Targeting inflammatory pathways in axial spondyloarthritis.

The triggers and pathogenesis of axial spondyloarthritis (axSpA) are not yet completely understood. However, therapeutic agents targeting tumor necrosis factor-α and interleukin-17 inflammatory pathways have proven successful in suppressing many of the clinical symptoms and signs of axSpA, giving us an indication of which pathways are responsible for initiating and maintaining the inflammation. The mechanisms that eventuate in syndesmophytes and ankyloses are less clear. This review addresses these two critical pathways of inflammation, discussing their nature and these factors that may activate or enhance the pathways in patients with axSpA. In addition, genetic and other markers important to the inflammatory pathways implicated in axSpA are explored, and prognostic biomarkers are discussed. Treatment options available for the management of axSpA and their associated targets are highlighted

The diagnosis and treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease and chronic bronchitis.

The syndrome of chronic obstructive pulmonary disease (COPD) consists of chronic bronchitis (CB), bronchiectasis, emphysema, and reversible airway disease that combine uniquely in an individual patient. Older patients are at risk for COPD and its components--emphysema, CB, and bronchiectasis. Bacterial and viral infections play a role in acute exacerbations of COPD (AECOPD) and in acute exacerbations of CB (AECB) without features of COPD. Older patients are at risk for resistant bacterial organisms during their episodes of AECOPD and AECB. Organisms include the more-common bacteria implicated in AECOPD/AECB such as Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. Less-common nonenteric, gram-negative organisms including Pseudomonas aeruginosa, gram-positive organisms including Staphylococcus aureus, and strains of nontuberculosis Mycobacteria are more often seen in AECOPD/AECB episodes involving elderly patients with frequent episodes of CB or those with bronchiectasis. Risk-stratified antibiotic treatment guidelines appear useful for purulent episodes of AECOPD and episodes of AECB. These guidelines have not been prospectively validated for the general population and especially not for the elderly population. Using a risk-stratification approach for elderly patients, first-line antibiotics (e.g., amoxicillin, ampicillin, pivampicillin, trimethoprim/sulfamethoxazole, and doxycycline), with a more-limited spectrum of antibacterial coverage, are used in patients who are likely to have a low probability of resistant organisms during AECOPD/AECB. Second-line antibiotics (e.g., amoxicillin/clavulanic acid, second- or third-generation cephalosporins, and respiratory fluoroquinolones) with a broader spectrum of coverage are reserved for patients with significant risk factors for resistant organisms and those who have failed initial antibiotic treatment

The Integration of Positron Emission Tomography With Magnetic Resonance Imaging

A number of laboratories and companies are currently exploring the development of integrated imaging systems for magnetic resonance imaging (MRI) and positron emission tomography (PET). Scanners for both preclinical and human research applications are being pursued. In contrast to the widely distributed and now quite mature PET/computed tomography technology, most PET/MRI designs allow for simultaneous rather than sequential acquisition of PET and MRI data. While this offers the possibility of novel imaging strategies, it also creates considerable challenges for acquiring artifact-free images from both modalities. This paper discusses the motivation for developing combined PET/MRI technology, outlines the obstacles in realizing such an integrated instrument, and presents recent progress in the development of both the instrumentation and of novel imaging agents for combined PET/MRI studies. The performance of the first-generation PET/MRI systems is described. Finally, a range of possible biomedical applications for PET/MRI are outlined

Cryogenic Propellant Scavenging

A detailed description of a computer model that has been developed for assessing the feasibility of low g cryogen propellant scavenging from the space shuttle External Tank (ET) is given. Either pump-assisted or pressure-induced propellant transfer may be selected. The program will accept a wide range of input variables, including the fuel to be transferred (LOX or LH2), heat leaks, tank temperatures, and piping and equipment specifications. The model has been parametrically analyzed to determine initial design specification for the system

Catastrophes and complicated intraoperative events during robotic lung resection.

Intraoperative complications and catastrophes are an accepted and perhaps inevitable aspect of all surgeries. Anatomic pulmonary resection puts in close proximity the tracheal-bronchial tree, pulmonary vasculature, heart and great vessels within the small volume area of the chest. Fortunately, major complications and catastrophes are uncommon regardless of surgical approach. Pulmonary arterial injury is the most frequently reported. Most injuries necessitate a thoracotomy for definitive management though novel techniques are emerging for minimally invasive management. This section focuses on intraoperative pulmonary artery and vein injuries, major airway injuries and transections, injuries to major abdominal organs and effects of carbon dioxide insufflation during robotic pulmonary resection

Spin Polarization and Transport of Surface States in the Topological Insulators Bi2Se3 and Bi2Te3 from First Principles

We investigate the band dispersion and the spin texture of topologically protected surface states in the bulk topological insulators Bi2Se3 and Bi2Te3 by first-principles methods. Strong spin-orbit entanglement in these materials reduces the spin-polarization of the surface states to ~50% in both cases; this reduction is absent in simple models but of important implications to essentially any spintronic application. We propose a way of controlling the magnitude of spin polarization associated with a charge current in thin films of topological insulators by means of an external electric field. The proposed dual-gate device configuration provides new possibilities for electrical control of spin.Comment: 4+ pages, 3 figure

The current state of per oral endoscopic myotomy for achalasia.

Achalasia is an acquired neuromuscular disorder that has been treated using a variety of modalities throughout medical history. Recently, the technique of per oral endoscopic myotomy (POEM) was introduced to treat the disease using a truly minimally invasive, natural orifice technique that is rapidly being adopted across the world. This review outlines the development of POEM, the technique itself, and gives a comparison to other procedures, specifically laparoscopic Heller myotomy (LHM)

Renormalization of Molecular Electronic Levels at Metal-Molecule Interfaces

The electronic structure of benzene on graphite (0001) is computed using the GW approximation for the electron self-energy. The benzene quasiparticle energy gap is predicted to be 7.2 eV on graphite, substantially reduced from its calculated gas-phase value of 10.5 eV. This decrease is caused by a change in electronic correlation energy, an effect completely absent from the corresponding Kohn-Sham gap. For weakly-coupled molecules, this correlation energy change is seen to be well described by a surface polarization effect. A classical image potential model illustrates trends for other conjugated molecules on graphite.Comment: 4 pages, 3 figures, 2 table

Binary Central Stars of Planetary Nebulae Discovered Through Photometric Variability III: The Central Star of Abell 65

A growing number of close binary stars are being discovered among central stars of planetary nebulae. Recent and ongoing surveys are finding new systems and contributing to our knowledge of the evolution of close binary systems. The push to find more systems was largely based on early discoveries which suggested that 10 to 15% of all central stars are close binaries. One goal of this series of papers is confirmation and classification of these systems as close binaries and determination of binary system parameters. Here we provide time-resolved multi-wavelength photometry of the central star of Abell 65 as well as further analysis of the nebula and discussion of possible binary--nebula connections. Our results for Abell 65 confirm recent work showing that it has a close, cool binary companion, though several of our model parameters disagree with the recently published values. With our longer time baseline of photometric observations from 1989--2009 we also provide a more precise orbital period of 1.0037577 days.Comment: Accepted for publication in the Astronomical Journa

Ultrafast dynamics of coherences in the quantum Hall system

Using three-pulse four-wave-mixing optical spectroscopy, we study the ultrafast dynamics of the quantum Hall system. We observe striking differences as compared to an undoped system, where the 2D electron gas is absent. In particular, we observe a large off-resonant signal with strong oscillations. Using a microscopic theory, we show that these are due to many-particle coherences created by interactions between photoexcited carriers and collective excitations of the 2D electron gas. We extract quantitative information about the dephasing and interference of these coherences.Comment: 4 pages, 4 figures, to be published in Phys. Rev. Let