Repeating adrenal vein sampling when neither aldosterone/cortisol ratio exceeds peripheral yields a high incidence of aldosterone-producing adenoma

Objectives:In primary aldosteronism, adrenal vein sampling (AVS) suggests unilateral aldosterone-producing adenoma (APA) when the aldosterone/cortisol (A/F) ratio is less than or equal to peripheral on one side and at least two times peripheral on the other. When A/F ratios are lower bilaterally than peripheral despite adequate samples (adrenal venous cortisol 3 times peripheral), we recommend repeat AVS. This study aimed to determine the frequency of this occurrence and outcomes in such cases.Methods:We performed a retrospective observational study of all cases of primary aldosteronism undergoing initial AVS over a 34-year period.Results:Initial AVS in 1397 patients returned satisfactory and discriminatory results in 1066 (76.3%) but 37 patients (2.6%) had adequate samples but bilateral A/F ratios no higher than peripheral. Of the 22 of these 37 who agreed to repeat AVS, 10 demonstrated unilateral aldosterone production, and eight of these had unilateral adrenalectomy disclosing APAs and resulting in cure (3) or improvement (5) in hypertension. Eight had bilateral aldosterone production. Four studies were inconclusive. Patients with initial unsatisfactory AVS because of bilaterally low A/F ratios had significantly (P=0.023) more unilateral disease [10 of 18 satisfactory repeat studies (55.6%) vs. 326 of 1066 satisfactory initial studies (30.6%)] and a significantly higher (67.6 vs. 49.9%, P=0.034) percentage of males.Conclusion:As the incidence of APAs was high in a subgroup with low A/F bilaterally on initial AVS, these patients should be offered repeat AVS. This might reflect both a greater dependence of aldosterone production on adrenocorticotrophic hormone (ACTH) in APAs and the pulsatile nature of ACTH secretion

The Design and Application of Target-Focused Compound Libraries

Target-focused compound libraries are collections of compounds which are designed to interact with an individual protein target or, frequently, a family of related targets (such as kinases, voltage-gated ion channels, serine/cysteine proteases). They are used for screening against therapeutic targets in order to find hit compounds that might be further developed into drugs. The design of such libraries generally utilizes structural information about the target or family of interest. In the absence of such structural information, a chemogenomic model that incorporates sequence and mutagenesis data to predict the properties of the binding site can be employed. A third option, usually pursued when no structural data are available, utilizes knowledge of the ligands of the target from which focused libraries can be developed via scaffold hopping. Consequently, the methods used for the design of target-focused libraries vary according to the quantity and quality of structural or ligand data that is available for each target family. This article describes examples of each of these design approaches and illustrates them with case studies, which highlight some of the issues and successes observed when screening target-focused libraries

Mechanistic Drivers of Reemergence of Anthropogenic Carbon in the Equatorial Pacific

AbstractRelatively rapid reemergence of anthropogenic carbon (Cant) in the Equatorial Pacific is of potential importance for its impact on the carbonate buffering capacity of surface seawater and thereby impeding the ocean's ability to further absorb Cant from the atmosphere. We explore the mechanisms sustaining Cant reemergence (upwelling) from the thermocline to surface layers by applying water mass transformation diagnostics to a global ocean/sea ice/biogeochemistry model. We find that the upwelling rate of Cant (0.4 PgC yr−1) from the thermocline to the surface layer is almost twice as large as air‐sea Cant fluxes (0.203 PgC yr−1). The upwelling of Cant from the thermocline to the surface layer can be understood as a two‐step process: The first being due to diapycnal diffusive transformation fluxes and the second due to surface buoyancy fluxes. We also find that this reemergence of Cant decreases dramatically during the 1982/1983 and 1997/1998 El Niño events

Control of an Outbreak of Human Parainfluenza Virus 3 in Hematopoietic Stem Cell Transplant Recipients

Human parainfluenza virus 3 (HPIV3) infection can cause significant morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). There are no standard guidelines for the prevention and control of HPIV3 in the outpatient setting. After 2 HSCT inpatients diagnosed with HPIV3 were noted to have had multiple recent HSCT outpatient clinic (OPC) visits, an investigation of policy and procedures in the HSCT OPC was undertaken, and active surveillance for respiratory viral illness was instituted in the at-risk HSCT population. Between July 19 and August 30, 2005, 13 patients were diagnosed with HPIV3 infection. Morbidity in affected patients was significant, and mortality was high (38.5%) and not affected by antiviral therapy. Molecular typing identified several genetically distinct groups of the hemagglutinin-neuraminidase gene of the 11 available isolates. Based on sequence relatedness among the isolates and the demographic and exposure history of the patients, in many of these cases HPIV3 infection likely was acquired in the HSCT OPC. The major infection control interventions were introduced between August 20 and August 24. An epidemic curve revealed that HPIV3 infection frequency peaked between August 17 and August 26, with no cases identified after August 30. Prompt attention and focus on infection control interventions were associated with a rapid decrease in the number of incident cases. Policies and procedures regarding patients with respiratory viral illnesses in HSCT OPC populations should be formulated and universally reinforced with HSCT clinic staff to prevent the spread of these infections

Density-functional Study of Small Molecules within the Krieger-Li-Iafrate Approximation

We report density-functional studies of several small molecules ($H_{2}, N_{2}, CO, H_{2}O$, and $CH_{4}$) within the Krieger-Li-Iafrate (KLI) approximation to the exact Kohn-Sham local exchange potential, using a three-dimensional real-space finite-difference pseudopotential method. It is found that exchange-only KLI leads to markedly improved eigenvalue spectra compared to those obtained within the standard local-density approximation (LDA), the generalized gradient approximation (GGA), and the Hartree-Fock (HF) method. For structural properties, exchange-only KLI results are close to the corresponding HF values. We find that the addition of LDA or GGA correlation energy functionals to the KLI exact exchange energy functional does not lead to systematic improvements.Comment: 16 pages including 1 fugure, to be published in Phys. Rev. A Nov. 1 '9

Electronic structure of NiS_{1-x}Se_x

We investigate the electronic structure of the metallic NiS$_{1-x}$Se$_x$ system using various electron spectroscopic techniques. The band structure results do not describe the details of the spectral features in the experimental spectrum, even for this paramagnetic metallic phase. However, a parameterized many-body multi-band model is found to be successful in describing the Ni~2$p$ core level and valence band, within the same model. The asymmetric line shape as well as the weak intensity feature in the Ni~2$p$ core level spectrum has been ascribed to extrinsic loss processes in the system. The presence of satellite features in the valence band spectrum shows the existence of the lower Hubbard band, deep inside the $pd$ metallic regime, consistent with the predictions of the dynamical mean field theory.Comment: To be published in Physical Review B, 18 pages and 5 figure

Bystander Affiliation Influences Intervention Behavior: A Virtual Reality Study

Traditional work on bystander intervention in violent emergencies has found that the larger the group, the less the chance that any individual will intervene. Here, we tested the impact on helping behavior of the affiliation of the bystanders with respect to the participants. We recruited 40 male supporters of the U.K. Arsenal football club for a two-factor between groups study with 10 participants per group. Each participant spoke with a virtual human Arsenal supporter (V), the scenario displayed in a virtual reality system. During this conversation, another virtual character (P), not an Arsenal fan, verbally abused V for being an Arsenal fan leading eventually to physical pushing. There was a group of three virtual bystanders who were all either Arsenal supporters indicated by their shirts, or football fans wearing unbranded shirts. These bystanders either encouraged the participant to intervene or dissuaded him. We recorded the number of times that participants intervened to help V during the aggression. We found that participants were more likely to intervene when the bystanders were out-group with respect to the participant. By comparing levels of intervention with a “baseline” study (identical except for the presence of bystanders), we conclude that the presence of in-group bystanders decreases helping. We argue therefore that, other things being equal, diffusion of responsibility is more likely to be overcome when participant and victim share group membership, but bystanders do not. Our findings help to develop understanding of how diffusion of responsibility works by combining elements of both the bystander effect and the social identity approach to bystander behavior

Surface patterning of carbon nanotubes can enhance their penetration through a phospholipid bilayer

Nanotube patterning may occur naturally upon the spontaneous self-assembly of biomolecules onto the surface of single-walled carbon nanotubes (SWNTs). It results in periodically alternating bands of surface properties, ranging from relatively hydrophilic to hydrophobic, along the axis of the nanotube. Single Chain Mean Field (SCMF) theory has been used to estimate the free energy of systems in which a surface patterned nanotube penetrates a phospholipid bilayer. In contrast to un-patterned nanotubes with uniform surface properties, certain patterned nanotubes have been identified that display a relatively low and approximately constant system free energy (10 kT) as the nanotube traverses through the bilayer. These observations support the hypothesis that the spontaneous self-assembly of bio-molecules on the surface of SWNTs may facilitate nanotube transduction through cell membranes.Comment: Published in ACS Nano http://pubs.acs.org/doi/abs/10.1021/nn102763

NASA Image eXchange (NIX)

This paper discusses the technical aspects of and the project background for the NASA Image exchange (NIX). NIX, which provides a single entry point to search selected image databases at the NASA Centers, is a meta-search engine (i.e., a search engine that communicates with other search engines). It uses these distributed digital image databases to access photographs, animations, and their associated descriptive information (meta-data). NIX is available for use at the following URL: http://nix.nasa.gov./NIX, which was sponsored by NASAs Scientific and Technical Information (STI) Program, currently serves images from seven NASA Centers. Plans are under way to link image databases from three additional NASA Centers. images and their associated meta-data, which are accessible by NIX, reside at the originating Centers, and NIX utilizes a virtual central site that communicates with each of these sites. Incorporated into the virtual central site are several protocols to support searches from a diverse collection of database engines. The searches are performed in parallel to ensure optimization of response times. To augment the search capability, browse functionality with pre-defined categories has been built into NIX, thereby ensuring dissemination of 'best-of-breed' imagery. As a final recourse, NIX offers access to a help desk via an on-line form to help locate images and information either within the scope of NIX or from available external sources