Numerical Method for Electromagnetic Wave Propagation Problem in a Cylindrical Anisotropic Waveguide with Longitudinal Magnetization

The propagation of monochromatic electromagnetic waves in metal circular cylindrical dielectric waveguide with longitudinal magnetization filled with anisotropic inhomogeneous waveguide is considered. The physical problem is reduced to solving a transmission eigenvalue problem for a system of ordinary differential equations. Spectral parameters of the problem are propagation constants of the waveguide. Numerical results are obtained using a modification of the projecting methods. The comparison with known exact solutions (for particular values of parameters) are made

Dynamic changes in cellular infiltrates with repeated cutaneous vaccination: a histologic and immunophenotypic analysis

<p>Abstract</p> <p>Background</p> <p>Melanoma vaccines have not been optimized. Adjuvants are added to activate dendritic cells (DCs) and to induce a favourable immunologic milieu, however, little is known about their cellular and molecular effects in human skin. We hypothesized that a vaccine in incomplete Freund's adjuvant (IFA) would increase dermal Th1 and Tc1-lymphocytes and mature DCs, but that repeated vaccination may increase regulatory cells.</p> <p>Methods</p> <p>During and after 6 weekly immunizations with a multipeptide vaccine, immunization sites were biopsied at weeks 0, 1, 3, 7, or 12. In 36 participants, we enumerated DCs and lymphocyte subsets by immunohistochemistry and characterized their location within skin compartments.</p> <p>Results</p> <p>Mature DCs aggregated with lymphocytes around superficial vessels, however, immature DCs were randomly distributed. Over time, there was no change in mature DCs. Increases in T and B-cells were noted. Th2 cells outnumbered Th1 lymphocytes after 1 vaccine 6.6:1. Eosinophils and FoxP3⁺cells accumulated, especially after 3 vaccinations, the former cell population most abundantly in deeper layers.</p> <p>Conclusions</p> <p>A multipeptide/IFA vaccine may induce a Th2-dominant microenvironment, which is reversed with repeat vaccination. However, repeat vaccination may increase FoxP3⁺T-cells and eosinophils. These data suggest multiple opportunities to optimize vaccine regimens and potential endpoints for monitoring the effects of new adjuvants.</p> <p>Trail Registration</p> <p>ClinicalTrials.gov Identifier: NCT00705640</p

The role of leukotriene receptor blockers in the treatment of allergic rhinitis in combination with chronic rhinosinusitis with nasal polyps

Background. Leukotrienes play an important role in the pathogenesis of allergic rhinitis (AR) and eosinophilic type of chronic rhinosinusitis with nasal polyps (CRSwNP). There is a phenotype of CRSwNP in combination with AR, which has specifics of local inflammation.The aim of our study was to investigate the efficacy of using an antileukotriene drug in the treatment of AR in combination with CRSwNP.Materials and methods. 63 patients with AR and bilateral CRSwNP after endoscopic bilateral polypotomy were randomly divided into 2 groups. In the 1st group 32 people (age 50.28 ± 1.37 years) were prescribed a basic therapy with nasal spray of mometasone furoate at a daily dose of 400 µg in combination with montelukast 1 tab. 10 mg at night, in the 2nd group 31 people (age 50.31 ± 1, 16 years old) received only mometasone furoate monotherapy. Endoscopic examination of the nasal cavity was performed once every 3 months. The follow-up period was 1 year.Results. After 3 months in the 1st group of patients there was a recurrence of polyp growth was observed in 25% of cases, in the 2nd group in 35.5% of patients (p &lt; 0.05). After 6 months, the number of relapses of CRSwNP decreased to 15.6% of cases in group 1 and to 22.6% in group 2 (p &lt; 0.05). After 9 months in group 1 recurrence of NP was recorded in 12.5% of patients and nasal polyps were completely absent during endoscopic examination in 9.4% of cases, in the 2nd group, relapse was detected in 19.35% of patients (p &lt; 0.05). 1 year after surgery, in group 1, relapse of NP was found in 12.5% of patients with AR and in 12.5% of cases was remission of the pathological process with cancellation of basic therapy. In group 2, recurrence of NP was in 16.1% of cases, there were no reasons for withdraw treatment of intranasal glucocorticosteroids in this group.Discussion. The clinical effectiveness of the addition of Montelukast to basic therapy has been reflected in a reduction in the growth rate of polyposic vegetation, the number of repeated operations and the stabilization of the flow of chronic inflammatory process.Conclusions. In the case of the clinical phenotype of AR with CRSwNP, the addition of a leukotriene receptor blocker montelukast to the basic therapy of intranasal glucocorticosteroids made it possible to improve drug control of both diseases and reduce the frequency of CRSwNP relapses

On the dynamical generation of the Maxwell term and scale invariance

Gauge theories with no Maxwell term are investigated in various setups. The dynamical generation of the Maxwell term is correlated to the scale invariance properties of the system. This is discussed mainly in the cases where the gauge coupling carries dimensions. The term is generated when the theory contains a scale explicitly, when it is asymptotically free and in particular also when the scale invariance is spontaneously broken. The terms are not generated when the scale invariance is maintained. Examples studied include the large $N$ limit of the $CP^{N-1}$ model in $(2+\epsilon)$ dimensions, a 3D gauged $\phi^6$ vector model and its supersymmetric extension. In the latter case the generation of the Maxwell term at a fixed point is explored. The phase structure of the $d=3$ case is investigated in the presence of a Chern-Simons term as well. In the supersymmetric $\phi^6$ model the emergence of the Maxwell term is accompanied by the dynamical generation of the Chern-Simons term and its multiplet and dynamical breaking of the parity symmetry. In some of the phases long range forces emerge which may result in logarithmic confinement. These include a dilaton exchange which plays a role also in the case when the theory has no gauge symmetry. Gauged Lagrangian realizations of the 2D coset models do not lead to emergent Maxwell terms. We discuss a case where the gauge symmetry is anomalous.Comment: 38 pages, 4 figures; v2 slightly improved, typos fixed, references added, published versio

The Spectrum of Clinical Utilities in Molecular Pathology Testing Procedures for Inherited Conditions and Cancer: A Report of the Association for Molecular Pathology

Clinical utility describes the benefits of each laboratory test for that patient. Many stakeholders have adopted narrow definitions for the clinical utility of molecular testing as applied to targeted pharmacotherapy in oncology, regardless of the population tested or the purpose of the testing. This definition does not address all of the important applications of molecular diagnostic testing. Definitions consistent with a patient-centered approach emphasize and recognize that a clinical test result\u27s utility depends on the context in which it is used and are particularly relevant to molecular diagnostic testing because of the nature of the information they provide. Debates surrounding levels and types of evidence needed to properly evaluate the clinical value of molecular diagnostics are increasingly important because the growing body of knowledge, stemming from the increase of genomic medicine, provides many new opportunities for molecular testing to improve health care. We address the challenges in defining the clinical utility of molecular diagnostics for inherited diseases or cancer and provide assessment recommendations. Starting with a modified analytic validity, clinical validity, clinical utility, and ethical, legal, and social implications model for addressing clinical utility of molecular diagnostics with a variety of testing purposes, we recommend promotion of patient-centered definitions of clinical utility that appropriately recognize the valuable contribution of molecular diagnostic testing to improve patient care

Holographic GB gravity in arbitrary dimensions

We study the properties of the holographic CFT dual to Gauss-Bonnet gravity in general $D \ge 5$ dimensions. We establish the AdS/CFT dictionary and in particular relate the couplings of the gravitational theory to the universal couplings arising in correlators of the stress tensor of the dual CFT. This allows us to examine constraints on the gravitational couplings by demanding consistency of the CFT. In particular, one can demand positive energy fluxes in scattering processes or the causal propagation of fluctuations. We also examine the holographic hydrodynamics, commenting on the shear viscosity as well as the relaxation time. The latter allows us to consider causality constraints arising from the second-order truncated theory of hydrodynamics.Comment: 48 pages, 9 figures. v2: New discussion on free fields in subsection 3.3 and new appendix B on conformal tensor fields. Added comments on the relation between the central charge appearing in the two-point function and the "central charge" characterizing the entropy density in the discussion. References adde

A scoring tool to predict mortality and dependency after cerebral venous thrombosis

Abstract Background and purpose: A prognostic score was developed to predict dependency and death after cerebral venous thrombosis (CVT) to identify patients for targeted therapy in future clinical trials. Methods: Data from the International CVT Consortium were used. Patients with pre- existent functional dependency were excluded. Logistic regression was used to predict poor outcome (modified Rankin Scale score 3– 6) at 6 months and Cox regression to predict 30- day and 1- year all- cause mortality. Potential predictors derived from previous studies were selected with backward stepwise selection. Coefficients were shrunk using ridge regression to adjust for optimism in internal validation. Results: Of 1454 patients with CVT, the cumulative number of deaths was 44 (3%) and 70 (5%) for 30 days and 1 year, respectively. Of 1126 patients evaluated regarding functional outcome, 137 (12%) were dependent or dead at 6 months. From the retained predictors for both models, the SI2NCAL2C score was derived utilizing the following components: absence of female- sex- specific risk factor, intracerebral hemorrhage, infection of the central nervous system, neurological focal deficits, coma, age, lower level of hemoglobin (g/l), higher level of glucose (mmol/l) at admission, and cancer. C- statistics were 0.80 (95% confidence interval [CI] 0.75– 0.84), 0.84 (95% CI 0.80– 0.88) and 0.84 (95% CI 0.80– 0.88) for the poor outcome, 30- day and 1- year mortality model, respectively. Calibration plots indicated a good model fit between predicted and observed values. The SI2NCAL2C score calculator is freely available at www.cereb ralve noust hromb osis.com. Conclusions: The SI2NCAL2C score shows adequate performance for estimating individual risk of mortality and dependency after CVT but external validation of the score is warranted

Entanglement entropies in free fermion gases for arbitrary dimension

We study the entanglement entropy of connected bipartitions in free fermion gases of N particles in arbitrary dimension d. We show that the von Neumann and Renyi entanglement entropies grow asymptotically as N^(1-1/d) ln N, with a prefactor that is analytically computed using the Widom conjecture both for periodic and open boundary conditions. The logarithmic correction to the power-law behavior is related to the area-law violation in lattice free fermions. These asymptotic large-N behaviors are checked against exact numerical calculations for N-particle systems.Comment: 6 pages, 9 fig

Further investigation of confirmed urinary tract infection (UTI) in children under five years: a systematic review.

Background: Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods: We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI) in children under five years of age. Results: 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68) and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8). None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR), as an alternative to micturating cystourethrography (MCUG) (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29); these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion: There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required

Влияние телемедицинской консультации на исход заболевания у больных с внутримозговыми кровоизлияниями

RELEVANCE. Telemedicine solves the problem of the availability of highly qualified personnel at the decision-making stage in the management of patients with intracerebral hemorrhage. AIM OF STuDY We set out to evaluate the effect of teleconsultation on outcomes in patients with intracerebral hemorrhage 30 days after the event.MATERIAL AND METHODS. A prospective, open, nonrandomized clinical trial in two parallel groups. The first group included adult patients up to 80 years of age with a hemorrhagic stroke from 4 to 36 points according to NIHSS due to unilateral supratentorial intracerebral hematoma of non-aneurysmal genesis, who were examined by a neurosurgeon and resuscitator of the Regional Vascular Center in a ward. The second group included similar patients, but they received telemedicine consultation of the above specialists. The primary endpoint of the study was mortality 30 days after the onset of the stroke. The hypothesis of non-superiority was tested where the 95% confidence interval (CI) for the difference in mortality between the groups should not go over 15 percentage points.RESULTS. A total of 140 patients (70 in each group) with intracerebral hematomas were studied. Mortality in the bedside group was 14.3% (CI 7.1%; 24.7%), and in the remote group it was 25.7% (16.0%; 37.6%), p=0.091. However, there was no evidence of superiority, since the difference between the groups in mortality was 11.4 with CI from –0.07 to 24.5 percentage points, which was beyond the predefined limit.CONCLUSIONS. At the current level of development of medicine and information technology, telemedicine cannot fully replace the traditional (bedside) consultation of an expert level of neurosurgeon and neuroresuscitator in patients with intracerebral hematomas.Authors declare lack of the conflicts of interests.АКТУАЛЬНОСТЬ. Телемедицина решает проблему доступности высококвалифицированных кадров на этапе принятия решений по ведению больных с внутримозговыми кровоизлияниями (ВМК).ЦЕЛЬ. Оценить влияние телеконсультирования на исход заболевания через 30 суток после события у больных с ВМК.МАТЕРИАЛ И МЕТОДЫ. Перспективное открытое нерандомизированное клиническое исследование в двух параллельных группах. В 1-ю группу включены взрослые пациенты до 80 лет с геморрагическим инсультом (от 4 до 36 баллов по NIHSS), возникшим вследствие развития односторонней супратенториальной внутримозговой гематомы (ВМГ) неаневризматического генеза, и получавшие консультации нейрохирурга и реаниматолога Регионального сосудистого центра у постели больного. Во 2-ю группу вошли пациенты с тем же диагнозом, но получавшие телемедицинскую консультацию вышеперечисленных специалистов. В качестве первичной конечной точки исследования была выбрана летальность через 30 сут от начала инсульта. Тестировалась гипотеза непревосходства, при которой 95% доверительный интервал (ДИ) для разницы в показателях летальности между группами не должен выходить за границу 15 процентных пунктов.РЕЗУЛЬТАТЫ. Были проанализированы данные о 140 больных с ВМГ (по 70 в каждой группе). Летальность при выполнении консультаций у постели больного составила 14,3% (ДИ 7,1%; 24,7%) (1-я группа), а при ее дистанционном осуществлении — 25,7% (16,0%; 37,6%), p=0,091 (2-я группа). Однако непревосходства доказано не было, так как разница в летальности между группами составила 11,4 с ДИ от –0,07 до 24,5 процентных пунктов, что выходит за предустановленную границу.ВЫВОДЫ. При текущем уровне развития медицины и информационных технологий телемедицина не может полноценно заменить традиционную (прикроватную) консультацию нейрохирурга и нейрореаниматолога экспертного уровня у постели больного при внутримозговых гематомах