Plasmonenresonanzen von sichelförmigen metallischen Nanoobjekten

Metallische Objekte in der Größenordnung der optischen Wellenlänge zeigen Resonanzen im optischen Spektralbereich. Mit einer Kombination aus Kolloidlithographie, Metallfilmbedampfung und reaktivem Ionenstrahl¨atzen wurden Nanosicheln aus Gold bzw. Silber mit identischer Form und Orientierung in Sichelform mit einer Größe von 60nm bis 400nm hergestellt. Der Öffnungswinkel der Nanosicheln lässt sich kontinuierlich einstellen. Durch die einheitliche Orientierung lassen sich Messungen am Ensemble direkt auf das Verhalten des Einzelobjektes übertragen, wie ein Vergleich der Extinktionsspektren einer Ensemblemessung am UV/Vis/NIR-Spektrometer mit einer Einzelpartikelmessung in einem konfokalen Mikroskop zeigt. Die optische Antwort der Nanosicheln wurde als zwei-dimensionales Modell mit einer Finite Elemente Methode berechnet. Das Ergebnis sind mehrere polarisationsabhängige Resonanzen im optischen Spektrum. Diese lassen sich durch Variation des Öffnungswinkels und der Gr¨oße der Nanosichel verschieben. Durch Beleuchten lassen sich plasmonische Schwingungen anregen, die ein stark lokalisiertes Nahfeld an den Spitzen und in der Öffnung der Nanosicheln erzeugen. Das Nahfeld der Partikelresonanz wurde mit einer Fotolackmethode nachgewiesen. Die Untersuchungen am UV/Vis/NIR-Spektrometer zeigen mehrere polarisationsabhängige Resonanzen im Spektralbereich von 300 nm bis 3200 nm. Die Resonanzen der Nanosicheln lassen sich durch den Öffnungswinkel und den Durchmesser in der Größenordnung der Halbwertbreite im optischen Spektrum verschieben. In der Anwendung als Chemo- bzw. Biosensor zeigen Gold-Nanosicheln eine ähnliche Empfindlichkeit wie vergleichbare Sensoren auf der Basis von dünnen Metallstrukturen. Das Nahfeld zeichnet sich durch eine starke Lokalisierung aus und dringt, je nach Multipolordnung, zwischen 14 nm und 70 nm in die Umgebung ein. Quantenpunkte wurden an das Nahfeld der Nanosicheln gekoppelt. Die Emission der Quantenpunkte bei einer Wellenlänge von 860nm wird durch die Resonanz der Nanosicheln verstärkt. Die Nanosicheln wurden als optische Pinzette eingesetzt. Bei einer Anregung mit einem Laser bei einer Wellenlänge von 1064 nm wurden Polystyrolkolloide mit einem Durchmesser von 40 nm von den resonanten Nanosicheln eingefangen. Die Nanosicheln zeigen außergewöhnliche optische Eigenschaften, die mithilfe der Geometrieparameter über einen großen Bereich verändert werden können. Die ersten Anwendungen haben Anknüpfungspunkte zur Verwendung in der Sensorik, Fluoreszenzspektroskopie und als optische Pinzette aufgezeigt.

Struktur und Funktion des Lipoproteins von Nereis virens (Annelida)

Ein discoidales Lipoprotein aus dem Polychaeten Nereis virens (Annelida) wurde eingehend charakterisiert. Im Vordergrund standen dabei die transportierten Lipide, sowie die Ultrastruktur des Partikels. Das Nereis-Lipoprotein besitzt eine für Invertebraten atypische Lipidzusammensetzung: Außer den Phospholipiden gibt es keine klar dominierende Lipidklasse. Die Charakterisierung der Apolipoproteine zeigt Gemeinsamkeiten mit den Apolipophorinen der Insekten: Wie diese besitzt das Nereis-Lipoprotein zwei Apolipoproteine, die in einer 1:1-Stöchiometrie angeordnet sind. Das größere Protein (ApoNvLp I) ist dabei stärker zum wässrigen Medium exponiert ist als das kleinere (ApoNvLp II). Beide Proteinuntereinheiten sind N-glycosyliert. ApoNvLp II ist zusätzlich noch O-glycosyliert. Bei den Sekundärstrukturen dominieren β-Strukturen (35%) gegenüber α-Helices (14%); 28% waren ungeordnete Strukturen. Die Masse wurde mit verschiedenen Methoden bestimmt: sie liegt zwischen ~800 kDa (Gelfiltration) und ~860 kDa (Analytische Ultrazentrifugation). Der Sedimentationskoeffizient beträgt 9,7 S. Der zelluläre Lipoproteinrezeptor wurde aus einer großen Anzahl von Zellen und Geweben isoliert. Die biochemische Charakterisierung des Rezeptormoleküls zeigte es als ein monomeres, integrales, N- und O-glycosyliertes Membranprotein mit einer Masse von ~114 kDa. Die Bindungscharakteristika (Abhängigkeit von Ca2+, Disulfidbrücken) weisen es als Mitglied der LDLR-Superfamilie aus. In vitro-Inkubationsversuche mit fluoreszenzmarkierten Lipoproteinen zeigten die Aufnahme sowohl in Oocyten als auch in freie Coelomzellen (Elaeocyten) sowie in Spermatogonien- und Tetradenstadien. Auffällig war, dass die Lipide zusammen mit den Apolipoproteinen in die Dottergranula der Eizellen eingelagert wurden und nicht direkt in die Lipidtropfen. Auch bei den Elaeocyten wurden die Lipide nicht direkt in den Lipidtropfen eingelagert. Intakte Lipoproteine konnten per Dichtegradienten-Ultrazentrifugation nur aus Spermatogonien isoliert werden. Die isolierten Lipoproteine hatten die gleiche ‚Morphologie’ wie die aus der Coelomflüssigkeit isolierten, zeigten jedoch sehr viele Peptidfragmente im SDS-Gel, was auf eine beginnende Degradation hinweist. Es wird ein Modell für den Lipidtransport in Nereis virens vorgeschlagen, bei dem den Elaeocyten eine entscheidende Rolle im Lipidstoffwechsel zufällt.

Le nuove procedure di analisi di sicurezza in ambito urbano ed extra urbano

Nel 2011 si sono registrati in Italia 205.638 incidenti stradali con lesioni a persone. Il numero dei morti (entro il 30° giorno) è stato di 3.860, quello dei feriti ammonta a 292.019.Rispetto all’obiettivo fissato dall’Unione Europea nel Libro Bianco del 2001, che prevedeva la riduzione della mortalità del 50% entro il 2010, benché sia vicina a questo traguardo, l’Italia non ha ancora raggiunto tale livello (Figura I.1). Sulle strade urbane si sono verificati 157.023 incidenti, con 213.001 feriti e 1.744 morti. Sulle Autostrade gli incidenti sono stati 11.007, con 18.515 feriti e 338 decessi. Sulle altre strade extraurbane, ad esclusione delle Autostrade, si sono verificati 37.608 incidenti, con 65.503 feriti e 1.778 morti. L’indice di mortalità mostra che gli incidenti più gravi avvengono sulle strade extraurbane (escluse le autostrade), dove si registrano 4,7 decessi ogni 100 incidenti. Gli incidenti sulle strade urbane sono meno gravi, con 1,1 morti ogni 100 incidenti. Sulle Autostrade tale indice è pari a 3,1. L’indice di mortalità si mantiene superiore alla media giornaliera (1,9 decessi ogni 100 incidenti) per tutto l’arco di tempo che va dalle 21 alle 7 del mattino, raggiungendo il valore massimo intorno alle 5 del mattino (6,0 decessi ogni 100 incidenti). La domenica è il giorno nel quale si registra il livello più elevato dell’indice di mortalità (2,8 morti per 100 incidenti). In 7 casi su 10 (69,7%) le vittime sono i conducenti di veicoli, nel 15,3% i passeggeri trasportati e nel 15,1% i pedoni. La categoria di veicolo più coinvolta in incidente stradale è quella delle autovetture(66,1%), seguono motocicli (14,0%), i ciclomotori (5,4%) e le biciclette (4,5%).

Estimating loss to follow-up in HIV-infected patients on antiretroviral therapy: the effect of the competing risk of death in Zambia and Switzerland

Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ≥18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells <100 cells/µl and 15.4% among patients starting with ≥350 cells/µL. The estimates from CR cumulative incidence were 22.9% and 13.6%, respectively. Little difference was found between naïve and CR analyses in Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings.

Lipid profiles and outcome in patients treated by intravenous thrombolysis for cerebral ischemia

OBJECTIVE:To determine whether low low-density lipoprotein cholesterol (LDL-C) but not high-density lipoprotein cholesterol (HDL-C) and triglyceride concentrations are associated with worse outcome in a large cohort of ischemic stroke patients treated with IV thrombolysis. METHODS:Observational multicenter post hoc analysis of prospectively collected data in stroke thrombolysis registries. Because of collinearity between total cholesterol (TC) and LDL-C, we used 2 different models with TC (model 1) and with LDL-C (model 2). RESULTS:Of the 2,485 consecutive patients, 1,847 (74%) had detailed lipid profiles available. Independent predictors of 3-month mortality were lower serum HDL-C (adjusted odds ratio [(adj)OR] 0.531, 95% confidence interval [CI] 0.321-0.877 in model 1; (adj)OR 0.570, 95% CI 0.348-0.933 in model 2), lower serum triglyceride levels ((adj)OR 0.549, 95% CI 0.341-0.883 in model 1; (adj)OR 0.560, 95% CI 0.353-0.888 in model 2), symptomatic ICH, and increasing NIH Stroke Scale score, age, C-reactive protein, and serum creatinine. TC, LDL-C, HDL-C, and triglycerides were not independently associated with symptomatic ICH. Increased HDL-C was associated with an excellent outcome (modified Rankin Scale score 0-1) in model 1 ((adj)OR 1.390, 95% CI 1.040-1.860). CONCLUSION:Lower HDL-C and triglycerides were independently associated with mortality. These findings were not due to an association of lipid concentrations with symptomatic ICH and may reflect differences in baseline comorbidities, nutritional state, or a protective effect of triglycerides and HDL-C on mortality following acute ischemic stroke.

Intraoperative determination of the load-displacement behavior of scoliotic spinal motion segments: preliminary clinical results

Introduction: Spinal fusion is a widely and successfully performed strategy for the treatment of spinal deformities and degenerative diseases. The general approach has been to stabilize the spine with implants so that a solid bony fusion between the vertebrae can develop. However, new implant designs have emerged that aim at preservation or restoration of the motion of the spinal segment. In addition to static, load sharing principles, these designs also require a profound knowledge of kinematic and dynamic properties to properly characterise the in vivo performance of the implants. Methods: To address this, an apparatus was developed that enables the intraoperative determination of the load–displacement behavior of spinal motion segments. The apparatus consists of a sensor-equipped distractor to measure the applied force between the transverse processes, and an optoelectronic camera to track the motion of vertebrae and the distractor. In this intraoperative trial, measurements from two patients with adolescent idiopathic scoliosis with right thoracic curves were made at four motion segments each. Results: At a lateral bending moment of 5 N m, the mean flexibility of all eight motion segments was 0.18 ± 0.08°/N m on the convex side and 0.24 ± 0.11°/N m on the concave side. Discussion: The results agree with published data obtained from cadaver studies with and without axial preload. Intraoperatively acquired data with this method may serve as an input for mathematical models and contribute to the development of new implants and treatment strategies.

The Resilience of Self-Esteem in Late Adulthood

OBJECTIVE: The authors examined the resilience of self-esteem after loss in the lives of older adults. Specifically, the authors investigated the relationship between loss and change in self-esteem during a 3-year period. METHOD: A subsample of older adults (n = 1,278) from the Americans' Changing Lives Study was used to examine loss in the domains of health, financial security, or work and career and self-esteem before and after the loss. RESULTS: There was a small but significant decrease in self-esteem between Wave I and Wave II of the study. Loss in one of the domains explained less than 1% of the variance in self-esteem change. DISCUSSION: The low incidence of loss and small change in high levels of self-esteem are further evidence of resilience in older adults' psychological well-being. The implications for older adults' use of cognitive strategies to manage losses and promote gains are discussed.

Intrapatient reproducibility of the BISxp monitor

BACKGROUND: The Bispectral Index (BIS) reportedly reflects anesthetic depth. It is recommended that anesthetic agents should be titrated to maintain the BIS between 40 and 60 arbitrary BIS units during anesthesia. For anesthesia providers to follow this recommendation, the monitor should be predictably affected by different anesthetic agents and have good interpatient and intrapatient reproducibility. The authors hypothesized that when two BISxp devices (Aspect Medical Systems, Newton, MA) are placed concurrently on the same patient, their readings are concordant throughout the anesthetic period. METHODS: Simultaneous BIS recordings from two BISxp monitors were obtained during anesthesia at 5-s intervals from 12 participants. RESULTS: In total 22,860 concurrent paired BIS readings were obtained. For 10.7% of the time, there were sustained periods of 30 s or greater where the readings suggested a different depth of anesthesia. For 6% of the time, there were sustained periods of 30 s or greater where the readings differed by 10 or more arbitrary BIS units. The regression coefficient (R) for the two devices was 0.65 (range, 0.35-0.92). There was zero bias between the devices, and the 95% limits of agreement ranged between -18 and +17. CONCLUSION: A conflicting anesthetic management was suggested by the simultaneous BIS readings 10.7% of the time. These results suggest that BISxp does not always provide a reproducible single number. Anesthesia providers should not rely exclusively on the BIS reading when assessing depth of anesthesia.

Health risk appraisal in older people 1: are older people living alone an "at-risk" group?

BACKGROUND: In the UK, population screening for unmet need has failed to improve the health of older people. Attention is turning to interventions targeted at 'at-risk' groups. Living alone in later life is seen as a potential health risk, and older people living alone are thought to be an at-risk group worthy of further intervention. AIM: To explore the clinical significance of living alone and the epidemiology of lone status as an at-risk category, by investigating associations between lone status and health behaviours, health status, and service use, in non-disabled older people. Design of study: Secondary analysis of baseline data from a randomised controlled trial of health risk appraisal in older people. SETTING: Four group practices in suburban London. METHOD: Sixty per cent of 2641 community-dwelling non-disabled people aged 65 years and over registered at a practice agreed to participate in the study; 84% of these returned completed questionnaires. A third of this group, (n = 860, 33.1%) lived alone and two-thirds (n = 1741, 66.9%) lived with someone else. RESULTS: Those living alone were more likely to report fair or poor health, poor vision, difficulties in instrumental and basic activities of daily living, worse memory and mood, lower physical activity, poorer diet, worsening function, risk of social isolation, hazardous alcohol use, having no emergency carer, and multiple falls in the previous 12 months. After adjustment for age, sex, income, and educational attainment, living alone remained associated with multiple falls, functional impairment, poor diet, smoking status, risk of social isolation, and three self-reported chronic conditions: arthritis and/or rheumatism, glaucoma, and cataracts. CONCLUSION: Clinicians working with independently-living older people living alone should anticipate higher levels of disease and disability in these patients, and higher health and social risks, much of which will be due to older age, lower educational status, and female sex. Living alone itself appears to be associated with higher risks of falling, and constellations of pathologies, including visual loss and joint disorders. Targeted population screening using lone status may be useful in identifying older individuals at high risk of falling.