Epsilon-aminocaproic acid for treatment of fibrinolysis during liver transplantation

In 97 adult patients receiving liver transplants, the coagulation system was monitored by thrombelastography and by coagulation profile including PT; a PTT; platelet count; level of factors I, II, V, VII, VIII, IX, X, XI, and XII; fibrin degradation products; ethanol gel test; protamine gel test; and euglobulin lysis time. Preoperatively, fibrinolysis defined as a whole blood clot lysis index of less than 80% was present in 29 patients (29.9%), and a euglobulin lysis time of less than 1 h was present in 13 patients. Fibrinolysis increased progressively during surgery in 80 patients (82.5%) and was most severe on reperfusion of the graft liver in 33 patients (34%). When whole blood clot lysis (F < 180 min) was observed during reperfusion of the graft liver, blood coagulability was tested by thrombelastography using both a blood sample treated in vitro with ε-aminocaproic acid (0.09%) and an untreated sample. Blood treated with ε-aminocaproic acid showed improved coagulation without fibrinolytic activity in all 74 tests. When whole blood clot lysis time was less than 120 min, generalized oozing occurred, and the effectiveness of ε-aminocaproic acid was demonstrated in vitro during the pre-anhepatic and post-anhepatic stages, ε-aminocaproic acid (1 g, single intravenous dose) was administered. In all 20 patients treated with ε-aminocaproic acid, fibrinolytic activity disappeared; whole blood clot lysis was not seen on thrombelastography during a 5-h observation period, and whole blood clot lysis index improved from 28.5 ± 29.5% to 94.8 ± 7.4% (mean ± SD, P < 0.001). None of the treated patients had hemorrhagic or thrombotic complications. In patients undergoing liver transplantation, the judicious use of a small dose of ε-aminocaproic acid, when its efficacy was confirmed in vitro, effectively treated the severe fibrinolysis without clinical thrombotic complications

Laser treatment in diabetic retinopathy

Diabetic retinopathy is a leading cause of visual impairment and blindness in developed countries due to macular edema and proliferative diabetic retinopathy (PDR). For both complications laser treatment may offer proven therapy: the Diabetic Retinopathy Study demonstrated that panretinal scatter photocoagulation reduces the risk of severe visual loss by >= 50% in eyes with high-risk characteristics. Pan-retinal scatter coagulation may also be beneficial in other PDR and severe nonproliferative diabetic retinopathy (NPDR) under certain conditions. For clinically significant macular edema the Early Treatment of Diabetic Retinopathy Study could show that immediate focal laser photocoagulation reduces the risk of moderate visual loss by at least 50%. When and how to perform laser treatment is described in detail, offering a proven treatment for many problems associated with diabetic retinopathy based on a high evidence level. Copyright (c) 2007 S. Karger AG, Basel

Precise measurement of positronium hyperfine splitting using the Zeeman effect

Positronium is an ideal system for the research of the quantum electrodynamics (QED) in bound state. The hyperfine splitting (HFS) of positronium, $\Delta_{\mathrm{HFS}}$, gives a good test of the bound state calculations and probes new physics beyond the Standard Model. A new method of QED calculations has revealed the discrepancy by 15\,ppm (3.9$\sigma$) of $\Delta_{\mathrm{HFS}}$ between the QED prediction and the experimental average. There would be possibility of new physics or common systematic uncertainties in the previous all experiments. We describe a new experiment to reduce possible systematic uncertainties and will provide an independent check of the discrepancy. We are now taking data and the current result of $\Delta_{\mathrm{HFS}} = 203.395\,1 \pm 0.002\,4 (\mathrm{stat.}, 12\,\mathrm{ppm}) \pm 0.001\,9 (\mathrm{sys.}, 9.5\,\mathrm{ppm})\,\mathrm{GHz}$ has been obtained so far. A measurement with a precision of $O$(ppm) is expected within a year.Comment: 8 pages, 8 figures, 2 tables, proceeding of LEAP2011, accepted by Hyperfine Interaction

Adding complexity to theories of paradox, tensions, and dualities of innovation and change: introduction to Organization Studies Special Issue on paradox, tensions, and dualities of innovation and change

Approaches to paradox have deep historical roots. Eastern philosophers such as Lao Tzu and Confucius described the world as a mystical interplay of interdependent contradictions (Chen, 2002; Li, 2014). The Tao te Ching, for example, opens with the puzzling and circular first line, “The Tao that can be told is not the eternal Tao.” Western scholars such as Aristotle and Hegel depicted paradox as irrational and unsolvable puzzles or double binds. The classic example is the liar’s paradox, with the statement “I am lying” leading one in strange loops between honesty and falsehood. Both these traditions stress that our greatest insights derive from grappling with intricate, interwoven and often irrational contradiction

Knowledge, attitude and practices of pediatricians regarding the prevention of oral diseases in Italy

BACKGROUND: Pediatricians are in an ideal position to advise families about the prevention and management of oral diseases in children. The objective of the study was to determine knowledge, attitude, and practices regarding the prevention of oral diseases among pediatricians in Italy. METHODS: A systematic random sample of 1000 pediatricians received a questionnaire on socio-demographic and practice characteristics; knowledge on risk factors; attitude and practices towards the prevention of oral diseases. RESULTS: A total of 507 pediatricians participated. More than half knew the main risk factors for oral diseases and this knowledge was higher in primary care pediatricians (p = 0.007), in those with a higher number of hours worked per week (p = 0.012), and who believed that oral diseases may be prevented (p = 0.017). Pediatricians with higher knowledge about the main risk factors (p = 0.006) believe that they have an important role in preventing oral diseases and that they can perform an oral examination. Almost all (89%) prescribed fluoride supplements and those younger (p = 0.016), with a higher number of patients seen in workday (p = 0.001), with longer practice activity (p = 0.004), those who believe that fluoride is effective in preventing caries (p < 0.0001), and who learned about prevention from scientific sources (p = 0.002) were more likely to prescribe fluoride. One-fourth and 40.6% provides and recommends a dental visit once a year and primary care pediatricians (p = 0.014) and those who believed that routine visit is important in preventing oral diseases (p < 0.0001) were more likely to recommend a dental visit once a year. CONCLUSION: The results showed a lack of knowledge among pediatricians although almost all believed that they had an important responsibility in preventing oral diseases and provided an oral examination

Approximation of the critical buckling factor for composite panels

This article is concerned with the approximation of the critical buckling factor for thin composite plates. A new method to improve the approximation of this critical factor is applied based on its behavior with respect to lamination parameters and loading conditions. This method allows accurate approximation of the critical buckling factor for non-orthotropic laminates under complex combined loadings (including shear loading). The influence of the stacking sequence and loading conditions is extensively studied as well as properties of the critical buckling factor behavior (e.g concavity over tensor D or out-of-plane lamination parameters). Moreover, the critical buckling factor is numerically shown to be piecewise linear for orthotropic laminates under combined loading whenever shear remains low and it is also shown to be piecewise continuous in the general case. Based on the numerically observed behavior, a new scheme for the approximation is applied that separates each buckling mode and builds linear, polynomial or rational regressions for each mode. Results of this approach and applications to structural optimization are presented

Diurnal influences of fasted and non-fasted brisk walking on gastric emptying rate, metabolic responses, and appetite in healthy males

Growing evidence suggests circadian rhythms, nutrition and metabolism are intimately linked. Intermittentfasting (IMF) has become an increasingly popular intervention for metabolic health and combining IMF withexercise may lead to benefits for weight management. However, little is known about the diurnal variation offasted exercise. This study aimed to investigate the diurnal influences on gastric emptying rate (GER), metabolicresponses, and appetite to fasted and non-fasted exercise. Twelve healthy males completed four 45 min walks ina randomised order. Walks were completed in the morning (AM) and evening (PM) and either fasted (FASTED)or after consumption of a standardised meal (FED). GER of a semi-solid lunch was subsequently measured for 2 husing the13C breath test. Blood glucose concentration, substrate utilisation, and ratings of appetite were mea-sured throughout. Energy intake was also assessed for the following 24 h. GER Tlagwas slower in PM-FASTEDcompared to AM-FASTED, AM-FED, and PM-FED (75 ± 18 min vs. 63 ± 14 min,P= 0.001, vs. 65 ± 10 min,P= 0.028 and vs. 67 ± 16 min,P= 0.007). Blood glucose concentration was greater in the FED trials incomparison to the FASTED trials pre-lunch (P 0.05) or 24 h post-energy intake (P= 0.476). Thesefindings suggest that evening fasted exercise results in delayed GER, withoutchanges in appetite. No compensatory effects were observed for appetite, and 24 h post-energy intake for bothfasted exercise trials, therefore, increased fat oxidation holds positive implications for weight management

Electrophysiological Heterogeneity of Fast-Spiking Interneurons: Chandelier versus Basket Cells

In the prefrontal cortex, parvalbumin-positive inhibitory neurons play a prominent role in the neural circuitry that subserves working memory, and alterations in these neurons contribute to the pathophysiology of schizophrenia. Two morphologically distinct classes of parvalbumin neurons that target the perisomatic region of pyramidal neurons, chandelier cells (ChCs) and basket cells (BCs), are generally thought to have the same "fast-spiking" phenotype, which is characterized by a short action potential and high frequency firing without adaptation. However, findings from studies in different species suggest that certain electrophysiological membrane properties might differ between these two cell classes. In this study, we assessed the physiological heterogeneity of fast-spiking interneurons as a function of two factors: species (macaque monkey vs. rat) and morphology (chandelier vs. basket). We showed previously that electrophysiological membrane properties of BCs differ between these two species. Here, for the first time, we report differences in ChCs membrane properties between monkey and rat. We also found that a number of membrane properties differentiate ChCs from BCs. Some of these differences were species-independent (e.g., fast and medium afterhyperpolarization, firing frequency, and depolarizing sag), whereas the differences in the first spike latency between ChCs and BCs were species-specific. Our findings indicate that different combinations of electrophysiological membrane properties distinguish ChCs from BCs in rodents and primates. Such electrophysiological differences between ChCs and BCs likely contribute to their distinctive roles in cortical circuitry in each species. © 2013 Povysheva et al