Anomalous Size Effect of Pt Ultrathin Nanowires on Oxygen Reduction Reaction.

The classical size effect of Pt particles on oxygen reduction reaction (ORR) suggests that the activity and durability would decrease with reducing the particle size, self-limiting the effectiveness in maximizing the Pt utilization efficiency with the particle-size-reduction strategy. Herein, we discover an anomalous size effect based on Pt nanowires (NWs) with tunable diameters, where the monotonically increasing activity and durability for ORR were observed with decreasing the diameter from 2.4 to 1.1 nm. Our results reveal that the dominant role of increased compressive strain induced by decreasing the diameter of NWs in weakening the adsorption and suppressing the Pt dissolution accounts for this anomalous size effect, where the reduced low-coordinated sites on NWs, the intrinsic structural advantage, is the root. Our findings not only expand the knowledge to the classical size effect but also provide new implications to break through the size limit in the design of Pt-based ORR catalysts.

CDrift: An Algorithm to Correct Linear Drift From A Single High-Resolution STEM Image.

In this work, a new method to determine and correct the linear drift for any crystalline orientation in a single-column-resolved high-resolution scanning transmission electron microscopy (HR-STEM) image, which is based on angle measurements in the Fourier space, is presented. This proposal supposes a generalization and the improvement of a previous work that needs the presence of two symmetrical planes in the crystalline orientation to be applicable. Now, a mathematical derivation of the drift effect on two families of asymmetric planes in the reciprocal space is inferred. However, though it was not possible to find an analytical solution for all conditions, a simple formula was derived to calculate the drift effect that is exact for three specific rotation angles. Taking this into account, an iterative algorithm based on successive rotation/drift correction steps is devised to remove drift distortions in HR-STEM images. The procedure has been evaluated using a simulated micrograph of a monoclinic material in an orientation where all the reciprocal lattice vectors are different. The algorithm only needs four iterations to resolve a 15° drift angle in the image.

[Urinary tract surgery in patients with ovarian peritoneal carcinomatosis treated with cytoreduction and hyperthermic intraoperative intraperitoneal chemotherapy]. / Cirugía del tracto urinario en pacientes con carcinomatosis peritoneal ovárica tratadas con citorreducción y quimioterapia intraperitoneal intraoperatoria hipertérmica.

INTRODUCTION: The objective of the present work is to describe our experience in the surgery of the ureter and bladder in patients with primary and recurrent ovarian cancer subjected to peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). PATIENTS AND METHOD: Those patients who required surgical procedures on the distal ureter or bladder, were selected from a prospective data base constructed at the beginning of the peritoneal carcinomatosis program in our centre. Seven patients fulfilled this requirement and were included in the study. A total of 81 patients diagnosed with primary or recurrent ovarian cancer from December 2007 to April 2011 were included for maximum effort cytoreduction and HIIC. RESULTS: It was necessary to perform some surgical manoeuvre on the ureter or bladder in seven patients, with a median age of 46 years (40-71). Four patients were operated on due to recurrence of the ovarian disease and in the other 3 patients the indication was surgical rescue after non-optimal surgery in another centre. There was direct tumour involvement of the lower urinary tract in 4 of them. Three patients (42%) in the series developed at least one postoperative complication. CONCLUSION: The performing of peritonectomy procedures that include the eventual resection of the ureter or bladder, and the subsequent application of HIIC in a selected group of patients with peritoneal dissemination due to an ovarian carcinoma can be done with reasonable rates of postoperative morbidity. These surgical procedures may be necessary to achieve optimal surgery.

Calculation of integrated intensities in aberration-corrected Z-contrast images.

Inclusion of spatial incoherence has been shown to give quantitative agreement between non-aberration-corrected high-angle annular dark-field scanning transmission electron microscopy images and theoretical simulations. Here we show that, using the same approach, a significant improvement in the correlation between calculated and experimental normalized integrated intensities is obtained in the InAsP ternary semiconductor alloy, but residual discrepancies remain. We have demonstrated, in good agreement with experimental intensities obtained in calibrated samples, that normalized integrated intensities show a low dependence on the sample thickness over a wide range of thickness values. This behaviour does not occur in conventional (non-aberration-corrected) images and constitutes a powerful tool for straightforward interpretation of high-resolution images in terms of atomic column-resolved compositional maps.

Compositional analysis with atomic column spatial resolution by 5th-order aberration-corrected scanning transmission electron microscopy.

We show in this article that it is possible to obtain elemental compositional maps and profiles with atomic-column resolution across an InxGa1-xAs multilayer structure from 5th-order aberration-corrected high-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM) images. The compositional profiles obtained from the analysis of HAADF-STEM images describe accurately the distribution of In in the studied multilayer in good agreement with Muraki's segregation model [Muraki, K., Fukatsu, S., Shiraki, Y. & Ito, R. (1992). Surface segregation of In atoms during molecular beam epitaxy and its influence on the energy levels in InGaAs/GaAs quantums wells. Appl Phys Lett 61, 557-559].

Change in the Pattern of Posttransplantation Anemia in Kidney Receptors: Sex Role in Recipients and Type of Donor.

OBJECTIVE: Posttransplant anemia (PTA) in kidney recipients is a complication that has repercussions mainly of cardiovascular consequence. The objective of this study is to determine the prevalence of anemia, as well as the relationship between kidney recipient and donor sex, in the presence or absence of anemia at 12 months after kidney transplant (KT). MATERIAL AND METHODS: Observational, longitudinal study of KTs made over a 5-year period, from 2013 to 2017, in a renal transplant unit from La Raza National Health Care Medical Center. Three hundred twenty-eight records were analyzed. Hemoglobin (Hb) and the presence or absence of anemia according to the definition by the World Health Organization were analyzed. The association between kidney recipient sex and donor type (living or deceased) was evaluated. Analysis of central tendency and dispersion were performed and the mean difference was established with χ2 test or Student t test. Significance level was set at P < .05. RESULTS: The mean Hb (standard deviation) before KT was 10.38 (2.16) g/dL; Hb at 12 months was 14.47 (2.37) g/dL with an absolute increase of 4.09 g/dL. Before KT, male kidney recipients had a mean Hb of 10.54 (2.17) g/dL. At 12 months post-KT, mean Hb was 15.33 (2.25) with a change of 4.79 g/dL. Before KT, female kidney recipients had a mean Hb of 10.16 (2.13) g/dL. At 12 months post-KT, mean Hb was 13.31 (2.01) with a change of 3.15 g/dL. The difference between both sexes was 1.64 g/dL at the end of 12 months. Sixteen out of 152 (10.5%) patients had a serum creatinine (Cr) < 1.2 mg/dL and anemia; 36 out of 176 (20.5%) patients had a Cr ≥ 1.2 mg/dL and anemia (P = .014). In the bivariate logistic regression with an odds ratio of 2.047 (95% confidence interval, 1027-4078; P = .042) for higher Cr levels and the presence of persistent anemia. CONCLUSIONS: There is a prevalence of anemia in female kidney recipients and recipients of kidneys from deceased donors. There is a higher risk of persistent anemia in the case of patients with some degree of graft failure at 12 months.

Use of urokinase in percutaneous drainage of large breast abscesses.

OBJECTIVE: The purpose of this study was to evaluate intracavitary urokinase therapy versus irrigation with a saline solution in percutaneous drainage of large breast abscesses. METHODS: A prospective randomized study was conducted in 19 nonlactating women (median age, 35.7 years) with breast abscesses of greater than 3 cm. Percutaneous drainage with an ultrasound-guided catheter was performed in group A patients (saline solution) and group B patients (urokinase). Postdrainage care and ultrasound-guided drainage control were performed on an outpatient basis. The Student t test, Fisher exact test, chi(2) test, and Mann-Whitney U test were used for statistical analysis. RESULTS: Percutaneous drainage with saline or urokinase irrigation was successful in all cases. No statistically significant differences were observed between groups A and B for clinical parameters and sonographic characteristics of the abscesses. However, a statistically significant difference was observed between the two groups for the average drainage times (P < 0.012), which were 3.8 days for the urokinase group and 5.3 days for the saline group. A recurrence was observed in 1 saline group patient who had a diagnosis of a chronic abscess, which was resolved with intracavitary urokinase irrigation. CONCLUSIONS: Percutaneous drainage of large breast abscesses in nonlactating women with intracavitary urokinase irrigation is a simple and safe procedure. It reduces the treatment time and improves the clinical course of patients more than conventional drainage with saline irrigation.

A method to determine the strain and nucleation sites of stacked nano-objects.

We determine the compositional distribution with atomic column resolution in a horizontal nanowire from the analysis of aberration-corrected high resolution Z-contrast images. The strain field in a layer capping the analysed nanowire is determined by anisotropic elastic theory from the resulting compositional map. The reported method allows preferential nucleation sites for epitaxial nanowires to be predicted with high spatial resolution, as required for accurate tuning of desired optical properties. The application of this method has been exemplified in this work for stacked InAs(P) horizontal nanowires grown on InP separated by 3 nm thick InP layers, but we propose it as a general method to be applied to other stacked nano-objects.

[Spirometric evaluation of respiratory involvement in asymptomatic multinodular goiter with an intrathoracic component]. / Valoración espirométrica de la afectación respiratoria en el bocio multinodular asintomático con componente intratorácico.

Respiratory tract obstruction is underestimated in asymptomatic intrathoracic goiter. Our aim was to evaluate the involvement of the upper airway of asymptomatic patients with intrathoracic multinodular goiter, assessing the effect on respiratory function by means of spirometry. We selected 21 patients with asymptomatic intrathoracic goiter on whom a thyroidectomy had been performed. Spirometry was done in supine decubitus and in standing position before and 3 months after surgery. The preoperative study in decubitus showed mild obstruction in 4 cases (20%). In 2 of these cases this condition was also present in standing position (10%). Spirometry became normal after surgery in the 4 patients with obstruction. To conclude, spirometry in asymptomatic intrathoracic goiter shows mild obstruction of respiratory function in 10% to 20% of cases, depending on position. Surgery was associated with normalization of the abnormal parameters and an improvement in the remaining parameters. These data support the need to schedule surgery as soon as possible.

The Peak Pairs algorithm for strain mapping from HRTEM images.

Strain mapping is defined as a numerical image-processing technique that measures the local shifts of image details around a crystal defect with respect to the ideal, defect-free, positions in the bulk. Algorithms to map elastic strains from high-resolution transmission electron microscopy (HRTEM) images may be classified into two categories: those based on the detection of peaks of intensity in real space and the Geometric Phase approach, calculated in Fourier space. In this paper, we discuss both categories and propose an alternative real space algorithm (Peak Pairs) based on the detection of pairs of intensity maxima in an affine transformed space dependent on the reference area. In spite of the fact that it is a real space approach, the Peak Pairs algorithm exhibits good behaviour at heavily distorted defect cores, e.g. interfaces and dislocations. Quantitative results are reported from experiments to determine local strain in different types of semiconductor heterostructures.

Origin of reduced magnetization and domain formation in small magnetite nanoparticles.

The structural, chemical, and magnetic properties of magnetite nanoparticles are compared. Aberration corrected scanning transmission electron microscopy reveals the prevalence of antiphase boundaries in nanoparticles that have significantly reduced magnetization, relative to the bulk. Atomistic magnetic modelling of nanoparticles with and without these defects reveals the origin of the reduced moment. Strong antiferromagnetic interactions across antiphase boundaries support multiple magnetic domains even in particles as small as 12-14 nm.

Effects of repeated yearly exposure to exercise-training on blood pressure and metabolic syndrome evolution.

OBJECTIVE: To study if repeated yearly training programs consolidate the transient blood pressure (BP) improvements of one exercise program into durable adaptations. METHODS: Obese middle-age individuals with metabolic syndrome (MetS) underwent high-intensity aerobic interval training during 16 weeks (November to mid-March) in 3 consecutive years [training group (TRAIN); N = 23]. Evolution of MetS components was compared with a matched-group that remained sedentary [control group (CONT); N = 26]. RESULTS: At the end of the first training program (0-4 months), TRAIN lowered systolic arterial pressure, blood glucose, waist circumference and MetS Z-score below CONT (-8.5 ±â€Š2.5 mmHg; -19.9 ±â€Š2.6 mg/dl; -3.8 ±â€Š0.1 cm and -0.3 ±â€Š0.1, respectively, all P < 0.05). With detraining (month 4-12) TRAIN adaptations relapsed to the levels of baseline (month 0) except for BP. A second exercise program (month 12-16) lowered blood glucose and waist circumference below CONT (-19.0 ±â€Š2.0 mg/dl; -4.1 ±â€Š0.1 cm). After detraining (month 16-24) BP, blood glucose and Z-score started below CONT values (-6.8 ±â€Š0.9 mmHg; -24.6 ±â€Š2.5 mg/dl and -0.4 ±â€Š0.05, respectively, all P < 0.05) and those differences enlarged with the last training program (month 24-28). Ten-year atherosclerotic cardiovascular disease risk estimation increased only in CONT (8.6 ±â€Š1.1-10.1 ±â€Š1.3%; year 2-3; P < 0.05). CONCLUSION: At least two consecutive years of 4-month aerobic interval training are required to chronically improve MetS (Z-score). The chronic effect is mediated by BP that does not fully return to pretraining values allowing a cumulative improvement. On the other hand, sedentarism in MetS patients during 3 years increases their predicted atherosclerotic diseases risk. CLINICALTRIALS. GOV IDENTIFIER: NCT03019796.

Associations of HLA-C alleles with multinodular goiters: study in a population from southeastern Spain.

HYPOTHESIS: Several immunological alterations have been found in patients with multinodular goiter (MG). These alterations, together with the association described between certain autoimmune thyroid diseases and alleles of the major histocompatibility complex (HLA alleles), justify the need for studies of the HLA alleles and MG in an attempt to identify associations. DESIGN: Case-control study. SETTING: Tertiary referral center. PATIENTS: Ninety consecutive patients underwent surgical procedures for MG. The control group comprised 100 unrelated, healthy, white subjects. INTERVENTION: Genotyping for HLA-C alleles was done using the molecular biological technique of polymerase chain reaction using sequence-specific primers and was carried out for all of the patients. MAIN OUTCOME MEASURES: The analyzed variables included age, sex, family history of thyroid pathological abnormalities, clinical features of the patient, clinical grading of the goiter, intrathoracic thyroid component, goiter weight, associated carcinoma, and the HLA-C gene. RESULTS: A significant association was observed between the lower incidence of the HLA-Cw4 allele and the appearance of MG (15.5% vs 8.3%, respectively; P = .001; relative risk [RR] = 0.49). These results suggest that the HLA-Cw4 allele can exert a protective effect against MG. Analysis of the different clinical variables shows the most significant association to be the absence of the HLA-Cw4 allele in patients with goiters with an intrathoracic component (P = .001; RR = 0.19) and in patients with goiters weighing more than 200 g (P = .02; RR = 0.17). Associations between the HLA-C alleles and MG were also observed, such as the presence of the HLA-Cw7 allele and a family history of thyroid pathological abnormalities (P = .03; RR = 3.91) as well as the HLA-Cw1 allele and the presence of goiter-associated thyroid carcinoma (P = .02; RR = 8.60). CONCLUSIONS: The HLA-Cw4 allele can act as a protector against the development of MG, as it occurs less frequently in the population with MG, and those with this allele develop smaller goiters with no intrathoracic component.

Diagnostic efficiency of sestamibi gammagraphy and Doppler sonography in the preoperative assessment of breast lesions.

INTRODUCTION: It would be desirable to have preoperative methods that allow an adequate selection of patients with breast lesions to rule out breast cancer. The aim of the present study is to evaluate the efficiency of preoperative Sestamibi gammagraphy and Doppler sonography regarding the differential diagnosis of malignancy in breast lesions. MATERIAL AND METHODS: A prospective observational study was conducted on 88 consecutive patients with breast lesions. All the patients underwent preoperative Doppler sonography with an echo-enhancing agent and Sestamibi gammagraphy. All the patients had histopathological study of the surgical specimen to compare with the result of the preoperative techniques. These comparisons were done both for the overall series and separately for palpable and non-palpable lesions. RESULTS: In the overall series results, both tests separately and the two combined, are related significantly to the malignant histological diagnosis (p < 0.001). In palpable lesions, there is a considerable increase in sensitivity, and especially in specificity, attaining 100%, with the combination of both tests. In non-palpable lesions, a relationship was only found between the results of the Sestamibi gammagraphy and the malignant histological diagnosis (93.3%; p < 0.05). CONCLUSIONS: Sestamibi gammagraphy and Doppler sonography are two efficient exploratory techniques in the preoperative assessment of malignancy in breast lesions, especially for palpable lesions, and this efficiency is greater when they are combined.

[Physicians faced with living liver donation: an attitudinal study in a Spanish hospital with a living donor liver transplant program]. / El personal médico ante la donación hepática de vivo. Estudio de opinión en un hospital español con programa de trasplante hepático de donante vivo.

INTRODUCTION: Mortality on the waiting list for liver transplants is high. Consequently, alternatives such as living donation are being sought. Therefore, one of the aspects that should be improved is the attitude of healthcare professionals toward this type of donation in order to create a favorable climate. The objective of this study was to identify attitudes toward living liver donation among physicians in a hospital with a living donor liver transplant program and to analyze the variables that affect these attitudes. PATIENTS AND METHODS: A random sample stratified by type of service (n = 369) was performed among physicians in the hospital. Attitudes were evaluated using a survey validated in our geographical area. In each service, the head of service, or in their absence, an attending physician, was contacted. This person was given an explanation of the study and was made responsible for distributing the questionnaire in selected work shifts. The questionnaire was completed anonymously and was self-administered. Statistical analysis consisted of chi2 test, Student's t-test, and a logistic regression analysis. RESULTS: The survey completion rate was 93% (n = 345). Of those surveyed, 15% (n = 52) were in favor of living liver donation whether related or unrelated. This percentage increased to 85% (n = 292) if donation was related. Of the remainder, 8% (n = 27) did not accept living liver donation and the remaining 7% (n = 26) were undecided. This attitude was associated with only two factors: the respondent's belief that he or she might need a transplant in the future (p = 0.003) -90% of those who believed that they might need a transplant at some point in the future were in favor-, and the respondent's acceptance (if transplantation were necessary at some point in the future) of a living donated liver from a family member or a friend (p = 0.000). Thus, 96% of those who would be prepared to accept a living organ were in favor. In the multivariate analysis, both variables remained significant: the respondent's belief that he or she might need a transplant in the future (odds ratio [OR] = 2.36) and, if this were the case, the respondent's acceptance of a living donated liver (OR = 7.11). CONCLUSIONS: Attitudes toward living liver donation among physicians in a hospital with a living donor transplant program were highly favorable. Consequently, these health professionals may be a key element for the promotion of living donation at the present time when this form of donation is being encouraged to avoid mortality on waiting lists.

Surgical management of multinodular goiter with compression symptoms.

HYPOTHESIS: Multinodular goiter (MG) with compression symptoms has a clinical profile different from that of goiter without these symptoms. The surgical treatment of MG with compression symptoms has a high rate of sternotomy and morbidity. DESIGN: Retrospective study conducted between 1970 and 1999. SETTING: Tertiary referral center. PATIENTS: One hundred fifty-seven patients with MG with compression symptoms were reviewed from 672 patients with MG undergoing surgery in our department. We used 515 patients with MG without compression symptoms as a control group. INTERVENTION: All 157 patients underwent programmed surgery for thyroidectomy. MAIN OUTCOME MEASURES: General patient data, history and symptoms, exploration (both physical and with complementary techniques), data on the surgery and surgeon, and postsurgery morbidity and evolution. The chi2 test, the t test, and a logistic regression test were applied. RESULTS: Multinodular goiter with compression symptoms is characterized by its appearance in persons older than 55 years, a preoperative evolution of more than 10 years, and an intrathoracic component in more than 75% (P<.001). All the patients underwent surgery, with 6 (4%) requiring a sternotomy. Twenty-four percent had complications (n = 37), 3% of which corresponded to 4 cases of permanent recurrent laryngeal nerve injury. Eleven patients (7%) had an associated thyroid carcinoma, 9 of them corresponding to microcarcinomas. However, 5 were multifocal, and there was 1 anaplastic carcinoma, from which the patient died. All the papillary carcinomas are currently asymptomatic. The symptoms were remitted after surgery in all the cases except 1 dysphonia. Of the 32 patients receiving partial surgery, 9 (28%) had recurrence, of whom 6 underwent reoperation to complete the thyroidectomy. CONCLUSIONS: Multinodular goiter with compression symptoms occurs in long-evolving goiters with an intrathoracic component. Surgery is the definitive treatment, as it excludes malignancy, involves low rates of permanent morbidity and mortality, and, if the technique is total thyroidectomy, avoids recurrences.

Anticonvulsant drug hypersensitivity.

BACKGROUND: Cutaneous adverse reactions are frequently described with anticonvulsant drugs, especially with aromatic drugs such as carbamazepine, phenytoin, and phenobarbital. Patch tests could be useful for diagnosing this clinical picture. Hypersensitivity to several anticonvulsant drugs is common but unpredictable. MATERIAL AND METHODS: 15 patients from our allergy section, suffering from anticonvulsant skin allergy, were included. We describe their analitic alterations, responsible drugs, and anticonvulsants tolerated, the results of patch tests with anticonvulsant drugs (5% pet. and aq.), and skin biopsies wherever carried out. RESULTS: 23 adverse skin reactions with different anticonvulsant drugs occurred in the 15 patients: 13 resulted in fever and generalized cutaneous rash, 7 patients suffered only from cutaneous rash. There was one case of palpable purpura, one of erythema multiforme (target lesions), and another one suffered only cutaneous pruritus. Eosinophilia was found in 5 cases. Liver enzymes were elevated in 9 (7 of whom suffered fever and cutaneous rash). The responsible drugs were carbamazepine (8 adverse reactions), phenytoin (5), lamotrigine (4), phenobarbital (4), sodium valproate (1), and felbamate (1). The drugs tolerated were sodium valproate (6 patients), topiramate (4), vigabatrin (2), lamotrigine (1), clonazepam (1), and gabapentin (1). We found 12 positive patch tests: 6 with carbamazepine, 3 with phenytoin and, 1 each with lamotrigine, sodium valproate and phenobarbital. Skin biopsies were carried out in 5 patients, 4 of whom showed some characteristic findings of erythema multiforme (lymphocytic exocytosis, dyskeratotic cells, vacuolation of basal cells and pigmentary incontinence) and the other one showed a typical leucocytoclastic angitis. CONCLUSIONS: The cutaneous adverse reactions more frequently seen in our allergy section because of anticonvulsant drugs are rashes with fever. Eosinophilia and elevated levels of liver enzymes are frequently associated. This clinical picture is called "anticonvulsant hypersensitivity syndrome." The drugs implicated most frequently are carbamazepine and phenytoin. Hypersensitivity to more than one drug was variable and unpredictable. The best-tolerated drug was sodium valproate, but it was not tolerated by a patient with phenytoin and carbamazepine hypersensitivity. Patch tests are useful for diagnosing anticonvulsant hypersensitivity. The most frequently findings in the skin biopsies were typical of erythema multiforme.