fully powered randomised controlled trial, comparing HIIT to usual-care supervised exercise programmes is warranted.</p

Competing risks of death in women treated with adjuvant aromatase inhibitors for early breast cancer on NCIC CTG MA.27

Baseline patient and tumor characteristics differentially affected type of death in the MA.17 placebo-controlled letrozole trial where cardiovascular death was not separately identified. The MA.27 trial allowed competing risks analysis of breast cancer (BC), cardiovascular, and other type (OT) of death. MA.27 was a phase III adjuvant breast cancer trial of exemestane versus anastrozole. Effects of baseline patient and tumor characteristics were tested for whether factors were associated with (1) all cause mortality and (2) cause-specific mortality. We also fit step-wise forward cause-specific-adjusted models. 7576 women (median age 64 years; 5417 (72 %) < 70 years and 2159 (28 %) ≥ 70 years) were enrolled and followed for median 4.1 years. The 432 deaths comprised 187 (43 %) BC, 66 (15 %) cardiovascular, and 179 (41 %) OT. Five baseline factors were differentially associated with type of death. Older patients had greater BC (p = 0.03), cardiovascular (p < 0.001), and other types (p < 0.001) of mortality. Patients with pre-existing cardiovascular history had worse cardiovascular mortality (p < 0.001); those with worse ECOG performance status had worse OT mortality (p < 0.001). Patients with T1 tumors (p < 0.001) and progesterone receptor positive had less BC mortality (p < 0.001). Fewer BC deaths occurred with node-negative disease (p < 0.001), estrogen receptor-positive tumors (p = 0.001), and without adjuvant chemotherapy (p = 0.005); worse cardiovascular mortality (p = 0.01), with trastuzumab; worse OT mortality, for non-whites (p = 0.03) and without adjuvant radiotherapy (p = 0.003). Overall, 57 % of deaths in MA.27 AI-treated patients were non-breast cancer related. Baseline patient and tumor characteristics differentially affected type of death with women 70 or older experiencing more non-breast cancer death

Fully Gapped Single-Particle Excitations in the Lightly Doped Cuprates

The low-energy excitations of the lightly doped cuprates were studied by angle-resolved photoemission spectroscopy. A finite gap was measured over the entire Brillouin zone, including along the d_{x^2 - y^2} nodal line. This effect was observed to be generic to the normal states of numerous cuprates, including hole-doped La_{2-x}Sr_{x}CuO_{4} and Ca_{2-x}Na_{x}CuO_{2}Cl_{2} and electron-doped Nd_{2-x}Ce_{x}CuO_{4}. In all compounds, the gap appears to close with increasing carrier doping. We consider various scenarios to explain our results, including the possible effects of chemical disorder, electronic inhomogeneity, and a competing phase.Comment: To appear in Phys. Rev.

Stresses in cement mantles of hip replacements: effect of femoral implant sizes, body mass index and bone quality

The effects of femoral prosthetic heads of diameters 22 and 28 mm were investigated on the stability of reconstructed hemi-pelves with cement mantles of thicknesses 1-4 mm and different bone qualities. Materialise medical imaging package and I-Deas finite element (FE) software were used to create accurate geometry of a hemi-pelvis from CT-scan images. Our FE results show an increase in cement mantle stresses associated with the larger femoral head. When a 22 mm femoral head is used on acetabulae of diameters 56 mm and above, the probability of survivorship can be increased by creating a cement mantle of at least 1 mm thick. However, when a 28 mm femoral head is used, a cement mantle thickness of at least 4 mm is needed. Poor bone quality resulted in an average 45% increase in the tensile stresses of the cement mantles, indicating resulting poor survivorship rate