Magnetocaloric and Giant Magnetoresistance Effects in La-Ba-Mn-Ti-O Epitaxial Thin Films: Influence of Phase Transition and Magnetic Anisotropy

Magnetic perovskite films have promising properties for use in energy-efficient spintronic devices and magnetic refrigeration. Here, an epitaxial ferromagnetic La_0.67Ba_0.33Mn_0.95Ti_0.05O₃ (LBMTO-5) thin film was grown on SrTiO₃(001) single crystal substrate by pulsed laser deposition. High-resolution X-ray diffraction proved the high crystallinity of the film with tetragonal symmetry. The magnetic, magnetocaloric and magnetoresistance properties at different directions of the applied magnetic field with respect to the ab plane of the film were investigated. An in-plane uni-axial magnetic anisotropy was evidenced. The LBMTO-5 epilayer exhibits a second-order ferromagnetic-paramagnetic phase transition around 234 K together with a metal–semiconductor transition close to this Curie temperature (T_C). The magnetic entropy variation under 5 T induction of a magnetic field applied parallel to the film surface reaches a maximum of 17.27 mJ/cm³ K. The relative cooling power is 1400 mJ/cm³ K (53% of the reference value reported for bulk Gd) for the same applied magnetic field. Giant magnetoresistance of about 82% under 5 T is obtained at a temperature close to T_C. Defined as the difference between specific resistivity obtained under 5 T with the current flowing along the magnetic easy axis and the magnetic field oriented transversally to the current, parallel and perpendicular to the sample plane, respectively, the in-plane magneto-resistance anisotropy in 5 T is about 9% near the T_C.     

Analysis of genetic and serology of hepatitis A virus infection during and after outbreak in two junior high schools in Surabaya,Indonesia

Outbreaks of hepatitis A have occurred in some cities in Indonesia. In Surabaya, the capital city of East Java province, Indonesia, hepatitis A outbreaks have been reported since2013, with a marked increase in the number of cases in 2015. The aim of the present study was to analyze the genetic and serology of acute symptomatic cases (early infection) during a hepatitis A outbreak and asymptomatic cases after the outbreak in two junior high schools in Surabaya in 2015 to 2016. Students with acute symptomatic hepatitis A during the outbreak and other students who were asymptomatic 3 to 4 months after the outbreak were enrolled. Asymptomatic students had no symptoms from the outbreak until they were enrolled. Sera were collected to identify anti-hepatitis A virus (HAV) IgM (by enzyme-linked immunosorbent assay) and HAV genetic variations/genotypes (using polymerase chain reaction [PCR]-sequencing and phylogenetic analysis). A total of 33 (97.1%) out of 34 sera of students with acute symptoms were positive for anti-HAV IgM and 18% of them were positive by PCR, identified as HAV subgenotype IA. No prominent amino acid variations were observed from reported HAV sequences from Indonesia. Among 38 sera of asymptomatic students, most (55.3%) were positive for anti-HAV IgM, while none were positive by PCR. In conclusion, HAV-IA was the only subgenotype identified in acute symptomatic cases during the outbreak. The percentage of HAV-specific IgM-positive cases was very high among acute symptomatic students, but that was also high among asymptomatic students, which might contribute as the important source of infection during the outbreak.     

Cardiac output by Doppler echocardiography in the premature baboon: Comparison with radiolabeled microspheres

Summary Pulsed-Doppler echocardiography (PDE) is a useful noninvasive method for determining left ventricular output (LVO). However, despite increasingly widespread use in neonatal intensive care units, validation studies in prematures with cardiopulmonary disease are lacking. The purpose of this study was to compare radiolabeled microsphere (RLM) and PDE measurements of LVO, using the critically ill premature baboon as a model of the human neonate. Twenty-two paired RLM and PDE measurements of LVO were obtained in 14 animals between 3 and 24 h of age. Average PDELVO was 152 ml/min/kg (range, 40–258 ml/min/kg) compared to 158 ml/min/kg (range, 67–278 ml/min/kg) measured by RLM. Linear regression analysis of the paired measurements showed good correlation with a slope near unity (y=0.94x+4.20,r=0.91, SEE=25.7 ml). We conclude that PDE determinations of LVO compare well with those measured by RLM in the premature baboon. PDE appears to provide a valid estimate of LVO and should be useful in human prematures with cardiopulmonary distress.The opinions expressed are those of the authors and do not necessarily reflect those of the USAF or the Department of Defense.     

Knowledge of epilepsy in the general population based on two French cities: Implications for stigma

The objective of this study was to assess the knowledge and attitudes of people living in two French counties. The data were collected from 1777 adults in the general population who were interviewed. Knowledge of and attitudes toward epilepsy in these French samples proved largely favorable: 90.6% identified epilepsy as different from a mental disorder or lunacy, and 79.2% correctly identified epilepsy as a brain disorder. The majority agreed with the statements that people with epilepsy should have the opportunity to get married and that children with epilepsy should be allowed to go to school with others. However, gaps in knowledge and erroneous beliefs prevailed, notably among men, old people, and individuals with low levels of education. This study yielded encouraging results. However, further studies are needed to confirm these findings and gain a better understanding of the contribution of French public knowledge to the causative factors generating stigma in France.     

The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care

Purpose: To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. Methods: The current implementation status of a sports and physical activity stimulation programme in 12 rehabilitation centres and 5 hospitals with a rehabilitation department was described by scoring fidelity and satisfaction. Seventy-one rehabilitation professionals filled out a questionnaire on how sports and physical activity, including stimulation activities, were implemented into rehabilitation care. Total fidelity scores (in %) were calculated for each organization. Professionals’ satisfaction was rated on a scale from 1 to 10. Results: In most organizations sports and physical activity were to some extent integrated during and after rehabilitation (fidelity scores: median?=?54%, IQR?=?23%). Physical activity stimulation was not always embedded as standard component of a rehabilitation treatment. Professionals’ satisfaction rated a median value of 8.0 (IQR?=?0.0) indicating high satisfaction rates. Conclusions: The fidelity outcome showed that activities to stimulate sports and physical activity during and after rehabilitation were integrated into rehabilitation care, but not always delivered as standardized component. These findings have emphasized the importance to focus on integrating these activities into routines of organizations.

• Implications for Rehabilitation

• Components of an evidence-based programme to stimulate sports and physical activity during and after rehabilitation can be used to measure the current status of the integration of sports and physical activity in rehabilitation care in a structural and effective way.

• The method described in the current study can be used to compare the content of the rehabilitation care regarding the integration of sports and physical activity among organizations both on a national and international level.

• Sports and physical activity are seen as important ingredients for successful rehabilitation care in The Netherlands.

     

AKI in Low-Risk versus High-Risk Patients in Intensive Care

Background and objectives

AKI in critically ill patients is usually part of multiorgan failure. However, nonrenal organ failure may not always precede AKI and patients without evidence of these organ failures may not be at low risk for AKI. This study examined the risk and outcomes associated with AKI in critically ill patients with and without cardiovascular or respiratory organ failures at presentation to the intensive care unit (ICU).

Design, setting, participants, & measurements

A large, academic medical center database, with records from July 2000 through October 2008, was used and the authors identified a low-risk cohort as patients without cardiovascular and respiratory organ failures defined as not receiving vasopressor support or mechanical ventilation within the first 24 hours of ICU admission. AKI was defined using Kidney Disease Improving Global Outcomes criteria. The primary end points were moderate to severe AKI (stages 2–3) and risk-adjusted hospital mortality.

Results

Of 40,152 critically ill patients, 44.9% received neither vasopressors nor mechanical ventilation on ICU day 1. Stages 2–3 AKI occurred less frequently in the low-risk patients versus high-risk patients within 24 hours (14.3% versus 29.1%) and within 1 week (25.7% versus 51.7%) of ICU admission. Patients developing AKI in both risk groups had higher risk of death before hospital discharge. However, the adjusted odds of hospital mortality were greater (odds ratio, 2.99; 95% confidence interval, 2.62 to 3.41) when AKI occurred in low-risk patients compared with those with respiratory or cardiovascular failures (odds ratio, 1.19; 95% confidence interval, 1.09 to 1.3); interaction P<0.001.

Conclusions

Patients admitted to ICU without respiratory or cardiovascular failure have a substantial likelihood of developing AKI. Although survival for low-risk patients is better than for high-risk patients, the relative increase in mortality associated with AKI is actually greater for low-risk patients. Strategies aimed at preventing AKI should not exclude ICU patients without cardiovascular or respiratory organ failures.     

The impact of the CYP2C9 and VKORC1 polymorphisms on acenocoumarol dose requirements in a Romanian population

AimTo investigate the genotype–phenotype correlation in Romanian patients treated with acenocoumarol.Material and methodsWe studied 301 consecutive patients who required treatment with acenocoumarol, admitted within the Municipal Hospital of Cluj-Napoca and the Heart Institute “Niculae St?nciou” in Cluj-Napoca over a 3-year period. For each patient we recorded clinical parameters which could interfere with the achievement of stable therapeutic international normalized ratio (INR). We performed genetic analysis which consisted of genotyping the CYP2C9 gene and the VKORC1 gene. Patients were divided in three groups according to the acenocoumarol dose needed to reach a stable INR: the low dose group (≤ 7 mg/week), the medium dose group (> 7 mg and < 28 mg/week) and the high acenocoumarol dose group (> 28 mg/week).ResultsWe found that patients' age was significantly different between groups (p < 0.001). No differences existed between groups regarding the pathologies which required anticoagulation therapy or the concomitant treatment. The following parameters increased the odds of receiving a low dose of acenocoumarol: patient's age over 65 years (OR, 3.2; p = 0.01; 95%CI: 1.24–8.25), the presence of the CYP2C9*3 allele (OR, 3.4; p = 0.006; 95%CI: 1.41–8.34), and the GA or AA genotype of c.-1639G>A polymorphism of VKORC1 (OR, 6.5; p = 0.01; 95%CI: 1.38–30.5; respectively OR, 11.6; p = 0.003; 95%CI: 2.26–59.58). A high acenocoumarol dose was less likely to be administered to an elderly patient (OR, 0.24; p = 0.001; 95%CI: 0.1–0.56) or to a patient with the GA or AA genotype (OR, 0.2; p < 0.001; 95CI%: 0.09–0.45; respectively OR, 0.05; p = 0.006; 95%CI: 0.007–0.43).ConclusionThe stable therapeutic dose of acenocoumarol is dependent of patient's age, the presence of the CYP2C9*3 allele and the c.-1639G>A polymorphism of VKORC1.     

Sociocultural and psychological features of perceived stigma reported by people with epilepsy in Benin

Purpose: Stigma is a major burden of epilepsy. In sub‐Saharan Africa the few studies that addressed epilepsy stigma emphasize enacted, rather than perceived, stigma. This inattention may compromise clinical management and delay help seeking, thereby contributing to the treatment gap. We assessed perceived stigma and identified sociocultural and psychological factors explaining greater stigma among people with epilepsy (PWE) in Benin. Methods: PWE included in this study were ascertained using a door‐to‐door survey in the general population in a Beninese rural area. We applied both qualitative and quantitative research methods to assess stigma and patient’s experience and beliefs. An Explanatory Model Interview Catalogue (EMIC) and verbally administered questionnaires provided data for demographic, clinical, and sociocultural features. Sociocultural features were evaluated in terms of illness‐related experience and sociocultural representations of epilepsy. Depression and anxiety were also screened. Results: Eighty PWE were included. About 68.7% reported feeling stigmatized. Multivariate regression revealed that factors independently associated with perceived stigma were experience of social isolation (p < 0.001), experience of marital problems (p < 0.01), and presence of anxiety disorder (p < 0.01). Discussion: Perceived stigma is an important issue in epilepsy in Benin. Social factors seem to be more influential than sociocultural representation of epilepsy. Insofar as research is needed in other African countries to determine the nature and relevant features of stigma to improve treatment and control.     

Biodynamics. Effect of pacing strategy on energy expenditure during a 1500-m cycling time trial

PURPOSE: A critical assumption in modeling optimal pacing strategy is that the amount of anaerobic energy that can be produced during a time trial is a constant value, independent of pacing strategy. To test this assumption, the effect of manipulations of pacing strategy on anaerobic work produced during a 1500-m cycling time trial was studied. Additionally, the effect of pacing strategy on aerobic and total work was studied. METHODS: Nine well-trained cyclists performed three 1500-m cycle ergometer time trials with different strategies (conservative (SUB), even paced (EVEN), and aggressive (SUPRA)). Anaerobic work, aerobic work, and total work were calculated on the basis of V O2, RER, gross efficiency, and external power output. RESULTS: ANOVA showed that total anaerobic work did not differ per strategy (EVEN: 27,604 +/- 1103 J, SUB: 26,495 +/- 1958 J, and SUPRA: 26,949 +/- 2062 J). No differences in aerobic work (EVEN: 28,266 +/- 1623 J,SUB: 27,950 +/- 1418 J, SUPRA: 27,844 +/- 1965 J) were evident, either. Subjects were able to accomplish significantly (P < 0.05) more total work during EVEN (55,870 +/- 2245 J) than during SUB and SUPRA (54,444 +/- 2306 and 54,794 +/- 2402 J, respectively). CONCLUSION: No difference in anaerobic and aerobic work was found per pacing strategy. Though relevant for sports performance, the differences in total work were relatively small (approximately 2%), considering the broad range of imposed strategies. The assumption that anaerobic work is a constant value, independent of pacing strategy, seems valid in the range of different strategies that are currently simulated in the energy flow models.