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Aim Fatty acid-binding protein-4 (FABP4) is an adipokine associated with obesity and signs of the metabolic syndrome. We aimed to investigate at birth in term neonates with normal and abnormal intrauterine growth concentrations of FABP4 and associate them with various perinatal parameters. Methods Serum cord blood FABP4 levels were prospectively determined by ELISA in 80 singleton term appropriate-for-gestational-age (AGA), intrauterine growth-restricted (IUGR) and large-for-gestational-age (LGA) neonates. Results Compared to the AGA group, cord blood FABP4 levels were increased in the IUGR and LGA groups. Additionally, they were higher in early-term than full-term neonates. A significant U-shaped correlation was recorded between serum FABP4 levels and birthweight. A significant negative correlation between cord blood FABP4 and gestational age in the whole study population was noted. Conclusion Cord blood FABP4 levels were significantly higher at the extremes of foetal growth at term and negatively correlated with gestational age, being increased in early-term versus full-term neonates. Further longitudinal studies with larger sample sizes are required to elucidate FABP4 implication in foetal growth and its association with future adverse cardiometabolic outcomes in the offspring.

Hospitals that are not prepared to respond effectively to public health emergencies may risk increased morbidity and mortality of casualties, reduced ability to protect their own staff and facilities, and a prolonged recovery phase resulting in financial losses and negative publicity within the community.

Between December 2014 and March 2021, 144 patients with aortic (Ao) or mitral (Mi) paravalvular leaks (PVLs) were enrolled at 21 sites in 10 countries. Safety data were available for 137 patients, who were included in the safety analysis fraction (SAF), 93 patients with Mi PVLs and 44 patients with Ao PVLs. The full analysis set (FAS) comprised 112 patients with available stratum (aortic/mitral leak) as well as baseline (BL), 180-day or later assessments (2 years). Procedural success (implantation of the device with a proper closure of the PVL, defined as reduction in paravalvular regurgitation of ≥one grade as assessed by echocardiography post implantation) was achieved in 91.3% of FAS patients with Mi PVLs and in 90.0% of those with Ao PVLs. The proportion of patients suffering from significant or severe heart failure (HF), classified as New York Heart Association (NYHA) class III/IV, decreased from 80% at baseline to 14.1% at 2-year follow-up (FAS). The proportion of FAS patients needing hemolysis-related blood transfusion decreased from 35.5% to 3.8% and from 8.1% to 0% in Mi patients and Ao patients, respectively. In total, 35 serious adverse events (SAEs) were reported in 27 patients (19.7%) of the SAF population. The SAEs considered possibly or probably related to the device included device embolization (three patients), residual leak (two patients) and vascular complication (one patient). During follow-up, 12/137 (8.8%) patients died, but none of the deaths was considered to be device-related. Patients implanted with the Occlutech Paravalvular Leak Device (PLD) showed long-lasting improvements in clinical parameters, including NYHA class and a reduced dependency on hemolysis-related blood transfusions.

Objectives The aim of this study was to evaluate 1-year clinical safety and efficacy of the dual-therapy COMBO stent in a large, all-comers patient-level pooled cohort. Background The COMBO stent (OrbusNeich Medical, Fort Lauderdale, Florida) is a novel stent with abluminal sirolimus elution from a biodegradable polymer and a luminal pro-healing anti-CD34+ antibody layer, which attracts circulating endothelial progenitor cells. These endothelial progenitor cells can quickly mature into normal endothelium, providing rapid endothelialization. Methods The MASCOT (Multinational Abluminal Sirolimus Coated biO-engineered stenT) (N = 2,614, 61 global sites) and REMEDEE (Randomized study to Evaluate the safety and effectiveness of an abluMinal sirolimus coatED bio-Engineered StEnt Post Market Registry) (N = 1,000, 9 European sites) registries are 2 prospective, multicenter studies evaluating clinical outcomes after attempted COMBO stent placement in all-comer patients undergoing percutaneous coronary intervention. In this patient-level pooled analysis we analyzed 1-year target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Furthermore, we determined predictors of 1-year TLF. Results A total of 3,614 patients (63.5 ± 11.2 years of age; 23.8% women) were included in this analysis. The prevalence of diabetes mellitus was 29.3%, and 54.3% patients presented with acute coronary syndrome. The primary endpoint of 1-year TLF occurred in 140 (3.9%) patients, with incidence of cardiac death in 1.6%, target vessel myocardial infarction in 1.2%, clinically driven target lesion revascularization in 2.2%, and definite stent thrombosis in 0.5% patients. Insulin-treated diabetes mellitus, chronic renal failure, and American College of Cardiology/American Heart Association lesion type B2/C were independent predictors of 1-year TLF. Conclusions In this large patient-level pooled analysis of patients treated with the dual-therapy COMBO stent excellent results at 1-year were observed. (MASCOT - Post Marketing Registry [MASCOT]; NCT02183454; Prospective Registry to Assess the Long-term Safety and Performance of the COMBO Stent [REMEDEE Reg]; NCT01874002)

Objective: Lactation is associated with a dramatic increase of maternal bone turnover, leading to a reversible bone loss. Early life nutrition may influence later osteoporosis risk. Protein...

This paper was designed to evaluate the functional outcome and assess the long-term quality of life (QoL) of patients who underwent restorative proctocolectomy with mucosectomy and hand suture ileal pouch-anal anastomosis (IPAA) over 20 years. Restorative proctocolectomy with IPAA is the surgical treatment of choice to all familial adenomatous polyposis (FAP) patients and those with ulcerative colitis (UC) not responding to conservative management. The procedure has been modified from a transanal hand-suture IPAA after mucosectomy to a stapled IPAA without mucosectomy, but the benefits are still debatable. We studied retrospectively all UC and FAP patients subjected to the procedure between 1987 and 2006, using the SF-36 Health Survey, the Wexner score for incontinence, and an additional questionnaire evaluating various aspects of functional outcome and late complications. A total of 326 patients (53% male) were included in the study. Pouchitis was recorded in 31% of UC and 5% of FAP patients. Anastomotic stricture was observed in 24% of UC and 8% of FAP patients. IPAA-related pouch failures occurred in 9% of UC and 3% of FAP. The median number of bowel movements per 24 hours was 6 (range: 2–20) with 1 (range: 0–8) bowel motion occurring at night. Wexner score was 3.27 (±0.32) for UC and 1.22 (±0.36) for FAP. The overall norm-based SF-36 score for physical/mental health status was 52.85/50.31 and 57.29/50.05 respectively. Restorative proctocolectomy with mucosectomy and hand suture IPAA is a safe procedure with good functional results and quality of life in well-satisfied patients. Pouchitis, anastomotic strictures, and pouch failures were mainly observed in the UC group.

To study the concentrations of preadipocyte factor-1 (Pref-1) -an inhibitor of adipocyte differentiation, implicated in adipose tissue metabolism, late metabolic disorders and fetal growth- in maternal and umbilical cord serum, as well as maternal milk and correlate above concentrations with intrauterine growth and other perinatal parameters.Pref-1 concentrations were determined by ELISA in antepartum maternal and umbilical cord serum, as well as day 3 to 4 postpartum breast milk, deriving from 80 women, who delivered 40 appropriate (AGA), 20 large for gestational age (LGA) and 20 intrauterine growth restricted (IUGR) neonates, classified by the use of customized birth-weight standards adjusted for significant determinants of fetal growth.Umbilical cord serum Pref-1 concentrations were significantly higher than antepartum maternal ones (p 0.001), while breast milk concentrations were the lowest (p 0.001 concerning umbilical serum, p 0.001 concerning maternal serum). Umbilical cord serum Pref-1 concentrations were significantly lower in the LGA group than in the AGA one (p = 0.044). Breast milk and maternal serum Pref-1 concentrations did not differ between the three intrauterine growth groups. Maternal serum and breast milk Pref-1 concentrations did not correlate with maternal age, body mass index before and after gestation, birth weight, body length, and customized centile. A positive weak correlation was recorded between maternal serum and milk Pref-1 concentrations (r = 0.238, p = 0.034).Pref-1 concentrations in umbilical cord serum are higher than in antepartum maternal serum, probably pointing to its fetal origin and role in intrauterine growth. Breast milk concentrations, being extremely low, and possibly implying infant protection from metabolic disorders, positively correlate with maternal serum ones, conceivably suggesting a transfer of the substance from the circulation to the breast. Umbilical cord serum Pref-1 concentrations were lower in LGA fetuses/neonates, as compared to respective AGA ones.

We study the Brownian motion of a particle in a bounded circular 2-dimensional domain, in search for a stationary target on the boundary of the domain. The process switches between two modes: one where it performs a two-dimensional diffusion inside the circle and one where it travels along the one-dimensional boundary. During the diffusion, the Brownian particle resets to its initial position with a constant rate $r$. The Fokker-Planck formalism allows us to calculate the mean time to absorption (MTA) as well as the optimal resetting rate for which the MTA is minimized. From the derived analytical results the parameter regions where resetting reduces the search time can be specified. We also provide a numerical method for the verification of our results., 11 pages, 10 figures

Intestinal neuronal dysplasia (IND) is a well-defined entity which raises controversy among authors, described as a congenital malformation of gastrointestinal innervation and caused by dysplastic embryonal development of the enteric nervous system. It is potentially associated with mild and chronic gastrointestinal motility disturbances. IND is rarely reported in adults and especially elderly patients. The present study reports on the case of a 71-year-old man suffering from longstanding idiopathic constipation and who was misdiagnosed for more than 60 years, despite several hospital admissions and a sigmoidectomy in the meantime. On the last admission, the patient presented with megacolon, abdominal pain and X-ray finding of bowel obstruction. Due to massive large bowel dilatation, an exploratory laparotomy failed to reveal any obvious mechanical cause, and a subtotal colectomy and Hartmann's procedure was performed. Bowel continuity was performed 3 months later. Analysis of full-thickness biopsies revealed enlarged myenteric and submucosal neurons as well as an increased number of giant cells and increased acetylcholinesterase activity in the mucosa. The diagnosis of IND was established. The main diagnostic criteria, the underlining pathophysiology and the recommended therapeutic approach of this rare entity are extensively reviewed.

Epidemiological and clinical data of 193 human cases of murine typhus in Cyprus were recorded and analysed during a 9-year period (2000-2008). The incidence rate was estimated at 24.5 cases/100,000 population/year. The incidence rate varied considerably between rural, urban and semi-urban areas, with residents in rural areas accounting for 79.3% of the total cases. Most (72.5%) of the cases occurred in late summer (July and August) and early autumn (September to October) with a peak in September. Well-established persistent endemic foci with clusters of cases were identified and characterised as 'high risk' areas. Presence of or contact with rats and fleas, presence of domestic/peridomestic animals and residence in rural areas, especially locations near the 'green line' (a narrow zone patrolled by UN forces that separates the northern and southern parts of the island), increased the possibility of murine typhus infection. The results of the current study enhance the belief that murine typhus is a serious public health problem in Cyprus.

Malignant melanoma is the malignancy with the highest propensity for cardiac metastasis. Metastasis to the heart usually occurs in the setting of disseminated disease and is therefore commonly associated with a poor prognosis. We report the case of a 51-year-old woman with a previous history of cutaneous malignant melanoma who presented with a symptomatic, isolated right atrial metastasis attached via a narrow stalk to the interatrial septum, thus resembling a myxoma. The lesion was completely resected, rendering the patient symptom and, potentially, disease-free. The case illustrates the importance of cardiac evaluation in the management of patients with melanoma.

Fleas collected from rats during a three-year period (2000-2003) in 51 areas of all provinces of Cyprus were tested by molecular analysis to characterize the prevalence and identity of fleaborne rickettsiae. Rickettsia typhi, the causative agent of murine typhus, was detected in Xenopsylla cheopis (4%) and in Leptopsylla segnis (6.6%). Rickettsia felis was detected in X. cheopis (1%). This is the first report of R. typhi in X. cheopis and L. segnis from rats, in Cyprus, and the first report of R. felis in X. cheopis in Europe. The role of fleas (mainly X. cheopis) was confirmed in the epidemiologic cycle of murine typhus in Cyprus by interrelation of current results with those of previous studies. The geographic distribution of fleas coincided with the geographic distribution of the pathogen they can harbor, which emphasizes the potential risk of flea-transmitted infections in Cyprus.

The Global Information Grid (GIG), is a large and complex undertaking that is intended to integrate virtually all DoD information systems, services, and applications into one seamless, reliable, and secure network. The GIG Transport Segment will be comprised of multiple different network types, each implementing a QoS solution that best fits the network's user needs. Each QoS solution implements different QoS mechanisms across the data, control, and management functional planes and may be reliant on network hardware that is not implemented GIG-wide. Interoperability challenges between these different QoS solutions need to be documented and analyzed to facilitate the delivery of traffic end-to-end across multiple GIG networks. This paper will provide an overview of the GIG Transport Segment, describe network-to-network interface connections, categorize different types of QoS solutions that are being applied to GIG networks, and discuss inter-domain challenges associated with interconnecting these types of solutions.

We consider the one-dimensional diffusion in a bounded domain with stochastic resetting. We start our analysis by presenting a method to derive the master equation for different resetting mechanisms. In the next step we compute the non-equilibrium steady state for a special case of this differential equation. Then we consider the existence of an absorbing point in the system and calculate the mean time to absorption of the diffusive particle by the target. Numerical and analytical calculations of the optimal resetting rate reveal a second order phase transition. Finally we discuss different special cases of the presented problem.

The explosion of a single wire with a high current pulse has long been established as an excellent source of x-ray radiation. However, experimental analysis of single wire explosions shows that the radiation is emitted from an inhomogeneous plasma consisting of high-density high-energy emitting points located randomly in a low density background column. The X- pinch, in which two or more crossed wires are exploded by a large current pulse driven by a low inductance source, is a good source of soft x-ray radiation in the energy range of 100 eV to 10 keV. The geometry of the crossed wire load ensures that the plasma emitting the bulk of the harder radiation is reproducibly located at the crossing point of the wires. This renders the source ideal for applications such as x-ray microscopy and lithography. Previous work on X- pinches has been carried out using elaborate high-voltage pulsed power generators delivering a brief high current pulse. Results are presented here of a first comprehensive study of X-pinch discharges driven by a low energy (4 kJ), low voltage (30 kV) 9 (mu) F capacitor bank. X- ray emission from X-pinches made from a variety of wires of different sizes and materials is characterized and compared with x-ray emission from single wire discharges. Radiation output is measured for different spectral regimes and information is presented concerning both the spatial and temporal emission of the radiation. Conditions for optimal soft x-ray yield on such low power machines are established.