Impact of Decmedetomidine on Opioid and Benzodiazepine Dosing Requirements in Children.

Poster presented at: Annual Update on Pediatric Cardiovascular Disease; February 2008; Scottsdale Arizona

Experimentally Bounding Deviations From Quantum Theory in the Landscape of Generalized Probabilistic Theories

Many experiments in the field of quantum foundations seek to adjudicate between quantum theory and speculative alternatives to it. This requires one to analyze the experimental data in a manner that does not presume the correctness of the quantum formalism. The mathematical framework of generalized probabilistic theories (GPTs) provides a means of doing so. We present a scheme for determining which GPTs are consistent with a given set of experimental data. It proceeds by performing tomography on the preparations and measurements in a self-consistent manner, i.e., without presuming a prior characterization of either. We illustrate the scheme by analyzing experimental data for a large set of preparations and measurements on the polarization degree of freedom of a single photon. We first test various hypotheses for the dimension of the GPT vector space for this degree of freedom. Our analysis identifies the most plausible hypothesis to be dimension 4, which is the value predicted by quantum theory. Under this hypothesis, we can draw the following additional conclusions from our scheme: (i) that the smallest and largest GPT state spaces that could describe photon polarization are a pair of polytopes, each approximating the shape of the Bloch sphere and having a volume ratio of 0.977±0.001, which provides a quantitative bound on the scope for deviations from the state and effect spaces predicted by quantum theory, and (ii) that the maximal violation of the Clauser, Horne, Shimony, and Holt inequality can be at most 1.3%±0.1 greater than the maximum violation allowed by quantum theory, and the maximal violation of a particular inequality for universal noncontextuality can not differ from the quantum prediction by more than this factor on either side. The only possibility for a greater deviation from the quantum state and effect spaces or for greater degrees of supraquantum nonlocality or contextuality, according to our analysis, is if a future experiment (perhaps following the scheme developed here) discovers that additional dimensions of GPT vector space are required to describe photon polarization, in excess of the four dimensions predicted by quantum theory to be adequate to the task

Dorsal muscle group area and surgical outcomes in liver transplantation

Introduction Better measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes. Methods Our study population included liver transplant recipients with a preoperative CT scan. Cross‐sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one‐ and five‐yr mortality and one‐yr complications. The relationship between dorsal muscle group area and post‐transplantation outcome was assessed using univariate and multivariate techniques. Results Dorsal muscle group area measurements were strongly associated with psoas area ( r  = 0.72; p < 0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one‐yr mortality (odds ratio [ OR ] = 0.53, p = 0.001), five‐yr mortality ( OR  = 0.53, p < 0.001), and one‐yr complications ( OR  = 0.67, p = 0.007). Conclusion Larger dorsal muscle group muscle size is associated with improved post‐transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109316/1/ctr12422.pd

N-glycosylation of mouse TRAIL-R and human TRAIL-R1 enhances TRAIL-induced death.

APO2L/TRAIL (TNF-related apoptosis-inducing ligand) induces death of tumor cells through two agonist receptors, TRAIL-R1 and TRAIL-R2. We demonstrate here that N-linked glycosylation (N-glyc) plays also an important regulatory role for TRAIL-R1-mediated and mouse TRAIL receptor (mTRAIL-R)-mediated apoptosis, but not for TRAIL-R2, which is devoid of N-glycans. Cells expressing N-glyc-defective mutants of TRAIL-R1 and mouse TRAIL-R were less sensitive to TRAIL than their wild-type counterparts. Defective apoptotic signaling by N-glyc-deficient TRAIL receptors was associated with lower TRAIL receptor aggregation and reduced DISC formation, but not with reduced TRAIL-binding affinity. Our results also indicate that TRAIL receptor N-glyc impacts immune evasion strategies. The cytomegalovirus (CMV) UL141 protein, which restricts cell-surface expression of human TRAIL death receptors, binds with significant higher affinity TRAIL-R1 lacking N-glyc, suggesting that this sugar modification may have evolved as a counterstrategy to prevent receptor inhibition by UL141. Altogether our findings demonstrate that N-glyc of TRAIL-R1 promotes TRAIL signaling and restricts virus-mediated inhibition

Py-GC/MS applied to the analysis of synthetic organic pigments: characterization and identification in paint samples

A collection of 76 synthetic organic pigments was analysed using pyrolysis–gas chromatography/mass spectrometry (Py-GC/MS). The purpose of this work was to expand the knowledge on synthetic pigments and to assess characteristic pyrolysis products that could help in the identification of these pigments in paint samples. We analysed several classes of synthetic pigments not previously reported as being analysed by this technique: some metal complexes, β-naphthol pigment lakes, BONA pigment lakes, disazopyrazolone, triarylcarbonium, dioxazine, anthraquinone, indanthrone, isoindoline and thioindigo classes. We also report for the first time the Py-GC/MS analysis of a number of naphthol AS, benzimidazolone, phthalocyanine and perylene pigments and other miscellaneous pigments including pigments with unpublished chemical structure. We successfully used the Py-GC/MS technique for the analysis of paints by artists Clyfford Still and Jackson Pollock to identify the synthetic organic pigments and the binding media

Lung function from school age to adulthood in primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) presents with symptoms early in life and the disease course may be progressive, but longitudinal data on lung function are scarce. This multinational cohort study describes lung function trajectories in children, adolescents and young adults with PCD. We analysed data from 486 patients with repeated lung function measurements obtained between the age of 6 and 24 years from the International PCD Cohort and calculated z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio using the Global Lung Function Initiative 2012 references. We described baseline lung function and change of lung function over time and described their associations with possible determinants in mixed-effects linear regression models. Overall, FEV1, FVC and FEV1/FVC z-scores declined over time (average crude annual FEV1 decline was -0.07 z-scores), but not at the same rate for all patients. FEV1 z-scores improved over time in 21% of patients, remained stable in 40% and declined in 39%. Low body mass index was associated with poor baseline lung function and with further decline. Results differed by country and ultrastructural defect, but we found no evidence of differences by sex, calendar year of diagnosis, age at diagnosis, diagnostic certainty or laterality defect. Our study shows that on average lung function in PCD declines throughout the entire period of lung growth, from childhood to young adult age, even among patients treated in specialised centres. It is essential to develop strategies to reverse this tendency and improve prognosi

Performance of QuantiFERON-TB Gold In-Tube (QFTGIT) for the diagnosis of Mycobacterium tuberculosis (Mtb) infection in Afar Pastoralists, Ethiopia

<p>Abstract</p> <p>Background</p> <p>Currently, T-cell based gamma interferon (IFNγ) release assays (IGRAs) are acknowledged as the best methods available for the screening of latent tuberculosis infection (LTBI) and also as aid for the diagnosis of active tuberculosis (TB). To our information, the performance of these diagnostic tests has not been evaluated in Ethiopia. Therefore, the intent of this study was to evaluate the performance of QuantiFERON-TB Gold In-Tube (QFTGIT) in patients clinically suspected of active pulmonary TB (PTB) as well as in healthy subjects prior to its utilization for the epidemiological study of active TB and LTBI in Afar pastoralists.</p> <p>Methods</p> <p>The sensitivity of QFTGIT was evaluated in 140 subjects who were clinically suspected of PTB using the cut-off value recommended by the manufacturer (≥ 0.35 IU/ml) and disease-specific cut-off value. Sputum culture result was used as a gold standard. The specificity of the test was evaluated both in patients and in 55 tuberculin skin test (TST) negative healthy subjects.</p> <p>Results</p> <p>Out of the 140 study participants, 37 (26.4%) were positive for active PTB by culture. Out of the 37 subjects who had positive results by culture, 6 individuals were HIV-seropositive. Out of the 103 subjects who were negative by culture, 6 subjects had indeterminate results and 21 were HIV-seropositive. The performance of the test was assessed using data from 107 (31 culture positive and 76 culture negative) individuals who were clinically suspected of PTB and HIV-seronegatives. Using the manufacturer recommended cut-off value, the sensitivity of the test was 64.5% (20/31), while its specificity was 36.8% (28/76). The sensitivity of the test was increased to 77.4%, while the specificity was reduced to 23.7% using a cut-off value ≥ 0.1 IU/ml of IFNγ as disease-specific cut-off value. In TST negative healthy subjects, the specificity of the test was 58.2%.</p> <p>Conclusion</p> <p>Our findings revealed a low sensitivity of QFTGIT in the diagnosis of <it>Mycobacterium tuberculosis (Mtb) </it>infection in the present study area using the cut-off value recommended by the manufacturer. Nevertheless, the sensitivity increased from 64.5% to 77.4% by lowering the cut-off value recommended by the manufacturer to ≥ 0.1 IU/ml of IFNγ level. Hence, it is of practical importance to evaluate the performance of QFTGIT in population under different settings prior to its application either for the diagnosis of active TB or LTBI.</p