QT interval prolongation and torsades de pointes in a patient undergoing treatment with vorinostat: A case report and review of the literature

Vorinostat is a histone deacetylase inhibitor used in the treatment of recurrent or persistent cases of cutaneous T-cell lymphoma (CTCL). A retrospective review of 116 patients from phase I and II clinical trials who had a baseline and at least one subsequent ECG revealed that four patients had Grade 2 and one patient had Grade 3 QTc interval prolongation; however, a MEDLINE search found no reported cases of torsades de pointes (TdP) in patients treated with vorinostat. We describe the case of a 49 year-old male with a history of CTCL actively undergoing treatment with vorinostat. During day 1 of hospitalization, he developed a pulseless polymorphic ventricular tachycardia requiring resuscitation. He was found to have a QTc of 826 ms. Following correction of potassium and magnesium, QTc gradually decreased and no further ventricular arrhythmia was noted. Other factors implicated in this case included concurrent sertraline and doxepin therapy (both drugs have been associated with the development of TdP in overdose). The mechanism of development of TdP in this patient is postulated to be related to vorinostat use in combination with hypokalemia and concomitant treatment with medications associated with QTc prolongation. This case highlights the importance of post-market surveillance

Photoemission evidence for crossover from Peierls-like to Mott-like transition in highly strained VO2_2

We present a spectroscopic study that reveals that the metal-insulator transition of strained VO$_2$ thin films may be driven towards a purely electronic transition, which does not rely on the Peierls dimerization, by the application of mechanical strain. Comparison with a moderately strained system, which does involve the lattice, demonstrates the crossover from Peierls- to Mott-like transitions

Observation of surface states on heavily indium doped SnTe(111), a superconducting topological crystalline insulator

The topological crystalline insulator tin telluride is known to host superconductivity when doped with indium (Sn$_{1-x}$In$_{x}$Te), and for low indium contents ($x=0.04$) it is known that the topological surface states are preserved. Here we present the growth, characterization and angle resolved photoemission spectroscopy analysis of samples with much heavier In doping (up to $x\approx0.4$), a regime where the superconducting temperature is increased nearly fourfold. We demonstrate that despite strong p-type doping, Dirac-like surface states persist

Neutron-proton interaction in rare-earth nuclei: Role of tensor force

We investigate the role of the tensor force in the description of doubly odd deformed nuclei within the framework of the particle-rotor model. We study the rare-earth nuclei 174Lu, 180Ta, 182Ta, and 188Re using a finite-range interaction, with and without tensor terms. Attention is focused on the lowest K=0 and K=1 bands, where the effects of the residual neutron-proton interaction are particularly evident. Comparison of the calculated results with experimental data evidences the importance of the tensor-force effects.Comment: 8 pages, 5 figures, to be published on Physical Review

Morris dancers, matriarchs and paperbacks:Doing the village in contemporary Britain

To call a place rural is to categorize it as a particular kind of place and, often, to presume that particular kinds of being innately occur there. Over the past 20 years, however, trends in British rural studies have problematized easy ascription; this article is an ethnographic contribution within those trends. If it is no longer adequate to read the rural as a container for being, then, as I contend here, rurality can be explored anew through doing. I draw upon David Matless’s (1994) frame of ‘doing the village’ representationally, and amplify it to include concepts of place as representational and relational. I thus use ‘doing’ to read the multiple ways in which diverse residents in a Northern England village engage with both their real locality and with nationally shared rural imaginings

Relating geologic units and mobility system kinematics contributing to Curiosity wheel damage at Gale Crater, Mars

Curiosity landed on plains to the north of Mount Sharp in August 2012. By June 2016 the rover had traversed 12.9 km to the southwest, encountering extensive strata that were deposited in a fluvial-deltaic-lacustrine system. Initial drives across sharp sandstone outcrops initiated an unacceptably high rate of punctures and cracks in the thin aluminum wheel skin structures. Initial damage was found to be related to the drive control mode of the six wheel drive actuators and the kinematics of the rocker-bogie suspension. Wheels leading a suspension pivot were forced onto sharp, immobile surfaces by the other wheels as they maintained their commanded angular velocities. Wheel damage mechanisms such as geometry-induced stress concentration cracking and low-cycle fatigue were then exacerbated. A geomorphic map was generated to assist in planning traverses that would minimize further wheel damage. A steady increase in punctures and cracks between landing and June 2016 was due in part because of drives across the sharp sandstone outcrops that could not be avoided. Wheel lifetime estimates show that with careful path planning the wheels will be operational for an additional ten kilometers or more, allowing the rover to reach key strata exposed on the slopes of Mount Sharp

In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis.

OBJECTIVES: Intraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis. METHODS: Vascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217-237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring. RESULTS: 18F-Fluciclatide uptake co-localised with regions of increased αvβ3 integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax 1.29 vs 1.21, p=0.02). CONCLUSIONS: In vivo expression of αvβ3 integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3 integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis

Progression of Hypertrophy and Myocardial Fibrosis in Aortic Stenosis: A Multicenter Cardiac Magnetic Resonance Study

Background: Aortic stenosis is accompanied by progressive left ventricular hypertrophy and fibrosis. We investigated the natural history of these processes in asymptomatic patients and their potential reversal post-aortic valve replacement (AVR).  Methods: Asymptomatic and symptomatic patients with aortic stenosis underwent repeat echocardiography and magnetic resonance imaging. Changes in peak aortic-jet velocity, left ventricular mass index, diffuse fibrosis (indexed extracellular volume), and replacement fibrosis (late gadolinium enhancement [LGE]) were quantified.  RESULTS: In 61 asymptomatic patients (43% mild, 34% moderate, and 23% severe aortic stenosis), significant increases in peak aortic-jet velocity, left ventricular mass index, indexed extracellular volume, and LGE mass were observed after 2.1±0.7 years, with the most rapid progression observed in patients with most severe stenosis. Patients with baseline midwall LGE (n=16 [26%]; LGE mass, 2.5 g [0.8–4.8 g]) demonstrated particularly rapid increases in scar burden (78% [50%–158%] increase in LGE mass per year). In 38 symptomatic patients (age, 66±8 years; 76% men) who underwent AVR, there was a 19% (11%–25%) reduction in left ventricular mass index (P<0.0001) and an 11% (4%–16%) reduction in indexed extracellular volume (P=0.003) 0.9±0.3 years after surgery. By contrast midwall LGE (n=10 [26%]; mass, 3.3 g [2.6–8.0 g]) did not change post-AVR (n=10; 3.5 g [2.1–8.0 g]; P=0.23), with no evidence of regression even out to 2 years.  Conclusions: In patients with aortic stenosis, cellular hypertrophy and diffuse fibrosis progress in a rapid and balanced manner but are reversible after AVR. Once established, midwall LGE also accumulates rapidly but is irreversible post valve replacement. Given its adverse long-term prognosis, prompt AVR when midwall LGE is first identified may improve clinical outcomes

“Nonsense Rides Piggyback on Sensible Things”: The Past, Present, and Future of Graphology

“Nonsense rides piggyback on sensible things”, declares professional sceptic and questioned-document analyst Joe Nickell concerning graphology. This chapter examines graphology’s enduring allure and reach, despite its controversies, and considers its relationship with other types of handwriting analysis. It first asks: is it possible to metaphorically “dissect” the page of handwritten texts, to scrutinize writing as a “medical paratext” rich in information about the writer’s state of health? It then interrogates the nature of the connection between physical and mental states and handwriting. It demonstrates how academics are going “back to basics” with their enquiries into individual difference and handwriting features, and how digital methodologies are contributing to this. Thus, this chapter is an updated study of graphology, providing a wider understanding of the concept of the paratext by considering the information captured in handwriting in the context of a digital age