Esophageal Mapping and Temperature Regulation for Catheter Ablation

The purpose of this document is to provide a development summary for a proposed esophageal temperature mapping device used during catheter ablation. Catheter ablation therapy is performed in the left atria with hot or cold materials to create scar tissue to treat atrial fibrillation. However, utilized temperatures and absorbed energies from the catheter can cause undesired esophageal damage. Therefore, this medical device is designed to monitor esophageal temperature and map its location during catheter ablation. If dangerous temperatures are reached, the device will alarm the surgeon. This document provides an in-depth overview of the esophageal temperaturemapping device’s development and contains seven sections: introduction and background, customer requirements and design specifications, stage gate process, description of final prototype design, prototype development, IQ/OQ/PQ, and conclusions and recommendations

There are three major Neisseria gonorrhoeae β-lactamase plasmid variants which are associated with specific lineages and carry distinct TEM alleles

Neisseria gonorrhoeae is a significant threat to global health with an estimated incidence of over 80 million cases each year and high levels of antimicrobial resistance. The gonococcal β-lactamase plasmid, pbla, carries the TEM β-lactamase, which requires only one or two amino acid changes to become an extended-spectrum β-lactamase (ESBL); this would render last resort treatments for gonorrhoea ineffective. Although pbla is not mobile, it can be transferred by the conjugative plasmid, pConj, found in N. gonorrhoeae. Seven variants of pbla have been described previously, but little is known about their frequency or distribution in the gonococcal population. We characterised sequences of pbla variants and devised a typing scheme, Ng_pblaST that allows their identification from whole genome short-read sequences. We implemented Ng_pblaST to assess the distribution of pbla variants in 15 532 gonococcal isolates. This demonstrated that only three pbla variants commonly circulate in gonococci, which together account for >99 % of sequences. The pbla variants carry different TEM alleles and are prevalent in distinct gonococcal lineages. Analysis of 2758 pbla-containing isolates revealed the co-occurrence of pbla with certain pConj types, indicating co-operativity between pbla and pConj variants in the spread of plasmid-mediated AMR in N. gonorrhoeae. Understanding the variation and distribution of pbla is essential for monitoring and predicting the spread of plasmid-mediated β-lactam resistance in N. gonorrhoeae

The clinical significance and impact of interleukin 15 on keratinocyte cell growth and migration

Chronic wounds represent a significant burden to health services and are associated with patient morbidity. Novel methods to diagnose and/or treat problematic wounds are needed. Interleukin (IL)-15 is a cytokine involved in a number of biological processes and disease states such as inflammation, healing and cancer progression. The current study explores the expression profile of IL-15 and IL-15 receptor α (IL-15Rα) in chronic wounds and its impact on keratinocytes. IL-15 and IL-15Rα expression were examined in healing and non-healing chronic wounds using qPCR and immunohistochemical analysis. The impact of recombinant IL-15 (rhIL-15) on human adult low calcium temperature (HaCaT) keratinocyte growth and migratory potential was further examined. IL-15 transcript expression was slightly, though non-significantly elevated in healing chronic wounds compared with non-healing chronic wounds. IL-15 protein staining was minimal in both subtypes of chronic wounds. By contrast, IL-15Rα transcript and protein expression were both observed to be enhanced in non-healing chronic wounds compared with healing chronic wounds. The treatment of HaCaT cells with rhIL-15 generally enhanced cell growth and promoted migration. Analysis with small molecule inhibitors suggested that the pro-migratory effect of rhIL-15 may be associated with ERK, AKT, PLCγ and FAK signalling. IL-15 may promote healing traits in keratinocytes and the differential expression of IL-15Rα is observed in chronic wounds. Together, this may imply a complex role for this interleukin in wound healing

Assessing a Monitoring Scale of Physiological Health and Risk Assessment Among Those Exposed to Heated Environments: A Brief Report

Background: Prevention of heat illness is of considerable medical interest within the field of occupational work. There are many established methods of perceptual health assessment; however, many are rather unpractical and timely. The objective was to improve the practicality and timeliness of perceptual physiological monitoring; a Heat Thermal Sensation scale has been developed. The usefulness of the scale was assessed on its ability to monitor physiological variable. Materials and Methods: Ten apparently healthy individuals performed physically exerting activity while exposed to 37 °C. Sensation and physiology were measured throughout. Results: The perceptual monitoring scale demonstrated weak positive correlations with human physiological variables including cardiorespiratory stresses. It demonstrated no correlation with thermoregulation stress. Conclusion: The scale needs further development to better improve heat illness practices to those commonly exposed in extreme heat during occupational work

Reef fishes weaken dietary preferences after coral mortality, altering resource overlap

The direct and indirect effects of climate change can affect, and are mediated by, changes in animal behaviour. However, we often lack sufficient empirical data to assess how large-scale disturbances affect the behaviour of individuals, which scales up to influence communities. Here, we investigate these patterns by focusing on the foraging behaviour of butterflyfishes, prominent coral-feeding fishes on coral reefs, before and after a mass coral bleaching event in Iriomote, Japan. In response to 65% coral mortality, coral-feeding fishes broadened their diets, showing a significant weakening of dietary preferences across species. Multiple species reduced their consumption of bleaching-sensitive Acropora corals, while expanding their diets to consume a variety of other coral genera. This resulted in decreased dietary overlap among butterflyfishes. Behavioural changes in response to bleaching may increase resilience of coral reef fishes in the short term. However, coral mortality has reduced populations of coral-feeders world-wide, indicating the changes in feeding behaviour we document here may not be sufficient to ensure long-term resilience of butterflyfishes on coral reefs

Manacled to Identity: Cosmopolitanism, Class, and ‘The Culture Concept’ in Stephen Crane

This article begins with a close reading of Stephen Crane’s short story ‘Manacled’ from 1900, which situates this rarely considered short work within the context of contemporary debates about realism. I then proceed to argue that many of the debates raised by the tale have an afterlife in our own era of American literary studies, which has frequently focused on questions of ‘identity’ and ‘culture’ in its reading of realism and naturalism to the exclusion of the importance of cosmopolitan discourses of diffusion and exchange across national borders. I then offer a brief reading of Crane’s novel George’s Mother, which follows Walter Benn Michaels in suggesting that the recent critical attention paid to particularities of cultural difference in American studies have come to conflate ideas of class and social position with ideas of culture in ways that have ultimately obscured the presence of genuine historical inequalities in US society. In order to challenge this critical commonplace, I situate Crane’s work within a history of transatlantic cosmopolitanism associated with the ideas of Franz Boas and Matthew Arnold to demonstrate the ways in which Crane’s narratives sought out an experience of the universal within their treatments of the particular

Serum Galactose-Deficient IgA1 Level Is Not Associated with Proteinuria in Children with IgA Nephropathy

Introduction. Percentage of galactose-deficient IgA1 (Gd-IgA1) relative to total IgA in serum was recently reported to correlate with proteinuria at time of sampling and during follow-up for pediatric and adult patients with IgA nephropathy. We sought to determine whether this association exists in another cohort of pediatric patients with IgA nephropathy. Methods. Subjects were younger than 18 years at entry. Blood samples were collected on one or more occasions for determination of serum total IgA and Gd-IgA1. Gd-IgA1 was expressed as serum level and percent of total IgA. Urinary protein/creatinine ratio was calculated for random specimens. Spearman's correlation coefficients assessed the relationship between study variables. Results. The cohort had 29 Caucasians and 11 African-Americans with a male : female ratio of 1.9 : 1. Mean age at diagnosis was 11.7 ± 3.7 years. No statistically significant correlation was identified between serum total IgA, Gd-IgA1, or percent Gd-IgA1 versus urinary protein/creatinine ratio determined contemporaneously with biopsy or between average serum Gd-IgA1 or average percent Gd-IgA1 and time-average urinary protein/creatinine ratio. Conclusion. The magnitude of proteinuria in this cohort of pediatric patients with IgA nephropathy was influenced by factors other than Gd-IgA1 level, consistent with the proposed multi-hit pathogenetic pathways for this renal disease

nWASP Inhibition Increases Wound Healing via TrKb/PLCγ Signalling

Background: Chronic wounds represent a major burden to patients and healthcare systems and identifying new therapeutic targets to encourage wound healing is a significant challenge. This study evaluated nWASP as a new therapeutic target in human wound healing and determined how this can be regulated. (2) Methods: Clinical cohorts from patients with chronic wounds were tested for the expression of nWASP and cell models were employed to evaluate the influence of nWASP on cellular functions that are key to the healing process following knockdown and/or the use of nWASP-specific inhibitors. (3) Results: nWASP was significantly elevated at transcript levels in human non-healing chronic wounds versus healing tissues. nWASP inhibitors, wiskostatin and 187-1, along with the knockdown of nWASP, modified both HaCaT and HECV cell behaviour. We then identified two signalling pathways affected by nWASP inhibition: TrkB signalling and downstream PLCγ1 phosphorylation were impaired by nWASP inhibition in HaCaT cells. The healing of wounds in a diabetic murine model was significantly improved with an nWASP inhibitor treatment. (4) Conclusions: This study showed that nWASP activity was related to the non-healing behaviour of chronic wounds and together with the findings in the in vivo models, it strongly suggested nWASP as a therapeutic target in non-healing wounds that are regulated via TrkB and PLCγ1 signalling

Suzaku Observations of Abell 1795: Cluster Emission to R_200

We report Suzaku observations of the galaxy cluster Abell 1795 that extend to r_200 ~ 2 Mpc, the radius within which the mean cluster mass density is 200 times the cosmic critical density. These observations are the first to probe the state of the intracluster medium in this object at r > 1.3 Mpc. We sample two disjoint sectors in the cluster outskirts (1.3 < r < 1.9 Mpc) and detect X-ray emission in only one of them to a limiting (3-sigma) soft X-ray surface brightness of B(0.5-2 keV) = 1.8 x 10^-12 erg s^-1 cm^-2 deg^-2, a level less than 20% of the cosmic X-ray background brightness. We trace the run of temperature with radius at r > 0.4 Mpc and find that it falls relatively rapidly (T ~ r^-0.9), reaching a value about one third of its peak at the largest radius we can measure it. Assuming the intracluster medium is in hydrostatic equilibrium and is polytropic, we find a polytropic index of 1.3 +0.3-0.2 and we estimate a mass of 4.1 +0.5-0.3 x 10^14 M_solar within 1.3 Mpc, somewhat (2.7-sigma) lower than that reported by previous observers. However, our observations provide evidence for departure from hydrostatic equilibrium at radii as small as r ~ 1.3 Mpc ~ r_500 in this apparently regular and symmetrical cluster.Comment: 19 pages, 12 figures, accepted for publication in PAS

Macrolides and lincosamides in cattle and pigs : Use and development of antimicrobial resistance

Peer reviewe