Gastrointestinal tract symptoms and self-reported abuse: a population-based study

BACKGROUND/AIMS: A link between abuse and irritable bowel syndrome (IBS) has been reported in outpatients but remains controversial. No population-based studies have investigated this issue. The aim of this study was to determine the prevalence of abuse and its association with symptoms in a representative community sample. METHODS: An age- and sex-stratified random sample of residents of Olmsted County, Minnesota ranging in age from 30 to 49 years was mailed a valid self-report symptom questionnaire. Abuse was assessed by standard published criteria. RESULTS: Of the 919 responders (74%), the age-adjusted prevalence of any abuse was 41% in women and 11% in men, resulting in an age- and sex-adjusted prevalence of 26%. Symptoms of IBS, dyspepsia, and frequent heartburn were reported by 14%, 23%, and 12%, respectively. There was a significant association between IBS and sexual abuse, emotional or verbal abuse, and abuse in childhood and adulthood. Similarly, dyspepsia and heartburn were both significantly associated with abuse. In the population, 31% had visited a physician for gastrointestinal symptoms; the odds of visiting a physician were highest in those reporting abuse in adulthood and childhood. CONCLUSIONS: Self-reported abuse is common in middle-aged subjects; those who report abuse are more likely to have symptoms consistent with IBS, dyspepsia, or heartburn and to visit a physician for bowel symptoms.     

Neuroleptic use and behavioral disturbance in nursing homes: a 1-year study

This article discusses a longitudinal study of change in disruptive behaviors among nursing home residents treated with neuroleptics compared with those not treated with neuroleptics. Observations were made of 201 participants on admission to and after 1 year in eight skilled nursing facilities. Nine disruptive behaviors were measured using the Psychogeriatric Dependency Rating Scale with nursing assistants. Neuroleptic use was documented from medication records. Odds ratios are reported for the association of behavior at baseline and use of neuroleptics on nine problem behaviors. For those who received neuroleptics during the year, there was greater change in both developing and resolving disruptive behaviors than for those not receiving neuroleptics. For both groups, restless or pacing behavior and belligerent behavior manifested by refusing instructions changed the most, both in developing and in apparently resolving. Our results show that change in disruptive behaviors occurs among nursing home residents regardless of neuroleptic use, but it occurs more frequently among those who receive neuroleptic medication. Knowledge of which disruptive behaviors are most likely to resolve or develop is important in training nursing home staff to cope with the behaviors as well as in planning interventions that may modify such behaviors.     

New nonsteroidal androgen receptor modulators based on 4-(trifluoromethyl)-2(1H)-pyrrolidino[3,2-g] quinolinone

Typhoid fever is often associated with abnormal liver biochemical tests, but severe hepatic involvement with a clinical feature of acute hepatitis is a rare complication. There have been more than 150 cases of salmonella hepatitis reported from both developed and developing countries. The documented incidence varies widely from less than 1% to 26% patients with enteric fever. The possible associated factors for development of salmonella hepatitis are virulence of the organisms, delayed treatment and poor general health of the patients. The pathogenesis of severe hepatic involvement in salmonella infection may be multifactorial and includes endotoxin, local inflammatory and/or host immune reactions. Clinical jaundice in salmonella hepatitis usually occurs within the first 2 weeks of the febrile illness. Hepatomegaly and moderate elevation of transaminase levels are common findings. Extreme hepatic dysfunction with hepatic encephalopathy is a rare coexisting complication in salmonella hepatitis. A positive culture for salmonella from blood or stool is essential to differentiate salmonella hepatitis from other causes of acute hepatitis. Hepatic pathology is characterized by the presence of typhoid nodules with marked hyperplasia of reticuloendothelial cells. The prognosis is usually good as salmonella hepatitis responds well to a specific antibiotic therapy and juandice resolves with clinical improvement. The clinical course can be severe with a mortality rate as high as 20%, particularly with delayed treatment or in patients with other complications of salmonella infection. As enteric fever is a common infection, the recognition of salmonella hepatitis is of clinical importance.     

A novel low complexity data demodulation algorithm for pulse position modulation

In this paper, a low complexity data demodulation algorithm is proposed that requires time of arrival information of the received signal exclusively. As an application example, the algorithm is applied to an ultra-wideband impulse radio communication system with pulse position modulation. The algorithm is insensitive to a common time delay for all pulses, that means, it does not require an accurate synchronization between the transmitter and the receiver. For the performance estimation, only a symbol synchronization is assumed, i.e., that there is a priori knowledge which pulse marks the beginning of a received data symbol. The performance of the proposed algorithm is evaluated for straightforward time of arrivals estimators, such as a maximum detector or a threshold detector. It is shown that the proposed algorithm outperforms a least squares algorithm in all considered scenarios. In particular, an increased robustness against additive white Gaussian noise, impulse like noise, and multiuser interference is demonstrated as well as an improved performance for multipath propagation channels.     

Towards mesoscopic thermodynamics: Small systems in higher-order states

A higher-order generalization of the usual thermodynamic formalism is presented for systems with the number of particlesN large in comparison with 1, but sufficiently small that one or many higher-order fluctuations of energy (or other observables) are measurable, directly or indirectly. Then 1 «N «N _A , whereN _A is the Avogadro number, andn2, wheren is the highest order of fluctuations (central statistical moments). The systems are then open, finite and compact, and they have compact boundary surfaces, so that the energy is non-additive and temperatures are non-intensive, in general. Such systems will be called comesoscopic, while a finite or infinite super-system of such systems will be called mesoscopic. Three ideal models of comesoscopic systems are discussed in detail with one or two higher-order temperatures. General conclusions concerning hierarchical composite systems are drawn afterwards.

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Hemi- and Homozygous Loss-of-Function Mutations in DSG2 (Desmoglein-2) Cause Recessive Arrhythmogenic Cardiomyopathy with an Early Onset

About 50% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients are frequently unknown and a genetic contribution might be underestimated. Here, we used a next-generation sequencing (NGS) approach and in addition single nucleotide polymor-phism (SNP) arrays for the genetic analysis of two independent index patients without familial medical history. Of note, this genetic strategy revealed a homozygous splice site mutation (DSG2–c.378+1G>T) in the first patient and a nonsense mutation (DSG2–p.L772X) in combination with a large deletion in DSG2 in the second one. In conclusion, a recessive inheritance pattern is likely for both cases, which might contribute to the hidden medical history in both families. This is the first report about these novel loss-of-function mutations in DSG2 that have not been previously identi-fied. Therefore, we suggest performing deep genetic analyses using NGS in combination with SNP arrays also for ACM index patients without obvious familial medical history. In the future, this finding might has relevance for the genetic counseling of similar cases.     

Dynamic “Molecular Portraits” of Biomembranes Drawn by Their Lateral Nanoscale Inhomogeneities

To date, it has been reliably shown that the lipid bilayer/water interface can be thoroughly characterized by a sophisticated so-called “dynamic molecular portrait”. The latter reflects a combination of time-dependent surface distributions of various physicochemical properties, inherent in both model lipid bilayers and natural multi-component cell membranes. One of the most important features of biomembranes is their mosaicity, which is expressed in the constant presence of lateral inhomogeneities, the sizes and lifetimes of which vary in a wide range—from 1 to 10³ nm and from 0.1 ns to milliseconds. In addition to the relatively well-studied macroscopic domains (so-called “rafts”), the analysis of micro- and nanoclusters (or domains) that form an instantaneous picture of the distribution of structural, dynamic, hydrophobic, electrical, etc., properties at the membrane-water interface is attracting increasing interest. This is because such nanodomains (NDs) have been proven to be crucial for the proper membrane functioning in cells. Therefore, an understanding with atomistic details the phenomena associated with NDs is required. The present mini-review describes the recent results of experimental and in silico studies of spontaneously formed NDs in lipid membranes. The main attention is paid to the methods of ND detection, characterization of their spatiotemporal parameters, the elucidation of the molecular mechanisms of their formation. Biological role of NDs in cell membranes is briefly discussed. Understanding such effects creates the basis for rational design of new prospective drugs, therapeutic approaches, and artificial membrane materials with specified properties.     

Synthesis of titanium aluminide coatings on aluminum and titanium surfaces by mechanical alloying and subsequent annealing

Intermetallic Ti-Al-based coatings were synthesized by mechanical alloying in a vibratory ball mill and subsequent annealing. A titanium layer was deposited on aluminum specimens and an aluminum layer and aluminum-titanium mixture were deposited on titanium specimens. Under the effect of milling balls, powder particles deposit at the substrates, forming layers that have a very good cohesion with the substrate. During subsequent heating, diffusion layers on the basis of titanium-aluminum phases are synthesized as a result of the chemical interaction between titanium and aluminum. In the case of titanium layer deposited on aluminum, the temperature interval of transformations is 600–650°C; first, a Ti₃Al₅-based phase is formed; then, as diffusion saturation with Al increases, an Al₂Ti-based layer appears; and finally, the Al₃Ti compound is formed. The reaction rates depend on the temperature and the duration of annealing. On titanium with a (Ti + Al) layer deposited on its surface, the Al₃Ti, Al₂Ti, TiAl, and Ti₃Al compounds are formed in a temperature interval of 600–900°C. In the case of deposition a homogeneous aluminum layer on titanium, only Al₃Ti and Ti₃Al phases were observed after annealing.     

Monitoring the tensile deformation in real unidirectional Kevlar-epoxy composites

Two acoustic emission (AE) parameters, event count rate (ER) and the skewness of the peak amplitude distribution (PAD), were found to correlate with mechanical and damage mechanisms in unidirectional Kevlar-epoxy composites loaded in tension. The ER of the AE reached a local maximum at about 0.3σ_cu (σ_cu= composite tensile strength), a minimum at about 0.6–0.7σ_cu, and increasing ER rates were noted as failure stress approached, with a peak at final failure.Along with our proposed approach to evaluate the PAD as a tool for characterizing processes, damage mechanisms and failure modes, the third statistical moment of the PAD, the skewness, was found to be able to distinguish between various mechanisms. From the beginning of loading until completion of the fibre straightening process, 0.6–0.7σ_cu, the value of the skewness steadily decreased, and then gradually increased to final failure. This behaviour is explained by a model based on the non-elastic mechanisms which contribute to the monitored AE. At final failure, the PAD's skewness value was affected by macroscopic failure modes. When this mode comprises fibre fracture with little matrix and interface splitting, the skewness decreased; when fibre failure was accompanied by matrix and interface splitting, its value changed slightly or even increased.