Plasma homocysteine and the risk of venous thromboembolism: insights from the FIELD study

Background The lipid-lowering effect of fenofibrate is accompanied by a rise in plasma homocysteine, a potential risk factor for venous thromboembolism (VTE). This study investigated the relationship between homocysteine and the risk of VTE in patients treated with fenofibrate. Methods and results The relationship between homocysteine and deep-vein thrombosis or pulmonary embolism was investigated in 9522 participants of the 5-year Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial. All subjects received fenofibrate during a 6-week active run-in phase before randomization. A Cox proportional-hazards model was used to assess the effect of homocysteine on risk of venous thromboembolic events. During active-drug run-in, homocysteine rose on average by 6.5 μmol/L, accompanied by a substantial rise in plasma creatinine (+12%). Fenofibrate-induced changes in homocysteine and creatinine were fully reversible in the placebo group but persisted in the treatment group until reversing at the end of therapy. During follow-up, 1.8% had at least one episode of deep-vein thrombosis or pulmonary embolism: 103 on fenofibrate and 68 on placebo (log-rank P=0.006). In multivariate analysis, every 5 µmol/L higher baseline homocysteine was associated with 19% higher risk of VTE. Fenofibrate treatment was associated with 52% higher risk, but the change in homocysteine with fenofibrate was not significantly associated with VTE after adjustment for baseline homocysteine. Conclusions Hyperhomocysteinemia is prospectively associated with VTE. Fenofibrate may predispose individuals with high pretreatment homocysteine towards VTE. The fenofibrate-induced increase in homocysteine did not, however, explain the risk associated with fenofibrate therapy

Multimodality Imaging Assessment of Tetralogy of Fallot: From Diagnosis to Long-Term Follow-Up

Tetralogy of Fallot (TOF) is the most common complex congenital heart disease with long-term survivors, demanding serial monitoring of the possible complications that can be encountered from the diagnosis to long-term follow-up. Cardiovascular imaging is key in the diagnosis and serial assessment of TOF patients, guiding patients’ management and providing prognostic information. Thorough knowledge of the pathophysiology and expected sequalae in TOF, as well as the advantages and limitations of different non-invasive imaging modalities that can be used for diagnosis and follow-up, is the key to ensuring optimal management of patients with TOF. The aim of this manuscript is to provide a comprehensive overview of the role of each modality and common protocols used in clinical practice in the assessment of TOF patients

No imminent quantum supremacy by boson sampling

It is predicted that quantum computers will dramatically outperform their conventional counterparts. However, large-scale universal quantum computers are yet to be built. Boson sampling is a rudimentary quantum algorithm tailored to the platform of photons in linear optics, which has sparked interest as a rapid way to demonstrate this quantum supremacy. Photon statistics are governed by intractable matrix functions known as permanents, which suggests that sampling from the distribution obtained by injecting photons into a linear-optical network could be solved more quickly by a photonic experiment than by a classical computer. The contrast between the apparently awesome challenge faced by any classical sampling algorithm and the apparently near-term experimental resources required for a large boson sampling experiment has raised expectations that quantum supremacy by boson sampling is on the horizon. Here we present classical boson sampling algorithms and theoretical analyses of prospects for scaling boson sampling experiments, showing that near-term quantum supremacy via boson sampling is unlikely. While the largest boson sampling experiments reported so far are with 5 photons, our classical algorithm, based on Metropolised independence sampling (MIS), allowed the boson sampling problem to be solved for 30 photons with standard computing hardware. We argue that the impact of experimental photon losses means that demonstrating quantum supremacy by boson sampling would require a step change in technology.Comment: 25 pages, 9 figures. Comments welcom

Quantum Algorithms for the Most Frequently String Search, Intersection of Two String Sequences and Sorting of Strings Problems

We study algorithms for solving three problems on strings. The first one is the Most Frequently String Search Problem. The problem is the following. Assume that we have a sequence of $n$ strings of length $k$. The problem is finding the string that occurs in the sequence most often. We propose a quantum algorithm that has a query complexity $\tilde{O}(n \sqrt{k})$. This algorithm shows speed-up comparing with the deterministic algorithm that requires $\Omega(nk)$ queries. The second one is searching intersection of two sequences of strings. All strings have the same length $k$. The size of the first set is $n$ and the size of the second set is $m$. We propose a quantum algorithm that has a query complexity $\tilde{O}((n+m) \sqrt{k})$. This algorithm shows speed-up comparing with the deterministic algorithm that requires $\Omega((n+m)k)$ queries. The third problem is sorting of $n$ strings of length $k$. On the one hand, it is known that quantum algorithms cannot sort objects asymptotically faster than classical ones. On the other hand, we focus on sorting strings that are not arbitrary objects. We propose a quantum algorithm that has a query complexity $O(n (\log n)^2 \sqrt{k})$. This algorithm shows speed-up comparing with the deterministic algorithm (radix sort) that requires $\Omega((n+d)k)$ queries, where $d$ is a size of the alphabet.Comment: THe paper was presented on TPNC 201

Experimental analysis on the influence of nozzle geometry over the dispersion of liquid n-dodecane sprays

[EN] Understanding and controlling mixing and combustion processes is fundamental in order to face the challenges set by the ever more demanding pollutant regulations and fuel consumption standards of direct injection diesel engines. The fundamentals of these processes haven been long studied by the diesel spray community from both experimental and numerical perspectives. However, certain topics, such as the influence of nozzle geometry over the spray atomization, mixing, and combustion process, are still not completely well understood and predicted by numerical models. The present study seeks to contribute to the current understanding of this subject, by performing state of the art optical diagnostics to liquid sprays injected through two singe-hole nozzles of different conicity. The experiments were carried out in a nitrogen-filled constantpressure-flow facility. Back pressures were set to produce the desired engine-like density conditions in the chamber, at room temperature. The experimental setup consists in a diffused back-illumination setup with a fast pulsed LED light source and a high-speed camera. The diagnostics focused on detecting the liquid spray contour and evaluating the influence of nozzle geometry over the time-resolved and quasi-steady response of the spray dispersion, at similar injection conditions. Results show a clear influence of nozzle geometry on spray contour fluctuations, where the cylindrical nozzle seems to produce larger dispersion in both time-resolved fluctuations and quasi-steady values, when compared to the conical nozzle. This evidences that the turbulence and radial velocity profiles originated at the cylindrical nozzle geometry are able to affect not only the microscopic scales inside the nozzle, but also macroscopic scales, such as the steady spray. Observations from this study indicate that the effects of the flow characteristics within the nozzle are carried on to the first millimeters of the spray, in which the rest of the spray formation downstream is pre-defined.This work was sponsored by Ministerio de Economía y Competitividad of the Spanish Government in the frame of the Project “Comprensión de la influencia de combustibles no convencionales en el proceso de inyección y combustión tipo diesel,” Reference TRA2012-36932. Additionally, the optical equipment used for the project was purchased with funding from Ministerio de Economía y Competitividad FEDER-ICTS-2012-06. The authors would finally like to thank José Enrique Del Rey and María del Carmen Tomás for their collaboration in the setup of the experiments and laboratory work.Payri, R.; Salvador, F.; Gimeno, J.; Viera-Sotillo, JP. (2015). Experimental analysis on the influence of nozzle geometry over the dispersion of liquid n-dodecane sprays. Frontiers in Mechanical Engineering. 1. https://doi.org/10.3389/fmech.2015.00013S

Impregnation of bone chips with antibiotics and storage of antibiotics at different temperatures: an in vitro study

<p>Abstract</p> <p>Background</p> <p>Allograft bone used in joint replacement surgery can additionally serve as a carrier for antibiotics and serve as a prophylaxis against infections. However, <it>in vitro </it>dose-response curves for bone chips impregnated with different kinds of antibiotics are not available. In addition, while it would be desirable to add the antibiotics to allograft bone chips before these are stored in a bone bank, the effects of different storage temperatures on antibiotics are unknown.</p> <p>Methods</p> <p>Five different antibiotics (cefazolin, clindamycin, linezolid, oxacillin, vancomycin) were stored, both as pills and as solutions, at -80°C, -20°C, 4°C, 20°C and 37°C; in addition, bone chips impregnated with cefazolin and vancomycin were stored at -80°C and -20°C. After 1 month, 6 months and 1 year, the activity of the antibiotics against <it>Staphylococcus epidermidis </it>was measured using an inoculated agar. The diameter of the <it>S. epidermidis</it>-free zone was taken as a measure of antibiotic activity.</p> <p>In a separate experiment, <it>in vitro </it>dose-response curves were established for bone chips impregnated with cefazolin and vancomycin solutions at five different concentrations.</p> <p>Finally, the maximum absorbed amounts of cefazolin and vancomycin were established by impregnating 1 g of bone chips with 5 ml of antibiotic solution.</p> <p>Results</p> <p>A decrease of the <it>S. epidermidis</it>-free zone was seen with oxacillin and cefazolin solutions stored at 37°C for 1 month, with vancomycin stored at 37°C for 6 months and with cefazolin and oxacillin solutions stored at 20°C for 6 months. The activity of the other antibiotic solutions, pills and impregnated bone chips was not affected by storage. The <it>in vitro </it>dose-response curves show that the free-zone diameter increases logarithmically with antibiotic concentration. The absorbed antibiotic amount of one gram bone chips was determined.</p> <p>Conclusions</p> <p>Storage of antibiotics in frozen form or storage of antibiotic pills at temperatures up to 37°C for 12 months does not affect their activity. However, storage of antibiotic solutions at temperatures above 20°C does affect the activity of some of the antibiotics investigated. The <it>in vitro </it>dose-response curve can be used to determine the optimal concentration(s) for local application. It provides the opportunity to determine the antibiotic content of bone chips, and thus the amount of antibiotics available locally after application.</p

Peroxisome proliferators-activated alpha agonist treatment ameliorates hepatic damage in rats with obstructive jaundice: an experimental study

<p>Abstract</p> <p>Background</p> <p>Peroxisome proliferators-activated receptor alpha (PPARα) activation modulates cholesterol metabolism and suppresses bile acid synthesis. This study aims to evaluate the effect of short-term administration of fenofibrate, a PPARα agonist, on proinflammatory cytokines, apoptosis, and hepatocellular damage in cholestasis.</p> <p>Methods</p> <p>Forty male Wistar rats were randomly divided into four groups: I = sham operated, II = bile duct ligation (BDL), III = BDL + vehicle (gum Arabic), IV = BDL + fenofibrate (100 mg/kg/day). All rats were sacrificed on 7^thday after obtaining blood samples and liver tissue. Total bilirubin, aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), gamma-glutamyl transferase, (GGT), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1 β), and total bile acid (TBA) in serum, and liver damage scores; portal inflammation, necrosis, bile duct number, in liver tissue were evaluated. Apoptosis in liver was also assessed by immunohistochemical staining.</p> <p>Results</p> <p>Fenofibrate administration significantly reduced serum total bilirubin, AST, ALT, ALP, and GGT, TNF-α, IL-1 β levels, and TBA (<it>P </it>< 0.01). Hepatic portal inflammation, hepatic necrosis, number of the bile ducts and apoptosis in rats with BDL were more prominent than the sham-operated animals (<it>P </it>< 0.01). PPARα induction improved all histopathologic parameters (<it>P </it>< 0.01), except for the number of the bile duct, which was markedly increased by fenofibrate therapy (<it>P </it>< 0.01).</p> <p>Conclusion</p> <p>Short-term administration of fenofibrate to the BDL rats exerts beneficial effects on hepatocellular damage and apoptosis.</p

Delivery of a Chlamydial Adhesin N-PmpC Subunit Vaccine to the Ocular Mucosa Using Particulate Carriers

Trachoma, caused by the intracellular bacterium Chlamydia trachomatis (Ct), remains the world's leading preventable infectious cause of blindness. Recent attempts to develop effective vaccines rely on modified chlamydial antigen delivery platforms. As the mechanisms engaged in the pathology of the disease are not fully understood, designing a subunit vaccine specific to chlamydial antigens could improve safety for human use. We propose the delivery of chlamydia-specific antigens to the ocular mucosa using particulate carriers, bacterial ghosts (BGs). We therefore characterized humoral and cellular immune responses after conjunctival and subcutaneous immunization with a N-terminal portion (amino acid 1-893) of the chlamydial polymorphic membrane protein C (PmpC) of Ct serovar B, expressed in probiotic Escherichia coli Nissle 1917 bacterial ghosts (EcN BGs) in BALB/cmice. Three immunizations were performed at two-week intervals, and the immune responses were evaluated two weeks after the final immunization in mice. In a guinea pig model of ocular infection animals were immunized in the same manner as the mice, and protection against challenge was assessed two weeks after the last immunization. N-PmpC was successfully expressed within BGs and delivery to the ocularmucosa was well tolerated without signs of inflammation. N-PmpC- specific mucosal IgA levels in tears yielded significantly increased levels in the group immunized via the conjunctiva compared with the subcutaneously immunized mice. Immunization with N-PmpC EcN BGs via both immunization routes prompted the establishment of an N-PmpC-specific IFN gamma immune response. Immunization via the conjunctiva resulted in a decrease in intensity of the transitional inflammatory reaction in conjunctiva of challenged guinea pigs compared with subcutaneously and non-immunized animals. The delivery of the chlamydial subunit vaccine to the ocular mucosa using a particulate carrier, such as BGs, induced both humoral and cellular immune responses. Further investigations are needed to improve the immunization scheme and dosage

Cancer mortality in a cohort of asbestos textile workers

A cohort of 889 men and 1077 women employed for at least 1 month between 1946 and 1984 by a former Italian leading asbestos (mainly textile) company, characterised by extremely heavy exposures often for short durations, was followed up to 1996, for a total of 53 024 person-years of observation. Employment data were obtained from factory personnel records, while vital status and causes of death were ascertained through municipality registers and local health units. We observed 222 cancer deaths compared with 116.4 expected (standardized mortality ratio, SMR=191). The highest ratios were found for pleural (SMR=4105), peritoneal (SMR=1817) and lung (SMR=282) cancers. We observed direct relationships with duration of employment for lung and peritoneal cancer, and with time since first employment for lung cancer and mesothelioma. Pleural cancer risk was independent from duration (SMR=3428 for employment <1 year, 7659 for 1–4 years, 2979 for 5–9 years and 2130 for ⩾10 years). Corresponding SMRs for lung cancer were 139, 251, 233 and 531. Nonsignificantly increased ratios were found for ovarian (SMR=261), laryngeal (SMR=238) and oro-pharyngeal (SMR=226) cancers. This study confirms and further quantifies the central role of latency in pleural mesothelioma and of cumulative exposure in lung cancer

Breast cancer resistance protein identifies clonogenic keratinocytes in human interfollicular epidermis

INTRODUCTION: There is a practical need for the identification of robust cell-surface markers that can be used to enrich for living keratinocyte progenitor cells. Breast cancer resistance protein (ABCG2), a member of the ATP binding cassette (ABC) transporter family, is known to be a marker for stem/progenitor cells in many tissues and organs. METHODS: We investigated the expression of ABCG2 protein in normal human epidermis to evaluate its potential as a cell surface marker for identifying and enriching for clonogenic epidermal keratinocytes outside the pilosebaceous tract. RESULTS: Immunofluorescence and immunoblotting studies of human skin showed that ABCG2 is expressed in a subset of basal layer cells in the epidermis. Flow cytometry analysis showed approximately 2-3% of keratinocytes in non-hair-bearing epidermis expressing ABCG2; this population also expresses p63, β1 and α6 integrins and keratin 14, but not CD34, CD71, C-kit or involucrin. The ABCG2-positive keratinocytes showed significantly higher colony forming efficiency when co-cultured with mouse 3T3 feeder cells, and more extensive long-term proliferation capacity in vitro, than did ABCG2-negative keratinocytes. Upon clonal analysis, most of the freshly isolated ABCG2-positive keratinocytes formed holoclones and were capable of generating a stratified differentiating epidermis in organotypic culture models. CONCLUSIONS: These data indicate that in skin, expression of the ABCG2 transporter is a characteristic of interfollicular keratinocyte progentior cells and suggest that ABCG2 may be useful for enriching keratinocyte stem cells in human interfollicular epidermis