Regulation of vascular endothelial growth factor bioactivity in patients with acute lung injury

Background: Reduced bioactive vascular endothelial growth factor (VEGF) has been demonstrated in several inflammatory lung conditions including the acute respiratory distress syndrome (ARDS). sVEGFR-1, a soluble form of VEGF-1 receptor, is a potent natural inhibitor of VEGF. We hypothesised that sVEGFR-1 plays an important role in the regulation of the bioactivity of VEGF within the lung in patients with ARDS. Methods: Forty one patients with ARDS, 12 at risk of developing ARDS, and 16 normal controls were studied. Bioactive VEGF, total VEGF, and sVEGFR-1 were measured by ELISA in plasma and bronchoalveolar lavage (BAL) fluid. Reverse transcriptase polymerase chain reaction for sVEGFR-1 was performed on BAL cells. Results: sVEGFR-1 was detectable in the BAL fluid of 48% (20/41) of patients with early ARDS (1.4– 54.8 ng/ml epithelial lining fluid (ELF)) compared with 8% (1/12) at risk patients (p = 0.017) and none of the normal controls (p = 0.002). By day 4 sVEGFR-1 was detectable in only 2/18 ARDS patients (p = 0.008). Patients with detectable sVEGFR-1 had lower ELF median (IQR) levels of bioactive VEGF than those without detectable sVEGFR-1 (1415.2 (474.9–3192) pg/ml v 4761 (1349–7596.6) pg/ml, median difference 3346 pg/ml (95% CI 305.1 to 14711.9), p = 0.016), but there was no difference in total VEGF levels. BAL cells expressed mRNA for sVEGFR-1 and produced sVEGFR-1 protein which increased following incubation with tumour necrosis factor a. Conclusion: This study shows for the first time the presence of sVEGFR-1 in the BAL fluid of patients with ARDS. This may explain the presence of reduced bioactive VEGF in patients early in the course of ARDS

Prediction models in the design of neural network based ECG classifiers: A neural network and genetic programming approach

BACKGROUND: Classification of the electrocardiogram using Neural Networks has become a widely used method in recent years. The efficiency of these classifiers depends upon a number of factors including network training. Unfortunately, there is a shortage of evidence available to enable specific design choices to be made and as a consequence, many designs are made on the basis of trial and error. In this study we develop prediction models to indicate the point at which training should stop for Neural Network based Electrocardiogram classifiers in order to ensure maximum generalisation. METHODS: Two prediction models have been presented; one based on Neural Networks and the other on Genetic Programming. The inputs to the models were 5 variable training parameters and the output indicated the point at which training should stop. Training and testing of the models was based on the results from 44 previously developed bi-group Neural Network classifiers, discriminating between Anterior Myocardial Infarction and normal patients. RESULTS: Our results show that both approaches provide close fits to the training data; p = 0.627 and p = 0.304 for the Neural Network and Genetic Programming methods respectively. For unseen data, the Neural Network exhibited no significant differences between actual and predicted outputs (p = 0.306) while the Genetic Programming method showed a marginally significant difference (p = 0.047). CONCLUSIONS: The approaches provide reverse engineering solutions to the development of Neural Network based Electrocardiogram classifiers. That is given the network design and architecture, an indication can be given as to when training should stop to obtain maximum network generalisation

Loss of Cone Molecular Markers in Rhodopsin-Mutant Human Retinas with Retinitis Pigmentosa

Purpose: To examine the effect of rhodopsin mutations on cone photoreceptors in human retinas with retinitis pigmentosa (RP). Methods: Four RP retinas with rhodopsin mutations and four normal retinas were examined by immunofluorescence with a battery of cell-specific antibodies against cone and rod cytoplasmic and outer segment membrane proteins. Areas of the retinas were studied that showed maximal preservation of photoreceptor structure. Results: All four RP retinas showed loss of rods, ranging from mild (T-17-M), to more severe (P-23-H), to advanced degeneration (Q-64-ter and G-106-R). The majority of cones in the T-17-M and P-23-H retinas were cytologically normal but showed loss of immunoreactivity for the cytoplasmic proteins 7G6, calbindin, and X-arrestin. The cone outer segments (OS) remained positive for cone opsins and peripherin-2 (rds/peripherin). All remaining cones in the Q-64-ter and G-106-R retinas were degenerate, with short to absent OS, but had strong reactivity for these cytoplasmic and OS membrane markers. Cones in the maculas of the RP retinas were degenerate, with short to absent OS, but retained strong labeling for the cytoplasmic and OS proteins. Conclusions: Even before cones show cytologic changes in response to rod cell degeneration, they lose immunoreactivity for certain cytoplasmic proteins. These cones later show shortening and loss of OS, although their OS membrane proteins remain well labeled. Cones may down regulate expression of both cytoplasmic and outer segment membrane proteins in response to mutant rod cell dysfunction and/or cell death in human RP retinas. Such cytologic and immunocytochemical changes in the cones may presage death of these critical cells in the later stages of RP

What are the experiences of adults returning to work following recovery from Guillain-Barré syndrome? An interpretative phenomenological analysis

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2009 Informa UK Ltd.Purpose. Guillain-Barré syndrome (GBS) is a transient inflammatory disorder affecting peripheral nerves, characterised by weakness and numbness in limbs, upper body and face. Residual problems affect a large minority, and complicate return to work. This qualitative study explored the experiences of people who returned to work following their diagnosis of GBS and recovery, to gain insight into factors that facilitated or inhibited this process. Method. Five people participated in in-depth interviews. Individual and common experiences were explored through interpretative phenomenological analysis. Findings. Three recurring themes are presented: the perceived value of work; losing and recovering a familiar identity at work; and dilemmas around using support and adaptations at work. Certain individual issues also emerged but are beyond the scope of this article. Participants tended to measure their recovery in terms of returning to work yet continued to experience certain physical and psychosocial difficulties at work related to GBS, which required active coping strategies. Limited public awareness of GBS was perceived as a hindrance when returning to work. Conclusion. This study provides a rich account of the experiences that people encounter returning to work following GBS. Rehabilitation specialists may offer more effective preparation for this process, drawing upon the issues identified

Using Existing Programs as Vehicles to Disseminate Knowledge, Provide Opportunities for Scientists to Assist Educators, and to Engage Students in Using Real Data.

Many national and statewide programs throughout the K-12 science education environment teach students about science in a hands-on format, including programs such as Global Learning and Observations to Benefit the Environment (GLOBE), Project Learning Tree (PLT), Project Wild, Project Wet, and Hoosier River Watch. Partnering with one or more of these well-known programs can provide many benefits to both the scientists involved in disseminating research and the K-12 educators. Scientists potentially benefit by broader dissemination of their research by providing content enrichment for educators. Educators benefit by gaining understanding in content, becoming more confident in teaching the concept, and increasing their enthusiasm in teaching the concepts addressed. Here we discuss an innovative framework for professional development that was implemented at Purdue University, Indiana in July 2013. The professional development incorporated GLOBE protocols with iPad app modules and interactive content sessions from faculty and professionals. By collaborating with the GLOBE program and scientists from various content areas, the Department of Earth, Atmospheric, and Planetary Sciences at Purdue University successfully facilitated a content rich learning experience for educators. Such activity is promoted and supported by Purdue University Libraries where activities such as Purdue’s GIS Day are efforts of making authentic learning sustainable in the State of Indiana and for national consideration

Leveraging Case Study Research: A Mechanism to Measure Teaching Effectiveness

This article shares findings from a descriptive, multiple case study assessing graduate outcomes 2.5 years after the completion of a teacher education program. Case study was used as an alternative to value-added measures to holistically examine complex attributes of effective teaching. Mixed methods data collection included graduate and supervisor surveys, self and supervisor evaluation of skills and dispositions, interviews, and classroom observations. Results indicated participants effectively applied the knowledge, skills, and dispositions the program was designed to achieve in the areas of Learner and Learning, Content, Instructional Practice, and Professional Responsibility. Three major recommendations emerged: 1) the necessity to develop established proficiency levels for new teachers related to diverse learners, 2) the need for shared responsibility of outcomes and targeted induction support, and 3) support for supervisor evaluation as a viable mechanism for education program accountability of teaching effectiveness of graduates

Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

There is increasing evidence that blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen) are associated with an increased risk of incident cardiovascular events; however, their associations with mortality are not established. We therefore studied the associations of these variables with cardiovascular events and total mortality in 1238 men and women aged 25-64 years, followed for 13 years in the first North Glasgow MONICA (MONItoring CArdiovascular disease) survey and West of Scotland centres in the Scottish Heart Health Study. After adjustment for age and sex, increasing whole blood viscosity, plasma viscosity, haematocrit and fibrinogen (analysed by both von Clauss and heat precipitation assays) were significantly associated with mortality. Only the association for fibrinogen (von Clauss assay) remained significant after adjustment for major cardiovascular risk factors. We conclude that clottable fibrinogen may be independently associated with mortality. However, the significance of this association, and the extent to which viscosity is associated with mortality, remain to be established in larger studies and meta-analyses

SPIRITS 16tn in NGC 3556: A heavily obscured and low-luminosity supernova at 8.8 Mpc

We present the discovery by the SPitzer InfraRed Intensive Transients Survey (SPIRITS) of a likely supernova (SN) in NGC 3556 at only 8.8 Mpc, which, despite its proximity, was not detected by optical searches. A luminous infrared (IR) transient at $M_{[4.5]} = -16.7$ mag (Vega), SPIRITS 16tn is coincident with a dust lane in the inclined, star-forming disk of the host. Using IR, optical, and radio observations, we attempt to determine the nature of this event. We estimate $A_V \approx$ 8 - 9 mag of extinction, placing it among the three most highly obscured IR-discovered SNe to date. The [4.5] light curve declined at a rate of 0.013 mag day$^{-1}$, and the $[3.6] - [4.5]$ color grew redder from 0.7 to $\gtrsim$ 1.0 mag by 184.7 days post discovery. Optical/IR spectroscopy shows a red continuum, but no clearly discernible features, preventing a definitive spectroscopic classification. Deep radio observations constrain the radio luminosity of SPIRITS 16tn to $L_{\nu} \lesssim 10^{24}$ erg s$^{-1}$ Hz$^{-1}$ between 3 - 15 GHz, excluding many varieties of radio core-collapse SNe. A type Ia SN is ruled out by the observed red IR color, and lack of features normally attributed to Fe-peak elements in the optical and IR spectra. SPIRITS 16tn was fainter at [4.5] than typical stripped-envelope SNe by $\approx$ 1 mag. Comparison of the spectral energy distribution to SNe II suggests SPIRITS 16tn was both highly obscured, and intrinsically dim, possibly akin to the low-luminosity SN 2005cs. We infer the presence of an IR dust echo powered by a peak luminosity of the transient of $5 \times 10^{40}$ erg s$^{-1} < L_{\mathrm{peak}} < 4\times10^{43}$ erg s$^{-1}$, consistent with the observed range for SNe II. This discovery illustrates the power of IR surveys to overcome the compounding effects of visible extinction and optically sub-luminous events in completing the inventory of nearby SNe.Comment: 25 pages, 10 figures, submitted to Ap