A wideband scalar network analyzer for biomedical dehydration measurements

This paper presents a wideband microwave approach towards biomedical dehydration monitoring. The introduced concept is verified via invasive measurements on several blood samples. A microwave measurement circuit, based of a two-port scalar vector network analyzer is presented. The circuit operates between 5GHz and 20GHz using a planar permittivity sensor. Measurements of all subcomponents are shown together with measurements of a Water-NaCl-Glycerol solution.

Validation of Dermaphot(®) for the assessment of steroid-induced skin atrophy

Currently, there are no accurate and simple methods available to measure this risk of atrophy in patients treated with topical glucocorticosteroids. In the present clinical trial, we validated a new score (Dermaphot(®) score) to assess the atrophogenic potential of glucocorticosteroids. 36 healthy adult volunteers were included in an investigator-initiated, blinded, randomized, intra-individual comparison, vehicle controlled multi-centre study. Subjects were treated in a randomized manner for 3 weeks with pimecrolimus cream 1 %, mometasone furoate (1 mg/g), clobetasol propionate 0.05 % and vehicle. In addition, ultrasound examination for skin thickness was performed. Data demonstrated a direct correlation of the achieved Dermaphot(®) score and the ultrasound thickness measurements. Our study shows that the Dermaphot(®) score can be used as a simple method to evaluate the atrophogenic potential of glucocorticosteroids. Respectively, we showed that the new score is an easy, valid and sensitive new tool for early detecting and quantifying even subclinical glucocorticosteroid-induced skin damage. We demonstrated that the score is able to differentiate the extent of skin atrophy (damage) after 3 weeks of topical glucocorticosteroid application with different levels of skin transparency and levels of telangiectasia.

Ultrasound screening strategies for the diagnosis of congenital anomalies of the kidney and urinary tract

PURPOSE

Congenital anomalies of the kidneys and urinary tract (CAKUT) are among the most common anomalies in newborn infants, and may cause chronic renal disease in newborns. We investigated the sensitivity and specificity of different ultrasound-based screening strategies for CAKUT.

MATERIALS AND METHODS

Newborns (n = 4331) were analyzed for CAKUT in at least one ultrasound examination as a part of the Survey of Neonates in Pomerania (SNiP), a 7-year population-based study on neonates in Western Pomerania (Germany). Intrauterine ultrasound examinations were compared with early postnatal ultrasound findings (from days 3 - 7 of life) and pathological findings within the first 6 months of postnatal life.

RESULTS

Cases of CAKUT were detected in 309 (3.7 %) kidneys in one ultrasound examination at the following points of time at least: (i) prenatally in 56 newborns (18.2 %), (ii) 3 - 7 days postnatally in 201 newborns (65.2 %) and (iii) in 52 newborns (17 %) during the 6-month follow-up. The prevalence was significantly higher in male infants, and hydronephrosis was found to be the most frequent obstructive nephropathy (83.3 %). Significant co-morbidity was observed with CNS malformations. The diagnostic sensitivity was significantly higher in postnatal ultrasound screening (79.6 vs. 18.2 % prenatally), while the specificity was above 99 % at all time points.

CONCLUSION

This study demonstrates a high prevalence of CAKUT and demonstrates the importance of combined prenatal and postnatal ultrasound examinations for early CAKUT diagnosis.

Reinforcement of stereolithographic resins for rapid prototyping with cellulose nanocrystals

We report on the mechanical properties of optically curable stereolithographic resins (SLRs) which were reinforced through the addition of small amounts of cellulose nanocrystals (CNCs). The resin/filler mixtures are readily accessible via simple mixing processes. A detailed rheological investigation of such mixtures and the successful processing of these materials on a commercial SLR machine show that at low filler concentrations (below 5%) the processability of the materials is barely impacted. The storage modulus, E', increased steadily with increasing CNC content in the regimes below and above the glass transition. A remarkable modulus enhancement was observed in the rubbery regime, where E' increased by 166, 233, and 587% for CNC/SLR nanocomposites with 0.5, 1.0, and 5.0% w/w CNC, respectively. The modulus increase was less pronounced in the glassy state, where E' increased by 21, 32 and 57%, for the same compositions. The increase in tensile strength was of similar magnitude. In comparison to previously reported CNC and carbon-nanofiller based nanocomposites, the presently investigated nanocomposites display a comparably large increase of stiffness and strength, which appear to originate from the high level of dispersion and the intimate contact of the CNCs with the SLR matrix. Through the fabrication of 3-dimensional parts, it was shown that the CNC-filled resins can be processed with standard equipment in a stereolithographic process that is widely used for rapid prototyping and rapid manufacturing.

From boiling point to glass transition temperature: transport coefficients in molecular liquids follow three-parameter scaling

The phenomenon of the glass transition is an unresolved problem in condensed matter physics. Its prominent feature, the super-Arrhenius temperature dependence of the transport coefficients, remains a challenge to be described over the full temperature range. For a series of molecular glass formers, we combined τ(T) collected from dielectric spectroscopy and dynamic light scattering covering a range 10(-12) s < τ(T) < 10(2) s. Describing the dynamics in terms of an activation energy E(T), we distinguish a high-temperature regime characterized by an Arrhenius law with a constant activation energy E(∞) and a low-temperature regime for which E(coop)(T) ≡ E(T)-E(∞) increases exponentially while cooling. A scaling is introduced, specifically E(coop)(T)/E(∞) [proportionality] exp[-λ(T/T(A)-1)], where λ is a fragility parameter and T(A) a reference temperature proportional to E(∞). In order to describe τ(T) still the attempt time τ(∞) has to be specified. Thus, a single interaction parameter E(∞) describing the high-temperature regime together with λ controls the temperature dependence of low-temperature cooperative dynamics.

HER2 testing in gastric cancer: a practical approach

Trastuzumab in combination with capecitabine or 5-fluorouracil and cisplatin is approved by the European Medicines Agency for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive (immunohistochemistry 3+ or immunohistochemistry 2+/fluorescence in situ hybridization-positive or immunohistochemistry 2+/silver in situ hybridization-positive) metastatic adenocarcinoma of the stomach or gastro-esophageal junction. Approvals are underway in other countries, with recent approvals granted in the United States and Japan. Experience and data from trastuzumab use in breast cancer have highlighted the importance of quality HER2 testing and scoring to ensure accurate identification of patients eligible for treatment. HER2 testing in gastric cancer differs from testing in breast cancer due to inherent differences in tumor biology; gastric cancer more frequently shows HER2 heterogeneity (focal staining) and incomplete membrane staining. Consequently, gastric cancer-specific HER2 testing protocols have been developed and standardized and it is imperative that these recommendations be adhered to. Given the predictive value of HER2 protein levels with response in the trastuzumab for GAstric cancer study (ToGA), immunohistochemistry should be the initial testing methodology and fluorescence in situ hybridization or silver in situ hybridization should be used to retest immunohistochemistry 2+ samples. Wherever possible, bright-field methodologies should be used as these are considered to be superior to fluorescent methodologies at identifying heterogeneous staining. Specific training is required before embarking on HER2 testing in gastric cancer, irrespective of the experience of HER2 testing in breast cancer. This paper provides the most up-to-date practical guidance on HER2 testing and scoring in patients with gastric and gastro-esophageal junction cancer, as agreed by a panel of expert pathologists with extensive experience of HER2 testing particularly reflecting the European Medicines Agency-approved indication. It is anticipated that these recommendations should ensure accurate and consistent HER2 testing, which will allow appropriate selection of patients eligible for treatment with trastuzumab.

Indication of reactor ν(e) disappearance in the Double Chooz experiment

The Double Chooz experiment presents an indication of reactor electron antineutrino disappearance consistent with neutrino oscillations. An observed-to-predicted ratio of events of 0.944±0.016(stat)±0.040(syst) was obtained in 101 days of running at the Chooz nuclear power plant in France, with two 4.25 GW(th) reactors. The results were obtained from a single 10 m(3) fiducial volume detector located 1050 m from the two reactor cores. The reactor antineutrino flux prediction used the Bugey4 flux measurement after correction for differences in core composition. The deficit can be interpreted as an indication of a nonzero value of the still unmeasured neutrino mixing parameter sin(2)2θ(13). Analyzing both the rate of the prompt positrons and their energy spectrum, we find sin(2)2θ(13)=0.086±0.041(stat)±0.030(syst), or, at 90% C.L., 0.017<sin(2)2θ(13)<0.16.

Generation, selection and preclinical characterization of an Fc-optimized FLT3 antibody for the treatment of myeloid leukemia

The therapeutic efficacy of humanized or chimeric second-generation antitumor antibodies is clearly established, but often limited. In recent years, defined modifications of the glycosylation pattern or the amino-acid sequence of the human immunoglobulin G1 Fc part have resulted in the development of third-generation antibodies with improved capability to recruit Fc receptor-bearing effector cells. The first antibodies of this kind, currently evaluated in early clinical trials, are directed against lymphoma-associated antigens. Fc-engineered antibodies targeting myeloid leukemia are not yet available. We here report on the generation and preclinical characterization of an Fc-optimized antibody directed to the FMS-related tyrosine kinase 3 (FLT3), an antigen expressed on the leukemic blasts of all investigated patients with acute myeloid leukemia (AML). This antibody, termed 4G8SDIEM, mediated markedly enhanced cellular cytotoxicity against FLT3-expressing cell lines as well as blasts of AML patients. FLT3 expression levels on AML cells varied between 300 and 4600 molecules/cell and, in most cases, were substantially higher than those detected on normal hematopoietic precursor cells and dendritic cells (approximately 300 molecules/cell). Antibody-mediated cytotoxicity against these normal cells was not detectable. 4G8SDIEM has been produced in pharmaceutical quality in a university-owned production unit and is currently used for the treatment of leukemia patients.

A comparison of a less invasive piriformis-sparing approach versus the standard posterior approach to the hip

We undertook a randomised controlled trial to compare the piriformis-sparing approach with the standard posterior approach used for total hip replacement (THR). We recruited 100 patients awaiting THR and randomly allocated them to either the piriformis-sparing approach or the standard posterior approach. Pre- and post-operative care programmes and rehabilitation regimes were identical for both groups. Observers were blinded to the allocation throughout; patients were blinded until the two-week assessment. Follow-up was at six weeks, three months, one year and two years. In all 11 patients died or were lost to follow-up.

There was no significant difference between groups for any of the functional outcomes. However, for patients in the piriformis-sparing group there was a trend towards a better six-minute walk test at two weeks and greater patient satisfaction at six weeks. The acetabular components were less anteverted (p = 0.005) and had a lower mean inclination angle (p = 0.02) in the piriformis-sparing group. However, in both groups the mean component positions were within Lewinnek’s safe zone. Surgeons perceived the piriformis-sparing approach to be significantly more difficult than the standard approach (p = 0.03), particularly in obese patients.

In conclusion, performing THR through a shorter incision involving sparing piriformis is more difficult and only provides short-term benefits compared with the standard posterior approach.

Optical scattering lengths in large liquid-scintillator neutrino detectors

For liquid-scintillator neutrino detectors of kiloton scale, the transparency of the organic solvent is of central importance. The present paper reports on laboratory measurements of the optical scattering lengths of the organic solvents phenylxylylethane, linear alkylbenzene (LAB), and dodecane, which are under discussion for next-generation experiments such as SNO+ (Sudbury Neutrino Observatory), HanoHano, or LENA (Low Energy Neutrino Astronomy). Results comprise the wavelength range of 415-440 nm. The contributions from Rayleigh and Mie scattering as well as from absorption/re-emission processes are discussed. Based on the present results, LAB seems to be the preferred solvent for a large-volume detector.

Influence of educational programs on attitudes of medical students towards psychiatry: Effects of psychiatric experience, gender, and personality dimensions

BACKGROUND

Attitudes of medical students form the basis for medical actions. Because of the specific characteristics of psychiatric patients, positive attitudes of medical students towards psychiatry should be a higher goal in medical education.

AIM

We hypothesize that medical students in different educational programs develop different attitudes towards psychiatry.

METHODS

In a cross-sectional study, students enrolled in different educational programs completed the 'attitudes towards psychiatry' questionnaire (ATP-30). Data concerning experiences in psychiatry, personality traits and socio-demographic variables including gender were also analyzed.

RESULTS

The response rate of students in the PBL-curriculum (n = 61) was >90%, in the traditional curriculum (n = 280) >75%. Attitudes towards psychiatry of male students in the Problem-Based Learning program were equal to the female students' attitudes in both programs. Female students' attitudes in the traditional curriculum reached comparably good results while male students' displayed the worst attitudes. The personality factors 'openness to experience' and 'agreeableness' correlated significantly with positive attitudes towards psychiatry. PBL-students showed significantly more 'openness to experience'.

CONCLUSION

Educational programs might play a role for the development of attitudes towards psychiatry, especially in male students. Factors influencing enrollment into special educational programs should also have been taken into account. An independent study with a larger number of participants will be required to support these findings.

Diameter of basalt columns derived from fracture mechanics bifurcation analysis

The diameter of columnar joints forming in cooling basalt and drying starch increases with decreasing growth rate. This observation can be reproduced with a linear-elastic three-dimensional fracture mechanics bifurcation analysis, which has been done for a periodic array of hexagonal columnar joints by considering a bifurcation mode compatible with observations on drying starch. In order to be applicable to basalt columns, the analysis has been carried out with simplified stationary temperature fields. The critical diameter differs from the one derived with a two-dimensional model by a mere factor of 1/2. By taking into account the latent heat released at the solidification front, the results agree fairly well with observed column diameters.

Softening of the radial breathing mode in metallic carbon nanotubes

The softening of the radial breathing mode (RBM) of metallic single walled carbon nanotubes (m-SWNTs) due to electron-phonon coupling has been studied by observing the Fermi level [see text] dependence of the RBM Raman peak. In situ Raman spectra were obtained from several individual m-SWNTs while varying [see text] electrochemically. The RBM frequency of an intrinsic m-SWNT is shown to be down-shifted relative to highly doped tubes by approximately 2 cm(1). The down-shift is greatest for small diameter and small chiral angle SWNTs. Most tubes show no change in RBM linewidth. A comparison is drawn between the RBM and the G band (A(LO) phonon) with respect to the [see text] dependence of their frequencies and linewidths.

Structural transitions in RNi(10)Si(2) intermetallics

Intermetallic compounds of the type RFe(10)Si(2) and RCo(10)Si(2) crystallize in the ThMn(12) structure (space group I4/mmm) whilst the heavy rare earth series RNi(10)Si(2) crystallize in a maximal subgroup of I4/mmm, P4/nmm. Reported here are neutron powder diffraction investigations for TbNi(10)Si(2) and ErNi(10)Si(2) which show that the P4/nmm structure undergoes a high temperature order-disorder phase transition at approximately 930 °C above which the ordered Ni and Si fractions revert to a random distribution on 4d and 4e sites. The volume expansion has been tracked in detail via the temperature dependence of the lattice parameters, whilst the temperature dependence of the thermal expansion coefficients α(11), α(33) and α(volume) has been determined from the lattice parameters. Associated with the order-disorder transition is a transition associated with a displacement of the R ion along the c-axis. Both transitions are of second order and the critical exponent associated with the order-disorder and displacive transitions, β = 0.31, is in excellent agreement with the exponent determined for the three-dimensional Ising model.

The chemokine receptor Cxcr3 is not essential for acute cardiac allograft rejection in mice and rats

Chemokine receptors have gained attention as potential targets for novel therapeutic strategies. We investigated the mechanisms of allograft rejection in chemokine receptor Cxcr3-deficient mice using a model of acute heart allograft rejection in the strain combination BALB/c to C57BL/6. Allograft survival was minimally prolonged in Cxcr3-deficient mice compared to wild-type (wt) animals (8 vs. 7 days) and treatment with a subtherapeutic dose of cyclosporine A (CsA) led to similar survival in Cxcr3-deficient and wt recipients (13 vs. 12 days). At rejection grafts were histologically indistinguishable. Microarray analysis revealed that besides Cxcr3 only few genes were differentially expressed in grafts or in spleens from transplanted or untransplanted animals. Transcript analysis by quantitative RT-PCR of selected cytokines, chemokines, or chemokine receptors or serum levels of selected cytokines and chemokines showed similar levels between the two groups. Furthermore, in a rat heart allograft transplantation model treatment with a small molecule CXCR3 antagonist did not prolong survival despite full blockade of Cxcr3 in vivo. In summary, Cxcr3 deficiency or pharmacologic blockade does not diminish graft infiltration, tempo and severity of rejection. Thus, Cxcr3 does not appear to play a pivotal role in the allograft rejection models described here.

Sapphire-GaN-based planar integrated free-space optical system

We report on the design and fabrication of a planar integrated free-space optical system working on the basis of binary phase diffractive optical elements (DOEs) realized in GaN on a sapphire substrate. Group III-nitride/sapphire substrates enable the parallel monolithic integration of passive microoptical elements like lenses and gratings as demonstrated here and optoelectronic devices like light emitters and photodetectors on a single wafer. We present an approach for the simultaneous optimization of the efficiency of transmissive and reflective diffractive optical elements processed in a single lithographic etching step.

Reversible photoswitching enables single-molecule fluorescence fluctuation spectroscopy at high molecular concentration

We demonstrate that photoswitchable markers enable fluorescence fluctuation spectroscopy at high molecular concentration. Reversible photoswitching allows precise control of the density of fluorescing entities, because the equilibrium between the fluorescent ON- and the dark OFF-state can be shifted through optical irradiation at a specific wavelength. Depending on the irradiation intensity, the concentration of the ON-state markers can be up to 1,000 times lower than the actual concentration of the labeled molecular entity. Photoswitching expands the range of single-molecule detection based experiments such as fluorescence fluctuation spectroscopy to large entity concentrations in the micromolar range.

Chromogenic in situ hybridisation for the assessment of HER2 status in breast cancer: an international validation ring study

Introduction

Before any new methodology can be introduced into the routine diagnostic setting it must be technically validated against the established standards. To this end, a ring study involving five international pathology laboratories was initiated to validate chromogenic in situ hybridisation (CISH) against fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) as a test for assessing human epidermal growth factor receptor 2 (HER2) status in breast cancer.

Methods

Each laboratory performed CISH, FISH and IHC on its own samples. Unstained sections from each case were also sent to another participating laboratory for blinded retesting by CISH ('outside CISH').

Results

A total of 211 invasive breast carcinoma cases were tested. In 76 cases with high amplification (HER2/CEP17 ratio >4.0) by FISH, 73 cases (96%) scored positive (scores ≥ 6) by 'outside CISH'. For FISH-negative cases (HER2/CEP17 ratio <2.0), 94 of 100 cases (94%) had CISH scores indicating no amplification (score ≤ 5), and only three cases were positive by CISH; in the three remaining cases, no CISH result could be obtained. For cases with low-level amplification using FISH (HER2/CEP17 ratio 2.0–4.0), 20 of 35 had CISH scores indicating gene amplification. Inter-laboratory concordance was also very high: 95% for normal HER2 copy number (1–5 copies); and 92% for cases with HER2 copy numbers ≥ 6. CISH intra-laboratory concordance with IHC was 92% for IHC-negative cases (IHC 0/1+) and 91% for IHC 3+ cases. Among IHC 2+ cases, CISH was 100% concordant with samples showing high amplification by FISH, and 94% concordant with FISH-negative samples.

Conclusion

These results show that CISH inter- and intra-laboratory concordance to FISH and IHC is very high, even in equivocal IHC 2+ cases. Therefore, we conclude that CISH is a methodology that is a viable alternative to FISH in the HER2 testing algorithm.

Raman spectroscopy as a probe of graphene and carbon nanotubes

Progress in the use of Raman spectroscopy to characterize graphene samples for the number of graphene layers and doping level they contain is briefly reviewed. Comparisons to prior studies on graphites and carbon nanotubes are used for inspiration to define future promising directions for Raman spectroscopy research on few layer graphenes.

Four-year results after brachytherapy for diffuse coronary in-stent restenosis: will coronary radiation therapy survive?

BACKGROUND

Prior to the introduction of drug-eluting stents (DES), diffuse coronary in-stent restenosis (ISR) was mainly treated by brachytherapy (BT), with good short-term and mid-term results. However, there exist limited data on the long-term effects of BT that justify its continuous use.

MATERIALS AND METHODS

Two hundred patients with diffuse ISR treated with intravascular BT were retrospectively followed over 4 years. Group A (n=134) was treated with the noncentered (90)Sr/Y BetaCath radiation system, whereas Group B (n=66) was treated with the centered 32P Galileo source wire system. Primary endpoints after 4 years were target lesion restenosis (TLS) and target lesion revascularization (TLR). Secondary endpoints were target vessel revascularization (TVR) and nontarget vessel revascularization (NTVR), as well as major adverse cardiac events (MACE).

RESULTS

Follow-up at 4 years yielded a TLS rate of 37.6% (Group A, 40.8%; Group B, 31.1%; P=.48). TLR was performed in 34.8% of patients (37.5% in Group A vs. 29.5% in Group B; P=.55). Ten percent of patients underwent coronary bypass surgery. Percutaneous coronary intervention was performed more often in Group A (27.5%) than in Group B (19.7%), while TVR was less frequent in Group A (10.0%) than in Group B (18.0%). NTVR was undertaken in 25.0% of Group A patients versus 21.3% of Group B patients, and MACE occurred in 1.7% of Group A patients versus 3.3% of Group B patients. These differences were not statistically significant (P>.05).

CONCLUSIONS

While excellent short-term and mid-term results after coronary BT are widely accepted, a high TLS rate can be observed after 4 years. The potential superiority of DES to BT will depend on the availability of long-term clinical data.