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The Exclusion of Restrictive Lung Disease by Spirometric Criteria in Patients with a Reduced Forced Vital Capacity

Reductions in forced vital capacity (EVC) as determined by spirometry may result from restrictive or obstructive disease, either alone or in combination. Restrictive disease is implied when measures of forced expiratory flow are relatively maintained, and obstructive disease is present when flow measurements are disproportionately reduced. In the presence of air flow obstruction, the possibility of concomitant restrictive disease contributing to the reduction in FVC is difficult to assess from spirometry alone. Static lung volumes are usually necessary to establish this diagnosis. We evaluated the FEV1/EVC%o obtained at spirometry compared to its predicted normal value. We found it to be useful in eliminating the need for additional testing in many cases in which the question of mixed obstructive and restrictive disease had been raised. Specifically, in patients with obstructive disease and a reduced FVC, an FEV1/FVC% of less than 81%, of the age-, height-, and sex-matched predicted value largely excluded the possibility that concomitant restrictive disease was also present (p\u3c.05). Higher values had no predictive value

Convexity criteria and uniqueness of absolutely minimizing functions

We show that absolutely minimizing functions relative to a convex Hamiltonian $H:\mathbb{R}^n \to \mathbb{R}$ are uniquely determined by their boundary values under minimal assumptions on $H.$ Along the way, we extend the known equivalences between comparison with cones, convexity criteria, and absolutely minimizing properties, to this generality. These results perfect a long development in the uniqueness/existence theory of the archetypal problem of the calculus of variations in $L^\infty.$Comment: 34 page

Sponge-Like Behaviour in Isoreticular Cu(Gly-His-X) Peptide-Based Porous Materials

We report two isoreticular 3D peptide-based porous frameworks formed by coordination of the tripeptides Gly-l-His-Gly and Gly-l-His-l-Lys to Cu(II) which display sponge-like behaviour. These porous materials undergo structural collapse upon evacuation that can be reversed by exposure to water vapour, which permits recovery of the original open channel structure. This is further confirmed by sorption studies that reveal that both solids exhibit selective sorption of H(2)O while CO(2) adsorption does not result in recovery of the original structures. We also show how the pendant aliphatic amine chains, present in the framework from the introduction of the lysine amino acid in the peptidic backbone, can be post-synthetically modified to produce urea-functionalised networks by following methodologies typically used for metal–organic frameworks built from more rigid “classical” linkers

Discrete Cylindrical Vector Beam Generation from an Array of Optical Fibers

A novel method is presented for the beam shaping of far field intensity distributions of coherently combined fiber arrays. The fibers are arranged uniformly on the perimeter of a circle, and the linearly polarized beams of equal shape are superimposed such that the far field pattern represents an effective radially polarized vector beam, or discrete cylindrical vector (DCV) beam. The DCV beam is produced by three or more beams that each individually have a varying polarization vector. The beams are appropriately distributed in the near field such that the far field intensity distribution has a central null. This result is in contrast to the situation of parallel linearly polarized beams, where the intensity peaks on axis

Effectiveness of inactivated influenza vaccines in preventing influenza-associated deaths and hospitalizations among Ontario residents aged ≥ 65 years: estimates with generalized linear models accounting for healthy vaccinee effects.

BACKGROUND: Estimates of the effectiveness of influenza vaccines in older adults may be biased because of difficulties identifying and adjusting for confounders of the vaccine-outcome association. We estimated vaccine effectiveness for prevention of serious influenza complications among older persons by using methods to account for underlying differences in risk for these complications. METHODS: We conducted a retrospective cohort study among Ontario residents aged ≥ 65 years from September 1993 through September 2008. We linked weekly vaccination, hospitalization, and death records for 1.4 million community-dwelling persons aged ≥ 65 years. Vaccine effectiveness was estimated by comparing ratios of outcome rates during weeks of high versus low influenza activity (defined by viral surveillance data) among vaccinated and unvaccinated subjects by using log-linear regression models that accounted for temperature and time trends with natural spline functions. Effectiveness was estimated for three influenza-associated outcomes: all-cause deaths, deaths occurring within 30 days of pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations. RESULTS: During weeks when 5% of respiratory specimens tested positive for influenza A, vaccine effectiveness among persons aged ≥ 65 years was 22% (95% confidence interval [CI], -6%-42%) for all influenza-associated deaths, 25% (95% CI, 13%-37%) for deaths occurring within 30 days after an influenza-associated pneumonia/influenza hospitalization, and 19% (95% CI, 4%-31%) for influenza-associated pneumonia/influenza hospitalizations. Because small proportions of deaths, deaths after pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations were associated with influenza virus circulation, we estimated that vaccination prevented 1.6%, 4.8%, and 4.1% of these outcomes, respectively. CONCLUSIONS: By using confounding-reducing techniques with 15 years of provincial-level data including vaccination and health outcomes, we estimated that influenza vaccination prevented ~4% of influenza-associated hospitalizations and deaths occurring after hospitalizations among older adults in Ontario

790-2 Baseline Electrocardiogram Predicts 30-day Mortality Among 32,812 Patients with Acute Myocardial Infarction Treated with Thrombolysis

To determine the initial electrocardiographic variables predictive of survival among patients with acute myocardial infarction, we analyzed the baseline 12-lead ECGs in 32,812 patients enrolled into the GUSTO trial. All patients had≥0.1mV of ST segment elevation in at least one lead and received thrombolytic therapy. Those with LBBB or ventricular rhythm were excluded from analysis. Clinical follow-up was > 99.5% complete. 2218 (6.8%) patients died within 30 days of the initial ECG. Death within 30 days was more common in patients with RBBB (17%), LAFB (14%), and LPFB (17%), than in those with a normal conduction pattern (6%). Patients with ECG evidence of previous MI in a location distinct from the acute MI had a higher risk of death (9.8% vs. 5.9%) than those without prior infarction (p<0.0001). The variable having the greatest univariate predictive power for 30-day survival was the sum of the absolute ST-segment deviation in each lead (x2=341), as shown in the following mortality curve.Other ST segment variables that predicted 30-day survival were the sum of ST-segment elevation in each lead (x2=287). the maximum ST elevation in anyone lead (X2=257), and the number of leads with ST elevation (x2=250). When multivariate modeling was performed the sum of the absolute ST deviations, number of leads with ST elevation, prior ECG MI, RBBB, and LAFB each added independent prognostic information.We conclude that an ECG at the time of presentation contains substantial prognostic information which can be used to help stratify risk among thrombelytic-treated patients with acute myocardial infarction

Report from the Passive Microwave Data Set Management Workshop

Passive microwave data sets are some of the most important data sets in the Earth Observing System Data and Information System (EOSDIS), providing data as far back as the early 1970s. The widespread use of passive microwave (PM) radiometer data has led to their collection and distribution over the years at several different Earth science data centers. The user community is often confused by this proliferation and the uneven spread of information about the data sets. In response to this situation, a Passive Microwave Data Set Management Workshop was held 17 ]19 May 2011 at the Global Hydrology Resource Center, sponsored by the NASA Earth Science Data and Information System (ESDIS) Project. The workshop attendees reviewed all primary (Level 1 ]3) PM data sets from NASA and non ]NASA sensors held by NASA Distributed Active Archive Centers (DAACs), as well as high ]value data sets from other NASA ]funded organizations. This report provides the key findings and recommendations from the workshop as well as detailed tabluations of the datasets considered

Patch Materials for Pulmonary Artery Arterioplasty and Right Ventricular Outflow Tract Augmentation: A Review

Patch augmentation of the right ventricular outflow tract (RVOT) and pulmonary artery (PA) arterioplasty are relatively common procedures in the surgical treatment of patients with congenital heart disease. To date, several patch materials have been applied with no agreed upon clinical standard. Each patch type has unique performance characteristics, cost, and availability. There are limited data describing the various advantages and disadvantages of different patch materials. We performed a review of studies describing the clinical performance of various RVOT and PA patch materials and found a limited but growing body of literature. Short-term clinical performance has been reported for a multitude of patch types, but comparisons are limited by inconsistent study design and scarce histologic data. Standard clinical criteria for assessment of patch efficacy and criteria for intervention need to be applied across patch types. The field is progressing with improvements in outcomes due to newer patch technologies focused on reducing antigenicity and promoting neotissue formation which may have the ability to grow, remodel, and repair

Acute Hypersensitivity of Pluripotent Testicular Cancer-Derived Embryonal Carcinoma to Low-Dose 5-Aza Deoxycytidine Is Associated with Global DNA Damage-Associated p53 Activation, Anti-Pluripotency and DNA Demethylation

Human embryonal carcinoma (EC) cells are the stem cells of nonseminoma testicular germ cells tumors (TGCTs) and share remarkable similarities to human embryonic stem (ES) cells. In prior work we found that EC cells are hypersensitive to low nanomolar doses of 5-aza deoxycytidine (5-aza) and that this hypersensitivity partially depended on unusually high levels of the DNA methyltransferase, DNMT3B. We show here that low-dose 5-aza treatment results in DNA damage and induction of p53 in NT2/D1 cells. In addition, low-dose 5-aza results in global and gene specific promoter DNA hypomethylation. Low- dose 5-aza induces a p53 transcriptional signature distinct from that induced with cisplatin in NT2/D1 cells and also uniquely downregulates genes associated with pluripotency including NANOG, SOX2, GDF3 and Myc target genes. Changes in the p53 and pluripotency signatures with 5-aza were to a large extent dependent on high levels of DNMT3B. In contrast to the majority of p53 target genes upregulated by 5-aza that did not show DNA hypomethylation, several other genes induced with 5-aza had corresponding decreases in promoter methylation. These genes include RIN1, SOX15, GPER, and TLR4 and are novel candidate tumors suppressors in TGCTs. Our studies suggest that the hypersensitivity of NT2/D1 cells to low-dose 5-aza is multifactorial and involves the combined activation of p53 targets, repression of pluripotency genes, and activation of genes repressed by DNA methylation. Low-dose 5-aza therapy may be a general strategy to treat those tumors that are sustained by cells with embryonic stem-like properties. GEO number for the microarray data: GSE42647