Manipulation of Magnetic Skyrmion Density in Continuous Ir/Co/Pt Multilayers.

We show that magnetic skyrmions can be stabilised at room temperature in continuous [Ir/Co/Pt]5 multilayers on SiO2/Si substrates without the prior application of electric current or magnetic field. While decreasing the Co thickness, a transition of the magnetic domain patterns from worm-like state to separated stripes is observed. The skyrmions are clearly imaged in both states using magnetic force microscopy. The density of skyrmions can be significantly enhanced after applying the "in-plane field procedure". Our results provide means to manipulate magnetic skyrmion density, further allowing for the optimised engineering of skyrmion-based devices.

Sex-related differences in arterial spin-labelled perfusion of metabolically active brain structures in neonatal hypoxic-ischaemic encephalopathy.

AIM: To investigate the sex-related differences in arterial spin-labelled (ASL) perfusion of metabolically active brain structures in neonatal hypoxic-ischaemic encephalopathy (HIE). MATERIALS AND METHODS: Seventy-three term neonates were identified for a retrospective case-control study following an institutional review board (IRB) approved protocol. The cerebral pulsed arterial spin labelling values were compared by permutation test to identify metabolically active brain structures with significant perfusion changes between 10 male controls and eight female controls, and between 31 HIE males and 24 HIE females. RESULTS: In the perfusion comparison between HIE male and female neonates, significantly lower perfusion was found in the thalamus in males (p=0.02). The other brain clusters, including basal ganglia, hippocampus cluster, cingulate gyrus cluster, brainstem cluster, sensorimotor cortex cluster, and cerebellum and peduncle cluster, demonstrated no significant differences between HIE males and females. In the perfusion comparison between male and female controls, there were no significant perfusion changes in those brain clusters. CONCLUSION: Brain perfusion in neonatal HIE differs between males and females in the thalamus, a metabolically active region within neonates, with males demonstrating lower perfusion. This difference in perfusion may reflect sex-related disparities in response to and recovery from hypoxic-ischaemic events.

A Double-Edged Sword: Neurologic Complications and Mortality in Extracorporeal Membrane Oxygenation Therapy for COVID-19-Related Severe Acute Respiratory Distress Syndrome at a Tertiary Care Center.

In this clinical case series, we report our experience to date with neurologic complications of extracorporeal membrane oxygenation therapy for COVID-19 Acute Respiratory Distress Syndrome. We have found an unexpectedly increased rate of complications as demonstrated by neuroimaging compared with meta-analysis data in extracorporeal membrane oxygenation therapy for all Acute Respiratory Distress Syndrome etiologies over the past few decades and compared with the most recent baseline data describing the incidence of neurologic complication in all patients with COVID-19. For our 12-patient cohort, there was a rate of intracranial hemorrhage of 41.7%. Representative cases and images of devastating intracranial hemorrhage are presented. We hypothesize that the interplay between hematologic changes inherent to extracorporeal membrane oxygenation and inflammatory and coagulopathic changes that have begun to be elucidated as part of the COVID-19 disease process are responsible. Continued analysis of extracorporeal membrane oxygenation therapy in this disease paradigm is warranted.

Retrospective, dual-centre review of imaging findings in neurosarcoidosis at presentation: prevalence and imaging sub-types.

AIM: To assess the prevalence of various imaging manifestations in neurosarcoidosis (NS) patients at presentation and to explore if specific imaging findings may cluster in different sub-groups. MATERIALS AND METHODS: A retrospective, dual-institution, systematic imaging review was undertaken of the magnetic resonance imaging (MRI) findings in 100 consecutive NS patients who presented over a 15-year period. Clustering analysis (k-mode) was performed to evaluate co-occurrence of imaging findings. RESULTS: Non-enhancing white matter (NEWM) lesions were the most common imaging abnormality (56%), followed by leptomeningeal (47%) and pachymeningeal (32%) involvement. Other common manifestations included cranial nerve involvement (30%), parenchymal granulomas (27%), hypothalamic-pituitary-adrenal axis involvement (26%), and hydrocephalus (14%). Additionally, a higher prevalence of perivascular enhancement (23%), cerebrovascular events (including ischaemic and haemorrhagic events; 17%), and ependymal involvement (20%) were noted than recognised previously. Additional k-mode analysis was performed to explore underlying disease sub-clusters. This was evaluated for clusters varying between two though five (k=2-5). For k=4, the analysis revealed that the imaging findings may possibly be divided into disease sub-sets of four groups, each with varying distribution of imaging manifestations and clinical manifestations. CONCLUSION: Overall, NEWM lesions and meningeal involvement are the most common imaging manifestations of NS. The prevalence of perivascular enhancement, cerebrovascular events, and ependymal involvement is likely higher than reported previously. Additionally, different imaging findings in NS may cluster together and imaging subtypes in NS possibly exist.

Comparison of direct immunofluorescence and cell culture for detecting Chlamydia trachomatis.

Conventional cell culture methods were compared with a direct immunofluorescence test (MicroTrak, Syva UK, Maidenhead, Berkshire) to detect Chlamydia trachomatis in 137 patients (126 women, 11 men) attending a sexually transmitted diseases (STD) clinic. Results obtained by the two tests agreed in 87.6% of cases. Of 34 positive specimens, 17 were detected by culture and fluorescence, 15 by fluorescence only, and two by culture only. The excess of specimens that were negative on culture but positive on fluorescence might be accounted for by delays in culture (up to 18 hours). The MicroTrak test appears to be of value in peripheral hospitals that have to rely on transporting specimens to larger centres for culture.

Vocational adjustment and survival on chronic hemodialysis.

The survival of 71 patients on chronic dialysis correlated positively with vocational rehabilitation. Employed patients (n = 47) survived longer (p less than 0.001) than unemployed (n = 24). Within the employed group, parttime workers (n = 23) lived longer (p less than 0.01) than fulltime workers (n = 24). Although patients on chronic dialysis appear to live longer if employed, fulltime employment may be excessively stressful in a patient population whose treatment makes large demands on the patient's time.

Differential alcohol use patterns and personality traits among three Alcoholics Anonymous attendance level groups: further considerations of the affiliation profile.

The present study was designed to identify personality and drinking behavior correlates associated with membership in Alcoholics Anonymous (A.A.). Affiliation profiles were developed on the basis of frequency of A.A. attendance; subtypes were defined as non, low, and high affiliates, respectively. An initial canonical correlation analysis assessed the amount of common variance between personality and drinking characteristics. Subsequent discriminant function analyses on the second-order scales of the drinking and personality variables sets identified those variables differentiating the A.A. affiliated groups. High levels of affiliation were associated with a greater degree of anxiety, a tendency to be more affected by feelings rather than intellect, and more deterioration in the physical, exhibited significant differences in perceived benefits, style, and consequences of alcohol usage. The potential therapeutic utility of A.A. affiliation profiles was discussed.

Patient selection for lumbar discectomy. An objective approach.

A reproducible method is presented for selecting patients with low-back pain and sciatica for lumbar discectomy based on specific objective criteria in four categories: neurologic signs, sciatic tension signs, personality factors (MMPI scores), and lumbar myelography. Operative findings for 50 consecutive cases selected using this method revealed complete nucleus pulposus herniation in 43 cases. This contrasts with complete herniation in only 5 of 26 patients undergoing lumbar discectomy before the method was employed. This objective preoperative evaluation method reduced negative disc explorations and improved early surgical results. We recommend its use for patients being considered for elective lumbar discectomy.

Comparison of the utility of two abbreviated forms of the MMPI for psychiatric screening of the elderly.

Assessed the utility of the Faschingbauer Abbreviated MMPI (FAM) and MMPI-168 for use with the elderly. FAM and MMPI-168 items were extracted from the MMPIs of 24 older male veteran medical or alcoholic patients. The results indicate that both abbreviated forms are highly correlated with and yield similar diagnostic inferences to the standard MMPI. For this sample population, the FAM was significantly (p less than .001) more in accordance with the standard MMPI than the MMPI-168.

Personality organization as an aspect of back pain in a medical setting.

The MMPI profiles of 74 low back pain patients who had previously been classified as "functional,""organic," or "mixed" were sorted into six profile groups. The six profile groups were those used by Pichot, Perse, Lekous, Dureau, Perez, and Rychewaert (1972); denial, "conversion V" without defensiveness, "conversion V" with defensiveness, depressed/anxious, psychotic and normal. Results indicate that all six profile types are well represented in the low back pain group. Evidence is also presented which shows that each of the pathological MMPI profile types examined across "functional," "organic," and "mixed" classification is significantly more elevated than a normal profile group on two scales (Lb, DOR) designed to measure functional aspects of pain. Pathological MMPI profile groups did not differ significantly from each other on the "functional" pain scales. The data presented in this study point to the relationship of various forms of psychopathology with "functional pain." The findings of this study would not support a homogeneous "pain personality" for low back pain patients. However, combined "conversion V" profiles accounted for 58% of the "functional" group, 45% of the "mixed" group and 35% of the "organic" group.

Predicting alcohol treatment program drop-outs.

The feasibility of using psychological tests to predict patient drop-outs from an alcohol treatment program was studied. Eighty-four alcoholic male veterans being treated in an inpatient program were administrered the Rotter Locus of Control scale (I-E) and the MMPI-168 at the beginning of the treatment. Those patients who completed an 8 week inpatient program and a one year outpatient program were compared to those patients who completed the inpatient phase, but dropped out during the outpatient phase on the five MMPI-168 factors and the total I-E score. The two groups differed significantly only on the I-E. The data was also subjected to a discriminant analysis to generate a prediction equation. The prediction equation correctly classified 82% of the drop-outs.

Application of the somatization factor of the MMPI-168 with low back pain patients.

The usefulness of the Somatization factor of the MMPI-168 with low back pain patients was examined in two separate studies. In study 1, 58 male veteran low back pain patients who had been divided into organic and mixed groups served as Ss. MMPI protocols were rescored for the five factors of Overall, Hunter, and Butcher (1973). The organic and mixed groups differed only on the Somatization factor. A cutting score of raw greater than or equal to 8 (T = 75) was determined to classify the sample correctly 74.5% of the time. In study 2, a second sample of 48 male veteran low back pain patients was divided into mixed, organic, and functional groups. The mixed group was subdivided further into a mixed-pain group who still were having pain and were seeking treatment and a mixed-relief group who were experiencing a reduction of pain and were returning to vocational activities. The functional and mixed-pain groups differed from the organic and mixed-relief groups on the Somatization and Depression factors. The cutting score determined in the study 1 correctly classified patients 83% of the time.

Psychological correlates of survival on renal dialysis.

The Minnesota Multiphasic Personality Inventory was administered to 47 male patients on the Renal Dialysis Unit at the Seattle VA Hospital. The patients were divided into three survival groups for comparison. Group A died within 1 year of initiating dialysis. Group B had been alive on dialysis between 3 and 7 years, while group C had been alive between 7 and 10 years at the time of data analysis. Group A differed significantly from group B on the Hs, D, and Hy scales, and from group C on the F, Hs, D, and Pt scales. Interpretation of the mean MMPI profiles implies that persons in group A are characterized by feelings of helplessness, high levels of depression, anxiety, and preoccupation with somatic difficulties, whereas those in groups B and C tended to be dependent, have mild levels of depression, and have a sense of hopefulness about the future. The authors suggest that psychiatric intervention might increase the longevity of those patients judged to be moderately to severely depressed with somatic preoccupations.

Application of the Faschingbauer Abbreviated MMPI with alcoholic patients.

There is a need to examine the usefulness of an abbreviated form of the MMPI with alcoholic patients. The Faschingbauer Abbreviated MMPI (FAM) was administered to 225 male alcoholics. The correlations between the T-scores for the FAM and their full MMPI counterparts ranged from .761 to .919. Examination of the high-point code for each FAM-MMPI pair yielded 52.89% with identical high-point codes. A comparison between the MMPI and the FAM pairs showed that 78% of the profiles had the same number of scales with T-score above 70 plus or minus one scale. The authors suggest that when a full MMPI administration is not feasible, the FAM is a valid substitute for alcoholic populations.

Relationship between psychopathology, experienced control and perceived locus of control: in search of alcoholic subtypes.

Alcoholic Ss were categorized into four subtypes based upon differential levels of perceived locus of control and experienced control. The relationship between generalized psychopathology, as measured by the MMPI, and subtype classification was investigated. Alcoholics with an internal locus of control and high levels of experienced control exhibited the least psychopathology. The greatest degree of psychopathology was found among Ss with an external locus of control and minimal levels of experienced control. The implications of these results with respect to psychosocial functioning and drinking behavior among alcoholic subgroups were discussed.

A novel olefinic rearrangement. The enzymic conversion of cholesta-7,9-dien-3 -ol into cholesta-8,14-dien-3 -ol.

1. [3alpha-(3)H]Cholesta-7,9-dien-3beta-ol is converted in high yield into cholesterol by a 10000g(av.) supernatant fraction of rat liver homogenate. 2. Incubation of cholesta-7,9-dien-3beta-ol with [4-(3)H]NADPH and rat liver microsomal fractions under anaerobic conditions resulted in (3)H being incorporated into the 14alpha-position of cholest-7-en-3beta-ol. 3. Under anaerobic conditions in the absence of NADPH cholesta-7,9-dien-3beta-ol was isomerized into cholesta-8,14-dien-3beta-ol by rat liver microsomal fractions.