Sleep and wakefulness disturbances in Swiss pharmacy customers

BACKGROUND AND OBJECTIVE: Sleep disturbances are prevalent but often overlooked or underestimated. We suspected that sleep disorders might be particularly common among pharmacy customers, and that they could benefit from counselling. Therefore, we described the prevalence and severity of symptoms associated with sleep and wakefulness disorders among Swiss pharmacy customers, and estimated the need for counselling and treatment. METHODS: In 804 Swiss pharmacies (49% of all community pharmacies) clients were invited to complete the Stanford Sleep Disorders Questionnaire (SDQ), and the Epworth Sleepiness Scale (EPW). The SDQ was designed to classify symptoms of sleep and wakefulness into the four most prevalent disorders: sleep apnoea syndrome (SAS), insomnia in psychiatric disorders (PSY), periodic leg movement disorders/restless legs (RLS) and narcolepsy (NAR). Data were entered into an internet-linked database for analysis by an expert system as a basis for immediate counselling by the pharmacist. RESULTS: Of 4901 participants, 3238 (66.1%) were female, and 1663 (33.9%) were male. The mean age (SD) of females and males was 52.4 (18.05), and 55.1 (17.10) years, respectively. The percentages of female and male individuals above cut-off of SDQ subscales were 11.4% and 19.8% for sleep apnoea, 40.9% and 38.7% for psychiatric sleep disorders, 59.3% and 46.8% for restless legs, and 10.4% and 9.4% for narcolepsy respectively. The prevalence of an Epworth Sleepiness Scale score >11 was 16.5% in females, and 23.9% in males. Reliability assessed by Cronbach's alpha was 0.65 to 0.78 for SDQ subscales, and for the Epworth score. CONCLUSIONS: Symptoms of sleep and wakefulness disorders among Swiss pharmacy customers were highly prevalent. The SDQ and the Epworth Sleepiness Scale score had a satisfactory reliability to be useful for identification of pharmacy customers who might benefit from information and counselling while visiting pharmacies. The internet-based system proved to be a helpful tool for the pharmacist when counselling his customers in terms of diagnostic classification and severity of symptoms associated with the sleeping and waking state.

Fiducial and differential cross sections of Higgs boson production measured in the four-lepton decay channel in pp collisions at √s=8 TeV with the ATLAS detector

Measurements of fiducial and differential cross sections of Higgs boson production in the H →ZZ* → 4ℓ decay channel are presented. The cross sections are determined within a fiducial phase space and corrected for detection efficiency and resolution effects. They are based on 20.3 fb−1 of pp collision data, produced at √s = 8 TeV centre-of-mass energy at the LHC and recorded by the ATLAS detector. The differential measurements are performed in bins of transverse momentum and rapidity of the four-lepton system, the invariant mass of the subleading lepton pair and the decay angle of the leading lepton pair with respect to the beam line in the four-lepton rest frame, as well as the number of jets and the transverse momentum of the leading jet. The measured cross sections are compared to selected theoretical calculations of the Standard Model expectations. No significant deviation from any of the tested predictions is found. c

The hundred most cited articles in bariatric surgery

BACKGROUND Many studies quantitatively analyzing scientific papers have appeared in the last 2 years. Citation analysis is a commonly used bibliometric method. In spite of some limitations, it remains a good measure of the impact an article has on a specific field, specialty, or a journal. The aim of this study was to analyze the qualities and characteristics of the 100 most cited articles in the field of bariatric surgery. METHODS The Thomson Reuters Web of Knowledge was used to list all bariatric surgery-related articles (BSRA) published from 1945 to 2014. The top 100 most cited BSRA in 354 surgical and high impact general journals were selected for further analysis. RESULTS Most of the articles were published in the 2000s (60%). The top 100 most cited were published in 17 of the 354 journals. Leading countries were USA followed by Canada and Australia. Most of the articles published (76%) were clinical experience articles. The most common level of evidence was IV (42%). CONCLUSIONS Many of the milestone papers in bariatric surgery have been included in this bibliometric study. A huge increase in research activity during the last decade is clearly visible in the field. It is apparent that the number of citations of an article is not related to its level of evidence; a fact that is increasingly being emphasized in surgical research.

Mechanism of IFN-induced apoptosis and sensitization by the proteasome inhibitor bortezomib in bladder cancer cells

Bladder cancer is the fifth most common cancer with more than 50,000 cases diagnosed each year. Interferon-α (IFNα) is mostly used in combination with BCG for the treatment of transitional cell carcinoma (TCC). To examine the effects of IFNα on bladder cancer cells, I analyzed a panel of 20 bladder cancer cell lines in terms of their sensitivity to IFNα-induced apoptosis and the underlying mechanisms. I identified three categories: cells that die after 48hr, after 72h, and cells resistant even after 72hr of IFNα treatment. Examination of the IFN-signal transduction pathway revealed that the defect was not due to abrogation of IFN signaling. Further analysis demonstrated dependency of IFN-induced apoptosis on caspase-8, implicating the role of death receptors in IFN-induced cell death. Of the six most-IFN-sensitive cell lines, the majority upregulated Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) at the mRNA and protein level and IFN-induced cell death was mediated through TRAIL, while a minority of the most IFN-sensitive cells undergo apoptosis through a TNFα-dependent mechanism. IFNα resistance was due to either absence of TRAIL upregulation at the mRNA or protein level, resistance to exogenous rhTRAIL itself or lack of sensitization to IFN-induced cell death. Downregulation of XIAP, or XIAP inactivation through its regulator NFκB has been reported to sensitize tumor cells to death receptor-induced cell death. Baseline and IFN-inducible XIAP levels were examined in the most and least IFN-sensitive cells, knocking down XIAP and the p65 subunit of NFκB enhanced IFN-induced cell death, implicating XIAP downregulation as a mechanism through which bladder cancer cells are sensitized to IFN-induced apoptosis. To determine whether or not the proteasome inhibitor Bortezomib (BZ) sensitizes bladder cancer cells to IFN-induced cell death, the combined effects of IFN+BZ and the underlying molecular mechanisms were examined both in vitro and in vivo using two bladder xenograft models. In both models, tumor growth inhibition was the result of either increased cell death of tumor cells exerted by the two agents and/or inhibition of angiogenesis. In vitro, MAP downregulation in response to the combined treatment of IFN+BZ accounts for one of the mechanisms mediating IFN+BZ cell death in bladder cancer cells. ^

Identification and characterization of mutations in SMC contractile genes involved in thoracic aortic aneurysms and dissections

Aortic aneurysms and dissections are the 15th most common cause of death in the United States. Genetic factors contribute to the pathogenesis of thoracic aortic aneurysms and dissections (TAAD). Currently, six loci and four genes have been identified for familial TAAD. Notably, mutations in smooth muscle cell (SMC) contractile genes, ACTA2 and MYH11, are responsible for 15% of familial TAAD, suggesting that proper SMC contraction is important for normal aorta function. Therefore, we hypothesize that mutations in other genes encoding SMC contractile proteins also cause familial TAAD. ^ To test this hypothesis, we used a candidate gene approach to identify causative mutations in SMC contractile genes for familial TAAD. Sequencing DNA in 80 TAAD patients from unrelated families, we identified putative mutations in eight contractile genes. We chose myosin light chain kinase (MLCK ) S1759P for further study for the following reasons: (1) Serine 1759 is conserved between vertebrates and invertebrates. (2) S1759P is predicted to be functionally deleterious by bioinformatics. (3) Low blood pressure is observed in SMC-selective MLCK-deficient mice. ^ In the presence of Ca2+/Calmodulin (CaM), MLCK containing CaM binding and kinase domains are activated to phosphorylate myosin light chain, thereby initiate SMC contraction. The CaM binding sequence of MLCK forms an α-helix structure required for CaM binding. MLCK Serine 1759 is located within the CaM binding domain. S1759P is predicted to decrease the α-helix composition in the CaM binding domain. Hence, we hypothesize that MLCK mutations cause TAAD through disturbing CaM binding and MLCK activity. ^ We further sequenced MLCK in DNA samples from additional 86 probands with familial TAAD. Two more mutations, MLCK A1754T and R1480Stop, were identified, supporting that MLCK mutations cause familial TAAD. ^ To define whether MLCK mutations disrupted CaM binding and MLCK activity, we performed co-immunoprecipitation and kinase assays. Decreased CaM binding and kinase activity was detected in A1754T and S1759P. Moreover, R1480Stop is predicted to truncate kinase and CaM binding domains. We conclude that MLCK mutations disrupt CaM binding and MLCK activity. ^ Collectively, our study is first to show mutations in genes regulating SMC contraction cause TAAD. This finding further highlights the importance of SMC contraction in maintaining aorta function. ^

Contribution to the quality improvement of the antenna measurement using post-processing techniques = Contribución a la mejora de la calidad de medida de antena usando técnicas de post-procesado

One important task in the design of an antenna is to carry out an analysis to find out the characteristics of the antenna that best fulfills the specifications fixed by the application. After that, a prototype is manufactured and the next stage in design process is to check if the radiation pattern differs from the designed one. Besides the radiation pattern, other radiation parameters like directivity, gain, impedance, beamwidth, efficiency, polarization, etc. must be also evaluated. For this purpose, accurate antenna measurement techniques are needed in order to know exactly the actual electromagnetic behavior of the antenna under test. Due to this fact, most of the measurements are performed in anechoic chambers, which are closed areas, normally shielded, covered by electromagnetic absorbing material, that simulate free space propagation conditions, due to the absorption of the radiation absorbing material. Moreover, these facilities can be employed independently of the weather conditions and allow measurements free from interferences. Despite all the advantages of the anechoic chambers, the results obtained both from far-field measurements and near-field measurements are inevitably affected by errors. Thus, the main objective of this Thesis is to propose algorithms to improve the quality of the results obtained in antenna measurements by using post-processing techniques and without requiring additional measurements. First, a deep revision work of the state of the art has been made in order to give a general vision of the possibilities to characterize or to reduce the effects of errors in antenna measurements. Later, new methods to reduce the unwanted effects of four of the most commons errors in antenna measurements are described and theoretical and numerically validated. The basis of all them is the same, to perform a transformation from the measurement surface to another domain where there is enough information to easily remove the contribution of the errors. The four errors analyzed are noise, reflections, truncation errors and leakage and the tools used to suppress them are mainly source reconstruction techniques, spatial and modal filtering and iterative algorithms to extrapolate functions. Therefore, the main idea of all the methods is to modify the classical near-field-to-far-field transformations by including additional steps with which errors can be greatly suppressed. Moreover, the proposed methods are not computationally complex and, because they are applied in post-processing, additional measurements are not required. The noise is the most widely studied error in this Thesis, proposing a total of three alternatives to filter out an important noise contribution before obtaining the far-field pattern. The first one is based on a modal filtering. The second alternative uses a source reconstruction technique to obtain the extreme near-field where it is possible to apply a spatial filtering. The last one is to back-propagate the measured field to a surface with the same geometry than the measurement surface but closer to the AUT and then to apply also a spatial filtering. All the alternatives are analyzed in the three most common near-field systems, including comprehensive noise statistical analyses in order to deduce the signal-to-noise ratio improvement achieved in each case. The method to suppress reflections in antenna measurements is also based on a source reconstruction technique and the main idea is to reconstruct the field over a surface larger than the antenna aperture in order to be able to identify and later suppress the virtual sources related to the reflective waves. The truncation error presents in the results obtained from planar, cylindrical and partial spherical near-field measurements is the third error analyzed in this Thesis. The method to reduce this error is based on an iterative algorithm to extrapolate the reliable region of the far-field pattern from the knowledge of the field distribution on the AUT plane. The proper termination point of this iterative algorithm as well as other critical aspects of the method are also studied. The last part of this work is dedicated to the detection and suppression of the two most common leakage sources in antenna measurements. A first method tries to estimate the leakage bias constant added by the receiver’s quadrature detector to every near-field data and then suppress its effect on the far-field pattern. The second method can be divided into two parts; the first one to find the position of the faulty component that radiates or receives unwanted radiation, making easier its identification within the measurement environment and its later substitution; and the second part of this method is able to computationally remove the leakage effect without requiring the substitution of the faulty component. Resumen Una tarea importante en el diseño de una antena es llevar a cabo un análisis para averiguar las características de la antena que mejor cumple las especificaciones fijadas por la aplicación. Después de esto, se fabrica un prototipo de la antena y el siguiente paso en el proceso de diseño es comprobar si el patrón de radiación difiere del diseñado. Además del patrón de radiación, otros parámetros de radiación como la directividad, la ganancia, impedancia, ancho de haz, eficiencia, polarización, etc. deben ser también evaluados. Para lograr este propósito, se necesitan técnicas de medida de antenas muy precisas con el fin de saber exactamente el comportamiento electromagnético real de la antena bajo prueba. Debido a esto, la mayoría de las medidas se realizan en cámaras anecoicas, que son áreas cerradas, normalmente revestidas, cubiertas con material absorbente electromagnético. Además, estas instalaciones se pueden emplear independientemente de las condiciones climatológicas y permiten realizar medidas libres de interferencias. A pesar de todas las ventajas de las cámaras anecoicas, los resultados obtenidos tanto en medidas en campo lejano como en medidas en campo próximo están inevitablemente afectados por errores. Así, el principal objetivo de esta Tesis es proponer algoritmos para mejorar la calidad de los resultados obtenidos en medida de antenas mediante el uso de técnicas de post-procesado. Primeramente, se ha realizado un profundo trabajo de revisión del estado del arte con el fin de dar una visión general de las posibilidades para caracterizar o reducir los efectos de errores en medida de antenas. Después, se han descrito y validado tanto teórica como numéricamente nuevos métodos para reducir el efecto indeseado de cuatro de los errores más comunes en medida de antenas. La base de todos ellos es la misma, realizar una transformación de la superficie de medida a otro dominio donde hay suficiente información para eliminar fácilmente la contribución de los errores. Los cuatro errores analizados son ruido, reflexiones, errores de truncamiento y leakage y las herramientas usadas para suprimirlos son principalmente técnicas de reconstrucción de fuentes, filtrado espacial y modal y algoritmos iterativos para extrapolar funciones. Por lo tanto, la principal idea de todos los métodos es modificar las transformaciones clásicas de campo cercano a campo lejano incluyendo pasos adicionales con los que los errores pueden ser enormemente suprimidos. Además, los métodos propuestos no son computacionalmente complejos y dado que se aplican en post-procesado, no se necesitan medidas adicionales. El ruido es el error más ampliamente estudiado en esta Tesis, proponiéndose un total de tres alternativas para filtrar una importante contribución de ruido antes de obtener el patrón de campo lejano. La primera está basada en un filtrado modal. La segunda alternativa usa una técnica de reconstrucción de fuentes para obtener el campo sobre el plano de la antena donde es posible aplicar un filtrado espacial. La última es propagar el campo medido a una superficie con la misma geometría que la superficie de medida pero más próxima a la antena y luego aplicar también un filtrado espacial. Todas las alternativas han sido analizadas en los sistemas de campo próximos más comunes, incluyendo detallados análisis estadísticos del ruido con el fin de deducir la mejora de la relación señal a ruido lograda en cada caso. El método para suprimir reflexiones en medida de antenas está también basado en una técnica de reconstrucción de fuentes y la principal idea es reconstruir el campo sobre una superficie mayor que la apertura de la antena con el fin de ser capaces de identificar y después suprimir fuentes virtuales relacionadas con las ondas reflejadas. El error de truncamiento que aparece en los resultados obtenidos a partir de medidas en un plano, cilindro o en la porción de una esfera es el tercer error analizado en esta Tesis. El método para reducir este error está basado en un algoritmo iterativo para extrapolar la región fiable del patrón de campo lejano a partir de información de la distribución del campo sobre el plano de la antena. Además, se ha estudiado el punto apropiado de terminación de este algoritmo iterativo así como otros aspectos críticos del método. La última parte de este trabajo está dedicado a la detección y supresión de dos de las fuentes de leakage más comunes en medida de antenas. El primer método intenta realizar una estimación de la constante de fuga del leakage añadido por el detector en cuadratura del receptor a todos los datos en campo próximo y después suprimir su efecto en el patrón de campo lejano. El segundo método se puede dividir en dos partes; la primera de ellas para encontrar la posición de elementos defectuosos que radian o reciben radiación indeseada, haciendo más fácil su identificación dentro del entorno de medida y su posterior substitución. La segunda parte del método es capaz de eliminar computacionalmente el efector del leakage sin necesidad de la substitución del elemento defectuoso.

The book of common prayer : and administration of the sacraments, and other rites and ceremonies of the church, according to the use of the Church of England ; together with the Psalter, or Psalms of David.

Mode of access: Internet.

The four Gospels and the Acts of the apostles in Persian.

Edited by C.B. Lewis. cf. Brit. mus. Cat.

The Book of common prayer, and administration of the sacraments and other rites and ceremonies of the church, according to the use of the Protestant Episcopal Church in the United States of America; together with the psalter or Psalms of David.

Bound in brown leather; stamped in gold. Front cover detached.

A rational illustration of the Book of common prayer of the Church of England : being the substance of every thing liturgical in Bishop Sparrow, Mr. L'Estrange, Dr. Comber, Dr. Nichols, and all former ritualists, commentators, and others, upon the same subject /

"Ecclesiastical writers cited in this book": p. [511]-512.

The four Macnicols and An adventure in Thule : two stories for the young.

Mode of access: Internet.

The Book of common prayer and administration of the sacraments; and other rites and ceremonies of the church, according to the use of the Protestant Episcopal church in the United States of America. Together with the Psalter, or Psalms of David.

[On cover: Cunningham]

The Seer; or, Common-places refreshed.

Essays collected from the author's periodical writings. Most of them from the London journal. cf. Pref.

The book of common prayer, and administration of the sacraments, and other rites and ceremonies of the Church, according to the use of the Protestant Episcopal Church in the United States of America, together with the Psalter, or the Psalms of David.

Seal of "Aux. N.Y. Bible & Common prayer book soc." on verso of t.-p.

The book of common prayer and administration of the sacraments, and other rites and ceremonies of the church. Together with the Psalter, or Psalms of David.

Mode of access: Internet.