Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute hemoperitoneum as a result of hemorrhage from liver metastases is an uncommon but serious condition. The use of appropriate imaging is important in the diagnosis and can have a profound impact on subsequent management. This case is important because the presentation was of recurrent syncopal episodes with an unusual underlying cause. This case highlights the need to consider this diagnosis in the differential in patients presenting with collapse in the acute setting.</p> <p>Case presentation</p> <p>We present the case of an 85-year-old Caucasian man who was admitted following a collapse episode and was found to be persistently hypotensive despite aggressive resuscitation. An acute intra-peritoneal bleed originating from hepatic metastases from an unknown primary was identified promptly with computed tomography imaging and was subsequently managed conservatively.</p> <p>Conclusions</p> <p>This case aims to convey key teaching points: (A) the need to consider intra-abdominal hemorrhage in the differential diagnosis when assessing patients with collapse; and (B) the use of appropriate imaging such as computed tomography can facilitate a prompt diagnosis and appropriate management steps can then be taken accordingly.</p

Temperature dependent CO2 behavior in microporous 1-D channels of a metal-organic framework with multiple interaction sites

The MOF with the encapsulated CO2 molecule shows that the CO2 molecule is ligated to the unsaturated Cu(II) sites in the cage using its Lewis basic oxygen atom via an angular eta(1)-(O-A) coordination mode and also interacts with Lewis basic nitrogen atoms of the tetrazole ligands using its Lewis acidic carbon atom. Temperature dependent structure analyses indicate the simultaneous weakening of both interactions as temperature increases. Infrared spectroscopy of the MOF confirmed that the CO2 interaction with the framework is temperature dependent. The strength of the interaction is correlated to the separation of the two bending peaks of the bound CO2 rather than the frequency shift of the asymmetric stretching peak from that of free CO2. The encapsulated CO2 in the cage is weakly interacting with the framework at around ambient temperatures and can have proper orientation for wiggling out of the cage through the narrow portals so that the reversible uptake can take place. On the other hand, the CO2 in the cage is restrained at a specific orientation at 195 K since it interacts with the framework strong enough using the multiple interaction sites so that adsorption process is slightly restricted and desorption process is almost clogged.ope

The Galactic Center: A Laboratory for Fundamental Astrophysics and Galactic Nuclei

As the closest example of a galactic nucleus, the Galactic center presents an exquisite laboratory for learning about supermassive black holes (SMBH) and their environs. Detailed studies of stellar dynamics deep in the potential well of a galaxy, with exisiting and future large ground-based telescopes, offer several exciting directions in the coming decade. First, it will be possible to obtain precision measurements of the Galaxy's central potential, providing both a unique test of General Relativity (GR) and a detection of the extended dark matter distribution that is predicted to exist around the SMBH. Tests of gravity have not previously been possible on the mass scale of a SMBH. Similarly, only upper limits on the extended matter distribution on small scales currently exist; detection of dark matter on these scales is an important test of Lambda-CDM and the detection of stellar remnants would reveal a population that may dominate the stellar dynamics on the smallest scales. Second, our detailed view of the SMBH and its local gas and stellar environment provides insight into how SMBHs at the centers of galaxies form, grow and interact with their environs as well as on the exotic processes at work in the densest stellar clusters in the Universe. The key questions, still unanswered, of when and how SMBHs formed in the early universe, and the myriad ways in which feedback from SMBHs can affect structure formation, can be informed by directly observing the physical processes operating at the SMBH.Comment: An ASTRO2010 White Paper. Animations and high resolution images can be found at http://www.astro.ucla.edu/~ghezgroup/gc/pictures/Future_GCorbits.shtm

Intermediate and extreme mass-ratio inspirals — astrophysics, science applications and detection using LISA

Black hole binaries with extreme (gtrsim104:1) or intermediate (~102–104:1) mass ratios are among the most interesting gravitational wave sources that are expected to be detected by the proposed laser interferometer space antenna (LISA). These sources have the potential to tell us much about astrophysics, but are also of unique importance for testing aspects of the general theory of relativity in the strong field regime. Here we discuss these sources from the perspectives of astrophysics, data analysis and applications to testing general relativity, providing both a description of the current state of knowledge and an outline of some of the outstanding questions that still need to be addressed. This review grew out of discussions at a workshop in September 2006 hosted by the Albert Einstein Institute in Golm, Germany

The 2014 interferometric imaging beauty contest

This is the final version of the article. Available from SPIE via the DOI in this record.From Conference Volume 9146: Optical and Infrared Interferometry IV. Jayadev K. Rajagopal; Michelle J. Creech-Eakman; Fabien Malbet. Montréal, Quebec, Canada, June 22, 2014Here we present the results of the 6th biennial optical interferometry imaging beauty contest. Taking advantage of a unique opportunity, the red supergiant VY CMa and the Mira variable R Car were observed in the astronomical H-band with three 4-telescope configurations of the VLTI-AT array using the PIONIER instrument. The community was invited to participate in the subsequent image reconstruction and interpretation phases of the project. Ten groups submitted entries to the beauty contest, and we found reasonable consistency between images obtained from independent workers using quite different algorithms. We also found that significant differences existed between the submitted images, much greater than in past beauty contests that were all based on simulated data. A novel crowd-sourcing" method allowed consensus median images to be constructed, filtering likely artifacts and retaining real features." We definitively detect strong spots on the surfaces of both stars as well as distinct circumstellar shells of emission (likely water/CO) around R Car. In a close contest, Joel Sanchez (IAA-CSIC/Spain) was named the winner of the 2014 interferometric imaging beauty contest. This process has shown that new comers" can use publicly-available imaging software to interpret VLTI/PIONIER imaging data, as long as sufficient observations are taken to have complete uv coverage { a luxury that is often missing. We urge proposers to request adequate observing nights to collect sufficient data for imaging and for time allocation committees to recognise the importance of uv coverage for reliable interpretation of interferometric data. We believe that the result of the proposed broad international project will contribute to inspiring trust in the image reconstruction processes in optical interferometry

Evolution of form in metal-organic frameworks

Self-assembly has proven to be a widely successful synthetic strategy for functional materials, especially for metal-organic materials (MOMs), an emerging class of porous materials consisting of metal-organic frameworks (MOFs) and metal-organic polyhedra (MOPs). However, there are areas in MOM synthesis in which such self-assembly has not been fully utilized, such as controlling the interior of MOM crystals. Here we demonstrate sequential self-assembly strategy for synthesizing various forms of MOM crystals, including double-shell hollow MOMs, based on single-crystal to single-crystal transformation from MOP to MOF. Moreover, this synthetic strategy also yields other forms, such as solid, core-shell, double and triple matryoshka, and single-shell hollow MOMs, thereby exhibiting form evolution in MOMs. We anticipate that this synthetic approach might open up a new direction for the development of diverse forms in MOMs, with highly advanced areas such as sequential drug delivery/release and heterogeneous cascade catalysis targeted in the foreseeable future.ope

REST is a hypoxia-responsive transcriptional repressor

Cellular exposure to hypoxia results in altered gene expression in a range of physiologic and pathophysiologic states. Discrete cohorts of genes can be either up- or down-regulated in response to hypoxia. While the Hypoxia-Inducible Factor (HIF) is the primary driver of hypoxia-induced adaptive gene expression, less is known about the signalling mechanisms regulating hypoxia-dependent gene repression. Using RNA-seq, we demonstrate that equivalent numbers of genes are induced and repressed in human embryonic kidney (HEK293) cells. We demonstrate that nuclear localization of the Repressor Element 1-Silencing Transcription factor (REST) is induced in hypoxia and that REST is responsible for regulating approximately 20% of the hypoxia-repressed genes. Using chromatin immunoprecipitation assays we demonstrate that REST-dependent gene repression is at least in part mediated by direct binding to the promoters of target genes. Based on these data, we propose that REST is a key mediator of gene repression in hypoxia

Design, baseline characteristics, and retention of African American light smokers into a randomized trial involving biological data

<p>Abstract</p> <p>Background</p> <p>African Americans experience significant tobacco-related health disparities despite the fact that over half of African American smokers are light smokers (use ≤10 cigarettes per day). African Americans have been under-represented in smoking cessation research, and few studies have evaluated treatment for light smokers. This paper describes the study design, measures, and baseline characteristics from <it>Kick It at Swope III </it>(KIS-III), the first treatment study of bupropion for African American light smokers.</p> <p>Methods</p> <p>Five hundred forty African American light smokers were randomly assigned to receive bupropion (150mg bid) (n = 270) or placebo (n = 270) for 7 weeks. All participants received written materials and health education counseling. Participants responded to survey items and provided blood samples for evaluation of phenotype and genotype of CYP2A6 and CYP2B6 enzymes involved in nicotine and bupropion metabolism. Primary outcome was cotinine-verified 7-day point prevalence smoking abstinence at Week 26 follow-up.</p> <p>Results</p> <p>Of 2,628 individuals screened, 540 were eligible, consented, and randomized to treatment. Participants had a mean age of 46.5 years and 66.1% were women. Participants smoked an average of 8.0 cigarettes per day, had a mean exhaled carbon monoxide of 16.4ppm (range 1-55) and a mean serum cotinine of 275.8ng/ml. The mean Fagerström Test for Nicotine Dependence was 3.2, and 72.2% of participants smoked within 30 minutes of waking. The average number of quit attempts in the past year was 3.7 and 24.2% reported using pharmacotherapy in their most recent quit attempt. Motivation and confidence to quit were high.</p> <p>Conclusion</p> <p>KIS-III is the first study designed to examine both nicotine and bupropion metabolism, evaluating CYP2A6 and CYP2B6 phenotype and genotype in conjunction with psychosocial factors, in the context of treatment of African American light smokers. Of 1629 smokers screened for study participation, only 18 (1.1%) were ineligible to participate in the study because they refused blood draws, demonstrating the feasibility of recruiting and enrolling African American light smokers into a clinical treatment trial involving biological data collection and genetic analyses. Future evaluation of individual factors associated with treatment outcome will contribute to advancing tailored tobacco use treatment with the goal of enhancing treatment and reducing health disparities for African American light smokers.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="URL">NCT00666978</a></p