Use of Colour Duplex Ultrasound as a First Line Surveillance Tool Following EVAR is Associated with a Reduction in Cost Without Compromising Accuracy

CT scanning remains the postoperative surveillance imaging modality of choice following EVAR. Concerns regarding cost, exposure to ionising radiation and intravenous contrast have led to a search for a less expensive, equally efficacious and safer method of monitoring EVAR patients after endograft deployment. This study evaluated the cost saving obtained if CDUS was employed as a first line surveillance tool following EVAR, as well as comparing the two entities in terms of efficacy. Patients & methods: Postoperative surveillance CTs and CDUS scans in the 145 patients who have undergone EVAR from 1st June 2003 to 1st July 2010 were compared for the detection of endoleak and determination of residual sac size. Results: Adopting a protocol where CDUS was employed as the first line surveillance tool following EVAR would result in a reduction in the number of postoperative CTs required in 2010 from 235 to 36. Based on 2010 costings, this would equate to an estimated reduction in expenditure from V117,500 to V34,915 a saving of V82,585. CDUS had a sensitivity of 100% and a specificity of 85% in the detection of endoleaks compared to CT. The positive predictive value was 28% and negative predictive value 100%. The Pearson Coefficient correlation of 0.96 indicates a large degree of correlation between CDUS and CT when measuring residual aneurysm size following EVAR. Conclusion: CDUS can replace CT as the first line surveillance tool following EVAR. This is associated with a significant reduction in the cost of surveillance without any loss of imaging accurac

Use of Colour Duplex Ultrasound as a First Line Surveillance Tool Following EVAR is Associated with a Reduction in Cost Without Compromising Accuracy

CT scanning remains the postoperative surveillance imaging modality of choice following EVAR. Concerns regarding cost, exposure to ionising radiation and intravenous contrast have led to a search for a less expensive, equally efficacious and safer method of monitoring EVAR patients after endograft deployment. This study evaluated the cost saving obtained if CDUS was employed as a first line surveillance tool following EVAR, as well as comparing the two entities in terms of efficacy. Patients & methods: Postoperative surveillance CTs and CDUS scans in the 145 patients who have undergone EVAR from 1st June 2003 to 1st July 2010 were compared for the detection of endoleak and determination of residual sac size. Results: Adopting a protocol where CDUS was employed as the first line surveillance tool following EVAR would result in a reduction in the number of postoperative CTs required in 2010 from 235 to 36. Based on 2010 costings, this would equate to an estimated reduction in expenditure from V117,500 to V34,915 a saving of V82,585. CDUS had a sensitivity of 100% and a specificity of 85% in the detection of endoleaks compared to CT. The positive predictive value was 28% and negative predictive value 100%. The Pearson Coefficient correlation of 0.96 indicates a large degree of correlation between CDUS and CT when measuring residual aneurysm size following EVAR. Conclusion: CDUS can replace CT as the first line surveillance tool following EVAR. This is associated with a significant reduction in the cost of surveillance without any loss of imaging accurac

Carboxypeptidase O is a Lipid Droplet-associated Enzyme Able to Cleave both Acidic and Polar C-terminal Amino Acids

Carboxypeptidase O (CPO) is a member of the M14 family of metallocarboxypeptidases with a preference for the cleavage of C-terminal acidic amino acids. CPO is largely expressed in the small intestine, although it has been detected in other tissues such as the brain and ovaries. CPO does not contain a prodomain, nor is it strongly regulated by pH, and hence appears to exist as a constitutively active enzyme. The goal of this study was to investigate the intracellular distribution and activity of CPO in order to predict physiological substrates and function. The distribution of CPO, when expressed in MDCK cells, was analyzed by immunofluorescence microscopy. Soon after addition of nutrient-rich media, CPO was found to associate with lipid droplets, causing an increase in lipid droplet quantity. As media became depleted, CPO moved to a broader ER distribution, no longer impacting lipid droplet numbers. Membrane cholesterol levels played a role in the distribution and in vitro enzymatic activity of CPO, with cholesterol enrichment leading to decreased lipid droplet association and enzymatic activity. The ability of CPO to cleave C-terminal amino acids within the early secretory pathway (in vivo) was examined using Gaussia luciferase as a substrate, C-terminally tagged with variants of an ER retention signal. While no effect of cholesterol was observed, these data show that CPO does function as an active enzyme within the ER where it removes C-terminal glutamates and aspartates, as well as a number of polar amino acids

Exosomes: From potential culprits to new therapeutic promise in the setting of cardiac fibrosis

Fibrosis is a significant global health problem associated with many inflammatory and degenerative diseases affecting multiple organs, individually or simultaneously. Fibrosis develops when extracellular matrix (ECM) remodeling becomes excessive or uncontrolled and is associated with nearly all forms of heart disease. Cardiac fibroblasts and myofibroblasts are the main effectors of ECM deposition and scar formation. The heart is a complex multicellular organ, where the various resident cell types communicate between themselves and with cells of the blood and immune systems. Exosomes, which are small extracellular vesicles, (EVs), contribute to cell-to-cell communication and their pathophysiological relevance and therapeutic potential is emerging. Here, we will critically review the role of endogenous exosomes as possible fibrosis mediators and discuss the possibility of using stem cell-derived and/or engineered exosomes as anti-fibrotic agents

A Cluster of Legionnaires' Disease and Associated Pontiac Fever Morbidity in Office Workers, Dublin, June-July 2008

In June and July 2008, two office workers were admitted to a Dublin hospital with Legionnaires' disease. Investigations showed that cooling towers in the basement car park were the most likely source of infection. However, positive results from cooling tower samples by polymerase chain reaction (PCR) did not correlate with subsequent culture results. Also, many employees reported Pontiac fever-like morbidity following notification of the second case of Legionnaires' disease. In total, 54 employees attended their general practitioner or emergency department with symptoms of Legionnaires' disease or Pontiac fever. However, all laboratory tests for Legionnaires' disease or Pontiac fever were negative. In this investigation, email was used extensively for active case finding and provision of time information to employees and medical colleagues. We recommend clarification of the role of PCR in the diagnosis of legionellosis and also advocate for a specific laboratory test for the diagnosis of the milder form of legionellosis as in Pontiac fever

Platelets induce free and phospholipid-esterified 12-hydroxyeicosatetraenoic acid generation in colon cancer cells by delivering 12-lipoxygenase

Platelets promote tumor metastasis by inducing promalignant phenotypes in cancer cells and directly contributing to cancer-related throm-botic complications. Platelet-derived extracellular vesicles (EVs) can promote epithelial-mesenchymal transition (EMT) in cancer cells, which confers high-grade malignancy. 12S-hydroxyeicosatetraenoic acid (12-HETE) generated by platelet-type 12-lipoxygenase (12-LOX) is considered a key modulator of cancer metastasis through unknown mechanisms. In plate-lets, 12-HETE can be esterified into plasma membrane phospholipids (PLs), which drive thrombosis. Using cocultures of human platelets and human colon adenocarcinoma cells (line HT29) and LC-MS/MS, we investigated the impact of platelets on cancer cell biosynthesis of 12S-HETE and its esterification into PLs and whether platelet ability to transfer its mo-lecular cargo might play a role. To this aim, we performed coculture experiments with CFSE[5-(and-6)-carboxyfluorescein diacetate, succinimidyl ester]-loaded platelets. HT29 cells did not generate 12S-HETE or express 12-LOX. However, they ac-quired the capacity to produce 12S-HETE mainly esterified in plasmalogen phospholipid forms following the uptake of platelet-derived medium-sized EVs (mEVs) expressing 12-LOX. 12-LOX was detected in plasma mEV of patients with adenomas/ adenocarcinomas, implying their potential to deliver the protein to cancer cells in vivo. In cancer cells exposed to platelets, endogenous but not exogenous 12S-HETE contributed to changes in EMT gene expression, mitigated by three structurally unrelated 12-LOX inhibitors. In conclusion, we showed that platelets induce the generation of primarily esteri-fied 12-HETE in colon cancer cells following mEV-mediated delivery of 12-LOX. The modification of cancer cell phospholipids by 12-HETE may functionally impact cancer cell biology and represent a novel target for anticancer agent development

QCD Sum Rule Analysis of the Decays B→Kℓ+ℓ−B \to K \ell^+ \ell^- and B→K∗ℓ+ℓ−B \to K^* \ell^+ \ell^-

We use QCD sum rules to calculate the hadronic matrix elements governing the rare decays $B \to K \ell^+ \ell^-$ and $B \to K^* \ell^+ \ell^-$ induced by the flavour changing neutral current $b \to s$ transition. We also study relations among semileptonic and rare $B \to K^{(*)}$ decay form factors. The analysis of the invariant mass distribution of the lepton pair in $B \to K^{(*)} \ell^+ \ell^-$ and of the angular asymmetry in $B \to K^* \ell^+ \ell^-$ provides us with interesting tests of the Standard Model and its extensions.Comment: 26 pages REVTEX + 7 figures. Some typos corrected, figure 5 and 7 modified. This version will appear on Physical Review

Mature exotic conifer stands have greater catches of the EU-protected Geomalacus maculosus than adjacent peatland or clear-felled stands—implications for forestry

© 2017, INRA and Springer-Verlag France SAS, part of Springer Nature. Key message: Mature exotic Sitka spruce (Picea sitchensis; Bong. Carrière)-dominated stands, particularly trees of greater circumference, result in greater numbers ofGeomalacus maculosus(Allman) captures than adjacent clear-felled stands and adjacent peatland with Before-After-Control-Impact-Paired analysis indicating lower catches ofG. maculosuspost-felling. Context: The discovery of EU-protected Geomalacus maculosus in commercial plantations requires an understanding of the implications of forestry practices for the species within the context of sustainable forest management. Aims: 1.Compare Geomalacus maculosus captures across mature exotic Sitka spruce-dominated stands, previously clear-felled stands and adjacent peatland habitats.2.Assess the suitability, for forest managers, of population estimate models for G. maculosus.3.Assess the implications of felling by comparing relative abundances of G. maculosus directly before and after clear-felling at a mature exotic Sitka spruce-dominated stand. Methods: Geomalacus maculosus catches were compared at four sites across two to three mature (43–45 years old) conifer stands per site, one clear-felled stand per site, and one adjacent peatland per site using refuge traps and hand searching. Capture-mark-recapture studies were undertaken to estimate population sizes. A BACIP (Before-After-Control-Impact-Paired) analysis was undertaken in one forest stand at one forest site to determine impacts of a clear-felling event. Results: Mean catches of Geomalacus maculosus adults in the mature forest stands were over 10 and 11 times greater than mean catches on peatland and clear-fell stands, respectively. The Schnabel model for estimating population size was most suited for mature forest stands but could not be utilised for the other habitats. BACIP analysis showed a significant impact of clear-felling with a 95% reduction in mean G. maculosus catches after a clear-felling event where none of the individuals marked prior to felling were recaptured compared to 21% recapture rates at the control site. Greater tree circumference in mature conifer stands correlated with greater catches. Conclusion: Guidelines are needed to ensure the protection of Geomalacus maculosus in commercial forestry. Interventions could include patch/tall stump retention at final felling and/or translocation of the protected species

Can the Mechanism for π1→ηπ,η′π\pi_1\to \eta\pi,\eta'\pi Hybrid Decays be Detected?

Two mechanisms for the $\pi_1$ ($J^{PC}=1^{-+}$) hybrid meson decay processes $\pi_1\to\eta\pi,\eta'\pi$ are investigated. These mechanisms are applied to $\phi\to\eta\gamma,\eta'\gamma$ and $J/\psi\to\eta\gamma,\eta'\gamma$ decays to illustrate the validity of the decay mechanisms and to obtain independent information on the coupling of $\eta,\eta'$ to quark and gluonic operators. From this information, we find that $\Gamma(\pi_1\to\eta\pi)/\Gamma(\pi_1\to\eta'\pi)$ is substantially different in the two decay mechanisms, and hence future experimental measurements of this ratio will provide valuable information for substantiating the hybrid nature of these states and for determining the mechanism for these hybrid decays.Comment: 5 pages, revtex, 1 eps figure embedded in manuscript. Analysis and references extended in v