Tissue Doppler imaging following paediatric cardiac surgery : early patterns of change and relationship to outcome

In this study, tissue Doppler imaging (TDI) was used to assess changes in ventricular function following repair of congenital heart defects. The relationship between TDI indices, myocardial injury and clinical outcome was explored. Forty-five children were studied; 35 withcardiac lesions and 10 controls. TDI was performed preoperatively, on admission to paediatric intensive care unit (PICU) and day 1. Regional myocardial Doppler signals were acquired from the right ventricle (RV), left ventricle (LV) and septum. TDI indices included: peak systolicvelocities, isovolumetric velocities (IVV) and isovolumetric acceleration (IVA). Preoperatively, bi-ventricular TDI velocities in the study groupwere reduced compared with normal controls. Postoperatively, RV velocities were significantly reduced and this persisted to day-1 (PreOp vs. PICU and day-1: 7.7+2.2 vs. 3.4+1.0, P < 0.0001 and 3.55+1.29, P < 0.0001). LV velocities initially declined but recovered towards baseline by day-1 (PreOp vs. PICU: 5.31+1.50 vs. 3.51+1.23, P < 0.0001). Isovolumetric parameters in all regions were reduced throughout the postoperative period. Troponin-I release correlated with longer X-clamp times (r=0.82, P < 0.0001) and reduced RV velocities (r=0.42, P=0.028). Reduced pre- and postoperative LV velocities correlated with longer ventilation (PreOp: r=0.54, P=0.002; PostOp: r=0.42, P=0.026). This study identified reduced postoperative RV velocities correlated with myocardial injury while reduced LV TDI correlated with longer postoperative ventilation

Reactive oxygen molecule-mediated injury in endothelial and renal tubular epithelial cells in vitro

Reactive oxygen molecule-mediated injury in endothelial and renal tubular epithelial cells in vitro. To investigate renal tubular epithelial cell injury mediated by reactive oxygen molecules and to explore the relative susceptibility of epithelial cells and endothelial cells to oxidant injury, we determined cell injury in human umbilical vein endothelial cells and in four renal tubular epithelial cell lines including LLC-PK1, MDCK, OK and normal human kidney Cortical epithelial cells (NHK-C). Cells were exposed to reactive oxygen molecules including superoxide anion, hydrogen peroxide and hydroxy 1 radical generated by xanthine oxidase and hypoxanthine. We determined early sublethal injury with efflux of 3H-adenine metabolites and a decline in ATP levels, while late lytic injury and cell detachment were determined by release of51 chromium. When the cells were exposed to 25, 50, and 100 mU/ml xanthine oxidase with 5.0mM hypoxanthine, ATP levels were significantly lower (P < 0.001) in LLC-PK1, NHK-C and OK cells compared to MDCK cells while ATP levels were significantly lower (P < 0.01) in endothelial cells compared to all tubular cell lines. A similar pattern of injury was seen with efflux of 3H-adenine metabolites. When the cells were exposed to 50 mU/ml xanthine oxidase with 5.0mM hypoxanthine for five hours, total 51chromium release was significantly (P < 0.001) greater in LLC-PK1, NHK-C and OK cells compared to MDCK cells, while total 51chromium release was significantly (P < 0.001) greater in endothelial cells compared to all tubular cells. However, lytic injury was the greatest in LLC-PK1 cells and NHK-C cells while cell detachment was the greatest in endothelial cells. MDCK cells were remarkably resistant to oxidant-mediated cell detachment and cell lysis. In addition, we determined ATP levels, 3H-adenine release and 51chromium release in LLC-PK1, NHK-C and endothelial cells in the presence of superoxide dismutase to dismute superoxide anion, catalase to metabolize hydrogen peroxide, DMPO to trap hydroxyl radical and DMTU to scavenge hydrogen peroxide and hydroxyl radical. We found that catalase and DMTU (scavengers of hydrogen peroxide) provided significant protection from ATP depletion, prevented efflux of 3H-adenine metabolites and cell detachment while DMPO (scavenger of hydroxyl radical) prevented lytic injury. In addition, we found that the membrane-permeable iron chelator, phenanthroline, and preincubation with deferoxamine prevented cell detachment and cell lysis, confirming the role of hydroxyl radical in cell injury. We conclude that among tubular epithelial cells, cells with proximal tubular characteristics including LLC-PK1, NHK-C and OK cells were more susceptible to oxidant injury than MDCK cells which originate from distal tubules. Endothelial cells responded to oxidant injury with a greater fall in ATP levels, efflux of 3H-adenine metabolites and cell detachment, while tubular epithelial cells demonstrated greater cell lysis. Finally, it appears that hydrogen peroxide mediates ATP depletion and efflux of 3H-adenine metabolites while hydrogen peroxide and hydroxyl radical mediate cell detachment and cell lysis

Experts\u27 Advice to Information Systems Doctoral Students

This paper summarizes the results of a panel discussion offering advice to doctoral students in advancing through their programs and getting a start on their career. The panel was held at the 2003 Annual Conference of the Southern Association for Information Systems, and panelists included five senior MIS faculty members who, combined, have chaired over 80 dissertations. Topics included choosing a dissertation topic, dealing with the dissertation committee, completing the dissertation, the job hunt, marketability, building a publication record, and advice for new faculty

Parathyroid hormone-stimulated calcium absorption in cTAL from vitamin D-deficient rabbits

Parathyroid hormone-stimulated calcium absorption in cTAL from vitamin D-deficient rabbits. Cortical thick ascending limbs of Henle's loop were dissected from the kidneys of chronically vitamin D-deficient or -replete rabbits and perfused in vitro. Unidirectional transepithelial calcium fluxes from lumen to bath were measured with 45Ca. The tubules were bathed in a solution containing 150mM sodium and perfused with a solution containing 60mM sodium to simulate conditions in the cortical thick ascending limb in vivo. Transepithelial voltages were equal across tubules from vitamin D-deficient and -replete rabbits. Likewise, baseline and parathyroid hormone-stimulated calcium fluxes were the same in tubules from the two groups. Because calcidiol and calcitriol were undetectable in the serum of the vitamin D-deficient rabbits, we suggest that neither of these endogenous vitamin D metabolites is essential in the regulation of calcium absorption in this portion of the rabbit nephron

Equity Matters: Digital and Online Learning for Students with Disabilities

Equity Matters: Digital and Online Learning for Students with Disabilities presents some preliminary understandings from a number of Center research projects and experiences to inform the various stakeholder groups of the emerging trends, outcomes, challenges, and promising practices in this developing field of practice. Special education was founded on, and continues to operate as, a collaboration among students with disabilities, families, professionals, and policymakers. In addition, the digital education industry’s growing, major influence in this realm of education makes collaboration with this sector critical. The overall goal of this publication is to spark discussion, reflection, and debate, with a focus on enhancing understanding within all participant groups, leading to the design of more responsive systems, practices, and policy to support enhanced outcomes for all learners—especially students with disabilities

Surveying Standard Model Flux Vacua on T6/Z2×Z2T^6/Z_2\times Z_2

We consider the SU(2)LxSU(2)R Standard Model brane embedding in an orientifold of T6/Z2xZ2. Within defined limits, we construct all such Standard Model brane embeddings and determine the relative number of flux vacua for each construction. Supersymmetry preserving brane recombination in the hidden sector enables us to identify many solutions with high flux. We discuss in detail the phenomenology of one model which is likely to dominate the counting of vacua. While Kahler moduli stabilization remains to be fully understood, we define the criteria necessary for generic constructions to have fixed moduli.Comment: 30 pages, LaTeX, v2: added reference

Inflating in a Better Racetrack

We present a new version of our racetrack inflation scenario which, unlike our original proposal, is based on an explicit compactification of type IIB string theory: the Calabi-Yau manifold P^4_[1,1,1,6,9]. The axion-dilaton and all complex structure moduli are stabilized by fluxes. The remaining 2 Kahler moduli are stabilized by a nonperturbative superpotential, which has been explicitly computed. For this model we identify situations for which a linear combination of the axionic parts of the two Kahler moduli acts as an inflaton. As in our previous scenario, inflation begins at a saddle point of the scalar potential and proceeds as an eternal topological inflation. For a certain range of inflationary parameters, we obtain the COBE-normalized spectrum of metric perturbations and an inflationary scale of M = 3 x 10^{14} GeV. We discuss possible changes of parameters of our model and argue that anthropic considerations favor those parameters that lead to a nearly flat spectrum of inflationary perturbations, which in our case is characterized by the spectral index n_s = 0.95.Comment: 20 pages, 7 figures. Brief discussion on the non-gaussianity of this model, one more figure of the field trajectories added as well as other minor changes to the tex

Musical events and perceptual ecologies

This paper, followed by two responses, discusses the application of ecological theory to an understanding of a number of issues in the aesthetics of music. It argues for an understanding of music as based in event perception, with an expanded conception of the sources that are specified by those events. Building on the theory of affordances, it considers the limitations of an information theoretic conception of musical complexity, discusses the importance of perceptual learning (understood as shaping by a structured environment) in understanding the affordances of music for different listeners, and raises the challenging problem of the terms in which musical materials might be appropriately described. The apparent tension between ecological and aesthetic positions—in which adaptation and accommodation seem to be at odds with a modernist aesthetic perspective which prioritizes the unsettling and defamiliarizing function of art—is confronted, before the paper concludes with some observations about different disciplinary perspectives on aesthetics, and matters of specificity and generality