Associations of clinical features and prognosis with age at disease onset in patients with systemic lupus erythematosus

The objective of this study is to evaluate the association of clinical features and prognosis with age at disease onset in patients with systemic lupus erythematosus (SLE) in a large, multicenter Chinese cohort. Medical records of 1898 SLE inpatients from 15 hospitals were reviewed and classified into three groups according to their ages at disease presentation. Categorical data were analyzed by chi-square test and potentially associated factors were tested by multinomial logistic regression. Among the patients studied, 259 (13.6%) were juvenile onset (≤18 years), 1444 (76.1%) were early onset (>18 and ≤45 years) and 195 (10.3%) were late onset (>45 years). Whenever manifestations occurred, most patients (>80%) were diagnosed within two years. Juvenile-onset patients were more likely to be untreated before admission ( p < 0.001) and have mucocutaneous manifestations ( p < 0.001), but musculoskeletal symptoms ( p < 0.05) and leukopenia ( p < 0.05) were less frequent, while comorbidities were much higher in patients with late-onset SLE ( p < 0.001). Neuropsychiatric, cardiopulmonary, renal and gastrointestinal involvement, disease activity index and damage scores were similar among three groups. Anti-Sm antibodies were less prevalent in late-onset patients ( p < 0.05) and antimalarial drugs were more often applied to juvenile-onset patients ( p < 0.001). As expected, mortality was elevated in the late-onset SLE group ( p < 0.05), in which nearly half died of infections, which was much higher than those in the other two groups ( p < 0.001). Logistic regression confirmed that patients with juvenile- and early-onset disease were associated with high incidence of being untreated prior to admission, and with low incidence of comorbidities as well as deaths caused by infection compared to patients with late-onset lupus. Interestingly, our data showed that more patients with late-onset disease had a SLEDAI score change of >7 at discharge. In conclusion, age at onset has an impact on SLE disease status, and infection is the main cause of death in those with late-onset lupus. Considering that the late-onset patients had simultaneously easily controllable diseases and high incidence of comorbidities, a different treatment strategy from younger patients should be considered.

Magnetoplasmons in quasineutral epitaxial graphene nanoribbons

We present an infrared transmission spectroscopy study of the inter-Landau-level excitations in quasineutral epitaxial graphene nanoribbon arrays. We observed a substantial deviation in energy of the L(0(-1)) → L(1(0)) transition from the characteristic square root magnetic-field dependence of two-dimensional graphene. This deviation arises from the formation of an upper-hybrid mode between the Landau-level transition and the plasmon resonance. In the quantum regime, the hybrid mode exhibits a distinct dispersion relation, markedly different from that expected for conventional two-dimensional systems and highly doped graphene.

Feeding Artemisia annua alters digesta pH and muscle lipid oxidation products in broiler chickens

Because of growing consumer concern about the use of antimicrobials and the ban on most antibiotic feed additives in the European Union, there is increased interest in using alternatives to antimicrobials in poultry diets. Dried leaves of Artemisia annua have been used in Oriental medicine due to their antimicrobial activities. In the current study, the effect of including A. annua in broiler diets on hindgut and ceca pH, lipid oxidation products, and phenolic content of dark and white meat, and bird performance were investigated. A total of 96 broiler chicks were kept in 48 cages. Two cages with 2 birds per each cage are considered as 1 replicate, and there were 8 replications per treatment. The birds were fed corn-soy diets containing 0% (control), 2% (ART2), or 4% (ART4) dried A. annua leaves from d 14 through d 42. Cecal digesta pH was the lowest in birds fed the ART4 diet (P < 0.02), whereas the pH of ileal digesta was the lowest in ART2 (P < 0.01). Lipid oxidation products measured as TBA reactive substances (TBARS) were lower in the breast and thigh muscle of birds fed ART2 and ART4 diets compared with the control (P < 0.0001). No difference was found in total fat content of the liver, abdominal fat pads, or breast or thigh muscle content (P > 0.05). Artemisia annua addition did not affect final BW, weight gain, feed consumption, carcass weight, or feed:gain. No difference was observed in the relative weight of liver, abdominal fat, spleen, or heart tissue. Gastric acidity is protective against intestinal colonization and translocation of pathogenic bacteria. Therefore, gut pH and muscle tissue TBARS reduction in birds fed ART2 and ART4 suggest that A. annua may prove useful as a natural phytogenic feed additive with antioxidant potential that could be incorporated into poultry diets.

Photonic generation of phase-coded microwave signals with tunable carrier frequency

A photonic scheme to generate a phase-coded microwave signal with tunable carrier frequency based on a simple single-trip and two-pass structure is proposed. Facilitated by the fiber Bragg grating and phase modulator along the trip, both frequency doubling and signal phase coding could be achieved simultaneously. Phase-coded microwave signals at 20 and 22 GHz are experimentally generated.

Photonic arbitrary waveform generation based on crossed frequency to time mapping

Microwave photonic arbitrary waveform generation based on incoherent frequency-to-time-mapping (FTTM) accompanied by intersymbol interference, so called crossed FTTM (CFTTM). The pulse shape can be defined and tuned by properly adjusting the spectrum shaper (symbol shape) and the degree of intersymbol interference. UWB-, triangular-, rectangle-, comb- and user-defined pulse shapes are experimentally obtained.

Peripheral blood CD40-CD40L expression in human breast cancer

BACKGROUND

Breast cancer is the most common cancer in women. T cell-based immunotherapy for cancer has attracted much attention recently. CD40 and CD40L occupy an important position of specific immune response. In this paper, we want to study the role of co-stimulatory molecules CD40/CD40L and their clinical significance in peripheral blood of patients with breast cancer.

METHODS

Thirty breast cancer patients served as observation group, who were diagnosed as having infiltrating ductal breast cancer histopathologically, and 30 healthy as control group. Flow cytometric analysis was conducted to detect the expression of CD40 and CD40L on B and T lymphocytes in peripheral blood. The relationship between the CD40/CD40L expression levels and pathological grades was analyzed.

RESULTS

The expression levels of CD40/CD40L on B cells and T cells in breast cancer patients were significantly higher than those in the controls (all P < 0.001), and CD40/CD40L levels had a significant positive relationship with pathological grades (all P < 0.001).

CONCLUSIONS

The upregulated levels of co-stimulators CD40/CD40L on B cells and T cells may play an important role in the immune pathogenesis of breast cancer.

Laparoscopic versus open surgery for rectal cancer: a clinical comparative study

OBJECTIVE

To compare short-term surgical outcomes and long-term survival following laparoscopic or open resection for rectal cancer.

METHODS

A total of 381 patients undergoing laparoscopic surgery and 276 undergoing open surgery for curative resection of rectal cancer were included. Long-term survival and peri- and postoperative data were retrospectively reviewed from a prospectively-collected database.

RESULTS

Surgical groups were comparable regarding age, gender, tumour stage and preoperative comorbidities. Laparascopic surgery was associated with significantly longer duration of surgery, less intraoperative blood loss and fewer postoperative infections than open surgery. Patients who underwent laparoscopic resection had significantly earlier recovery of gastrointestinal function than those who underwent open surgery. There were no significant between-group differences in number of lymph nodes excised, specimen length or distal margin. The 3- and 5-year survival rates and overall survival were similar in the two groups, and survival was not influenced by tumour location.

CONCLUSION

Laparoscopic surgery can achieve the same oncological results as open resection in patients with rectal cancer, supporting its continued use in the management of this disease.

Bandwidth improvement for slow light using amplification characteristics of cascaded vertical-cavity surface-emitting lasers

A scheme to improve the bandwidth of slow light using cascaded vertical-cavity surface-emitting lasers (VCSELs) is proposed and experimentally demonstrated. In the scheme, a proper adjustment on the gain peaks of two cascaded VCSELs enables the generation of the desired composite gain spectrum, which has flat-top gain and delay profiles with enhanced peak values. By employing the improved gain and delay profiles in a slow light system, a large delay can be achieved within a wider bandwidth. In the experiment, by using two cascaded VCSELs, a tunable slow light up to 135 ps for a 5 Gbits/s pseudorandom binary sequence is demonstrated with relatively low signal distortion.

Photonic generation of impulse ultrawideband signals with switchable shapes and polarities based on frequency-to-time mapping

A photonic approach to generate impulse ultrawideband (UWB) signals with switchable shapes and polarities based on the frequency-to-time mapping technique is proposed and demonstrated. UWB monocycle, doublet, and triplet signals with two polarities can be obtained by adjusting the switchable spectrum shaper.

PDM RZ-to-NRZ and NRZ-to-PRZ format conversions using a variable DGD element inside a polarization-diversified loop

A novel scheme for bit-rate-variable polarization-division-multiplexed return-to-zero to nonreturn-to-zero and NRZ to pseudo-return-to-zero format conversions is proposed using a variable differential-group-delay element inside a polarization-diversified loop. Conversion for both 2×10 and 2×12.5 Gbit/s PDM signals are successfully demonstrated with approximately 1 dB additional power penalty by properly adjusting DGD values of the variable DGD element.

Spin transition in the ν=8/3 fractional quantum Hall effect

We present here the results from a density dependent study of the activation energy gaps of the fractional quantum Hall effect states at Landau level fillings ν=8/3 and 7/3 in a series of high quality quantum wells. In the density range from 0.5×10(11) to 3×10(11) cm(-2), the 7/3 energy gap increases monotonically with increasing density, supporting its ground state being spin polarized. For the 8/3 state, however, its energy gap first decreases with increasing density, almost vanishes at n~0.8×10(11) cm(-2), and then turns around and increases with increasing density, clearly demonstrating a spin transition.

Simultaneous all-optical RZ-to-NRZ format conversion for two tributaries in PDM signal using a single section of highly nonlinear fiber

Simultaneous all-optical RZ-OOK to NRZ-OOK format conversion for two tributaries in PDM signal is demonstrated utilizing a single section of highly nonlinear fiber through polarization nonlinear loop mirror configuration. Less than 1-dB power penalty is achieved in a 2 × 12.5-Gb/s PDM system, and only 1.4-dB SNR penalty is obtained in a 2 × 40-Gb/s PDM system.

Reversible watermarking based on invariant image classification and dynamical error histogram shifting

In this article, we present a novel reversible watermarking scheme. Its originality stands in identifying parts of the image that can be watermarked additively with the most adapted lossless modulation between: Pixel Histogram Shifting (PHS) or Dynamical Error Histogram Shifting (DEHS). This classification process makes use of a reference image derived from the image itself, a prediction of it, which has the property to be invariant to the watermark addition. In that way, watermark embedded and reader remain synchronized through this image of reference. DEHS is also an original contribution of this work. It shifts predict-errors between the image and its reference image taking care of the local specificities of the image, thus dynamically. Conducted experiments, on different medical image test sets issued from different modalities and some natural images, show that our method can insert more data with lower distortion than the most recent and efficient methods of the literature.

Secondary preventive medication persistence and adherence 1 year after stroke

OBJECTIVE

Data on long-term use of secondary prevention medications following stroke are limited. The Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) Registry assessed patient, provider, and system-level factors influencing continuation of prevention medications for 1 year following stroke hospitalization discharge.

METHODS

Patients with ischemic stroke or TIA discharged from 106 hospitals participating in the American Heart Association Get With The Guidelines-Stroke program were surveyed to determine their use of warfarin, antiplatelet, antihypertensive, lipid-lowering, and diabetes medications from discharge to 12 months. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications except those stopped according to health care provider instructions.

RESULTS

Of the 2,880 patients enrolled in AVAIL, 88.4% (2,457 patients) completed 1-year interviews. Of these, 65.9% were regimen persistent and 86.6% were regimen adherent. Independent predictors of 1-year medication persistence included fewer medications prescribed at discharge, having an adequate income, having an appointment with a primary care provider, and greater understanding of why medications were prescribed and their side effects. Independent predictors of adherence were similar to those for persistence.

CONCLUSIONS

Although up to one-third of stroke patients discontinued one or more secondary prevention medications within 1 year of hospital discharge, self-discontinuation of these medications is uncommon. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions.

Termination of two-dimensional metallic conduction near the metal-insulator transition in a Si/SiGe quantum well

We report in this Letter our recent low-temperature transport results in a Si/SiGe quantum well with moderate peak mobility. An apparent metal-insulating transition is observed. Within a small range of densities near the transition, the conductivity σ displays a nonmonotonic temperature dependence. After an initial decrease at high temperatures, σ first increases with decreasing temperature T, showing a metallic behavior. As T continues decreasing, a downturn in σ is observed. This downturn shifts to a lower T at higher densities. More interestingly, the downturn temperature shows a power-law dependence on the mobility at the downturn position, suggesting that a similar downturn is also expected to occur deep in the apparent metallic regime at albeit experimentally inaccessible temperatures. This thus hints that the observed metallic phase in 2D systems might be a finite temperature effect.