Dysfunction of Mitral Ball Valve Prosthesis

Three case histories of patients with malfunctions of Smeloff-Cutter mitral ball valve prostheses are presented here - one underwent successful replacement. The clinical diagnosis was made by observing a marked variation in the A2OC interval and intermittent absence of the opening click. Phonocardiograms were diagnostic in all three cases. while echocardiograms and even angiograms did not uniformly diagnose prosthetic valve dysfunction. Periodic phonocardiographic evaluations may be helpful in early detection of the prosthetic valve dysfunction. Once the diagnosis is established, immediate surgical treatment is imperative to prevent sudden death

Citraconate inhibits ACOD1 (IRG1) catalysis, reduces interferon responses and oxidative stress, and modulates inflammation and cell metabolism

Although the immunomodulatory and cytoprotective properties of itaconate have been studied extensively, it is not known whether its naturally occurring isomers mesaconate and citraconate have similar properties. Here, we show that itaconate is partially converted to mesaconate intracellularly and that mesaconate accumulation in macrophage activation depends on prior itaconate synthesis. When added to human cells in supraphysiological concentrations, all three isomers reduce lactate levels, whereas itaconate is the strongest succinate dehydrogenase (SDH) inhibitor. In cells infected with influenza A virus (IAV), all three isomers profoundly alter amino acid metabolism, modulate cytokine/chemokine release and reduce interferon signalling, oxidative stress and the release of viral particles. Of the three isomers, citraconate is the strongest electrophile and nuclear factor-erythroid 2-related factor 2 (NRF2) agonist. Only citraconate inhibits catalysis of itaconate by cis-aconitate decarboxylase (ACOD1), probably by competitive binding to the substrate-binding site. These results reveal mesaconate and citraconate as immunomodulatory, anti-oxidative and antiviral compounds, and citraconate as the first naturally occurring ACOD1 inhibitor

Citraconate inhibits ACOD1 (IRG1) catalysis, reduces interferon responses and oxidative stress, and modulates inflammation and cell metabolism

Although the immunomodulatory and cytoprotective properties of itaconate have been studied extensively, it is not known whether its naturally occurring isomers mesaconate and citraconate have similar properties. Here, we show that itaconate is partially converted to mesaconate intracellularly and that mesaconate accumulation in macrophage activation depends on prior itaconate synthesis. When added to human cells in supraphysiological concentrations, all three isomers reduce lactate levels, whereas itaconate is the strongest succinate dehydrogenase (SDH) inhibitor. In cells infected with influenza A virus (IAV), all three isomers profoundly alter amino acid metabolism, modulate cytokine/chemokine release and reduce interferon signalling, oxidative stress and the release of viral particles. Of the three isomers, citraconate is the strongest electrophile and nuclear factor-erythroid 2-related factor 2 (NRF2) agonist. Only citraconate inhibits catalysis of itaconate by cis-aconitate decarboxylase (ACOD1), probably by competitive binding to the substrate-binding site. These results reveal mesaconate and citraconate as immunomodulatory, anti-oxidative and antiviral compounds, and citraconate as the first naturally occurring ACOD1 inhibitor. [Image: see text

A tailored multi-model ensemble for air traffic management: Demonstration and evaluation for the Eyjafjallajökull eruption in May 2010

High quality volcanic ash forecasts are crucial to minimize the economic impact of volcanic hazards on air traffic. Decision-making is usually based on numerical dispersion modeling with only one model realization. Given the inherent uncertainty of such approach, a multi-model multi-source term ensemble has been designed and evaluated for the Eyjafjallaj&ouml;kull eruption in May 2010. Its use for air traffic management is discussed. Two multi-model ensembles were built: the first is based on the output of four dispersion models and their own implementation of ash ejection. All a priori model source terms were constrained by observational evidence of the volcanic ash cloud top as a function of time. The second ensemble is based on the same four dispersion models, which were run with three additional source terms: (i) a source term obtained with background modeling constrained with satellite data (a posteriori source term), (ii) its lower bound estimate, and (iii) its upper bound estimate. The a priori ensemble gives valuable information about the probability of ash dispersion during the early phase of the eruption, when observational evidence is limited. However, its evaluation with observational data reveals lower quality compared to the second ensemble. While the second ensemble ash column load and ash horizontal location compare well to satellite observations, 3D ash concentrations are negatively biased. This might be caused by the vertical distribution of ash, which is too much diluted in all model runs, probably due to defaults in the a posteriori source term and vertical transport and/or diffusion processes in all models. Relevant products for the air traffic management are horizontal maps of ash concentration quantiles (median, 75 %, 99 %) at a fine-resolved flight level grid. These maps can be used for route optimization in the areas where ash does not pose a direct and urgent threat to aviation. Cost-optimized consideration of such hazards will result in much less impact on flight cancellations, reroutings, and traffic flow congestions.</p