Vancomycin administration in continuous ambulatory peritoneal dialysis: the risk of ototoxicity

Patients diagnosed with nodules (NO = 40) in a large university hospital clinic and an age-stratum matched nondiseased group (ND = 200) described adverse outcomes of vocal impairment on work and work-related communications. NOs were significantly more likely than NDs to report symptoms of hoarseness (73% vs. 26%), high-note difficulty (70% vs. 20%), difficulty speaking with a lower voice (53% vs. 13%) and a tired voice (50% vs. 10%), and their greatest source of physical discomfort was associated with scratchiness (61% vs. 3%). The average number of symptoms was four in NOs and less than one in NDs. Nodule patients were most concerned about the effects their voice problem would have on their future career (78% vs. 24%) and 49% of NOS reported their voice problem had an adverse work effect in the past compared with 4% of NDs. Having a voice condition limited current job performance in 39% of the NO group but only in 2% of the ND group. The results suggest that a diagnosis of nodules plays a major role in disrupting careers and work activities and that available educational programs and additional research are needed for improving their functional ability and preventing adverse outcomes in the lives of individuals with voice disorders.     

Characterizing the shape of anatomical structures with Poisson's equation

Poisson's equation, a fundamental partial differential equation in classical physics, has a number of properties that are interesting for shape analysis. In particular, the equipotential sets of the solution graph become smoother as the potential increases. We use the displacement map, the length of the streamlines formed by the gradient field of the solution, to measure the "complexity" (or smoothness) of the equipotential sets, and study its behavior as the potential increases. We believe that this function complexity = f(potential), which we call the shape characteristic, is a very natural way to express shape. Robust algorithms are presented to compute the solution to Poisson's equation, the displacement map, and the shape characteristic. We first illustrate our technique on two-dimensional synthetic examples and natural silhouettes. We then perform two shape analysis studies on three-dimensional neuroanatomical data extracted from magnetic resonance (MR) images of the brain. In the first study, we investigate changes in the caudate nucleus in Schizotypal Personality Disorder (SPD) and confirm previously published results on this structure. In the second study, we present a data set of caudate nuclei of premature infants with asymmetric white matter injury. Our method shows structural shape differences that volumetric measurements were unable to detect.     

Selective peptidic and peptidomimetic inhibitors of Candida albicans myristoylCoA: protein N-myristoyltransferase: a new approach to antifungal therapy

MyristoylCoA: protein N-myristoyltransferase (NMT) catalyzes the cotranslational covalent attachment of a rare cellular fatty acid, myristate, to the N-terminal Gly residue of a variety of eukaryotic proteins. The myristoyl moiety is often essential for expression of the biological functions for these proteins. Attachment of C14:0 alone provides barely enough hydrophobicity to allow stable association with membranes. The partitioning of N-myrisotylproteins is therefore often modulated by "switches" that function through additional covalent or noncovalent modifications. Candida albicans, the principal cause of systemic fungal infection in immunocompromised humans, contains a single NMT gene that is essential for its viability. The functional properties of the acylCoA binding site of human and C. albicans NMT are very similar. However, there are distinct differences in their peptide binding sites. An ADP ribosylation factor (Arf) is included among the few cellular protein substrates of the fungal enzyme. Alanine scanning mutagenesis of an octapeptide derived from an N-terminal Arf sequence (GLYASKLS-NH2) disclosed that Gly1, Ser5, and Lys6 play predominant roles in binding. ALYASKLS-NH2 is an inhibitor competitive for peptide [Ki(app) = 15.3 +/- 6.4 microM] and noncompetitive for myristoylCoA. Remarkably, replacement of the N-terminal tetrapeptide with an 11-aminoundecanoyl group results in a competitive inhibitor (11-aminoundecanoyl-SKLS-NH2) that is approximately 40-fold more potent [Ki(app) = 0.40 +/- 0.03 microM] than the starting octapeptide. Removal of Leu-Ser from the C-terminus generates a competitive dipeptide inhibitor (11-aminoundecanoyl-SK-NH2) with a Ki(app) of 11.7 +/- 0.4 microM, equivalent to that of the starting octapeptide. A derivative dipeptide inhibitor containing a C-terminal N-cyclohexylethyl lysinamide moiety has the advantage of being more potent (IC50 = 0.11 +/- 0.03 microM) and resistant to digestion by cellular carboxypeptidases. Rigidifying the flexible aminoundecanoyl chain results in very potent general NMT inhibitors (IC50 = 40-50 nM). Substituting a 2-methylimidazole for the N-terminal amine and adding a benzylic alpha-methyl group with R stereochemistry to the rigidifying element produces even more potent inhibitors (IC50 = 20-50 nM) that are up to 500-fold selective for the fungal compared to human enzyme. A related less potent member of this series of compounds is fungistatic. Its growth inhibitory effects are associated with a reduction in cellular protein N-myristoylation, judged using cellular Arf as a reporter. These studies establish that NMT is a new antifungal target.     

MXene Composite and Coaxial Fibers with High Stretchability and Conductivity for Wearable Strain Sensing Textiles

The integration of nanomaterials with high conductivity into stretchable polymer fibers can achieve novel functionalities such as sensing physical deformations. With a metallic conductivity that exceeds other solution‐processed nanomaterials, 2D titanium carbide MXene is an attractive material to produce conducting and stretchable fibers. Here, a scalable wet‐spinning technique is used to produce Ti₃C₂T_x MXene/polyurethane (PU) composite fibers that show both conductivity and high stretchability. The conductivity at a very low percolation threshold of ≈1 wt% is demonstrated, which is lower than the previously reported values for MXene‐based polymer composites. When used as a strain sensor, the MXene/PU composite fibers show a high gauge factor of ≈12900 (≈238 at 50% strain) and a large sensing strain of ≈152%. The cyclic strain sensing performance is further improved by producing fibers with MXene/PU sheath and pure PU core using a coaxial wet‐spinning process. Using a commercial‐scale knitting machine, MXene/PU fibers are knitted into a one‐piece elbow sleeve, which can track various movements of the wearer's elbow. This study establishes fundamental insights into the behavior of MXene in elastomeric composites and presents strategies to achieve MXene‐based fibers and textiles with strain sensing properties suitable for applications in health, sports, and entertainment.     

Home treatment of mild to moderate bleeding episodes using recombinant factor VIIa (Novoseven) in haemophiliacs with inhibitors

OBJECTIVE: To assess the safety and efficacy of a fixed dose of recombinant activated factor VII (rFVIIa; NovoSeven) in the home setting for mild to moderately severe joint, muscle; and mucocutaneous bleeding episodes in patients with haemophilia A or B with inhibitors. DESIGN: Multicentre, open-label, single arm, phase III study of one year duration. METHODS; Patients or their caregivers administered up to three doses of rFVIIa (90 microg/kg i.v.) at 3 h intervals within 8 h of the onset of a mild to moderate bleeding episode. Once the subject considered that rFVIIa had been "effective" with regard to haemostasis (after 1-3 injections), one further (maintenance) dose of rFVIIa was administered. RESULTS: Of 60 patients enrolled, 56 experienced at least one bleed, and 46 completed the one year study. 614 of 877 bleeds (70%) were evaluable according to protocol definitions. Haemostasis was rated as "effective" in 92% (566/614) of evaluable bleeds after a mean of 2.2 injections. For successfully treated episodes, the time from onset of bleeding until administration of the first injection was 1.1+/-2.0 h (mean+/-SD). Twenty-four hours after initial successful response, haemostasis was reported as having been maintained in 95% of cases. Efficacy was comparable for muscle, joint and target joint, and mucocutaneous bleeding episodes. In an intent-to-treat analysis of all 877 bleeding events, efficacy outcomes were equivalent to the evaluable bleeds, with an effective response in 88% of treated episodes. Treatment-related adverse events occurred in 32 (3% of all) bleeding episodes and consisted of re-bleeds/new bleeds in more than 50% (18/32) of these events. A single episode of superficial thrombophlebitis was the only thrombotic complication encountered, and there were no patient withdrawals due to adverse events. Development of FVII(a) antibodies could not be detected, and hypersensitivity reactions to rFVIIa were not reported. CONCLUSION: rFVIIa is effective and well tolerated when used in the home setting to treat mild to moderate bleeding episodes in patients with haemophilia A or B with inhibitors.     

Object–Oriented Enterprise Modeling and Simulation of AEC Projects

In this paper we describe an object–oriented framework for developing enterprise models of Architecture, Engineering, Construction projects, and a methodology for formalizing these models such that they can be used for discrete event simulation of information processing and coordination in project execution. The simulation results can be used to predict the probable effects of carrying out proposed changes in planning and managing projects.
In our enterprise modeling framework we represent engineering design projects in terms of deliverables (requirements and solutions), plans (activities and process relations), and organization (participants and organizational relations). The resulting project model is the starting point for identifying coordination requirements between project team participants. Our methodology uses matrix techniques derived from qualtiy function deployment (QFD) to identify interactions between project requirements and solutions and calculate measures of product complexity . We then describe information flow between project activities in a similar matrix and calculate measures of process uncertainty . Finally, we identify the responsibilities of project team members and use a matrix to point out organizational interdependencies .
We apply our framework and methodology to model and simulate engineering design for a major extension of an electrical power substation. Our simulation results demonstrate how project performance is contingent on the fit between the project policies and the objectives and preferences of the project team.     

Ornithine decarboxylase gene deletion mutants of Leishmania donovani

A knockout strain of Leishmania donovani lacking both ornithine decarboxylase (ODC) alleles has been created by targeted gene replacement. Growth of Deltaodc cells in polyamine-deficient medium resulted in a rapid and profound depletion of cellular putrescine pools, although levels of spermidine were relatively unaffected. Concentrations of trypanothione, a spermidine conjugate, were also reduced, whereas glutathione concentrations were augmented. The Deltaodc L. donovani exhibited an auxotrophy for polyamines that could be circumvented by the addition of the naturally occurring polyamines, putrescine or spermidine, to the culture medium. Whereas putrescine supplementation restored intracellular pools of both putrescine and spermidine, exogenous spermidine was not converted back to putrescine, indicating that spermidine alone is sufficient to meet the polyamine requirement, and that L. donovani does not express the enzymatic machinery for polyamine degradation. The lack of a polyamine catabolic pathway in intact parasites was confirmed radiometrically. In addition, the Deltaodc strain could grow in medium supplemented with either 1,3-diaminopropane or 1, 5-diaminopentane (cadaverine), but polyamine auxotrophy could not be overcome by other aliphatic diamines or spermine. These data establish genetically that ODC is an essential gene in L. donovani, define the polyamine requirements of the parasite, and reveal the absence of a polyamine-degradative pathway.     

Heterogeneous reactions of methylglyoxal in acidic media: implications for secondary organic aerosol formation

Recent environmental chamber studies have suggested that acid-catalyzed particle-phase reactions of organic carbonyls contribute to the formation of secondary organic aerosol (SOA). We report the first measurements of uptake of methylglyoxal on liquid H2SO4 over the temperature range of 250-298 K and acidic range of 55-85 wt %. From the time-dependent uptake the effective Henry's law solubility constant (H*) was determined. Heterogeneous reactions of methylglyoxal are shown to decrease with acidity and involve negligible formation of sulfate esters. Hydration and polymerization likely explain the measured uptake of methylglyoxal on H2SO4 and the measurements do not support an acid-catalyzed uptake of methylglyoxal. The results imply that heterogeneous reactions of methylglyoxal contribute to organic aerosol formation in less acidic media and hydration and polymerization of methylglyoxal in the atmospheric aerosol-phase are dependent on the hygroscopicity, rather than the acidity of the aerosols.     

Regulation of human globin gene expression in mouse erythroleukemia x human fibroblast hybrid cells

A somatic cell hybrid, XX-8, was obtained from a fusion of tetraploid mouse erythroleukemia cells with human Lesch-Nyhan skin fibroblasts. This hybrid cell was previously shown (1) to produce human beta- but no human gamma-globin mRNA sequences after induction with dimethylsulfoxide. In this study we show that: (a) human beta- and gamma-globin genes are present in XX-8 cells in approximately equal numbers; (b) no human gamma-globin mRNA sequences can be detected in either the cytoplasmic or nuclear RNA fractions even with several different inducers; (c) after induction the human beta-globin gene is converted from a DNase I insensitive or closed structure to a DNase I open configuration, while the human gamma-globin gene remains closed; and (d) no human beta-globin polypeptide can be detected in the intact induced cells, indicating that fibroblast globin genes, even when induced to make mRNA in an erythroid environment, do not synthesize an RNA that is translated efficiently.     

Kainate-induced apoptosis in cultured murine cerebellar granule cells elevates expression of the cell cycle gene cyclin D1

Recent evidence suggests that neuronal apoptosis is the consequence of an inappropriate reentry into the cell cycle. Expression of the cell cycle gene cyclin D1, a G1-phase cell cycle regulator, was examined in primary cultures of murine cerebellar granule cells (CGCs) during kainate (KA)-mediated apoptosis. Using cultures of CGCs, we found that a 24-h exposure to KA (1-3,000 microM) induced a concentration-dependent cell death with neurons exhibiting characteristic apoptotic morphology and extensive labeling using the terminal transferase-mediated nick end-DNA labeling (TUNEL) method. KA induced a time- and concentration-dependent increase in expression of cyclin D1 as determined by immunocytochemistry and western blot analysis. KA-induced apoptosis and cyclin D1 expression exhibited a similar concentration dependence and were significantly attenuated by the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (50 microM), indicating a KA receptor-mediated effect. Here we present evidence for the first time that KA-induced apoptosis in cultured CGCs involves the induction of cyclin D1, suggesting its involvement in excitotoxic receptor-mediated apoptosis.