Direct observation of vortices in an electron fluid.

Vortices are the hallmarks of hydrodynamic flow. Strongly interacting electrons in ultrapure conductors can display signatures of hydrodynamic behaviour, including negative non-local resistance1-4, higher-than-ballistic conduction5-7, Poiseuille flow in narrow channels8-10 and violation of the Wiedemann-Franz law11. Here we provide a visualization of whirlpools in an electron fluid. By using a nanoscale scanning superconducting quantum interference device on a tip12, we image the current distribution in a circular chamber connected through a small aperture to a current-carrying strip in the high-purity type II Weyl semimetal WTe2. In this geometry, the Gurzhi momentum diffusion length and the size of the aperture determine the vortex stability phase diagram. We find that vortices are present for only small apertures, whereas the flow is laminar (non-vortical) for larger apertures. Near the vortical-to-laminar transition, we observe the single vortex in the chamber splitting into two vortices; this behaviour is expected only in the hydrodynamic regime and is not anticipated for ballistic transport. These findings suggest a new mechanism of hydrodynamic flow in thin pure crystals such that the spatial diffusion of electron momenta is enabled by small-angle scattering at the surfaces instead of the routinely invoked electron-electron scattering, which becomes extremely weak at low temperatures. This surface-induced para-hydrodynamics, which mimics many aspects of conventional hydrodynamics including vortices, opens new possibilities for exploring and using electron fluidics in high-mobility electron systems.

Comparison of outcomes after endovascular and open repair of abdominal aortic aneurysms in low-risk patients.

BACKGROUND: In randomized trials endovascular aortic aneurysm repair (EVAR) has been shown to have superior perioperative outcomes compared with open aneurysm repair (OAR). However, outcomes in patients at low risk of complications are unclear and many surgeons still prefer OAR in this cohort. The objective was to analyse perioperative and longer-term outcomes of OAR and EVAR in this low-risk group of patients. METHODS: All elective infrarenal EVARs and OARs in the Vascular Study Group of New England database were reviewed from 2003 to 2014. The Medicare scoring system was used to identity patients at low risk of perioperative complications and death. Perioperative and longer-term outcomes were analysed in this cohort. A Kaplan-Meier plot was constructed for evaluation of longer-term survival. Further propensity matching and multivariable analysis were performed to analyse additional differences between the two groups. RESULTS: Some 1070 patients who underwent EVAR and 476 who had OAR were identified. Mean(s.d.) age was 67·3(5·7) and 65·1(6·3) years respectively (P < 0·001). EVAR was associated with a lower overall perioperative complication rate (4·2 versus 26·5 per cent; P < 0·001). There was no difference in 30-day mortality (0·4 versus 0·6 per cent; P = 0·446). Overall survival at 3 years was similar after EVAR and OAR (92·5 versus 92·1 per cent respectively; P = 0·592). In multivariable analyses there was no difference in freedom from reintervention (odds ratio 1·69, 95 per cent c.i. 0·73 to 3·90; P = 0·220) or survival (hazard ratio 0·85, 0·61 to 1·20; P = 0·353). CONCLUSION: In patients predicted to be at low risk of perioperative death following aneurysm repair, EVAR resulted in fewer perioperative complications than OAR. However, perioperative mortality, reinterventions and survival rates in the longer term appeared similar between endovascular and open repair.

Donor brain death inhibits tolerance induction in miniature swine recipients of fully MHC-disparate pulmonary allografts.

We have previously shown that a short course of high-dose tacrolimus induces long-term tolerance to fully mismatched lung allografts procured from healthy MHC-inbred miniature swine. Here, we investigate whether donor brain death affects tolerance induction. Four recipient swine were transplanted with fully mismatched lung grafts from donors that were rendered brain dead and mechanically ventilated for 4 h before procurement (Group 1). These recipients were compared to two control groups (Group 2: 4 h of donor ventilation without brain death [n = 5]; and Group 3: no donor brain death with <1 h of ventilation [n = 6]). All recipients were treated with a 12-day course of tacrolimus. In contrast to both groups of control animals, the swine transplanted with lung allografts from brain dead donors all rejected their grafts by postoperative day 45 and showed persistent responsiveness to donor antigen by MLR. Several additional swine underwent brain death induction and/or mechanical ventilation alone to determine the effects of these procedures on the expression of proinflammatory molecules. Significant increases in serum concentrations of IL-1, TNF-α and IL-10 were seen after brain death. Upregulation of IL-1 and IL-6 gene expression was also observed.

Minimally invasive surgery for thoracoabdominal aortic aneurysms.

Open surgical repair of thoracoabdominal aortic aneurysms (TAAA) remains a highly morbid procedure. In recent years, several minimally invasive techniques have been introduced to treat TAAA. These include hybrid procedures and purely endovascular approaches using modified aortic endografts. Although still investigational, this burgeoning technology has the potential to improve outcomes in TAAA repair, as well as to circumvent the morbidity and mortality associated with the traditional surgical approach to TAAA. While the reported experience is limited to several institutional case series, results are encouraging, and suggest that fenestrated and branched endografts are likely to figure prominently in the management of TAAA in the future. An overview of these minimally invasive techniques, as well as the role of computer-assisted imaging analysis, is provided.

Ocular bacillary angiomatosis in an immunocompromised man.

An immunocompromised man presented with an inflammatory eyelid lesion. Biopsy was performed; histopathology and special staining confirmed a diagnosis of bacillary angiomatosis. The man was treated with oral erythromycin, and the lesion resolved. The etiologic agents of bacillary angiomatosis are Bartonella henselae and Bartonella quintana, Gram-negative coccobacilli. The organisms stain positively with the Warthin-Starry silver stain. Lesions can be cutaneous or visceral and have been commonly described in immunocompromised patients. Histopathologic examination of lesions reveals angiogenesis and cellular proliferation. Bacillary angiomatosis can be treated with oral antibiotics.

Let us unite against COVID-19 - a New Zealand perspective.

Novel coronavirus 2019 (COVID-19) has shaken the existence of mankind worldwide, including that of New Zealand. In comparison to other countries, New Zealand has had a very low number of confirmed and probable cases as well as COVID-19-related deaths. New Zealand closed its borders and rapidly declared a stringent lockdown to eliminate COVID-19. The country's 'go hard, go early' policy serves as an exemplar for the rest of the world to date. The mysterious nature of COVID-19 has caused tremendous stress and uncertainty leading to universal conflict between public health and state economy. Mental health services and non-government organisations have been proactive in the fight against COVID-19. Though there has been no significant rise in referrals to secondary mental health services to date (4 May 2020), a rapid surge in mental health presentations is widely anticipated. Telehealth may prove to be an efficient and cost-effective tool for the provision of future health services.

The indirect alloresponse impairs the induction but not maintenance of tolerance to MHC class I-disparate allografts.

We studied the effects of indirect allorecognition on the induction and maintenance phases of tolerance in miniature swine cotransplanted with heart and kidney allografts. MHC class I-mismatched heart and kidney grafts were cotransplanted in recipients receiving CyA for 12 days. Recipients were unimmunized or immunized with a set of donor-derived or control third-party MHC class I peptides either 21 days prior to transplantation or over 100 days after transplantation. T-cell proliferation, delayed type hypersensitivity reaction (DTH) and antibody production were assessed. All animals injected with donor MHC class I peptides developed potent indirect alloresponses specific to the immunizing peptides. While untreated recipients developed stable tolerance, all animals preimmunized with donor allopeptides rejected kidney-heart transplants acutely. In contrast, when peptide immunization was delayed until over 100 days after kidney-heart transplantation, no effects were observed on graft function or in vitro measures of alloimmunity. Donor peptide immunization prevented tolerance when administered to recipients pre transplantation but did not abrogate tolerance when administered to long-term survivors post transplantation. This suggests that the presence of T cells activated via indirect allorecognition represent a barrier to the induction but not the maintenance of tolerance.

Emergent nanoscale superparamagnetism at oxide interfaces.

Atomically sharp oxide heterostructures exhibit a range of novel physical phenomena that are absent in the parent compounds. A prominent example is the appearance of highly conducting and superconducting states at the interface between LaAlO3 and SrTiO3. Here we report an emergent phenomenon at the LaMnO3/SrTiO3 interface where an antiferromagnetic Mott insulator abruptly transforms into a nanoscale inhomogeneous magnetic state. Upon increasing the thickness of LaMnO3, our scanning nanoSQUID-on-tip microscopy shows spontaneous formation of isolated magnetic nanoislands, which display thermally activated moment reversals in response to an in-plane magnetic field. The observed superparamagnetic state manifests the emergence of thermodynamic electronic phase separation in which metallic ferromagnetic islands nucleate in an insulating antiferromagnetic matrix. We derive a model that captures the sharp onset and the thickness dependence of the magnetization. Our model suggests that a nearby superparamagnetic-ferromagnetic transition can be gate tuned, holding potential for applications in magnetic storage and spintronics.

Cellular and secretory mechanisms related to delayed radiation-induced microvessel dysfunction in the spinal cord of rats.

PURPOSE: This study aimed to investigate long-term, radiation-induced changes in microvessel permeability, the profile of the vasoactive mediators endothelin and nitric oxide, and the response of specific cell systems in the irradiated spinal cord of rats. METHODS AND MATERIALS: The thoracolumbar spinal cords of Fischer rats were irradiated to a dose of 15 Gy, and the rats were sacrificed at various times afterward. Endothelin levels and nitric oxide-synthase (NOS) activity were assayed in extracts of spinal cords. Microvascular permeability and the effect of treatment with recombinant human manganese superoxide dismutase (r-hMnSOD) were assessed quantitatively. Immunohistochemistry evaluated astrocytes, microglia, vascular basal membrane, and neurofilaments. RESULTS: None of the rats developed neurologic dysfunction. Endothelin levels were significantly reduced at 18 h after irradiation and markedly attenuated after 10 days (p < 0.007). Thereafter, endothelin levels returned to normal values at 56 days after radiation and escalated to markedly high levels after 120 and 180 days (p < 0.002). NOS activity remained very low throughout the period of follow-up and failed to counterbalance the shifts in endothelin levels. Treatment with r-hMnSOD had no effect on normal vascular permeability but it abolished the abnormally increased permeability measured at 18 h after radiation and again after 120 and 180 days. Standard microscopic evaluation failed to reveal abnormalities in the irradiated spinal cord, but immunohistochemical staining showed a progressive increase in the number of microglial cells per field after 120 and 180 days (p < 0003). A similar increase in the number of astrocytic cells per field was noted after more than 180 days, but an earlier short lasting peak was also noted at 14 days after radiation. No abnormalities were found in blood vessel configuration, density, diameter, and basal membrane staining, or in the neurofilaments. CONCLUSION: Marked imbalance in the regulatory function of endothelium-derived mediators of the vascular tone is present after radiation therapy probably inducing chronic vasoconstriction. This imbalance favors localized procoagulation that may enhance the consequent loss of function measured as increased permeability. Microglial proliferation may account for continuous release of superoxide that may enhance disruption of normal permeability. The latter is corrected by SOD treatment. Astrocytic proliferation may present a response to the mitogenic effect of endothelin and to microglial-derived paracrine effect of cytokines.

Weight history and hypertension.

The relationship between weight change and hypertension was examined among men and women 25-64 years of age surveyed in the National Health and Nutrition Examination Survey (NHANES-I). Any single weight measurement (current weight, weight at an earlier age, or the difference between these two weights) was found to be a significant univariate predictor of hypertension, with current weight being most predictive. Initial weight and weight change were not associated with increased blood pressure, however, when controlling for current weight. These results do not distinguish a difference in risk of hypertension in adults with overweight or obesity of long-standing vs that of adults with overweight or obesity of more recent onset.

An assessment of peak expiratory flow as a surrogate measurement of FEV1 in stable asthmatic children.

We examined the relationship over 24 hours between percent-predicted values (PPV) of peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) in a group of 23 stable untreated asthmatic children 6 to 17 years of age by means of regression analysis as well as the percentage difference between the PPV of these two measurements. Although the Pearson correlation coefficient between the PPV was consistently high, ranging between 0.854 and 0.892, the assumption that such a finding substantiates the substitution of PEF for FEV1 is called into question. Over 50 percent of the subjects displayed a 10 percent or greater difference in the PPV between the two measurements, regardless of the time of day the two respiratory variable were determined, while over one-third of all subjects evidenced a 20 percent or greater discrepancy between the PPV of the two measures. While, on a group basis, there was no statistically significant difference in the mean percentage difference over 24 hours between the PPV of FEV1, when compared with the corresponding measurement of PEF, reliance on PEF alone in individual subjects may result in a false impression of the patency of the airways in comparison to the FEV1.

Survival time and season-of-treatment initiation in children with acute lymphoblastic leukemia.

We examined survival in childhood acute lymphoblastic leukemia (ALL) as a function of season-of-treatment initiation. Survival for 1797 children aged 15 and under from the Surveillance, Epidemiology, and End Results (SEER) cancer registry, diagnosed and treated from 1973-1986 was obtained. There was no significant seasonal pattern for survival by season-of-treatment initiation. Neither age, gender, nor treatment type served as effect modifiers or confounders in this relationship. Female gender, age between one and ten years, and certain broad categories of treatment type were significant predictors of survival in separate univariate analyses, however. The nonsignificance of the results do not support the concept that season-of-treatment initiation is a prognostic factor in survival from ALL in children.

Month-of-birth and incidence of acute lymphoblastic leukemia in children.

As a means of examining the virus-relatedness of acute lymphoblastic leukemia (ALL) in children, we investigated the association between month-of-birth and the occurrence of ALL in 1487 children aged 0-15 years at the time of diagnosis. Our hypothesis being that evidence of seasonal variation in births of ALL cases would suggest exposure to a transmissible etiologic agent during the perinatal period. The data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program and consisted of children diagnosed during the years 1973-1986. Aggregate monthly incidence rates of ALL stratified by month-of-birth, for each SEER site, all sites combined, and for broad geographic regions were calculated. No evidence for an association between month-of-birth and childhood ALL was found.

Season-of-birth and acute leukemia of infancy.

Because of its short and clearly delineated latency period, acute leukemia of infancy is particularly suited to etiologic analysis. From 1950 to mid-1985, 31 infants with acute leukemia (less than 1 year of age) were registered at the University of Texas, M.D. Anderson Cancer Center at Houston. The medical records of these infants were reviewed for demographic and birth information. Of the 31 infants, 14 (45%) were Hispanic. The sex ratio was 3:1 male/female) for white infants and 5:9 for Hispanic infants. Of the white infants, half had acute lymphocytic leukemia, compared with all but one of the Hispanic infants. There was a significant excess of winter births among the infants diagnosed with acute leukemia (P less than 0.05). The significant association between season-of-birth and the occurrence of leukemia cases is suggestive of periodicity of an environmental etiologic agent, perhaps acting in concert with endogenous rhythmicities in susceptibility to that agent. This finding is deserving of further study.

Circadian assessment of lipids in the hyperphagic obese rat compared with lean litter-mates.

Time and feeding influences on cholesterol, triglyceride, glucose and insulin levels, and serum cholinesterase activity were assessed in a genetically-hyperlipidemic hyperphagic obese rat model, and compared with its lean litter-mate. Following a 28-day acclimation to a 12-hr light/dark cycle, blood samples were obtained every 2 hr from rats via tail bleed for a 24-hr period. Synchronization with other animal studies was established by endogenous serum cortisol levels [acrophase 18-20 hr after light onset (HALO) in both groups]. Triglycerides cholesterol, insulin and glucose levels were significantly elevated in obese versus lean rats. Obese rats were observed to feed throughout the 24-hr cycle, whereas lean litter-mates ate only during the dark cycle. No circadian rhythmicity was found in glucose levels with either rat group. Insulin levels were not correlated. Although triglyceride levels peaks at 13 HALO in lean rats, no pattern was observed in obese rats. Cholesterol levels were unchanged with time in either group. Cholinesterase activity followed a circadian rhythm in the lean, but not obese, rats with an acrophase estimated at 8 HALO. In contrast to previous reports, enzyme activity was not correlated with triglyceride levels in either rat group. Circadian similarities in insulin levels between rat groups suggest changes in insulin metabolism and/or secretion which are likely to be independent of feeding or activity. Conversely, triglyceride levels remained elevated throughout the 24-hr period in obese rats, whereas significant increases were observed in lean rats during the dark active cycle. These data suggest that triglyceride levels, and not insulin and cholesterol levels, are most likely dependent on feeding patterns.

Administration-time-dependency of the pharmacokinetic behavior and therapeutic effect of a once-a-day theophylline in asthmatic children.

Using a double-blind, placebo-control, crossover study design, 8 asthmatic children (8-15 years) were evaluated for temporal patterns in airways function throughout separate study periods when treatment was placebo or Theo-24 once-daily on separate occasions at 0600, 1500 or 2100 hr. During 39-hr in-hospital observations, pulmonary function and serum theophylline concentrations (STC) were assessed every 3 hr under all treatments. The pharmacokinetics of Theo-24 varied greatly depending on the dosing time. For the afternoon and evening dosings, the Cmax, Tmax, AUC, % swing, % fluctuation, % AUC fluctuation, % nocturnal excess and Cav(2-6 hr) were all statistically significantly greater than for the morning dosing. Compared with the placebo regimen, dosing patients with Theo-24 at 1500 hr disrupted circadian patterns of airways function, especially airways patency, while dosing at 2100 hr, reduced the amplitude and shifted the acrophase of several spirometric measures to a slightly earlier time. Theo-24 treatment irrespective of dosing time resulted in comparable enhancement of the group 24-hr mean, minimum and maximum values of airways patency with reference to placebo baselines. Theo-24 dosing at 1500 or 2100 hr, however, resulted in the best effect on the airways as assessed by the 24-hr mean FEV 1.0 level in 7 of the 8 asthmatic children. When the drug was given at 1500 hr, the time of lowest FEV 1.0 was shifted from the nighttime hours in 5 of 8 patients. These findings suggest that clinicians need to individualize the theophylline dosing schedule of patients to best control the symptoms of asthma.

Biological monitoring of exposure to cadmium, a human carcinogen, as a result of active and passive smoking.

Cadmium (Cd), a known human carcinogen, is one of the components of tobacco and also has many industrial uses. Smoking Cd-contaminated cigarettes at work may cause an increase in blood levels and toxicity of Cd. For a population of nonexposed workers, we compared blood Cd and urine cotinine (Cot) levels as biological markers of exposure to cigarette smoke of active smokers (AS) and passive smokers (PS) with those of unexposed nonsmokers (UNS) in 158 workers. The mean Cd in AS (0.097 microgram%; ie, 0.097 microgram/100 mL whole blood) was significantly higher than in UNS (0.085 microgram%), and was very close to the mean Cd levels in PS (0.093 microgram%). Mean Cd levels in exposed past smokers (0.105 microgram% was higher than in nonexposed past smokers (P < 0.05) and in AS. The mean Cot level was significantly higher in AS than in PS or in UNS. Increased smoking was associated directly with increased blood Cd and urine Cot. Our results supported and proved quantitatively that exposure to cigarette smoke is harmful to both AS and PS, as we show that in both cases there is an increase in blood Cd. According to our results, exposure to cigarette smoke via active and passive smoking increases blood Cd by an average of 0.01 micrograms% over the background (UNS). We conclude that exposure to cigarette smoke is a confounder to be taken into account when carrying out epidemiological studies and surveillance programs on workers exposed to Cd at work.

Three-dimensional microplate-enhanced alveolar ridge augmentation--an alternative to nerve transposition.

The placement of endosseous implants in the atrophic posterior mandible has presented a challenge to the surgeon and restorative dentist. Traditional procedures either require nerve transposition or utilization of implants placed at less than favorable angles. A technique is presented for the three-dimensional augmentation of the atrophic alveolar ridge utilizing microplate-enhanced guided bone regeneration technology. The applications of this technique in other intraoral and extraoral sites are currently under investigation by the authors.

Artificial insemination and natural mating in the crossbreeding of the Muscovy drake and the Pekin duck.

Artificial insemination and natural mating were used for the crossbreeding of the Muscovy drake with the Pekin duck in order to produce the Mule duck. An average fertility rate of 48% was reached by artificially inseminating twice a week. In small flocks, however, when the male to female ratio was 1:2.5 (or higher), natural mating yielded a fertility rate of 80%.

An improved method for obtaining semen from Muscovy drakes and some of its quantitative and qualitative characteristics.

An improved method for obtaining semen from the Muscovy drake using an "artificial vagina" was developed and employed on a commercial scale. With such a procedure, the ejaculate volume was 1.12 +/- .85 ml, semen concentration was 1.35 +/- .43 X 10(9) cells/ml with 8.6 +/- 6.3% abnormal sperm cells. Average spermatozoal motility was graded as 3.59 +/- .93 on a scale of 0 to 5 and the initial pH was found to be 7.30 +/- .23 within 5 min of ejaculation.