Gaseous detectors based on large-size GEM-foils are planned to be used for a variety of upgrades and new experiments using high-rate and high-intensity particle beams. An excellent quality control of ...GEM-foils is a mandatory prerequisite to select the best foils for the assembly of a GEM detector. The high voltage stability of the foils is here of uppermost importance. In particular discharges that occur at the same position need to be detected. A spark detection system has been developed to automatically detect and record the time and position of sparks. The system is based on a commercial web camera installed in a housing for the tests and a custom-made, LabVIEW-based software for control and operation. An automatic Spark-Detection System for GEM foils was designed, built and characterized. It is able to detect and record discharges in large-size GEM foils during the quality control procedure. The spark detection e ciency was estimated to be higher than 97 %, the position resolution was determined to be approximately 0.5 mm. With this system, the characterization of GEM foils can be standardized to a much greater degree than before.
Objective. Intestinal ischaemia is a life-threatening condition with high mortality, and the lack of accurate and readily available diagnostic methods often results in delay in diagnosis and ...treatment. The aim of this study was to investigate the accuracy of different plasma biomarkers in diagnosing intestinal ischaemia. Material and methods. Prospective inclusion of patients older than 50 years with acute abdomen admitted to hospital in Karlskrona, Sweden, between 2001 and 2003. Venous blood was sampled prior to any surgery and within 24 h from onset of pain. D-lactate, alpha glutathione S-transferase, intestinal fatty acid binding protein, creatine kinase B, isoenzymes of lactate dehydrogenase (LD) and alkaline liver phosphatase (ALP) were analysed. D-dimer was analysed using four different commercially available test kits. Results. In-hospital mortalities among patients with (n = 10) and without (n = 61) intestinal ischaemia were 40 % and 3 %, respectively (p = 0.003). D-dimer was associated with intestinal ischaemia (p = 0.001) independently of which assay was used. No patient presenting with a normal D-dimer had intestinal ischaemia. D-dimer >0.9 mg L had a specificity, sensitivity and accuracy of 82 %, 60 % and 79 %, respectively. Total LD, isoenzymes of LD 1-4 and liver isoenzyme of ALP (ALP liver) were significantly higher in patients with intestinal ischaemia, and accuracies for LD 2 (cut-off 2.3 µkat L) and ALP liver (cut-off 0.7 µkat L) were 69 % and 66 %, respectively. Conclusions. D-dimer may be used as an exclusion test for intestinal ischaemia, but lacks specificity. The other plasma biomarkers studied had insufficient accuracy for this group of patients. Further studies are needed.
Abstract Dengue viruses co-circulate as four serologically distinct viruses (DENV1–4) that commonly infect individuals sequentially. Current DENV candidate vaccines incorporate the entire virion ...envelope E protein (E) ectodomain thereby stimulating both DENV serotype-specific and cross-reactive antibodies. Because the latter may enhance naturally acquired infection, such vaccine formulations must be tetravalent. We evaluated the neutralizing and enhancing antibody response to E domain III (dIII) proteins, in which serotype-specific neutralizing determinants are concentrated. Mice immunized with insect cell-secreted recombinant DENV-dIII proteins individually, and in tetravalent combination, produced serotype-specific IgG1 neutralizing antibodies that nevertheless exhibited measurable DENV enhancing activity in FcγR-bearing cells. Vaccine strategies directed to DENV-dIII-targeted neutralizing antibody production remain attractive but will likely require further modifications to induce safe, protective immunity.
Objectives Quantify the association of CFTR mutations of different classes and specific identities with carriage of eight clinically relevant airway infections. Methods After obtaining IRB approval, ...we analyzed data from the CFFPR from 2003–2011. We examined carriage of Pseudomonas aeruginosa, methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA), Burkholderia sp., Alcaligenes xylosoxidans, Stenotrophomonas maltophilia, Aspergillus sp. and Candida sp. We used logistic regression (glm function in R), corrected by patient age, to compare carriage by F508del homozygotes and heterozygotes, classifying heterozygotes both by mutation class (I–V) and specific non-F508del mutation. Results Focusing on 18564 patients with genetic and microbiological data in 2010, we found that a mutation of class IV or V. decreases carriage of all infections: P. aeruginosa (OR 0.54, p<0.0001), MSSA (OR 0.92, p = 0.0002), MRSA (OR 0.57, p<0.0001), Burkholderia (OR 0.57, p<0.0001), A. xylosoxidans (OR 0.63, p<0.0001), S. maltophilia (OR 0.70, p<0.0001), Aspergillus (OR 0.70, p<0.0001), Candida (OR 0.85, p<0.0001). Five specific mutations were associated with reduced carriage of P. aeruginosa at the p<0.001 level (2789+5G→A, 5T, A455E, D1152H and R117H). In addition, carriage of MRSA and S. maltophilia and Aspergillus was lower in patients with the R117H mutation. Conclusion CF patients with milder mutations (class IV and V) have better survivorship. We show lower carriage of eight important airway pathogens is associated with milder mutation class and with specific disease-causing CFTR mutations.
Hepatocellular carcinoma (HCC) is the fifth most common cancer, but the third leading cause of cancer death, in the world, with more than 500,000 fatalities annually. The major etiology of HCC/liver ...cancer in people is hepatitis B virus (HBV), followed by hepatitis C virus infection (HCV), although nonviral causes also play a role in a minority of cases. Recent molecular studies confirm what was suspected: that HCC tissue from different individuals have many phenotypic differences. However, there are clearly features that unify HCC occurring in a background of viral hepatitis B and C. HCC due to HBV and HCV may be an indirect result of enhanced hepatocyte turnover that occurs in an effort to replace infected cells that have been immunologically attacked. Viral functions may also play a more direct role in mediating oncogenesis. This review considers the molecular and cellular mechanisms involved in primary hepatocellular carcinoma, using a viral perspective.
Our center has used a strategy of pancreas importation owing to long regional waitlist times. Here we assess the clinical outcomes and financial considerations of this strategy.
This was a ...retrospective observational cohort study of patients who received a pancreas transplant at Montefiore Medical Center (MMC) from 2014 to 2017 (n = 28). Clinical parameters, including hemoglobin A1c and complications, were analyzed. The cohort was compared with United Network for Organ Sharing (UNOS) Region 9 with the use of the UNOS/Organ Procurement and Transplantation Network database. Cost analysis of length of stay (LOS), standard acquisition (SAC) fees, and transportation was performed with the use of internal financial data.
Pancreas importation resulted in significantly shorter simultaneous pancreas kidney transplant waitlist times compared with Region 9: 518 days vs 1001 days (P = .038). In addition, postoperative complications and 1-year HbA1c did not differ between groups: local 6.30% vs import 6.17% (P = .87). Patients receiving local pancreata stayed an average of 9.2 days compared with 11 days for the import group (P = .36). As such, pancreas importation was associated with higher mean charges ($445,968) compared with local pancreas recipients ($325,470).
Long waitlist times in Region 9 have encouraged our center's adoption of pancreas importation to address the needs of our patient population. This practice has resulted in a reduction of waitlist times by an average of 483 days. Understandably, centers have long been wary of importation owing to perceived risk in clinical outcomes. In our single-center experience, we have demonstrated equivalent postoperative glucose control and graft survival. Importantly, there does appear to be increased costs associated with importation, which are mainly driven by LOS. Curiously, importation from regions with lower SAC fees has the potential to offset costs related to transportation expenses. Notwithstanding these findings, pancreas importation does have the potential to lessen the financial societal burden through reduction in waitlist times.
•Given the increased regional wait times and unmet need for pancreas allografts in UNOS Region 9, Montefiore Medical Center (MMC) implemented a strategy of pancreas graft importation.•Utilizing this importation strategy, MMC was able to lower median waitlist times in comparison to the remainder of Region 9, with SPK wait times being significantly lower at MMC.•When comparing clinical outcomes between the locally acquired and imported grafts at MMC, both postoperative complications and one year HbA1c were comparable between the two groups.•Lower SAC fees from imported organs offset travel expenditure.•Imported grafts were associated with higher inpatient hospital charges, driven by length of stay (LOS).
After radical retropubic prostatectomy a rise of the prostate-specific antigen (PSA) indicates a local recurrent or metastatic disease. If the bone scan shows no apparent bone metastasis, ...morphological imaging methods like x-ray computed tomography, magnetic resonance imaging or transrectal ultrasound often cannot distinguish between postoperative scar and local recurrence. Therefore we investigated the feasibility of fluorine-18-fluorodeoxyglucose positron emission tomography (F-18 FDG PET) for metabolic characterization of prostatic cancer, especially for differentiation of scar or recurrent prostate cancer after radical prostatectomy.
Dynamic PET with 370 MBq F-18 deoxyglucose (F-18 FDG) up to 60 min p.i. was performed in 2 patients with biopsy-proven benign prostatic hyperplasia, in 11 patients with a histologically proven prostate cancer prior to radical retropubic prostatectomy (RRP) and 7 patients with suspected local recurrence (with negative bone scan) after RRP prior to biopsy of anastomosis (3 local recurrence, 4 postoperative scar).
Prostate cancer showed a very low F-18 FDG uptake. The placement of regions of interest was only possible by the use of other imaging methods. There was not difference between the F-18 FDG uptake of benign prostate hyperplasia, prostate carcinoma, postoperative scar or local recurrence after radical prostatectomy.
F-18 FDG seems not to be useful to distinguish between postoperative scar and local recurrence after radical prostatectomy.
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