Emerging symmetric strain response and weakening nematic fluctuations in strongly hole-doped iron-based superconductors.

Electronic nematicity is often found in unconventional superconductors, suggesting its relevance for electronic pairing. In the strongly hole-doped iron-based superconductors, the symmetry channel and strength of the nematic fluctuations, as well as the possible presence of long-range nematic order, remain controversial. Here, we address these questions using transport measurements under elastic strain. By decomposing the strain response into the appropriate symmetry channels, we demonstrate the emergence of a giant in-plane symmetric contribution, associated with the growth of both strong electronic correlations and the sensitivity of these correlations to strain. We find weakened remnants of the nematic fluctuations that are present at optimal doping, but no change in the symmetry channel of nematic fluctuations with hole doping. Furthermore, we find no indication of a nematic-ordered state in the AFe2As2 (A = K, Rb, Cs) superconductors. These results revise the current understanding of nematicity in hole-doped iron-based superconductors.

Improved virological and immunological efficacy of resistance-guided switch in antiretroviral therapy: a Frankfurt HIV cohort analysis.

To evaluate the treatment outcome of antiretroviral therapy, depending on the use and utility of a concept of resistance-guided switch, patients from the Frankfurt HIV cohort have been followed for 24 weeks. If available, prior resistance data have been evaluated and patients were grouped into their expected viral response. The data of 354 patients were thus analysed, taking into account the genotypic sensitivity score of the administered medication (> or ≤2). When looking at the proportion of patients who achieved a viral load of <50/ml, the response rates differed significantly better for patients with a favourable resistance scoring as compared to an unfavourable one (71.9 % as compared to 56.0 %, p = 0.008). Interestingly, patients with a favourable resistance score also showed a better immunological response, as measured by median CD4 cell count of 391/µl [interquartal range (IQR) 250-530/µl] against 287/µl (IQR 174-449/µl) and a larger total increase of 141/µl against 38/µl. A significant virological and immunological benefit could be demonstrated for patients of a cohort with resistance-guided antiretroviral therapy adjustments.

[Influence of intraoperative noise protection on postoperative pain: demonstrated exemplified by total knee arthroplasty]. / Einfluss der intraoperativen Schallprotektion auf postoperative Schmerzen : Dargestellt am Beispiel der Knieendoprothetik.

BACKGROUND: It is known that implied memory of intraoperative noise influences postoperative pain. The aim of this study was to evaluate the influence of different intraoperative noise protection methods during total knee arthroplasty on postoperative pain scores. MATERIAL AND METHODS: A total of 83 patients were included in this prospectively designed, double-blind trial and underwent total knee arthroplasty with psoas compartment and sciatic nerve regional anesthesia and additionally propofol sedation. After randomization patients were assigned either to the noise protection group, the music group or the control group. Postoperative pain scores (VAS) were evaluated in each group. RESULTS: In the three different time intervals evaluated there were no significant differences between the groups. Also the pain maxima for each postoperative day showed no significant difference but there was a slight trend to the advantage of the music group. CONCLUSION: Even though there were no significant effects of music or noise protection on postoperative pain scores, it can be concluded, as has been done by many other authors that music should be used in the perioperative setting for general patient comfort.

Detailed endocardial mapping accurately predicts the transmural extent of myocardial infarction.

OBJECTIVES: This study delineates between infarcts varying in transmurality by using endocardial electrophysiologic information obtained during catheter-based mapping. BACKGROUND: The degree of infarct transmurality extent has previously been linked to patient prognosis and may have significant impact on therapeutic strategies. Catheter-based endocardial mapping may accurately delineate between infarcts differing in the transmural extent of necrotic tissue. METHODS: Electromechanical mapping was performed in 13 dogs four weeks after left anterior descending coronary artery ligation, enabling three-dimensional reconstruction of the left ventricular chamber. A concomitant reduction in bipolar electrogram amplitude (BEA) and local shortening indicated the infarcted region. In addition, impedance, unipolar electrogram amplitude (UEA) and slew rate (SR) were quantified. Subsequently, the hearts were excised, stained with 2,3,5-triphenyltetrazolium chloride and sliced transversely. The mean transmurality of the necrotic tissue in each slice was determined, and infarcts were divided into <30%, 31% to 60% and 61% to 100% transmurality subtypes to be correlated with the corresponding electrical data. RESULTS: From the three-dimensional reconstructions, a total of 263 endocardial points were entered for correlation with the degree of transmurality (4.6 +/- 2.4 points from each section). All four indices delineated infarcted tissue. However, BEA (1.9 +/- 0.7 mV, 1.4 +/- 0.7 mV, 0.8 +/- 0.4 mV in the three groups respectively, p < 0.05 between each group) proved superior to SR, which could not differentiate between the second (31% to 60%) and third (61% to 100%) transmurality subgroups, and to UEA and impedance, which could not differentiate between the first (<30%) and second transmurality subgroups. CONCLUSIONS: The degree of infarct transmurality extent can be derived from the electrical properties of the endocardium obtained via detailed catheter-based mapping in this animal model.

Intramuscular versus surface electromyography of the diaphragm for determining neuromuscular blockade.

We determined the neuromuscular blockade of 0.2 mg. kg(-1) mivacurium at the diaphragm by using two new methods of electromyographic (EMG) monitoring and compared it with acceleromyography of the orbicularis oculi (OO) and the corrugator supercilii (CS) muscle. After the induction of anesthesia in 15 patients undergoing gynecologic laparoscopic surgery, evoked EMG responses at the diaphragm were obtained by using skin electrodes at the back of the patient, placed lateral to T12/L1 or L1/L2, and a laparoscopically applied wire electrode inserted into the dorsolateral portion of the diaphragm. Acceleromyography at the right OO and the left CS was performed. The facial and phrenic nerves were stimulated transcutaneously (onset: every 10 s, offset: every 15 s, single twitch stimulation). Lag and onset time, peak effect, and clinical duration (time to reach 75% of control value and time to reach 90% of control value) were measured and the results were compared by using analysis of variance; P < 0.05 showed significant difference. Pearson's correlation test and the Bland-Altman test were used to compare the two diaphragmatic monitoring methods. Mean peak effects of >98% were reached at all sites. Onset times at diaphragm (skin, IM) were significantly (P < 0.005) shorter than at the CS or OO (100 +/- 14 s and 98 +/- 16 s vs 147 +/- 39 s, 185 +/- 38 s) without being statistically different between OO and CS. There was a good correlation of lag, onset time, time to reach 75% of control value, and time to reach 90% of control value (r = 0.8, 0.9, 0.8, and 0.75; P < 0.01) between the two diaphragmatic methods. Mean difference and limits of agreements are -2 +/- 15 s, 1 +/- 21 s, -1 +/- 2.3 min, and -2 +/- 3.4 min. We showed a shorter onset and clinical duration at the diaphragm in comparison with CS and OO. Two methods of EMG of the diaphragm correlated well and showed good comparability. The novel method of surface diaphragmatic EMG at the patient's back may be useful during routine clinical anesthesia.

Comparison of the scope of allopathic and osteopathic medical school health promotion programs for students.

PURPOSE: To compare the number and scope of health promotion programs for students in allopathic and osteopathic medical schools in the U.S. and Canada. DESIGN: A one-time cross-sectional survey design was applied in this study. SETTING: This study was conducted in 141 accredited allopathic and 17 accredited osteopathic medical schools. SUBJECTS: A total of 158 representatives from the allopathic and osteopathic medical schools participated in this study. The response rate for the survey was 100%. MEASURES: A structured telephone interview was conducted to survey representatives from the medical schools. The survey contained 85 multiple-choice questions organized into four sections: administrative characteristics, types of institutional and health promotion program policies, participation incentives and facilities, and type/scope of health promotion program activities. Chi-square analysis was used to analyze survey variables by type of medical education and level of intervention. RESULTS: Of the 158 medical schools, only 20% (n = 32) provided a health promotion program for students. Although osteopathic institutions (29.4%) had a greater percentage of programs than allopathic schools (19.2%), there was no significant difference in scope of program offerings by type of medical education. Allopathic programs offered exercise and nutrition/weight management significantly more often and at a higher level of intervention. Lastly, allopathic programs had significantly more monetary resources available for programming. Following prudent research protocol, investigators should be mindful of the limitations of this study. In this study, some school representatives chose not to answer personnel- and finance-related questions. Additionally, because of the self-report nature of the survey, the responses given to the questions may not have been accurate. CONCLUSION: Allopathic and osteopathic medical school health promotion programs for students were very similar in scope.

Screening for colorectal neoplasia: physicians' adherence to complete diagnostic evaluation.

This prospective study was done in a health maintenance organization colorectal cancer screening program to determine whether 166 persons found to have abnormal fecal occult blood test results typically underwent complete diagnostic evaluation (i.e., either colonoscopy or barium enema x-ray plus flexible sigmoidoscopy). Chart audit data show that 137 (82%) subjects contacted a physician to discuss follow-up. A complete diagnostic evaluation was recommended to only 52 (38%) patients who talked with a physician. Forty-two (81%) patients who were advised to get a complete diagnostic evaluation actually complied. Significant differences in clinical findings were observed for patients who did and did not have a complete diagnostic evaluation.

Cryopreservation of Digitalis lanata Shoot Tips.

A method for the preservation in liquid nitrogen of shoot tips (meristems) of D. LANATA is described. It includes the following steps: (a) hardening of shoots by cultivation at 4 degrees C for 8 weeks, (b) treatment of the explanted shoot tips with cryoprotectors, e.g., 2 mol DMSO l (-1) for 2 h, (c) either ultrarapid cooling (ca. 4000 K min (-1)) of the shoot tips by submerging in liquid nitrogen or slow cooling (ca. 0.5 K min (-1)) of the shoot tips to -40 degrees C using a suitable freezer, (d) storage of the shoot tips at -196 degrees C in liquid nitrogen, (e) ultrarapid rewarming of the ultrarapidly cooled shoot tips by placing them directly into nutrient medium or rapid rewarming of the ampoules containing the slowly cooled shoot tips with water at 40 degrees C, and (f) recultivation of the shoot tips at the surface of a solidified nutrient medium containing 2.5 micromol BA 1 (-1). About 70% of the shoot tips survived this procedure and about 30% of the shoot tips regenerated shoots.

Ericksonian hypnosis and strategic interventions for sexual orientation confusion.

Erickson's utilization approach provides a model of hypnotic and strategic intervention for persons seeking psychotherapy because of sexual orientation confusion. Case studies outline examples of hypnotic and strategic short-term interventions. These cases include the use of metaphor, utilizing resistances, anchoring, and synesthesia.

A preliminary study in medical anthropology in Brunei, Borneo.

Nine rural village communities in the jungle of Brunei, Borneo were studied to ascertain possible effects of rapid social change on the health of the inhabitants. The social mores and religious beliefs of the rural tribes--Iban, Dusun, and Punan--have undergone but little change over many hundreds of years. During the past three decades, however, enormous social pressures for change have envolved from extraordinary economic prosperity of the region, due to the exploitation of large discoveries of oil and gas. Much of the money has been invested in health care, with the result that malaria, typhus and other tropical scourges have been virtually wiped out. Child and maternal mortality have been reduced to the standards of some of the healthiest countries in the world. The young of the formerly illiterate population are being rapidly educated in new schools scattered throughout the nation. New roads are penetrating the jungle and a thriving lumber industry has been established. Motor boats for the rivers, T.V. and even a national airline have been added. Despite these incursions a vigorous proseletizing by the Moslem and to a lesser extent by the Christian church, the villagers have held tenaciously to their ancient animistic beliefs. Living in long houses, they have also been able to maintain a tightly cohesive patriarchal family structure. Against this background there is as yet little or no evidence of the major diseases of Western society--coronary artery disease and hypertension, although most forms of cancer are commonly encountered. Brunei offers a splendid opportunity to test the putative relationship of chronic vascular disease to social structure and a way of life. Future studies may be made prospectively as the almost inevitable breakdown of old customs and patterns of living occurs in the face of rapid modernization.