Carpal tunnel pressure measurement during two-portal endoscopic carpal tunnel release

Background: Although there remain concerns of median nerve damage during endoscopic carpal tunnel release for carpal tunnel syndrome, carpal tunnel pressure variations during Chow's two-portal techinique have not been well investigated. Methods: We performed a modified two-portal endoscopic carpal tunnel release on 30 patients by inserting a catheter pressure transducer into the carpal tunnel for continuous pressure measurement during the procedure. Grip and pinch strengths, Semmes-Weinstein monofilament test, and nerve conduction studies were examined preoperatively and at postoperative 1, 3, and 6 months. Numbness and the Disabilities of the Arm, Shoulder and Hand score were also evaluated pre and postoperatively. Findings: Subjective symptoms and nerve conduction study findings improved uneventfully. The pressure was always observed to be maximum pressure immediately before the cannula was withdrawn from the exit portal, and carpal tunnel pressure >300 mm Hg was recorded in most of the patients. Interpretation: A transient increase in the carpal tunnel pressure occurred in all the patients; however, it did not correlate with their clinical outcome or with increased risk of pen-operative complications. Since time-pressure threshold of the median nerve during endoscopic carpal tunnel release is still unknown, our results did not guarantee its safety.ArticleCLINICAL BIOMECHANICS. 25(9):893-898 (2010)journal articl

Thermal annealing response following irradiation of a CMOS imager for the JUICE JANUS instrument

ESA's JUICE (JUpiter ICy moon Explorer) spacecraft is an L-class mission destined for the Jovian system in 2030. Its primary goals are to investigate the conditions for planetary formation and the emergence of life, and how does the solar system work. The JANUS camera, an instrument on JUICE, uses a 4T back illuminated CMOS image sensor, the CIS115 designed by Teledyne e2v. JANUS imager test campaigns are studying the CIS115 following exposure to gammas, protons, electrons and heavy ions, simulating the harsh radiation environment present in the Jovian system. The degradation of 4T CMOS device performance following proton fluences is being studied, as well as the effectiveness of thermal annealing to reverse radiation damage. One key parameter for the JANUS mission is the Dark current of the CIS115, which has been shown to degrade in previous radiation campaigns. A thermal anneal of the CIS115 has been used to accelerate any annealing following the irradiation as well as to study the evolution of any performance characteristics. CIS115s have been irradiated to double the expected End of Life (EOL) levels for displacement damage radiation (2×1010 protons, 10 MeV equivalent). Following this, devices have undergone a thermal anneal cycle at 100°C for 168 hours to reveal the extent to which CIS115 recovers pre-irradiation performance. Dark current activation energy analysis following proton fluence gives information on trap species present in the device and how effective anneal is at removing these trap species. Thermal anneal shows no quantifiable change in the activation energy of the dark current following irradiation

A Two-Zone Model for Type I X-ray Bursts on Accreting Neutron Stars

We construct a two-zone model to describe H and He burning on the surface of an accreting neutron star and use it to study the triggering of type I X-ray bursts. Although highly simplified, the model reproduces all of the bursting regimes seen in the more complete global linear stability analysis of Narayan & Heyl (2003), including the regime of delayed mixed bursts. The results are also consistent with observations of type I X-ray bursts. At accretion rates Mdot < 0.1 Mdot_Edd, thermonuclear He burning via the well-known thin-shell thermal instability triggers bursts. As Mdot increases, however, the trigger mechanism evolves from the fast thermal instability to a slowly growing overstability involving both H and He burning. The competition between nuclear heating via the beta-limited CNO cycle and the triple-alpha process on the one hand, and radiative cooling via photon diffusion and emission on the other hand, drives oscillations with a period approximately equal to the H-burning timescale. If these oscillations grow, the gradually rising temperature at the base of the helium layer eventually provokes a thin-shell thermal instability and hence a delayed mixed burst. For Mdot > 0.25 Mdot_Edd, there is no instability or overstability, and there are no bursts. Nearly all other theoretical models predict that bursts should occur for all Mdot < Mdot_Edd, in conflict with both our results and observations. We suggest that this discrepancy arises from the assumed strength of the hot CNO cycle breakout reaction 15O(alpha,gamma)19Ne in these other models. That observations agree much better with the results of Narayan & Heyl and our two-zone model, both of which neglect breakout reactions, may imply that the true 15O(alpha,gamma)19Ne cross section is much smaller than assumed in previous investigations.Comment: 13 pages, 8 figures, accepted by Ap

Evasion of cytotoxic T lymphocyte (CTL) responses by nef-dependent induction of Fas ligand (CD95L) expression on simian immunodeficiency virus-infected cells.

Published versio

Insect spiracle as the main penetration route of pyrethroids

The penetration route of adhered pyrethroids following direct aerosol spraying was studied in the German cockroach (Blattella germanica) by investigating the relationship between the application site of insecticide and knockdown efficacy. In direct spray, KT50 was 26.4 s and the adhered amount of pyrethroid was 0.745 μg. On the contrary, required amount of pyrethroid to obtain the same KT50 was one-eighth in topical application to the mesothoracic spiracle, while 2.6 times to the ventral mesothorax. KT50 of cockroaches with blocked mesothoracic spiracles was greater than those with unblocked spiracles by 1.8-fold. The amount of directly sprayed pyrethroid penetrating through the inner wall of the mesothoracic trachea was significantly higher than the amount penetrating through the body wall of the ventral mesothorax. Therefore, the knockdown effect of the direct spray was believed to be caused by the flow of pyrethroids into the mesothoracic spiracles and its subsequent penetration through the inner wall of the mesothoracic trachea

Contributions of Mamu-A*01 Status and TRIM5 Allele Expression, But Not CCL3L Copy Number Variation, to the Control of SIVmac251 Replication in Indian-Origin Rhesus Monkeys

CCL3 is a ligand for the HIV-1 co-receptor CCR5. There have recently been conflicting reports in the literature concerning whether CCL3-like gene (CCL3L) copy number variation (CNV) is associated with resistance to HIV-1 acquisition and with both viral load and disease progression following infection with HIV-1. An association has also been reported between CCL3L CNV and clinical sequelae of the simian immunodeficiency virus (SIV) infection in vivo in rhesus monkeys. The present study was initiated to explore the possibility of an association of CCL3L CNV with the control of virus replication and AIDS progression in a carefully defined cohort of SIVmac251-infected, Indian-origin rhesus monkeys. Although we demonstrated extensive variation in copy number of CCL3L in this cohort of monkeys, CCL3L CNV was not significantly associated with either peak or set-point plasma SIV RNA levels in these monkeys when MHC class I allele Mamu-A*01 was included in the models or progression to AIDS in these monkeys. With 66 monkeys in the study, there was adequate power for these tests if the correlation of CCL3L and either peak or set-point plasma SIV RNA levels was 0.34 or 0.36, respectively. These findings call into question the premise that CCL3L CNV is important in HIV/SIV pathogenesis

TRIM5α Modulates Immunodeficiency Virus Control in Rhesus Monkeys

The cytoplasmic TRIM5α proteins of certain mammalian lineages efficiently recognize the incoming capsids of particular retroviruses and potently restrict infection in a species-specific manner. Successful retroviruses have evolved capsids that are less efficiently recognized by the TRIM5α proteins of the natural hosts. To address whether TRIM5α contributes to the outcome of retroviral infection in a susceptible host species, we investigated the impact of TRIM5 polymorphisms in rhesus monkeys on the course of a simian immunodeficiency virus (SIV) infection. Full-length TRIM5α cDNAs were derived from each of 79 outbred monkeys and sequenced. Associations were explored between the expression of particular TRIM5 alleles and both the permissiveness of cells to SIV infection in vitro and clinical sequelae of SIV infection in vivo. Natural variation in the TRIM5α B30.2(SPRY) domain influenced the efficiency of SIVmac capsid binding and the in vitro susceptibility of cells from the monkeys to SIVmac infection. We also show the importance in vivo of the interaction of SIVmac with different allelic forms of TRIM5, demonstrating that particular alleles are associated with as much as 1.3 median log difference in set-point viral loads in SIVmac-infected rhesus monkeys. Moreover, these allelic forms of TRIM5 were associated with the extent of loss of central memory (CM) CD4+ T cells and the rate of progression to AIDS in the infected monkeys. These findings demonstrate a central role for TRIM5α in limiting the replication of an immunodeficiency virus infection in a primate host

Immunization with Cocktail of HIV-Derived Peptides in Montanide ISA-51 Is Immunogenic, but Causes Sterile Abscesses and Unacceptable Reactogenicity

BACKGROUND: A peptide vaccine was produced containing B and T cell epitopes from the V3 and C4 Envelope domains of 4 subtype B HIV-1 isolates (MN, RF, CanO, & Ev91). The peptide mixture was formulated as an emulsion in incomplete Freund's adjuvant (IFA). METHODS: Low-risk, healthy adult subjects were enrolled in a randomized, placebo-controlled dose-escalation study, and selected using criteria specifying that 50% in each study group would be HLA-B7+. Immunizations were scheduled at 0, 1, and 6 months using a total peptide dose of 1 or 4 mg. Adaptive immune responses in16 vaccine recipients and two placebo recipients after the 2nd immunization were evaluated using neutralization assays of sera, as well as ELISpot and ICS assays of cryopreserved PBMCs to assess CD4 and CD8 T-cell responses. In addition, (51)Cr release assays were performed on fresh PBMCs following 14-day stimulation with individual vaccine peptide antigens. RESULTS: 24 subjects were enrolled; 18 completed 2 injections. The study was prematurely terminated because 4 vaccinees developed prolonged pain and sterile abscess formation at the injection site-2 after dose 1, and 2 after dose 2. Two other subjects experienced severe systemic reactions consisting of headache, chills, nausea, and myalgia. Both reactions occurred after the second 4 mg dose. The immunogenicity assessments showed that 6/8 vaccinees at each dose level had detectable MN-specific neutralizing (NT) activity, and 2/7 HLA-B7+ vaccinees had classical CD8 CTL activity detected. However, using both ELISpot and ICS, 8/16 vaccinees (5/7 HLA-B7+) and 0/2 controls had detectable vaccine-specific CD8 T-cell responses. Subjects with moderate or severe systemic or local reactions tended to have more frequent T cell responses and higher antibody responses than those with mild or no reactions. CONCLUSIONS: The severity of local responses related to the formulation of these four peptides in IFA is clinically unacceptable for continued development. Both HIV-specific antibody and T cell responses were induced and the magnitude of response correlated with the severity of local and systemic reactions. If potent adjuvants are necessary for subunit vaccines to induce broad and durable immune responses, careful, incremental clinical evaluation is warranted to minimize the risk of adverse events. TRIAL REGISTRATION: ClinicalTrials.gov NCT00000886

Dual Neonate Vaccine Platform against HIV-1 and M. tuberculosis

Acquired immunodeficiency syndrome and tuberculosis (TB) are two of the world's most devastating diseases. The first vaccine the majority of infants born in Africa receive is Mycobacterium bovis bacillus Calmette-Guérin (BCG) as a prevention against TB. BCG protects against disseminated disease in the first 10 years of life, but provides a variable protection against pulmonary TB and enhancing boost delivered by recombinant modified vaccinia virus Ankara (rMVA) expressing antigen 85A (Ag85A) of M. tuberculosis is currently in phase IIb evaluation in African neonates. If the newborn's mother is positive for human immunodeficiency virus type 1 (HIV-1), the baby is at high risk of acquiring HIV-1 through breastfeeding. We suggested that a vaccination consisting of recombinant BCG expressing HIV-1 immunogen administered at birth followed by a boost with rMVA sharing the same immunogen could serve as a strategy for prevention of mother-to-child transmission of HIV-1 and rMVA expressing an African HIV-1-derived immunogen HIVA is currently in phase I trials in African neonates. Here, we aim to develop a dual neonate vaccine platform against HIV-1 and TB consisting of BCG.HIVA administered at birth followed by a boost with MVA.HIVA.85A. Thus, mMVA.HIVA.85A and sMVA.HIVA.85A vaccines were constructed, in which the transgene transcription is driven by either modified H5 or short synthetic promoters, respectively, and tested for immunogenicity alone and in combination with BCG.HIVA222. mMVA.HIVA.85A was produced markerless and thus suitable for clinical manufacture. While sMVA.HIVA.85A expressed higher levels of the immunogens, it was less immunogenic than mMVA.HIVA.85A in BALB/c mice. A BCG.HIVA222–mMVA.HIVA.85A prime-boost regimen induced robust T cell responses to both HIV-1 and M. tuberculosis. Therefore, proof-of-principle for a dual anti-HIV-1/M. tuberculosis infant vaccine platform is established. Induction of immune responses against these pathogens soon after birth is highly desirable and may provide a basis for lifetime protection maintained by boosts later in life

Manifesto of computational social science

The increasing integration of technology into our lives has created unprecedented volumes of data on society's everyday behaviour. Such data opens up exciting new opportunities to work towards a quantitative understanding of our complex social systems, within the realms of a new discipline known as Computational Social Science. Against a background of financial crises, riots and international epidemics, the urgent need for a greater comprehension of the complexity of our interconnected global society and an ability to apply such insights in policy decisions is clear. This manifesto outlines the objectives of this new scientific direction, considering the challenges involved in it, and the extensive impact on science, technology and society that the success of this endeavour is likely to bring about.The publication of this work was partially supported by the European Union’s Seventh Framework Programme (FP7/2007–2013) under grant agreement No. 284709, a Coordination and Support Action in the Information and Communication Technologies activity area (‘FuturICT’ FET Flagship Pilot Project). We are grateful to the anonymous reviewers for the insightful comments.Publicad