Electrical cardioversion of atrial fibrillation or flutter with conscious sedation in the age of cost containment

OBJECTIVE: To determine if there is a significant difference in the degree of pelvic organ prolapse assigned during examination in the standing position compared with the dorsal lithotomy position with the patient performing maximal Valsalva maneuver. METHODS: Fifty-one women with symptoms of pelvic organ prolapse were examined in both the dorsal lithotomy position, while performing maximal Valsalva, and in the standing position at the same visit by one of two examiners. Nine site-specific measures and summary stages were recorded, as outlined by the International Continence Society's classification system for pelvic organ prolapse. The data were analyzed by Wilcoxon signed-rank test and correlation coefficients. RESULTS: The mean age was 52 +/- 15 years. Excellent correlation was noted between all six points representing the vaginal prolapse. The R values for point Aa were 0.97, Ba 0.96, C 0.98, Ap 0.97, Bp 0.96, and D 0.97. The total vaginal length, perineal body, and genital hiatus measurements were performed in the dorsal lithotomy position with the patient at rest and were not repeated. The stages were identical in 48 of 51 patients. The average stage in the dorsal lithotomy position was 2.3 and in the standing position, 2.3. There was no statistically significant difference between the stage or any of the measured points in the dorsal lithotomy and standing examinations. CONCLUSION: The degree of pelvic organ prolapse can be assessed adequately in the dorsal lithotomy position with the patient performing maximal Valsalva. It is not necessary to routinely repeat the examination in the standing position.     

Essential Oils Biofilm Modulation Activity,Chemical and Machine Learning Analysis. Application on Staphylococcus aureus Isolates from Cystic Fibrosis Patients

Bacterial biofilm plays a pivotal role in chronic Staphylococcus aureus (S. aureus) infection and its inhibition may represent an important strategy to develop novel therapeutic agents. The scientific community is continuously searching for natural and “green alternatives” to chemotherapeutic drugs, including essential oils (EOs), assuming the latter not able to select resistant strains, likely due to their multicomponent nature and, hence, multitarget action. Here it is reported the biofilm production modulation exerted by 61 EOs, also investigated for their antibacterial activity on S. aureus strains, including reference and cystic fibrosis patients’ isolated strains. The EOs biofilm modulation was assessed by Christensen method on five S. aureus strains. Chemical composition, investigated by GC/MS analysis, of the tested EOs allowed a correlation between biofilm modulation potency and putative active components by means of machine learning algorithms application. Some EOs inhibited biofilm growth at 1.00% concentration, although lower concentrations revealed different biological profile. Experimental data led to select antibiofilm EOs based on their ability to inhibit S. aureus biofilm growth, which were characterized for their ability to alter the biofilm organization by means of SEM studies.     

Aerodynamic effects of trees on pollutant concentration in street canyons

This paper deals with aerodynamic effects of avenue-like tree planting on flow and traffic-originated pollutant dispersion in urban street canyons by means of wind tunnel experiments and numerical simulations. Several parameters affecting pedestrian level concentration are investigated, namely plant morphology, positioning and arrangement. We extend our previous work in this novel aspect of research to new configurations which comprise tree planting of different crown porosity and stand density, planted in two rows within a canyon of street width to building height ratio W/H = 2 with perpendicular approaching wind. Sulfur hexafluoride was used as tracer gas to model the traffic emissions. Complementary to wind tunnel experiments, 3D numerical simulations were performed with the Computational Fluid Dynamics (CFD) code FLUENT™ using a Reynolds Stress turbulence closure for flow and the advection-diffusion method for concentration calculations. In the presence of trees, both measurements and simulations showed considerable larger pollutant concentrations near the leeward wall and slightly lower concentrations near the windward wall in comparison with the tree-less case. Tree stand density and crown porosity were found to be of minor importance in affecting pollutant concentration. On the other hand, the analysis indicated that W/H is a more crucial parameter. The larger the value of W/H the smaller is the effect of trees on pedestrian level concentration regardless of tree morphology and arrangement. A preliminary analysis of approaching flow velocities showed that at low wind speed the effect of trees on concentrations is worst than at higher speed. The investigations carried out in this work allowed us to set up an appropriate CFD modelling methodology for the study of the aerodynamic effects of tree planting in street canyons. The results obtained can be used by city planners for the design of tree planting in the urban environment with regard to air quality issues.     

Leaf‐Nets (LN): A New Quantitative Method for Sampling Macroinvertebrates in Non‐Wadeable Streams and Rivers

The ecological knowledge of large rivers is still scarce or highly fragmented mainly because of complex, laborious and expensive procedures to collect informative samples from the benthic biota. Standard sampling protocols for macroinvertebrates were mainly developed and calibrated for wadeable streams, while a number of heterogeneous non‐standard sampling procedures are available for large rivers. We propose the new, easy‐to‐build and cost‐effective leaf‐nets (LN) method to quantitatively sample benthic invertebrates in non‐wadeable waterways. The LN method uses Phragmites australis leaves as substrate and combines the characteristics of the leaf‐bags and the Hester–Dendy (HD) multiplates methods. We compared the effectiveness of the LN and HD methods in a near‐pristine and in an impacted stream‐reach (downstream an aquaculture plant) of a non‐wadeable second‐order stream of Central Apennines (Italy). Twenty‐five of the 34 cumulatively collected macroinvertebrate taxa were common to both methods, while seven taxa were found only on LN and two only on HD. Taxonomic richness and total macroinvertebrate abundance were higher for LN assemblages. Number of Ephemeroptera, Plecoptera and Trichoptera taxa (EPT) also tended to be higher on LN. Assemblage composition was different on LN and HD. Both methods documented a significant decrease in EPT taxa and a concomitant increase in the total abundance of more pollution‐tolerant taxa in the impacted stream‐reach, but the LN method was more sensitive to impact‐associated changes in macroinvertebrate assemblage structure. In contrast to the hardboard plates of HD, the assembled leaves of the LN may act as a direct or indirect food source and may better mimic the texture and composition of more heterogeneous natural substrates thus favouring the migration–colonization process from both bottom and littoral benthic invertebrates. The sampling efficiency, cost effectiveness and simplicity warrant the routine use of the new LN method in large‐river ecological assessment. Copyright © 2015 John Wiley & Sons, Ltd.     

Fabrication of gold tips by chemical etching in aqua regia

We present a method to produce sharp gold tips for applications in apertureless near-field optical microscopy and spectroscopy. Thin gold wires are tapered by chemical etching in aqua regia, covered by an isooctane protective layer. Tips with apical radii of curvature of <50 nm are obtained with a 40% yield. The tip performances have been checked by shear-force imaging of amyloid fibrils samples and compared to optical fiber probes. The analysis of the tip morphology, carried out by scanning electron microscopy, shows the existence of two different etching processes occurring in bulk and at the liquid-liquid interface. A simple analytical model is presented to describe the dynamics of the tip formation at the liquid-liquid meniscus interface that fits remarkably well the experimental results in terms of tip shape and length.     

A study on selective reduction of NOx by propane on Co-Beta

Selective catalytic reduction of NOx by propane was investigated on Co-Beta to clarify the loaded states of cobalt and their role in catalytic activity. At low ion exchange levels less than 100%, loaded cobalt is highly dispersed, which has a high selectivity for NOx reduction. At ion exchange levels much higher than 100%, Co₃O₄ appears as identified by Raman spectroscopy, and it contributes to propane oxidation by oxygen and lowers the selectivity especially at high temperatures. This revised version was published online in July 2006 with corrections to the Cover Date.     

Identifying neurologically impaired children through a test of auditory perception.

Determined if an experimental test of Auditory Perception (TAP) could discriminate between 30 neurologically impaired and 30 normal children. The relationships were established between each subtest of the Test of Auditory Perception (TAP) and the Bender Visual Motor Gestalt Test. When the TAP was administered under normal testing procedures, 4 of the 6 subtests discriminated the experimental from the control Ss at the .01 level. All of the TAP subtests discriminated the neurologically impaired from from normal Ss at the .01 level under conditions of background noise. Correlations between the TAP subtests were positive but low in value. Negative correlations were found between each of the TAP subtests and the Bender Gestalt. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Flavonoids and furocoumarins distribution of unripe chinotto (<Emphasis Type="Italic">Citrus</Emphasis> × <Emphasis Type="Italic">myrtifolia Rafinesque</Emphasis>) fruit: beverage processing homogenate and juice characterization

The present study reports for the first time qualitative and quantitative data about flavonoids and furocoumarins distribution of unripe Citrus × myrtifolia Rafinesque homogenate, used as ingredient of the popular soft drink Chinotto. No data are available in literature about the chemical characterization of flavonoids and furocoumarins of the chinotto homogenate used to produce the industrial extract. Samples for analysis were therefore processed to better reproduce the crude materials used to obtain industrial chinotto extract: the whole fruits were cut in half, seeds removed, softly squeezed discarding part of the juice, and homogenized in small pieces. The polyphenolics separation was made by HPLC–PDA detector coupled to ESI/MS/MS in positive and negative mode. It has allowed the identification and relative quantification of 16 compounds, among which the flavone-C-glycoside lucenin-2, the 3-hydroxy-3-methylglutaryl flavanone glycoside melitidin and five polymethoxylated flavones have been detected for the first time in Citrus × myrtifolia. The flavonoids and furocoumarins distribution was compared with one of the Citrus × myrtifolia juice, and the antioxidant activity of both samples was assessed by ORAC (Oxygen Radical Absorbance Capacity)-fluorescein assay.     

Evaluation of the Molecular Landscape in PD-L1 Positive Metastatic NSCLC: Data from Campania,Italy

Background: Immune-checkpoint inhibitors (ICIs) have increased and improved the treatment options for patients with non-oncogene-addicted advanced stage non-small cell lung cancer (NSCLC). However, the role of ICIs in oncogene-addicted advanced stage NSCLC patients is still debated. In this study, in an attempt to fill in the informational gap on the effect of ICIs on other driver mutations, we set out to provide a molecular landscape of clinically relevant oncogenic drivers in programmed death-ligand 1 (PD-L1) positive NSCLC patients. Methods: We retrospectively reviewed data on 167 advanced stage NSCLC PD-L1 positive patients (≥1%) who were referred to our clinic for molecular evaluation of five driver oncogenes, namely, EGFR, KRAS, BRAF, ALK and ROS1. Results: Interestingly, n = 93 (55.7%) patients showed at least one genomic alteration within the tested genes. Furthermore, analyzing a subset of patients with PD-L1 tumor proportion score (TPS) ≥ 50% and concomitant gene alterations (n = 8), we found that n = 3 (37.5%) of these patients feature clinical benefit with ICIs administration, despite the presence of a concomitant KRAS gene alteration. Conclusions: In this study, we provide a molecular landscape of clinically relevant biomarkers in NSCLC PD-L1 positive patients, along with data evidencing the clinical benefit of ICIs in patient NSCLC PD-L1 positive alterations.