Objective This study evaluated the feasibility, safety and 1-year results of mechanochemical endovenous ablation (MOCA™) of small saphenous vein (SSV) insufficiency. Design Prospective cohort study. ...Materials and methods Fifty consecutive patients were treated for primary SSV insufficiency with MOCA™ using the ClariVein® device and polidocanol. Initial technical success, complications, patient satisfaction and visual analogue scale (VAS) pain score were assessed. Anatomic and clinical success was assessed at 6 weeks and at 1 year. Results Initial technical success of MOCA™ was 100%. At the 6-week assessment, all treated veins were occluded. The 1-year follow-up duplex showed anatomic success in 94% (95% confidence interval, 0.87–1). Venous clinical severity score (VCSS) decreased significantly from 3.0 (interquartile range (IQR) 2–5) before treatment to 1.0 (IQR 1–3, P < 0.001) at 6 weeks and to 1.0 (IQR 1–2, P < 0.001) at 1 year. Median procedural VAS score for pain was 2 (IQR 2–4). No major complications were observed, especially no nerve injury. Conclusions MOCA™ is a safe, feasible and efficacious technique for treatment of SSV insufficiency. One-year follow-up shows a 94% anatomic success rate and no major complications.
In order to estimate the forces exerted on ship propellers during ice navigation, the rotational dynamics of the propulsion system need to be accurately modelled. The blade measurements of ice loads ...on the propellers of ships during ice navigation is challenged by the harsh operating environment. Shaft line measurements are therefore performed inboard, and the required propeller loads are subsequently estimated through the use of a dynamic model and the solution of an inverse problem. The inverse problem is mathematically ill-posed and requires the determination of the ice-induced load on the propeller blade from shaft line measurements. The present study investigated full-scale torsional responses on the shaft line of a polar supply and research vessel during navigation through sea ice on a 68-day voyage between Cape Town and Antarctica. The vessel spent almost 11 days in ice with observed concentrations above 90% and a maximum thickness of 3 m. The aim was to evaluate the extreme ice-induced moments on the shaft line and thereby determine how sparsely published operational loadings compare to the design loads of an ice-going vessel. Ice-induced moments on the propeller were obtained from operational measurements through three previously published approaches to solving the ill-conditioned inverse problem. The regularization methods used included truncated Singular Value Decomposition, truncated Generalized Singular Value Decomposition and Tikhonov regularization. The maximum ice-induced external moment was found to be 941.5 kNm, which was just within the maximum allowed ice-induced torque on the propeller. The duration of ice impacts on the propeller ranged from 25 to 228 ms. A secondary peak was evident in torsional responses obtained from propeller-ice impacts which is thought to be a shear stress wave that propagates and reflects back in the shaft line. From the inversely determined ice-induced loads, the number of impacts, the duration, the shape and the damping of water on the propeller was identifiable. The results obtained were physically reasonable, indicating that the current methods are suitable for obtaining ice-induced loading on the propeller from shaft line measurements.
•Propeller ice impacts are measured on the shaft-line of an ice-going vessel.•An inverse problem is solved to estimate impact-induced moments at the propeller.•Five ice-induced load cases are presented.•The maximum allowed ice-induced propeller torque was marginally not exceeded.•Regularization methods crucially influence the appraisal of safe design margins.
In Europe an abundance of humus taxonomies exists starting with early approaches in the late 19th century. Frequently used in an international context, they do not cover all site conditions in the ...European area. Although having basic concepts and general lines, the European (and North American, Canadian) classification systems differ in important parameters used for the description and classification of humus forms. These discrepancies result in incongruities, so they require adjustments when exchanging partially compatible soil data, even between nearby countries. In 2003, 26 European specialists in humus forms met in Trento (Italy) and decided to formulate rules of classification based on morphogenetic descriptions and diagnostic horizons, adapted to European ecological conditions. Taking into account old and new European and North American systems of humus forms classification, six main references (Anmoor, Mull, Moder, Mor, Amphi and Tangel) were defined, each of them further divided into more detailed categories. This inventory assigned a strong discriminatory power to the action of soil animals. Both semiterrestrial (anoxic) and terrestrial (aerated) topsoils were classified. Descriptors of diagnostic horizons were conceived in accordance with recent international soil classifications. Assigning an ‘ecological value’ to each main humus form along a gradient from biologically active forms, degrading and incorporating all organic remains, to those characterized by the accumulation of poorly transformed organic matter, this European system of classification avoids a strong hierarchical structure and allows a flexible approach open to additional ecological contributions and renditions.
► European specialists conceive principles of a new classification of humus forms. ► Only morphological characters with evident functional effects were considered. ► Ten basic humus forms were circumscribed, available in a wide array of ecosystems. ► Environmental factors determine the structure of the classification tree.
INTERLEUKIN-10 AND THE INTERLEUKIN-10 RECEPTOR Moore, Kevin W; de Waal Malefyt, Rene; Coffman, Robert L ...
Annual review of immunology,
01/2001, Letnik:
19, Številka:
1
Journal Article
Recenzirano
Interleukin-10 (IL-10), first recognized for its ability to inhibit
activation and effector function of T cells, monocytes, and macrophages, is a
multifunctional cytokine with diverse effects on most ...hemopoietic cell types.
The principal routine function of IL-10 appears to be to limit and ultimately
terminate inflammatory responses. In addition to these activities, IL-10
regulates growth and/or differentiation of B cells, NK cells, cytotoxic and
helper T cells, mast cells, granulocytes, dendritic cells, keratinocytes, and
endothelial cells. IL-10 plays a key role in differentiation and function of a
newly appreciated type of T cell, the T regulatory cell, which may figure
prominently in control of immune responses and tolerance in vivo. Uniquely
among hemopoietic cytokines, IL-10 has closely related homologs in several
virus genomes, which testify to its crucial role in regulating immune and
inflammatory responses. This review highlights findings that have advanced our
understanding of IL-10 and its receptor, as well as its in vivo function in
health and disease.
The small heat shock protein family (sHsp) comprises molecular chaperones able to interact with incorrectly folded proteins. Alzheimer's disease (AD) is characterized by pathological lesions such as ...senile plaques (SPs), cerebral amyloid angiopathy (CAA) and neurofibrillary tangles (NFTs), predominantly consisting of the incorrectly folded proteins amyloid‐β (Aβ) and tau respectively. The aim of this study was to investigate the association of the chaperones Hsp20, HspB2, αB‐crystallin and Hsp27 with the pathological lesions of AD brains. For this purpose, a panel of well‐characterized antibodies directed against these sHsps was used in immunohistochemistry and immunoblotting. We observed extracellular expression of Hsp20, Hsp27 and HspB2 in classic SPs, and Hsp20 expression in diffuse SPs. In addition, extracellular expression of HspB2 was observed in CAA. Both Hsp27 and αB‐crystallin were also observed in astrocytes associated with both SPs and CAA. Furthermore, none of the sHsps were observed in NFTs in AD brains. We conclude that specific sHsp species may be involved in the pathogenesis of either SPs or CAA in AD.
Mycobacterium bovis infection in wildlife species occurs worldwide. However, few cases of M. bovis infection in captive elephants have been reported. We describe 2 incidental cases of bovine ...tuberculosis in free-ranging African elephants (Loxodonta africana) from a tuberculosis-endemic national park in South Africa and the epidemiologic implications of these infections.
How and why tumors metastasize is still a matter of debate. The assumption is that mutations render tumor cells with a metastatic phenotype, enabling entrance in and transport through lymph or blood ...vessels. Distant outgrowth is thought to occur only in a suitable microenvironment (the seed and soil hypothesis). However, the anatomical location of most metastases in cancer patients suggests entrapment of tumor cells in the first microcapillary bed that is encountered. We here investigated how vascular endothelial growth factor-A (VEGF-A) attributes to the metastatic process. We describe here that VEGF-A enhances spontaneous metastasis by inducing intravasation of heterogeneous tumor cell clusters, surrounded by vessel wall elements, via an invasion-independent mechanism. These tumor clusters generate metastatic tissue embolisms in pulmonary arteries. Treatment of tumor-bearing mice with the antiangiogenic compound ZD6474 prevented the development of this metastatic phenotype. This work shows that tumors with high constitutive VEGF-A expression metastasize via the formation of tumor emboli and provides an alternative rationale for anti-VEGF-A therapy, namely to inhibit metastasis formation.
During ice navigation, blade measurements of ice-induced moments on ship propellers, are challenged by the harsh operating environment. To overcome this problem, shaft line measurements are performed ...inboard, and the required propeller loads are subsequently estimated using a dynamic model and the solution of an inverse problem. The inverse problem is mathematically ill-posed and requires the determination of the ice-induced moment on the propeller blades from shaft line measurements. Full-scale torsional response data is presented as calculated from indirect strain measurements on the shaft line of a polar supply and research vessel. The vessel operated on a 68-day voyage between Cape Town and Antarctica and spent almost 11 days in sea ice with observed concentrations above 90% and a maximum thickness of 3 m. Data for five ice-induced load cases are presented, including the shaft torque from indirect measurements and the estimated ice-induced moment, which is obtained by solving an ill-posed inverse problem. The ice-induced moments on the propeller are obtained by approximating the drive-train as a viscously damped, elastic lumped mass model. The ice-induced moment is then determined through existing approaches to solving the ill-conditioned inverse problem. The lumped mass model is presented along with algorithms to solve the inverse problem, including truncated singular value decomposition, truncated generalized singular value decomposition and Tikhonov׳s method. The resulting time series data for the inversely calculated ice-induced moments is published to provide industry with load cases for ice-going propulsion design.
Objective prognostic information is essential for good clinical decision making. In case of unknown diseases, scarcity of evidence and limited tacit knowledge prevent obtaining this information. ...Prediction models can be useful, but need to be not only evaluated on how well they predict, but also how stable these models are under fast changing circumstances with respect to development of the disease and the corresponding clinical response. This study aims to provide interpretable and actionable insights, particularly for clinicians. We developed and evaluated two regression tree predictive models for in-hospital mortality of COVID-19 patient at admission and 24 hours (24 h) after admission, using a national registry. We performed a retrospective analysis of observational routinely collected data.
Two regression tree models were developed for admission and 24 h after admission. The complexity of the trees was managed via cross validation to prevent overfitting. The predictive ability of the model was assessed via bootstrapping using the Area under the Receiver-Operating-Characteristic curve, Brier score and calibration curves. The tree models were assessed on the stability of their probabilities and predictive ability, on the selected variables, and compared to a full-fledged logistic regression model that uses variable selection and variable transformations using splines. Participants included COVID-19 patients from all ICUs participating in the Dutch National Intensive Care Evaluation (NICE) registry, who were admitted at the ICU between February 27, 2020, and November 23, 2021. From the NICE registry, we included concerned demographic data, minimum and maximum values of physiological data in the first 24 h of ICU admission and diagnoses (reason for admission as well as comorbidities) for model development. The main outcome measure was in-hospital mortality. We additionally analysed the Length-of-Stay (LoS) per patient subgroup per survival status.
A total of 13,369 confirmed COVID-19 patients from 70 ICUs were included (with mortality rate of 28%). The optimism-corrected AUROC of the admission tree (with seven paths) was 0.72 (95% CI: 0.71-0.74) and of the 24 h tree (with 11 paths) was 0.74 (0.74-0.77). Both regression trees yielded good calibration and variable selection for both trees was stable. Patient subgroups comprising the tree paths had comparable survival probabilities as the full-fledged logistic regression model, survival probabilities were stable over six COVID-19 surges, and subgroups were shown to have added predictive value over the individual patient variables.
We developed and evaluated regression trees, which operate at par with a carefully crafted logistic regression model. The trees consist of homogenous subgroups of patients that are described by simple interpretable constraints on patient characteristics thereby facilitating shared decision-making.
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