Long Term Variceal Sclerotherapy: Is Endoscopic Sclerosis a Unique Therapeutic Approach and a True Alternative to Surgery?

Endoscopic sclerotherapy has been used to control acute variceal haemorrhage which persists despite conservative therapy, prevent recurrent variceal haemorrhage in patients with a history of oesophageal haemorrhage, and to prevent a haemorrhage in patients with oesophageal varices who never bled

Computational Efficiency of Frequency-- and Time--Domain Calculations of Extreme Mass--Ratio Binaries: Equatorial Orbits

Gravitational waveforms and fluxes from extreme mass--ratio inspirals can be computed using time--domain methods with accuracy that is fast approaching that of frequency--domain methods. We study in detail the computational efficiency of these methods for equatorial orbits of fast spinning Kerr black holes, and find the number of modes needed in either method --as functions of the orbital parameters-- in order to achieve a desired accuracy level. We then estimate the total computation time and argue that for high eccentricity orbits the time--domain approach is more efficient computationally. We suggest that in practice low--$m$ modes are computed using the frequency--domain approach, and high--$m$ modes are computed using the time--domain approach, where $m$ is the azimuthal mode number.Comment: 19 figures, 6 table

A proof of uniqueness of the Gurarii space

We present a short and elementary proof of isometric uniqueness of the Gurarii space.Comment: 6 pages, some improvements incorporate

Contemplating Mindfulness at Work: An Integrative Review

Mindfulness research activity is surging within organizational science. Emerging evidence across multiple fields suggests that mindfulness is fundamentally connected to many aspects of workplace functioning, but this knowledge base has not been systematically integrated to date. This review coalesces the burgeoning body of mindfulness scholarship into a framework to guide mainstream management research investigating a broad range of constructs. The framework identifies how mindfulness influences attention, with downstream effects on functional domains of cognition, emotion, behavior, and physiology. Ultimately, these domains impact key workplace outcomes, including performance, relationships, and well-being. Consideration of the evidence on mindfulness at work stimulates important questions and challenges key assumptions within management science, generating an agenda for future research

Functional outcome of patients with spinal cord injury: rehabilitation outcome study

Objective: To increase our knowledge of neurological recovery and functional outcome of patients with spinal cord injuries in order to make more successful rehabilitation programmes based on realistic goals.Design: Descriptive analysis of data gathered in an information system.Setting: Rehabilitation centre in The Netherlands with special department for patients with spinal cord injuries.Subjects: Fifty-five patients with traumatic spinal cord lesions admitted to the rehabilitation centre from 1988 to 1994. Main outcome measures: The functional improvement was presented in terms of progress in independence in nine daily activity skills. Independence was rated on a four-point scale.Results: From admission to discharge, lesions in 100% of patients with tetraplegia and 96% of patients with paraplegia remained complete. Significant progress in independence was made in self-care, ambulation and bladder and bowel care. Differences were found in the extent of functional improvement between subgroups of patients with different levels and extent of lesion. Contrary to expectations based on theoretical models, patients with complete paraplegia did not achieve maximal independence in self-care. Independent walking was only attained by patients with incomplete lesions. Regarding outcome of bladder and bowel care, poor results were found, especially the independence in defaecation and toilet transfers.Conclusions: The results of this study provided more insight into the functional outcome of a group of patients with traumatic spinal cord injury. More research is needed to evaluate the rehabilitation programmes for these patients

Genomic reconstruction of a novel, deeply branched sediment archaeal phylum with pathways for acetogenesis and sulfur reduction

Marine and estuary sediments contain a variety of uncultured archaea whose metabolic and ecological roles are unknown. De novo assembly and binning of high-throughput metagenomic sequences from the sulfate–methane transition zone in estuary sediments resulted in the reconstruction of three partial to near-complete (2.4–3.9 Mb) genomes belonging to a previously unrecognized archaeal group. Phylogenetic analyses of ribosomal RNA genes and ribosomal proteins revealed that this group is distinct from any previously characterized archaea. For this group, found in the White Oak River estuary, and previously registered in sedimentary samples, we propose the name ‘Thorarchaeota'. The Thorarchaeota appear to be capable of acetate production from the degradation of proteins. Interestingly, they also have elemental sulfur and thiosulfate reduction genes suggesting they have an important role in intermediate sulfur cycling. The reconstruction of these genomes from a deeply branched, widespread group expands our understanding of sediment biogeochemistry and the evolutionary history of Archaea

HAT-P-49b: A 1.7 M_J Planet Transiting a Bright 1.5 M_S F-Star

We report the discovery of the transiting extrasolar planet HAT-P-49b. The planet transits the bright (V = 10.3) slightly evolved F-star HD 340099 with a mass of 1.54M_S and a radius of 1.83 R_S. HAT-P-49b is orbiting one of the 25 brightest stars to host a transiting planet which makes this a favorable candidate for detailed follow-up. This system is an especially strong target for Rossiter- McLaughlin follow-up due to the fast rotation of the host star, 16 km/s. The planetary companion has a period of 2.6915 d, mass of 1.73 M_J and radius of 1.41 R_J. The planetary characteristics are consistent with that of a classical hot Jupiter but we note that this is the fourth most massive star to host a transiting planet with both M_p and R_p well determined.Comment: Accepted to the Astronomical Journa

Histone deacetylase 4 interacts with 53BP1 to mediate the DNA damage response

Anumber of proteins are recruited to nuclear foci upon exposure to double-strand DNA damage, including 53BP1 and Rad51, but the precise role of these DNA damage–induced foci remain unclear. Here we show in a variety of human cell lines that histone deacetylase (HDAC) 4 is recruited to foci with kinetics similar to, and colocalizes with, 53BP1 after exposure to agents causing double-stranded DNA breaks. HDAC4 foci gradually disappeared in repair-proficient cells but persisted in repair-deficient cell lines or cells irradiated with a lethal dose, suggesting that resolution of HDAC4 foci is linked to repair. Silencing of HDAC4 via RNA interference surprisingly also decreased levels of 53BP1 protein, abrogated the DNA damage–induced G2 delay, and radiosensitized HeLa cells. Our combined results suggest that HDAC4 is a critical component of the DNA damage response pathway that acts through 53BP1 and perhaps contributes in maintaining the G2 cell cycle checkpoint

“Bull's-eye” sign on gadolinium-enhanced magnetic resonance venography determines thrombus presence and age: A preliminary study

AbstractPurpose: Venous thrombosis is associated with a significant inflammatory response, which can be visualized by gadolinium magnetic resonance venography (MRV). Gadolinium extravasates into tissue during inflammation, producing perithrombus enhancement on magnetic resonance scanning. This study determines (1) whether gadolinium enhancement occurs during deep venous thrombosis (DVT); and (2) whether this enhancement changes with time and can therefore establish the age of thrombus.Methods: Patients with a diagnosis of iliofemoral DVT by duplex ultrasound who were referred for MRV to document central thrombus extent were studied. T1 weighted images were obtained before and after gadolinium injection (0.1 mmol/kg); repeat scans were obtained up to 3 months thereafter. At the level of maximum thrombus, measurements of signal intensity were made at the periphery (rim), and the center of the thrombosed vein, as well as the contralateral normal vein, on images after gadolinium enhancement. Rim-center vein signal intensity ratios were then calculated and followed.Results: A total of 39 scans were obtained in 14 patients (eight men, six women). The thrombosed veins were enlarged, with a peripheral rim of enhancement (“bull's-eye” sign). The rim-center ratio for thrombosed veins (2.16 ± 0.18) was different from that of normal veins (0.66 ± 0.10; n = 39; p < 0.001). For all acute studies (≤14 days) the rim-center ratio was 2.38 ± 0.17 (n = 31), whereas for all chronic studies (>14 days) the rim-center ratio was 1.29 ± 0.44 (n = 8; p = 0.001). Among patients who underwent both early and late studies, the rim-center ratio dropped significantly, from 2.33 ± 0.20 acutely to 1.29 ± 0.44 in chronic studies (n = 8; p = 0.03). One patient with active malignancy had a paradoxic increase in rim-center ratio over time and a clinical recurrence of symptoms, suggesting active thrombosis.Conclusions: We conclude that (1) a pattern of peripheral gadolinium enhancement (bull's-eye sign) is seen around acutely thrombosed veins on gadolinium-enhanced MRV, facilitating DVT diagnosis; and (2) the ratio of signal intensity at the rim versus the center of the thrombosed vein may be a good discriminator of acute compared with chronic DVT, which may help direct therapy. (J Vasc Surg 1997;26:809-16.