Parker Solar Probe Enters the Magnetically Dominated Solar Corona.

The high temperatures and strong magnetic fields of the solar corona form streams of solar wind that expand through the Solar System into interstellar space. At 09:33 UT on 28 April 2021 Parker Solar Probe entered the magnetized atmosphere of the Sun 13 million km above the photosphere, crossing below the Alfvén critical surface for five hours into plasma in casual contact with the Sun with an Alfvén Mach number of 0.79 and magnetic pressure dominating both ion and electron pressure. The spectrum of turbulence below the Alfvén critical surface is reported. Magnetic mapping suggests the region was a steady flow emerging on rapidly expanding coronal magnetic field lines lying above a pseudostreamer. The sub-Alfvénic nature of the flow may be due to suppressed magnetic reconnection at the base of the pseudostreamer, as evidenced by unusually low densities in this region and the magnetic mapping.

Alfvénic velocity spikes and rotational flows in the near-Sun solar wind.

The prediction of a supersonic solar wind1 was first confirmed by spacecraft near Earth2,3 and later by spacecraft at heliocentric distances as small as 62 solar radii4. These missions showed that plasma accelerates as it emerges from the corona, aided by unidentified processes that transport energy outwards from the Sun before depositing it in the wind. Alfvénic fluctuations are a promising candidate for such a process because they are seen in the corona and solar wind and contain considerable energy5-7. Magnetic tension forces the corona to co-rotate with the Sun, but any residual rotation far from the Sun reported until now has been much smaller than the amplitude of waves and deflections from interacting wind streams8. Here we report observations of solar-wind plasma at heliocentric distances of about 35 solar radii9-11, well within the distance at which stream interactions become important. We find that Alfvén waves organize into structured velocity spikes with duration of up to minutes, which are associated with propagating S-like bends in the magnetic-field lines. We detect an increasing rotational component to the flow velocity of the solar wind around the Sun, peaking at 35 to 50 kilometres per second-considerably above the amplitude of the waves. These flows exceed classical velocity predictions of a few kilometres per second, challenging models of circulation in the corona and calling into question our understanding of how stars lose angular momentum and spin down as they age12-14.

Highly structured slow solar wind emerging from an equatorial coronal hole.

During the solar minimum, when the Sun is at its least active, the solar wind1,2 is observed at high latitudes as a predominantly fast (more than 500 kilometres per second), highly Alfvénic rarefied stream of plasma originating from deep within coronal holes. Closer to the ecliptic plane, the solar wind is interspersed with a more variable slow wind3 of less than 500 kilometres per second. The precise origins of the slow wind streams are less certain4; theories and observations suggest that they may originate at the tips of helmet streamers5,6, from interchange reconnection near coronal hole boundaries7,8, or within coronal holes with highly diverging magnetic fields9,10. The heating mechanism required to drive the solar wind is also unresolved, although candidate mechanisms include Alfvén-wave turbulence11,12, heating by reconnection in nanoflares13, ion cyclotron wave heating14 and acceleration by thermal gradients1. At a distance of one astronomical unit, the wind is mixed and evolved, and therefore much of the diagnostic structure of these sources and processes has been lost. Here we present observations from the Parker Solar Probe15 at 36 to 54 solar radii that show evidence of slow Alfvénic solar wind emerging from a small equatorial coronal hole. The measured magnetic field exhibits patches of large, intermittent reversals that are associated with jets of plasma and enhanced Poynting flux and that are interspersed in a smoother and less turbulent flow with a near-radial magnetic field. Furthermore, plasma-wave measurements suggest the existence of electron and ion velocity-space micro-instabilities10,16 that are associated with plasma heating and thermalization processes. Our measurements suggest that there is an impulsive mechanism associated with solar-wind energization and that micro-instabilities play a part in heating, and we provide evidence that low-latitude coronal holes are a key source of the slow solar wind.

Association of body mass index and waist circumference with severity of knee osteoarthritis.

AIM: The aim of the present study was to investigate the association of the body mass index (BMI) and waist circumference (WC) with the severity of radiographic severity of knee osteoarthritis (rKOA) Methods. A cross-sectional study had been applied during the research which included 150 patients diagnosed at the General Hospital in Uzice and Health Center in Arilje (Serbia). The study included patients over the age of 50 diagnosed with OA according to The European League Against Rheumatism (EULAR) criteria. Data on social-demographic characteristics, health habits, and personal and family histories of the participants were collected through a specific questionnaire designated for this research. The severity of the disease was assessed pursuant to radiological changes using the Кellgren-Lawrence grading scale (K-L). The state of nourishment was assessed according to the BMI and WC. RESULTS: According to multivariate logistic regression analyses, after adjustment on age, sex, marital status, formal education, present occupation, smoking, alcohol consumption and physical activity, higher grades of rKOA (grade III and grade IV) were significantly related to BMI (p = 0.038) and WC (p < 0.001). The association was much stronger for obesity defined as BMI ≥30 kg/m2 (p = 0.002) and for abdominal obesity - WC > 102 cm in men and > 88 cm in women (p = 0.009). CONCLUSION: This study showed that obesity defined as BMI ≥30 kg/m2 and abdominal obesity are strongly related to K-L of rKOA, the associations being of very similar extent.

The FIELDS Instrument Suite for Solar Probe Plus: Measuring the Coronal Plasma and Magnetic Field, Plasma Waves and Turbulence, and Radio Signatures of Solar Transients.

NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.

Relationship Between Pain and CEAP C Categories of Chronic Venous Disease.

In this study, we investigated whether the occurrence and intensity of leg pain are related to C class of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification for chronic venous disease (CVeD). This cross-sectional study, conducted in Serbia, included 2841 patients: 2027 (71.3%) women and 814 (28.7%) men with CVeD diagnosed by general practitioners. For the first time, the Numeric Rating Scale of 0 to 5 units was used to assess the intensity of pain. For the analysis, univariate and multivariate logistic and linear regressions were applied. Pain in the legs was reported by 90.5% of the patients. The occurrence of pain significantly (P < .001) increased with increasing C class. Of the patients who reported pain in the legs, 42.0% had moderate pain, 23.7% had moderate to severe pain, 22.8% had light pain, 11.2% had severe pain, and 0.3% had very severe pain. Severity of pain differed significantly (P < .001) according to C class. Light and moderate pain gradually decreased and severe pain gradually increased from C0 to C6 class. These associations remained significant after adjustment for age, body mass index, and family history of CVeD.

Stressful life events and type 2 diabetes.

OBJECTIVES: The purpose of this study is to compare cases with type 2 diabetes and their controls for the frequency of stressful life events and social support before the occurrence of the disease. METHODS: The study of cases and their controls was undertaken in Belgrade. A case group comprised 179 subjects in whom type 2 diabetes was for the first time diagnosed in the 'Savski Venac' Medical Center during the period 2005-2007 year. The diagnosis was made by a specialist of internal medicine according to criteria of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. For each case two controls were chosen among patients with trauma (fracture, reposition, internal/external fixation) who were treated at the 'Banjica' Institute for Orthopedic-Surgical Diseases during the same period. Cases and controls were matched by sex, age (±2 years) and place of residence (Belgrade). Data were collected on demographic characteristics, habits, personal history, stressful life events, social support and family medical history. RESULTS: According to multivariate analysis low social support in personal history, such as relatives/friends help and financial assistance in solving problems, and bad management of monthly income were significantly positively related to type 2 diabetes. However, significantly more controls than cases had no financial insurance in case of urgent need CONCLUSION: Examine psychosocial factors play a role in the development of type 2 diabetes.

Second look at congenital vascular malformations: current classification, diagnostic and treatment principles.

Congenital vascular malformations (CVMs) are not rare disorders, with the overall incidence of 1.5%. Due to their complex embryology and various clinical presentations, there was a long lasting confusion among vascular specialists regarding the etiology, classification, basic principles of evaluation and treatment of these anomalies. The introduction of the Hamburg classification and its adoption by experts around the world made further studies of CVMs and comparison of results among different specialists possible. Precise diagnosis of the type and extent of the malformation is paramount for the choice of adequate treatment. In most instances this can be achieved with a detailed history, careful physical examination and a combination of appropriate non-invasive studies. Invasive tests should be reserved for confirmation of diagnosis and serve as a road map for treatment planning. Modern treatment of CVMs is based on a multidisciplinary team approach involving specialists in vascular surgery, interventional radiology, pediatrics, nuclear medicine, orthopedic surgery, plastic and reconstructive surgery and physical therapy. Surgical and endovascular techniques are used in conjunction to minimize morbidity and improve treatment outcomes.

Reversal of novelty-induced hyperlocomotion and hippocampal c-Fos expression in GluA1 knockout male mice by the mGluR2/3 agonist LY354740.

Dysfunctional glutamatergic neurotransmission has been implicated in schizophrenia and mood disorders. As a putative model for these disorders, a mouse line lacking the GluA1 subunit (GluA1-KO) of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor displays a robust novelty-induced hyperlocomotion associated with excessive neuronal activation in the hippocampus. Agonists of metabotropic glutamate 2/3 receptors (mGluR2/3) inhibit glutamate release in various brain regions and they have been shown to inhibit neuronal activation in the hippocampus. Here, we tested a hypothesis that novelty-induced hyperlocomotion in the GluA1-KO mice is mediated via excessive hippocampal neuronal activation by analyzing whether an mGluR2/3 agonist inhibits this phenotypic feature. GluA1-KO mice and littermate wildtype (WT) controls were administered with (1S,2S,5R,6S)-2-aminobicyclo[3.1.0]hexane-2,6-dicarboxylic acid (LY354740) (15 mg/kg, i.p.) 30 min before a 2-h exposure to novel arenas after which c-Fos immunopositive cells were analyzed in the hippocampus. LY354740 (15 mg/kg) decreased hyperactivity in male GluA1-KO mice, with only a minimal effect in WT controls. This was observed in two cohorts of animals, one naïve to handling and injections, another pre-handled and accustomed to injections. LY354740 (15 mg/kg) also reduced the excessive c-Fos expression in the dorsal hippocampal CA1 pyramidal cell layer in maleGluA1-KO mice, while not affecting c-Fos levels in WT mice. In female mice, no significant effect for LY354740 (15 mg/kg) on hyperactive behavior or hippocampal c-Fos was observed in either genotype or treatment cohort. A higher dose of LY354740 (30 mg/kg) alleviated hyperlocomotion of GluA1-KO males, but not that of GluA1-KO females. In conclusion, the excessive behavioral hyperactivity of GluA1-KO mice can be partly prevented by reducing neuronal excitability in the hippocampus with the mGluR2/3 agonist suggesting that the hippocampal reactivity is strongly involved in the behavioral phenotype of GluA1-KO mice.

Body mass index and primary chronic venous disease--a cross-sectional study.

OBJECTIVES: This study aims to investigate whether overweight and obesity are related to the clinical (C) category of clinical, etiologic, anatomic and pathophysiologic (CEAP) classification of chronic venous disease (CVD). DESIGN: A cross-sectional study. MATERIALS AND METHODS: The study was conducted in Serbia, in the year 2011. Men and women aged >18 years, consecutively coming to venous specialists because of venous problems in the legs, were included in the study. Patients demographic, anthropometric and clinical data were collected. For the analysis, univariate and multivariate logistic regressions were used. RESULTS: The study comprised 1116 subjects with primary CVD, 384 (34.4%) men and 732 (65.6%) women. Among them 464 (41.6%) were normal-weight patients (body mass index (BMI) < 25.0 kg m(-2)), 476 (42.7%) were overweight (BMI = 25.0-29.9 kg m(-2)) and 176 (15.8%) were obese (BMI ≥ 30.0 kg m(-2)). According to multivariate analysis, the CEAP C category of CVD was significantly more advanced in overweight and obese patients, the association being more pronounced in obese. Compared groups did not differ in the presence of venous reflux. In univariate analysis, venous obstruction was related to overweight and obesity but this association did not substantially affect the relationship between obesity and CEAP C categories of CVD. CONCLUSION: The CEAP C categories of CVD were significantly related to overweight and obesity, and this association was independent of age, sex and some other postulated risk factors.

The influence of alcohol intoxication on the severity of injuries suffered by drivers in road traffic accidents.

PURPOSE: To determine the severity of injuries in drunk and sober drivers in traffic accidents, by using the Injury Severity Score (ISS), as well as the most vulnerable body region of those involved. METHODS: This was an observational case-control study covering a 1-year period of patients treated in the emergency department of the Health Center in Kraljevo, Serbia. Seventy-five patients were identified as drunken drivers [blood alcohol concentration (BAC) >0.03 %] (group of cases), while 70 patients were found to be sober drivers (group of controls). Injuries were categorized by body region according to the ISS. RESULTS: Half of all drivers (51.7 %) injured in traffic accidents were under the influence of alcohol. Males represented a substantial majority of both groups. In both categories of drivers, the greatest incidence of traffic accidents was in the age group 19-35 years. Injuries of drunken drivers were more frequently present in all body regions except in the areas of limbs with shoulder and pelvic bones. Drivers under the influence of alcohol have a 3.80 times greater risk of suffering deadly injuries in traffic accidents. The average ISS in drunken drivers was higher in comparison to sober drivers (p < 0.05). The greatest ISS was in the drunk group with BAC level over 0.051 % (the ISS range was 15-20). A strong correlation was found between the BAC level and the degree of injury (r = 0.63). CONCLUSION: The severity of injuries and, especially, the 3.80 times greater risk of suffering deadly injuries in traffic accidents for drunken drivers obliges us to pay attention to prevention strategies.

Risk factors for chronic venous disease.

OBJECTIVE: Chronic venous disease (CVD) is a common problem in developing and developed countries. METHODS: A cross-sectional study, conducted in two major towns in Serbia, comprised 3225 subjects over 18 years old, enrolled in the survey consecutively by general practitioners (GPs) within their normal framework. Diagnosis of CVD was made by GPs on the basis of symptoms and visual examination. Data on potential risk factors were collected by the use of a questionnaire. RESULTS: The prevalence of CVD was significantly higher in women (73.7%) than in men (70.1%), although severe forms of CVD were significantly more frequent in men. Risk factors for CVD were age, body mass index ≥ 25.00 kg/m(2), family history of CVD, history of blood clots in veins and ever-smoking in both sexes, and menopause, increased number of child births and physical inactivity in women. CONCLUSION: The results obtained suggest the possibility of CVD prevention by modification of some behavioural risk factors.

Postmenopausal palpable ovary and ovarian cancer.

INTRODUCTION: Ultrasound (US) examination is a much more reliable method for evaluation of potential ovarian cancer risk than gynecologic palpation. The aim of our study was to analyze the US characteristics of patients with palpable ovaries in light of potential for malignancy. PATIENTS AND METHODS: We analyzed 70 women ten years after menopause without increased CA 125 values. They underwent clinical and US exams (abdominal and transvaginal ultrasound), with special emphasis on US Doppler exam. RESULTS: Bimanuel gynecological examination showed palpable ovaries in 14 patients (palpable ovary group), and the remaining 56 patients were defined as the control group. US showed increased dimensions of palpable ovaries. Atypical follicular activity, deviation from verticalization, atypical ovaries and hyperechogenic punctations classified under germ cell cysts occurred statistically significantly more often in the palpable ovary group. Doppler flow showed pathological vascularization in five patients with palpable ovaries and the estrogen level was increased. After four to six months in these five patients we found a mild increase of estrogen levels and higher Doppler abnormality. Six months later, two patients had irregular bleeding and underwent surgical treatment. CONCLUSION: Every adnexal mass after menopausis demands special attention. Bimanuel gynecological exams should be used liberally. It is necessary to follow the dimensions of the ovary, describe the echostructure, as well as the edges of the ovary and other anatomical structures. Doppler flow measurement and estrogen levels are predictive and give more information. Controls should be in three to six month intervals in order to make a decision for surgical treatment.

Usefulness of beta hCG as tumor marker in the diagnosis and follow up of patients with ovarian cancer.

PURPOSE: To test the possibility of using beta human chorionic gonadotropin (ß-hCG) as a tumor marker in ovarian cancer by determining its diagnostic and prognostic value, and see for any relationship between disease stage, histological tumor types and serum and ascitic fluid ß-hCG levels, as well as to identify false positive and false negative results. METHODS: This was a prospective study in 60 surgically treated patients with ovarian cancer in the period 2006- 2010. The diagnosis was confirmed postoperatively based on the histopathological findings and the continuous determination of ß-hCG serum levels, during the 2 postoperative years at regular quarterly intervals. The obtained results were statistically processed using multivariate analysis. RESULTS: ß-hCG showed no reliable diagnostic value in ovarian cancer. A statistically significant difference between serum ß-hCG levels and different FIGO stages was noted, but not between ß-hCG levels and different histological groups of tumors. There were 10.2% of false positive and 18.9% of false negative results in all measurements. CONCLUSION: The use of ß-hCG as a tumor marker for ovarian cancer is justified only in patients with preoperatively high levels in advanced FIGO stages (III and IV), regardless of histological type of tumor.

Relationship between education and atherosclerotic disease risk factors in patients with peripheral arterial disease.

AIM: The aim of the present study was to investigate whether different levels of education are associated with different atherosclerotic disease risk factors. METHODS: The cross-sectional study, involving 388 consecutive patients with verified peripheral arterial disease, was performed in Belgrade. Formal education level was used as a proxy for socioeconomic status. Anthropometric parameters and data on cardiovascular risk factors were analyzed in participants with different levels of education. In the analysis, univariate and multivariate logistic regressions were used. RESULTS: Multivariate analysis showed that low education was significantly positively related to alcohol consumption (Odds Ratio - OR, 4.67; 95% confidence interval - CI, 1.80-12.12), increased triglycerides (OR, 2.73; 95% CI, 1.13-6.61), and physical activity during work (OR, 43.10; 95% CI 14.37-129.28), and negatively related to former smoking (OR, 0.11; 95% CI, 0.03-0.46) and sports and leisure - time physical activity (OR, 0.13; 95% CI, 0.04-0.41 and OR, 0.25; 95% CI, 0.11-0.57). Medium education was significantly positively related to increased triglycerides (OR, 1.74; 95% CI 1.01-2.98) and increased LDL-cholesterol (OR 2.37; 95% CI, 1.35-4.18), and to physical activity during work (OR, 2.22; 95% CI, 1.34-3.67), and negatively related to age (OR, 0.95; 95% CI, 0.92-0.98) and leisure - time physical activity (OR, 0.47; 95% CI, 0.30-0.74). CONCLUSION: It can be concluded that if there are differences in the risk of the occurrence of peripheral arterial disease by education status, they could be only partly explained by differences in the observed atherosclerotic disease risk factors.

Vulvar neoplasm and reconstruction of a lesion with a vertical rectus abdominis myocutaneous flap: case report.

A 41-year-old nulliparous woman was admitted to the Institute of Gynecology and Obstetrics in 2007 with a painless tumor mass invading the whole vulvoperineal and gluteal region. Pathohistological biopsy revealed FIGO Stage II squamocellular invasive carcinoma, but clinically it was Stage IVa verucal vulvar carcinoma because of malignant infiltration to the distal part of the vagina and bilateral gluteal region. The patient underwent radical vulvectomy with bilateral inguinofemoral lymphadenectomy and partial vaginectomy. Reconstruction was performed after three weeks using a distally based vertical rectus abdominis myocutaneous flap (VRAM). A new entrance of the vagina was created. The patient was further treated with radiation therapy.

Radical abdominal trachelectomy in managing early cervical invasion.

The purpose of the study was to determine if radical abdominal trachelectomy with pelvic lymphadenectomy could be a method for treatment of early cervical cancer to preserve fertility. We examined 12 patients who were surgically treated from 2002 to 2006. The diagnostic method to determine cervical cancer was histologic examination by cone or biopsy. The histologic condition was well differented planocellular carcinoma. Two of the patients had Stage Ia1, seven had Ia2, and three had Ib1. We performed radical abdominal trachelectomy with pelvic lymphadenectomy. Resection edges were pathohistologically analyzed extemporaneously, as well as selective lymph nodes. According to the extempore analysis we determined if radical trachelectomy should be done. In one patient resection edges were positive, so she underwent radical hysterectomy. Postoperatively we found a positive lymph node in one patient, so radiation therapy was continued. In the two-year follow-up period we did not find any signs of residual cancer. We concluded that radical trachelectomy with pelvic lymphadenectomy could be an appropriate method for treatment of early-stage cervical cancer.

Radicality of surgical treatment for cervical cancer.

Analyses were carried out on 545 Wertheim-Meigs radical hysterectomies performed at the Institute of Gynecology and Obstetrics of the Clinical Center of Serbia during a four-year period from 2002 to 2006. More than ten lymphatic glands in 84.4% of patients were removed. The apical part of the vagina was removed in 77.8% of cases, and 77.6% of patients had the right part of the vagina removed. Distribution of surgical radicality according to FIGO stage of disease has been demonstrated. Comparison of research results in the period from 1996 to 2000 shows a significantly more radical approach concerning the number of lymphatic glands removed during this period.

A pilot examination of social context and everyday physical activity among adults receiving Community Mental Health Services.

OBJECTIVE: Community mental health center (CMHC) clients include a variety of people with moderate to severe mental illnesses who also report a number of physical health problems. Physical activity (PA) has been identified as one intervention to improve health among this population; however, little is known about the role of social context in PA. The purpose of this study was to examine the role of social context in everyday PA among CMHC clients. METHOD: Data were collected from CMHC clients in two cultures using accelerometery and experience sampling methods. Data were analyzed using hierarchical linear modeling. RESULTS: Independence in housing nor culture was significantly associated with levels of PA. Being alone was significantly negatively related to PA level. CONCLUSION: Social isolation appears to be negatively related to PA at the level of everyday life. Physical activity interventions with this population should consider including social components as a part of PA.

Medicamentous treatment of chronic venous insufficiency using semisynthetic diosmin--a prospective study.

INTRODUCTION: Chronic venous insufficiency (HVI) is manifested by the progressive signs of venous stasis. This disorder is treated by: compressive bandaging, medicaments, sclerotherapy, surgery, etc. AIM: Prospective study of the effects of semisynthetic diosmin (clinical signs, quality of life, local biochemical parameters) on patients with HVI to whom no other method of treatment has previously been administered. METHOD APPLIED: This prospective study analysed the presence of risk factors and personal history of 80 patients with HVI. Diagnosis of HVI was based on the clinical apperance and the color duplex scan. Each patient's clinical signs (pain, oedma, feeling of heaviness and tightness in the lower leg), quality of life (physical, social, and psychological), and CEAP stage were assessed prior to and 30 days after the treatment with Phlebodia 600. For 15 patients with unilateral varicose veins, local values of lactates and gass analysis were taken under the conditions before and following the static load, and venous control samples were taken from the healthy leg. The acquired data were processed by means of descriptive statistics, while the significance of nonparametric features was measured by Wilcoxon test. RESULTS: HVI is somewhat more frequent among females than among mails, on the left than on the right leg, and at the average age of 52.3 +/- 10.5. The patients with HVI are basicly engaged in professions with static load and have positive family history. The patients mainly started medical treatment 12.5 +/- 8.6 years after the first symptoms of the disease. Clinical improvement was recorded on the state of 65/80 patients. After the treatment numerical values of some of the clinical signs were statisticaly lower compared to the values before the administration of semisynthetic diosmin: oedema (0.94:1.50), pain (1.10:1.84), feeling of heaviness (1.20:1.96), and tightness (1.14:1.78). After the administration of the tested medication, parameters of physical, social, and psychological quality-of life were significantly improved (p<0,0001), accompanied with significantly improved (p<0,0001) CEAP stage of HVI (3.00:3.40). Local biochemical parameters had not been significantly changed. CONCLUSION: Administration of semisynthetic diosmin during 30 days results in significant improvement of clinical signs, quality of life and CEAP stage of HVI.