Explore the vast range of titles available.

Sustained growth in the arrhythmia population at Stanford Health Care led to an independent nurse practitioner–run outpatient direct current cardioversion (DCCV) program in 2012. DCCVs performed by a medical doctor, a nurse practitioner under supervision, or nurse practitioners from 2009 to 2014 were compared for safety and efficacy. A retrospective review of the electronic medical records system (Epic) was performed on biodemographic data, cardiovascular risk factors, medication history, procedural data, and DCCV outcomes. A total of 869 DCCVs were performed on 557 outpatients. Subjects were largely men with an average age of 65 years; 1/3 were obese; most had atrial fibrillation; and majority of subjects were on warfarin. The success rate of the DCCVs was 93.4% (812 of 869) with no differences among the groups. There were no short-term complications: stroke, myocardial infarction, or death. The length of stay was shortest in the NP group compared to the other groups (p <0.001). In conclusion, the success rate of DCCV in all groups was extremely high, and there were no complications in any of the DCCV groups.

Primary congenital glaucoma (PCG) is a rare type of glaucoma that is inherited in an autosomal recessive manner. PCG can lead to blindness if not detected early in children aged 3 or younger. PCG varies in presentation among various populations, where disease presentation and disease severity vary by mutation. The most common gene implicated in PCG is cytochrome p450 1B1 (CYP1B1). Here, we sought to review the literature for mutations in CYP1B1 and their presentation among different populations. Areas of interest include recent findings on disease presentation and potential implications on our understanding of PCG pathophysiology.

In this paper, multiferroic binary compounds BaTiO 3 (BTO) and YFeO 3 (YFO) were synthesized by the solid-state reaction method with varying concentration of x from 0 to 1.0 in the step size of 0.25. The prepared binary compounds have undergone the various characterizations like XRD, FTIR, Dielectric spectroscopy, and P–E loop analysis. The XRD of the compounds shows the single-phase structure symmetry varying from orthorhombic to tetragonal as the concentration of BTO increased. The bending and stretching vibration of the bond is confirmed by the FTIR. Dielectric results show the NTCR and non-Debye type relaxation in multiferroic compounds. The temperature-dependent dielectric properties revealed that the phase transition takes place in all the prepared compounds which confirms the ferroelectric nature of the compounds which makes promising application in the field of sensors. The P–E loop results show ferroelectric and leaky behavior of the compounds which have a significant potential in energy storage devices. The paramagnetic behavior of the composites at room temperature (RT) is confirmed by theoretical analysis of the polycrystalline samples.

In present article, the polycrystalline composites, Ba x Y (1-x) Ti x Fe (1-x) O 3 (BYTF x ), were synthesized through the solid-state reaction method with different concentration of x. The prepared composites were characterized by XRD, FTIR, SEM and UV–Visible spectroscopy. The crystallographic studies of doping effect of BaTiO 3 (BTO) in YFeO 3 (YFO) are studied through detailed analysis of XRD data. Scherer and W–H plot analyses have been carried out to estimate the crystallite size and amount of the strain present in the composites. The results of XRD show that unit cell is contracting and the structural symmetry is varying from orthorhombic to tetragonal in nature on doping of BTO. The surface morphology of the compounds is studied through SEM micrographs. The bond formation and distortions induced by doping are probed through FTIR analysis. The force constant and bond length are estimated through detailed analysis of FTIR data. The obtained results promise us for better dielectric properties of compounds. Band gap of prepared compound is estimated through UV–Vis data analysis. The obtained wide band gap nature as semiconductors make them suitable as photorefractive materials.

Klebsiella pneumoniae (Kp) has gained prominence in the last two decades due to its global spread as a multidrug-resistant (MDR) pathogen. Further, carbapenem-resistant Kp are emerging at an alarming rate. The objective of this study was (1) to evaluate the prevalence of β-lactamases, especially carbapenemases, in Kp isolates from India, and (2) determine the most prevalent sequence type (ST) and plasmids, and their association with β-lactamases. Clinical samples of K. pneumoniae (n = 65) were collected from various pathology labs, and drug susceptibility and minimum inhibitory concentrations (MIC) were detected. Whole genome sequencing (WGS) was performed for n = 22 resistant isolates, including multidrug-resistant (MDR) (n = 4), extensively drug-resistant (XDR) (n = 15), and pandrug-resistant (PDR) (n = 3) categories, and genomic analysis was performed using various bioinformatics tools. Additional Indian MDRKp genomes (n = 187) were retrieved using the Pathosystems Resource Integration Center (PATRIC) database. Detection of β-lactamase genes, location (on chromosome or plasmid), plasmid replicons, and ST of genomes was carried out using CARD, mlplasmids, PlasmidFinder, and PubMLST, respectively. All data were analyzed and summarized using the iTOL tool. ST231 was highest, followed by ST147, ST2096, and ST14, among Indian isolates. blaampH was detected as the most prevalent gene, followed by blaCTX-M-15 and blaTEM-1. Among carbapenemase genes, blaOXA-232 was prevalent and associated with ST231, ST2096, and ST14, which was followed by blaNDM-5, which was observed to be prevalent in ST147, ST395, and ST437. ST231 genomes were most commonly found to carry Col440I and ColKP3 plasmids. ST16 carried mainly ColKP3, and Col(BS512) was abundantly present in ST147 genomes. One Kp isolate with a novel MLST profile was identified, which carried blaCTX-M-15, blaOXA-1, and blaTEM-1. ST16 and ST14 are mostly dual-producers of carbapenem and ESBL genes and could be emerging high-risk clones in India.

Measurement of normal corneal thickness and corneal epithelial thickness is important in keratorefractive surgery, glaucoma, following extended contact lens wear, and in patients with corneal disease. Clinically, a central corneal thickness less than 500 µm is considered to be moderately-to-extremely thin. The purpose of this study was to compare biological differences in patients with clinically thin compared to normal corneal thickness values in healthy young adults using Fourier domain optical coherence tomography. In total, 168 eyes from 84 patients aged 19-38 years were scanned using an Avanti optical coherence tomographer. To eliminate circadian effects on corneal thickness, all patients were scanned within a 4-hour window. Corneal thickness was measured across the central 6 mm of the cornea. Total central corneal thickness, corneal epithelial thickness, and corneal stromal thickness were compared between males and females and tested for correlations with age, use of systemic hormones, degree of myopia, and corneal curvature. The average central corneal thickness for males and females was 540.5±32.0 μm and 525.2±33.0 μm, respectively ( =0.020). Thirty-eight eyes had corneal thickness measurements below 500 µm; 12% (6 eyes) from males and 28% (16 eyes) from females ( =0.008). All women with corneas below 500 μm were bilaterally thin. This finding differed for men. Corneal thinning was not associated with age, use of systemic hormones, or degree of myopia. Females had steeper keratometry (K) readings ( =0.01 for flat K, =0.002 for steep K) than males. No differences in layer offset values between normal thickness corneas and thin corneas were evident, suggesting that the reduced thickness was not pathological. The results of this study indicate that a subpopulation of healthy young adults have non-pathologically thin corneas, well below 500 μm; and that these thinner corneas are more frequent in females. This underscores the importance of accurate corneal thickness measurements prior to keratorefractive surgery and when evaluating intraocular pressure in glaucoma.

Genetic linkage maps play fundamental roles in understanding genome structure, explaining genome formation events during evolution, and discovering the genetic bases of important traits. A high-density cotton (Gossypium spp.) genetic map was developed using representative sets of simple sequence repeat (SSR) and the first public set of single nucleotide polymorphism (SNP) markers to genotype 186 recombinant inbred lines (RILs) derived from an interspecific cross between Gossypium hirsutum L. (TM-1) and G. barbadense L. (3-79). The genetic map comprised 2072 loci (1825 SSRs and 247 SNPs) and covered 3380 centiMorgan (cM) of the cotton genome (AD) with an average marker interval of 1.63 cM. The allotetraploid cotton genome produced equivalent recombination frequencies in its two subgenomes (At and Dt). Of the 2072 loci, 1138 (54.9%) were mapped to 13 At-subgenome chromosomes, covering 1726.8 cM (51.1%), and 934 (45.1%) mapped to 13 Dt-subgenome chromosomes, covering 1653.1 cM (48.9%). The genetically smallest homeologous chromosome pair was Chr. 04 (A04) and 22 (D04), and the largest was Chr. 05 (A05) and 19 (D05). Duplicate loci between and within homeologous chromosomes were identified that facilitate investigations of chromosome translocations. The map augments evidence of reciprocal rearrangement between ancestral forms of Chr. 02 and 03 versus segmental homeologs 14 and 17 as centromeric regions show homeologous between Chr. 02 (A02) and 17 (D02), as well as between Chr. 03 (A03) and 14 (D03). This research represents an important foundation for studies on polyploid cottons, including germplasm characterization, gene discovery, and genome sequence assembly.

Background: We present outcomes of Ahmed Glaucoma Valve (AGV) implantation in treating refractory glaucoma in a tertiary hospital in Oman. Refractory glaucoma was defined as previously failed conventional glaucoma surgery and an uncontrolled intraocular pressure (IOP) of more than 21 mm Hg despite treatment with three topical and/or oral therapy. Materials and Methods: This historical cohort study was conducted in 2010. Details of medical and surgical treatment were recorded. Ophthalmologists examined eyes and performed glaucoma surgeries using AGV. The best corrected distant vision, IOP, and glaucoma medications were prospectively reviewed on 1 st day, 1 st , 6 th , 12 th week postoperatively, and at the last follow up. Result: Glaucoma specialists examined and treated 40 eyes with refractory glaucoma of 39 patients (20 males + 19 females). Neo-vascular glaucoma was present in 23 eyes. Vision before surgery was <3/60 in 21 eyes. At 12 weeks, one eye had vision better than 6/12, seven eyes had vision 6/18 to 6/60, and eight eyes had vision 6/60 to 3/60. Mean IOP was reduced from 42.9 (SD 16) to 14.2 (SD 8) and 19.1 (SD 7.8) mmHg at one and 12 weeks after surgery, respectively. At 12 weeks, five (12.5%) eyes had IOP controlled without medication. In 33 (77.5%) eyes, pressure was controlled by using one or two eye drops. The mean number of preoperative anti-glaucoma medications (2.38; SD 1.1) was reduced compared to the mean number of postoperative medications (1.92; SD 0.9) at 12 weeks. Conclusion: We succeeded in reducing visual disabilities and the number of anti-glaucoma medications used to treat refractory glaucoma by AGV surgery.

Background Short-term starvation prior to chemotherapy administration protects mice against toxicity. We undertook dose-escalation of fasting prior to platinum-based chemotherapy to determine safety and feasibility in cancer patients. Methods 3 cohorts fasted before chemotherapy for 24, 48 and 72 h (divided as 48 pre-chemo and 24 post-chemo) and recorded all calories consumed. Feasibility was defined as ≥ 3/6 subjects in each cohort consuming ≤ 200 kcal per 24 h during the fast period without excess toxicity. Oxidative stress was evaluated in leukocytes using the COMET assay. Insulin, glucose, ketones, insulin-like growth factor-1 (IGF-1) and IGF binding proteins (IGFBPs) were measured as biomarkers of the fasting state. Results The median age of our 20 subjects was 61, and 85 % were women. Feasibility criteria were met. Fasting-related toxicities were limited to ≤ grade 2, most commonly fatigue, headache, and dizziness. The COMET assay indicated reduced DNA damage in leukocytes from subjects who fasted for ≥48 h ( p  = 0.08). There was a non-significant trend toward less grade 3 or 4 neutropenia in the 48 and 72 h cohorts compared to 24 h cohort ( p  = 0.17). IGF-1 levels decreased by 30, 33 and 8 % in the 24, 48 and 72 h fasting cohorts respectively after the first fasting period. Conclusion Fasting for 72 h around chemotherapy administration is safe and feasible for cancer patients. Biomarkers such as IGF-1 may facilitate assessment of differences in chemotherapy toxicity in subgroups achieving the physiologic fasting state. An onging randomized trial is studying the effect of 72 h of fasting. Trial registration NCT00936364 , registered propectively on July 9, 2009.