Relationship of cognitive function in patients with schizophrenia in remission to disability: a cross-sectional study in an Indian sample

Background: Cognitive deficits in various domains have been consistently replicated in patients with schizophrenia. Most studies looking at the relationship between cognitive dysfunction and functional disability are from developed countries. Studies from developing countries are few. The purpose of the present study was to compare the neurocognitive function in patients with schizophrenia who were in remission with that of normal controls and to determine if there is a relationship between measures of cognition and functional disability. <p/>Methods: This study was conducted in the Psychiatric Unit of a General Hospital in Mumbai, India. Cognitive function in 25 patients with schizophrenia in remission was compared to 25 normal controls. Remission was confirmed using the brief psychiatric rating scale (BPRS) and scale for the assessment of negative symptoms (SANS). Subjects were administered a battery of cognitive tests covering aspects of memory, executive function and attention. The results obtained were compared between the groups. Correlation analysis was used to look for relationship between illness factors, cognitive function and disability measured using the Indian disability evaluation and assessment scale. <p/>Results: Patients with schizophrenia showed significant deficits on tests of attention, concentration, verbal and visual memory and tests of frontal lobe/executive function. They fared worse on almost all the tests administered compared to normal controls. No relationship was found between age, duration of illness, number of years of education and cognitive function. In addition, we did not find a statistically significant relationship between cognitive function and scores on the disability scale. <p/>Conclusion: The data suggests that persistent cognitive deficits are seen in patients with schizophrenia under remission. The cognitive deficits were not associated with symptomatology and functional disability. It is possible that various factors such as employment and family support reduce disability due to schizophrenia in developing countries like India. Further studies from developing countries are required to explore the relationship between cognitive deficits, functional outcome and the role of socio-cultural variables as protective factors

Training in critical care echocardiography

Echocardiography is useful for the diagnosis and management of hemodynamic failure in the intensive care unit so that competence in some elements of echocardiography is a core skill of the critical care specialist. An important issue is how to provide training to intensivists so that they are competent in the field. This article will review issues related to training in critical care echocardiography

Opportunities for CO2 Storage around Scotland; An Integrated Strategic Research Study

Carbon Capture and Storage (CCS) is one of the critical technologies worldwide which will enable reduction of carbon dioxide (CO2) emissions arising from large industrial sites. CCS allows the continued use of a diverse mix of energy sources, including fossil fuels, which improves the security of cost-effective electricity supply. Scotland has the opportunity and responsibility to reduce CO2 emissions arising from burning of fossil fuels and their impact on climate change. The EU plans to have 12 CCS plants operating by 2015. In February 2009, the UK Secretary of State for Energy and Climate Change stated an aspiration for the UK to have more than one demonstration project in operation enabled by government funding. However, these targets cannot be delivered without the underpinning knowledge from studies such as this. Commitment to large-scale investment in CO2 capture plant will require proven storage capability. This study • presents the first high-level screening of CO2 storage sites available to Scotland • evaluates the means by which CO2 can be transported from power plants and other industrial activities to storage sites, and • investigates the costs and business constraints. This is the most comprehensive and fully integrated study performed in the UK, and was achieved by a collaborative partnership of Scottish Government, research universities and institutes, and a broad base of support from industry and business. The conclusions show that Scotland has an extremely large CO2 storage resource. This is overwhelmingly in offshore saline aquifers (deeply buried porous sandstones filled with salt water) together with a few specific depleted hydrocarbon fields. The resource can easily accommodate the industrial CO2 emissions from Scotland for the next 200 years. There is very likely to be sufficient storage to allow import of CO2 from NE England, this equating to over 25% of future UK large industry and power CO2 output. Preliminary indications are that Scotland's offshore CO2 storage capacity is very important on a European scale, comparable with that of offshore Norway, and greater than Netherlands, Denmark and Germany combined.Carbon Capture and Storage (CCS) is one of the critical technologies worldwide which will enable reduction of carbon dioxide (CO2) emissions arising from large industrial sites. CCS allows the continued use of a diverse mix of energy sources, including fossil fuels, which improves the security of cost-effective electricity supply. Scotland has the opportunity and responsibility to reduce CO2 emissions arising from burning of fossil fuels and their impact on climate change. The EU plans to have 12 CCS plants operating by 2015. In February 2009, the UK Secretary of State for Energy and Climate Change stated an aspiration for the UK to have more than one demonstration project in operation enabled by government funding. However, these targets cannot be delivered without the underpinning knowledge from studies such as this. Commitment to large-scale investment in CO2 capture plant will require proven storage capability. This study • presents the first high-level screening of CO2 storage sites available to Scotland • evaluates the means by which CO2 can be transported from power plants and other industrial activities to storage sites, and • investigates the costs and business constraints. This is the most comprehensive and fully integrated study performed in the UK, and was achieved by a collaborative partnership of Scottish Government, research universities and institutes, and a broad base of support from industry and business. The conclusions show that Scotland has an extremely large CO2 storage resource. This is overwhelmingly in offshore saline aquifers (deeply buried porous sandstones filled with salt water) together with a few specific depleted hydrocarbon fields. The resource can easily accommodate the industrial CO2 emissions from Scotland for the next 200 years. There is very likely to be sufficient storage to allow import of CO2 from NE England, this equating to over 25% of future UK large industry and power CO2 output. Preliminary indications are that Scotland's offshore CO2 storage capacity is very important on a European scale, comparable with that of offshore Norway, and greater than Netherlands, Denmark and Germany combined

Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration

Global Chronic Total Occlusion Crossing Algorithm

The authors developed a global chronic total occlusion crossing algorithm following 10 steps: 1) dual angiography; 2) careful angiographic review focusing on proximal cap morphology, occlusion segment, distal vessel quality, and collateral circulation; 3) approaching proximal cap ambiguity using intravascular ultrasound, retrograde, and move-the-cap techniques; 4) approaching poor distal vessel quality using the retrograde approach and bifurcation at the distal cap by use of a dual-lumen catheter and intravascular ultrasound; 5) feasibility of retrograde crossing through grafts and septal and epicardial collateral vessels; 6) antegrade wiring strategies; 7) retrograde approach; 8) changing strategy when failing to achieve progress; 9) considering performing an investment procedure if crossing attempts fail; and 10) stopping when reaching high radiation or contrast dose or in case of long procedural time, occurrence of a serious complication, operator and patient fatigue, or lack of expertise or equipment. This algorithm can improve outcomes and expand discussion, research, and collaboration.info:eu-repo/semantics/publishedVersio

Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients.

BACKGROUND: Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk. METHODS: We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery. The primary end point was a composite of death, stroke, or rehospitalization at 1 year. Both noninferiority testing (with a prespecified margin of 6 percentage points) and superiority testing were performed in the as-treated population. RESULTS: At 71 centers, 1000 patients underwent randomization. The mean age of the patients was 73 years, and the mean Society of Thoracic Surgeons risk score was 1.9% (with scores ranging from 0 to 100% and higher scores indicating a greater risk of death within 30 days after the procedure). The Kaplan-Meier estimate of the rate of the primary composite end point at 1 year was significantly lower in the TAVR group than in the surgery group (8.5% vs. 15.1%; absolute difference, -6.6 percentage points; 95% confidence interval [CI], -10.8 to -2.5; P<0.001 for noninferiority; hazard ratio, 0.54; 95% CI, 0.37 to 0.79; P = 0.001 for superiority). At 30 days, TAVR resulted in a lower rate of stroke than surgery (P = 0.02) and in lower rates of death or stroke (P = 0.01) and new-onset atrial fibrillation (P<0.001). TAVR also resulted in a shorter index hospitalization than surgery (P<0.001) and in a lower risk of a poor treatment outcome (death or a low Kansas City Cardiomyopathy Questionnaire score) at 30 days (P<0.001). There were no significant between-group differences in major vascular complications, new permanent pacemaker insertions, or moderate or severe paravalvular regurgitation. CONCLUSIONS: Among patients with severe aortic stenosis who were at low surgical risk, the rate of the composite of death, stroke, or rehospitalization at 1 year was significantly lower with TAVR than with surgery. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov number, NCT02675114.)

The Myxococcus xanthus rfbABC operon encodes an ATP-binding cassette transporter homolog required for O-antigen biosynthesis and multicellular development.

A wild-type sasA locus is critical for Myxococcus xanthus multicellular development. Mutations in the sasA locus cause defective fruiting body formation, reduce sporulation, and restore developmental expression of the early A-signal-dependent gene 4521 in the absence of A signal. The wild-type sasA locus has been located on a 14-kb cloned fragment of the M. xanthus chromosome. The nucleotide sequence of a 7-kb region containing the complete sasA locus was determined. Three open reading frames encoded by the genes, designated rfbA, B and C were identified. The deduced amino acid sequences of rfbA and rfbB show identity to the integral membrane domains and ATPase domains, respectively, of the ATP-binding cassette (ABC) transporter family. The highest identities are to a set of predicted ABC transporters required for the biosynthesis of lipopolysaccharide O-antigen in certain gram-negative bacteria. The rfbC gene encodes a predicted protein of 1,276 amino acids. This predicted protein contains a region of 358 amino acids that is 33.8% identical to the Yersinia enterocolitica O3 rfbH gene product, which is also required for O-antigen biosynthesis. Immunoblot analysis revealed that the sasA1 mutant, which was found to encode a nonsense codon in the beginning of rfbA, produced less O-antigen than sasA+ strains. These data indicate that the sasA locus is required for the biosynthesis of O-antigen and, when mutated, results in A-signal-independent expression of 4521