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Magnetically confined plasmas in the high confinement regime are regularly subjected to relaxation oscillations, termed edge localized modes (ELMs), leading to large transport events. Present ELM theories rely on a combined effect of edge current and the edge pressure gradients which result in intermediate mode number (nâ 10-15) structures (filaments) localized in the perpendicular plane and extended along the field lines. By detailed localized measurements of the magnetic field perturbation associated to type-I ELM filaments, it is shown that these filaments carry a substantial current.
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BACKGROUND: Marginal ulceration after Roux-en-Y gastric bypass (RYGB) is diagnosed in 1% to 16% of patients. The factors predisposing patients to marginal ulceration are still unclear. METHODS: A total of 260 patients who underwent laparoscopic RYGB were retrospectively reviewed. Data regarding demographics, comorbidities, body mass index (BMI), Helicobacter pylori infection, gastrojejunal (GJ) anastomotic leaks, postoperative bleeding, operative time, type of suture material, and marginal ulcer formation were collected. Fisher's exact test was used for statistical analysis of discrete variables, and Student's t-test was used for continuous variables. Statistical significance was set at an alpha of 0.05. RESULTS: The overall marginal ulceration rate was 7%. Demographic data (age, gender distribution, BMI) did not differ significantly between patients who experienced marginal ulceration and those who did not (p > 0.05). Similarly, technical factors (choice of permanent or absorbable suture for the GJ anastomosis, attending as primary surgeon, robotic GJ, operative time, postoperative hematocrit drop) were not statistically different between the two groups (p > 0.05). Finally, the prevalence of comorbidities (diabetes, hypertension, obstructive sleep apnea, musculoskeletal complaints, dyslipidemia, gastroesophageal reflux disease [GERD] and peptic ulcer disease [PUD]) did not differ significantly between the two groups (p > 0.05). However, preoperative H. pylori infection, although adequately treated, was twice as common among the patients who had marginal ulceration (32%) as among those who did not (12%) (p = 0.02). All the patients who experienced marginal ulcers had complete resolution of symptoms with proton pump inhibitors and sucralfate. No reoperations were required for marginal ulceration. CONCLUSION: Helicobacter pylori may potentiate marginal ulcer formation. The authors hypothesize that H. pylori damages the mucosal barrier in a way that persists postoperatively, which may precipitate marginal ulceration even when the organism has been medically eradicated.
Assuntos
Derivação Gástrica/efeitos adversos , Infecções por Helicobacter/epidemiologia , Laparoscopia/efeitos adversos , Úlcera Péptica/epidemiologia , Adulto , Distribuição por Idade , Anastomose em-Y de Roux/efeitos adversos , Causalidade , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Ácido Gástrico/metabolismo , Derivação Gástrica/métodos , Mucosa Gástrica/patologia , Mucosa Gástrica/virologia , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/isolamento & purificação , Humanos , Incidência , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/cirurgia , Úlcera Péptica/patologia , Complicações Pós-Operatórias/patologia , Probabilidade , Estudos Retrospectivos , Medição de Risco , Distribuição por SexoRESUMO
The gene functions of MIG1 and MIG2 are well known for their role in glucose control in Saccharomyces cerevisiae. A prototrophic mig1 disruptant (T468) and mig1mig2 double disruptant (T475) as well as their congenic wild-type strain (CEN.PK 113-7D) were analysed for changes in their peripheral metabolism (batch cultivations on sugar mixtures) and central metabolism (batch and continuous cultivations as well as acceleratostats). Sucrose metabolism was alleviated of glucose control in the mig1 disruptant, and even more so in the mig1mig2 disruptant compared with their wild-type strain. The lag phase in a batch cultivation grown on a glucose-galactose mixture was reduced by 50% in either disruptant, i.e. additional disruption of MIG2 in a mig1 background did not further alleviate galactose metabolism from glucose control. In contrast, both disruptants exhibited a more stringent glucose control of maltose metabolism compared with the wild-type strain. Growing on glucose, the mig1mig2 double disruptant exhibited a 12% higher specific growth rate than the wild-type strain, as well as a significantly higher respiratory capacity.
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Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo , Saccharomyces cerevisiae/fisiologia , Meios de Cultura , Galactose/metabolismo , Expressão Gênica , Genes Fúngicos , Glucose/metabolismo , Glucose/farmacologia , Maltose/metabolismo , Saccharomyces cerevisiae/crescimento & desenvolvimento , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae , Transformação GenéticaRESUMO
Organized bone ingrowth in endosteal porous implants fabricated from VMC titanium alloy and surgically implanted with a tight interference fit, securely anchored the implants in fresh and healed mandibular premolar sites of miniature swine. This bone-implant union retained its integrity under high as well as slight masticatory stresses up to one-year after implantation. Bone invasion of the alumina porcelain implants was impeded by the lack of adequate interconnecting porosity; when the porosity was increased, insufficient ceramic strength prohibited a tight initial bone-implant fit. As a consequence, inadequate initial implant stability resulted in a soft tissue encapsulation of the majority of the ceramic implants. Histological examination and mechanical testing results were similar for bone-ingrown implants exposed to different experimental stresses for 4, 5, 8, and 12 months. Bone ingrowth and interface shear strengths were also similar in the different VMC pore sizes and shapes investigated. The design of intraoral attachments appeared critical, at least in swine where no postoperative treatment was administered. Gingival inflammation and alveolar bone resorption caused by calculus were severe around truncated cone-shaped devices. Slender transgingival posts, occlusal caps, and crown restorations were less susceptible to calculus accumulation, resulting in a more satisfactory gingival and subgingival response. Excessive epithelial invagination was a problem only in implants with transgingival truncated cones. Good adherence of soft tissue to metal under the gingival mucosa prevented epithelial migration around implants with other transgingival devices. Alveolar bone resportion around the tops of bone-ingrown implants was minimal at the time intervals examined (up to one year); however, a definite conclusion should be delayed until longer-term implants under full occlusion are evaluated.
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Implantação Dentária/instrumentação , Alumínio , Animais , Cerâmica , Ligas Dentárias , Porcelana Dentária , Análise do Estresse Dentário , Estudos de Avaliação como Assunto , Mandíbula/anatomia & histologia , Mastigação , Óxidos , Dióxido de Silício , Propriedades de Superfície , Telas Cirúrgicas , Suínos , TitânioRESUMO
We study modulational instability (MI) of plane waves in nonlocal nonlinear Kerr media. For a focusing nonlinearity we show that, although the nonlocality tends to suppress MI, it can never remove it completely, irrespective of the particular profile of the nonlocal response function. For a defocusing nonlinearity the stability properties depend sensitively on the response function profile: for a smooth profile (e.g., a Gaussian) plane waves are always stable, but MI may occur for a rectangular response. We also find that the reduced model for a weak nonlocality predicts MI in defocusing media for arbitrary response profiles, as long as the intensity exceeds a certain critical value. However, it appears that this regime of MI is beyond the validity of the reduced model, if it is to represent the weakly nonlocal limit of a general nonlocal nonlinearity, as in optics and the theory of Bose-Einstein condensates.
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The dynamics of soliton and quasisoliton solutions of the cubic third-order nonlinear Schrödinger equation is studied. Regular solitons exist due to a balance between the nonlinear terms and (linear) third-order dispersion; they are not important at small alpha(3) (alpha(3) is the coefficient in the third derivative term) and vanish at alpha(3)-->0. The most essential, at small alpha(3), is a quasisoliton emitting resonant radiation (resonantly radiating soliton). Its relationship with the other (steady) quasisoliton, called embedded soliton, is studied analytically and also in numerical experiments. It is demonstrated that the resonantly radiating solitons emerge in the course of nonlinear evolution, which shows their physical significance.
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Models of inviscid incompressible fluid are considered, with the kinetic energy (i.e., the Lagrangian functional) taking the form L approximately integral k(alpha)/vk/2dk in 3D Fourier representation, where alpha is a constant, 0
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We study the effects produced by competition of two physical mechanisms of energy localization in inhomogeneous nonlinear systems. As an example, we analyze spatially localized modes supported by a nonlinear impurity in the generalized nonlinear Schrödinger equation and describe three types of nonlinear impurity modes, one- and two-hump symmetric localized modes and asymmetric localized modes, for both focusing and defocusing nonlinearity and two different (attractive or repulsive) types of impurity. We obtain an analytical stability criterion for the nonlinear localized modes and consider the case of a power-law nonlinearity in detail. We discuss several scenarios of the instability-induced dynamics of the nonlinear impurity modes, including the mode decay or switching to a new stable state, and collapse at the impurity site.
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Campylobacter jejuni is the most frequent cause of severe gastroenteritis in the developed world. The major symptom of campylobacteriosis is inflammatory diarrhoea. The molecular mechanisms of this infection are poorly understood compared to those of less frequent disease-causing pathogens. In a previous study, we identified C. jejuni proteins that antibodies in human campylobacteriosis patients reacted with. One of the immunogenic proteins identified (Cj0917) displays homology to carbon starvation protein A (CstA) from Escherichia coli, where this protein is involved in the starvation response and peptide uptake. In contrast to many bacteria, C. jejuni relies on amino acids and organic acids for energy, but in vivo it is highly likely that peptides are also utilized, although their mechanisms of uptake are unknown. In this study, Biolog phenotype microarrays have been used to show that a ΔcstA mutant has a reduced ability to utilize a number of di- and tri-peptides as nitrogen sources. This phenotype was restored through genetic complementation, suggesting CstA is a peptide uptake system in C. jejuni. Furthermore, the ΔcstA mutant also displayed reduced motility and reduced agglutination compared to WT bacteria; these phenotypes were also restored through complementation. Murine dendritic cells exposed to UV-killed bacteria showed a reduced IL-12 production, but the same IL-10 response when encountering C. jejuni ΔcstA compared to the WT strain. The greater Th1 stimulation elicited by the WT as compared to ΔcstA mutant cells indicates an altered antigenic presentation on the surface, and thus an altered recognition of the mutant. Thus, we conclude that C. jejuni CstA is important not only for peptide utilization, but also it may influence host-pathogen interactions.
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Proteínas de Bactérias/metabolismo , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/fisiologia , Dipeptídeos/metabolismo , Aglutinação , Sequência de Aminoácidos , Animais , Proteínas de Bactérias/genética , Infecções por Campylobacter/imunologia , Campylobacter jejuni/genética , Campylobacter jejuni/imunologia , Carbono/metabolismo , Células Dendríticas/imunologia , Células Dendríticas/microbiologia , Feminino , Teste de Complementação Genética , Interações Hospedeiro-Patógeno/imunologia , Humanos , Interleucina-12/análise , Interleucina-12/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Dados de Sequência Molecular , Nitrogênio/metabolismo , Fenótipo , Filogenia , Alinhamento de Sequência , Deleção de SequênciaRESUMO
Viscoelastic vortical fluid motion in a strongly coupled particle system has been observed experimentally. Optical tracking of particle motion in a complex plasma monolayer reveals high grain mobility and large scale vortex flows coexistent with partial preservation of the global hexagonal lattice structure. The transport of particles is superdiffusive and ascribed to Lévy statistics on short time scales and to memory effects on the longer scales influenced by cooperative motion. At these longer time scales, the transport is governed by vortex flows covering a wide spectrum of temporal and spatial scales.
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We study the propagation of intense optical beams in layered Kerr media. With appropriate shapes, beams with a power close to the self-focusing threshold are shown to propagate over long distances as quasi-stationary waveguides in cubic media supporting a periodic nonlinear refractive index.
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OBJECTIVE: To analyse congruence on medication throughout patient courses, including an acute admission to a medical department. DESIGN: A prospective, observational study. Data were collected from patient records in primary health care, hospital departments, from the Health Insurance database and through patient interviews. SETTING: Departments of internal medicine, general practice and patients' homes. MAIN OUTCOME MEASURES: Number, type and character of discrepancies between paired sources of information on patient medication at predefined time points throughout the complete patient course. Assessment of likelihood and severity of potential untoward effects of discrepancies. RESULTS: Data were obtained for 75 of 99 consecutive patients included. Patients stated use of four drugs (median, range 0-17) at admission, five (0-16) at discharge and four (0-15) 1 month after discharge. At admission, 11 patients used no drugs. A median of one (0-20) to three (0-16) discrepancies per patient were identified in seven paired source comparisons with no improvement along patient course. Full agreement throughout the course was found in six patients (8%; 95% confidence interval: 3-17%). No association was found among source discrepancies and number of drugs and age. Of discrepancies, 4-13% were considered serious and likely to cause untoward effects. Discrepancies due to synonymous and analogous drugs accounted for 2-7% of the discrepancies. CONCLUSION: Congruence between sources of information on medication throughout patient courses cannot be obtained with separate medication charts. Discrepancies among patient, general practitioner and hospital give rise to a definitive risk of serious untoward effects.