78 research outputs found

    Guest Recital

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    Localized Plasticity in the Streamlined Genomes of Vinyl Chloride Respiring Dehalococcoides

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    Vinyl chloride (VC) is a human carcinogen and widespread priority pollutant. Here we report the first, to our knowledge, complete genome sequences of microorganisms able to respire VC, Dehalococcoides sp. strains VS and BAV1. Notably, the respective VC reductase encoding genes, vcrAB and bvcAB, were found embedded in distinct genomic islands (GEIs) with different predicted integration sites, suggesting that these genes were acquired horizontally and independently by distinct mechanisms. A comparative analysis that included two previously sequenced Dehalococcoides genomes revealed a contextually conserved core that is interrupted by two high plasticity regions (HPRs) near the Ori. These HPRs contain the majority of GEIs and strain-specific genes identified in the four Dehalococcoides genomes, an elevated number of repeated elements including insertion sequences (IS), as well as 91 of 96 rdhAB, genes that putatively encode terminal reductases in organohalide respiration. Only three core rdhA orthologous groups were identified, and only one of these groups is supported by synteny. The low number of core rdhAB, contrasted with the high rdhAB numbers per genome (up to 36 in strain VS), as well as their colocalization with GEIs and other signatures for horizontal transfer, suggests that niche adaptation via organohalide respiration is a fundamental ecological strategy in Dehalococccoides. This adaptation has been exacted through multiple mechanisms of recombination that are mainly confined within HPRs of an otherwise remarkably stable, syntenic, streamlined genome among the smallest of any free-living microorganism

    Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

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    BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

    Pulse-Shape Control in an All Fiber Multi-Wavelength Doppler Lidar

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    Pulse distortion during amplification in fiber amplifiers due to gain saturation and cross talk in a multi-wavelength Doppler lidar are discussed. We present a feedback control technique which is capable of adjusting any predefined pulse shape and show some examples of feedback controlled pulse shapes

    Pulse-Shape Control in an All Fiber Multi-Wavelength Doppler Lidar

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    Pulse distortion during amplification in fiber amplifiers due to gain saturation and cross talk in a multi-wavelength Doppler lidar are discussed. We present a feedback control technique which is capable of adjusting any predefined pulse shape and show some examples of feedback controlled pulse shapes

    Pharmacy: Three Dimensional Drug Losses

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    Case 7: Hydranencephaly

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    Relationship of Fetal Ultrasound Measurements to Postnatal Anthropometric Variables and Maternal Measurements

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    Understanding of the continuity of fetal with postnatal growth and the heritability of fetal size has been based largely on studies of birth size. Because intrauterine influences may be greater near birth, birth size may be a poor representative of growth earlier in fetal life. This paper presents correlations between ultrasound dimensions measured twice during fetal life between 13 and 36 weeks of gestation and analogous anthropometric variables measured twice postnatally between 6 and 16 months on the same individuals (n=51). Measurements taken during these age intervals should be free of the most intensified intrauterine influences operating near birth. Shared variance between the two periods (about 10-35%) is significant but substantially lower than variance shared between measurements taken within each period (36 to 90%). Correlations between the repeated fetal measurements are lower than those between postnatal dimensions (0.6 versus 0.9). Maternal linear and cranial dimensions have higher associations with postnatal than with fetal measurements, while measures of maternal prepregnancy body fatness are negatively associated with fetal cranial dimensions. Birth weight has similar correlations with fetal and postnatal measurements (between 0.3 and 0.5). However, birth weight explains significant variance for fetal cranial dimensions but not fetal femur length. These findings indicate that significant variance in fetal size is shared with postnatal size. Greater continuity is apparent for linear (femur length and recumbent length) than for cranial dimensions. This suggests that intrauterine influences may have more intense effects on cranial than on linear growth
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