Revealing the quantum nature of the voltage-induced conductance changes in oxygen engineered yttrium oxide-based RRAM devices

In this work, the quasi-analog to discrete transition occurring in the current-voltage characteristic of oxygen engineered yttrium oxide-based resistive random-access memory (RRAM) devices is investigated in detail. In particular, the focus of our research is not on the absolute conductance values of this characteristic but on the magnitude of its conductance changes occurring during the reset process of the device. It is found that the detected changes correspond to conductance values predominantly of the order of the quantum unit of conductance G0 = 2e2/h, where e is the electron charge and h the Planck constant. This feature is observed even at conductance levels far above G0, i.e. where electron transport is seemingly diffusive. It is also observed that such behavior is reproducible across devices comprising yttrium oxide layers with different oxygen concentrations and measured under different voltage sweep rates. While the oxygen deficiency affects the total number of quantized conductance states, the magnitude of the changes in conductance, close to 1 G0, is invariant to the oxygen content of the functional layer.

Multinational comparison study of aircraft pilot healthcare avoidance behaviour

BACKGROUND

US and Canadian pilots are required to meet medical standards to secure their active flying status, but a subgroup exhibit healthcare avoidance behaviour due to fear of loss of that status. This phenomenon has the potential to impact pilot health, aeromedical screening and aviation safety. No international comparison study of pilot healthcare avoidance currently exists between US and Canadian pilots.

AIMS

To compare the rate and subtypes of healthcare avoidance behaviour secondary to fear for loss of flying status between US and Canadian pilots.

METHODS

A comparison analysis of data collected during two independent, non-probabilistic, cross-sectional internet surveys including any individual certified to perform flying duties in the USA (US survey) or Canada (Canadian survey).

RESULTS

There were 4320 US pilots and 1415 Canadian pilots who completed informed consent and 3765 US pilots and 1405 Canadian pilots were included in the results. There were 56% of US pilots who reported a history of healthcare avoidance behaviour compared to 55% of Canadian pilots (P = 0.578). A multivariable logistic regression that included age, pilot type and gender showed that US pilots were slightly more likely than Canadian pilots to report this behaviour (odds ratio 1.22, 95% confidence interval 1.06-1.4).

CONCLUSIONS

Healthcare avoidance behaviour due to fear of loss of flying status has a relatively high prevalence in both US and Canadian pilot populations.

Sex-Related Mortality After Burns: A Scoping Review in the Sadc-Region

Findings on mortality by sex after burns in low- and middle-income countries (LMICs) are contradictory and, where differences have been described, the reasons are often based on speculation and not on the analysis of factors that could have affected the outcome, such as patient or injury characteristics or provided care. Since the paucity of studies on burns from single LMICs is notorious, merging data from neighboring countries with similar socio-economic backgrounds might provide a larger dataset, contributing to identifying recurrent causes. This scoping review aimed therefore to analyze differences in mortality after burns between the sexes, as well as to identify aspects that could explain possible differences, in countries belonging to the South African Development Community (SADC) region. Studies in English published between 2010 and 2020 were identified according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines by searching PubMed and/or Medline, Clinical Trials and Cochrane Library, and using the screening tool "Covidence". The 13 included studies could not consistently show association between sex and mortality after burns, but contradictory findings. In the case of differences in outcome between the sexes, explanations were mainly based on speculation (e.g., hormonal differences, self-harm intention), while rarely burn specific factors were reported and included in the analysis of the mortality risk. This study indicates the need for prospective burn specific data collection in LMICs that would contribute to identifying factors associated with death.

Polymerogenic neuroserpin causes mitochondrial alterations and activates NFκB but not the UPR in a neuronal model of neurodegeneration FENIB

The neurodegenerative condition FENIB (familiar encephalopathy with neuroserpin inclusion bodies) is caused by heterozygous expression of polymerogenic mutant neuroserpin (NS), with polymer deposition within the endoplasmic reticulum (ER) of neurons. We generated transgenic neural progenitor cells (NPCs) from mouse fetal cerebral cortex stably expressing either the control protein GFP or human wild type, polymerogenic G392E or truncated (delta) NS. This cellular model makes it possible to study the toxicity of polymerogenic NS in the appropriated cell type by in vitro differentiation to neurons. Our previous work showed that expression of G392E NS in differentiated NPCs induced an adaptive response through the upregulation of several genes involved in the defence against oxidative stress, and that pharmacological reduction of the antioxidant defences by drug treatments rendered G392E NS neurons more susceptible to apoptosis than control neurons. In this study, we assessed mitochondrial distribution and found a higher percentage of perinuclear localisation in G392E NS neurons, particularly in those containing polymers, a phenotype that was enhanced by glutathione chelation and rescued by antioxidant molecules. Mitochondrial membrane potential and contact sites between mitochondria and the ER were reduced in neurons expressing the G392E mutation. These alterations were associated with a pattern of ER stress that involved the ER overload response but not the unfolded protein response. Our results suggest that intracellular accumulation of NS polymers affects the interaction between the ER and mitochondria, causing mitochondrial alterations that contribute to the neuronal degeneration seen in FENIB patients.

Identification of a novel Candida metapsilosis isolate reveals multiple hybridization events

Candida metapsilosis is a member of the Candida parapsilosis species complex, a group of opportunistic human pathogens. Of all the members of this complex, C. metapsilosis is the least virulent, and accounts for a small proportion of invasive Candida infections. Previous studies established that all C. metapsilosis isolates are hybrids, originating from a single hybridization event between two lineages, parent A and parent B. Here, we use MinION and Illumina sequencing to characterize a C. metapsilosis isolate that originated from a separate hybridization. One of the parents of the new isolate is very closely related to parent A. However, the other parent (parent C) is not the same as parent B. Unlike C. metapsilosis AB isolates, the C. metapsilosis AC isolate has not undergone introgression at the mating type-like locus. In addition, the A and C haplotypes are not fully collinear. The C. metapsilosis AC isolate has undergone loss of heterozygosity with a preference for haplotype A, indicating that this isolate is in the early stages of genome stabilization.

Role of the left coronary artery geometry configuration in atherosusceptibility: CFD simulations considering sPTT model for blood

The achievement of clinically viable methodologies to simulate the hemodynamics in patient-specific coronary arteries is still a major challenge. Therefore, the novelty of this work is attained by the introduction of the viscoelastic property of blood in the numerical simulations, to study the role of the left coronary artery (LCA) geometry configuration in the atherosusceptibility. Apparently healthy patients were used and four different methodologies were tested. The methodology giving the most accurate results at the same time of having the lowest computational time is the one considering the viscoelastic property of blood and computational fluid dynamics. A Pearson correlation analysis was used to highlight relationships between geometric configuration and hemodynamic descriptors based on the simulated wall shear stress (WSS). The left main stem (LMS) has the greatest atherosusceptibility followed by the left anterior descending artery (LAD) since the relative residence time (RRT) average values are 3.81 and 3.70 Pa^-1, respectively. The geometric parameters with relevant contribution to directional flow change are the cross-sectional areas, especially the one of LMS segment (A_LMS), and the curvature of LMS segment. For LMS and LAD segments, when A_LMS increases, blood flow disturbance (r = 0.81 in LMS and r = 0.74 in LAD) and atherosusceptibility (r = 0.84 in LMS and r = 0.85 in LAD) increases. When the LMS curvature decreases, the WSS magnitude (r = 0.80 in LMS and r = 0.83 in LAD) decreases, and disturbance (r=-0.80 in LMS and r=-0.91 in LAD) and atherosusceptibility (r=-0.74 in LMS and r=-0.74 in LAD) increases.

Kinetics and drainage index in function of pH, in the dewatering of arsenic iron sludge

Water for human consumption containing arsenic from natural and anthropogenic sources is a public health problem worldwide. Therefore, different technologies must be used to remove it from the water (coagulation-filtration assisted with ferric chloride, adsorption, membranes, etc.). While these technologies produce water that is free from arsenic, they also produce toxic residuals with high arsenic concentrations, which must be treated in order to decrease their volume and thereby facilitate transport and final disposal. Thus, the main purpose of this investigation was to study the physical and chemical properties of arsenic iron sludge in thickening, chemical conditioning, and dewatering processes, as well as to propose new kinetic criteria for obtaining the drainage index (E_g) based on polymer dose, mesh permeability, specific resistance to filtration, and pH. We found a significant improvement in the physical and chemical properties when thickening the sludge, in particular, floc size increased and specific resistance to filtration and Z-potential decreased due to weakened repulsive forces, resulting in more sedimentation. The polymer AN913VHM (PF2) had the best behavior in the chemical conditioning and dewatering tests, with an optimal dose of 8 mg/L and a mesh permeability of 80-100 ft³/min ft², which made it possible to retain more flocs (60% in 3.74 min). The pH affected the amount of total solids in the cake, with more solids obtained at a pH of 6 (25.93 g/L) and 6.5 (21.81 g/L), and with rapid drainage of surface water (69.28%). Furthermore, new kinetic criteria were obtained for a drainage time of 120 s in order to eliminate 60% of the total volume of the filtrate mass, with E_g of 3.05 at a pH of 6. This value is considered medium drainage for this type of sludge, which is difficult to treat.

Goal-directed fluid therapy on laparoscopic colorectal surgery within enhanced recovery after surgery program

INTRODUCTION

Enhanced recovery after surgery protocols (ERAS) are used in peri-operative care to reduce the stress response to surgical aggression. As fluid overload has been associated with increased morbidity and delayed hospital discharge, a major aspect of this is fluid management. Intra-operative goal-directed fluid protocols have been shown to reduce post-operative complications, particularly in high risk patients.?.

OBJECTIVE

To compare 2fluid therapy models (zero-balance versus goal-directed fluid therapy) in patients who were scheduled for laparoscopic colorectal surgery within an ERAS program, recording the rate of complications such as surgical site infection, ileus, post-operative náusea and vomiting, and variability of the estimated glomerular filtration rate (eGFR).

MATERIALS AND METHODS

An observational, retrospective study was conducted including adults who were scheduled for elective laparoscopic colorectal surgery within an ERAS program, and to investigate the postoperative complication rate.

RESULTS

A total of 128 patients were included in this study; 43 (33.6%) in the zero-balance group and 85 (66.4%) in the goal-directed fluid therapy group. The total fluids administered was lower in the goal-directed fluid therapy group, as well as the incidence of post-operative complications (surgical site infection, anastomotic leak, ileus, and postoperative náusea and vomiting). No significant differences were found for length of stay, intra-operative urine output, and variability of the eGFR.?.

CONCLUSION

The results of this study show that by using a goal-directed fluid therapy algorithm, the total amount of fluids administered can be reduced, as well as obtaining a lower incidence of post-operative complications.

Singular fibres of the Gelfand-Cetlin system on 𝔲(n)

In this paper, we show that every singular fibre of the Gelfand-Cetlin system on co-adjoint orbits of unitary groups is a smooth isotropic submanifold which is diffeomorphic to a two-stage quotient of a compact Lie group by free actions of two other compact Lie groups. In many cases, these singular fibres can be shown to be homogeneous spaces or even diffeomorphic to compact Lie groups. We also give a combinatorial formula for computing the dimensions of all singular fibres, and give a detailed description of these singular fibres in many cases, including the so-called (multi-)diamond singularities. These (multi-)diamond singular fibres are degenerate for the Gelfand-Cetlin system, but they are Lagrangian submanifolds diffeomorphic to direct products of special unitary groups and tori. Our methods of study are based on different ideas involving complex ellipsoids, Lie groupoids and also general ideas coming from the theory of singularities of integrable Hamiltonian systems.This article is part of the theme issue 'Finite dimensional integrable systems: new trends and methods'.

UPR activation specifically modulates glutamate neurotransmission in the cerebellum of a mouse model of autism

An increasing number of rare mutations linked to autism spectrum disorders have been reported in genes encoding for proteins involved in synapse formation and maintenance, such as the post-synaptic cell adhesion proteins neuroligins. Most of the autism-linked mutations in the neuroligin genes map on the extracellular protein domain. The autism-linked substitution R451C in Neuroligin3 (NLGN3) induces a local misfolding of the extracellular domain, causing defective trafficking and retention of the mutant protein in the endoplasmic reticulum (ER). The activation of the unfolded protein response (UPR), due to misfolded proteins accumulating in the ER, has been implicated in pathological and physiological conditions of the nervous system. It was previously shown that the over-expression of R451C NLGN3 in a cellular system leads to the activation of the UPR. Here, we have investigated whether this protective cellular response is detectable in the knock-in mouse model of autism endogenously expressing R451C NLGN3. Our data showed up-regulation of UPR markers uniquely in the cerebellum of the R451C mice compared to WT littermates, at both embryonic and adult stages, but not in other brain regions. Miniature excitatory currents in the Purkinje cells of the R451C mice showed higher frequency than in the WT, which was rescued inhibiting the PERK branch of UPR. Taken together, our data indicate that the R451C mutation in neuroligin3 elicits UPR in vivo, which appears to trigger alterations of synaptic function in the cerebellum of a mouse model expressing the R451C autism-linked mutation.

Energy Cost of Active and Sedentary Music Video Games: Drum and Handheld Gaming vs. Walking and Sitting

To compare energy expenditure during and after active and handheld video game drumming compared to walking and sitting. Ten experienced, college-aged men performed four protocols (one per week): no-exercise seated control (CTRL), virtual drumming on a handheld gaming device (HANDHELD), active drumming on drum pads (DRUM), and walking on a treadmill at ~30% of VO_2max (WALK). Protocols were performed after an overnight fast, and expired air was collected continuously during (30min) and after (30min) exercise. DRUM and HANDHELD song lists, day of the week, and time of day were identical for each participant. Significant differences (p < 0.05) among the average rates of energy expenditure (kcal·min^-1) during activity included WALK > DRUM > HANDHELD. No significant differences in the rates of energy expenditure among groups during recovery were observed. Total energy expenditure was significantly greater (p < 0.05) during WALK (149.5 ± 30.6 kcal) compared to DRUM (118.7 ± 18.8 kcal) and HANDHELD (44.9±11.6 kcal), and greater during DRUM compared to HANDHELD. Total energy expenditure was not significantly different between HANDHELD (44.9 ± 11.6 kcal) and CTRL (38.2 ± 6.0 kcal). Active video game drumming at expert-level significantly increased energy expenditure compared to handheld, but it hardly met moderate-intensity activity standards, and energy expenditure was greatest during walking. Energy expenditure with handheld video game drumming was not different from no-exercise control. Thus, traditional aerobic exercise remains at the forefront for achieving the minimum amount and intensity of physical activity for health, individuals desiring to use video games for achieving weekly physical activity recommendations should choose games that require significant involvement of lower-body musculature, and time spent playing sedentary games should be a limited part of an active lifestyle.

Chiral Spin-Orbital Liquids with Nodal Lines

Strongly correlated materials with strong spin-orbit coupling hold promise for realizing topological phases with fractionalized excitations. Here, we propose a chiral spin-orbital liquid as a stable phase of a realistic model for heavy-element double perovskites. This spin liquid state has Majorana fermion excitations with a gapless spectrum characterized by nodal lines along the edges of the Brillouin zone. We show that the nodal lines are topological defects of a non-Abelian Berry connection and that the system exhibits dispersing surface states. We discuss some experimental signatures of this state and compare them with properties of the spin liquid candidate Ba_{2}YMoO_{6}.

Comparison of Hydrolyzed Protein Baits and Various Grape Juice Products as Attractants for Anastrepha Fruit Flies (Diptera: Tephritidae)

Mexican fruit flies, Anastrepha ludens (Loew; Diptera: Tephritidae), have traditionally been trapped in citrus orchards in Mexico using protein hydrolysates as bait. Recently, CeraTrap(®), an enzymatic hydrolyzed protein, has emerged as an effective lure for monitoring A. ludens at the orchard level and is currently being used by growers in the region of Veracruz. Several studies have revealed that grape juice is highly attractive to A. ludens, and recent work supports its potential use for regulation purposes. In our study, the attraction of A. ludens to different grape products was evaluated in citrus orchards and in comparison to other Anastrepha species in an area composed of mango and chicozapote orchards. Attraction to grape lures was compared with CeraTrap and the standard protein Captor +borax trap. In general, CeraTrap was more attractive than different commercial grape products in several experiments. Only Jumex, a commercial grape juice, did not differ significantly from CeraTrap in the capture of A. ludens males and females in a citrus crop. However, several drawbacks were detected when using Jumex grape juice: 1) higher tendency to capture males, 2) less selectivity against non-targeted insects, 3) higher capture of beneficial lacewings, and iv) the need to re-bait weekly owing to lower stability. In the area containing mango and chicozapote, CeraTrap was more attractive than Captor + borax for Anastrepha obliqua and Anastrepha serpentina, followed by grape juice products, which were the least attractive for these fruit fly species.

Emergent SU(3) Symmetry in Random Spin-1 Chains

We show that generic SU(2)-invariant random spin-1 chains have phases with an emergent SU(3) symmetry. We map out the full zero-temperature phase diagram and identify two different phases: (i) a conventional random-singlet phase (RSP) of strongly bound spin pairs [SU(3) "mesons"] and (ii) an unconventional RSP of bound SU(3) "baryons," which are formed, in the great majority, by spin trios located at random positions. The emergent SU(3) symmetry dictates that susceptibilities and correlation functions of both dipolar and quadrupolar spin operators have the same asymptotic behavior.

Economic and Highly Effective Trap-Lure Combination to Monitor the Mexican Fruit Fly (Diptera: Tephritidae) at the Orchard Level

Monitoring population levels of the Mexican fruit fly, Anastrepha ludens (Loew) (Diptera: Tephritidae), at the orchard level prior and during the fruit ripening period can result in significant savings in the costs of managing this pestiferous insect. Unfortunately, to date, no highly effective and economically viable trap is available to growers. To move toward this goal, trap-lure combinations were evaluated in trials performed in citrus orchards in Veracruz, Mexico. CeraTrap, an enzymatic hydrolyzed protein from pig intestinal mucose, was 3.6 times more attractive to A. ludens than the most commonly used bait of Captor (hydrolyzed protein and borax) when using Multilure traps. When several commercial traps were evaluated, the efficacy of a simple and inexpensive transparent polyethylene (PET) bottle with 10-mm lateral holes was similar to that of the costly Multilure trap when baited with CeraTrap and significantly more effective than a Multilure trap baited with Captor. PET bottles filled with Cera Trap, rebaited at 8-wk intervals, and tested in trials encompassing 72 ha of citrus groves, were significantly more effective than Multilure traps baited with Captor that need to be serviced weekly. In addition to this relevant finding, CeraTrap baited traps detected A. ludens at lower population densities and attracted a significantly higher number of flies at all densities when compared with Captor-baited traps. We conclude that CeraTrap represents a cost-effective and highly efficient bait that will enable us to pursue the goal of developing economic thresholds, a badly needed management tool for A. ludens.

Improving health behaviours of Latina mothers of youths and adults with intellectual and developmental disabilities

BACKGROUND

Latina mothers who care for children with intellectual and developmental disabilities (IDD) over the lifespan struggle to take care of their own health needs in the context of their caregiving experience. Services are typically aimed at the persons with IDD and not their family caregivers. Yet, attending to family caregiver needs may contribute to better long-term care of persons with IDD who remain at home. To address this unmet need, we developed a culturally sensitive health education intervention for Latina mothers who care for youth and adults with IDD. The aim of the intervention is to improve maternal health-related self-efficacy and health behaviours, and to reduce stress.

METHOD

A randomised control design was employed to determine preliminary efficacy of the intervention. Paired sample t-tests were conducted to examine within-group changes from baseline to 3-month post-test. Repeated-measures analysis of covariance was used to examine the group-by-time interaction effects.

RESULTS

Intervention participants showed greater increases between pre- and post-test in health-related self-efficacy; self-care, nutrition and overall health behaviours. Both groups reported decreases in depressive symptoms and caregiver burden.

CONCLUSIONS

While additional research is needed to determine long-term effects and to replicate findings, our results suggest that this culturally sensitive health intervention is a promising way to increase health behaviours which may lead to overall good health for Latina mothers who care for children with IDD across the lifespan.

Non-Gaussian spatial correlations dramatically weaken localization

We perform variational studies of the interaction-localization problem to describe the interaction-induced renormalizations of the effective (screened) random potential seen by quasiparticles. Here we present results of careful finite-size scaling studies for the conductance of disordered Hubbard chains at half-filling and zero temperature. While our results indicate that quasiparticle wave functions remain exponentially localized even in the presence of moderate to strong repulsive interactions, we show that interactions produce a strong decrease of the characteristic conductance scale g^{*} signaling the crossover to strong localization. This effect, which cannot be captured by a simple renormalization of the disorder strength, instead reflects a peculiar non-Gaussian form of the spatial correlations of the screened disordered potential, a hitherto neglected mechanism to dramatically reduce the impact of Anderson localization (interference) effects.

HIF-1 promotes the expression of its α-subunit via an epigenetically regulated transactivation loop

A HIF-1 protein–protein interaction inhibitor is used to establish the presence of a HIF-1α transactivation loop in hypoxia.

Irrelevant and independent natural extension for sets of desirable gambles

The results in this paper add useful tools to the theory of sets of desirable gambles, a growing toolbox for reasoning with partial probability assessments. We investigate how to combine a number of marginal coherent sets of desirable gambles into a joint set using the properties of epistemic irrelevance and independence. We provide formulas for the smallest such joint, called their independent natural extension, and study its main properties. The independent natural extension of maximal coherent sets of desirable gambles allows us to define the strong product of sets of desirable gambles. Finally, we explore an easy way to generalise these results to also apply for the conditional versions of epistemic irrelevance and independence. Having such a set of tools that are easily implemented in computer programs is clearly beneficial to fields, like AI, with a clear interest in coherent reasoning under uncertainty using general and robust uncertainty models that require no full specification.

The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency

Background

The major concept behind augmentation therapy with human α₁-antitrypsin (AAT) is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys)-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema.

Objective

To evaluate the short-term effects of augmentation therapy (Prolastin^®) on plasma levels of AAT, C-reactive protein, and chemokines/cytokines.

Materials and methods

Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12) on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8), monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL).

Results

There were significant fluctuations in serum (but not in exhaled breath condensate) levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, and vascular endothelial growth factor within a week of augmentation therapy. In general, augmented individuals had higher AAT and lower serum levels of IL-8 than nonaugmented subjects. Prolastin added for 3 hours to neutrophils from protease inhibitor phenotype ZZ individuals in vitro reduced IL-8 release but showed no effect on cytokine/chemokine release from human bronchial epithelial cells.

Conclusion

Within a week, augmentation with Prolastin induced fluctuations in serum levels of AAT polymers and cytokine/chemokines but specifically lowered IL-8 levels. It remains to be determined whether these effects are related to the Prolastin preparation per se or to the therapeutic efficacy of augmentation with AAT.

Preclinical activity of LBH589 alone or in combination with chemotherapy in a xenogeneic mouse model of human acute lymphoblastic leukemia

Histone deacetylases (HDACs) have been identified as therapeutic targets due to their regulatory function in chromatin structure and organization. Here, we analyzed the therapeutic effect of LBH589, a class I-II HDAC inhibitor, in acute lymphoblastic leukemia (ALL). In vitro, LBH589 induced dose-dependent antiproliferative and apoptotic effects, which were associated with increased H3 and H4 histone acetylation. Intravenous administration of LBH589 in immunodeficient BALB/c-RAG2(-/-)γc(-/-) mice in which human-derived T and B-ALL cell lines were injected induced a significant reduction in tumor growth. Using primary ALL cells, a xenograft model of human leukemia in BALB/c-RAG2(-/-)γc(-/-) mice was established, allowing continuous passages of transplanted cells to several mouse generations. Treatment of mice engrafted with T or B-ALL cells with LBH589 induced an in vivo increase in the acetylation of H3 and H4, which was accompanied with prolonged survival of LBH589-treated mice in comparison with those receiving vincristine and dexamethasone. Notably, the therapeutic efficacy of LBH589 was significantly enhanced in combination with vincristine and dexamethasone. Our results show the therapeutic activity of LBH589 in combination with standard chemotherapy in pre-clinical models of ALL and suggest that this combination may be of clinical value in the treatment of patients with ALL.

ANCA-associated vasculitis is linked to carriage of the Z allele of α₁ antitrypsin and its polymers

BACKGROUND

Small studies have linked α1 antitrypsin (α1AT) deficiency to patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV).

OBJECTIVE

To test the validity and the mechanism of this association between α1AT and AAV.

METHODS

The distribution of α1AT deficiency alleles Z and S was compared between 856 White Europeans with AAV and 1505 geographic and ethnically matched healthy controls. Genotyping was performed by allelic discrimination assay.

RESULTS

were compared between cases and controls using χ(2) tests. The serum and renal biopsies for α1AT polymers were compared using the polymer-specific 2C1 antibody. The role of α1AT polymers in promoting inflammation was investigated by examining their ability to prime neutrophils for ANCA activation as assessed by CD62L shedding, superoxide production and myeloperoxidase degranulation. Results The Z but not the S allele was over-represented in the patients compared with controls (HR=2.25, 95% CI 1.60 to 3.19). Higher concentrations of polymers of α1AT were detected in serum from patients carrying the Z allele than in those not carrying the Z allele (median (IQR) 1.40 (0.91-3.32) mg/dl vs 0.17 (0.06-0.28) mg/dl, p<0.001); polymers of α1AT were also seen in the renal biopsy of a patient with vasculitic glomerulonephritis. Polymers of α1AT primed neutrophils with CD62L shedding and increased superoxide production following ANCA activation. Carriage of the Z allele was not associated with disease severity, survival or relapse.

CONCLUSIONS

The Z but not the S deficiency allele is associated with AAV. Polymers of α1AT are present in the serum and glomeruli of at least some patients with the Z allele, which may promote inflammation through priming of neutrophils.

Assessment of routine malaria diagnosis in the Venezuelan Amazon

The quality of routine malaria diagnosis is a crucial topic of malaria control. The aim of this assessment was to monitor and evaluate the quality of routine malaria diagnosis in Amazonas (Venezuela) and to improve the quality control system. The traditional non-blinded quality control system was found to be overburdened with diagnostic samples. A modified sampling system with fewer samples to be tested was proposed. Expert microscopists blindly double-checked 1000 slides and 550 rapid diagnostic tests (RDT) (OptiMAL-IT) from health posts (HP). For Plasmodium vivax, HP microscopy and OptiMAL-IT showed sensitivies of 86% and 63%, respectively. For P. falciparum, HP microscopy and OptiMAL-IT showed sensitivities of 68% and 89%, respectively. Both methods lost accuracy when fewer parasites occurred in the sample. HP microscopists from different municipalities displayed significant differences in diagnostic quality. Overall, quality of routine malaria diagnosis in the Venezuelan Amazon is good but not optimal. The change from the traditional non-blinded quality control system to blinded cross-checking of a minimal selection of samples is - comparatively - a low cost intervention with possibly high impact on the quality of routine malaria diagnosis. The introduction of RDTs should be discussed carefully in order not to displace an existing network of HP microscopists.

Quantum ripples in strongly correlated metals

We study how well-known effects of the long-ranged Friedel oscillations are affected by strong electronic correlations. We first show that their range and amplitude are significantly suppressed in strongly renormalized Fermi liquids. We then investigate the interplay of elastic and inelastic scattering in the presence of these oscillations. In the singular case of two-dimensional systems, we show how the anomalous ballistic scattering rate is confined to a very restricted temperature range even for moderate correlations. In general, our analytical results indicate that a prominent role of Friedel oscillations is relegated to weakly interacting systems.

Cost effectiveness of deferasirox compared to desferrioxamine in the treatment of iron overload in lower-risk, transfusion-dependent myelodysplastic syndrome patients

OBJECTIVE

The study evaluated the cost effectiveness of deferasirox (Exjade * ) compared to non-proprietary desferrioxamine (DFO) for the control of transfusional iron overload in lower risk myelodysplastic syndromes (MDS) patients. A UK National Health Service perspective was adopted.

METHODS

Recent clinical evidence has demonstrated the efficacy and safety of deferasirox in transfusion-dependent MDS patients with elevated serum ferritin levels. An economic model was used to extrapolate the clinical benefits of iron chelation therapy (ICT) in a cohort of lower risk MDS patients. Costs for drug acquisition, drug administration and monitoring, and quality of life (utility) outcomes associated with mode of drug administration were derived from a variety of sources. The incremental cost per QALY gained for deferasirox was estimated. Costs and outcomes were discounted at 3.5% in line with UK standards.

RESULTS

The base-case cost effectiveness of deferasirox versus DFO was estimated to be £20,822 per QALY gained, the key driver being the additional quality of life benefits associated with a simpler mode of administration for deferasirox. A mean survival benefit for both forms of ICT of 4.5 years was estimated. The results were sensitive to drug dose, days of DFO administration, and patient weight.

CONCLUSIONS

In the UK, a cost per QALY below £20,000-30,000 is considered cost effective. Hence, the results from this economic analysis suggest deferasirox is cost effective in lower risk, transfusion-dependent, MDS patients. Limitations with the analysis include a lack of comparative randomised controlled trial evidence, in particular to differentiate survival and clinical outcomes for deferasirox and DFO.