[Effects of cortical bone trajectory screw in adjacent-segment disease after posterior lumbar interbody fusion].

Objective: To investigate the effect of the cortical bone trajectory (CBT) screw fixation combined with midline lumbar fusion (MIDLF) for adjacent spondylopathy after posterior lumbar interbody fusion. Methods: A retrospective analysis was conducted in 16 patients, including 9 males and 7 females, with a mean age of (68±6) years, who underwent revision surgery for adjacent spondylopathy after posterior lumbar fusion surgery using CBT combined with MIDLF technology in Sir Run Run Shaw Hospital, Zhejiang University from May 2013 to August 2019. The reasons for revision were radiculalgia in 4 cases, intermittent claudication in 10 cases and protrusive dissociate in 2 cases. Eleven cases had 1 segment fused in the first operation, while the other 5 cases received fusion in 2 segments. The average interval time between the first operation and the revision operation was (7.5±2.0) years. For the levels underwent revision, 1 case was L2/3, 6 cases were L3/4, 7 cases were L4/5 and 2 cases were L5/S1. Before the operation, all the patients took X-rays scans of the thoracic and lumbar spine. CT and MRI scans were also performed. The operation time, intraoperative bleeding, surgical complications, visual analog scale (VAS) of low back and leg pain before the operation and at each follow-up were all recorded. Oswestry disability index (ODI) questionnaire was used to evaluate the functional improvement of patients after the operation. Results: All operations were completed successfully. The operation time was 120-240 (170±30) mins, intraoperative bleeding was 100-280 (220±45) ml. One case had a slight split in the isthmus, and the screw was inserted smoothly after adjusting the insertion point. In one case, the cerebrospinal fluid leaked during the operation and was successfully treated with conservative methods including no pillow supine treatment and strengthened anti-infection. The average follow-up time was of (19.5±1.3) months. The VAS of low back pain was 2.9±1.7 before the operation and it was 1.8±0.5 at the last follow-up, and the difference was statistically significant (P<0.01). The VAS of leg pain was 5.9±1.5 before the operation and it was 1.5±0.4 at the last the follow-up (P<0.01). The ODI score was 34.5±3.2 preoperatively and it decreased to 12.6±4.2 at the last follow-up, the difference was statistically significant (P<0.01). Conclusion: CBT technique combined with MIDLF for the adjacent-segment disease after posterior lumbar interbody fusion is minimally invasive and convenient, with good clinical effects. This technique can be used as an option for the revision of adjacent spondylopathy.

The effects of acute hyponatraemia on bone turnover in patients with subarachnoid haemorrhage: A preliminary report.

CONTEXT: Animal data and cross-sectional human studies have established that chronic hyponatraemia predisposes to osteoporosis; the effects of acute hyponatraemia on bone turnover have not been determined. Our objective was to test the hypothesis that acute hyponatraemia leads to dynamic effects on bone turnover. DESIGN: A prospective observational pilot study. METHODS: Bone turnover markers [C-terminal crosslinking telopeptide of type 1 collagen (CTX-1), N-propeptide of type 1 collagen (P1NP) and osteocalcin] were measured prospectively over one week in 22 eunatraemic patients with subarachnoid haemorrhage. Patients treated with glucocorticoids were excluded. RESULTS: Eight patients developed acute hyponatraemia, median nadir plasma sodium concentration 131 mmol/L (IQR 128-132), and 14 remained eunatraemic, nadir plasma sodium concentration 136 mmol/L (IQR 133-137). Significant main effects of hyponatraemia were found for P1NP (p = .02) and P1NP:CTX-1 ratio (p = .02), both fell in patients with acute hyponatraemia, with significant interaction between hyponatraemia and time from baseline for P1NP (p = .02). Significant main effects of time from baseline (p < .001) but not hyponatraemia (p = .07) were found for osteocalcin. For CTX-1, significant main effects of time from baseline (p = .001) but not hyponatraemia (p = .65) were found. There was a positive correlation between change in P1NP:CTX-1 ratio and nadir plasma sodium concentration, r = +.43, p = .04. Median serum cortisol (measured on days 1, 3 and 7) was higher in the hyponatraemia group than in those who remained eunatraemic, 545 nmol/L (IQR 373-778) versus 444 nmol/L (IQR 379-542) p = .03. CONCLUSION: These data suggest that acute mild hyponatraemia is associated with a reduction in bone formation activity.

GSK3ß Impairs KIF1A Transport in a Cellular Model of Alzheimer's Disease but Does Not Regulate Motor Motility at S402.

Impairment of axonal transport is an early pathologic event that precedes neurotoxicity in Alzheimer's disease (AD). Soluble amyloid-ß oligomers (AßOs), a causative agent of AD, activate intracellular signaling cascades that trigger phosphorylation of many target proteins, including tau, resulting in microtubule destabilization and transport impairment. Here, we investigated how KIF1A, a kinesin-3 family motor protein required for the transport of neurotrophic factors, is impaired in mouse hippocampal neurons treated with AßOs. By live cell imaging, we observed that AßOs inhibit transport of KIF1A-GFP similarly in wild-type and tau knock-out neurons, indicating that tau is not required for this effect. Pharmacological inhibition of glycogen synthase kinase 3ß (GSK3ß), a kinase overactivated in AD, prevented the transport defects. By mass spectrometry on KIF1A immunoprecipitated from transgenic AD mouse brain, we detected phosphorylation at S402, which conforms to a highly conserved GSK3ß consensus site. We confirmed that this site is phosphorylated by GSK3ß in vitro Finally, we tested whether a phosphomimic of S402 could modulate KIF1A motility in control and AßO-treated mouse neurons and in a Golgi dispersion assay devoid of endogenous KIF1A. In both systems, transport driven by mutant motors was similar to that of WT motors. In conclusion, GSK3ß impairs KIF1A transport but does not regulate motor motility at S402. Further studies are required to determine the specific phosphorylation sites on KIF1A that regulate its cargo binding and/or motility in physiological and disease states.

[Antibacterial effectiveness of calcium silicate-based root canal sealer against Enterococcus faecalis biofilms in infected dentinal tubules in vitro].

Objective: To evaluate the antiseptic effect of combined using of 5% sodium hypochlorite and calcium silicate-based root canal sealer against Enterococcus faecalis (Ef) biofilms in infected dentinal tubules in vitro. Methods: Cells of Ef were inoculated into the dentinal tubules of single-rooted teeth (without caries, periapical lesions and malformations extracted due to periodontal disease or orthodontic reasons; collected from Department of Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University) with centrifugation and incubated in brain-heart infusion (BHI) to form 3-week-old biofilms. The infected samples were subjected to sodium hypochlorite or sterile water bathing for 10 minutes followed by calcium silicate-based root canal sealer (iRoot SP) (calcium silicate-based group), Gutta-percha group and sterile water group placed on the root canal wall for 1, 4 and 12 weeks. There were two samples in each treatment at each point. The antiseptic effectiveness of combined use of sodium hypochlorite and calcium silicate-based root canal sealer was analyzed by laser scanning confocal microscope (LSCM), ANOVA and LSD-t test. Results: After treatment with 5% sodium hypochlorite, in calcium silicate-based group for 4 and 12 weeks more Ef biofilm cells [(75.3±3.5)% and (74.8±3.8)%] were killed than in Gutta-percha group [(65.9±4.1)% and (63.0±3.7)%] and sterile water group [(63.9±4.0)% and (64.2±3.5)%] (P<0.05). After being treated with sterile water, the proportion of dead bacterial cells in calcium silicate-based group for 1, 4 and 12 weeks [(27.5±4.6)%, (43.0±4.4)% and (40.3±6.1)%] were more than those in Gutta-percha group and sterile water group (P<0.05). After being treated with 5% sodium hypochlorite or sterile water, more biofilm bacteria were killed in calcium silicate-based group for 4 and 12 weeks than in calcium silicate-based group for 1 week (P<0.05). Conclusions: The combined use of sodium hypochlorite and calcium silicate-based root canal sealer kills more biofilm cells in infected dentinal tubules.

[Stress and electrochemical corrosion of titanium produced by laser rapid forming].

Objective: To investigate the stress corrosion and electrochemical corrosion resistance of titanium produced through laser rapid forming (LRF), and to provide a basis for their clinical application. Methods: Forged commercial pure titanium (CP-Ti) was used as control group and LRF pure titanium was used as LRF group. All samples were placed in acidic artificial saliva containing fluorine (pH=7), and loaded with a stress of 1.2 × σ(0.2) Pa (σ(0.2) represents the yield strength of material). Stress corrosion resistance of specimens that have been soaked for 30 days was analyzed by naked eye observation, X-ray diffraction analysis and scanning electron microscopy. For samples placed in artificial saliva, neutral fluoride solution (pH=7) and acidic fluoride solution (pH=3) (4 test pieces in each corrosive medium), and their electrochemical corrosion resistance was evaluated by free corrosion potential (Ecorr) measurements, corrosion current (Icorr), electrochemical impedance spectroscopy (EIS), and anodic polarization curves. Results: With the prolongation of immersion time, the corrosion products gradually increased. The stress corrosion of CP-Ti group was significantly more than that of LRF-Ti group, and the pit diameter was significantly larger than that of LRF-Ti group. The electrochemical corrosion results showed that the Ecorr (-469 mV) of LRF-Ti in artificial saliva was higher than that of CP-Ti (-555 mV), and the Ecorr (-925 mV) of LRF-Ti was higher than that of CP-Ti (-943 mV) in neutral fluoride solution. In acid fluoride solution, the Ecorr (-943 mV) of LRF-Ti was higher than that of CP-Ti (-956 mV). The Ecorr of the same metal was the highest in artificial saliva and the lowest in acid fluoride solution; the Icorr of the same metal was the lowest in artificial saliva and the highest in acid fluoride solution. Conclusions: Under the same corrosion conditions, LRF Ti demonstrated better stress and electrochemical corrosion resistance than CP-Ti.

Experimental upper bound and theoretical expectations for parity-violating neutron spin rotation in 4He.

Neutron spin rotation is expected from quark-quark weak interactions in the standard model, which induce weak interactions among nucleons that violate parity. We present the results from an experiment searching for the effect of parity violation via the spin rotation of polarized neutrons in a liquid 4He medium. The value for the neutron spin rotation angle per unit length in 4He, d ϕ / d z = [ + 2.1 ± 8.3 (stat.) - 0.2 + 2.9 (sys.) ] × 10 - 7 rad/m, is consistent with zero. The result agrees with the best current theoretical estimates of the size of nucleon-nucleon weak amplitudes from other experiments and with the expectations from recent theoretical approaches to weak nucleon-nucleon interactions. In this paper we review the theoretical status of parity violation in the n → + 4He system and discuss details of the data analysis leading to the quoted result. Analysis tools are presented that quantify systematic uncertainties in this measurement and that are expected to be essential for future measurements.

[Killing activity of nonequilibrium plasma against young and old Enterococcus faecalis biofilms with long-term exposure in infected root canals in vitro].

Objective: To evaluate the antimicrobial activity of nonequilibrium plasma against Enterococcus faecalis (Ef) biofilms in vitro and to obtain novel evidence of root canal disinfection with nonequilibrium plasma. Methods: Sterile cover slips and single-rooted canals were filled with Ef and incubated to form 1-week-old and 3-week-old biofilms, respectively. The infected samples were subjected to nonequilibrium plasma, 2% chlorhexidine digluconate (CHX) and saline for 3, 10 and 30 minutes, respectively. After treatment, the killing effectiveness of nonequilibrium plasma was analyzed by using laser scanning confocal microscopy (LSCM) and colony forming unit (CFU) counting. Results: The 3-dimentional reconstruction LSCM images showed that about 48.3%-79.8% of 1-week-old Ef biofilm cells and 40.0%-67.4% of 3-week-old biofilm cells were killed by nonequilibrium plasma and 2% CHX compared to saline (P<0.05). The proportion of killing activity was lower after 3 minutes (40.0%-50.9% killing) than after 10 minutes (65.3%-77.8% killing) and 30 minutes (66.4%-79.8% killing) (P<0.05). And the killing of biofilm bacteria was fastest during the first 3 minutes (13.3%-17.0% killing per minute) and slow down greatly after 10 minutes. Remarkably more bacteria were killed in 1-week-old Ef biofilms (48.3%-79.8% killing) than in 3-week-old biofilms (P<0.05). Conclusions: The nonequilibrium plasma killed more Ef biofilm cells in infected root canals showed promotional as an additional approach against bacterial biofilms during root canal disinfection.

Contactless respiration rate measurement using optical method and empirical mode decomposition.

BACKGROUND: At the emergency triage center, assessment of the present of the danger signs and measurement of vital signs are measured according to the guidelines. The respiration rate is still posing a challenge to the doctor as it is impractical to use conventional devices. Attaching measurement devices to the patient will induce artificial measurements (self-awareness stress effects) besides being time-consuming. Currently, the medical officers visually count the number of times the chest movement in a minute, sometimes poses cultural challenges especially for female patients. OBJECTIVE: The main objective of this paper is to develop a robust algorithm to extract respiration rate using the contactless displacement sensor. METHODS: In this study, chest movements were used as an indicative of inspiration and expiration to measure respiratory rate using the contactless displacement sensor. The contactless optical signals were recorded from 32 healthy subjects in four different controlled breathing conditions: rest, coughing, talking and hand movement to obtain the motion artifacts that the patients may have in the emergency department. The Empirical mode decomposition (EMD) algorithm was used to derive continuous RR signal from the contactless optical signal. RESULTS: The analysis showed that there is a good correlation (0.9702) with RMSE of 0.33 breaths per minutes between the contact respiration rate and contactless respiration rate using empirical mode decomposition method. CONCLUSION: It can be concluded that the empirical mode decomposition method can extract the respiration rate of the contactless optical signal from chest movement.

A slow neutron polarimeter for the measurement of parity-odd neutron rotary power.

We present the design, description, calibration procedure, and an analysis of systematic effects for an apparatus designed to measure the rotation of the plane of polarization of a transversely polarized slow neutron beam as it passes through unpolarized matter. This device is the neutron optical equivalent of a crossed polarizer/analyzer pair familiar from light optics. This apparatus has been used to search for parity violation in the interaction of polarized slow neutrons in matter. Given the brightness of existing slow neutron sources, this apparatus is capable of measuring a neutron rotary power of dϕ/dz = 1 × 10(-7) rad/m.

Evidence-based management of patients with chest tube drainage system to reduce complications in cardiothoracic vascular surgery wards.

AIM: This evidence-based project was to implement the best practice to provide safe and effective care to patients with chest tube drainage system in cardiothoracic wards. METHODS: Best practice recommendations on monitoring and maintenance of chest drains were retrieved from the Joanna Briggs Institute COnNECT+ database. A checklist was developed based on these recommendations. Nurses in the two cardiovascular wards were taught how to use the checklist. Two post-implementation audits on the nurses' compliance to use the checklist were conducted. Data were analysed using the Joanna Briggs Institute Practical Application of Evidence System. RESULTS: Initial post-implementation audit results showed that the compliance rates of monitoring underwater seal, suction pressure and connector were 100%, checking of dressings 90%, and swinging and/or bubbling 70%. The checklist also detected 36 near-miss events. The second post-implementation audit results showed that the compliance rate of monitoring insertion site for air infiltration was 100%, checking of dressings 78%, and swinging and/or bubbling 91%. Fifty-seven near-miss events were detected. CONCLUSION: The use of the checklist prevented adverse events during the evidence implementation period. It can thus be concluded that using a systematic guide to observe and monitor patients with chest tubes enhances the effectiveness and safety of nursing care in the hospital.

Secondary triage classification using an ensemble random forest technique.

BACKGROUND: Triage of patients in the emergency department is a complex task based on several uncertainties and ambiguous information. Triage must be implemented within two to five minutes to avoid potential fatality and increased waiting time. OBJECTIVE: An intelligent triage system has been proposed for use in a triage environment to reduce human error. METHODS: This system was developed based on the objective primary triage scale (OPTS) that is currently used in the Universiti Kebangsaan Malaysia Medical Center. Both primary and secondary triage models are required to develop this system. The primary triage model has been reported previously; this work focused on secondary triage modelling using an ensemble random forest technique. The randomized resampling method was proposed to balance the data unbalance prior to model development. RESULTS: The results showed that the 300% resampling gave a low out-of-bag error of 0.02 compared to 0.37 without pre-processing. This model has a sensitivity and specificity of 0.98 and 0.89, respectively, for the unseen data. CONCLUSION: With this combination, the random forest reduces the variance, and the randomized resembling reduces the bias, leading to the reduced out-of-bag error.

Risk-adapted donor lymphocyte infusion based on chimerism and donor source in pediatric leukemia.

Donor lymphocyte infusion (DLI) is commonly used to treat leukemia relapse following stem cell transplantation. In florid relapse, however, the efficacy of DLI is limited with substantial risk of severe graft-versus-host disease (GvHD). Here, we develop a novel risk-adapted strategy characterized by pre-emptive DLI initiated at the time of mixed chimerism, a small starting dose based on donor source, dose-escalation guided by real-time chimerism monitoring and withholding of DLI immediately in patients achieving full donor chimerism. A total of 178 DLIs were given to 38 patients with mixed chimerism; thereafter, 33 patients (86.8%) had donor chimerism successfully increased, including 30 (78.9%) who had chimerism fully converted back to 100% donor. Cumulative incidence of relapse was significantly lower (P=0.00004) and overall survival higher (P=0.0003) in patients with chimerism fully corrected as compared with those of patients whose chimerism remained mixed. Only 13.2% of the patients developed acute grade III-IV GvHD with no associated mortality. In conclusion, the risk-adapted DLI strategy is useful in minimizing the risk of childhood leukemia relapse, GvHD and death.

2D divertor heat flux distribution using a 3D heat conduction solver in National Spherical Torus Experiment.

The divertor heat flux footprint in tokamaks is often observed to be non-axisymmetric due to intrinsic error fields, applied 3D magnetic fields or during transients such as edge localized modes. Typically, only 1D radial heat flux profiles are analyzed; however, analysis of the full 2D divertor measurements provides opportunities to study the asymmetric nature of the deposited heat flux. To accomplish this an improved 3D Fourier analysis method has been successfully applied in a heat conduction solver (TACO) to determine the 2D heat flux distribution at the lower divertor surface in the National Spherical Torus Experiment (NSTX) tokamak. This advance enables study of helical heat deposition onto the divertor. In order to account for heat transmission through poorly adhered surface layers on the divertor plate, a heat transmission coefficient, defined as the surface layer thermal conductivity divided by the thickness of the layer, was introduced to the solution of heat conduction equation. This coefficient is denoted as α and a range of values were tested in the model to ensure a reliable heat flux calculation until a specific value of α led to the constant total deposited energy in the numerical solution after the end of discharge. A comparison between 1D heat flux profiles from TACO and from a 2D heat flux calculation code, THEODOR, shows good agreement. Advantages of 2D heat flux distribution over the conventional 1D heat flux profile are also discussed, and examples of 2D data analysis in the study of striated heat deposition pattern as well as the toroidal degree of asymmetry of peak heat flux and heat flux width are demonstrated.

Magnetic topology changes induced by lower hybrid waves and their profound effect on edge-localized modes in the EAST tokamak.

Strong mitigation of edge-localized modes has been observed on Experimental Advanced Superconducting Tokamak, when lower hybrid waves (LHWs) are applied to H-mode plasmas with ion cyclotron resonant heating. This has been demonstrated to be due to the formation of helical current filaments flowing along field lines in the scrape-off layer induced by LHW. This leads to the splitting of the outer divertor strike points during LHWs similar to previous observations with resonant magnetic perturbations. The change in the magnetic topology has been qualitatively modeled by considering helical current filaments in a field-line-tracing code.

Effects of activating NK cell receptor expression and NK cell reconstitution on the outcomes of unrelated donor hematopoietic cell transplantation for hematologic malignancies.

Inhibitory NK cell receptors are recognized as important determinants of NK cell activity in hematopoietic cell transplantation (HCT). The role of activating receptors and their acquisition after HCT is less certain. Therefore, we comprehensively evaluated both inhibitory and activating receptors in 59 patients receiving unrelated donor HCT. NK cell numbers normalized quickly relative to B and T cells; however, the expression of both inhibitory and activating isoforms of killer immunoglobulin-like receptors (KIRs) was delayed. Most NK cells expressed an immature phenotype during the first 6 months post-HCT; however, we found high expression of activating NKp46 and NKp44 natural cytotoxicity receptors (NCRs), and cytotoxicity was preserved. Early reconstituting NK cells from unmanipulated grafts showed lower cytotoxicity than those from T-cell-depleted grafts. Differences in NK cell reconstitution had significant effects on clinical outcomes. Patients whose NK cells reconstituted earlier had better survival and lower relapse rates. The best survival group was recipients who possessed HLA-C2 but their donor lacked the cognate-activating KIR2DS1. Collectively, our data underscore the clinical relevance of reconstituting NK cells and their activating KIRs and NCRs. In addition to NK cell quantification and genotyping, comprehensive assessment of NK cell functions and phenotypes, including activating receptors, is essential.

First observation and Dalitz analysis of the D0-->K(0)Setapi(0) decay.

Using 9.0 fb(-1) of integrated luminosity in e(+)e(-) collisions near the Upsilon(4S) mass collected with the CLEO II.V detector we report the first observation of the decay D0-->K(0)(S)etapi(0). We measure the ratio of branching fractions, BR(D0-->K(0)(S)etapi(0))BR / (D0-->K(0)(S)pi(0))=0.46+/-0.07+/-0.06. We perform a Dalitz analysis of 155 selected D0-->K(0)(S)etapi(0) candidates and find leading contributions from a(0)(980)K(0)(S) and K(*)(892)eta intermediate states.

Modelling the isotope enrichment of leaf water.

Farquhar and Gan have proposed a model for the spatial variation in the isotopic enrichment of H(2)(18)O across a leaf, which is specifically formulated for monocotyledoneous leaves. The model is based on the interaction between mass fluxes longitudinally within the xylem, and fluxes laterally through veinlets into the lamina mesophyll, where moisture leaves the leaf through transpiration. The lighter, more abundant, molecule H(2)(16)O escapes preferentially with the evaporating water, resulting in the enrichment of H(2)(18)O at these sites. Enriched water diffuses throughout the leaf, and it is this spatial distribution of enriched water which the model seeks to capture. In this paper we present a general formulation of the model in terms of mass flux, extending it to include variable transpiration rates across the leaf surface, as well as a tapering xylem. Solutions are developed for the general case and, since the solutions present in the form of Kummer functions, properties are established as well as methods for estimating the solutions under certain conditions relevant to the biology. The model output is compared with Gan's data collected from maize plants.

On the progressive enrichment of the oxygen isotopic composition of water along a leaf.

A model has been derived for the enrichment of heavy isotopes of water in leaves, including progressive enrichment along the leaf. In the model, lighter water is preferentially transpired leaving heavier water to diffuse back into the xylem and be carried further along the leaf. For this pattern to be pronounced, the ratio of advection to diffusion (Péclet number) has to be large in the longitudinal direction, and small in the radial direction. The progressive enrichment along the xylem is less than that occurring at the sites of evaporation in the mesophyll, depending on the isolation afforded by the radial Péclet number. There is an upper bound on enrichment, and effects of ground tissue associated with major veins are included. When transpiration rate is spatially nonuniform, averaging of enrichment occurs more naturally with transpiration weighting than with area-based weighting. This gives zero average enrichment of transpired water, the modified Craig-Gordon equation for average enrichment at the sites of evaporation and the Farquhar and Lloyd (In Stable Isotopes and Plant Carbon-Water Relations, pp. 47-70. Academic Press, New York, USA, 1993) prediction for mesophyll water. Earlier results on the isotopic composition of evolved oxygen and of retro-diffused carbon dioxide are preserved if these processes vary in parallel with transpiration rate. Parallel variation should be indicated approximately by uniform carbon isotope discrimination across the leaf.

Observation of B-->K(0)(S)pi(+)pi(-) and Evidence for B-->K(*+/-)pi(-/+).

We report on a search for charmless hadronic B decays to the three-body final states K(0)(S)h(+)pi(-), K(+)h(-)pi(0), K(0)(S)h(+)pi(0) (h(+/-) denotes a charged pion or kaon), and their charge conjugates, using 13.5 fb(-1) of integrated luminosity produced near sqrt[s]=10.6 GeV, and collected with the CLEO detector. We observe the decay B-->K0pi(+)pi(-) with a branching fraction (50(+10)(-9)(stat.)+/-7(syst.))x10(-6) and the decay B-->K(*+)(892)pi(-) with a branching fraction (16(+6)(-5)(stat.)+/-2(syst.))x10(-6).

Measurement of B(D+-->K(*0)l(+)nu(l)).

Using 13.53 fb(-1) of CLEO data, we have measured the ratios of the branching fractions R(+)(e),R(+)(mu) and the combined branching fraction ratio R(+)(l), defined by R(+)(l)=[B(D+-->K(*0)l(+)nu(l))]/[B(D+-->K-pi(+)pi(+))]. We find R(+)(e)=0.74+/-0.04+/-0.05, R(+)(mu)=0.72+/-0.10+/-0.05, and R(+)(l)=0.74+/-0.04+/-0.05, where the first and second errors are statistical and systematic, respectively. The known branching fraction B(D+-->K-pi(+)pi(+)) leads to B(D+-->K(*0)e(+)nu(e))=(6.7+/-0.4+/-0.5+/-0.4)%, B(D+-->K(*0)mu(+)nu(mu))=(6.5+/-0.9+/-0.5+/-0.4)%, and B(D+-->K(*0)l(+)nu(l))=(6.7+/-0.4+/-0.5+/-0.4)%, where the third error is due to the uncertainty in B(D+-->K-pi(+)pi(+)).