Role of splenectomy in human liver transplantation under modern-day immunosuppression

Between January 1987 and October 1991, 1466 patients underwent consecutive Orthotopic Liver Transplantation (OLTx) at the University of Pittsburgh. Forty of these patient's had concomitant splenectomy with OLTx. These patients were compared to 147 randomly selected OLTx patients without splenectomy within the same time period. One-year patient and graft survival (PS and GS) were lower in splenectomized (Splx) patients compared to nonsplenectomized (non-Splx) patients (59% vs 86% PS, 55% vs 80% GS, respectively). One-month and one-year patient mortality in the Splx group was higher than in the non-splx patients (20% vs 3.4% P < 0.001 for one month; 40% vs 14.3%, P = 0.003 for one year, respectively). One-month and one-year sepsis-related mortality was also high in Splx patients (17.5% vs 2.7%, P = 0.0022, for one month, and 30% vs 11.5%, P = 0.0043, for one year, respectively). We conclude that concomitant splenectomy with OLTx has a significantly higher patient mortality mainly due to its septic complications and, at present, unless there is a specific indication for a splenectomy, the routine addition of this procedure to liver allograft surgery would not be recommended

Developing a phenomenological equation to predict yield strength from composition and microstructure in β processed Ti-6Al-4V

A constituent-based phenomenological equation to predict yield strength values from quantified measurements of the microstructure and composition of β processed Ti-6Al-4V alloy was developed via the integration of artificial neural networks and genetic algorithms. It is shown that the solid solution strengthening contributes the most to the yield strength (~80% of the value), while the intrinsic yield strength of the two phases and microstructure have lower effects (~10% for both terms). Similarities and differences between the proposed equation and the previously established phenomenological equation for the yield strength prediction of the α+β processed Ti-6Al-4V alloys are discussed. While the two equations are very similar in terms of the intrinsic yield strength of the two constituent phases, the solid solution strengthening terms and the ‘Hall-Petch’-like effect from the alpha lath, there is a pronounced difference in the role of the basketweave factor in strengthening. Finally, Monte Carlo simulations were applied to the proposed phenomenological equation to determine the effect of measurement uncertainties on the estimated yield strength values

Mobile Service Clouds: A self-managing infrastructure for autonomic mobile computing services

Abstract. We recently introduced Service Clouds, a distributed infrastructure designed to facilitate rapid prototyping and deployment of autonomic communication services. In this paper, we propose a model that extends Service Clouds to the wireless edge of the Internet. This model, called Mobile Service Clouds, enables dynamic instantiation, composition, configuration, and reconfiguration of services on an overlay network to support mobile computing. We have implemented a prototype of this model and applied it to the problem of dynamically instantiating and migrating proxy services for mobile hosts. We conducted a case study involving data streaming across a combination of PlanetLab nodes, local proxies, and wireless hosts. Results are presented demonstrating the effectiveness of the prototype in establishing new proxies and migrating their functionality in response to node failures.

Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females) underwent tumor removal through eyelid crease (17 eyes), conjunctival (nine eyes), lateral canthal (two eyes), and transcaruncular (two eyes) approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range) age and follow-up duration were 48.5 (31–87) years old and 24.5 (4–375) weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases), pleomorphic adenoma (5 cases), solitary fibrous tumor (4 cases), neurofibroma (2 cases), schwannoma (2 cases), and orbital varix (1 case). None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia

Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas.

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this rare cutaneous lymphoma. Thirty-four patients with a median age of 77 years (range 19-89 years) presented primarily with extensive annular necrotic plaques or tumor lesions with frequent mucous membrane involvement. The 5-year survival was 32% with a median survival of 12 months. A subset of 17 patients had a prodrome of chronic patches prior to the development of aggressive ulcerative lesions. We identified cases with lack of CD8 or αβ T-cell receptor expression yet with similar clinical and pathological presentation. Allogeneic stem cell transplantation provided partial or complete remissions in 5/6 patients. We recommend the term primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphoma as this more broad designation better describes this clinical-pathologic presentation, which allows the inclusion of cases with CD8 negative and/or αβ/γδ T-cell receptor chain double-positive or double-negative expression. We have identified early skin signs of chronic patch/plaque lesions that are often misdiagnosed as eczema, psoriasis, or mycosis fungoides. Our experience confirms the poor prognosis of this entity and highlights the inefficacy of our standard therapies with the exception of allogeneic stem cell transplantation in selected cases

Synthesizing Iterators from Abstraction Functions

A technique for synthesizing iterators from declarative abstraction functions written in a relational logic specification language is described. The logic includes a transitive closure operator that makes it convenient for expressing reachability queries on linked data structures. Some optimizations, including tuple elimination, iterator flattening, and traversal state reduction, are used to improve performance of the generated iterators. A case study demonstrates that most of the iterators in the widely used JDK Collections classes can be replaced with code synthesized from declarative abstraction functions. These synthesized iterators perform competitively with the hand-written originals. In a user study the synthesized iterators always passed more test cases than the hand-written ones, were almost always as efficient, usually took less programmer effort, and were the qualitative preference of all participants who provided free-form comments

Altered localisation of the copper efflux transporters ATP7A and ATP7B associated with cisplatin resistance in human ovarian carcinoma cells

Metals in Catalysis, Biomimetics & Inorganic Material

States and transitions in black-hole binaries

With the availability of the large database of black-hole transients from the Rossi X-Ray Timing Explorer, the observed phenomenology has become very complex. The original classification of the properties of these systems in a series of static states sorted by mass accretion rate proved not to be able to encompass the new picture. I outline here a summary of the current situation and show that a coherent picture emerges when simple properties such as X-ray spectral hardness and fractional variability are considered. In particular, fast transition in the properties of the fast time variability appear to be crucial to describe the evolution of black-hole transients. Based on this picture, I present a state-classification which takes into account the observed transitions. I show that, in addition to transients systems, other black-hole binaries and Active Galactic Nuclei can be interpreted within this framework. The association between these states and the physics of the accretion flow around black holes will be possible only through modeling of the full time evolution of galactic transient systems.Comment: 30 pages, 11 figures, To appear in Belloni, T. (ed.): The Jet Paradigm - From Microquasars to Quasars, Lect. Notes Phys. 794 (2009

Methylation-capture and Next-Generation sequencing of free circulating DNA from human plasma

Background Free circulating DNA (fcDNA) has many potential clinical applications, due to the non-invasive way in which it is collected. However, because of the low concentration of fcDNA in blood, genome-wide analysis carries many technical challenges that must be overcome before fcDNA studies can reach their full potential. There are currently no definitive standards for fcDNA collection, processing and whole-genome sequencing. We report novel detailed methodology for the capture of high-quality methylated fcDNA, library preparation and downstream genome-wide Next-Generation Sequencing. We also describe the effects of sample storage, processing and scaling on fcDNA recovery and quality. Results Use of serum versus plasma, and storage of blood prior to separation resulted in genomic DNA contamination, likely due to leukocyte lysis. Methylated fcDNA fragments were isolated from 5 donors using a methyl-binding protein-based protocol and appear as a discrete band of ~180 bases. This discrete band allows minimal sample loss at the size restriction step in library preparation for Next-Generation Sequencing, allowing for high-quality sequencing from minimal amounts of fcDNA. Following sequencing, we obtained 37×106-86×106 unique mappable reads, representing more than 50% of total mappable reads. The methylation status of 9 genomic regions as determined by DNA capture and sequencing was independently validated by clonal bisulphite sequencing. Conclusions Our optimized methods provide high-quality methylated fcDNA suitable for whole-genome sequencing, and allow good library complexity and accurate sequencing, despite using less than half of the recommended minimum input DNA

Analogy-Making as a Core Primitive in the Software Engineering Toolbox

An analogy is an identification of structural similarities and correspondences between two objects. Computational models of analogy making have been studied extensively in the field of cognitive science to better understand high-level human cognition. For instance, Melanie Mitchell and Douglas Hofstadter sought to better understand high-level perception by developing the Copycat algorithm for completing analogies between letter sequences. In this paper, we argue that analogy making should be seen as a core primitive in software engineering. We motivate this argument by showing how complex software engineering problems such as program understanding and source-code transformation learning can be reduced to an instance of the analogy-making problem. We demonstrate this idea using Sifter, a new analogy-making algorithm suitable for software engineering applications that adapts and extends ideas from Copycat. In particular, Sifter reduces analogy-making to searching for a sequence of update rule applications. Sifter uses a novel representation for mathematical structures capable of effectively representing the wide variety of information embedded in software. We conclude by listing major areas of future work for Sifter and analogy-making in software engineering.Comment: Conference paper at SPLASH 'Onward!' 2020. Code is available at https://github.com/95616ARG/sifte