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The fuel crisis throughout the world made many countries to be aware of their vulnerability to oil shortages. So many researches are still in progress and focus on the growth of bio fuel usage. In this regard, alternative fuels and the drivetrain play a major rule in critical emission issues. However, at the same time, enormous and vast number of vehicles have started to claim and place their heavy demand for alternative sources of fuel. Of course, gasoline and diesel, the conventional fuels will become scarce and much costlier. With a present known reserves and steep rise of demand and rate of consumption, hope of crude oil import is not going to last long. The CFD investigation is to find the combustion characteristics of the BioFuel with the various compositions of mixing with diesel, the Kirloskar IC Engine is taken for this research and the results of pressure, velocity, turbulence kinetic energy, temperature gradients, fuel combustions, oxidizers volume fractions also obtained from the CFD analysis results. CFD Analysis of Biodiesel combustion done in ANSYS Fluent. Software modeling of IC Engine done in CATIA V5 Software. Jatropha Methyl Ester (JME) and Mahua Methyl Ester (MME) are used for this research. Combustion characteristics in addition to emission parameters are assessed then a conclusion can be drawn. [ABSTRACT FROM AUTHOR]

Free-standing, micrometer long TiO 2 nanotube arrays (TiNTs) were synthesized via anodization by utilizing selected transition metals and non-transition elements as cathode materials. Free-standing TiNTs arrays with the maximum tube length up to 153 µm was fabricated with Ti cathode material, whereas, the cost effective cathodes materials of charcoal and graphite pencil yielded nearly 100 µm long nanotubes for an anodization time of 48 h. The barrier layer was removed from the bottom of the free-standing TiNT arrays using chemical etching process. The as-synthesized open ended free-standing amorphous arrays were then crystallized into anatase phase. The annealed free-standing TiNT array was powdered and mixed with TiO 2 nanoparticles (NP) to form TiNT/TiO 2 NP composite and then utilized as photoanodes to fabricate dye sensitized solar cells (DSSCs). The J-V characteristics and the performances of the solar cells were studied and compared. The results indicate that the TiNT arrays developed with different cathode materials are similar to or in some cases superior to those nanotubes obtained using Pt cathode. Thus, the strategy employed in this work provides a simple, efficient and economical fabrication method for large scale production of TiNT arrays. [ABSTRACT FROM AUTHOR]

We report the fabrication of hematite nanotubes/reduced graphene oxide (α-Fe 2 O 3 NTs/rGO) nanocomposites via a one-step hydrothermal process without using any template. The structure and morphology of the samples are confirmed by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), high resolution transmission electron microscopy (HRTEM) and X-ray photoelectron spectroscopy (XPS). Electrochemical performances of the samples are investigated employing cyclic voltammetry (CV), galvanostatic charge-discharge (GCD) and electrochemical impedance spectroscopy (EIS). The α-Fe 2 O 3 NTs/rGO demonstrated a maximum specific capacitance of 262.2 F g −1 at 1 A g −1 and good cyclic stability at 5 A g −1 with 96% capacitance retention after 500 cycles. The integration of α-Fe 2 O 3 NTs with rGO sheets improved the electrochemical performances. [ABSTRACT FROM AUTHOR]

Background: Aortobronchial fistula after TEVAR remains a vexing clinical problem associated with high mortality. Although a combination of endovascular and open surgical strategies have been reported in managing this pathology, there is as yet no definitive treatment algorithm that can be used for all patients. We discuss our approach to an aortobronchial fistula associated with an overtly infected aortic endograft. Case presentation: A 49-year-old female sustained a traumatic aortic transection 14 years prior, managed by an endovascular stent-graft. Due to persistent endoleak, she underwent open replacement of her descending thoracic aorta 4 years later. Ten years after her open aortic surgery, the patient presented with hemoptysis, and a pseudoaneurysm at her distal aortic suture line was identified on computed tomography, whereupon she underwent placement of an endograft. Eight weeks later, she presented with dyspnea, recurrent hemoptysis, malaise and fever, with clinical and radiographic evidence of an aortobronchial communication and an infected aortic stent-graft. The patient underwent management via a two-stage open surgical approach, constituting an extra-anatomic bypass from her ascending aorta to distal descending aorta and subsequent radical excision of her descending aorta with all associated infected prosthetic material and repair of the airway. Conclusion: Aortobronchial fistula after TEVAR represents a challenging complex clinical scenario. Extra-anatomic aortic bypass followed by radical debridement of all contaminated tissue may provide the best option for durable longer-term outcomes. [ABSTRACT FROM AUTHOR]

A post-flowering die-off of bamboo in an established bird-census plot afforded us an opportunity to investigate the response of bamboo-dwelling birds to a natural transformation of their habitat. In 1984 and 1985 SR and JT generated spot maps for an 80-ha plot in terra firme forest near the Cocha Cashu Biological Station, Manu National Park, Peru. Two mapped bamboo patches in the plot totaled approximately 30 ha. In 2001 and 2002, the bamboo flowered and died. In 2009, JS revisited the plot and generated spot maps for the former bamboo patches and adjacent forest. By 2009, trees had grown up in the erstwhile bamboo patches, creating stands of second growth surrounded by mature forest. Twelve species of bamboo specialists were no longer present but almost no new species had invaded. We conclude that the maintenance of high bird diversity in western Amazonian forests does not depend on the spatial heterogeneity caused by dying off of bamboo. This result contrasts with, but does not contradict, previous research demonstrating the importance of some disturbances such as treefalls opening gaps to avian biodiversity in neotropical forests. A few bamboo specialists, including the Brown-rumped Foliage-Gleaner (Automolus melanopezus), Goeldi's Antbird (Myrmeciza goeldii), Flammulated Pygmy-Tyrant (Hemitriccusflammulatus), and Dusky-tailed Flatbill (Ramphotrigon fuscicauda), persisted in the die-offs. Their choices of microsites suggested that vegetation structure rather than plant-species composition is an important determinant of habitat suitability for these specialists. [ABSTRACT FROM AUTHOR]

The article focuses on the decision of the U.S. Supreme Court case Federal Aviation Administration v. Cooper regarding share personal information. The Court ruled that sharing of confidential records without a citizen's permission violated the U.S. Privacy Act of 1974. It informs that remedies of the Privacy Act make the Act powerless in order to stop government agencies from sharing personal information without consequence.

This paper proposes the concept of a bus rapid transit (BRT) or light rail system that effectively requires only one dedicated but reversible lane to support two-way traffic in the median of a busy commute corridor with regular provision of left-turn lanes. Traffic crossing is accommodated on the otherwise unused or underused median space resulting from provision of left-turn lanes. Conceptual design options and geometric-configuration sketches for bus stops and crossing spaces are provided. System performance in terms of travel speed, headway operations, distance between two neighboring crossing spaces, and number of crossing spaces is also analyzed. To ensure practicality, we study implementation of such a system on an existing corridor. Such a system is also useful as an intermediate step toward a two-dedicated-lane system because of its potential for facilitating transit-oriented development. [ABSTRACT FROM AUTHOR]

A simple synthetic route to prepare carbon-coated copper or nickel nanoparticles is developed in an ionic liquid under microwave heating. The obtained products are characterized by XRD, UV-spectroscopy, and Raman spectroscopy. The morphologies are studied with the help of TEM, HRSEM, and HRTEM. A bulk transport property for carbon coated nickel is reported in this letter. [ABSTRACT FROM AUTHOR]

The concept of automated highway systems (AHS) has been primarily motivated by the rapidly worsening traffic congestion on metropolitan highways and the potential of AHS for drastically increasing vehicle throughput in the existing right-of-way. The overwhelming majority of the research has been focused on automobile-AHS. This paper focuses on the automation of inter-city trucking for the purpose of increasing trucking productivity, of which vehicle throughput is only one of many factors. In the AHS literature, various operating concepts have been developed for an "end-state AHS," but little attention has been paid to the critical issue of how to realize such ultimate systems through a planned sequence of deployment steps. We believe that truck-AHS operating concepts and their deployment sequences must be developed with a needs-driven and technology-steered approach. We first identify the needs of the long-haul trucking industry and the major concerns of key stakeholders. A major need of the long-haul trucking industry is to increase the productivity of its drivers and trucks. A major desire of transportation agencies is to help that industry increase its productivity in a safe and efficient manner but without sacrificing either safety or the infrastructure. A major desire of the driving public is safety. Based on customer needs, stakeholder concerns, and available or promising truck-automation technologies, we then develop design options for several key aspects of truck-AHS operations. After comparing the merits of these options, we develop system operating concepts and deployment sequences to satisfy the customer needs. [ABSTRACT FROM AUTHOR]

Reviews how the report by the National Academy of Sciences, developed for the U.S. Department of Defense, issued in late 1984, has affected defense policy. Focus on the possible consequences of nuclear war on the environment and population; Proposition from Senator William Cohen that the U.S. nuclear weapons policies must consider the outcome of their use; Public reactions and debate over nuclear winter; How the use of nuclear weapons may cause global changes in temperature.

Highway congestion has in recent years become a pervasive problem for urban and suburban areas alike. The concept of Automated Highway Systems is based on the belief that integration of sensing, communication, and control technologies into vehicles and highways can lead to a large improvement in capacity and safety without requiring a significant amount of additional highway right-of-way. A fundamental determinant of Automated Highway Systems capacity is the vehicle-following rule, the rule that governs the behavior of vehicles traveling along a common lane (e.g., the spacing between any two longitudinally adjacent vehicles). Vehicle following affects the longitudinal capacity (achievable flow within a lane), the lateral capacity (achievable flow between lanes) and the conflicting relationship between the longitudinal flow and lateral capacity. The issues are investigated by developing probabilistic models for vehicle I platoon and gap distributions, for vehicles that travel in platoons, in slots, or as free-agents. Mathematical models are also developed to estimate the completion time of a lane change, which can be used as a surrogate for the lateral capacity. Numerical results for the three major vehicle-following rules and their comparison are also provided. [ABSTRACT FROM AUTHOR]

Background/aims A decrease in strabismus surgery in children has been previously documented in the UK. This study aims to examine whether the incidence of strabismus surgery in children is still decreasing and, if so, the possible reasons for this. Methods Data on strabismus surgery from 2000 to 2010 in children in Scotland, England and Wales were obtained. Population statistics for the age group 0-14 years were obtained for England, Scotland and Wales. Annual incidence of strabismus surgery per 100 000 age-specific population was calculated. Data on the number of sight tests in children conducted by the hospital eye service from 1995 to 2004 in these regions were also obtained. Results From 2000 to 2006, the annual incidence of paediatric strabismus operations decreased significantly in England (p=0.01) and Scotland ( p=0.03), and showed a decreasing trend in Wales ( p=0.06). Surgical rates, however, remained fairly constant from 2006 to 2010. The number of sight tests in children performed by the hospital eye service has remained fairly constant from 1995 to 2004 in England, Wales and Scotland. Conclusions Rates of strabismus surgery in children, especially for esotropia, continued to decrease between 2000 and 2006, but may have stabilised from 2006 to 2010. [ABSTRACT FROM AUTHOR]

Presents information on the work of the U.S. Agency for International Development (AID) in international development assistance for environmental protection in developing countries. Function of AID; Projects pursued by AID; Lawsuit filed against AID for its refusal to prepare environmental impact statements.

The article presents the author's views on the International Classification of Diseases-11 (ICD-11) draft launched by the World Health Organization (WHO) on its website. Various topics discussed include difference between earlier versions and this one, how it will influence people living in low- and middle-income countries (LMICs) and medical care financing.

Determination of CSF oligoclonal bands (OCBs) remains the most useful immunological marker in the diagnosis of MS. Measurement of immunoglobulin light chains in the CSF have been suggested to be highly sensitive and specific for MS in limited studies. Clinical data were obtained retrospectively in 160 patients who had CSF OCBs measured in the neuroimmunology department. Patients were divided into four groups based on their clinical diagnoses—MS, non-MS inflammatory diseases, noninflammatory CNS diseases and controls. Control group consisted of patients who had lumbar punctures for other conditions like BIH, migraine, MND etc. CSF and serum kappa and lambda concentrations were obtained and their relative indices calculated. A value of mean±3SD of the controls was used as the cut-off for determining the positivity. Mean (±SEM) CSF kappa concentration in control population was 0.13±0.03 mg/l. The CSF kappa concentration in the MS cohort was 8.01±1.33 mg/l (p<0.001), with much lower values obtained in the other groups. The ratio of CSF kappa/lambda concentration was significantly different in the MS group compared to the other disease groups. Although there was a tendency for higher light chain concentrations in the CSF in the more progressive MS subtypes, this was not statistically significant. The sensitivity of OCBs in MS was 88.9% and that of the total kappa-lambda index was 95.2%, potentially making this a useful investigation, especially in the OCB negative patients. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including role of information technology (IT) in business, electronic commerce, and Internet shopping.

An introduction is presented in which the editor discusses various reports within the issue on topics including role of information technology (IT) in business, technology-related managerial issues, and new knowledge and skills of latest technologies.

The ideal temperature for hypothermic circulatory arrest (HCA) during acute type A aortic dissection (ATAAD) repair has yet to be determined. We examined the clinical impact of different degrees of hypothermia during dissection repair. Out of 240 cases of ATAAD between June 2014 and December 2019, 228 patients were divided into two groups according to lowest intraoperative temperature: moderate hypothermic circulatory arrest (MHCA) (20–28°C) versus deep hypothermic circulatory arrest (DHCA) (<20°C). From this, 74 pairs of propensity-matched patients were analysed with respect to operative data and short-term clinical outcomes. Independent predictors of a composite outcome of 30-day mortality and stroke were identified. Mean lowest temperature was 25.5±3.9°C in the MHCA group versus 16.0±2.9°C in DHCA. Overall 30-day mortality of matched cohort was 11.5% (17 deaths), there were no significant different between matched groups. Cardiopulmonary bypass (CPB) times were longer in DHCA (221.0±69.9 vs 190.7±74.5 mins, p=0.01). Antegrade cerebral perfusion (ACP) during HCA predicted a lower composite risk of 30-day mortality and stroke (OR 0.38). Female sex (OR 4.71), lower extremity ischaemia at presentation (OR 3.07), and CPB >235 minutes (OR 2.47), all portended worse postoperative outcomes. A surgical strategy of MHCA is at least as safe as DHCA during repair of acute type A aortic dissection. ACP during HCA is associated with reduced 30-day mortality and stroke, whereas female sex, lower extremity ischaemia, and longer CPB times are all predictive of poorer short-term outcomes. [ABSTRACT FROM AUTHOR]

Background: The SYNTAX score (SX) is an angiographic grading system to determine the burden and complexity of coronary artery disease (CAD) and to guide operators as to the appropriateness of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG). However, variability of the SX may exist since the assessment relies on individual clinicians to visually interpret lesion severity and characteristics. We therefore aimed to assess SX variability and reproducibility among interpreting physicians.Methods: Fifty patient angiograms were randomly selected from a registry of patients with multi-vessel CAD (treated with PCI or CABG) completed at our institution during the years 2011-2018. Each angiogram was evaluated by 6 clinicians on 2 separate occasions (minimum 8 weeks between occasions) for a total of 600 SX. Our goal was to evaluate both inter- and intra- observer reliability of SX scores. Variation in both raw score as well as risk classification (low, intermediate or high SX) was observed. Inter- and intra-observer reliability were assessed using the intra-class correlation coefficient (ICC), Cohen's weighted Kappa, and Fleiss' Kappa.Results: SYNTAX scores on both assessments and across all 6 cardiologists had a mean score of 25.3. On the first assessment, the ICC for the inter-observer reliability of SX scores was 0.61 (95% CI: 0.50, 0.73). Across the 6 observers, only 16% of angiograms were classified in the same risk classification by all observers. 34% of angiograms had less than a majority agreement (3 or less observers) on risk classification. The weighted Kappa for intra-observer reliability of risk classification scores ranged from 0.30 to 0.81. Across the 6 observers, the proportion of angiograms classified as the same risk classification between each observer's 1st and 2nd assessment ranged from 46% to 84%.Conclusion: This study shows a wide inter- and intra- user variability in calculating SX. Our data indicates a significant limitation in using the SX to guide revascularization strategies. Further studies are needed to determine more reliable ways to quantitate burden of CAD. [ABSTRACT FROM AUTHOR]

Background: Species may respond to a warming climate by moving to higher latitudes or elevations. Shifts in geographic ranges are common responses in temperate regions. For the tropics, latitudinal temperature gradients are shallow; the only escape for species may be to move to higher elevations. There are few data to suggest that they do. Yet, the greatest loss of species from climate disruption may be for tropical montane species. Methodology/Principal Findings: We repeat a historical transect in Peru and find an average upward shift of 49 m for 55 bird species over a 41 year interval. This shift is significantly upward, but also significantly smaller than the 152 m one expects from warming in the region. To estimate the expected shift in elevation we first determined the magnitude of warming in the locality from historical data. Then we used the temperature lapse rate to infer the required shift in altitude to compensate for warming. The range shifts in elevation were similar across different trophic guilds. Conclusions: Endothermy may provide birds with some flexibility to temperature changes and allow them to move less than expected. Instead of being directly dependent on temperature, birds may be responding to gradual changes in the nature of the habitat or availability of food resources, and presence of competitors. If so, this has important implications for estimates of mountaintop extinctions from climate change. [ABSTRACT FROM AUTHOR]

Zusammenfassung  Das Vorliegen einer Placenta increta ist eine seltene, aber potenziell lebensbedrohliche Risikokonstellation nach einer vorangegangenen Schnittentbindung. Es wird �ber eine 29-j�hrige 2. Gravida 1. Para berichtet, bei der es w�hrend einer Sectio caesarea aufgrund dieser Plazentationsst�rung zu einer dramatischen Blutung kam, die nur durch eine postpartale Hysterektomie beherrscht werden konnte. Der Fall zeigt, dass insbesondere beim Vorliegen der beiden wichtigsten Risikofaktoren, Resectio und Placenta praevia, an die M�glichkeit einer Placenta increta gedacht und angemessene Vorbereitungen getroffen werden sollten. [ABSTRACT FROM AUTHOR]

The problem of finding an x∈Rn such that Ax&les;b and x&ges;0 arises in numerous contexts. We propose a new optimization method for solving this feasibility problem. After converting Ax&les;b into a system of equations by introducing a slack variable for each of the linear inequalities, the method imposes an entropy function over both the original and the slack variables as the objective function. The resulting entropy optimization problem is convex and has an unconstrained convex dual. If the system is consistent and has an interior solution, then a closed-form formula converts the dual optimal solution to the primal optimal solution, which is a feasible solution for the original system of linear inequalities. An algorithm based on the Newton method is proposed for solving the unconstrained dual problem. The proposed algorithm enjoys the global convergence property with a quadratic rate of local convergence. However, if the system is inconsistent, the unconstrained dual is shown to be unbounded. Moreover, the same algorithm can detect possible inconsistency of the system. Our numerical examples reveal the insensitivity of the number of iterations to both the size of the problem and the distance between the initial solution and the feasible region. The performance of the proposed algorithm is compared to that of the surrogate constraint algorithm recently developed by Yang and Murty. Our comparison indicates that the proposed method is particularly suitable when the number of constraints is larger than that of the variables and the initial solution is not close to the feasible region. [Copyright &y& Elsevier]

Background: Hybrid coronary revascularization (HCR) constitutes a left internal mammary artery graft to the left anterior descending (LAD) coronary artery, coupled with percutaneous coronary intervention (PCI) for non‐LAD lesions. This management strategy is not commonly offered to patients with complex multivessel disease. Our objective was to evaluate 8‐year survival in patients with triple‐vessel disease (TVD) treated by HCR, compared with that of concurrent matched patients managed by traditional coronary artery bypass grafting (CABG) or multivessel PCI. Methods: A retrospective review was undertaken of 4805 patients with TVD who presented between January 2009 and December 2016. A cohort of 100 patients who underwent HCR were propensity‐matched with patients treated by CABG or multivessel PCI. The primary endpoint was all‐cause mortality at 8 years. Results: Patients with TVD who underwent HCR had similar 8‐year mortality (5.0%) as did those with CABG (4.0%) or multivessel PCI (9.0%). A composite endpoint of death, repeat revascularization, and new myocardial infarction, was not significantly different between patient groups (HCR 21.0% vs CABG 15.0%, P =.36; HCR 21.0% vs PCI 25.0%, P =.60). Despite a higher baseline synergy between percutaneous coronary intervention with taxus and cardiac surgery(SYNTAX) score, HCR was able to achieve a lower residual SYNTAX score than multivessel PCI (P =.001). Conclusions: In select patients with TVD, long‐term survival and FREEDOM from major adverse cardiovascular events after HCR are similar to that seen after traditional CABG or multivessel PCI. HCR should be considered for patients with multivessel disease, presuming a low residual SYNTAX score can be achieved. [ABSTRACT FROM AUTHOR]

Mitochondrial DNA sequence of the sub-unit 1 of cytochrome c oxidase (Cox1) and ribosomal DNA sequence of the first internal transcribed spacer (ITS-1) of Fasciola collected from mithun and cattle from Arunachal Pradesh, India were characterized at molecular level in order to identify the species of parasite. Based on sequence and phylogenetic analysis, the identity of the parasite was confirmed as Fasciola gigantica in mithun as well as from cattle. In order to know histopathological alteration in Fasciola infection, a histopathological study was performed on eight liver specimens, out of 110 animals studied during the period from 2010-2016. Histopathological examination of F.gigantica infected liver showed extensive fibrous connective tissue proliferation with necrosis of hepatocytes and infiltration of polymorphonuclear cell. There was evidence of migratory tracts of parasites with losing of normal lobular hepatic architecture. Bile duct proliferation was followed by congestion of portal vein with perivascular cuffing with surrounding degeneration of hepatocytes. The hepatocytes showed pyknosis with hyperplasia of bile duct. [ABSTRACT FROM AUTHOR]

Background: Direct cannulation of the innominate artery for selective antegrade cerebral perfusion has been shown to be safe in elective proximal aortic reconstructions. We sought to evaluate the safety of this technique in acute aortic dissection.Methods: A multi-institutional retrospective review was undertaken of patients who underwent proximal aortic reconstruction for Stanford type A dissection between 2006 and 2016. Those patients who had direct innominate artery cannulation for selective antegrade cerebral perfusion were selected for analysis.Results: Seventy-five patients underwent innominate artery cannulation for ACP for Stanford Type A Dissections. Isolated replacement of the ascending aorta was performed in 36 patients (48.0%), concomitant aortic root replacement was required in 35 patients (46.7%), of whom 7 had a valve-sparing aortic root replacement, ascending aorta and arch replacement was required in 4 patients (5%). Other procedures included frozen elephant trunk (n = 11 (14.7%)), coronary artery bypass grafting (n = 20 (26.7%)), and peripheral arterial bypass (n = 4 (5.3%)). Mean hypothermic circulatory arrest time was 19 ± 13 min. Thirty-day mortality was 14.7% (n = 11). Perioperative stroke occurred in 7 patients (9.3%).Conclusions: This study is the first comprehensive review of direct innominate artery cannulation through median sternotomy for selective antegrade cerebral perfusion in aortic dissection. Our experience suggests that this strategy is a safe and effective technique compared to other reported methods of cannulation and cerebral protection for delivering selective antegrade cerebral perfusion in these cases. [ABSTRACT FROM AUTHOR]

Background: There is, as yet, no broad consensus regarding the optimal surgical approach for patients requiring reoperative mitral valve surgery. Consequently, we sought to evaluate the perioperative outcomes for patients undergoing redo mitral surgery via right mini thoracotomy as compared with traditional resternotomy.Methods: A comprehensive retrospective review of our prospectively collected database was undertaken from January 2011 to December 2017. We propensity matched 90 patients who underwent reoperative mitral valve surgery via right mini thoracotomy with a concurrent cohort of patients who had redo median sternotomy. Intraoperative data and short-term clinical outcomes were analyzed.Results: The 30-day mortality was 3.3% (six deaths) in the entire cohort, not significantly different between redo sternotomy and mini thoracotomy groups. Patients who had their procedure via right mini thoracotomy had reduced intensive care unit (P = .029) and overall hospital (P < .0001) lengths of stay, a diminished requirement for perioperative transfusion (P = .023), and a trend towards faster postoperative extubation. Right thoracotomy patients experienced shorter cardiopulmonary bypass (P = .012) and cardiac arrest (P < .0001) times than did the sternotomy cases. Peripheral cannulation was utilized more frequently in the mini thoracotomy group, as were fibrillatory arrest techniques.Conclusion: Reoperative mitral valve surgery via right mini thoracotomy is safe, and is associated with shorter extracorporeal circulation times, reduced transfusion, and faster postoperative recovery. [ABSTRACT FROM AUTHOR]

The preparation of copper oxides/reduce graphene oxide (Cu 2 O-CuO/rGO) nanocomposites via a simple hydrothermal route is reported. The Cu 2 O-CuO/rGO nanocomposites are synthesized through redox reaction between CuCl 2 ·2H 2 O and graphene oxide (GO) without using any reducing agent. The X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) results authenticate the formation of Cu 2 O-CuO/rGO nanocomposites. It is evident from the high resolution transmission electron microscopy (HRTEM) images that the Cu 2 O-CuO nanorods are firmly wrapped on the rGO sheets. The electrochemical properties are investigated employing cyclic voltammetry (CV), galvanostatic charge-discharge (GCD) and electrochemical impedance spectroscopy (EIS) techniques. The Cu 2 O-CuO/rGO1 nanocomposites demonstrate highest specific capacitance of 436.6 F g −1 at 1 A g −1 and excellent cyclic stability with no variation in the capacitance even after 1000 cycles. [ABSTRACT FROM AUTHOR]

Arterial cannulation in acute DeBakey type I dissection can be difficult. Moreover, the residual dissected aorta is susceptible to further adverse events in the future. Implanting a stent-graft into the descending aorta during the initial dissection repair ('frozen elephant trunk') has been demonstrated to promote favourable aortic remodelling, mitigating some of these longer-term complications. We describe a technique for cannulation of the ascending aorta in acute dissection that facilitates expeditious antegrade deployment of a frozen elephant trunk. [ABSTRACT FROM AUTHOR]

Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living‑related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2nd, 4th, 6th, and 9th months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6‑8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control. [ABSTRACT FROM AUTHOR]

Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living‑related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2nd, 4th, 6th, and 9th months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6‑8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the prevalence and distribution of Escherichia coli O157:H7 lineage-specific polymorphism assay (LSPA) 6 genotypes from cattle (n = 313) and clinical human (n = 203) isolates from northern and southern Alberta, Canada, to understand possible associations of genotypes with host and geographic location. The majority of cattle isolates (feedlot and dairy) typed as LSPA-6 111111 (72.2%), with proportionately higher LSPA-6 222222 (19.4%) than other LSPA-6 genotypes (10.7%). Clinical human isolates also typed primarily as LSPA-6 111111 (90.1%), but a higher percentage of genotypes (6.8%) other than LSPA-6 222222 (3.1%) was observed. A significantly higher frequency of LSPA-6 111111 in southern Alberta cattle (P < 0.0001) and a significant difference in LSPA-6 genotypes between human versus feedlot cattle from northern Alberta (P < 0.0001) were detected. LSPA-6 211111 genotype was third and second most common in cattle and humans, respectively, and several new LSPA-6 genotypes (n = 19) were also discovered. Despite avoiding overrepresentation of isolates from specific farms or outbreaks, higher strain diversity among cattle by pulsed-field gel electrophoresis (PFGE; 50 genotypes) in contrast to human (9 PFGE genotypes) isolates was observed. The majority of cattle (74.4%) and human (90.6%) isolates were susceptible to the antimicrobials tested. Within resistant cattle isolates, sulfisoxazole-tetracycline resistance was common (62.5%) and was accounted for by the presence of sul1 and sul2, and tet(A) and tet(B) determinants. An association between LSPA-6 and PFGE genotypes but not between geographic location and PFGE genotype for both hosts was evident. [ABSTRACT FROM AUTHOR]

Iron-derived reactive oxygen species are involved in the pathogenesis of numerous vascular disorders. One abundant source of redox active iron is heme, which is inherently dangerous when it escapes from its physiologic sites. Here, we present a review of the nature of heme-mediated cytotoxicity and of the strategies by which endothelium manages to protect itself from this clear and present danger. Of all sites in the body, the endothelium may be at greatest risk of exposure to heme. Heme greatly potentiates endothelial cell killing mediated by leukocytes and other sources of reactive oxygen. Heme also promotes the conversion of low-density lipoprotein to cytotoxic oxidized products. Hemoglobin in plasma, when oxidized, transfers heme to endothelium and lipoprotein, thereby enhancing susceptibility to oxidant-mediated injury. As a defense against such stress, endothelial cells upregulate heme oxygenase-1 and ferritin. Heme oxygenase opens the porphyrin ring, producing biliverdin, carbon monoxide, and a most dangerous product—redox active iron. The latter can be effectively controlled by ferritin viasequestration and ferroxidase activity. These homeostatic adjustments have been shown to be effective in the protection of endothelium against the damaging effects of heme and oxidants; lack of adaptation in an iron-rich environment led to extensive endothelial damage in humans. [ABSTRACT FROM AUTHOR]

The article discusses multiple levels of conduction block on surface electrocardiography in a 75-year-old patient following surgical left atrial ablation of atrial fibrillation. Echocardiogram results of the patient show a normal left ventricular ejection fraction with myxomatous mitral valve leaflets as well as severe mitral regurgitation. It adds that the ECG results of the patient following surgical ablation present an unusual example of surface ECG manifestation of atrial tachycardia with intra-atrial block.

B Learning Objectives: b Pulmonary complications are some of the more frequently encountered adverse events after cardiac surgery, and encompass a broad spectrum of pathology, ranging from basal atelectasis, reduced lung compliance and poor functional residual capacity, all the way through to infective pneumonitis and/or an adult respiratory distress syndrome. Non-invasive ventilation is often helpful to treat postoperative respiratory failure and reduce the rate of re-intubation, yet the use of transport BiPAP and high-flow oxygen cannula therapy via nasal cannula seems under-utilized. B Results: b Eight patients utilized transport BiPAP, whereas 12 patients received transport high-flow oxygen via nasal cannula during early mobility after sternotomy. [Extracted from the article]