Methods The two questionnaires were administered to 589 patients

Methods. The two questionnaires were administered to 589 patients with

chronic heart failure who were registered with 97 primary care physicians. The applicability, internal consistency and validity of the MLHFQ were evaluated and comparisons were made with the SF-36.

Results. More than 90% of patients completed the questionnaires. The percentage of uncompleted items was low. Cronbach’s alpha ranged from 0.79 to 0.94 for the various MLHFQ dimensions. Exploratory factorial analysis identified two factors that explained 65.8% of the variance. Moderate to good correlations were observed between similar dimensions of the MLHFQ and SF-36 (correlation coefficient 0.43 to 0.73). There C59 mw were significant associations between scores on the MLHFQ and clinical measures of disease severity.

Conclusions. When used in primary care. the MLHFQ had a high level of acceptability and good psychometric properties compared with the SF-36. Consequently, it would be useful for assessing health-related quality of life in patients with chronic heart failure.”
“Scorpion envenomation in pregnant victims has been scarcely studied. We would like to suggest an association between yellow scorpion sting during the third trimester of pregnancy and adverse

fetal outcome. The particular deleterious mechanism of scorpion venom has not been elucidated yet.”
“Virtual reality videogames can be used check details to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal

stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame Dihydrotestosterone molecular weight hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.”
“Carbon monoxide (CO) intoxication has serious adverse effects to the mother and fetus and a result of intrauterine hypoxia, it leads to fetal death or severe neurological sequelae. In this article, a preterm infant who was acutely exposed to CO at the 33rd weeks of gestation before delivery was presented. The baby was delivered by emergent cesarean section at the 34th weeks of gestation due to findings of fetal distress and he had severe hypoxic ischemic encephalopathy leading to death. Results and treatment modalities of CO poisoning during pregnancy were reviewed.”
“Introduction and objectives. Studies indicate that dyslipidemia is undertreated.

(Obstet Gynecol 2011;118:436-9) DOI: 10 1097/AOG 0b013e3182164864

(Obstet Gynecol 2011;118:436-9) DOI: 10.1097/AOG.0b013e3182164864″
“Background:

Systematic clinical trials are often unavailable to evaluate and optimize operational telestroke networks. In a complementary approach, readily available routine clinical data were analyzed in this study to evaluate the effect of a telestroke network over a 4-year period. Methods: Routine clinical data from the HELIOS hospital information system were compared before and after implementation of the NeuroNet concept, including neurologic acute stroke teleconsultations, standard operating procedures, and peer review quality management in 3 hospital cohorts: 5 comprehensive stroke centers, 5 NeuroNet hospitals, and 5 matched control hospitals. Results: During the study period, the rate of thrombolytic therapy increased by 4.8% AZD1152 price in NeuroNet hospitals, while ischemic stroke in-hospital mortality decreased (relative risk reduction similar to 29% in NeuroNet and control hospitals). The odds ratio for thrombolytic therapy in comprehensive stroke centers compared

to NeuroNet hospitals was reduced from 3.7 to 1.3 between 2006 and 2009. Comprehensive stroke care coding according to German Diagnosis Related Groups definitions increased by 45% in NeuroNet (P < .0001) and by 18% Selleck GSK461364 in control hospitals. Conclusions: Routine clinical data on in-hospital mortality, the rate of thrombolytic therapy, and comprehensive stroke care coding reflect different aspects of acute stroke care improvement related to the implementation of the telemedical NeuroNet concept and unified quality management (standard operating procedure teaching concept, peer review process). Similar evaluation processes could contribute to quality monitoring in other telestroke networks.”
“Hypothesis: It is possible to implant a stimulating electrode

array in the semicircular canals without damaging rotational sensitivity or hearing. The electrodes will evoke robust and precisely controlled eye movements.

Background: selleck inhibitor A number of groups are attempting to develop a neural prosthesis to ameliorate abnormal vestibular function. Animal studies demonstrate that electrodes near the canal ampullae can produce electrically evoked eye movements. The target condition of these studies is typically bilateral vestibular hypofunction. Such a device could potentially be more widely useful clinically and would have a simpler roadmap to regulatory approval if it produced minimal or no damage to the native vestibular and auditory systems.

Methods: An electrode array was designed for insertion into the bony semicircular canal adjacent to the membranous canal. It was designed to be sufficiently narrow so as to not compress the membranous canal. The arrays were manufactured by Cochlear, Ltd., and linked to a Nucleus Freedom receiver/stimulator.

In addition, many of the cells administered intrathecally survive

In addition, many of the cells administered intrathecally survived and a subset of them expressed mature neural-lineage markers, including the mature neuron marker NeuN and glial fibrillary acidic protein, typical of astrocytes. Animals that received hUCB-MSCs had significantly improved motor function and reduced ischemic damage when compared with untreated control animals. Regardless of the administration route, the group treated with 1 x 10(6)

hUCB-MSCs showed better neurological recovery, without significant differences between the two treatment groups. Importantly, intrathecal administration of 5 x 10(5) hUCB-MSCs significantly reduced ischemic damage, but not in the intravenously treated group. Furthermore, the cells administered Selleckchem Tyrosine Kinase Inhibitor Library intrathecally survived and

migrated into the ischemic area more extensively, and differentiated significantly into neurons and astrocytes.

Conclusions: Together, these results indicate that intrathecal administration of MSCs by LP may be useful and feasible for MSCs treatment of brain injuries, such as stroke, or neurodegenerative disorders.”
“Over the lifecycle of an orally inhaled product (OIP), multi-stage cascade impactor Selleckchem Copanlisib (CI) measurements are used for different purposes and to address different questions. Full-resolution CIs can provide important information during product development and are widely used but are time- and resource-intensive, highly variable, ACY-1215 mouse and suboptimal for OIP quality control (QC) testing. By contrast, Efficient Data Analysis (EDA) combined with Abbreviated Impactor Measurement (AIM) systems pertinent either for QC and-possibly-for adult Human Respiratory Tract (pHRT) has been introduced for OIP performance assessment during and post-development. This article summarizes available evidence and discusses a strategy for using either abbreviated or full-resolution CI systems depending on the purpose

of the measurement, such that adequate, accurate, and efficient testing of aerodynamic particle size distribution (APSD) of OIPs can be achieved throughout the lifecycle of a product. Under these proposals, a comprehensive testing program should initially be conducted by full-resolution CI in OIP development to ascertain the product’s APSD. Subsequently, correlations should be established from the selected AIM CIs to the corresponding full-resolution system, ideally developing specifications common to both techniques. In the commercial phase, it should be possible to release product using AIM/EDA, keeping the full-resolution CI for investigations, change control, and trouble-shooting, thus optimizing resources for APSD characterization throughout the product lifecycle. If an in vitro-in vivo relationship is established and clinically relevant sizes are known, an AIM-pHRT could serve as a quick indicator that clinically relevant fractions have not changed and also, in the management of post-approval changes.


“1,25-dihydroxyvitamin D(3) (1,25D) is tightly regulated b


“1,25-dihydroxyvitamin D(3) (1,25D) is tightly regulated by circulating factors, containing fibroblast growth factor 23 (FGF23). However, this control is disturbed

in chronic kidney disease. Renal transplantation (RTX) alters 1,25D homeostasis. To examine the clinical relevance of 1,25D in RTX, we drew blood samples from 27 renal transplant recipients (20 cyclosporine-based, seven non-cyclosporine-based) and examined serum concentrations of 25-hydroxyvitamin D(3) (25D), 1,25D, and FGF23. Our protocol for cyclosporine was as follows, an initial dose of 8 mg/kg two d before RTX, and subsequently adjusted on the basis of the pharmacokinetic profile. No baseline differences were observed between cyclosporine-based and non-cyclosporine-based regimens before U0126 clinical trial RTX. All variables except 1,25D levels changed similarly between the two groups. In the cyclosporine-based regimen, 1,25D levels increased OSI-906 datasheet steeply on day 2 and re-increased

from days 7 to 21. Post-transplant FGF23 levels sharply decreased until day 14. Interestingly, the cyclosporine-treated group revealed an unexpected tendency between circulating 1,25D and FGF23 on day 21. Multiple regression analyses indicated the cyclosporine pharmacokinetic profile as a significant predictor for 1,25D levels. Post-transplant 1,25D production is induced by a steep fall in serum FGF23 and prompt graft function on day 2; 1,25D levels thereafter may be stimulated by circulating abundant cyclosporine.”
“Resistive switching memory cells with polycrystalline (AgI)(0.2)(Ag2MoO4)(0.8) (AIMO) solid electrolyte films as storage medium were fabricated on SiO2/Pt/Ti/Si substrates by using pulse laser deposition technique and focused ion beam lithography. check details X-ray diffraction, scanning electron microscopy, and energy dispersive x-ray analysis have been employed to investigate the structure, the surface morphology, and the composition of AIMO thin films. The Ag/AIMO/Pt memory cells with sandwich structure exhibit stable, reproducible, and reliable resistive switching characteristics. The ratio

of resistance between high resistance states and low resistance states can reach similar to 10(5). Moreover, the low resistance is similar to 500 at a compliance current of 0.5 mA, which is favorable to reduce the power dissipation of the entire circuit. The switching-on mechanism has been discussed and the metallic conduction characteristic has also been verified. The fast response speed and the good retention properties further indicate that polycrystalline AIMO thin film is a potential candidate for the next generation nonvolatile memory.”
“Background: Belgian politicians submitted a proposal to rescind the law on anonymity of organ donation and transplantation and facilitate contact between donor families and recipients. It remains uncertain if recipients support this proposal.

Gastric cancer is considered an age-related disease, and the tota

Gastric cancer is considered an age-related disease, and the total number of newly diagnosed cases has been increasing as a result of the higher life expectancy. Therefore, the basic mechanisms underlying gastric tumorigenesis is worth investigation. This review provides an overview of the epigenetic mechanisms, such as DNA methylation, histone modifications, chromatin remodeling complex and miRNA, involved in gastric cancer. As the studies in gastric cancer selleck products continue, the mapping of an epigenome code is not far for this disease. In conclusion, an epigenetic therapy might appear in the not too distant future.”
“OBJECTIVE: To estimate the value of fetal brain

Doppler in predicting the risk of cesarean delivery for nonreassuring fetal status and neonatal acidosis after labor induction in small-for-gestational-age fetuses with normal umbilical C59 concentration artery Doppler.

METHODS: Fetal brain Doppler parameters, including cerebral tissue perfusion measured by fractional moving blood volume, cerebroplacental ratio, and middle cerebral artery pulsatility index, were evaluated before labor induction

in a cohort of 210 term small-for-gestational-age fetuses with normal umbilical artery Doppler and 210 control participants matched by gestational age. The value of the cerebral Doppler indices to predict the risk of cesarean delivery, cesarean delivery for nonreassuring fetal status, and neonatal acidosis was analyzed.

RESULTS: Overall, small-for-gestational-age fetuses showed a significant higher incidence of cesarean delivery (37.6% compared with 19.5%, P<.001), cesarean delivery for nonreassuring fetal status (29% compared with 4.8%, P<.001), and neonatal acidosis (7.6% compared with 2.4%, P=.03) than control participants. Within the small-for-gestational-age Buparlisib group, middle cerebral artery vasodilation was associated with the highest risk of cesarean delivery (67.7% compared with 32.4%, P<.001) and cesarean delivery for nonreassuring fetal status (58.1% compared with 24%, P<.001). In the subgroup of normal middle cerebral artery, incorporation of cerebroplacental

ratio further distinguished two groups with different risks of cesarean delivery (51.4% compared with 27.5%, P<.01) and cesarean delivery for nonreassuring fetal status (37.8% compared with 20.4%, P=.01). Middle cerebral artery vasodilation was associated with increased risk of neonatal acidosis (odds ratio, 9.0). Fractional moving blood volume was not associated with the risk of cesarean delivery for nonreassuring fetal status or neonatal acidosis.

CONCLUSION: Evaluation of brain Doppler indices before labor induction discriminates small-for-gestational-age fetuses at high risk of cesarean delivery for nonreassuring fetal status and neonatal acidosis. (Obstet Gynecol 2011;117:618-26) DOI:10.1097/AOG.

As a whole, our data support earlier hypotheses that the Mimosoid

As a whole, our data support earlier hypotheses that the Mimosoideae subfamily has a basic number

of x = 13 and underwent karyotypic evolution by polyploidy. selleck chemical However, x = 13 seems to be a secondary basic number that originated from an ancestral stock with x(1) = 7, in which polyploidy followed by descending disploidy gave rise to the current lineages with x = 13. Another lineage, including current representatives of Calliandra with x = 8, may have arisen by ascending disploidy directly from an ancestral monoploid stock with x(1) = 7.”
“We performed in situ observation of low-frequency inelastic light scattering in a zincogermanate glass showing nanocrystallization of semiconductive Zn(2)GeO(4) to elucidate the this website crystallization and phase transformation dynamics. In supercooledliquid state, an anomalous damping behavior of Boson peak was observed as the elastic softening happened. Combination of Boson and TEM studies revealed that the Boson damping is due to the liquid-liquid phase separation, which occurs prior to nanocrystallization, suggesting possibility of in situ spectroscopic observation of phase separation. (C) 2011 American Institute of Physics. [doi:10.1063/1.3602085]“
“Cross-linked enzyme aggregates of

papain were prepared in commercial macroporous silica gel (CLEAs-MSG) in order to improve the operability and mechanical stability of CLEAs CLEAs-MSG was obtained from simple adsorption precipitation and one-step-cross-linking CLEAs-MSG was characterized by stable structure that did not leak out enzyme from the macropores because of covalent bonding between CLEAs and MSG The optimal temperature of papain CLEAs in MSG was 40-90 C and the optimal pH was 7 0 which were improved compared to free papain and CLEAs The CLEAs-MSG also enhanced the storage stability and thermal stability Moreover the CLEAs-MSG exhibited good reusability due to its suitable size and active properties By using CLEAs-MSG of papain as biocatalyst the kinetically controlled z-Ala-Gln synthesis was achieved with the yield of 32 9% which was almost equal to that by using free papain as biocatalyst (C) 2010 Elsevier B V All rights reserved”
“Belostoma,

a genus of the family Belostomatidae, includes species of great ecological importance as biocontrol agents. Few species of these species have been the subject of cytogenetic IAP inhibitor analyses. Karyotypic evolution in this genus involves agmatoploidy and simploidy; there are also different sex chromosome systems. We examined two Belostoma species (B. dilatatum and B. candidulum) collected from the Paranapanema River Basin (Brazil). Mitotic and meiotic analysis revealed 2n(male) = 26 + X1X2X3Y for B. dilatatum and 2n(male) = 14 + XY for B. candidulum; both karyotypes have holokinetic chromosomes. Differences in heterochromatin distribution were also observed between the species, besides variation in the localization of CMA(3)(+)/DAPI(-) blocks.

001) Postoperative cross-sections showed no significant differen

001). Postoperative cross-sections showed no significant differences between the systems. Neither of the systems completely eliminated debris and smear layer. No procedural incidents occurred with the instruments. Mean working time was significantly shorter for FlexMaster than for AET (P = .0001).

Conclusions. AET cannot be recommended for preparation of curved root canals, owing to unacceptable straightening. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111: 251-259)”
“Bacterial pneumonia with empyema is a serious complication of influenza and commonly resulted in death during the 1918 influenza pandemic. We hypothesize that deaths Sapitinib caused by parapneumonic empyema are increasing in Utah

once again despite advances in critical care and the availability of antimicrobial drugs and new vaccines. In this study, we analyzed the historical relationship between deaths caused by empyema and influenza pandemics by using 100 years of data from Utah. Deaths caused by empyema have indeed increased from 2000-2004 when compared with the historic low death rates of 1950-1975. Vaccine strategies and antimicrobial drug stockpiling to control empyema will be important as we prepare for the next influenza pandemic.”
“The arguments are presented that the assumption of a zero electric

field at the charge carrier injection electrode/organic interface, as assumed by the current-voltage model of shallow traps occupying a single energy level within the organic semiconductor charge transport band as well as by the model of MI-503 order traps exponentially distributed in energy, is invalid in principle. In consequence of this fact, it is shown that the value of material parameters is strongly related to the bias dependent non-zero electric field at the charge-injecting interface. A set of published room temperature current-voltage data of a single layer, electron-only, metal/organic semiconductor structure is used in order to show explicitly that the singularity of free (or total) electron charge carriers

at the injecting interface Alpelisib and the associated space charge limited current characteristics reflects an unrealistic assumption of the above two models. For the model of traps exponentially distributed in energy, the charge traps density and the associated non-zero interfacial electric field are uniquely determined under a subsidiary condition of minimal energy of charges in an external electric field. The resulting (bias dependent) spatial distribution of the internal electric field and the spatial dependence of the electron density turns out to be practically uniform throughout the organic sample in agreement with the predictions of the model of shallow traps occupying a single energy level. The internal electric field and the charge density within the narrow midway region of the organic are, at each bias, invariant to the variation of the trap density and the associated interfacial electric field.

In this work, a pharmacological approach is reported, aimed at de

In this work, a pharmacological approach is reported, aimed at deciphering the role of calcium as a second messenger in the transduction pathway leading to the inhibitory effect of 2,4-dichlorophenoxyacetic acid (2,4-D), Ferroptosis inhibitor clinical trial in regulating monoterpene indole alkaloid (MIA) biosynthesis in Catharanthus roseus cells. It is demonstrated here that auxin-dependent MIA biosynthesis is differentially

regulated by two distinct calcium release components from internal stores in C. roseus showing pharmacological profiles similar to those displayed by animal RyR and IP3 channels. MIA biosynthesis is stimulated by caffeine (Ca2+-release activator through RyR channels) and by heparin and TMB8 (Ca2+-release inhibitors of IP3 channels) whereas MIA biosynthesis is inhibited by mastoparan (Ca2+-release activator of IP3 channels) and by ruthenium red and DHBP (Ca2+-release inhibitors of RyR 8-Bromo-cAMP channels). Furthermore, calcium,

as 2,4-D, acts on MIA biosynthesis by regulating the monoterpene moiety of the MIA biosynthesis pathway since calcium channel modulators preferentially modulate g10h expression, the gene encoding the enzyme of the secoiridoid monoterpene pathway, that is the major target of 2,4-D action. In addition, the simultaneous use of caffeine (an activator of RyR channel in animals) and TMB8 (an inhibitor of the IP3 channel) in 2,4-D treated cells triggers a synergistic effect on MIA accumulation. This finding suggests an opposite and co-ordinated action of multiple Ca2+-release pathways in 2,4-D signal transduction, adding a new level of complexity to calcium signalling in plants and questioning the existence of RyR and IP3 channels in plants.”
“Hulls from dry edible beans are rich in phenolic compounds recognized as possessing antioxidant

activity. The aim of this study was to characterize antioxidant properties of bean hull extract (BHE) and to determine whether BHE supplementation (at 400 or 800 mg/kg for 3 months) affects serum biochemical markers and bone structure in 12-month-old male C57BL/6 mice. Mice supplemented with 800 mg BHE/kg had lower serum tartrate-resistant acid phosphatase and parathyroid hormone concentrations than those on control diet or supplemented with 400 mg BHE/kg. BHE supplementation Q-VD-Oph caused slight decrease in oxidized glutathione concentration in blood (P = 0.07). Compared to the control group, BHE supplementation at 800 mg/kg for 3 months improved bone structural indices, bone mineral density and trabecular thickness in the third lumbar vertebra. These results suggest that BHE supplementation may have beneficial effects on bone health in mice by decreasing bone resorption. Published by Elsevier Ltd.”
“Objective Non-disclosure of a cancer diagnosis is a common practice in many Asian cultures where family-based medical decision making is the norm.


“The association between estrogens “”withdrawal”" and atta


“The association between estrogens “”withdrawal”" and attacks of migraine without aura is well-known. The aim of the study was to examine the features of laser evoked potentials (LEPs), including habituation, in women suffering from migraine without aura versus healthy controls, during the pre-menstrual and late luteal phases. Nine migraine without aura and 10 non-migraine

healthy women, were evaluated during the pre-menstrual phase and late luteal phase. The LEPs were recorded during the inter-critical phase. The right supraorbital zone and the dorsum of the right hand were stimulated. Three consecutive series of 20 laser stimuli were obtained for each stimulation site. Laser pain perception was rated by a 0-100 VAS after each stimulation series. Migraine patients exhibited increased LEPs amplitude and reduced habituation compared to normal subjects. Laser-pain perception was Lazertinib increased during the pre-menstrual phase in both patients and controls. Migraine patients and controls showed increased P2 and N2-P2 amplitude in the pre-menstrual phase, on both stimulation sites. During the pre-menstrual phase the N2-P2 habituation appeared to be reduced in Combretastatin A4 molecular weight both migraine and healthy women. The estrogen withdrawal occurring during the menstrual cycle may favor reduced habituation of nociceptive cortex, which may facilitate pain

symptoms and migraine in predisposed women.”
“BACKGROUND: Bacterial strains belonging to the genus Bacillus, isolated from Cr- polluted soil (tannery sludge) were employed as consortium for Cr(III) removal from tannery effluents. Kaolin clay, a natural adsorbent, was used as supporting material for bacterial biofilm formation. The use of clay-supported bacterial biofilm has not previously been employed for the treatment of tannery

effluents containing Cr(III) salt.

RESULTS: Commercial tannery effluent containing 1000 ppm initial metal ion concentration was treated in stages. The initial Cr(III) concentration of 1000 ppm was brought down to 2 ppm, a permissible level for discharge, after the fourth stage. The bacterial isolates were found to be Bacillus subtilis VITSCCr01 and Bacillus cereus VITSCCr02 by 16s rRNA gene sequencing. Batch assay and confocal laser scanning Sapanisertib cell line microscopy results revealed the role of kaolin as a support material in biofilm formation. Best fit was obtained with the Freundlich adsorption isotherm. Themechanism of sorption was confirmed by Fourier transform infrared (FT-IR) spectroscopy and scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS).

CONCLUSION: Cr(III) removal from tannery effluent using low cost adsorbents such as kaolin and bacteria proved to be effective for metal concentrations <= 1000 ppm; this is normally not possible using conventional treatment methods. This work has demonstrated feasible sorption of Cr(III), especially during post-tanning operations.

We have established a 34-item fatigue bank allowing for more prec

We have established a 34-item fatigue bank allowing for more precise and flexible measurement of fatigue, while still being backward compatible with the QLQ-C30 fatigue scale.”
“Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity. A nidus may be endogenous PP2 clinical trial or exogenous. Rhinoliths are uncommon and often an asymptomatic condition diagnosed accidentally during a routine examination; but sometimes they may cause complications such as unilateral nasal obstruction, fetid rhinorrhea, or epistaxis. This article describes a case of rhinolith involving a 21-year-old female. The flat panel detector-based cone beam computed tomography

(FPD-CBCT) findings, differential diagnosis, and treatment in a case of rhinolith are presented.

(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e65-e67)”
“This study evaluated the efficacy and toxicity of belotecan (CKD-602), a new camptothecin analogue topoisomerase I inhibitor, in patients with recurrent or refractory epithelial ovarian cancer. Data from 63 patients who had been treated with intravenous belotecan (0.5 mg/m(2)/day), administered for 5 days every 3 weeks at a single Selleck SBC-115076 institute in Seoul, Korea, were collected retrospectively. The overall response rate was 30.2% including 9 patients with complete remission (CR) and the progression free survival was a median of 6.5 (0.7 – 29.7) months. The platinum-sensitive group had a significantly higher response rate and longer progression-free survival more than the platinum-resistant group. The most common adverse effect of belotecan was hematologic toxicity which was tolerable. As a single chemotherapy agent, belotecan was effective in treating recurrent or refractory epithelial ovarian cancer, and had acceptable toxicity. Further

studies of the efficacy of belotecan in combination with platinum or the other agents are warranted.”
“In order to improve the magnetic and electrical selleck products properties of low resistance alumina based magnetic tunnel junctions, an off-axis method of sputtering has been investigated. It is shown that the tunnel magnetoresistance ratio can be greatly increased when there is an offset between the target and the wafer axes during the deposition of the ultrathin aluminum layer (off-axis sputtering) prior to its natural oxidation. The ferromagnetic coupling between the pinned and the free layer through the alumina barrier is also reduced compared to a classical on-axis deposition. This observation is interpreted as an improvement of the barrier quality, reducing both the roughness and the pinholes density. We assume that when the Al layer is sputtered off-axis, the magnetic and aluminum layers are protected from energetic neutralized Ar atoms bombardment. (C) 2010 American Institute of Physics. [doi: 10.1063/1.