Use of an Extracorporeal Femoral-carotid Shunt in the Management of Complex Supra-aortic Disease

AbstractManagement of symptomatic multifocal supra-aortic atherosclerotic disease presents a complex surgical challenge. We describe a novel approach where a temporary extra-corporeal femoro-carotid shunt was used to maintain cerebral perfusion during hybrid surgical and endovascular treatment for tandem supra-aortic lesions

Estimation of the Health Impact and Cost-Effectiveness of Influenza Vaccination with Enhanced Effectiveness in Canada

INTRODUCTION: The propensity for influenza viruses to mutate and recombine makes them both a familiar threat and a prototype emerging infectious disease. Emerging evidence suggests that the use of MF59-adjuvanted vaccines in older adults and young children enhances protection against influenza infection and reduces adverse influenza-attributable outcomes compared to unadjuvanted vaccines. The health and economic impact of such vaccines in the Canadian population are uncertain. METHODS: We constructed an age-structured compartmental model simulating the transmission of influenza in the Canadian population over a ten-year period. We compared projected health outcomes (quality-adjusted life years (QALY) lost), costs, and incremental cost-effectiveness ratios (ICERs) for three strategies: (i) current use of unadjuvanted trivalent influenza vaccine; (ii) use of MF59-adjuvanted influenza vaccine adults ≥65 in the Canadian population, and (iii) adjuvanted vaccine used in both older adults and children aged < 6. RESULTS: In the base case analysis, use of adjuvanted vaccine in older adults was highly cost-effective (ICER = $2111/QALY gained), but such a program was "dominated" by a program that extended the use of adjuvanted vaccine to include young children (ICER =$1612/QALY). Results were similar whether or not a universal influenza immunization program was used in other age groups; projections were robust in the face of wide-ranging sensitivity analyses. INTERPRETATION: Based on the best available data, it is projected that replacement of traditional trivalent influenza vaccines with MF59-adjuvanted vaccines would confer substantial benefits to vaccinated and unvaccinated individuals, and would be economically attractive relative to other widely-used preventive interventions

A field study of team working in a new human supervisory control system

This paper presents a case study of an investigation into team behaviour in an energy distribution company. The main aim was to investigate the impact of major changes in the company on system performance, comprising human and technical elements. A socio-technical systems approach was adopted. There were main differences between the teams investigated in the study: the time of year each control room was studied (i.e. summer or winter),the stage of development each team was in (i.e. 10 months), and the team structure (i.e. hierarchical or heterarchical). In all other respects the control rooms were the same: employing the same technology and within the same organization. The main findings were: the teams studied in the winter months were engaged in more `planning’ and `awareness’ type of activities than those studies in the summer months. Newer teams seem to be engaged in more sharing of information than older teams, which maybe indicative of the development process. One of the hierarchical teams was engaged in more `system-driven’ activities than the heterarchical team studied at the same time of year. Finally, in general, the heterarchical team perceived a greater degree of team working culture than its hierarchical counterparts. This applied research project confirms findings from laboratory research and emphasizes the importance of involving ergonomics in the design of team working in human supervisory control

A family of nitrogen enriched metal organic frameworks with CCS potential

Materials with enhanced carbon capture capacities are required to advance post-combustive amelioration methods; these are necessary to reduce atmospheric carbon dioxide emissions and the associated rate of global temperature increase. Current technologies tend to be very energy intensive processes with high levels of waste produced; this work presents three new metal organic framework materials with embedded Lewis base functionalities, imparted by the nitrogen-rich ligand, demonstrating an affinity for carbon dioxide. Thus , we report the synthesis and characterization of a series of metal organic framework materials using a range of metal centers (Co, Ni, and Zn) with the 1,4-bis(pyridin-4-yl)-1,2,4,5-tetrazine organic linker, in the presence of ammonium hexafluorosilicate. Three distinct crystal structures are reported for Zn-pytz(hydro) 1D chains, and Ni-pytz and Co-pytz isostructural 1D Ladders. Co-pytz shows an uptake of 47.53mg CO2/g of sorbent, which equates to 15 wt % based on available nitrogen sites within the structure, demonstrating potential for carbon capture applications

Unexpected selective gas adsorption on a 'non-porous' metal organic framework

A metal organic framework Cu(tpt)BF 4· 3 4 H 2O was synthesized as a potential carbon capture material, with the aim being to exploit the Lewis base interaction of the incorporated ligand functionalities with acidic gas. The material displays high thermal stability but an exceptionally low surface area; however, this contrasts starkly with its ability to capture carbon dioxide, demonstrating significant activated diffusion within the framework. The full characterization of the material shows a robust structure, where the CO 2 sorption is 120% greater than current industrial methods using liquid amine solutions; the thermal energy required for sorbent regeneration is reduced by 65%, indicating the true industrial potential of the synthesized material

miR-21-mediated regulation of 15-hydroxyprostaglandin dehydrogenase in colon cancer

This work is licensed under a Creative Commons Attribution 4.0 International License.Elevated prostaglandin E2 (PGE2) levels are observed in colorectal cancer (CRC) patients, and this increase is associated with poor prognosis. Increased synthesis of PGE2 in CRC has been shown to occur through COX-2-dependent mechanisms; however, loss of the PGE2-catabolizing enzyme, 15-hydroxyprostaglandin dehydrogenase (15-PGDH, HPGD), in colonic tumors contributes to increased prostaglandin levels and poor patient survival. While loss of 15-PGDH can occur through transcriptional mechanisms, we demonstrate that 15-PGDH can be additionally regulated by a miRNA-mediated mechanism. We show that 15-PGDH and miR-21 are inversely correlated in CRC patients, with increased miR-21 levels associating with low 15-PGDH expression. 15-PGDH can be directly regulated by miR-21 through distinct sites in its 3′ untranslated region (3′UTR), and miR-21 expression in CRC cells attenuates 15-PGDH and promotes increased PGE2 levels. Additionally, epithelial growth factor (EGF) signaling suppresses 15-PGDH expression while simultaneously enhancing miR-21 levels. miR-21 inhibition represses CRC cell proliferation, which is enhanced with EGF receptor (EGFR) inhibition. These findings present a novel regulatory mechanism of 15-PGDH by miR-21, and how dysregulated expression of miR-21 may contribute to loss of 15-PGDH expression and promote CRC progression via increased accumulation of PGE2.NIH R01 CA134609NIH R01 AR069044NIH/NCI Cancer Center Support Grant (P30 CA168524)New Jersey Commission on Cancer ResearchAmerican Heart Association (15GRNT23240019

Compound Ranking Based on a New Mathematical Measure of Effectiveness Using Time Course Data from Cell-Based Assays

The half maximal inhibitory concentration (IC50) has several limitations that make it unsuitable for examining a large number of compounds in cytotoxicity studies, particularly when multiple exposure periods are tested. This article proposes a new approach to measure drug effectiveness, which allows ranking compounds according to their toxic effects on live cells. This effectiveness measure, which combines all exposure times tested, compares the growth rates of a particular cell line in the presence of the compound with its growth rate in the presence of DMSO alone. Our approach allows measuring a wider spectrum of toxicity than the IC50 approach, and allows automatic analyses of a large number of compounds. It can be easily implemented in linear regression software, provides a comparable measure of effectiveness for each investigated compound (both toxic and non-toxic), and allows statistically testing the null hypothesis that a compound is non-toxic versus the alternative that it is toxic. Importantly, our approach allows defining an automated decision rule for deciding whether a compound is significantly toxic. As an illustration, we describe the results of a cell-based study of the cytotoxicity of 24 analogs of novobiocin, a C-terminal inhibitor of heat shock protein 90 (Hsp90); the compounds were ranked in order of cytotoxicity to a panel of 18 cancer cell lines and 1 normal cell line. Our approach may also be a good alternative to computing the half maximal effective concentration (EC50) in studies searching for compounds that promote cell growth

Distributed situation awareness in dynamic systems: Theoretical development and application of an ergonomics methodology

The purpose of this paper is to propose foundations for a theory of situation awareness based on the analysis of interactions between agents (i.e., both human and non-human) in subsystems. This approach may help promote a better understanding of technology-mediated interaction in systems, as well as helping in the formulation of hypotheses and predictions concerning distributed situation awareness. It is proposed that agents within a system each hold their own situation awareness which may be very different from (although compatible with) other agents. It is argued that we should not always hope for, or indeed want, sharing of this awareness, as different system agents have different purposes. This view marks situation awareness as a 1 dynamic and collaborative process that binds agents together on tasks on a moment-by-moment basis. Implications of this viewpoint for development of a new theory of, and accompanying methodology for, distributed situation awareness are offered

Central Nervous System Function in Youth With Type 1 Diabetes 12 Years After Disease Onset

OBJECTIVE—In this study, we used neurocognitive assessment and neuroimaging to examine brain function in youth with type 1 diabetes studied prospectively from diagnosis

Validation of the Dutch version of the Multidimensional Adolescent Functioning Scale (MAFS)

Background: The Multidimensional Adolescent Functioning Scale (MAFS) is a 23-item, self-report questionnaire assessing psychosocial functioning in adolescents aged 12-17 years. It captures three domains of functioning: \u27general functioning\u27, \u27family-related functioning\u27, and \u27peer-related functioning\u27. The original English version has good psychometric properties. The aim of the current paper was to translate the MAFS to Dutch and to investigate the psychometric properties of this translation. Methods: After translation, the Dutch MAFS was assessed in 397 adolescents aged 12-17 years, assessed at schools. Internal consistency, factor structure and correlations with other questionnaires assessing functioning, psychopathology and well-being were investigated. Results: A hierarchical/bifactor model with a general factor that loads on all items (MAFS-general) and three group factors, loading respectively on the GF, FF and PF items, was found to describe the data best. Internal consistency of the MAFS total score (&alpha; = 0.87) was good and of the subscales (&alpha; = 0.74-0.80) acceptable. Comparable alphas were found in males and females. Correlations between MAFS subscales ranged from 0.33 to 0.43, indicating sufficient differentiation. The MAFS general factor score and group factor scores showed positive correlations with other measures of good functioning and well-being, and negative correlations with measures of psychopathology, supporting convergent and divergent validity. Conclusions: The Dutch translation of the MAFS has adequate psychometric properties to assess three domains of functioning in adolescents from the general population aged 12-17 years. The MAFS is freely accessible in the Appendix and easy to administe