Mortality in Sepsis and its relationship with Gender.

BACKGROUND AND OBJECTIVE: Sepsis remains a leading cause of death across the world, carrying a mortality rate of 20-50%. Women have been reported to be less likely to suffer from sepsis and to have a lower risk of mortality from sepsis compared to men. The objective of this study was to determine the relationship between gender and mortality in sepsis, and compare cytokine profiles of male and female patients. METHODS: This was a prospective case series on 97 patients admitted with sepsis. Clinical and microbiological data was gathered, blood samples were collected for cytokine (IL-10, IL-6 and TNFα) levels and patients were followed up for clinical outcome. RESULTS: There were 54% males and 46% females, with no significant difference of age or comorbids between genders. Respiratory tract infection was the commonest source of sepsis, and was more common in females (60%) compared to males (39%) (p=0.034). Males had a higher mortality (p=0.048, RR 1.73) and plasma IL-6 level(p=0.040) compared to females. Mean IL-6 plasma level was significantly (p\u3c0.01) higher in patients who died vs. who recovered. CONCLUSION: Our study shows that males with sepsis have a 70% greater mortality rate, and mortality is associated with a higher IL-6 plasma level

Modeling of the MEMS Reactive Ion Etching Process Using Neural Networks

Abstract Reactive ion etch (RIE) is commonly used in microelectromechanical systems (MEMS) fabrication as plasma etching method, where ions react with wafer surface substrate in plasma environment. Due to the importance of RIE in the MEMS field, two prediction models are established to predict the wafer status in reactive ion etching process: back-propagation neural network (BPNN) and principle component analysis BPNN (PCABPNN). These models have the potential to reduce the overall cost of ownership of MEMS equipment by increasing the wafer yield, and not depend upon monitoring wafers or expensive metrology rather it will enable inexpensive real-time wafer-to-wafer control applications in RIE. The artificial neural net (ANN) is trained with historical available input-output process data. Once trained, the ANN forecasts the process output rapidly if given the input values

Time-dependent density-matrix functional theory for biexcitonic phenomena

We formulate a time-dependent density-matrix functional theory (TDDMFT) approach for higher-order correlation effects like biexcitons in optical processes in solids based on the reduced two-particle density-matrix formalism within the normal orbital representation. A TDDMFT version of the Schr\"odinger equation for biexcitons in terms of one- and two-body reduced density matrices is derived, which leads to finite biexcitonic binding energies already with an adiabatic approximation. Biexcitonic binding energies for several bulk semiconductors are calculated using a contact biexciton model

First principles calculations of the electronic and geometric structure of Ag27Cu7Ag_{27}Cu_{7} nanoalloy

\emph{Ab initio} calculations of the structure and electronic density of states (DOS) of the perfect core-shell $Ag_{27}Cu_{7}$ nanoalloy attest to its $D_{5h}$ symmetry and confirm that it has only 6 non-equivalent (2 $Cu$ and 4 $Ag$) atoms. Analysis of bond-length, average formation energy, heat of formation of $Ag_{27}Cu_{7}$ and $L1_2$ $Ag-Cu$ alloys provide an explanation for the relative stability of the former with respect to the other nanoalloys in the same family. The HOMO-LUMO gap is found to be 0.77 eV, in agreement with previous results. Analysis of the DOS of $Ag_{27}Cu_{7}$, $L1_2$ $Ag-Cu$ alloys and related systems provides insight into the effects of low coordination, contraction/expansion and the presence of foreign atoms on the DOS of $Cu$ and $Ag$. While some characteristics of the DOS are reminiscent of those of the phonon-stable $L1_2$ $Ag-Cu$ alloys, the $Cu$ and $Ag$ states hybridize significantly in $Ag_{27}Cu_{7}$, compensating the $d$-band narrowing that each atom undergoes and hindering the dip in the DOS found in the bulk alloys. Charge density plots of $Ag_{27}Cu_{7}$ provide further insights into the relative strengths of the various interatomic bonds. Our results for the electronic and geometric structure of this nanoalloy can be explained in terms of length and strength hierarchies of the bonds, which may have implications also for the stability of alloy in any phase or size.Comment: 16 figure

To evaluate the correlation between gingival crevicular blood glucose and capillary blood glucose to screen diabetes mellitus in the dental office

Background: Most of the Indian population goes undiagnosed for diabetes due to unawareness. This will lead to more serious and long-term complications of diabetes. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection. Research has explored the dental office as a strategic venue of opportunity for glucose testing, examining the possibility of using gingival crevicular fluid (GCF) for diabetes screening. Aim: The aim of this study is to evaluate the reliability of gingival crevicular blood (GCB) to screen the diabetes. Methodology: Thirty patients were randomly selected based on bleeding on probing and probing depth. GCB and capillary finger blood (CFB) glucose levels were calculated using glucometer from patients. Data for glucose levels were statistically analyzed. Results: The correlation between GCB and CFB was high. Conclusion: GCB can be used as the screening test for diabetes in the dental office. Clinical Significance: GCB blood glucose level detection can be used as chairside screening test for diabetes patients

Diffusion of small two-dimensional Cu islands on Cu(111) studied with a kinetic Monte Carlo method

Diffusion of small two-dimensional Cu islands (containing up to 10 atoms) on Cu(111) has been studied using the newly developed self-learning Kinetic Monte Carlo (SLKMC) method which is based on a database of diffusion processes and their energetics accumulated automatically during the implementation of the SLKMC code. Results obtained from simulations in which atoms hop from one fcc hollow site to another are compared with those obtained from a parallel set of simulations in which the database is supplemented by processes revealed in complementary molecular dynamics simulations at 500K. They include processes involving the hcp (stacking-fault) sites, which facilitate concerted motion of the islands (simultaneous motion of all atoms in the island). A significant difference in the scaling of the effective diffusion barriers with island size is observed in the two cases. In particular, the presence of concerted island motion leads to an almost linear increase in the effective diffusion barrier with size, while its absence accounts for strong size-dependent oscillations and anomalous behavior for trimers and heptamers. We also identify and discuss in detail the key microscopic processes responsible for the diffusion and examine the frequencies of their occurrence, as a function of island size and substrate temperature.Peer reviewe

BMPR-II deficiency elicits pro-proliferative and anti-apoptotic responses through the activation of TGFbeta-TAK1-MAPK pathways in PAH

Pulmonary arterial hypertension (PAH) is a cardiovascular disorder associated with enhanced proliferation and suppressed apoptosis of pulmonary arterial smooth muscle cells (PASMCs). Heterozygous mutations in the type II receptor for bone morphogenetic protein (BMPR2) underlie the majority of the inherited and familial forms of PAH. The transforming growth factor beta (TGFbeta) pathway is activated in both human and experimental models of PAH. However, how these factors exert pro-proliferative and anti-apoptotic responses in PAH remains unclear. Using mouse primary PASMCs derived from knock-in mice, we demonstrated that BMPR-II dysfunction promotes the activation of small mothers against decapentaplegia-independent mitogen-activated protein kinase (MAPK) pathways via TGFbeta-associated kinase 1 (TAK1), resulting in a pro-proliferative and anti-apoptotic response. Inhibition of the TAK1-MAPK axis rescues abnormal proliferation and apoptosis in these cells. In both hypoxia and monocrotaline-induced PAH rat models, which display reduced levels of bmpr2 transcripts, this study further indicates that the TGFbeta-MAPK axis is activated in lungs following elevation of both expression and phosphorylation of the TAK1 protein. In ex vivo cell-based assays, TAK1 inhibits BMP-responsive reporter activity and interacts with BMPR-II receptor. In the presence of pathogenic BMPR2 mutations observed in PAH patients, this interaction is greatly reduced. Taken together, these data suggest dysfunctional BMPR-II responsiveness intensifies TGFbeta-TAK1-MAPK signalling and thus alters the ratio of apoptosis to proliferation. This axis may be a potential therapeutic target in PAH

BMPRII deficiency impairs apoptosis via the BMPRII-ALK1-BclX-mediated pathway in pulmonary arterial hypertension (PAH)

YesPulmonary Arterial Hypertension (PAH) is a devastating cardiovascular disorder characterised by the remodelling of pre-capillary pulmonary arteries. The vascular remodelling observed in PAH patients results from excessive proliferation and apoptosis resistance of pulmonary arterial smooth muscle (PASMCs) and endothelial cells (PAECs). We have previously demonstrated that mutations in the type II receptor for bone morphogenetic protein (BMPRII) underlie the majority of the familial and inherited forms of the disease. We have further demonstrated that BMPRII deficiency promotes excessive proliferation and attenuates apoptosis in PASMCs, but the underlying mechanisms remain unclear. The major objective of this study is to investigate how BMPRII deficiency impairs apoptosis in PAH. Using multidisciplinary approaches, we demonstrate that deficiency in the expression of BMPRII impairs apoptosis by modulating the alternative splicing of the apoptotic regulator, Bcl-x (B-cell lymphoma X) transcripts: a finding observed in circulating leukocytes and lungs of PAH subjects, hypoxia-induced PAH rat lungs as well as in PASMCs and PAECs. BMPRII deficiency elicits cell specific effects: promoting the expression of Bcl-xL transcripts in PASMCs whilst inhibiting it in ECs, thus exerting differential apoptotic effects in these cells. The pro-survival effect of BMPRII receptor is mediated through the activin receptor like kinase 1 (ALK1) but not the ALK3 receptor. Finally, we show that BMPRII interacts with the ALK1 receptor and pathogenic mutations in the BMPR2 gene abolish this interaction. Taken together, dysfunctional BMPRII responsiveness impairs apoptosis via the BMPRII-ALK1-Bcl-xL pathway in PAH. We suggest Bcl-xL as a potential biomarker and druggable target.This work was supported by a fellowship (awarded to MTN) from the Department of Health via the NIHR Comprehensive Biomedical Research Centre award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London, Heptagon Life Science Proof of Concept Fund (grant KCL24 to MTN), the Great Britain Sasakawa Foundation (grant B70 to MTN), the Royal Society (grant 43049 to MTN), the Medical Research Council (grant G900865 to RCT, MTN and NWM) and the University of Bradford (grants 003200, 66006/001NAS and DH005 to MTN). NS and MYB were supported by scholarships from the Commonwealth Scholarship Commission, UK and Scientific and Technological Research Council of Turkey (TUBITAK), respectively

Verbal Autopsy of Maternal Deaths in Two Districts of Pakistan-Filling Information Gaps

In Pakistan, the vital registration system is weak, and population-based data on the maternal mortality ratio are limited. This study was carried out to collect information on maternal deaths from different existing sources during the current year-2007 (prospective) and the past two years-2005 and 2006-(retrospective), identify gaps in information, and critically analyze maternal deaths at the community and health-facility levels in two districts in Pakistan. The verbal autopsy questionnaire was administered to households where a maternal death had occurred. No single source had complete data on maternal deaths. Risk factors identified among 128 deceased women were low socioeconomic status, illiteracy, low-earning jobs, parity, and bad obstetric history. These were similar to the findings of earlier studies. Half of the women did seek antenatal care, 34% having made more than four visits. Of the 104 women who died during or after delivery, 38% had delivered in a private facility and 18% in a government facility. The quality of services in both private and public sectors was inadequate. Sixty-nine percent of deaths occurred in the postpartum period, and 51% took place within 24 hours of delivery. The study identified gaps in reporting of maternal deaths and also provided profile of the dead women and the causes of death

Design of 11-Residue Peptides with Unusual Biophysical Properties: Induced Secondary Structure in the Absence of Water

AbstractA series of oligopeptides with β-forming and adhesive properties, were synthesized and analyzed for adhesion shear strength, secondary structure, and association properties. The sequences contained related hydrophobic core segments varying in length from 5 to 12 residues and flanked by di- or tri-lysine segments. Three remarkable peptides consisting of just 11 residues with hydrophobic core sequences of FLIVI, IGSII, and IVIGS flanked by three lysine residues gave the highest dry adhesion shear strength and displayed unusual biophysical properties in the presence and absence of water. KKKFLIVIKKK had its highest adhesion strength at 2% (w/v) at pH 12.0 and showed the highest adhesion strength after exposure to water (water resistance). Both KKKIGSIIKKK and KKKIVIGSKKK, at 4% (w/v) at pH 12.0, displayed nearly identical dry shear strength values to that with the FLIVI core sequence. The peptide with IGSII core, however, displayed a lower water resistance and the latter, IVIGS, showed no water resistance, completely delaminating upon soaking in water. These are the smallest peptides with adhesive properties reported to date and show remarkable adhesion strength even at lower concentrations of 0.2% (w/v), which corresponds to 1.6mM. The FLIVI containing peptide adopted a β-sheet secondary structure in water while the IGSII- and IVIGS-containing sequences folded similarly only in the absence of water. Analytical ultracentrifugation studies showed that when the FLIVI sequence adopts β-structure in aqueous solution, it associates into a large molecular weight assembly. The random coils of IGSII and IVIGS showed no tendency to associate at any pH