6,475 research outputs found

    Clinical case seminar - Hypogonadotropic hypogonadism as a presenting feature of late-onset X-linked adrenal hypoplasia congenita

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    Mutations in the orphan nuclear receptor DAX-1 cause X-linked adrenal hypoplasia congenita. Affected boys usually present with primary adrenal failure in early infancy or childhood. Impaired sexual development because of hypogonadotropic hypogonadism becomes apparent at the time of puberty. We report adult-onset adrenal hypoplasia congenita in a patient who presented with hypogonadism at 28 yr of age. Although he had no clinical evidence of adrenal dysfunction, compensated primary adrenal failure was diagnosed by biochemical testing. Semen analysis showed azoospermia, and he did not achieve fertility after 8 months of treatment with gonadotropins. A novel Y380D DAX-1 missense mutation, which causes partial loss of function in transient gene expression assays, was found in this patient. This case demonstrates that partial loss-of-function mutations in DAX1 can present with hypogonadotropic hypogonadism and covert adrenal failure in adulthood. Further, an important role for DAX-1 in spermatogenesis in humans is confirmed, supporting findings in the Dax1 (Ahch) knockout mouse

    Bayesian system identification of MDOF nonlinear systems using highly informative training data

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    The aim of this paper is to utilise the concept of “highly informative training data” such that, using Markov chain Monte Carlo (MCMC) methods, one can apply Bayesian system identification to multi-degree-of-freedom nonlinear systems with relatively little computational cost. Specifically, the Shannon entropy is used as a measure of information content such that, by analysing the information content of the posterior parameter distribution, one is able to select and utilise a relatively small but highly informative set of training data (thus reducing the cost of running MCMC)

    Snapshot Provisioning of Cloud Application Stacks to Face Traffic Surges

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    Traffic surges, like the Slashdot effect, occur when a web application is overloaded by a huge number of requests, potentially leading to unavailability. Unfortunately, such traffic variations are generally totally unplanned, of great amplitude, within a very short period, and a variable delay to return to a normal regime. In this report, we introduce PeakForecast as an elastic middleware solution to detect and absorb a traffic surge. In particular, PeakForecast can, from a trace of queries received in the last seconds, minutes or hours, to detect if the underlying system is facing a traffic surge or not, and then estimate the future traffic using a forecast model with an acceptable precision, thereby calculating the number of resources required to absorb the remaining traffic to come. We validate our solution by experimental results demonstrating that it can provide instantaneous elasticity of resources for traffic surges observed on the Japanese version of Wikipedia during the Fukushima Daiichi nuclear disaster in March 2011.Les pics de trafic, tels que l'effet Slashdot, apparaissent lorsqu'une application web doit faire face un nombre important de requêtes qui peut potentiellement entraîner une mise hors service de l'application. Malheureusement, de telles variations de traffic sont en général totalement imprévues et d'une grande amplitude, arrivent pendant une très courte période de temps et le retour à un régime normal prend un délai variable. Dans ce rapport, nous présentons PeakForecast qui est une solution intergicielle élastique pour détecter et absorber les pics de trafic. En particulier, PeakForecast peut, à partir des traces de requêtes reçues dans les dernières secondes, minutes ou heures, détecter si le système sous-jacent fait face ou non à un pic de trafic, estimer le trafic futur en utilisant un modèle de prédiction suffisamment précis, et calculer le nombre de ressources nécessaires à l'absorption du trafic restant à venir. Nous validons notre solution avec des résultats expérimentaux qui démontrent qu'elle fournit une élasticité instantanée des ressources pour des pics de trafic qui ont été observés sur la version japonaise de Wikipedia lors de l'accident nucléaire de Fukushima Daiichi en mars 2011

    An extragalactic supernebula confined by gravity

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    Little is known about the origins of the giant star clusters known as globular clusters. How can hundreds of thousands of stars form simultaneously in a volume only a few light years across the distance of the sun to its nearest neighbor? Radiation pressure and winds from luminous young stars should disperse the star-forming gas and disrupt the formation of the cluster. Globular clusters in our Galaxy cannot provide answers; they are billions of years old. Here we report the measurement of infrared hydrogen recombination lines from a young, forming super star cluster in the dwarf galaxy, NGC 5253. The lines arise in gas heated by a cluster of an estimated million stars, so young that it is still enshrouded in gas and dust, hidden from optical view. We verify that the cluster contains 4000-6000 massive, hot "O" stars. Our discovery that the gases within the cluster are bound by gravity may explain why these windy and luminous O stars have not yet blown away the gases to allow the cluster to emerge from its birth cocoon. Young clusters in "starbursting" galaxies in the local and distant universe may be similarly gravitationally confined and cloaked from view.Comment: Letter to Natur

    Discovery of lead compounds targeting the bacterial sliding clamp using a fragment-based approach

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    The bacterial sliding clamp (SC), also known as the DNA polymerase III β subunit, is an emerging antibacterial target that plays a central role in DNA replication, serving as a protein-protein interaction hub with a common binding pocket to recognize linear motifs in the partner proteins. Here, fragment-based screening using X-ray crystallography produced four hits bound in the linear-motif-binding pocket of the Escherichia coli SC. Compounds structurally related to the hits were identified that inhibited the E. coli SC and SC-mediated DNA replication in vitro. A tetrahydrocarbazole derivative emerged as a promising lead whose methyl and ethyl ester prodrug forms showed minimum inhibitory concentrations in the range of 21-43 μg/mL against representative Gram-negative and Gram-positive bacteria species. The work demonstrates the utility of a fragment-based approach for identifying bacterial sliding clamp inhibitors as lead compounds with broad-spectrum antibacterial activity. © 2014 American Chemical Society

    The Cost-Effectiveness of Early Access to HIV Services and Starting cART in the UK 1996–2008

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    To calculate use, cost and cost-effectiveness of people living with HIV (PLHIV) starting routine treatment and care before starting combination antiretroviral therapy (cART) and PLHIV starting first-line 2NRTIs+NNRTI or 2NRTIs+PI(boosted), comparing PLHIV with CD4≤200 cells/mm3 and CD4>200 cells/mm3. Few studies have calculated the use, cost and cost-effectiveness of routine treatment and care before starting cART and starting cART above and below CD4 200 cells/mm3.Use, costs and cost-effectiveness were calculated for PLHIV in routine pre-cART and starting first-line cART, comparing CD4≤200 cells/mm3 with CD4>200 cells/mm3 (2008 UK prices).cART naïve patients CD4≤200 cells/mm3 had an annual cost of £6,407 (95%CI £6,382 to £6,425) PPY compared with £2,758 (95%CI £2,752 to £2,761) PPY for those with CD4>200 cells/mm3; cost per life year gained of pre-cART treatment and care for those with CD4>200 cells/mm3 was £1,776 (cost-saving to £2,752). Annual cost for starting 2NRTIs+NNRTI or 2NRTIs+PI(boosted) with CD4≤200 cells/mm3 was £12,812 (95%CI £12,685-£12,937) compared with £10,478 (95%CI £10,376-£10,581) for PLHIV with CD4>200 cells/mm3. Cost per additional life-year gained on first-line therapy for those with CD4>200 cells/mm3 was £4639 (£3,967 to £2,960).PLHIV starting to use HIV services before CD4≤200 cells/mm3 is cost-effective and enables them to be monitored so they start cART with a CD4>200 cells/mm3, which results in better outcomes and is cost-effective. However, 25% of PLHIV accessing services continue to present with CD4≤200 cells/mm3. This highlights the need to investigate the cost-effectiveness of testing and early treatment programs for key populations in the UK

    Initial conditions, Discreteness and non-linear structure formation in cosmology

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    In this lecture we address three different but related aspects of the initial continuous fluctuation field in standard cosmological models. Firstly we discuss the properties of the so-called Harrison-Zeldovich like spectra. This power spectrum is a fundamental feature of all current standard cosmological models. In a simple classification of all stationary stochastic processes into three categories, we highlight with the name ``super-homogeneous'' the properties of the class to which models like this, with P(0)=0P(0)=0, belong. In statistical physics language they are well described as glass-like. Secondly, the initial continuous density field with such small amplitude correlated Gaussian fluctuations must be discretised in order to set up the initial particle distribution used in gravitational N-body simulations. We discuss the main issues related to the effects of discretisation, particularly concerning the effect of particle induced fluctuations on the statistical properties of the initial conditions and on the dynamical evolution of gravitational clustering.Comment: 28 pages, 1 figure, to appear in Proceedings of 9th Course on Astrofundamental Physics, International School D. Chalonge, Kluwer, eds N.G. Sanchez and Y.M. Pariiski, uses crckapb.st pages, 3 figure, ro appear in Proceedings of 9th Course on Astrofundamental Physics, International School D. Chalonge, Kluwer, Eds. N.G. Sanchez and Y.M. Pariiski, uses crckapb.st

    Cardiovascular magnetic resonance of myocardial infarction after blunt chest trauma: a heartbreaking soccer-shot

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    Cardiac injury occasionally occurs as a result of blunt chest trauma. Most cardiac complications in chest trauma are due to myocardial contusion rather than direct damage to the coronary arteries. However, traumatic coronary injury has been reported, and a variety of underlying pathophysiological mechanisms have been proposed. We present a 26 year old patient presenting with an acute coronary syndrome as a consequence of a soccer-shot impact to the chest. CMR showed apical inferior infarction, as well as multiple small septal lesions which were presumed to have resulted from embolization. The culprit lesion was a proximal 75% LAD stenosis with a prominent plaque-rupture and thrombus-formation, and the distal LAD was occluded by thromboembolic material
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