Management of Noncatastrophic Internal Carotid Artery Injury in Endoscopic Skull Base Surgery.

Arterial injuries are the most feared complication of endoscopic skull base surgery. During resection of the middle fossa component of a large ventral skull base chondrosarcoma, arterial bleeding was encountered near the right internal carotid artery (ICA). Durable hemostasis could not be achieved with packing and the patient was taken for an emergent angiogram that revealed a pseudoaneurysm of the proximal intradural ICA. Given the presence of good collateral flow through the anterior and posterior communicating arteries, the right ICA was sacrificed by coil embolization. The patient was taken back to the operating room for closure then transferred to the intensive care unit and maintained on vasopressors for five days to ensure adequate perfusion. The right ICA was coil embolized and the patient was taken back to the operating room for closure. The patient recovered without complication. Arterial injuries, although serious, are not always catastrophic. Critical steps are immediate recognition of bleeding, vascular imaging, and vessel sacrifice if necessary

Design, construction, sequence analysis and bioinformatics study of RTB-ipaD gene cassette: A new way in generation of Shigellosis vaccine

زمینه و هدف: شیگلا شایع ترین عامل اسهال می‌باشد. آنتی‌ژن پلاسمیدی IpaD برای تهاجم باکتری به درون سلول میزبان ضروری می‌باشد. یکی از چالش‌ها در باره واکسن مخاطی علیه شیگلا بر پایه پروتئین IpaD قدرت پایین آن می‌باشد. به نظر می‌رسد که با متصل کردن IpaD به یک ناقل و ادجوانت مناسب همچون زیر واحد B سم ریسین، می‌توان پروتئین IpaD را بسیار ایمنوژنیک نمود. این مطالعه به منظور تولید وکتور بیانی نوترکیب دارای کاست ژنی RTB-ipaD، آنالیز تعیین توالی و بررسی بیوانفورماتیکی آن انجام گرفته است. روش بررسی: در این مطالعه ژن های RTB و (163-483) ipaD در وکتور pGEM-T همسانه‌سازی شدند. ژن ipaD به روش برش آنزیمی با ژن RTB به همراه لینکر کد کننده GPGP در وکتور pGEM متصل شد. سپس قطعه کایمریک RTB-ipaD در وکتور بیانی pET28a(+) زیر همسانه‌سازی گردید. در پایان آنالیز تعیین توالی و بررسی بیوانفورماتیکی کاست ژنی انجام گرفت. یافته‌ها: صحت ساخت کاست ژنی RTB-ipaD در وکتور بیانی pET28a(+) با واکنش PCR و هضم آنزیمی مورد تایید قرار گرفت. نتایج حاصل از تعیین توالی کاست ژنی مطابق با توالی ذخیره شده در بانک ژنی بود. مطالعات بیوانفورماتیکی بر مبنای شاخص سازگاری کدون نشان داد این کاست قابلیت بیان در گیاه ترانس ژن و برخی سویه های باکتری اشرشیاکلی را دارد. نتیجه‌گیری: اتصال RTB به عنوان ناقل و ادجوانت به آنتی‌ژن IpaD رویکردی نوین و مطلوب در جهت تولید واکسن مخاطی شیگلوزیس می‌باش

Addressing the programming challenges of practical interferometric mesh based optical processors

We demonstrate a novel mesh of Mach-Zehnder interferometers (MZIs) for programmable optical processors. The proposed mesh, referred to as Bokun mesh, is an architecture that merges the attributes of the prior topologies Diamond and Clements. Similar to Diamond, Bokun provides diagonal paths passing through every individual MZI enabling direct phase monitoring. However, unlike Diamond and similar to Clements, Bokun maintains a minimum optical depth leading to better scalability. Providing the monitoring option, Bokun's programming is faster improving the total energy efficiency of the processor. The performance of Bokun mesh enabled by an optimal optical depth is also more resilient to the loss and fabrication imperfections compared to architectures with longer depth such as Reck and Diamond. Employing an efficient programming scheme, the proposed architecture improves energy efficiency by 83% maintaining the same computation accuracy for weight matrix changes at 2 kHz

Carbon Nanotube–Liposome Complexes in Hydrogels for Controlled Drug Delivery via Near-Infrared Laser Stimulation

Externally controllable drug delivery systems are crucial for a variety of biological applications where the dosage and timing of drug delivery need to be adjusted based on disease diagnosis and progression. Here, we have developed an externally controllable drug delivery system by combining three extensively used platforms: hydrogels, liposomes, and single-walled carbon nanotubes (SWCNTs). We have developed carbon nanotube–liposome complexes (CLCs) and incorporated these structures into a 3D alginate hydrogel for use as an optically controlled drug delivery system. The CLC structures were characterized by using a variety of imaging and spectroscopic techniques, and an optimal SWCNT/lipid ratio was selected. The optimal CLCs were loaded with a model drug (FITC-Dex), incorporated into a hydrogel, and their release profile was studied. It was shown that release of the drug cargo can be triggered by using an NIR laser stimulation tuned to the optical resonance of a particular SWCNT species. It was further shown that the amount of released cargo can be tuned by varying the NIR stimulation time. This system demonstrates the externally controlled delivery of drug cargo and can be used for different applications including cancer chemotherapy delivery

Effect of the exercise programme on the quality of life of prostate cancer survivors: A randomized controlled trial

publishedVersionUnit License Agreemen

Climate change adaptation in conflict-affected countries:A systematic assessment of evidence

People affected by conflict are particularly vulnerable to climate shocks and climate change, yet little is known about climate change adaptation in fragile contexts. While climate events are one of the many contributing drivers of conflict, feedback from conflict increases vulnerability, thereby creating conditions for a vicious cycle of conflict. In this study, we carry out a systematic review of peer-reviewed literature, taking from the Global Adaptation Mapping Initiative (GAMI) dataset to documenting climate change adaptation occurring in 15 conflict-affected countries and compare the findings with records of climate adaptation finance flows and climate-related disasters in each country. Academic literature is sparse for most conflict-affected countries, and available studies tend to have a narrow focus, particularly on agriculture-related adaptation in rural contexts and adaptation by low-income actors. In contrast, multilateral and bilateral funding for climate change adaptation addresses a greater diversity of adaptation needs, including water systems, humanitarian programming, and urban areas. Even among the conflict-affected countries selected, we find disparity, with several countries being the focus of substantial research and funding, and others seeing little to none. Results indicate that people in conflict-affected contexts are adapting to climate change, but there is a pressing need for diverse scholarship across various sectors that documents a broader range of adaptation types and their results

Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study

BACKGROUND: Development of reliable and objective evaluation methods is required, particularly for natural and goal-oriented upper-extremity tasks. Three-dimensional imaging measurement techniques have turned out to be a powerful tool for a quantitative and qualitative assessment of multijoint movements. The purpose of this study was to develop and test a method of three-dimensional motion analysis for the activity "drinking from a glass" and describe the drinking task with kinematic variables in control subjects. METHODS: A protocol was developed for the drinking activity including the set-up of cameras and positions of the markers and the subject. The drinking task included reaching, forward transport with glass, drinking, back transport and returning the hand to the initial position. An optoelectronic system was used for the three-dimensional kinematic motion capture. Movement times, velocities, joint angles and interjoint coordination for shoulder and elbow were computed and analyzed for twenty control subjects. Test-retest consistency was evaluated for six subjects. RESULTS: The test protocol showed good consistency in test-retest. Phase definitions for the drinking task were defined and verified. Descriptive kinematic variables were obtained for movement times, positions, velocities and joint angles for shoulder and elbow joint. Interjoint coordination between shoulder and elbow joint in reaching phase showed a high correlation. CONCLUSION: This study provides a detailed description of the three-dimensional kinematic analysis of the drinking task. Our approach to investigate and analyze a goal-oriented daily activity has a great clinical potential. Consequently, the next step is to use and test this protocol on persons with impairments and disabilities from upper extremities

Reprogramming the assembly of unmodified DNA with a small molecule

The ability of DNA to store and encode information arises from base pairing of the four-letter nucleobase code to form a double helix. Expanding this DNA ‘alphabet’ by synthetic incorporation of new bases can introduce new functionalities and enable the formation of novel nucleic acid structures. However, reprogramming the self-assembly of existing nucleobases presents an alternative route to expand the structural space and functionality of nucleic acids. Here we report the discovery that a small molecule, cyanuric acid, with three thymine-like faces reprogrammes the assembly of unmodified poly(adenine) (poly(A)) into stable, long and abundant fibres with a unique internal structure. Poly(A) DNA, RNA and peptide nucleic acid all form these assemblies. Our studies are consistent with the association of adenine and cyanuric acid units into a hexameric rosette, which brings together poly(A) triplexes with a subsequent cooperative polymerization. Fundamentally, this study shows that small hydrogen-bonding molecules can be used to induce the assembly of nucleic acids in water, which leads to new structures from inexpensive and readily available materials

Monitoring of Regulatory T Cell Frequencies and Expression of CTLA-4 on T Cells, before and after DC Vaccination, Can Predict Survival in GBM Patients

PURPOSE: Dendritic cell (DC) vaccines have recently emerged as an innovative therapeutic option for glioblastoma patients. To identify novel surrogates of anti-tumor immune responsiveness, we studied the dynamic expression of activation and inhibitory markers on peripheral blood lymphocyte (PBL) subsets in glioblastoma patients treated with DC vaccination at UCLA. EXPERIMENTAL DESIGN: Pre-treatment and post-treatment PBL from 24 patients enrolled in two Phase I clinical trials of dendritic cell immunotherapy were stained and analyzed using flow cytometry. A univariate Cox proportional hazards model was utilized to investigate the association between continuous immune monitoring variables and survival. Finally, the immune monitoring variables were dichotomized and a recursive partitioning survival tree was built to obtain cut-off values predictive of survival. RESULTS: The change in regulatory T cell (CD3(+)CD4(+)CD25(+)CD127(low)) frequency in PBL was significantly associated with survival (p = 0.0228; hazard ratio = 3.623) after DC vaccination. Furthermore, the dynamic expression of the negative co-stimulatory molecule, CTLA-4, was also significantly associated with survival on CD3(+)CD4(+) T cells (p = 0.0191; hazard ratio = 2.840) and CD3(+)CD8(+) T cells (p = 0.0273; hazard ratio = 2.690), while that of activation markers (CD25, CD69) was not. Finally, a recursive partitioning tree algorithm was utilized to dichotomize the post/pre fold change immune monitoring variables. The resultant cut-off values from these immune monitoring variables could effectively segregate these patients into groups with significantly different overall survival curves. CONCLUSIONS: Our results suggest that monitoring the change in regulatory T cell frequencies and dynamic expression of the negative co-stimulatory molecules on peripheral blood T cells, before and after DC vaccination, may predict survival. The cut-off point generated from these data can be utilized in future prospective immunotherapy trials to further evaluate its predictive validity

Alopecia-Areata Like Alopecia in Mycosis Fungoides, a Case Report

Mycosis Fungoides (MF) is a cutaneous T-cell lymphoma (2,5). Alopecia is rarely seen in this disease, and the reported cases are in the form of follicular mucinosis (1,2,4). In this case report a patient is presented whose lesions all showed alopecia without mucinosis. Furthermore there was a patch of alopecia without any epidermal changes, which was clinicaly identical with alopecia areata, and histologically identical with MF. After six months of treatment there is regrowth of almost normal hair on all of the lesion