TLR induces reorganization of the IgM-BCR complex regulating murine B-1 cell responses to infections.

In mice, neonatally-developing, self-reactive B-1 cells generate steady levels of natural antibodies throughout life. B-1 cells can, however, also rapidly respond to infections with increased local antibody production. The mechanisms regulating these two seemingly very distinct functions are poorly understood, but have been linked to expression of CD5, an inhibitor of BCR-signaling. Here we demonstrate that TLR-mediated activation of CD5+ B-1 cells induced the rapid reorganization of the IgM-BCR complex, leading to the eventual loss of CD5 expression, and a concomitant increase in BCR-downstream signaling, both in vitro and in vivo after infections of mice with influenza virus and Salmonella typhimurium. Both, initial CD5 expression and TLR-mediated stimulation, were required for the differentiation of B-1 cells to IgM-producing plasmablasts after infections. Thus, TLR-mediated signals support participation of B-1 cells in immune defense via BCR-complex reorganization

Primary stroke in a woman with sickle cell anemia responsive to hydroxyurea therapy.

The most common cause of stroke in children with sickle cell anemia is infarction due to ischemia. In adults, however, stroke is most commonly hemorrhagic in nature. Other causes of stroke in patients with sickle cell disease are very rare. In this short communication, we describe a woman with sickle cell anemia responsive to hydroxyurea (HU) therapy who had primary stroke due to paradoxical embolization caused by a large atrial septal defect. Successful management of the stroke included surgical closure of the defect with trans-esophageal echocardiographic guidance. To the best of our knowledge, this is the first patient with sickle cell anemia and stroke due to congenital heart disease who did not require open heart surgery for successful management

Interacting classical and quantum particles

We apply Hall and Reginatto's theory of interacting classical and quantum ensembles to harmonically coupled particles, with a view to understanding its experimental implications. This hybrid theory has no free parameters and makes distinctive predictions that should allow it to be experimentally distinguished from quantum mechanics. It also bears on the questions of quantum measurement and quantum gravity.Comment: 7 pages, 6 figure

Decision analytic model for evaluation of suspected coronary disease with stress testing and coronary CT angiography.

RATIONALE AND OBJECTIVES: The aim of this study was to apply a decision analytic model for the evaluation of coronary artery disease (CAD) to define the optimal utilization of coronary computed tomographic angiography (cCTA) and stress testing. MATERIALS AND METHODS: The model tested in this study assumes that CAD is evaluated with a stress test and/or cCTA and that a patient with positive evaluation results undergoes cardiac catheterization. On the basis of values of sensitivity, specificity, and radiation dose from the published literature and test costs from the Medicare fee schedule, a decision tree model was constructed as a function of disease prevalence. RESULTS: The false-negative rate is lowest when cCTA is used as an isolated test. The false-positive rate is minimized when cCTA is used in combination with stress echocardiography. Effective radiation is minimized by use of stress electrocardiography or stress echocardiography alone or prior to cCTA. When the pretest probability of CAD is low, a strategy that uses stress echocardiography followed by cCTA minimizes the false-positive rate and effective radiation exposure, with relatively low imaging costs and with a false-negative rate only slightly higher than a strategy including stress myocardial scintigraphy. As the pretest probability of CAD increases above 20%, the false-negative rate of stress echocardiography followed by cCTA increases by \u3e5% relative to cCTA alone. CONCLUSION: Effective radiation dose and imaging costs for the workup of CAD may be minimized by an appropriate combination of stress testing and cCTA. A strategy that uses stress echocardiography followed by cCTA is most appropriate for the evaluation of low-risk patients with CAD with a pretest probability \u3c 20%, while cCTA alone may be more appropriate in intermediate-risk patients

Cosmic Origins Spectrograph and FUSE Observations of T ~ 10^5 K Gas In A Nearby Galaxy Filament

We present a detection of a broad Ly-alpha absorber (BLA) with a matching O VI line in the nearby universe. The BLA is detected at z = 0.01028 in the high S/N spectrum of Mrk 290 obtained using the Cosmic Origins Spectrograph. The Ly-alpha absorption has two components, with b(HI) = 55 +/- 1 km/s and b(HI) = 33 +/- 1 km/s, separated in velocity by v ~ 115 km/s. The O VI, detected by FUSE at z = 0.01027, has a b(OVI) = 29 +/- 3 km/s and is kinematically well aligned with the broader HI component. The different line widths of the BLA and OVI suggest a temperature of T = 1.4 x 10^5 K in the absorber. The observed line strength ratios and line widths favor an ionization scenario in which both ion-electron collisions and UV photons contribute to the ionization in the gas. Such a model requires a low-metallicity of -1.7 dex, ionization parameter of log U ~ -1.4, a large total hydrogen column density of N(H) ~ 4 x 10^19 cm^-2, and a path length of 400 kpc. The line of sight to Mrk 290 intercepts at the redshift of the absorber, a megaparsec scale filamentary structure extending over 20 deg in the sky, with several luminous galaxies distributed within 1.5 Mpc projected distance from the absorber. The collisionally ionized gas in this absorber is likely tracing a shock-heated gaseous structure, consistent with a few different scenarios for the origin, including an over-dense region of the WHIM in the galaxy filament or highly ionized gas in the extended halo of one of the galaxies in the filament. In general, BLAs with metals provide an efficient means to study T ~ 10^5 - 10^6 K gas in galaxy halos and in the intergalactic medium. A substantial fraction of the baryons "missing" from the present universe is predicted to be in such environments in the form of highly ionized plasma.Comment: Astrophysical Journal Accepte

Novel Approaches to Coronary Perforations: Everything But the Kitchen Sink.

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Fragmentation production of doubly heavy baryons

Baryons with a single heavy quark are being studied experimentally at present. Baryons with two units of heavy flavor will be abundantly produced not only at future colliders, but also at existing facilities. In this paper we study the production via heavy quark fragmentation of baryons containing two heavy quarks at the Tevatron, the LHC, HERA, and the NLC. The production rate is woefully small at HERA and at the NLC, but significant at $pp$ and $p\bar{p}$ machines. We present distributions in various kinematical variables in addition to the integrated cross sections at hadron colliders.Comment: 13 pages, macro package epsfig needed, 6 .eps figure files in a separate uuencoded, compressed and tarred file; complete paper available at http://www.physics.carleton.ca/~mad/papers/paper.p

Transradial-Transfistula Access for Cardiac Catheterization in Patients With Abandoned Hemodialysis Fistulas

Guidelines consider radial access a relative contraindication in patients with end-stage renal disease as part of a vessel preservation strategy. Radial access distal to a hemodialysis fistula, what we term transradial-transfistula access, offers a solution to radially access this population without affecting their vessel preservation plan. (Level of Difficulty: Advanced.