Large Artery Occlusive Disease

Extracranial and intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack (TIA). Given the high prevalence of large artery atherosclerosis in the general population, optimally treating each patient to minimize future stroke risk is paramount. To optimally define treatment, as based upon the individual patient’s history, examination, and anatomical imaging findings, clinicians can compartmentalize this disease entity into four distinct clinical scenarios: 1(a) asymptomatic and 1(b) symptomatic extracranial carotid stenosis, (2) intracranial atherosclerosis, and (3) atherosclerotic vertebrobasilar disease. In this chapter, we work to provide a framework for clinicians evaluating and treating such patients

Cerebral Venous Thrombosis: A Clinical Overview

Cerebral venous thrombosis (CVT) is a less common cause of stroke that is an often under recognized entity in clinical practice. The goal of this chapter will be to provide clinicians with the knowledge to succinctly recognize the various presentations of CVT, emphasizing rapid diagnosis and the potential treatments necessary to produce optimal clinical outcomes. Detailed descriptions of the relevant anatomy and associated clinical syndromes will be discussed. Detailed sections regarding CVT epidemiology, pathophysiology, etiology, diagnosis and treatment will be provided. Prognosis and long-term follow-up will also be discussed. Relevant literature will be cited and clinical trials across the spectrum of CVT will be highlighted

Large Loops of Magnetic Current and Confinement in Four Dimensional U(1)U(1) Lattice Gauge Theory

We calculate the heavy quark potential from the magnetic current due to monopoles in four dimensional $U(1)$ lattice gauge theory. The magnetic current is found from link angle configurations using the DeGrand-Toussaint identification method. The link angle configurations are generated in a cosine action simulation on a $24^4$ lattice. The magnetic current is resolved into large loops which wrap around the lattice and simple loops which do not. Wrapping loops are found only in the confined phase. It is shown that the long range part of the heavy quark potential, in particular the string tension, can be calculated solely from the large, wrapping loops of magnetic current.Comment: 15 pages (Latex file plus 3 postscript files appended), Univeristy of Illinois Preprint ILL-(TH)-93-\#1

Vaccinia virus protein A46R targets multiple Toll-like-interleukin-1 receptor adaptors and contributes to virulence

Viral immune evasion strategies target key aspects of the host antiviral response. Recently, it has been recognized that Toll-like receptors (TLRs) have a role in innate defense against viruses. Here, we define the function of the vaccinia virus (VV) protein A46R and show it inhibits intracellular signalling by a range of TLRs. TLR signalling is triggered by homotypic interactions between the Toll-like-interleukin-1 resistance (TIR) domains of the receptors and adaptor molecules. A46R contains a TIR domain and is the only viral TIR domain-containing protein identified to date. We demonstrate that A46R targets the host TIR adaptors myeloid differentiation factor 88 (MyD88), MyD88 adaptor-like, TIR domain-containing adaptor inducing IFN-beta (TRIF), and the TRIF-related adaptor molecule and thereby interferes with downstream activation of mitogen-activated protein kinases and nuclear factor kappaB. TRIF mediates activation of interferon (IFN) regulatory factor 3 (IRF3) and induction of IFN-beta by TLR3 and TLR4 and suppresses VV replication in macrophages. Here, A46R disrupted TRIF-induced IRF3 activation and induction of the TRIF-dependent gene regulated on activation, normal T cell expressed and secreted. Furthermore, we show that A46R is functionally distinct from another described VV TLR inhibitor, A52R. Importantly, VV lacking the A46R gene was attenuated in a murine intranasal model, demonstrating the importance of A46R for VV virulence

Moving beyond the ‘language problem': developing an understanding of the intersections of health, language and immigration status in interpreter-mediated health encounters

Health systems internationally are dealing with greater diversity in patient populations. However the focus on ‘the language problem’ has meant little attention is paid to diversity within and between migrant populations; and how interpreted consultations are influenced by intersecting migratory, ethnicity and sociodemographic variables. Our analysis of the experiences of patients, health care providers and interpreters in Scotland evidences the need to move beyond language, addressing multiple hidden inequalities in health care access and provision that operate in both clinic and, especially, home-based settings. We call for a practice-evidenced research agenda promoting cultural communication across health care and home settings, acknowledging immigration status as a social determinant of health. Sur le plan international, des systèmes de santé font face à une diversité croissante dans ses populations de patients. Cependant, l’accent sur ‘le problème de langue’ se traduit dans une manque d’attention à la diversité a l’intérieur même et entre des populations des migrants; et la façon par laquelle des variables migratoire, ethnique et sociodémographique influencent elles-mêmes des consultations interprétées. Notre analyse des expériences des patients, des professionnels fournissant de soins de santé et des interprètes offre des preuves du besoin de dépasser le problème de langue. Et en faisant cela, nous adressons des multiples inégalités, souvent cachées dans des contextes de soins de santé, dans les milieux clinique et domicile. Nous proposons un programme de recherche basé sur la pratique, qui favorise la communication culturelle dans des milieux clinique et domicile, et qui reconnait le statut d’immigration comme un déterminant social de la santé

Liposomal delivery of p-ialB and p-omp25 DNA vaccines improves immunogenicity but fails to provide full protection against B. melitensis challenge

BACKGROUND: We have previously demonstrated protective efficacy against B. melitensis using formulations of naked DNA vaccines encoding genes ialB and omp25. The present study was undertaken to further understand the immune response generated by the protective vaccination regimens and to evaluate cationic liposome adsorption as a delivery method to improve vaccine utility. METHODS: The protective efficacy and immunogenicity of vaccines delivered as four doses of naked DNA, a single dose of naked DNA or a single dose of DNA surface adsorbed to cationic liposomes were compared using the BALB/c murine infection model of B. melitensis. Antigen-specific T cells and antibody responses were compared between the various formulations. RESULTS: The four dose vaccination strategy was confirmed to be protective against B. melitensis challenge. The immune response elicited by the various vaccines was found to be dependent upon both the antigen and the delivery strategy, with the IalB antigen favouring CD4+ T cell priming and Omp25 antigen favouring CD8+. Delivery of the p-ialB construct as a lipoplex improved antibody generation in comparison to the equivalent quantity of naked DNA. Delivery of p-omp25 as a lipoplex altered the profile of responsive T cells from CD8+ to CD4+ dominated. Under these conditions neither candidate delivered by single dose naked DNA or lipoplex vaccination methods was able to produce a robust protective effect. CONCLUSIONS: Delivery of the p-omp25 and p-ialB DNA vaccine candidates as a lipoplex was able to enhance antibody production and effect CD4+ T cell priming, but was insufficient to promote protection from a single dose of either vaccine. The enhancement of immunogenicity by lipoplex delivery is a promising step toward improving the practicality of these two candidate vaccines, and suggests that this lipoplex formulation may be of value in situations where improvements to CD4+ responses are required. However, in the case of Brucella vaccine development it is suggested that further modifications to the candidate vaccines and delivery strategies will be required in order to deliver sustained protection

The Coulomb law in the pure gauge U(1) theory on a lattice

We study the heavy charge potential in the Coulomb phase of pure gauge compact U(1) theory on the lattice. We calculate the static potential $V_W(T,{\vec R})$ from Wilson loops on a $16^3 \times 32$ lattice and compare with the predictions of lattice perturbation theory. We investigate finite size effects and, in particular, the importance of non-Coulomb contributions to the potential. We also comment on the existence of a maximal coupling in the Coulomb phase of pure gauge U(1) theory.Comment: 14 pages. LaTeX file and 3 postscript figure

Scaling analysis of the magnetic monopole mass and condensate in the pure U(1) lattice gauge theory

We observe the power law scaling behavior of the monopole mass and condensate in the pure compact U(1) gauge theory with the Villain action. In the Coulomb phase the monopole mass scales with the exponent \nu_m=0.49(4). In the confinement phase the behavior of the monopole condensate is described with remarkable accuracy by the exponent \beta_{exp}=0.197(3). Possible implications of these phenomena for a construction of a strongly coupled continuum U(1) gauge theory are discussed.Comment: Added references [1

Representations of sport in the revolutionary socialist press in Britain, 1988–2012

This paper considers how sport presents a dualism to those on the far left of the political spectrum. A long-standing, passionate debate has existed on the contradictory role played by sport, polarised between those who reject it as a bourgeois capitalist plague and those who argue for its reclamation and reformation. A case study is offered of a political party that has consistently used revolutionary Marxism as the basis for its activity and how this party, the largest in Britain, addresses sport in its publications. The study draws on empirical data to illustrate this debate by reporting findings from three socialist publications. When sport did feature it was often in relation to high profile sporting events with a critical tone adopted and typically focused on issues of commodification, exploitation and alienation of athletes and supporters. However, readers’ letters, printed in the same publications, revealed how this interpretation was not universally accepted, thus illustrating the contradictory nature of sport for those on the far left

Meson Cloud of the Nucleon in Polarized Semi-Inclusive Deep-Inelastic Scattering

We investigate the possibility of identifying an explicit pionic component of the nucleon through measurements of polarized $\Delta^{++}$ baryon fragments produced in deep-inelastic leptoproduction off polarized protons, which may help to identify the physical mechanism responsible for the breaking of the Gottfried sum rule. The pion-exchange model predicts highly correlated polarizations of the $\Delta^{++}$ and target proton, in marked contrast with the competing diquark fragmentation process. Measurement of asymmetries in polarized $\Lambda$ production may also reveal the presence of a kaon cloud in the nucleon.Comment: 23 pages REVTeX, 7 uuencoded figures, accepted for publication in Zeit. Phys.