The Dutch EPS Registry:increasing the knowledge of encapsulating peritoneal sclerosis

Encapsulating peritoneal sclerosis (EPS) is a rare condition characterised by fibrotic thickening of the visceral peritoneum, leading to encapsulating of the intestines with partial or total intestinal obstruction. EPS is a serious complication of peritoneal dialysis (PD) with high morbidity and a mortality exceeding 50%. At present, there is uncertainty concerning the incidence and the risk factors involved in the development of EPS. To address these questions a nationwide registry has been initiated. The primary goals of the registry are to record the incidence of EPS and investigate the association of different variables, such as PD duration, medication, dialysis solutions and kidney transplantation with EPS. The registry will improve the knowledge of EPS and will serve to develop guidelines and necessary management strategies. From the registry different research activities can be initiated. A major challenge lies in the establishment of criteria that allow a timely diagnosis of EPS. At present, there are no diagnostic tools that can accurately detect EPS at an early stage. For this reason, besides patients with proven EPS, the clinical suspicion of EPS will be a sufficient criterion for inclusion in the registry. This nationwide EPS registry is currently enrolling patients

Reduction of Two-Dimensional Dilute Ising Spin Glasses

The recently proposed reduction method is applied to the Edwards-Anderson model on bond-diluted square lattices. This allows, in combination with a graph-theoretical matching algorithm, to calculate numerically exact ground states of large systems. Low-temperature domain-wall excitations are studied to determine the stiffness exponent y_2. A value of y_2=-0.281(3) is found, consistent with previous results obtained on undiluted lattices. This comparison demonstrates the validity of the reduction method for bond-diluted spin systems and provides strong support for similar studies proclaiming accurate results for stiffness exponents in dimensions d=3,...,7.Comment: 7 pages, RevTex4, 6 ps-figures included, for related information, see http://www.physics.emory.edu/faculty/boettcher

Seeing motion and apparent motion

In apparent motion experiments, participants are presented with what is in fact a succession of two brief stationary stimuli at two different locations, but they report an impression of movement. Philosophers have recently debated whether apparent motion provides evidence in favour of a particular account of the nature of temporal experience. I argue that the existing discussion in this area is premised on a mistaken view of the phenomenology of apparent motion and, as a result, the space of possible philosophical positions has not yet been fully explored. In particular, I argue that the existence of apparent motion is compatible with an account of the nature of temporal experience that involves a version of direct realism. In doing so, I also argue against two other claims often made about apparent motion, viz. that apparent motion is the psychological phenomenon that underlies motion experience in the cinema, and that apparent motion is subjectively indistinguishable from real motion

Identifying Epidermolysis Bullosa Patient Needs and Perceived Treatment Benefits:An Explorative Study Using the Patient Benefit Index

Epidermolysis bullosa (EB) is a genetic blistering skin condition for which no cure exists. Symptom alleviation and quality of life are therefore central to EB care. This study aimed to gain insight into EB patient needs and benefits from current clinical care. Two questionnaires were administered cross-sectionally to adult EB patients at the Dutch expertise centre for blistering diseases. Patient needs and benefits were analyzed using the patient benefit index survey (PBI-S). Ancillary data were compiled pertaining to self-reported EB severity, pain and pruritus, as well as current and previous treatments. In total, 104 participants were included (response rate 69.8%). Sixty-eight participants comprised the analyzed cohort (n = 36 omitted from analysis). The needs given the highest importance were to get better skin quickly (64.7%) and to be healed of all skin alterations (61.8%). A positive correlation between pain and EB severity and the importance of most needs was observed. Minimal clinically important differences within the PBI-S, relating to reported benefits from clinical care, were reported by 60.3% of the cohort. This study highlights a discrepancy between patient needs and feasible treatment outcomes. Utilizing the PBI-S in conjunction with well-established multidisciplinary care may catalyze the process of tailoring treatments to the needs of individual patients

Nanocrystalline silicon oxide interlayer in monolithic perovskite silicon heterojunction tandem solar cells with total current density gt;39 mA cm2

Silicon heterojunction solar cells are implemented as bottom cells in monolithic perovskite silicon tandem solar cells. Commonly they are processed with a smooth front side to facilitate wet processing of the lead halide perovskite cell on top. The inherent drawback of this design, namely, enhanced reflection of the cell, can be significantly reduced by replacing the amorphous or nanocrystalline silicon front side n layer of the silicon cell by a nanocrystalline silicon oxide n layer. It is deposited with the same commonly used plasma enhanced chemical vapor deposition and can be tuned to feature opto electrical properties for enhanced light coupling into the Si bottom cell, namely, low parasitic absorption and an intermediate refractive index of 2.6. We demonstrate that a 80 100 nm thick layer results in 0.9 mA cm 2 current gain in the bottom cell yielding tandem cells with a top cell bottom cell total current above 39 mA cm 2 . These first nc SiO x H coupled tandem cells reach an efficiency gt;23.

Multidisciplinary Approach to Aerospike Nozzle Design

A model of a linear aerospike rocket nozzle that consists of coupled aerodynamic and structural analyses has been developed. A nonlinear computational fluid dynamics code is used to calculate the aerodynamic thrust, and a three-dimensional finite-element model is used to determine the structural response and weight. The model will be used to demonstrate multidisciplinary design optimization (MDO) capabilities for relevant engine concepts, assess performance of various MDO approaches, and provide a guide for future application development. In this study, the MDO problem is formulated using the multidisciplinary feasible (MDF) strategy. The results for the MDF formulation are presented with comparisons against separate aerodynamic and structural optimized designs. Significant improvements are demonstrated by using a multidisciplinary approach in comparison with the single-discipline design strategy

Twisting Graphene Nanoribbons into Carbon Nanotubes

Although carbon nanotubes consist of honeycomb carbon, they have never been fabricated from graphene directly. Here, it is shown by quantum molecular-dynamics simulations and classical continuum-elasticity modeling, that graphene nanoribbons can, indeed, be transformed into carbon nanotubes by means of twisting. The chiralities of the tubes thus fabricated can be not only predicted but also externally controlled. This twisting route is an opportunity for nanofabrication, and is easily generalizable to ribbons made of other planar nanomaterials.Comment: 9 pages, 10 figure

Perfluorinated alkyl acids and fecundity assessment in striped mullet (\u3ci\u3eMugil cephalus\u3c/i\u3e) at Merritt Island national wildlife refuge

This study investigated wild caught striped mullet (Mugil cephalus) at Merritt Island National Wildlife Refuge (MINWR) for levels of 15 perfluoroalkyl acids (PFAA) in tandem with individual fecundity measurements (Oocyte sub-stage 2 late, n=42) and oocyte reproductive stages (Stages 1–5, n=128). PFAAmeasurementswere quantified in stripedmullet liver (n=128),muscle (n=49), and gonad (n=10). No significant negative impacts of liver PFAA burden on wild-caught,mullet fecundity endpoints were observed in this study; however, changes in PFAAwere observed in the liver asmullet progressed through different sub-stages of oocyte development. Of the PFAA with significant changes by sub-stage of oocyte development, the carboxylic acids (perfluorooctanoic acid, perfluorononanoic acid, and perfluorotridecanoic acid) increased in the liver with increasing sub-stage while the sulfonic acid and its precursor (perfluorooctanesulfonic acid (PFOS) and perfluorooctanesulfonamide, respectively) decreased in the liver with increasing sub-stage of oocyte development. This is a unique find and suggests PFAA change location of compartmentalization as mullet progress towards spawning. Investigations also revealed higher than expected median muscle and gonad levels of PFOS in striped mullet collected at MINWR (9.01 ng/g and 80.2 ng/g, respectively)

Mechanisms of Impaired Exercise Capacity in Short Duration Experimental Hyperthyroidism

Abstract To investigate the mechanism of reduced exercise tolerance in hyperthyroidism, we characterized cardiovascular function and determinants of skeletal muscle metabolism in 18 healthy subjects aged 26±1 yr (mean±SE) before and after 2 wk of daily ingestion of 100 pg of triiodothyronine (T3). Resting oxygen uptake, heart rate, and cardiac output increased and heart rate and cardiac output at the same submaximal exercise intensity were higher in the hyperthyroid state (P < 0.05). However, maximal oxygen uptake decreased after T3 administration (3.08±0.17 vs. 2.94±0.19 l/min; P < 0.001) despite increased heart rate and cardiac output at maximal exercise (P < 0.05). Plasma lactic acid concentration at an equivalent submaximal exercise intensity was elevated 25% (P < 0.01) and the arteriovenous oxygen difference at maximal effort was reduced (P < 0.05) in the hyperthyroid state. These effects were associated with a 21-37% decline in activities of oxidative (P < 0.001) and glycolytic (P < 0.05) enzymes in skeletal muscle and a 15% decrease in type 11A muscle fiber cross-sectional area (P < 0.05). Lean body mass was reduced (P < 0.001) and the rates of whole body leucine oxidation and protein breakdown were enhanced (P < 0.05). Thus, exercise tolerance is impaired in short duration hyperthyroidism because of decreased skeletal muscle mass and oxidative capacity related to accelerated protein catabolism but cardiac pump function is not reduced. (J. Clin

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery