Enteral versus parenteral nutrition in critically ill patients with severe pancreatitis: a meta-analysis

Whether enteral nutrition (EN) is superior to parenteral nutrition (PN) in critically ill patients with severe acute pancreatitis remains unknown. The objective of this meta-analysis was to assess the effects of EN versus PN on clinical outcomes in a subgroup of pancreatitis patients. Relevant randomized controlled trials (RCTs) were searched in Scopus, PubMed and Web of Science from inception to August 2016. Ultimately, five RCTs including 348 patients were enrolled in this analysis. Compared with PN, EN was associated with a significant reduction in overall mortality (risk ratio (RR)=0.36, 95% confidence interval (CI) 0.20-0.65, P=0.001) and the rate of multiple organ failure (RR=0.39, 95% CI 0.21-0.73, P=0.003). EN should be recommended as the preferred route of nutrition for critically ill patients with severe acute pancreatitis.

Sources and dynamics of fluorescent particles in hospitals

Fluorescent particles can be markers of bioaerosols and are therefore relevant to nosocomial infections. To date, little research has focused on fluorescent particles in occupied indoor environments, particularly hospitals. In this study, we aimed to determine the spatial and temporal variation of fluorescent particles in two large hospitals in Brisbane, Australia (one for adults and one for children). We used an Ultraviolet Aerodynamic Particle Sizer (UVAPS) to identify fluorescent particle sources, as well as their contribution to total particle concentrations. We found that the average concentrations of both fluorescent and non-fluorescent particles were higher in the adults' hospital (0.06×10⁶ and 1.20×10⁶  particles/m³ , respectively) than in the children's hospital (0.03×10⁶ and 0.33×10⁶  particles/m³ , respectively) (P<.01). However, the proportion of fluorescent particles was higher in the children's hospital. Based on the concentration results and using activity diaries, we were able to identify sources of particle production within the two hospitals. We demonstrated that particles can be easily generated by a variety of everyday activities, which are potential sources of exposure to pathogens. Future studies to further investigate their role in nosocomial infection are warranted.

Can procalcitonin be used to diagnose Gram-negative bloodstream infection? Evidence based on a meta-analysis

OBJECTIVE

Procalcitonin (PCT) is a useful biomarker for systemic bacterial infection, and many studies have described the correlation between high serum PCT level and Gram-negative bloodstream infection (BSI), whereas the diagnostic accuracy of PCT for this kind of episode has not been summarized. This study aimed to estimate the overall accuracy of serum PCT for diagnosing Gram-negative BSI through a meta-analysis.

MATERIALS AND METHODS

We searched PubMed, EMBASE, Web of Science, and Scopus database for studies that met the inclusion criteria. The pooled sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were calculated using bivariate random-effects models. Summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were used to summarize overall diagnostic accuracy.

RESULTS

Our meta-analysis included 13 studies involving 4,513 subjects. Summary estimates for PCT in diagnosing Gram-negative BSI were as follows: sensitivity, 0.73 (95% CI 0.68 to 0.78); specificity, 0.74 (95% CI 0.64 to 0.81); PLR, 2.77 (95% CI 2.07 to 3.70); NLR, 0.37 (95% CI 0.31 to 0.42); DOR, 7.59 (95% CI 5.31 to 10.85); AUC, 0.79 (95% CI 0.75 to 0.82). The corresponding summary performance estimates for using PCT in differentiating Gram-negative BSI from gram-positive BSI were as follows: sensitivity, 0.73 (95% CI 0.66 to 0.78); specificity, 0.70 (95% CI 0.59 to 0.78); PLR, 2.40 (95% CI, 1.83 to 3.15); NLR, 0.39 (95% CI 0.33 to 0.46); DOR, 6.15 (95% CI 4.40 to 8.60); AUC, 0.77 (95% CI 0.73 to 0.81).

CONCLUSIONS

PCT may have a limited diagnostic value for Gram-negative BSI.

Neoadjuvant versus adjuvant chemoradiation for stage II-III esophageal squamous cell carcinoma: a single institution experience

Esophageal cancer is the eighth most common cancer worldwide. It is the fourth most common cause of cancer death in China and esophageal squamous cell carcinoma (ESCC) is the most prevalent histologic type. Many clinical trials have explored the value of neoadjuvant or adjuvant chemoradiation therapy in potentially resectable ESCC; however, these studies have produced conflicting results. This retrospective study was performed to investigate whether patients with resectable stage II/III ESCC should receive neoadjuvant or adjuvant therapy in addition to surgery. A review of stage II/III thoracic ESCC patients who underwent esophagectomy and either neoadjuvant or adjuvant chemoradiation was performed. Chemotherapy regimen consisted of cisplatin 75 mg/m2 divided into 3 days and fluorouracil 500 mg/m2 on days 1 to 5. The patients who underwent neoadjuvant therapy were treated with one cycle of chemotherapy concurrently with radiotherapy (40 Gy in 20 fractions, 5 days/week), and those receiving adjuvant therapy were treated with two cycles of chemotherapy concurrently with radiotherapy (46-50 Gy in 23-25 fractions, 5 days/week). A total of 122 patients met inclusion criteria, of which 49 underwent neoadjuvant chemoradiation and 73 underwent adjuvant chemoradiation. Median follow up was 36.5 months. The median survival times and 3, 5-year overall survival (OS) rates for the neoadjuvant and adjuvant groups were 39.3 versus 31.5 months, and 53.0%, 45.7% versus 42.9%, 29.7%, respectively (P = 0.091). For the patients with stage III ESCC, the median survival times and 5-year OS rates for the neoadjuvant and adjuvant groups were 39.3 versus 21.3 months, and 43.4% versus 21.0%, respectively (P = 0.021). Among lymph node-positive patients, the median survival times and 5-year OS rates for the neoadjuvant and adjuvant groups were 55.6 versus 23.7 months, and 43.0% versus 25.7%, respectively (P = 0.085). The incidence of perioperative and postoperative complications was comparable between the two groups (P > 0.05). For patients with resectable stage II/III ESCC, neoadjuvant chemoradiation does not increase postoperative complications and is associated with a trend toward better OS when compared to adjuvant chemoradiation.

[Diversity of HIV-1 subtypes and primary HIV-1 drug resistance among 302 newly confirmed HIV infections/AIDS in Henan province, China]

OBJECTIVE

To investigate HIV-1 subtype diversity and the frequency of primary drug resistance in newly confirmed HIV infections/AIDS, and the ratio of recently infected cases in Henan.

METHODS

Newly confirmed HIV infections/AIDS from June 2013 to October 2013 and from June 2014 to October 2014 in the municipal CDC and county CDC of six cities in Henan province (Nanyang, Luohe, Pingdingshan, Shangqiu, Xuchang and Zhengzhou) were included in this study. Information on demographics, route of infection and antiviral therapy regimen were obtained from report cards, and at follow-up visits. After collection of blood samples from 402 individuals for confirmatory diagnostic tests, 100 were excluded because of hemolysis or insufficient samples in 11 cases, and incomplete amplification results in 89 cases. Recent HIV infection was determined by the BED capture immunoassay. An in-house method were used for genotypic drug resistance tests and sequence analysis.

RESULTS

Among the 302 individuals included, the mean age was (44.0±15.5) years, and 160 (53.0%) and 142 (47.0%) cases were confirmed in 2013 and 2014, respectively. The ratio of recent infections was 29.5% (89 cases), inside, the ratio of recent infections were 31.3% (20/64), 40.5% (30/74), 21.3% (32/150), 3/8 and 4/6 in 01_AE, 07_BC, B, 01_B and other subtypes (B/C, C, 01_BC and 08_BC) (χ(2)=13.48, P=0.009). The frequency of the B subtype was higher in former infections, at 55.4% (118/213), than in recent infections, at 36% (32/89) (χ(2)=9.49, P=0.002). In contrast, the ratios of both 07_BC and other subtypes were lower in former infections (20.7% (44/213) and 1% (2/213), respectively) than recent infections (33.7% (30/89), χ(2)=5.78, P=0.016 and 5% (4/89), χ(2)=4.08; P=0.044, respectively). The frequency of primary HIV-1 drug resistance was 6.0% (18 cases) in 302 subjects. The frequency of resistance to nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs was 2.7% (8 cases) and 3.6% (11 cases), respectively. Primary HIV-1 drug resistance was more frequent in subtypes B and 07_BC, at 8.7% (13 cases) and 5.4% (4 cases), respectively.

CONCLUSION

Newly confirmed HIV infections/AIDS in Henan province harbored certain proportion of none-B subtypes, the frequency of primary resistance tended to be high in HIV-1B infection. The molecular epidemiology of HIV and the development of primary drug resistance should be regularly monitored.

Nonlinear modulation of interacting between COMT and depression on brain function

BACKGROUND

The catechol-O-methyltransferase (COMT) gene is related to dopamine degradation and has been suggested to be involved in the pathogenesis of major depressive disorder (MDD). However, how this gene affects brain function properties in MDD is still unclear.

METHODS

Fifty patients with MDD and 35 cognitively normal participants underwent a resting-state functional magnetic resonance imaging scan. A voxelwise and data-drive global functional connectivity density (gFCD) analysis was used to investigate the main effects and the interactions of disease states and COMT rs4680 gene polymorphism on brain function.

RESULTS

We found significant group differences of the gFCD in bilateral fusiform area (FFA), post-central and pre-central cortex, left superior temporal gyrus (STG), rectal and superior temporal gyrus and right ventrolateral prefrontal cortex (vlPFC); abnormal gFCDs in left STG were positively correlated with severity of depression in MDD group. Significant disease×COMT interaction effects were found in the bilateral calcarine gyrus, right vlPFC, hippocampus and thalamus, and left SFG and FFA. Further post-hoc tests showed a nonlinear modulation effect of COMT on gFCD in the development of MDD. Interestingly, an inverted U-shaped modulation was found in the prefrontal cortex (control system) but U-shaped modulations were found in the hippocampus, thalamus and occipital cortex (processing system).

CONCLUSION

Our study demonstrated nonlinear modulation of the interaction between COMT and depression on brain function. These findings expand our understanding of the COMT effect underlying the pathophysiology of MDD.

[Application of immunohistochemistry for p16 and GATA3 and molecular HPV typing in diagnosis of secondary bladder involvement by cervical carcinoma]

Objective: To investigate the expression of p16 and GATA3 and the detection of human papillomavirus (HPV) in secondary bladder involvement by cervical carcinomas. Methods: Sixteen cases of cervical carcinoma with bladder involvement diagnosed from December 2008 to March 2016 were collected and evaluated by light microscopy, immunohistochemistry for p16 and GATA3 detection and PCR-reverse dot blot for molecular typing of HPV. Results: The age of the patients ranged from 25 to 76 years with median of 52 years. Morphologically, 14 cases(14/16) showed tumor nests infiltrating lamina propria or muscle bundles of the bladder. By immunohistochemistry, 15 cases (15/16) were found to be diffusely and strongly positive for p16, and 1 showed patchy staining pattern. Seven cases (7/7) of corresponding original cervical cancers were also diffusely and strongly positive for p16. GATA3 staining was negative in 13 cases (13/16), and focal weak to moderate positivity was detected in 3 cases.Three cases (3/7) of corresponding original cervical cancers showed focal weak to moderate positivity of GATA3. Fifteen cases (15/16) showed concordant high risk HPV-positivity, including HPV16 in 8 cases and HPV31 in one case. Five cases showed co-infection of HPV16 and HPV18. One case showed co-infection with HPV18 and HPV45. Conclusion: Differential diagnosis by p16 or GATA3 alone is of limited value. Combination of immunohistochemistry for p16 and GATA3 and molecular typing for HPV detection are useful to distinguish primary bladder carcinoma from the secondary involvement by cervical carcinoma.

Association of cytokine gene polymorphisms (IL‑6, IL‑12B, IL‑18) with Behcet's disease : A meta-analysis

PURPOSE

This study aims to investigate the association of cytokine gene polymorphisms with the risk of Behcet's disease (BD) via comprehensive meta-analysis.

METHODS

The Embase and PubMed databases covering the period from the earliest possible year to May 2015 were searched. A total of 13 eligible articles including 2,065 BD patients and 1,559 controls were recruited. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of the associations. Potential publication bias was evaluated using Egger's linear regression test.

RESULTS

Meta-analysis indicated associations between IL‑6 rs1800795, IL‑12B rs3212227, and IL‑18 rs1946518 in all study subjects: IL‑18 rs1946518 in the dominant model (IL‑18 rs1946518: OR = 0.48, 95 % CI: 0.34-0.70, P = 0.000) and the homozygote model (IL‑18 rs1946518: OR = 0.40, 95 % CI: 0.25-0.65, P = 0.000); and IL‑6 rs1800795 and IL‑12B rs3212227 in the dominant model (IL‑6 rs1800795: OR = 0.53, 95 % CI: 0.39-0.72, P = 0.000; IL‑12B rs3212227: OR = 1.26, 95 % CI: 1.06-1.48, P = 0.007; IL‑18 rs1946518: OR = 0.46, 95 % CI: 0.33-0.65, P = 0.000). No significant evidence for associations of IL‑18 rs187238 polymorphisms with BD susceptibility was detected.

CONCLUSION

In summary, this meta-analysis finds that IL‑6 rs1800795 and IL‑18 rs1946518 polymorphisms decrease the risk of BD. However, IL‑12B rs3212227 increases BD susceptibility. Further large-scale investigation of this association is necessary.

Abstract P1-04-07: Environmental influence on epigenetic markers in the development of breast cancer

Aberrant DNA methylation plays an important role in breast cancer initiation and progression. We hypothesize that environmental risk factors contribute to causal alterations in DNA methylation and that such causal changes have already occurred prospectively in normal breast tissue before tumor occurrence. In order to test this hypothesis, normal breast tissue from healthy women must be used. We therefore conducted an integrative molecular epidemiological study that combined the environmental regulation of DNA methylation in normal breast tissue and the differential DNA methylation profiling in tumor and normal breast tissue. We examined for the first time the environmental impact on DNA methylation in normal breast tissue from healthy women and determine the association of these epigenetic changes with breast cancer development. Potentially causal DNA methylation markers identified from our study has the potential to make a major scientific and clinical impact in understanding breast cancer etiology as well as developing novel, more effective prevention and treatment strategies.

Citation Format: He C, Wu W, Gao H, Nephew K, Li L, Schneider B, Han J, Liu Y. Environmental influence on epigenetic markers in the development of breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-04-07.

[Anti-β(2)GPⅠantibodies accelerate the formation of atherosclerosis in high fat diet fed ApoE deficient mice]

Objective: To investigate the effects of anti-β(2) glycoprotein Ⅰ(β(2)GPⅠ) antibody on atherosclerosis in ApoE deficient mice. Methods: A total of 24 male ApoE deficient mice of specific pathogen free level(six to eight-week old)were divided into normal control group, high fat diet group, high fat diet with anti-β(2)GPⅠ group, high fat diet with homologous control antibody group (n=6 each group). During the feeding period, mice were weighed every 2 weeks and were intraperitoneally injected with anti-β(2)GPⅠIgG (100 μg/per) and homologous control IgG (100 μg/per) according to grouping once a week. At the 16th week, the carotid arterial lipid deposition was observed by small animal magnetic resonance imaging, and blood samples were collected from internal vein of eyeball and the concentrations of TC, TG, HDL-C and LDL-C in plasma were measured after EDTA anticoagulant treatment. AI was calculated. The mice were then sacrificed and carotid arteries were removed, hematoxylin-eosin staining was used to observe the atherosclerotic lesions near the bifurcation of carotid artery and to calculate lesion size. Results: (1) The body weight of mice was significantly higher in the high fat diet group compared to other 3 groups(all P<0.05), which was similar among high fat diet+ anti-β(2)GPⅠantibody group, high fat diet+ homologous control IgG group and normal diet control group (P>0.05). (2) After 16 weeks, plasma concentrations of TC and LDL-C in high fat diet group, high fat diet+ anti-β(2)GPⅠantibody group and high fat diet+ homologous control IgG group were significantly higher than in normal diet group (all P<0.05), there was no significant difference among high fat diet groups. The level of HDL-C was significantly higher in high fat diet control group than in normal diet control group. The concentration of TG was similar among groups. However, the value of AI in high fat+ anti-β(2)GPⅠ antibody group was significantly higher than in other groups (all P<0.05). (3) After 16 weeks, magnetic resonance imaging revealed that mice in high fat diet+ anti-β(2)GPⅠ antibody group had more obviously lipid deposition in the carotid arteries, it was significantly higher than that in the other groups, and the cross sections of carotid arteries stained with HE also demonstrated obviously carotid lumen stenosis and the percentage of carotid plaque area to carotid artery was (37.545±1.351)% in the high fat diet+ anti-β(2)GPⅠ antibody group, it was significantly higher than normal diet group ((1.235±0.460)%), high fat diet control group((11.635±2.751)%) and high fat diet+ homologous control IgG group ((11.815±2.623)%), all P<0.01. In high fat diet+ anti-β(2)GPⅠ antibody group, the area of carotid plaque was (3.121±0.124)×10(4) μm(2,) it was also significantly higher than normal diet group ((0.094±0.015)×10(4) μm(2)), high fat diet control group ((1.309±0.147)×10(4) μm(2)) and high fat diet+ homologous control IgG group ((1.027±0.228)×10(4)μm(2)), all P<0.01. Conclusion: Anti-β(2)GPⅠ antibody can promote atherosclerotic plaque formation in high fat diet fed ApoE deficient mice.

[The prevalence of primary HIV-1 drug resistance in newly reported HIV infections in Henan]

OBJECTIVE

To study the prevalence of primary HIV-1 drug resistance in newly reported HIV infected individuals receiving no antiviral treatment in Henan.

METHODS

Network direct reporting information of newly reported HIV infection cases in six cities of Henan during January to June, 2013 and January to June, 2014 were collected, and blood samples were collected from the cases to conduct genotypic drug resistance test and sequence analysis.

RESULTS

Primary HIV-1 drug resistance was detected in 45 of 624 newly reported HIV infection cases, the prevalence of primary HIV-1 drug resistance was 7.21%, which was classified as moderate. Univariate analysis revealed that the prevalence of primary HIV-1 drug resistance was higher in females(χ(2)=11.463, P = 0.001), in age group <20 years(χ(2)=8.969, P=0.011), in illiterates(χ(2)=18.072, P=0.001)and in cases of HIV subtype B infection(χ(2)=9.897, P=0.019). Multi-univariate analysis revealed that the risk of primary HIV-1 drug resistance was high in females(OR=2.194, 95%CI: 1.111-4.331). Non-nucleoside reverse transcriptase inhibitor(NNRTI), Nucleoside reverse transcriptase inhibitor(NRTI)and Protease inhibitor(PI)resistance mutations were found in 4.97%, 3.53% and 1.12% of the cases, respectively. M184V/I(2.08%)and K103N/S(2.88%)were the most commonly emerged NRTI and NNRTI resistance mutation. Multiple NRTI resistance mutation was found in four cases. HIV subtype B infections accounted for largest proportion(51.76%, 323/624), followed by CRF07_BC cases(23.72%, 148/624)and CRF01_AE cases(19.71%, 123/624).

CONCLUSION

The prevalence of primary HIV-1 drug resistance was moderate in the newly reported HIV infected individuals in Henan. The surveillance for HIV-1 drug resistance transmission should be strengthened and drug resistance test before the antiviral treatment should be given.

A pilot study of traditional indoor biomass cooking and heating in rural Bhutan: gas and particle concentrations and emission rates

Although many studies have reported the health effects of biomass fuels in developing countries, relatively few have quantitatively characterized emissions from biomass stoves during cooking and heating. The aim of this pilot study was to characterize the emission characteristics of different biomass stoves in four rural houses in Bhutan during heating (metal chimney stove), rice cooking (traditional mud stove), fodder preparation (stone tripod stove), and liquor distillation (traditional mud stove). Three stage measurements (before, during, and after the activity had ceased) were conducted for PM_2.5 , particle number (PN), CO, and CO₂ . When stoves were operated, the pollutant concentrations were significantly elevated above background levels, by an average of 40 and 18 times for PM_2.5 and CO, respectively. Emission rates (mg/min) ranged from 1.07 × 10² (PM_2.5 ) and 3.50 × 10² (CO) for the stone tripod stove during fodder preparation to 6.20 × 10² (PM_2.5 ) and 2.22 × 10³ (CO) for the traditional mud stove during liquor distillation. Usable PN data were only available for one house, during heating using a metal chimney stove, which presented an emission rate of 3.24 × 10¹³ particles/min. Interventions to control household air pollution in Bhutan, in order to reduce the health risks associated with cooking and heating, are recommended.

Coupling effects of the electric field and bending on the electronic and magnetic properties of penta-graphene nanoribbons

The magnetic configuration transitions for P-GNRs vs. critical electric field strength on applying different bending strains.

Hypoxia inducible factor-1α-induced interleukin-33 expression in intestinal epithelia contributes to mucosal homeostasis in inflammatory bowel disease

Intestinal epithelial cells (IECs), an important barrier to gut microbiota, are subject to low oxygen tension, particularly during intestinal inflammation. Hypoxia inducible factor-1α (HIF-1α) is expressed highly in the inflamed mucosa of inflammatory bowel disease (IBD) and functions as a key regulator in maintenance of intestinal homeostasis. However, how IEC-derived HIF-1α regulates intestinal immune responses in IBD is still not understood completely. We report here that the expression of HIF-1α and IL-33 was increased significantly in the inflamed mucosa of IBD patients as well as mice with colitis induced by dextran sulphate sodium (DSS). The levels of interleukin (IL)-33 were correlated positively with that of HIF-1α. A HIF-1α-interacting element was identified in the promoter region of IL-33, indicating that HIF-1α activity regulates IL-33 expression. Furthermore, tumour necrosis factor (TNF) facilitated the HIF-1α-dependent IL-33 expression in IEC. Our data thus demonstrate that HIF-1α-dependent IL-33 in IEC functions as a regulatory cytokine in inflamed mucosa of IBD, thereby regulating the intestinal inflammation and maintaining mucosal homeostasis.

Tuning the electronic and magnetic properties of graphene-like SiGe hybrid nanosheets by surface functionalization

In this paper, the structural, electronic and magnetic properties of fully and partially surface modified SiGe nanosheets (NSs) have been investigated using first-principles calculations based on density functional theory. The results demonstrate that the electronic and magnetic properties of SiGe NSs can be tuned by decorating H, Cl and F atoms on Si sites in SiGe NSs. It is shown that by decorating their surface with H, F, and Cl atoms, H-SiGe, F-SiGe, and Cl-SiGe NSs in FM states are predicted to behave as a semiconductor, half-metal, and metal, respectively. The diverse electronic and magnetic properties define the potential applications of SiGe nanosheets in electronics and spintronics.

[Efficacy of GLIDE chemotherapy for patients with newly diagnosed advanced-stage or relapsed/refractory extranodal natural killer cell lymphoma]

目的

研究GLIDE（吉西他滨、门冬酰胺酶、异环磷酰胺、地塞米松、依托泊苷）方案治疗初发进展期及复发难治性结外鼻型NK/T细胞淋巴瘤（ENKL）患者的有效性及安全性。

方法

纳入2010年3月至2016年3月收治的初发进展期及复发难治性ENKL患者42例，给予GLIDE方案化疗，中位疗程数为3(2~6）个，评估化疗结束后缓解率及早期（2个疗程后）缓解率，采用Kaplan-Meier方法统计无进展生存（PFS）及总生存（OS），同时采用Cox回归方法进行多因素分析，寻找影响患者PFS及OS的独立预后因素。

结果

31例（73.8%）患者达到完全缓解（CR），其中22例（52.4%）为早期CR，31例CR患者中14例接受序贯自体造血干细胞移植（ASCT）。1年PFS与OS率分别为65.6％和82.7%，4年PFS与OS率分别为48.2％和63.1%，中位OS时间未达到，中位PFS时间为30.5个月。多因素分析提示美国东部肿瘤协作组体能状态评分（ECOG评分）0~1分以及CR后序贯ASCT为减少复发、延长患者生存的有利因素。

结论

GLIDE方案能够有效治疗初发进展期及复发难治性ENKL, ECOG评分0~1分及CR后序贯ASCT治疗是患者获得较长PFS和OS时间的独立预后因素。

Interfacial Symmetry Control of Emergent Ferromagnetism at the Nanoscale

The emergence of complex new ground states at interfaces has been identified as one of the most promising routes to highly tunable nanoscale materials. Despite recent progress, isolating and controlling the underlying mechanisms behind these emergent properties remains among the most challenging materials physics problems to date. In particular, generating ferromagnetism localized at the interface of two nonferromagnetic materials is of fundamental and technological interest. Moreover, the ability to turn the ferromagnetism on and off would shed light on the origin of such emergent phenomena and is promising for spintronic applications. We demonstrate that ferromagnetism confined within one unit cell at the interface of CaRuO3 and CaMnO3 can be switched on and off by changing the symmetry of the oxygen octahedra connectivity at the boundary. Interfaces that are symmetry-matched across the boundary exhibit interfacial CaMnO3 ferromagnetism while the ferromagnetism at symmetry-mismatched interfaces is suppressed. We attribute the suppression of ferromagnetic order to a reduction in charge transfer at symmetry-mismatched interfaces, where frustrated bonding weakens the orbital overlap. Thus, interfacial symmetry is a new route to control emergent ferromagnetism in materials such as CaMnO3 that exhibit antiferromagnetism in bulk form.

[Value of ratio of sensory nerves conductive velocity along palm-median finger/wrist-palm in diagnosing the carpal tunnel syndrome]

OBJECTIVE

To Verify the value of the ratio of sensory nerves conductive velocity along palm-median finger /wrist-palm minus 1 for diagnosis of the mild-moderate carpal tunnel syndrome(CTS).

METHODS

The different value between 1 and the ratio of sensory nerves conductive velocity along palm-median finger/wrist-palm was defined as index-CTS which was used to assess the severity of CTS.The index-CTS of 100 palms from healthy controls and 58 palms from mild-moderate CTS patients were calculated and compared.Multiple regression was used to identify the relative factors of index-CTS.The ROC curve was used to evaluate the sensitivity and specificity of index-CTS at different values.

RESULTS

The value of index-CTS from healthy controls and patients both fitted Gaussian distribution.The mean value were -0.053±0.042 vs 0.055±0.074 in the controls and the patients respectively.The difference was statistically significant between the two groups by T-test(P<0.001). Multiple regression analysis showed that Tinel sign, Phalen sign, laterality, clinical grade, electrical grade were identifiable factors related to index-CTS.When index-CTS was over 0.001 and Ⅳ-DL over 0.395 ms , specificity of diagnosis by both can get 92%, but index-CTS showed more higher sensitivity(98.3% vs 89.7%).

CONCLUSIONS

Rising index-CTS could be the most significant electrophysiological feature in CTS.It can be used as a sensitive marker to assess the extent of conduction block of median nerve in carpal tunnel.