Noninvasive biometric monitoring technologies for patients with heart failure.

Heart failure remains one of the leading causes of mortality and hospitalizations in the US that not only impacts quality of life but also poses a significant public health burden. The majority of affected patients are admitted with signs and symptoms of congestion. Despite the initial enthusiasm, traditional remote monitoring strategies focusing primarily on weight gain failed to improve clinical outcomes.

Photonic features of blue phase liquid crystals under curved confinement.

Blue phase (BP) liquid crystals represent a fascinating state of soft matter that showcases unique optical and electro-optical properties. Existing between chiral nematic and isotropic phases, BPs are characterized by a three-dimensional cubic lattice structure resulting in selective Bragg reflections of light and consequent vivid structural colors. However, the practical realization of these material systems is hampered by their narrow thermal stability and multi-domain crystalline nature.

Survival After Simultaneous Heart-kidney Transplant in Recipients With a Durable LVAD and Chronic Kidney Disease: Effect of the 2018 Heart Allocation Policy Change.

Background: Heart transplantation remains the most definitive therapy for qualified candidates with end-stage heart failure. Concomitant kidney disease is common in this population prompting an increase in simultaneous heart-kidney (SHK) transplantation in recent years. The goal of our study was to explore the effects of the 2018 heart allocation policy (HAP) change on candidate listing characteristics and compare survival rates at 1 y in patients that were supported with a left ventricular assist device (LVAD) pretransplant and underwent SHK or heart alone transplant (HAT).

Globalization, international mobility and the liberal international order.

Since the Second World War, globalization has been underpinned by a liberal international order, a rules-based system structured around the principles of economic interdependence, democracy, human rights and multilateralism. However, the relationship between international mobility and the liberal international order (LIO) is contested. In the article, I disaggregate 'international mobility' into three regimes: the travel regime, the voluntary (labour) migration regime, and the refugee regime-each governed by distinct norms and operating procedures.

Simplifying the ISCHEMIA trial algorithm for clinical practice: Identifying left main coronary artery disease using coronary artery calcium scans.

Background: Several recent trials have evaluated invasive versus medical therapy for stable ischemic heart disease. Importantly, patients with significant left main coronary stenosis (LMCS) were excluded from these trials. In the ISCHEMIA trial, these patients were identified by a coronary CT angiogram (CCTA), which adds time, expense, and contrast exposure.

Loss of Pulsatility: Another Cause of Syncope in Patients with Left Ventricular Assist Devices.

We report a case of a 55-year-old man who presented with recurrent syncope 15 months after HeartWare left ventricular assist device (LVAD) implantation and was found to have diminished LVAD flow and pulsatility on tilt table testing leading to severe orthostatic hypotension (OH). The prevalence of OH is common, but autonomic dysfunction leading to OH has not been well described in patients with chronic LVAD support. The diagnosis of OH in this setting is challenging due to the decreased pulsatility in the flow generated by LVADs, and tilt table testing can be useful in the evaluation of OH in these patients.

Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

Background: Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage.

Methods: This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization.

EssC: domain structures inform on the elusive translocation channel in the Type VII secretion system.

The membrane-bound protein EssC is an integral component of the bacterial Type VII secretion system (T7SS), which is a determinant of virulence in important Gram-positive pathogens. The protein is predicted to consist of an intracellular repeat of forkhead-associated (FHA) domains at the N-terminus, two transmembrane helices and three P-loop-containing ATPase-type domains, D1-D3, forming the C-terminal intracellular segment. We present crystal structures of the N-terminal FHA domains (EssC-N) and a C-terminal fragment EssC-C from Geobacillus thermodenitrificans, encompassing two of the ATPase-type modules, D2 and D3.

Utility of Oncotype DX Risk Assessment in Patients With Invasive Lobular Carcinoma.

Introduction/background: Oncotype DX (Genomic Health, Redwood City, CA) uses reverse transcriptase polymerase chain reaction analysis to measure tumor gene expression for determining recurrence risk (RR) and guiding chemotherapy decisions for breast cancer patients. Invasive lobular carcinoma (ILC) is a histologic subtype that has not been the focus of prior studies validating Oncotype DX. The study purpose was to develop a model using histologic tumor characteristics to predict uniformly low Oncotype DX Recurrence Scores (RS) in ILC.

Metals associated with stormwater-relevant brake and tire samples.

Properly apportioning the loads of metals in highway stormwater runoff to the appropriate sources requires accurate data on source composition, especially regarding constituents that help to distinguish among sources. Representative tire and brake samples were collected from privately owned vehicles and aqueous extracts were analyzed for twenty-eight elements. Correlation principal components analysis (PCA) revealed that tires were most influenced by Zn, Pb, and Cu, while brakes were best characterized by Na and Fe followed by Ba, Cu, Mg, Mn, and K; the latter three may be due to roadside soil contributions.

Male-male homosexology: seven short discourses.

Homosexology is that branch of the science of sexology that deals with same sex relationships. It is subdivided into ideation, imagery, and praxis. Praxeology is the science of praxis.

Communicating with parents of the newborn with intersex: transcript of an interview.

The following is the actual transcript of an interview with a father whose child, who had a severe micropenis, was 3 weeks of age. The diagnosis had not yet been made, and a decision concerning sex of rearing had not yet been made. This text illustrates numerous important issues concerning communications with parents of infants with intersex.

History, causality, and sexology.

In 1896, Krafft-Ebing published Psychopathia Sexualis. Popularly defined as hereditary weakness or taintedness in the family pedigree, degeneracy was called upon as a causal explanation for perversions of the sexual instinct. Although Krafft-Ebing accepted Karl Ulrichs proposal that homosexuality could be innate and probably located in the brain, he paid little attention to neuropathological sexology.

Multiplex versus multiple taxonomy of paraphilia: case example.

Several different paraphilias are presently diagnosed in some individuals whereas a more parsimonious taxonomy would be that of one multiplex paraphilia. A multiplex paraphilia may be expressed by variations of content at different times in an individual's life or in different situations. The present case example shows the unfolding of a multiplex paraphilia over a lifetime.

46,XY intersex individuals: phenotypic and etiologic classification, knowledge of condition, and satisfaction with knowledge in adulthood.

Objectives: The objective of this study was to identify and study adults who have a 46,XY karyotype and presented as infants or children with variable degrees of undermasculinization of their genitalia (female genitalia, ambiguous genitalia, or micropenis). Participants' knowledge of their condition, satisfaction with their knowledge, and desire for additional education about their intersex condition were assessed.

Methods: Participants were classified according to the cause underlying their intersex condition based on review of medical and surgical records.

Ambiguous genitalia with perineoscrotal hypospadias in 46,XY individuals: long-term medical, surgical, and psychosexual outcome.

Objectives: To identify and study adults (21 years or older) who have a 46,XY karyotype and presented as infants or children with genital ambiguity, including a small phallus and perineoscrotal hypospadias, reared male or female.

Methods: Participants were classified according to the cause underlying their intersex condition based on review of medical and surgical records. Long-term medical and surgical outcome was assessed with a written questionnaire and physical examination.

Amative orientation: the hormonal hypothesis examined.

The hypothesis that human male and female amative orientation, arousal and courtship are sex-hormone dependent had as its precursor John Hunter's recorded but unpublished 18th century experiments of cross-sexed gonadal transplants in chicks. The hypothesis gained momentum in the 20th century after the discovery and eventual marketing of the sex hormones, and after the experimental demonstration by William C. Young that, in guinea-pigs, cross-sexed hormone administered prenatally influenced their subsequent male/female courtship and mating behavior.

Congenital micropenis: long-term medical, surgical and psychosexual follow-up of individuals raised male or female.

Objectives: To document long-term medical, surgical and psychosexual outcome of individuals with congenital micropenis (13 males, 5 females).

Methods: Physical measurements from childhood were collected retrospectively from medical records and at adulthood by physical examination. An adult psychosexual assessment was conducted with a written questionnaire and oral discussion.

Effects of standard and eccentric overload strength training in young women.

Purpose: According to the force-velocity relationship of human skeletal muscle, the maximal load one can lift is limited by the concentric movement phase, and the eccentric phase is always underloaded. In the present study, we hypothesized that acute exercise training using an eccentric overload compared with standard loading would lead to greater neuromuscular and strength adaptations.

Methods: Sedentary women (age 20.

Complete androgen insensitivity syndrome: long-term medical, surgical, and psychosexual outcome.

Controversy concerning the most appropriate treatment guidelines for intersex children currently exists. This is due to a lack of long-term information regarding medical, surgical, and psychosexual outcome in affected adults. We have assessed by questionnaire and medical examination the physical and psychosexual status of 14 women with documented complete androgen insensitivity syndrome (CAIS).

New phylism theory and the homosexualization of the visualization of lust.

Nature needs nurture is the paradigm that replaces nature versus nurture. Nature's determinants are phylismic, i.e.

Case consultation: ablatio penis.

In male infants, traumatic ablation of the penis, with or without loss of the testicles may occur as a sequel to mutilatory violence, accidental injury, or circumcision error. Post-traumatically, one program of case management is surgical sex reassignment to live as a girl, with female hormonal therapy at the age of puberty. The other program is genital reconstructive surgery to live as a boy, with male hormonal therapy at puberty if the testicles are missing.