Dysplasia severity is associated with poor quality of life in patients with Barrett's esophagus referred for endoscopic eradication therapy.

Limited data exist regarding patient-reported outcomes and quality of life (QOL) experienced by patients with Barrett's esophagus (BE) referred for endoscopic eradication therapy (EET). Specifically, the impact of grade of dysplasia has not been explored. The purpose of this study is to measure patient-reported symptoms and QOL and identify factors associated with poor QOL in BE patients referred for EET. This was a prospective multicenter study conducted from January 2015 to October 2017, which included patients with BE referred for EET. Participants completed a set of validated questionnaires to measure QOL, symptom severity, and psychosocial factors. The primary outcome was poor QOL defined by a PROMIS score >12. Multivariable logistic regression analysis was performed to identify factors associated with poor QOL. In total, 193 patients participated (mean age 64.6 years, BE length 5.5 cm, 82% males, 92% Caucasians) with poor QOL reported in 104 (53.9%) participants. On univariate analysis, patients with poor QOL had lower use of twice daily proton pump inhibitor use (61.5% vs. 86.5%, P = 0.03), shorter disease duration (4.9 vs. 5.9 years, P = 0.04) and progressive increase in grade of dysplasia (high-grade dysplasia: 68.8% vs. 31.3%, esophageal adenocarcinoma: 75.5% vs. 24.5%, P < 0.001). Multivariate analysis demonstrated that high-grade dysplasia was independently associated with poor QOL (OR: 5.57, 95% CI: 1.05, 29.5, P = 0.04). In summary, poor QOL is experienced by the majority of patients with BE referred for EET and the degree of dysplasia was independently associated with poor QOL, which emphasizes the need to incorporate patient-centered outcomes when studying treatment of BE-related dysplasia.

Speed limit of the insulator-metal transition in magnetite.

As the oldest known magnetic material, magnetite (Fe3O4) has fascinated mankind for millennia. As the first oxide in which a relationship between electrical conductivity and fluctuating/localized electronic order was shown, magnetite represents a model system for understanding correlated oxides in general. Nevertheless, the exact mechanism of the insulator-metal, or Verwey, transition has long remained inaccessible. Recently, three-Fe-site lattice distortions called trimerons were identified as the characteristic building blocks of the low-temperature insulating electronically ordered phase. Here we investigate the Verwey transition with pump-probe X-ray diffraction and optical reflectivity techniques, and show how trimerons become mobile across the insulator-metal transition. We find this to be a two-step process. After an initial 300 fs destruction of individual trimerons, phase separation occurs on a 1.5±0.2 ps timescale to yield residual insulating and metallic regions. This work establishes the speed limit for switching in future oxide electronics.

Images of a spin-torque-driven magnetic nano-oscillator.

We present the first space- and time-resolved images of the spin-torque-induced steady-state oscillation of a magnetic vortex in a spin-valve nanostructure. We find that the vortex structure in a nanopillar is considerably more complicated than the 2D idealized structure often-assumed, which has important implications for the driving efficiency. The sense of the vortex gyration is uniquely determined by the vortex core polarity, confirming that the spin-torque acts as a source of negative damping even in such a strongly nonuniform magnetic system. The orbit radius is ∼10 nm, in agreement with micromagnetic simulations.

Reaction chemistry of 1,1'-ferrocene dicarboxylate towards M(ii) salts (M = Co, Ni, Cu): solid-state structure and electrochemical, electronic and magnetic properties of bi- and tetrametallic complexes and coordination polymers.

The synthesis and characterisation of a series of novel complexes of type [((tmeda)M-OC(O)-fc-(micro-CO(2)))(2)(micro-H(2)O)] (M = Co, ; M = Ni, ), zwitter-ionic [((pmdta)(H(2)O)Cu(+)-OC(O)-fc-CO(2)(-))(CH(3)OH)] (), and coordination polymer [(tmeda)Cu((OC(O))(2)fc)](n) () (fc = ferrocene-1,1'-diyl, (eta(5)-C(5)H(4))(2)Fe; tmeda = N,N,N',N'-tetramethylethylenediamine; pmdta = 1,1,4,7,7-N,N,N',N'',N''-pentamethyldiethylenetriamine) composed of ferrocene dicarboxylates and [(tmeda)/(pmdta)M](2+) entities is reported. These complexes could be prepared from [M(NO(3))(2)(tmeda)] (M = Co, ; M = Ni, ; M = Cu, ) and [Cu(NO(3))(2)(pmdta)] (), respectively, with stoichiometric amounts of 1,1'-ferrocene dicarboxylic acid () in presence of [n-Bu(4)N]OH-H(2)O. The molecular structures of , , , and in the solid state have been determined by single-crystal X-ray structure analysis. Electrochemical and UV-vis-NIR spectroscopic studies of these complexes are discussed in terms of electronic communication between the redox-active transition metals. In addition, the magnetic properties of and have been studied by susceptibility measurements vs. temperature. In complex , the two cobalt(ii) ions are antiferromagnetically coupled, while in the Ni-Ni coupling is ferromagnetic with J approximately +2.2(1) cm(-1).

Mid-IR spectra of different conformers of phenylalanine in the gas phase.

The experimental mid- and far-IR spectra of six conformers of phenylalanine in the gas phase are presented. The experimental spectra are compared to spectra calculated at the B3LYP and at the MP2 level. The differences between B3LYP and MP2 IR spectra are found to be small. The agreement between experiment and theory is generally found to be very good, however strong discrepancies exist when -NH2 out-of-plane vibrations are involved. The relative energies of the minima as well as of some transition states connecting the minima are explored at the CCSD(T) level. Most transition states are found to be less than 2000 cm(-1) above the lowest energy structure. A simple model to describe the observed conformer abundances based on quasi-equilibria near the barriers is presented and it appears to describe the experimental observation reasonably well. In addition, the vibrations of one of the conformers are investigated using the correlation-corrected vibrational self-consistent field method.

Does contrast medium administration in organ donors affect early kidney graft function?

Since the upper age for organ donors has been raised, a higher incidence of preexistent organ damage and functional impairment is to be expected. Coronary artery sclerosis increases with age. It can only be diagnosed with certainty by coronary angiography. Since contrast medium administration may cause renal damage when risk factors are present, this study sought to establish whether angiography negatively influenced the early postoperative function of kidney grafts. We compared the clinical courses of 36 recipients of kidneys from donors in whom coronary angiography or levography had been performed with 36 recipients of kidneys from donors who had not been subjected to contrast medium. The results showed that the administration of contrast medium had no influence on renal function at 3 or 6 months after transplantation. In conclusion, fears that donor kidneys might be harmed by contrast medium appeared to therefore be unfounded.

Vibrational spectroscopy and the development of new force fields for biological molecules.

The role of vibrational spectroscopy in the testing of force fields of biological molecules and in the determination of improved force fields is discussed. Analysis shows that quantitative testing of potential energy surfaces by comparison with spectroscopic data generally requires calculations that include anharmonic couplings between different vibrational modes. Applications of the vibrational self-consistent field (VSCF) method to calculations of spectroscopy of biological molecules are presented, and comparison with experiment is used to determine the merits and flaws of various types of force fields. The main conclusions include the following: (1) Potential surfaces from ab initio methods at the level of MP2 yield very satisfactory agreement with spectroscopic experimental data. (2) By the test of spectroscopy, ab initio force fields are considerably superior to the standard versions of force fields such as AMBER or OPLS. (3) Much of the spectroscopic weakness of AMBER and OPLS is due to incorrect description of anharmonic coupling between different vibrational modes. (4) Potential surfaces of the QM/MM (Quantum Mechanics/Molecular Mechanics) type, and potentials based on improved versions of semi-empirical electronic structure theory, which are feasible for large biological molecules, yield encouraging results by the test of vibrational spectroscopy.

Bringing health care information to the deaf community.

BACKGROUND: The Deaf community reports limited access to health promotion information and care. Literature review, key informant interviews, and focus groups generated a clearer understanding of the community. Health care providers, educators, and policymakers could improve medical care to the Deaf community by: 1) better understanding its culture and language; 2) creating more health education programs specifically for the Deaf community; 3) developing opportunities for more deaf people and American Sign Language (ASL) users to enter the health professions; and 4) creating incentives for hearing health care providers to become ASL proficient.

[Abdominal wall metastases as a complication of percutaneous endoscopic gastrostomy in carcinoma of the upper aerodigestive tract]. / Bauchdeckenmetastasen als Komplikation der PEG-Anlage bei Karzinomen des oberen Aerodigestivtraktes.

Percutaneous endoscopic gastrostomy (PEG) has become an important adjunct in the care of head and neck cancer patients. In the literature of the last 10 years, 16 cases of abdominal wall metastasis after PEG implantation were reported. We performed 387 PEG procedures in patients with head and neck cancers. In this paper, we describe two patients with advanced head and neck cancers who underwent PEG prior to cancer therapy and developed metastatic cancer at the PEG site 3 or 4 months later. Although the mechanism of spread cannot be confirmed, direct seeding from passage through the cancer seems likely. Methods of establishing enteral access which avoid tumor-contaminated fields, such as the use of an overtube during conventional PEG or PEG procedure after tumor resection, may be appropriate in head and neck cancer patients. Another possibility of origin is the hematogenous spread of cancer cells from metastases on the abdominal wall.

Bringing breast cancer education to deaf women.

BACKGROUND: The Deaf community has not been adequately served by mainstream public health interventions. METHODS: A breast cancer education program adapted for the needs of the Deaf community was evaluated by 123 deaf and hard-of-hearing women using pre- and post-surveys and focus groups. RESULTS: Among the findings were the difficulty of recruiting Deaf community members to education and research programs; low adherence to breast cancer screening guidelines; insufficient breast-health knowledge; endorsement of the program; and suggestions for strengthening it. CONCLUSION: Deaf women will benefit from breast cancer education programs that specifically address their language, culture, and preferred learning styles.

[A young patient with multiple arterial occlusions]. / Junge Patientin mit multiplen arteriellen Verschlüssen.

BACKGROUND: Mild hyperhomocysteinemia due to genetic causes and nutrition factors is well known as an independent strong risk factor for premature arterial occlusive disease. CASE REPORT: A 27-year-old female with a history of two episodes of small bowel ileus due to vascular causes presented with subacute pain in the left lower extremity. Angiography revealed a short segmental occlusion in the P III segment of the popliteal artery with small vessel collateralization and proximal occlusion of the superior mesenteric artery und the coeliac trunk. Vascular risk factors in this patient included smoking over a duration of 10 years, use of oral contraceptives (estrogen and gestagen combination) and elevated levels of homocysteine in the fasting state and after methionin loading. The patient was treated conservatively with intravenous application of prostaglandins, additionally she underwent training to improve her walking capability. After 4 weeks of the fasting state as well as after methionin loading were normalized by an oral substitution with folate and B vitamins. So far it was not possible to prove a genetic defect of the enzymes participating in the metabolism of homocysteine. CONCLUSION: This clinical conference of a young female patient with occlusion of several arteries illustrates the differential diagnosis of premature occlusive vascular disease with special regard to mild hyperhomocysteinemia as an independent risk factor.

The signer effect on MMPI performance of deaf respondents.

In order to determine the existence of a signer effect, two videotapes of the same 38 Minnesota Multiphasic Personality Inventory (MMPI) critical items, translated into American Sign Language (ASL) and signed by different signers, were administered to 35 deaf adults. Results of this study demonstrate an insignificant signer effect and underscore the potential utility and practicality of future ASL translations of self-report tests for use with deaf individuals. Caveats for future translations include the necessity for constant attention to translation refinements and for utilizing native ASL users with appropriate training in psychology as signers.

[Anthropometric studies of healthy, athletic girls 9 to 12 years of age]. / Anthropometrische Untersuchungen an gesunden, sporttreibenden Mädchen im Alter von 9 bis 12 Jahren.

Norm values of the bodily efficiency inform about the level of health and development of the growing-up generation. Anthropometric results from 550 healthy sporting girls of the town Weissenfels aged 9 till 12 years are given in tabulated form (means and standard deviations from 8 anthropometric parameters) differentiated in regard of the biological age of the girls. Impressive differences can be seen. Consequences for the practice are discussed. The given results may be compared with the corresponding ones for boys also aged from 9 till 12, presented before in this journal.

[Physical measurements of healthy, athletic girls 9-12 years of age in percentile values]. / Körpermasse von gesunden, sporttreibenden Mädchen im Alter von 9-12 Jahren in Perzentilwerten.

Eight anthropometric data from 550 healthy sporting girls aged 9-12 years are presented as percentiles in tabular form. The results are of importance for the medical practice.

[Evaluation of body mass of 9-to-12-year-old girls with reference to stage of biological development]. / Beurteilung der Körpermasse 9- bis 12jähriger Mädchen bei Beachtung des biologischen Entwicklungsstandes.

Variations in the body weight of 550 healthy sporting girls aged 9 to 12 years (urban population) were examined with reference to the stage of their biological development. A classification in percentages (from 80% to 150%) for the evaluation of body weight in medical practice is depicted in tabular form and provides a ready and reliable means for examining body weight as a basis which may have therapeutic consequences.

[Anthropometric studies of healthy boys participating in sports 9-12 years of age]. / Anthropometrische Untersuchungen an gesunden, sporttreibenden Jungen im Alter von 9 bis 12 Jahren.

Norm values of bodily efficiency inform about the level of health and development of the growing-up generation. Anthropometric results from 595 healthy sporting boys of the town Weissenfels aged 9 till 12 years are given in tabulated form (means and standard deviations from 8 anthropometric parameters) differentiated in regard of the biological age of the boys. Impressive differences can be seen. Consequences for the practice are discussed.

[Physical measurement of healthy, athletic boys 9-12 years of age in percentile values]. / Körpermasse von gesunden, sporttreibenden Jungen im Alter von 9-12 Jahren in Perzentilwerten.

Values of physical capacity indicate the level of health and development of children to the sports physician and are of importance in other reaches. Anthropometric data from 595 healthy sporting boys aged 9-12 years are presented as percentiles.