Tailoring of magnetism & electron transport of manganate thin films by controlling the Mn-O-Mn bond angles via strain engineering.

Strain engineering beyond substrate limitation of colossal magnetoresistant thin (La0.6Pr0.4)0.7Ca0.3MnO3 (LPCMO) films on LaAlO3-buffered SrTiO3 (LAO/STO) substrates has been demonstrated using metalorganic aerosol deposition technique. By growing partially relaxed 7-27 nm thick heteroepitaxial LAO buffer layers on STO a perfect lattice matching to the LPCMO has been achieved. As a result, strain-free heteroepitaxial 10-20 nm thick LPCMO/LAO/STO films with bulk-like ferromagnetic metallic ground state were obtained. Without buffer the coherently strained thin LPCMO/STO and LPCMO/LAO films were insulating and weakly magnetic. The reason for the optimized magnetotransport in strain-free LPCMO films was found to be a large octahedral Mn-O-Mn bond angle φOOR ~ 166-168° as compared to the significantly smaller one of φOOR ~ 152-156° determined for the tensile (LPCMO/STO) and compressively (LPCMO/LAO) strained films.

Assessment of a novel smartglass-based point-of-care fusion approach for mixed reality-assisted targeted prostate biopsy: A pilot proof-of-concept study.

Purpose: While several biopsy techniques and platforms for magnetic resonance imaging (MRI)-guided targeted biopsy of the prostate have been established, none of them has proven definite superiority. Augmented and virtual reality (mixed reality) smartglasses have emerged as an innovative technology to support image-guidance and optimize accuracy during medical interventions. We aimed to investigate the benefits of smartglasses for MRI-guided mixed reality-assisted cognitive targeted biopsy of the prostate. Methods: For prospectively collected patients with suspect prostate PIRADS lesions, multiparametric MRI was uploaded to a smartglass (Microsoft® Hololens I), and smartglass-assisted targeted biopsy (SMART TB) of the prostate was executed by generation of a cognitive fusion technology at the point-of-care. Detection rates of prostate cancer (PCA) were compared between SMART TB and 12-core systematic biopsy. Assessment of SMART-TB was executed by the two performing surgeons based on 10 domains on a 10-point scale ranging from bad (1) to excellent (10). Results: SMART TB and systematic biopsy of the prostate were performed for 10 patients with a total of 17 suspect PIRADS lesions (PIRADS 3, n = 6; PIRADS 4, n = 6; PIRADS 5, n = 5). PCA detection rate per core was significant (p < 0.05) higher for SMART TB (47%) than for systematic biopsy (19%). Likelihood for PCA according to each core of a PIRADS lesion (17%, PIRADS 3; 58%, PIRADS 4; 67%, PIRADS 5) demonstrated convenient accuracy. Feasibility scores for SMART TB were high for practicality (10), multitasking (10), execution speed (9), comfort (8), improvement of surgery (8) and image quality (8), medium for physical stress (6) and device handling (6) and low for device weight (5) and battery autonomy (4). Conclusion: SMART TB has the potential to increase accuracy for PCA detection and might enhance cognitive MRI-guided targeted prostate biopsy in the future.

Pneumococcal bacteremia in three community teaching hospitals from 1980 to 1989.

STUDY OBJECTIVE: To review the clinical and laboratory findings in a large number of patients with pneumococcal bacteremia in the 1980s and identify risk factors associated with increased mortality. DESIGN: Retrospective review of medical records identified by blood culture logbooks and ICD-9 codes. SETTING: Three community teaching hospitals affiliated with a medical school in northeastern Ohio. PATIENTS: 385 inpatients with pneumococcal bacteremia admitted between Jan 1, 1980 and Dec 31, 1989. MEASUREMENTS: Important clinical and laboratory information was abstracted from patients' medical records, compiled, computerized, and analyzed. MAIN RESULTS: The patients' mean age was 48 years. The overall mortality was 25 percent. The mortality increased with age, reaching 42 percent in patients over 65 years old. For these elderly patients, the mortality was higher (55 percent) for patients admitted from nursing homes than patients from the community (36 percent). Higher mortality was also associated with congestive heart failure (p = 0.001), alcoholism/cirrhosis (p = 0.02), diabetes mellitus (p = 0.05), and malignancy (p = 0.02). A platelet count less than 150,000/mm3, renal dysfunction (serum creatinine > 2 mg/dl), and the number of lobes involved were also associated with mortality. Patients receiving standard therapy (penicillin, ampicillin, erythromycin, or cephalosporins) had lower mortality. Of the previously specified risk factors for mortality, only age, whether standard therapy was administered, the number of lobes involved, and the serum creatinine level proved to be independent risk factors according to logistic regression. CONCLUSIONS: The overall mortality from pneumococcal bacteremia has not decreased during the past 40 years. Risk factors associated with increased mortality were identified. Prevention by immunization with polyvalent pneumococcal polysaccharide vaccine should be practiced more widely.

Evidence for an induced plasma membrane mating receptor in the myxomycete Didymium iridis.

Haploid myxamoeboid mating types, CR5-11A11 and HON 1-2A1, of the acellular myxomycete Didymium iridis, were isolated and grown in liquid culture. Previously it has been postulated that a molecule, possibly a hormone, is responsible for the induction of mating competency through receptor site synthesis. The intention of this study was to isolate the molecule and to determine its mode of action. Experiments were designed in order to learn whether it acts only upon the cells which produce it (self-induction) or does it have an effect only on opposite mating types (cross-induction). It was found that plasmodia can only form on solid media, although zygotes are readily formed in liquid media. Moreover, competency of cells to fuse, or to form receptors required that they be haploid and in a specific phase of the cell cycle, namely G1 of interphase. The use of high pressure liquid chromatography techniques was also employed in order to investigate the inducer molecule. It was demonstrated that the inducer molecule was similarly produced by both mating types, and its production was essentially paralleled by cell numbers. It was also discovered that mating competency is self-induced and these results are discussed.

Functional evaluation of quadriplegic patients using a hand neuroprosthesis.

The objective of this retrospective study was to compare the abilities of quadriplegic patients to complete activities of daily living with and without the use of a portable hand neuroprosthesis. The neuroprosthesis provided synthetic hand grasp through functional neuromuscular stimulation of paralyzed forearm and hand muscles. Data were obtained from telephone interviews, patient records, and videotapes. Twenty-two quadriplegic patients were included in the study; 15 were functional at a C5 spinal cord injury level and seven at a C6 level. The median success rate (ie, the percentage of patients who could complete each activity) across the ten activities was 89% with the hand neuroprosthesis but was only 49% without the hand neuroprosthesis. All patients could perform more tasks when the neuroprosthesis was used, although the relative improvement of C5 patients was larger than that of C6 patients.

First metatarsophalangeal joint arthrodesis. Treatment for sesamoid fractures.

Fractures of both hallucal sesamoids are not commonly reported in the literature. The authors address various surgical procedure choices and present a case history. In their case, conservative treatment failed; therefore, surgical intervention was elected, and fusion of the first metatarsophalangeal joint was performed.

Implantable functional neuromuscular stimulation in the tetraplegic hand.

Functional neuromuscular stimulation of the upper extremity provides manipulative capacity to persons with high level tetraplegia who have insufficient voluntary muscles available for tendon transfer surgery. We report an enhancement of the technique to include surgical implantation of a multichannel receiver-stimulator, sensory feedback stimulation, and tendon transfers. Tendon transfers were done with spastic, rather than voluntary motors employing standard surgical techniques. The system described has been operational for more than 1 1/2 years.

Functional neuromuscular stimulation neuroprostheses for the tetraplegic hand.

Functional neuromuscular stimulation (FNS) of the C5 and C6 tetraplegic upper extremity has been shown to be a valid clinical tool for restoring controlled movement in the paralyzed hand. The current clinical system consists of a shoulder position transducer controlling an external microprocessor-based stimulator, which excites paralyzed muscle via the peripheral nerve using percutaneous leads or a multichannel, implantable stimulator. Tendon transfer surgery of paralyzed but innervated muscle may augment the neurologically deficient upper extremity by allowing the substitution of stronger motors or the addition of new motors where flaccid paralysis (dennervation) eliminates the usual muscle from a grasp pattern. Sensory feedback in the form of machine state and cognitive information can be provided to the normally innervated C5 dermatome skin by subcutaneous electrodes. C5- and C6-level tetraplegics using FNS can independently perform single-hand manipulative tasks at a level similar to that of subjects with intact C7 roots, although they lack the elbow control.

A therapeutic feeding programme. II: Links with language and learning.

The feeding programme described in Part I of this study produced immediate change in the eating patterns of disturbed children, who then became available for learning and language development in a way they had not been previously. The authors give a broad outline of the principles and practice of functional learning, and the educational technique they used. They describe the language development of one child in detail, and the methods used. Follow-up details are also given for the three children described in Part I of the study.

A therapeutic feeding programme. I: Theory and practice of feeding.

Feeding problems are often commented on in the literature, but very little has been reported on the systematic examination of these problems. In the present study feeding disturbances were treated as part of a full diagnostic and treatment programme for disturbed children in a small residential psychiatric unit. The feeding programme was based on the early work of Clancy and colleagues in Australia, and consisted of offering the child food in a set situation by the same 'feeder'. A one-way screen was used for observation and video-recording. Three children are described in detail, and a striking effect was the immediacy of change in their feeding disturbances. It is stressed that early feeding difficulties of disturbed children can give rise or contribute to ever-widening faulty development.

Postoperative results of opponensplasty and flexor tendon transfer in patients with spinal cord injuries.

Key pinch, palmar pinch, and grasp strength were evaluated after opponensplasty and flexor tendon transfer in 24 patients who had suffered cervical spinal cord injuries during a 17-year period. The patients had 57 tendon transfers: 35 opponensplasties and 22 flexor tendon transfers. The average follow-up was 4.2 years. The brachioradialis and pronator teres were the most frequently used motors for the opponensplasty and flexor tendon transfer. Key pinch strength averaged 1.47 kg (range of 0.13 to 4.70 kg). Grasp strength averaged 2.81 kg (range of trace to 10.0 kg). Palmar pinch was obtained in 45% of the extremities; the overall result was 1.04 kg (range of 0.20 to 3.00 kg). In general, patients with higher functional classifications achieved better results. We believe that intraoperative length-tension studies were an important factor in improving the results. The choice of muscle for opponensplasty or flexor transfer when two different adequate motors were available did not seem to affect the outcome of key pinch or grasp. We believe that tendon transfers are beneficial and should be considered in all patients with spinal cord injuries regardless of age at injury if at least 1 year has elapsed since injury and the patients are neurologically stable and have participated in a rehabilitation program.