Masculinization of the Chest in Transmen with Large Breasts.

Background and Objectives Surgery to masculinize the chest is a frequently sought-after procedure by transmen who wish to conform their physical appearance to their gender identity. In our study, the outcomes of surgical masculinization comprising subcutaneous mastectomy through a modified elliptical incision, liposuction, reduced inert nipple-areola grafting, and quilting stitches were analyzed. Materials and Methods Thirty-two transmen with large breasts and hypertrophied nipples and areolae underwent the above-mentioned masculinizing procedure in this prospective cohort study. Our statistically validated institutional aesthetic outcome assessment score (IAOAS) was used to analyze the outcomes at the end of the follow-up period. Results The average period of follow-up was 24.5 months. The average final IAOAS was 23.1. The rate of complications was found to be associated with using breast binders. In all, 22 of 32 patients (68.75%) had an excellent outcome score, while 10 patients (31.25%) had a good outcome score ( p = 0.025). Conclusion Top surgery is crucial for transmasculine patients to achieve their desired gender identity as males. It is imperative that this procedure is performed to their complete satisfaction. Our single-staged comprehensive approach of subcutaneous mastectomy and liposuction with reduced inert nipple and areola grafts, which aids in a swift transition to a male role, is a prerequisite for bottom surgery at our institute.

Decorating MnO2 nanosheets on MOF-derived Co3O4 as a battery-type electrode for hybrid supercapacitors.

Metal-organic framework-derived materials are now considered potential next-generation electrode materials for supercapacitors. In this present investigation, Co3O4@MnO2 nanosheets are synthesized using ZIF-67, which is used as a sacrificial template through a facile hydrothermal method. The unique vertically grown nanosheets provide an effective pathway for rapidly transporting electrons and ions. As a result, the ZIF-67 derived Co3O4@MnO2-3 electrode material shows a high specific capacitance of 768 C g-1 at 1 A g-1 current density with outstanding cycling stability (86% retention after 5000 cycles) and the porous structure of the material has a good BET surface area of 160.8 m2 g-1. As a hybrid supercapacitor, Co3O4@MnO2-3//activated carbon exhibits a high specific capacitance (82.9 C g-1) and long cycle life (85.5% retention after 5000 cycles). Moreover, a high energy density of 60.17 W h kg-1 and power density of 2674.37 W kg-1 has been achieved. This attractive performance reveals that Co3O4@MnO2 nanosheets could find potential applications as an electrode material for high-performance hybrid supercapacitors.

Synthesis and crystal structure of 1-hy-droxy-8-methyl-9H-carbazole-2-carbaldehyde.

Two crystallographically independent mol-ecules are present in the asymmetric unit of the title compound, C14H11NO2, with virtually identical geometries. The carbazole units are planar. The hy-droxy group at position 1, carbaldehyde group at position 2, and methyl group at position 8 (with the exception of two H atoms) are coplanar with the attached benzene rings. The dihedral angle between the two benzene rings is 2.20 (9)° in mol-ecule A and 2.01 (9)° in mol-ecule B. The pyrrole ring makes dihedral angles of 0.82 (10) and 1.40 (10)° [0.84 (10) and 1.18 (10)° in mol-ecule B] with the (-CH3)-substituted and (-OH and -CHO) substituted benzene rings, respectively. The mol-ecular structure is stabilized by the intra-molecular O-H⋯O hydrogen bonds, while the crystal structure features N-H⋯O and C-H⋯O hydrogen bonds. A range of π-π contacts further stabilizes the crystal structure.

Gold-Iron oxide yolk-shell nanoparticles (YSNPs) as magnetic probe for fluorescence-based detection of 3 base mismatch DNA.

Seed-mediated Gold-Iron oxide yolk-shell nanoparticles (YSNPs) were synthesized and functionalized with cy5 attached- thiolated single strand DNA probe for the detection of mutated DNA. The optimum concentration of thiolated DNA determined from a bathochromic shift of surface plasmon resonance (SPR) peak, was 0.177µM. The effect of pH (2-10), temperature (4, 37, 60 and 100 °C), and ionic strengths (1 M to 4 M) on the stability of ssDNA probe tethered YSNPs, studied with the assistance of flocculation parameter. The detection of mutation in DNA was possible using such ssDNA probe functionalized and stabilized nanoparticles. The hybridization of the oligonucleotide probe with the complementary, non-complementary and mutated DNA strands are determined via their respective intensities of the fluorescence of cy5, an efficient fluorescent marker. The intensities help in the comprehension of the specificity of the system. The report predicts controlled efficiency of hybridization with the aid of Hamaker constant, which is determined as 1.15 × 10-20 J for DNA functionalized YSNPs. The minimum concentration of target DNA detected using this methodology was 1.2 × 10-11 mol/L.

Chemometric tool to study the mechanism of arsenic contamination in groundwater of Puducherry region, South East coast of India.

To understand occurrence, distribution and source of arsenic, 175 groundwater samples from coastal aquifers of the Puducherry region were collected and analyzed for major ions and trace metals. The concentration of As in groundwater of study area ranges from not detectable - 28.88 µg/L during the post-monsoon and not detectable - 36.88 µg/L in the pre-monsoon. The desirable limit for As in groundwater is 10 µg/L as per World Health Organization and Bureau of Indian standard. About 13.64 and 11.50% of groundwater samples shows arsenic concentration higher than recommended limit. Hydrochemical facies which dominate during pre and post monsoon are Na-K-Cl-SO4, Ca-Cl and Ca-Mg-Cl-SO4type and Na-K-Cl-SO4, mixedCa-Na-HCO3, Ca-HCO3 and mixed Ca-Mg-Cl type respectively. The Gibbs diagram suggested that rock-water interaction is major process controlling hydrochemistry of groundwater. From the Pourbaix diagram, it is inferred that H3AsO3 is the principal As species in groundwater. The PHREEQC modelling indicates supersaturation of ferric oxides and hydroxide mineral phases in aquifer system which on reductive dissolution releases arsenic into groundwater. Statistical analysis (Spearman Correlation and Principal Component Analysis) showed that reductive dissolution of As-bearing minerals and Fe-oxyhydroxides in the presence of organic matter is the major process contributing arsenic into groundwater. The relationship between As, K+ and HCO-3 indicates agricultural and competitive exchange process which is an additional contributor of arsenic in groundwater. The sources which act as a sink and responsible for the release of As into the groundwater are marine sediments enriched in As and Fe-bearing minerals and organic matter.

Crystal structure of (E)-2-(furan-2-yl-methyl-idene)-2,3,4,9-tetra-hydro-1H-carbazol-1-one.

The title compound, C17H13NO2, crystallizes with two conformationally very similar independent mol-ecules (A and B) in the asymmetric unit. In the crystal, the individual mol-ecules are linked by pairs of N-H⋯O hydrogen bonds forming A-A and B-B inversion dimers, with R22(10) rings. They stack alternately up the a-axis direction and are linked by C-H⋯π inter-actions, forming sheets parallel to the ab plane.

Risk of melanocytic nevi and nonmelanoma skin cancer in children after allogeneic hematopoietic stem cell transplantation.

There is a known increased risk of skin cancer in the adult population after hematopoietic stem cell transplantation (HSCT). However, late dermatologic effects that children may experience after HSCT have not been well described. The primary objective of this study was to characterize nevi and skin cancers affecting children after allogeneic HSCT. A cross-sectional cohort study of 85 pediatric HSCT recipients and 85 controls matched for age, sex and skin phototype was performed at a single institution. All participants underwent a full skin examination. Median age at study visit was 13.8 years in HSCT patients with median time post-HSCT of 3.6 years. HSCT patients had significantly more nevi than control patients (median (range): 44 (0-150) vs 11 (0-94), P<0.0001). HSCT patients also had significantly more nevi >5 mm in diameter and atypical nevi than controls. Factors associated with increased nevus count included malignant indication for HSCT, pretransplant chemotherapy, TBI exposure and myeloablative conditioning. A total of 16.5% of HSCT patients developed cancerous, precancerous lesions and/or lentigines. Our study suggests that pediatric HSCT recipients have an increased risk of benign and atypical melanocytic proliferations and nonmelanoma skin cancer that can manifest even during childhood.

Circulating fibroblast growth factor-23 increases following intermittent parathyroid hormone (1-34) in postmenopausal osteoporosis: association with biomarker of bone formation.

Uncertainties exist regarding whether FGF-23 production is influenced by PTH and its involvement in bone formation. We evaluated FGF-23 response and its relation to changes in biomarkers of bone formation following intermittent PTH treatment. Twenty-seven women with a mean [SD] age of 75.8 [5.4] years with postmenopausal osteoporosis were treated with PTH(1-34) for 18 months. Bone mineral density (BMD) was measured at 6 and 18 months at the lumbar spine (LS) and total hip (TH). Blood samples were obtained at baseline, 1-3, 6-9, and 12-18 months. Serum calcium, phosphate, PTH, 25(OH)vitamin D, 1,25(OH)(2)vitamin D, markers of bone turnover, FGF-23, and sclerostin were measured. BMD increased at both the LS (11.6%, P < 0.001) and TH (2.5%, P < 0.01). The bone formation marker P1NP increased early (baseline mean [SD] 39.9 [24.4] µg/l, 1-3 months 88 [37.9] µg/l; P < 0.001) and remained higher than baseline throughout 18 months. FGF-23 also increased, with a peak response at 6-9 months (increase 65%, P = 0.002). Serum phosphate remained stable. A significant increase in 1.25(OH)(2)vitamin D (P = 0.02) was seen at 1-3 months only. A small but significant reduction in sclerostin was seen at 6-9 (P = 0.02) and 12-18 months (P = 0.06). There was a positive correlation between changes in P1NP and FGF-23 (6-9 months r = 0.78, P < 0.001). FGF-23 is increased by intermittent PTH(1-34). This is related to early changes in P1NP, suggesting that the skeletal effects of PTH may involve FGF-23. Further studies are required to elucidate this.

4-Methyl-7,8,9,10-tetra-hydro-cyclo-hepta-[b]indol-6(5H)-one.

In the title compound, C(14)H(15)NO, the seven-membered ring exhibits a slightly distorted twist-boat conformation. The pyrrole ring forms a dihedral angle of 1.44 (10)° with the fused benzene ring. N-H⋯O hydrogen bonds form a centrosymmetric dimer and weak C-H⋯π inter-actions are also found in the crystal structure.

4,8-Dimethyl-pyrano[2,3-a]carbazol-2(11H)-one.

The mol-ecule of the title compound, C(17)H(13)NO(2), is nearly planar, the r.m.s. deviation for all non-H atoms excluding the two methyl C atoms being 0.089 Å. Inter-molecular N-H⋯O and C-H⋯O hydrogen bonds are found in the crystal structure. C-H⋯π inter-actions are also found. The H atoms of the methyl group attached to the benzene ring are disordered equally over two positions.

Biosorption of trivalent chromium by free and immobilized blue green algae: kinetics and equilibrium studies.

The process of biosorption of trivalent chromium (Cr(3+)) by live culture of Spirulina platensis and the sorption potential by the dried biomass, in both free and immobilized states have been investigated for a simulated chrome liquor in the concentration range of 100-4500 ppm. Both live and dried biomass were very good biosorbents as they could remove high amounts of chromium from tannery wastewater. Polyurethane foam and sodium alginate were used as immobilizing agents and their performances compared. Biosorption kinetic data on Cr(3+) sorption onto dried biomass were analyzed using pseudo-first-and pseudo-second-order kinetic models in batch column experiments. The second-order equation was more appropriate to predict the rate of biosorption. Subsequently, the effects of height of packing & diameter of the column, concentration of blue-green algae (BGA) in varying amounts of sodium alginate, chromium concentration were studied. The results fit into both Langmuir & Freundlich isotherm models with very high regression coefficients. Furthermore, equilibrium studies using retan chrome liquor (RCL), with a chromium concentration of 1660 ppm, obtained from a tannery also showed promising results. In general, our studies indicate the efficacy of the algal species in removal of chromium from tannery wastewater.

7,8,9,10-Tetra-hydro-cyclo-hepta-[b]indol-6(5H)-one.

In the title mol-ecule, C(13)H(13)NO, the dihedral angle between the benzene and pyrrole rings is 1.05 (5)°. The cyclo-heptene ring adopts a slightly distorted boat conformation. In the crystal structure, inter-molecular N-H⋯O hydrogen bonds form centrosymmetric dimers. A C-H⋯π inter-action, involving the benzene ring, is also found in the structure.

6-Meth-oxy-2,3,4,9-tetra-hydro-1H-carbazol-1-one.

The carbazole unit of the title mol-ecule, C(13)H(13)NO(2), is not planar. The dihedral angle between the benzene ring and the pyrrole ring is 1.69 (6)°. The cyclo-hexene ring adopts an envelope conformation. Inter-molecular C-H⋯O and N-H⋯O hydrogen bonds are present in the crystal structure. A C-H⋯π inter-action, involving the benzene ring, is also found in the crystal structure.

6-Chloro-3,4-di-hydro-9H-carbazol-1(2H)-one.

The carbazole unit of the title mol-ecule, C(12)H(10)ClNO, is not planar. The dihedral angle between the benzene and pyrrole rings is 1.35 (10)°. The cyclo-hexene ring adopts an envelope conformation. In the crystal structure, inter-molecular N-H⋯O hydrogen bonds form centrosymmetric dimers.

Antianginal response to once-daily diltiazem CD in patients receiving concomitant beta-blockers, long-acting nitrates, or both. Diltiazem CD Study Group.

STUDY OBJECTIVE: To determine the safety and efficacy of diltiazem CD 180 mg administered once/day in patients with chronic stable angina inadequately controlled with P-blockers, long-acting nitrates, or both. DESIGN: Multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. SETTING: Medical clinics in the private and academic sectors. PATIENTS: Of 172 patients, 170 completed the 2-week double-blind treatment period. INTERVENTION: . Patients received either diltiazem CD 180 mg or placebo once/day in combination with existing antianginal therapy. MEASUREMENTS AND MAIN RESULTS: The time to termination of exercise tolerance testing, 24 hours after the dose increased significantly in the diltiazem CD group (37.2 sec) compared with the placebo group (21.3 sec, p=0.0438). Time to onset of angina during exercise testing also increased (57.6 vs 35.0 sec, respectively, p=0.0324), as did time to moderate angina (37.5 vs 20.6 sec, respectively, p=0.0354). The rates of total angina attacks and of angina attacks on exertion were significantly reduced in the diltiazem CD group versus placebo (p<0.05). Significant reductions in systolic and diastolic blood pressures and heart rate-blood pressure product measured at rest, submaximum exercise, and exercise termination were observed in diltiazem CD-treated patients compared with placebo (p<0.05). The frequency of treatment-related adverse events was identical in the two groups, 15.1%. CONCLUSION: Diltiazem CD 180 mg once/day is an effective, safe, and beneficial initial dosage when added to existing antianginal therapy.

The comparative predictive accuracy of spectral turbulence analysis and time-domain analysis for sustained monomorphic ventricular tachycardia in postinfarction patients with conduction defects.

Signal-averaged electrocardiograms obtained in 86 postinfarction patients with right bundle branch block (RBBB), left bundle branch block (LBBB), or intraventricular conduction defect (IVCD), underwent time-domain analysis (TDA) and spectral turbulence analysis (STA) to determine which approach provided the more effective marker for patients with sustained monomorphic ventricular tachycardia. TDA parameter included the root mean square value of the last 40 ms of the vectormagnitude complex and the duration of the low amplitude signal below 40 microV. STA utilized a summation lead (X + Y + Z) and quantitated four parameters: interslice correlation mean, interslice correlation standard deviation, low slice correlation ratio, and spectral entropy. High-pass filters of 40 Hz and 25 Hz were used to study the total patient population with noise levels > or = microV and a subset of 67 patients with noise levels < or = 0.5 microV. The techniques compared their effectiveness as measured by their positive predictive values (PPV), negative predictive values (NPV), sensitivity (Sn), and specificity (Sp). In RBBB, STA was uniformly a more powerful tool utilizing either filter at both noise levels. In LBBB, STA was consistently more powerful at both noise levels at 40 Hz and, generally, more powerful at 25 Hz with isolated exceptions. In conduction defects in which QRS was > 100 ms but < 120 ms, TDA was equal to or more effective than STA, with the exception of PPV and Sp at 40 Hz at 1-microV noise level and the Sp at 0.5 microV. The addition of ejection fraction data to STA score resulted in further overall improvement in performance, but above conclusions were unchanged.

Relation of peri-infarction block to ventricular late potentials in patients with inferior wall myocardial infarction.

This study explores the relation of the presence of peri-infarction block to ventricular late potentials in patients with inferior wall myocardial infarction (MI). The hypothesis was that both the gross peri-infarction block pattern and subtle low-level ventricular late potentials are expressions of conduction abnormality associated with infarction. The consequent question arose whether peri-infarction block may have the same association with sustained ventricular arrhythmias that has been demonstrated in postinfarction patients with ventricular late potentials. Seventy patients with documented Q-wave MI were divided into those with (23) and those without (47) peri-infarction block. Signal-averaged electrocardiograms were obtained. Analysis of the vectormagnitude complex revealed that the total duration of that complex and the duration of terminal potential under 40 microV in the peri-infarction group exceeded that in the group without peri-infarction block (p less than 0.0001). The voltage in the last 40 ms of the vectormagnitude complex was also significantly less in the peri-infarction group (p less than 0.0005). There were 13 instances of sustained ventricular tachycardia, ventricular fibrillation or sudden death occurring subsequent to infarction not associated with the acute ischemic event, 11 of which occurred in the peri-infarction group. The significantly higher incidence of late potentials along with the significantly higher incidence of sustained ventricular arrhythmias in the peri-infarction block on the surface electrocardiogram may provide another marker for identifying persons at increased risk for these arrhythmias subsequent to MI.

Patterns of body surface potential and ventriculograms specific to occlusion of subdivisions of the coronary arteries.

The thoracic activation map patterns, the distribution of occlusions, and the ventriculograms obtained at cardiac catheterization were examined in 166 patients with multivessel coronary disease without conduction defects or prior coronary intervention. The mean potential and ventriculographic configurations were determined for 15 groups, each formed on the basis of significant luminal occlusion (less than or equal to 90%) of an individual coronary arterial subdivision. We mathematically extracted distinctive map and wall motion patterns specific for isolated occlusion of each of the 15 major subdivisions. For these prototypes we found the following: 1) Definitive change in electrical pattern (less than 2 SD from the normal mean) occurred frequently outside the electrode sites of the standard electrocardiogram. 2) Focal akinesis systematically followed lesion site down the arterial courses; early electrical activation patterns corresponded to identifiable anatomic loss. 3) Certain paradoxes arose, for example, similar wall motion change but quite dissimilar electrical patterns from posterior descending artery occlusion of right coronary versus left circumflex origin. This technique unmasks component surface electrical patterns and ventriculographic deformities otherwise unrecognized in multisite, multivessel disease.