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Chronic low-grade inflammation contributes to the pathology and complications of type 2 diabetes (T2D). Interleukin-10 (IL10), an anti-inflammatory cytokine, is suggested to play a protective role in T2D. However, the impact of T2D on IL10 function has not been previously assessed. We examined the ability of IL10 to inhibit inflammation in human T2D immune cells and explored underlying mechanisms using macrophage models. IL10 was less effective at inhibiting tumour necrosis factor (TNF)-α secretion in T2D whole blood cultures, which was not explained by altered IL10 receptor surface expression. These findings were observed in macrophages exposed to high glucose, which demonstrated similar IL10 resistance or hyporesponsiveness. These findings were also not explained by changes in IL10 receptor protein or other downstream signaling proteins. High glucose was also shown to impair the ability of IL10 to activate STAT3, a downstream signaling protein of IL10. Treatment with the SHIP1 agonist, AQX-MN100, reversed IL10 hyporesponsiveness in macrophages cultured in high glucose and showed equal effectiveness at different glucose conditions. This data supports the idea that IL10 hyporesponsiveness may contribute to chronic inflammation in T2D. These novel findings suggest that strategies aimed to overcome IL10 hyporesponsiveness may hold therapeutic potential for reducing inflammation in T2D.

This paper aims at manipulating loop alignment in knitting a three-dimensional (3D) shape by its geometry. Two loop alignment methods are introduced to handle a surface with positive Gaussian curvature. As weft knitting is a two-dimensional (2D) knitting mechanism that the knitting cam carrying the feeders moves in two directions only, left and right, the knitted fabric generated grows in width and length but not in depth. Therefore, a 3D shape is required to be flattened to a 2D plane with surface area preserved for knitting. On this flattened plane, dimensional measurements are taken for loop alignment. The way these measurements being taken derived two different loop alignment methods. In this paper, only plain knitted structure was considered. Each knitted loop was taken as a basic unit for loop alignment in order to achieve the required geometric dimensions, without the inclusion of other stitches which give textural dimensions to the fabric. Two loop alignment methods were experimented and compared. Only one of these two can successfully preserve the dimensions of the shape., {"references":["Yanxue, M. & Lamar, T. A. M. Three-dimensional shaping for knitted garments. Research Journal of Textile and Apparel 2013; 17 (3): 128-139.","Yang S, Mao L. Application of returning knit in woollen sweater design. Wool Textile Journal 2009; 37(1):44-48.","Benítez J, Thome N. Application of differential geometry to cartography. International Journal of Mathematical Education in Science and Technology 2004; 35(1):20-38..","Ng R, Yu W. Distortion Theory of Stereographic Draping with Flexible Fabric on Surface of Constant Curvature. Sen'i Gakkaishi 2006; 62(5):67-73.","Atchison S A Mathematical History of Cartography. Taxes: Texas A&M University; 2011.","Polking, J. C. & (2000). Mapping the Sphere. Retrieved January 23, 2015 from Rice University, Department of Mathematics Web site: http://math.rice.edu/~polking/cartography/cart.pdf"]}

Descending aortic (DA) surgery poses a high risk for spinal and cerebral infarction and routine use of lumbar drains allows for measurement of CSF markers of neurologic injury. Erythropoiesis medications have extensive preclinical data demonstrating neuroprotection. We hypothesized that prophylactic darbepoetin alfa (DARB) given before surgery reduces neurologic injury in patients undergoing DA repair. We performed a prospective adaptive dose-finding trial of prophylactic DARB ( www.clinicaltrials.gov NCT00647998) that terminated prematurely following publication of an erythropoietin stroke study showing possible harm. Enrollment halted before dose adjustments; nine patients each received 1 mg/kg IV DARB immediately before surgery. A prospective cohort of nine untreated patients was subsequently obtained for comparison. The primary outcome of death or neurologic impairment at discharge occurred in 1/9 (11 %) DARB patients and 3/9 (33 %) controls (p = 0.58). There were no statistical differences in changes of CSF biomarkers from baseline to 48 h comparing DARB patients to controls: S100β, median 214 versus 260 ng/ml (p = 0.69); glial fibrillary acidic protein (GFAP), median 0.022 versus 0.58 ng/ml (p = 0.45). In patients with early perioperative neurologic ischemia, there were greater changes in CSF biomarkers, compared to those without ischemia: S100β, median 2301 versus 124 ng/ml (p = 0.04); GFAP, median 31.78 versus 0.31 ng/ml (p = 0.34). There were no significant effects of prophylactic DARB on clinical outcome or CSF markers of neurologic injury in this pilot study, although all point estimates favored treatment. DA repair is a promising model of prophylactic neuroprotection.

This study investigates the relationship between Indoor Environmental Quality (IEQ) and learning performance in air-conditioned university teaching rooms via subjective assessment and objective measurement. Together with the data of air temperature, relative humidity, air speed, mean radiant temperature, CO 2 concentration, equivalent sound pressure level, horizontal illumination level, occupant activity and clothing insulation level measured in four classrooms and four large lecture halls, self-reported learning performance (in calculating, reading, understanding and typing) and perceived IEQ are evaluated. The results show strong associations of the overall IEQ votes with the environmental parameters. While thermal comfort, indoor air quality and visual environment are of comparable importance, aural environment is the major determining factor. The study also reveals that all IEQ complaints have similar impact on learning performance and there is a good correlation between learning performance and the number of complaints. To aid design needs, empirical expressions that approximate the impact of unsatisfactory IEQ on learning performance loss are proposed.

The aim of this study was to investigate the prognostic value of the preoperative total lymphocyte count in peripheral blood as a predictor of postoperative complications and mortality in cardiac surgery.A retrospective, observational study.The Novosibirsk State Research Institute of Circulation Pathology (single institution).All adults undergoing primary cardiopulmonary bypass in 2009.None.The cohort size was 1,368 patients operated upon with cardiopulmonary bypass. Patient characteristics, hospital mortality, postoperative complications, ventilation time, intensive care unit, and hospital stay were analyzed. A preoperative total lymphocyte count1,500 cells/μL was associated with significantly higher mortality by univariate (p0.0001) and multivariate (p0.044) analyses. A low preoperative total lymphocyte count was associated with more frequent inotropic support (p0.001); postoperative heart arrhythmia (p0.001); dialysis-dependent acute renal failure (p0.001); and a prolonged ventilation time (p = 0.001), intensive care unit stay (p0.001), and hospital stay (p = 0.007).A low preoperative total lymphocyte count in peripheral blood is a useful prognostic criterion for the evaluation of a complicated postoperative period in cardiac patients operated under cardiopulmonary bypass.

The purpose of this study was to explore the long term effect of a service learning project on medical and nursing students' knowledge in aging and their attitudes toward older adults. A total of 124 students were recruited and then randomized to intervention group (IG) and control group (CG). A pre-and-post-intervention design measured students' knowledge in aging (using modified Palmore's Fact on Aging Quiz) and attitudes toward older adults (using Kogan's Old People Scale). A total of 103 students completed all the activities and questionnaires. After the intervention, there were significant differences between the IG and CG on Palmore's mental health (MH) (P = .04), Palmore's total score (P = .02) and Kogan's negative attitudes toward older adults (P = .001). All students increased their positive attitude toward older adults after the intervention. However, both the IG and CG showed a decrease in positive attitudes 1 month after the interventon, and such decrease varied, depending on the programme which students attended. The current study showed that the 10-week service learning activities significantly increased medical and nursing students' overall knowledge of aging and their understanding of mental health needs in old age, and reduced their negative attitudes toward older adults. However, the effect is not long-lasting. On the other hand, its effect on positive attitudes toward older adults cannot be concluded. Periodic contacts with older adults via service learning activities may be needed to sustain attitude change toward older adults.

Facemasks are widely used as a protective measure by general public to prevent inhalation of airborne pathogens including seasonal, swine and other forms of influenza and severe acute respiratory syndrome (SARS), etc. However, scientific data on effectiveness of facemasks in reducing infections in the community are extremely limited and even inconsistent. In this work, two manikins labelled as ‘source’ and ‘susceptible’ were used to measure the protection provided by facemasks under various emission scenarios. The source was modified to generate polydisperse ultrafine particles, whereas the susceptible was modified to mimic a realistic breathing pattern. The facemask was challenged by both pseudo-steady and highly transient emissions generated by an expiratory process where parameters, such as separation distance between manikins, emission velocity and expiratory duration, were controlled and measured systematically. Performances of four different types of facemask fits, varying from ideal to normal wearing practice, were also investigated. Under the pseudo-steady concentration environment, facemask protection was found to be 45 per cent, while under expiratory emissions, protection varied from 33 to 100 per cent. It was also observed that the separation between the source and the manikin was the most influential parameter affecting facemask protection.

Bus cabin air quality has not been incessantly monitored in Hong Kong. This study investigates the in-cabin exposure levels of CO, CO2 and PM10 for running buses in Hong Kong that are equipped with Euro II, III and IV engines. A representative urban—suburban bus route was chosen and there were no significantly different in-cabin CO levels reported among engine types and between rush and non-rush hours. However, in-cabin CO level was found significantly associated with ambient/roadside CO level; the former was altogether higher than the latter due to the bus’ own exhaust. Regarding in-cabin PM10 concentration, the engine type played a major role. The outcome demonstrates that new buses (i.e. Euro IV) generally provide a better in-cabin environment for commuters. Therefore, implementation of an air filtration upgrade, together with a routine filter cleaning schedule, is an effective measure to ameliorate bus cabin air quality. This study also provides useful information for further investigation into the causal relationship between health risks and long-term air pollution exposure in local bus cabins.

OBJETIVO: Buscando novas formas de preservação de tecidos utilizamos o polietileno-glicol, método L-Hydro (LH), que consiste na extração controlada de substâncias antigênicas e incorporação de agente antinflamatório e antitrombótico. MÉTODOS: Em dez carneiros jovens, substituímos o tronco pulmonar, em sete, por homoenxertos pulmonares (HP) tratados pelo processo L-H e, em três, por HP a fresco, implantados ortotopicamente, seguidos por 320 dias. Os carneiros foram avaliados por exames laboratoriais e ecocardiográficos. Ao cabo dos 320 dias foram sacrificados, procedendo-se à avaliação hemodinâmica, radiológica, macro/microscópica, óptica e eletrônica, varredura e transmissão. Resultados foram analisados pelo teste t de Student de amostras independentes para dados contínuos, análise de variância para medidas repetidas, pelo teste exato de Fisher para dados categóricos. RESULTADOS: Evolução clínica e exames laboratoriais não conseguiram estabelecer diferenças significativas entre os grupos. Ecocardiograma revelou diferença quanto ao gradiente médio pulmonar, significativa aos 10 meses, maior no grupo controle. Avaliação radiológica e macroscópica não estabeleceu diferenças. Na avaliação microscópica, óptica/eletrônica, células de revestimento e intersticiais foram encontradas nos dois grupos igualmente. O porcentual de revestimento celular calculado nos dois grupos foi semelhante. Nódulos de celularidade foram observados somente no grupo de homoenxertos a fresco. CONCLUSÕES: Estes dados indicam que os dois grupos apresentaram desempenho clínico e hemodinâmico semelhante. Ao ecocardiograma o grupo LH apresentou melhor desempenho, e evidências histológicas de repopulação celular intersticial e endotelial. Na análise macro/microscópica, óptica/eletrônica, o grupo L-Hydro apresentou macroscopia, estrutura histológica e ultraestrutural semelhante ao homoenxerto fresco, à exceção de nódulos de maior celularidade intersticial, presentes apenas no homoenxerto a fresco.OBJECTIVE: In an effort to make available homografts preserved in a simpler and less costly way, we evaluated the polyethyleneglycol, L-Hydro (LH) method, that consists in the controlled extraction of antigenic substances and the incorporation of anti-inflammatory and anti-thrombotic agent. METHODS: We substituted the pulmonary trunk in ten ovines, seven received LH treated pulmonary homografts and three, fresh pulmonary homografts, orthotopically implanted and followed-up for 320 days. Ovines where evaluated by means of laboratory tests, echocardiographic exams. At the 320 days, were euthanized, hemodynamic, radiology, macroscopic, optic/electronic microscopic, scanning/transmission evaluations were performed. Results were analyzed by Student t test of independent samples for continuous data, by variance analysis of repeated measures, and by Fisher exact test for categorical data. RESULTS: We couldn't establish relevant differences in clinical evolution and laboratory tests between groups. Echocardiogram revealed difference in pulmonary medium gradient, which was significant 10 months follow-up, higher in the control group. Radiologic and macroscopic evaluations didn't established differences. In the optic/electronic microscopic evaluation, liner and interstitial cells were equally found in both groups. The cell liner percent calculated in both groups was similar. Cellularity nodules were observed only infresh homograft group. CONCLUSIONS: These data indicate that both groups presented similar clinical/hemodynamic performances. The LH group's echocardiogram presented a better performance. It also presented histological evidences of interstitial and endothelial cell repopulation. In the macro/optic and electronic microscopic analysis, group L-H presented macroscopy/histological structure and ultra-structural similar to the fresh group, with the exception of nodules with higher interstitial cellularity, present only in the fresh homograft group.

Zone refining has been extensively used as a process of final purification of materials. Extensive theoretical and experimental efforts have been made to improve the purification efficiency of zone refining by optimizing parameters such as the length and the number of passes of the liquid zone. In the present study, a genetic algorithm (GA) integrated to a mass transfer numerical model has been used in the search of optimized operational parameters of the zone refining process. Experiments were carried out with naphthalene as the reference material having rhodamine as the impurity. Transparent organic substances, such as naphthalene, have been widely used as metals analogues materials because they allow in situ observations of microstructure evolution. Numerical predictions of the impurity profile along the refined naphthalene ingot is also ascertained by the present experimental data. Zone refining experiments were carried out by varying the zone length in each zone pass in order to permit the optimized ...

Recent advances in the management of acute Stanford type A dissection have highlighted the clinical importance of clinical presentation and extent of dissection. The Penn classification of type A clinical presentations is based on ischemic profiles that not only determine mortality but also influence management options. The extent of type A dissection as summarized by the DeBakey classification significantly determines the role of endovascular intervention in this important disease. We propose an integration of these three classifications of acute type A dissection as a framework for future advances in diagnosis, intervention and prognosis.

Germline mutations in the two breast cancer susceptibility genes, BRCA1 and BRCA2 account for a significant portion of hereditary breast/ovarian cancer. De novo mutations such as multiple exon deletion are rarely occurred in BRCA1 and BRCA2. During our mutation screening for BRCA1/2 genes to Chinese women with risk factors for hereditary breast/ovarian cancer, we identified a novel germline mutation, consisting of a deletion from exons 1 to 12 in BRCA1 gene, in a patient diagnosed with early onset triple negative breast cancer with no family history of cancer. None of her parents carried the mutation and molecular analysis showed that this novel de novo germline mutation resulted in down-regulation of BRCA1 gene expression. © 2011 The Author(s)., published_or_final_version

Background: Our recent work has shown the feasibility of using a refined immunomagnetic enrichment (IE) assay to detect cytokeratin 20-positive circulating tumour cells (CK20 pCTCs) in colorectal cancer (CRC) patients. We attempted to improve the sensitivity for CRC by detecting another intestinal-type differentiation marker, CDX2 pCTCs, using the same methodology. Methods: CDX2 pCTCs were detected in patients with CRC, colorectal adenoma (CAD), benign colorectal diseases (BCD), other common cancers (OCC) and normal subjects (NS). Statistical analysis was used to correlate CDX2 pCTCs to the clinicohistopathological factors, recurrence, metastasis and survival after follow-up for 42 months in CRC patients. Results: CDX2 pCTCs were detected in 81% CRC patients (73 out of 90, median number=21.5 CTCs), 7.5% CAD patients (3 out of 40), 0% patients with BCD (0 out of 90), 2.5% patients with OCC (2 out of 80) and 0% NS (0 out of 40). Furthermore, statistical analysis showed that CDX2 pCTC numbers were associated with tumour- node-metastasis stage and lymph node status. Using the median CDX2 pCTC numbers as the cutoff points, stratified groups of CRC patients had significant differences in their recurrence and survival. Conclusions: This study showed that the refined IE assay can detect CDX2 pCTCs with high sensitivity and that CDX2 pCTCs can generate clinically important information for CRC patients.

Background: Endometrial cancer is the most common gynaecological malignancy in the United Kingdom. Diagnosis currently involves subjective expert interpretation of highly processed tissue, primarily using microscopy. Previous work has shown that infrared (IR) spectroscopy can be used to distinguish between benign and malignant cells in a variety of tissue types. Methods: Tissue was obtained from 76 patients undergoing hysterectomy, 36 had endometrial cancer. Slivers of endometrial tissue (tumour and tumour-adjacent tissue if present) were dissected and placed in fixative solution. Before analysis, tissues were thinly sliced, washed, mounted on low-E slides and desiccated; 10 IR spectra were obtained per slice by attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy. Derived data was subjected to principal component analysis followed by linear discriminant analysis. Post-spectroscopy analyses, tissue sections were haematoxylin and eosin-stained to provide histological verification. Results: Using this approach, it is possible to distinguish benign from malignant endometrial tissue, and various subtypes of both. Cluster vector plots of benign (verified post-spectroscopy to be free of identifiable pathology) vs malignant tissue indicate the importance of the lipid and secondary protein structure (Amide I and Amide II) regions of the spectrum. Conclusion: These findings point towards the possibility of a simple objective test for endometrial cancer using ATR-FTIR spectroscopy. This would facilitate earlier diagnosis and so reduce the morbidity and mortality associated with this disease.

AIMS: Ovarian cancer has the highest mortality of any gynaecological malignancy; this is due to rapid peritoneal spread of tumour cells and neovascularization. Understanding the mechanisms underlying this is critical to developing early diagnostic or treatment strategies. We devised a pilot study to examine the role of γ-SYNUCLEIN (γ-SYN), oestrogen receptor (ER)α, and the splice variant ERαΔ3. METHODOLOGY: With ethical approval, ovarian tissue was collected from patients (n=24) undergoing oopherectomy for non-ovarian pathology or primary surgery for suspected ovarian cancer. Quantitative gene expression analysis was employed for γ-SYN, ERα, and ERαΔ3. To identify the in situ localization, immunofluorescence for γ-syn was carried out. RESULTS: Ovarian tumour tissue exhibited an elevated expression of γ-SYN and high-grade tumours had an elevated ERαΔ3:ERα ratio compared with benign tissue. The majority of previous studies point to the γ-syn protein being present in epithelial cells of high-grade disease. Our study supports this, but additionally we conclusively identify its presence in the endothelial cells of vasculature surrounding low-grade disease; immunofluorescence was strongest in the apical cells surrounding the lumen. CONCLUSION: Our results demonstrate for the first time that there are readily-expressed levels of γ-SYN and ERαΔ3 in normal ovarian tissue and ovarian tumours. In high-grade disease, γ-syn and an elevated ERαΔ3:ERα ratio might confer metastatic potential to the tumourigenic cells and promote neoangiogenesis. Future in vitro studies might be necessary to delineate such a mechanism, which could potentially be the basis of early intervention.

Background A comprehensive three-dimensional echocardiography based approach is applied to preoperative mitral valve (MV) analysis in patients with ischemic mitral regurgitation (IMR). This method is used to characterize the heterogeneous nature of the pathologic anatomy associated with IMR. Methods Intraoperative real-time three-dimensional transesophageal echocardiograms of 18 patients with IMR (10 with anterior, 8 with inferior infarcts) and 17 patients with normal MV were analyzed. A customized image analysis protocol was used to assess global and regional determinants of annular size and shape, leaflet tethering and curvature, relative papillary muscle anatomy, and anatomic regurgitant orifice area. Results Both mitral annular area and MV tenting volume were increased in the IMR group as compared with patients with normal MV (mitral annular area=1,065 ± 59 mm 2 versus 779 ± 44 mm 2 , p = 0.001; and MV tenting volume=3,413 ± 403 mm 3 versus 1,696 ± 200 mm 3 , p = 0.001, respectively). Within the IMR group, patients with anterior infarct had larger annuli (1,168 ± 99 mm 2 ) and greater tenting volumes (4,260 ± 779 mm 3 versus 2,735 ± 245 mm 3 , p = 0.06) than the inferior infarct subgroup. Papillary-annular distance was increased in the IMR group relative to normal; these distances were largest in patients with anterior infarcts. Whereas patients with normal MV had very consistent anatomic determinants, annular shape and leaflet tenting distribution in the IMR group were exceedingly variable. Mean anatomic regurgitant orifice area was 25.8 ± 3.0 mm 2 , and the number of discrete regurgitant orifices varied from 1 to 4. Conclusions Application of custom analysis techniques to three-dimensional echocardiography images allows a quantitative and systematic analysis of the MV, and demonstrates the extreme variability in pathologic anatomy that occurs in patients with severe IMR.

Agnew's general strain theory (GST) and Gottfredson and Hirschi's self-control theory represent significant theoretical developments in sociology of deviance over the last two decades. Both theories offer unique insights into the well-known controversy of gender disparity in crime and delinquency. Incorporating their ideas and testing them in a Chinese context, this study investigates the role of self-control, which has been seldom included in GST assessments, in moderating the strain-delinquency relationship and analyzes whether this conditioning effect varies by gender. Using data from 1,015 Chinese students in Hong Kong, negative binominal regression models found that self-control is a gender-specific conditioning factor of strain. Self-control mitigates the effects of certain strains on delinquency for females only. Yet, unexpectedly, coercive parenting decreases male delinquency and moderates the impact of low self-control in males. The implications of Chinese cultural forces for the perception of strain and the conditioning influence of self-control merit closer attention.

Mutations in tp53 are thought to be one of the most common mechanisms by which cancer cells evade tumor suppression. Yet the exact mechanism of tumor suppression by P53 remains to be fully understood. The transcription factor P53 is activated in response to oncogenic stresses and exerts distinct anti-proliferative functions based on the stressor and cell type. Although numerous mammalian ChIP-Seq studies have identified thousands of P53 binding sites, the functionality of these binding sites remains to be established. To study how P53 binding following DNA damage differs between cell types, we performed comparisons between P53 ChIP-Seq data from Drosophila embryos at different developmental stages and a Drosophila cell line (Kc167). Differential expression analysis using RNA-Seq indicated that at an early stem cell-like developmental stage of Drosophila embryos there is P53-dependent induction of pro-apoptotic genes in response to irradiation but not in the later differentiated stages. We aim to establish functionally significant P53 binding sites by combining ChIP-Seq and RNA-Seq data from Drosophila embryos as well as Kc167. The functional significance of these binding sites will be identified by CRISPR-Cas9–mediated genome editing. Preliminary genome-wide motif analysis studies also exhibited that homotypic clustering of P53 consensus motifs is associated with P53 binding. We will also perform comparison studies of DNA damage-induced P53 binding in humans, mice and flies to identify analogous patterns. Preliminary studies revealed that a majority of the P53 binding sites are located at the repetitive regions of the Drosophila genome, especially the Long terminal repeats (LTRs) and Long interspersed nuclear elements (LINEs) as seen previously in mammals by other groups including Botcheva et al and Chang et al. P53 has been known to regulate the expression of retrotransposons and maintain genetic stability by keeping the number of repeats in control. We further aim to see if the functions carried out by P53 differ between repetitive vs. non-repetitive binding regions in Drosophila. This comparative genomics study will help identify the functionally significant P53 binding sites thus further our understanding of tumor suppression by P53. The knowledge obtained from this study will also be valuable in devising novel strategies to restore P53 function in cancers. Citation Format: Varsha Sundaresan, Ying Li, Benedetto DiCiaccio, Victor T. Lin, Adrian A. Acuna Higaki, Nicole F. Pelletier, Jessica T. Cheung, Lei Zhou. Elucidating the factors determining P53 binding and transcriptomic response to DNA damage [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5367.

Recent years have witnessed the emergence of novel technologies that enable less invasive endovascular treatment of descending thoracic aortic disease (TAD). This has occurred against a backdrop of improved identification of various disease processes and better results with open surgical repair. The natural history of the specific acute aortic syndromes that affect the descending thoracic aorta has also been described with more clarity and has become more commonly recognized. This is in part secondary to the widespread availability and application of advanced imaging technologies that permit precise diagnoses. As data are accumulating, these pathological processes involving the descending thoracic aorta are no longer thought of as simply variants of one another but as distinct entities with well-defined clinical behavior. As the technology for endovascular repair continues to mature and its utilization increases, there is a need for a careful assessment of the current state of medical management, traditional open therapy, and evolving endovascular treatment of distinct thoracic aortic pathologies. The purpose of this scientific statement is to present a contemporary review of the various pathological processes that affect the descending thoracic aorta: Aneurysms, dissections, intramural hematomas (IMHs), penetrating atherosclerotic ulcers (PAUs), and aortic transections. These disorders will be considered in detail, with an exploration of the natural history, available treatment options, and controversies regarding management. Current intervention criteria will be reviewed with respect to both open surgical repair and endovascular treatment. Our goal is to provide the healthcare professional with a better understanding of the pathophysiology of the various disease processes that involve the descending thoracic aorta and to review current outcomes and technical pitfalls associated with these therapies to facilitate strong, evidence-based decision making in the care of these patients. Treatment of descending TAD involves complex, exigent decision making in an era of evolving technology. Survival data for nonoperative …

Collaborator of ARF (CARF) was first cloned as an ARF partner in yeast two-hybrid screens. It enhances ARF-dependent and -independent p53 functions, which are central to the control of cell growth and tumor suppression in human cells. CARF interacts with ARF, p53, and MDM2 proteins, and in turn gets regulated by MDM2-mediated degradation, suggesting a self-regulatory loop. CARF is upregulated during replicative, oncogenic, and stress-induced senescence. Overexpression of CARF induced premature senescence in normal human fibroblasts that was mediated by upregulation of p53-p21(CIP1/WAF1) and p16(INK4a)- pRB pathways. Knockdown of CARF resulted in mitotic arrest leading to excessive chromosomal condensation, aneuploidy, and apoptosis, suggesting that CARF is essential for cell survival. Most recently, we have found that CARF causes bidirectional regulation of p53 and pRB pathways, either arresting or promoting growth, and thus, it could be a potential threshold link between aging and cancer.

SUMMARY investigation of the SH wave seismograms indicates that rupture occurred on a shallowly dipping fault, propagating in all directions from the hypocentre. The average rupture velocity in the downdip and updip directions are ∼2.0-3 and ∼1.0 km s −1 , respectively. The maximum slip is found to be ∼12 m and is located downdip of the earthquake's hypocentre. Taken over the fault as a whole, the average stress drop is ∼0.55 MPa. Used in conjunction with relocated aftershocks, we find that two barriers constrain the faulting extent of slip, creating a rupture area of ∼165 km × 140 km. These barriers coincide with submarine topographic features, are domain boundaries for the seismic gaps along the arc, and have high concentrations of large aftershocks near them. The high slip regions align with the orientation of the subducting plate, and resemble in size and shape the many seamounts about to subduct. The 2003 Tokachi-Oki earthquake was the largest earthquake to occur globally in that year and reruptured the portion of the Kuril- Japan Trench that last broke in the great Tokachi-Oki earthquake of 1952 (Hamada & Suzuki 2004). The abundance of local data in this region coupled with the large magnitude of the event has led to a range of models for the rupture being proposed. These solutions are summarised in Table 1. All of these solutions have the total moment for the earthquake significantly below that obtained from the long-period seismological data by the global CMT (GCMT) solution, with some solutions having less than one third of the GCMT moment. This study aims to address this anomaly, by first investigating the long-period moment tensor solution and then by finding a rupture model which is consistent with both broad-band teleseismic data and the long-period solution.

Selective white matter (WM) damage is a known sequela of mild hypoxic-ischemic (HI) injury in the neonatal rat model. The aim of this study was to evaluate longitudinally mild HI-induced WM damage (represented by the external capsule [EC]) by diffusion tensor MR imaging (DTI) and to correlate the findings with histology.Seven-day-old Sprague-Dawley rats (n = 19) underwent unilateral ligation of the left common carotid artery followed by hypoxia for 50 minutes to create mild HI injury. DTI was performed longitudinally at 5 time points from day 1 to day 90 postinjury (n = 19, 16, 13, 11, 9, respectively), and fractional anisotropy (FA), trace, radial diffusivity (lambda( perpendicular)), and axial diffusivity (lambda(//)) of the injury and control contralateral ECs were quantified. Rats were randomly sacrificed (n = 15, in total), and the corresponding ECs were stained with hematoxylin-eosin, Luxol fast blue (LFB), and neurofilament (NF) to evaluate morphologic changes, amount of myelin, and axonal count at every time point. A paired t test was applied to evaluate statistical differences between both ECs, and the Pearson correlation test was used to evaluate the relationships between DTI indices and histologic evaluations. In addition, longitudinal changes in DTI indices and histologic evaluations were analyzed by a linear mixed model and an analysis of variance test, respectively.We demonstrated significantly decreased FA, increased lambda( perpendicular), and similar lambda(//) in the injury compared with the control EC, which was persistent through all time points. Histologic evaluation by LFB and NF staining showed reduced myelin stain intensity in the injury EC and similar axonal counts in both ECs. Longitudinally, there was an increase in FA, a decrease in lambda( perpendicular) and trace, and stability in lambda(//) in both ECs. Also, there was progressive reduction in the differences in FA, trace, and lambda( perpendicular) between the injury and control EC, especially between day 1 and day 7 postinjury and in tandem with changes in myelin stain. FA was significantly correlated with myelin stain (r = 0.681, P.01) and axonal count (r = 0.673, P.01), whereas lambda( perpendicular) was significantly correlated with myelin stain only (r = -0.528, P.01), and lambda(//), with axonal count only (r = 0.372, P = .043).Diffusion indices can reflect dysmyelination in mild HI injury, continual myelination of both injury and control ECs with growth, and the partial recovery of myelin postinjury. We propose that diffusion indices may be used as biomarkers to monitor noninvasively the longitudinal changes of mild HI-induced WM damage.

Study objective We assessed whether the ordering of imaging studies in patients with suspected venous thromboembolism was consistent with the results of D-dimer testing. Methods We performed a retrospective chart review of consecutive cases in which a D-dimer assay was performed at an urban academic emergency department during a 13-month period. Measurements included D-dimer result and results of imaging for venous thromboembolism. The primary outcome measure was the percentage of patients in each D-dimer category (positive or negative result with a cutoff value of 500 ng fibrinogen equivalent units/dL) who underwent subsequent imaging within 48 hours. We also report the results of the imaging studies obtained. Results A total of 553 D-dimer tests were ordered, with 266 (48.1%) negative and 287 (51.9%) positive results. Of patients with a negative D-dimer result, 37 (14%; 95% confidence interval [CI] 10% to 19%) underwent at least 1 imaging study. Of patients with a positive D-dimer result, 137 (48%; 95% CI 42% to 54%) did not undergo imaging. Conclusion Evaluation for venous thromboembolism occasionally proceeded despite a negative D-dimer result, whereas frequently no further evaluation occurred despite a positive result. These findings suggest that actual clinical practice differs from what is recommended by published algorithms that guide evaluation of patients with suspected venous thromboembolism.

Most patients with type 1 diabetes rely on multiple daily insulin injections to maintain blood glucose control. However, insulin injections carry the risk of inducing hypoglycemia and do not eliminate diabetic complications. We sought to develop and evaluate a regulatable cell-based system for delivery of insulin to treat diabetes. We generated two intestinal cell lines in which human insulin expression is controlled by mifepristone. Insulin mRNA expression was dependent on the mifepristone dose and incubation time and cells displayed insulin and C-peptide immunoreactivity and glucose-induced insulin release following mifepristone treatment. Cell transplantation followed by mifepristone administration reversed streptozotocin (STZ)-induced diabetes in mice, and this effect was dependent on the mifepristone dose delivered. These data support the notion that engineering regulatable insulin expression within a cell already equipped for regulated secretion may be efficacious for the treatment of insulin-dependent diabetes.

Neuroblastoma is the most common extracranial solid tumor in children. Primary omental neuroblastoma has never been reported in the English literature. A 4-year-old girl presented with a mobile abdominal mass; primary omental neuroblastoma was diagnosed. There was tumor recurrence after complete tumor resection. She received chemotherapy and underwent laparoscopic resection of the recurrent tumor. There was no tumor recurrence after 1 year of follow-up.

Acute hypertension during cardiac surgery can be difficult to manage and may adversely affect patient outcomes. Clevidipine is a novel, rapidly acting dihydropyridine L-type calcium channel blocker with an ultrashort half-life that decreases arterial blood pressure (BP). The Evaluation of CLevidipine In the Perioperative Treatment of Hypertension Assessing Safety Events trial (ECLIPSE) was performed to compare the safety and efficacy of clevidipine (CLV) with nitroglycerin (NTG), sodium nitroprusside (SNP), and nicardipine (NIC) in the treatment of perioperative acute hypertension in patients undergoing cardiac surgery.We analyzed data from three prospective, randomized, open-label, parallel comparison studies of CLV to NTG or SNP perioperatively, or NIC postoperatively in patients undergoing cardiac surgery at 61 medical centers. Of the 1964 patients enrolled, 1512 met postrandomization inclusion criteria of requiring acute treatment of hypertension based on clinical criteria. The patients were randomized 1:1 for each of the three parallel comparator treatment groups. The primary outcome was the incidence of death, myocardial infarction, stroke or renal dysfunction at 30 days. Adequacy and precision of BP control was evaluated and is reported as a secondary outcome.There was no difference in the incidence of myocardial infarction, stroke or renal dysfunction for CLV-treated patients compared with the other treatment groups. There was no difference in mortality rates between the CLV, NTG or NIC groups. Mortality was significantly higher, though, for SNP-treated patients compared with CLV-treated patients (P=0.04). CLV was more effective compared with NTG (P=0.0006) or SNP (P=0.003) in maintaining BP within the prespecified BP range. CLV was equivalent to NIC in keeping patients within a prespecified BP range; however, when BP range was narrowed, CLV was associated with fewer BP excursions beyond these BP limits compared with NIC.CLV is a safe and effective treatment for acute hypertension in patients undergoing cardiac surgery.

Spinal cord ischemia and stroke are recognized complications of descending thoracic (DTA) and thoracoabdominal aortic (TAA) operations. However, there are limited data available on outcomes since the advent of thoracic endovascular aortic repair (TEVAR).We reviewed charts from consecutive patients who underwent open DTA and TAA operations, excluding type IV repair, from January, 2000 through April, 2005.A total of 224 open DTA and TAA operations were included in the analysis. During this period 108 additional patients received TEVAR, accounting for 66% of all DTA repairs. Among the 224 patients who underwent open surgery, 63 patients (28%) developed spinal ischemia postprocedure, 13 (6%) had a stroke, and 9 (4%) had both. The 30 day in-hospital mortality was 18%. Neurologic complications were strongly associated with mortality: 64% of patients with stroke died compared to 17% without (P0.001) and 39% of patients with spinal ischemia died compared to 14% without (P0.001). At discharge, 29% had a poor outcome from surgery, defined as death or moderate-to-severe neurologic disability. A multivariable logistic regression incorporating characteristics known prior to surgery resulted in a score to stratify risk of poor outcome by giving one point each for ageor =60, history of cerebrovascular disease, Crawford extent II or III repair, and acute rupture. Patients with scoreor =3 had an estimated 60% risk for poor outcome, while those with scoreor =1 had an estimated risk of 7-11%.Ischemic neurologic complications were frequent and strongly associated with poor outcomes after open DTA and TAA repair among patients not eligible for TEVAR. Risk of death or neurologic disability can be estimated based on factors known prior to surgery.

Meckel’s diverticulum, the most common congenital anomaly of the gastrointestinal tract, is prone to develop complications in the pediatric population. The authors report their 10-year experience with the management of complicated Meckel’s diverticulum in children using laparoscopy. A retrospective review of all complicated Meckel’s diverticulum cases involving children from 1998 to 2007 was performed. The efficacy and safety of laparoscopy used to manage complicated Meckel’s diverticulum were assessed. Over a 10-year period, 20 children (17 boys and 3 girls) with a mean age of 5 years (range, 7 months to 13 years) were included in the study. Of the 20 children, 12 presented with gastrointestinal bleeding, 2 had intestinal obstruction, 3 had abdominal pain mimicking acute appendicitis, 2 had inguinal hernia, and 1 had intussusception. Diagnostic laparoscopy was performed for all the patients. Laparoscopically assisted transumbilical Meckel’s diverticulectomy was performed successfully for 18 of the children. The operative time ranged from 50 to 190 min (mean, 115 min). All the children had an uneventful recovery except one, who experienced a postoperative wound infection. Ectopic gastric mucosa was found in 14 cases. Diverse pediatric surgical conditions result from Meckel’s diverticulum. Laparoscopy is a safe and effective method for the management of complicated Meckel’s diverticulum.

The influence of the alkali resistant surfactant Dowfax 2A1 on single ion track etching in 30 μm polycarbonate foils is studied at low etch rate (5 M NaOH at 41.5 ± 2 °C) using electro conductivity measurements. At surfactant concentrations above 10−4 vol.% break-through times are predictable (Δt/t

Background This preliminary study served as a pilot for an ongoing analysis of spectral power in adults with Down syndrome (DS) using a 151 channel whole head magnetoencephalography (MEG). The present study is the first step for examining and comparing cortical responses during spontaneous and task related activity in DS. Method Cortical responses were recorded with a 151 channel whole head MEG system in three adults with DS and three age-matched adults without DS. MEG data were obtained at rest with eyes open and during observation of point-light displays of human motion and object motion. Data from both groups were evaluated by spectral analysis. Results The preliminary results showed greater alpha (8–14 Hz) power particularly in the occipital and parietal areas during the eyes open condition in the adults with DS in relation to a normal comparison group. The visual task had little effect on alpha power in the comparison group. Engaging in the visual task reduced power in alpha across all regions in the DS group to the level observed in comparisons. In the gamma band (30–50 Hz), power values were similar across both groups for the eyes open condition. In the comparison group, large reductions in gamma were observed in the occipital and bilateral temporal areas during the visual task. This change was not observed in the DS group. Conclusions The results from this pilot study suggest that MEG may be useful in characterizing task-specific changes in cortical activity in individuals with DS. Future studies with a larger group of individuals will further contribute to our understanding of the neurophysiology of Down syndrome.

Backgound Stroke has emerged as an important complication of thoracic endovascular aortic repair (TEVAR). Identifying risk factors for stroke is important to define the risks of this procedure. Methods All neurologic complications were analyzed in a prospective database of patients in thoracic aortic stent graft trials from 1999 to 2006. Serial neurological examination was performed. Stroke was defined as any new onset focal neurologic deficit. Results The TEVAR was performed on 171 patients; 52 had lesions requiring coverage of the proximal descending thoracic aorta (extent A), 50 requiring coverage of the distal descending aorta (extent B), and 69 requiring coverage of the entire descending thoracic aorta (extent C). The incidence of stroke was 5.8%. Eighty-nine percent (8 of 9) of strokes occurred within 24 hours of operation. Stroke was associated with a 33% in-hospital mortality rate. Risk factors identified for stroke included prior stroke (odds ratio [OR] 9.4, confidence interval [CI] 2.3 to 38.1, p = 0.002) and extent A or C coverage (OR 5.5, CI 1.7–12.5, p = 0.001). The stroke rate in patients with both prior stroke and extent A or C coverage was 27.7%. Severe atheromatous disease involving the aortic arch by computed tomographic scan was strongly associated with perioperative stroke (OR = 14.8, CI 1.7 to 675.6, p = 0.0016). Transesophageal echocardiography demonstrated mobile atheroma in two patients with stroke. Conclusions Stroke after TEVAR was associated with a high mortality. The TEVAR of the proximal descending aorta (extent A or C) in patients with a history of stroke had the highest perioperative stroke rate. These risk factors, together with high grade aortic atheroma of the aortic arch, predicted a high probability for cerebral embolization and can be used to identify patients at high risk for stroke as a consequence of TEVAR.

Calcification of glutaraldehyde-treated bioprosthetic heart valves is a major cause of long-term failure. We studied porcine aortic valves treated by the L-Hydro process and implanted into 14 juvenile sheep (group 1). Another 10 sheep were implanted with glutaraldehyde-treated porcine bioprostheses (group 2). The animals were sacrificed after 150 days and the explanted valves were analyzed for calcification. Hemodynamic measurements by echocardiography and angiography were carried out prior to sacrifice. Macroscopic analysis showed calcification and loss of mobility of the leaflets in all group 2 implants and in one group 1 implant. Light microscopy showed foci of calcification in all group 2 implants and in 3 valves from group 1. A significant reduction in the level of calcification was found in porcine bioprostheses treated by the L-Hydro process and implanted into the juvenile sheep model.

The objectives of this study were to test the predictive power of self-control theory for delinquency in a Chinese context, and to explore if social factors as predicted in social bonding theory, differential association theory, general strain theory, and labeling theory have effects on delinquency in the presence of self-control. Self-report data were collected from 1,015 Chinese secondary school students (463 boys and 552 girls) in Hong Kong aged between 14 and 19. Bivariate results showed that low self-control is correlated with delinquency in the Chinese setting. We also found that low self-control is linked to a range of negative social conditions in Chinese adolescents, including disrupted social bonds, delinquent association, deviant definition, educational under-achievement, coercive parenting, negative school experiences, negative relations with peers, stressful life events, and labeling by parents and teachers. However, contrary to self-control theory and many previous studies based on Western samples, self-control fails to predict delinquency when social variables are controlled for among Chinese adolescents. The effects of social factors on delinquency remain significant net of self-control. This suggests that it is the combination of self-control and social factors in the prediction of delinquency that might be variant across cultures. These findings from adolescents from Hong Kong only partially support the culture-free thesis of self-control theory. The implications of Chinese cultural forces on the influence of self-control merit closer attention.

Background: Intussusception is one of the most common causes of intestinal obstruction in infancy. Non-operative reduction using air enema or other hydrostatic reduction methods has been the standard treatment in most cases. However, if the non-operative method is not indicated or fails, open surgery is still necessary. With the tremendous development of the minimally invasive approach in handling surgical conditions in children in the last decade, this has been applied recently for the reduction of intussusception in children. We herein reviewed our experience of using the combined approach, namely, pneumatic reduction and, if failed, laparoscopic reduction in the management of childhood intussusception. Methods: We carried out a retrospective analysis of all children with intussusception managed at Prince of Wales Hospital between December 1998 and December 2004. The minimally invasive approach was used as far as possible. The method of reduction, success rate and the incidence of complication were analysed. Results: Over a 6-year period, there were 146 patients with 167 episodes of intussusception. Pneumatic reduction was carried out in 160 occasions and was successful in 134 (83.8%). In 33 patients, operative reduction was required. Of these, laparoscopic reduction was attempted in 15 and was successful in 13 (86.7%). In those with either pneumatic or laparoscopic reduction, no procedure-related complication was encountered and they had a significant shorter hospital stay (median 3.0 day) than those requiring laparotomy (median 8.0 day) (t-test, P

BACKGROUND: Cyanide toxicity is a complication of sodium nitroprusside administration. Cardiac surgery may increase the risk of cyanide toxicity, because hemolysis during cardiopulmonary bypass (CPB) may catalyze the release of free cyanide from sodium nitroprusside. METHODS: We obtained serial blood specimens from 25 cardiac surgical patients during CPB. Plasma specimens were analyzed for free hemoglobin concentration and ability to generate free cyanide anion upon exposure to sodium nitroprusside. RESULTS: Hemolysis based on plasma-free hemoglobin concentration increased over time during CPB at an average rate of 0.27 mg x dL(-1) x min(-1) (P < 0.001). The concentration of free cyanide generated by the addition of sodium nitroprusside to the plasma samples was directly related to the plasma-free hemoglobin concentration (P < 0.001). CONCLUSION: CPB-associated hemolysis and free hemoglobin release accelerated the immediate release of free cyanide from sodium nitroprusside. These in vitro findings suggest that cardiac surgical patients may be at increased risk of cyanide toxicity in response to the perioperative administration of sodium nitroprusside.

A two-point maximum entropy regularization method (TPMEM) was investigated for signal enhancement of magnetoencephalography (MEG) data, as a potential replacement for current low-pass (LP) filtering techniques. TPMEM was found to have superior noise reduction and signal recovery capabilities over the LP filter, and MEG data processed with TPMEM yields less error in reconstructed dipole position and orientation.

Magnetoencephalography (MEG) was recorded while 5-7 year-old children were performing a visual-spatial memory recognition task. Full-term children showed greater gamma-band (30-50 Hz) amplitude in the right temporal region during the task, than children who were born extremely preterm. These results may represent altered brain processing in extremely preterm children who escape major impairment.

Room temperature measurements were made of electrical conductivity (σ), Hall coefficient (RH) and Seebeck coefficient (α) on filamentary samples of p-type CuInSe2 and CuIn1−xGaxSe2 with x⩽0.3, cut from vertically grown Bridgman ingots. Analysis of the results was done on a two-carrier basis, due to the higher ratio of electron to hole mobility (b) in these materials compared to elemental semiconductors. This treatment yielded a preferred b-value of 5 and to lower calculated hole concentrations than (RHe)−1 and higher hole mobilities than RHσ, based on a one-carrier interpretation. This effect was particularly marked in p-type samples with a hole concentration below 1017 cm−3, where even a few percent of minority electrons can play an important role.

Histogram feature representation is important in many classification applications for characterization of the statistical distribution of different pattern attributes, such as the color and edge orientation distribution in images. While the construction of these feature representations is simple, this very simplicity may compromise the classification accuracy in those cases where the original histogram does not provide adequate discriminative information for making a reliable classification. In view of this, we propose an optimization approach based on evolutionary computation (Back, Evolutionary algorithms in theory and practice, Oxford University Press, New York, 1996; Fogel, Evolutionary computation: toward a new philosophy of machine intelligence, 2nd edn. IEEE, Piscataway, NJ 1998) to identify a suitable transformation on the histogram feature representation, such that the resulting classification performance based on these features is maximally improved while the original simplicity of the representation is retained. To facilitate this optimization process, we propose a hierarchical classifier structure to demarcate the set of categories in such a way that the pair of category subsets with the highest level of dissimilarities is identified at each stage for partition. In this way, the evolutionary search process for the required transformation can be considerably simplified due to the reduced level of complexities in classification for two widely separated category subsets. The proposed approach is applied to two problems in multimedia data classification, namely the categorization of 3D computer graphics models and image classification in the JPEG compressed domain. Experimental results indicate that the evolutionary optimization approach, facilitated by the hierarchical classification process, is capable of significantly improving the classification performance for both applications based on the transformed histogram representations.

Markku Kaste ja Filip Scheperjans työryhmän jäsenenä. Background: The kidney-brain interaction has been a topic of growing interest. Past studies of the effect of kidney function on intracerebral hemorrhage (ICH) outcomes have yielded inconsistent findings. Although the second, main phase of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) suggests the effectiveness of early intensive blood pressure (BP) lowering in improving functional recovery after ICH, the balance of potential benefits and harms of this treatment in those with decreased kidney function remains uncertain. Study Design: Secondary analysis of INTERACT2, which randomly assigned patients with ICH with elevated systolic BP (SBP) to intensive (target SBP 90, 60-90, and Outcomes: The effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms. Results: Of 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P = 0.5 for homogeneity). Limitations: Generalizability issues arising from a clinical trial population. Conclusions: Decreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs. Am J Kidney Dis. 68(1): 94-102. (C) 2016 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY-NC-ND license.

We present evidence of amplified emission mediated by surface plasmon polaritons (SPPs) from a CdS0.2Se0.8 nanoribbon (NR) supported on a gold-coated silicon substrate. Room temperature amplified emission is observed from the nanoribbon above excitation irradiances ~25 W/cm2 when it is supported on the gold coated silicon substrate. The nanoribbon is shown to act as a resonator cavity, leading to amplification of discrete wavelengths in the emission spectrum. Evidence for the formation of SPP waves between the gold-coated substrate and the nanoribbon is shown and the resulting wavenumber increase allows for the matching of theoretical resonance wavelengths with those observed experimentally.